RESUMO
Non-vitamin K antagonist oral anticoagulants (NOACs) - direct oral anticoagulants - are getting the ever-broadening use in clinical practice. However, many problems related to optimal use of NOACs in specific clinical situations remain unresolved. European Heart Rhythm Association in April 2018 issued the renovated recommendations on the use of NOACs in patients with atrial fibrillation. The authors of recommendations presented some specific clinical variants for which they formulated practical advices based on the evidence obtained in randomized clinical trials. They also outlined the indications for use of NOACs, formulated practical start-program and scheme of subsequent follow-up management of patients taking NOACs. Recommendations contain information on pharmacokinetics of NOACs and their interactions with other drugs, consideration of feasibility of NOACs use in patients with chronic renal insufficiency or advanced liver disease. Many other practical problems are covered as well.
Assuntos
Fibrilação Atrial , Insuficiência Renal Crônica , Acidente Vascular Cerebral , Administração Oral , Anticoagulantes , Fibrilação Atrial/tratamento farmacológico , HumanosRESUMO
We report a clinical case of SLE in a women affected at the age of 63 years who had recurrent nephrotic syndrome with the development of renal insufficiency at the onset and a good outcome of therapy with a large total dose cyclophosphamide.
Assuntos
Ciclofosfamida/administração & dosagem , Relação Dose-Resposta a Droga , Monitoramento de Medicamentos/métodos , Feminino , Humanos , Imunossupressores/administração & dosagem , Testes de Função Renal/métodos , Pessoa de Meia-Idade , Síndrome Nefrótica/diagnóstico , Síndrome Nefrótica/etiologia , Síndrome Nefrótica/fisiopatologia , Recidiva , Insuficiência Renal/diagnóstico , Insuficiência Renal/etiologia , Insuficiência Renal/fisiopatologia , Prevenção Secundária/métodos , Resultado do TratamentoRESUMO
Cardiovascular diseases (CVD) in patients with rheumatoid arthritis (RA) are ranked first in the structure of comorbidity and mortality. This review includes recent data on common pathogenic mechanisms of inflammation and atherosclerosis, the impact of traditional and specific risk factors, biomarkers of CVD in RA patients. Variants of CVD in RA, the possible pathogenic mechanisms of their development and methods of diagnosis and prevention are described.
Assuntos
Artrite Reumatoide/epidemiologia , Doenças Cardiovasculares , Administração dos Cuidados ao Paciente/métodos , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/terapia , Comorbidade , HumanosRESUMO
A case of severe recurrent cryoglobulinemic vasculitis with hepatic lesions and diffuse skin necrosis is described. The relevant literature data and approaches to the treatment of different forms of the disease are discussed.
Assuntos
Crioglobulinemia/etiologia , Hepatite C Crônica/complicações , Vasculite/etiologia , Adulto , Feminino , HumanosRESUMO
This review covers publications on rheumatological syndromes associated with HIV-infection.