Between 1981 and 1985, a total of 289 patients were seen at our anticoagulation clinic. Two hundred and fortyseven received long-term oral anticoagulation therapy because of a cardiac condition, 42 for deep vein thrombosis with or without pulmonary embolism. While on treatment, 106 patients fasted 309 Ramadan months and 183 patients elected not to fast during 594 Ramadan months. The incidence of thromboembolic events and hemorrhagic complications in the two groups was compared and no statistically significant differences were found. We conclude that Ramadan fasting, or any other form of short-term fasting, has no adverse effects on the efficacy and safety of long-term oral anticoagulation. JN Saour, JO Sieck, M Khan, L Mammo, Does Ramadan Fasting Complicate Anticoagulation Therapy. 1989; 9(6): 538-540 It is currently estimated that more than 555 million people belong to the Muslim faith.
Rheumatic fever (RF)/rheumatic heart disease (RHD) and post-streptococcal glomerulonephritis are thought to be autoimmune diseases, and follow group A streptococcal (GAS) infection. Different GAS M types have been associated with rheumatogenicity or nephritogenicity and categorized into either of two distinct classes (I or II) based on amino acid sequences present within the repeat region ('C' repeats) of the M protein. Sera from ARF patients have previously been shown to contain elevated levels of antibodies to the class I-specific epitope and myosin with the class I-specific antibodies also being cross-reactive to myosin, suggesting a disease association. This study shows that immunoreactivity of the class I-specific peptide and myosin does not differ between controls and acute RF (ARF)/RHD in populations that are highly endemic for GAS, raising the possibility that the association is related to GAS exposure, not the presence of ARF/RHD. Peptide inhibition studies suggest that the class I epitope may be conformational and residue 10 of the peptide is critical for antibody binding. We demonstrate that correlation of antibody levels between the class I and II epitope is due to class II-specific antibodies recognizing a common epitope with class I which is contained within the sequence RDL-ASRE. Our results suggest that antibody prevalence to class I and II epitopes and myosin is associated with GAS exposure, and that antibodies to these epitopes are not an indicator of disease nor a pathogenic factor in endemic populations.
BACKGROUND AND OBJECTIVES:Interruption of the Inferior Vena Cava (IVC) is recommended in certain cases to prevent Pulmonary Embolism (PE). Reported data on the efficacy and rate of complications vary considerably.PATIENTS AND METHODS:We conducted a retrospective analysis of patients who had a temporary or permanent IVC filter inserted at our institution during the past 5 years.RESULTS:Seventy-seven of 225 patients (34%) with Venous Thrombosis (VT) had an IVC filter inserted. Deep vein thrombosis and PE were the most common causes for anticoagulation. Bleeding was the reason for IVC filter insertion in 48 (62%). The only complication found was the breaking of a temporary filter during removal related to the procedure. However, 3 patients (out of 10) had a recurrence of VT after prolonged discontinuation of anticoagulation.CONCLUSIONS:Our criteria for indication of IVC filter insertion are in line with current standard of care. The immediate and delayed complications caused by IVC filter insertion was low. Active bleeding was the most common indication for filter insertion, whereas inherited thrombophilia was relatively common.
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