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  1 / 23118 MEDLINE  
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[PMID]:29381746
[Au] Autor:Koyama K; Katayama S; Muronoi T; Tonai K; Goto Y; Koinuma T; Shima J; Nunomiya S
[Ad] Endereço:Division of Intensive Care, Department of Anesthesiology & Intensive Care Medicine, Jichi Medical University School of Medicine, Tochigi, Japan.
[Ti] Título:Time course of immature platelet count and its relation to thrombocytopenia and mortality in patients with sepsis.
[So] Source:PLoS One;13(1):e0192064, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: The pathogenesis of thrombocytopenia in patients with sepsis is not fully understood. The aims of this study were to investigate changes in thrombopoietic activity over time by using absolute immature platelet counts (AIPC) and to examine the impact of platelet production on thrombocytopenia and mortality in patients with sepsis. METHODS: This retrospective observational study included adult patients with sepsis admitted to the intensive care unit at a university hospital. Two hundred five consecutive sepsis patients were stratified into four groups according to nadir platelet count: severe (nadir ≤40×103/µL), moderate (41-80×103/µL), or mild thrombocytopenia (81-120×103/µL), or normal-increased platelet count (>120×103/µL). The development of thrombocytopenia was assessed during the first week; mortality was assessed at day 28. RESULT: Of the 205 patients included, 61 (29.8%) developed severe thrombocytopenia. On admission, AIPC did not differ among the four groups. In patients with severe thrombocytopenia, AIPC decreased significantly from days 2 to 7, but remained within or above the normal range in the other three groups (overall group comparison, P<0.0001). Multivariate analysis including coagulation biomarkers revealed that AIPC was independently associated with the development of severe thrombocytopenia (day 3 AIPC, odds ratio 0.49 [95% confidence interval (CI) 0.35-0.66], P<0.0001; day 5 AIPC, 0.59 [95% CI 0.45-0.75], P<0.0001). AIPC was a significant predictor of 28-day mortality in Cox hazard models adjusted for Acute Physiology and Chronic Health Evaluation II and Sequential Organ Failure Assessment scores (day 3 AIPC, hazard ratio 0.70 [95% CI 0.52-0.89], P = 0.0029; day 5 AIPC, 0.68 [95% CI 0.49-0.87], P = 0.0012). CONCLUSIONS: Thrombopoietic activity was generally maintained in the acute phase of sepsis. However, a decrease in AIPC after admission was independently associated with the development of severe thrombocytopenia and mortality, suggesting the importance of suppressed thrombopoiesis in the pathophysiology of sepsis-induced thrombocytopenia.
[Mh] Termos MeSH primário: Contagem de Plaquetas
Sepse/complicações
Trombocitopenia/patologia
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Feminino
Seres Humanos
Masculino
Meia-Idade
Estudos Retrospectivos
Sepse/mortalidade
Trombocitopenia/complicações
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180131
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0192064


  2 / 23118 MEDLINE  
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[PMID]:29380037
[Au] Autor:Miyashita N; Onozawa M; Hayasaka K; Yamada T; Migita O; Hata K; Okada K; Goto H; Nakagawa M; Hashimoto D; Kahata K; Kondo T; Kunishima S; Teshima T
[Ad] Endereço:Department of Hematology, Hokkaido University Faculty of Medicine, Graduate School of Medicine, Kita 15, Nishi 7, Kita-ku, Sapporo, 0608638, Japan.
[Ti] Título:A novel heterozygous ITGB3 p.T720del inducing spontaneous activation of integrin αIIbß3 in autosomal dominant macrothrombocytopenia with aggregation dysfunction.
[So] Source:Ann Hematol;97(4):629-640, 2018 Apr.
[Is] ISSN:1432-0584
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:We identified a novel heterozygous ITGB3 p.T720del mutation in a pedigree with macrothrombocytopenia exhibiting aggregation dysfunction. Platelet aggregation induced by ADP and collagen was significantly reduced, while ristocetin aggregation was normal. Integrin αIIbß3 was partially activated in a resting status, but platelet expression of αIIbß3 was downregulated. Functional analysis using a cell line showed spontaneous phosphorylation of FAK in αIIb/ß3 (p.T720del)-transfected 293T cells in suspension conditions. Abnormal cytoplasmic protrusions, membrane ruffling, and cytoplasmic localization of αIIbß3 were observed in αIIb/ß3 (p.T720del)-transfected CHO cells. Such morphological changes were reversed by treatment with an FAK inhibitor. These findings imply spontaneous, but partial, activation of αIIbß3 followed by phosphorylation of FAK as the initial mechanism of abnormal thrombopoiesis. Internalization and decreased surface expression of αIIbß3 would contribute to aggregation dysfunction. We reviewed the literature of congenital macrothrombocytopenia associated with heterozygous ITGA2B or ITGB3 mutations. Reported mutations were highly clustered at the membrane proximal region of αIIbß3, which affected the critical interaction between αIIb R995 and ß3 D723, resulting in a constitutionally active form of the αIIbß3 complex. Macrothrombocytopenia caused by a heterozygous activating mutation of ITGA2B or ITGB3 at the membrane proximal region forms a distinct entity of rare congenital thrombocytopenia.
[Mh] Termos MeSH primário: Deleção de Genes
Genes Dominantes
Heterozigoto
Integrina beta3/genética
Complexo Glicoproteico GPIIb-IIIa de Plaquetas/agonistas
Trombocitopenia/genética
[Mh] Termos MeSH secundário: Adulto
Animais
Células CHO
Cricetulus
Saúde da Família
Feminino
Células HEK293
Seres Humanos
Integrina beta3/metabolismo
Japão
Masculino
Meia-Idade
Mutagênese Sítio-Dirigida
Linhagem
Complexo Glicoproteico GPIIb-IIIa de Plaquetas/metabolismo
Proteínas Recombinantes/metabolismo
Trombocitopenia/sangue
Trombocitopenia/metabolismo
Trombocitopenia/fisiopatologia
Adulto Jovem
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (ITGB3 protein, human); 0 (Integrin beta3); 0 (Platelet Glycoprotein GPIIb-IIIa Complex); 0 (Recombinant Proteins)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180131
[St] Status:MEDLINE
[do] DOI:10.1007/s00277-017-3214-4


  3 / 23118 MEDLINE  
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[PMID]:29350259
[Au] Autor:Zhu X; Zhang J; Wang Q; Fu H; Chang Y; Kong Y; Lv M; Xu L; Liu K; Huang X; Zhang X
[Ad] Endereço:Peking University People's Hospital, Peking University Institute of Hematology, Beijing, 100044, China.
[Ti] Título:Diminished expression of ß2-GPI is associated with a reduced ability to mitigate complement activation in anti-GPIIb/IIIa-mediated immune thrombocytopenia.
[So] Source:Ann Hematol;97(4):641-654, 2018 Apr.
[Is] ISSN:1432-0584
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:Anti-GPIIb/IIIa-mediated complement activation has been reported to be important in the pathogenesis of immune thrombocytopenia (ITP). However, the role of the complement system and the involved regulatory mechanism remain equivocal. Beta2-glycoprotein I (ß2-GPI), known as the main target for antiphospholipid autoantibodies, has been demonstrated as a complement regulator. Here, we investigated the complement-regulatory role of ß2-GPI in anti-GPIIb/IIIa-mediated ITP. Plasma complement activation and enhanced complement activation capacity (CAC) were found in ITP patients with anti-GPIIb/IIIa antibodies in vivo and in vitro. Diminished plasma levels of ß2-GPI were shown in patients of this group, which was inversely correlated with C5b-9 deposition. C5b-9 generation was inhibited by approximate physiological concentrations of ß2-GPI, in a dose-dependent manner. Inhibition of C3a generation by ß2-GPI and the existence of ß2-GPI/C3 complexes in plasma indicated a regulation on the level of the C3 convertase. Furthermore, ß2-GPI down-regulated the phosphorylation levels of c-Jun N-terminal kinase (JNK) and cleavage of BH3 interacting domain death agonist (Bid) and ultimately harbored platelet lysis. Our findings may provide a novel link between diminished plasma levels of ß2-GPI and enhanced complement activation, indicating ß2-GPI as a potential diagnostic biomarker and therapeutic target in the treatment of anti-GPIIb/IIIa-mediated ITP.
[Mh] Termos MeSH primário: Ativação do Complemento
Regulação para Baixo
Isoanticorpos/metabolismo
Complexo Glicoproteico GPIIb-IIIa de Plaquetas/antagonistas & inibidores
Púrpura Trombocitopênica Idiopática/metabolismo
beta 2-Glicoproteína I/metabolismo
[Mh] Termos MeSH secundário: Adulto
Idoso
Biomarcadores/sangue
Plaquetas/imunologia
Plaquetas/metabolismo
Plaquetas/patologia
China/epidemiologia
Convertases de Complemento C3-C5/metabolismo
Complemento C3a/metabolismo
Feminino
Seres Humanos
Masculino
Meia-Idade
Complexo Glicoproteico GPIIb-IIIa de Plaquetas/metabolismo
Complexo Glicoproteico GPIb-IX de Plaquetas/antagonistas & inibidores
Complexo Glicoproteico GPIb-IX de Plaquetas/metabolismo
Púrpura Trombocitopênica Idiopática/imunologia
Púrpura Trombocitopênica Idiopática/patologia
Púrpura Trombocitopênica Idiopática/fisiopatologia
Risco
Trombocitopenia/sangue
Trombocitopenia/imunologia
Trombocitopenia/metabolismo
Trombose/epidemiologia
Trombose/etiologia
Adulto Jovem
beta 2-Glicoproteína I/sangue
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biomarkers); 0 (Isoantibodies); 0 (Platelet Glycoprotein GPIIb-IIIa Complex); 0 (Platelet Glycoprotein GPIb-IX Complex); 0 (beta 2-Glycoprotein I); 0 (glycoprotein receptor GPIb-IX); 80295-42-7 (Complement C3a); EC 3.4.21.- (Complement C3-C5 Convertases)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180120
[St] Status:MEDLINE
[do] DOI:10.1007/s00277-017-3215-3


  4 / 23118 MEDLINE  
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[PMID]:29214792
[Au] Autor:Park M; Kim M; Park J; Cho J
[Ad] Endereço:Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon, Korea.
[Ti] Título:Life-Threatening Thrombocytopenia Following Intravenous Contrast Media Infusion.
[So] Source:Yonsei Med J;59(1):158-161, 2018 Jan.
[Is] ISSN:1976-2437
[Cp] País de publicação:Korea (South)
[La] Idioma:eng
[Ab] Resumo:Radiocontrast media-induced acute severe thrombocytopenia is a very rare complication and potentially life-threatening. Here, we report the case of a 63-year-old male patient with severe acute thrombocytopenia following first exposure to intravenous non-ionic contrast media without immediate allergic reactions. His platelet count dropped from 107000/µL to 2000/µL after six hours of radiocontrast infusion. After administration of corticosteroid and transfusion of platelet concentrates, the platelet count returned gradually to normal within 5 days. To the best of our knowledge, non-ionic contrast media-induced isolated acute severe thrombocytopenia following no signs or symptoms of immediate allergic reaction has never been described.
[Mh] Termos MeSH primário: Meios de Contraste/administração & dosagem
Meios de Contraste/efeitos adversos
Trombocitopenia/etiologia
[Mh] Termos MeSH secundário: Doença Aguda
Administração Intravenosa
Seres Humanos
Infusões Intravenosas
Masculino
Meia-Idade
Contagem de Plaquetas
[Pt] Tipo de publicação:CASE REPORTS
[Nm] Nome de substância:
0 (Contrast Media)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171208
[St] Status:MEDLINE
[do] DOI:10.3349/ymj.2018.59.1.158


  5 / 23118 MEDLINE  
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[PMID]:28749085
[Au] Autor:Llewellyn EA; Todd JM; Sharkey LC; Rendahl A
[Ad] Endereço:Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St Paul, MN, 55108.
[Ti] Título:A pilot study evaluating the prognostic utility of platelet indices in dogs with septic peritonitis.
[So] Source:J Vet Emerg Crit Care (San Antonio);27(5):569-578, 2017 Sep.
[Is] ISSN:1476-4431
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To characterize platelet indices at time of diagnosis of septic peritonitis in dogs and to assess the relationship between platelet parameter data and survival to discharge in dogs treated surgically. DESIGN: Retrospective, observational, descriptive pilot study from 2009 to 2014. SETTING: University teaching hospital. ANIMALS: Forty-eight dogs diagnosed with septic peritonitis were included in this study. Thirty-six dogs had surgical source control. Blood samples from 46 healthy control dogs were used for reference interval (RI) generation. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Dogs with septic peritonitis had significantly increased mean values for mean platelet volume (MPV), plateletcrit (PCT), and platelet distribution width (PDW) with increased proportions of dogs having values above the RI compared to healthy dogs. A significantly increased proportion of dogs with septic peritonitis had platelet counts above (12.5%) and below (8.3%) the RI, with no significant difference in mean platelet count compared to healthy dogs. No significant differences in the mean platelet count, MPV, PCT, or PDW were found between survivors and nonsurvivors in dogs with surgical source control; however, dogs with MPV values above the RI had significantly increased mortality compared to dogs within the RI (P = 0.025). Values outside the RI for other platelet parameters were not associated with significant differences in mortality. CONCLUSIONS: Dogs with septic peritonitis have increased frequency of thrombocytosis and thrombocytopenia with increased MPV, PCT, and PDW. An increased MPV may be a useful indicator of increased risk of mortality in dogs treated surgically.
[Mh] Termos MeSH primário: Transtornos Plaquetários/veterinária
Doenças do Cão/sangue
Peritonite/veterinária
Contagem de Plaquetas/veterinária
Sepse/veterinária
[Mh] Termos MeSH secundário: Animais
Transtornos Plaquetários/sangue
Cães
Volume Plaquetário Médio
Peritonite/sangue
Projetos Piloto
Prognóstico
Valores de Referência
Estudos Retrospectivos
Sepse/sangue
Trombocitopenia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170728
[St] Status:MEDLINE
[do] DOI:10.1111/vec.12628


  6 / 23118 MEDLINE  
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[PMID]:28749042
[Au] Autor:Hooi KS; Lemetayer JD
[Ad] Endereço:Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON, N1G 2W1, Canada.
[Ti] Título:The use of intravesicular alteplase for thrombolysis in a dog with urinary bladder thrombi.
[So] Source:J Vet Emerg Crit Care (San Antonio);27(5):590-595, 2017 Sep.
[Is] ISSN:1476-4431
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To describe the use of alteplase for intravesicular thrombolysis in a dog after development of urinary tract obstruction from a blood clot in the urinary bladder. CASE SUMMARY: A 5.8 kg, 6.5-year-old female neutered Bichon Frise was presented for signs of acute hematuria. A complete blood count (CBC) revealed marked thrombocytopenia and leukopenia, and nonregenerative anemia. Bone marrow aspirate cytology revealed mild hypercellularity, mild megakaryocytic hyperplasia, mildly left-shifted erythroid maturation, and moderately left-shifted myeloid maturation, suggesting ongoing recovery from an acute bone marrow insult. Thrombocytopenia and hematuria resolved concurrently; however, stranguria and oliguria developed acutely. Ultrasonography identified two large presumed thrombi within the urinary bladder. A urinary catheter was placed and 4 doses of 0.5 mg of alteplase diluted in 10 mL of 0.9% sodium chloride were instilled into the bladder with a 4-hour dwell time at 12-hour intervals. Prothombin and activated partial thromboplastin times were monitored during therapy and remained within normal limits. One thrombus was successfully dissolved after 48 hours of therapy and the remaining thrombus was reduced in size and was voided upon removal of the urinary catheter. NEW OR UNIQUE INFORMATION PROVIDED: This report describes the use of alteplase in a dog for thrombolysis of intravesicular thrombi. In patients that develop intravesicular thrombi, intravesical instillation of alteplase can be considered as a method for dissolution of these thrombi.
[Mh] Termos MeSH primário: Fibrinolíticos/uso terapêutico
Trombocitopenia/veterinária
Ativador de Plasminogênio Tecidual/uso terapêutico
Doenças da Bexiga Urinária/veterinária
[Mh] Termos MeSH secundário: Administração Intravesical
Animais
Cães
Feminino
Fibrinolíticos/administração & dosagem
Trombocitopenia/tratamento farmacológico
Trombose/tratamento farmacológico
Ativador de Plasminogênio Tecidual/administração & dosagem
Doenças da Bexiga Urinária/tratamento farmacológico
[Pt] Tipo de publicação:CASE REPORTS
[Nm] Nome de substância:
0 (Fibrinolytic Agents); EC 3.4.21.68 (Tissue Plasminogen Activator)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170728
[St] Status:MEDLINE
[do] DOI:10.1111/vec.12627


  7 / 23118 MEDLINE  
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[PMID]:29157612
[Au] Autor:Igawa T; Sato Y
[Ad] Endereço:Department of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan.
[Ti] Título:TAFRO Syndrome.
[So] Source:Hematol Oncol Clin North Am;32(1):107-118, 2018 02.
[Is] ISSN:1558-1977
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:TAFRO syndrome is a newly recognized variant of idiopathic multicentric Castleman disease (iMCD) that involves a constellation of syndromes: thrombocytopenia (T), anasarca (A), fever (F), reticulin fibrosis (R), and organomegaly (O). Thrombocytopenia and severe anasarca accompanied by relatively low serum immunoglobulin levels are characteristic clinical findings of TAFRO syndrome that are not present in iMCD-not otherwise specified (iMCD-NOS). Lymph node biopsy is recommended to exclude other diseases and to diagnose TAFRO syndrome, which reveals characteristic histopathological findings similar to hyaline vascular-type CD. TAFRO syndrome follows a more aggressive course, compared with iMCD-NOS, and there is no standard treatment.
[Mh] Termos MeSH primário: Doença de Castleman
Edema
Febre
Trombocitopenia
[Mh] Termos MeSH secundário: Doença de Castleman/diagnóstico
Doença de Castleman/patologia
Edema/diagnóstico
Edema/patologia
Febre/diagnóstico
Febre/patologia
Seres Humanos
Síndrome
Trombocitopenia/diagnóstico
Trombocitopenia/patologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180307
[Lr] Data última revisão:
180307
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171122
[St] Status:MEDLINE


  8 / 23118 MEDLINE  
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[PMID]:29207378
[Au] Autor:Akkiz H; Carr BI; Yalçin K K; Guerra V; Kuran S; Altintas E; Üsküdar O; Karaogullarindan Ü; Özakyol A; Tokmak S; Yücesoy M; Bahçeci HI; Ülkü A; Akçam T; Yalçin Polat K; Ekinci N; Simsek H; Örmeci N; Sonsuz A; Demir M; Kiliç M; Uygun A; Balli T; Demir A; Arslan B; Doran F
[Ad] Endereço:Gastroenterology Department, Çukurova Üniversitesi, Adana, Turkey.
[Ti] Título:Characteristics of Hepatocellular Carcinoma Aggressiveness Factors in Turkish Patients.
[So] Source:Oncology;94(2):116-124, 2018.
[Is] ISSN:1423-0232
[Cp] País de publicação:Switzerland
[La] Idioma:eng
[Ab] Resumo:A large cohort of hepatocellular carcinoma (HCC) patients from several collaborating Turkish institutions were examined for the tumor parameters of maximum diameter (MTD), portal vein thrombosis (PVT), and α-fetoprotein (AFP) levels. A relationship was found between MTD and blood platelet levels. Patients with large ≥5 cm tumors who had normal platelet levels had significantly larger tumors, higher percent of PVT, and significantly lower blood total bilirubin and liver cirrhosis than similar ≥5 cm tumor patients having thrombocytopenia. A comparison of patients with and without PVT showed significantly larger tumors, greater multifocality, blood AFP, and C-reactive protein levels, and, interestingly, lower HDL levels in the patients with PVT. Fifty-eight percent of the total cohort had AFP levels ≤100 IU/mL (and 42.1% had values ≤20 IU/mL). These patients had significantly smaller tumors, less tumor multifocality and percent PVT, lower total bilirubin, and less cirrhosis. There was considerable geographic heterogeneity within Turkey in the patterns of HCC presentation, with areas of higher and lower hepatitis B virus, hepatitis D virus, cirrhosis, and tumor aggressiveness parameters. Turkish patients thus have distinct patterns of presentation, but the biological relationships between MTD and both platelets and bilirubin levels are similar to the relationships that have been reported in other ethnic patient groups.
[Mh] Termos MeSH primário: Carcinoma Hepatocelular/patologia
Neoplasias Hepáticas/patologia
[Mh] Termos MeSH secundário: Bilirrubina/sangue
Biomarcadores Tumorais/sangue
Plaquetas/patologia
Proteína C-Reativa/metabolismo
Carcinoma Hepatocelular/sangue
Carcinoma Hepatocelular/metabolismo
Feminino
Seres Humanos
Cirrose Hepática/sangue
Cirrose Hepática/metabolismo
Cirrose Hepática/patologia
Testes de Função Hepática/métodos
Neoplasias Hepáticas/sangue
Neoplasias Hepáticas/metabolismo
Masculino
Meia-Idade
Veia Porta/patologia
Prognóstico
Estudos Prospectivos
Trombocitopenia/sangue
Trombocitopenia/metabolismo
Trombocitopenia/patologia
Turquia
Trombose Venosa/sangue
Trombose Venosa/metabolismo
Trombose Venosa/patologia
alfa-Fetoproteínas/metabolismo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biomarkers, Tumor); 0 (alpha-Fetoproteins); 9007-41-4 (C-Reactive Protein); RFM9X3LJ49 (Bilirubin)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171206
[St] Status:MEDLINE
[do] DOI:10.1159/000484564


  9 / 23118 MEDLINE  
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[PMID]:29181882
[Au] Autor:Pollak U; Mishaly D; Kenet G; Vardi A
[Ad] Endereço:Department of Pediatric Cardiac Intensive Care, The Edmond J. Safra International Congenital Heart Center, The Edmond and Lily Safra Children's Hospital, The Chaim Sheba Medical Center, Tel Aviv, Israel.
[Ti] Título:Heparin-induced thrombocytopenia complicating children after the Fontan procedure: Single-center experience and review of the literature.
[So] Source:Congenit Heart Dis;13(1):16-25, 2018 Jan.
[Is] ISSN:1747-0803
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Heparin-induced thrombocytopenia (HIT) is a life-threatening complication of heparin therapy. The risk for HIT correlates with the cumulative dosage of heparin exposure. In Fontan patients, recurrent systemic anticoagulation, traditionally with heparin, is used to alleviate the thrombotic complications that may occur postoperatively when the venous pressure rises and the systemic venous flow into the pulmonary arteries becomes sluggish, putting them at increased risk. As a pressure gradient-dependent circulation, elevation in systemic venous pressure, most often by venous thrombosis, contributes to circuit failure. Therefore, when HIT complicates patients after the Fontan procedure, it is associated with a high thrombotic morbidity and mortality; thus, a high index of suspicion is mandatory, based on the clinical signs of HIT. It is crucial to intervene early with alternative anticoagulants when HIT is suspected as this step may improve outcome in these patients.
[Mh] Termos MeSH primário: Técnica de Fontan
Heparina/efeitos adversos
Complicações Pós-Operatórias
Trombocitopenia/induzido quimicamente
Trombose/prevenção & controle
[Mh] Termos MeSH secundário: Anticoagulantes/efeitos adversos
Anticoagulantes/uso terapêutico
Criança
Cardiopatias Congênitas/cirurgia
Heparina/uso terapêutico
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Anticoagulants); 9005-49-6 (Heparin)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180219
[Lr] Data última revisão:
180219
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171129
[St] Status:MEDLINE
[do] DOI:10.1111/chd.12557


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[PMID]:29411014
[Au] Autor:Shen YM; Wolfe H; Barman S
[Ad] Endereço:Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas.
[Ti] Título:Evaluating Thrombocytopenia During Heparin Therapy.
[So] Source:JAMA;319(5):497-498, 2018 Feb 06.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Anticoagulantes/efeitos adversos
Heparina/efeitos adversos
Intestino Delgado/cirurgia
Trombocitopenia/induzido quimicamente
Trombose Venosa/cirurgia
[Mh] Termos MeSH secundário: Anticoagulantes/uso terapêutico
Seres Humanos
Intestino Delgado/irrigação sanguínea
Isquemia/cirurgia
Masculino
Artéria Mesentérica Superior
Oclusão Vascular Mesentérica/cirurgia
Meia-Idade
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anticoagulants); 9005-49-6 (Heparin)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180215
[Lr] Data última revisão:
180215
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180208
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2017.21898



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