Thrombotic storm, hemostasis disorders and thromboinflammation in COVID-19

The rate of thrombosis and disseminated intravascular coagulation (DIC) has been increasing in COVID-19 patients. Key features related to such condition include minimal or no risk of bleeding, moderate thrombocytopenia, high plasma fibrinogen as well as complement components level in the areas of thrombotic microangiopathy. The clinical picture is not typical for classic DIC. This review systematizes the pathogenetic mechanisms of hypercoagulation in sepsis and its extreme forms in patients with COVID-19. The latter consist of the thrombosis-related immune mechanisms, the complement activation, the macrophage activation syndrome, the formation of antiphospholipid antibodies, the hyperferritinemia, and the dysregulation of the renin-angiotensin system. Taking into consideration the pathogenetic mechanisms, the biomarkers had been identified related to the prognosis of the disease development. Patients with pre-existing cardiovascular disease and other risk factors, including obesity, diabetes, hypertension, and aging pose the peak risk of dying from COVID-19. We also summarize new data on platelet and endothelial dysfunction, immunothrombosis, and, as a result, thrombotic storm as essential components of COVID-19 severe features

HIBISCUS: Hydroxychloroquine for the secondary prevention of thrombotic and obstetrical events in primary antiphospholipid syndrome

The relapse rate in antiphospholipid syndrome (APS) remains high, i.e. around 20%-21% at 5 years in thrombotic APS and 20-28% in obstetrical APS [2, 3]. Hydroxychloroquine (HCQ) appears as an additional therapy, as it possesses immunomodulatory and anti-thrombotic various effects [4-16]. Our group recently obtained the orphan designation of HCQ in antiphospholipid syndrome by the European Medicine Agency. Furthermore, the leaders of the project made the proposal of an international project, HIBISCUS, about the use of Hydroxychloroquine in secondary prevention of obstetrical and thrombotic events in primary APS. This study has been launched in several countries and at now, 53 centers from 16 countries participate to this international trial. This trial consists in two parts: a retrospective and a prospective study. The French part of the trial in thrombosis has been granted by the French Minister of Health in December 2015 (the academic trial independent of the pharmaceutical industry PHRC N PAPIRUS) and is coordinated by one of the members of the leading consortium of HIBISCUS

MONOCHORIONIC MULTIPLE PREGNANCY

The article describes the concept of monochorionic multiple pregnancies, the relevance and epidemiology of the topic, as well as complications in pregnancy and delivery in monochorionic twins

FATHER OF BRITISH OBSTETRICS

The article highlights historic aspects of medical and research work of the British obstetrician of the XVIII century William Smelli

About the image of mother with child in fine arts. Part II. Renaissance

The article highlights aspects of the topic a mother and a child in fine arts of the Renaissance. Paintings by Dutch artists Robert Campen and Jan Van Eyck, Italian paintings by Leonardo da Vinci, Michelangelo, Sandro Botticelli, Raphael, as well as paintings by Diego de Silva y Velazquez, Peter Paul Rubens and Rembrandt are presented

ANDRE LEVRE

The article highlights historic aspects of medical and research work of the French obstetrician of the XVIII century Andre Levre

CHRISTIAN GERHARD LEOPOLD

The article highlights historic aspects of medical and research work of the German obstetrician of the XIX-XX centuries Christian Gerhard Leopold

EDUARDO PORRO

This article describes the historical aspects of life, medical and scientific practice of the Italian obstetrician Eduardo Porro, as well as his invaluable contribution to obstetrics

The Great Baudelocque

The article highlights historic aspects of medical and research work oft he French gynecologist-obstetrician of the XVIII - XIX centuries Jean Louis Baudelocque

ERNST WERTHEIM

The article considers the historical aspects of life, medical and scientific activities of the Austrian gynecologist Ernst Wertheim. Describes his invaluable contribution to the operational cancers