Acute myocardial infarction in a patient with hypofibrinogenemia: a case report

<p>Abstract</p> <p>Introduction</p> <p>Congenital fibrinogen deficiency is a rare coagulation disorder usually responsible for hemorrhagic diathesis. However, it can be associated with thrombosis and there have been limited reports of arterial thrombotic complications in these patients.</p> <p>Case presentation</p> <p>A 42-year-old Tunisian man with congenital hypofibrinogenemia and no cardiovascular risk factors presented with new onset prolonged angina pectoris. An electrocardiogram showed features of inferior acute myocardial infarction. His troponin levels had reached 17 ng/L. Laboratory findings confirmed hypofibrinogenemia and ruled out thrombophilia. Echocardiography was not useful in providing diagnostic elements but did show preserved left ventricular function. Coronary angiography was not performed and our patient did not receive any anticoagulant treatment due to the major risk of bleeding. Magnetic resonance imaging confirmed myocardial necrosis. Our patient was managed with aspirin, a beta-blocker, an angiotensin-converting enzyme inhibitor and statin medication. The treatment was well tolerated and no ischemic recurrence was detected.</p> <p>Conclusion</p> <p>Although coronary thrombosis is a rare event in patients with fibrinogen deficiency, this condition is of major interest in view of the difficulties observed in managing these patients.</p

Combined Effect of Dietary Cadmium and Benzo(a)pyrene on Metallothionein Induction and Apoptosis in the Liver and Kidneys of Bank Voles

Bank voles free living in a contaminated environment have been shown to be more sensitive to cadmium (Cd) toxicity than the rodents exposed to Cd under laboratory conditions. The objective of this study was to find out whether benzo(a)pyrene (BaP), a common environmental co-contaminant, increases Cd toxicity through inhibition of metallothionein (MT) synthesis—a low molecular weight protein that is considered to be primary intracellular component of the protective mechanism. For 6 weeks, the female bank voles were provided with diet containing Cd [less than 0.1 μg/g (control) and 60 μg/g dry wt.] and BaP (0, 5, and 10 μg/g dry wt.) alone or in combination. At the end of exposure period, apoptosis and analyses of MT, Cd, and zinc (Zn) in the liver and kidneys were carried out. Dietary BaP 5 μg/g did not affect but BaP 10 μg/g potentiated rather than inhibited induction of hepatic and renal MT by Cd, and diminished Cd-induced apoptosis in both organs. The hepatic and renal Zn followed a pattern similar to that of MT, attaining the highest level in the Cd + BaP 10-μg/g group. These data indicate that dietary BaP attenuates rather than exacerbates Cd toxicity in bank voles, probably by potentiating MT synthesis and increasing Zn concentration in the liver and kidneys

Još o toksičnosti kadmija - s posebnim osvrtom na nastanak oksidacijskoga stresa i na interakcije s cinkom i magnezijem

Discovered in late 1817, cadmium is currently one of the most important occupational and environmental pollutants. It is associated with renal, neurological, skeletal and other toxic effects, including reproductive toxicity, genotoxicity, and carcinogenicity. There is still much to find out about its mechanisms of action, biomarkers of critical effects, and ways to reduce health risks. At present, there is no clinically efficient agent to treat cadmium poisoning due to predominantly intracellular location of cadmium ions. This article gives a brief review of cadmium-induced oxidative stress and its interactions with essential elements zinc and magnesium as relevant mechanisms of cadmium toxicity. It draws on available literature data and our own results, which indicate that dietary supplementation of either essential element has beneficial effect under condition of cadmium exposure. We have also tackled the reasons why magnesium addition prevails over zinc and discussed the protective role of magnesium during cadmium exposure. These findings could help to solve the problem of prophylaxis and therapy of increased cadmium body burden.Iako je otkriven tek 1817. godine, kadmij je trenutačno jedan od najvažnijih onečišćivača životne i radne sredine. Štetno djeluje na bubrege, živčani sustav, kosti, reproduktivni sistem, a ima i genotoksične i karcinogene efekte. Nužna su dalja istraživanja vezana za mehanizme njegove toksičnosti, biomarkere efekata, kao i načine smanjenja rizika za zdravlje. Osim toga, do danas nije otkriven agens efikasan u terapiji trovanja kadmijem s obzirom na to da je kadmij intracelularni kation. U ovom radu dan je sažet pregled važnih mehanizama toksičnosti kadmija, kao što su nastanak oksidativnog stresa i interakcije s esencijalnim elementima, cinkom i magnezijem, na osnovi dostupnih literaturnih podataka, kao i naših ispitivanja koja upućuju na to da povećani unos navedenih esencijalnih elemenata pokazuje pozitivne efekte pri ekspoziciji kadmiju. Obrazložena je prednost suplementacije magnezijem pred suplementacijom cinkom i razmatrana preventivna uloga magnezija pri intoksikaciji kadmijem. Ovi su rezultati doprinos rješavanju problema profi lakse i terapije trovanja kadmijem