Thrombosis in Cushing's disease; raising the flag of concern.

Cushing's disease (CD) is associated with an increased risk of venous thromboembolic events. The purpose of this review is to discuss preventive strategies for post-operative thrombosis in CD patients and their impact on patient outcomes. A systematic review under PRISMA guidelines was conducted within PubMed, Embase, Web of Science, and Cochrane databases through July 2022. Of the 3207 papers retrieved, seven articles were included in this systematic review. Four hundred forty-eight patients were presented in the reviewed studies and the overall reported mortality was 2.67% (12/448). Three studies utilized prophylaxis methods including graduated compression stockings (GCS) and early ambulation (EA) while the remaining four studies only used anticoagulation medicine. Only 20 patients received pre-operative prophylactic treatment, while 366 patients received post-operative prophylaxis which was delivered either immediately after surgery or at different time intervals within 2 days following the surgery. Thrombotic events mainly occurred within two to 3 months after surgery. Overall, a higher frequency of thromboembolic events and mortality was observed in the control groups in comparison to groups receiving prophylaxis. A combination of anticoagulation, EA, and GCS might reduce thrombotic events and mortality in CD patients after treatment. Although the early commencement of a prophylactic anticoagulation regimen on the same day of surgery and continuing up to 3 months seems beneficial, the application of a prophylactic regimen should be utilized with caution since the number of included studies was insufficient to draw a strong conclusion, as well as neither prospective study nor randomized controlled trials existed.

Improvements in permeation and fouling resistance of PVC ultrafiltration membranes via addition of Tetronic-1107 and Triton X-100 as two non-ionic and hydrophilic surfactants.

Two non-ionic and hydrophilic surfactant additives, Tetronic-1107 and Triton X-100, were added to poly(vinyl chloride)/NMP polymeric solution to prepare ultrafiltration membranes via immersion precipitation. Surfactants at three different weight percentages up to 6 wt% were added, and the fabricated membranes were characterized and their performance for water treatment in the presence of bovine serum albumin (BSA) as a foulant was assessed. The scanning electron microscopy images indicated remarkable changes in morphology due to higher thermodynamic instability after surfactant addition. The membranes are more porous with more macro-voids in the sub-layer. Plus, the membranes become more hydrophilic. Water flux increases for the modified membranes by nearly two times and the ability of membranes for flux recovery increases from 66% to over 83%. BSA rejection reduces slightly with the addition of surfactants, however this parameter is still almost over 90% for the membranes with the highest amount of surfactants.