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1.
Res Pract Thromb Haemost ; 8(3): 102394, 2024 Mar.
Article in English | MEDLINE | ID: mdl-38706781

ABSTRACT

A State of the Art lecture entitled "Connecting Fibrinolysis and Dyslipidemia" was presented at the International Society on Thrombosis and Haemostasis Congress 2023. Hemostasis balances the consequences of blood clotting and bleeding. This balance relies on the proper formation of blood clots, as well as the breakdown of blood clots. The primary mechanism that breaks down blood clots is fibrinolysis, where the fibrin net becomes lysed and the blood clot dissolves. Dyslipidemia is a condition where blood lipid and lipoprotein levels are abnormal. Here, we review studies that observed connections between impaired fibrinolysis and dyslipidemia. We also summarize the different correlations between thrombosis and dyslipidemia in different racial and ethnic groups. Finally, we summarize relevant and new findings on this topic presented during the 2023 International Society on Thrombosis and Haemostasis Congress. More studies are needed to investigate the mechanistic connections between impaired fibrinolysis and dyslipidemia and whether these mechanisms differ in racially and ethnically diverse populations.

2.
Arterioscler Thromb Vasc Biol ; 44(3): 533-544, 2024 03.
Article in English | MEDLINE | ID: mdl-38235555

ABSTRACT

Both hyperlipidemia and thrombosis contribute to the risks of atherosclerotic cardiovascular diseases, which are the leading cause of death and reduced quality of life in survivors worldwide. The accumulation of lipid-rich plaques on arterial walls eventually leads to the rupture or erosion of vulnerable lesions, triggering excessive blood clotting and leading to adverse thrombotic events. Lipoproteins are highly dynamic particles that circulate in blood, carry insoluble lipids, and are associated with proteins, many of which are involved in blood clotting. A growing body of evidence suggests a reciprocal regulatory relationship between blood clotting and lipid metabolism. In this review article, we summarize the observations that lipoproteins and lipids impact the hemostatic system, and the clotting-related proteins influence lipid metabolism. We also highlight the gaps that need to be filled in this area of research.


Subject(s)
Atherosclerosis , Thrombosis , Humans , Quality of Life , Blood Coagulation , Atherosclerosis/pathology , Blood Coagulation Factors , Lipoproteins , Fibrinolysis
3.
Res Pract Thromb Haemost ; 7(6): 102164, 2023 Aug.
Article in English | MEDLINE | ID: mdl-37680312

ABSTRACT

Background: Patients with COVID-19 have a higher risk of thrombosis and thromboembolism, but the underlying mechanism(s) remain to be fully elucidated. In patients with COVID-19, high lipoprotein(a) (Lp(a)) is positively associated with the risk of ischemic heart disease. Lp(a), composed of an apoB-containing particle and apolipoprotein(a) (apo(a)), inhibits the key fibrinolytic enzyme, tissue-type plasminogen activator (tPA). However, whether the higher Lp(a) associates with lower tPA activity, the longitudinal changes of these parameters in hospitalized patients with COVID-19, and their correlation with clinical outcomes are unknown. Objectives: To assess if Lp(a) associates with lower tPA activity in COVID-19 patients, and how in COVID-19 populations Lp(a) and tPA change post infection. Methods: Endogenous tPA enzymatic activity, tPA or Lp(a) concentration were measured in plasma from hospitalized patients with and without COVID-19. The association between plasma tPA and adverse clinical outcomes was assessed. Results: In hospitalized patients with COVID-19, we found lower tPA enzymatic activity and higher plasma Lp(a) than that in non-COVID-19 controls. During hospitalization, Lp(a) increased and tPA activity decreased, which associates with mortality. Among those who survived, Lp(a) decreased and tPA enzymatic activity increased during recovery. In patients with COVID-19, tPA activity is inversely correlated with tPA concentrations, thus, in another larger COVID-19 cohort, we utilized plasma tPA concentration as a surrogate to inversely reflect tPA activity. The tPA concentration was positively associated with death, disease severity, plasma inflammatory, and prothrombotic markers, and with length of hospitalization among those who were discharged. Conclusion: High Lp(a) concentration provides a possible explanation for low endogenous tPA enzymatic activity, and poor clinical outcomes in patients with COVID-19.

4.
Science ; 381(6661): eadh5207, 2023 09.
Article in English | MEDLINE | ID: mdl-37651538

ABSTRACT

Apolipoprotein B (apoB)-lipoproteins initiate and promote atherosclerotic cardiovascular disease. Plasma tissue plasminogen activator (tPA) activity is negatively associated with atherogenic apoB-lipoprotein cholesterol levels in humans, but the mechanisms are unknown. We found that tPA, partially through the lysine-binding site on its Kringle 2 domain, binds to the N terminus of apoB, blocking the interaction between apoB and microsomal triglyceride transfer protein (MTP) in hepatocytes, thereby reducing very-low-density lipoprotein (VLDL) assembly and plasma apoB-lipoprotein cholesterol levels. Plasminogen activator inhibitor 1 (PAI-1) sequesters tPA away from apoB and increases VLDL assembly. Humans with PAI-1 deficiency have smaller VLDL particles and lower plasma levels of apoB-lipoprotein cholesterol. These results suggest a mechanism that fine-tunes VLDL assembly by intracellular interactions among tPA, PAI-1, and apoB in hepatocytes.


Subject(s)
Apolipoproteins B , Atherosclerosis , Hepatocytes , Lipoproteins, VLDL , Plasminogen Activator Inhibitor 1 , Tissue Plasminogen Activator , Humans , Apolipoproteins B/blood , Atherosclerosis/blood , Atherosclerosis/metabolism , Hepatocytes/metabolism , Lipoproteins, VLDL/metabolism , Plasminogen Activator Inhibitor 1/blood , Plasminogen Activator Inhibitor 1/metabolism , Tissue Plasminogen Activator/metabolism , Animals , Mice , Mice, Inbred C57BL
5.
Best Pract Res Clin Haematol ; 35(3): 101386, 2022 Sep.
Article in English | MEDLINE | ID: mdl-36494155

ABSTRACT

Reports of racial and ethnic disparities regarding both rates of infection of the SARS-CoV-2 virus and morbidity of the coronavirus disease-19 (COVID-19) contain profound differences depending on the population. Our previous study has shown that patients with COVID-19 who developed hypertriglyceridemia during hospitalization have a 2.3 times higher mortality rate. However, whether the correlation between hypertriglyceridemia and mortality has disparity among different racial and ethnic groups is unknown. In this study, we investigated the impact of race/ethnicity on the correlation between hypertriglyceridemia and mortality in hospitalized patients with COVID-19. De-identified information from 904 hospitalized patients diagnosed with COVID-19 between March 2020 and June 2021 were extracted from the Medical College of Wisconsin Clinical Data Warehouse. A multivariable regression analysis suggested that the Asians and non-White Hispanics had 4 or 3.9 times higher mortality rate, respectively, after adjusting for age, morbid obesity (BMI ≥40), and gender. The hypertriglyceridemia (≥150 mg/dL) was associated with higher mortality, after adjusting for age, gender, and morbid obesity. The baseline hypertriglyceridemia occurrence had relevantly more consistent percentages among all racial/ethnic groups. However, non-White Hispanic and Asian patients had the highest frequencies of peak hypertriglyceridemia occurrence during hospitalization. The peak hypertriglyceridemia developed during hospitalization correlates with the incidence of thrombosis after adjusting for morbid obesity, age, and sex. In summary, in this retrospective study of 904 hospitalized COVID-19 patients, Asians and non-White Hispanics had a greater likelihood of developing hypertriglyceridemia during hospitalization and mortality than White patients.


Subject(s)
COVID-19 , Obesity, Morbid , Humans , United States , SARS-CoV-2 , Retrospective Studies , White People , Black or African American
6.
Cureus ; 13(11): e19456, 2021 Nov.
Article in English | MEDLINE | ID: mdl-34926029

ABSTRACT

Atypical pneumonia shows clinical features that are different from those of typical pneumonia, and it can mimic other entities. We report the case of a 42-year-old male with a solitary pulmonary nodule found in an X-ray for a preoperative evaluation. Our patient was asymptomatic, and a pulmonary neoplasm was the first diagnostic suspicion. The round-shaped nodule seen in the X-ray turned out to be a linear ground glass opacity in a thoracic CT scan. Viral pneumonia due to SARS-CoV-2 was diagnosed. We emphasize here the educational value of this case report. We do not report a new radiological finding because lung nodules resembling neoplasms have already been reported in the medical literature. However, some clinical features of COVID-19 are relatively new and can mimic other entities, and the results of some investigations and clinicians' interpretations of them can be misleading. Atypical radiological findings make it necessary to widen the spectrum of alternative diagnoses.

8.
BMJ Case Rep ; 20172017 Jul 27.
Article in English | MEDLINE | ID: mdl-28754755

ABSTRACT

Fusobacterium necrophorum is the oropharyngeal pathogen usually associated with Lemierre's syndrome, a pharyngeal infection which evolves to sepsis, septic emboli and thrombophlebitis of the adjacent neck vessels. It is an uncommon causative bacteria of a liver abscess, and an extensive workup should, therefore, be performed in order to rule out potential sources of the infection. This case report describes the workup that led to the diagnosis of a colorectal carcinoma, which was deemed to be the source of the Fusobacterium bacteraemia.


Subject(s)
Abdominal Pain/microbiology , Bacteremia/microbiology , Fusobacterium Infections/microbiology , Fusobacterium necrophorum/isolation & purification , Liver Abscess/microbiology , Sepsis/microbiology , Anti-Bacterial Agents/therapeutic use , Ceftriaxone/therapeutic use , Fusobacterium Infections/complications , Fusobacterium Infections/drug therapy , Humans , Liver Abscess/complications , Liver Abscess/drug therapy , Male , Metronidazole/therapeutic use , Middle Aged , Nausea/microbiology , Penicillanic Acid/analogs & derivatives , Penicillanic Acid/therapeutic use , Piperacillin/therapeutic use , Piperacillin, Tazobactam Drug Combination , Sepsis/drug therapy , Treatment Outcome , Vomiting/microbiology
9.
BMJ Case Rep ; 20172017 May 22.
Article in English | MEDLINE | ID: mdl-28536213

ABSTRACT

Lymphatic malformations, also known as lymphangiomas or cystic hygromas, are benign masses that typically affect newborns and infants and involve the head and neck regions. They are, however, rare in adults and even rarer in the axillary region. Although surgery is considered to be the treatment of choice, we present a rare case of a recurrent cystic hygroma 32 years after the first surgical operation. Due to the cosmetic concerns and the risks of a surgical approach, non-surgical therapy with percutaneous sclerosants was performed, with a good outcome after a 2-year follow-up period.


Subject(s)
Lymphangioma, Cystic/therapy , Neoplasm Recurrence, Local/therapy , Soft Tissue Neoplasms/therapy , Adult , Axilla , Female , Humans
11.
Hipertens. riesgo vasc ; 33(2): 69-73, abr.-jun. 2016. ilus, tab
Article in Spanish | IBECS | ID: ibc-151981

ABSTRACT

Describimos el caso de un varón de 37 años con antecedentes de hipertensión arterial de varios años de evolución, en tratamiento farmacológico, que ingresa por un cuadro de astenia generalizada con disminución de fuerza en ambos miembros inferiores. En la analítica realizada en Urgencias de detecta una hipopotasemia severa, por lo que se inicia el estudio de posible hipertensión arterial secundaria. Con la sospecha inicial de hiperaldosteronismo primario se realiza analítica completa, incluyendo actividad de renina plasmática basal, que está claramente suprimida, así como aldosterona plasmática basal, que resulta normal. Así mismo, se realiza una TC abdominal que muestra la existencia de un adenoma suprarrenal. Por este motivo se decide realizar una sobrecarga oral de sodio con determinación posterior de actividad de renina plasmática, que sigue estando suprimida, aldosterona plasmática, que sigue siendo normal, y aldosterona en orina de 24 h, que aparece claramente elevada y confirma así el diagnóstico de sospecha. Tras la cirugía el paciente se mantiene normotenso, sin necesidad de tratamiento farmacológico y con niveles de potasio sérico normales


We report a case of a 37 year-old man with a long history of hypertension under treatment, who was admitted at our institution with intense fatigue and weakness of lower limbs. The laboratory results at Emergency Department showed severe hypokalemia. A study of secondary hypertension was carried out. With the initial suspicion of primary hyperaldosteronism, complete blood test was done including plasma renine activity, which was completely suppressed, and plasma aldosterone concentration, which resulted normal. Likewise, an abdomen CT was performed and revealed a left adrenal mass consistent of suprarrenal adenoma. Therefore, a salt loading suppression test was done with subsequent measure of plasmatic renine activity, which was still suppressed, plasma aldosterone concentration, that persisted normal, and a 24-h urinary aldosterone excretion rate, which was clearly high, supporting the suspected diagnosis. After the adrenalectomy, the patient remained asymptomatic with normal blood pressure without treatment and with normal serum potassium levels


Subject(s)
Humans , Male , Adult , Hypokalemia/etiology , Hyperaldosteronism/diagnosis , Hypertension/complications , Adrenocortical Adenoma/diagnosis , Adrenal Gland Neoplasms/surgery
12.
Hipertens Riesgo Vasc ; 33(2): 69-73, 2016.
Article in Spanish | MEDLINE | ID: mdl-26869044

ABSTRACT

We report a case of a 37 year-old man with a long history of hypertension under treatment, who was admitted at our institution with intense fatigue and weakness of lower limbs. The laboratory results at Emergency Department showed severe hypokalemia. A study of secondary hypertension was carried out. With the initial suspicion of primary hyperaldosteronism, complete blood test was done including plasma renine activity, which was completely suppressed, and plasma aldosterone concentration, which resulted normal. Likewise, an abdomen CT was performed and revealed a left adrenal mass consistent of suprarrenal adenoma. Therefore, a salt loading suppression test was done with subsequent measure of plasmatic renine activity, which was still suppressed, plasma aldosterone concentration, that persisted normal, and a 24-h urinary aldosterone excretion rate, which was clearly high, supporting the suspected diagnosis. After the adrenalectomy, the patient remained asymptomatic with normal blood pressure without treatment and with normal serum potassium levels.


Subject(s)
Hyperaldosteronism/diagnosis , Hypokalemia/etiology , Adenoma , Adrenal Cortex Neoplasms , Adrenal Gland Neoplasms , Adrenalectomy , Adult , Aldosterone , Humans , Hypertension , Male , Renin
14.
J Zoo Wildl Med ; 46(4): 895-903, 2015 Dec.
Article in English | MEDLINE | ID: mdl-26667547

ABSTRACT

Few reports of neoplastic diseases in manatees exist in the veterinary literature. This case series presents reproductive neoplasia noted in eight wild and long-term captive female Florida manatees (Trichechus manatus latirostris) obtained through carcass recovery and animal rehabilitation programs between April 2009 and May 2014. All cases were evaluated histologically, and diagnoses of uterine carcinoma (n = 1), granulosa cell tumor (n = 2), ovarian adnexal tumor (n = 1), and leiomyoma (n = 5) were made. The underlying cause of tumor development and effects on reproductive success is currently unknown, but possible asymmetric reproductive aging and/or a correlation between obesity and reproductive disorder in long-term nonreproductive female manatees are of interest and warrant further investigation.


Subject(s)
Animals, Wild , Animals, Zoo , Ovarian Neoplasms/veterinary , Trichechus , Uterine Neoplasms/veterinary , Animals , Female , Ovarian Neoplasms/pathology , Uterine Neoplasms/pathology
15.
Prog. obstet. ginecol. (Ed. impr.) ; 54(1): 21-23, ene. 2011. ilus
Article in Spanish | IBECS | ID: ibc-85769

ABSTRACT

El schwanoma en la espina dorsal es una entidad poco frecuente cuyo principal problema es la sintomatología causada por el aumento de tamaño y su consecuente compresión medular. Una peculiaridad de esta neoplasia benigna es la presencia de receptores para estrógenos y progesterona en las células de Schwann, que se ha relacionado con un mayor crecimiento de estos tumores en pacientes gestantes(AU)


Schwannoma of the spine is a rare entity. The main problem caused by this tumor are the symptoms provoked by its increasing size and the consequent spinal cord compression. A peculiarity of this benign neoplasm is the presence of estrogen and progesterone receptors in Schwann cells, which has been linked to greater growth of these tumors in pregnant patients(AU)


Subject(s)
Humans , Female , Pregnancy , Adult , Neurilemmoma/complications , Neurilemmoma/diagnosis , Spine/pathology , Spinal Cord Compression/pathology , Spinal Cord Compression , Paraparesis, Spastic/complications , Adrenal Cortex Hormones/administration & dosage , Adrenal Cortex Hormones/therapeutic use , Laminectomy , Neurilemmoma/physiopathology , Neurilemmoma , Spine , Muscle Spasticity/complications
16.
J Am Vet Med Assoc ; 237(4): 429-36, 2010 Aug 15.
Article in English | MEDLINE | ID: mdl-20707754

ABSTRACT

OBJECTIVE: To determine risk factors for lens luxation and cataracts in captive pinnipeds in the United States and the Bahamas. DESIGN: Cross-sectional study. ANIMALS: 111 pinnipeds (99 California sea lions [Zalophus californianus], 10 harbor seals [Phoca vitulina], and 2 walruses [Odobenus rosmarus]) from 9 facilities. PROCEDURES: Eyes of each pinniped were examined by a veterinary ophthalmologist for the presence of cataracts or lens luxations and photographed. Information detailing husbandry practices, history, and facilities was collected with a questionnaire, and descriptive statistical analyses were performed for continuous and categorical variables. Odds ratios and associated 95% confidence intervals were estimated from the final model. RESULTS: Risk factors for lens luxation, cataracts, or both included age >or= 15 years, history of fighting, history of ocular disease, and insufficient access to shade. CONCLUSIONS AND CLINICAL RELEVANCE: Diseases of the lens commonly affect captive pinnipeds. Access to UV-protective shade, early identification and medical management of ocular diseases, and prevention of fighting can limit the frequency or severity of lens-related disease in this population. An extended life span may result from captivity, but this also allows development of pathological changes associated with aging, including cataracts.


Subject(s)
Caniformia , Cataract/veterinary , Eye Abnormalities/veterinary , Animals , Bahamas/epidemiology , Cataract/epidemiology , Eye Abnormalities/epidemiology , Eye Injuries/veterinary , Female , Housing, Animal , Male , Odds Ratio , Risk Factors , United States/epidemiology
17.
Hybrid Hybridomics ; 22(6): 393-6, 2003 Dec.
Article in English | MEDLINE | ID: mdl-14683600

ABSTRACT

Spleen cells from BALB/c mice immunized with recombinant TmpA were fused with mouse myeloma cells (P3/X63-Ag8), and five hybridomas secreting monoclonal antibodies were obtained. These hybridomas specifically recognize TmpA and do not cross-react with other molecules such as recombinant HBsAg of HBV and synthetic HCV core peptides. The monoclonal antibodies were IgG1 subclass and ascitic fluid from these hybridomas was purified by affinity chromatography on Protein A-Sepharose CL-4B column to isolate the IgG1 active fraction. The affinity constant of these monoclonal antibodies ranged from 6.4 x 10(8) and 1.73 x 10(10) M(-1).


Subject(s)
Antibodies, Monoclonal/chemistry , Bacterial Proteins/chemistry , Bacterial Proteins/immunology , Immunoassay/methods , Membrane Proteins/chemistry , Membrane Proteins/immunology , Recombinant Proteins/chemistry , Spleen/metabolism , Animals , Antibody Specificity , Chromatography, Affinity , Epitopes , Hybridomas/metabolism , Immunoglobulin G/chemistry , Kinetics , Mice , Mice, Inbred BALB C , Peptides/chemistry , Protein Binding , Recombinant Proteins/immunology , Spleen/cytology , Syphilis/diagnosis , Treponema pallidum/metabolism
18.
Head Neck ; 15(6): 537-45, 1993.
Article in English | MEDLINE | ID: mdl-8253562

ABSTRACT

This is a retrospective review of 409 cases of papillary thyroid cancer treated at the Hospital of Oncologia, National Medical Center, IMSS in Mexico City. The clinical features, histopathologic findings, analysis of recurrences and survivals according to age, sex, tumor size, and modality of treatment are described. The results showed that tumoral diameter > 5 cm, distant metastasis at diagnosis, age > 40 years, and tumoral infiltration beyond the thyroid capsule significantly affect the patient's survival.


Subject(s)
Carcinoma, Papillary/therapy , Thyroid Neoplasms/therapy , Actuarial Analysis , Adolescent , Adult , Aged , Aged, 80 and over , Carcinoma, Papillary/epidemiology , Carcinoma, Papillary/mortality , Child , Female , Hospitals, Special , Humans , Male , Medical Oncology , Mexico , Middle Aged , Neoplasm Recurrence, Local/epidemiology , Retrospective Studies , Sex Distribution , Survival Analysis , Thyroid Neoplasms/epidemiology , Thyroid Neoplasms/mortality
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