Persistent Peril: Recurrent Deep Vein Thrombosis and Pulmonary Embolism in a Patient With Protein S Deficiency Despite Optimal Anticoagulation Therapies.

The clotting system has evolved as an adaptive mechanism to prevent blood loss during vascular damage. However, the intricate nature of the clotting cascade and the complexities of human life can sometimes lead to the unnatural activation of this delicate cascade. This can result in blood clot formation within the cardiovascular system, contributing to a wide range of pathological conditions. Abnormal intravascular coagulation most commonly occurs in the deep veins of the lower extremities, and can emboli to other organs, hence, it is termed "venous thromboembolism" (VTE). In this report, we introduce a challenging case of VTE that poses a dilemma for current medical management. The patient with possible protein S deficiency underwent various guideline-directed medical treatments, yet experienced recurrent VTE episodes, including deep vein thrombosis (DVT) and pulmonary embolism (PE), leading to hospital readmissions. This case report sheds light on our challenges in effectively treating VTE.

Cardiac fat pat change after laparoscopic sleeve gastrectomy and Roux-en-Y gastric bypass surgery: a systematic review and meta-analysis.

Cardiac fat pad is a metabolically active organ that plays a role in energy homeostasis and cardiovascular diseases and generates inflammatory cytokines. Many studies have shown remarkable associations between cardiac fat thickness and cardiovascular diseases, making it a valuable target for interventions. Our meta-analysis aimed to investigate the effects of the 2 most popular bariatric surgeries (sleeve gastrectomy [SG] and Roux-en-Y gastric bypass [RYGB]) in cardiac fat pad reduction. A systematic review of the literature was done by searching in Scopus, Web of Science, Cochrane, and PubMed for articles published by September 16, 2022. This review followed the meta-analysis rules based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. Nineteen studies met the inclusion criteria out of 128 potentially useful studies, including a total number of 822 patients. The results of subgroup analysis on the type of surgery showed that bariatric surgeries decreased the mean fat pad diameter, but the reduction was greater in SG than in RYGB. Epicardial and pericardial fat type showed a significant decrease of fat pad diameter. The results of subgroup analysis indicated RYGB had a significant reduction in mean fat pad volume. Computed tomography scan and cardiac magnetic resonance imaging showed a significant reduction of the mean cardiac fat pad volume. Epicardial and paracardial fat type showed a significant decrease in volume. The cardiac fat pad diameter and volume were significantly reduced after bariatric surgeries. SG showed greater reduction in fat pad diameter in comparison with RYGB, and RYGB had a significant reduction in mean fat pad volume.

Spontaneous Isolated Superior Mesenteric Artery Dissection With Thrombosis: A Case Report of a Rare Presentation of Acute Abdominal Pain.

Spontaneous isolated superior mesenteric artery dissection is a very rare vascular disease that involves the superior mesenteric artery or its branches, with an incidence as low as 0.08%. The majority of cases occur in patients of Asian descent. Due to advances in imaging modalities, particularly abdominal computed tomography angiography, the diagnosis of this disease has been increasing. Herein, we present a rare case of spontaneous isolated superior mesenteric artery dissection with thrombosis in a young male patient with no past medical history. The importance of this disease as a differential diagnosis for acute abdominal pain is emphasized.

La dissection isolée spontanée de l'artère mésentérique supérieure est une maladie vasculaire très rare qui affecte l'artère mésentérique supérieure ou ses branches, et dont l'incidence s'élève à peine à 0,08 %. La majorité des cas surviennent chez des patients d'ascendance asiatique. En raison des progrès réalisés dans les modalités d'imagerie, et en particulier de l'angiographie abdominale par tomodensitométrie, le diagnostic de cette affection est en hausse. Nous présentons ici un rare cas de dissection isolée spontanée de l'artère mésentérique supérieure avec thrombose chez un jeune patient sans antécédents médicaux. L'importance de cette maladie dans le diagnostic différentiel de la douleur abdominale aiguë est mise en évidence.

Effects of psychological or physical prenatal stress on attention and locomotion in juvenile rats.

Background: Prenatal stress has been shown to affect the cognition of offspring, including memory and learning abilities.Methods: In the current study, the long-term effects of chronic prenatal exposure to the physical or psychological stress on locomotion and attention were evaluated by using open field test (OFT) and prepulse inhibition (PPI) of the acoustic startle reflex (ASR). In addition, the level of corticosterone was measured after the ASR trial.Results: Male and female rodents that underwent prenatal physical and psychological stress had an augmented velocity in OFT, and only male animals showed an increased ASR. Neither male nor female offsprings had an alteration in the level of corticosterone and PPI values regardless of the stress type.Conclusion: Our results revealed that exposure to stress during the development of fetus increases ASR in a sex-dependent manner. This finding might implicate the effect of prenatal stress on attention in male offspring regardless of the stress type.

Behavioral consequences of simultaneous postnatal exposure to MK-801 and static magnetic field in male Wistar rats.

Various experimental studies reported some neurobehavioral adverse effects of static magnetic field (SMF) exposure. The reason is unclear, but one of the possibilities might be alternations in the level of the neurotransmitters and their receptors. Considering the critical role of N-Methyl D-aspartate (NMDA) receptors in the molecular regulation of cognition, motor control, and synaptic plasticity, it is important to investigate interactions between SMF exposure and administration of NMDA receptor blockers such as MK-801. Now, we administered low-dose (0.1 mg/kg) MK-801 to the male Wistar rats, from postnatal day (P) 6 to 10 and investigate whether its effects change under the influence of SMF exposure. Morris water maze, open field test, rotarod, and elevated plus maze tests were performed on P60-63 to evaluate long-term effects on learning and memory, locomotion activities, and anxiety-like behaviors. Our results showed that administration of low-dose MK-801 did not lead to significant adverse effects on their long-term anxiety-like behaviors, locomotion, learning, and memory; however, simultaneous exposure to SMF can result in these adverse effects. In conclusion, exposure to SMF can augment the neurobehavioral effects of MK-801, by enhancing the blockage of the NMDA receptors. Further studies are required to confirm these results.