Diagnostic Studies for Thrombophilia in Women on Hormonal Therapy and During Pregnancy, and in Children

Abstract Objective.—To review the role of acquired and inherited prothrombotic risk factors that increase the risk of thrombosis in oral contraceptive users, during pregnancy, and in neonates, infants, and children; and to determine by the consensus opinion of recognized experts in the field which risk factors should be determined in which individuals at which time. Data Sources.—Review of the medical literature and current clinical practice by a panel of experts in the field of thrombophilia. Data Extraction and Synthesis.—The experts made an extensive review of the published literature and prepared a draft manuscript, which included preliminary recommendations. The draft manuscript was circulated to participants in the College of American Pathologists Conference XXXVI: Diagnostic Issues in Thrombophilia prior to the conference. The manuscript and recommendations were then presented at the conference for discussion. Recommendations were accepted if a consensus of the 26 experts attending the conference was reached. The results of the discussion were used to revise the manuscript into its final form. Conclusions.—This report reviews the options for testing for thrombophilic states in women using oral contraceptives, during pregnancy, and in neonates and children. General guidelines for testing in these clinical situations are provided, along with citation of the appropriate supporting literature.

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Role of niacin in current clinical practice

Minerva Medica ◽

10.23736/s0026-4806.18.05826-3 ◽

2019 ◽

Vol 110 (1) ◽

Cited By ~ 1

Author(s):

Abhishek Sharma ◽

Nidhi Madan

Keyword(s):

Clinical Practice ◽

Current Clinical Practice

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Cephalosporins: A Focus on Side Chains and β-Lactam Cross-Reactivity

Pharmacy ◽

10.3390/pharmacy7030103 ◽

2019 ◽

Vol 7 (3) ◽

pp. 103 ◽

Cited By ~ 9

Author(s):

Saira B. Chaudhry ◽

Michael P. Veve ◽

Jamie L. Wagner

Keyword(s):

Risk Factors ◽

Clinical Practice ◽

Antimicrobial Stewardship ◽

Clinical Utility ◽

Cross Reactivity ◽

Penicillin Allergy ◽

Side Chain ◽

Safety And Efficacy ◽

History Of

Cephalosporins are among the most commonly prescribed antibiotic classes due to their wide clinical utility and general tolerability, with approximately 1–3% of the population reporting a cephalosporin allergy. However, clinicians may avoid the use of cephalosporins in patients with reported penicillin allergies despite the low potential for cross-reactivity. The misdiagnosis of β-lactam allergies and misunderstanding of cross-reactivity among β-lactams, including within the cephalosporin class, often leads to use of broader spectrum antibiotics with poor safety and efficacy profiles and represents a serious obstacle for antimicrobial stewardship. Risk factors for cephalosporin allergies are broad and include female sex, advanced age, and a history of another antibiotic or penicillin allergy; however, cephalosporins are readily tolerated even among individuals with true immediate-type allergies to penicillins. Cephalosporin cross-reactivity potential is related to the structural R1 side chain, and clinicians should be cognizant of R1 side chain similarities when prescribing alternate β-lactams in allergic individuals or when new cephalosporins are brought to market. Clinicians should consider the low likelihood of true cephalosporin allergy when clinically indicated. The purpose of this review is to provide an overview of the role of cephalosporins in clinical practice, and to highlight the incidence of, risk factors for, and cross-reactivity of cephalosporins with other antibiotics.

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The Progression of Hemophilic Arthropathy: The Role of Biomarkers

International Journal of Molecular Sciences ◽

10.3390/ijms21197292 ◽

2020 ◽

Vol 21 (19) ◽

pp. 7292

Author(s):

Gianluigi Pasta ◽

Salvatore Annunziata ◽

Alberto Polizzi ◽

Laura Caliogna ◽

Eugenio Jannelli ◽

...

Keyword(s):

Clinical Practice ◽

English Language ◽

Hemophilia A ◽

Data Extraction ◽

A Priori ◽

Inclusion Criteria ◽

Hemophilic Arthropathy ◽

Study Selection ◽

Potential Use

Background: Hemophilia A and B are X-linked congenital bleeding disorders characterized by recurrent hemarthroses leading to specific changes in the synovium and cartilage, which finally result in the destruction of the joint: this process is called hemophilic arthropathy (HA). This review highlights the most prominent molecular biomarkers found in the literature to discuss their potential use in the clinical practice to monitor bleeding, to assess the progression of the HA and the effectiveness of treatments. Methods: A review of the literature was performed on PubMed and Embase, from 3 to 7 August 2020. Study selection and data extraction were achieved independently by two authors and the following inclusion criteria were determined a priori: English language, available full text and articles published in peer-reviewed journal. In addition, further articles were identified by checking the bibliography of relevant articles and searching for the studies cited in all the articles examined. Results: Eligible studies obtained at the end of the search and screen process were seventy-three (73). Conclusions: Despite the surge of interest in the clinical use of biomarkers, current literature underlines the lack of their standardization and their potential use in the clinical practice preserving the role of physical examination and imaging in early diagnosis.

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Oral contraceptive therapy and the surgical management of ENT patients: a review of current clinical practice

Clinical Otolaryngology ◽

10.1111/j.1365-2273.1990.tb00792.x ◽

1990 ◽

Vol 15 (6) ◽

pp. 525-528 ◽

Cited By ~ 1

Author(s):

R. G. WILLIAMS ◽

M. P. J. YARDLEY

Keyword(s):

Clinical Practice ◽

Oral Contraceptive ◽

Surgical Management ◽

Current Clinical Practice ◽

Contraceptive Therapy ◽

Oral Contraceptive Therapy

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Abdominal venous thrombosis in neonates and infants: role of prothrombotic risk factors - a multicentre case-control study

British Journal of Haematology ◽

10.1046/j.1365-2141.2000.02349.x ◽

2000 ◽

Vol 111 (2) ◽

pp. 534-539 ◽

Cited By ~ 98

Author(s):

Christine Heller ◽

Rosemarie Schobess ◽

Karin Kurnik ◽

Ralf Junker ◽

Gudrun Gunther ◽

...

Keyword(s):

Risk Factors ◽

Venous Thrombosis ◽

Case Control Study ◽

Case Control ◽

Prothrombotic Risk Factors ◽

Neonates And Infants ◽

Control Study

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Hyperhomocyst(e)inemia and Thrombophilia

Archives of Pathology & Laboratory Medicine ◽

10.5858/2002-126-1367-hat ◽

2002 ◽

Vol 126 (11) ◽

pp. 1367-1375 ◽

Cited By ~ 3

Author(s):

Nigel S. Key ◽

Ronald C. McGlennen

Keyword(s):

Arterial Thrombosis ◽

Medical Literature ◽

Homocysteine Level ◽

Data Extraction ◽

Plasma Homocysteine ◽

Testing Methods ◽

Plasma Homocysteine Level ◽

Key Points ◽

Criteria For Diagnosis

Abstract Objective.—To review the role of an elevated total plasma homocysteine level (hyperhomocyst[e]inemia) in patients with venous or arterial thrombosis, as reflected by the medical literature and the consensus opinion of recognized experts in the field. Data Sources.—Review of the medical literature, primarily from the last 10 years. Data Extraction and Synthesis.—The literature was reviewed to identify key points defining the condition, and the clinical study design of each article was examined. A draft manuscript was prepared and circulated prior to the conference to every participant in the College of American Pathologists Conference XXXVI: Diagnostic Issues in Thrombophilia. Each of the key points and associated recommendations was then presented for discussion at the conference. Recommendations were accepted if a consensus of the 70% of the experts attending the conference was reached. The results of the discussion were used to revise the manuscript into its final form. Conclusions.—Consensus was reached on 9 recommendations concerning the criteria for diagnosis, the method of testing, and the approach for clinical management. A major point of consensus was that no causal role of hyperhomocyst(e)inemia in venous or arterial thrombosis is yet established. Testing methods used to measure homocysteine directly are sensitive and reliable, and provide more information than does genotyping for markers linked to abnormal plasma homocysteine.

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Evaluation of the need for pharmacogenomics testing among physicians in the West Bank of Palestine

Drug Metabolism and Personalized Therapy ◽

10.1515/dmdi-2021-0121 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Yazun Jarrar ◽

Rami Musleh ◽

Anas Hamdan ◽

Mustafa Ghanim

Keyword(s):

Medical Education ◽

Clinical Practice ◽

West Bank ◽

School Curriculum ◽

Interindividual Variation ◽

Current Clinical Practice ◽

Cross Sectional Survey ◽

The West ◽

Cross Sectional

Abstract Objectives Pharmacogenomics (PGx) testing optimizes pharmacotherapy and reduces interindividual variation in drug responses. However, it is still not implemented in clinical practice in the West Bank of Palestine (WBP). The aim of this study was to determine the need for PGx education and testing among physicians from different specialties in WBP. Methods This study used a cross-sectional survey that was administered to 381 physicians from different cities in WBP. The questionnaire consisted of 27 closed-ended questions that evaluate the exposure and attitude toward PGx education, the role of PGx testing in clinical practice, and the capabilities of physicians in PGx testing. Results It was found that exposure to PGx education is low, with most of the respondents (81.1%) answering that PGx was not an integral part of their medical education. The majority (>90%) of the participants agreed that PGx should be included in the medical school curriculum. It was also found that 58.5% of the participants agreed that PGx testing is relevant to their current clinical practice. In addition, most of the participant physicians (>60%) think that they are currently not capable of prescribing and making decisions for pharmacotherapy based on PGx testing. Conclusions It is concluded that there is a high need for PGx education and implementation in clinical practice in WBP. We recommend adding PGx courses to the curricula of medical schools and going forward with the implementation of PGx testing in clinical practice in WBP.

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Abdominal venous thrombosis in neonates and infants: role of prothrombotic risk factors - a multicentre case-control study

British Journal of Haematology ◽

10.1111/j.1365-2141.2000.02349.x ◽

2000 ◽

Vol 111 (2) ◽

pp. 534-539 ◽

Cited By ~ 2

Author(s):

Christine Heller ◽

Rosemarie Schobess ◽

Karin Kurnik ◽

Ralf Junker ◽

Gudrun Günther ◽

...

Keyword(s):

Risk Factors ◽

Venous Thrombosis ◽

Case Control Study ◽

Case Control ◽

Prothrombotic Risk Factors ◽

Neonates And Infants ◽

Control Study

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Identification of Risk Factors for Exertional Heat Illness: A Brief Commentary on Genetic Testing

Journal of Sport Rehabilitation ◽

10.1123/jsr.16.3.222 ◽

2007 ◽

Vol 16 (3) ◽

pp. 222-226 ◽

Cited By ~ 5

Author(s):

Sheila Muldoon ◽

Rolf Bunger ◽

Patricia Deuster ◽

Nyamkhishig Sambuughin

Keyword(s):

Risk Factors ◽

Genetic Testing ◽

Sports Medicine ◽

Data Extraction ◽

Data Sources ◽

Hereditary Diseases ◽

Heat Illness ◽

Data Synthesis ◽

Exertional Heat Illness ◽

Type Data

Objective:This commentary discusses known links between Exertional Heat Illness (EHI), Malignant Hyperthermia (MH), and other hereditary diseases of muscle. Genetic and functional testing is also evaluated as measures of fitness to return to duty/play.Data Sources:Reviews and research articles from Sports Medicine, Applied Physiology, and Anesthesiology.Data Extraction:Detailed comparisons of existing literature regarding clinical cases of EHI and MH and the potential utility of genetic testing, specifically the ryanodine receptor (RYR1) gene and other genes related to disorders of skeletal muscle.Data Synthesis:EHI is a complex disorder wherein physiological, environmental, and hereditary factors interact to endanger an individual’s ability to maintain thermal homeostasis.Conclusions:Individuals’ genetic background is likely to play an important role, particularly when EHI recurs. Recurrent EHI has been associated with MH and other genetic disorders, highlighting the importance of identification and exclusion of individuals with known high risk factors.

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