exudates and Embolism

A study was conducted on a total of 100 women attending the Family Planning Clinic in Kuala Lumpur. 50 took combined low-dose estrogen and progesterone pills for a year or more and the other 50 used different methods of birth control. Platelet aggregation, ATP release, Thromboxane B2, and 6-keto-prostaglandin F1alpha estimations were made to evaluate the effect of oral contraceptives (OCs) on platelet function and prostanoid production. The results showed no significant differences in the parameters measured in the 2 groups investigated. These findings are comparable to those reported by other studies, suggesting relatively low risk, if any, of thrombosis in OC users.

Topics: Asia; Asia, Southeastern; Biology; Blood; Clinical Laboratory Techniques; Contraception; Contraceptives, Oral; Cross-Sectional Studies; Developing Countries; Diagnosis; Disease; Embolism; Family Planning Services; Malaysia; Physiology; Platelet Aggregation; Research; Research Design; Risk Factors; Thromboembolism; Vascular Diseases

To examine the prevalence and risk factors of retinal arteriolar emboli, a risk predictor of stroke, in an Asian population.. Population-based cross-sectional study.. Retinal emboli were ascertained from retinal photographs obtained from both eyes of 3,265 Asian Malays, aged 40 to 80 years, according to a standardized protocol. Risk factors were assessed from detailed standardized interviews, clinical examinations, and laboratory investigations.. The overall prevalence of retinal emboli was 0.6% (95% confidence interval [CI], 0.58 to 0.62). A finding of retinal emboli was strongly associated with increasing age (P = .005, for trend), but age-stratified prevalence rates were still lower than those reported from previous population-based studies of White persons. After adjusting for age and gender, the presence of retinal emboli was associated with cigarette smoking (odds ratio [OR], 5.96; 95% CI, 1.75 to 20.32), elevated total cholesterol (OR, 5.21; 95% CI, 1.93 to 12.82), low-density lipoprotein cholesterol (OR, 2.98; 95% CI, 1.20 to 7.39), and self-reported history of angina (OR, 5.67; 95% CI, 1.62 to 19.91). These associations remained significant in multivariate analysis with additional adjustment for other risk factors.. Retinal emboli are less common in Asians than in similarly aged White persons, but are associated with similar cardiovascular risk factors.

Topics: Adult; Aged; Aged, 80 and over; Angina Pectoris; Arterioles; Cholesterol, LDL; Cross-Sectional Studies; Embolism; Female; Humans; Hypercholesterolemia; Malaysia; Male; Middle Aged; Prevalence; Retinal Artery; Retinal Diseases; Risk Factors; Singapore; Smoking; Stroke

This report describes a pregnant lady in early trimester that was admitted with fever and left loin pain and was initially treated as presumed pyelonephritis. Subsequently she was found to have infective endocarditis with vegetation on the mitral valve. The course of her illness was complicated by acute pulmonary edema and septic embolization to the cerebellum. A decompressive craniectomy and resection of the lateral lobe of cerebellum was performed. Although the presenting features and risk factors are well described, the atypical presentations of infective endocarditis in pregnancy remain a diagnostic challenge for the treating physician. This report highlights the importance of rapid detection of endocarditis in pregnancy and the treatment of systemic complications.

Topics: Adult; Cerebellar Diseases; Embolism; Endocarditis; Female; Humans; Malaysia; Pregnancy; Sepsis

Long term use of low doses of combination oral contraceptives appears to increase plasminogen level, thereby increasing fibrinolytic activity and reducing the risk of thromboembolism. Blood levels of plasminogen, tissue plasminogen activator (tPA), and plasminogen activator inhibitor (PAI), were measured before and after stress (5 minutes of stair climbing) in a group of 30 women, 23-40 years old, who had taken 30 mcg of ethinyl estradiol with 150 mcg of desogestrel or levonorgestrel for at least 1 year. Similar measurements were taken from a control group of 30 women matched for age, height, and weight. Plasminogen and tPA levels in both groups increased significantly after exercise. The level of PAI did not change significantly with stress in either group. The level of plasminogen was significantly higher in the group taking contraceptives, whether before or after exercise, when compared to the control group. Levels of tPA and PAI, although slightly increased in the oral contraceptive group, were not significantly different between the two groups. The increase in plasminogen may be due to the estrogen component of the contraceptives. Stress seems to increase fibrinolytic response.

Topics: Asia; Asia, Southeastern; Biology; Blood; Blood Coagulation; Clinical Laboratory Techniques; Clinical Trials as Topic; Contraception; Contraceptive Agents; Contraceptive Agents, Female; Contraceptives, Oral; Contraceptives, Oral, Combined; Developing Countries; Diagnosis; Disease; Embolism; Family Planning Services; Fibrinolysis; Hematologic Tests; Levonorgestrel; Malaysia; Physiology; Research; Thromboembolism; Thrombosis; Vascular Diseases

Researchers compared the results of hematocrit and blood viscosity tests of 16 women using a combined oral contraceptive (COC) with 30 mcg ethinyl estradiol/150 mcg desogestrel (group 1), 11 women using a COC with 30 mcg ethinyl estradiol/150 mcg levonorgestrel (group 2), and 16 women who did not use any OCs (control group), all who attended the National Population and Family Development Clinic at the General Hospital in Kuala Lumpur, Malaysia. They wanted to examine the effects of COCs on blood viscosity, which is inversely related to blood flow, and hematocrit. The women were matched for age. The hematocrit level of women who took the ethinyl estradiol/desogestrel COC was significantly higher than that of the control group (41.5% vs. 37.4%; p.001). On the other hand, the hematocrit level of women who took the ethinyl estradiol/levonorgestrel COC was close to that of the control group (38.5% vs. 37.4%). Even though the mean whole blood viscosity for group 2 was higher than that of group 1 and the control group (6.6 cps vs. 5.5 cps), the difference was insignificant. Yet whole blood viscosity of group 2 at the higher shear rates (46, 115, and 230 per second) was significantly higher than the control group (p.05). The whole blood viscosities of group 1 and the control group did not differ considerably. This supported the theory that hematocrit contributes to blood viscosity. Further these results agreed with those of another study which also showed increased blood viscosity and hematocrit in healthy women taking OCs. Thus thromboembolic events in women taking OCs could be a result of a drop in rate of blood flow which at the lower shear rates could increase red cell aggregation and clotting. In conclusion, health providers could use these indicators to monitor women who have used OCs over a considerable period for thrombotic risks to determine if OC use should continue.

Topics: Asia; Asia, Southeastern; Biology; Blood; Blood Coagulation; Case-Control Studies; Clinical Laboratory Techniques; Contraception; Contraceptive Agents; Contraceptive Agents, Female; Contraceptives, Oral; Contraceptives, Oral, Combined; Contraceptives, Oral, Hormonal; Cross-Sectional Studies; Desogestrel; Developing Countries; Diagnosis; Disease; Embolism; Ethinyl Estradiol; Family Planning Services; Hematocrit; Hematologic Tests; Levonorgestrel; Malaysia; Methods; Physiology; Research; Research Design; Thromboembolism; Thrombosis; Vascular Diseases

A prospective study was made of 40 consecutive patients who presented with peripheral arterial embolism to the Vascular Surgical Service in UKM. Atrial fibrillation was the most common source of the embolus. Twelve patients did not present until the affected limb(s) were in established gangrene. Thirty-two embolectomies were performed on 25 patients. Only 10 of these patients were discharged well with their limbs intact. Four patients required amputation because embolectomy did not restore viability of the limbs. Eleven patients died following embolectomy. The overall mortality for arterial embolism was 50%. Among the survival (n = 20), only 11 patients were discharged with their limbs intact. The cause of the poor result was related to the delay in definitive treatment and the poor general state of the patients. It was concluded that the prognosis for arterial embolism was very poor. This result needs to be improved and recommendations are made to achieve this.

Topics: Adult; Aged; Aged, 80 and over; Atrial Fibrillation; Embolism; Female; Humans; Ischemia; Leg; Malaysia; Male; Middle Aged; Prospective Studies

The effect of low-dose oral contraceptives (OCs) on hemorheology and fibrinolytic response was investigated in 107 women attending the Malaysia Maternity Hospital in Kuala Lumpur. The OC contained 0.03 mg estrogen and 0.15 mg progestagen. Study subjects were divided into 3 groups. The 30 women in Group 1 took the low-dose OC for 3-6 months, while the 27 subjects in Group 2 took the pill for a duration of 1-2 years. Group 3 was comprised of 49 controls. The 3 groups were comparable in terms of age, weight, height, and parity and included Malays, Chinese, and Indians. No significant differences were noted between the 3 groups in any of the parameters analyzed (platelet aggregate ratio, fibrinogen levels, red blood cell deformability index, euglobulin clot lysis time, and full blood count). Since the level of estrogen in the OC analyzed in this study did not cause significant alterations in any of these blood parameters, it is concluded that low-dose OCs do not confer a risk of thrombosis in their users.

Topics: Asia; Asia, Southeastern; Biology; Blood; Blood Coagulation; Cardiovascular System; Cerebrovascular Circulation; Contraception; Contraceptive Agents; Contraceptive Agents, Female; Contraceptives, Oral; Developing Countries; Disease; Embolism; Family Planning Services; Fibrinolysis; Malaysia; Physiology; Platelet Aggregation; Research; Risk Factors; Thromboembolism; Thrombosis; Vascular Diseases

The defendant, an obstetrician and gynaecologist, was accused of voluntarily causing a woman to miscarry, such miscarriage having been performed without good faith and an intention to save the woman's life. The Court upheld the conviction of the defendant, rejecting his argument, supported by an expert witness, that he had performed the abortion in order to avoid the possibility of pulmonary embolism, which might result because the woman had enlarged varicose veins. It held that the argument was not reasonable under the current law and that procuring an abortion was a serious matter to be done only as a last resort to save the life of a woman or to save her from becoming a mental "wreck."

Topics: Abortion, Induced; Abortion, Therapeutic; Asia; Asia, Southeastern; Crime; Delivery of Health Care; Developing Countries; Disease; Embolism; Family Planning Services; Health; Health Personnel; Jurisprudence; Legislation as Topic; Malaysia; Physicians; Pulmonary Embolism; Social Problems; Vascular Diseases