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Introducción: La TVP es una de las patologías vasculares más comunes en el mundo, cuya aparición es una combinación de diferentes factores de riesgo tanto genéticos como no genéticos, por lo que se considera una enfermedad prevenible, sin embargo, en la actualidad la identificación de estos factores puede representar un desafío para el clínico, lo que lleva a que esta sea clasificada como no provocada o idiopática. Este artículo tiene como objetivo hacer una revisión sobre los factores de riesgo, tanto genéticos como no genéticos que puedan orientar al clínico en la sospecha y prevención de la TVP. Metodología: Se realizó una revisión de la literatura en las bases de datos PubMed y Elsevier con el propósito de recopilar información actualizada sobre los factores de riesgo y características genéticas asociadas a la trombosis venosa profunda (TVP). Se emplearon los términos DeSC de trombosis de vena profunda, trombosis venosa y flebotrombosis juntos con sus equivalencias en MeSH, combinadas con los conectores booleanos AND y OR para refinar la búsqueda. Se revisaron un total de 80 artículos publicados entre 2018 y 2023, los cuales fueron evaluados inicialmente según unos criterios de inclusión y exclusión, seleccionando 50 para ser usados en esta revisión. Los criterios de inclusión comprendieron estudios que abordaran específicamente los factores de riesgo, tanto genéticos como no genéticos para el desarrollo de la TVP y sus generalidades. Se incluyeron estudios de investigación originales y en menor medida artículos de revisión. Los criterios de exclusión se centraron en estudios que no estuvieran disponibles en idioma español o inglés y estudios relacionados con población pediátrica. Se seleccionaron artículos de procedencia global que incluyeran población mayor de 18 años y que se adecuaran al período de publicación entre 2018 y 2023. Se optó por utilizar las bases de datos PubMed y Elsevier debido a su amplia cobertura en medicina y su gran aceptación en la comunidad científica. Conclusión: Se evidenció que son múltiples los factores de riesgo que predisponen para la aparición de la TVP, de los cuales, en la mayoría ellos la intervención médica puede impactar positivamente para el desarrollo de la enfermedad, incluyendo las alteraciones genéticas y sus implicaciones.

Como es sabido, la ecografía es una herramienta complementaria muy útil en la exploración, y entre otros muchos usos, es una técnica de imagen relativamente novedosa para el diagnóstico de la enfermedad tromboembólica ofreciendo una evaluación rápida, no invasiva, y de fácil acceso en una gran variedad de escenarios clínicos. En particular, permite la detección simultánea de la disfunción del ventrículo derecho y la presencia de trombosis venosa, así como la mejora del examen físico restante, parece ser una herramienta útil para ayudar en la evaluación y el tratamiento del paciente con enfermedad tromboembólica venosa. De hecho, en el presente reporte, permitió descubrir una distensión vesical persistente y una trombosis venosa secundaria no diagnosticada previamente, que muy probablemente se formó debido al aumento de la presión venosa inducida por la vejiga, y así facilitó la realización de diversos procedimientos para tratar adecuadamente al paciente.

Objective: To determine whether an educational intervention strategy would improve the frequency of medical prescriptions for adequate thromboprophylaxis in a medicine service. Methods: Quasi-experimental study, in which in the pre-intervention phase the frequencies of indication of appropriate thromboprophylaxis by physicians from the medicine service were obtained. An 8-week educational intervention was carried out with this same group of doctors. In the post-intervention phase, the frequency of adequate thromboprophylaxis was measured at 2 and 4 months after the intervention. Results: The educational intervention was implemented in 112 resident physicians in medicine specialties. All prescriptions were made by the first-year resident physicians and endorsed by their supervising physician. Prior to the intervention, 47 (44.35%) adequate prescriptions were obtained, 13 (12.26%) suboptimal, 4 (3.77%) inadequate, and 42 (39, 62%) no prescription. After the intervention, the following 2 months were obtained: 78 (75.72%) adequate prescriptions, 7 (6.79%) suboptimal, 4 (2.91%) inadequate and 15 (14.58%) no prescriptions, there being a significant difference with the baseline level. At the subsequent 4 months post-intervention, the following were obtained: 86 (83.49%) adequate, 5 (4.85%) suboptimal, 2 (1.94%) inadequate and 10 (9.72%) no prescription, with a difference significant with the baseline level. There was no increase in the frequency of overuse. Conclusions: The application of an educational strategy to medical personnel was effective in increasing correctly indicated thromboprophylaxis prescriptions in a medical service. No overuse of thromboprophylaxis was found after the intervention. [ABSTRACT FROM AUTHOR]

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Introducción. La trombosis venosa cerebral es una causa infrecuente de enfermedad cerebrovascular que viene en aumento a nivel mundial. A pesar de ello, actualmente, en Colombia no se cuenta con estudios suficientes que nos permitan caracterizar epidemiológicamente la enfermedad en nuestra población para identificar los factores de riesgo y las complicaciones más frecuentes en nuestro medio. Objetivo. Describir las características clínicas, demográficas y radiológicas, y los factores de riesgo de una serie de pacientes con trombosis venosa cerebral de dos hospitales de Colombia. Materiales y métodos. Es un estudio descriptivo retrospectivo de pacientes hospitalizados, atendidos en el servicio de neurología de dos hospitales de Bogotá desde diciembre de 2018 hasta diciembre del 2020. Resultados. Se incluyeron 33 pacientes. Las frecuencias más altas correspondieron a mujeres en edad fértil, en puerperio (n=7; 33,3 %) y pacientes con patologías autoinmunes (n=10; 30,3 %). El síntoma inicial más común fue la cefalea (n=31; 93,9 %), seguido de focalización neurológica (n=9; 27,2%) y crisis epiléptica (n=8; 24,2 %). El 51 % (n=17) de los pacientes tuvo un examen físico normal. El infarto venoso cerebral se presentó en el 21,1 % (n=7), la hemorragia subaracnoidea en el 12,1 % (n=4) y el hematoma intraparenquimatoso en el 9 % (n=3) del total de pacientes. El 60,6 % (n=20) quedó con nivel independiente en la escala funcional de Barthel. Ningún paciente falleció. Conclusiones. Se encontraron características sociodemográficas, clínicas y radiológicas similares a lo reportado en la literatura mundial. Con respecto a las diferencias, se encontró en nuestro estudio compromiso de la circulación venosa cerebral profunda en un porcentaje ligeramente mayor a lo descrito, pero sin aumento de complicaciones, ni mortalidad.

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La trombosis portal puede ocurrir en pacientes cirróticos y no cirróticos. En esta revisión se tratará la trombosis portal benigna en ambos tipos de pacientes. Se estima que la incidencia anual de trombosis portal en pacientes con cirrosis avanzada es del 10-15%, mientras que en pacientes no cirróticos se sitúa en apenas 0.7 por 100.000 habitantes/año, presentando hasta un 60% factores etiológicos sistémicos. Las manifestaciones clínicas dependen del momento evolutivo en el que se encuentre la trombosis (aguda frente a crónica) y de la extensión del trombo. La anticoagulación es el tratamiento de elección en la mayoría de casos, si bien es necesario individualizar en cada paciente.

Introducción: el síndrome de la vena cava superior es un conjunto de síntomas y signos causados por el deterioro del flujo sanguíneo de la mitad superior del tórax, el cuello, la cabeza y las extremidades superiores a la aurícula derecha debido a la obstrucción parcial o completa de la vena cava superior. Los tumores malignos, como el cáncer pulmonar y el linfoma, son la principal causa hasta en el 90% de los casos. El síndrome de la vena cava superior se ha informado como complicación rara del cáncer de tiroides, a consecuencia de la invasión mediastínica por el tumor o por la invasión intravascular del mismo con trombosis. Información del paciente: se describe el caso de una paciente femenina de 87 años de edad, con historia clínica de cáncer de tiroides, que asistió al Servicio de Urgencias por tos húmeda, disnea y escasa emisión de orina, la que presentó como complicación de esta neoplasia el síndrome de la vena cava superior por trombosis de la vena cava, de ambas yugulares y de la raíz de la arteria pulmonar. Conclusión: el síndrome de la vena cava superior, aunque no es muy común, se presenta con alguna frecuencia, por eso la necesidad del diagnóstico del proceso, sea benigno o maligno. El manejo de estos enfermos presenta siempre grandes dificultades porque, en muchas ocasiones, se comportan como graves urgencias clínicas.

Background and objective. Free tissue transfer has become an increasingly important tool in Plastic Reconstructive Surgery. Despite the high success rates reported in the literature, the procedure can fail due to variables unrelated to the surgical technique. We carried out this study to know the frequency of complications in a group of patients undergoing free tissue transfer at the Clínica Los Nogales in Bogotá, Colombia, as well as determining factors unrelated to the surgical technique to propose measures that optimize the probability of success of the procedure. Methods. Descriptive case series study, in which we retrospectively analyzed the medical records of 40 patients undergoing free flap reconstruction between 2017 and 2021. We evaluated the preoperative, intraoperative, and postoperative variables of each of these patients. Results. The 40 cases of free tissue transfer included 37 reconstructions (92.5%) secondary to oncological resection and 3 to acute trauma (7.5%). The anterolateral thigh (ALT) flap was the most frequently performed free flap (50%), followed by the deep inferior epigastric artery perforator (DIEP) flap (22.5%), the fibular free flap (17.5%) and the radial flap (10%). Fifteen per cent of the reconstructions were unsuccessful: in 10% of cases due to venous thrombosis, and in 5% of cases due to arterial thrombosis of the anastomosis. Age, radiotherapy and preoperative hemoglobin level do not seem to affect flap survival. Smoking was a determining factor in the occurrence of important complications of the flap. Postoperative medical complications occurred in 20% of cases, predominantly cardiac complications. Conclusions. Each period of free flap reconstruction involves factors that are likely to influence the outcome of the procedure. Our study indicates that age and smoking history are key factors in this regard. [ABSTRACT FROM AUTHOR]

Introduction: superior vena cava syndrome is a group of symptoms and signs caused by deterioration of blood flow from the upper half of the thorax, neck, head and upper extremities to the right atrium due to partial or complete obstruction of the superior vena cava. Malignant tumors, such as lung cancer and lymphoma, are the main cause in up to 90% of cases. Superior vena cava syndrome has been reported as a rare complication of thyroid cancer, resulting from mediastinal invasion by the tumor or intravascular invasion of the tumor with thrombosis. Patient information: it is described the case of an 87-year-old female patient, with clinical history of thyroid cancer, who was admitted to the Emergency Department due to wet cough, dyspnea and poor urine output, who presented superior vena cava syndrome as a complication of this neoplasm due to thrombosis of the vena cava, both jugular veins and the root of the pulmonary artery. Conclusion: the superior vena cava syndrome, although it is not very common, occurs with some frequency, that is why it is necessary to diagnose the process, whether benign or malignant. The management of these patients always presents great difficulties because, on many occasions, they behave as serious clinical emergencies. [ABSTRACT FROM AUTHOR]

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Copyright of Cirugía y Cirujanos is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: We aimed to anlayse the relationship between anti-Xa activity below range and thomboembolic events., Design: Single center prospective observational longitudinal cohort study (February-November 2021)., Setting: Patients admitted to the ICU of a University Hospital., Participants: Patients with severe COVID-19 pneumoniae., Interventions: Enoxaparin was used for prophylactic and therapeutic anticoagulation. Enoxaparin dosing and dose adjustment were based on anti-Xa activity according to the hospital protocol., Main Variables of Interest: Target: thomboembolic events., Predictors: demographics, pharmacotherapy, anti-Xa measurements, clinical data, and laboratory results. Logistic regression was used to identify independent risk factors for thomboembolic events., Results: Data were available for 896 serum anti-Xa measurements from 228 subjects. Overall, 71.9% were male, with a median age of 62. Most patients needed invasive mechanical ventilation (87.7%) and mortality was 24.1%. A total of 28.9% new thomboembolic events were diagnosed. There were 27.1% anti-Xa measesurements below range. When multivariable logistic regression analysis was performed anti-Xa activity below range (RR, 4.2; p = 0.000), C-reactive protein (25 mg/L increase) (RR, 1.14; p = 0.005) and D-dimer (1000 ng/L increase) (RR, 1.06; p = 0.002) were the independent factors related to new thomboembolic events in patients with severe COVID-19., Conclusions: Anti-Xa activity below range, C-reactive protein and D-dimer were the independent factors related to thomboembolic events in patients with severe COVID-19. Purposely designed clinical trials should be carried out to confirm the benefit of an anti-Xa monitoring., (Copyright © 2024 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.)

Produced in the liver, Antithrombin III, now simply antithrombin (AT), is a vitamin K-independent serine protease inhibitor in the coagulation pathway. It is the most important primary physiologic inhibitor of thrombin in the human body. In addition to thrombin, AT also inhibits other coagulation serine proteases including VIIa, IXa, Xa, XIa, XIIa. (1-2) The deficiency of AT may be inherited or acquired. The incidence of inherited AT deficiency is about 1:2000-5000 in general population and is the least common of the three main anticoagulant deficiencies (the other two being protein C deficiency and protein S deficiency). (3) Its inheritance is generally in autosomal dominant fashion. The resultant procoagulant state leads to unprovoked recurrent venous thromboses and thromboembolic events such as deep vein thrombosis or pulmonary embolism which generally appear at the post-pubertal period, compared to the very low occurrence in the prepubertal period.(4) The diagnosis is based on both quantitative and qualitative measurement of AT level.(5) The measured AT activity in functional tests in healthy subjects is generally around 80% to 120%, and AT level of less than 70% is considered as being AT deficiency. This evaluation should be made while not on anticoagulation therapy, because heparin decreases AT levels for up to 10 days following its discontinuation and warfarin increases its level. (6) Patients with inherited AT deficiency rarely develops renal failure which may be caused by renal vein thrombosis or glomerular injury associated with fibrin accumulation. (7) In these young patients with end stage renal disease (ESRD), renal transplantation is currently the best therapeutic option to improve the quality of life and to avoid the risk of complications of other renal replacement treatment particularly thrombosis of the hemodialysis access. Kidney transplantation in patients with an occluded iliac veins and inferior vena cava (IVC) is a very challenging surgery to perform.(8-9) Despite the reported success in few cases for children, kidney transplant surgeries with thrombotic diseases in adults remain very limited in the literature. Herein, we present a successful kidney transplantation by using a polytetrafluoroethylene (PTFE) graft in a young male patient with AT deficiency associated with totally occluded IVC and iliac veins. [ABSTRACT FROM AUTHOR]

BACKGROUND: Within cerebral vascular disease, venous thrombosis is an entity that until now has been little considered due to its low frequency (0.5 to 1%) worldwide, according to different reports in the literature. Currently, there is a great difference between the incidence reported in the different populations studied, as well as the risk factors for its development. In Mexico, the information is relatively low and variable frequencies ranging from 0.43 to 8% have been reported. OBJECTIVE: To determine the incidence of cerebral venous thrombosis in patients who were treated at Hospital Ángeles Pedregal, Mexico City, in a period of 5 years (2013 to 2018). MATERIALS AND METHODS: A descriptive, single-center study of a retrospective cohort that included all patients diagnosed with cerebral venous thrombosis (CVT) from January 2103 to December 2018 al Hospital Ángeles Pedregal, Mexico City. RESULTS: During the study period, there were 17 cases of cerebral venous thrombosis; headache was the most frequent symptom, and the most frequent predisposing factor was infectious. CONCLUSIONS: Cerebral venous thrombosis in Mexico is more frequent than that reported in world literature, as it was observed in this study with an incidence of 7.6%. [ABSTRACT FROM AUTHOR]

Introducción: La enfermedad tromboembólica venosa es la tercera causa de enfermedad cardiovascular, siendo un problema de salud pública debido a la carga de la enfermedad y los costos de la misma. No existen estudios epidemiológicos que describan el comportamiento conjunto de los dos eventos en el suroccidente colombiano; por consiguiente, el objetivo es determinar la prevalencia, características sociodemográficas, clínicas y complicaciones por la enfermedad en pacientes de un centro hospitalario de la ciudad de Popayán. Materiales y métodos: estudio descriptivo, observacional y retrospectivo, en el cual se tomó como población a todos los pacientes de 18 a más años con diagnóstico de ETEV. Resultados: La prevalencia fue de 0,008%. De los 120 pacientes con enfermedad tromboembólica venosa, la media de edad fue 61,53 años, la mayoría de género femenino y procedentes de Popayán. El factor de riesgo más frecuente fue la edad mayor de 40 años (80%), el síntoma más frecuente fue edema de miembros inferiores (79,1%) en pacientes con dicha condición y el ecodoppler fue la técnica diagnostica utilizada en el 100%. La disnea (76,19%) fue más frecuente en los pacientes con tromboembolia pulmonar, con electrocardiograma normal y derrame pleural en la radiografía de tórax. La técnica diagnóstica más frecuente fue la angiotomografía (90,02%). El 79,2% presentaban protección tromboembólica con heparina de bajo peso molecular en su mayoría, 27,5% de los pacientes presentaron al menos una complicación y la mortalidad estuvo presente en 5,8%. El porcentaje de reingresos fue del 17,5%. Conclusiones: la identificación temprana de factores de riesgo, signos y síntomas permiten el diagnóstico y la intervención temprana para disminuir la progresión a complicaciones, recurrencias y reingresos.

La vena porta es un conducto que drena el flujo esplácnico al hígado y se puede ocluir por diferentes patologías, variando su presentación clínica de acuerdo con la causa de la obstrucción. Es muy importante diferenciar la trombosis portal asociada o no a la cirrosis, ya que su tratamiento y pronóstico es diferente. La trombosis venosa portal extrahepática es una condición netamente de origen vascular, y es la principal causa de trombosis portal en niños y adultos. Presentamos tres casos tratados con derivación meso-Rex, con seguimiento a 6 meses.

Introducción: la Enfermedad Tromboembólica Venosa (ETV) incluyen: trombosis venosa superficial, venosa profunda, de las venas ováricas, pélvica séptica y el trombo embolismo pulmonar. Objetivo: realizar revisión sobre factores de riesgo, diagnóstico, manejo y tratamiento de ETV en pacientes obstétricas. Metodología: revisión temática que incluye estudios clínicos y epidemiológicos, revisiones sistemáticas, temáticas, consensos, reuniones de expertos, guías clínicas y protocolos sobre ETV en el embarazo. Revisadas las bases de datos PubMed, ScienceDirect, OvidSP y Scielo, durante los años 2000 y 2011, en los idiomas inglés y español. Resultados: la búsqueda arrojó 214 estudios. 76 cumplieron con los criterios de inclusión y fueron revisados. Existe una buena aproximación a los factores de riesgo para el desarrollo de ETV en mujeres gestantes. Existe un test clínico para identificar mujeres con riesgo de TVP. Existen estudios de imagen que ofrecen diferentes porcentajes de sensibilidad y especificidad. La gammagrafía por perfusión es una buena y segura herramienta en la mujer gestante. El diagnóstico temprano debe ser seguido de una temprana y adecuada acción terapéutica. HBPM ha reemplazado el uso de la HNF. Conclusiones: se debe identificar la presencia de factores de riesgo en toda la población gestante, de acuerdo a los hallazgos; realizar medidas terapéuticas generales o farmacológicas. Rev.cienc.biomed. 2012;3(1):124-135

Introducción. En mujeres, el riesgo de desarrollar enfermedad tromboembólica venosa (ETV) es 5 a 6 veces mayor durante el embarazo, riesgo que puede aumentar considerablemente si existen antecedentes personales o familiares de otros estados protrombóticos. La ETV es una de las principales causas de morbimortalidad en esta población, por lo que para evaluar la pertinencia de usar tromboprofilaxis, ya sea farmacológica o no farmacológica, es necesario reconocer oportunamente los factores de riesgo clínico asociados a esta condición. Objetivo. Describir el uso de pruebas de tamizaje de estados protrombóticos y de la tromboprofilaxis farmacológica y no farmacológica para prevenir la ETV durante la gestación, durante el parto y durante el puerperio. Materiales y métodos. Se realizó una revisión de la literatura en Embase, ClinicalKey, ScienceDirect, Access Medicine, Scopus, ProQuest, PubMed y LILACS. Se buscaron estudios sobre trombofilia y tromboprofilaxis en el embarazo publicados entre enero de 2004 y marzo de 2018 en inglés y en español. Resultados. En la búsqueda inicial se identificaron 126 artículos, de los cuales 52 cumplieron los criterios de inclusión. La mayoría de estudios correspondió a revisiones narrativas (n=15), revisiones sistemáticas (n=8) y guías de práctica clínica (n=6). Conclusión. Se recomienda el uso de pruebas de tamizaje de estados protrombóticos durante la gestación, el parto y el puerperio, ya que la identificación oportuna de la ETV permite disminuir las tasas de morbimortalidad en esta población mediante la implementación de medidas tromboprofilácticas, sean o no farmacológicas.

Objective: To evaluate the association between statin consumption and development of post-thrombotic syndrome (PTS). Methods: Retrospective cohort study which included patients with a first episode of deep vein thrombosis (DVT) between 06/2006 and 12/2017, included in the Institutional Registry of ThromboEmbolic Disease of the Italian Hospital of Buenos Aires, Argentina. Exposure to statin use (SU) was considered between the 30 days before and up to 180 days after the diagnosis of DVT. PTS was defined as recorded dataset on registry. The development of PTS was evaluated with Cox proportional hazards model, raw and adjusted hazard ratios (HR) were reported. Confusion was considered by indication of SU and a propensity score (PS) was used for adjustment. We reported HR with their 95% confidence interval (CI); p value < 0.05 was considered statistically significant. Results: Of 1393 patients, 905 were included for the analysis, of which 273 were SU and 632 non-statin users (NSU). At follow-up, incidence of PTS was: 6.59% (18) in the SU group and 8.07% (51) in the NSU group, with p = 0.412. Crude HR for PTS for SU was not significant (0.78; 95% CI: 0.43-1.41; p = 0.414). Adjusted HR of SU by age, sex, non-steroidal anti-inflammatory drugs, corticosteroids, immobility, anticoagulant, high blood pressure, diabetes, dyslipidemia, chronic renal failure, coronary heart disease, stroke, heart failure and cancer disease was 0.45 (95% CI: 0.13-1.5; p = 0.196) for PTS. While HR for the development of PTS adjusted by age, sex, non-steroidal anti-inflammatory drugs, corticosteroids, immobility, anticoagulant treatment, cancer disease and PS of the SU was 0.52 (95% CI: 0.17-1.66; p = 0.272). Conclusion: No statistically significant association was found between CE and the development of SPT, although there were a small number of events detected in both groups. [ABSTRACT FROM AUTHOR]

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Los sarcomas de vena cava son neoformaciones poco frecuentes de origen mesenquimal, que pueden proceder de cualquier tejido que contenga fibras de músculo liso. Suelen ser asintomáticos hasta alcanzar un gran tamaño, o bien presentar clínica insidiosa e inespecífica, siendo diagnosticados como hallazgo incidental en pruebas de imagen realizadas por diversas indicaciones.

La trombosis venosa profunda de extremidades superiores (TVPES) es una entidad clínica infrecuente. Las causas secundarias asociadas con mayor frecuencia son: la presencia de catéter venoso central y el padecer de cáncer.Se reporta un caso de TVPES que estuvo relacionado a la caída sufrida con probable traumatismo de la vena subclavia y a la eritrocitosis excesiva que padecía. El diagnostico se realizó con ecografía duplex. El tratamiento anticoagulante empleado fue con heparina de bajo peso molecular al inicio y posteriormente con warfarina. El paciente evolucionó favorablemente. En personas que habitan en altura y que desarrollan eritrocitosis excesiva, esta pudiera ser un factor importante en la génesis de la TVPES.

Background: Patients with nephrotic syndrome are at high risk of venous thromboembolism (VTE), especially for primary membranous nephropathy (PMN). The phospholipase A2 receptor (PLA2R) is a marker of primary membranous nephropathy activity. This study investigated the predictive value of PLA2R antibodies in PMN for VTE., Methods: In this retrospective study, we included 97 PMN patients and evaluated the predictive value of serum PLA2R antibodies for VTE risk. Lower extremity venous ultrasound, renal vein ultrasound, or spiral computed tomography pulmonary arteriography were used to assess VTE events. Serum anti-PLA2R antibodies were detected by enzyme-linked immunosorbent assay (ELISA). The risk of VTE was stratified according to serum albumin levels., Results: Twenty PMN patients (21%) had thromboembolic events. Eight (15%) of patients with serum albumin >25g/l developed VTE, 6 of whom were positive for serum PLA2R antibodies. Positive serum PLA2R antibodies were significantly associated with VTE events in patients with serum albumin >25g/l (p=0.01). Age, sex, blood creatinine, serum albumin, and 24-h urine protein levels were not statistically different between the two groups. Kaplan-Meier analysis using the log-rank test revealed anti-PLA2R positive membranous nephropathy patients had more probability of VTE events than anti-PLA2R negative patients. Univariate Cox proportional hazards analysis revealed that lnPLA2R-Ab is an unfavorable predictor for VTE events in patients with serum albumin >25g/l (hazard ratio (HR) 2.1, p=0.01)., Conclusions: The PLA2R antibody was a risk predictor for thromboembolic events in patients with primary membranous nephropathy with serum albumin >25g/l., (Copyright © 2023 Elsevier España, S.L.U. All rights reserved.)

Cerebral venous thrombosis represents 0.5% of all strokes in the world. However, the phenotypic expression of the disease in developing countries such as Mexico is often underestimated by multiple factors, including low suspicion of the disease, lack of diagnostic studies and subclinical pattern of the disease. Since more than 30 years, Mexican population has been considered with a risk factor for the development of prothrombotic phenomena in traditional sites; however, in the last decade prevalence of venous thrombosis in atypical sites, such as the cerebral venous system, has increased dramatically, thus, it is mandatory for the non-neurologist physician to know about the disease, apparently uncommon in our population. [ABSTRACT FROM AUTHOR]

La incidencia de Tromboembolismo Venoso (TEV) en el embarazo se incrementa aproximadamente de 4 a 50 veces más en comparación con mujeres no embarazadas, debido a las modificaciones que el propio embarazo produce sobre los factores de la coagulación y los sistemas fibrinolíticos. Se estima que la TEV complica entre 1 y 1,5 por cada 1.000 embarazos. Durante el embarazo la hemostasia materna se caracteriza por ser un estado protrombótico en el cual se producen cambios en el sistema hemostático, con el objetivo de prevenir una posible hemorragia durante las primeras etapas del embarazo, parto y puerperio. Sin embargo, la adaptación del sistema hemostático materno al embarazo predispone a la madre a un riesgo incrementado de TEV. El diagnóstico de los eventos tromboembólicos en el embarazo constituye un reto para los equipos tratantes, ya que los hallazgos clínicos y de laboratorio característicos de esta enfermedad pueden estar enmascarados en los cambios fisiológicos propios de la gestación, por lo que el inicio de su evaluación suele ser complejo. Para el correcto y oportuno diagnóstico de TVP y TEP se requiere de una combinación de varios elementos que incluye: síntomas y signos, estudios de laboratorio e imagenología. El uso de anticoagulantes en pacientes obstétricas requiere de un plan de interrupción del embarazo lo más controlado posible. En la práctica clínica cotidiana esto no siempre es posible, debido a la incapacidad de predecir el momento de inicio del trabajo de parto. Por este motivo las recomendaciones relativas al manejo analgésico y anestésico del parto están basadas en el conocimiento de los cambios fisiológicos, farmacocinético y farmacodinámico de los anticoagulantes utilizados, lo que se analiza en extenso en esta revisión.

The general incidence of venous thromboembolism is about two cases per 1,000 a year, also it has been reported in Intensive Care Units an incidence greater than four per 1,000 a year. In neuroquirurgical patients, a higher risk is estimated due to inmovility and other causes, which influence the endotelial activation and promote thrombosis, including the vascular cerebral hemorragic event or ischemic event and myocardial injury. Due to the lack of guides which allow us a better particular management of this kind of patients, this review of literature was conducted covering both clinical practice guidelines from different countries as well as review articles which gives us an approach of the current trends. material and methods: Retrospective and review study, search in the medical research platforms: MEDLINE, PUBMED, Cochrane and Clinical Key. The search included review articles as well as methodized reviews, and practical clinical guides, terms applied MeSH, thromboembolism, venous thrombosis, thromboprophylaxis, spine surgery, antithrombotic pre surgery management, prothrombotic stages, and perioperative stroke. Conclusion: For the patients submitted to spine surgery with or without risk factors, the administration of heparine of low molecular weight pre-surgery and the use of intermittent pneumatic compression is indicated. In this case as an alternative to the intermittent compression devices, gradual compression elastic socks can be used. [ABSTRACT FROM AUTHOR]

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Copyright of Médicas UIS is the property of Universidad Industrial de Santander and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The objective of the systematic review is to analyze the efficacy of direct-acting oral anticoagulants (DOAC) in the prophylaxis of thrombosis in antiphospholipid syndrome (APS). We searched for clinical trials, cohort studies and meta-analyses published from January 1, 2012 to September 30, 2022. Articles that analyzed the efficacy of DOAC in the prevention of thrombosis recurrence, with or without comparison with antivitamin K (VKA) drugs, were selected. DOACs, specifically rivaroxaban and apixaban, were significantly less effective than VKAs in preventing recurrence of thrombosis in patients with APS and prior arterial thrombosis or the concomitant presence of two or three different antiphospholipid antibodies. The proportion of patients with severe bleeding as side effect are similar in those treated with DOAC and with VKA. The results argue against the use of DOAC in the treatment of patients with thrombotic APS., (Copyright © 2023 Elsevier España, S.L.U. All rights reserved.)