Plasmatic Plasminogen Activator Inhibitor Activity in Patients with Primary Breast Cancer

Blood rheology during chemotherapy in patients with ovarian cancer.

The use of platinum based chemotherapy in ovarian malignancy and other cancer types is known to be associated with deep vein thrombosis. In a prospective study of 47 patients with ovarian cancer of International Federation of Gynecology and Obstetrics stage Ib-IV, serial rheological parameters were determined (plasma viscosity, red blood cell aggregation under conditions of stasis and low shear) in addition to hemoglobin, hematocrit, leukocytes, platelets, and fibrinogen. At the same time the incidence of deep vein thrombosis was recorded before, during six cycles of first line cisplatinum/epirubicin/cyclophosphamide chemotherapy, and 2 months thereafter (two-months check-up). Only six pati…

Acute Cerebrovascular Disease in the Young

Background and Purpose— Strokes have especially devastating implications if they occur early in life; however, only limited information exists on the characteristics of acute cerebrovascular disease in young adults. Although risk factors and manifestation of atherosclerosis are commonly associated with stroke in the elderly, recent data suggests different causes for stroke in the young. We initiated the prospective, multinational European study Stroke in Young Fabry Patients (sifap) to characterize a cohort of young stroke patients. Methods— Overall, 5023 patients aged 18 to 55 years with the diagnosis of ischemic stroke (3396), hemorrhagic stroke (271), transient ischemic attack (1071) we…

Hyperviscosity syndrome in patients with ovarian carcinoma

BACKGROUND In patients with ovarian carcinoma, an hematocrit-independent hyperviscosity syndrome is often present. The syndrome is characterized by normal or low hematocrit and hemoglobin concentration, an elevated platelet count, and an increase in clotting factor turnover. Because deep vein thrombosis (DVT) often complicates the course of ovarian carcinoma, the aim of this study was to investigate the possible association of hyperviscosity syndrome with the development of DVT. METHODS Rheologic estimations of the blood included red blood cell (RBC) aggregation (stasis and low shear), plasma viscosity (pv), blood cell count, and fibrinogen, which were performed before primary surgery and t…

State-of-the-Art Review : Chemotherapy and Thrombosis in Gynecologic Malignancy

Thromboembolism is a severe and frequent problem in gynecologic malignancy. The average DVT incidence during chemotherapy of 5% might represent the lower range of incidence because < 55% of thrombotic complication manifest clinical signs. However, it seems likely that in addition to chemotherapy other risk factors such as menopausal status, BMI of patients, or type of preceding surgery must coincide before thrombosis manifests. While monitoring of patients using sophisticated coagulation tests did not identify patients' risk for DVT during chemotherapy, an evaluation of the coagulation status before initiating chemotherapy is recommended. Patients with a venous access device (e.g., indwelli…

Comparison of Unfractionated Versus Low Molecular Weight Heparin for Deep Vein Thrombosis Prophylaxis During Breast and Pelvic Cancer Surgery: Efficacy, Safety, and Follow-up

In a prospective, double-blind randomized trial the efficacy and safety of low molecular weight heparin and un fractionated heparin were compared for the prevention of post operative deep vein thrombosis in patients undergoing major surgery for breast and pelvic cancer. Three hundred fifty-eight patients were randomly allocated to the two treatment groups. Thirty-four of these were excluded from the study. Of the re maining 324 patients, 164 received 5000 IU unfractionated heparin three times daily and 160 received 3000 anti-Xa units of low molecular weight heparin once daily. Treatment was started 2 to 5 hours preoperatively and continued for 7 days. The occurrence of deep vein thrombosis…

The search for Muon neutrinos from northern hemisphere gamma-ray bursts with AMANDA

We present the results of the analysis of neutrino observations by the Antarctic Muon and Neutrino Detector Array (AMANDA) correlated with photon observations of more than 400 gamma-ray bursts (GRBs) in the Northern Hemisphere from 1997 to 2003. During this time period, AMANDA's effective collection area for muon neutrinos was larger than that of any other existing detector. Based on our observations of zero neutrinos during and immediately prior to the GRBs in the dataset, we set the most stringent upper limit on muon neutrino emission correlated with gamma-ray bursts. Assuming a Waxman-Bahcall spectrum and incorporating all systematic uncertainties, our flux upper limit has a normalizatio…