Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0012739 (disseminated intravascular coagulation)
 8,673 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Selective reduction in multiple gestation refers to abortion of specific fetuses, either because of congenital defect of grand multiple gestation. Fetal indications for which selective termination has been reported are Down syndrome, microcephaly, hemophilia A, spina bifida, thalassemia major and Tay-Sachs disease. Grand multiple gestations, defined as 4 or more fetuses in a pregnancy, have been selectively terminated in cases of 4-9 fetuses. Most couples choose to reduce multiple gestations to twin pregnancies. Very short women with multiple gestation are particularly at risk. Methods used have included needle aspiration of amniotic fluid, cardiac puncture and aspiration, and intrathoracic injection of KC1 or calcium gluconate. Potassium chloride is preferred because it is rapid, so results can be determined immediately without having to repeat the procedure. It is preferable to time the termination at 11 weeks' gestation to lower the risk of disseminated intravascular coagulation, which can result from absorption of fetal tissue. Most gynecologists prefer to select for fundal implantations. The ethical alternatives of this type of termination are either to abort the entire pregnancy, or risk the life of the mother as well as the life and well-being of all the fetuses. Most women with multiple gestations are those with history of infertility, who have gone to greater expense and emotional investment to become pregnant. Legally, selective reduction is a type of 1st trimester abortion, subject to institutional experimental protocols and patient's informed consent.
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PMID:Selective reduction in multiple gestation. 273 40

Thromboembolic (TE) events have been frequently reported in beta-thalassemic patients in association with known risk factors such as diabetes, complex cardiopulmonary abnormalities, hypothyroidism, liver function anomalies, and postsplenectomy thrombocytosis. In a recent survey involving 9 Italian thalassemic centers, we identified 32 patients with TE episodes in a total of 735 subjects, of whom 683 had thalassemia major and 52 thalassemia intermedia, corresponding to 3.95 and 9.61%, respectively. There was a great variation in localization: the main one (16/32) was CNS, with a clinical picture of headache, seizures and hemiparesis. Other localizations were the pulmonary (3 patients), mesenteric (1 patient) and portal (2 patients) sites. There were 6 cases of deep venous thrombosis (2 in the upper limbs, 4 in the lower ones). Intracardiac thrombosis was found in 2 subjects and clinical and laboratory signs of DIC were observed in 2 others during pregnancy. Since our patients with TE events present a statistically significantly higher incidence of associated dysfunction (cardiomyopathy, diabetes, liver function anomalies, hypothyroidism) than those without TE events (50 vs. 13.8%), we suggest close monitoring of those patients who are at higher risk of developing TE events because of the presence of one or more of these predisposing factors.
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PMID:Thromboembolic events in beta thalassemia major: an Italian multicenter study. 985 99

Severe anemia, growth retardation, diabetes mellitus, cardiac disorders, and, infrequently, stroke are well-known complications of thalassemia major. We report a girl, age 7 years, 2 months, with beta-thalassemia major associated with chronic renal failure, diabetes mellitus, and cardiomyopathy in whom a silent stroke was noted during follow-up. She was diagnosed with thalassemia major at age 6 months, chronic renal failure at age 3 years, 3 months, and diabetes mellitus and cardiomyopathy at age 7 years. Although cranial computed tomography was found to be normal at the age of 3 years, 3 months, magnetic resonance imaging showed cerebral infarct in the right frontal region at 7 years, 2 months. A thrombophilic panel revealed increased factor VIII and decreased protein C concentrations. She died from disseminated intravascular coagulation at age 7 years, 9 months. We did not record any clinical findings of stroke during her follow-up. We think that diabetes mellitus, dilated cardiomyopathy, and increased factor VIII and decreased protein C concentrations led to the occurrence of cerebral infarct. In conclusion, we emphasize that children with thalassemia major should be monitored closely for stroke. We also suggest that stroke can show a silent progression in severely affected children, as in our case.
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PMID:Silent stroke in a case of beta-thalassemia major associated with chronic renal failure and diabetes mellitus. 1469 9