scholarly journals Thromboembolic Complications in Covid-19: From Clinical Scenario to Laboratory Evidence

Life ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 395
Author(s):  
Alberto Palazzuoli ◽  
Michela Giustozzi ◽  
Gaetano Ruocco ◽  
Francesco Tramonte ◽  
Edoardo Gronda ◽  
...  
Keyword(s):  
Cardiovascular Complications ◽  
Risk Category ◽  
Moderate Risk ◽  
Factors Associated ◽  
Appropriate Treatment ◽  
Increased Risk ◽  
Recent Statement ◽  
European Society Of Cardiology ◽  
Prophylactic Anticoagulation

SARS-Cov-2 infection, a pandemic disease since March 2020, is associated with a high percentage of cardiovascular complications mainly of a thromboembolic (TE) nature. Although clinical patterns have been described for the assessment of patients with increased risk, many TE complications occur in patients with apparently moderate risk. Notably, a recent statement from the European Society of Cardiology (ESC) atherosclerosis and vascular biology working group pointed out the key role of vascular endothelium for the recruitment of inflammatory and thrombotic pathways responsible for both disseminated intravascular coagulation and cardiovascular complications. Therefore, a better understanding of the pathophysiological process linking infection to increased TE risk is needed in order to understand the pathways of this dangerous liaison and possibly interrupt it with appropriate treatment. In this review, we describe the histological lesions and the related blood coagulation mechanisms involved in COVID-19, we define the laboratory parameters and clinical risk factors associated with TE events, and propose a prophylactic anticoagulation treatment in relation to the risk category. Finally, we highlight the concept that a solid risk assessment based on prospective multi-center data would be the challenge for a more precise risk stratification and more appropriate treatment.

scholarly journals The hardness of the vessel wall in patients with arterial hypertension

2015 ◽  
Vol 12 (2) ◽  
pp. 43-48
Author(s):  
O D Ostroumova ◽  
A I Kochetkov ◽  
I I Kopchenov ◽  
T F Guseva ◽  
O V Bondarec
Keyword(s):  
Arterial Hypertension ◽  
Vessel Wall ◽  
Antihypertensive Drugs ◽  
Blood Pressure Level ◽  
Vascular Wall ◽  
Cardiovascular Complications ◽  
Increased Risk ◽  
The Status ◽  
The Difference

The article deals with the role of the hardness of the vessel wall in the pathogenesis of arterial hypertension and its complications and cardiovascular mortality. We discussed the factors increasing the hardness of the vessel wall, such as age, blood pressure level, atherosclerosis, smoking and diabetes mellitus. We showed the indicators reflecting the status of the vascular wall and which could play a role of markers of increased risk of cardiovascular complications. We reviewed the data concerning the improvement of the parameters of the hardness of the vessel wall under the influence of antihypertensive therapy using the angiotensin II type 1 receptor blocker - candesartan. We discussed the possible mechanisms of the candesartan influence on the elastic properties of the vessels. We stressed that the effect on the hardness of the arteries on using antihypertensive drugs, even within the same class, was different, which, apparently, was associated with the difference in the pharmacokinetic properties.

scholarly journals The role of endothelial damage and dyslipidemia in the development of cardiovascular pathology in psoriatic arthritis

2021 ◽  
Vol 97 (2) ◽  
pp. 16-22
Author(s):  
Zarema R. Khismatullina ◽  
Ksenia M. Koreshkova
Keyword(s):  
Psoriatic Arthritis ◽  
Vascular Wall ◽  
Cardiovascular Complications ◽  
Endothelial Damage ◽  
Very Low Density Lipoproteins ◽  
Cardiovascular Pathology ◽  
Immune Mediated ◽  
Increased Risk ◽  
Complications And Mortality

An increased risk of cardiovascular events has now been identified in patients with psoriatic arthritis. The chronic immune-mediated inflammation underlying psoriatic arthritis (PA) leads to the development of dyslipidemia, atherosclerosis and its complications, in particular, a high risk of cardiovascular complications. For PA, dyslipidemias are most characteristic, manifested by an increased level of low and very low density lipoproteins, triglycerides and total cholesterol, which correlates with the activity of the disease. The literature review studied the pathogenesis of dyslipidemias and vascular wall lesions in psoriatic arthritis, analyzed the literature on cardiovascular complications and mortality among patients with PA, studied the issues of total cardiovascular risk, presented the results of numerous clinical studies that allow PA to be considered a disease associated with increased the risk of cardiovascular complications. Considering the role of proinflammatory cytokines in the pathogenesis of psoriatic arthritis, early detection of endothelial lesions represents the most promising direction in the prevention of cardiovascular diseases, which are the main cause of mortality in this group of patients.

scholarly journals Factors Associated with Adverse Cardiovascular Events in Cancer Patients Treated with Bevacizumab

2020 ◽  
Vol 9 (8) ◽  
pp. 2664
Author(s):  
Doan T. M. Ngo ◽  
Trent Williams ◽  
Sophie Horder ◽  
Leonard Kritharides ◽  
Janette Vardy ◽  
...  
Keyword(s):  
Hospital Admissions ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Cardiovascular Effects ◽  
Cardiovascular Complications ◽  
Local Health ◽  
Bleeding Events ◽  
Factors Associated ◽  
Increased Risk ◽  
Cardiovascular Assessment

Background: Bevacizumab, a vascular endothelial growth factor (VEGF) monoclonal antibody commonly used for the treatment of various cancers, is often associated with adverse cardiovascular effects such as hypertension, cardiac and cerebral ischemia, thrombosis, and bleeding events. Factors associated with increased risks of adverse cardiovascular effects with bevacizumab have not been intensively studied. In this study, we determined factors associated with hospital admissions due to cardiovascular complications in patients who received bevacizumab for cancer treatment. Methods and Results: We retrospectively collected data for all patients treated with bevacizumab between the 1st January 2016 and the 31st December 2017 at the Hunter New England Local Health District. Patients’ characteristics and their medical history were obtained from hospital electronic medical records. Outcome data were sourced from the Institutional Cardiac and Stroke Outcomes Unit database. A total of n = 230 patients (mean age 65, males n = 124 (53.9%)) were treated with bevacizumab during the study period. N = 28 patients were admitted to hospital for a major cardiovascular-related event. Higher total treatment dose (p < 0.05), concomitant hypertension (p = 0.005), diabetes (p = 0.04), atrial fibrillation (p = 0.03), and lack of use of statin therapy (p = 0.03) were key contributors to hospital admission. Conclusions: Results of our study highlight the fact that patients with concomitant baseline cardiovascular disease/risk factors are at an increased risk of cardiovascular hospitalization related to bevacizumab treatment. Careful baseline cardiovascular assessment may be an essential step to minimize cardiovascular complications.

The role of physical factors of the working environment in the formation of arterial hypertension

2020 ◽  
pp. 692-693
Author(s):  
A. V. Melentev ◽  
P. V. Serebryakov
Keyword(s):  
Arterial Hypertension ◽  
Working Conditions ◽  
Significant Contribution ◽  
Cardiovascular Complications ◽  
Working Environment ◽  
Physical Factors ◽  
Noise And Vibration ◽  
Increased Risk ◽  
Influence Of Noise

The influence of noise and vibration on the development of arterial hypertension in workers employed in adverse working conditions was studied. It is shown that these physical factors of the working environment make a significant contribution to the formation of an increased risk of cardiovascular complications

scholarly journals Role of Adipokines in Atherosclerosis: Interferences with Cardiovascular Complications in Rheumatic Diseases

2012 ◽  
Vol 2012 ◽  
pp. 1-14 ◽  
Author(s):  
Morena Scotece ◽  
Javier Conde ◽  
Rodolfo Gómez ◽  
Verónica López ◽  
Jesús Pino ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
Cardiovascular Diseases ◽  
Rheumatic Diseases ◽  
Lupus Erythematosus ◽  
Cardiovascular Complications ◽  
Risk Of Mortality ◽  
Increased Risk ◽  
Pathologic Alteration ◽  
Holistic Vision

Patients with rheumatic diseases have an increased risk of mortality by cardiovascular events. In fact, several rheumatic diseases such as rheumatoid arthritis, osteoarthritis, systemic lupus erythematosus, and ankylosing spondylitis are associated with a higher prevalence of cardiovascular diseases (CVDs). Although traditional cardiovascular risk factors have been involved in the pathogenesis of cardiovascular diseases in rheumatic patients, these alterations do not completely explain the enhanced cardiovascular risk in this population. Obesity and its pathologic alteration of fat mass and dysfunction, due to an altered pattern of secretion of proinflammatory adipokines, could be one of the links between cardiovascular and rheumatic diseases. Indeed, the incidence of CVDs is augmented in obese individuals with rheumatic disorders. Thus, in this paper we explore in detail the relationships among adipokines, rheumatic diseases, and cardiovascular complications by giving to the reader a holistic vision and several suggestions for future perspectives and potential clinical implications.

Central line-associated complications during treatment with DA-R-EPOCH therapy for NHL.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 7543-7543 ◽  
Author(s):  
Rachel Julie David ◽  
Andrea Baran ◽  
Jennifer Kelly ◽  
Patrick Michael Reagan ◽  
Carla Casulo ◽  
...  
Keyword(s):  
B Cell ◽  
Univariate Analysis ◽  
Significant Risk ◽  
B Cell Lymphoma ◽  
Central Line ◽  
Increased Risk ◽  
Grade 3 ◽  
Prophylactic Anticoagulation ◽  
Experienced Grade

7543 Background: Certain non-Hodgkin lymphomas (NHL) such as primary mediastinal B-cell, Burkitt’s, and high-grade B-cell lymphoma with MYC and BCL2 rearrangements are often treated with infusional dose-adjusted rituximab, etoposide, prednisone, vincristine, cyclophosphamide and doxorubicin (DA-R-EPOCH), which requires a central line. We have observed meaningful line-associated complications (LAC) in patients (pts) treated with DA-R-EPOCH. With the ongoing use of this regimen, we sought to identify the rates and correlates of LAC in this population. Methods: We retrospectively identified all pts treated with DA-R-EPOCH at the Wilmot Cancer Institute between 3/2011 and 10/2015. Our primary endpoint was the rate of LAC, including venous thromboembolism (VTE), extravasation, and line-associated infection (LAI) diagnosed during DA-R-EPOCH therapy. Our secondary endpoint was the rate of VTE during therapy. Rates and 95% confidence intervals (95% CI) were calculated for all endpoints. Univariate logistic regression was used to calculate odds ratios to evaluate potential predictors. Results: 43 pts received DA-R-EPOCH during the study period. 70% of pts were male; median age was 52 years. 17 pts (39.5%, 95% CI 0.25 - 0.56) experienced at least 1 LAC: 15 pts (35%, 95% CI 0.21 - 0.51) had VTE; 3 pts had LAI; and 2 pts experienced extravasations. Grade 3 toxicity was seen in 41% (7/17): 4 pts with VTE, and 3 pts with LAI. Both extravasation events were grade 2, and both occurred with mediports. In univariate analysis, BMI ≥ 35 kg/m² and receiving therapy via peripherally inserted central catheter (PICC) line were significantly associated with an increased risk of VTE (p=0.04 and p=0.02, respectively). Conclusions: 40% of pts receiving DA-R-EPOCH therapy for treatment of NHL developed LAC, almost half of whom experienced grade 3 toxicities. Clinicians need to balance these risks when selecting therapy, particularly with the lack of randomized data to support the DA-R-EPOCH approach in many circumstances. Given observed extravasations, we avoid mediports in favor of PICC lines, however this approach carries a significant risk of VTE. Future studies are needed to evaluate the role of prophylactic anticoagulation in this population.

scholarly journals Cancer Genetics Clinics and the Surgeon: A Valuable Role for Family History Screening

2007 ◽  
Vol 89 (2) ◽  
pp. 127-129 ◽  
Author(s):  
GL Williams ◽  
J Gray ◽  
J Beynon
Keyword(s):  
Colorectal Cancer ◽  
Family History ◽  
Cancer Genetics ◽  
Risk Category ◽  
Moderate Risk ◽  
Familial Predisposition ◽  
Increased Risk ◽  
Colorectal Surgeon ◽  
Surgical Clinic ◽  
Valuable Role

INTRODUCTION This study examines how a colorectal surgeon can use a regional cancer genetics service to deal safely and efficiently, with community referrals for colorectal cancer screening on the basis of family history. PATIENTS AND METHODS A retrospective review of consecutive asymptomatic people with a strong family of colorectal cancer referred by the surgeon to the genetics service over a 30-month period. RESULTS A total of 45 people were referred by the surgeon to the cancer genetics service. Following official verification of family histories, 15 were thought to be in a low-risk category for developing colorectal cancer, 18 were moderate risk, 4 had a high-to-moderate risk and 2 satisfied the criteria for HNPCC. After official authentication, it was discovered that 20% of people had mistakenly informed the surgeon of important inaccuracies in their family history. CONCLUSIONS The cancer genetics service seeks to identify accurately those at increased risk of developing colorectal cancer due to their family history. It has the time, resources and expertise to verify officially a family history that cannot be properly done in a busy surgical clinic. This study shows that it can provide a valuable role for correctly identifying and counselling people who truly require screening due to their familial predisposition for colorectal cancer.

Hypertensive Disorders of Pregnancy and Preterm Birth Rates among Black Women

2018 ◽  
Vol 36 (02) ◽  
pp. 148-154 ◽  
Author(s):  
Rebecca Baer ◽  
Laura Jelliffe-Pawlowski ◽  
Mary Norton ◽  
Ashish Premkumar
Keyword(s):  
Preterm Birth ◽  
Black Women ◽  
Gestational Hypertension ◽  
Chronic Hypertension ◽  
Inclusion Criteria ◽  
Maternal Factors ◽  
Factors Associated ◽  
Relative Risks ◽  
Increased Risk

Objective The objective of this study was to investigate the role of gestational hypertension (gHTN) and chronic hypertension (cHTN) on rates of preterm birth (PTB) among black women. Study Design Singleton live births between 20 and 44 weeks' gestation among black women in California from 2007 to 2012 were used for analysis. Risk of PTB by subtype and gestational age among women with cHTN or gHTN, including preeclampsia, was calculated via Poisson's logistic regression modeling. Risks were adjusted for maternal factors associated with increased risk of PTB. Results A total of 154,950 women met the inclusion criteria. Of the 5,948 women in the sample with cHTN, 26.2% delivered preterm; for the 11,728 women with gHTN, 21.6% delivered preterm. Women with gHTN or cHTN had a higher risk of medically indicated and spontaneous PTB, both at less than 32 and 32 to 36 weeks, when compared with nonhypertensive women (adjusted relative risks [aRRs]: 3.4–11.6). Women with superimposed preeclampsia had higher risks of spontaneous (aRR: 2.8, 95% confidence interval [CI]: 2.3–3.4) and medically indicated PTB (aRR: 2.8, 95% CI: 2.0–3.8), especially PTB < 32 weeks, when compared with women with preeclampsia. Conclusion Among black women, superimposed preeclampsia increased the risk for spontaneous and medically indicated PTB, especially PTB < 32 weeks.

scholarly journals Anoreksja niemowlęca – kryteria rozpoznania, etiologia, sposoby leczenia

2021 ◽  
pp. 213-229
Author(s):  
Małgorzata Cichecka-Wilk
Keyword(s):  
Family System ◽  
Behavior Disorder ◽  
Traumatic Experiences ◽  
Negative Consequences ◽  
Eating Pattern ◽  
Appropriate Treatment ◽  
Increased Risk ◽  
The Family ◽  
Treatment Measures

Infantile anorexia is one form of feeding behavior disorder. The group of these disorders usually affects infants and young children whose food consumption in some way deviates from the norm. Their main feature is the difficulty in establishing a regular eating pattern. Which means that the infant does not regulate its eating rhythm according to the physiological feeling of hunger or satiety. In the case of infant anorexia, a characteristic symptom is a persistent reluctance to eat. A sick infant does not signal hunger and is not interested in eating. This leads to a height/weight deficiency and other negative consequences for the child’s development and health. The diagnosis excludes traumatic experiences or a physical illness that could better explain the infant’s reactions. The causes of the occurrence of infantile anorexia are mainly seen in the mental factors related to dysfunctional interactions in the family system, although an increasing amount of research also points to a large role of biological factors in its etiology. Above all, it’s believed to have a very strong genetic component. Infantile anorexia is a potentially curable disease, provided it is diagnosed and appropriate treatment measures are taken. The latter consist in psychotherapy and the introduction of eating patterns. Failure to take such steps may result in the persistence of symptoms and the increased risk of acute or chronic child malnutrition, and in extreme cases may jeopardize the child’s life.

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