scholarly journals Unexplained arterial thrombosis: approach to diagnosis and treatment

Hematology ◽  
2021 ◽  
Vol 2021 (1) ◽  
pp. 76-84
Author(s):  
Jori E. May ◽  
Stephan Moll
Keyword(s):  
Bleeding Risk ◽  
Management Plan ◽  
Left Ventricular ◽  
The Past ◽  
Common Causes ◽  
Dual Pathway ◽  
Diagnostic Framework ◽  
Pathway Inhibition ◽  
Structured Approach

Abstract Arterial thrombotic events in younger patients without a readily apparent etiology present significant diagnostic and management challenges. We present a structured approach to diagnosis with consideration of common causes, including atherosclerosis and embolism, as well as uncommon causes, including medications and substances, vascular and anatomic abnormalities, systemic disorders, and thrombophilias. We highlight areas of management that have evolved within the past 5 years, including the use of dual-pathway inhibition in atherosclerotic disease, antithrombotic therapy selection in embolic stroke of undetermined source and left ventricular thrombus, the role of closure of patent foramen ovale for secondary stroke prevention, and the thrombotic potential of coronavirus disease 2019 infection and vaccination. We conclude with a representative case to illustrate the application of the diagnostic framework and discuss the importance of consideration of bleeding risk and patient preference in determining the appropriate management plan.

scholarly journals Antithrombotic Therapy in Myocardial Infarction: Historic Perils and Current Challenges—A 70-Year Journey

2020 ◽  
Vol 120 (10) ◽  
pp. 1352-1356
Author(s):  
Dion Stub ◽  
Himawan Fernando ◽  
James D. McFadyen ◽  
Jathushan Palasubramaniam ◽  
James Shaw ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Antiplatelet Therapy ◽  
Antithrombotic Therapy ◽  
Anticoagulation Therapy ◽  
Bleeding Risk ◽  
Coronary Intervention ◽  
Dual Pathway ◽  
Pathway Inhibition ◽  
Direct Acting

AbstractThere have been numerous and intriguing advancements in antithrombotic therapy for myocardial infarction since it was described in the earliest issues of Thrombosis and Haemostasis. In this article, we revisit historical breakthroughs and describe the four most challenging contemporary themes relating to antithrombotic therapy in myocardial infarction. In all four, the challenge is to find the best balance of reducing specific levels of ischaemic risks without increasing bleeding risk. The first is the question of the optimal duration of dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI). This includes discussion of monotherapy after a period of DAPT. The second relates to the role of genotype and phenotype-guided individualisation of antiplatelet therapy. There is emerging evidence for a role of pheno/genotyping in identifying individuals at high risk for recurrent ischaemic events or in guiding the timing of cardiac surgery for patients on DAPT. The third addresses the increasing evidence for dual pathway inhibition, for example, with rivaroxaban in addition to aspirin in patients where high ischaemic and low bleeding risk is demonstrated. Finally the fourth highlights the challenge of the most appropriate combination of antiplatelet and anticoagulation therapy for patients with known atrial fibrillation after PCI. In most individuals, oral P2Y12 inhibitor therapy combined with a direct acting oral anticoagulant appears to be the best strategy based on the available evidence. Overall, the progress in antithrombotic therapy achieved over the last seven decades is remarkable, however, there are important issues to address and progress still to be made.

scholarly journals Role of otoendoscope as a preoperative tool in tympanoplasty

2020 ◽  
Vol 6 (4) ◽  
pp. 695
Author(s):  
Showkat Ahmad Showkat ◽  
Nadhia Bhagat ◽  
Mohammed Shafi Bhat ◽  
Bilal Shafiq
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Chronic Suppurative Otitis Media ◽  
Technical Improvement ◽  
Suppurative Otitis Media ◽  
The Past ◽  
Sinus Tympani ◽  
Common Causes ◽  
The Common

<p class="abstract"><strong>Background:</strong> Chronic suppurative otitis media (CSOM) is one of the common causes for hearing impairment and disability. Despite continuous technical improvement, the basic optical principles and their limitations have remained the same over the past three decades. This study aimed at visualizing and evaluating the middle ear structures with the aid of 0 and 30-degree otoendoscopes preoperatively in cases of chronic suppurative otitis media.</p><p class="abstract"><strong>Methods:</strong> In this prospective study, 70 patients (40 females and 30 males) above the age of 10 years with CSOM were subjected to otoendoscopy using 0- and 30-degree endoscopes. The various middle ear structures and hidden spaces like facial recess, sinus tympani, hypotympanum were visualized preoperatively.  </p><p class="abstract"><strong>Results:</strong> Middle ear structures and blind niches were better evaluated preoperatively using 0 and 30-degree otoendoscopes and a definitive operative plan was formulated.</p><p class="abstract"><strong>Conclusions:</strong> Otoendoscopy provided a significant better visualization of all the middle ear structures and various hidden spaces.</p>

scholarly journals Dissolution of large intracardiac thrombus, potential role of the emerging oral fibrinolytic agent

2016 ◽  
Vol 25 (1) ◽  
pp. 62-6
Author(s):  
Rony M. Candrasatria ◽  
Manoefris Kasim
Keyword(s):  
Thrombolytic Agent ◽  
Case Series ◽  
Bleeding Risk ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Intracardiac Thrombus ◽  
Ventricular Ejection Fraction ◽  
Artery Disease

Intracardiac thrombus may persist in some cases even after anticoagulant therapy. This opens a possibility to add a potent thrombolytic agent into therapeutic regimen without increasing bleeding risk any further. Increasing evidence showed a promising efficacy and safety of oral fibrin specific lumbrokinase as a thrombolytic agent. To the best of our knowledge, report of the use of lumbrokinase on intracardiac thrombus is limited. We reported two cases of intracardiac thrombi. In first patient, after two-month therapy with lumbrokinase, the previous 8 cm2 left atrial thrombus was completely disappeared. Second patient had left ventricular thrombus due to low left ventricular ejection fraction caused by coronary artery disease. A significant dissolution in thrombus size on repeated follow-up was found. Both patients did not experience any significant adverse effect. This case series aims to present the potential use of lumbrokinase as as oral antithrombotic therapy in intracardiac thrombus.

Residual risk reduction opportunities in patients with chronic coronary syndrome. Role of dual pathway inhibition

2020 ◽  
Vol 13 (7) ◽  
pp. 695-706
Author(s):  
José R. González-Juanatey ◽  
Manuel Almendro-Delia ◽  
Juan Cosín-Sales ◽  
Sergi Bellmunt-Montoya ◽  
Juan José Gómez-Doblas ◽  
...  
Keyword(s):  
Risk Reduction ◽  
Residual Risk ◽  
Coronary Syndrome ◽  
Dual Pathway ◽  
Pathway Inhibition

On Future Directions in Pathology

1982 ◽  
Vol 40 ◽  
pp. 274-277
Author(s):  
Benjamin F. Trump ◽  
Irene K. Berezesky ◽  
Raymond T. Jones
Keyword(s):  
Electron Microscopy ◽  
Transmission Electron Microscopy ◽  
Clinical Pathology ◽  
Future Directions ◽  
Diagnostic Pathology ◽  
The Past ◽  
Transmission Electron ◽  
Organ Systems ◽  
The Many

The role of electron microscopy and associated techniques is assured in diagnostic pathology. At the present time, most of the progress has been made on tissues examined by transmission electron microscopy (TEM) and correlated with light microscopy (LM) and by cytochemistry using both plastic and paraffin-embedded materials. As mentioned elsewhere in this symposium, this has revolutionized many fields of pathology including diagnostic, anatomic and clinical pathology. It began with the kidney; however, it has now been extended to most other organ systems and to tumor diagnosis in general. The results of the past few years tend to indicate the future directions and needs of this expanding field. Now, in addition to routine EM, pathologists have access to the many newly developed methods and instruments mentioned below which should aid considerably not only in diagnostic pathology but in investigative pathology as well.

A literature review on firms' internationalisation through e-commerce

2019 ◽  
pp. 121-143
Author(s):  
Riccardo Resciniti ◽  
Federica De Vanna
Keyword(s):  
Systematic Review ◽  
Literature Review ◽  
International Business ◽  
Decision Process ◽  
Foreign Markets ◽  
New Markets ◽  
Integrative Framework ◽  
The Past ◽  
The Relationship

The rise of e-commerce has brought considerable changes to the relationship between firms and consumers, especially within international business. Hence, understanding the use of such means for entering foreign markets has become critical for companies. However, the research on this issue is new and so it is important to evaluate what has been studied in the past. In this study, we conduct a systematic review of e-commerce and internationalisation studies to explicate how firms use e-commerce to enter new markets and to export. The studies are classified by theories and methods used in the literature. Moreover, we draw upon the internationalisation decision process (antecedents-modalities-consequences) to propose an integrative framework for understanding the role of e-commerce in internationalisation

Concealment of Illegally Obtained Assets in Nigeria: Revisiting the Role of the Churches in Money Laundering

2020 ◽  
Vol 28 (1) ◽  
pp. 106-121
Author(s):  
Kato Gogo Kingston
Keyword(s):  
Economic Growth ◽  
Money Laundering ◽  
Financial Crime ◽  
The Past ◽  
Key Drivers ◽  
Nigerian Government

Financial crime in Nigeria – including money laundering – is ravaging Nigeria's economic growth. In the past few years, the Nigerian government has made efforts to tackle money laundering by enacting laws and setting up several agencies to enforce the laws. However, there are substantial loopholes in the regulatory and enforcement regimes. This article seeks to unravel the involvement of the churches as key drivers in money laundering crimes in Nigeria. It concludes that the permissive secrecy which enables churches to conceal the names of their financiers and donors breeds criminality on an unimaginable scale.

Provision of Remedies for Violation of Economic, Social and Cultural Rights: A Comparative Study of the United Nations, Inter-American and African Human Rights Systems

2020 ◽  
Vol 28 (2) ◽  
pp. 298-318
Author(s):  
Roman Girma Teshome
Keyword(s):  
Human Rights ◽  
United Nations ◽  
Comparative Study ◽  
Economic Rights ◽  
Regional Monitoring ◽  
Cultural Rights ◽  
The Past ◽  
The United Nations ◽  
To Receive

The effectiveness of human rights adjudicative procedures partly, if not most importantly, hinges upon the adequacy of the remedies they grant and the implementation of those remedies. This assertion also holds water with regard to the international and regional monitoring bodies established to receive individual complaints related to economic, social and cultural rights (hereinafter ‘ESC rights’ or ‘socio-economic rights’). Remedies can serve two major functions: they are meant, first, to rectify the pecuniary and non-pecuniary damage sustained by the particular victim, and second, to resolve systematic problems existing in the state machinery in order to ensure the non-repetition of the act. Hence, the role of remedies is not confined to correcting the past but also shaping the future by providing reforming measures a state has to undertake. The adequacy of remedies awarded by international and regional human rights bodies is also assessed based on these two benchmarks. The present article examines these issues in relation to individual complaint procedures that deal with the violation of ESC rights, with particular reference to the case laws of the three jurisdictions selected for this work, i.e. the United Nations, Inter-American and African Human Rights Systems.

Sign in / Sign up

Export Citation Format

Share Document