scholarly journals A Case ofBrucellaEndocarditis in Association with Subclavian Artery Thrombosis

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Claudia Colomba ◽  
Lucia Siracusa ◽  
Raffaella Rubino ◽  
Marcello Trizzino ◽  
Francesco Scarlata ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Arterial Thrombosis ◽  
Clinical Presentation ◽  
Severe Disease ◽  
Systemic Infection ◽  
Cardiovascular Complications ◽  
Careful Attention ◽  
Artery Thrombosis ◽  
Mediterranean Countries

Brucellosis is a common zoonosis, endemic in Mediterranean countries, and caused by bacteria ofBrucellagenus. Brucellosis is a systemic infection and the clinical presentation varies widely from asymptomatic and mild to severe disease. Cardiovascular complications are extremely rare. We present a case of arterial thrombosis in a previously healthy young patient withBrucellaendocarditis. Careful attention must be paid to any sign or symptom of thrombosis in patients affected by brucellosis, regardless of the presence of endocarditis and cardiovascular risk factors.

scholarly journals Splenic Infarction and Infectious Diseases in Korea

2020 ◽  
Author(s):  
Jae Hyoung Im ◽  
Moon-Hyun Chung ◽  
Hye-Jin Lee ◽  
Hea Yoon Kwon ◽  
JiHyeon Baek ◽  
...  
Keyword(s):  
Risk Factors ◽  
Immune Cells ◽  
Clinical Presentation ◽  
Scrub Typhus ◽  
Systemic Infection ◽  
Splenic Infarction ◽  
University Hospital ◽  
Radiological Findings ◽  
Epstein Barr ◽  
The Relationship

Abstract Background The spleen contains immune cells and exhibits a pattern of infarction different from other organs; as such, splenic infarction (SI) may provide important clues to infection. However, the nature of the relationship between SI and infectious disease(s) is not well understood. Accordingly, this retrospective study investigated the relationship between SI and infection. Methods Hospital records of patients with SI, who visited Inha University Hospital (Incheon, Republic of Korea) between January 2008 and December 2018, were reviewed. Patient data regarding clinical presentation, causative pathogens, risk factors, and radiological findings were collected and analyzed.Results Of 353 patients with SI, 101 with infectious conditions were enrolled in this study, and their data were analyzed to identify associations between SI and infection. Ten patients were diagnosed with infective endocarditis (IE), and 26 exhibited bacteremia without IE. Twenty-seven patients experienced systemic infection due to miscellaneous causes (negative result on conventional automated blood culture), including the following intracellular organisms: parasites (malaria [n =12], babesiosis [n =1]); bacteria (scrub typhus [n =5]); viruses (Epstein–Barr [n =1], cytomegalovirus [n =1]); and unidentified pathogen[s] (n =7). Splenomegaly was more common among patients with miscellaneous systemic infection; infarction involving other organs was rare. Thirty-eight patients had localized infections (e.g., respiratory, intra-abdominal, or skin and soft tissue infection), and most (35 of 38) had other risk factors for SI. Conclusions In this study, various infectious conditions were found to be associated with SI, and intracellular organisms were the most common causative pathogens. Further studies are needed to examine other possible etiologies and the underlying pathophysiological mechanisms.

scholarly journals Obesity in Humans Is Characterized by Gut Inflammation as Shown by Pro-Inflammatory Intestinal Macrophage Accumulation

2021 ◽  
Vol 12 ◽  
Author(s):  
Theresa V. Rohm ◽  
Regula Fuchs ◽  
Rahel L. Müller ◽  
Lena Keller ◽  
Zora Baumann ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Vegetable Intake ◽  
Cardiovascular Complications ◽  
Processed Meat ◽  
Low Grade ◽  
Blood Monocytes ◽  
Unhealthy Lifestyle ◽  
Gut Inflammation

Chronic low-grade inflammation is a hallmark of obesity and associated with cardiovascular complications. However, it remains unclear where this inflammation starts. As the gut is constantly exposed to food, gut microbiota, and metabolites, we hypothesized that mucosal immunity triggers an innate inflammatory response in obesity. We characterized five distinct macrophage subpopulations (P1-P5) along the gastrointestinal tract and blood monocyte subpopulations (classical, non-classical, intermediate), which replenish intestinal macrophages, in non-obese (BMI<27kg/m2) and obese individuals (BMI>32kg/m2). To elucidate factors that potentially trigger gut inflammation, we correlated these subpopulations with cardiovascular risk factors and lifestyle behaviors. In obese individuals, we found higher pro-inflammatory macrophages in the stomach, duodenum, and colon. Intermediate blood monocytes were also increased in obesity, suggesting enhanced recruitment to the gut. We identified unhealthy lifestyle habits as potential triggers of gut and systemic inflammation (i.e., low vegetable intake, high processed meat consumption, sedentary lifestyle). Cardiovascular risk factors other than body weight did not affect the innate immune response. Thus, obesity in humans is characterized by gut inflammation as shown by accumulation of pro-inflammatory intestinal macrophages, potentially via recruited blood monocytes. Understanding gut innate immunity in human obesity might open up new targets for immune-modulatory treatments in metabolic disease.

Arterial Hypertension and Multiple Myeloma: Physiopathology and Cardiovascular Risk and ‘Practical’ Indications in Patients Receiving Carfilzomib

2019 ◽  
Vol 15 (1) ◽  
pp. 47-53 ◽  
Author(s):  
Alberto Milan ◽  
Giulia Bruno ◽  
Ilaria Maffei ◽  
Andrea Iannaccone ◽  
Agnese Ravera ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multiple Myeloma ◽  
Cardiovascular Risk ◽  
Arterial Hypertension ◽  
Proteasome Inhibitors ◽  
Good Control ◽  
Cardiovascular Complications ◽  
Uncontrolled Hypertension ◽  
Refractory Multiple Myeloma ◽  
Current Guidelines

The introduction of carfilzomib in the treatment of relapsing and refractory multiple myeloma has allowed a significant increase in survival. The most frequent adverse effect of Carfilzomib treatment is arterial hypertension, even though the exact physiopathological mechanism are still unclear. MM patients, on the other hand, often present significant cardiovascular risk factors and comorbidities. Uncontrolled hypertension is frequently the cause of cardiovascular complications. It has been estimated that up to 50% of subjects in the general population are unaware of their hypertensive condition and only half of those who are aware of this risk factor present good control of blood pressure. Although the management of arterial hypertension is clearly important in reducing the risk of cardiovascular events, and is well described by the current guidelines, no clear indications are provided on how to approach and treat specifically MM patients undergoing treatment with proteasome inhibitors. The aim of our work is to summarize a practical approach to the stratification of cardiovascular risk of hypertensive in patients who are candidates for or actively treated with carfilzomib for refractory multiple myeloma (MMR). MM patients eligible for carfilzomib treatment should preliminary undergo a careful cardiovascular risk stratification. Perspective studies will help to better identify the specific risk factors that should be considered and treated in these patients.

scholarly journals The Pathophysiology of HIV-/HAART-Related Metabolic Syndrome Leading to Cardiovascular Disorders: The Emerging Role of Adipokines

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
John Palios ◽  
Nikolaos P. E. Kadoglou ◽  
Stylianos Lampropoulos
Keyword(s):  
Risk Factors ◽  
Metabolic Syndrome ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Highly Active Antiretroviral Therapy ◽  
Cardiovascular Complications ◽  
Cardiovascular Disorders ◽  
Highly Active ◽  
Arterial Blood ◽  
Immunodeficiency Virus

Individuals infected with human immunodeficiency virus (HIV) frequently demonstrate metabolic syndrome (MS) associated with increased incidence of cardiovascular disorders. Characteristics of HIV infection, such as immunodeficiency, viral load, and duration of the disease, in addition to the highly active antiretroviral therapy (HAART) have been suggested to induce MS in these patients. It is well documented that MS involves a number of traditional cardiovascular risk factors, like glucose, lipids, and arterial blood pressure abnormalities, leading to extensive atherogenic arterial wall changes. Nevertheless, the above traditional cardiovascular risk factors merely explain the exacerbated cardiovascular risk in MS. Nowadays, the adipose-tissue derivatives, known as adipokines, have been suggested to contribute to chronic inflammation and the MS-related cardiovascular disease. In view of a novel understanding on how adipokines affect the pathogenesis of HIV/HAART-related MS and cardiovascular complications, this paper focuses on the interaction of the metabolic pathways and the potential cardiovascular consequences. Based on the current literature, we suggest adipokines to have a role in the pathogenesis of the HIV/HAART-related MS. It is crucial to understand the pathophysiology of the HIV/HAART-related MS and apply therapeutic strategies in order to reduce cardiovascular risk in HIV patients.

scholarly journals Arterial hypertension and dyslipidemia in a HIV-positive patient treated with antiretroviral therapy

2012 ◽  
Vol 6 (1) ◽  
pp. 5-14
Author(s):  
Alessandro Maloberti ◽  
Paolo Villa ◽  
Dario Dozio ◽  
Francesca Citterio ◽  
Giorgia Grosso ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Clinical History ◽  
Organ Damage ◽  
Cardiovascular Complications ◽  
Specific Population ◽  
Metabolic Alteration ◽  
Peculiar Case

The introduction of antiretroviral therapy (ART) has substantially modified the clinical history and epidemiology of HIV infection with an important decline in infective causes of death and an increase in non-infective comorbidities particularly in cardiovascular complications. HIV infection has been related to an increased cardiovascular risk due to the presence of three factors: classic cardiovascular risk factors (shared with the general population), HIV infection itself (indirectly due to the inflammation and directly due to viral molecule) and ART-related chronic metabolic alterations. We describe a peculiar case of metabolic alteration in an HIV infected patient on ART with particular attention to the diagnosis and therapeutic aspects. Giving the higher cardiovascular risk of this specific population it is advisable that the clinician performs a frequent re-assessment of risk factors and cardiovascular organ damage. An early detection of metabolic alteration must lead to an aggressive specific therapy; this must be done by taking care of the HIV-infected subject fragility and the interactions with ART.

scholarly journals Coronary Artery Disease in Women: A Comprehensive Appraisal

2021 ◽  
Vol 10 (20) ◽  
pp. 4664
Author(s):  
Nili Schamroth Pravda ◽  
Orith Karny-Rahkovich ◽  
Arthur Shiyovich ◽  
Miri Schamroth Pravda ◽  
Naomi Rapeport ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Sex Differences ◽  
Cardiovascular Risk ◽  
Coronary Artery ◽  
Cardiovascular Risk Factors ◽  
Clinical Presentation ◽  
Artery Disease

Coronary artery disease (CAD) is a significant cause of illness and death amongst women. The pathophysiology, manifestations, and outcomes of CVD and CAD differ between sexes. These sex differences remain under-recognized. The aim of this review is to highlight and raise awareness of the burden and unique aspects of CAD in women. It details the unique pathophysiology of CAD in women, cardiovascular risk factors in women (both traditional and sex-specific), the clinical presentation of CAD in women, and the range of disease in obstructive and non-obstructive CAD in women.

Gender Differences in the Presentation and Outcomes of Hospitalized Patients With COVID-19

2021 ◽  
Vol 16 (6) ◽  
Author(s):  
Carloalberto Biolè ◽  
Matteo Bianco ◽  
Iván J Núñez-Gil ◽  
Enrico Cerrato ◽  
Amanda Spirito ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gender Differences ◽  
Renal Failure ◽  
Cardiovascular Risk ◽  
Laboratory Tests ◽  
Clinical Presentation ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
International Registry ◽  
Male Patients

Gender-related differences in COVID-19 clinical presentation, disease progression, and mortality have not been adequately explored. We analyzed the clinical profile, presentation, treatments, and outcomes of patients according to gender in the HOPE-COVID-19 International Registry. Among 2,798 enrolled patients, 1,111 were women (39.7%). Male patients had a higher prevalence of cardiovascular risk factors and more comorbidities at baseline. After propensity score matching, 876 men and 876 women were selected. Male patients more often reported fever, whereas female patients more often reported vomiting, diarrhea, and hyposmia/anosmia. Laboratory tests in men presented alterations consistent with a more severe COVID-19 infection (eg, significantly higher C-reactive protein, troponin, transaminases, lymphocytopenia, thrombocytopenia, and ferritin). Systemic inflammatory response syndrome, bilateral pneumonia, respiratory insufficiency, and renal failure were significantly more frequent in men. Men more often required pronation, corticosteroids, and tocilizumab administration. A significantly higher 30-day mortality was observed in men vs women (23.4% vs 19.2%; P = .039). Trial Numbers: NCT04334291/EUPAS34399.

Observation versus antiplatelet therapy as primary prophylaxis for thrombosis in low-risk essential thrombocythemia

Blood ◽  
2010 ◽  
Vol 116 (8) ◽  
pp. 1205-1210 ◽  
Author(s):  
Alberto Alvarez-Larrán ◽  
Francisco Cervantes ◽  
Arturo Pereira ◽  
Eduardo Arellano-Rodrigo ◽  
Virginia Pérez-Andreu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Venous Thrombosis ◽  
Antiplatelet Therapy ◽  
Essential Thrombocythemia ◽  
Arterial Thrombosis ◽  
Primary Prophylaxis ◽  
Low Risk ◽  
Increased Risk ◽  
Risk Patients

Abstract The effectiveness of antiplatelet therapy as primary prophylaxis for thrombosis in low-risk essential thrombocythemia (ET) is not proven. In this study, the incidence rates of arterial and venous thrombosis were retrospectively analyzed in 300 low-risk patients with ET treated with antiplatelet drugs as monotherapy (n = 198) or followed with careful observation (n = 102). Follow-up was 802 and 848 person-years for antiplatelet therapy and observation, respectively. Rates of thrombotic events were 21.2 and 17.7 per 1000 person-years for antiplatelet therapy and observation, respectively (P = .6). JAK2 V617F–positive patients not receiving antiplatelet medication showed an increased risk of venous thrombosis (incidence rate ratio [IRR]: 4.0; 95% CI: 1.2-12.9; P = .02). Patients with cardiovascular risk factors had increased rates of arterial thrombosis while on observation (IRR: 2.5; 95% CI: 1.02-6.1; P = .047). An increased risk of major bleeding was observed in patients with platelet count greater than 1000 × 109/L under antiplatelet therapy (IRR: 5.4; 95% CI: 1.7-17.2; P = .004). In conclusion, antiplatelet therapy reduces the incidence of venous thrombosis in patients with JAK2-positive ET and the rate of arterial thrombosis in patients with associated cardiovascular risk factors. In the remaining low-risk patients, this therapy is not effective as primary prophylaxis of thrombosis, and observation may be an adequate option.

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