1,721,119 research outputs found
Chronic granulomatous disease
No full textChronic granulomatous disease (CGD) is a rare primary immunodeficiency due to an abnormal function of the nicotinamide adenine dinucleotide phosphate (NADPH) oxidase; NADPH oxidase is a key enzyme for the cellular "respiratory burst", the cellular process that converts molecular oxygen to the oxygen free-radical superoxide. As a consequence of NADPH oxidase defect, CGD patients suffer from recurrent life-threatening infections and from exceeding inflammatory responses leading to granulomas. This article analyzes clinical aspects of CGD. Furthermore, using the CGD model, we focused on the future perspective to reduce atherosclerosis and its complications
The role of nicotinamide adenine dinucleotide phosphate oxidase in the pathogenesis of hypertension
No full textOxidative stress is believed to play a crucial role in the initiation and progression of atherosclerosis. In particular, oxidative stress could be involved in the pathogenesis of hypertension but, until now, there is still a debate whether oxidative stress is a cause or a result of hypertension. Nicotinamide adenine dinucleotide phosphate (NADPH) activation is considered as the major reactive oxygen species source and could be implicated in the pathogenesis of hypertension. A large body of evidences coming from animal studies have generally supported the hypothesis that high blood pressure is associated with increased oxidative stress and with NADPH activation; conversely, human studies provided divergent results. This review analyses the data reported so far to determine the role of NADPH oxidase in the pathogenesis of hypertension. © 2009 Adis Data Information BV. All rights reserved
Radial artery pseudo-aneurysm detected with a portable handheld ultrasound device in a COVID-19 patient
Full text linkThrombopoietin receptor agonists and risk of portal vein thrombosis in patients with liver disease and thrombocytopenia: A meta-analysis
No full textBackground: Treatment of thrombocytopenia with thrombopoietin receptor agonists (TPORAs) seems to be associated with portal vein thrombosis (PVT) in patients with chronic liver disease (CLD). We performed a meta-analysis of the trials carried out in this clinical setting to assess if such association is detectable. Methods: We performed a meta-analysis with studies that compared the effect of TPORAS vs placebo in patients with CLD and thrombocytopenia. Results: Four studies, including 1953 patients, reported the incidence of PVT in patients with CLD and thrombocytopenia treated with TPORAs or placebo. No significant difference was found for incidence of PVT in patients treated with TPORAs compared with placebo (O.R.: 2.8; 95% C.I., 0.97–8.16; p = 0.055). A significant association between PVT and TPORAs was observed only in patients treated with eltrombopag (O.R.: 3.8; 95% C.I., 1.14–13.2; p = 0.03). Three studies, including 514 patients who were undergoing an elective invasive procedure, analyzed the incidence of PVT in TPORAs—treated patients with CLD and thrombocytopenia; no significant difference was found for incidence of PVT in patients treated with TPORAs compared with placebo (O.R.: 2.6; 95% C.I., 0.6–11.6; p = 0.212). A significant difference was found for incidence of arterial and venous thrombo-embolic events in CLD patients treated with eltrombopag compared with placebo-treated patients (O.R.: 3.4; 95% C.I., 1.5–7.7; p = 0.003). Conclusion: The results of this meta-analysis show that TPORAs are not associated with PVT in CLD patients even in the case of surgical procedure. PVT risk seems to be associated only with eltrombopag use
Should all acutely ill medical patients be treated with antithrombotic drugs? A review of the interventional trials
No full textAfter reports from observational studies suggesting an association between acutely ill medical patients and venous thromboembolism (VTE), interventional trials with anticoagulants drugs have demonstrated a significant reduction of VTE during and immediately after hospitalisation. Although several guidelines suggest the clinical relevance of reducing this outcome, there is a low tendency to use anticoagulants in patients hospitalised for acute medical illness. We speculated that such underuse may be dependent on a low perception that patients included in the trials are actually at risk of thromboembolism. Therefore, the aim of this study was to analyse the clinical settings included in the interventional trials and their relationship with thrombotic risk. Analysis of interventional trials revealed that the majority of patients included in the trials (about 80%) were affected by heart failure, acute respiratory syndrome or infections. Among these three illnesses, literature data shows an association with venous thrombosis only in patients with acute infections; this finding was, however, supported only by retrospective study. On the contrary, there is scarce or no evidence that heart failure and acute respiratory syndrome are associated with venous thrombosis. These data underscore the need of better defining the thrombotic risk profile of acutely ill medical patients included in interventional trials with anticoagulants.After reports from observational studies suggesting an association between acutely ill medical patients and venous thromboembolism (VTE), interventional trials with anticoagulants drugs have demonstrated a significant reduction of VTE during and immediately after hospitalisation. Although several guidelines suggest the clinical relevance of reducing this outcome, there is a low tendency to use anticoagulants in patients hospitalised for acute medical illness. We speculated that such underuse may be dependent on a low perception that patients included in the trials are actually at risk of thromboembolism. Therefore, the aim of this study was to analyse the clinical settings included in the interventional trials and their relationship with thrombotic risk. Analysis of interventional trials revealed that the majority of patients included in the trials (about 80%) were affected by heart failure, acute respiratory syndrome or infections. Among these three illnesses, literature data shows an association with venous thrombosis only in patients with acute infections; this finding was, however, supported only by retrospective study. On the contrary, there is scarce or no evidence that heart failure and acute respiratory syndrome are associated with venous thrombosis. These data underscore the need of better defining the thrombotic risk profile of acutely ill medical patients included in interventional trials with anticoagulants
Sex related differences in patients with acute venous thromboembolism treated with new oral anticoagulants. A meta-analysis of the interventional trials
No full textBACKGROUND:
Gender differences have been reported in patients with acute VTE treated with antithrombotic drugs.
OBJECTIVE:
To address the relationship between gender and new oral anticoagulants (NOACs), we performed a meta-analysis to evaluate the incidence of recurrent VTE and major plus clinically relevant non-major bleedings in males and females, with acute VTE, treated with NOACs over the treatment period.
DESIGN:
Systematic review and meta-analysis of double blind randomized controlled trials (RCTs).
DATA SOURCES:
MEDLINE, Cochrane Library of Clinical Trials (up to September 2015).
STUDY SELECTION:
RCTs that compared the beneficial and harmful effects of NOAC drugs (apixaban, dabigatran, edoxaban and rivaroxaban).
DATA EXTRACTION:
Three authors abstracted data. Study-specific risk ratios (RR) were combined using random-effects model.
RESULTS:
Nine studies including 16,372 patients were selected. No significant difference for the incidence of recurrent VTE was found between men and women. Compared to men, women had a higher incidence of major bleedings plus clinically relevant minor bleedings (5.3% and 7.9% respectively; RR: 0.635; 95% CI: 0.54-0.74; p<0.001). The subgroup analysis showed a significant gender difference in incidence of major bleedings and clinically relevant minor bleedings only for Edoxaban (RR: 0.52; 95% CI: 0.42-0.64; p<0.001).
CONCLUSIONS:
This meta-analysis showed, compared to men, a higher risk of bleeding in women with acute VTE treated with NOACs. Future trials should evaluate the effect of gender on bleeding in patients with acute VTE treated with NOACs
- …
