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[PMID]:29440610
[Au] Autor:Harcourt-Brown N; Harcourt-Brown F
[Ad] Endereço:30 Crab Lane, Bilton, Harrogate, North Yorkshire HG1 3BE.
[Ti] Título:Preventing rabbit haemorrhagic disease.
[So] Source:Vet Rec;182(6):172-173, 2018 02 10.
[Is] ISSN:2042-7670
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Infecções por Caliciviridae/prevenção & controle
Vírus da Doença Hemorrágica de Coelhos
[Mh] Termos MeSH secundário: Animais
Transtornos Hemorrágicos
Coelhos
[Pt] Tipo de publicação:LETTER; COMMENT
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180223
[Lr] Data última revisão:
180223
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180215
[St] Status:MEDLINE
[do] DOI:10.1136/vr.k576


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[PMID]:28802375
[Au] Autor:Patel PN; Arambula AM; Wheeler AP; Penn EB
[Ad] Endereço:Division of Pediatric Otolaryngology, Department of Otolaryngology, Vanderbilt University Medical Center, Nashville, TN, USA. Electronic address: priyesh.patel@vanderbilt.edu.
[Ti] Título:Post-tonsillectomy hemorrhagic outcomes in children with bleeding disorders at a single institution.
[So] Source:Int J Pediatr Otorhinolaryngol;100:216-222, 2017 Sep.
[Is] ISSN:1872-8464
[Cp] País de publicação:Ireland
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To report on the post-tonsillectomy bleeding outcomes and factors associated with hemorrhage among children with pre- or post-operatively diagnosed bleeding disorders treated with an institutional protocol. METHODS: Retrospective cohort study of patients with hematologic disorders who underwent tonsillectomy between 2003 and 2016 and were treated with perioperative desmopressin or factor replacement and/or aminocaproic acid. Postoperative outcomes were compared to controls matched for age, sex, and indication for surgery. Analysis of factors associated with hemorrhage was performed in patients with bleeding disorders using Mann-Whitney U or chi-squared tests. RESULTS: 45 patients with hematologic disorders met inclusion criteria. Platelet dysfunction, including von Willebrand Disease (vWD), was the most common diagnosis (77.8%). Most patients had a preoperative diagnosis of a bleeding disorder and received perioperative hematologic medications (86.7%). Compared to matched controls, patients with hematologic disorders experienced more postoperative bleeding (15.5%; 12 bleeds, 7 patients vs. 1.7%; 1 bleed, 1 patient, p = 0.05) and had longer postoperative stays (1.3 days vs. 0.4 days, p < 0.001). Among the patients with hematologic disorders, patients who experienced a postoperative bleed were significantly more likely to have a factor deficiency (e.g. Hemophilia over vWD) and have a postoperative diagnosis (compared to preoperative diagnosis) for which they did not receive perioperative hematologic medication. Of patients with a postoperative bleed, all those diagnosed postoperatively required at least one surgical intervention to control bleeding compared to 33% of patients with a preoperative diagnosis. A history of post-surgical bleeding, male sex, age at surgery, and pharyngitis as surgical indication were not associated with higher hemorrhage rates in this group. CONCLUSIONS: This study suggests a clinically important magnitude of increased bleeding risk in patients with hematologic disease. This risk appears to decrease with the use of an institutional protocol consisting of desmopressin or factor replacement and an antifibrinolytic agent extending through postoperative day 10.
[Mh] Termos MeSH primário: Transtornos Hemorrágicos/complicações
Hemorragia Pós-Operatória/etiologia
Tonsilectomia/efeitos adversos
[Mh] Termos MeSH secundário: Adolescente
Antifibrinolíticos/uso terapêutico
Criança
Estudos de Coortes
Feminino
Seres Humanos
Masculino
Hemorragia Pós-Operatória/tratamento farmacológico
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antifibrinolytic Agents)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170907
[Lr] Data última revisão:
170907
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170814
[St] Status:MEDLINE


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[PMID]:28624906
[Au] Autor:Di Minno G; Navarro D; Perno CF; Canaro M; Gürtler L; Ironside JW; Eichler H; Tiede A
[Ad] Endereço:Dipartimento di Medicina Clinica e Chirurgia, Regional Reference Centre for Coagulation Disorders, Federico II University, Via S. Pansini 5, 80131, Naples, Italy. diminno@unina.it.
[Ti] Título:Pathogen reduction/inactivation of products for the treatment of bleeding disorders: what are the processes and what should we say to patients?
[So] Source:Ann Hematol;96(8):1253-1270, 2017 Aug.
[Is] ISSN:1432-0584
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:Patients with blood disorders (including leukaemia, platelet function disorders and coagulation factor deficiencies) or acute bleeding receive blood-derived products, such as red blood cells, platelet concentrates and plasma-derived products. Although the risk of pathogen contamination of blood products has fallen considerably over the past three decades, contamination is still a topic of concern. In order to counsel patients and obtain informed consent before transfusion, physicians are required to keep up to date with current knowledge on residual risk of pathogen transmission and methods of pathogen removal/inactivation. Here, we describe pathogens relevant to transfusion of blood products and discuss contemporary pathogen removal/inactivation procedures, as well as the potential risks associated with these products: the risk of contamination by infectious agents varies according to blood product/region, and there is a fine line between adequate inactivation and functional impairment of the product. The cost implications of implementing pathogen inactivation technology are also considered.
[Mh] Termos MeSH primário: Transtornos da Coagulação Sanguínea/terapia
Segurança do Sangue/métodos
Transfusão de Sangue/métodos
Transtornos Hemorrágicos/terapia
[Mh] Termos MeSH secundário: Segurança do Sangue/normas
Patógenos Transmitidos pelo Sangue/isolamento & purificação
Desinfecção/métodos
Seres Humanos
Medição de Risco
Fatores de Risco
Sepse/prevenção & controle
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170804
[Lr] Data última revisão:
170804
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170619
[St] Status:MEDLINE
[do] DOI:10.1007/s00277-017-3028-4


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[PMID]:28445073
[Au] Autor:Poole LG; Massey VL; Siow DL; Torres-Gonzáles E; Warner NL; Luyendyk JP; Ritzenthaler JD; Roman J; Arteel GE
[Ad] Endereço:1 Department of Pharmacology and Toxicology.
[Ti] Título:Plasminogen Activator Inhibitor-1 Is Critical in Alcohol-Enhanced Acute Lung Injury in Mice.
[So] Source:Am J Respir Cell Mol Biol;57(3):315-323, 2017 Sep.
[Is] ISSN:1535-4989
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Chronic alcohol exposure is a clinically important risk factor for the development of acute respiratory distress syndrome, the most severe form of acute lung injury (ALI). However, the mechanisms by which alcohol sensitizes the lung to development of this disease are poorly understood. We determined the role of the antifibrinolytic protein plasminogen activator inhibitor-1 (PAI-1) in alcohol enhancement of experimental endotoxin-induced ALI. Wild-type, PAI-1 , and integrin ß mice were fed ethanol-containing Lieber-DeCarli liquid or a control diet for 6 weeks, followed by systemic LPS challenge. LPS administration triggered coagulation cascade activation as evidenced by increased plasma thrombin-antithrombin levels and pulmonary fibrin deposition. Ethanol-exposed animals showed enhanced PAI-1 expression and pulmonary fibrin deposition with coincident exaggeration of pulmonary inflammatory edematous injury. PAI-1 deficiency markedly reduced pulmonary fibrin deposition and greatly reduced inflammation and injury without impacting upstream coagulation. Interestingly, pulmonary platelet accumulation was effectively abolished by PAI-1 deficiency in ethanol/LPS-challenged mice. Moreover, mice lacking integrin α ß , the primary platelet receptor for fibrinogen, displayed a dramatic reduction in early inflammatory changes after ethanol/LPS challenge. These results indicate that the mechanism whereby alcohol exaggerates LPS-induced lung injury requires PAI-1-mediated pulmonary fibrin accumulation, and suggest a novel mechanism whereby alcohol contributes to inflammatory ALI by enhancing fibrinogen-platelet engagement.
[Mh] Termos MeSH primário: Lesão Pulmonar Aguda/metabolismo
Lesão Pulmonar Aguda/patologia
Etanol/efeitos adversos
Inibidor 1 de Ativador de Plasminogênio/metabolismo
[Mh] Termos MeSH secundário: Lesão Pulmonar Aguda/complicações
Lesão Pulmonar Aguda/prevenção & controle
Animais
Plaquetas/metabolismo
Fibrina/metabolismo
Transtornos Hemorrágicos/complicações
Transtornos Hemorrágicos/patologia
Integrina beta3/metabolismo
Lipopolissacarídeos
Camundongos Endogâmicos C57BL
Modelos Biológicos
Inibidor 1 de Ativador de Plasminogênio/deficiência
Edema Pulmonar/complicações
Edema Pulmonar/patologia
Edema Pulmonar/prevenção & controle
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Integrin beta3); 0 (Lipopolysaccharides); 0 (Plasminogen Activator Inhibitor 1); 3K9958V90M (Ethanol); 9001-31-4 (Fibrin)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:171021
[Lr] Data última revisão:
171021
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170427
[St] Status:MEDLINE
[do] DOI:10.1165/rcmb.2016-0184OC


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[PMID]:28060126
[Au] Autor:Hashmi SK; Velasquez MP; Yee DL; Hui SK; Mahoney D; Srivaths LV
[Ad] Endereço:Departments of Pediatrics/Hematology Section, Transfusion Medicine & Coagulation, Baylor College of Medicine and Texas Children's Hospital, Houston, TX.
[Ti] Título:Pediatric Acquired von Willebrand Syndrome in Cardiopulmonary Disorders: Do Laboratory Abnormalities Predict Bleeding Risk?
[So] Source:J Pediatr Hematol Oncol;39(2):121-125, 2017 Mar.
[Is] ISSN:1536-3678
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:There are conflicting reports on whether or not laboratory abnormalities in pediatric acquired von Willebrand syndrome (AVWS) predict bleeding manifestations in patients with cardiopulmonary disorders (CPD). We retrospectively reviewed charts of patients with AVWS and CPD (n=16) seen at Texas Children's Hospital from 2003 to 2012. The most common CPD were valve stenoses, ventricular septal defects, and pulmonary hypertension. All patients had loss of high molecular weight multimers. Fifteen (94%) patients presented with bleeding symptoms, with menorrhagia and epistaxis being the most common. Von Willebrand ristocetin cofactor activity (VWF:RCo), as well as the use of anticoagulant or antiplatelet medication, did not predict bleeding manifestations (P=0.70 and 0.84, respectively). VWF:RCo/VWF antigen (Ag) ratio of <0.7 was significantly associated with presence of bleeding symptoms. All patients who had complete repair of their cardiac defect experienced normalization of VWF multimers and VWF:RCo/Ag ratio, as well as bleeding symptom resolution. We conclude that increased bleeding risk is associated with low VWF:RCo/Ag ratio in pediatric AVWS due to CPD. However, other laboratory abnormalities such as VWF:RCo level and qualitative multimer analysis, do not appear to predict bleeding. Future studies exploring quantification of multimer loss may be helpful in further assessing bleeding risk associations.
[Mh] Termos MeSH primário: Cardiopatias Congênitas/complicações
Transtornos Hemorrágicos/sangue
Hipertensão Pulmonar/complicações
Doenças de von Willebrand/sangue
[Mh] Termos MeSH secundário: Adolescente
Criança
Pré-Escolar
Feminino
Cardiopatias Congênitas/sangue
Cardiopatias Congênitas/cirurgia
Hemorreologia
Hemorragia/etiologia
Transtornos Hemorrágicos/etiologia
Seres Humanos
Hipertensão Pulmonar/sangue
Lactente
Masculino
Multimerização Proteica
Estudos Retrospectivos
Medição de Risco
Resistência ao Cisalhamento
Adulto Jovem
Doenças de von Willebrand/etiologia
Fator de von Willebrand/química
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (von Willebrand Factor)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170912
[Lr] Data última revisão:
170912
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170107
[St] Status:MEDLINE
[do] DOI:10.1097/MPH.0000000000000738


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[PMID]:27556351
[Au] Autor:Flevaris P; Vaughan D
[Ad] Endereço:Department of Medicine, Northwestern University, Chicago, Illinois.
[Ti] Título:The Role of Plasminogen Activator Inhibitor Type-1 in Fibrosis.
[So] Source:Semin Thromb Hemost;43(2):169-177, 2017 Mar.
[Is] ISSN:1098-9064
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Extracellular matrix (ECM) deposition during wound healing is a physiological response to an insult. Wound healing becomes deregulated in the setting of chronic injury or long-standing metabolic disease, leading to the accumulation of ECM components and fibrosis. Matrix protein turnover is determined by the rate of synthesis as well as the rate of proteolytic degradation and clearance by matrix metalloproteinases (MMPs). The persistent activation of interstitial myofibroblasts, coupled with defects in matrix proteolysis, ultimately disrupts tissue architecture and leads to biochemical and mechanical organ dysfunction with eventual organ failure. Plasminogen activator inhibitor type-1 (PAI-1) regulates tissue homeostasis and wound healing by inhibiting plasmin-mediated MMP activation. Multiple reports using models of liver, lung, and kidney fibrosis suggest that PAI-1 deficiency or inhibition of PAI-1 activity attenuates fibrosis. The disinhibition of plasmin-mediated MMP activation leads to collagen degradation and its diminished accumulation, resulting in the reduction of fibrotic matrix deposition in these organs. Paradoxically, homozygous deficiency of PAI-1 promotes age-dependent spontaneous cardiac fibrosis, suggesting a protective role for PAI-1 in the heart. It remains unclear whether PAI-1-deficient cardiac fibroblasts have increased proliferative, migratory, or differentiation capabilities, that allow them to overcome increased plasmin and MMP activity and matrix clearance. In this review, we examine the specific roles of PAI-1 in fibrosis of different organs including the lung, liver, kidney, and cardiovascular system.
[Mh] Termos MeSH primário: Fibrose/tratamento farmacológico
Transtornos Hemorrágicos/terapia
Inibidor 1 de Ativador de Plasminogênio/deficiência
Inativadores de Plasminogênio/uso terapêutico
[Mh] Termos MeSH secundário: Fibrose/patologia
Seres Humanos
Inibidor 1 de Ativador de Plasminogênio/metabolismo
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Plasminogen Activator Inhibitor 1); 0 (Plasminogen Inactivators); 0 (SERPINE1 protein, human)
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170502
[Lr] Data última revisão:
170502
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160825
[St] Status:MEDLINE
[do] DOI:10.1055/s-0036-1586228


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[PMID]:27418638
[Au] Autor:Chapin J; Bamme J; Hsu F; Christos P; DeSancho M
[Ad] Endereço:1 Division of Hematology/Oncology, Weill Cornell Medicine, New York, NY, USA.
[Ti] Título:Outcomes in Patients With Hemophilia and von Willebrand Disease Undergoing Invasive or Surgical Procedures.
[So] Source:Clin Appl Thromb Hemost;23(2):148-154, 2017 Mar.
[Is] ISSN:1938-2723
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Adults with hemophilia A (HA), hemophilia B (HB), and von Willebrand disease (VWD) frequently require surgery and invasive procedures. However, there is variability in perioperative management guidelines. We describe our periprocedural outcomes in this setting. A retrospective chart review from January 2006 to December 2012 of patients with HA, HB, and VWD undergoing surgery or invasive procedures was conducted. Type of procedures, management including the use of continuous factor infusion, and administration of antifibrinolytics were reviewed. Adverse outcomes were defined as acute bleeding (<48 hours), delayed bleeding (≥48 hours), transfusion, inhibitor development, and thrombosis. We identified 59 patients with HA and HB. In all, 24 patients had severe hemophilia and 12 had mild/moderate hemophilia. Twelve patients had inhibitors. There were also 5 female carriers of HA and 6 patients with VWD. There were 34 major surgeries (26 orthopedic, 8 nonorthopedic) and 129 minor surgeries. Continuous infusion was used in 55.9% of major surgeries versus 8.5% of minor surgeries. Antifibrinolytics were administered in 14.7% of major surgeries versus 23.2% of minor surgeries. In all, 4 patients developed acute bleeding and 10 patients developed delayed bleeding. Delayed bleeding occurred in 28.6% of genitourinary procedures and in 16.1% of dental procedures. Five patients acquired an inhibitor and 2 had thrombosis. In conclusion, patients with HA, HB, or VWD had similar rates of adverse outcomes when undergoing minor surgeries or major surgeries. This finding underscores the importance of an interdisciplinary management and procedure-specific guidelines for patients with hemophilia and VWD prior to even minor invasive procedures.
[Mh] Termos MeSH primário: Transtornos Hemorrágicos/complicações
Transtornos Hemorrágicos/cirurgia
Procedimentos Cirúrgicos Operatórios/efeitos adversos
[Mh] Termos MeSH secundário: Adulto
Idoso
Gerenciamento Clínico
Feminino
Hemofilia A/complicações
Hemofilia A/cirurgia
Hemofilia B/complicações
Hemofilia B/cirurgia
Hemorragia/etiologia
Seres Humanos
Masculino
Meia-Idade
Período Perioperatório
Guias de Prática Clínica como Assunto/normas
Estudos Retrospectivos
Resultado do Tratamento
Doenças de von Willebrand/complicações
Doenças de von Willebrand/cirurgia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1702
[Cu] Atualização por classe:170227
[Lr] Data última revisão:
170227
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160716
[St] Status:MEDLINE
[do] DOI:10.1177/1076029616658116


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[PMID]:27254440
[Au] Autor:González-Guerrero C; Lozano-Andreu T; Roch-Santed M; Rivera-Sánchez L; Brandariz-Núñez D; Pastó-Cardona L; Juárez-Giménez JC; Montoro-Ronsano JB
[Ad] Endereço:aPharmacy Service, Universitary Hospital of Vall d'Hebron bPharmacy Service, Universitary Hospital of Bellvitge, Barcelona, Spain.
[Ti] Título:Evaluation of the efficiency under current use of human fibrinogen concentrate in trauma patients with life-threatening hemorrhagic disorders.
[So] Source:Blood Coagul Fibrinolysis;28(1):66-71, 2017 Jan.
[Is] ISSN:1473-5733
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:The aim of the study was to assess the influence of fibrinogen concentrate on survival when it is used in trauma patients with life-threatening hemorrhagic disorders. Secondly, to evaluate when the fibrinogen concentrate administration maximizes its efficacy, and to describe what other concomitant treatment the patients received in order to control their life-threatening hemorrhage. Retrospective, observational, and multicenter study was carried out in three trauma areas between June 2012 and June 2014. The totality of trauma patients with a documented life-threatening hemorrhage who received a fibrinogen concentrate prescription was included in the study. Demographic and analytical data, admission diagnosis, treatment indication, fibrinogen concentrate dose, survival after 1 and 7 days, hospitalization time, and concomitant blood product treatment were collected. One hundred and twenty-three patients were finally included. The mean dose of fibrinogen concentrate administered was 2.87 g. The mean initial fibrinogen plasma level was 1.49 g/l, which rose to 2.26 g/l. The number of patients who survived after 24 h was 80.49%, and 69.11% after 7 days. Lower fibrinogen plasma levels are statistically associated with a higher probability of death after 7 days (P = 0.004). The most suitable threshold to recommend the fibrinogen concentrate administration has been found to be 1.5 g/dl (P = 0006, after 24 h; P = 0.032, after 7 days). Finally, the most common concomitant treatment was the erythrocytes concentrate. A statistically significant relationship between lower fibrinogen plasma levels and a higher probability of death after 7 days has been found. Our data support the threshold of 1.5 g/l as the recommended level to administer fibrinogen concentrate in trauma patients.
[Mh] Termos MeSH primário: Fibrinogênio/uso terapêutico
Transtornos Hemorrágicos/tratamento farmacológico
Ferimentos e Lesões/tratamento farmacológico
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Feminino
Fibrinogênio/análise
Seres Humanos
Masculino
Meia-Idade
Estudos Retrospectivos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Nm] Nome de substância:
9001-32-5 (Fibrinogen)
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160603
[St] Status:MEDLINE
[do] DOI:10.1097/MBC.0000000000000543


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[PMID]:27108228
[Au] Autor:Adeyemi-Fowode OA; Santos XM; Dietrich JE; Srivaths L
[Ad] Endereço:Department of Pediatrics, Baylor College of Medicine, Houston, Texas; Division of Pediatric and Adolescent Gynecology, Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas. Electronic address: adeyemi@bcm.edu.
[Ti] Título:Levonorgestrel-Releasing Intrauterine Device Use in Female Adolescents with Heavy Menstrual Bleeding and Bleeding Disorders: Single Institution Review.
[So] Source:J Pediatr Adolesc Gynecol;30(4):479-483, 2017 Aug.
[Is] ISSN:1873-4332
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:STUDY OBJECTIVE: To identify complications and efficacy of the levonorgestrel-releasing intrauterine device (LNgIUD) in adolescents with heavy menstrual bleeding (HMB) and bleeding disorders (BD). DESIGN, SETTING, AND PARTICIPANTS: A retrospective chart review of 13 postmenarchal adolescent girls with HMB/BD who underwent placement of an LNgIUD. INTERVENTIONS: Placement of an LNgIUD. MAIN OUTCOME MEASURES: Primary outcome was to identify complications from placement of an LNgIUD. Secondary outcome was to evaluate the efficacy of the LNgIUD in adolescents with BD. RESULTS: Thirteen patients met study criteria. The mean age of diagnosis of HMB was 14.08 ± 1.75 years. BD or bleeding risk factor diagnoses included low von Willebrand (VW) activity in 5, type I VW disease in 5, type IIM VW disease in 1, low VW activity and factor 7 deficiency in 1, and acquired VW disease and factor 7 deficiency in 1. Before LNgIUD placement, other hormonal therapy (n = 13) and hemostatic therapy (antifibrinolytic agents, desmopressin acetate; n = 8) yielded poor control of HMB. The LNgIUD was placed using anesthesia with periprocedure hemostatic therapy with no complications. All patients reported significant improvement in HMB after LNgIUD placement and 60% achieved amenorrhea, with mean time to improvement of 94 ± 69 days. Mean hemoglobin and ferritin levels increased after LNgIUD placement compared with before LNgIUD placement values (P = .02, P = .0085, respectively). Use of supplemental hormonal and hemostatic agents decreased (n = 4) after LNgIUD placement. None required LNgIUD removal; 1 spontaneously expelled the LNgIUD with subsequent replacement. CONCLUSION: Study results indicated the LNgIUD is an effective therapeutic option in postmenarchal adolescents with HMB due to BD/bleeding risk factor with minimal complications, high compliance rate, improvement in HMB and anemia, and no periprocedural bleeding with hemostatic management.
[Mh] Termos MeSH primário: Anticoncepcionais Femininos/uso terapêutico
Transtornos Hemorrágicos/terapia
Dispositivos Intrauterinos Medicados/efeitos adversos
Levanogestrel/uso terapêutico
Menorragia/terapia
[Mh] Termos MeSH secundário: Adolescente
Criança
Anticoncepcionais Femininos/efeitos adversos
Feminino
Transtornos Hemorrágicos/complicações
Seres Humanos
Levanogestrel/efeitos adversos
Menorragia/etiologia
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Contraceptive Agents, Female); 5W7SIA7YZW (Levonorgestrel)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170803
[Lr] Data última revisão:
170803
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160425
[St] Status:MEDLINE


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[PMID]:26886363
[Au] Autor:Harel R; Shani D; Donohoe K
[Ad] Endereço:Hematology/Oncology Faculty, NSLIJ/Lenox Hill Hospital, New York, USA.
[Ti] Título:A case of congenital prothrombin deficiency and idiopathic thrombocytopenic purpura in a pregnant female.
[So] Source:Blood Coagul Fibrinolysis;28(1):100-101, 2017 Jan.
[Is] ISSN:1473-5733
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Hereditary prothrombin deficiency is an autosomal recessive disorder with an estimated incidence of 1 in 2 million . Presentation of the disease is variable; however, it is usually associated with moderate to severe bleeding tendencies including muscle hematomas, hemarthrosis, intracranial, mucosal, and postoperative bleeding. Here we report a case of a 35-year-old pregnant woman with congenital hypoprothrombinemia and idiopathic thrombocytopenic purpura, review the literature, and discuss its epidemiology, presentation, diagnosis, and treatment.
[Mh] Termos MeSH primário: Transtornos Hemorrágicos/complicações
Hipoprotrombinemias/complicações
Púrpura Trombocitopênica Idiopática/complicações
[Mh] Termos MeSH secundário: Adulto
Feminino
Seres Humanos
Gravidez
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160218
[St] Status:MEDLINE
[do] DOI:10.1097/MBC.0000000000000534



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