Hematogenous thrombophilia as an additional risk factor for cerebral circulation disorders

2021 ◽  
Author(s):  
И.В. Куртов ◽  
С.П. Кривова ◽  
Р.К. Хайретдинов ◽  
И.Л. Давыдкин
Keyword(s):  
Risk Factor ◽  
Factor Viii ◽  
Blood Coagulation ◽  
Genetic Polymorphisms ◽  
Additional Risk Factor ◽  
Factor Viii Level ◽  
Aged Patients ◽  
Additional Risk ◽  
Viii Level ◽  
The Impact

Введение. Гематогенная тромбофилия служит дополнительным фактором риска нарушений мозгового кровообращения (НМК). Цель исследования: изучить влияние повышенного уровня фактора VIII и нарушений в системе фибринолиза на НМК у пациентов с сочетанной патологией системы свертывания крови. Материалы и методы. Обследовано 20 пациентов с перенесенными ишемическими инсультами в возрасте от 36 до 56 лет. Определяли показатели плазменного, тромбоцитарного звеньев гемостаза, системы фибринолиза, а также генетические полиморфизмы системы гемостаза. Результаты. У всех пациентов выявлены различные сочетания генетических полиморфизмов, связанных с изменениями антикоагулянтного звена гемостаза, а также дефекты системы фибринолиза и коагуляционного звена гемостаза, что является дополнительным фактором риска НМК. Заключение. У пациентов молодого и среднего возраста, перенесших острое НМК по ишемическому типу, необходимо исследование системы свертывания крови, включающее определение содержания фактора VIII в крови, показателей системы фибринолиза и уровня гомоцистеина. Background. Hematogenous thrombophilia is an additional risk factor for cerebral circulatory disorders (ССD). Objectives: to study the impact of increased factor VIII level and disturbances of fibrinolysis system on ССD in patients with combined pathology of blood coagulation. Patients/Methods. We examined 20 patients with ischemic strokes aged from 36 to 56 years. The parameters of plasma hemostasis, platelet function, fibrinolysis system, as well as the genetic polymorphisms of hemostasis system were determined. Results. All patients had different combinations of genetic polymorphisms associated with anticoagulant hemostasis changes, as well as defects in fibrinolysis system and coagulation hemostasis that is an additional risk factor for ischemic stroke. Conclusions. In young and middle-aged patients with history of acute ischemic ССD, it is necessary to study blood coagulation, including the determination of blood factor VIII level, fibrinolysis system parameters and homocysteine content.

scholarly journals Early and Late Complications After Abdominal Surgery in Patients With COVID-19 in Armenia

2021 ◽  
Author(s):  
Karine Aloyan ◽  
Hayk Harutyunyan ◽  
Arayik Voskanyan
Keyword(s):  
Risk Factor ◽  
Postoperative Complications ◽  
Abdominal Surgery ◽  
Medical Center ◽  
Late Complications ◽  
Additional Risk Factor ◽  
Surgical Mortality ◽  
Rt Pcr ◽  
Additional Risk ◽  
The Impact

Abstract Background Coronavirus disease 2019 (COVID-19) is one of the challenging topics in surgery nowadays. Available data indicate high surgical mortality and many postoperative complications in surgical patients with various stages of coronavirus infection. But still a little is known on early and late outcomes of abdominal surgery in patients with COVID-19, especially in countries with limited resources. In this article we describe early and late complications after abdominal surgery in patients recovering from COVID-19. We define early and late complications as those developing during 1-30 and 31-60 postoperative days, accordingly. Methods A prospective cohort study is conducted at Astghik Medical Center, Yerevan, Armenia, from February 1 until October 31, 2020. The study population comprised 259 patients with COVID-19 and 245 patients without COVID-19 matched by operation type, age, sex, and comorbidities, underwent abdominal surgery. Differences between early (1-30 postoperative days) and late (31-60 postoperative days) complications in both groups were analyzed. Patients with COVID-19 had been diagnosed based on both clinical and laboratory (RT-PCR, reverse transcriptase-polymerase chain reaction assay in nasopharyngeal swabs) criteria at least 14 days before abdominal surgery. Patients without COVID-19 were not screened at time of surgery, but were free from any respiratory symptoms and had negative RT-PCR results during preoperative 14 days. The primary endpoints were early and late postoperative complications. Secondary endpoints were to determine 60-day surgical mortality and the impact of comorbidities as additional risk factor of postoperative complications in patients with COVID-19. Results A total of 29 patients with COVID-19 developed early or late postoperative complications. Only 4 patients without COVID-19 with early postoperative complications were identified. The median age of patients with COVID-19 who had early and late postoperative complications were 54.5 (range: 45-64) and 69.5 (range: 65-74), correspondingly. At least one comorbidity was present in 25 (86.2%) of 29 patients with COVID-19 who developed early or late postoperative complications. A 60-day surgical mortality was 14.3%. Conclusion COVID-19 is associated with high risk for postoperative complications of abdominal surgery even if surgical procedures are performed after 14 days of COVID-19 onset. Only patients aged 45 to 74 years developed complications in our study. Presence of at least one comorbidity was an additional risk factor of postoperative complications. Larger and better designed studies are needed to find out indicators for early detection of postoperative complications in patients with COVID-19, especially in people older than 45 years and in those with comorbidities.

scholarly journals Extrasystolic arrhythmia – an unaccounted risk factor of atherosclerosis development in main arteries?

2021 ◽  
Vol 6 (2) ◽  
pp. 48-53
Author(s):  
Olga A. Germanova ◽  
Giuseppe Galati ◽  
Vladimir A. Germanov ◽  
Yurii V. Shchukin ◽  
Andrei V. Germanov
Keyword(s):  
Risk Factor ◽  
Type A ◽  
Left Ventricular ◽  
Tibialis Posterior ◽  
Control Group ◽  
Additional Risk Factor ◽  
Hydraulic Shock ◽  
Additional Risk ◽  
Atherosclerotic Process ◽  
The Impact

Objectives to determine the hemodynamic changes within arterial vessels in different variants of extrasystole, to analyze whether extrasystole is an additional risk factor for the development of atherosclerosis. Material and methods. The study included 286 patients (175 men and 111 women) with extrasystole of more than 3000 per day and 88 patients with extrasystole of less than 3000 per day as a control group. When selecting eligible patients for the study, we tried to minimize the impact of traditional risk factors of atherosclerosis. The presence of cardiocerebral complications in medical history was also considered. The examination methods used in the study are electrocardiography, phonocardiography, 24-hour electrocardiography monitoring, Doppler ultrasound of the brachiocephalic vessels, lower extremities arteries, renal arteries, transthoracic or transesophageal echocardiography. Stress echocardiography was performed if indicated; as well as renal artery angiography, coronary angiography, computed tomography of the brain with angioprogram. When performing a biochemical blood test, the lipid spectrum and hemostasiogram were necessarily determined. All patients underwent left ventricular apexcardiography, as well as sphygmography, recorded on arteries of elastic type (a. Carotis communis) and muscular-elastic type (a. Tibialis posterior). The clinical examinations were confirmed and modeled using the original "Device for modeling of intra-arterial circulation", developed by us (RF patent No. 202780 dated 05.03.2021). Results. We determined an increase in the main parameters of the heart biomechanics and the kinetics of the main arteries in the 1st post-extrasystolic wave in patients with various types of extrasystole with the following pattern: the earlier extrasystole had appeared in the cardiocycle, the greater was the increase in the parameters under observation. A universal concept of hydraulic shock and possible cases of its formation were described. Conclusion. Extrasystole is an additional risk factor for the onset and progression of atherosclerosis. Hydraulic shock during the passage of the 1st post-extrasystolic wave is a powerful traumatic factor for the walls of the arteries, which can lead to the formation of an atherosclerotic process.

scholarly journals Elevated factor VIII levels and arterial stroke: a review of literature with a case report

2021 ◽  
Vol 57 (1) ◽  
Author(s):  
Dinesh Khandelwal ◽  
Vaibhav Mathur ◽  
Arvind Vyas ◽  
Chandani Shah ◽  
Chandrajeet Singh Ranawat ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Factor Viii ◽  
Young Patients ◽  
Treatment Protocol ◽  
Factor Viii Level ◽  
Identifiable Risk Factor ◽  
Viii Level ◽  
Independent Effects

Abstract Background Cerebral arterial thromboses or ischemic strokes may be caused by cumulative or independent effects of a variety of risk factors. High factor VIII level is one of those important but less known risk factors for arterial and venous thrombosis. We hereby provide a comprehensive review of the role of high factor VIII levels as a risk factor of arterial thrombosis. Moreover, we present our views on inclusion of factor VIII testing in the etiology workup protocol of young patients with ischemic strokes and their treatment with anticoagulant therapy. Case presentation We illustrate a case of 32-year-old North Indian female patient with Ischemic stroke whose only identifiable risk factor was revealed to be an elevated factor VIII level. She was treated with oral anticoagulant with an uneventful follow-up of 6 months. Conclusions Elevated factor VIII levels have their independent and additive effects in causation and prognosis of arterial strokes. We herein discuss the mechanism of this association, the feasibility and yield of routine testing, appropriate cut-off levels, and further treatment protocol especially in young stroke patients.

Laboratory Detection of Female Carriers of Canine Hemophilia

1964 ◽  
Vol 12 (02) ◽  
pp. 368-376 ◽  
Author(s):  
B. J Parks ◽  
K. M Brinkhous ◽  
P. F Harris ◽  
G. D Penick
Keyword(s):  
Factor Viii ◽  
Partial Thromboplastin Time ◽  
Screening Test ◽  
Factor Viii Level ◽  
Viii Level ◽  
Antihemophilic Factor ◽  
Female Carriers

SummaryFemales known to be heterozygous for canine hemophilia had a plasma antihemophilic factor (AHF, factor VIII) level of about 50%, as determined by bioassay and by the effectiveness of their transfused plasma in raising the AHF levels of hemophilic dogs. Determination of the plasma AHF should serve to identify transmitter females prior to appearance of affected progeny in litters. Lyon’s hypothesis appears to apply to our findings.The simple partial thromboplastin time (PTT) test was prolonged in heterozygous females. Modifications of the test, by the addition of thrombin, a serum accelerator preparation, or kaolin, gave consistently longer PTT values for heterozygotes than for normal dogs. The PTT appears useful as a screening test for carriers of canine hemophilia.

HLA-DP variation as additional risk factor in IDDM

Diabetes ◽  
1990 ◽  
Vol 39 (7) ◽  
pp. 855-857 ◽  
Author(s):  
S. Easteal ◽  
M. R. Kohonen-Corish ◽  
P. Zimmet ◽  
S. W. Serjeantson
Keyword(s):  
Risk Factor ◽  
Additional Risk Factor ◽  
Additional Risk

Prevalence and prognostic impact of left ventricular systolic dysfunction after acute myocardial infarction

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
T.J Jernberg ◽  
E.O Omerovic ◽  
E.H Hamilton ◽  
K.L Lindmark ◽  
L.D Desta ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Myocardial Infarction ◽  
Atrial Fibrillation ◽  
Risk Factor ◽  
Reperfusion Therapy ◽  
Left Ventricular ◽  
Funding Source ◽  
Additional Risk Factor ◽  
Additional Risk

Abstract Background Left ventricular dysfunction after an acute myocardial infarction (MI) is associated with poor outcome. The PARADISE-MI trial is examining whether an angiotensin receptor-neprilysin inhibitor reduces the risk of cardiovascular death or worsening heart failure (HF) in this population. The aim of this study was to examine the prevalence and prognosis of different subsets of post-MI patients in a real-world setting. Additionally, the prognostic importance of some common risk factors used as risk enrichment criteria in the PARADISE-MI trial were specifically examined. Methods In a nationwide myocardial infarction registry (SWEDEHEART), including 87 177 patients with type 1 MI between 2011–2018, 3 subsets of patients were identified in the overall MI cohort (where patients with previous HF were excluded); population 1 (n=27 568 (32%)) with signs of acute HF or an ejection fraction (EF) <50%, population 2 (n=13 038 (15%)) with signs of acute HF or an EF <40%, and population 3 (PARADISE-MI like) (n=11 175 (13%)) with signs of acute HF or an EF <40% and at least one risk factor (Age ≥70, eGFR <60, diabetes mellitus, prior MI, atrial fibrillation, EF <30%, Killip III-IV and STEMI without reperfusion therapy). Results When all MIs, population 1 (HF or EF <50%), 2 (HF or EF <40%) and 3 (HF or EF <40% + additional risk factor (PARADISE-MI like)) were compared, the median (IQR) age increased from 70 (61–79) to 77 (70–84). Also, the proportion of diabetes (22% to 33%), STEMI (38% to 50%), atrial fibrillation (10% to 24%) and Killip-class >2 (1% to 7%) increased. After 3 years of follow-up, the cumulative probability of death or readmission because of heart failure in the overall MI population and in population 1 to 3 was 17.4%, 26.9%, 37.6% and 41.8%, respectively. In population 2, all risk factors were independently associated with death or readmission because of HF (Age ≥70 (HR (95% CI): 1.80 (1.66–1.95)), eGFR <60 (1.62 (1.52–1.74)), diabetes mellitus (1.35 (1.26–1.44)), prior MI (1.16 (1.07–1.25)), atrial fibrillation (1.35 (1.26–1.45)), EF <30% (1.69 (1.58–1.81)), Killip III-IV (1.34 (1.19–1.51)) and STEMI without reperfusion therapy (1.34 (1.21–1.48))) in a multivariable Cox regression analysis. The risk increased with increasing number of risk factors (Figure 1). Conclusion Depending on definition, post MI HF is present in 13–32% of all MI patients and is associated with a high risk of subsequent death or readmission because of HF. The risk increases significantly with every additional risk factor. There is a need to optimize management and improve outcomes for this high risk population. Figure 1 Funding Acknowledgement Type of funding source: Private company. Main funding source(s): Novartis

Factor-VIII Inhibitor in Less Severely Affected Haemophilic Patients

1975 ◽  
Author(s):  
E. G. D. Tuddenham ◽  
A. L. Bloom ◽  
J. C. Giddings ◽  
C. A. Barrett
Keyword(s):  
Factor Viii ◽  
Factor Viii Inhibitor ◽  
Factor Viii Level ◽  
Replacement Treatment ◽  
Viii Level ◽  
Viii Inhibitor ◽  
In Vivo Recovery ◽  
Better Than

The occurrence of factor VIII inhibitor in five mild or moderately affected liaemophilic patients is described. In four patients the inhibitor inactivated endogenous factor VIII an dtemporarily converted them to severely affected haemophiliacs with factor VIII level of 0%. In the fifth patient, a brother of one of the others, the inhibitor although more potent did not inactivate the patient’s own factor VIII and did not completely inactivate normal factor VIII in vitro. This patient responded to treatment with factor-VIII concentrate but the in-vivo recovery was reduced. The patient’s plasma was tested against a panel of normal donors but it inactivated factor VIII in each to a similar extent and no evidence for normal factor-VIII groups was obtained. In the other patients the response to replacement treatment was also better than that usually seen in severely affected haemophilic patients with inhibitor. In the two related patients the inhibitors have so far persisted but in the unrelated patients the inhibitors eventually disappeared and did not always recur with subsequent therapy. The incidence of factor- VIII inhibitor in less severe haemophiliacs (factor VIII > 3% ) in this centre is 6% suggesting that the complication is more frequent in this type of patient than hitherto recognised.

scholarly journals Further Experience on the Effect of High Pre-Donation Factor VIII Levels in Blood Donors on the Factor VIII Content of Small-Pool Fractions

1977 ◽  
Author(s):  
H. Beeser ◽  
H. Eqli
Keyword(s):  
Factor Viii ◽  
High Plasma ◽  
Activity Levels ◽  
Factor Viii Activity ◽  
Factor Viii Level ◽  
Plasma Factor ◽  
Viii Level ◽  
Factor Viii Concentrates ◽  
Small Pool ◽  
Concentrate Preparation

Because of the well known wide normal range of the factor VIII activity between 60 to 170% I man, selecting of donors with high activity levels would be of advantaae for the preparation of factor VIII concentrates. This is especially true for preparing small-pool fractions, as for technical reasons the final product cannot be controlled for its factor VIII content. In preliminary investigations, we reported on elsewhere, high factor VIII activity in donors estimated before a donation had been rarely reproducible before a second donation after 8-12 weeks. So as a preliminary result of finding a donor’s factor VIII level varying from donation to donation selecting of plasmas with high factor VIII content for concentrate preparation could only be establishedby re-estimating the activity before each donation. Proceeding in this way would be much too troublesome. To get more reliable information whether a healthy subject’s high factor VIII plasma level is distinctly varying or rather constant we assayed the plasma of 200 donors with factor VIII activity > 120% two times more before donation. The results confirmed our preliminary findings, especially the fact that a high plasma factor VIII activity in experienced donors was rarely reproducible when re-estimated before a second and third donation. As a consequence selecting of donors with high factor VIII procoaqulant activity for preparing small-pool factor VIII concentrates is impracticable.

scholarly journals Socio-economic impact in the late diagnosis of retinopathy of prematurity

2016 ◽  
Vol 11 (1) ◽  
pp. 45-48
Author(s):  
Daniela POPESCU ◽  
◽  
Dumitru MATEI ◽  
◽  
◽  
...  
Keyword(s):  
Risk Factor ◽  
Human Resources ◽  
Retinopathy Of Prematurity ◽  
Social Impact ◽  
Treatment Programs ◽  
Additional Risk Factor ◽  
Fundus Examination ◽  
Additional Risk ◽  
Simple Process ◽  
Socio Economic Impact

Retinopathy of prematurity (ROP) represents a determinate cause of blindness in children that could be avoided. Blindness due to ROP and the stage of it when its being diagnosed is mostly determined by: socioeconomic degree of country development; availability of the screening in neonatal care; gestational age and hospital screenings; treatment programs available at any given time in the country; screening and treatment costs (material and human resources). ROP is the number one cause of blindness in Romania at the time being. Early discovery decreases exponentially the chances of blindness onset. Low birth weight (LBW), fewer than 1,500 g, represents an additional risk factor together with the degree of prematurity. Mandatory screening both during hospitalization as well as in the first 4-6 weeks after birth may avoid a major social problem. It is a simple process – eye exam with fundus examination – and it depends entirely on the availability, consistency and seriouseness of the parents. Thus a major social impact with disastrous consequences could be avoided.

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