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Prevention of venous thromboembolism

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https://www.readbyqxmd.com/read/28102773/the-optimal-duration-of-anticoagulant-therapy-after-unprovoked-venous-thromboembolism-still-a-challenging-issue
#1
Giovanna Elmi, Giuseppe Di Pasquale, Raffaele Pesavento
As about 50 % of patients with unprovoked venous thromboembolism (VTE) will develop new episodes after discontinuing therapy, indefinite treatment is suggested in patients with low or moderate bleeding risk. Baseline and post-baseline factors can help clinicians to identify patients at high risk of recurrence, who require extended treatment. Residual vein obstruction and D-dimer assay have been shown to be suitable methods for assessing the risk of VTE recurrences after a first unprovoked VTE. In treatment for VTE the use of direct oral anticoagulants (DOAC) is growing instead of the standard adjusted dose of vitamin K antagonists...
January 19, 2017: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/28102615/comparative-effectiveness-of-venous-thromboembolism-prophylaxis-options-for-the-patient-undergoing-total-hip-and-knee-replacement-a-network-meta-analysis
#2
A Kapoor, A Ellis, N Shaffer, J Gurwitz, A Chandramohan, J Saulino, A Ishak, T Okubanjo, F Michota, E Hylek, T A Trikalinos
: Essentials Despite trial data, guidelines have not endorsed direct oral Xa inhibitors above other options. We provide profiles of venous thromboembolism and hemorrhage risk for 12 options. Direct oral Xa inhibitors had a favorable profile compared with low-molecular-weight heparin. Other options did not have favorable profiles compared with low-molecular-weight heparin. SUMMARY: Background There are numerous trials and several meta-analyses comparing venous thromboembolism (VTE) prophylaxis options after total hip and knee replacement (THR and TKR)...
November 7, 2016: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28100898/new-oral-anticoagulants-turkey-noac-turk-multicenter-cross-sectional-study
#3
Servet Altay, Özlem Yıldırımtürk, Hüseyin Altuğ Çakmak, Lütfü Aşkın, Ümit Yaşar Sinan, Feyzullah Beşli, Ömer Gedikli, Özge Özden Tok
OBJECTIVE: New oral anticoagulants (NOACs) are increasingly used both for prevention of stroke in non-valvular atrial fibrillation (NVAF) and the treatment of venous thromboembolism (VTE). In this study, we aimed to evaluate the current patterns of NOACs treatment in Turkey. Moreover, demographic and clinical parameters and bleeding and/or embolic events under NOACs treatment were analyzed. METHODS: The New Oral Anticoagulants-TURKey (NOAC-TURK) study was designed as a multicenter cross-sectional study...
January 17, 2017: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/28099298/low-dose-aspirin-is-effective-chemoprophylaxis-against-clinically-important-venous-thromboembolism-following-total-joint-arthroplasty-a-preliminary-analysis
#4
Javad Parvizi, Ronald Huang, Camilo Restrepo, Antonia F Chen, Matthew S Austin, William J Hozack, Jess H Lonner
BACKGROUND: Aspirin is a safe and effective prophylaxis for the prevention of venous thromboembolism following total joint arthroplasty. The optimal dose of aspirin prophylaxis is unknown. Our hypothesis was that lower-dose aspirin is as effective as higher-dose aspirin for the prevention of venous thromboembolism and is associated with fewer gastrointestinal side effects. METHODS: In a prospective, crossover study, we analyzed 4,651 primary total joint arthroplasty cases performed from July 2013 to June 2015...
January 18, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28098122/a-case-of-abdominal-aortic-thrombosis-associated-with-the-nephrotic-syndrome
#5
Jannet Labidi, Yosra Selmi, Yosra Ben Ariba, Zied Elloumi, Saleh Othmani
Thromboembolic disease is an important and frequent complication in patients with the nephrotic syndrome (NS), and the consequences are often severe. Usually, the venous system is affected. Arterial thrombosis has rarely been reported and occurs mainly in children. We report the case of a 27-year-old man with a history of NS due to focal and segmental glomerulosclerosis resistant to steroids and cyclosporine, admitted for bilateral pain in the calves. Aortogram revealed a suspended thrombus in the abdominal aorta just below the origin of the renal arteries with embolism into the left tibioperoneal trunk and the right anterior tibial artery...
January 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28093732/long-term-hormone-therapy-for-perimenopausal-and-postmenopausal-women
#6
REVIEW
Jane Marjoribanks, Cindy Farquhar, Helen Roberts, Anne Lethaby, Jasmine Lee
BACKGROUND: Hormone therapy (HT) is widely provided for control of menopausal symptoms and has been used for the management and prevention of cardiovascular disease, osteoporosis and dementia in older women. This is an updated version of a Cochrane review first published in 2005. OBJECTIVES: To assess effects of long-term HT (at least 1 year's duration) on mortality, cardiovascular outcomes, cancer, gallbladder disease, fracture and cognition in perimenopausal and postmenopausal women during and after cessation of treatment...
January 17, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28092428/reproducibility-of-clinical-events-adjudications-in-a-trial-of-venous-thromboembolism-prevention
#7
P Girard, A Penaloza, F Parent, B Gable, O Sanchez, P Durieux, P Hausfater, S Dambrine, G Meyer, P-M Roy
BACKGROUND: When clinical trials use clinical endpoints, establishing independent Clinical Events Committees (CEC) is recommended to homogenize the interpretation of investigators data. However, the reproducibility of CEC adjudications is almost unexplored. OBJECTIVES: To assess the reproducibility of CEC adjudications in a trial of venous thromboembolism (VTE) prevention. METHODS: The PREVENU study, a multicenter trial of VTE prevention, included 15,351 hospitalized medical patients...
January 16, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28089655/statins-and-primary-prevention-of-venous-thromboembolism-a-systematic-review-and-meta-analysis
#8
Setor K Kunutsor, Samuel Seidu, Kamlesh Khunti
BACKGROUND: Statins have been suggested to have a protective effect on venous thromboembolism (which includes deep vein thrombosis and pulmonary embolism), but the evidence is uncertain. We sought to evaluate the extent to which statins are associated with first venous thromboembolism events. METHODS: We did a systematic review and meta-analysis of observational cohort studies and randomised controlled trials (RCTs). Relevant studies that reported associations between statins and first venous thromboembolism outcomes were identified from MEDLINE, Embase, Web of Science, Cochrane Library, and a manual search of bibliographies for studies published up until July 18, 2016, and from email correspondence with investigators...
January 12, 2017: Lancet Haematology
https://www.readbyqxmd.com/read/28089654/statins-in-prevention-of-venous-thromboembolism
#9
Anetta Undas
No abstract text is available yet for this article.
January 12, 2017: Lancet Haematology
https://www.readbyqxmd.com/read/28088580/grand-round-anticoagulation-in-chronic-liver-disease
#10
REVIEW
Ameet Dhar, Benjamin H Mullish, Mark R Thursz
In this Grand Round, we first present a case of a man with decompensated liver disease who subsequently developed a fatal pulmonary embolism, having not been prescribed prophylactic anticoagulation to prevent venous thromboembolic disease. We go on to discuss the burden of thrombotic disease in those with chronic liver disease, before a more detailed discussion regarding the current evidence, safety data, and clinical dilemmas regarding the use of anticoagulation in patients with chronic liver disease, as well as discussing potential future directions within this field...
January 11, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28079734/thoracic-epidural-anesthesia-and-prophylactic-three-times-daily-unfractionated-heparin-within-an-enhanced-recovery-after-surgery-pathway-for-colorectal-surgery
#11
Alexander B Stone, Michael C Grant, Brandyn D Lau, Deborah B Hobson, Michael B Streiff, Elliot R Haut, Christopher L Wu, Elizabeth C Wick
BACKGROUND AND OBJECTIVES: Venous thromboembolism (VTE) is a common cause of preventable harm. Perioperative thoracic epidural analgesia (TEA) presents a challenge to optimal VTE prophylaxis. Our primary aim was to characterize missed doses of VTE prophylaxis associated with epidural catheter placement and removal. Our secondary aim was to measure the effect of an enhanced recovery after surgery (ERAS) pathway on the rate of TEA-associated missed VTE prophylaxis. METHODS: We retrospectively reviewed a prospectively collected database of 1264 colorectal surgery patients at a single academic center...
January 9, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28078350/efficacy-and-safety-of-extended-thromboprophylaxis-for-medically-ill-patients-a-meta-analysis-of-randomised-controlled-trials
#12
Francesco Dentali, Nicola Mumoli, Domenico Prisco, Andrea Fontanella, Matteo Nicola Dario Di Minno
Compelling evidence suggests that the risk of pulmonary embolism (PE) and deep-vein thrombosis (DVT) persists after hospital discharge in acutely-ill medical patients. However, no studies consistently supported the routine use of extended-duration thromboprophylaxis (ET) in this setting. We performed a meta-analysis to assess efficacy and safety of ET in acutely-ill medical patients. Efficacy outcome was defined by the prevention of symptomatic DVT, PE, venous thromboembolism (VTE) and VTE-related mortality...
January 12, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28077893/the-prediction-of-the-risk-level-of-pulmonary-embolism-and-deep-vein-thrombosis-through-artificial-neural-network
#13
Laleh Agharezaei, Zhila Agharezaei, Ali Nemati, Kambiz Bahaadinbeigy, Farshid Keynia, Mohammad Reza Baneshi, Abedin Iranpour, Moslem Agharezaei
BACKGROUND: Venous thromboembolism is a common cause of mortality among hospitalized patients and yet it is preventable through detecting the precipitating factors and a prompt diagnosis by specialists. The present study has been carried out in order to assist specialists in the diagnosis and prediction of the risk level of pulmonary embolism in patients, by means of artificial neural network. METHOD: A number of 31 risk factors have been used in this study in order to evaluate the conditions of 294 patients hospitalized in 3 educational hospitals affiliated with Kerman University of Medical Sciences...
October 2016: Acta Informatica Medica: AIM
https://www.readbyqxmd.com/read/28067012/venous-thromboembolism-in-pediatric-trauma-patients-ten-year-experience-and-long-term-follow-up-in-a-tertiary-care-center
#14
Christine M Leeper, Madhav Vissa, James D Cooper, Lynn M Malec, Barbara A Gaines
BACKGROUND: Pediatric trauma patients are at high risk for development of venous thromboembolism (VTE). Our objective is to describe incidence, risk factors, and timing of development of VTE, anticoagulation complications, and long-term VTE outcomes in a critically injured pediatric population. PROCEDURE: We did a retrospective review of pediatric (0-17 years) trauma admissions to intensive care unit from 2005 to 2014. Our center employs VTE screening and prevention protocols for high-risk patients based on hypercoagulable history, age, injuries, and medical interventions...
January 9, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28062249/extracranial-arterial-and-venous-thromboembolism-in-patients-with-atrial-fibrillation-a-meta-analysis-of-randomized-controlled-trials
#15
Kang-Ling Wang, Harry R Büller, Shinya Goto, Chun-Yi Lin, En-Yu Lai, Chun-Chih Chiu, Chern-En Chiang, Robert P Giugliano
BACKGROUND: Thromboembolism prevention is central to atrial fibrillation (AF) management. Randomized controlled trials (RCTs) have primarily focused on stroke prevention. Detailed analyses of extracranial thromboembolic events, particularly in patients with low dose non-vitamin K antagonist oral anticoagulants (NOACs), are scarce. OBJECTIVES: To assess efficacy of NOACs in prevention of extracranial arterial and venous thromboembolism. METHODS: We searched PubMed, CENTRAL, and CINAHL through April 2016 for phase III RCTs of NOACs in patients with AF...
January 3, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28062137/direct-oral-anti-coagulants-compared-with-vitamin-k-inhibitors-and-low-molecular-weight-heparin-for-the-prevention-of-venous-thromboembolism-in-patients-with-cancer-a-meta-analysis-study
#16
REVIEW
Natale Daniele Brunetti, Enrico Gesuete, Luisa De Gennaro, Michele Correale, Pasquale Caldarola, Antonio Gaglione, Matteo Di Biase
BACKGROUND: Prior meta-analysis studies showed that direct oral anticoagulants (DOAs) are as effective and safe as warfarin for the prevention of recurrences in patients with venous thrombo-embolism(VTE) and cancer. However, randomized studies also showed that low-molecular-weight-heparin (LMWH) performs better than warfarin in subjects with cancer. We therefore aimed to assess whether, even after pooling data with warfarin and LMWH, the use of DOAs remains safe and effective. METHODS: We performed a meta-analysis of randomized controlled trials with the aim of assessing the efficacy and safety of DOAs in patients with VTE and cancer...
December 27, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/28058458/-vitamin-k-antagonists-is-their-prescription-really-medical-malpractice-%C3%A2-today
#17
E Rafflenbeul, J Müller-Ehmsen
Atrial fibrillation and venous thromboembolisms are frequent cardiovascular diseases. Until a few years ago only vitamin K antagonists (VKA) were available for oral anticoagulation as primary and secondary prevention of thrombembolic events. Currently, the non-vitamin K dependent new oral anticoagulants (NOAC) dabigatran, rivaroxaban, apixaban and edoxaban are approved for use. The approval studies, meta-analyses and data from registries provide evidence for the superiority of NOAC vs. VKA with respect to reduction of thrombembolisms and reduced bleeding complications; therefore, in the 2016 European Society of Cardiology (ESC) guidelines the use of NOAC is recommended as first line therapy for anticoagulation in atrial fibrillation (recommendation grade I/evidence level A)...
January 2017: Der Internist
https://www.readbyqxmd.com/read/28056795/bleeding-outcomes-associated-with-rivaroxaban-and-dabigatran-in-patients-treated-for-atrial-fibrillation-a-systematic-review-and-meta-analysis
#18
Pravesh Kumar Bundhun, Mohammad Zafooruddin Sani Soogund, Abhishek Rishikesh Teeluck, Manish Pursun, Akash Bhurtu, Wei-Qiang Huang
BACKGROUND: Warfarin is commonly used as a secondary prevention of stroke in patients with atrial fibrillation (AF). However, limitations have been observed even with the use of this medication. Recently, several newer direct oral anticoagulants (DOACs) have been approved for use by the food and drug administrations. Unfortunately, these newer drugs have seldom been compared directly with each other. Therefore, this study aimed to compare the bleeding events associated with rivaroxaban and dabigatran in patients treated for non-valvular AF...
January 6, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28054341/intermittent-pneumatic-compression-in-combination-with-low-molecular-weight-heparin-in-the-prevention-of-venous-thromboembolic-events-in-esophageal-cancer-surgery
#19
Kevin Parry, Amir-Hossein Sadeghi, Sylvia van der Horst, Jan Westerink, Jelle P Ruurda, Richard van Hillegersberg
INTRODUCTION: Aim of this study was to evaluate the use of Intermittent Pneumatic Compression (IPC) in the prevention of symptomatic venous thromboembolic events (VTE) in patients undergoing esophagectomy for cancer. METHODS: From a prospective database, all patients operated between 2010 and 2014 received IPC in addition to LMWH and were compared to a historical cohort of patients treated LMWH only (2004-2009). RESULTS: Of the 313 included patients, 195 (62%) received IPC...
January 5, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28053389/is-pre-operative-assessment-of-coagulation-profile-with-thrombelastography-teg-useful-in-predicting-venous-thromboembolism-vte-following-orthopaedic-surgery
#20
Apurve Parameswaran, Vignesh P Krishnamoorthy, Anil T Oommen, Anita Jasper, Ravi J Korula, Sukesh C Nair, Pradeep M Poonnoose
INTRODUCTION: Epidemiologic data on the incidence of venous thromboembolism (VTE) in Indian population vary widely. Most studies show that the incidence of VTE is lower in Asian patients than in Western population. Screening tools to identify high-risk patients should enable us to reduce this complication. METHODS: The incidence of VTE in 101 patients who underwent knee or hip arthroplasty, or surgery for hip fractures, without chemoprophylaxis for deep vein thrombosis (DVT) was documented...
October 2016: Journal of Clinical Orthopaedics and Trauma
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