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Thrombosis in children

Patcharee Komwilaisak, Werasak Sasanakul, Ampaiwan Chuansumrit, Somjai Kanjanapongkul, Somporn Wangruangsathit, Apasri Lusawat, Pimlak Charoenkwan, Nongnuch Sirachainan
The prevalence of protein S (PS) deficiency in Asian patients with venous thromboembolism is around 8-30%, higher than that in Caucasian populations. The present study reports the genotypes (including one novel mutation) and phenotypes of children with PS deficiency at a tertiary care institute. A total of six patients were included, three with arterial ischemic stroke, two with cerebral venous sinus thrombosis, and one with deep vein thrombosis. PS mutations were identified in four patients: p.R355C, p.G336D, p...
October 17, 2016: Pediatric Blood & Cancer
Lorena Monge Galindo, Ruth Fernando Martínez, Cristina Fuertes Rodrigo, David Fustero de Miguel, Victoria Pueyo Royo, Juan Pablo García Iñiguez, Javier López-Pisón, José Luis Peña-Segura
INTRODUCTION: We present our experience on idiopathic intracranial hypertension (IIH), before and after the introduction of a specific diagnosis and management protocol. METHOD: A descriptive retrospective study was conducted on patients with IIH over a 25year period (1990-2015), comparing the last 7years (after introduction of the protocol) with the previous 18years. RESULTS: Among the 18,865 patients evaluated, there were 54 cases of IIH (29 infants and 25 children)...
October 13, 2016: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
Lianxing Zhao, Chunsheng Li, Rui Shao, Yingying Fang
Having encountered several subjects with venous thromboembolism (VTE) in 1 family in which 1 proband has recurrent VTE (rVTE), we aimed to assess the risk of VTE in first-degree relatives, especially the children of individuals with rVTE, and to investigate the association of endothelial nitric oxide synthase (eNOS) G894T polymorphism between Chinese persons with rVTE and their offspring.We collected information about family histories and blood samples from 126 individuals with rVTE who had presented to our institute from 2003 to 2014, and 126 population-based controls and the first-degree relatives of subjects in these 2 groups...
October 2016: Medicine (Baltimore)
Andreas Hanslik, Erwin Kitzmüller, Ulrich S Tran, Katharina Thom, Hratsch Karapetian, Nicole Prutsch, Jasmin Voitl, Ina Michel-Behnke, Fiona Newall, Christoph Male
BACKGROUND: Unfractionated heparin (UFH) is used for prophylaxis and treatment of thrombosis in children. Laboratory monitoring of UFH is needed to prevent over- or under-anticoagulation. OBJECTIVES: Study objectives were to investigate i) the association between UFH dose and UFH effect as monitored by anti-IIa, ii) the relationship of anti-IIa and anti-Xa effects, and iii) the influence of patients' age and other factors on UFH effect. PATIENTS AND METHODS: Randomized controlled trial in children during cardiac catheterization, comparing high-dose UFH (100 units/kg bolus) versus low-dose UFH (50 units/kg bolus)...
October 13, 2016: Journal of Thrombosis and Haemostasis: JTH
Ursula I Tuor, Min Qiao, Manasi Sule, Melissa Morgunov, Tadeusz Foniok
Stroke is a major cause of disability in adults and children. Recently, we have developed an adult rat model of minor stroke containing a peri-infarct region with a modest T2 increase and mild ischemic damage. We hypothesized that a neonatal minor stroke with mild peri-ischemic changes could also be produced, but with potential ontogenic differences. Using our minor photothrombosis method, we produced a range of severities of ischemic lesions (mini, minor, moderate and severe) within magnetic resonance imaging (MRI) slices of adult and neonatal rats...
October 12, 2016: NMR in Biomedicine
Hyoung Soo Choi, Chang Won Choi, Heon Min Kim, Hye Won Park
BACKGROUND: While venous thromboembolism (VTE) is uncommon, its incidence is increasing in children. We aimed to evaluate the incidence, risk factors, treatment, and outcome of pediatric VTE cases at a single tertiary hospital in Korea. METHODS: We retrospectively analyzed the records of consecutive pediatric VTE patients admitted to the Seoul National University Bundang Hospital between April 2003 and March 2016. RESULTS: Among 70,462 hospitalizations, 25 pediatric VTE cases were identified (3...
September 2016: Blood Research
M L Avila, L R Brandão, S Williams, M I Montoya, J Stinson, A Kiss, B M Feldman
BACKGROUND: Postthrombotic syndrome (PTS) is a complication of deep vein thrombosis defined by the presence of characteristic signs and symptoms. We developed a discriminative and evaluative index for the assessment of upper and lower extremity (UE/LE) pediatric PTS. METHODS: The items to be included in the index were voted for by 26 pediatric thrombosis experts invited to participate in a Delphi survey. Subsequent item weighting was based on item importance elicited using multi-criteria decision analysis (MCDA); 122 health care providers and patients/parents participated in item weighting...
October 6, 2016: Journal of Thrombosis and Haemostasis: JTH
Santosh S Hanmod, Rohith Jesudas, Roshni Kulkarni, Meera Chitlur
Neonates form a unique cohort with distinct features associated with the hemostatic system compared with older children and adults. The development of the human hemostatic system begins around 10 weeks in utero and continues to evolve during childhood. This dynamic period termed developmental hemostasis should be taken into consideration when diagnosing a neonate with disorders of bleeding or thrombosis.
October 5, 2016: Seminars in Thrombosis and Hemostasis
Giancarlo Nicosia, Domenico Cicala, Giuseppe Mirone, Pietro Spennato, Vincenzo Trischitta, Claudio Ruggiero, Gianluigi Guarneri, Mario Muto, Giuseppe Cinalli
INTRODUCTION: Acute basilar artery occlusion (ABAO) is an infrequent but potentially fatal cause of strokes in both adults and children, and it is usually due to vertebral artery dissection (VAD). VAD has been found to be usually a consequence of traumatic vertebral artery injury. ABAO usually presents with symptoms of acute ischemic stroke (AIS) of the posterior circulation or transient ischemic attack (TIA). It may lead to death or long-term disability if not promptly recanalized. Basilar artery recanalization in children can be achieved safely and with excellent clinical outcome using endovascular thrombectomy with the new generation self-expanding and retrievable stents...
October 4, 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
L Badet, X Matillon, R Codas, M-O Timsit, R Thuret, F Kleinclauss, D Demede
AIMS: To describe indications, surgical aspects, results and outcomes of kidney transplantation in children. MATERIAL AND METHODS: An exhaustive systematic review of the scientific literature was performed in the Medline database ( and Embase ( using different associations of the following keywords (MESH): "kidney transplantation", "pediatric", "children", "outcomes". Publications obtained were selected based on methodology, language, date of publication (last 10 years) and relevance...
September 29, 2016: Progrès en Urologie
Alexandra Marquez, Veronika Shabanova, Edward Vincent S Faustino
OBJECTIVE: We determined whether in critically ill children with an untunneled central venous catheter, the risk of catheter-associated deep venous thrombosis can be predicted within 24 hours after insertion of the catheter. DESIGN: Secondary analysis of two multicenter prospective cohort studies. SETTING: PICUs in Northeastern United States. PATIENTS: A total of 175 children admitted to the PICU within 24 hours after insertion of an untunneled central venous catheter who did not receive anticoagulation were included...
September 22, 2016: Pediatric Critical Care Medicine
Susan M Hastings, Shriprasad Deshpande, Scott Wagoner, Kevin O Maher, David N Ku
Extracorporeal membrane oxygenation (ECMO) for cardiopulmonary support of critically ill patients is used frequently in the pediatric population. ECMO is burdened by complications, including thrombosis and hemorrhage. Here we demonstrate the focused location of clots, their histological composition, and the relationship of in situ thrombus to local hemodynamics in ECMO circuits.Pediatric ECMO circuits from Children's Healthcare of Atlanta, Emory University (Atlanta, GA) were obtained following removal from extracorporeal support over a 2...
September 20, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Gowri Shankar, Vinay Jadhav, Ravindra S, Narendra Babu, Ramesh S
Children with malignancy require venous access that is reliable, safe and compliant on a long-term basis. There is little data available on utilization of totally implantable venous access devices (TIVAD) for long term chemotherapy in children in an Indian setting [1]. We report our long-term follow-up results of utilization of totally implantable venous access devices for long-term chemotherapy in children. This was a retrospective analysis of 122 children requiring long-term chemotherapy done between January 2008 and December 2013...
September 2016: Indian Journal of Surgical Oncology
Antonio Sánchez Andrés, Inmaculada Salvador Mercader, Julia Seller Moya, José Ignacio Carrasco Moreno
INTRODUCTION: Kawasaki disease (KD) is an acute vasculitis of unknown origin and predominant in males. The long-term effects of the disease depend on whether there are coronary lesions, particularly aneurysms. The prognosis of patients with giant aneurysms is very poor due to their natural progression to coronary thrombosis or severe obstructive lesions. OBJECTIVES: A series of 8 cases is presented where the epidemiology and diagnostic methods are described. The treatment of the acute and long-term cardiovascular sequelae is also reviewed...
September 16, 2016: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
Susanne Regus, Veronika Almási-Sperling, Werner Lang
INTRODUCTION: Arteriovenous fistula (AVF) creation in children could be extremely challenging for vascular surgeons due to small vessels with a high tendency of vasospasm. This could be one reason for primary failures (PF) and early access thrombosis. There exists no guideline for the need of intraoperative heparin administration during hemodialysis fistula creation. The aim of this study was to evaluate the effect of intra-operative heparin administration on immediate outcome. METHODS: Medical records of 42 pediatric patients aged between 7 and 17 years were retrospectively reviewed...
September 20, 2016: Journal of Vascular Access
Ewan D McNicol, Aikaterini Tzortzopoulou, Roman Schumann, Daniel B Carr, Aman Kalra
BACKGROUND: This is an updated version of the original Cochrane review first published in 2008. Scoliosis surgery is often associated with substantial blood loss and potentially detrimental effects in children. Antifibrinolytic agents are often used to reduce perioperative blood loss. Clinical trials have evaluated their efficacy in children undergoing surgical correction of scoliosis, but no systematic review has been published. This review was first published in 2008 and was updated in 2016...
September 19, 2016: Cochrane Database of Systematic Reviews
Cristina Hotoleanu
Genetic risk factors predispose to thrombophilia and play the most important etiopathogenic role in venous thromboembolism (VTE) in people younger than 50 years old. At least one inherited risk factor could be found in about half of the cases with a first episode of idiopathic VTE.Roughly, genetic risk factors are classified into two main categories: loss of function mutations (such as deficiencies of antithrombin, protein C, protein S) and gain of function mutations, (such as prothrombin mutation G20210A, factor V Leiden)...
September 17, 2016: Advances in Experimental Medicine and Biology
C Heleen van Ommen, Jeanine J Sol
Neonatal hemostasis differs qualitatively, but in particular quantitatively, from hemostasis in older children and adults. Nevertheless, hemostasis in healthy neonates is functionally stable with no tendency to bleeding or thrombotic complications. In sick neonates, however, risk factors may disrupt this equilibrium and lead to thrombosis. The most important risk factor is the central venous catheter. Management of neonatal central venous catheter thrombosis is challenging, as no controlled trials have been performed...
September 16, 2016: Seminars in Thrombosis and Hemostasis
Maryam Ghadimi Mahani, Prachi P Agarwal, Cynthia K Rigsby, Jimmy C Lu, Soudabeh Fazeli Dehkordy, Robyn A Wright, Adam L Dorfman, Rajesh Krishnamurthy
The total cavopulmonary connection (TCPC), or Fontan procedure, diverts systemic venous blood directly into the pulmonary arteries and is the palliative surgery of choice for patients with a wide variety of congenital heart diseases with single-ventricle physiologic characteristics. Pulmonary embolism and thrombosis are known complications and are among the major causes of morbidity and mortality in patients after TCPC. Magnetic resonance (MR) imaging is usually performed for postoperative evaluation of patients after single-ventricle repair; however, screening for thrombosis or embolism with MR imaging is not always feasible because of the emergent nature of the clinical presentation or because of artifacts from metallic devices or coils...
September 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Pier Luigi Meroni, Lorenza Maria Argolini, Irene Pontikaki
INTRODUCTION: Antiphospholipid syndrome (APS) is a systemic autoimmune disease characterized by vascular thrombosis and/or pregnancy morbidity associated with the persistent presence of antiphospholipid antibodies (aPL) including lupus anticoagulant (LA), anticardiolipin antibodies (aCL), and anti-β2 glycoprotein I antibodies (aβ2GPI). AREAS COVERED: APS is considered as the most common acquired hypercoagulation state of autoimmune origin in children. Unfortunately, data about incidence, prevalence, thrombosis risk and effective treatment in paediatric APS are limited and unmethodical...
October 2016: Expert Review of Hematology
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