Publications by authors named "Melanie Ferreira"

5 Publications

  • Page 1 of 1

Reduced-dose intravenous thrombolysis for acute intermediate high-risk pulmonary embolism: Rationale and design of the PEITHO-3 trial.

Thromb Haemost 2021 Sep 24. Epub 2021 Sep 24.

Hopital Europeen Georges Pompidou, Paris, France.

Intermediate high-risk pulmonary embolism (PE) is characterised by right ventricular (RV) dysfunction and elevated circulating cardiac troponin levels despite apparent haemodynamic stability at presentation. In these patients, full-dose systemic thrombolysis reduced the risk of haemodynamic decompensation or death but increased the risk of life-threatening bleeding. Reduced-dose thrombolysis may be capable of improving safety while maintaining reperfusion efficacy. The Pulmonary Embolism International Trial (PEITHO)-3 study (EudraCT 2018-000816-96) is a randomised, placebo-controlled, double-blind, multicentre, multinational trial with long-term follow-up. We will compare the efficacy and safety of a reduced-dose alteplase regimen with standard heparin anticoagulation. Patients with intermediate high-risk PE will also fulfil at least one clinical criterion of severity: systolic blood pressure ≤ 110 mmHg, respiratory rate >20 breaths/min, or history of heart failure. The primary efficacy outcome is the composite of all-cause death, haemodynamic decompensation or PE recurrence within 30 days of randomisation. Key secondary outcomes, to be included in hierarchical analysis, are fatal or GUSTO severe or life-threatening bleeding; net clinical benefit (primary efficacy outcome plus severe or life-threatening bleeding); and all-cause death, all within 30 days. All outcomes will be adjudicated by an independent committee. Further outcomes include PE-related death, haemodynamic decompensation, or stroke within 30 days; dyspnoea, functional limitation or RV dysfunction at 6 months and 2 years; and utilisation of healthcare resources within 30 days and 2 years. The study is planned to enrol 650 patients. The results are expected to have a major impact on risk-adjusted treatment of acute PE and inform guideline recommendations.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1055/a-1653-4699DOI Listing
September 2021

The cannabinoid receptor 1 is involved in renal fibrosis during chronic allograft dysfunction: Proof of concept.

J Cell Mol Med 2019 11 30;23(11):7279-7288. Epub 2019 Aug 30.

Inserm UMR_S 1155, Hôpital Tenon, Paris, France.

Chronic allograft dysfunction (CAD), defined as the replacement of functional renal tissue by extracellular matrix proteins, remains the first cause of graft loss. The aim of our study was to explore the potential role of the cannabinoid receptor 1 (CB1) during CAD. We retrospectively quantified CB1 expression and correlated it with renal fibrosis in 26 kidney-transplanted patients who underwent serial routine kidney biopsies. Whereas CB1 expression was low in normal kidney grafts, it was highly expressed during CAD, especially in tubular cells. CB1 expression significantly increased early on after transplantation, from day 0 (D0) to month 3 post-transplant (M3) (22.5% ± 15.4% vs 33.4% ± 13.8%, P < .01), and it remained stable thereafter. CB1 expression correlated with renal fibrosis at M3 (P = .04). In an in vitro model of tacrolimus-mediated fibrogenesis by tubular cells, we found that tacrolimus treatment significantly induced mRNA and protein expression of CB1 concomitantly to col3a1 and col4a3 up regulation. Administration of rimonabant, a CB1 antagonist, blunted collagen synthesis by tubular cells (P < .05). Overall, our study strongly suggests an involvement of the cannabinoid system in the progression of fibrosis during CAD and indicates the therapeutic potential of CB1 antagonists in this pathology.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/jcmm.14570DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6815790PMC
November 2019

Direct oral anti-Xa inhibitors and vaginal bleeding.

Authors:
Melanie Ferreira

Lancet Haematol 2016 Oct;3(10):e451-e452

Internal Medicine Department, Hospital Garcia de Orta, Almada 2805, Portugal. Electronic address:

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/S2352-3026(16)30128-4DOI Listing
October 2016

Heavy menstrual bleeding on rivaroxaban.

Br J Haematol 2016 Apr 27;173(2):314-5. Epub 2015 Jul 27.

King's Thrombosis Centre, King's College Hospital, London, UK.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/bjh.13583DOI Listing
April 2016

Iron-induced thrombocytopenia in severe iron-deficiency anemia.

Expert Rev Hematol 2015 Apr 11;8(2):247-51. Epub 2015 Feb 11.

Internal Medicine Department, Hospital Garcia de Orta, Av Torrado da Silva, 2805-267 Almada, Portugal.

Iron deficiency anemia (IDA) is commonly associated with reactive thrombocytosis, but thrombocytopenia is relatively uncommon and generally associated with more severe IDA. Even more rarely described has been thrombocytopenia following iron replacement therapy to treat IDA, and the underlying mechanism remains unclear. The authors present the case of a patient with severe IDA, who developed thrombocytopenia after the initiation of iron therapy. An analysis is made of all the previous reports of similar cases, to compare and start on the path of understanding this rare entity.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1586/17474086.2015.1010504DOI Listing
April 2015
-->