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https://www.readbyqxmd.com/read/29025542/acute-and-recurrent-pericarditis
#1
REVIEW
Massimo Imazio, Fiorenzo Gaita
Acute and recurrent pericarditis is the most common pericardial syndrome encountered in clinical practice either as an isolated process or as part of a systemic disease. The diagnosis is based on clinical evaluation, electrocardiogram, and echocardiography. The empiric therapy is based on nonsteroidal anti-inflammatory drugs plus colchicine as first choice, resorting to corticosteroids for specific indications (eg, systemic inflammatory disease on corticosteroids, pregnancy, renal failure, concomitant oral anticoagulants), for contraindications or failure of the first-line therapy...
November 2017: Cardiology Clinics
https://www.readbyqxmd.com/read/29024233/use-of-d-dimer-measurement-to-guide-anticoagulant-treatment-in-recurrent-pregnancy-loss-associated-with-antiphospholipid-syndrome
#2
Shi Hua Bao, Shi Le Sheng, Hong Liao, Qian Zhou, Sophia Twum Frempong, Wei Yan Tu
PROBLEM: To examine whether the level of plasma D-dimer can guide anticoagulant treatment in recurrent pregnancy loss (RPL) associated with antiphospholipid syndrome (APS). METHODS: A total of 1096 RPL women with APS between 2012 and 2015 in a single-center hospital were randomly divided into two groups (group A, 75 mg of low-dose aspirin [LDA] daily; group B, 75 mg of LDA plus 4100 U of low molecular weight heparin [LMWH] subcutaneously daily); 1015 of the total successfully completed the trial...
October 11, 2017: American Journal of Reproductive Immunology: AJRI
https://www.readbyqxmd.com/read/29017305/spontaneous-epidural-hematoma-associated-with-venous-phlebolith-in-cervical-spine-and-possible-pathogenesis
#3
Dong Hwan Kim, Dong Ha Kim, Kyoung Hyup Nam, Byung Kwan Choi, In Ho Han
Although the etiology of spontaneous spinal epidural hematoma (SSEH) is unclear, SSEH is known to be associated with anticoagulants, coagulopathy, vascular malformation, hypertension, and pregnancy. However, no report has been issued on the relation between SSEH and venous phlebolith. Here, the authors present an extremely rare case of SSEH associated with phlebolith in the cervical spine and suggest a possible pathogenesis. A 36-year-old man without any relevant medical history presented with neck pain and numbness and severe radiating pain on the left arm...
September 2017: Korean Journal of Spine
https://www.readbyqxmd.com/read/28985591/antiphospholipid-syndrome-and-recurrent-miscarriage-a-systematic-review-and-meta-analysis
#4
REVIEW
Thaís da Silva Santos, Andressa Lorena Ieque, Hayalla Corrêa de Carvalho, Ana Maria Sell, Maria Valdrinez Campana Lonardoni, Izabel Galhardo Demarchi, Quirino Alves de Lima Neto, Jorge Juarez Vieira Teixeira
Antiphospholipid syndrome (APS) is an autoimmune condition that is associated with thrombosis and morbidity in pregnancy. The exact mechanisms by which these associations occur appear to be heterogeneous and are not yet well understood. The aim of this study was to identify and analyze publications in recent years to better understand the diagnosis and its contribution to monitoring APS among women with recurrent miscarriage (RM). This systematic review and meta-analysis was conducted using the PubMed and Web of Knowledge databases, with articles published between 2010 and 2014, according to the PRISMA statement...
September 2017: Journal of Reproductive Immunology
https://www.readbyqxmd.com/read/28978853/idiopathic-thrombosis
#5
Hiroko Tsuda
Idiopathic thrombosis involves a group of inherited thrombophilia predisposed to severe thrombosis of early onset and associated with an adverse outcome due to recurrence, and therefore, requires long-term anticoagulation therapy. The causative factors of a predisposition to thrombosis include immobility, dehydration, infection, surgery, injury, cancer, pregnancy, and estrogen use. The inherited deficiencies of antithrombin (AT), protein C (PC), and protein S (PS) are specified as "Specific Pediatric Chronic Diseases...
2017: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
https://www.readbyqxmd.com/read/28968483/antiplatelet-and-anticoagulant-agents-for-secondary-prevention-of-stroke-and-other-thromboembolic-events-in-people-with-antiphospholipid-syndrome
#6
REVIEW
Malgorzata M Bala, Magdalena Celinska-Lowenhoff, Wojciech Szot, Agnieszka Padjas, Mateusz Kaczmarczyk, Mateusz J Swierz, Anetta Undas
BACKGROUND: Antiphospholipid syndrome (APS) is a systemic autoimmune disease characterized by arterial or venous thrombosis (or both) and/or pregnancy morbidity in association with the presence of antiphospholipid antibodies. The prevalence is estimated at 40 to 50 cases per 100,000 people. The most common sites of thrombosis are cerebral arteries and deep veins of the lower limbs. People with a definite APS diagnosis have an increased lifetime risk of recurrent thrombotic events. OBJECTIVES: To assess the effects of antiplatelet or anticoagulant agents, or both, for the secondary prevention of recurrent thrombosis, particularly ischemic stroke, in people with antiphospholipid syndrome...
October 2, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28948451/a-diagnostic-approach-to-stroke-in-young-adults
#7
REVIEW
Christopher A Stack, John W Cole
Optimal diagnosis and management of stroke in young adults benefit from a multidisciplinary team, including a vascular neurology specialist. In addition to the "standard" vascular risk factors including smoking, hypertension, diabetes, and hyperlipidemia, one needs to consider alternative etiologies including substance abuse, carotid/vertebral artery dissections, and rare genetic conditions among others. Once a young patient is determined to have had a stroke, the next question a clinician should ask is why did this patient have a stroke? A "heart to head" diagnostic approach is recommended...
September 25, 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28933640/the-impact-of-antithrombin-deficiency-on-women-s-reproductive-health-experiences-and-healthcare-decision-making
#8
Ariela L Marshall, Juliana Perez Botero, Aneel A Ashrani, Rajiv K Pruthi, John A Heit, Ashish Chintakuntlawar, Jennifer C Guenther, Mrinal M Patnaik
BACKGROUND: Women with inherited antithrombin (AT) deficiency are at high risk for venous thromboembolism (VTE), especially during times of estrogen exposure, but little is known about patient-oriented reproductive decision-making in this population. MATERIALS AND METHODS: Provider-administered survey of women with AT deficiency. Participants were asked to discuss their diagnosis of AT deficiency and questioned about (1) contraception, (2) pregnancies, and (3) menorrhagia, and the impact of their AT deficiency on each reproductive health experience...
September 21, 2017: Journal of Women's Health
https://www.readbyqxmd.com/read/28918617/right-ventricular-thrombosis-combined-with-fetal-death-and-acrocyanosis-in-pregnancy
#9
Feridoun Sabzi, Aghigh Heidari
Prepartum or postpartum right ventricular thrombosis (RVT) is an exceedingly rare and potentially lethal phenomenon in pregnancy. We here report a case of a pregnant patient with near term pregnancy admitted for dyspnea, amniotic fluids discharge and labor pain in a gynecology center that an eight-month dead fetus was diagnosed and delivered vaginally by induction. A post delivery period was complicated by aggravation of her dyspnea and pleuritic chest pain that she referred for further evaluation in our cardiac center...
July 2017: Acta Medica Iranica
https://www.readbyqxmd.com/read/28914273/patterns-and-appropriateness-of-thrombophilia-testing-in-an-academic-medical-center
#10
Nicholas Cox, Stacy A Johnson, Sara Vazquez, Ryan P Fleming, Matthew T Rondina, David Kaplan, Stephanie Chauv, Gabriel V Fontaine, Scott M Stevens, Scott Woller, Daniel M Witt
BACKGROUND: Clinical guidelines recommend against routine use of thrombophilia testing in patients with acute thromboembolism. Thrombophilia testing rarely changes acute management of a thrombotic event. OBJECTIVE: To determine appropriateness of thrombophilia testing in a teaching hospital. DESIGN: Retrospective cohort study. SETTING: One academic medical center in Utah. PARTICIPANTS: All patients who received thrombophilia testing between July 1, 2014, and December 31, 2014...
September 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28913590/challenges-of-anticoagulation-therapy-in-pregnancy
#11
REVIEW
Annemarie E Fogerty
Thrombotic complications in pregnancy represent a major cause of morbidity and mortality. Pregnancy is a primary hypercoagulable state due to enhanced production of clotting factors, a decrease in protein S activity, and inhibition of fibrinolysis. These physiologic changes will yield a collective rate of venous thromboembolism (VTE) of about 1-2 in 1000 pregnancies for the general obstetric population, which represents a five- to tenfold increased risk in pregnancy compared to age-matched non-pregnant peers...
September 14, 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28900802/assessment-of-m2-anxa5-haplotype-as-a-risk-factor-in-couples-with-placenta-mediated-pregnancy-complications
#12
Nina Rogenhofer, Lara R M Nienaber, Lea C Amshoff, Nadia Bogdanova, David Petroff, Peter Wieacker, Christian J Thaler, Arseni Markoff
PURPOSE: The aim of this study was to confirm the associated M2/ANXA5 carrier risk in women with placenta-mediated pregnancy complications (PMPC) and to test their male partners for such association. Further analysis evaluated the influence of maternal vs. paternal M2 alleles on miscarriage. METHODS: Two hundred eighty-eight couples with preeclampsia (PE), intrauterine growth restriction (IUGR), or premature birth (PB) were recruited (n = 96 of each phenotype)...
September 13, 2017: Journal of Assisted Reproduction and Genetics
https://www.readbyqxmd.com/read/28891082/thrombolysis-for-massive-pulmonary-embolism-in-pregnancy
#13
Mojdeh S Heavner, Min Zhang, Chelsea E Bast, Lindsey Parker, Rachel F Eyler
Pregnant women are at high risk for venous thromboembolism, including pulmonary embolism (PE), given expected changes in coagulation, fibrinolysis, and venous blood flow. In fact, PE is the leading cause of maternal death in the United States. Non-pregnant patients who develop PE with hypotension or showing signs of deterioration after anticoagulation receive thrombolytics as a standard of care. Pregnant women, however, have been excluded from clinical trials with thrombolytics and all data available in this population is published as case reports or case series...
September 11, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28885339/role-of-chemotherapy-and-thrombolysis-in-treatment-of-choriocarcinoma-accompanied-with-pulmonary-embolism-a-case-report-with-literature-review
#14
Mei Yang, Li Peng
RATIONALE: Choriocarcinoma accompanied with pulmonary embolism (PE) is rare and difficult to diagnose and treat. There are about 25 cases reported in literature, which presented variable clinical characteristics and prognosis. PATIENT CONCERNS: We reported a case of choriocarcinoma presenting PE as the first manifestation in a 26-year-old Chinese female. DIAGNOSES: Four months before her admission to our hospital, she presented to a local hospital with respiratory manifestations, and was first diagnosed as bronchitis and treated with antibiotics without improvement, and subsequently suspected of having pulmonary tuberculosis and receive anti-tuberculosis therapy, with no response...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28881030/the-association-between-anticoagulation-therapy-maternal-characteristics-and-a-failed-cfdna-test-due-to-a-low-fetal-fraction
#15
Whitney Burns, Nathanael Koelper, Andrea Barberio, Mary DeAgostino-Kelly, Michael Mennuti, Mary D Sammel, Lorraine Dugoff
OBJECTIVES: The objective of this study was to identify maternal characteristics associated with a failed cell-free DNA (cfDNA) test due to a low fetal fraction (FF). METHOD: Retrospective cohort study of women with singleton pregnancies who had cfDNA screening at 10-25 weeks gestation between October 2011 and January 2016. cfDNA screening was performed using methylation techniques until October 2013; thereafter, samples were run with massively parallel sequencing...
September 7, 2017: Prenatal Diagnosis
https://www.readbyqxmd.com/read/28866693/a-15-year-single-centre-retrospective-study-of-antiphospholipid-syndrome-patients-from-northern-malaysia
#16
M A Islam, F Alam, S H Gan, T H Sasongko, W S Wan Ghazali, K K Wong
BACKGROUND: Antiphospholipid syndrome (APS) is an autoimmune disorder characterised by thrombosis and/or pregnancy morbidity in the presence of antiphospholipid antibodies (aPLs) based on the Sydney criteria. We aimed to explore the clinico-laboratory features and treatment strategies of APS patients retrospectively. METHODOLOGY: The medical records of APS patients registered under Hospital Universiti Sains Malaysia (Kelantan state) between 2000 and 2015 were reviewed...
August 2017: Malaysian Journal of Pathology
https://www.readbyqxmd.com/read/28803708/anti-phospholipid-syndrome-current-opinion-on-mechanisms-involved-laboratory-characterization-and-diagnostic-aspects
#17
REVIEW
Jean Amiral, Marie Peyrafitte, Claire Dunois, Anne Marie Vissac, Jerard Seghatchian
Anti-phospholipid syndrome is a complex and severe clinical situation, associated with symptoms such as recurrent thrombosis, arterial or venous, at any site, pregnancy loss, and other related syndromes. These clinical burdens, are highly variable from patient to patient, and are associated with biological abnormalities, such as the presence of the Lupus Anticoagulant or phospholipid dependent antibodies, confirmed on two occasions at least 12 weeks apart. From the diagnosis standpoint, both, functional (clotting) or immunological assays, are difficult to standardize and to optimize, due to the absence of reference material, or a characteristic clinical group, and international reference preparations...
July 15, 2017: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/28799251/comparison-of-anticoagulation-regimens-for-pregnant-women-with-prosthetic-heart-valves-a-meta-analysis-of-prospective-studies
#18
Jing Wang, Kangqi Li, Hongyan Li, Weiwei Zhu, Haiyan Sun, Congxiao Lu
INTRODUCTION: Pregnancy is associated with a hypercoagulable state, which makes pregnant women with prosthetic heart valves at high risk of thromboembolism. Proper anticoagulation regimen should take both the maternal protection and the fetal outcomes into consideration. However, no consensus on the present anticoagulation regimen for those women has been reached yet, especially in the first trimester of pregnancy. AIMS: The present meta-analysis is conducted to compare anticoagulation efficiency and feto-maternal complications of heparin and warfarin in the first trimester...
August 11, 2017: Cardiovascular Therapeutics
https://www.readbyqxmd.com/read/28792912/adverse-pregnancy-outcomes-and-inherited-thrombophilia
#19
Dominik Dłuski, Radzisław Mierzyński, Elżbieta Poniedziałek-Czajkowska, Bożena Leszczyńska-Gorzelak
AIM: (1) To evaluate the prevalence of inherited thrombophilia in pregnant women with adverse pregnancy outcomes: intrauterine growth retardation (IUGR), preeclampsia (PE) and placental abruption. (2) To assess the impact of inherited thrombophilia on the nature of obstetric complications. (3) To assess levels of protein S, protein C, antithrombin III and homocysteine in pregnant women with adverse pregnancy outcomes. SUBJECTS AND METHODS: The study comprised 162 pregnant women...
August 9, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28782117/risk-factors-for-blood-transfusion-in-patients-undergoing-high-order-cesarean-delivery
#20
Jessica Spiegelman, Mirella Mourad, Stephanie Melka, Simi Gupta, Jennifer Lam-Rachlin, Andrei Rebarber, Daniel H Saltzman, Nathan S Fox
BACKGROUND: The objective was to identify risk factors associated with blood transfusion in patients undergoing high-order Cesarean delivery (CD). STUDY DESIGN AND METHODS: This was a retrospective cohort study of patients undergoing third or more CD by a single maternal-fetal medicine practice between 2005 and 2016. We compared risk factors between women who did and did not receive a red blood cell transfusion during the operation or before discharge. Repeat analysis was performed after excluding women with placenta previa...
August 7, 2017: Transfusion
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