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Prevention of venous thromboembolism

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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/28640782/perioperative-venous-thromboembolism-a-review
#2
Ronald J Gordon, Frederick W Lombard
Venous thromboembolism (VTE) is a significant problem in the perioperative period, increasing patient morbidity, mortality, and health care costs. It is also considered the most preventable of the major postoperative complications. Despite widespread adoption of prophylaxis guidelines, it appears that morbidity from the disease has not substantially changed within the past 2 decades. It is becoming clear that current prophylaxis efforts are not sufficient. Using more potent anticoagulants may decrease the incidence of VTE, but increase the risk for bleeding and infection...
June 20, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28640322/effectiveness-and-safety-of-rivaroxaban-versus-warfarin-for-treatment-and-prevention-of-recurrence-of-venous-thromboembolism
#3
Craig I Coleman, Craig Coleman, Thomas J Bunz, Alexander G G Turpie
The efficacy and safety or rivaroxaban versus enoxaparin/vitamin K antagonist for treatment and prevention recurrence of venous thromboembolism (VTE) was demonstrated in the randomised EINSTEIN trials. We assessed the effectiveness and safety of rivaroxaban versus warfarin in VTE patients managed in routine practice. Using US MarketScan claims from 1/2012-6/2015, we included adults with a primary diagnosis of deep vein thrombosis (DVT) or pulmonary embolism (PE) during a hospitalisation/emergency department visit, newly-initiated on rivaroxaban or warfarin within 30-days after the VTE and with ≥180-days of continuous medical/prescription benefits prior to the VTE (baseline)...
June 22, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28637842/thromboembolism-in-active-ulcerative-colitis
#4
Ian Y Goh, Stefan Saric, Paul Leschke, Mark McFarlane, Pankaj K Jha
Inflammatory bowel disease (IBD) has a range of both intestinal and extraintestinal manifestations. Thromboembolism involving the arterial and/or venous systems is rare. Early recognition and treatment of thrombosis in patients with IBD may prevent progression and minimise complications. However, clear guidelines on the duration of treatment and indications for primary prophylaxis need to be established. We report a case of a young patient with ulcerative colitis, who developed multiple site arterial and venous thrombosis, all occurring within short intervals of each other...
June 20, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28634363/long-term-health-outcomes-in-patients-with-prader-willi-syndrome-a-nationwide-cohort-study-in-denmark
#5
E Hedgeman, S P Ulrichsen, S Carter, N C Kreher, K P Malobisky, M M Braun, J Fryzek, M S Olsen
BACKGROUND: Prader-Willi syndrome (PWS) is a rare congenital disease that affects growth, sexual development, cognitive function and behavior. Individuals exhibit food preoccupation and hyperphagia, which may lead to obesity with premature morbidity and mortality. The aim of this work was to evaluate the risk of venous thromboembolisms (VTE), myocardial infarction, pulmonary hypertension, sleep apnea, depression, anxiety and all-cause mortality among persons with PWS as compared to an age- and sex-matched general population cohort...
June 21, 2017: International Journal of Obesity: Journal of the International Association for the Study of Obesity
https://www.readbyqxmd.com/read/28634095/comparative-effectiveness-and-safety-of-drug-prophylaxis-for-prevention-of-venous-thromboembolism-after-total-knee-arthroplasty
#6
Guy Cafri, Elizabeth W Paxton, Yuexin Chen, Craig T Cheetham, Michael K Gould, Janet Sluggett, Stefano A Bini, Monti Khatod
BACKGROUND: Rates of venous thromboembolism in contemporary studies of primary total knee arthroplasty (TKA) have been reported to be as high as 3.5%. Although drug prophylaxis is effective, the best option among these regimens is not well established. The purpose of this study was to evaluate the comparative effectiveness and safety of aspirin, low-molecular-weight heparin, synthetic pentasaccharide factor Xa inhibitors, and vitamin K antagonist. METHODS: Data were from a US total joint replacement registry, with 30,499 patients receiving unilateral TKA from May 16, 2006, to December 31, 2013...
May 31, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28632418/therapeutic-monitoring-of-unfractionated-heparin-trials-and-tribulations
#7
Israfil Baluwala, Emmanuel Favaloro, Leonardo Pasalic
Heparin is one of the oldest biological medicines with an established role in prevention and treatment of arterial and venous thromboembolism. Published therapeutic ranges for unfractionated heparin (UFH) mostly precede the large increase in the number of activated partial thromboplastin time (APTT) reagent/instrument combinations that now show wide variability. Areas covered: This paper explores the use of UFH, the development of heparin therapeutic ranges (HTRs), and the strengths and limitations of the methods used to monitor heparin's anticoagulant effect...
June 20, 2017: Expert Review of Hematology
https://www.readbyqxmd.com/read/28623568/evaluation-of-venous-thromboembolism-prophylaxis-in-a-major-hospital-in-a-developing-country
#8
Lubna Gharaibeh, Hanan Sartawi, Diana Ayyad, Tareq Juma, Kamal Albassoumi, Enas Ismail
Background Venous thromboembolism is the most common preventable cause of hospital death. Despite that, there is still a large gap between what we know about venous thromboembolism prophylaxis and what is happening in current practice. Objective To evaluate VTE prophylaxis in Al-Basheer hospital and assess the extent of agreement of physicians' practice with the guidelines. Setting Al-Basheer governmental hospital in Jordan between January 2016 and June 2016. Method In this cross-sectional observational study, patients were randomly selected from medical and surgical wards...
June 16, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28610674/elevated-serum-d-dimer-level-is-associated-with-an-increased-risk-of-acute-exacerbation-in-interstitial-lung-disease
#9
Genta Ishikawa, Samuel O Acquah, Mary Salvatore, Maria L Padilla
BACKGROUND: Early recognition of patients with interstitial lung disease (ILD) who have an increased risk of developing acute exacerbation (AE) or preclinical AE may be clinically useful, since AE is associated with poor outcome and preventive measures would be of interest to ILD researchers. This study evaluated the relationship between elevated serum D-dimer level (≥0.4 mcg/mL) and subsequent AE or preclinical AE in patients with ILD. METHODS: This single-center, retrospective study was performed from October 2009 through September 2015 in patients with ILD who were ≥18 years old and had idiopathic pulmonary fibrosis, other idiopathic interstitial pneumonias, chronic hypersensitivity pneumonitis, ILD related to collagen tissue disease, or combined pulmonary fibrosis/emphysema...
July 2017: Respiratory Medicine
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/28609766/should-we-screen-for-janus-kinase-2-v617f-mutation-in-cerebral-venous-thrombosis
#11
Matthias Lamy, Paola Palazzo, Pierre Agius, Jean Claude Chomel, Jonathan Ciron, Aline Berthomet, Paul Cantagrel, Julia Prigent, Pierre Ingrand, Mathieu Puyade, Jean-Philippe Neau
BACKGROUND: The presence of Janus Kinase 2 (JAK2) V617F mutation represents a major diagnostic criterion for detecting myeloproliferative neoplasms (MPN) and even in the absence of overt MPN, JAK2 V617F mutation is associated with splanchnic vein thrombosis. However, the actual prevalence and diagnostic value of the JAK2 V617F mutation in patients with cerebral venous thrombosis (CVT) are not known. The aims of this study were to assess the prevalence of JAK2 V617F mutation in a large group of consecutive CVT patients, to detect clinical, biological, and radiological features associated with the mutation, and to determine the long-term venous thrombosis recurrence rate in CVT patients with JAK2 mutation but without overt MPN in order to recommend the best preventive treatment...
June 14, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28605879/a-rct-study-of-rivaroxaban-low-molecular-weight-heparin-and-sequential-medication-regimens-for-the-prevention-of-venous-thrombosis-after-internal-fixation-of-hip-fracture
#12
Yilun Tang, Kunzheng Wang, Zhibin Shi, Pei Yang, Xiaoqian Dang
The guidelines for the prevention of venous thromboembolism in orthopedic surgeries have reached a consensus on the postoperative conventional anticoagulation. However, the choice of anticoagulant drugs is yet controversial. The use of the drug rivaroxaban is expensive. Since the compliance of patients with low-molecular-weight heparin is considerably low, a cost-effective, efficacious and convenient anticoagulant program is essential. The present study investigated the efficacy, safety, patient compliance, and cost-effectiveness of low-molecular-weight heparin with sequential Rivaroxaban anticoagulant therapy in patients with a hip fracture, following internal fixation...
June 8, 2017: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/28594794/-use-of-a-thrombin-inhibitor-for-treatment-of-deep-vein-thrombosis-and-pulmonary-thromboembolism-in-patients-with-thrombophilia
#13
A S Petrikov, Ia N Shoĭkhet, D V Dudin, I A Karbyshev
Presented herein are the results of oral administration of dabigatran etexilate for treatment and secondary prevention of lower-limb deep vein thrombosis (DVT) and pulmonary thromboembolism (PTE) in patients with established thrombophilia, studying its efficacy and safety in prolonged administration during a year as compared with warfarin. The study group included a total of fifty-seven 18-to-79-year-old patients (33 men and 24 women) with DVT and PTE, taking dabigatran etexilate. The comparison group was composed of a total of 126 patients (65 men and 61 women) with DVT and PTE, taking warfarin...
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/28594426/new-developments-in-anticoagulants-past-present-and-future
#14
Jeffrey I Weitz, Job Harenberg
Thrombosis is a leading cause of death and disability worldwide, and anticoagulants are the mainstay of its prevention and treatment. Starting with unfractionated heparin (UFH) and vitamin K antagonists (VKAs) such as warfarin, the choices of anticoagulants have exploded in the past 20 years. With over 90 % subcutaneous bioavailability, no need for coagulation monitoring and dose adjustment, and a lower risk of heparin-induced thrombocytopenia, low-molecular-weight heparin and fondaparinux have replaced UFH for prevention and initial treatment of venous thromboembolism and for secondary prevention in cancer patients...
June 8, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28583301/the-toronto-thromboprophylaxis-patient-safety-initiative-topps-a-cluster-randomised-trial
#15
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/28579397/meta-analysis-of-heparin-therapy-for-preventing-venous-thromboembolism-in-acute-spinal-cord-injury
#16
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/28577388/recurrence-of-venous-thromboembolism-among-adults-acute-leukemia-patients-treated-at-the-university-of-texas-md-anderson-cancer-center-incidence-and-risk-factors
#17
Nhiem V Luong, Michael H Kroll, Khanh Vu
The purpose was to determine the incidence and risk factors for venous thromboembolism (VTE) recurrence among adult acute leukemia patients. We performed a retrospective study of adult acute leukemia patients who were treated at our institution between November 1999 and May 2005. Medical records of 139 patients with an initial VTE were reviewed and followed up to May 2010 for VTE recurrence. Of these 139 patients [86 with acute myelogenous leukemia (AML), 53 with acute lymphocytic leukemia (ALL)], 27 (19.4%, 16 AML and 11 ALL) had VTE recurrence...
May 24, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28567119/direct-oral-anticoagulants-and-digestive-bleeding-therapeutic-management-and-preventive-measures
#18
REVIEW
David Deutsch, Christian Boustière, Emile Ferrari, Pierre Albaladejo, Pierre-Emmanuel Morange, Robert Benamouzig
The use of direct oral anticoagulants (DOACs) was an important step forward in the management of atrial fibrillation and venous thromboembolism (VTE). The DOACs, anti-IIa for dabigatran and anti-Xa for rivaroxaban, apixaban and edoxaban, all have a rapid onset of action and a short half life. There is no need for routine hemostasis testing for treatment monitoring of a DOAC. Compared with vitamin K antagonists (VKAs), DOACs may increase the risk of gastrointestinal bleeding (relative risk 1.25). Withholding the DOAC treatment, evaluating the time of the last intake and estimating the patient's renal function are the first steps in the management of gastrointestinal bleeding...
June 2017: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/28557900/controversies-in-venous-thromboembolism
#19
Suman Yadam, Anand Popuri, Yousef Hattab, Tariq Cheema
Numerous controversies exist in the diagnosis of venous thromboembolism despite all the guidelines that are currently available. Screening of malignancy in venous thromboembolism has been a debated issue, as it has not been shown to change mortality. Calf vein thrombosis is also a controversial topic, but evidence points to risk stratifying those patients. Overdiagnosis, most notably from the finding of subsegmental pulmonary embolism, ultimately requires evaluating the risk and benefit for each patient. In addition, treatment of upper extremity deep vein thrombosis is a challenging scenario that is quite common in clinical practice...
July 2017: Critical Care Nursing Quarterly
https://www.readbyqxmd.com/read/28557893/prophylaxis-for-venous-thromboembolism
#20
Kiet Ma, Sulaiman Alhassan, Rihab Sharara, Meilin Young, Anil C Singh, Eric Bihler
Venous thromboembolisms are major risk factors for many of our hospitalized patients. These events, however, can be prevented with prophylactic measurements when administered appropriately and on a timely basis. As patients are admitted, discharged, transferred, and scheduled for procedures on an hourly basis, anticoagulation and deep vein thrombosis prophylaxis are held or discontinued in anticipation for possible procedures. This results in delay of care and intervals where patients may not be covered with any prophylactic measurements...
July 2017: Critical Care Nursing Quarterly
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