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Background. Pathological changes in vitamin B12 levels are a common laboratory finding. The increase in serum vitamin B12 levels is termed B12 hypervitaminemia, often perceived as a benign disorder, leading to its underestimation. Objective.This paper aims to examine the potential pathogenetic mechanisms and the association of vitamin B12 excess with various diseases. Methodology. A literature search was conducted using the PubMed, DOAJ, and Google Scholar databases. The search was focused on original articles, review papers, and reference lists published in English since 2000. Results. Increased vitamin B12 levels are encountered in hematological disorders, solid tumors, renal and hepatic diseases, as well as inflammatory conditions. Vitamin B12 supplements increase the levels and can exacerbate underlying pathological conditions. The pathophysiology involves disturbances in the biology and metabolism of vitamin B12 and its carrier proteins. Falsely elevated values can arise due to interferences in quantitative assays. Elevated vitamin B12 may represent an incidental finding, accompany findings of underlying disease, and coexist with manifestations of functional deficiency. Conclusion. Elevated vitamin B12 may serve as an early indicator for the diagnosis and monitoring of serious diseases. Understanding the underlying pathogenetic mechanisms and establishing diagnostic algorithms are crucial areas for future research. [ABSTRACT FROM AUTHOR]

Context.--Cancer is characterized by the development of a prothrombotic state Approximately 15% to 20% and 1.5% to 3.1% of cancer patients develop venous and arterial thrombosis, respectively, whereas 18% to 20% of idiopathic venous events are caused by an occult neoplasia. The highest risk is observed in hematologic, gastrointestinal, and lung malignancies, as well as in patients with active disease, especially in the first 3 months after cancer diagnosis. Hospitalization, surgical interventions, and implanted venous devices increase the thrombotic risk. Patients with metastatic disease, febrile neutropenia, infections, and severe comorbidities experience more frequently a thrombotic event. A contemporary prechemotherapy predictive model incorporates both clinical and biologic parameters, such as the primary cancer site, platelet count, white blood cell count, hemoglobin, use of erythropoietic agents, and body mass index. Several studies aim to clarify the prognostic value of tissue factor, P-selectin, thrombin generation, microparticles, and D-dimers. Objectives.--To summarize current views on epidemiology, risk factors, and predictive variables, discussing the future perspectives and existing limitations in clinical practice. Data Sources.--Review of published literature, including review papers, epidemiologic studies, and clinical trials, in online medical databases. Conclusions.--The thrombogenic properties of tumor cells affect the prognosis and quality of life for the cancer population. Despite the improved awareness and prompt use of thromboprophylaxis, recent studies reported increased rates of thrombotic events, whereas the annual risks for thrombosis recurrence and bleeding are 21% and 12%, respectively. The clinical use of risk factors and prognostic parameters could allow for patient risk stratification and individualization of anticoagulant treatment. (Arch Pathol Lab Med. 2013;137:1286-1295; doi: 10.5858/arpa.2012-0490-RA), INTRODUCTION The association between venous thromboembolism (VTE) and cancer has been described for more than 140 years, since Armand Trousseau reported that patients with idiopathic thrombosis frequently developed cancer in [...]

Background: Helicobacter pylori infects half of world's population causing local tissue damage in gastric mucosa. The implication in a variety of extraintestinal disorders is less clear and the available studies often lead to conflicting results. Aim: This article will review the implication of Helicobacter pylori in the development of non-malignant haematological disorders in adults. Epidemiological data, possible pathogenetic mechanisms and the role of eradication therapy are analyzed. Methodology: Relevant articles published in English during the last two decades were found through PubMed and SCOPUS. Results: Significant advances have been made in understanding the pathophysiology of Helicobacter pylori-induced haematological disorders. The investigation of persistently thrombocytopenic and anaemic patients in absence of other causative factors should include Helicobacter pylori assays. Half of infected thrombocytopenic patients respond to eradication, whereas the outcomes are less clear in anaemic disorders. Bacterial strains and genetic factors seem to influence the outcome of bacterium eradication. The implication of Helicobacter pylori in atherosclerosis remains controversial and it is attributed either to inflammation process or to direct alteration in haemostatic factors. Conclusion: Large randomized studies are needed to determine the subpopulation at risk of developing Helicobacter pylori-related haematological disorders. In this case prompt screening and eradication treatment could be of major importance. [ABSTRACT FROM AUTHOR]

Antiplatelet agents, aspirin and clopidogrel, have a crucial role in the treatment and prevention of cardiovascular events. Aspirin inhibits the cyclooxygenase-dependent platelet function, whereas clopidogrel inhibits the P2Y12-adenosine diphosphate receptor. Various clinical and genetic factors involved in treatment resistance, which often affects the clinical outcome. Currently, the absence of standardized platelet function assays hampers the correlation between laboratory findings and clinical implications. Treatment approach includes the improvement of patient's compliance, dose escalation and combined antiplateletet regimes. Several ongoing studies assess novel inhibitors of P2Y12 receptor, thrombin, thromboxane and platelet glycoprotein GPIIb/IIIa. This study is an overview of the clinical significance of antiplatelet resistance, examines the available platelet function tests; and presents their limitations in routine practice and the alternative treatment options. [ABSTRACT FROM AUTHOR]