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https://www.readbyqxmd.com/read/28620416/antiphospholipid-syndrome-multiple-manifestations-in-a-single-patient-a-high-suspicion-is-still-needed
#1
Uroosa Ibrahim, Shiksha Kedia, Gwenalyn Garcia, Jean Paul Atallah
Antiphospholipid Syndrome (APS) is an autoimmune disorder with clinical and laboratory features of vascular thrombosis, pregnancy loss, and persistent antiphospholipid antibodies (aPLs). The pathophysiology is thought to involve the activation of endothelial cells, monocytes, platelets, and complement by aPLs. Disease can range from asymptomatic to rapidly fatal catastrophic APS. We present a case of a 34-year-old male referred for pancytopenia and splenomegaly. On examination, he had decreased sensation and 4/5 power in the left upper extremity...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28618257/is-a-therapeutic-anticoagulation-window-needed-for-delivery-when-using-prophylactic-low-molecular-weight-heparin-during-pregnancy-a-retrospective-monocentric-study
#2
Assila Roueli, Elsa Cesario, Julien Amsellem, Antoine Agman, Danièle Vauthier-Brouzes, Jacky Nizard
OBJECTIVES: The aim of the study was to evaluate the usefulness of therapeutic window for delivery for patients under prophylactic anticoagulation by low molecular weight heparin (LMWH) by comparing those who had a planned delivery versus those who delivered spontaneously. STUDY DESIGN: This retrospective monocentric study included pregnant patients with prophylactic anticoagulation (one injection per day of enoxaparin 4000UI), who delivered after 24 weeks of gestation...
June 1, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28607782/placental-chorangiosis-increased-risk-for-cesarean-section
#3
Shariska S Petersen, Raminder Khangura, Dmitry Davydov, Ziying Zhang, Roopina Sangha
We describe a patient with Class C diabetes who presented for nonstress testing at 36 weeks and 4 days of gestation with nonreassuring fetal heart tones (NRFHT) and oligohydramnios. Upon delivery, thrombosis of the umbilical cord was grossly noted. Pathological analysis of the placenta revealed chorangiosis, vascular congestion, and 40% occlusion of the umbilical vein. Chorangiosis is a vascular change of the placenta that involves the terminal chorionic villi. It has been proposed to result from longstanding, low-grade hypoxia in the placental tissue and has been associated with such conditions such as diabetes, intrauterine growth restriction (IUGR), and hypertensive conditions in pregnancy...
2017: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28589438/obstetrical-history-of-women-with-cerebral-vein-thrombosis-outcome-of-the-pregnancies-before-and-after-the-thrombotic-event
#4
Daniela Poli, Caterina Cenci, Sophie Testa, Oriana Paoletti, Elena Silvestri, Emilia Antonucci
Cerebral vein thrombosis (CVT) is a rare disease usually affecting young people, especially women, with a high prevalence of thrombophilic defects. It is known that thrombophilia is associated with pregnancy complications; therefore, a high rate of complications could be expected in women with the previous CVT who become pregnant. This study examined the whole obstetric history of women who suffered from CVT to evaluate the incidence of pregnancy complications during their entire lifespan. We prospectively followed consecutive patients with CVT, limiting the analysis to females and their obstetrical history...
June 6, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28578513/the-role-of-fv-1691g-a-fii-20210g-a-mutations-and-mthfr-677c-t-1298a-c-and-103g-t-fxiii-gene-polymorphisms-in-pathogenesis-of-intraventricular-hemorrhage-in-infants-born-before-32-weeks-of-gestation
#5
Dawid Szpecht, Janusz Gadzinowski, Agnieszka Seremak-Mrozikiewicz, Grażyna Kurzawińska, Krzysztof Drews, Marta Szymankiewicz
BACKGROUND: Congenital thrombophilia is associated with an increased intraventricular hemorrhage (IVH) risk among newborns, but it may also play a protective role. The role of genetic polymorphisms involved in the coagulation pathway of IVH pathogenesis is probably a consequence of an increased risk of thrombosis in the fine blood vessels in the germinal matrix region. MATERIAL AND METHODS: The aim of this study was to evaluate the possible relationship between Factor V (FV) 1691G>A, Factor II (FII) 20210G>A mutations and methylenetetrahydrofolate reductase (MTHFR) 677C>T; 1298A>C and Factor XIII (FXIII) 103G>T gene polymorphisms and the occurrence of IVH in 100 infants born from 24 + 0 to 32 + 0 weeks of gestation, born from singleton pregnancy, before 32 + 0 weeks of gestation, exposed to antenatal steroid therapy, and without congenital abnormalities...
June 3, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28577390/feasibility-of-the-von-willebrand-disease-prevent-trial
#6
Margaret V Ragni, Nicoletta Machin, Andra H James, Craig D Seaman, Lynn M Malec, Craig M Kessler, Barbara A Konkle, Peter A Kouides, Anne T Neff, Claire S Philipp, Maria M Brooks
BACKGROUND: Despite treatment, women with von Willebrand disease (VWD) have lower von Willebrand factor (VWF) levels and greater blood loss at delivery than controls. Current weight-based dosing does not account for the ~1.5-fold increase in blood volume in pregnancy. METHODS: To evaluate the feasibility of a trial to prevent postpartum hemorrhage (PPH), we reviewed pre-pregnancy and 8th month VWF levels in women with VWD with and without PPH following vaginal delivery, assessed VWF concentrate use at delivery by U...
May 25, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28566284/diagnosis-and-management-of-deep-vein-thrombosis-in-pregnancy
#7
Faizan Khan, Christian Vaillancourt, Ghada Bourjeily
No abstract text is available yet for this article.
May 31, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28561252/general-care-of-the-pregnant-patient-in-the-intensive-care-unit
#8
Timothy M E Crozier
Pregnant women represent a small subset of all intensive care unit (ICU) admissions and may require intensive care for "obstetric" or "nonobstetric" reasons. Women may be admitted to the ICU at any stage of pregnancy or in the postpartum period. Pregnancy may be discovered at the time of admission to the ICU. Pregnancy impacts on ICU care in a variety of ways and requires a multidisciplinary approach to management. Pregnancy is associated with considerable physiological changes that affect most organ systems, including an expansion in blood volume, an increase in minute ventilation, and an increased risk of thrombosis...
April 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28557898/special-circumstances-and-populations
#9
Ashley Singh, Megan Foster, Pamela Chapman, Yousef Hattab, Sulaiman Alhassan, Omar Bajwa
Venous thromboembolism is a condition that includes both deep venous thrombosis and pulmonary embolism. Venous thromboembolism disease can result because of a combination of risk factors, including patient-related, treatment-related, and, more specifically, cancer-related factors. It is not disease-specific or a population-specific disorder, but it is more prevalent in certain specialty populations. This article will cover those specialty populations including cancer, pregnancy, and athletes.
July 2017: Critical Care Nursing Quarterly
https://www.readbyqxmd.com/read/28557891/clinical-presentation-and-risk-factors-of-venous-thromboembolic-disease
#10
Sulaiman Alhassan, Anca Pelinescu, Viral Gandhi, Mouhib Naddour, Anil C Singh, Eric Bihler
Venous thromboembolism (VTE) has a wide range of clinical presentations. Deep venous thrombosis may occur in upper or lower extremities or in visceral veins. Extremity deep venous thrombosis usually manifests with unilateral painful swelling in the limb, while visceral deep venous thrombosis manifestations vary on the basis of the involved organ. Pulmonary embolism classically manifests with sudden pleuritic chest pain and unexplained dyspnea. Superficial thrombophlebitis usually presents with acute inflammation around a palpable thrombosed superficial vein...
July 2017: Critical Care Nursing Quarterly
https://www.readbyqxmd.com/read/28542047/inferior-vena-cava-thrombus-in-a-postpartum-patient-with-fontan-physiology-a-case-report
#11
Jessica A Tashjian, Hannah Fraint, James DiNardo, Kathryn Rouine-Rapp
Women with complex congenital heart disease, such as those with single-ventricle physiology, are surviving into adulthood and becoming pregnant. Because of their complex physiology, common peripartum complications pose unique risks. We describe a patient with a single ventricle who underwent an external vascular conduit, nonfenestrated Fontan procedure in childhood and then presented during the postpartum period with extensive thrombosis in her lower extremity deep venous system and inferior vena cava. In this article, we will discuss single-ventricle physiology and the implications of pregnancy, anesthetic considerations, and data for maternal and fetal outcomes in this population...
May 23, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28538012/antiphospholipid-syndrome-an-update-for-clinicians-and-scientists
#12
Andrew P Vreede, Paula L Bockenstedt, Jason S Knight
PURPOSE OF REVIEW: Antiphospholipid syndrome (APS) is a leading acquired cause of thrombosis and pregnancy loss. Upon diagnosis (which is unlikely to be made until at least one morbid event has occurred), anticoagulant medications are typically prescribed in an attempt to prevent future events. This approach is not uniformly effective and does not prevent associated autoimmune and inflammatory complications. The goal of this review is to update clinicians and scientists on mechanistic and clinically relevant studies from the past 18 months, which have especially focused on inflammatory aspects of APS pathophysiology...
May 22, 2017: Current Opinion in Rheumatology
https://www.readbyqxmd.com/read/28520321/-multifocal-osteonecrosis-revealing-an-antiphospholipid-syndrome-case-report
#13
S Legrève, G Brands
This article illustrates the case of a 30-year-old woman presenting with multifocal osteonecrosis as the first symptom of a primary antiphospholipid syndrome. The association of multifocal osteonecrosis and primary antiphospholipid syndrome without any medical history of vascular thrombosis or pregnancy complications remains rare.
May 2017: Revue Médicale de Liège
https://www.readbyqxmd.com/read/28515823/lupus-negative-libman-sacks-endocarditis-complicated-by-catastrophic-antiphospholipid-syndrome
#14
Ghulam Murtaza, Joy Iskandar, Tara Humphrey, Sujeen Adhikari, Aneesh Kuruvilla
Libman-Sacks endocarditis is characterized by sterile and verrucous lesions that predominantly affect the aortic and mitral valves. In most cases, patients do not have significant valvular dysfunction. However, patients with significant valvular dysfunction may present with serious complications such as cardiac failure, arrhythmias, and thromboembolic events. Recently, association of Libman-Sacks endocarditis with antiphospholipid antibody syndrome (APS) has been made. APS is most commonly defined by venous and arterial thrombosis, recurrent pregnancy loss, and thrombocytopenia...
April 2017: Cardiology Research
https://www.readbyqxmd.com/read/28514122/-is-anti-thrombotic-prophylaxis-warranted-in-fertility-and-in-vitro-fertilization-treatments
#15
REVIEW
Enav Yefet, Amir Weiss
INTRODUCTION: Assisted reproductive technology (ART) treatments are potential risk factors for thromboembolism (TE) due to excessive estrogen levels. Recently, several studies have shed new light on this matter. AIMS: To review the literature to assess the risk for TE during ART and to establish guidelines regarding thrombophylaxis. METHODS: A search was conducted of PubMed, Medline, Cochrane and clinicaltrials.gov. The search terms were fertility, assisted reproductive technology, IVF, thromboembolism, thrombosis and anticoagulation...
July 2016: Harefuah
https://www.readbyqxmd.com/read/28503969/essential-thrombocythemia-a-review-of-the-clinical-features-diagnostic-challenges-and-treatment-modalities-in-the-era-of-molecular-discovery
#16
Sarah Chuzi, Brady L Stein
Essential thrombocythemia (ET) is a chronic myeloproliferative neoplasm that is associated with diminished quality of life, thrombohemorrhagic complications, and transformation to myelofibrosis (MF) and acute leukemia (AML). The important recent discoveries of driver mutations, including the calreticulin gene in addition to JAK2 and MPL, have led to a greater understanding of disease pathogenesis and set the stage for the advent of more sophisticated prognostic, diagnostic, and therapeutic strategies. In this paper we summarize recent studies describing the molecular basis of ET...
May 15, 2017: Leukemia & Lymphoma
https://www.readbyqxmd.com/read/28492861/vena-cava-filter-use-in-trauma-and-rates-of-pulmonary-embolism-2003-2015
#17
Alan D Cook, Brian W Gross, Turner M Osler, Katelyn J Rittenhouse, Eric H Bradburn, Steven R Shackford, Frederick B Rogers
Importance: Vena cava filter (VCF) placement for pulmonary embolism (PE) prophylaxis in trauma is controversial. Limited research exists detailing trends in VCF use and occurrence of PE over time. Objective: To analyze state and nationwide temporal trends in VCF placement and PE occurrence from 2003 to 2015 using available data sets. Design, Setting, and Participants: A retrospective trauma cohort study was conducted using data from the Pennsylvania Trauma Outcome Study (PTOS) (461 974 patients from 2003 to 2015), the National Trauma Data Bank (NTDB) (5 755 095 patients from 2003 to 2014), and the National (Nationwide) Inpatient Sample (NIS) (24 449 476 patients from 2003 to 2013) databases...
May 10, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28489135/accuracy-of-ultrasound-to-detect-thrombosis-in-pregnancy-a-systematic-review
#18
Aldemar Araujo Castro, Fernando José Camello de Lima, Célio Fernando de Sousa-Rodrigues, Fabiano Timbó Barbosa
Objective: To determine the diagnostic accuracy of ultrasound to detect deep--vein thrombosis in pregnant patients. Method: We searched Pubmed, LILACS, Scopus, Google Scholar and System for Information on Grey Literature from inception to April 2016. The reference lists of the included studies were analyzed. Original articles from accuracy studies that analyzed ultrasonography to diagnose deep-vein thrombosis in pregnant women were included. Reference standard was the follow-up time...
March 2017: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/28488549/prevalence-of-1691g-a-f5-20210g-a-f2-and-677c-t-mthfr-polymorphisms-in-bosnian-women-with-pregnancy-loss
#19
Emir Mahmutbegovic, Damir Marjanovic, Edin Medjedovic, Nevena Mahmutbegovic, Serkan Dogan, Amina Valjevac, Ewa Czerska, Anna Pawińska-Matecka, Agnieszka Madlani, Grazyna Adler
The relationship between genetic risk factors of thrombophilia and pregnancy loss (PL) is being discussed. The focus has been on F5 1691G>A, F2 20210G>A, and MTHFR 677C>T polymorphisms that may predispose women to microthrombosis during the stages of embryo implantation and placentation. Although, the frequencies of these polymorphisms were reported in different populations, such studies have not yet been performed in Bosnian population. In this study, we determined the prevalence of F5 G>A (rs1801133), F2 G>A (rs1800595) and MTHFR C>T (rs1801020) polymorphisms in Bosnian women...
May 10, 2017: Bosnian Journal of Basic Medical Sciences
https://www.readbyqxmd.com/read/28483615/severe-mesenteric-ischemia-in-a-pregnant-woman-with-antiphospholipid-syndrome
#20
Andrea Padricelli, Anna Maria Giribono, Doriana Ferrara, Flavia Spalla, Umberto Bracale, Luca Del Guercio, Giuseppe Servillo, Carlo Ruotolo, Umberto Marcello Bracale
The antiphospholipid syndrome (APS), either primary or secondary form, is considered an autoimmune disease with presence of at least one clinical and one laboratory abnormalities as defined by The Sydney criteria. Clinical criteria include vascular thrombosis of venous, artery, small vessel in any organ and recurrent pregnancy pathologies. Mesenteric ischemia is a rare and threatening manifestation of APS. We herein report a case of 34-years old pregnant woman referred to our Emergency Room with thoracic and abdominal acute pain...
May 5, 2017: Annals of Vascular Surgery
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