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C0499: Retrobulbar Optic Neuropathy Revealing Ischemic Stroke without Risk Factors
POSTERS / Thrombosis Research 133S3 (2014) S35–S123
0.53±1.37 SD respectively with statistically significant (p < 0.001) difference showing good response to Prasugrel (PRISA). None of the patient suffered side effect after the loading dose of prasugrel during PCI at 2 weeks follow-up. Conclusions: Prasugrel (PRISA® ) was seen to be clinically effective, well tolerated & safe with significant MPA reduction after loading dose of prasugrel during PCI and at 14 days follow-up. C0471 INFLUENCE OF ASPIRIN ON PLATELET-LEUKOCYTE ADHESIVE INTERACTIONS IN PATIENTS WITH STABLE ANGINA A. Solpov1 , M. Avetisyan1 , P. Tereshkov1 , O. Bolshacova1 , Y. Solovieva1 , Y. Vitkovsky1 . 1 Chita Medical Academy Normal Physiology, Russia Background: Aspirin is the most commonly used inhibitor of platelet function. It is able to inhibit the aggregation of platelets, and has anti-inflammatory properties. Atherosclerosis is known to develop with the participation of monocytes, neutrophils and lymphocytes. Previously, we have found that platelets are able to enter in adhesive interactions with different subpopulations of lymphocytes and contribute to contact with the various components of the extracellular matrix under flow conditions. The role of different adhesion molecules in the formation of platelet– cell aggregates was studied. The purpose of this study was to investigate the influence of aspirin on platelet–leukocyte adhesive interactions in patients with stable angina receiving aspirin. Methods: We used the blood of twenty healthy men and thirtytwo patients with coronary artery disease. Patients were divided into two groups: those who did not take inhibitors of platelet function, and those receiving aspirin therapy. Blood samples were pre-incubated with specific antibodies for platelets, lymphocytes, T-cell gamma/delta and alpha/beta; B-cell, P-selectin and their negative controls (Beckman Coulter). Counting of cell aggregates was performed using flow cytometry FC500 (Beckman Coulter, Brea, CA, USA). A minimum of 5,000 lymphocytes was counted per test. Results: It was observed an increase in the number of platelet– leukocyte aggregates from the general pool of lymphocytes. Total leukocyte–platelet aggregates (PLC) increased by 54.3% (p = 0.045) in comparison with the control group. The number of platelet aggregates with granulocytes (PGC) increased by 59.5% (p = 0.043) due to neutrophils. Monocytes–platelet coaggregation (PMC) increased by 50.5% (p = 0.011). It was found that aspirin reduced the number of coaggregates compared with patients who did not take it. PLC decreased by 31.3% (p = 0.013), number of PNC by 4.85% (p = 0.018), the number of PGC fell by 53.67% (p = 0.025), PMC reduced by 37.5% (p = 0.034). Aspirin reduced the number of platelet–cells aggregates with T-helper cells, and in gamma/delta T lymphocytes population to control group numbers. Conclusions: Thus, aspirin inhibits degree of platelet–leukocyte interaction in patients with stable angina. C0498 FINGER EMERGENCY IN INTERNAL MEDICINE I. Boukhris1 , E. Cherif1 , I. Kechaou1 , S. Azzabi1 , A. Hariz1 , Z. Kaouech1 , C. Kooli1 , L. ben Hassine1 , N. Khalfallah1 . 1 Medecine Interne. Charles Nicolle Hospital, Tunis, Tunisia Background: Digital necrosis are mostly associated with underlying pathology, they are a common skin manifestation of connective tissue diseases and vascularitis. The aim of the study was to investigate demographic, clinical, serologic features, etiological diseases, treatment and evolutions in patients with digital necrosis. Methods: The study included 9 patients with digital necrosis hospitalized in a Tunisian internal medicine department within a period of 18 years, from 1990 to 2008.
S53
Results: There were 5 men and 4 women, ages ranging between 27 and 77 years (mean age 55 years). Sites of digital necrosis were: toes in 5 patients, fingers in only one patient at both in 2 patients. Clinical symptoms were dominated by the presence of pain, coldness associated in some cases to abolition of pulse upstream. There were increases of inflammatory indices in all the cases. Digital necrosis was associated to Buerger’s disease in one case, cryoglobulinemia in one case, Takayasu disease in one case, CREST syndrome in one case, mixed connective tissue in one case, myositis in one case, congenital afibrinogenemia in one case and atherosclerosis in two cases. Patients were treated with symptomatic treatment based on anticoagulation and vasodilators. Corticosteroids were indicated in 3 cases. Patient with cryoglobulinemia had plasmapheresis. Complications were noted in 5 patients necessitating amputation. Conclusions: Digital necrosis is a serious consequence of vascular lesions caused by several mechanisms involving the functional prognosis. The results of our study highlight the etiological diversity despite the small number of patients. C0499 RETROBULBAR OPTIC NEUROPATHY REVEALING ISCHEMIC STROKE WITHOUT RISK FACTORS I. Boukhris1 , I. Rachdi1 , I. Kechaou1 , S. Azzabi1 , A. Hariz1 , E. Cherif1 , C. Kooli1 , Z. Kaouech1 , L. ben Hassine1 , N. Khalfallah1 . 1 Medecine Interne. Charles Nicolle Hospital, Tunis, Tunisia Background: Posterior ischemic neuropathy occurred in three main settings: in the perioperative period following a variety of surgical procedures, associated with giant cell arteritis, and associated with nonarteritic systemic vascular disease. It represents one of the major causes of blindness or seriously impaired vision. We report a case of retrobulbar optic neuropathy revealing recidivant ischemic stroke in a young patient without vascular risk factors. Methods: One case report. Results: A 38-years-old men with no past medical or surgical history, was referred for etiological diagnosis brutal visual disorder which led to demonstration of homonymous lateral hemianopsia in the ophthalmic exam. Funduscopic examination showed a retinal vasculitis and evoked visual potential revealed a bilateral retrobulbar optic neuropathy. On physical exam, there were no hypertension, nor oral or genital ulcers, nor skin lesions such as folliculitis nor signs of thrombosis. Pathergy test was negative. Biological tests didn’t show diabetes or dyslipemia and electrocardiogram was without abnormalities. On supraaortic trunks duplex, there was not artery carotid disease. A magnetic resonance angiography was performed, revealing recidivant posterior ischemic stroke. The patient was put under antigregants. Conclusions: The discovery of retrobulbar optic neuropathy in a young patient must lead to search ischemic stroke even if there is no risk factors. C0521 NON-ALCHOLIC FATTY LIVER DISEASE AND SUBCLINICAL ORGAN DAMAGE: A NEW PREDICTOR OF ASYMPTOMATIC EXTRACORONARY ATHEROSCLEROSIS AND ENDOTHELIAL DYSFUNCTION G. Cioni1 , R. Marcucci1 , M. Pazzi1 , L. Rossi1 , G. Gensini1 , R. Abbate1 , M. Boddi1 . 1 Department of Experimental and Clinical Medicine, University of Florence, Italy, Largo Brambilla 3 (Florence), Italy Background: We investigated the predictive power of NFLD occurrence in identifying extra-coronary atherosclerosis, evaluated by carotid-IMT (c-IMT) and femoral-IMT (f-IMT), and endothelial dysfunction, in patients with no history of cardiovascular diseases. Methods: We investigated C-IMT, f-IMT, NFLD, by ultrasound, and endothelial function, by peripheral-arterial-tonometry (PAT),
0.53±1.37 SD respectively with statistically significant (p < 0.001) difference showing good response to Prasugrel (PRISA). None of the patient suffered side effect after the loading dose of prasugrel during PCI at 2 weeks follow-up. Conclusions: Prasugrel (PRISA® ) was seen to be clinically effective, well tolerated & safe with significant MPA reduction after loading dose of prasugrel during PCI and at 14 days follow-up. C0471 INFLUENCE OF ASPIRIN ON PLATELET-LEUKOCYTE ADHESIVE INTERACTIONS IN PATIENTS WITH STABLE ANGINA A. Solpov1 , M. Avetisyan1 , P. Tereshkov1 , O. Bolshacova1 , Y. Solovieva1 , Y. Vitkovsky1 . 1 Chita Medical Academy Normal Physiology, Russia Background: Aspirin is the most commonly used inhibitor of platelet function. It is able to inhibit the aggregation of platelets, and has anti-inflammatory properties. Atherosclerosis is known to develop with the participation of monocytes, neutrophils and lymphocytes. Previously, we have found that platelets are able to enter in adhesive interactions with different subpopulations of lymphocytes and contribute to contact with the various components of the extracellular matrix under flow conditions. The role of different adhesion molecules in the formation of platelet– cell aggregates was studied. The purpose of this study was to investigate the influence of aspirin on platelet–leukocyte adhesive interactions in patients with stable angina receiving aspirin. Methods: We used the blood of twenty healthy men and thirtytwo patients with coronary artery disease. Patients were divided into two groups: those who did not take inhibitors of platelet function, and those receiving aspirin therapy. Blood samples were pre-incubated with specific antibodies for platelets, lymphocytes, T-cell gamma/delta and alpha/beta; B-cell, P-selectin and their negative controls (Beckman Coulter). Counting of cell aggregates was performed using flow cytometry FC500 (Beckman Coulter, Brea, CA, USA). A minimum of 5,000 lymphocytes was counted per test. Results: It was observed an increase in the number of platelet– leukocyte aggregates from the general pool of lymphocytes. Total leukocyte–platelet aggregates (PLC) increased by 54.3% (p = 0.045) in comparison with the control group. The number of platelet aggregates with granulocytes (PGC) increased by 59.5% (p = 0.043) due to neutrophils. Monocytes–platelet coaggregation (PMC) increased by 50.5% (p = 0.011). It was found that aspirin reduced the number of coaggregates compared with patients who did not take it. PLC decreased by 31.3% (p = 0.013), number of PNC by 4.85% (p = 0.018), the number of PGC fell by 53.67% (p = 0.025), PMC reduced by 37.5% (p = 0.034). Aspirin reduced the number of platelet–cells aggregates with T-helper cells, and in gamma/delta T lymphocytes population to control group numbers. Conclusions: Thus, aspirin inhibits degree of platelet–leukocyte interaction in patients with stable angina. C0498 FINGER EMERGENCY IN INTERNAL MEDICINE I. Boukhris1 , E. Cherif1 , I. Kechaou1 , S. Azzabi1 , A. Hariz1 , Z. Kaouech1 , C. Kooli1 , L. ben Hassine1 , N. Khalfallah1 . 1 Medecine Interne. Charles Nicolle Hospital, Tunis, Tunisia Background: Digital necrosis are mostly associated with underlying pathology, they are a common skin manifestation of connective tissue diseases and vascularitis. The aim of the study was to investigate demographic, clinical, serologic features, etiological diseases, treatment and evolutions in patients with digital necrosis. Methods: The study included 9 patients with digital necrosis hospitalized in a Tunisian internal medicine department within a period of 18 years, from 1990 to 2008.
S53
Results: There were 5 men and 4 women, ages ranging between 27 and 77 years (mean age 55 years). Sites of digital necrosis were: toes in 5 patients, fingers in only one patient at both in 2 patients. Clinical symptoms were dominated by the presence of pain, coldness associated in some cases to abolition of pulse upstream. There were increases of inflammatory indices in all the cases. Digital necrosis was associated to Buerger’s disease in one case, cryoglobulinemia in one case, Takayasu disease in one case, CREST syndrome in one case, mixed connective tissue in one case, myositis in one case, congenital afibrinogenemia in one case and atherosclerosis in two cases. Patients were treated with symptomatic treatment based on anticoagulation and vasodilators. Corticosteroids were indicated in 3 cases. Patient with cryoglobulinemia had plasmapheresis. Complications were noted in 5 patients necessitating amputation. Conclusions: Digital necrosis is a serious consequence of vascular lesions caused by several mechanisms involving the functional prognosis. The results of our study highlight the etiological diversity despite the small number of patients. C0499 RETROBULBAR OPTIC NEUROPATHY REVEALING ISCHEMIC STROKE WITHOUT RISK FACTORS I. Boukhris1 , I. Rachdi1 , I. Kechaou1 , S. Azzabi1 , A. Hariz1 , E. Cherif1 , C. Kooli1 , Z. Kaouech1 , L. ben Hassine1 , N. Khalfallah1 . 1 Medecine Interne. Charles Nicolle Hospital, Tunis, Tunisia Background: Posterior ischemic neuropathy occurred in three main settings: in the perioperative period following a variety of surgical procedures, associated with giant cell arteritis, and associated with nonarteritic systemic vascular disease. It represents one of the major causes of blindness or seriously impaired vision. We report a case of retrobulbar optic neuropathy revealing recidivant ischemic stroke in a young patient without vascular risk factors. Methods: One case report. Results: A 38-years-old men with no past medical or surgical history, was referred for etiological diagnosis brutal visual disorder which led to demonstration of homonymous lateral hemianopsia in the ophthalmic exam. Funduscopic examination showed a retinal vasculitis and evoked visual potential revealed a bilateral retrobulbar optic neuropathy. On physical exam, there were no hypertension, nor oral or genital ulcers, nor skin lesions such as folliculitis nor signs of thrombosis. Pathergy test was negative. Biological tests didn’t show diabetes or dyslipemia and electrocardiogram was without abnormalities. On supraaortic trunks duplex, there was not artery carotid disease. A magnetic resonance angiography was performed, revealing recidivant posterior ischemic stroke. The patient was put under antigregants. Conclusions: The discovery of retrobulbar optic neuropathy in a young patient must lead to search ischemic stroke even if there is no risk factors. C0521 NON-ALCHOLIC FATTY LIVER DISEASE AND SUBCLINICAL ORGAN DAMAGE: A NEW PREDICTOR OF ASYMPTOMATIC EXTRACORONARY ATHEROSCLEROSIS AND ENDOTHELIAL DYSFUNCTION G. Cioni1 , R. Marcucci1 , M. Pazzi1 , L. Rossi1 , G. Gensini1 , R. Abbate1 , M. Boddi1 . 1 Department of Experimental and Clinical Medicine, University of Florence, Italy, Largo Brambilla 3 (Florence), Italy Background: We investigated the predictive power of NFLD occurrence in identifying extra-coronary atherosclerosis, evaluated by carotid-IMT (c-IMT) and femoral-IMT (f-IMT), and endothelial dysfunction, in patients with no history of cardiovascular diseases. Methods: We investigated C-IMT, f-IMT, NFLD, by ultrasound, and endothelial function, by peripheral-arterial-tonometry (PAT),