Home Treatment Versus Early Discharge From the Hospital: A Dilemma in the Management of Proximal Vein Thrombosis With Low Molecular Weight Heparins

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Idiopathic Deep Vein Thrombosis and Subsequent Cancer: Suggestions for a Patient-Oriented and Practical Approach:

The relationship between an idiopathic deep vein thrombosis and a cancer is well established. It is not clear yet whether all patients with an idiopathic deep vein thrombosis should be thoroughly investigated for an occult cancer or only some. As a matter of fact, once a physician is faced with a patient who has an idiopathic deep vein thrombosis, three approaches are possible, mainly: 1) a wait and see approach; 2) a limited investigation; and 3) an extensive or invasive investigation. No sure criteria for the selection of the patients who should be extensively investigated are available. Suggestions have been made in this regard. Negative family or personal history for thrombosis, advanced age, deep vein thrombosis of upper limbs, existence of silent deep vein thrombosis in contralateral leg, tendency to relapse and/or to migrate, constitutional symptoms, or smoking may represent important clues that may justify an extensive study. This patient-oriented approach is mainly based on the experience of the caring physician

Low incidence of venous thrombosis in homozygous patients with NT 20210 G to a prothrombin polymorphism.

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Bleeding manifestations in heterozygotes with congenital FVII deficiency: a comparison with unaffected family members during a long observation period.

To determine whether heterozygotes with FVII deficiency have a bleeding tendency or not.Eighty-four patients (OK) heterozygous for FVII deficiency, at the onset of the study, were paired with unaffected family members and followed for a long period of time (mean 22.6 years) for the occurrence of bleeding. Diagnosis of heterozygosis had to be based on family studies, clotting, immunological assays and genetic analysis.The mean FVII activity level was 0.51 IU/dl (range 35-65) and 94 IU/dl (range 88-118) in the heterozygotes and in the normal counterparts, respectively. Documented bleeding manifestations occurred in eight heterozygotes and in seven normal subjects. Statistical analysis of the difference was not significant. Bleeding manifestations were easy bruising, bleeding after tooth extractions, menorrhagia, epistaxis with no difference among the two groups. There was no strict correlation between bleeding and FVII activity levels.The study indicates that heterozygotes for FVII deficiency show rare bleeding manifestations which are also present in the unaffected family members with normal FVII levels. This indicates that Factor VII activity levels played no role in the occurrence of the bleeding symptoms. Furthermore, FVII levels of around 0.40 IU/dl are capable of assuring a normal hemostasis

Congenital factor XI and factor VII deficiencies assure an apparent opposite protection against arterial or venous thrombosis: An intriguing observation.

To investigate the prevalence and type of thrombotic events reported in patients with congenital factor XI (FXI) or factor VII (FVII) deficiency.Data on all patients with congenital FXI or FVII deficiency and a thrombotic event were gathered by means of a time unlimited PubMed search carried out in June 2014 and in February 2015. Appropriate keywords including the medical subject headings were used in both instances. Side tables were also consulted and cross-checking of the references was carried out to avoid omissions. The thrombosis event had to be proven by objective methods.Forty-three patients with FXI deficiency had arterial thrombosis and only eight had venous thrombosis. On the contrary, only five patients with FVII deficiency had arterial thrombosis whereas 31 patients had venous thrombosis. The arterial/venous ratios were 5.37 and 0.17 for FXI or FVII, respectively.Arterial thrombosis is frequent in FXI deficiency whereas venous thrombosis is rare. The reverse is true for FVII deficiency. The significance of these findings is discussed especially in view of the recent use of synthetic anti-FXI compounds in the prophylaxis of post-orthopedic surgery of venous thrombosis complications

Myocardial infarction and arterial thrombosis in severe (homozygous) FXII deficiency: no apparent causative relation.

Twenty-one patients (12 female and 9 male) with severe (homozygous) factor XII (FXII) deficiency and 58 (32 female and 26 male) with heterozygous FXII deficiency were observed for an average 16.2 years. No patient with homozygous FXII deficiency experienced myocardial infarction or any other arterial thrombosis. The same was true for heterozygotes. The cases of FXII deficiency and arterial thrombosis reported in the literature were evaluated. In every instance, associated risk factors were present that could justify the arterial thrombosis. Dyslipidemia, hypertension, smoking, and diabetes mellitus were the most frequent findings. The examination of the few papers that dealt with the prevalence of arterial thrombosis in patients with severe FXII deficiency showed that only 1 patient of 61 experienced myocardial infarction. In conclusion, it seems that the role of FXII deficiency in the pathogenesis of arterial thrombosis is minor

Congenital prothrombin defects: they are not only associated with bleeding but also with thrombosis: a new classification is needed.

Congenital prothrombin deficiency is one of the rarest clotting disorders. It is commonly subdivided in Type I defects or cases of 'true' prothrombin deficiency characterized by a concomitant decrease in FII activity and antigen and in Type II or dysprothrombinemias, in which FII activity is low but FII antigen is normal or near normal. A bleeding tendency, often a severe one, is the hallmark of the two-defects even though the bleeding is usually less severe in the Type 2 defects or dysprothrombinemias.An extensive search of published cases of prothrombin deficiency was carried out in Pubmed and Scopus. The search started in 2012, after the publication of the first family with dysprothrombinemia and venous thrombosis. A few additional families were found.Recent studies have demonstrated that the Type 2 defects are heterogeneous. Several heterozygous mutations involving the Arg596 residue of exon 14 have been demonstrated not be associated with a bleeding tendency but, surprisingly, with venous thromboses. Mutations in close areas of prothrombin have failed to show the same pattern.These observations have required a reclassification of prothrombin defects. To the Type I and Type II defects, a Type III has to be added characterized by the absence of bleeding and the presence of venous thrombosis. It is not clear yet if this special variant of Type II defect is limited to the Arg596 mutations or if other residues may be involved

Effect of electrical stimulation and others genetic and environmental factors on colour of lamb meat

The research aimed to assess the effect of breed, sex, age at slaughter, rearing system and electrical stimulation on some colorimetric characteristics measured on the muscles Longissimus dorsi (LD), Gluteobiceps (Gb), Semimembranosus (Sm) and Rectus femoris (RF) of lambs belonging to the genetic types Gentile di Puglia (GP), Ile de France (IF) and the cross-breeds F1, F2 and F3. The IF lambs provided meat with the highest value of hue and lightness and the lowest chroma and redness. The F1 lambs showed the highest values of redness while the F2 crossbreed significantly differed from the other three genetic types only in pH, which was always the lowest. The F3 crossbreed revealed similar behaviour to the other genetic types, except for the pH which was always higher than in GP, F1 and F2. The differences between sexes were restricted to L* and pH values, being higher in the male. The lambs slaughtered at 56 days showed high a* values, while b* and hue were on average higher in younger lambs (35 days). The lambs reared with maternal milk in comparison with the artificially reared ones provided meat with the highest a* chroma and b* and the lowest hue values. Electrical stimulation of the carcass seems to have produced the same effects as the usual ageing time in cold store. The RF muscle provided the brightest meat; Sm showed the highest values of b* and chroma; LD provided the “darkest” meat and the lowest values of b* and hue; Gb produced a lower a* value than muscles LD, RF and Sm

Activity Budgets and Forage Selection of Podolian Cattle, a Semiwild Bovine Breed

This study aimed to describe the behaviour of Podolian breed, a semiwild cattle breed kept in a natural environment (as either a small group of young bulls or cows within a family herd), and the interaction of these animals with the environment in terms of ingestion from natural pastures. Diurnal grazing behavioural pattern was monitored through continuous focal animal recording method. The activity budget of free-ranging animals was characterized by high locomotor and feeding activities. They exhibited a high degree of adaptability to the local phytocoenosis with high levels of ferns' and tree foliage intakes performed by cows and the selection of a diet more nutritious than pasture performed by young bulls. These results along with the low levels of agonistic interactions recorded in the two experiments suggest that extensive systems based on grazing allow social stability and provide a natural environment for the expression of cattle species-specific behaviour