Resume Nous avons detecte, par une methode PCR originale, la mutation facteur V Leiden sur 1 137 echantillons cliniques correspondants a des patients presentant des antecedents de thrombose veineuse. Le genotype realise a permis de montrer que 314 d'entre eux (soit 27,6 %) etaient heterozygotes, et 11 (0,9 %) homozygotes pour la mutation. Sur cette base nous proposons la methode de detection directe de l'anomalie moleculaire dans les grandes series de patients.

Détection directe par PCR de la mutation du facteur V Leiden: analyse routinière sur plus de 1 000 échantillons cliniques

Resume La mutation du facteur V Leiden, responsable d’une resistance a la proteine C activee, est une affection prothrombotique observee chez environ 20 % des malades ayant un premier episode de thrombose veineuse profonde. Nous rapportons le cas d’une femme de 30 ans, suivie pour des crises douloureuses abdominales recidivantes, hospitalisee pour un infarctus du grele par thrombose mesenterique veineuse et arterielle, ayant necessite une resection etendue du grele. Le bilan a la recherche de facteurs de risque de thrombose mettait en evidence une resistance a la proteine C activee secondaire a une mutation homozygote du facteur V Leiden. Un traitement anticoagulant au long cours etait institue. Des douleurs abdominales inexpliquees doivent faire evoquer une ischemie mesenterique, laquelle peut etre secondaire a une mutation du facteur V Leiden.

Douleurs abdominales chroniques par ischémie mésentérique liée à une mutation du facteur V Leiden

The aim of this work was to assess the prevalence of a genetic predisposition to disseminated intravascular coagulation (DIC) among acutely poisoned patients. Activated protein C resistence (APCR) is a genetically determined cause of thrombophilia and DIC development. One hundred seventy-six subjects were divided into three groups: one consisted of 83 acutely poisoned patients with DIC; a second consisted of 57 acutely poisoned patients without DIC; the third group consisted of 91 healthy controls. Abnormal results of APCR testing were found in 24.1% of the poisoned DIC group, 5.3% of the poisoned nonDIC group, and 3.3% of the control group. Genetic tests were performed in 37 selected patients. Factor V Leiden mutation (G/A genotype) was determined to be present in people whose R index value was below 1.9. These results raise the possibility that outcomes of acute poisonings may be influenced by genetic predisposition.

The Leiden mutation and activated protein C resistance as risk factors for disseminated intravascular coagulation in acutely poisoned patients.

Prophylaxis of deep vein thrombosis with standard heparin and low molecular weight heparin has been studied in many clinical trials in surgical patients and in few and various medical conditions in hospitalized subjects. Clinical trials have been conducted in patients with recent myocardial infarction, heart failure, stroke, pulmonary sepsis, cancer, or any acute disease with a high risk factors for deep vein thrombosis (previous thromboembolism, thrombophilia, obesity, recent bedridden, dehydratation.). The combination of a high risk disease with a high risk factor related to the history of the patient might reasonably conduct to a prophylaxis with low molecular weight heparins. The duration of this treatment has to be short and limited to the period of the acute medical condition inducing a high risk for deep vein thrombosis. Prophylaxis has to be offered to patients with ischemic stroke, cardiac failure, recent myocardial infarction, active cancer or any other acute medical disease in patients with a previous thromboembolism or thrombophilia history. Bedridden status and age are not, by themselves, an indication for prophylaxis with heparins. A widespread diffusion of these recommendations is needed to reduce overprescriptions.

Prevention of deep venous thrombosis in medical patients : what became of the 1995 plea for clinical trials ?

Background: Coronavirus disease of 2019 or COVID-19 is characterised by two main features: the first is the respiratory compromise which corresponds to acute respiratory distress syndrome while the second corresponds to the state of hypercoagulability responsible for thromboembolic complications particularly pulmonary embolism which is the subject of this work. Indeed, a high prevalence of pulmonary embolism has been reported throughout the pandemic period with a significant morbidity and mortality. This reflects the severity of this life-threatening emergency chiefly in the elderly, hemodynamically unstable patients, and patients with severe underlying conditions, mainly cardio-pulmonary comorbidities. The aim of our study is to point out the incidence, the risk factors, the clinical and paraclinical features, the management strategies, and the overall prognosis of pulmonary embolism in critically ill COVID-19 and non-COVID-19 patients. Patients and methods: It is a retrospective observational study carried out over a two-year-period from January 2019 (non-COVID-19) to December 2020 (COVID-19). Over the study period, 42 cases of COVID-19 and non-COVID-19 pulmonary embolism were collected from an overall set of 611 patients admitted to the medical intensive care unit of the IBN ROCHD university hospital of Casablanca. Results: The mean age in the COVID-19 group was 64-year-old versus 46-year-old in the non-COVID-19 group. The sex ratio was 1.2 and 0.94 in the non-COVID-19 and COVID-19 group, respectively. Clinical symptomatology was dominated by respiratory failure and chest pain in non-COVID-19 patients while in the COVID-19 group, semiology was dominated by dyspnea, cough, and chest pain. The major sign of severity in both groups was tachypnea. The chest X-ray was performed in all our patients, it displayed radiological abnormalities in all patients mainly hyper clarity in pulmonary fields. D-dimers were performed in all patients within the two study groups. A chest computed tomography angiogram was performed for all patients and showed unilateral pulmonary embolism in 61% of cases in the non-COVID-19 group versus 61.3% in the COVID-19 group. Cardiac ultrasound was performed for all patients. It showed dilatation of right cavities in both groups (81.8% in non-COVID-19 versus 93.5% in COVID-19 patients). Venous ultrasound of the lower limbs was performed in 96.8% of COVID-19 patients and in 72.7% of non-COVID-19 patients. With regards to management, all COVID-19 and non-COVID-19 patients received anticoagulation therapy based on standard heparin and anti-vitamin K. Mortality accounted for 54.5% in non-COVID-19 patients versus 74.2% in COVID-19 patients. Conclusion: COVID-19 pulmonary embolism is often associated with significantly higher morbidity and mortality as compared with non-COVID-19 pulmonary embolism.

/pdf/pulmonary-embolism-in-critically-ill-covid-19-and-non-covid-elgn2t2b.pdf

Pulmonary Embolism in Critically Ill COVID-19 And Non-COVID-19 Patients: Systematic Analysis of Risk Factors, Diagnostic and Management Strategies, and Prognosis.

Le diagnostic biologique de la résistance à la protéine C activée

6 – Maladie Thromboembolique Veineuse

Le traitement antithrombotique de la maladie thromboembolique veineuse

8 – Moyens Thérapeutiques Actuels et Modernes

Resume Le premier plan occupe par les heparines de bas poids moleculaire dans la strategie therapeutique des accidents thromboemboliques veineux est une innovation de la derniere reunion de consensus nord-americaine sur les traitements antithrombotiques publiee dans un numero special de la revue Chest en 2001. Compte tenu du rapport benefice-risque particulierement avantageux, cette recommandation est du niveau de preuve le plus eleve soit 1A. Le debut precoce du traitement anticoagulant oral associe a l'utilisation de nomogramme permet de reduire notablement la duree du chevauchement et d'atteindre le seuil d'international normalized ratio (INR) souhaite plus regulierement. La surveillance biologique est simplifee. L'evaluation bi-hebdomadaire de la numeration plaquettaire est systematique durant le pemier mois de traitement alors que l'activite anti-Xa n'est reservee qu'aux patients ayant une fonction renale alteree ou des poids extremes. Cependant, plusieurs points restent encore discutes : l'administration uni ou biquotidienne et la duree du traitement en fonction de la persistance eventuelle de facteurs favorisants, du type de thrombophilie et du terrain. La strategie antithrombotique devient ainsi de plus en plus ciblee, basee sur les preuves et adaptee au cas par cas selon le niveau de risque thrombotique.

Le traitement de la thrombose veineuse profonde par les héparines de bas poids moléculaire. Commentaires sur les recommandations du Consensus Nord-Américain

Handle everyday research tasks with reliable, citation-backed results

Your personal Research Agent to handle research tasks with citation-backed results

Popular Tasks used by Researchers

How can I help with your research?

Meet SciSpace

Get more enhanced response by uploading the PDFs you want me to reference.

No relevant PDFs in your library

SciSpace is the AI research assistant for academics. Run systematic literature reviews on 280M+ papers, and write papers with cited sources. Trusted by 1M+ students, PhDs & researchers.

SciSpace | AI for Research

Analyze PDFs

Code & Manuscripts

Funding & Grants

Literature & Patents

Medical & Clinical Data

Systematic Review

Visualize & Present

Web & Data

Build a Google Scholar-like website for your research.

Build a website

Create charts and images for your research

Create a Chart

Write a paper for submission to a journal

Draft a manuscript

Patent Search

Design eye-catching scientific posters in minutes.

Scientific Poster Generation

Systematic Literature Review

One task is running at the moment. Your messages will be shown right after.

Drag and drop or click here to browse

Loved by <highlight>1 million+</highlight> researchers

Extract a list of specific topics and their sources from unstructured text

Topics

Compare and analyze relevant papers that matches with your search

Papers

Get insights from PDFs and bookmarked papers from your library

My library

Recent searches

Try searching for:

Catch AI-generated content in scholarly and non-scholarly content

{ai} Detector

Ai Writer

Get PDF Summaries, highlighted text explanations 

Chat with PDF

Effortlessly create in-text citations and bibliographies in APA and 2,500 other formats

Citation generator

Get explanations, summaries, and answers on academic papers

Ease up your research workflow with {scispace}'s cohort of exciting AI tools

Elevate your academic writing skills and convey your ideas the way you want

Paraphraser

Explore our range of reading and writing tools

Your file is being prepared and should be ready in a few minutes. If it's a large file, it might take a bit longer. You can close this window, and we'll email you the file when it's done.

You have reached a maximum limit of <strong>{limit}</strong> columns in the table. Remove at least <strong>1</strong> column to add or create another one.

I. Elalamy

Author Tools

Chat about Author