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Arterial ischemic stroke in childhood and adolescence : Time-critical emergency in pediatrics
Nervenarzt. 2022 Nov 16:1-13. doi: 10.1007/s00115-022-01409-9. Online ahead of print.ABSTRACTChildhood arterial ischemic stroke is one of the most time-critical pediatric emergencies but is often diagnosed with a prognostically relevant time delay. The reasons are low awareness, sometimes unspecific clinical presentation with a wide variety of critical differential diagnoses and less coordinated acute care structures. The revascularization strategies established for adults also show sometimes spectacular success in children. These should therefore also be made available for affected children if possible, although the evide...
Source: Hamostaseologie - November 16, 2022 Category: Hematology Authors: Lucia Gerstl Ingo Borggraefe Florian Heinen Martin Olivieri Source Type: research

Individualized antithrombotic therapy.
Conclusion: An extensive therapeutic arsenal to interfere with clot formation requires an individualized approach considering the disease condition and co-morbidities of the patient, the anticoagulants' and patientcharacteristics. This review builds on and extens previous publications of the authors on this topic. PMID: 25597592 [PubMed - as supplied by publisher]
Source: Hamostaseologie - January 19, 2015 Category: Hematology Authors: Lüscher TF, Steffel J Tags: Hamostaseologie Source Type: research

Advances in anticoagulation management of patients undergoing cardioversion of nonvalvular atrial fibrillation.
Abstract Atrial fibrillation (AF) is a major cause of stroke. The restoration of sinus rhythm through cardioversion, either chemical or electrical is a common practice. Interestingly, there is an incremental increase from the baseline risk for embolisation in the immediate post-cardioversion period, with most events occurring within 10 days from cardioversion. Especially patients with recent onset AF show the lowest rates of antithrombotic therapy, while having a high stroke risk. Despite the increased risk for embolisation, anticoagulation in patients undergoing cardioversion of atrial fibrillation is often inade...
Source: Hamostaseologie - March 13, 2017 Category: Hematology Authors: Benetos G, Bonou M, Toutouzas K, Diamantopoulos P, Viniou N, Barbetseas J Tags: Hamostaseologie Source Type: research

Anticoagulation in Atherosclerotic Disease.
Abstract The prevention of atherothrombotic events is an essential therapeutic goal in the treatment of patients with arteriosclerotic diseases. After plaque rupture, a rapidly growing thrombus can lead to acute vascular occlusion and thus heart attack, stroke or limb ischaemia. The acute therapy combines anticoagulation and platelet inhibition. However, the only available therapy so far in the primary and secondary prevention of stable patients is the platelet inhibitors aspirin and clopidogrel. Despite the use of antiplatelet therapies, including aspirin and P2Y12-receptor antagonists, some patients with artery ...
Source: Hamostaseologie - October 17, 2018 Category: Hematology Authors: Al Said S, Bode C, Duerschmied D Tags: Hamostaseologie Source Type: research

What is confirmed in the treatment of atrial fibrillation?
Inn Med (Heidelb). 2022 Nov 10. doi: 10.1007/s00108-022-01418-5. Online ahead of print.ABSTRACTAtrial fibrillation is the most common clinically relevant cardiac arrhythmia. Important goals in the treatment of atrial fibrillation are improvement of the quality of life, relief of symptoms and the prevention of stroke. New in the current European guidelines on atrial fibrillation from 2020 is a structured approach with the introduction of the 4S-AF scheme (4S estimation of the risk of stroke, severity of symptoms, degree of severity of atrial fibrillation load and substrate, AF atrial fibrillation) for better characterizatio...
Source: Hamostaseologie - November 10, 2022 Category: Hematology Authors: Volker Liebe Mathieu Kruska Daniel D ürschmied Ibrahim Akin Source Type: research

Oral anticoagulation and vitamin K deficiency.
Abstract A 61-year old woman with atrial fibrillation developed macrohaematuria during anticoagulant treatment with a direct oral factor Xa inhibitor for stroke prevention. Abnormal results of coagulation assays were first interpreted as an effect of the anticoagulant. However, upon further testing diagnosis of vitamin K deficiency was established. After vitamin K supplementation, coagulation tests normalized and macrohaematuria disappeared. Treatment with broad spectrum antibiotics for urinary tract infection was finally established as a rare cause for vitamin K deficiency in the patient. PMID: 24919584 [Pub...
Source: Hamostaseologie - June 12, 2014 Category: Hematology Authors: Eichinger S Tags: Hamostaseologie Source Type: research

The role of mast cells in atherosclerosis.
Abstract Rupture of an atherosclerotic plaque is the major underlying cause of adverse cardiovascular events such as myocardial infarction or stroke. Therapeutic interventions should therefore be directed towards inhibiting growth of atherosclerotic lesions as well as towards prevention of lesion destabilization. Interestingly, the presence of mast cells has been demonstrated in both murine and human plaques, and multiple interventional murine studies have pointed out a direct role for mast cells in early and late stages of atherosclerosis. Moreover, it has recently been described that activated lesional mast cell...
Source: Hamostaseologie - November 7, 2014 Category: Hematology Authors: Wezel A, Quax PH, Kuiper J, Bot I Tags: Hamostaseologie Source Type: research

Peri- and postinterventional antithrombotic therapy in TAVI. Do we need antiplatelet therapy?
Abstract Interventional treatment of aortic valve stenosis by transcatheter aortic valve replacement (TAVR) has become routine practice in elderly and high risk patients in recent years. Similar to other vascular interventional or surgical procedures TAVR carries thrombotic risks such as stroke, myocardial infarction or systemic embolism as well as peri-procedural bleeding risks. These risks comprise the access site, the type of prosthesis, and the individual risk profile of the patient. Not only during the peri-procedural period but also during longterm follow-up the current target population for TAVR procedures ...
Source: Hamostaseologie - January 7, 2015 Category: Hematology Authors: Moser M Tags: Hamostaseologie Source Type: research

The role of the kynurenine pathway of tryptophan metabolism in cardiovascular disease. An emerging field.
Abstract Coronary heart disease and stroke, the deadliest forms of cardiovascular disease (CVD), are mainly caused by atherosclerosis, a chronic inflammatory disease of the artery wall driven by maladaptive immune responses in the vessel wall. Various risk factors for CVD influence this pathogenic process, including diabetes mellitus, hypertension, dyslipidaemia, and obesity. Indoleamine 2,3-dioxygenase (IDO), an enzyme catalyzing the rate-limiting step in the kynurenine pathway of tryptophan degradation, is strongly induced by inflammation in several tissues, including the artery wall. An increasing body of evide...
Source: Hamostaseologie - January 19, 2015 Category: Hematology Authors: Polyzos KA, Ketelhuth DF Tags: Hamostaseologie Source Type: research

MRI, the technology for imaging of thrombi and inflammation.
Abstract Atherosclerosis and its sequelae have a major impact on morbidity and mortality. The rupture of an inflamed atherosclerotic plaque is a crucial event, since it can result in acute thrombotic closure of an arterial vessel, resulting e. g. in myocardial infarction or stroke. Not only detection of early plaque rupture with imminent closure is therefore of clinical interest, but also timely detection of vascular inflammation and atherosclerotic plaque progression. However, plaque inflammation or even plaque rupture without vessel occlusion is not reliably detectable by current imaging techniques. Coronary a...
Source: Hamostaseologie - January 30, 2015 Category: Hematology Authors: von Zur Muhlen C, Bode C Tags: Hamostaseologie Source Type: research

Platelets and vascular inflammation of the brain.
CONCLUSION: Platelets and platelet associated mechanisms may offer novel starting points to understand neurovascular diseases from a different point of view and to develop novel approaches to access the disease. PMID: 25987266 [PubMed - as supplied by publisher]
Source: Hamostaseologie - May 19, 2015 Category: Hematology Authors: Mezger M, Göbel K, Kraft P, Meuth SG, Kleinschnitz C, Langer HF Tags: Hamostaseologie Source Type: research

Clinical pearls: Laboratory assessments of direct oral anticoagulants (DOACS).
We describe Clinical Pearls for DOAC assessment using common and esoteric coagulation testing. PMID: 28678302 [PubMed - as supplied by publisher]
Source: Hamostaseologie - July 5, 2017 Category: Hematology Authors: Gosselin RC, Gosselin R, Douxfils J, Adcock D Tags: Hamostaseologie Source Type: research

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