RESUMEN
AIM: Chronic subdural hematoma (CSDH) is typically in elderly and rarely in young people. To prevent complications and re-bleeding after surgical treatment of CSDH it is important to assess the risk factors as coagulation disorders especially in young patients (below 65 years) with no history of head trauma, alcohol abuse or anticoagulant therapy. PATIENTS AND METHODS: This study consists of 16 patients (12 males, 4 females) with age ranging from 27 to 59 years (median 48,25 years) operated for CSDH. All patients are submitted to routine coagulation parameters pre-operatively and complete screening for unknown coagulation deficit in the follow-up. RESULTS: Factor VII was altered in 6 out of 16 patients and one patient had the alteration of the Von Willebrand factor. Recurrence occurred in 4 out of 16 patients and all of these patients were positive for factor VII deficiency. Three pts were in therapy with ASA. No patients were alcoholists or suffered from hematological disease. CONCLUSION: In this study we documented that the decreased activity of VII factor may play a role in the pathophysiology and recurrence of spontaneous CSDH in young adults. We suggest that for young patients aged under 65 y.o. suffered from CSDH the screening of coagulation factors is useful to planning a safely and correct surgical therapy.
Asunto(s)
Trastornos de las Proteínas de Coagulación/complicaciones , Hematoma Subdural Crónico/etiología , Adulto , Deficiencia del Factor VII/complicaciones , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
Patients who undergo a renal transplant also require a pharmacological immunosuppressor therapy with cyclosporine (CsA) as well as anti-hypertensive calcium channel-blockers (CCBs); the former suppresses interferon and interleukin-2 production thus interfering with T cell cell-mediated activity, while the latter are used in order to counteract the nephrotoxicity of CsA which causes the local release, of thromboxane A2 with vascular vasoconstriction in the kidney. The use of both these drugs, particularly if used in association, leads to the onset of a clinical picture of variable entity, characterized mainly by a hypertrophy originating usually at the level of interdental papillae, and more pronounced in the anterior maxillary areas and the vestibular surfaces of the teeth, in a more or less symptomatic manner. The therapy is above all preventive, with an appropriate oral hygiene program, both professionally as well as at home, and with the use of substitutive drugs that do not present such side effects.
Asunto(s)
Bloqueadores de los Canales de Calcio/efectos adversos , Ciclosporina/efectos adversos , Hipertrofia Gingival/inducido químicamente , Enfermedad Injerto contra Huésped/prevención & control , Inmunosupresores/efectos adversos , Trasplante de Riñón , Inhibidores de la Enzima Convertidora de Angiotensina/uso terapéutico , Bloqueadores de los Canales de Calcio/administración & dosificación , Bloqueadores de los Canales de Calcio/farmacología , Bloqueadores de los Canales de Calcio/uso terapéutico , Ciclosporina/administración & dosificación , Ciclosporina/farmacología , Ciclosporina/uso terapéutico , Interacciones Farmacológicas , Hipertrofia Gingival/prevención & control , Humanos , Inmunosupresores/administración & dosificación , Inmunosupresores/farmacología , Inmunosupresores/uso terapéutico , Enfermedades Renales/prevención & control , Higiene Bucal , Tromboxano A2/metabolismo , Vasoconstricción/efectos de los fármacosRESUMEN
Human viruses play a fundamental role in the pathogenesis of periodontal disease due to their intrinsec capacity to interfere with immune system of the host. Herpesvirus maybe involved in the onset or progress of a number of periodontal diseases while HIV seems to be related to the linear gingival erythema (LGE) and necrotizing ulcerative periodontitis (NUP).