Abstract:
:The use of heparin may be complicated by two types of thrombocytopenia (HAT): type I occurs early, is transient, and has no clinical relevance, while type II may lead to very severe manifestations (arterial or venous thromboses and more rarely bleedings), that are still underestimated by some clinicians. HAT-type II most frequently develops after use of therapeutic doses of unfractionated heparin (UH) but has also been described less frequently after use of very low doses of UH, of low molecular weight heparins (LMWH), and even of polysulfated glycosaminoglycosans devoid of anticoagulant action. The estimation of the incidence of HAT-type II and of related thromboses is a very difficult matter. Recent observations suggest that thromboses (notably venous) may be more frequent than previously estimated. HAT-type II pathophysiology includes the formation of immune complexes at the surface of platelets; the antigen has been shown to be most often platelet factor 4 bound to heparin while the antibody is recognized by platelet Fc gamma RII receptors. Thromboses result most probably from activation of both platelets (leading to the formation of microparticles) and endothelial cells. Several biological tests are presently available for diagnosing HAT-type II but none of them has been shown to be ideal. The prevention of HAT-type II requires history taking preference of LMWH to UH, early start of oral anticoagulation, and platelet monitoring from the fifth day of heparin therapy. The therapy of HAT-type II implies immediate discontinuation of heparin and avoidance of platelet transfusions, unless severe bleeding occurs. If further antithrombotic treatment is deemed necessary (probably in all cases), several options are possible but presently, the most recommended ones are Org 10172 or Ancrod; embolectomy or thrombolysis may also be required if a new thrombotic event has developed. A very difficult dilemma concerns patients previously sensitized to heparin and who present a clinical situation that theoretically mandates re-exposure to UH, such as by-pass surgery; prostacyclin analogues may be successfully used in such cases. Recent developments in the therapy of HAT-type II include recombinant hirudin or synthetic analogs, or use of some intravenous immunoglobulin preparations. Possible candidates are the heparin synthetic pentasaccharide and recombinant tissue factor pathway inhibitor.
journal_name
Acta Clin Belgjournal_title
Acta clinica Belgicaauthors
Fondu Pdoi
10.1080/17843286.1995.11718474subject
Has Abstractpub_date
1995-01-01 00:00:00pages
343-57issue
6eissn
1784-3286issn
2295-3337journal_volume
50pub_type
杂志文章,评审abstract::There is a need for legal control of sensitivity discs. False results are obtained by the use of discs containing an antibiotic and an unlabelled antimicrobial drug. Results of sensitivity tests (performed by the disc agar diffusion method) using Levocyclin8 discs furnished by the manufacturers were highly improbable....
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1080/17843286.1976.11717057
更新日期:1976-01-01 00:00:00
abstract::Mastocytosis is a heterogeneous disease caused by excessive mast cell (MC) proliferation. Diagnosis of systemic mastocytosis (SM) is based on the presence of major and minor criteria defined by the World Health Organization. Symptoms of MC activation can also occur in patients without SM or without allergic or inflamm...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1080/17843286.2017.1293312
更新日期:2017-04-01 00:00:00
abstract::P-glycoprotein, a pump located in the plasma cell membrane, extrudes several clinically important drugs from the cell, and hence causes multidrug resistance. Reversing clinical drug resistance is possible by using agents that inhibit the activity of P-glycoprotein. We describe the results of sequential flow cytometric...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1080/17843286.2000.11754299
更新日期:2000-07-01 00:00:00
abstract:OBJECTIVES:Q fever is a global zoonosis that can cause both acute and chronic infections in humans through aerogenic transmission. Although Q fever was discovered already 80 years ago, this infectious disease remains largely unknown. We studied a case series in a Belgian tertiary care hospital. METHODS:A laboratory an...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1080/17843286.2016.1165397
更新日期:2016-10-01 00:00:00
abstract::Gestational diabetes (GDM) is a frequent medical condition during pregnancy. GDM is associated with an increased risk of complications for both the mother and the baby during pregnancy and birth. Women with GDM also have an increased risk of developing type 2 diabetes later in life. Two large randomised intervention t...
journal_title:Acta clinica Belgica
pub_type: 杂志文章,评审
doi:10.2143/ACB.67.4.2062669
更新日期:2012-07-01 00:00:00
abstract:OBJECTIVES AND METHODS: High-grade B-cell lymphoma, NOS (HGBL) have an aggressive clinical behavior and poor outcome using regimens currently employed for diffuse large B-cell lymphoma (DLBCL) such as rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP). Promising results have been reported wi...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1080/17843286.2017.1412888
更新日期:2018-12-01 00:00:00
abstract::Central venous catheters are widely used in clinical practice. Air embolism is a rare, but potentially life threatening complication of central venous catheterisation. We describe a case of collapse and transient hemiplegia after removal of central venous catheter. This was accidentally performed with the patient in u...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1179/acb.2010.009
更新日期:2010-01-01 00:00:00
abstract::A multihospital study allowed us to follow a total of 62 serologically proven cases of Nephropathia epidemica (NE) in the Belgian region between Sambre and Meuse during the 1992-1993 period. The clinical picture consisted of sudden high fever (100% of the cases), headache (71%), abdominal or lumbar pains (80%) and, as...
journal_title:Acta clinica Belgica
pub_type: 杂志文章,多中心研究
doi:10.1080/17843286.1995.11718447
更新日期:1995-01-01 00:00:00
abstract::Over the past few years there have been enormous changes in the management of stroke patients. General practitioners, ambulance personnel/paramedics and the general public need to be well informed that stroke is a medical emergency. Prevention of secondary brain damage by normalising vital parameters and combating fev...
journal_title:Acta clinica Belgica
pub_type: 杂志文章,评审
doi:10.1080/17843286.1999.11754250
更新日期:1999-10-01 00:00:00
abstract:BACKGROUND:Multicentric Castleman's disease (MCD) is a rare, non-clonal lymphoproliferative disorder characterized by constitutional symptoms, anaemia and generalised lymphadenopathy. Its incidence among the HIV-positive population seems to have increased during the past decades. AIM:The present study intends to compa...
journal_title:Acta clinica Belgica
pub_type: 杂志文章,评审
doi:10.2143/ACB.66.1.2062510
更新日期:2011-01-01 00:00:00
abstract::Background Neurologic and liver involvement in Wilson's disease (WD) is well-documented, however, few reports demonstrated cardiac involvement. Tpe and Tpe/QT are new measures of ventricular repolarization which were recently suggested as predictor of arrythmogenesis. We aimed to evaluate ventricular depolarization an...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1080/17843286.2018.1443001
更新日期:2018-10-01 00:00:00
abstract:AIM:To present the cases of lactic acidosis encountered in our department among metformin-treated type 2 diabetic patients and to investigate the role of contraindications to metformin use. METHODS:A survey of medical records of metformin-treated type 2 diabetic patients hospitalised for various medical conditions dur...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1179/acb.2009.008
更新日期:2009-01-01 00:00:00
abstract::Saccharomyces boulardii is widely used as a probiotic compound and is generally thought to be safe. We report one case of fungemia caused by Saccharomyces cerevisiae occurring in an elderly patient treated orally with S. boulardii in association with vancomycin for Clostridium difficile colitis. We do not recommend ad...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1179/acb.2004.033
更新日期:2004-07-01 00:00:00
abstract::Epidemiological studies have shown that chronic kidney disease (CKD) is a major health problem especially in an older population. Given the growing segment of the elderly population and the important implication of renal disease on health care, this review discusses the structural and functional changes of the ageing ...
journal_title:Acta clinica Belgica
pub_type: 杂志文章,评审
doi:10.1179/acb.2008.002
更新日期:2008-01-01 00:00:00
abstract:CASE:A 45-year-old man presented at the emergency department (ED) with stomach pain since eight days. The patient was not worried about his symptoms and requested only pain relief. The emergency physician requested a consult of the gastroenterologist. Clinical examination was unremarkable. However, 12-lead ECG and isch...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1080/17843286.2018.1460019
更新日期:2018-12-01 00:00:00
abstract::Primary sclerosing cholangitis (PSC) and idiopathic pulmonary fibrosis (IPF) were each separately described in association with a variety of chronic idiopathic inflammatory diseases such as retroperitoneal fibrosis, Sicca complex or Riedel's thyroiditis. We report a case which may be the first description of the assoc...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1080/17843286.1989.11717982
更新日期:1989-01-01 00:00:00
abstract::Background and objective: The prevalence of potentially inappropriate prescribing (PIP) among nursing home (NH) residents is high. This study aimed to investigate the acceptance and implementation of pharmacist recommendations based on a screening tool for PIP, the Ghent Older People's Prescriptions community Pharmacy...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1080/17843286.2019.1634323
更新日期:2020-12-01 00:00:00
abstract::Background: Metastatic clear-cell renal cell carcinoma (m-ccRCC) patients with bone metastases (BM) treated with vascular endothelial growth factor receptor (VEGFR) tyrosine kinase inhibitors (TKI) have a poorer outcome compared to patients without BM. We aimed to investigate whether an increased incidence of VEGFR-TK...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1080/17843286.2018.1551744
更新日期:2019-12-01 00:00:00
abstract::The National Institute for Insurance of Disease and Disablement (RIZIV/INAMI) in Belgium reimburses the costs of long term oxygen therapy (LTOT) by concentrators since 1984 and by liquid oxygen since 1988 for specific categories of patients supervised by approved medical centers. Since then we prescribed these therapi...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1080/17843286.1995.11718439
更新日期:1995-01-01 00:00:00
abstract::We present the case of a 51-year-old woman who presented a right supraclavicular mass corresponding to lymphadenitis with atypical mycobacterium (Mycobacterium genavense). Later, she developed subcutaneous purulent small nodules containing the same germ. The presence of this mycobacterium was in the context of recurre...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1179/0001551213Z.00000000016
更新日期:2014-04-01 00:00:00
abstract::We performed a systematic survey of original papers published in The Lancet throughout the years 1945, 1946, 1970 and 1995. The Lancet was chosen due to a conservative layout through these years, and the year 1946 added to the analysis to ponder for any war-induced bias. The general layout and structure of the journal...
journal_title:Acta clinica Belgica
pub_type: 历史文章,杂志文章
doi:10.1179/acb.2004.011
更新日期:2004-03-01 00:00:00
abstract::We report a rare case of fulminant congestive heart failure with fatal outcome in a 21-year-old girl with systemic lupus erythematosus (SLE). A young woman was admitted in the intensive care unit for pericardial tamponade associated with disseminated coagulopathy and refractory shock secondary to multiple coronary ane...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1179/2295333714Y.0000000063
更新日期:2014-12-01 00:00:00
abstract::The term "microvesicular steatosis of the liver" refers to a variant form of hepatic fat accumulation whose histologic features contrast with the much more common macrovesicular steatosis. Microvesicular steatosis of the liver was originally described in association with conditions who share a number of biochemical an...
journal_title:Acta clinica Belgica
pub_type: 杂志文章,评审
doi:10.1080/17843286.1990.11718105
更新日期:1990-01-01 00:00:00
abstract::The kidneys play a major role in the regulation of the salt balance and thereby regulate blood pressure. Salt sensitivity is acquired or genetically-induced and is noted in about 50% of patients with essential hypertension. This property leads to a high cardiovascular risk. In this situation, the benefit of salt restr...
journal_title:Acta clinica Belgica
pub_type: 杂志文章,评审
doi:10.1179/acb.2007.053
更新日期:2007-09-01 00:00:00
abstract::We report on one patient with Wegener's granulomatosis (WG) and two patients with microscopic polyangiitis (MPA). The patient with WG had signs of a respiratory infection and showed a c-ANCA pattern with proteinase 3 (PR3) specificity. The patients with MPA presented with pulmonary haemorrhage and signs of renal damag...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1179/acb.2003.58.3.008
更新日期:2003-05-01 00:00:00
abstract::Although post-transplant lymphoproliferative disorder is a classical complication encountered after kidney transplantation, its diagnosis can still be challenging and its outcome life-threatening. Most cases are related to Epstein-Barr virus (EBV) infection and occur mainly in the first year post-transplant, favoured ...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1179/2295333714Y.0000000112
更新日期:2015-06-01 00:00:00
abstract::The present study compares two new factor VIII preparations currently used in the treatment of haemophilia. A Factor VIII was partially purified from plasma obtained from unpaid voluntary Belgian donors in the blood transfusion centers of Lille and Amsterdam and virus-inactivated by exposure to solvent-detergent (FVII...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1080/17843286.1991.11718180
更新日期:1991-01-01 00:00:00
abstract::Histiocytosis X of the lung is associated with bone lesions in 4 to 20%. We report a case in which the diagnosis was missed in spite of repeated bronchoscopies with transbronchial lavage. The diagnosis was finally established by isotope bone scan, subsequent skeletal CT-scan and bone biopsy. ...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1080/17843286.1994.11718372
更新日期:1994-01-01 00:00:00
abstract:BACKGROUND:Malignant cardiac tamponade is a life-threatening condition that requires prompt treatment and effective management to prevent recurrence. This paper describes safety and efficacy outcomes after intrapericardial instillation of bleomycin as well as possible predictors of survival. METHODS:We performed a 10-...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1080/17843286.2020.1790180
更新日期:2020-07-05 00:00:00
abstract::The HOPE and EUROPA clinical studies have shown that treatment with the angiotensin-converting enzyme (ACE) inhibitors, ramipril and perindopril, may reduce the occurrence of major cardiovascular events in patients with proven atherosclerotic disease. The recently published results of the PRoFESS and TRANSCEND trials ...
journal_title:Acta clinica Belgica
pub_type: 杂志文章,随机对照试验
doi:10.1179/acb.2010.022
更新日期:2010-03-01 00:00:00