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https://www.readbyqxmd.com/read/28290648/deep-venous-thrombosis-and-pulmonary-embolism-current-therapy
#1
Jason Wilbur, Brian Shian
Pulmonary embolism and deep venous thrombosis are the two most important manifestations of venous thromboembolism (VTE), which is the third most common life-threatening cardiovascular disease in the United States. Anticoagulation is the mainstay of VTE treatment. Most patients with deep venous thrombosis or low-risk pulmonary embolism can be treated in the outpatient setting with low-molecular-weight heparin and a vitamin K antagonist (warfarin) or direct-acting oral anticoagulants. Inpatient treatment of VTE begins with parenteral agents, preferably low-molecular-weight heparin...
March 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/28286494/clinical-practice-evidence-based-recommendations-for-the-treatment-of-cervical-dystonia-with-botulinum-toxin
#2
REVIEW
Maria Fiorella Contarino, Joost Van Den Dool, Yacov Balash, Kailash Bhatia, Nir Giladi, Johannes H Koelman, Annemette Lokkegaard, Maria J Marti, Miranda Postma, Maja Relja, Matej Skorvanek, Johannes D Speelman, Evelien Zoons, Joaquim J Ferreira, Marie Vidailhet, Alberto Albanese, Marina A J Tijssen
Cervical dystonia (CD) is the most frequent form of focal dystonia. Symptoms often result in pain and functional disability. Local injections of botulinum neurotoxin are currently the treatment of choice for CD. Although this treatment has proven effective and is widely applied worldwide, many issues still remain open in the clinical practice. We performed a systematic review of the literature on botulinum toxin treatment for CD based on a question-oriented approach, with the aim to provide practical recommendations for the treating clinicians...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28279213/cardiovascular-risk-factors-are-major-determinants-of-thrombotic-risk-in-patients-with-the-lupus-anticoagulant
#3
Florian Posch, Johanna Gebhart, Jacob H Rand, Silvia Koder, Peter Quehenberger, Vittorio Pengo, Cihan Ay, Ingrid Pabinger
BACKGROUND: Patients with the lupus anticoagulant (LA) are at an increased risk of thrombotic events, which in turn increase the risk of death. Understanding the determinants of thrombotic risk in patients with LA may pave the way towards targeted thromboprophylaxis. In the Vienna Lupus Anticoagulant and Thrombosis Study (LATS), we systematically evaluate risk factors for thrombotic events in patients with LA. METHODS: We followed 150 patients (mean age: 41.3 years, female gender: n = 122 (81...
March 10, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28278524/management-of-thrombotic-antiphospholipid-syndrome
#4
Cecilia Beatrice Chighizola, Maria Gabriella Raimondo, Pier Luigi Meroni
Persistent serum positivity for antiphospholipid antibodies (aPL) is required to diagnose antiphospholipid syndrome (APS), an autoimmune disease characterized by recurrent vascular thrombosis and/or pregnancy morbidity. The current therapeutic management of patients with thrombotic APS aims at preventing recurrences and long-term complications by attenuating the procoagulant state. There is overall consensus to reserve moderate-intensity anticoagulation to aPL-positive patients with a previous venous thrombosis; the therapeutic options for those with a history of arterial event comprise antiplatelet agents and high-intensity anticoagulation...
March 9, 2017: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/28274514/cerebral-venous-sinus-thrombosis-in-pregnancy-and-puerperium-a-pooled-systematic-review
#5
REVIEW
Ahmed I Kashkoush, Henry Ma, Nitin Agarwal, David Panczykowski, Daniel Tonetti, Gregory M Weiner, William Ares, Cynthia Kenmuir, Ashutosh Jadhav, Tudor Jovin, Brian T Jankowitz, Bradley A Gross
Pregnancy and puerperium are risk factors for cerebral venous sinus thrombosis (CVST); however studies describing diagnosis and management in this population are limited. The objective of this study was to amalgamate published case reports and series regarding diagnosis and management of CVST in pregnancy and puerperium. Searches of PubMed and the Cochrane library were performed using search terms "pregnancy"/"puerperium" and "sinus occlusion"/"sinus thrombosis". Studies were included in our pooled analysis if they included individual patient symptoms, management approach and follow-up condition...
March 5, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28262241/hemostatic-issues-in-pregnancy-induced-liver-disease
#6
Ton Lisman, William Bernal
Liver diseases may be accompanied by profound changes in the hemostatic system including thrombocytopenia, decreased plasma levels of pro- and anticoagulants, and alterations in plasma levels of fibrinolysis. The net effect of the hemostatic changes in chronic and acute liver diseases is a hemostatic system that is in relative balance due to the simultaneous decline in pro- and antihemostatic drivers. A unique category of liver diseases are those induced by pregnancy. In acute fatty liver of pregnancy, profound hemostatic changes occur, which may be caused by a combination of liver failure and disseminated intravascular coagulation...
March 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28262239/lmwh-in-ivf-biomarkers-and-benefits
#7
Simon Fishel, Deborah J Baker, Ian A Greer
There is biological plausibility that coagulation activation underlies a proportion of in vitro fertilisation IVF failures and recurrent early clinical pregnancy loss (RPL). However, low-molecular-weight heparin (LMWH) use, based upon previous clinical outcome alone, is not effective in preventing RPL. RPL is heterogeneous in mechanism. Identifying those with an underlying thrombotic mechanism would allow stratification for LMWH treatment. Annexin A5 is an anticoagulant protein expressed on the trophoblast surface...
March 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28262237/outcome-after-discontinuing-anticoagulant-therapy-in-women-with-venous-thromboembolism-during-hormonal-use
#8
Ángeles Blanco-Molina, Javier Trujillo-Santos, Raffaele Pesavento, Vladimir Rosa, Conxita Falgá, Carles Tolosa, Lucia Mazzolai, Ángel Sampériz, Rita Duce, Manuel Monreal
INTRODUCTION: Whether women developing venous thromboembolism (VTE) while using hormonal therapy should be classified as having "unprovoked" or "provoked" VTE is controversial. METHODS: We used the RIETE (Registro Informatizado Enfermedad TromboEmbólica) database to compare the rate of symptomatic VTE recurrences after discontinuing anticoagulation in 3 subgroups of women aged ≤50years without cancer, pregnancy or puerperium: (1) those with hormonal therapy and no additional risk factors (hormonal users only); (2) those with unprovoked VTE; and (3) those with additional risk factors, with or without hormonal therapy...
March 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28262233/antiphospholipid-syndrome
#9
Ricard Cervera
The antiphospholipid syndrome (APS) is defined by the development of venous and/or arterial thromboses, often multiple, and pregnancy morbidity (mainly, recurrent fetal losses), in the presence of antiphospholipid antibodies (aPL). Some estimates indicate that the incidence of the APS is around 5 new cases per 100,000 persons per year and the prevalence around 40-50 cases per 100,000 persons. The aPL are positive in approximately 13% of patients with stroke, 11% with myocardial infarction, 9.5% of patients with deep vein thrombosis and 6% of patients with pregnancy morbidity...
March 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28262232/anticoagulants-to-prevent-recurrent-placenta-mediated-pregnancy-complications-is-it-time-to-put-the-needles-away
#10
Leslie Skeith, Marc Rodger
Placenta-mediated pregnancy complications, such as pre-eclampsia, placental abruption, birth of a small-for-gestational age infant and late pregnancy loss, are common and carry significant morbidity and mortality. The etiology of placenta-mediated pregnancy complications is likely multifactorial and may include abnormal coagulation activation of the maternal-fetal interface. The use of antepartum low-molecular-weight heparin (LMWH) prophylaxis to prevent recurrent placenta-mediated pregnancy complications has become common practice despite limited and conflicting evidence to support its use...
March 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28262231/antiphospholid-antibodies-and-the-risk-of-pregnancy-complications
#11
Jean-Christophe Gris, Sylvie Bouvier, Eva Nouvellon, Géraldine Lissalde-Lavigne, Erick Mercier, Jean-Pierre Balducchi, Pierre Marès
Antiphospholipid antibodies (APLAbs) are generally considered as risk factors for foetal death, for premature birth ≤34weeks due to severe pre-eclampsia or severe placental insufficiency and for recurrent consecutive spontaneous abortions <10weeks. Among these three obstetrical morbidities, only the first one is however not regularly questioned. The coexistence of an inflammatory disease and/or of thrombotic manifestations increases the obstetrical risks. Among the three criteria APLAbs, i.e. lupus anticoagulant (LA), anticardiolipin (aCL) Abs, anti-β2 glycoprotein-I (aβ2GP1)Abs, LA seems the more widely associated to clinical risks, the clinical impact of aβ2GP1Abs is progressively defined and the pejorative impact of triple positivity is still discussed...
March 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28238314/-obstetrical-aps-is-there-a-place-for-additional-treatment-to-aspirin-heparin-combination
#12
A Mekinian, G Kayem, J Cohen, L Carbillon, N Abisror, L Josselin-Mahr, M Bornes, O Fain
Obstetrical APS is defined by thrombosis and/or obstetrical morbidity associated with persistent antiphospholipid antibodies. The aspirin and low molecular weighted heparin combination dramatically improved obstetrical outcome in APS patients. Several factors could be associated with obstetrical prognosis, as previous history of thrombosis, associated SLE, the presence of lupus anticoagulant and triple positivity of antiphospholipid antibodies. Obstetrical APS with isolated recurrent miscarriages is mostly associated with isolated anticardiolipids antibodies and have better obstetrical outcome...
January 2017: Gynecol Obstet Fertil Senol
https://www.readbyqxmd.com/read/28194864/anticoagulant-options-in-pregnancy-for-women-with-mechanical-valves
#13
C McLintock
No abstract text is available yet for this article.
February 14, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28176193/obstetric-outcomes-of-recurrent-pregnancy-loss-patients-diagnosed-w%C3%A4-th-inherited-thrombophilia
#14
C Karadağ, T Yoldemir, S D Karadağ, C İnan, Z N Dolgun, L Aslanova
BACKGROUND: Recurrent pregnancy loss (RPL) is defined by two or more failed pregnancies. The relation between RPL and inherited thrombophilia requires anticoagulant therapy during pregnancy. However the obstetric outcomes have not been well defined in these RPL patients diagnosed with inherited thrombophilia, who have been given anticoagulant therapy. AIM: To investigate the obstetric outcomes in pregnant women with RPL who are given low molecular weight heparin (LMWH) and low-dose aspirin due to diagnosis of inherited thrombophilia...
February 7, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28168066/management-of-venous-thromboembolism-in-patients-with-hereditary-antithrombin-deficiency-and-pregnancy-case-report-and-review-of-the-literature
#15
Mohammad Refaei, Lydia Xing, Wendy Lim, Mark Crowther, Kochawan Boonyawat
Background. Hereditary antithrombin deficiency is a thrombogenic disorder associated with a 50-90% lifetime risk of venous thromboembolism (VTE), which is increased during pregnancy and the puerperium in these patients. We present a case of a woman with antithrombin (AT) deficiency who presented with a VTE despite therapeutic low molecular weight heparin (LMWH). Though the pregnancy was deemed unviable, further maternal complications were mitigated through the combined use of therapeutic anticoagulation and plasma-derived antithrombin concentrate infusions to normalize her functional antithrombin levels...
2017: Case Reports in Hematology
https://www.readbyqxmd.com/read/28153662/antiphospholipid-antibody-profile-based-obstetric-outcomes%C3%A2-of-primary-antiphospholipid-syndrome-the%C3%A2-pregnants-study
#16
Gabriele Saccone, Vincenzo Berghella, Giuseppe Maria Maruotti, Tullio Ghi, Giuseppe Rizzo, Giuliana Simonazzi, Nicola Rizzo, Fabio Facchinetti, Andrea Dall'Asta, Silvia Visentin, Laura Sarno, Serena Xodo, Dalila Bernabini, Francesca Monari, Amanda Roman, Ahizechukwu Chigoziem Eke, Ariela Hoxha, Amelia Ruffatti, Ewoud Schuit, Pasquale Martinelli
BACKGROUND: Antiphospholipid syndrome is an autoimmune, hypercoagulable state that is caused by antiphospholipid antibodies. Anticardiolipin antibodies, anti-β2 glycoprotein-I, and lupus anticoagulant are the main autoantibodies found in antiphospholipid syndrome. Despite the amassed body of clinical knowledge, the risk of obstetric complications that are associated with specific antibody profile has not been well-established. OBJECTIVE: The purpose of this study was to assess the risk of obstetric complications in women with primary antiphospholipid syndrome that is associated with specific antibody profile...
January 30, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28153433/thrombocytopenia-as-a-thrombotic-risk-factor-in-patients-with-antiphospholipid-antibodies-without-disease-criteria
#17
Rosalia Demetrio Pablo, Pedro Muñoz, Marcos López-Hoyos, Vanesa Calvo, Leyre Riancho, Victor Manuel Martínez-Taboada
INTRODUCTION: The antiphospholipid syndrome (APS) is an acquired immune disorder defined by the presence of thrombosis (arterial and/or venous) and/or pregnancy morbidity along with the presence of positive antiphospholipid antibodies (aPL). There is a clear relationship between aPL and some events not included in the clinical criteria, including haematologic. OBJECTIVES: a) to study the probability of developing clinical APS in patients with positive aPL and thrombopenia; b) to identify potential risk factors for thrombosis, and c) to study the association between thrombocytopenia and aPL...
January 30, 2017: Medicina Clínica
https://www.readbyqxmd.com/read/28150927/-pregnancy-after-bariatric-surgery
#18
Franco Pepe, Francesco DE Luca, Mariagrazia Stracquadanio, Claudia Garraffo, Veronica C Santonocito, Agata Privitera
Pregnancy after bariatric surgery has some peculiarities related to obesity, type of surgery, amount of weight loss, time elapsed from the surgery and adherence to medical prescriptions. Pregnant woman is at risk of nutritional deficiencies and it is unclear whether there is an increased incidence of intestinal complications during pregnancy after bariatric surgery and whether this kind of complications are more frequent during cesarean section. The fetus is at high risk of prematurity and fetal growth restriction, but they seem not at increased risk of birth defects (DTN) except in individual cases of folic acid deficiency (DTN) or vitamin K defect (similar abnormalities in patients receiving oral anticoagulants)...
April 2017: Minerva Ginecologica
https://www.readbyqxmd.com/read/28124411/imaging-for-the-exclusion-of-pulmonary-embolism-in-pregnancy
#19
REVIEW
Thijs E van Mens, Luuk Jj Scheres, Paulien G de Jong, Mariska Mg Leeflang, Mathilde Nijkeuter, Saskia Middeldorp
BACKGROUND: Pulmonary embolism is a leading cause of pregnancy-related death. An accurate diagnosis in pregnant patients is crucial to prevent untreated pulmonary embolism as well as unnecessary anticoagulant treatment and future preventive measures. Applied imaging techniques might perform differently in these younger patients with less comorbidity and altered physiology, who largely have been excluded from diagnostic studies. OBJECTIVES: To determine the diagnostic accuracy of computed tomography pulmonary angiography (CTPA), lung scintigraphy and magnetic resonance angiography (MRA) for the diagnosis of pulmonary embolism during pregnancy...
January 26, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28120818/pregnancy-and-menopause-in-patients-with-systemic-lupus-erythematosus-and-or-antiphospholipid-syndrome-practical-guide-from-eular
#20
Roberta Vagelli, Chiara Tani, Marta Mosca
Over the last few decades, in reproductive medicine have allowed an improvement in the management and outcome of pregnancy in connective tissue diseases (CTD), such as Systemic progress Lupus Erythematosus and Antiphospholipid Syndrome; however, pregnancy and other related issues represent a crucial moment for patients and their family and some unmet needs are still present. In routine clinical practise, health professionals involved in the care of SLE and/or APS patients need to consider many aspects of the reproductive life of patients, involving not only pregnancy and family planning but also fertility, contraception, cancer surveillance and menopause...
January 25, 2017: Polskie Archiwum Medycyny Wewnętrznej
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