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Anticoagulation and metabolic syndrome

Yu-Yang Chen, Qi Liu, Li Liu, Xiao-Rong Shu, Zi-Zhuo Su, Hai-Feng Zhang, Ru-Qiong Nie, Jing-Feng Wang, Shuang-Lun Xie
BACKGROUND: Metabolic syndrome (MS) is a risk factor for stroke and thromboembolism event. Left atrial or LA appendage (LA/LAA) thrombus is a surrogate of potential stroke. The relationship between MS and atrial thrombus remains unclear. In this study, we sought to investigate the effect of MS on risk stratification of LA/LAA thrombus formation in patients with nonvalvular atrial fibrillation (NVAF). METHODS: This cross-sectional study enrolled 294 consecutive NVAF patients without prior anticoagulant and lipid-lowering therapies...
2016: Chinese Medical Journal
Ingrid Dravecká
UNLABELLED: Polycystic ovary syndrome (PCOS) is a heterogeneous and complex endocrine disease which among the female population belongs to the most widespread endocrinopathies and it is the most frequent cause of hyperthyroidism, anticoagulation and infertility. Insulin resistance is one of the important diabetology factors impacting hyperglycaemia in a majority of women with PCOS (60-80 %). Clinical expressions of PCOS include reproduction disorders, metabolic characteristics and psychological implications...
2016: Vnitr̆ní Lékar̆ství
Radzislaw Mierzynski, Dominik Dluski, Dorota Darmochwal-Kolarz, Elzbieta Poniedziałek-Czajkowska, Bozena Leszczynska-Gorzelak, Zaneta Kimber-Trojnar, Agnieszka-Wankowicz, Jan Oleszczuk
Intra-uterine growth retardation (IUGR) represents one of the major problems in perinatal medicine. IUGR is one of main causes of perinatal mortality and morbidity. A huge number and variety of established and possible causes of IUGR have been described. There are currently no data about effective treatment of this fetal condition. IUGR has been described to be strictly involved in fetal programming. Fetal programming is the general idea, which tells us how during development of the embryo and fetus significant physiological parameters can be shaped by environmental events...
2016: Current Pharmaceutical Biotechnology
Lukshe Kanagaratnam, Moustapha Dramé, Thierry Trenque, Nadia Oubaya, Pierre Nazeyrollas, Jean-Luc Novella, Damien Jolly, Rachid Mahmoudi
Elderly subjects with cognitive disorders are at particularly high risk of adverse drug reactions (ADRs). The objectives of our systematic review were to describe the prevalence of ADRs in elderly patients with cognitive disorders, the different types of ADRs and the medications suspected of involvement; to describe whether the ADRs were preventable or not, and to identify risk factors for occurrence of ADRs in this population. A bibliographic search was performed in the following databases: PubMed, Embase, Google Scholar, Opengrey and Scopus...
March 2016: Maturitas
Daniele Pastori, Alessio Farcomeni, Daniela Poli, Emilia Antonucci, Francesco Angelico, Maria Del Ben, Roberto Cangemi, Gaetano Tanzilli, Gregory Yoke Hong Lip, Pasquale Pignatelli, Francesco Violi
Recent findings suggest that patients with non-valvular atrial fibrillation (AF), in addition to having a high risk for ischemic stroke, are also at risk for myocardial infarction (MI). The aim of the study was to combine factors predicting Major Adverse Cardiovascular Events (MACE) in AF patients, including fatal/nonfatal MI, cardiac revascularization, and cardiovascular death, into a simple risk score. Predictors of MACE were obtained from a prospective observational cohort study, including 1019 AF patients taking vitamin K antagonists from the Atherothrombosis Center, of Sapienza University of Rome...
March 2016: Internal and Emergency Medicine
Fanny Marcaire, François Malavieille, Virginie Pichot-Delahaye, Bernard Floccard, Thomas Rimmelé
OBJECTIVE: To describe a case of hepatic subcapsular hematoma causing an acute Budd-Chiari-like syndrome, leading to hepatic compartment syndrome, which combines compression of intrahepatic vessels on CT, acute liver failure, and refractory shock. DESIGN: Case report. SETTING: Surgical ICU of a university teaching hospital. PATIENT: Single case: A 64-year-old man hospitalized for 1 month in the ICU after multiple complications following bypass surgery, under anticoagulation after a recent aortic valve replacement and without a medical history of hepatic disease, underwent a percutaneous cholecystostomy for acute calculous cholecystitis...
March 2016: Critical Care Medicine
C Vayssière, L Sentilhes, A Ego, C Bernard, D Cambourieu, C Flamant, G Gascoin, A Gaudineau, G Grangé, V Houfflin-Debarge, B Langer, V Malan, P Marcorelles, J Nizard, F Perrotin, L Salomon, M-V Senat, A Serry, V Tessier, P Truffert, V Tsatsaris, C Arnaud, B Carbonne
Small for gestational age (SGA) is defined by weight (in utero estimated fetal weight or birth weight) below the 10th percentile (professional consensus). Severe SGA is SGA below the third percentile (professional consensus). Fetal growth restriction (FGR) or intra-uterine growth restriction (IUGR) usually correspond with SGA associated with evidence indicating abnormal growth (with or without abnormal uterine and/or umbilical Doppler): arrest of growth or a shift in its rate measured longitudinally (at least two measurements, 3 weeks apart) (professional consensus)...
October 2015: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Reza Hajhosseiny, Gareth K Matthews, Gregory Y H Lip
The prevalence of atrial fibrillation (AF) and AF-related stroke is set to increase dramatically in coming decades, with developing regions such as Latin America experiencing the greatest impact. These trends are primarily driven by aging populations and by the increasing prevalence of the metabolic syndrome. The metabolic syndrome describes an association between diabetes, hypertension, obesity, and dyslipidemia and an increased risk of cardiovascular disease. It is in large part the result of unbalanced diet and sedentary lifestyle...
November 2015: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Nirmala Jonnavithula, Praveen Reddy Elmati, Kiran Kumar Duddu, Pvln Murthy, Gopinath Ramachandran
Maintenance of homeostasis during anaesthesia in the patient with two major metabolic disorders whose systemic effects either compliment or contradict each other is a challenge to the anaesthesiologist. A 25-year-old male patient with Cushing's syndrome and known hyperhomocysteinemia was scheduled for open adrenalectomy. Both these disorders compound the hypercoagulable state and differ in glucose metabolism. In addition, obesity, difficult airway, electrolyte and metabolic derangements that accompany Cushing's syndrome warrant special attention...
March 2015: Indian Journal of Anaesthesia
Lenar Yessayan, Jerry Yee, Stan Frinak, David Kwon, Balazs Szamosfalvi
Concomitant severe metabolic alkalosis, hypernatremia, and kidney failure pose a therapeutic challenge. Hemodialysis to correct azotemia and abnormal electrolytes results in rapid correction of serum sodium, bicarbonate, and urea but presents a risk for dialysis disequilibrium and brain edema. We describe a patient with Zollinger-Ellison syndrome with persistent encephalopathy, severe metabolic alkalosis (highest bicarbonate 81 mEq/L), hypernatremia (sodium 157 mEq/L), and kidney failure despite 30 hours of intravenous crystalloids and proton pump inhibitor...
July 2015: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Damoun Safarpour, Sarah Buckingham, Bahman Jabbari
BACKGROUND: Chorea associated with high titers of antiphospholipid antibodies in the absence of antiphospholipid antibody syndrome has been seldom reported. CASE REPORT: An 89-year-old female developed persistent right side chorea associated with high titers of anticardiolipin antibody (antiphospholipid antibosies immunoglobulin (Ig)M, 45 MPL and 112 IgM aCL (MPL) after 3 months) but normal lupus anticoagulants. Her magnetic resonance imaging (MRI) showed no abnormality, but positron emission tomography (PET) demonstrated increased bilateral striatal metabolic activity, more on the left side...
2015: Tremor and Other Hyperkinetic Movements
Daniele Pastori, Pasquale Pignatelli, Francesco Angelico, Alessio Farcomeni, Maria Del Ben, Tommasa Vicario, Tommaso Bucci, Valeria Raparelli, Roberto Cangemi, Gaetano Tanzilli, Gregory Y H Lip, Francesco Violi
BACKGROUND: Recent findings suggest that patients with atrial fibrillation (AF), in addition being at thromboembolic risk, are at risk of myocardial infarction (MI). Our aim was to investigate predictors of MI and cardiovascular death in a cohort of patients with AF who were taking anticoagulants. METHODS: We prospectively followed up 1,019 patients with AF for a median of 33.7 months (3,223 person-years). All patients were treated with oral vitamin K antagonists...
June 2015: Chest
Liang Wang, Zhiyong Liu, Zhe Dong, Jieyi Pan, Xiaochun Ma
Heparin is a potent blood anticoagulant that has been demonstrated to attenuate inflammatory responses in sepsis. Sepsis is considered to be a microcirculation-mitochondrial distress syndrome. Azurocidin (AZU), a protein with strong heparin-binding potential that induces inflammatory responses and apoptosis, has been shown to increase the permeability of endothelial cells and induce the prognosis of sepsis. However, the function of AZU in mitochondrial oxygen metabolism has yet to be reported. The aim of the present study was to investigate whether heparin exhibits an antagonistic effect on AZU-induced mitochondrial dysfunction in human umbilical vein endothelial cells (HUVECs) and to further investigate the possible underlying mechanisms...
November 2014: Experimental and Therapeutic Medicine
Shou-Peng Li, Ji-Yuan Han, Peng Sun, Guo-Yan Wu, Xiang-Yan Bai
BACKGROUND: This study was undertaken to observe the concentration of SP-A/B and the pulmonary surfactant in the lung tissue of rats with acute lung injury/acute respiratory distress syndrome caused by paraquat poisoning after the treatment of metabolic antioxidant-lipoic acid and whether its influence was related to TNF-α. METHODS: Sixty-six male Sprage-Dawley rats were randomly divided into three groups: normal control group (NS group), 6 rats; paraquat poisoning group (PQ group), 30 rats; and paraquat+lipoic acid treatment group (LA group), 30 rats...
2014: World Journal of Emergency Medicine
Elisavet Grouzi
Heparin-induced thrombocytopenia (HIT) is a rare but potentially severe complication of heparin therapy that is strongly associated with venous and arterial thrombosis (HIT and thrombosis syndrome, HITTS), which requires urgent detection and treatment with a nonheparin anticoagulant. Argatroban, a synthetic direct thrombin inhibitor, is indicated for the treatment and prophylaxis of thrombosis in patients with HIT, including those undergoing percutaneous coronary intervention. Argatroban has a relatively short elimination half-life of approximately 45 minutes, which is predominantly performed via hepatic metabolism...
2014: Journal of Blood Medicine
Jan Vojáček
Recently, new peroral antithrombotic agents have proved better prevention of thrombotic complications in many clinical events such as acute coronary syndrome, tromboembolic disease or atrial fibrillation. New peroral anticoagulants (NPA) were introduced - dabigatran, rivaroxaban and apixaban and new antiplatelet agents - ticagrelol and prasugrel. Outcomes of pilot studies: RE-LY, ROCKET AF, ARISTOTLE, PLATO a TIMI 38 TRITON and subsequent clinical experiences supported their usage. NPA have proved non-inferiority in incidence of stroke or systemic embolism...
April 2014: Vnitr̆ní Lékar̆ství
Paula Anne Newman-Casey, Maxwell Stem, Nidhi Talwar, David C Musch, Cagri G Besirli, Joshua D Stein
PURPOSE: To determine risk factors associated with development of a branch retinal vein occlusion (BRVO) among a large group of managed-care plan beneficiaries in the United States. DESIGN: Retrospective, longitudinal cohort study. PARTICIPANTS: All beneficiaries age ≥55 years continuously enrolled for ≥2 years in a managed care network from 2001-2009 who had ≥2 visits to an eye care provider. METHODS: Multivariable Cox regression analyses identified sociodemographic factors, ocular and nonocular conditions associated with incident BRVO...
October 2014: Ophthalmology
D Kindgen-Milles
BACKGROUND: Perioperative acute kidney injury (AKI) is common and is associated with adverse clinical outcomes, excess mortality, and an increased risk for chronic renal failure. Recommendations to prevent perioperative AKI include the early identification of patients at risk, the avoidance of nephrotoxic drugs, and early goal-directed haemodynamic stabilization. The major causes for perioperative AKI are severe sepsis and septic shock, hypovolemia, bleeding and cardiac failure. POSSIBLE RENAL REPLACEMENT MODALITIES: The choice of modality, i...
June 2014: Medizinische Klinik, Intensivmedizin und Notfallmedizin
Radzisław Mierzynski, Elzbieta Poniedzialek-Czajkowska, Zaneta Kimber-Trojnar, Bozena Leszczynska-Gorzelak, Jan Oleszczuk
Pregnancy is a specific state of heightened coagulability related to the increase in procoagulant agents and to the reduced fibrinolysis. Pregnancy is associated with a 4-fold increased risk of developing venous thromboembolism (VTE) and this risk still increases to 14-fold during puerperium. A correlation between the metabolic syndrome and development of cardiovascular events and cerebrovascular incidents has been described. Such a relationship is referred to a hypercoagulable state due to increased serum levels of the plasminogen activator inhibitor-1 (PAI-1), fibrinogen, factor (F) VII and VIII, von Willebrand factor and from endothelial activation, caused by increased circulating adhesion molecules...
2014: Current Pharmaceutical Biotechnology
Armando Tripodi, Anna L Fracanzani, Massimo Primignani, Veena Chantarangkul, Marigrazia Clerici, Pier Mannuccio Mannucci, Flora Peyvandi, Cristina Bertelli, Luca Valenti, Silvia Fargion
BACKGROUND & AIMS: Non-alcoholic fatty liver disease (NAFLD) is characterized by increased risk of cardiovascular events and liver-fibrosis. Both could be explained by a procoagulant-imbalance that was surmised but never directly demonstrated. We investigated 113 patients with varying histological liver damage [steatosis (n=32), steatohepatitis (n=51), metabolic-cirrhosis (n=30)], 54 with alcoholic/viral-cirrhosis and 179 controls. METHODS: Plasma was evaluated for levels of pro- and anti-coagulants, and for thrombin-generation assessed as endogenous-thrombin-potential (ETP) with and without thrombomodulin or Protac® as protein C activators...
July 2014: Journal of Hepatology
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