The risk of thromboembolism (TE) is increased in patients with inflammatory bowel disease (IBD), mainly due to an increased risk of venous TE (VTE). The risk of arterial TE (ATE) is less pronounced, but an increased risk of cardiovascular diseases needs to be addressed in IBD patients. IBD predisposes to arterial and venous thrombosis through similar prothrombotic mechanisms, including triggering activation of coagulation, in part mediated by impairment of the intestinal barrier and released bacterial components. VTE in IBD has clinical specificities, i.e. , an earlier first episode in life, high rates during both active and remission stages, higher recurrence rates, and poor prognosis. The increased likelihood of VTE in IBD patients may be related to surgery, the use of medications such as corticosteroids or tofacitinib, whereas infliximab is antithrombotic. Long-term complications of VTE can include post-thrombotic syndrome and high recurrence rate during post-hospital discharge. A global clot lysis assay may be useful in identifying patients with IBD who are at risk for TE. Many VTEs occur in IBD outpatients; therefore, outpatient prophylaxis in high-risk patients is recommended. It is crucial to continue focusing on prevention and adequate treatment of VTE in patients with IBD.
Exposure to house dust allergens, mainly from domestic mites, is an important cause of allergic reactions in sensitized asthmatic patients. A total of 63 dust samples were collected from 16 flats in Bytom (south Poland); in each flat a person (age 4–17 years) suffering from bronchial asthma lived with his/her family. Mite density was calculated as the number of specimens per g of dust. The results were compared with household features and the data were statistically analyzed. In total 566 mite specimens were isolated, including 526 members of the family Pyroglyphidae (93%). The dominant species were Dermatophagoides pteronyssinus (60% of the total count) and Dermatophagoides farinae (32%). Pyroglyphids were found in all mite positive samples (68%) of which 35% also contained non-pyroglyphids, including glycyphagids, cheyletids and gamasids. The results suggest associations between the density of some mite taxa (per g of dust) and the following indoor environmental factors: presence of pets, number of inhabitants, coal-stoves as a type of heating, cleaning frequency, higher relative humidity, presence of flowers and PVC windows. The severity of asthma seems to be associated with the numbers of D. farinae, total domestic mites and live mites per g of dust.
Introduction: Post- thrombotic syndrome (PTS) is the most common complication of deep vein thrombosis (DVT), and develops in 20–50% of patients after a proximal DVT. Balneotherapy and hydrotherapy is justified in treatment of primary or post-thrombotic chronic venous insufficiency (CVI). M aterial: A review of articles was done in electronic databases Pubmed and Medline by keywords: postthrombotic syndrome, chronic venous insufficiency in conjunction with balneotherapy, hydrotherapy, kinesitherapy, coagulation. Results: Main risk of PST is considered as extensive proximal character of DVT, pre-existing CVI, older age, high body mass index, pre-existent varicosities. PTS refers to clinical manifestations of CVI, and is common cause of unilateral CVI. The thrombus itself may lead to venous valves destruction and reflux. The Villalta PTS scale may define and classify the severity of PTS Venous leg ulcers is the most advanced clinical manifestation of the disease. Prevention of PTS begins with prevention of initial and recurrent DVT includes use of compression stockings and anticoagulant medications. Treatment guidelines recommend anticoagulant therapy - five days with heparin followed by three months of oral anticoagulant after acute event, with subsequent long-term of extended therapy depending on patient’s risk of recurrence. Recent clinical trials indicate that the use of new anticoagulants (NOAS) reduces the incidence of PTS. Ultrasound compression test of the leg veins evaluates the degree of obstruction by clots. Medical therapy of CVI has still not efficient. Carbon dioxide baths and ozone baths have favorably affect hemostasis system. However there are only a few controlled studies evaluating effects of balneotherapy in primary and post-thrombotic CVI. The favorable effect of these mineral baths may result from both hydrostatic effects as well as the contribution with specific chemico-physical properties. The controlled trials (in patients with C3 -C5 stage) shown that balneohydrotherapy and kinesitherapy have decreased signs and symptoms in patients with primary and post - thrombotic CVI. Conclusions: The Health Resort treatment of patients with CVI in the mechanism of post-thrombotic syndrome should be preceded by evaluation of the venous system of the lower limb by compression ultrasound. Balneotherapy and hydroteraphy seem to be effective and safe procedures even in patients with advanced primary and post-thrombotic CVI stage.
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