Considerations in perioperative assessment of valproic acid coagulopathy

Abdallah, Claude

doi:10.4103/0970-9185.125685

Cited by 19 publications

(14 citation statements)

References 17 publications

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“…Correlation analysis was previously described in [ 16 ]. Pearson correlation studies- Lung cancer cell line gene expression data sets from the Cancer Cell Line Encyclopedia (CCLE) (GEO#GSE36133, 166 unique cell lines) and UT Southwestern Medical Center (GEO#GSE4824, 76 unique cell lines) were downloaded from Gene Expression Omnibus (GEO) and used to find genes correlated to GSK3βexpression.…”

Section: Methodsmentioning

confidence: 99%

Detrimental ELAVL-1/HuR-dependent GSK3β mRNA stabilization impairs resolution in acute respiratory distress syndrome

et al. 2017

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A hallmark of acute respiratory distress syndrome (ARDS) is accumulation of protein-rich edema in the distal airspaces and its removal is critical for patient survival. Previous studies have shown a detrimental role of Glycogen Synthase Kinase (GSK) 3β during ARDS via inhibition of alveolar epithelial protein transport. We hypothesized that post-transcriptional regulation of GSK3β could play a functional role in ARDS resolution. To address this hypothesis, we performed an in silico analysis to identify regulatory genes whose expression correlation to GSK3β messenger RNA utilizing two lung cancer cell line array datasets. Among potential regulatory partners of GSK3β, these studies identified the RNA-binding protein ELAVL-1/HuR (Embryonic Lethal, Abnormal Vision, Drosophila-Like) as a central component in a likely GSK3β signaling network. ELAVL-1/HuR is a RNA-binding protein that selectively binds to AU-rich elements of mRNA and enhances its stability thereby increasing target gene expression. Subsequent studies with siRNA suppression of ELAVL-1/HuR demonstrated deceased GSK3β mRNA and protein expression and improved clearance of FITC-albumin in A549 cells. Conversely, stabilization of ELAVL-1/HuR with the proteasome inhibitor MG-132 resulted in induction of GSK3β at mRNA and protein level and attenuated FITC-albumin clearance. Utilizing ventilator-induced lung injury or intra-tracheal installation of hydrochloric acid to induce ARDS in mice, we observed increased mRNA and protein expression of ELAVL-1/HuR and GSK3β. Together, our findings indicate a previously unknown interaction between GSK3β and ELAV-1 during ARDS, and suggest the inhibition of the ELAV-1- GSK3β pathways as a novel ARDS treatment approach.

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Section: Methodsmentioning

confidence: 99%

Detrimental ELAVL-1/HuR-dependent GSK3β mRNA stabilization impairs resolution in acute respiratory distress syndrome

et al. 2017

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“…Our results also show that PEG in children did not require extensive diagnostic evaluation before the procedure. In theory, valproic acid use could be considered a contraindication because of its association with coagulopathy . As only one of the 23 patients in our cohort had reversible bleeding that could be linked to valproic acid, we think that extra vigilance with respect to the possibility of postprocedure bleeding was sufficient.…”

Section: Discussionmentioning

confidence: 86%

“…Massive ascites was considered the only absolute contraindication. For instance, despite the fact that valproic acid use may be associated with coagulopathy , the current use of valproic acid was not considered a contraindication. In cases of severe scoliosis, the procedure was scheduled so that a paediatric surgeon was on hand to take over, if necessary, and perform an open gastrostomy.…”

Section: Methodsmentioning

confidence: 99%

Antibiotic prophylaxis does not reduce the infection rate following percutaneous endoscopic gastrostomy in infants and children

et al. 2017

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“…However, in reality, these recommendations are not followed; VPA and phenytoin are used widely in this population around the world, although most elderly individuals with epilepsy show focal‐onset seizures. VPA is also known to have a risk of inducing coagulopathy, and it should therefore be avoided for elderly patients because of the risk of stroke. Because elderly individuals often take other medications for concomitant diseases, drug interactions such as with enzyme inducers may adversely affect other medications …”

Section: Discussionmentioning

confidence: 99%

Activities of daily living are associated with outcomes of epilepsy treatment in elderly patients

et al. 2019

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Aim: Controlling epileptic seizures in elderly populations is widely considered to be relatively easy, but we hypothesized that the lifestyles of elderly individuals may affect the outcomes of epilepsy treatment. The purpose of this study was to review the activities of daily living (ADL) of elderly individuals with epilepsy and compare them with the outcomes of epilepsy treatment. Methods: Of the 177 patients ≥65 years old who were referred to our epilepsy centre, epilepsy was diagnosed in 84. ADL and treatment outcomes were then reviewed, with ADL classified into three levels: ADL I, without disability; ADL II, disabled only in some instrumental ADL; and ADL III, disabled in some basic ADL. Epilepsy syndromes and use of anti-seizure drugs were also evaluated. Results: Forty-five patients (53.6%) achieved freedom from seizures, 23 (27.4%) achieved ≥80% but <100% reduction in seizures, 5 (6%) achieved ≥50% but <80% reduction in seizures, and 11 (13.1%) achieved <50% reduction in seizures. Thirty-five patients (81.4%) with ADL I achieved freedom from seizures, compared with seven patients with ADL II (28.0%) and three patients with ADL III (19.0%). A significant difference was evident among the three groups (F = 6.145, P = 0.003). Conclusions: ADL should be taken into account when an epilepsy treatment is being selected.

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Considerations in perioperative assessment of valproic acid coagulopathy

Cited by 19 publications

References 17 publications

Detrimental ELAVL-1/HuR-dependent GSK3β mRNA stabilization impairs resolution in acute respiratory distress syndrome

Detrimental ELAVL-1/HuR-dependent GSK3β mRNA stabilization impairs resolution in acute respiratory distress syndrome

Antibiotic prophylaxis does not reduce the infection rate following percutaneous endoscopic gastrostomy in infants and children

Activities of daily living are associated with outcomes of epilepsy treatment in elderly patients

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