Kardiochirurgische Eingriffe bei schweren Blutungsdiathesen

2012 ◽  
Vol 32 (S 01) ◽  
pp. S83-S86 ◽  
Author(s):  
R. Schobess ◽  
A. Siegemund ◽  
C. J. Correia ◽  
J. Oppermann ◽  
J. Banusch ◽  
...  
Keyword(s):  
Case Report ◽  
Cardiovascular Diseases ◽  
Bleeding Risk ◽  
Coagulation Factors ◽  
Developed Countries ◽  
Severe Bleeding ◽  
Bleeding Diathesis ◽  
Concomitant Therapy ◽  
Kardiochirurgische Eingriffe ◽  
The Developed Countries

SummaryCardiovascular diseases are the most common disorder in the developed countries. Invasive cardiological and cardiosurgical techniques are known therapies.Yet, patients with severe hereditary haemorrhagical diseases (haemophilia, rare deficiencies of coagulation factors) have an increased bleeding risk by the use of anticoagulants. Therefore, the treatment of these patients requires a concomitant therapy.This article shows eight patients with a severe bleeding diathesis and cardiosurgical interventions in the years 2006 to 2011. This case report shall demonstrate that an adequate therapy can be accomplished with the help of a good cooperation between haemostaseologists and colleagues of the cardioinvasive/ cardiosurgical disciplines.

scholarly journals Fatal intracerebral hemorrhage secondary to Lonomia obliqua caterpillar envenoming: case report

2006 ◽  
Vol 64 (4) ◽  
pp. 1030-1032 ◽  
Author(s):  
Pedro André Kowacs ◽  
Juliana Cardoso ◽  
Marlene Entres ◽  
Edison Mattos Novak ◽  
Lineu César Werneck
Keyword(s):  
Case Report ◽  
Intracerebral Hemorrhage ◽  
Clinical Features ◽  
Healthy Woman ◽  
Severe Bleeding ◽  
Bleeding Diathesis ◽  
Pertinent Literature ◽  
Intracerebral Hemorrhages ◽  
Brain Hemorrhages ◽  
Lonomia Obliqua

The case of a 70 year-old, previously healthy woman who developed a severe bleeding diathesis shortly after touching a Lonomia obliqua caterpillar and finally died from multiple intracerebral hemorrhages is described. Brain hemorrhages are the leading cause of death in patients envenomed by the Lonomia species. The pertinent literature is reviewed and the most relevant clinical features highlighted, with emphasis on diagnosis. The use of new therapeutic options such as anti-Lonomia serum is discussed.

scholarly journals Copeptin - is There a Role for Another Cardiac Biomarker?

2011 ◽  
Vol 30 (3) ◽  
pp. 224-229 ◽  
Author(s):  
Adriana Unić ◽  
Dunja Rogić ◽  
Gordana Rajsman
Keyword(s):  
Cardiovascular Diseases ◽  
Clinical Laboratory ◽  
Surrogate Marker ◽  
Developed Countries ◽  
Cardiac Biomarker ◽  
Precursor Peptide ◽  
Novel Biomarkers ◽  
The Developed Countries ◽  
Routine Clinical Laboratory ◽  
New Biomarkers

Copeptin - is There a Role for Another Cardiac Biomarker?The discovery and development of new biomarkers continues to be a promising field. Since cardiovascular disease remains the principal cause of death in the developed countries, this is the area in which novel biomarkers have been most extensively evaluated. Arginine vasopressin (AVP or antidiuretic hormone) is one of the key hormones in the human body involved in cardiovascular homeostasis. It has so far escaped introduction into the routine clinical laboratory due to technical difficulties and pre-analytical errors. Copeptin, the C-terminal part of the AVP precursor peptide, was found to be a stable and sensitive surrogate marker for AVP release. During the past years, copeptin measurement has been shown to be of interest in a variety of clinical indications, including cardiovascular diseases such as heart failure, myocardial infarction, and stroke. This review summarizes the recent progress in the diagnostic use of plasma copeptin in cardiovascular diseases.

scholarly journals Significance of the combined tests application in serum and liquor of patients with suspected neurosyphilis

2007 ◽  
Vol 64 (4) ◽  
pp. 271-274
Author(s):  
Mihailo Mirkovic ◽  
Vilma Jovicic ◽  
Ivana Basta ◽  
Ivan Marjanovic ◽  
Dragana Lavrnic
Keyword(s):  
Case Report ◽  
Treponema Pallidum ◽  
Developed Countries ◽  
Differential Diagnostics ◽  
Psychotic Symptoms ◽  
Clinical Image ◽  
Western Blot Method ◽  
Normal Number ◽  
Tabes Dorsalis ◽  
The Developed Countries

Background. Tertiary syphilis develops in 8-40% of untreated patients. It is most commonly manifested in the form of neurosyphilis, which can be asymptomatic taking the form of tabes dorsalis or progressive paralyze. Nowadays, in the developed countries, progressive paralyze is a rather rare disease, although the incidence of this disease has been rising within the last decades. Case report. We reported a 74-year-old male with the clinical image of dementia showing psychotic symptoms. On cytobiochemical examination of cerebrospinal liquor, hyperproteinorhacmia of 0.70 g/l with the normal number of cells was revealed. Computed tomography of the brain showed the marked cortical cerebral and cerebellar reduction changes with multiple ischemic lesions. Within a routine examination of patients with demention, we performed serologic reactions to syphilis out of which the Veneral Disease Researc Laboratory (VDRL) test in serum and liquor was unreactive, while the Treponema pallidum hemagglutination (TPNA) test in serum and liquor was positive. Positivity in serum and liquor was additionally confirmed by the Western blot method and fluoroscent treponema antibody (FTA) test. The treatment with benzathine fenylpenicilline 2.4 g once weekly resulted in significant improving the psychotic symptoms of the disease even after two weeks. Conclusion. This case report showed that within the differential diagnostics in patients with demention or psychotic disorder it is obligatory to consider syphilis of the nervous system, as well as to apply a combination of various tests which, besides the typical liquor findings, significantly improve the accuracy of diagnosis. Such approach is especially important regarding the fact that neurosyphilis can remain clinically quite asymptomatic for a long period, which could lead to late therapy, while, on the contrary, an adequate and timely treatment can contribute to a significant recovery of any patients.

scholarly journals The role of homocysteine and methylenetetrahydrofolate reductase, methionine synthase, methionine synthase reductase polymorphisms in the development of cardiovascular diseases and hypertension

2012 ◽  
Vol 153 (12) ◽  
pp. 445-453 ◽  
Author(s):  
Krisztina Marosi ◽  
Annamária Ágota ◽  
Veronika Végh ◽  
József Gábor Joó ◽  
Zoltán Langmár ◽  
...  
Keyword(s):  
Cardiovascular Diseases ◽  
Methylenetetrahydrofolate Reductase ◽  
Developed Countries ◽  
Methionine Synthase ◽  
Gene Variants ◽  
Mthfr Polymorphisms ◽  
Methionine Synthase Reductase ◽  
Reductase Gene ◽  
The Developed Countries

Cardiovascular diseases (CVDs) are the leading causes of death in the developed countries. Elevated homocysteine level is as an independent risk factor of CVDs. The C677T and A1298C variants of methylenetetrahydrofolate reductase gene (MTHFR) have been shown to influence folate and homocysteine metabolisms. However, the relationship between MTHFR polymorphisms and hyperhomocysteinemia has not been well established yet. The gene variants were also reported to be associated with CVDs. In addition, the C677T polymorphisms may play a role in the development of hypertension. Recent research evidence has suggested that MTHFR variants might be independently linked to CVDs and hypertension, because of the involvement of the MTHFR enzyme product (5-methyl-tetrahydrofolate /5-MTHF) in the regulation of endothelial functions. Further research is required to investigate the association between gene polymorphisms of folate-metabolizing enzymes and CVDs, and to identify the possible role of the relevant gene variants in the molecular pathogenesis of hyperhomocysteinemia. Orv. Hetil., 2012, 153, 445–453.

scholarly journals Post traumatic cutaneous mucormycosis: a diagnostic dilemma

2021 ◽  
Vol 8 (5) ◽  
pp. 1610
Author(s):  
Kharishma P. Nair ◽  
Siddartha Gowthaman S. ◽  
Meghana S. Bagalgotkar ◽  
Vinoth S. ◽  
Ramanathan Manickam
Keyword(s):  
Developing Countries ◽  
Stem Cell ◽  
Case Report ◽  
Treatment Protocol ◽  
Invasive Fungal Disease ◽  
Developed Countries ◽  
Diagnostic Dilemma ◽  
Post Traumatic ◽  
Cutaneous Mucormycosis ◽  
The Developed Countries

The incidence of mucormycosis, an invasive fungal disease, is more in the developing countries, especially among the immunocompromised individuals. However, this disease can also occur in those without any predisposing factors. In the developed countries, those undergoing haematopoetic stem cell transplantation were more prone to developing this disease. There can be varied presentations of mucormycosis. It could be rhinocerebral, pulmonary, cutaneous, gastrointestinal or even disseminated forms. Post traumatic mucormycosis is infrequently reported and is often difficult to diagnose earlier due to its unusual presentation. In this case report, we describe two patients who acquired cutaneous mucormycosis following traumatic wounds and how they characteristically presented with 3 zones which was identified by us and has not been reported of earlier. This can help in diagnosis of this condition earlier and to follow the treatment protocol accordingly and prevent the morbidity and mortality associated with this disease.

Nafamostat as Anticoagulant for Membrane Plasmapheresis in high Bleeding risk Patients

1992 ◽  
Vol 15 (10) ◽  
pp. 595-600 ◽  
Author(s):  
E. Kinugasa ◽  
T. Akizawa ◽  
Y. Nakashima ◽  
M. Wakasa ◽  
S. Koshikawa
Keyword(s):  
Bleeding Risk ◽  
Severe Bleeding ◽  
Nafamostat Mesilate ◽  
Bleeding Diathesis ◽  
Systemic Blood ◽  
Coagulation Time ◽  
Risk Patients ◽  
High Bleeding Risk ◽  
Activated Coagulation Time ◽  
Enzymatic Inhibitor

Nafamostat mesilate (NM), an ultrashort-acting multi-enzymatic inhibitor, is a useful anticoagulant in high bleeding risk patients needing hemodialysis. We applied NM as a membrane plasmapheresis (MP) anticoagulant in patients with high bleeding risk. Eleven patients, the majority with hepatic failure and active hemorrhagic foci or severe bleeding diathesis, could be treated with MP 22 times under anticoagulation by 20-40 mg/h/NM by continuous infusion without any trouble. Celite-activated coagulation time (CCT) at the plasma separator inlet and outlet was adequately prolonged during MP, but CCT in systemic blood showed no prolongation throughout the procedure, because NM was rapidly inactivated. There was no observable blood coagulation in the extracorporeal circuit including the plasma separator. No adverse reaction or exacerbation of hemorrhage was noted throughout the MP. NM thus appears to be a useful and safe anticoagulant not only for hemodialysis but also for MP in high bleeding risk patients.

scholarly journals One Disease, Two Approaches. Acute Post-Streptococcal Glomerulonephritis – A Case Report of Two Young Patients

2021 ◽  
Vol 8 (8) ◽  
pp. 492-497
Author(s):  
Tudor Lungu ◽  
Kinga Krisztina Nagy
Keyword(s):  
Case Report ◽  
Young Patients ◽  
Treatment Method ◽  
Developed Countries ◽  
Skin Infections ◽  
Immune Mediated ◽  
Maximum Benefit ◽  
Post Streptococcal Glomerulonephritis ◽  
The Developed Countries ◽  
The Right

Objective: Acute post-streptococcal glomerulonephritis (APSGN) is the most studied immune-mediated glomerulonephritis, being caused by streptococcal infections such as pharyngotonsillitis or skin infections (impetigo, erysipelas). Globally it is the main form of glomerular suffering among pediatric patients, especially between the ages of 3 and 15, but in the developed countries, the incidence of this condition has decreased significantly in the last decades. The majority of the medical literature indicates that the treatment in such a disease is symptomatic (the major goal being controlling of the edema and hypertension) associated with antibiotics for streptococcal infection. Due to some situations where antibiotic treatment cannot be administered, this case report hypothesized that homeopathy is a possible alternative treatment method for conventional therapy. We presented two cases diagnosed with APSGN: a nine-year-old boy treated homeopathically at home and a three-year-old girl treated conventionally during hospitalization. Analyzing the two cases, we observed that the patients were cured regardless of the therapeutic method approached. This aspect has an advantage in situations where there are limitations in the administration of allopathic treatment. According to homeopathic understanding, the success rate is higher when there are clear homeopathic symptoms for choosing the right remedy. Many more cases and much more research is needed to conclude that classical homeopathy can be a treatment option for this pathology. In conclusion, it is important to find a personalized therapy (allopathy or homeopathy) for each patient that will bring the maximum benefit, depending on the particularity of the case

Prevalence and geographic distribution of haemophilia in Costa Rica

2010 ◽  
Vol 30 (S 01) ◽  
pp. S28-S31 ◽  
Author(s):  
J. Arroyo ◽  
L. Salazar-Sánchez ◽  
G. Jiménez-Cruz ◽  
P. Chaverri ◽  
E. Arrieta-Bolaños ◽  
...  
Keyword(s):  
Costa Rica ◽  
Survival Rates ◽  
Coagulation Factors ◽  
Developed Countries ◽  
Health Centers ◽  
Distribution Analysis ◽  
Distribution Maps ◽  
Immunodeficiency Virus ◽  
The Many ◽  
Low Prevalence

SummaryHaemophilia is the most frequent hereditary haemorrhagic illness and it is due to the deficiency of coagulation factors VIII (haemophilia A, HA) or IX (haemophilia B, HB).The prevalence of this disease varies according to the country, those having better survival rates having also higher prevalences. Specifically in Costa Rica, there are around 130 HA and 30 HB families. This study reports the prevalence and a spatial distribution analysis of both types of the disease in this country. The prevalence of haemophilia in this country is 7 cases per 100 000 men, for HA it is 6 cases per 100 000 and for HB it is 1 case per 100 000 male inhabitants. The prevalence of this disease is low when compared with other populations. This low prevalence could be due to the many patients that have died because of infection with human immunodeficiency virus during the 1980s. The prevalence of haemophilia in Costa Rica is almost one half of that present in developed countries. Nevertheless, the ratio between HA and HB follows world tendency: 5 : 1. In this study, nationwide geographical distribution maps were drawn in order to visualize the origin of severe cases and how this influences the pattern of distribution for both types of haemophilia. By means of these maps, it was possible to state that there is no association between the sites of maximum prevalence of mutated alleles and ethnicity. With this study, haemophilia prevalence distribution maps can be used to improve efforts for the establishment of hemophilia clinics or specialized health centers in those areas which hold the highest prevalences in this country. Also, this knowledge can be applied to improve treatment skills and offer the possibility of developing focused genetic counseling for these populations.

How to Assure Stable Development in Unstable Financial Environment?

2007 ◽  
pp. 4-26 ◽  
Author(s):  
M. Ershov
Keyword(s):  
Stock Market ◽  
Developed Countries ◽  
Market Liquidity ◽  
Market Mechanisms ◽  
Russian Economy ◽  
The Developed Countries ◽  
Russian Stock Market ◽  
Stable Development ◽  
Financial Environment

Growing involvement of Russian economy in international economic sphere increases the role of external risks. Financial problems which the developed countries are encountered with today result in volatility of Russian stock market, liquidity problems for banks, unstable prices. These factors in total may put longer-term prospects of economic growth in jeopardy. Monetary, foreign exchange and stock market mechanisms become the centerpiece of economic policy approaches which should provide for stable development in the shaky environment.

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