Pregnancy and delivery are critical events in women with von Willebrand's disease type 3. Prophylactic treatment for delivery and early postpartum period is recommended. Vaginal delivery is considered safe. However, experience is based on rare case reports. We report the management of two pregnancies and successful deliveries in a woman with von Willebrand's disease type 3.
Abstract-The polychaete annelid marine worms propel themselves in a variety of challenging locomotion environments by a unique form of tail-to-head body undulations, combined with the synchronized action of numerous parapodial lateral appendages. This combined parapodial and undulatory mode of locomotion is termed pedundulatory in the present work. Robotic analogues of this type of locomotion are being studied, both in simulation, and via experiments with biomimetic robotic prototypes, which combine undulatory movements of their multi-link body with appropriately coordinated parapodial link oscillations. Extensive experimental studies of locomotion on sand demonstrate the potential of the pedundulatory robotic prototypes, especially their rich gait repertoire and their enhanced performance compared to robotic prototypes relying only on body undulations.
Heritable thrombophilia as a concept in hemostasis has been continuously discovered parallel to the knowledge on physiology of bleeding disorders. Since the 1980s it has become increasingly popular to search for thrombophilia in patients with thromboembolism and their relatives. Although initially no direct evidence existed for any advantage for the patients, successive clinical studies have helped to understand the risk of thrombosis and to stratify the patients in relation to the thrombophilic defect. In the meantime national and international guidelines have been published, suggesting which candidates should be examined and what tests should be performed. In the present paper we summarise and explain the rationale of these guidelines from the european point of view.
Nach der Einführung des Aspirins in die kardiovaskuläre Medizin Ende der 40er Jahre konnten sich erst in den 90er Jahren neue Substanzen als äquivalente oder bessere Antiaggregantien etablieren. Es sind dies das orale Clopidogrel (Plavix®), welches die ADP-induzierte Plättchenaggregation hemmt und die intravenösen GPIIb/IIIa-Hemmer (ReoPro®, Aggrastat®, Integrilin®), welche den Fibrinogenrezeptor auf den Plättchen blockieren. Aspirin behält weiterhin seinen festen Platz in der primären und sekundären Prävention der kardiovaskulären Krankheiten. Clopidogrel kann Patienten mit Aspirin-Unverträglichkeit oder bei rezidivierenden kardiovaskulären Ereignissen unter Aspirin verabreicht werden. Für eine allgemeine Empfehlung zur Umstellung von Aspirin auf Clopidogrel bei allen Indikationen fehlt noch die komplette Evidenz. Die Kombination Aspirin plus Clopidogrel verspricht noch besseren Schutz vor kardiovaskulären Komplikationen in ausgewählten Indikationen. Die GPIIb/IIIa-Hemmer haben sich als intravenöse Therapie in der Behandlung von Patienten mit Katheterinterventionen der Koronararterien gut etabliert. Die Hoffnung, dass die oralen GPIIb/IIIa-Hemmer den gleichen Erfolg haben könnten, hat sich definitiv in mehreren Studien nicht bestätigt. Die Entwicklung der neuen Antiaggregantien signalisiert eine Optimierung der Therapie der Patienten mit atherosklerotischer Krankheit.
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