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https://www.readbyqxmd.com/read/29895622/prothrombin-conversion-is-accelerated-in-the-antiphospholipid-syndrome-and-insensitive-to-thrombomodulin
#1
Romy M W Kremers, Stéphane Zuily, Hilde Kelchtermans, Tessa C Peters, Saartje Bloemen, Véronique Regnault, H Coenraad Hemker, Philip G de Groot, Denis Wahl, Bas de Laat
Antiphospholipid syndrome (APS) is a condition in which the presence of antibodies against phospholipid-binding proteins is associated with thrombophilia and/or pregnancy morbidity. Although antiphospholipid antibodies have anticoagulant characteristics in vitro, they are associated with thromboembolic complications. Thrombin generation (TG) is a sensitive global test of coagulation, and elevated TG is associated with thrombosis. Increased TG can be caused by increased prothrombin conversion, decreased thrombin inactivation, or a combination of both...
June 12, 2018: Blood Advances
https://www.readbyqxmd.com/read/29894348/eisenmenger-syndrome-in-pregnancy-when-is-it-time-for-ecmo-a-case-report
#2
Marie-Louise Meng, Annie Fu, Carolyn Westhoff, Matthew Bacchetta, Erika B Rosenzweig, Ruth Landau, Richard Smiley
We report the case of a 21-year-old primiparous woman at 22 weeks gestation who presented with a large uncorrected ventricular septal defect, severe pulmonary hypertension, and Eisenmenger syndrome. The patient elected for termination of pregnancy, which was performed under regional anesthesia. Hemodynamic changes apparently associated with uterine contraction immediately after termination resulted in increased right to left shunting across the ventricular septal defect requiring urgent venovenous extracorporeal membrane oxygenation...
June 11, 2018: A&A practice
https://www.readbyqxmd.com/read/29884138/the-complex-treatment-including-rituximab-in-the-management-of-catastrophic-antiphospholid-syndrome-with-renal-involvement
#3
Aleksandra Rymarz, Stanisław Niemczyk
BACKGROUND: Catastrophic antiphospholipid syndrome (CAPS) is a rare, life-threatening form of antiphospholipid syndrome (APS) involving many organs and leading to their insufficiency. The pathogenesis of CAPS is associated with the presence of antiphospholipid antibodies (aPL). Typical therapy includes anticoagulation, glucocorticoids, therapeutic plasma exchanges and/or intravenous immunoglobulin. Despite this aggressive treatment, the mortality rate of 37% is still high. Novel therapeutic agents are required...
June 8, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29881958/effectiveness-and-safety-of-rivaroxaban-versus-warfarin-in-patients-with-provoked-venous-thromboembolism
#4
Craig I Coleman, Alexander G G Turpie, Thomas J Bunz, Jan Beyer-Westendorf
A paucity of real-world data evaluating rivaroxaban in provoked venous thromboembolism (VTE) exists. We assessed the effectiveness and safety of rivaroxaban versus warfarin in provoked VTE patients treated in routine practice. Using MarketScan claims data from 1/2012 to 12/2016, we identified adults who had ≥ 1 primary hospitalization/emergency department discharge diagnosis code for VTE (index event) and a provoking factor, received rivaroxaban or warfarin as their first outpatient oral anticoagulant within 30-days of the index event and had ≥ 12-month of insurance coverage prior the index VTE...
June 7, 2018: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29877031/molecular-actions-of-heparin-and-their-implications-in-preventing-preeclampsia
#5
REVIEW
Jovian M Wat, Melanie Audette, John C Kingdom
Preeclampsia, a hypertensive disorder of pregnancy, continues to be a significant cause of global maternal morbidity. Low-dose aspirin remains the only standard of care prophylactic therapy for preventing preeclampsia, but is limited in efficacy. Heparin and its derivatives may further enhance the efficacy of aspirin therapy to prevent preeclampsia, but the mechanisms mediating this augmentative effect are not known. While heparin is an anticoagulant agent, it also possesses many anticoagulant-independent properties that may be relevant in the prevention of preeclampsia, including effects on placental, vascular, and inflammatory function...
June 7, 2018: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/29849283/occult-iliac-deep-vein-thrombosis-in-second-trimester-pregnancy-clues-on-bedside-ultrasound
#6
Roopa Avula, Michael Niemann, Nicole Dorinzi, Kristine Robinson, Melinda Sharon, Joseph Minardi
Isolated pelvic deep vein thromboses (DVT) are rare and difficult to diagnose, but they are more common in pregnant women and carry an increased risk of embolization. Pulmonary embolism is the most common non-obstetric cause of death in pregnancy. Compression ultrasound is the first-line imaging test for suspected lower extremity DVT, but it cannot usually aid in directly visualizing or easily diagnosing isolated pelvic DVT. Nonetheless, point-of-care ultrasound (POCUS) may provide valuable clues to help rule in pelvic DVT and expedite initiation of anticoagulant therapy...
August 2017: Clinical practice and cases in emergency medicine
https://www.readbyqxmd.com/read/29848449/biological-versus-mechanical-heart-valve-prosthesis-during-pregnancy-in-women-with-congenital-heart-disease
#7
Heleen Lameijer, Ymkje J van Slooten, Monique R M Jongbloed, Martijn A Oudijk, Marlies A M Kampman, Arie P van Dijk, Marco C Post, Barbara J Mulder, Krystyna M Sollie, Dirk J van Veldhuisen, Tjark Ebels, Joost P van Melle, Petronella G Pieper
BACKGROUND: We evaluate pregnancy outcome and anticoagulation regimes in women with mechanical and biological prosthetic heart valves (PHV) for congenital heart disease. METHODS: Retrospective multicenter cohort studying pregnancy outcomes in an existing cohort of patients with PHV. RESULTS: 52 women had 102 pregnancies of which 78 pregnancies (46 women) ≥20 weeks duration (59 biological, 19 mechanical PHV). Miscarriages (n = 19, ≤20 weeks) occurred more frequently in women using anticoagulation (P < ...
May 23, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29794382/cardiomyopathy-phenotypes-and-pregnancy-outcomes-with-left-ventricular-noncompaction-cardiomyopathy
#8
Yusuke Ueda, Chizuko A Kamiya, Atsushi Nakanishi, Chinami Horiuchi, Takekazu Miyoshi, Ryoichi Hazama, Mitsuhiro Tsuritani, Naoko Iwanaga, Reiko Neki, Jun Yoshimatsu
Little is known about pregnancies of left ventricular noncompaction cardiomyopathy (LVNC), much less cases in which LVNC was definitively diagnosed prepregnancy. We report the cases of three pregnant Japanese women definitively diagnosed with LVNC prepregnancy. Case 1 presented LVNC with restrictive phenotype. Her pregnancy was terminated due to exacerbated pulmonary hypertension and low output status at 30 weeks' gestation. Case 2 presented isolated LVNC with nonsustained ventricle tachycardia. A cesarean section was performed at 36 weeks' gestation because of placenta previa...
May 23, 2018: International Heart Journal
https://www.readbyqxmd.com/read/29780778/impact-of-presence-of-antiphospholipid-antibodies-on-in-vitro-fertilization-outcome
#9
Yeon Hee Hong, Se Jeong Kim, Kyoung Yong Moon, Seul Ki Kim, Byung Chul Jee, Won Don Lee, Seok Hyun Kim
Objective: To investigate prevalence of antiphospholipid antibody (APA) in Korean infertile women undergoing the first in vitro fertilization (IVF) treatment and to evaluate the influence of APA on the subsequent IVF outcomes. Method: Two hundred nineteen infertile women who destined the first IVF were prospectively enrolled in 2 infertility centers. Male factor or uterine factor infertility and women with past or current endocrine or immunologic disorders were completely excluded...
May 2018: Obstetrics & Gynecology Science
https://www.readbyqxmd.com/read/29778421/comparison-of-two-groups-for-the-apolipoprotein-e-polymorphisms-by-using-next-generation-sequencing-the-first-group-with-three-consecutive-abortions-and-the-second-group-with-at-most-one-abortion-in-three-consecutive-pregnancies
#10
Evren Gumus
The importance of apolipoprotein E genotypes and allelic polymorphisms in the etiology of recurrent miscarriage is controversial. We plan to investigate this in a two-group study involving more than a thousand participants. In total, 1046 subjects (802 participants in the first group, 244 participants in the second group) were investigated. Women in the first group had a history of ≥3 consecutive spontaneous miscarriage and women in the second group had at most one miscarriage in three consecutive pregnancies...
May 17, 2018: Gene
https://www.readbyqxmd.com/read/29772490/effects-of-multiple-inherited-and-acquired-thrombophilia-on-outcomes-of-in-vitro-fertilization
#11
Marcello Di Nisio, Adalisa Ponzano, Gian Mario Tiboni, Maria Domenica Guglielmi, Anne Wilhelmina Saskia Rutjes, Ettore Porreca
INTRODUCTION: The effects of multiple inherited and acquired thrombophilic defects on the outcome of in-vitro fertilization (IVF) remain unexplored. The aim of this study was to evaluate the association between multiple thrombophilia and clinical outcomes in a large prospective cohort of women undergoing IVF. MATERIALS AND METHODS: Consecutive women scheduled for IVF were eligible. The primary study outcome was live birth. Secondary outcomes included spontaneous abortion, clinical pregnancy, and symptomatic venous thromboembolism...
May 9, 2018: Thrombosis Research
https://www.readbyqxmd.com/read/29769494/clinical-profile-and-outcome-of-peripartum-cardiomyopathy-a-study-in-a-tertiary-cardiac-hospital-of-bangladesh
#12
N Fatema, S K Banerjee, C M Ahmed, A A Habib, F Rahman, S A Ahsan, H Hoque, R C Debnath, S Hashem, J Arzu
This study was done to evaluate the clinical profile, management and to analysis of pregnancy outcomes of peripartum cardiomyopathy pregnant women. Follow up was done after treatment and to see the prognosis. All patients admitted with peripartum cardiomyopathy from July 2009 to June 2014 in the department of Cardiology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh were considered for this observational study. Seventy two (72) women were evaluated. Primi-paras are 28 (39%) of the total study population...
April 2018: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/29764231/important-considerations-in-pregnant-patients-with-lupus-nephritis
#13
Gabriella Moroni, Claudio Ponticelli
In the last few decades, identification of predictors of pregnancy outcome and appropriate pregnancy planning have significantly reduced the maternal and fetal risks in pregnant women with lupus nephritis. Areas covered: Successful pregnancies have been reported even in women with chronic renal disease and renal insufficiency. However, refractory hypertension and severe renal or cardiac chronic dysfunction are still considered contraindications to pregnancy. Pre-term delivery and fetal growth restriction may still occur in SLE patients more frequently than in healthy women, even in pregnancies regularly planned and monitored by a team of nephrologists and gynaecologists...
May 15, 2018: Expert Review of Clinical Immunology
https://www.readbyqxmd.com/read/29752389/pregnancy-in-women-with-a-fontan-circulation-a-systematic-review-of-the-literature
#14
Alvaro Garcia Ropero, Shankar Baskar, Jolien W Roos Hesselink, Andrea Girnius, Dominica Zentner, Lorna Swan, Magalie Ladouceur, Nicole Brown, Gruschen R Veldtman
BACKGROUND: The Fontan operation has provided life-saving palliation and adult survival for individuals born with single ventricle physiology. Many now seek advice about safe pregnancy. Little data are, however, available, consisting mainly of anecdotal experience and small series. This article seeks to review the published literature and identify lessons learnt from this collective experience. METHODS AND RESULTS: We conducted a systematic review to evaluate maternal and fetal outcomes of pregnancy in women with a Fontan circulation...
May 2018: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/29745623/the-role-of-intraoperative-stroke-volume-variation-on-bleeding-during-functional-endoscopic-sinus-surgery
#15
Roberta Di Mauro, Fabiana Lucci, Federica Martino, Maria B Silvi, Eleonora Gidaro, Santo Di Lorenzo, Nicola Toschi, Stefano Di Girolamo, Mario Dauri
BACKGROUNDː Functional Endoscopic Sinus Surgery (FESS) is a minimally-invasive surgical technique for patients with paranasal sinus pathology. Surgical bleeding reduces operative field visibility and increases the incidence of serious complications. Epinephrine injection into the nasal mucosa and controlled hypotension are used to minimise bleeding. Hypotension carries risks and sometimes does not reduce surgical bleeding. The goal of this study is to discover which haemodynamic parameter better correlates with surgical bleeding...
May 9, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29739085/cerebral-venous-sinus-thrombosis-with-cerebral-hemorrhage-presenting-with-status-epilepticus-in-early-pregnancy
#16
Xuemin Feng, Teng Zhao, Jingyao Liu, Chunkui Zhou
BACKGROUND: CVST is an important cause of stroke during late pregnancy and in the puerperium, but it is seldom encountered during early pregnancy. We report a case of a 34-year-old woman presenting with convulsive status epilepticus in early pregnancy. METHODS: In this case, the cranial computed tomography detected hemorrhage. Magnetic resonance imaging revealed a bilateral hypointense signal involving the frontal lobes and a hyperintense lesion on the right temporal lobe on T1-weighted imaging, and a large bilateral hyperintense area involving the frontal lobes on T2-weighted and fluid-attenuated inversion recovery imaging...
April 1, 2018: Clinical Laboratory
https://www.readbyqxmd.com/read/29717570/extensive-pituitary-apoplexy-after-chemotherapy-in-a-patient-with-metastatic-breast-cancer
#17
Je Hun Jang, Young San Ko, Eun Kyeong Hong, Ho Shin Gwak
Surgery, anticoagulation therapy, pregnancy, and hormone treatments, such as bromocriptine, are well-characterized precipitating factors for pituitary apoplexy. However, whether cytotoxic chemotherapy for systemic cancer could cause pituitary apoplexy has not been investigated. Here, we present a case of a 41-year-old woman who developed a severe headache with decreased visual acuity after intravenous cytotoxic chemotherapy to treat metastatic breast cancer. Preoperative neuroimaging revealed pituitary adenoma with necrosis...
April 2018: Brain Tumor Research and Treatment
https://www.readbyqxmd.com/read/29717300/an-unusual-case-of-acute-abdomen-ovarian-vein-thrombosis
#18
Asmita Ghimire, Meeta Singh, Kesang Dikki Bista, Neebha Ojha, Sunita Bajracharya, Neeta Katuwal
Ovarian vein thrombosis is one of the rare causes for acute abdomen. Occult presentation of this disease may lead to diagnostic dilemma. A sixteen years female who was operated as a case of ectopic pregnancy was finally diagnosed as having ovarian vein thrombosis. She was successfully treated with anticoagulant.
March 13, 2018: Journal of Nepal Health Research Council
https://www.readbyqxmd.com/read/29716435/micromolar-zinc-in-annexin-a5-anticoagulation-as-a-potential-remedy-for-rprgl3-associated-recurrent-pregnancy-loss
#19
Hayrünnisa Danisik, Nadia Bogdanova, Arseni Markoff
Deficient expression of the placental anticoagulant annexin A5 (ANXA5) has been associated with thrombophilia-related pregnancy complications and ultimately with recurrent pregnancy loss (RPL). Carrier status of M2/ANXA5 ( RPRGL3), common ANXA5 promoter variant, has been identified as genetic cause of reduced ANXA5 levels and proposed as biomarker for successful anticoagulant treatment of RPL women. A murine model of AnxA5 loss of function displayed characteristic placental pathology and fetal loss that was alleviated through anticoagulant intervention...
January 1, 2018: Reproductive Sciences
https://www.readbyqxmd.com/read/29709455/the-approach-to-peripartum-management-of-anticoagulation-a-multidisciplinary-survey
#20
Sagar Rohailla, Ann Kinga Malinowski, Shital Gandhi, Anne McLeod, Rosane Nisenbaum, Nadine Shehata
OBJECTIVE: This study sought to determine whether there is practice variation in the treatment and prevention of acute venous thromboembolism (VTE) in pregnant patients, potentially to prioritize future studies. BACKGROUND: The risk of VTE during pregnancy is five-fold that of the non-pregnant state. Guidance is often lacking for the treatment and prophylaxis of VTE because there are few RCTs. METHODS: The study used a cross-sectional study design using a self-administered electronic questionnaire consisting of 11 case scenarios that were sent to hematologists, maternal-fetal medicine specialists, obstetricians and gynaecologists, and internal medicine specialists across Canada...
April 27, 2018: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
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