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Thromboprophylaxis

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https://www.readbyqxmd.com/read/29147590/paroxysmal-nocturnal-hemoglobinuria-in-pregnancy-a-dilemma-in-treatment-and-thromboprophylaxis
#1
Arpan Patel, Athira Unnikrishnan, Martina Murphy, Robert Egerman, Sarah Wheeler, Ashley Richards, John Wingard
Paroxysmal nocturnal hemoglobinuria (PNH) is a hematologic disorder characterized by an acquired somatic mutation in the phosphatidylinositol glycan class A gene which leads to a higher risk for increased venous and arterial thrombosis. Current treatment for PNH includes eculizumab. Pregnant patients who have PNH have higher risk for thrombosis and hemorrhage with both pregnancy and their underlying PNH. Treatment frequently poses conundrum. The safety and efficacy of eculizumab during pregnancy and breast feeding have not been extensively studied and contraception has been recommended due to potential for teratogenicity...
2017: Case Reports in Hematology
https://www.readbyqxmd.com/read/29144543/primary-thromboprophylaxis-in-individuals-without-cancer-admitted-to-a-geriatric-palliative-care-unit
#2
Adam J Gurau, Anna Berall, Jurgis Karuza, Giulia-Anna Perri
BACKGROUND/OBJECTIVES: The prevalence of individuals with advanced noncancer disease is increasing on palliative care units (PCUs), but there are no current guidelines to direct venous thromboembolism (VTE) prophylaxis decisions in these individuals. The aim of this study was to compare primary VTE prophylaxis in elderly adults with advanced noncancer diagnoses with that of those with advanced cancer on a dedicated geriatric PCU. DESIGN: Single-center retrospective chart review...
November 16, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29137835/venous-thromboembolism-risk-and-prophylaxis-in-the-portuguese-hospital-care-setting-the-arte-study
#3
Daniel Ferreira, Joaquim Abreu de Sousa, Paulo Felicíssimo, Ana França
INTRODUCTION: Venous thromboembolism (VTE) is a relatively common complication during hospital stay and determination of VTE risk is critical to choosing the best prophylactic strategy for each patient. OBJECTIVES: In the present study we studied the risk profile for VTE in hospitalized patients in a group of hospitals in Portugal. METHODS: Based on an open cohort of 4248 patients hospitalized in surgical, internal medicine, orthopedic or oncology departments, we determined thromboembolic risk at admission by applying a new score, modified from the Caprini and Khorana scores...
November 11, 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/29127514/does-tranexamic-acid-increase-the-risk-of-thromboembolism-after-bilateral-simultaneous-total-knee-arthroplasties-in-asian-population
#4
Young-Hoo Kim, Jang-Won Park, Jun-Shik Kim, Dong-Hyuk Seo
PURPOSE: To ascertain whether tranexamic acid reduces the blood loss and transfusion rate and volumes; increase the prevalence of deep vein thrombosis (DVT); and investigate factors associated with DVT in patients undergoing primary bilateral total knee arthroplasties (TKAs) without use of chemical thromboprophylaxis. METHODS: There were 874 patients (1748 knees) in the control group who did not receive tranexamic acid and 871 patients (1742 knees) in the study group who received tranexamic acid...
November 10, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/29127473/colorectal-cancer-and-thrombosis
#5
P A Rees, H W Clouston, S Duff, C C Kirwan
SIGNIFICANCE: Colorectal cancer (CRC), results in a hypercoagulable state which manifests clinically as venous thromboembolism (VTE), often presenting as a deep vein thrombosis (DVT) or pulmonary embolism (PE). The consequences of VTE in CRC can be devastating, resulting in long-term morbidity and are a frequent cause of death, even amongst those who would have otherwise had a favourable cancer prognosis. The incidence of VTE in all cancers is increasing, whilst the exact incidence of VTE in CRC is likely to be underestimated...
November 10, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/29124399/length-of-exposure-to-antiphospholipid-antibodies-rather-than-age-is-a-risk-factor-for-thrombosis-a-retrospective-single-centre-observational-study
#6
Iñigo Les, Naiara Parraza, Pilar Anaut, Saioa Eguiluz, Cristina Sánchez, María Enriqueta Preciado, Jesús Ángel Loza, Ander Andía
To investigate the association of age and other factors with thrombosis risk in antiphospholipid antibody (aPL) carriers, a retrospective observational study was conducted in a cohort of patients with medium-high aPL titres recruited in a tertiary care hospital. Assuming an age difference of 9.8 years between patients with and without thrombosis, we estimated that a sample size of 70 participants was required. Several variables besides age including gender, vascular risk factors, inherited thrombophilias, non-thrombotic clinical manifestations, laboratory parameters, aPL profile, length of aPL exposure, antithrombotic drugs and partial aPL score were assessed by univariate analysis followed by multivariate logistic regression...
November 10, 2017: Rheumatology International
https://www.readbyqxmd.com/read/29121664/does-preoperative-mechanical-prophylaxis-have-additional-effectiveness-in-preventing-postoperative-venous-thromboembolism-in-elderly-patients-with-hip-fracture-retrospective-case-control-study
#7
Ji-Hoon Nam, Dae-Hwan Kim, Je-Hyun Yoo, Ji-Hyo Hwang, Jun-Dong Chang
BACKGROUND: Elderly patients undergoing hip fracture surgery (HFS) are at increased risk of postoperative venous thromboembolism (VTE). To reduce this risk, combined postoperative mechanical and chemical thromboprophylaxis has been routinely performed after HFS in these patients. This retrospective case-control study was conducted to evaluate the additional effectiveness of preoperative mechanical thromboprophylaxis for the prevention of VTE following HFS in elderly patients. METHODS: Of 539 consecutive patients aged 70 years or older undergoing HFS, 404 (control group) did not receive preoperative mechanical thromboprophylaxis, while 135 (study group) received mechanical thromboprophylaxis using an intermittent pneumatic compression device and graduated compression stockings from the time of admission until surgery...
2017: PloS One
https://www.readbyqxmd.com/read/29120007/incidence-of-heterotopic-ossification-following-a-multimodal-pain-protocol-in-total-hip-arthroplasty-with-the-posterior-approach
#8
Peter B White, Prem N Ramkumar, Morteza Meftah, Narges Ghazi, Amar S Ranawat, Chitranjan S Ranawat
Heterotopic ossification (HO) is prevalent after total hip arthroplasty (THA). Oral nonsteroidal anti-inflammatory drugs and cyclooxygenase-2 (COX-2) inhibitors have reduced the incidence of HO; however, to the authors' knowledge, no studies have reported the incidence and severity of HO with a pain protocol highlighted by celecoxib in the pre- and postoperative period with a posterolateral approach. Between October 2014 and October 2015, a retrospective study was conducted of 687 consecutive primary THAs with minimum 1-year follow-up performed between January 2009 and December 2013...
November 8, 2017: Orthopedics
https://www.readbyqxmd.com/read/29118862/thromboprophylaxis-and-mortality-among-patients-who-developed-venous-thromboembolism-in-seven-major-hospitals-in-saudi-arabia
#9
Fahad M Al-Hameed, Hasan M Al-Dorzi, Abdulelah I Qadhi, Amira Shaker, Farjah H Al-Gahtani, Fawzi F Al-Jassir, Galila F Zahir, Tarig S Al-Khuwaitir, Mohammed H Addar, Mohamed S Al-Hajjaj, Mohamed A Abdelaal, Essam Y Aboelnazar
INTRODUCTION: Venous thromboembolism (VTE) during hospitalization is a serious and potentially fatal condition. Despite its effectiveness, evidence-based thromboprophylaxis is still underutilized in many countries including Saudi Arabia. OBJECTIVE OF THE STUDY: Our objectives were to determine how often hospital-acquired VTE patients received appropriate thromboprophylaxis, VTE-associated mortality, and the percentage of patients given anticoagulant therapy and adherence to it after discharged...
October 2017: Annals of Thoracic Medicine
https://www.readbyqxmd.com/read/29117862/successful-medical-management-of-acute-mesenteric-ischemia-due-to-superior-mesenteric-and-portal-vein-thrombosis-in-a-27-year-old-man-with-protein-s-deficiency-a-case-report
#10
N P Osti, D N Sah, R S Bhandari
BACKGROUND: Acute mesenteric ischemia poses a diagnostic challenge due to nonspecific clinical clues and lack of awareness owing to its rarity. Ischemia due to mesenteric venous thrombosis has a good prognosis compared to arterial cause and can be managed conservatively with early diagnosis. The portomesenteric venous system is an unusual site of thrombosis in patients with protein S deficiency, and its thrombosis is an uncommon cause of acute mesenteric ischemia. CASE PRESENTATION: We present a case of a 27-year-old Mongolian man who presented with acute abdominal pain increasing in severity, and refractory to repeated attempts at treatment with a misdiagnosis of acute peptic ulcer disease...
November 9, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29112550/european-guidelines-on-perioperative-venous-thromboembolism-prophylaxis-mechanical-prophylaxis
#11
Arash Afshari, Christian Fenger-Eriksen, Manuel Monreal, Peter Verhamme
: Institutional protocols need to address the indications for pharmacological and mechanical thromboprophylaxis. The use of graduated compression stockings (GCS) and intermittent pneumatic compression (IPC) strongly differs between institutions. As a consequence, no strong recommendations can be made based on the contemporary high-level evidence. Although different clinical practices can be supported, such approaches should be part of an institutional strategy to reduce the burden of venous thromboembolism (VTE)...
November 6, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29112549/european-guidelines-on-perioperative-venous-thromboembolism-prophylaxis-patients-with-preexisting-coagulation-disorders-and-after-severe-perioperative-bleeding
#12
Aamer Ahmed, Sibylle Kozek-Langenecker, François Mullier, Sue Pavord, Cedric Hermans
: In patients with inherited bleeding disorders undergoing surgery, we recommend assessment of individual risk for venous thromboembolism, taking into account the nature of the surgery and anaesthetic, type and severity of bleeding disorder, age, BMI, history of thrombosis, the presence of malignancy and other high-risk comorbidities. Venous thromboembolism risk should be balanced against the increased bleeding risk associated with anticoagulant use in patients with known bleeding disorders (Grade 1C). In these patients undergoing major surgery, we recommend against routine postoperative use of pharmacological thromboprophylaxis, especially for patients with haemophilia A and B (Grade 1B)...
November 6, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29112548/european-guidelines-on-perioperative-venous-thromboembolism-prophylaxis-aspirin
#13
Jean-Yves Jenny, Ingrid Pabinger, Charles Marc Samama
: There is a good rationale for the use of aspirin in venous thromboembolism prophylaxis in some orthopaedic procedures, as already proposed by the 9th American College of Chest Physicians' guidelines (Grade 1C). We recommend using aspirin, considering that it may be less effective than or as effective as low molecular weight heparin for prevention of deep vein thrombosis and pulmonary embolism after total hip arthroplasty, total knee arthroplasty and hip fracture surgery (Grade 1C). Aspirin may be less effective than or as effective as low molecular weight heparins for prevention of deep vein thrombosis and pulmonary embolism after other orthopaedic procedures (Grade 2C)...
November 6, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29112547/european-guidelines-on-perioperative-venous-thromboembolism-prophylaxis-chronic-treatments-with-antiplatelet-agents
#14
Juan V Llau, Pieter Kamphuisen, Pierre Albaladejo
: Antiplatelet agents (APA) are considered first-line therapy in preventing cardiovascular thrombotic events, but they are of limited value in the prophylaxis of venous thromboembolism (VTE) during the perioperative period. Consequently, many patients should receive both an APA and an anticoagulant. This combination can increase the bleeding risk and it is necessary to make some recommendations to minimise that risk. In patients receiving APA chronically, if the risk of VTE outweighs the risk of bleeding, we suggest pharmacological prophylaxis (grade 2C)...
November 6, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29112544/european-guidelines-on-perioperative-venous-thromboembolism-prophylaxis-day-surgery-and-fast-track-surgery
#15
Linas Venclauskas, Juan V Llau, Jean-Yves Jenny, Per Kjaersgaard-Andersen, Øivind Jans
: In recent years, day surgery and fast-track surgery have experienced a continuous increase in volume. Many procedures are now performed on an outpatient protocol, including general, orthopaedic, oncological, reconstructive or vascular surgery. The management of these patients is safe, but the incidence of venous thromboembolism in this population remains unknown. Several risk factors can be identified and stratified derived from studies of inpatient surgical management (e.g. Caprini score). Recommendations for thromboprophylaxis should be tailored from the assessment of both personal and procedure-related risk factors, although with a lack of evidence for application in outpatient management...
November 6, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29112543/european-guidelines-on-perioperative-venous-thromboembolism-prophylaxis-surgery-during-pregnancy-and-the-immediate-postpartum-period
#16
Anne-Sophie Ducloy-Bouthors, Andrea Baldini, Rezan Abdul-Kadir, Jacky Nizard
: Thromboembolic events in the pregnant and postpartum patient remain rare but potentially fatal complications. The aim of this section was to analyse the few prospective studies addressing the issue of thromboprophylaxis following a surgical procedure during and immediately after pregnancy, as well as national guidelines, and to propose European guidelines on this specific condition. Thromboprophylaxis is broadly recommended due to the combined risks of surgery and pregnancy or the postpartum period, regardless of the mode of delivery...
November 6, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29112542/european-guidelines-on-perioperative-venous-thromboembolism-prophylaxis-neurosurgery
#17
David Faraoni, Raquel Ferrandis, William Geerts, Matthew D Wiles
: Although there are numerous publications addressing venous thromboembolism and its prevention in neurosurgery, there are relatively few high-quality studies to guide decisions regarding thromboprophylaxis. In patients undergoing craniotomy, we recommend that if intermittent pneumatic compression (IPC) is used, it should be applied before the surgical procedure or on admission (Grade 1C). In craniotomy patients at particularly high risk for venous thromboembolism, we suggest considering the initiation of mechanical thromboprophylaxis with IPC preoperatively with addition of low molecular weight heparin (LMWH) postoperatively when the risk of bleeding is presumed to be decreased (Grade 2C)...
November 6, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29110872/venous-thromboembolism-risks-and-prophylaxis-in-king-fahad-hospital-madinah-saudi-arabia
#18
Ayman Kharaba, Mohammad Al Aboud, Madinah Reham Kharabah, Khaled Alyami, Amal Al Beihany
OBJECTIVE: To evaluate the risk factors, physician's compliance, and implementation of the American College of Chest Physicians (ACCP) guidelines for venous thromboembolism (VTE) prophylaxis at our hospital. METHODS: A retrospective cohort study was conducted in King Fahad Hospital, Madinah, Saudi Arabia, from July 2015 to September 2015. We used the ACCP 2012 guidelines to assess the VTE risk and to determine whether patients had received the recommended prophylaxis...
December 2017: Journal of Epidemiology and Global Health
https://www.readbyqxmd.com/read/29104003/assessment-of-the-procoagulant-potential-after-laparoscopic-sleeve-gastrectomy-a-potential-role-for-extended-thromboprophylaxis
#19
Amihai Rottenstreich, Ram Elazary, Jonathan B Yuval, Galia Spectre, Geffen Kleinstern, Yosef Kalish
BACKGROUND: Bariatric surgery is associated with increased thromboembolic risk, which may extend well beyond hospital stay. The hemostatic mechanisms implicated in this risk are not well established. OBJECTIVES: We aimed to determine the dynamics of hemostatic changes and procoagulant potential among patients undergoing laparoscopic sleeve gastrectomy, during both the early and late postoperative periods. SETTING: A university hospital. METHODS: Patients who underwent laparoscopic sleeve gastrectomy were recruited consecutively to this study...
September 28, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/29102371/are-factor-xa-inhibitors-effective-thromboprophylaxis-following-hip-fracture-surgery-a-large-national-database-study
#20
Sean T Campbell, Abiram Bala, Sam Y Jiang, Michael J Gardner, Julius A Bishop
INTRODUCTION: The purpose of this study was to evaluate the effectiveness of Factor Xa inhibitors (XaI) for thromboprophylaxis following hip fracture surgery in a large cohort of patients, and compare XaI against warfarin and enoxaparin. METHODS: Patients undergoing hip fracture surgery from 2007 to 2015 were identified in a large claims database. Patients prescribed warfarin, XaI, or enoxaparin within 2 weeks of surgery were identified and grouped into cohorts...
October 31, 2017: Injury
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