RESUMEN
Research shows that the presence of cancer increases the likelihood of developing venous thromboembolism (pulmonary thromboembolism and deep vein thrombosis) from as much as fourfold up to sevenfold. It is imperative that after early diagnosis we treat cancer-associated thrombosis with grave seriousness in order to reduce its morbidity and mortality. We present 14 case reports of patients with cancer-associated thrombosis including thrombosis related to malignant hemopathies.
Asunto(s)
Neoplasias , Embolia Pulmonar , Trombosis , Tromboembolia Venosa , Humanos , Neoplasias/complicaciones , Embolia Pulmonar/diagnóstico por imagen , Embolia Pulmonar/etiología , Embolia Pulmonar/terapia , Factores de Riesgo , Trombosis/diagnóstico por imagen , Trombosis/epidemiología , Trombosis/etiología , Tromboembolia Venosa/diagnóstico , Tromboembolia Venosa/epidemiología , Tromboembolia Venosa/etiologíaRESUMEN
Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), is a preventable cause of in-hospital death, and one of the most prevalent vascular diseases. There is a lack of knowledge with regards to contemporary presentation, management, and outcomes of patients with VTE. Many clinically important subgroups (including the elderly, those with recent bleeding, renal insufficiency, disseminated malignancy or pregnant patients) have been under-represented in randomized clinical trials. We still need information from real life data (as example RIETE). The paper presents case series with VTE in special conditions, including cancer associated thrombosis, malignant homeopathies, as well in high risk population.
Asunto(s)
Enfermedades Genéticas Congénitas/complicaciones , Fallo Renal Crónico/complicaciones , Neoplasias/complicaciones , Embolia Pulmonar/diagnóstico por imagen , Tromboembolia Venosa/diagnóstico por imagen , Trombosis de la Vena/diagnóstico por imagen , Adulto , Anciano , Comorbilidad , Femenino , Enfermedades Genéticas Congénitas/epidemiología , Humanos , Fallo Renal Crónico/epidemiología , Masculino , Persona de Mediana Edad , Neoplasias/epidemiología , Embarazo , Prevalencia , Embolia Pulmonar/epidemiología , Embolia Pulmonar/prevención & control , Embolia Pulmonar/terapia , Proyectos de Investigación , Factores de Riesgo , Tromboembolia Venosa/epidemiología , Tromboembolia Venosa/prevención & control , Tromboembolia Venosa/terapia , Trombosis de la Vena/epidemiología , Trombosis de la Vena/prevención & control , Trombosis de la Vena/terapiaRESUMEN
The article's aim was to determine predictors for short- and long-term prognosis of patients with pulmonary embolism (PE). Cohort prospective study based on the National registry on venous thromboembolism. Eighty-four patients with PE, on age 60.3 + 12.5 years, were selected and followed up in a prospective study. Pulmonary embolism was confirmed by computed tomography angiography in all the patients, while deep venous thrombosis was confirmed by ultrasound in 21 patients. Study population was followed up for 6.7 months. Multivariate regression analysis was done where right ventricular (RV) diameter (mean 37.5 mm), systolic pulmonary artery pressure (68 ± 23 mm Hg) measured by echocardiography, d-dimer level at baseline 2654.5 ± 420.3 ng/mL, number of comorbidities (2.4 ± 0.7), and present symptoms (3.1 ± 0.9) entered the model. The model was age-adjusted. d-dimer level was revealed as a predictor for the length of hospitalization (ß = .25, P = .05) and RV diameter as a factor for duration of anticoagulation (ß = .29, P = .05). Our results imply that the baseline measurement of these parameters independently influence both the short-term and long-term prognosis of patients with nonfatal PE.
Asunto(s)
Anticoagulantes/administración & dosificación , Presión Sanguínea , Angiografía por Tomografía Computarizada , Arteria Pulmonar , Embolia Pulmonar , Anciano , Femenino , Productos de Degradación de Fibrina-Fibrinógeno/metabolismo , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Pronóstico , Estudios Prospectivos , Arteria Pulmonar/diagnóstico por imagen , Arteria Pulmonar/fisiopatología , Embolia Pulmonar/sangre , Embolia Pulmonar/diagnóstico por imagen , Embolia Pulmonar/tratamiento farmacológico , Embolia Pulmonar/fisiopatología , Sistema de Registros , UltrasonografíaRESUMEN
These case reports aim to show that hyperfibrinogenemia is a risk factor for the progression and prognosis of peripheral arterial disease (PAD), in patients with and without diabetes mellitus type 2. We present a patient with PAD who has type 2 diabetes mellitus, who has previously been repeatedly treated for lower limb ischemia with multiple vascular surgeries performed. A few weeks before admission the patient developed critical lower limb ischemia, which was treated with an iliaco-popliteal and femorofemoral bypass. The patient had elevated serum fibrinogen values. In the current admission, renewed left limb ischemia was diagnosed, and surgically evaluated with a recommendation for amputation of the left limb as a surgical recommendation. Our second patient had a stable intermittent claudication, dyslipidemia and hyperfibrinogenemia. He was successfully treated for those risk factors. Regular monitoring of the patient showed improved claudication distance and quality of life Our case reports, supported by a literature review, demonstrate that hyperfibrinogenemia is a possible risk factor for progression and the prognosis of PAD.