1,720,991 research outputs found
How to effectively manage the event of bleeding complications when using anticoagulants
No full textSince affecting hemostasis, all the anticoagulant drugs carry a risk of bleeding. Minor bleeds may be managed without the need to reverse the anticoagulant effect, which is instead a key step to ensure efficacious hemostasis in major and life-threatening bleeding. Drug withdrawal applies to all anticoagulants. Unfractionated heparin can be neutralized by protamine, which may partly neutralize low-molecular-weight heparins. There is no antidote for fondaparinux, and recombinant factor VIIa (rFVIIa) may be considered for critical bleeding. For vitamin K antagonists-induced major bleeding, rapid reversal with prothrombin complex concentrates (PCC) or plasma and intravenous vitamin K to confer lasting correction are recommended. PCC, activated PCC and rFVIIa are suggested for major bleeding related to new direct oral anticoagulants (DOAC), despite proper studies are lacking. Premarketing studies are ongoing on new antidotes (idarucizumab, andexanet, aripazine), which appear to be suitable for the treatment of DOAC-induced life-threatening hemorrhage
ASSESSMENT DAY TESTING FIBRINOLYTICS IN PATIENTS AT RISK OF VOD AFTER TRANSPLANTATION OF HEMATOPOIETIC STEM CELLS: STUDY IN A PEDIATRIC POPULATION
No full textDestructive Membranous Periodontal Disease (Ligneous Gingivitis): A Literature Review.
No full textIntroduction: Destructive membranous periodontal disease, or ligneous gingivitis, is a rare condition involving nodular gingival enlargement with ulceration and periodontal tissue destruction. This review gives a brief account of the cases reported in the literature. An effort is also made to define the periodontal disease caused by plasminogen deficiency with a view to its potential inclusion in the classification of periodontal diseases. Materials and methods: A Medline-PubMed and manual search was conducted to find papers describing at least one case of ligneous disease involving the oral mucosa. Results: We identified 23 articles reporting 35 cases. For each patient, we analyzed various characteristics, including: age, gender, age of onset, oral symptoms, histological features, plasma plasminogen levels (functional activity, plasma antigen), genetic features, treatment, and results of treatment during the reported follow-up. Conclusions: Ligneous gingivitis is a rare periodontal disorder closely associated with ligneous conjunctivitis and plasminogen deficiency. Its diagnosis may be supported by the finding of genetic mutations responsible for the condition. Research is focusing on the future development of an effective therapy capable of arresting the disease's destructive evolution. Further studies, investigating features such as pocket depth and attachment loss, are needed for the appropriate classification of these periodontal diseases
WILMS tumor and veno-occlusive disease .
No full textAssessment of PLT-derived microparticles in patients with Wilms Tumo
Risk factors, antithrombotic treatment and outcome in retinal vein occlusion: an age-related prospective cohort study
Full text linkObjectives:
Antithrombotic treatment for retinal vein occlusion (RVO) is controversial, although RVO has
been surmised as a predictor of a subsequent vascular event. We aimed to evaluate risk factors, the effects
of antithrombotic therapy and the occurrence of subsequent vascular events in patients with a first episode
of RVO, according to age of RVO onset.
Methods:
In this prospective cohort study, patients with central
(CRVO) and branch RVO (BRVO) confirmed by fluorescein angiography were studied; they were divided
according to age. Cardiovascular risk factors and thrombophilia were evaluated. Anticoagulants or aspirin
were given for at least 3 months
.
Patients were followed every 6
–
12 months and vascular events were
recorded.
Results:
One hundred CRVO and 32 BRVO patients were enrolled. Five of 60 (8.3%) patients
<
50 yr and 4/72 (5.5%) over 50 yr had a hereditary thrombophilic defect. One or more cardiovascular risk
factors were found in 35 (58%) patients of the younger group, and in 66 (91%) of the older group (
P
<
0.001).
Antithrombotic treatment led to both a satisfactory recanalization of occluded veins and visual acuity
improvement especially in younger patients. Vascular events occurred in 19 (14%) cases after 4
3.3 yr
from RVO, more frequently in older than in younger patients (22% vs. 5%,
P
=
0.005).
Conclusions:
Distribution of cardiovascular, but not of thrombophilic risk factors seems to be influenced by age in RVO
patients. Patients with a first RVO, especially those
>
50 yr, are likely at risk of a subsequent vascular event
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Circulating microparticles of glial origin and tissue factor bearing in high-grade glioma: a potential prothrombotic role.
No full textUrokinase Plasminogen Activator, uPa Receptor, and Its Inhibitor in Vernal Keratoconjunctivitis
Full text linkAbstract
PURPOSE:
Plasminogen activators play a role, not only in fibrinolysis but also in events such as chemotaxis, collagen degradation, and cell spreading. The serine protease urokinase (uPA) is a potent chemoattractant for leukocytes that may be involved in the pathogenesis of severe forms of allergic conjunctivitis such as vernal keratoconjunctivitis (VKC).
METHODS:
Tear and peripheral blood samples were obtained from 20 patients with active VKC and from 19 normal subjects who formed the control group. Levels of plasminogen activity, uPA, tissue plasminogen activator (tPA), and their inhibitor, plasminogen activator inhibitor type-1 (PAI-1) were measured in tears and plasma of patients with VKC. The presence of tPA, uPA, and urokinase receptor (uPAR) in conjunctival tissues were evaluated by immunohistochemistry. uPA, uPAR, and PAI-1 expression and production were measured in conjunctival epithelial cell and fibroblast cultures treated with cytokines.
RESULTS:
Tear levels of uPA and tPA and tear plasminogen activity levels were significantly greater in patients with VKC than in control subjects. Increased staining for uPA and uPAR was found in VKC tissues compared with normal conjunctiva. Both conjunctival epithelial cells and fibroblasts demonstrated an increased expression of uPAR after exposure to IL-4 or -13, whereas uPA was highly expressed by epithelial cells exposed to IL-4. PAI-1 levels in culture medium were increased in IL-4-exposed epithelial cells compared to nonstimulated cells and were decreased in fibroblast culture.
CONCLUSIONS:
Increased expression of fibrinolytic system components and imbalance between plasminogen activators and PAI may be involved in the pathogenesis of severe allergic conjunctivitis, thus contributing to inflammatory cell migration and tissue remodeling
Plasma fibrinolytic capacity in renal transplant recipients: Effect of steroid-free immunosuppression therapy.
Full text linkBackground. Cardiovascular disease is the most common cause of death among renal transplant recipients (RTRs). Impaired fibrinolytic capacity caused by an increase in plasminogen activator inhibitor type 1 (PAI-1) levels is involved in the onset of atherosclerosis and thrombotic complications. Long-term steroid treatment may induce arterial hypertension and metabolic and prothrombotic changes (including up-regulation of PAI-1 synthesis), which increase the cardiovascular risk. We evaluated plasma fibrinolytic behavior in two groups of RTRs treated with different immunosuppressive regimens.
Methods. Twenty-seven RTRs were randomized to receive long-term (17 patients) or perioperative short-term (10 patients) steroids in addition to immunosuppression with cyclosporine A plus everolimus (Certican; Novartis, Basel, Switzerland) (7 patients) or FK506 plus mycophenolate mofetil (20 patients). In each patient, fibrinolytic capacity was studied with the 20-min venous occlusion test 1 and 6 months after transplantation. The following were assayed: euglobulin lysis time, tissue-type plasminogen activator antigen, and PAI-1 antigen and activity.
Results. One month after transplantation, a severe impairment of fibrinolytic capacity, mainly caused by an increase in PAI-1 antigen and activity levels, was seen in patients with and without steroid treatment. Six months after transplantation, an improvement in fibrinolytic potential as the result of a decrease in PAI-1 levels was observed only in patients without steroid therapy. None of the steroid-treated patients demonstrated PAI-1 values correlating with body mass index, blood pressure, and metabolic parameters, thus confirming the effect of exogenous factors on PAI-1 expression. Moreover, all patients revealed a slight impairment of stimulated endothelial tissue-type plasminogen activator release, regardless of any steroid treatment, which was probably attributable to calcineurin inhibitor-induced endothelial dysfunction.
Conclusions. Our study suggests that steroid-free immunosuppression is associated with a better fibrinolytic capacity in RTRs. This finding may contribute toward reducing the risk of cardiovascular events
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