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Получил от "Puff of Domoke"-A Case-Review on the Challenging Discrimination of CNS Demielining Beace and Moyamoya Angiopatia.

Moyamoya aнгиопатия (MMA) — цереброваскулярное заболевание, определяющее хроническое прогрессивное включение надклиноидных внутренних артерий сонной артерии и их основных веток. Патогенез ММА по-прежнему в значительной степени неизвестен. Множественный склероз (MS) является хроническим, подстрекательским и демиелинизирующим заболеванием центральной нервной системы, характеризующимся постепенным накоплением фокусных демиелионирующих повреждений, патофизиология которых была теоретической, но до сих пор не до конца понята. Помимо неправильной диагностики из-за имитирующих эти два расстройства осо

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… Previous neurological symptoms and the presence of brain parenchymal lesions prompted to start specific treatment: antiplatelet therapy was initiated (with clopidogrel, due to allergy to acetylsalicylic acid). … Right bypass surgery n.s. 18 month [ 7 ] (case 2) US/ n.s. 44/M Right hemiparesis; impaired vision Periventricular Brain: − n.p. − + ANA (+)—ENA (−) Left ACA, MCA and PCA stenosis MMA mimicking/ associated with MS (discussion not conclusive) TIA Aspirin + Clopidogrel b-interferon (stopped after MMA evidence …

BCR-ABL1 tyrosine kinase inhibitors for the treatment of chronic myeloid leukemia.

The management of chronic myeloid leukemia with BCR-ABL1 tyrosine kinase inhibitors has evolved chronic myeloid leukemia into a chronic, manageable disease. A patient-centered approach is important for the appropriate management of chronic myeloid leukemia and optimization of long-term treatment outcomes. The pharmacist plays a key role in treatment selection, monitoring drug-drug interactions, identification and management of adverse events, and educating patients on adherence. The combination of tyrosine kinase inhibitors with unique safety profiles and individual patients with unique medica

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… | Imatinib | Dasatinib | Nilotinib Acenocoumarol | CYP 2C9 inhibition → increased anticoagulation a | Increased risk of bleeding b | CYP 2C9 inhibition → increased anticoagulation Clopidogrel (antiplatelet) | CYP 3A4 and 2C19 inhibition → decreased clopidogrel bioactivation | • Increased risk of bleeding … • CYP 3A4 inhibition → decreased clopidogrel bioactivation | CYP 3A4 inhibition → decreased clopidogrel bioactivation Dalteparin | NR | Increased risk of bleeding | NR Enoxaparin | NR | Increased risk of bleeding | NR Heparin | PgP inhibition → increased imatinib exposure | • Increased risk of bleeding …

Simultaneous kissing stents (SKS) technique for treating bifurcation lesions in medium-to-large size coronary arteries.

The treatment of bifurcation lesions (BLs) is associated with high procedural complication and restenosis rates. Two techniques of BL interventions were compared: the simultaneous kissing stents (SKS) technique, involving 2 stents, 1 in the main vessel and 1 in the side branch (n = 100), and the conventional stent strategy (CSS) technique, involving a stent in the main vessel and provisional stenting for the side branch (n = 100). In-hospital and 30-day major adverse cardiac events were greater in the CSS group, with significantly less procedure time with the SKS technique. The incidence of ta

Alpha-lipoic acid as a trigger of insulin autoimmune syndrome: Current evidence, a case-based approach, diagnostic pitfalls, and practical management.

Insulin autoimmune syndrome (IAS), also known as Hirata disease, is a rare immune-mediated cause of endogenous hyperinsulinemic hypoglycemia characterized by circulating insulin autoantibodies (IAAs). It typically develops in individuals without prior exposure to exogenous insulin. Although IAS has been associated with viral infections and, less commonly, with autoimmune and hematologic disorders, medications and dietary supplements are considered the most frequent precipitating factors. Sulfhydryl-containing compounds are the most commonly implicated triggers. Methimazole represents the class

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… Thiol-containing compounds constituted the predominant high-risk category, with methimazole, captopril, and clopidogrel among the most frequently implicated agents. … Among the medications evaluated, captopril demonstrated the strongest association with IAS, followed by methimazole and clopidogrel. …

Unique Presentation of Bortezomib-Associated Thrombotic Microangiopathy Responsive to Therapeutic Plasma Exchange and Eculizumab Therapy.

Thrombotic microangiopathies (TMA) are a rare group of life-threatening hematological conditions characterized by thrombocytopenia and microangiopathic hemolytic anemia. Although our understanding of the pathophysiology and the availability of diagnostic testing has improved for primary TMAs, such as thrombotic thrombocytopenic purpura, the pathophysiology underlying secondary TMAs, including drug-induced TMAs (DITMAs), remains less clear. In this case report, we present the unique case of a patient with a history of multiple myeloma that presented four months after the initiation of bortezomi

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… Additionally, in patients with clopidogrel-induced TTP, TPE has been associated with decreased mortality [ 18 ]. … Clopidogrel-associated TTP: An update of pharmacovigilance efforts conducted by independent researchers, pharmaceutical suppliers, and the Food and Drug Administration Stroke 2004 35 533 537 10.1161/01.STR.0000109253.66918.5E 14707231 19. Izzedine H. …

Antiplatelet agents for chronic kidney disease.

BACKGROUND: Antiplatelet agents are widely used to prevent cardiovascular events. The risks and benefits of antiplatelet agents may be diffe … head-to-head comparisons of antiplatelet drugs, including prasugrel, ticagrelor, different doses of clopidogrel, abciximab, defibrotide, sarpogrelate and beraprost. AUTHORS' CONCLUSIONS: Antiplatelet agents probably reduced myocardial infarction and increased major bleeding, but do not appear to reduce all-cause and cardiovascular death among people with CKD …

Pharmacological treatment for Buerger's disease.

BACKGROUND: Buerger's disease (thromboangiitis obliterans) is a non-atherosclerotic, segmental inflammatory pathology that most commonly aff … , and folic acid with placebo. No studies assessed other pharmacological agents such as cilostazol, clopidogrel and pentoxifylline or compared oral versus intravenous prostanoid. Compared with aspirin, intravenous prostacyclin analogue iloprost improved ulcer healing (risk ratio (RR) 2.65; 95% confidence interval (CI) 1.15 to 6.11; 98 participants; 1 study; m …

Responsible, Safe, and Effective Use of Antithrombotics and Anticoagulants in Patients Undergoing Interventional Techniques: American Society of Interventional Pain Physicians (ASIPP) Guidelines.

BACKGROUND: Interventional pain management involves diagnosis and treatment of chronic pain. This specialty utilizes minimally invasive proc … procedure is performed.12. There is limited evidence that discontinuation of antiplatelet therapy (clopidogrel [Plavix®], ticlopidine [Ticlid®], Ticagrelor [Brilinta®] and prasugrel [Effient®]) avoids complications of significant bleeding and epidural hematomas.13. There is very limited evidence supporting the continuation or discontinuation of most NSAIDs, …

Gene Expression Profiling and Pathway Network Analysis Predicts a Novel Antitumor Function for a Botanical-Derived Drug, PG2.

PG2 is a botanical drug that is mostly composed of Astragalus polysaccharides (APS). Its role in hematopoiesis and relieving cancer-related fatigue has recently been clinically investigated in cancer patients. However, systematic analyses of its functions are still limited. The aim of this study was to use microarray-based expression profiling to evaluate the quality and consistency of PG2 from three different product batches and to study biological mechanisms of PG2. An integrative molecular analysis approach has been designed to examine significant PG2-induced signatures in HL-60 leukemia ce

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… Additionally, to examine the quality and consistency of PG2, several additional small molecules and herbal extracts were included in this study, including 15d-PGJ2 (15-delta prostaglandin J2 or 15-Deoxy-Delta12,14-Prostaglandin J2), clopidogrel, etoposide, EH ( Vitis ficifolia var. taiwaniana ), and … In addition, several small molecules and herbal extracts were also included in the comparative analysis, including 15-delta prostaglandin J2 (15d-PGJ2), clopidogrel, etoposide, Vitis ficifolia var. taiwaniana (EH), and Antrodia Camphorata (Ac9). …

Antithrombotic therapy to prevent cognitive decline in people with small vessel disease on neuroimaging but without dementia.

BACKGROUND: Cerebral small vessel disease is a progressive disease of the brain's deep perforating blood vessels. It is usually diagnosed ba … ts. The Secondary Prevention of Subcortical Stroke Study (SPS3) compared dual antiplatelet therapy (clopidogrel plus aspirin) to aspirin alone in 3020 participants with recent lacunar stroke. There was low-certainty evidence of no effect on cognitive outcomes as measured by the Cognitive Abilities Screening Instruments (CASI) assessed annually over five years …

Anticoagulation challenges in cancer patients: prevention, detection, and treatment strategies.

Cancer-associated thrombosis is one of the most common and serious complications in oncology patients, contributing significantly to morbidity and mortality. This prothrombotic state is driven by cancer-related factors, systemic inflammation, and treatment-induced endothelial injury. Anticoagulation management in these patients is challenging, as both thrombotic and bleeding risks must be carefully balanced, particularly in those with cardiovascular comorbidities. This review examines the complexities of anticoagulation in cancer-associated thrombosis through three clinical cases. Case 1 focus

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… Treatment generally begins with triple therapy—aspirin, clopidogrel, and anticoagulation—but is limited to a maximum of 7 days post-intervention to reduce bleeding risk [ 56 ]. … Following this initial period, therapy is typically streamlined to a single antiplatelet agent, usually clopidogrel, combined with anticoagulation. This approach provides ongoing protection against both VTE and arterial events while managing bleeding risk effectively. …

Acquired platelet disorders.

Platelets are essential to primary hemostasis, and defects in their number or function can lead to clinically significant bleeding or thrombosis. Acquired platelet disorders are far more common than the inherited forms and arise in a wide range of settings, including drug exposure, autoimmune, systemic, and critical illnesses. This review examines current understanding of the mechanisms driving acquired platelet dysfunction and outlines the diagnostic and therapeutic approaches that are shaping contemporary standards of care. Drug-related and immune-mediated platelet defects remain the most re

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… LTA can also be used to identify clopidogrel or aspirin resistance, thus contributing significantly to guiding appropriate antiplatelet regimen before interventional therapy ( 105 ). … If the initial approach measures were insufficient to control bleeding, platelet transfusion remains the principal modality to neutralize the effects of APT and can be used in bleeding with aspirin or thienopyridines (clopidogrel and prasugrel). …

Thalidomide for refractory gastrointestinal bleeding from vascular malformations in patients with significant comorbidities.

BackgroundRefractory gastrointestinal bleeding (GIB) secondary to gastrointestinal vascular malformations (GIVM) such as gastrointestinal angiodysplasia (GIAD) and gastric antral vascular ectasia (GAVE) remains challenging to treat when endoscopic therapy fails. Recently thalidomide has been suggested as a treatment option for refractory GIB.AimTo determine the outcome of patients treated with thalidomide for refractory GIB due to GIVM.MethodsIRB approved, single center, retrospective review of electronic medical records from January 2012 to November 2018. Patients age > 18 years old, who had

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… Five patients remained on antiplatelet or anticoagulation such as aspirin, warfarin, clopidogrel, or cilostazol. Two patients discontinued thalidomide: One due to cost and another due to drug interaction with methadone, after being treated with thalidomide for 17 mo and 3 mo respectively. … Four of our patients continued their anticoagulation or antiplatelet agents such as warfarin, aspirin, clopidogrel, or cilostazol, and still responded favorably to thalidomide. …

[Treatment of acute stroke -- an overview].

This paper provides an overview on the actual state of acute therapy in patients with ischemic stroke. The discussion focusses on intravenous and intraarterial thrombolysis, antithrombotic therapy, and the treatment of medical and neurological complications, and therapy recommendations are presented. Finally ongoing studies, particularly those concerning thrombolysis with glycoprotein IIb/IIIa receptor blockers and ultrasound-assisted thrombolysis, are presented.

Prevention of Anthracycline-Induced Cardiotoxicity: The Good and Bad of Current and Alternative Therapies.

Doxorubicin (Dox)-induced cardiotoxicity (DIC) remains a serious health burden, especially in developing countries. Unfortunately, the high cost of current preventative strategies has marginalized numerous cancer patients because of socio-economic factors. In addition, the efficacy of these strategies, without reducing the chemotherapeutic properties of Dox, is frequently questioned. These limitations have widened the gap and necessity for alternative medicines, like flavonoids, to be investigated. However, new therapeutics may also present their own shortcomings, ruling out the idea of "natur

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… A population-based study of the drug interaction between proton pump inhibitors and clopidogrel . Can Med Assoc J. ( 2009 ) 180 : 713 – 8 . 10.1503/cmaj.082001 19176635 PMC2659819 112. Choi YJ Kim N Jang I-J Cho J-Y Nam RH Park JH . … Pantoprazole does not reduce the antiplatelet effect of clopidogrel: a randomized controlled trial in Korea . Gut Liver. ( 2017 ) 11 : 504 – 11 . 10.5009/gnl16352 28395507 PMC5491085 …

The BNP-to-Albumin Ratio (BAR) as a Predictor of All-Cause Mortality in Elderly Patients with Atrial Fibrillation.

BackgroundThis study aimed to evaluate the prognostic value of the BNP-to-albumin ratio (BAR) for all-cause mortality in AF patients aged ≥60 years.MethodsThis single-center retrospective study included clinical data from 1458 AF patients treated at the First Affiliated Hospital of Kunming Medical University between December 2019 and December 2023. Using the optimal cutoff value determined by the restricted cubic spline, patients were divided into a low BAR group (BAR ResultsThe study ultimately included 842 patients with AF. Kaplan‒Meier analysis revealed that among elderly AF patients, the a

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… Pharmacological and interventional treatments during hospitalization included warfarin, new oral anticoagulants, aspirin or indobufen, clopidogrel or ticagrelor, statins, β-blockers, digoxin, diuretics, angiotensin-converting enzyme inhibitor/angiotensin receptor blocker/angiotensin receptor-neprilysin … 0.001 LVESV, mL 46 (33, 65) 40 (32, 56.75) 53 (36, 76.75) <0.001 LVEF, % 60 (51, 69.25) 65 (56, 71) 55 (46, 66) <0.001 Treatment modalities, n (%) Warfarin 65 (7.7%) 25 (6.0%) 40 (9.5%) 0.058 NOACs 632 (75.1%) 318 (75.9%) 314 (74.2%) 0.577 Aspirin or Indobufen 139 (16.4%) 78 (18.6%) 60 (14.2%) 0.082 Clopidogrel …

Pre-treatment clinical assessment in head and neck cancer: United Kingdom National Multidisciplinary Guidelines.

This is the official guideline endorsed by the specialty associations involved in the care of head and neck cancer patients in the UK. This … ients with critical aortic stenosis (AS) should be considered for pre-operative intervention. (G) • Clopidogrel should be discontinued 7 days pre-operatively; warfarin should be discontinued 5 days pre-operatively. (R) • Patients with thromboembolic disease or artificial heart valves require heparin therapy to bridge peri-operative warfarin cessation, this sh …

A new era of cancer immunotherapy: vaccines and miRNAs.

Cancer immunotherapy has transformed the treatment landscape, introducing new strategies to fight various types of cancer. This review examines the important role of vaccines in cancer therapy, focusing on recent advancements such as dendritic cell vaccines, mRNA vaccines, and viral vector-based approaches. The relationship between cancer and the immune system highlights the importance of vaccines as therapeutic tools. The discussion covers tumor cell and dendritic cell vaccines, protein/peptide vaccines, and nucleic acid vaccines (including DNA, RNA, or viral vector-based), with a focus on th

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… Another intriguing discovery was made in a study that assessed the role of clopidogrel in combination therapy for various cancers [ 75 ]. … The study revealed a complex interaction between clopidogrel and various chemotherapeutic agents, which enhanced the efficacy of certain drugs, such as 5-fluorouracil, and reduced the efficacy of others, such as doxorubicin [ 76 ]. …

Intractable right coronary artery spasm in the early postoperative period after heart transplantation: a case report.

Coronary artery spasm after heart transplantation is a very rare complication. In one observational study and many anecdotal reports, most cases of coronary artery spasm occurred more than 1 year after surgery and had good outcomes. However, cases of intractable coronary artery spasm during the early postoperative period resulting in fatality are limited. This report presents a case of two cardiac arrests caused by coronary artery spasms within a short period of time after heart transplantation.

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… For antiplatelet therapy, clopidogrel (37.5 mg daily) was administered owing to severe thrombocytopenia (lower than 10,000/mL without transfusion). Fig. 2 Coronary angiography (CAG) and intravascular ultrasound after cardiac arrest. …

Invited Lectures : Overviews Purinergic signalling: past, present and future.

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