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Thromboprophylaxis

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https://www.readbyqxmd.com/read/28647342/association-between-hospitalization-for-acute-medical-illness-and-vte-risk-a-lower-efficacy-of-thromboprophylaxis-in-elderly-patients-results-from-the-edith-case-control-study
#1
Florence Hemon, Fabrice Fouchard, Cécile Tromeur, Karine Lacut, Grégoire Le Gal, Dominique Mottier, Francis Couturaud, Aurélien Delluc
INTRODUCTION: Whether the association between hospitalization and venous thromboembolism (VTE) is modified by the use of thromboprophylaxis in older patients remains insufficiently evaluated. Our objective was to estimate VTE risk associated with hospitalization for acute medical illness depending on prescription of pharmacological thromboprophylaxis, in two different age categories using a 75years cutoff. METHODS: Using a case-control design, we estimated the risk for symptomatic VTE associated with hospitalization for acute medical illness depending on prescription of pharmacological thromboprophylaxis in two different age categories using a 75 years cut-off...
June 21, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28645935/liver-cirrhosis-in-patients-with-atrial-fibrillation-would-oral-anticoagulation-have-a-net-clinical-benefit-for-stroke-prevention
#2
Ling Kuo, Tze-Fan Chao, Chia-Jen Liu, Yenn-Jiang Lin, Shih-Lin Chang, Li-Wei Lo, Yu-Feng Hu, Ta-Chuan Tuan, Jo-Nan Liao, Fa-Po Chung, Tzeng-Ji Chen, Gregory Y H Lip, Shih-Ann Chen
BACKGROUND: Patients with liver cirrhosis have been excluded from randomized clinical trials of oral anticoagulation therapy for stroke prevention in atrial fibrillation. We hypothesized that patients with liver cirrhosis would have a positive net clinical benefit for oral anticoagulation when used for stroke prevention in atrial fibrillation. METHODS AND RESULTS: This study used the National Health Insurance Research Database in Taiwan. Among 289 559 atrial fibrillation patients aged ≥20 years, there were 10 336 with liver cirrhosis, and 9056 of them having a CHA2DS2-VASc score ≥2 were divided into 3 groups, that is, no treatment, antiplatelet therapy, and warfarin...
June 23, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28643079/similar-clinical-outcomes-with-preoperative-and-postoperative-start-of-thromboprophylaxis-in-tha-a-register-based-study
#3
Pål O Borgen, Are H Pripp, Eva Dybvik, Lilian Leistad, Ola E Dahl, Olav Reikerås
BACKGROUND: Elective THA is associated with a high risk of thromboembolic events. Although these events may be less common now than they were in the past, they can be serious, and most patients undergoing the procedure therefore still receive thromboprophylaxis. However, controversy remains regarding whether to begin thromboprophylaxis before THA or after to best balance the risks of clotting and bleeding. QUESTIONS/PURPOSES: We asked the following questions: (1) Is there a difference in bleeding events with pre- versus postoperative thromboprophylaxis? (2) Is there a difference in thromboembolic episodes after THA between the two regimens? (3) How do the two approaches of thromboprophylaxis influence mortality, readmissions, and other complications? METHODS: We used a population-based followup design with predefined data based on international health codification to assess clinical effects of LMWH prophylaxis initiated before or after THA...
June 22, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28640324/new-paradigms-in-venous-thromboprophylaxis-of-medically-ill-patients
#4
Alex C Spyropoulos, Alex Spyropoulos, Gary E Raskob
Acutelly-ill hospitalised medical patients are at risk of venous thromboembolism (VTE), both in-hospital and in the immediate post-discharge period, and mortality from VTE is thought to be particularly high in this patient population. However, despite previous mandates from international antithrombotic guidelines such as those of the American College of Chest Physicians (ACCP) for the "universal" use of thromboprophylaxis in hospitalised medical patients, global audits suggest that implementation of thromboprophylaxis continues to be challenging because of the perceived higher risk of bleeding and lower risk of VTE than that reported in clinical trials...
June 22, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28629235/atrial-fibrillation-as-a-complication-of-ibrutinib-therapy-clinical-features-and-challenges-of-management
#5
Bronwyn C Thorp, Xavier Badoux
Ibrutinib is a Bruton's tyrosine kinase (BTK) inhibitor finding increasingly widespread use in non-Hodgkin lymphoma. Evidence of an increased risk of atrial fibrillation (AF) emerged in Phase III studies with a median incidence of approximately 6%. The mechanism remains unknown, but inhibition of a cardioprotective pathway has been proposed. Ibrutinib induces a platelet function defect, increasing the bleeding risk of anticoagulation for AF stroke prophylaxis. Multiple potential drug interactions are an added complication...
June 20, 2017: Leukemia & Lymphoma
https://www.readbyqxmd.com/read/28628578/neuraxial-anesthesia-in-obstetric-patients-receiving-thromboprophylaxis-with-unfractionated-or-low-molecular-weight-heparin-a-systematic-review-of-spinal-epidural-hematoma
#6
Lisa R Leffert, Heloise M Dubois, Alexander J Butwick, Brendan Carvalho, Timothy T Houle, Ruth Landau
Venous thromboembolism remains a major source of morbidity and mortality in obstetrics with an incidence of 29.8/100,000 vaginal delivery hospitalizations; cesarean delivery confers a 4-fold increased risk of thromboembolism when compared with vaginal delivery. Revised national guidelines now stipulate that the majority of women delivering via cesarean and women at risk for ante- or postpartum venous thromboembolism receive mechanical or pharmacological thromboprophylaxis. This practice change has important implications for obstetric anesthesiologists concerned about the risk of spinal epidural hematoma (SEH) among anticoagulated women receiving neuraxial anesthesia...
July 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28622843/fatal-pulmonary-embolism-following-elective-total-knee-replacement-using-aspirin-in-multi-modal-prophylaxis-a-12year-study
#7
C Quah, E Bayley, N Bhamber, P Howard
BACKGROUND: The National Institute for Health and Clinical Excellence (NICE) has issued guidelines on which thromboprophylaxis regimens are suitable following lower limb arthroplasty. Aspirin is not a recommended agent despite being accepted in orthopaedic guidelines elsewhere. We assessed the incidence of fatal pulmonary embolism (PE) and all-cause mortality following elective primary total knee replacement (TKR) with a standardised multi-modal prophylaxis regime in a large teaching district general hospital...
June 13, 2017: Knee
https://www.readbyqxmd.com/read/28619086/patterns-of-venous-thromboembolism-risk-in-patients-with-localized-colorectal-cancer-undergoing-adjuvant-chemotherapy-or-active-surveillance-an-observational-cohort-study
#8
Jakob Michael Riedl, Florian Posch, Angelika Bezan, Joanna Szkandera, Maria Anna Smolle, Thomas Winder, Christopher H Rossmann, Renate Schaberl-Moser, Martin Pichler, Michael Stotz, Herbert Stöger, Armin Gerger
BACKGROUND: Venous thromoboembolism (VTE) is a frequent and burdensome complication of metastatic colorectal cancer (CRC). However, the epidemiology of VTE in patients with localized CRC after surgery in curative intent is incompletely understood. In this single-center observational cohort study, we investigate patterns of VTE risk in localized CRC, and define its relationship with baseline risk factors, adjuvant chemotherapy and CRC recurrence. METHODS: Five-hundred-sixteen patients with stage II/III CRC were included retrospectively at the time of surgery, and followed until the occurrence of VTE, CRC recurrence, or death (median age = 65...
June 15, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28617144/the-risk-of-stroke-among-acutely-ill-hospitalized-medical-patients-lessons-from-recent-trials-on-extended-duration-thromboprophylaxis
#9
Jolanta Marszalek, Sara Mehrsefat, Gerald Chi
Data from recent randomized controlled trials indicate that the incidence of stroke among acutely ill medical patients is unexpectedly high and approximates 1% at 90 days. Preliminary data suggest that betrixaban may reduce ischemic stroke in patients without atrial fibrillation. There is an unmet demand for stroke risk stratification schemes targeting hospitalized medical patients. The prognostic value of biomarkers such as natriuretic peptides and D-dimer in predicting short-term stroke remains uncertain...
June 21, 2017: Expert Review of Hematology
https://www.readbyqxmd.com/read/28610546/neuromuscular-electrical-stimulation-for-the-prevention-of-venous-thromboembolism
#10
Raveena Ravikumar, Katherine J Williams, Adarsh Babber, Hayley M Moore, Tristan Ra Lane, Joseph Shalhoub, Alun H Davies
Objective Venous thromboembolism, encompassing deep vein thrombosis and pulmonary embolism, is a significant cause of morbidity and mortality, affecting one in 1000 adults per year. Neuromuscular electrical stimulation is the transcutaneous application of electrical impulses to elicit muscle contraction, preventing venous stasis. This review aims to investigate the evidence underlying the use of neuromuscular electrical stimulation in thromboprophylaxis. Methods The Medline and Embase databases were systematically searched, adhering to PRISMA guidelines, for articles relating to electrical stimulation and thromboprophylaxis...
January 1, 2017: Phlebology
https://www.readbyqxmd.com/read/28599392/the-laboratory-control-of-anticoagulant-thromboprophylaxis-during-the-early-postpartum-period-after-cesarean-delivery
#11
Ekaterina M Koltsova, Anna N Balandina, Konstantin I Grischuk, Margarita A Shpilyuk, Elena A Seregina, Natalia M Dashkevich, Alexander V Poletaev, Alexey V Pyregov, Gennady T Sukhih, Ilya I Serebriyskiy, Fazly I Ataullakhanov
INTRODUCTION: The incidence of venous thromboembolism (VTE) after cesarean section is up to 0.6%, and the widespread use of cesarean section draws attention to this group. The dosage and duration of low-molecular-weight heparin (LMWH) prophylaxis after delivery is estimated by anamnestic risk-scales; however, the predictive potency for an individual patient's risk can be low. Laboratory hemostasis assays are expected to solve this problem. The aim of this study was to estimate the potency of tests to reflect the coagulation state of patients receiving LMWH in the early postpartum period...
May 25, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28597460/thromboprophylaxis-in-cancer-patients-undergoing-surgery
#12
Kay T Htun, Agnes Y Y Lee
No abstract text is available yet for this article.
June 8, 2017: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/28594049/venous-thromboembolism-past-present-and-future
#13
Sam Schulman, Walter Ageno, Stavros V Konstantinides
Venous thromboembolism (VTE), the third most frequent acute cardiovascular syndrome, is associated with a considerable disease burden which continues to grow along with the longer life expectancy of the population worldwide. In the past century, parenteral heparin prophylaxis was established for hospitalised patients at elevated risk of VTE. More recently, non-vitamin K antagonist oral anticoagulants (NOACs) with a direct inhibiting effect on factor Xa or thrombin, underwent extensive testing in clinical trials and have been approved for patients undergoing hip or knee replacement...
June 8, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28593335/key-points-to-optimizing-management-and-research-on-cancer-associated-thrombosis
#14
REVIEW
A Carmona-Bayonas, M Sánchez-Cánovas, J M Plasencia, A Custodio, E Martínez de Castro, J A Virizuela, F Ayala de la Peña, P Jiménez-Fonseca
Despite the fact that thromboembolism is relatively common in oncology patients and that the interrelationship between thrombotic risk and specific mechanisms of tumorigenesis has long been known, many cardinal elements of prevention and treatment remain unresolved. Among the existing knowledge gaps, the need to validate the Ay scale and compare it to the Khorana index, develop, and standardize the use of predictive biomarkers for thrombotic risk, conduct clinical trials in thromboprophylaxis adapted to thrombotic risk, evaluate the efficacy and safety of direct anticoagulants, select patients who can benefit from anticoagulants for antitumor treatment, validate the EPIPHANY study decision tree to choose patients with low-risk pulmonary embolism, and accumulate more practical experience in special situations (rethrombosis, prolonged therapy beyond 6 months, etc...
June 7, 2017: Clinical & Translational Oncology
https://www.readbyqxmd.com/read/28590907/real-practice-thromboprophylaxis-in-atrial-fibrillation
#15
Paola Deambrosis, Alessandra Bettiol, Jenny Bolcato, Roberta Pirolo, Giulia Franchin, Sakis Themistoclakis, Michele Pellizzari, Alessandro Chinellato, Pietro Giusti
This retrospective observational study was based on databases of the Local Health Authority of Treviso, Italy. It evaluated the prevalence and the effectiveness of oral anticoagulation treatment (OAT) for the management of nonvalvular atrial fibrillation (NVAF) in everyday clinical practice. Out of 6,138 NVAF patients, only 3,024 received vitamin K antagonist (VKA). Potential barriers decreasing the probability of being treated with VKA were female sex, older age, antiplatelet treatment and history of bleeding...
June 27, 2017: Acta Pharmaceutica
https://www.readbyqxmd.com/read/28590256/thromboembolism-prophylaxis-in-laparoscopic-surgery-for-gynecologic-benign-diseases-results-of-a-single-center-experience-in-922-procedures
#16
Emanuele Sturlese, Onofrio Triolo, Roberta Grasso, Antonio Simone Laganà, Annalisa Retto, Diego Rossetti, Salvatore Giovanni Vitale, Giuseppe Sarpietro, Rosanna De Dominici
AIM: The aim of this study is to assess the role of preoperative evaluation risk for venous tromboembolism (VTE) in patients submitted to laparoscopic surgery for gynecologic benign diseases. METHODS: Date from nine hundred twenty-two women affected by adnexal benign diseases treated with laparoscopic procedures were collected and included in this study. VTE risk was assessed by "on line Caprini score calculator". Patients with one or more negative risk factors for Caprini's score underwent to venous thromboembolism prophylaxis (VTP)...
June 8, 2017: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/28583301/the-toronto-thromboprophylaxis-patient-safety-initiative-topps-a-cluster-randomised-trial
#17
Artemis Diamantouros, Alex Kiss, Tina Papastavros, David U, Merrick Zwarenstein, William H Geerts
BACKGROUND: Although venous thromboembolism (VTE) is one of the most common and most preventable complications of hospital stay, review of the literature demonstrates large evidence-care gaps for VTE prevention. OBJECTIVES: This study aimed to determine if a multi-component quality improvement (QI) strategy, including the support of hospital leadership, use of order sets, audit and feedback, and active pharmacy involvement, could increase the use of appropriate thromboprophylaxis in patients hospitalized for hip fracture surgery (HFS), major general surgery (MGS) and acute medical illness (MED)...
May 27, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/28579855/thromboprophylaxis-with-apixaban-in-patients-undergoing-major-orthopedic-surgery-meta-analysis-and-trial-sequential-analysis
#18
REVIEW
Daniel Caldeira, Filipe B Rodrigues, Fausto J Pinto, Joaquim J Ferreira, João Costa
BACKGROUND: Venous thromboembolism (VTE) is a potentially fatal complication of orthopedic surgery, and until recently, few antithrombotic compounds were available for postoperative thromboprophylaxis. The introduction of the non-vitamin K antagonists oral anticoagulants (NOAC), including apixaban, has extended the therapeutic armamentarium in this field. Therefore, estimation of NOAC net clinical benefit in comparison with the established treatment is needed to inform clinical decision making...
2017: Clinical Medicine Insights. Blood Disorders
https://www.readbyqxmd.com/read/28579397/meta-analysis-of-heparin-therapy-for-preventing-venous-thromboembolism-in-acute-spinal-cord-injury
#19
REVIEW
Yang Liu, Hong Xu, Feifei Liu, Zenghui Lv, Shunli Kan, Guangzhi Ning, Shiqing Feng
OBJECTIVE: Venous thromboembolism (VTE) is a frequent complication in patients with acute spinal cord injury (SCI) and may have serious consequences. This study aimed to assess the efficacy and safety of heparin and low-molecular-weight heparin (LMWH) venous thromboprophylaxis in patients with acute SCI. METHODS: PubMed, Web of Science, EMBASE and the Cochrane library were searched from January 1980 to August 2016. The primary outcome was the incidence of VTE. Secondary outcomes included the incidences of Deep-vein thrombosis (DVT), pulmonary embolism (PE) and major bleeding...
June 1, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28569545/interview-with-alexander-cohen
#20
Alexander Ander Cohen
Ander Cohen speaks to Adam Price-Evans, Commissioning Editor of Future Cardiology: Alexander (Ander) Cohen MBBS (Hons), MSc, MD, FRACP is a vascular physician and epidemiologist at Guy's and St Thomas' Hospital, King's College (London, UK). He graduated with honors in medicine and honors in surgery from the University of Melbourne, Australia, and became a fellow of the Royal Australasian College of Physicians in 1990. He was awarded an MSc in Epidemiology from the London School of Hygiene and Tropical Medicine, University of London in 1991 with a thesis on the metabolic syndrome in South-Asian populations...
June 1, 2017: Future Cardiology
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