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thromboembolism in pregnancy

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https://www.readbyqxmd.com/read/28550190/patient-derived-anti-%C3%AE-2gp1-antibodies-recognize-a-peptide-motif-pattern-and-not-a-specific-sequence-of-residues
#1
Philippe de Moerloose, Céline Fickentscher, Françoise Boehlen, Jean-Marie Tiercy, Egbert K O Kruithof, Karim J Brandt
Antiphospholipid antibody syndrome is an autoimmune disease characterized by the presence of so-called antiphospholipid antibodies and clinical manifestations such as recurrent thromboembolic or pregnancy complications. Although the main antigenic determinant for antiphospholipid antibodies has been identified as the beta-2-glycoprotein 1 (β2GP1), the precise epitope recognized by antiphospholipid antibodies still remains largely unknown. In the present study, we wanted to identify a sequence in the domain I of β2GP1 able to induce the proliferation of CD4+ T cells isolated from antiphospholipid antibody syndrome patients but not from healthy donors and to interact with antiphospholipid antibodies...
May 26, 2017: Haematologica
https://www.readbyqxmd.com/read/28536761/-anticoagulation-direct-oral-anticoagulants
#2
B Kemkes-Matthes
Since direct oral anticoagulants (DOAC) have become available, use of anticoagulant treatment has become easier and safer-for patients suffering from thromboembolic diseases as well as for patients with atrial fibrillation: Because of constant bioavailability, fixed dose regimen treatment is possible, monitoring not necessary and severe bleeding complications-particularly intracranial hemorrhages-rare in comparison to vitamin K anticoagulants. To gain all these advantages, it is essential to give DOAC in the correct dosage...
May 23, 2017: Der Internist
https://www.readbyqxmd.com/read/28525397/an-unusual-case-of-sudden-death-is-there-a-relationship-between-thyroid-disorders-and-fatal-pulmonary-thromboembolism-a-case-report-and-review-of-literature
#3
Isabella Aquila, Silvia Boca, Fiorella Caputo, Matteo A Sacco, Santo Gratteri, Vittorio Fineschi, Pietrantonio Ricci
In adults, the most common cause of sudden death is coronary heart disease or defects in the cardiac conduction system; however, there are many cases of sudden death occurring from other causes such as fatal pulmonary thromboembolism. Several risk factors are recognized, including hospitalization, surgery, obesity, pregnancy, the use of oral contraceptives, traumatic fractures, and genetic conditions, which cause hypercoagulable states such as factor V Leiden mutations. Although many risk factors have been identified, the mortality rate is still high...
May 19, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28515823/lupus-negative-libman-sacks-endocarditis-complicated-by-catastrophic-antiphospholipid-syndrome
#4
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
#5
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/28474123/ct-pulmonary-angiogram-quality-comparison-between-early-and-later-pregnancy
#6
Yoel Siegel, Russ Kuker, James Banks, Gary Danton
PURPOSE: Pregnancy increases the risk for thromboembolic disease. CT pulmonary angiogram (CTPA) is widely used for the diagnosis of pulmonary embolus (PE); however, a significant number of scans are suboptimal or non-diagnostic in pregnant patients. This phenomenon is attributed to physiology during the gravid state. The aim of this study is to examine whether all stages of pregnancy are similarly at risk for suboptimal scans. METHODS: Pregnant patients who had CTPA scans between February 2008 and November 2014 were included...
May 4, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/28473677/antithrombotic-effects-of-hydroxychloroquine-in-a-pregnant-patient-with-antiphospholipid-syndrome-and-recurrent-venous-thromboembolism
#7
S P Gan, S G Ong
A pregnant woman with antiphospholipid syndrome presented with repeated venous thromboembolism (VTE) in the first and second trimesters of pregnancy despite receiving combination therapy with low-molecular-weight heparin and aspirin. The addition of hydroxychloroquine prevented further VTE recurrence, thus demonstrating its potential antithrombotic effects.
April 2017: Medical Journal of Malaysia
https://www.readbyqxmd.com/read/28470652/laboratory-diagnostics-of-antiphospholipid-syndrome
#8
Vittorio Pengo, Elisa Bison, Gentian Denas, Seena Padayattil Jose, Giacomo Zoppellaro, Alessandra Banzato
Diagnosis of antiphospholipid syndrome (APS) lies in the recognition of antiphospholipid antibodies (aPL). As standardization of tests for the detection of aPL is far from being optimal and reference material is not available, inappropriate diagnoses of APS are not unusual. In the last few years, the concept of triple test positivity has emerged as a useful tool to identify patients with APS. Clinical studies on patients and carriers of triple positivity clearly show that these individuals are at high risk of thromboembolic events and pregnancy loss...
May 3, 2017: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/28463088/the-relationship-between-social-support-and-health-related-quality-of-life-in-patients-with-antiphospholipid-hughes-syndrome
#9
Sofia Georgopoulou, Sofia Efraimidou, Sara Jane MacLennan, Fowzia Ibrahim, Thomas Cox
OBJECTIVE: Antiphospholipid (Hughes) syndrome (APS) is recognised as a systemic autoimmune disease defined by recurrent thromboembolic events and/or pregnancy morbidity. Little is known about the psychological burden of this long-term condition. This study aims to explore the relationship between social support and health-related quality of life (HRQoL) in patients with APS. METHODS: A total of 270 patients with a clinical diagnosis of APS participated in a cross-sectional online questionnaire survey...
May 2, 2017: Modern Rheumatology
https://www.readbyqxmd.com/read/28440905/clinical-follow-up-of-women-after-hypertensive-disease-in-pregnancy
#10
H A Boyd
That hypertensive disorders of pregnancy (HDP) affect maternal health even after delivery of the baby and the placenta, is no longer in doubt. Women with a history of HDP, preeclampsia in particular, have well-documented increased risks of later hypertension, ischemic heart disease, myocardial infarction, ischemic stroke, venous thromboembolism, and cardiomyopathy. However, our understanding of how "later" is defined - i.e. when exactly HDP-associated disease risks increase - is shifting. This article is protected by copyright...
April 25, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28432715/complications-of-pregnancy-and-labor-in-women-with-klippel-trenaunay-syndrome-a-nationwide-cross-sectional-study
#11
S E R Horbach, M M Lokhorst, C E U Oduber, S Middeldorp, J A M van der Post, C M A M van der Horst
OBJECTIVE: To evaluate complications of pregnancy, including thromboembolism, in women with extensive vascular malformations associated with Klippel-Trenaunay Syndrome (KTS). DESIGN: Nationwide cross-sectional study. SETTING: Two tertiary expert centers and the Dutch Klippel-Trenaunay patient organization. SAMPLE: Adult women with KTS. METHODS: Patients with KTS were invited to participate in a comprehensive online survey about their obstetric history...
April 22, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28425765/the-prevention-and-treatment-of-venous-thromboembolism-in-pregnancy
#12
Michela Villani, Walter Ageno, Elvira Grandone, Francesco Dentali
Venous thromboembolism (VTE) in pregnancy represents an important cause of maternal morbidity and mortality in developed countries, with an incidence of 0.5-2.2 per 1000 pregnancies. In addition to hemostatic changes occurring during normal pregnancy, several risk factors have been identified. Thus, a variety of clinical conditions as well as fetal and maternal risks linked to a possible anticoagulant therapy should be considered for the management of VTE during pregnancy. Unfortunately, there is a paucity of high-quality evidence from randomized trials in this field, and current recommendations are based on observational studies or evidence gathered from studies in the non-pregnant population...
May 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28420371/effect-of-pulmonary-arteriovenous-malformations-on-the-mechanical-properties-of-the-lungs
#13
Cécile Rotenberg, Marcel Bonay, Mostafa El Hajjam, Sandra Blivet, Alain Beauchet, Pascal Lacombe, Thierry Chinet
BACKGROUND: Pulmonary arteriovenous malformations (PAVMs) are present in approximately 15-50% individuals with hereditary hemorrhagic telangiectasia (HHT). They may be isolated but more often are multiple. The goal of this study was to evaluate the influence of PAVMs on lung mechanical properties. METHODS: We reviewed the files of all adult patients (age ≥ 18 years) referred to our Center for evaluation of HHT between 2005 and 2013. The diagnosis of HHT was based on the Curacao criteria and/or the presence of a pathogenic mutation...
April 19, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28382684/thromboembolism-and-in-vitro-fertilization-ndash-a-systematic-review
#14
Maria Sennström, Karin Rova, Margareta Hellgren, Ragnhild Hjertberg, Eva Nord, Lars Thurn, Pelle G Lindqvist
INTRODUCTION: There is no accepted consensus on thromboprophylaxis in relation to in-vitro fertilization (IVF). We aimed to study the frequency of thromboembolism and to assess thromboprophylaxis in relation to IVF. MATERIAL AND METHODS: We performed a systematic review. All study designs were accepted except single case reports. Language of included articles was restricted to English. RESULTS: Of 338 articles, 21 relevant articles (9 cohort studies, 6 case-control studies, 3 case series, and 3 reviews of case series) were identified...
April 6, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28369660/incidence-and-risk-factors-of-venous-thromboembolism-during-postpartum-period-a-population-based-cohort-study
#15
Päivi Johanna Galambosi, Mika Gissler, Risto Juhani Kaaja, Veli-Matti Ulander
The awareness of the incidence and timing of postpartum venous thromboembolic event (VTE) guides the use of thrombophophylaxis. Our aims were to assess the incidence and mortality of VTE and identify its associated risk factors during different postpartum periods MATERIAL AND METHODS: A population-based controlled cohort-study by combining four large registers in 2001-2011. All women with a recent delivery were identified. The incidence, risk factors and mortality of VTE 0-180 days after delivery were assessed by using all healthy delivered women as the control group...
March 30, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28360235/venous-thromboembolism-in-adults-screened-for-sickle-cell-trait-a-population-based-cohort-study-with-nested-case-control-analysis
#16
Iain Little, Yana Vinogradova, Elizabeth Orton, Joe Kai, Nadeem Qureshi
OBJECTIVE: To determine whether sickle cell carriers ('sickle cell trait') have an increased risk of venous thromboembolism (VTE). DESIGN: Cohort study with nested case-control analysis. SETTING: General population with data from 609 UK general practices in the Clinical Practice Research Datalink (CPRD). PARTICIPANTS: All individuals registered with a CPRD general practice between 1998 and 2013, with a medical record of screening for sickle cell between 18 and 75 years of age...
March 29, 2017: BMJ Open
https://www.readbyqxmd.com/read/28341055/obstetric-care-for-women-with-thalassemia
#17
REVIEW
Terence T Lao
Thalassemia is the commonest monogenic disease and manifests as severe anemia. It is increasingly encountered outside the Mediterranean region, Africa, Middle East, and Southeast Asia because of immigration. Pregnancy, previously uncommon in patients with homozygous β-thalassemia, is encountered increasingly because of improved management and assisted reproduction technology; however, preconceptional problems that include anemia, iron overload, cardiac dysfunction, thromboembolism, alloimmunization, infections, and endocrine and bone disorders, could influence maternal and obstetric outcome...
February 2017: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28338393/contraception-for-women-with-multiple-sclerosis-guidance-for-healthcare-providers
#18
Maria K Houtchens, Lauren B Zapata, Kathryn M Curtis, Maura K Whiteman
Family planning is essential for any comprehensive treatment plan for women of reproductive age with multiple sclerosis (MS), including counseling on using effective contraception to optimally time desired and prevent unintended pregnancies. This topical review summarizes the first evidence-based recommendations on contraception safety for women with MS. In 2016, evidence-based recommendations for contraceptive use by women with MS were included in US Medical Eligibility Criteria for Contraceptive Use. They were developed after review of published scientific evidence on contraception safety and consultation with experts...
May 2017: Multiple Sclerosis: Clinical and Laboratory Research
https://www.readbyqxmd.com/read/28331377/management-of-systemic-lupus-erythematosus-during-pregnancy-challenges-and-solutions
#19
REVIEW
Caroline L Knight, Catherine Nelson-Piercy
Systemic lupus erythematosus (SLE) is a chronic, multisystem autoimmune disease predominantly affecting women, particularly those of childbearing age. SLE provides challenges in the prepregnancy, antenatal, intrapartum, and postpartum periods for these women, and for the medical, obstetric, and midwifery teams who provide their care. As with many medical conditions in pregnancy, the best maternal and fetal-neonatal outcomes are obtained with a planned pregnancy and a cohesive multidisciplinary approach. Effective prepregnancy risk assessment and counseling includes exploration of factors for poor pregnancy outcome, discussion of risks, and appropriate planning for pregnancy, with consideration of discussion of relative contraindications to pregnancy...
2017: Open Access Rheumatology: Research and Reviews
https://www.readbyqxmd.com/read/28329059/anticoagulation-for-pregnant-women-with-mechanical-heart-valves-a-systematic-review-and-meta-analysis
#20
Rohan D'Souza, Jackie Ostro, Prakesh S Shah, Candice K Silversides, Ann Malinowski, Kellie E Murphy, Mathew Sermer, Nadine Shehata
Aims: To review maternal and foetal outcomes in women with mechanical heart valves (MHVs) treated with vitamin-K antagonists (VKAs), first-trimester heparin followed by VKAs (sequential treatment), low molecular weight heparin (LMWH) and unfractionated heparin (UFH) during pregnancy, in order to inform practice. Methods and results: Medline, Embase and Central were searched from inception until February 2016. Two reviewers independently screened 1786 titles, reviewed 110 full-texts and extracted data and assessed risk-of-bias from 46 articles...
May 14, 2017: European Heart Journal
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