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antiphospholipid guidelines

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https://www.readbyqxmd.com/read/29588359/antiphospholipid-syndrome-presenting-as-acute-mesenteric-venous-thrombosis-involving-a-variant-inferior-mesenteric-vein-and-successful-treatment-with-rivaroxaban
#1
Kevin Singh, Gulam Khan
Acute mesenteric venous thrombosis (MVT) is the rarest cause of acute mesenteric ischaemia, so thrombosis of a variant inferior mesenteric vein (IMV) is especially uncommon in the setting of antiphospholipid syndrome (APS). Here, we present such a case of seronegative APS initially manifesting as an anomalous IMV thrombosis in a 76-year-old woman. Although guidelines support anticoagulation with vitamin K antagonists in these patients, we anticoagulated with rivaroxaban (a direct oral anticoagulant (DOAC)) due to patient preference, which resulted in complete clinical and endoscopic resolution...
March 26, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29517495/hydroxychloroquine-balancing-the-need-to-maintain-therapeutic-levels-with-ocular-safety-an-update
#2
Nada Abdulaziz, Anjali R Shah, William J McCune
PURPOSE OF REVIEW: Antimalarial drugs including chloroquine, its less toxic quinolone-derivative hydroxychloroquine (HCQ), and quinacrine have become cornerstones in the treatment of autoimmune diseases including systemic lupus, rheumatoid arthritis, sarcoidosis, and Sjogren syndrome; cutaneous disorders, antiphospholipid syndrome, and have recently been employed at higher dioses in oncology. Benefits include anti-inflammatory effects, protection against thrombosis, and improved control of hyperglycemia and hyperlipidemia...
May 2018: Current Opinion in Rheumatology
https://www.readbyqxmd.com/read/29390512/venous-thromboembolism-related-to-cytomegalovirus-infection-a-case-report-and-literature-review
#3
Amar H Kelkar, Kavitha S Jacob, Eman B Yousif, John J Farrell
RATIONALE: Herein, we present a case of seemingly unprovoked portal vein thrombosis (PVT) occurring in the context of an acute cytomegalovirus (CMV) infection and prolonged debilitating fatigue. PATIENT CONCERNS: A 46-year-old male airline pilot presented with a 2 week history of abdominal pain, nausea, vomiting, watery diarrhea, and daily recurrent fevers. This was in the context of progressive, debilitating fatigue for 3 months forcing the patient to leave his job...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29368790/pravastatin-for-preventing-and-treating-preeclampsia-a-systematic-review
#4
Enrique Esteve-Valverde, Raquel Ferrer-Oliveras, Natàlia Gil-Aliberas, Antònia Baraldès-Farré, Elisa Llurba, Jaume Alijotas-Reig
Importance: We have performed a systematic search to summarize the role of statins for preventing and treating severe preeclampsia. Objective: The aim of this study was to examine whether pravastatin is a useful and safe alternative for treating preeclampsia during pregnancy. Evidence Acquisition: A systematic MEDLINE (PubMed) search was performed (1979 to June 2017), which was restricted to articles published in English, using the relevant key words of "statins," "pregnancy," "preeclampsia," "obstetrical antiphospholipid syndrome," and "teratogenicity...
January 2018: Obstetrical & Gynecological Survey
https://www.readbyqxmd.com/read/29328521/central-vein-sign-differentiates-multiple-sclerosis-from-central-nervous-system-inflammatory-vasculopathies
#5
Pietro Maggi, Martina Absinta, Matteo Grammatico, Luisa Vuolo, Giacomo Emmi, Giovanna Carlucci, Gregorio Spagni, Alessandro Barilaro, Anna Maria Repice, Lorenzo Emmi, Domenico Prisco, Vittorio Martinelli, Roberta Scotti, Niloufar Sadeghi, Gaetano Perrotta, Pascal Sati, Bernard Dachy, Daniel S Reich, Massimo Filippi, Luca Massacesi
OBJECTIVES: In multiple sclerosis (MS), magnetic resonance imaging (MRI) is a sensitive tool for detecting white matter lesions, but its diagnostic specificity is still suboptimal; ambiguous cases are frequent in clinical practice. Detection of perivenular lesions in the brain (the "central vein sign") improves the pathological specificity of MS diagnosis, but comprehensive evaluation of this MRI biomarker in MS-mimicking inflammatory and/or autoimmune diseases, such as central nervous system (CNS) inflammatory vasculopathies, is lacking...
February 2018: Annals of Neurology
https://www.readbyqxmd.com/read/29241089/association-of-psychosis-with-antiphospholipid-antibody-syndrome-a-systematic-review-of-clinical-studies
#6
Asma Hallab, Sadiq Naveed, Ahmed Altibi, Mariam Abdelkhalek, Huyen Thi Ngo, Thao Phuong Le, Kenji Hirayama, Nguyen Tien Huy
OBJECTIVE: In this systematic review, we reviewed the association between Antiphospholipid antibody syndrome (APS) and psychosis and focused on the prevalence, clinical presentation, immunologic and neurological workup, treatment options, and clinical outcomes. METHODOLOGY: We performed this systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)'s guidelines. We searched eight databases for potential articles and manually searched references and relevant articles of included studies...
January 2018: General Hospital Psychiatry
https://www.readbyqxmd.com/read/28968483/antiplatelet-and-anticoagulant-agents-for-secondary-prevention-of-stroke-and-other-thromboembolic-events-in-people-with-antiphospholipid-syndrome
#7
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/28961286/asymptomatic-cutaneous-polyarteritis-nodosa-treatment-options-and-therapeutic-guidelines
#8
Kate Ross, Jessika Contreras, David Aung-Din, Mary Lien
Cutaneous polyarteritis nodosa (CPAN) is a rare cutaneous small- to medium-vessel vasculitis of unknown etiology. Clinically it ranges in manifestation from livedo reticularis to large cutaneous ulcers and necrosis. Prognosis is favorable and progression to systemic polyarteritis nodosa is rare. There are multiple treatment options, none of which have proven to be definitively effective. Cutaneous polyarteritis nodosa has been associated with abnormal antibody testing with elevations of antiphospholipid cofactor antibody, lupus anticoagulant, anticardiolipin antibody, and anti-β 2 -glycoprotein I-dependent cardiolipin antibodies, as well as elevated anti-phosphatidylserine-prothrombin complex antibody...
August 2017: Cutis; Cutaneous Medicine for the Practitioner
https://www.readbyqxmd.com/read/28864642/closing-the-serological-gap-in-the-antiphospholipid-syndrome-the-value-of-non-criteria-antiphospholipid-antibodies
#9
Navid Zohoury, Maria Laura Bertolaccini, Jose Luis Rodriguez-Garcia, Zakera Shums, Oier Ateka-Barrutia, Maurizio Sorice, Gary L Norman, Munther Khamashta
OBJECTIVE: Most clinicians use the 2006 Sydney classification criteria to evaluate patients suspected of having antiphospholipid syndrome (APS). Although sensitive and specific for APS, many patients fulfilling clinical criteria for the syndrome are persistently negative for the specific serological tests ("laboratory criteria"). These "seronegative APS" (SN-APS) patients can go undiagnosed and untreated until they experience serious clinical events. This study's objective was to describe antibody profiles of SN-APS patients using non-criteria markers, assess the clinical utility of these markers separately and in combination, and suggest incorporation into guidelines for patients suspected of APS...
November 2017: Journal of Rheumatology
https://www.readbyqxmd.com/read/28804831/solid-phase-immunoassay-for-the-detection-of-anti-%C3%AE-2-glycoprotein-i-antibodies
#10
Rohan Willis, Elizabeth Papalardo, E Nigel Harris
The discovery in the 1990s that the protein beta-2-glycoprotein I (β2GPI) was an antigen of central importance in the antiphospholipid syndrome (APS) was soon followed by the development of ELISA assays capable of identifying anti-β2GPI antibodies recognizing this antigen. The determination of these antibodies has continued to play a major role in the management of APS patients because of their extremely high specificity for diagnosing the disease, despite their relatively poor sensitivity compared to anticardiolipin antibodies...
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/28804830/solid-phase-immunoassay-for-the-detection-of-anticardiolipin-antibodies
#11
Rohan Willis, Elizabeth Papalardo, E Nigel Harris
The anticardiolipin (aCL) test was first developed in the 1980s and proved to be a valuable addition to the lupus anticoagulant assay for identifying patients with a disorder that came to be later known as the antiphospholipid syndrome (APS). Although the test has relatively poor specificity for APS diagnosis, particularly at low positive levels, it has continued to play a major role in the identification and management of these patients because of its high sensitivity and ability to be measured in both serum and plasma, and despite concomitant presence of anticoagulants normally given to APS patients...
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/28800668/-epidemiology-risk-factors-and-risk-stratification-of-venous-thromboembolism-in-pregnancy-and-the-puerperium
#12
Panagiotis Tsikouras, Georg-Friedrich von Tempelhoff, Werner Rath
Venous thromboembolism (VTE) remains a leading cause of direct maternal deaths in the developed countries. The incidence of VTE has increased significantly during the past two decades. The absolute risk of VTE is estimated 0.6-2.2 per 1000 deliveries. Compared with age-matched non-pregnant women, the daily risk of VTE is increased 7- to 10-fold for antepartum VTE, but it is 15- to 35-fold for postpartum VTE. The incidence of pulmonary embolism (PE) during the first 6 weeks postpartum is nearly 15-fold higher compared to the incidence in pregnancy, and remains significantly increased up to 12 weeks postpartum...
August 2017: Zeitschrift Für Geburtshilfe und Neonatologie
https://www.readbyqxmd.com/read/28680464/-to-test-or-not-to-test-the-arguments-for-and-against-thrombophilia-testing-in-obstetrics
#13
REVIEW
Laura Ormesher, Louise E Simcox, Clare Tower, Ian A Greer
Clinicians increasingly investigate women for thrombophilias due to their associations with venous thromboembolism and placenta-mediated pregnancy complication. These associations, however, are modest and based largely on retrospective data from studies with heterogeneous classifications and populations, leading to discordance between evidence and guidelines. Current evidence suggests a contributory rather than causative role for thrombophilia in placenta-mediated pregnancy complication and venous thromboembolism...
June 2017: Obstetric Medicine
https://www.readbyqxmd.com/read/28678065/pregnancy-and-reproductive-aspects-of-systemic-lupus-erythematosus
#14
Laura Andreoli, Francesca Crisafulli, Angela Tincani
PURPOSE OF REVIEW: To discuss pregnancy and reproductive aspects in women with systemic lupus erythematosus (SLE) with particular focus on preconception counselling, maternal and foetal outcomes, safety and beneficial effects of drugs during pregnancy as well as contraception methods, assisted reproduction techniques and strategies for thromboembolism prophylaxis in patients with positive antiphospholipid antibodies. RECENT FINDINGS: Evidence-based recommendations for the management of family planning and women's health issues in SLE and/or APS have been developed by a multidisciplinary panel of experts...
September 2017: Current Opinion in Rheumatology
https://www.readbyqxmd.com/read/28630236/european-evidence-based-recommendations-for-diagnosis-and-treatment-of-childhood-onset-systemic-lupus-erythematosus-the-share-initiative
#15
Noortje Groot, Nienke de Graeff, Tadej Avcin, Brigitte Bader-Meunier, Paul Brogan, Pavla Dolezalova, Brian Feldman, Isabelle Kone-Paut, Pekka Lahdenne, Stephen D Marks, Liza McCann, Seza Ozen, Clarissa Pilkington, Angelo Ravelli, Annet van Royen-Kerkhof, Yosef Uziel, Bas Vastert, Nico Wulffraat, Sylvia Kamphuis, Michael W Beresford
Childhood-onset systemic lupus erythematosus (cSLE) is a rare, multisystem and potentially life-threatening autoimmune disorder with significant associated morbidity. Evidence-based guidelines are sparse and management is often based on clinical expertise. SHARE (Single Hub and Access point for paediatric Rheumatology in Europe) was launched to optimise and disseminate management regimens for children and young adults with rheumatic diseases like cSLE. Here, we provide evidence-based recommendations for diagnosis and treatment of cSLE...
November 2017: Annals of the Rheumatic Diseases
https://www.readbyqxmd.com/read/28474094/perioperative-management-of-patients-with-antiphospholipid-syndrome-a-single-center-experience
#16
Yemil Atisha-Fregoso, Eric Espejo-Poox, Eduardo Carrillo-Maravilla, Alma Lilia Pulido-Ramírez, Diego Lugo Baruqui, Gabriela Hernández-Molina, Antonio R Cabral
The objective was to describe the management and risk factors for complications of antiphospholipid syndrome (APS) patients who underwent a surgical procedure in a single center. We reviewed medical records of all patients with primary or secondary APS who underwent an elective surgery during a 6-year period. Demographical data, management of anticoagulation and complications were recorded. We identified 43 patients, mean age 37.9 ± 8.9 years, who underwent a total of 48 elective surgeries. All patients had history of at least one thrombotic event and were under vitamin K antagonists...
July 2017: Rheumatology International
https://www.readbyqxmd.com/read/28473426/european-evidence-based-recommendations-for-diagnosis-and-treatment-of-paediatric-antiphospholipid-syndrome-the-share-initiative
#17
REVIEW
Noortje Groot, Nienke de Graeff, Tadej Avcin, Brigitte Bader-Meunier, Pavla Dolezalova, Brian Feldman, Gili Kenet, Isabelle Koné-Paut, Pekka Lahdenne, Stephen D Marks, Liza McCann, Clarissa A Pilkington, Angelo Ravelli, Annet van Royen-Kerkhof, Yosef Uziel, Sebastiaan J Vastert, Nico M Wulffraat, Seza Ozen, Paul Brogan, Sylvia Kamphuis, Michael W Beresford
Antiphospholipid syndrome (APS) is rare in children, and evidence-based guidelines are sparse. Consequently, management is mostly based on observational studies and physician's experience, and treatment regimens differ widely. The Single Hub and Access point for paediatric Rheumatology in Europe (SHARE) initiative was launched to develop diagnostic and management regimens for children and young adults with rheumatic diseases. Here, we developed evidence-based recommendations for diagnosis and treatment of paediatric APS...
October 2017: Annals of the Rheumatic Diseases
https://www.readbyqxmd.com/read/28194050/the-laboratory-diagnosis-of-the-antiphospholipid-syndrome
#18
REVIEW
Jasmina Ahluwalia, Sreejesh Sreedharanunni
The Antiphospholipid Syndrome (APS) is classified based on the presence of both clinical and laboratory criteria. Both sets of criteria are subject to much review and intense research as it is becoming increasingly clear that no single test is specific for defining this autoimmune disorder. A number of leading international bodies have released guidelines in an attempt to improve the laboratory testing and reporting. The current review is an appraisal of some of the literature pertaining to the laboratory testing...
March 2017: Indian Journal of Hematology & Blood Transfusion
https://www.readbyqxmd.com/read/28050066/antiphospholipid-syndrome-a-diagnostic-challenge
#19
REVIEW
R S Mallhi, Neerja Kushwaha, T Chatterjee, J Philip
The antiphospholipid syndrome (APS) is an acquired autoimmune thrombophilic disorder that is characterized by thrombosis (venous, arterial and microvascular) and obstetric morbidity due to a diverse family of antibodies against phospholipid-binding proteins present in plasma. The term antiphospholipid antibody is actually a misnomer as the antibodies are not against the phospholipid per se, but target the plasma protein co-factors, which bind to anionic PLs. The exact etiology has not been elucidated and is multifactorial...
December 2016: Medical Journal, Armed Forces India
https://www.readbyqxmd.com/read/28011082/-neonatal-arterial-ischemic-stroke-review-of-the-current-guidelines
#20
E Saliba, T Debillon, S Auvin, O Baud, V Biran, J-L Chabernaud, S Chabrier, F Cneude, A-G Cordier, V Darmency-Stamboul, J-F Diependaele, T Debillon, M Dinomais, C Durand, A Ego, G Favrais, Y Gruel, L Hertz-Pannier, B Husson, S Marret, S N'Guyen The Tich, T Perez, E Saliba, J-B Valentin, C Vuillerot
Neonatal arterial ischemic stroke (NAIS) is a rare event that occurs in approximately one in 5000 term or close-to-term infants. Most affected infants will present with seizures. Although a well-recognized clinical entity, many questions remain regarding diagnosis, risk factors, treatment, and follow-up modalities. In the absence of a known pathophysiological mechanism and lack of evidence-based guidelines, only supportive care is currently provided. To address these issues, a French national committee set up by the French Neonatal Society (Société française de néonatologie) and the national referral center (Centre national de référence) for arterial ischemic stroke in children drew up guidelines based on an HAS (Haute Autorité de santé [HAS]; French national authority for health) methodology...
February 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
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