Pub Date : 2015-06-22DOI: 10.2174/1874303X01509010053
R. Radhakrishnan, S. Jacob, H. Pathak, V. Tamilarasi
Colistin is widely used in the treatment of multidrug resistant bacterial infections. Nephrotoxicity and neurotoxicity are risks associated with colistin use. We report the case of a 50 year old lady with end stage renal disease, treated with colistin for catheter related blood stream infection and developed muscle weakness and parasthesia. Concomitant use of meropenem may have precipitated neurotoxicity of colistin. Conventional hemodialysis was effective in reversing her signs and symptoms. Clinicians should be aware of the risk of neurotoxicity while using colistin, especially after a loading dose in patients with renal impairment. According to our knowledge, this is the first report of conventional hemodialysis reversing the neurotoxic effects of colistin.
{"title":"Colistin Induced Neurotoxicity in a Patient with End Stage Kidney Disease and Recovery with Conventional Hemodialysis","authors":"R. Radhakrishnan, S. Jacob, H. Pathak, V. Tamilarasi","doi":"10.2174/1874303X01509010053","DOIUrl":"https://doi.org/10.2174/1874303X01509010053","url":null,"abstract":"Colistin is widely used in the treatment of multidrug resistant bacterial infections. Nephrotoxicity and neurotoxicity are risks associated with colistin use. We report the case of a 50 year old lady with end stage renal disease, treated with colistin for catheter related blood stream infection and developed muscle weakness and parasthesia. Concomitant use of meropenem may have precipitated neurotoxicity of colistin. Conventional hemodialysis was effective in reversing her signs and symptoms. Clinicians should be aware of the risk of neurotoxicity while using colistin, especially after a loading dose in patients with renal impairment. According to our knowledge, this is the first report of conventional hemodialysis reversing the neurotoxic effects of colistin.","PeriodicalId":38952,"journal":{"name":"Open Urology and Nephrology Journal","volume":"8 1","pages":"53-55"},"PeriodicalIF":0.0,"publicationDate":"2015-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68066645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-06-10DOI: 10.2174/1874303X01509010045
J. Jamboti
Kidneys have a pivotal role in maintaining our homeostasis. Kidneys and heart work in tandem to maintain volume homeostasis. Heart failure impacts renal function in many ways including renal hypo perfusion but also due to increased venous pressure along with stimulation of various neuro-humoral responses. Renal failure induces cardiac damage and dysfunction by causing volume overload, inflammation and cardiomyocyte fibrosis. Concomitant comorbidities like Hypertension and Diabetes also play important role resulting in Cardiorenal Syndrome (CRS). Acute Dialysis Quality Initiative, 2007 recognized the bidirectional nature and different manifestations of CRS in acute and chronic settings. Diuretics are the most common drugs to treat the most common symptoms of CRS i.e., peripheral edema and pulmonary congestion. Diuretics could nevertheless contribute to worsening renal function (WRF). Initially it was accepted that WRF during the course of treatment of acute decompensated heart failure (ADHF) uniformly resulted in worse prognosis. However, in view of a few recent studies, the significance of WRF early in response to treatment of ADHF is being debated. The optimal dose and method of delivery of diuretics is still undecided. Isolated ultrafiltration does not improve renal function in patients with CRS despite the early promise. A large, multicentre trial ruled out any survival benefits with Recombinant Brain Natriuretic Peptide (Nesiritide). Despite good physiological basis and early promise with smaller studies, many drugs like Dobutamine, Rolofylline and Tolvaptan failed to show survival benefit in larger studies. However, two recent studies involving Relaxin and Neprilysin have shown good survival advantage. There had been little progress in treatment of CRS until studies involving Relaxin and Neprilysin inhibitor combination with ARB were published. There may after all, be a glimmer of hope in the field of CRS bogged by multiple negative studies. Keywords: Acute Decompensated Heart Failure (ADHF), Acute Dialysis Quality Initiative (ADQI), Anemia, Cardiorenal anemia, Atrial Natriuretic Peptide (ANP), Blood Urea Nitrogen (BUN), Brain-type Natriuretic Peptide (BNP), Cardio Renal Syndrome (CRS), Central Venous Pressure (CVP), Congestive Heart Failure (CHF), Diuretic Resistance (DR), Estimated Glomerular Filtration Rate (eGFR), Heart Failure (HF), Intra-abdominal Pressure (IAP), Juxta glomerular (JG) apparatus, Left Atrium (LA), Left Ventricular Ejection Fraction (LVEF), Neprilysin inhibitor, Neprilysin, Relaxin, Renin-Angiotensin- Aldosterone System (RAAS), Sacubitril, Serelaxin, Sympathetic Nervous System(SNS), Ultrafiltration (UF), Worsening Renal Function (WRF).
{"title":"Cardio renal syndromes 2015: Is there a silver lining to the dark clouds?","authors":"J. Jamboti","doi":"10.2174/1874303X01509010045","DOIUrl":"https://doi.org/10.2174/1874303X01509010045","url":null,"abstract":"Kidneys have a pivotal role in maintaining our homeostasis. Kidneys and heart work in tandem to maintain volume homeostasis. Heart failure impacts renal function in many ways including renal hypo perfusion but also due to increased venous pressure along with stimulation of various neuro-humoral responses. Renal failure induces cardiac damage and dysfunction by causing volume overload, inflammation and cardiomyocyte fibrosis. Concomitant comorbidities like Hypertension and Diabetes also play important role resulting in Cardiorenal Syndrome (CRS). Acute Dialysis Quality Initiative, 2007 recognized the bidirectional nature and different manifestations of CRS in acute and chronic settings. Diuretics are the most common drugs to treat the most common symptoms of CRS i.e., peripheral edema and pulmonary congestion. Diuretics could nevertheless contribute to worsening renal function (WRF). Initially it was accepted that WRF during the course of treatment of acute decompensated heart failure (ADHF) uniformly resulted in worse prognosis. However, in view of a few recent studies, the significance of WRF early in response to treatment of ADHF is being debated. The optimal dose and method of delivery of diuretics is still undecided. Isolated ultrafiltration does not improve renal function in patients with CRS despite the early promise. A large, multicentre trial ruled out any survival benefits with Recombinant Brain Natriuretic Peptide (Nesiritide). Despite good physiological basis and early promise with smaller studies, many drugs like Dobutamine, Rolofylline and Tolvaptan failed to show survival benefit in larger studies. However, two recent studies involving Relaxin and Neprilysin have shown good survival advantage. There had been little progress in treatment of CRS until studies involving Relaxin and Neprilysin inhibitor combination with ARB were published. There may after all, be a glimmer of hope in the field of CRS bogged by multiple negative studies. Keywords: Acute Decompensated Heart Failure (ADHF), Acute Dialysis Quality Initiative (ADQI), Anemia, Cardiorenal anemia, Atrial Natriuretic Peptide (ANP), Blood Urea Nitrogen (BUN), Brain-type Natriuretic Peptide (BNP), Cardio Renal Syndrome (CRS), Central Venous Pressure (CVP), Congestive Heart Failure (CHF), Diuretic Resistance (DR), Estimated Glomerular Filtration Rate (eGFR), Heart Failure (HF), Intra-abdominal Pressure (IAP), Juxta glomerular (JG) apparatus, Left Atrium (LA), Left Ventricular Ejection Fraction (LVEF), Neprilysin inhibitor, Neprilysin, Relaxin, Renin-Angiotensin- Aldosterone System (RAAS), Sacubitril, Serelaxin, Sympathetic Nervous System(SNS), Ultrafiltration (UF), Worsening Renal Function (WRF).","PeriodicalId":38952,"journal":{"name":"Open Urology and Nephrology Journal","volume":"13 1","pages":"45-52"},"PeriodicalIF":0.0,"publicationDate":"2015-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68066587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-05-15DOI: 10.2174/1874303X01508010041
M. Prabhu, Subhramanyam S.V, Sinoj Antony, Nayak K.S
Peritoneal Dialysis (PD) has been an underutilized modality in the treatment of Acute Kidney Injury (AKI). Concerns regarding clearance, fluid removal, infection, complications of therapy, and the hypercatabolic state of AKI has led to PD falling into disrepute. Recent studies have challenged this notion of ineffectiveness. The lower cost, and simplicity of the procedure makes it a particularly attractive option for the developing world which may lack even basic HD facilities, and patients continue to die for want of Renal Replacement Therapy (RRT). We present a review of the available literature about PD in the AKI setting with special reference to the developing world, including the procedure, costs, and effectiveness of the treatment. We also describe the procedure in detail to help 'hand hold' physicians interested in performing this lifesaving procedure.
{"title":"Manual Acute PD with Rigid Catheters: A Relook","authors":"M. Prabhu, Subhramanyam S.V, Sinoj Antony, Nayak K.S","doi":"10.2174/1874303X01508010041","DOIUrl":"https://doi.org/10.2174/1874303X01508010041","url":null,"abstract":"Peritoneal Dialysis (PD) has been an underutilized modality in the treatment of Acute Kidney Injury (AKI). Concerns regarding clearance, fluid removal, infection, complications of therapy, and the hypercatabolic state of AKI has led to PD falling into disrepute. Recent studies have challenged this notion of ineffectiveness. The lower cost, and simplicity of the procedure makes it a particularly attractive option for the developing world which may lack even basic HD facilities, and patients continue to die for want of Renal Replacement Therapy (RRT). We present a review of the available literature about PD in the AKI setting with special reference to the developing world, including the procedure, costs, and effectiveness of the treatment. We also describe the procedure in detail to help 'hand hold' physicians interested in performing this lifesaving procedure.","PeriodicalId":38952,"journal":{"name":"Open Urology and Nephrology Journal","volume":"8 1","pages":"41-44"},"PeriodicalIF":0.0,"publicationDate":"2015-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68065838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-02-20DOI: 10.2174/1874303X01508020010
R. Willis, E. González
The presence of pathogenic antiphospholipid antibodies (aPL) is the characterizing feature of the antiphospholipid syndrome (APS), mediating the recurrent pregnancy loss and thrombosis typical of the disease through its action on various antigenic targets. APS nephropathy is the characteristic clinico-pathological manifestation of renal involvement in APS and occurs as a result of vaso-occlusive disease in the intrarenal vasculature. The typical clinical features and morphological lesions of APS nephropathy have been well characterized and several studies have established a link between these features and the presence of various aPL. In this review, we outline the proposed pathophysiological mechanisms of aPL-mediated thrombosis, the characteristic clinical and morphological features of APS nephropathy and the evidence linking aPL action to the occurrence of APS nephropathy.
{"title":"Antiphospholipid antibodies and APS nephropathy","authors":"R. Willis, E. González","doi":"10.2174/1874303X01508020010","DOIUrl":"https://doi.org/10.2174/1874303X01508020010","url":null,"abstract":"The presence of pathogenic antiphospholipid antibodies (aPL) is the characterizing feature of the antiphospholipid syndrome (APS), mediating the recurrent pregnancy loss and thrombosis typical of the disease through its action on various antigenic targets. APS nephropathy is the characteristic clinico-pathological manifestation of renal involvement in APS and occurs as a result of vaso-occlusive disease in the intrarenal vasculature. The typical clinical features and morphological lesions of APS nephropathy have been well characterized and several studies have established a link between these features and the presence of various aPL. In this review, we outline the proposed pathophysiological mechanisms of aPL-mediated thrombosis, the characteristic clinical and morphological features of APS nephropathy and the evidence linking aPL action to the occurrence of APS nephropathy.","PeriodicalId":38952,"journal":{"name":"Open Urology and Nephrology Journal","volume":"8 1","pages":"10-17"},"PeriodicalIF":0.0,"publicationDate":"2015-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68066914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-02-20DOI: 10.2174/1874303X01508020018
J. Dlott
Antiphospholipid Antibody Syndrome (APS) is a highly prevalent cause of antibody-mediated thrombosis manifesting in venous thrombosis (DVT and PE), arterial thrombosis (most commonly stroke), and pregnancy complications. The diagnosis of definite APS requires both clinical and laboratory criterion as established by the working group of the International Congress on Antiphospholipid Antibodies (based on expert opinion). Since thrombosis and pregnancy loss are common in the general population, and antiphospholipid antibodies (aPL) occurs in a small percentage of the healthy public, it is important to demonstrate antibody persistence in patients who have the proper clinical indications in order to avoid misdiagnosis. Unfortunately, laboratory testing in this area lacks standardization, resulting in wide inter-laboratory variance. However, due to the commercialization of tests and automation, inter-laboratory variance has improved. Data on several new non-criterion tests suggest that they may improve the specificity or risk stratification for thrombosis. A new guidance document on aPL testing strives to achieve better consistency, but much work remains to be done in the area of standardization.
{"title":"Diagnosing Antiphospholipid Antibody Syndrome: A Review of the Criterion for Definite APS","authors":"J. Dlott","doi":"10.2174/1874303X01508020018","DOIUrl":"https://doi.org/10.2174/1874303X01508020018","url":null,"abstract":"Antiphospholipid Antibody Syndrome (APS) is a highly prevalent cause of antibody-mediated thrombosis manifesting in venous thrombosis (DVT and PE), arterial thrombosis (most commonly stroke), and pregnancy complications. The diagnosis of definite APS requires both clinical and laboratory criterion as established by the working group of the International Congress on Antiphospholipid Antibodies (based on expert opinion). Since thrombosis and pregnancy loss are common in the general population, and antiphospholipid antibodies (aPL) occurs in a small percentage of the healthy public, it is important to demonstrate antibody persistence in patients who have the proper clinical indications in order to avoid misdiagnosis. Unfortunately, laboratory testing in this area lacks standardization, resulting in wide inter-laboratory variance. However, due to the commercialization of tests and automation, inter-laboratory variance has improved. Data on several new non-criterion tests suggest that they may improve the specificity or risk stratification for thrombosis. A new guidance document on aPL testing strives to achieve better consistency, but much work remains to be done in the area of standardization.","PeriodicalId":38952,"journal":{"name":"Open Urology and Nephrology Journal","volume":"8 1","pages":"18-21"},"PeriodicalIF":0.0,"publicationDate":"2015-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68066999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-02-20DOI: 10.2174/1874303X01508010002
P. R. Sada, H. Cohen, D. Isenberg
Advances in our knowledge of the pathogenic mechanisms of antiphospholipid syndrome have been achieved in the past few years. Apart from the well-known role of anti-β2-glycoprotein I antibodies, complement, endocrine and genetic factors and a variety of other molecules are now under investigation. These new approaches should lead to novel explanations and potential new treatment options.
{"title":"The Pathophysiology of Antiphospholipid Syndrome","authors":"P. R. Sada, H. Cohen, D. Isenberg","doi":"10.2174/1874303X01508010002","DOIUrl":"https://doi.org/10.2174/1874303X01508010002","url":null,"abstract":"Advances in our knowledge of the pathogenic mechanisms of antiphospholipid syndrome have been achieved in the past few years. Apart from the well-known role of anti-β2-glycoprotein I antibodies, complement, endocrine and genetic factors and a variety of other molecules are now under investigation. These new approaches should lead to novel explanations and potential new treatment options.","PeriodicalId":38952,"journal":{"name":"Open Urology and Nephrology Journal","volume":"8 1","pages":"2-9"},"PeriodicalIF":0.0,"publicationDate":"2015-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68065657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-02-20DOI: 10.2174/1874303X01508010039
J. Makhija, A. Chaudhari, T. Vachharajani, H. Mehta
{"title":"LEARNING FROM IMAGES Frosty Man","authors":"J. Makhija, A. Chaudhari, T. Vachharajani, H. Mehta","doi":"10.2174/1874303X01508010039","DOIUrl":"https://doi.org/10.2174/1874303X01508010039","url":null,"abstract":"","PeriodicalId":38952,"journal":{"name":"Open Urology and Nephrology Journal","volume":"8 1","pages":"39-40"},"PeriodicalIF":0.0,"publicationDate":"2015-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68065796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-02-20DOI: 10.2174/1874303X01508020027
Mamatha Katikaneni, M. Gangam, S. Berney, S. Umer
Antiphospholipid syndrome (APS) is an autoantibody disorder characterized by the presence of antiphospholipid (APL) antibodies and heterogeneous clinical manifestations. Patients may present with recurrent thrombosis, obstetric morbidity, cardiac valvular lesions, thrombocytopenia, skin lesions, renal or neurologic abnormalities. We provide a comprehensive review of these diverse clinical features except renal and obstetric complications. Treatment of APS can be challenging as one tries to balance the benefit of anticoagulation therapy in this hypercoagulable state while minimizing the risk of bleeding. We discuss the various therapeutic options including the role of aspirin, warfarin, low molecular weight heparin, new direct thrombin inhibitors, hydroxychloroquine, intravenous gamma globulin, rituximab and others. Lower risk APS patients (i.e. first venous thrombosis) should receive warfarin with a target INR of 2.0-3.0. Higher risk patients (i.e. arterial thrombosis or recurrent venous events) have a target INR of >3.0. Currently, warfarin remains the mainstay in treatment of APS. Because of lack of adequate data, the newer oral direct inhibitors should be considered only when there is a known allergy/ intolerance or poor control with warfarin. Additional vascular and thrombotic risk factors should be aggressively reduced. Further studies involving large number of APS patients, diagnosed according to accepted criteria, are needed to better define the role of newer anticoagulants and other novel therapies.
{"title":"Antiphospholipid Syndrome (APS) - An Update on Clinical Features and Treatment Options","authors":"Mamatha Katikaneni, M. Gangam, S. Berney, S. Umer","doi":"10.2174/1874303X01508020027","DOIUrl":"https://doi.org/10.2174/1874303X01508020027","url":null,"abstract":"Antiphospholipid syndrome (APS) is an autoantibody disorder characterized by the presence of antiphospholipid (APL) antibodies and heterogeneous clinical manifestations. Patients may present with recurrent thrombosis, obstetric morbidity, cardiac valvular lesions, thrombocytopenia, skin lesions, renal or neurologic abnormalities. We provide a comprehensive review of these diverse clinical features except renal and obstetric complications. Treatment of APS can be challenging as one tries to balance the benefit of anticoagulation therapy in this hypercoagulable state while minimizing the risk of bleeding. We discuss the various therapeutic options including the role of aspirin, warfarin, low molecular weight heparin, new direct thrombin inhibitors, hydroxychloroquine, intravenous gamma globulin, rituximab and others. Lower risk APS patients (i.e. first venous thrombosis) should receive warfarin with a target INR of 2.0-3.0. Higher risk patients (i.e. arterial thrombosis or recurrent venous events) have a target INR of >3.0. Currently, warfarin remains the mainstay in treatment of APS. Because of lack of adequate data, the newer oral direct inhibitors should be considered only when there is a known allergy/ intolerance or poor control with warfarin. Additional vascular and thrombotic risk factors should be aggressively reduced. Further studies involving large number of APS patients, diagnosed according to accepted criteria, are needed to better define the role of newer anticoagulants and other novel therapies.","PeriodicalId":38952,"journal":{"name":"Open Urology and Nephrology Journal","volume":"8 1","pages":"27-38"},"PeriodicalIF":0.0,"publicationDate":"2015-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68066522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-02-20DOI: 10.2174/1874303X01508010001
S. Berney
In 1983, Graham R V Hughes, MD published a 2-page article in the British Medical Journal entitled “Thrombosis, abortion, cerebral disease, and the lupus anticoagulant” [1]. This is generally acknowledged as the first report associating the antibodies subsequently named the antiphospholipid antibodies (aPL) with multiple clinical occurrences, now known as the Antiphospholipid Antibody Syndrome (or Hughes Syndrome). The aPL reflect a heterogeneous collection of antibodies which cause/contribute to the pathologic manifestations, as well as the “false positive Veneral Disease Research Laboratory (VDRL)” test and the misnomer “lupus anticoagulant”. Since that initial publication, many groups have expounded upon Dr. Hughes’ observation leading to 14 International Congresses on aPL. During these meetings, clinical and research observations were presented and discussed and diagnostic criteria were proposed and refined. The most recent congress occurred in 2013 in Rio de Janeiro and the 15 is planned for 2016 in Istanbul.
1983年，医学博士Graham R V Hughes在《英国医学杂志》上发表了一篇两页的文章，题为“血栓、流产、脑病和狼疮抗凝剂”。这通常被认为是第一个将后来被命名为抗磷脂抗体(aPL)的抗体与多种临床症状联系起来的报告，现在被称为抗磷脂抗体综合征(或休斯综合征)。aPL反映了引起/促成病理表现的抗体的异质性集合，以及“假阳性的一般疾病研究实验室(VDRL)”测试和误称的“狼疮抗凝血剂”。自那篇论文发表以来，许多研究小组对休斯博士的观察结果进行了阐述，导致了14次aPL国际大会。在这些会议上，提出并讨论了临床和研究观察结果，提出并完善了诊断标准。最近一次大会于2013年在里约热内卢举行，第15届大会计划于2016年在伊斯坦布尔举行。
{"title":"Antiphospholipid Syndrome (APS)","authors":"S. Berney","doi":"10.2174/1874303X01508010001","DOIUrl":"https://doi.org/10.2174/1874303X01508010001","url":null,"abstract":"In 1983, Graham R V Hughes, MD published a 2-page article in the British Medical Journal entitled “Thrombosis, abortion, cerebral disease, and the lupus anticoagulant” [1]. This is generally acknowledged as the first report associating the antibodies subsequently named the antiphospholipid antibodies (aPL) with multiple clinical occurrences, now known as the Antiphospholipid Antibody Syndrome (or Hughes Syndrome). The aPL reflect a heterogeneous collection of antibodies which cause/contribute to the pathologic manifestations, as well as the “false positive Veneral Disease Research Laboratory (VDRL)” test and the misnomer “lupus anticoagulant”. Since that initial publication, many groups have expounded upon Dr. Hughes’ observation leading to 14 International Congresses on aPL. During these meetings, clinical and research observations were presented and discussed and diagnostic criteria were proposed and refined. The most recent congress occurred in 2013 in Rio de Janeiro and the 15 is planned for 2016 in Istanbul.","PeriodicalId":38952,"journal":{"name":"Open Urology and Nephrology Journal","volume":"8 1","pages":"1-1"},"PeriodicalIF":0.0,"publicationDate":"2015-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68065645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-02-20DOI: 10.2174/1874303X01508020022
Karen J. Gibbins, R. Silver
Antiphospholipid syndrome is a pro-thrombotic, pro-inflammatory condition defined by at least one clinical criterion and one laboratory finding. Clinical criteria are met by history of thrombosis or obstetric morbidity, including recurrent early pregnancy loss, fetal death, or delivery prior to 34 weeks gestation due to pre-eclampsia or placental insufficiency. Laboratory criteria are evidence of lupus anticoagulant or high titers of anticardiolipin or anti-s 2 - glycoprotein-I IgG or IgM. Treatment during pregnancy is primarily based on anticoagulant therapy, either at prophylactic or therapeutic doses depending on thrombosis history. This treatment certainly reduces thrombosis risk and may also improve obstetric outcome.
抗磷脂综合征是一种促血栓形成、促炎症的疾病，至少有一项临床标准和一项实验室发现。符合临床标准的有血栓形成史或产科发病史，包括复发性早孕流产、胎儿死亡或因先兆子痫或胎盘功能不全导致妊娠34周前分娩。实验室标准是狼疮抗凝血或高滴度抗心磷脂或抗s2 -糖蛋白- i IgG或IgM的证据。妊娠期间的治疗主要是基于抗凝治疗，根据血栓形成的历史使用预防性或治疗性剂量。这种治疗当然可以降低血栓形成的风险，也可以改善产科结果。
{"title":"Obstetrical Considerations and Management of Antiphospholipid Syndrome","authors":"Karen J. Gibbins, R. Silver","doi":"10.2174/1874303X01508020022","DOIUrl":"https://doi.org/10.2174/1874303X01508020022","url":null,"abstract":"Antiphospholipid syndrome is a pro-thrombotic, pro-inflammatory condition defined by at least one clinical criterion and one laboratory finding. Clinical criteria are met by history of thrombosis or obstetric morbidity, including recurrent early pregnancy loss, fetal death, or delivery prior to 34 weeks gestation due to pre-eclampsia or placental insufficiency. Laboratory criteria are evidence of lupus anticoagulant or high titers of anticardiolipin or anti-s 2 - glycoprotein-I IgG or IgM. Treatment during pregnancy is primarily based on anticoagulant therapy, either at prophylactic or therapeutic doses depending on thrombosis history. This treatment certainly reduces thrombosis risk and may also improve obstetric outcome.","PeriodicalId":38952,"journal":{"name":"Open Urology and Nephrology Journal","volume":"8 1","pages":"22-26"},"PeriodicalIF":0.0,"publicationDate":"2015-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68066500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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