Thrombophilias are hypercoagulable conditions that can be acquired or inherited. Most important hypercoagulable conditions =, testing procedures, duration of anticoagulation will be discussed here. Useful for Internal Medicine Boards and Hematology boards. Some aspects on duration of anticoagulation, HIT are high-yield for USMLE exams.
Thrombophilias are hypercoagulable conditions that can be acquired or inherited. Most important hypercoagulable conditions =, testing procedures, duration of anticoagulation will be discussed here. Useful for Internal Medicine Boards and Hematology boards. Some aspects on duration of anticoagulation, HIT are high-yield for USMLE exams.
CONGENITAL HYPERCOAGULABILITY,
ACQUIRED CAUSES OF HYPERCOAGULABILITY ,
EVALUATION AND WORKUP OF HYPERCOAGULABLE STATES ,
CHOICE AND DURATION OF ANTICOAGULATION THERAPY
A Complete & Effective Study Of Venous ThromboembolismMedical and Health
VENOUS THROMBOEMBOLISM: CAUSES, SYMPTOMS, DIAGNOSIS & TREATMENT
In this article, we’ll discuss thrombosis, thrombosis vs embolism, thrombosis definition, and thrombosis coronary. Our main headings are venous thromboembolism disease, venous thromboembolism symptoms, venous thromboembolism causes, venous thromboembolism diagnosis and treatment for venous thromboembolism. For complete article, head over to the given link, https://diseases8804.blogspot.com/2021/08/a-complete-effective-study-of-venous.html
CONGENITAL HYPERCOAGULABILITY,
ACQUIRED CAUSES OF HYPERCOAGULABILITY ,
EVALUATION AND WORKUP OF HYPERCOAGULABLE STATES ,
CHOICE AND DURATION OF ANTICOAGULATION THERAPY
A Complete & Effective Study Of Venous ThromboembolismMedical and Health
VENOUS THROMBOEMBOLISM: CAUSES, SYMPTOMS, DIAGNOSIS & TREATMENT
In this article, we’ll discuss thrombosis, thrombosis vs embolism, thrombosis definition, and thrombosis coronary. Our main headings are venous thromboembolism disease, venous thromboembolism symptoms, venous thromboembolism causes, venous thromboembolism diagnosis and treatment for venous thromboembolism. For complete article, head over to the given link, https://diseases8804.blogspot.com/2021/08/a-complete-effective-study-of-venous.html
One of the most developed cities of India, the city of Chennai is the capital of Tamilnadu and many people from different parts of India come here to earn their bread and butter. Being a metropolitan, the city is filled with towering building and beaches but the sad part as with almost every Indian city
The dimensions of healthcare quality refer to various attributes or aspects that define the standard of healthcare services. These dimensions are used to evaluate, measure, and improve the quality of care provided to patients. A comprehensive understanding of these dimensions ensures that healthcare systems can address various aspects of patient care effectively and holistically. Dimensions of Healthcare Quality and Performance of care include the following; Appropriateness, Availability, Competence, Continuity, Effectiveness, Efficiency, Efficacy, Prevention, Respect and Care, Safety as well as Timeliness.
Struggling with intense fears that disrupt your life? At Renew Life Hypnosis, we offer specialized hypnosis to overcome fear. Phobias are exaggerated fears, often stemming from past traumas or learned behaviors. Hypnotherapy addresses these deep-seated fears by accessing the subconscious mind, helping you change your reactions to phobic triggers. Our expert therapists guide you into a state of deep relaxation, allowing you to transform your responses and reduce anxiety. Experience increased confidence and freedom from phobias with our personalized approach. Ready to live a fear-free life? Visit us at Renew Life Hypnosis..
CRISPR-Cas9, a revolutionary gene-editing tool, holds immense potential to reshape medicine, agriculture, and our understanding of life. But like any powerful tool, it comes with ethical considerations.
Unveiling CRISPR: This naturally occurring bacterial defense system (crRNA & Cas9 protein) fights viruses. Scientists repurposed it for precise gene editing (correction, deletion, insertion) by targeting specific DNA sequences.
The Promise: CRISPR offers exciting possibilities:
Gene Therapy: Correcting genetic diseases like cystic fibrosis.
Agriculture: Engineering crops resistant to pests and harsh environments.
Research: Studying gene function to unlock new knowledge.
The Peril: Ethical concerns demand attention:
Off-target Effects: Unintended DNA edits can have unforeseen consequences.
Eugenics: Misusing CRISPR for designer babies raises social and ethical questions.
Equity: High costs could limit access to this potentially life-saving technology.
The Path Forward: Responsible development is crucial:
International Collaboration: Clear guidelines are needed for research and human trials.
Public Education: Open discussions ensure informed decisions about CRISPR.
Prioritize Safety and Ethics: Safety and ethical principles must be paramount.
CRISPR offers a powerful tool for a better future, but responsible development and addressing ethical concerns are essential. By prioritizing safety, fostering open dialogue, and ensuring equitable access, we can harness CRISPR's power for the benefit of all. (2998 characters)
Global launch of the Healthy Ageing and Prevention Index 2nd wave – alongside...ILC- UK
The Healthy Ageing and Prevention Index is an online tool created by ILC that ranks countries on six metrics including, life span, health span, work span, income, environmental performance, and happiness. The Index helps us understand how well countries have adapted to longevity and inform decision makers on what must be done to maximise the economic benefits that comes with living well for longer.
Alongside the 77th World Health Assembly in Geneva on 28 May 2024, we launched the second version of our Index, allowing us to track progress and give new insights into what needs to be done to keep populations healthier for longer.
The speakers included:
Professor Orazio Schillaci, Minister of Health, Italy
Dr Hans Groth, Chairman of the Board, World Demographic & Ageing Forum
Professor Ilona Kickbusch, Founder and Chair, Global Health Centre, Geneva Graduate Institute and co-chair, World Health Summit Council
Dr Natasha Azzopardi Muscat, Director, Country Health Policies and Systems Division, World Health Organisation EURO
Dr Marta Lomazzi, Executive Manager, World Federation of Public Health Associations
Dr Shyam Bishen, Head, Centre for Health and Healthcare and Member of the Executive Committee, World Economic Forum
Dr Karin Tegmark Wisell, Director General, Public Health Agency of Sweden
2. Thrombotic disorders
Congenital and acquired
diseases characterized
by formation of thrombus
that obstructs vascular
blood flow locally or
detaches and embolizes
to occlude blood flow
downstream
(thromboembolism).
6. Antithrombin deficiency
It is familial deficiency of AT
Autosomal dominant
70% of affected individuals will have an
episode of VTE before age of 60 years.
Pregnancy is a high-risk period for VTE
and this requires large doses of
LMWH(≥100U/kg/day).
AT concentrate (either plasma derived or
recombinant) is required for
cardiopulmonary bypass and may be
used as an adjunct to heparin in surgical
prophylaxis.
8. Protein C and S deficiencies
Protein C and S are Vit K-dependent
natural anticoagulants involved in
switching off coagulation factor activation
(factor Va and VIIIa) and thrombin
generation.
Inherited deficiency of either protein C
and protein S results in a prothrombotic
state with a fivefold relative risk of VTE
compared with the background
population.
Treatment- heparin, followed by Warfarin
9. Factor V Leiden
Results from single base pair mutation
which prevents cleavage and hence
inactivation of activated factor V.
Heterozygous: 5-10 times increased
risk for TE.
Homozygous: 50-100 times.
10. Factor Va
Arg 306 Arg 506 Arg 1765
Arginine
CGA
Glutamine
CAA
Factor Va resistant to APC cleavage
Factor V Leiden
11. Relative Risk for
Venous Thrombosis
Factor V Leiden Heterozygote x 7
Factor V Leiden Homozygote x 80
Oral Contraceptives x 3
Oral Contraceptives + Factor V Leiden x 35
Leiden Study Group Data
12. Prothrombin G20210A
Due to mutation in the non-coding 3´
end of the prothrombin gene is
associated with an increased plasma
level of prothrombin. Increased levels
of prothrombin enhanced thrombin
formation.
In the heterozygous state, it is
associated with a 2-3 fold increase in
risk of VTE
Only way for diagnosis: DNA-PCR
technique.
13. Antiphospholipid
Syndrome(APS)
Syndrome characterized by venous
and/or arterial thrombosis,
thrombocytopenia, or recurrent fetal
loss; associated with antibodies to
phospho-lipid-protein Complexes.
May present in isolation (primary APS)
or in associated conditions like
15. Antiphospholipid Syndrome
Antiphospholipid antibodies are
heterogenous and typically are directed
against proteins which bind to
phospholipids.
Targets for antiphospholipid antibodies
ß2-glycoprotein 1
Protein C
Annexin V
Prothrombin (may result in haemorrhagic
presentation)
16. Clinical features
Adverse pregnancy ourcome
Recurrent 1st trimester abortion (≥3)
Unexplained death of morphologically
normal fetus after 10 wks of gestation
Severe early pre-eclampsia
Venous thromboembolism
Arterial thromboembolism
Livedo reticularis, catastrophic APS,
transverse myelitis, skin necrosis,
chorea
18. Management
Arterial thrombosis, typically stroke,
associated with APS should be treated
with warfarin, as opposed to aspirin.
APS-associated VTE is one of the
situation in which the predicted
recurrence rate is high enough to
indicate long-term anticoagulation after a
first event.
In women with APS, it is likely that
intervention with heparin and possibly
aspirin increases the chance of
successful pregnancy outcome.
20. Disseminated Intravascular Coagulation
It is an acquired condition in which normal physiology of
coagulation is disturbed leading to widespread intravascular
coagulation process associated with injury to
microvasculature which results in organ dysfunction,
capillary leak & shock.
Occurs due to simultaneous action of the following 4
mechanisms
Increased thrombin generation
Suppressed physiological anticoagulant pathways
Activation & subsequent impairment of fibrinolysis
Activation of inflammatory pathways
21. ETIOLOGY
• Infection/sepsis
• Trauma
• Obstetric, e.g. amniotic fluid embolism, placental abruption, pre-
eclampsia
• Severe liver failure
• Malignancy, e.g. solid tumours and leukaemias
• Tissue destruction, e.g. pancreatitis, burns
• Vascular abnormalities, e.g. vascular aneurysms, liver
haemangiomas
• Toxic/immunological, e.g. ABO incompatibility, snake bite,
recreational drugs
25. Thrombotic Thrombocytopenic Purpura
Rare
Enzyme ADAMTS13, responsible for cleaving
large multimers of vWF into normal functional
units and its deficiency due to antibodies
binding to it and results in large vWF
multimers which cross-link platelets.
Causes extensive microscopic thrombosis,
with platelet consumption
Microthromboses cause end- organ
dysfunction
Hemolysis is due to shear stress,
producing schistocytes
26. Cause
Idiopathic- autoimmune,
severely decreased ADAMTS13 activity
Secondary- associated with
Cancer
BMT
Pregnancy
HIV-1 infection
Drugs- Quinine, Clopidogrel, cyclosporine, Tacrolimus,
Mitomycin-C, Interferon
Hereditary- Upshaw-Schulman syndrome