Cavum Septi Pellucidi in Boxers

2010 ◽  
Vol 61 (1) ◽  
pp. 29-32 ◽  
Author(s):  
Richard I. Aviv ◽  
George Tomlinson ◽  
Brian Kendall ◽  
Chandrashekhar Thakkar ◽  
Alan Valentine
Keyword(s):  
Control Group ◽  
Resonance Imaging ◽  
Cavum Septi Pellucidi ◽  
Mri Studies ◽  
Magnetic Resonance Imaging Mri ◽  
License Renewal ◽  
Type 3 ◽  
Parenchymal Abnormalities

Objective Controversy exists over the significance of the isolated finding of cavum septi pellucidi (CSP) and its prevalence rate in healthy individuals and in professional boxers. Few magnetic resonance imaging (MRI) studies have looked at large cohorts of boxers. The aim of this study was to identify the prevalence and extent of a CSP among professional boxers and to compare these with a control group. Methods MRI studies of 164 male boxers scanned for annual British boxing board license renewal were reviewed and compared with 43 control patients. CSP prevalence, size, and extent were recorded. Extent was classified as type 1, anterior to the fornix; type 2, extending up to the fornix; and type 3, extending into the cavum vergae. Parenchymal abnormalities were documented, and the Evan's ratio was used as an indication of brain atrophy. Results A CSP was present in 40% of controls and 49% of boxers. There was a trend to a higher CSP prevalence in boxers ( P = .099). No control patient had type 2 or 3 extension ( P < .0009), as opposed to 30% and 16% prevalence in boxers. Three boxers increased their extent over serial imaging. No difference in CSP size was established between the 2 groups ( P = .43), but there was an association between progressive scans and increased CSP size over time in boxers, independent of age ( P = .05). Eight boxers demonstrated a CSP on a subsequent scan not seen on an earlier scan. Conclusion The prevalence of a CSP is high among both control patients and boxers. There is a trend to a larger CSP with increasing number of scans without evidence of atrophy and independent of age. Boxers also have a greater posterior extent than controls. The findings may be explained by sudden increases in intracranial pressure that forced cerebrospinal fluid (CSF) through small defects in the septal leaflets, which result in an increase in size and or extent of a CSP.

scholarly journals Kappa Free Light Chains and IgG Combined in a Novel Algorithm for the Detection of Multiple Sclerosis

2020 ◽  
Vol 10 (6) ◽  
pp. 324
Author(s):  
Monika Gudowska-Sawczuk ◽  
Joanna Tarasiuk ◽  
Alina Kułakowska ◽  
Jan Kochanowicz ◽  
Barbara Mroczko
Keyword(s):  
Multiple Sclerosis ◽  
Oligoclonal Bands ◽  
Light Chains ◽  
Control Group ◽  
Free Light Chains ◽  
Pattern Type ◽  
Multiple Sclerosis Patients ◽  
Type 3

Background: It is well known that the cerebrospinal fluid (CSF) concentrations of free light chains (FLC) and immunoglobulin G (IgG) are elevated in multiple sclerosis patients (MS). Therefore, in this study we aimed to develop a model based on the concentrations of free light chains and IgG to predict multiple sclerosis. We tried to evaluate the diagnostic usefulness of the novel κIgG index and λIgG index, here presented for the first time, and compare them with the κFLC index and the λFLC index in multiple sclerosis patients. Methods: CSF and serum samples were obtained from 76 subjects who underwent lumbar puncture for diagnostic purposes and, as a result, were divided into two groups: patients with multiple sclerosis (n = 34) and patients with other neurological disorders (control group; n = 42). The samples were analyzed using turbidimetry and isoelectric focusing. The κIgG index, λIgG index, κFLC index, and λFLC index were calculated using specific formulas. Results: The concentrations of CSF κFLC, CSF λFLC, and serum κFLC and the values of κFLC index, λFLC index, and κIgG index were significantly higher in patients with multiple sclerosis compared to controls. CSF κFLC concentration and the values of κFLC index, λFLC index, and κIgG index differed in patients depending on their pattern type of oligoclonal bands. κFLC concentration was significantly higher in patients with pattern type 2 and type 3 in comparison to those with pattern type 1 and type 4. The κFLC index, λFLC index, and κIgG index were significantly higher in patients with pattern type 2 in comparison to those with pattern type 4. The κFLC index and κIgG index were significantly higher in patients with pattern type 2 in comparison to those with pattern type 1, and in patients with pattern type 3 compared to those with pattern type 4. The κIgG index was markedly elevated in patients with pattern type 3 compared to those with pattern type 1. In the total study group, κFLC, λFLC, κFLC index, λFLC index, κIgG index, and λIgG index correlated with each other. The κIgG index showed the highest diagnostic power (area under the curve, AUC) in the detection of multiple sclerosis. The κFLC index and κIgG index showed the highest diagnostic sensitivity, and the κIgG index presented the highest ability to exclude multiple sclerosis. Conclusion: This study provides novel information about the diagnostic significance of four markers combined in the κIgG index. More investigations in larger study groups are needed to confirm that the κIgG index can reflect the intrathecal synthesis of immunoglobulins and may improve the diagnosis of multiple sclerosis.

scholarly journals Types of the statics of the spine in patients of young, elderly and senile age

2020 ◽  
pp. 38-48
Author(s):  
A. M. Orel
Keyword(s):  
Quantitative Assessment ◽  
Qualitative Assessment ◽  
Control Group ◽  
Entire Group ◽  
X Ray ◽  
Qualitative And Quantitative ◽  
Utility Patent ◽  
Type 3

Introduction. A complete and systematic x-ray examination of all parts of the spine at the same time in elderly and senile people has not yet been carried out. On the other hand, radiography can identify spinal statics disorders that are typical for this category of people.The goal of research — describe the types of spinal statics disorders in young, elderly and senile people.Materials and methods. Digital radiography of all parts of the spine was performed in 103 patients with dorsopathies. The first group included 50 patients aged 60–74 years; men 16, women 34. The second study group included 21 patients aged 75–88 years, 6 men and 15 women. The third control group included 32 randomly selected people aged 21 to 45 years, 15 men and 17 women. The study belongs to the group of a posteriori x-ray processing and was carried out without the participation and additional irradiation of patients. On the screen of a personal computer, using the methods developed by the author, unified digital x-ray images of all parts of the spine of each patient were obtained. From the INION point, a vertical line occipital vertical descended along all the structures of the spine. Using the midpoint of the front and rear contour x-ray image of the vertebral body of the TII and TXII the front-rear axes were passed through until they intersect with the occipital vertical at the back and intersect with each other at the front. A qualitative assessment of the occipital vertical passage relative to the structures of the spine and a quantitative assessment of the angles of inclination and the angle of intersection of the front-rear axes of the TII and TXII vertebrae was carried out..Results. Five types (from 0 to 4) of spine statics were described and criteria for their qualitative and quantitative assessment were determined. It was found that in the control group, the most common type of spine statics was zero (0), while type 3 and 4 were not determined. In contrast, 3 and 4 types of spinal statics were most frequently observed in second group of patients. In the first group of patients, types 1 and 2 of spine statics were most often revealed, and other types of spine statics also occurred. Among the entire group of examined patients n=103 0 type of spinal statics disorder was detected in 27 (26,2 %) patients, type 1 in 35 (34 %), type 2 in 22 (21,3 %), type 3 in 11 (10,7 %) and type 4 in 8 patients (7,8 %). In patients with type 0 spinal statics, the angle of inclination of the front-rear axis of the TII vertebra was 16,67±8,49º, and of the TXII vertebra was 18,33±4,33º. In type 1 statics of the spine, the angle of inclination of the front-rear axis of the TII vertebra was 26,66±6,73º, and of the TXII vertebra was 21,17±4,92º. In type 2 spinal statics, the angle of inclination of the front-rear axis of the TII vertebra was 32,95± 6,82º, and of the TXII vertebra was 19,68±5,4º. In type III spinal statics, the angle of inclination of the front-rear axis of the TII vertebra was 41,09±9,22º, and of the TXII vertebra 26±11,05º. Type 4 statics of the spine were diagnosed in the presence of type 1–3 statics, in addition to which a pathological fracture or multiple compression fractures were detected in any part of the spine, or the vertebral bodies took the form of fish vertebrae.Conclusion. The study demonstrated the presence of characteristic prevailing types of spinal statics in young, elderly and senile people. These qualitative and quantitative criteria allow us to evaluate them. Based on the results of the study, an application for the utility patent of the Russian Federation «The Method for Evaluating Spine Statics», № 2019144992, priority dated 30.12.2019 was issued and filed. The identified qualitative and quantitative indicators can be used to develop criteria for determining the biological age of a person, which will contribute to improving the evidence-based approach to medicine. 

The Injury of the Calcaneocuboid Ligaments

2000 ◽  
Vol 21 (5) ◽  
pp. 379-384 ◽  
Author(s):  
Jonas Andermahr ◽  
Hans-Joachim Helling ◽  
David Maintz ◽  
Stefan Mönig ◽  
Jürgen Koebke ◽  
...  
Keyword(s):  
Compression Fracture ◽  
Tendon Graft ◽  
Persistent Symptoms ◽  
Ligament Rupture ◽  
Varus Stress ◽  
Magnetic Resonance Imaging Mri ◽  
Type 3 ◽  
Classification And Treatment

The selective rupture of the calcaneocuboid ligament is extremely rare and frequently misdiagnosed. This study tries to clarify the mechanism, classification and treatment of this entity. The necessity of radiographs with varus stress and in certain cases of computer tomography (CT) and magnetic resonance imaging (MRI), beside the routine antero-posterior and lateral views, is emphasized. Thirteen cases out of five-hundred-twenty-one sprain injuries of the ankle are described, classified and the therapy discussed: If on varus stress radiographs, there is a calcaneocuboid angle <10 degrees without a bony flake (type 1) strapping for six weeks is indicated. A calcaneocuboid angle >10 degrees with or without a small bony flake of the ligament insertion (type 2) should primarily be treated with a shoe cast for 6 weeks; if there are persistent symptoms a secondary peroneus brevis tendon graft is recommended. A calcaneocuboid angle >10 degrees with a big flake (type 3) should be treated by open reduction and refixation of the ligament. Complex injuries (type 4) are characterised by cuboid compression fracture and ligament rupture.

scholarly journals Different Types of Periampullary Duodenal Diverticula Are Associated with Occurrence and Recurrence of Bile Duct Stones: A Case-Control Study from a Chinese Center

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Zhen Sun ◽  
Wenhui Bo ◽  
Ping Jiang ◽  
Quan Sun
Keyword(s):  
Acute Pancreatitis ◽  
Bile Duct ◽  
Control Group ◽  
Successful Cannulation ◽  
Cbd Stones ◽  
Duodenal Diverticula ◽  
Different Types ◽  
Type 3

Aims. We here investigated the association of different types of periampullary diverticula (PAD) with pancreaticobiliary disease and with technical success of endoscopic retrograde cholangiopancreatography (ERCP).Methods. A total of 850 consecutive patients who underwent their first ERCP were entered into a database. Of these patients, 161 patients (18.9%) had PAD and the age- and sex-matched control group comprised 483 patients.Results. PAD was correlated with common bile duct (CBD) stones (59.6% versus 35.0% in controls;P=0.008) and negatively correlated with periampullary malignancy (6.8% versus 21.5% in controls;P=0.004). The acute pancreatitis was more frequent (62.5%) in patients with PAD type 1 followed by PAD type 2 (28.9%,P=0.017) and type 3 (28.0%,P=0.006). No significant differences were observed in successful cannulation rate and post-ERCP complications among the 3 types of PAD. Type 1 PAD patients had less recurrence of CBD stones than did the patients who had type 2 or type 3 PAD (53.8% versus 85.7%;P=0.043).Conclusions. PAD, especially type 1 PAD, is associated with an increased acute pancreatitis as well as occurrence and recurrence of CBD stones. PAD during an ERCP should not be considered as an obstacle to a successful cannulation.

scholarly journals Predatory activity of chlamydospores of the fungusPochonia chlamydosporia on Toxocara caniseggs under laboratory conditions

2013 ◽  
Vol 22 (1) ◽  
pp. 171-174 ◽  
Author(s):  
Juliana Milani Araujo ◽  
Jackson Victor de Araújo ◽  
Fabio Ribeiro Braga ◽  
Sebastião Rodrigo Ferreira ◽  
Alexandre de Oliveira Tavela
Keyword(s):  
Agar Medium ◽  
Toxocara Canis ◽  
Control Group ◽  
Vitro Assay ◽  
Petri Dishes ◽  
Egg Destruction ◽  
Type 3

The objective of this study was to use chlamydospores of the fungusPochonia chlamydosporia (isolates VC1 and VC4) against Toxocara canis eggs in a 15-day in vitro assay. One thousand T. canis eggs were placed in Petri dishes containing 2% water agar medium with different concentrations of chlamydospores (1,000, 10,000 or 100,000) of each fungal isolate of P. chlamydosporia (treated groups) and 1,000 eggs in Petri dishes without fungus (control group). Egg counts were performed to determine the ovicidal activity, which was classified as three effect levels: type 1, type 2 and type 3. Significant differences (P < 0.01) in egg destruction were found in comparison with the control group. The highest percentage of egg destruction was found in plates containing 100,000 chlamydospores (68.5% for VC1 and 70.5% for VC4). Chlamydospores of P. chlamydosporiawere effective in destroying T. canis eggs and may contribute in the future towards combating the eggs of this parasite.

Magnetic Resonance Imaging in Cardiac Amyloidosis: Unraveling the Stealth Entity

2021 ◽  
Author(s):  
Omair Shah ◽  
Naseer Choh ◽  
Tahleel Shera ◽  
Faiz Shera ◽  
Tariq Gojwari ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Cardiac Amyloidosis ◽  
Systemic Disease ◽  
False Negative ◽  
Imaging Features ◽  
Resonance Imaging ◽  
Type 3

AbstractAmyloidosis is a systemic disease involving many organs. Cardiac involvement is a significant cause of morbidity and mortality in these patients. Diagnosis of cardiac amyloidosis is based on endomyocardial biopsy which however is invasive and associated with complications. Noninvasive methods of diagnosis include magnetic resonance imaging (MRI) with various methods and sequences involved. Our study aims at describing MRI features of cardiac amyloidosis including new imaging sequences and to prognosticate the patients based on imaging features. We included 35 patients with suspected cardiac amyloidosis who underwent MRI at our center over 4 years. All images were retrieved from our archive and assessed by an experienced radiologist. Common morphological features in our patients included increased wall thickness of left ventricle (LV) (16. 1 ± 4.1 mm), right ventricle (RV) (6.3 ± 1.1 mm), and interatrial septum (6.2 ± 0.8 mm). Global late gadolinium enhancement (LGE) (n = 21 [65%]) including subendocardial or transmural was the most common pattern followed by patchy enhancement. Global transmural LGE was associated with worse prognosis. Four types of myocardial nulling patterns were observed on postcontrast time to invert (TI) scout imaging: normal nulling pattern (myocardium nulls after blood and coincident with spleen) and abnormal nulling pattern (ANP) which is further divided into three types: Type 1—myocardium nulls before blood pool but coincident with spleen, Type 2—myocardium nulling coincident with blood but not coincident with spleen, and Type 3—features of both Type 1 and Type 2. Type 3 ANP was the most common (n = 23) nulling pattern in our patients. Cardiac MRI is an essential in noninvasive diagnosis of cardiac amyloidosis. Transmural global LGE serves as a poor prognosticator in these patients. “Three-tier” TI scout imaging is essential to avoid false-negative enhancement results. Type 3 ANP is the most specific nulling pattern in cardiac amyloidosis.

scholarly journals AP2S1 and GNA11 mutations – not a common cause of familial hypocalciuric hypercalcemia

2017 ◽  
Vol 176 (2) ◽  
pp. 177-185 ◽  
Author(s):  
Silje Hovden ◽  
Lars Rejnmark ◽  
Søren A Ladefoged ◽  
Peter H Nissen
Keyword(s):  
Cross Sectional Study ◽  
Control Group ◽  
Familial Hypocalciuric Hypercalcemia ◽  
Gene Encoding ◽  
Cross Sectional ◽  
Calcium Sensing ◽  
Pathogenic Mutations ◽  
Type 3

Objective Familial hypocalciuric hypercalcemia (FHH) type 1 is caused by mutations in the gene encoding the calcium-sensing receptor (CASR). Recently, mutations affecting codon 15 in the gene AP2S1 have been shown to cause FHH type 3 in up to 26% of CASR-negative FHH patients. Similarly, mutations in the gene GNA11 have been shown to cause FHH type 2. We hypothesized that mutations in AP2S1 and GNA11 are causative in Danish patients with suspected FHH and that these mutations are not found in patients with primary hyperparathyroidism (PHPT), which is the main differential diagnostic disorder. Design Cross-sectional study. Methods We identified patients with unexplained hyperparathyroid hypercalcemia and a control group of verified PHPT patients through review of 421 patients tested for CASR mutations in the period 2006–2014. DNA sequencing of all amino acid coding exons including intron–exon boundaries in AP2S1 and GNA11 was performed. Results In 33 CASR-negative patients with suspected FHH, we found two (~6%) with a mutation in AP2S1 (p.Arg15Leu and p.Arg15His). Family screening confirmed the genotype–phenotype correlations. We did not identify any pathogenic mutations in GNA11. No pathogenic mutations were found in the PHPT control group. Conclusions We suggest that the best diagnostic approach to hyperparathyroid hypercalcemic patients suspected to have FHH is to screen the CASR and AP2S1 codon 15 for mutations. If the results are negative and there is still suspicion of an inherited condition (i.e. family history), then GNA11 should be examined.

FUNCTIONAL STATUS AND ADAPTIVE POTENTIAL IN FOREIGN STUDENTS WITH DIFFERENT TYPES OF VEGETATIVE REGULATION DURING TUITION

2020 ◽  
pp. 118-126
Author(s):  
A.M. Satarkulova
Keyword(s):  
Heart Rate ◽  
Foreign Students ◽  
Autonomic Regulation ◽  
The Body ◽  
Functional Changes ◽  
Different Types ◽  
Type 3 ◽  
Adaptive Abilities

The assessment and dynamic control over students’ status is a very important task. It allows timely detection of prenosological status prior to pathology and health maintenance in students. The objective of the paper is to assess the adaptive abilities of the body, to analyze changes in heart rate variability indicators in students with various types of autonomic regulation, to identify prenosological status and precursory pathological symptoms. Materials and Methods. The study enrolled 302 students from India, aged 21.54±1.43. Programming complex «Psychophysiologist» was used to register the main HRV parameters within 5 minutes. Health status was evaluated according to the index of functional changes and the scale of functional states. Results. N.I. Shlyk (2009) distinguished two groups of students with different types of autonomic regulation: type 1 (53 %) with moderate and type 2 (5 %) with marked characteristics of central regulation profile, type 3 (35 %) with moderate and type 4 (7 %) with marked characteristics of autonomous regulation profile. Main parameters of HRV and adaptation potential were defined for each student.All the parameters characterized functional and health status. Conclusions. It was shown that 82 % of trial subjects (type 1), 53 % (type 2), 94 % (type 3) and 95 % (type 4) demonstrated satisfactory adaptation and their physiological processes were at an optimal level. 18 % of students (type 1) demonstrated reduced adaptive abilities of the body. Moreover, they were under moderate stress. 47 % of subjects (type 2) were also under a significant stress, which was proven by excessively high SI, low SDNN and TP, and an increased index of functional changes. 5 % of students (type 4) revealed dysfunctional characteristics in the heart rhythm, peculiar to pathology. Keywords: foreign students, heart rate variability, types of autonomic regulation, adaptation potential, functional status. Оценка состояния студентов и динамический контроль за ним является важной задачей, поскольку позволяет своевременно выявлять у студентов донозологические состояния, предшествующие патологии, и способствовать сохранению здоровья. Цель. Оценка адаптивных возможностей организма, анализ изменений показателей вариабельности сердечного ритма у студентов с различными типами вегетативной регуляции, выявление донозологических состояний и ранних признаков патологии. Материалы и методы. В исследовании участвовало 302 студента в возрасте 21,54+1,43 года из Индии. Регистрировались основные параметры ВСР в течение 5 мин с использованием программно-аппаратного комплекса «Психофизиолог». Состояние и уровень здоровья оценивались по индексу функциональных изменений и шкале функциональных состояний. Результаты. По способу, предложенному Н.И. Шлык, выделены группы студентов с различными типами вегетативной регуляции: I (53 %) и II типы (5 %) – с умеренным и выраженным преобладанием центрального контура регуляции соответственно, III (35 %) и IV типы (7 %) – с умеренным и выраженным преобладанием автономного контура регуляции соответственно. У каждого из студентов определены основные параметры ВСР и адаптационного потенциала, характеризующие функциональное состояние и уровень здоровья. Выводы. Показано, что для 82 % обследуемых с I типом, 53 % со II типом, 94 % c III типом и 95 % с IV типом регуляции характерно состояние удовлетворительной адаптации, физиологические процессы сохраняются на оптимальном уровне. В группе студентов I типа у 18 % студентов адаптивные возможности организма снижены, выявлено состояние умеренного напряжения. У 47 % обследуемых II типа также зафиксировано состояние резко выраженного напряжения, индикатором которого является чрезмерно высокое значение SI, низкие величины SDNN и ТP, повышенное значение индекса функциональных изменений. В группе студентов с IV типом у 5 % учащихсяв регуляции ритма сердца выявлены дисфункциональные признаки, характерные для патологии. Ключевые слова: иностранные студенты, вариабельность сердечного ритма, типы вегетативной регуляции, адаптационный потенциал, функциональное состояние.

POLIOMYELITIS IN CANADIAN ESKIMOS: LABORATORY STUDIES. V. TYPE 1 AND TYPE 3 POLIOMYELITIS ANTIBODY LEVELS IN BAFFIN ISLAND ESKIMOS

1954 ◽  
Vol 32 (1) ◽  
pp. 119-125
Author(s):  
W. Wood ◽  
Eina M. Clark ◽  
F. T. Shimada ◽  
A. J. Rhodes
Keyword(s):  
Medical Records ◽  
Baffin Island ◽  
Tissue Cultures ◽  
Laboratory Studies ◽  
Poliomyelitis Virus ◽  
Antibody Titers ◽  
Antibody Levels ◽  
Type 3

Studies on the basic immunology of poliomyelitis in Canadian Eskimos have been continued. Some 87 sera collected from Eskimos at Pangnirtung, Baffin Island, have been examined for the presence of Type 1 and Type 3 poliomyelitis antibody by quantitative tests in tissue cultures. The same sera were previously examined for Type 2 antibody by quantitative tests in mice. The results of the three determinations are now presented together for comparison. These sera came from Eskimos aged 2 to 72 years of age. None of the Eskimos showed any evidence of paralysis. Examination of the medical records did not suggest that any paralytic disease had been present in this part of Baffin Island. Very few of the sera showed the presence of poliomyelitis antibody; thus, Type 1 antibody was demonstrated in the sera of 8%, Type 2 antibody in the sera of 9%, and Type 3 antibody in the sera of 14%. No significant number of Eskimos below the age of 45 years had acquired poliomyelitis antibody. The antibody titers mostly ranged between 10−1.0 and 10−2.0, and were significantly lower than the titers customarily found in recently paralyzed cases. These findings suggest that poliomyelitis infection occurred in Pangnirtung Eskimos many years before the date on which the samples were taken (1951). These results point to the worldwide prevalence of the three types of poliomyelitis virus.

Toward Personalized Treatment for Patients with Low von Willebrand Factor and Quantitative von Willebrand Disease

2021 ◽  
Vol 47 (02) ◽  
pp. 192-200
Author(s):  
James S. O'Donnell
Keyword(s):  
Von Willebrand Factor ◽  
Bleeding Risk ◽  
Von Willebrand Disease ◽  
Personalized Treatment ◽  
Treatment Plans ◽  
Type 3 ◽  
Von Willebrand ◽  
Willebrand Factor

AbstractThe biological mechanisms involved in the pathogenesis of type 2 and type 3 von Willebrand disease (VWD) have been studied extensively. In contrast, although accounting for the majority of VWD cases, the pathobiology underlying partial quantitative VWD has remained somewhat elusive. However, important insights have been attained following several recent cohort studies that have investigated mechanisms in patients with type 1 VWD and low von Willebrand factor (VWF), respectively. These studies have demonstrated that reduced plasma VWF levels may result from either (1) decreased VWF biosynthesis and/or secretion in endothelial cells and (2) pathological increased VWF clearance. In addition, it has become clear that some patients with only mild to moderate reductions in plasma VWF levels in the 30 to 50 IU/dL range may have significant bleeding phenotypes. Importantly in these low VWF patients, bleeding risk fails to correlate with plasma VWF levels and inheritance is typically independent of the VWF gene. Although plasma VWF levels may increase to > 50 IU/dL with progressive aging or pregnancy in these subjects, emerging data suggest that this apparent normalization in VWF levels does not necessarily equate to a complete correction in bleeding phenotype in patients with partial quantitative VWD. In this review, these recent advances in our understanding of quantitative VWD pathogenesis are discussed. Furthermore, the translational implications of these emerging findings are considered, particularly with respect to designing personalized treatment plans for VWD patients undergoing elective procedures.

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