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https://www.readbyqxmd.com/read/28938283/effect-of-tranexamic-acid-on-transfusion-a-randomized-clinical-trial-in-acetabular-fracture-surgery
#1
William D Lack, Brett D Crist, Rachel B Seymour, William Harvin, Madhav A Karunakar
OBJECTIVES: Given the increasing evidence that minimizing blood loss and limiting allogeneic transfusion can improve patient outcome, we are performing a randomized controlled trial of the use of tranexamic acid (TXA) during acetabular fracture surgery. DESIGN: Prospective, multicenter, and randomized. SETTING: Two level I trauma centers. PARTICIPANTS: Eighty-eight patients underwent randomization, with 42 assigned to the TXA group and 46 assigned to the placebo group...
October 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28938282/efficacy-and-safety-of-tranexamic-acid-in-orthopaedic-fracture-surgery-a-meta-analysis-and-systematic-literature-review
#2
Kamil M Amer, Saqib Rehman, Kamal Amer, Christopher Haydel
BACKGROUND: Tranexamic acid (TXA) is an antifibrinolytic drug that has been shown to be effective in reducing blood loss and the need for transfusions after several orthopaedic surgeries. However, the effectiveness of TXA use in orthopaedic fracture surgeries still remains unclear. The purpose of this meta-analysis was to review existing literature with interest in the effectiveness and safety of TXA treatment in reducing total blood loss and transfusion rates for patients who underwent surgery for fracture repairs...
October 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28938281/tranexamic-acid-in-orthopaedic-trauma-surgery-a-meta-analysis
#3
Elizabeth B Gausden, Rameez Qudsi, Myles D Boone, Brian OʼGara, Joseph J Ruzbarsky, Dean G Lorich
AIM: To systematically review and quantify the efficacy of tranexamic acid (TXA) use in reducing the risk of receiving a blood transfusion in patients undergoing orthopaedic trauma surgery, in reducing blood loss, and risk of thromboembolic events. METHODS: A systematic literature search was performed using MEDLINE, Embase, ClinicalTrials.gov, and conference proceeding abstracts from 2014 to 2016. A minimum of 2 reviewers screened each study and graded quality. The primary outcome measure was the risk of receiving a blood transfusion in the TXA group versus control...
October 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28937561/venous-thromboembolism-an-unrecognized-crisis-in-gynecologic-oncology
#4
Edward M Lichten
No abstract text is available yet for this article.
October 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28937086/pulmonary-thromboembolism-as-first-presentation-of-childhood-membranous-nephropathy
#5
Mohit Madken, Shankar Prasad Nagaraju, Ravindra Prabhu Attur, Mahesha Vankalakunti
Nephrotic syndrome is associated with an increased risk of thromboembolism. Pulmonary thromboembolism has been described in nephrotic syndrome with or without deep vein thrombosis. In this case report, we describe an unusual first presentation of childhood membranous nephropathy with massive pulmonary thrombus with pulmonary infarction with right renal vein thrombosis.
September 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28936998/venous-thromboembolism-due-to-hyperhomocysteinaemia-and-tuberculosis
#6
Ankush Chaudhary, Unnati Desai, Jyotsna M Joshi
An 18-year-old male presented to our hospital with complaints of episodic abdominal pain, dry cough and right pleuritic chest pain. He was diagnosed as a case of right tuberculous pleural effusion on the basis of the pleural fluid Genexpert report of Mycobacterium tuberculosis detected sensitive to rifampicin and was started on antituberculous therapy. Forty-five days later, he presented with acute onset breathlessness, swelling of the right leg, streaky haemoptysis and a fresh left-sided pleural effusion. Evaluation revealed venous thromboembolism (right lower lobar segment pulmonary embolism with right leg deep vein thrombosis)...
May 2017: National Medical Journal of India
https://www.readbyqxmd.com/read/28936124/the-risk-of-venous-thromboembolism-associated-with-peripherally-inserted-central-catheters-in-ambulant-cancer-patients
#7
Daniel Jones, Kurt Wismayer, George Bozas, June Palmer, Mandi Elliott, Anthony Maraveyas
BACKGROUND: Deep vein thrombosis (DVT) is a common complication of peripherally inserted central catheters (PICCs). PICCs are increasingly utilised in the management of cancer patients, a group which carries both additional risks for vascular thromboembolism as well as for complex morbidity. We analysed a cohort of cancer patients subjected to PICC insertion in a single cancer centre for the incidence of all-type vascular thromboembolism (VTE) and investigated relative risk factors. METHODS: In this clinical audit, the records of patients referred for PICC insertion in our centre in the period between 1/1/2011 and 1/4/2014 were retrospectively reviewed...
2017: Thrombosis Journal
https://www.readbyqxmd.com/read/28935927/effects-of-ticagrelor-in-a-mouse-model-of-ischemic-stroke
#8
Keita Yamauchi, Takahiko Imai, Masamitsu Shimazawa, Toru Iwama, Hideaki Hara
Ticagrelor is a direct acting and reversibly binding P2Y12 antagonist approved for the prevention of thromboembolic events. Its potential benefits in ischemic stroke have not been investigated sufficiently. Mice were subjected to 2 hours of transient middle cerebral artery occlusion (MCAO). Mice were orally treated with ticagrelor (10 or 30 mg/kg), aspirin (60 mg/kg), or vehicle at 3 and 24 hours before MCAO and 0 and 6 hours after reperfusion. The infarct volume and neurological deficits 22 hours after reperfusion were evaluated...
September 21, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28935831/anti-inflammatory-approaches-to-ischaemic-stroke-prevention
#9
REVIEW
Peter J Kelly, Sean Murphy, Sarah Coveney, Francisco Purroy, Robin Lemmens, Georgios Tsivgoulis, Chris Price
Stroke is a major cause of neurological morbidity and mortality. Atherosclerosis is a major contributor to first and recurrent stroke. A growing evidence base indicates that inflammation is a key process in the pathogenesis of atherosclerosis, leading to thromboembolic events. In this review, we summarise the evidence linking inflammation to stroke risk and discuss clinical trials addressing the 'inflammation hypothesis' in coronary disease and stroke.Trial registration number CONVINCE trial ClinicalTrials...
September 21, 2017: Journal of Neurology, Neurosurgery, and Psychiatry
https://www.readbyqxmd.com/read/28935434/diagnosis-of-venous-thromboembolism-in-pregnancy
#10
Wee-Shian Chan
The diagnosis of deep vein thrombosis (DVT) and pulmonary embolism (PE) during pregnancy still relies on objective imaging. Ancillary testing such as clinical prediction rules and D-dimer testing may have a role in excluding both DVT and PE in these pregnant patients even as we await results from prospective management studies. The anatomical distribution of DVT in pregnancy differs from those in non-pregnant patient with a greater propensity for proximal iliac vein thrombosis. Using leg ultrasonography with compression maneuvers from the femoral vein to popliteal vein and doppler assessment of the iliac vein in a single examination, appears adequate in most pregnant women with suspected DVT, in excluding DVT...
September 5, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28934665/venous-thromboembolism-in-children-with-cystic-fibrosis-retrospective-incidence-and-intrapopulation-risk-factors
#11
Jessica Knight-Perry, Brian R Branchford, Dianne Thornhill, Stacey L Martiniano, Scott D Sagel, Michael Wang
INTRODUCTION: Pediatric venous thromboembolism (VTE) is a rare but serious medical condition. Cystic fibrosis (CF) is a risk for recurrent pediatric VTE and has potential thrombophilic tendency. However, much remains unknown, including incidence and intrapopulation risk factors. METHODS: A retrospective cohort of pediatric CF patients followed at Children's Hospital Colorado from January 1st 2003 through May 20th 2016 was examined. Cases were identified by informatics and validated manually...
September 5, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28934519/intra-pericardial-use-of-recombinant-factor-viia-in-a-patient-with-acute-hemorrhagic-pericardial-effusion-following-transcutaneous-aortic-valve-replacement-a-case-report
#12
Vanya Jaitly, Kimberly Klein, Hlaing Tint, Alice Chen, Paul Allison, Bindu Akkanti, Pranav Loyalka, Brian Castillo
Perioperative bleeding can be a serious life-threatening complication in adult patients undergoing cardiac surgery, given the older age and additional comorbidities present in this patient population. The standard treatment options include transfusion of blood components and surgical re-exploration. We report the first case of an elderly female patient treated with local administration of recombinant factor VIIa (rFVIIa) for intractable hemorrhagic pericardial effusion, which developed following a transcutaneous aortic valve replacement (TAVR) procedure for severe aortic stenosis...
August 1, 2017: Laboratory Medicine
https://www.readbyqxmd.com/read/28934410/approach-to-cardio-oncologic-patients-with-special-focus-on-patients-with-cardiac-implantable-electronic-devices-planned-for-radiotherapy-results-of-the-european-heart-rhythm-association-survey
#13
Radoslaw Lenarczyk, Tatjana S Potpara, Kristina H Haugaa, Jean-Claude Deharo, Antonio Hernandez-Madrid, Maria Del Carmen Exposito Pineda, Marek Kiliszek, Nikolaos Dagres
The aim of this European Heart Rhythm Association (EHRA) survey was to evaluate clinical practice regarding cardio-oncologic patients, with special focus on patients with cardiac implantable electronic devices (CIEDs) planned for anticancer radiotherapy (RT), among members of the EHRA electrophysiology research network. Of the 36 responding centres, 89% managed patients who were diagnosed or treated oncologically, and this diagnosis affected 1-5% of cardiovascular patients in majority of centres (57%). The main side effects of anticancer therapy in patients treated by cardiologists were thromboembolic complications and left ventricular dysfunction (both reported as 'frequent' by 43% of the centres)...
September 1, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28933799/rivaroxaban-for-preventing-venous-thromboembolism-in-high-risk-ambulatory-patients-with-cancer-rationale-and-design-of-the-cassini-trial-rationale-and-design-of-the-cassini-trial
#14
Alok Khorana, Saroj Vadhan-Raj, Nicole M Kuderer, Ted Wun, Howard Liebman, Gerald Soff, Chandra Belani, Eileen M O'Reilly, Robert McBane, John Eikelboom, C V Damaraju, Karen Beyers, Flavia Dietrich, Ajay Kakkar, Hanno Riess, Renata D'Alpino Peixoto, Gary H Lyman
Venous thromboembolism (VTE) is a frequent complication of cancer associated with morbidity, mortality, increased hospitalizations and higher health care costs. Cancer patients at increased risk for VTE can be identified using a validated risk assessment score, and the incidence of VTE can be reduced in high-risk settings using anticoagulation. Rivaroxaban is a potent, oral, direct, factor Xa inhibitor approved for the prevention and treatment of thromboembolic events, including VTE. CASSINI is a double-blind, randomized, parallel-group, multicentre study comparing rivaroxaban with placebo in adult ambulatory patients with various cancers who are initiating systemic cancer therapy and are at high risk of VTE (Khorana score ≥ 2)...
September 21, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28933640/the-impact-of-antithrombin-deficiency-on-women-s-reproductive-health-experiences-and-healthcare-decision-making
#15
Ariela L Marshall, Juliana Perez Botero, Aneel A Ashrani, Rajiv K Pruthi, John A Heit, Ashish Chintakuntlawar, Jennifer C Guenther, Mrinal M Patnaik
BACKGROUND: Women with inherited antithrombin (AT) deficiency are at high risk for venous thromboembolism (VTE), especially during times of estrogen exposure, but little is known about patient-oriented reproductive decision-making in this population. MATERIALS AND METHODS: Provider-administered survey of women with AT deficiency. Participants were asked to discuss their diagnosis of AT deficiency and questioned about (1) contraception, (2) pregnancies, and (3) menorrhagia, and the impact of their AT deficiency on each reproductive health experience...
September 21, 2017: Journal of Women's Health
https://www.readbyqxmd.com/read/28932938/assessment-of-oral-anticoagulation-control-at-two-pharmacist-managed-clinics-in-brazil
#16
Rogério Guimarães de Lima Silva, Caryne Margotto Bertollo, Isadora Gonçalves Ferreira, Luisa Caldeira Brant, Maria Auxiliadora Parreiras Martins
Background Warfarin remains widely used by patients with cardiovascular diseases. When using warfarin, the quality of oral anticoagulation control is a critical determinant to minimize the risk of bleeding and thromboembolic events. Pharmacist engagement in patient care is relevant towards improving the quality of warfarin therapy. Objective To assess the quality of oral anticoagulation control measured by time in therapeutic range (TTR) at two pharmacist-managed anticoagulation clinics (AC). Method This study included adults with indication of continuous warfarin use...
September 20, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28932552/chylothorax-after-pediatric-cardiac-surgery-complicates-short-term-but-not-long-term-outcomes-a-propensity-matched-analysis
#17
Nikoletta R Czobor, György Roth, Zsolt Prodán, Daniel J Lex, Erzsébet Sápi, László Ablonczy, Mihály Gergely, Edgar A Székely, János Gál, Andrea Székely
BACKGROUND: The occurrence of postoperative chylothorax in children with congenital heart disease is a rare and serious complication in cardiac intensive care units (ICUs). The aim of our study was to identify the perioperative characteristics, treatment options, resource utilization and long term complications of patients having chylothorax after a pediatric cardiac surgery. METHODS: Patients were retrospectively assessed for the presence of chylothorax between January 2002 and December 2012 in a tertiary national cardiac center...
August 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28931509/development-and-validation-of-qmortality-risk-prediction-algorithm-to-estimate-short-term-risk-of-death-and-assess-frailty-cohort-study
#18
Julia Hippisley-Cox, Carol Coupland
Objectives To derive and validate a risk prediction equation to estimate the short term risk of death, and to develop a classification method for frailty based on risk of death and risk of unplanned hospital admission.Design Prospective open cohort study.Participants Routinely collected data from 1436 general practices contributing data to QResearch in England between 2012 and 2016. 1079 practices were used to develop the scores and a separate set of 357 practices to validate the scores. 1.47 million patients aged 65-100 years were in the derivation cohort and 0...
September 20, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28931100/-venous-thromboembolism-vte-current-diagnosis-and-therapy-with-special-attention-towards-oncologic-patients
#19
György Pfliegler
Deep vein thrombosis (DVT), pulmonary embolism (PE), or with the common name venous thromboembolism (VTE) are frequent manifestations of pathologic hemostasis in malignancies, thereby contributing to the large number of patients despite recent developments in thrombosis prevention. In the present paper up-to-date practice of diagnosis and therapy will be discussed partly based on the author's previous publications on epidemiology and prophylaxis of VTE in oncological patients.
September 20, 2017: Magyar Onkologia
https://www.readbyqxmd.com/read/28930952/military-use-of-tranexamic-acid-in-combat-trauma-does-it-matter
#20
Jeffrey T Howard, Zsolt T Stockinger, Andrew P Cap, Jeffrey A Bailey, Kirby R Gross
BACKGROUND: Tranexamic acid (TXA) has been previously reported to have a mortality benefit in civilian and combat-related trauma, and was thus added to the Joint Theater Trauma System Damage Control Resuscitation Clinical Practice Guideline. As part of ongoing system-wide performance improvement, the use of TXA has been closely monitored. The goal was to evaluate the efficacy and safety of TXA use in military casualties and provide additional guidance for continued use. METHODS: A total of 3,773 casualties were included in this retrospective, observational study of data gathered from a trauma registry...
October 2017: Journal of Trauma and Acute Care Surgery
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