An acute abdominal catastrophe and anuria in a patient with rheumatic heart disease on anticoagulant therapy

1968 ◽  
Vol 45 (2) ◽  
pp. 291-300
2017 ◽  
Vol 37 (1) ◽  
Author(s):  
Ni Li ◽  
Dawei Zheng ◽  
Lebo Sun ◽  
Huoshun Shi ◽  
Xiuying Zhu ◽  
...  

To investigate the contribution of brain natriuretic peptide (BNP) promoter DNA methylation to the risk of rheumatic heart disease (RHD) and the influence of warfarin anticoagulant therapy on BNP methylation levels for RHD patients after surgery. BNP methylation levels were determined by bisulfite pyrosequencing from plasma samples of RHD patients compared with healthy controls. Several factors influencing the RHD patients were included like age, smoking and cholesterol levels. A fragment of five CG sites (CpG1–5) in the promoter region of BNP gene was measured. BNP gene hypermethylation was found in CpG4 and CpG5 in RHD patients compared with non-RHD controls. A significant difference was also observed between RHD patients with long-term administration of warfarin and RHD patients who had recently undergone an operation. Moreover, single CpG4 and CpG5 analysis revealed a significant increase in methylation levels in men. BNP gene body hypermethylation is associated with the risk of RHD, and also influenced by the warfarin anticoagulant therapy of RHD patients after surgery, which could represent novel and promising targets for therapeutic development.


1970 ◽  
Vol 1 (1) ◽  
Author(s):  
Hong Liu

Objective: To investigate the perioperative treatment of patients with breast cancer complicated with rheumatic heart disease. Methods: The perioperative treatment of rheumatic heart disease in 2400 patients with breast cancer treated in our hospital from January 2007 to August 2011 were retrospectively analyzed. Results: Two of the 2400 patients with breast cancer had rheumatic heart disease, aged 71 and 55 years, respectively. One case with atrial fibrillation, and the other one case of mitral valve replacement valve, were treated with warfarin anticoagulant therapy. Two patients in the first 5 days before the withdrawal of warfarin, while low molecular weight heparin or fondaparinux sodium anticoagulant therapy, intraoperative careful hemostasis, as appropriate after the start of anticoagulant therapy. Patients within 24 hours after the incision area of ecchymosis, to adjust the anticoagulant drugs, to strengthen the drainage and hemostasis and other measures improved. Conclusion: Patients with breast cancer complicated with rheumatic heart disease are more complicated due to basic diseases, and their perioperative treatment is more complicated. Excessive anticoagulation or hemostatic treatment will lead to adverse reactions. Perioperative attention should be paid to monitor and adjust the patient INR value, intraoperative need to carefully hemostasis, as far as possible to stop bleeding, reduce coagulation, close observation of patients with local wound conditions, strengthen drainage, if necessary, add hemostatic, and more can be better The treatment effect.


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