P.5.032 Calcium homeostasis and signal transduction alternations in rat brain cortex under the influence of hypokinesia and GABA

Abstract

Venous thromboembolism (VTE) associated with extended quiet sitting is not a new clinical entity. This syndrome was first described during World War II, when prolonged, cramped sitting in air raid shelters during the London blitz was frequently followed by cases of pulmonary embolism (PE). During 1940, 21 of 24 reported deaths from PE occurred after prolonged sitting during bomb raids. The number of such “shelter deaths” caused by PE increased sixfold over previous periods but decreased significantly after sleeping bunks were provided.37 In 1954, Homans first correlated deep-vein thrombosis (DVT) with prolonged air travel when he presented two cases of DVT that occurred after 15 hours of flight.16 Because prolonged intercontinental air travel has become more common since the 1960s, the incidence of VTE associated with long air flight has probably increased. In recent years, this problem has been dubbed coach class thrombosis or economy class syndrome,7 alluding to the prolonged quiet sitting in a cramped position required by such travel. The obvious risk of PE from DVT of the legs makes this condition potentially life-threatening.12, 32, 39The best-known case of DVT related to air travel was that of the late former President Richard M. Nixon3 who had suffered a DVT of his left leg in 1965. In 1974, during a long trip to Europe, the Middle East, and the Soviet Union, he developed swelling and pain in the left leg. His personal physician diagnosed a DVT and started anticoagulation therapy. He also informed the President about the risk of fatal PE, but despite these warnings, the President continued the trip, experiencing recurrent symptoms in Egypt and the Soviet Union. After his resignation in August 1974, Mr. Nixon experienced several serious recurrences of swelling in the leg and episodes of PE. Hospitalization for treatment prevented him from testifying at the Watergate trial. Despite anticoagulation therapy, the thrombus extended into the iliac vein, causing severe swelling of the leg. Surgical ligation of the iliac vein resulted in bleeding complications and shock. Mr. Nixon's condition was serious for several days before he was able to make a full recovery.Today, it is well recognized that prolonged quiet sitting, especially during prolonged air travel, carries a risk of VTE. Although healthy passengers seem to be at very little risk, even during long flights, passengers with associated risk factors for thromboembolism seem to have a considerable risk.* 2, 10, 11, 21, 24, 31