The development of testicular germ cell tumour (TGCT) is believed to be under endocrine control but definitive proofs are lacking. Follicle stimulating hormone (FSH) levels are increased in numerous ...conditions associated with increased risk of TGCT and single nucleotide polymorphisms (SNPs) in the FSH receptor (FSHR) gene influence the sensitivity of the receptor to FSH. However, a possible effect of FSH on testicular carcinogenesis has never been explored. In order to analyse the possible association of FSHR polymorphisms with TGCT, we studied 188 TGTC cases and 152 controls for 12 FSHR SNPs. Only four SNPs were found to be informative, represented by two polymorphisms in exon 10 (Ala307Thr and Ser680Asn), and two polymorphisms in the promoter region (−114 T/C and −29 G/A). Differences in haplotype distribution were seen between TGCT cases and controls. In particular for non-seminoma, the Ala307/Ser680 allele lowers the risk of the disease, alone (P=0.014, relative risk 0.73; 95% confidence interval 0.57–0.92), or in combination with the −29 G allele and/or the −114 T allele. This study suggests for the first time that FSHR gene polymorphisms modulate susceptibility to TGCT. The variants with higher activity of the FSHR are associated with higher risk, suggesting a role for FSH in the carcinogenesis of this tumour.
Background:
DOACs are characterized by a higher incidence of gastrointestinal bleeding and this may be different among males and females. Female patients were underrepresented in the DOAC pivotal ...trials. We aimed to assess real-world differences in gastrointestinal bleeding with oral anticoagulants (DOACs and VKAs) among males and females with atrial fibrillation.
Methods:
We performed a population-based retrospective analysis on linked administrative claims. Atrial fibrillation patients of 65 years and above were considered. Bleeding risk factors were assessed through HASBED and previous history of gastrointestinal disease. A time-to-event analysis compared gastrointestinal bleeding between males and females.
Results:
The overall cohort consisted of 15338 (55% female) DOAC and 44542 (50% female) VKA users. Most of the patients showed HASBED ≥2. Incidence rate of GI bleeding was higher in females as compared to males among DOAC users (0.90% vs 0.59%), and significant gender difference in GI bleeding was found, after adjustment, in the Cox regression analysis (HR 1.48, 95%CI 1.02-2.16). In the VKA group, no significant difference among genders was found in the time-to-event analysis.
Conclusions:
Our data suggest that female patients treated with DOACs have a higher risk of GI bleeding versus male patients; this difference is not observed in VKA patients.
...major bleeding incidence in MHV patients is highly variable (1), reflecting differences in the studied cohorts and types of interventions. ...bridging with intermediate doses of LMWH in htr-MHV ...patients is effective, although complicated by nonfatal major bleeding.
Abstract Anticoagulation is recommended in Atrial Fibrillation (AF) patients for stroke prevention, and the bleeding risk associated suggests the need for a bleeding risk stratification. HAS-BLED ...score includes ‘labile INR’ referred to quality of anticoagulation. However, in naïve patients this item is not available. In addition, stroke and bleeding risk prediction scores shared several risk factors. Aims of our study were: 1) to evaluate if the HAS-BLED score in its refined form excluding ‘labile INR’ (HAS-BED) is still associated with bleeding risk; and 2) to evaluate the predictive ability for bleeding of both stroke and bleeding prediction models. We followed an inception cohort of 4579 AF patients enrolled in the START Register (NCT02219984). Major bleeds were recorded. During follow up (7014 pt-yrs) 115 patients experienced a major bleeding (rate 1.6 x100 pt-yrs). Patients at high risk were better identified by HAS-BLED and HAS-BED scores with respect to CHADS2 and CHA2 DS2 VASc. HAS-BLED has a slightly higher c value in comparison to CHADS2 and CHA2 DS2 VASc. However, among naïve patients the predictive ability for hemorrhage of HAS-BED score is overlapping with CHADS2 and CHA2 DS2 VASc. In low stroke risk patients (CHA2 DS2 VASc=0-1), only 6 patients are at high bleeding risk and none of them experienced major bleeding. In conclusion, in our prospective cohort of AF patients we found that HAS-BLED and HAS-BED scores identify patients at high bleeding risk. However, the predictive value for major bleeding of HAS-BED used in naïve patients is similar to CHADS2 or CHA2 DS2 -VASc, suggesting that stroke stratification scores could be sufficient for tailoring treatment.
The antiphospholipid syndrome (APS) is defined by the presence of thrombosis and/or pregnancy morbidity in combination with the persistent presence of circulating antiphospholipid antibodies: lupus ...anticoagulant, anticardiolipin antibodies and/or anti-β2-glycoprotein I antibodies in medium to high titers. The management of thrombosis in patients with APS is a subject of controversy. This set of recommendations is the result of an effort to produce guidelines for therapy within a group of specialist physicians in Cardiology, Neurology, Hematology, Rheumatology and Internal Medicine, with a clinical and research focus on APS.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, OILJ, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
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