Navegando por Palavras-chave "venous thromboembolism"
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- ItemSomente MetadadadosCytokine gene variants and venous thrombotic risk in the BRATROS (BRAZILIAN THROMBOSIS STUDY)(Elsevier B.V., 2007-01-01) Pieroni, Fabiano; Lourenco, Dayse M.; Morelli, Vania M.; Maffei, Francisco H.; Zago, Marco A.; Franco, Rendrik F.; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP); State Univ Sao Paolo; Fleury Res InstIntroduction: Venous thrombosis (VT) and inflammation are two closely related entities. in the present investigation we assessed whether there is a relation between genetic modifiers of the inflammatory response and the risk of VT.Materials and methods: 420 consecutive and unrelated patients with an objective diagnosis of deep VT and 420 matched controls were investigated. the frequencies of the following gene polymorphisms were determined in all subjects: TNF-alpha-308 G/A, LT-alpha+252 A/G, IL-6-174 G/C, IL1-ra 86 bp VNTR, IL-10-1082 A/G and CD-31 125 C/G.Results: Overall odds ratio (OR) for VT related to TNF-alpha-308 G/A, LT-alpha+252 A/G, IL-6-174 G/C, Al allele (4 bp repeat) of the IL1 -ra 86 bp VNTR, IL-10-1082 A/G and CD-31 125 C/G were respectively: 1.0 (CI95: 0.8-1.5), 1.3 (095: 1.0-1.7), 1.1 (CI95: 0.9-1.5), 1.6 (CI95: 1-2.5), 1.2 (CI95: 0.8-1.7) and 0.8 (CI95: 0.6-1.1). A possible interaction between polymorphisms was observed only for the co-inheritance of the mutant alleles of the LT-alpha+252 A/G and IL-10-1082 G/A polymorphisms (OR=2; CI95: 1.1-3.8). the risk of VT conferred by factor V Leiden and FII G20210A was not substantially altered by co-inheritance with any of the cytokine gene polymorphisms.Conclusions: Cytokine gene polymorphisms here investigated did not significantly influence venous thrombotic risk. (C) 2006 Elsevier B.V. All rights reserved.
- ItemSomente MetadadadosGeneric Versus Branded Enoxaparin in the Prevention of Venous Thromboembolism Following Major Abdominal Surgery: Report of an Exploratory Clinical Trial(Sage Publications Inc, 2011-11-01) Gomes, Marise; Ramacciotti, Eduardo; Henriques, Alexandre Cruz; Araujo, Gilson Roberto; Szultan, Luiz Arnaldo; Miranda, Fausto [UNIFESP]; Thethi, Indermohan; Loyola Univ; Hosp Base Brasilia; Irmandade Santa Casa Misericordia São Paulo; Universidade Federal de São Paulo (UNIFESP); Aurora Mem HospIntroduction: Several generic low-molecular-weight heparins (LMWHs) have recently become available worldwide, including the United States. Companies have filed for regulatory approval of generic versions in many countries, based only on compound biochemical characteristics or its immunogenicity. Methods: Prospective study to evaluate the comparative effect of 2 enoxaparins (Sanofi-Aventis branded enoxaparin [SAe] vs eurofarma-enoxaparin [Ee], a generic version) as prophylaxis for venous thromboembolism (VTE) following major abdominal surgery. A total of 200 patients were randomized in a 1:1 ratio either to receive 40 mg of SAe or Ee subcutaneously (sc) once daily (od) postoperatively for 7 to 10 days. Compressive ultrasound was performed on day 10 + 4. Results: No statistically significant differences between the 2 groups were detected. in all, 2 SAe patients presented deep vein thrombosis ([DVT] 2.1%), none of the Ee group. No major bleeding events occurred. Conclusions: This exploratory trial suggests that the generic LMWH is probably as safe and as effective as the branded enoxaparin (Lovenox, Brazil) in the prophylaxis of VTE in this population.
- ItemSomente MetadadadosHyperhomocysteinemia increases the risk of venous thrombosis independent of the C677T mutation of the methylenetetrahydrofolate reductase gene in selected Brazilian patients(Lippincott Williams & Wilkins, 2002-04-01) Morelli, V. M.; Lourenco, D. M.; D'Almeida, V; Franco, R. F.; Miranda, F.; Zago, M. A.; Noguti, MAE; Cruz, E.; Kerbauy, J.; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP)Fasting total homocysteine (tHcy) and the methylenetetrahydrofolate reductase (MTHFR) C677T mutation were evaluated in 91 patients with venous thromboembolism and without acquired thrombophilia, and in 91 age-matched and sex-matched controls. Hyperhomocysteinemia was detected in 11 patients (12.1%) and in two controls (2.2%), yielding an odds ratio (OR) for venous thrombosis of 6.1 [95% confidence interval (CI), 1.3-28.4]. After excluding 21 patients and four controls with other known genetic risk factors for venous thrombosis, the OR was not substantially changed (7.0; 95% Cl, 1.5-33.1). the prevalence of the MTHFR 677TT genotype was not significantly different in patients (9.9%) and in controls (5.5%), with an OR for venous thrombosis of 1.8 (95% CI, 0.6-5.8). Subjects with the MTHFR 677TT genotype showed higher levels of tHcy compared with the 677CC genotype in patients (P=0.010) and in controls (P=0.030). in conclusion, we found that fasting hyperhomocysteinemia is a risk factor for venous thrombosis in patients without known acquired thrombophilia and other genetic risk factors for venous thrombosis. Although tHcy levels are significantly higher in those homozygous for the MTHFR C677T mutation, this genotype does not increase the thrombotic risk in our study population. (C) 2002 Lippincott Williams Wilkins.
- ItemSomente MetadadadosNeurological Outcomes in Patients With Ischemic Stroke Receiving Enoxaparin or Heparin for Venous Thromboembolism Prophylaxis Subanalysis of the Prevention of VTE After Acute Ischemic Stroke With LMWH (PREVAIL) Study(Lippincott Williams & Wilkins, 2009-11-01) Kase, Carlos S.; Albers, Gregory W.; Bladin, Christopher; Fieschi, Cesare; Gabbai, Alberto Alain [UNIFESP]; O'Riordan, William; Pineo, Graham F.; PREVAIL Investigators; Boston Univ; Stanford Univ; Monash Univ; Univ Roma La Sapienza; Universidade Federal de São Paulo (UNIFESP); Paradise Valley Hosp; Univ CalgaryBackground and Purpose-The Prevention of VTE after Acute Ischemic Stroke with LMWH (PREVAIL) study demonstrated that enoxaparin was superior to unfractionated heparin (UFH) in preventing venous thromboembolism in patients with ischemic stroke and was associated with a small but statistically significant increase in extracranial hemorrhage rates. in this PREVAIL subanalysis, we evaluate the long-term neurological outcomes associated with the use of enoxaparin compared with UFH. We also determine predictors of stroke progression.Methods-Acute ischemic stroke patients aged >= 18 years, who could not walk unassisted, were randomized to receive enoxaparin (40 mg once daily) or UFH (5000 U every 12 hours) for 10 days. Patients were stratified according to baseline stroke severity using the National Institutes of Health Stroke Scale score. End points for this analysis included stroke progression (>= 4-point increase in National Institutes of Health Stroke Scale score), neurological outcomes up to 3 months postrandomization (assessed using National Institutes of Health Stroke Scale score and modified Rankin Scale score), and incidence of intracranial hemorrhage.Results-Stroke progression occurred in 45 of 877 (5.1%) patients in the enoxaparin group and 42 of 872 (4.8%) of those receiving UFH. Similar improvements in National Institutes of Health Stroke Scale and modified Rankin Scale scores were observed in both groups over the 90-day follow-up period. Incidence of intracranial hemorrhage was comparable between groups (20 of 877 [2.3%] and 22 of 872 [2.5%] in enoxaparin and UFH groups, respectively). Baseline National Institutes of Health Stroke Scale score, hyperlipidemia, and Hispanic ethnicity were independent predictors of stroke progression.Conclusions-The clinical benefits associated with use of enoxaparin for venous thromboembolism prophylaxis in patients with acute ischemic stroke are not associated with poorer long-term neurological outcomes or increased rates of symptomatic intracranial hemorrhage compared with UFH. (Stroke. 2009; 40: 3532-3540.)