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hypercoagulable states and stroke

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https://www.readbyqxmd.com/read/27920655/deep-vein-thrombosis-as-initial-manifestation-of-whipple-disease
#1
Mônica Souza de Miranda Henriques, Alexandre Rolim da Paz, Ana Beatriz Person Gaertner, Cibelle Ingrid Stephen Melo, Priscyanne Lins Filgueiras, Rafaella Alencar Jerome
INTRODUCTION: Wipple disease (WD) is a rare chronic disease caused by the bacillus Tropheryma whipplei. Constitutive, rheumatologic, gastrointestinal, cardiac, cerebral, lymphatic, cutaneous, and ophthalmological signs are possible systemic symptoms. However, thrombotic manifestations are rarely described as "stroke-like syndrome" or arterial thrombosis. Diagnosis is based on clinical manifestations and pathological examination. Laboratory findings may include anemia, leukocytosis, and thrombocytosis...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/27914836/perioperative-retinal-artery-occlusion-risk-factors-in-cardiac-surgery-from-the-united-states-national-inpatient-sample-1998-2013
#2
Tyler Calway, Daniel S Rubin, Heather E Moss, Charlotte E Joslin, Katharina Beckmann, Steven Roth
PURPOSE: To study the incidence and risk factors for retinal artery occlusion (RAO) in cardiac surgery. DESIGN: Retrospective study using the National Inpatient Sample (NIS). METHODS: The NIS was searched for cardiac surgery. Retinal artery occlusion was identified by International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes. Postulated risk factors based on literature review were included in multivariate logistic models...
November 30, 2016: Ophthalmology
https://www.readbyqxmd.com/read/27909535/search-for-the-ideal-antithrombotic-drug-utopian-task-likely-is-implemented-already
#3
REVIEW
Petras Stirbys Md PhD
Atrial fibrillation is the most prevalent cardiac arrhythmia with a high risk of ischemic stroke. Thromboprophylaxis plays a key role in prevention of cardioembolic and non-cardioembolic events. Oral antithrombotic drugs are most often used to reduce hypercoagulable state. Patients may suffer from both under- and overtreatment compromising the outcomes. Medication peculiarities at large are well-known and widely debated. Non-adherence to antithrombotic drug regimen poses a significant risk of stroke. There is a pressing need for more detailed delineation of risk factors, namely by incorporation of the letter "N" (meaning "Non-adherence to drug therapy") into the well-known risk score alphanumeric display: CHA2DS2N-VASc...
August 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27890301/thrombolytic-therapy-associated-acute-myocardial-infarction-in-patients-with-acute-ischemic-stroke-a-treatment-dilemma
#4
Chih-Jen Yang, Po-Chuan Chen, Chin-Sheng Lin, Chia-Lin Tsai, Shih-Hung Tsai
Acute myocardial infarction (AMI) is uncommon in the acute phase of acute ischemic stroke (AIS) and occurs in approximately 1% of the population. Here, we report a paradoxical case of AMI during tissue plasminogen activator (t-PA) infusion for AIS. We review and analyze the previously reported cases. We found that only patients with AMI which occurred after thrombolytic therapy for AIS who received an adequate combination of anticoagulation plus percutaneous coronary intervention survived their events. Several mechanisms have been proposed for the development of AMI after thrombolytic therapy...
November 22, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27829500/a-serum-nuclear-magnetic-resonance-based-metabolomic-signature-of-antiphospholipid-syndrome
#5
Angelica Palisi, Manuela Grimaldi, Paola Sabatini, Paola Montoro, Mario Scrima, Manuela Rodriquez, Anna Maria D'Ursi
Antiphospholipid syndrome (APS) is a rheumatic inflammatory chronic autoimmune disease inducing hypercoagulable state associated with vascular thrombosis and pregnancy loss in women. Cardiac, cerebral and vascular strokes in these patients are responsible for reduction in life expectancy. Timely diagnosis and accurate monitoring of disease are decisive to improve the accuracy of therapy. In the present work, we present a NMR-based metabolomic study of blood sera of APS patients. Our data show that individuals suffering APS have a characteristic metabolomic profile with abnormalities associated to the metabolism of methyl group donors, ketone bodies and amino acids...
January 30, 2017: Journal of Pharmaceutical and Biomedical Analysis
https://www.readbyqxmd.com/read/27766637/increased-prevalence-of-potential-right-to-left-shunting-in-children-with-sickle-cell-anaemia-and-stroke
#6
Michael M Dowling, Charles T Quinn, Claudio Ramaciotti, Julie Kanter, Ifeyinwa Osunkwo, Baba Inusa, Rathi Iyer, Janet L Kwiatkowski, Clarissa Johnson, Melissa Rhodes, William Owen, John J Strouse, Julie A Panepinto, Lynne Neumayr, Sharada Sarnaik, Patricia A Plumb, Nomazulu Dlamini, Fenella Kirkham, Linda S Hynan
'Paradoxical' embolization via intracardiac or intrapulmonary right-to-left shunts (RLS) is an established cause of stroke. Hypercoagulable states and increased right heart pressure, which both occur in sickle cell anaemia (SCA), predispose to paradoxical embolization. We hypothesized that children with SCA and overt stroke (SCA + stroke) have an increased prevalence of potential RLS. We performed contrasted transthoracic echocardiograms on 147 children (aged 2-19 years) with SCA + stroke) mean age 12·7 ± 4·8 years, 54·4% male) and a control group without SCA or stroke (n = 123; mean age 12·1 ± 4·9 years, 53·3% male)...
October 21, 2016: British Journal of Haematology
https://www.readbyqxmd.com/read/27745777/seasonal-variation-in-spontaneous-cervical-artery-dissection-comparing-between-uk-and-australian-sites
#7
Lucy C Thomas, Lesley Ann Hall, John R Attia, Elizabeth G Holliday, Hugh S Markus, Christopher R Levi
BACKGROUND: Cervical artery dissection (CAD) is a leading cause of stroke among middle-aged adults, but the etiology is unclear. Some reports of seasonal variation in CAD incidence have been suggested but may reflect extreme climatic conditions. Seasonal variation may implicate more transient seasonal causes such as proinflammatory or hypercoagulable states. This study aimed to assess whether CAD incidence varied with season between UK and Australian sites. Also, this study aimed to determine whether there was a different pattern of seasonal variation between arteries (carotid and vertebral) and any association between CAD incidence and clinical factors...
October 10, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/27597905/cerebrovascular-accident-due-to-thyroid-storm-should-we-anticoagulate
#8
Alex Gonzalez-Bossolo, Alexis Gonzalez-Rivera, Santiago Coste-Sibilia
Thyroid storm is a life-threatening condition that occurs secondary to an uncontrolled hyperthyroid state. Atrial fibrillation is a cardiovascular complication occurring in up to 15% of patients experiencing thyroid storm, and if left untreated this condition could have up to a 25% mortality rate. Thyroid storm with stroke is a rare presentation. This case report details a left middle cerebral artery (MCA) stroke with global aphasia and thyroid storm in a 53-year-old Hispanic male patient. Although uncommon, this combination has been reported in multiple case series...
2016: Case Reports in Endocrinology
https://www.readbyqxmd.com/read/27547468/cardiac-fibroelastoma-versus-thrombus-echocardiographic-evidence-can-be-misleading
#9
John P O'Laughlin, Gautam Verma, Iosif Gulkarov
We present a case of a young female with stroke symptoms who underwent valve sparing resection of a presumed fibroelastoma based on echocardiographic findings. After confirming embolic stroke, she underwent excision of the lesion, which on pathology revealed a nonbacterial thrombus. Ultimately, this led to a more extensive work-up leading to the discovery of a papillary serous ovarian carcinoma, the underlying cause of her hypercoagulable state. The initial echocardiographic findings painted the clear picture of a papillary tumor on the aortic valve which was likely the source of the emboli resulting in ischemic stroke...
2016: Case Reports in Cardiology
https://www.readbyqxmd.com/read/27514779/evaluation-of-hypercoagulability-state-in-perinatal-arterial-ischemic-stroke-with-rotation-thromboelastometry
#10
Ozan Kocak, Coskun Yarar, Ayşe Bozkurt Turhan, Olga Meltem Akay, Kursat Bora Carman, Ayten Yakut
BACKGROUND: Perinatal arterial ischemic stroke (PAIS) is an important cause of pediatric morbidity and mortality. The etiology of PAIS remains unknown. Several maternal-neonatal disorders, and especially prothrombotic risk factors, have been reported in infants with perinatal stroke (PS). Rotation thromboelastometry (ROTEM) can analyze the coagulation system, from the beginning of coagulation, through clot formation, and ending with fibrinolysis. The aim of this study was to evaluate the hypercoagulability state in PAIS patients using ROTEM...
December 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/27504560/nd-yag-laser-embolysis-in-a-young-woman-with-hemiretinal-artery-occlusion
#11
Ahsan Mukhtar, Sidra Malik, Muhammad Saim Khan, Mazhar Ishaq
Retinal artery occlusion is an uncommon condition but can lead to grave consequences if not managed in time. Elderly population with other comorbid conditions like hypertension, ischemic heart disease, hyperlipidemia and stroke are commonly affected. However, this condition may affect younger population with entirely different systemic associations. Thromboembolism, which usually takes place secondary to cardiac emboli or hypercoagulable states cause retinal artery occlusion in young population. A24-year lady presented with a short history of unilateral altitudinal visual loss...
July 2016: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/27425767/postpartum-ischemic-stroke-in-moyamoya-disease-associated-with-protein-z-deficiency-a-case-report
#12
Kunitaka Maruyama, Naoki Akioka, Daina Kashiwazaki, Naoya Kuwayama, Satoshi Kuroda
The authors describe herein the first adult case with moyamoya disease associated with protein Z deficiency. A 41-year-old woman was admitted to our hospital due to sudden onset of dysarthria and left extremity weakness 6 days after the delivery of her first baby. Previously, she repeated early fetal losses and was diagnosed with protein Z deficiency. Laboratory examination showed that the plasma concentration of protein Z was .73 µg/ml, being lower than the control. Radiological examination demonstrated typical findings of moyamoya disease with advanced stage on both sides...
September 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/27301942/prothrombotic-state-in-patients-with-a-left-atrial-appendage-thrombus-of-unknown-origin-and-cerebrovascular-events
#13
Rafal Meus, Maksim Son, Dorota Sobczyk, Anetta Undas
BACKGROUND AND PURPOSE: We hypothesized that formation of left atrial appendage (LAA) thrombi of unknown origin is associated with altered fibrin clot properties and blood hypercoagulability. METHODS: In a case-control study, we investigated 32 patients with a history of LAA thrombus after successful anticoagulant treatment versus 32 control subjects matched for age, sex, and diabetes mellitus. All subjects had previous ischemic stroke, transient ischemic attack, or migraine associated with patent foramen ovale...
July 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27250050/serum-d-dimer-levels-are-proportionally-associated-with-left-atrial-enlargement-in-patients-with-an-acute-ischemic-stroke-due-to-non-valvular-atrial-fibrillation
#14
Tae-Won Kim, In-Uk Song, Sung-Woo Chung, Joong-Seok Kim, Jaseong Koo, Kwang-Soo Lee
Objective Left atrial enlargement (LAE) may predispose individuals to blood stasis in atrial fibrillation (AF), and thus play a crucial role in thrombogenesis. The D-dimer level is one of the surrogate markers for a hypercoagulable state and reflects thrombus formation in AF. Since the D-dimer level reflects hypercoagulability as well as thrombus and fibrin burdens, LAE could be associated with a D-dimer elevation. However, no studies have explored this association or which factors contribute to increases in the D-dimer levels in patients with AF...
2016: Internal Medicine
https://www.readbyqxmd.com/read/27172912/associations-of-trauma-exposure-and-posttraumatic-stress-symptoms-with-venous-thromboembolism-over-22%C3%A2-years-in-women
#15
Jennifer A Sumner, Laura D Kubzansky, Christopher Kabrhel, Andrea L Roberts, Qixuan Chen, Ashley Winning, Paola Gilsanz, Eric B Rimm, Maria M Glymour, Karestan C Koenen
BACKGROUND: Trauma exposure and posttraumatic stress disorder (PTSD) have been linked to myocardial infarction and stroke in women, with biological and behavioral mechanisms implicated in underlying risk. The third most common cardiovascular illness, venous thromboembolism (VTE), is a specific health risk for women. Given previous associations with other cardiovascular diseases, we hypothesized that high levels of trauma and PTSD symptoms would be associated with higher risk of incident VTE in younger and middle-aged women...
May 12, 2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/27164518/middle-cerebral-artery-stroke-in-a-neonate-with-a-congenital-hypercoagulable-condition-following-repair-of-an-h-type-tracheoesophageal-fistula
#16
Megan L Garcia, Katharine Caldwell, Anna Kellund, Cynthia Reyes
We report a case of middle cerebral artery stroke with heterozygosity for 2 separate hypercoagulable conditions following repair of an H-type tracheoesophageal fistula (TEF) in an infant. Neonatal stroke is rare, occurring in 1 in 4000 births annually in the United States. Stroke after pediatric surgery occurs in approximately 0.05% of patients. Etiologies of stroke in neonates include cardiac, hematologic, vascular, traumatic, metabolic, pharmacologic, infectious, and hypoxemic insults. Thrombophilia has been described in 42% to 78% of neonates with neonatal stroke...
October 2016: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/27150169/embolic-stroke-in-cardiomyopathy-should-patients-be-anticoagulated
#17
REVIEW
Akhil Narang, Roberto M Lang
Despite advances in the treatment of patients with heart failure, mortality is still substantial. Part of this mortality is explained by cardioembolic stroke. Patients with heart failure are predisposed to developing cardioembolic strokes owing to abnormalities in Virchow's triad (endothelial function, relative hypercoagulable state, and static blood flow). Several randomized controlled trials have addressed whether patients with heart failure benefit from anticoagulation. Overall, the results suggest the risk of bleeding with anticoagulation outweighs any small benefit conferred by anticoagulation...
May 2016: Cardiology Clinics
https://www.readbyqxmd.com/read/27095355/management-and-outcome-of-spontaneous-cerebral-venous-sinus-thrombosis-in-a-5-year-consecutive-single-institution-cohort
#18
Darrin J Lee, Arjang Ahmadpour, Tamar Binyamin, Brian C Dahlin, Kiarash Shahlaie, Ben Waldau
Cerebral venous sinus thrombosis (CVST) is an uncommon form of stroke with a variable presentation, ranging from headaches, to coma and death. Although the American Stroke Association has developed guidelines for the treatment of CVST, data are sparse on the outcome after treatment with anticoagulation, thrombolysis, and thrombectomy. In this retrospective review, we describe the 5-year UC Davis experience with spontaneous CVST. Forty-one patients (mean age 37.5±23.1, range 0-96 years; 29 female) were identified with CVST...
April 19, 2016: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27094310/a-new-measure-for-in-vivo-thrombin-activity-in-comparison-with-in-vitro-thrombin-generation-potential-in-patients-with-hyper-and-hypocoagulability
#19
Oliver Königsbrügge, Silvia Koder, Julia Riedl, Simon Panzer, Ingrid Pabinger, Cihan Ay
The thrombin generation potential is an in vitro measure for the capacity of an individual to generate thrombin and recognized as a reflection of a hypo- or hypercoagulable status. Measurement of the in vivo thrombin activity, however, may be of clinical significance. We evaluated a new assay for in vivo thrombin activity and compared it to the in vitro thrombin generation potential in patients with hemophilia A (N = 15), oral anticoagulation for atrial fibrillation (AF) (N = 20), subjects with active cancer (N = 21), and healthy volunteers (N = 10)...
April 19, 2016: Clinical and Experimental Medicine
https://www.readbyqxmd.com/read/27089660/-is-atrial-fibrillation-a-pre-thrombotic-state
#20
Yoshio Uetsuka
Atrial fibrillation (AF) is said to be a pre-thrombotic state. In patients with AF, the left atrium is usually dilated and blood flow is sluggish, which enables the formation of a thrombus within the left atrium. This is consistent with two of Virchow's Triad, stasis of blood flow and endothelial injury, but the last of the Triad, hypercoagulability of blood, is difficult to explain in AF. There are reports that von Willebrand Factor (vWF), FVIII, fibrinogen, D-dimer, and Fragment 1+2 are elevated in AF patients...
December 2015: Rinsho Byori. the Japanese Journal of Clinical Pathology
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