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Thromboembolism guidelines

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https://www.readbyqxmd.com/read/29680814/spect-v-q-for-the-diagnosis-of-pulmonary-embolism-protocol-for-a-systematic-review-and-meta-analysis-of-diagnostic-accuracy-and-clinical-outcome
#1
Pierre-Yves Le Roux, Philippe Robin, Cécile Tromeur, Alexandra Davis, Helia Robert-Ebadi, Marc Carrier, Francis Couturaud, Grégoire Le Gal, Pierre-Yves Salaun
INTRODUCTION: Single photon emission computed tomography ventilation/perfusion (SPECT V/Q) imaging has many proponents within the nuclear medicine community and has already largely replaced planar V/Q scintigraphy in daily practice for the diagnosis of pulmonary embolism (PE). However, the test is still described in clinical guidelines as an experimental test because of insufficient evidence. METHODS AND ANALYSIS: We will conduct a systematic review and a meta-analysis of diagnostic accuracy and management outcome studies involving patients evaluated with V/Q SPECT for suspected acute PE...
April 21, 2018: BMJ Open
https://www.readbyqxmd.com/read/29680485/-seclusion-and-mechanical-restraints-in-psychiatric-care-prescriptions-procedures-pharmacological-management-and-monitoring
#2
Chloé Tezenas du Montcel, Célia Kowal, Audrey Leherle, Soraya Kabbaj, Ariel Frajerman, Emmanuel Le Guen, Nora Hamdani, Franck Schürhoff, Marion Leboyer, Antoine Pelissolo, Baptiste Pignon
We will briefly summarize the French recommendations concerning the use of seclusion and mechanical restraint. Acute agitation and aggression or self-injurious activity during psychotic and manic episodes are the main indication of prescription of the coercive measures. Their prescriptions respect specific modalities that will be explained. Although they proved to be efficient, seclusion and restrain need to stay a last resort option, considering the risk of physical complications and psychological consequences...
April 18, 2018: La Presse Médicale
https://www.readbyqxmd.com/read/29680153/management-of-venous-thromboembolism-in-cancer-patients-according-to-guidelines-after-educative-measures
#3
Armelle Pillet, Floriane Minne, Rafik Belhadj Chaidi, Gilles Chapelle, Aurélie Ferru
Guidelines for venous thromboembolism treatment with curative anticoagulation in cancer patients are poorly respected. Yet, venous thromboembolism is the second leading cause of death in cancer patients, after cancer progression. The aim of this study was to re-evaluate the application of these guidelines after the implementation of educational measures for patients and caregivers, and also to assess the acceptability and tolerance of treatment by patients. On the one hand, a prospective observational study conducted in cancer patients with VTE allowed to assess the rate of compliance to guidelines...
April 18, 2018: Bulletin du Cancer
https://www.readbyqxmd.com/read/29679144/antithrombotic-therapy-in-patients-with-non-valvular-atrial-fibrillation-undergoing-percutaneous-coronary-intervention-should-we-change-our-practice-after-the-pioneer-af-pci-and-re-dual-pci-trials
#4
D Duerschmied, J Brachmann, H Darius, N Frey, H A Katus, W Rottbauer, A Schäfer, H Thiele, C Bode, Uwe Zeymer
The number of patients with atrial fibrillation undergoing percutaneous coronary intervention (PCI) is increasing. Since these patients have a CHA2 DS2 -VASc score of 1 or higher, they should be treated with oral anticoagulation to prevent stroke. However, combination therapy with oral anticoagulation for prevention of embolic stroke and dual platelet inhibition for prevention of coronary thrombosis significantly increases bleeding complications. The optimal combination, intensity and duration of antithrombotic combination therapy is still not known...
April 20, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/29675062/indications-retrieval-rate-and-complications-of-inferior-vena-cava-filters-single-center-experience-in-saudi-arabia
#5
Abdullah Bin Shabib, Fahad Alsayed, Saad Aldughaythir, Hanan Habeeb, Sumayyah Al Tamimi, Emad Masuadi, Mohsen Alzahrani, Ali Alaklabi, Azzam Alotaibi, Rajkumar Rajendram, Mosaad Almegren
BACKGROUND: Inferior vena cava (IVC) filter is indicated in patients with acute venous thromboembolism (VTE) in whom therapeutic anticoagulation is contraindicated. While prophylactic insertion of an IVC filter may be considered for patients at high risk of VTE, there are significant differences between clinical guidelines on the role of IVC filters. These discrepancies have arisen predominantly because of the paucity of data on the efficacy and safety of IVC filters. We, therefore, evaluated the indications for filter insertion, the rate of filter retrieval and complications in patients who received IVC filters at King Abdulaziz Medical City (KAMC), Riyadh, Saudi Arabia...
April 2018: Annals of Thoracic Medicine
https://www.readbyqxmd.com/read/29670522/dabigatran-added-to-dual-antiplatelet-therapy-to-treat-a-left-ventricular-thrombus-in-an-87-year-old-patient-with-myocardial-infarction-and-very-high-bleeding-risk
#6
Maria Noflatscher, Nicolas Moes, Eva-Maria Gassner, Peter Marschang
Background: A left ventricular (LV) thrombus is detected in approximately 5-10% of patients after myocardial infarction (MI). If left untreated, these LV thrombi carry a significant risk of complications including embolic stroke. According to current guidelines, anticoagulation with vitamin K antagonists (VKA) is recommended to treat a LV thrombus. Case presentation: An 87 year old patient was referred to our department with non ST-elevation MI. Five months before, he had been diagnosed with a subacute ST elevation MI, which had been treated conservatively...
2018: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/29664857/restrictive-versus-liberal-strategy-for-red-blood-cell-transfusion-a-systematic-review-and-meta-analysis-in-orthopaedic-patients
#7
Wan-Jie Gu, Xiao-Ping Gu, Xiang-Dong Wu, Hao Chen, Joey S W Kwong, Lu-Yang Zhou, Shuo Chen, Zheng-Liang Ma
BACKGROUND: Current guidelines recommend restrictive criteria for red blood-cell transfusion in most clinical settings. However, patients undergoing orthopaedic surgery may require distinct transfusion criteria since benefits and potential harm often vary considerably based on patient characteristics and surgical procedures. We aimed to assess the efficacy and safety of restrictive transfusion in patients undergoing orthopaedic surgery, especially in important subgroups. METHODS: Electronic databases were searched to identify randomized controlled trials investigating restrictive (mostly a hemoglobin level of 8...
April 18, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29663464/uninterrupted-administration-of-edoxaban-vs-vitamin-k-antagonists-in-patients-undergoing-atrial-fibrillation-catheter-ablation-rationale-and-design-of-the-eliminate-af-study
#8
Stefan H Hohnloser, John Camm, Riccardo Cappato, Hans-Christoph Diener, Hein Heidbuchel, Hans-Joachim Lanz, Lluís Mont, Carlos A Morillo, Rüdiger Smolnik, Ophelia Q P Yin, Josef Kautzner
Patients with atrial fibrillation (AF) are at an approximately 0.5% to 3% increased risk of thromboembolism during and immediately after catheter ablation. Treatment guidelines recommend periprocedural oral anticoagulation plus unfractionated heparin during ablation. Rivaroxaban and dabigatran are the only non-vitamin K oral anticoagulants for which there are randomized controlled trials assessing uninterrupted anticoagulation in patients undergoing catheter ablation of AF. Edoxaban, a direct factor Xa inhibitor, is noninferior vs warfarin for the prevention of stroke or systemic embolism with less major bleeding in patients with nonvalvular AF...
April 17, 2018: Clinical Cardiology
https://www.readbyqxmd.com/read/29662292/post-polypectomy-bleeding-and-thromboembolism-risks-associated-with-warfarin-vs-direct-oral-anticoagulants
#9
Naohiro Yanagisawa, Naoyoshi Nagata, Kazuhiro Watanabe, Tatsuhiro Iida, Mariko Hamada, Sakurako Kobayashi, Takuro Shimbo, Junichi Akiyama, Naomi Uemura
AIM: To verify the validity of the endoscopy guidelines for patients taking warfarin or direct oral anticoagulants (DOAC). METHODS: We collected data from 218 patients receiving oral anticoagulants (73 DOAC users, 145 warfarin users) and 218 patients not receiving any antithrombotics (age- and sex-matched controls) who underwent polypectomy. (1) We evaluated post-polypectomy bleeding (PPB) risk in patients receiving warfarin or DOAC compared with controls; (2) we assessed the risks of PPB and thromboembolism between three AC management methods: Discontinuing AC with heparin bridge (HPB) (endoscopy guideline recommendation), continuing AC, and discontinuing AC without HPB...
April 14, 2018: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29661489/comparison-of-the-effects-of-edoxaban-an-oral-direct-factor-xa-inhibitor-on-venous-thromboembolism-between-patients-with-and-without-cancer
#10
Satoshi Ikeda, Seiji Koga, Yuki Yamagata, Masamichi Eguchi, Daisuke Sato, Takahiro Muroya, Tsuyoshi Yonekura, Akira Tsuneto, Tsuyoshi Yoshimuta, Yuji Koide, Hiroaki Kawano, Koji Maemura
BACKGROUND: Venous thromboembolism (VTE) is a frequent and serious complication of cancer. The current guidelines in the USA and Europe recommend low-molecular weight heparin (LMWH) for the treatment of cancer-associated VTE. In Japan, LMWH is not given for the treatment of VTE; instead edoxaban, an oral direct factor Xa inhibitor, was approved for the treatment of VTE in September 2014. However, the efficacy and safety of the factor Xa inhibitor in cancer patients have not been fully elucidated...
April 13, 2018: Journal of Cardiology
https://www.readbyqxmd.com/read/29651665/evaluation-and-management-of-thromboprophylaxis-in-moroccan-hospitals-at-national-level-the-avail-mona-study
#11
Z Tazi Mezalek, C Nejjari, L Essadouni, M Samkaoui, K Serraj, W Ammouri, N Kanjaa, Z Belkhadir, B Housni, M Awab, M Faroudy, W Bono, S Kabbaj, M Akkaoui, M Barakat, R Rifai, H Charaf, A Aziz, Y Elachhab, A Azzouzi
Venous thromboembolism (VTE) is a common clinical problem that is associated with substantial morbidity and mortality. The aim of this study was to describe the clinical practices in VTE prophylaxis in university and peripheral hospitals in Morocco. This is a national, cross-sectional, multicenter, observational study assessing the management of the VTE risk in selected Moroccan hospitals (four university and three peripheral). The thromboembolic risk of the selected patients was assessed according to the American College of Chest Physicians (ACCP) guidelines (2008)...
April 12, 2018: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29650686/use-of-direct-oral-anticoagulants-in-patients-with-cancer-practical-considerations-for-the-management-of-patients-with-nausea-or-vomiting
#12
REVIEW
Hanno Riess, Cihan Ay, Rupert Bauersachs, Cecilia Becattini, Jan Beyer-Westendorf, Francis Cajfinger, Ian Chau, Alexander T Cohen, Alok A Khorana, Anthony Maraveyas, Marcos Renni, Annie M Young
Direct oral anticoagulants (DOACs) have proven efficacy and safety and are approved for use in the prevention and treatment of thromboembolic events in patients with venous thromboembolism (VTE) and those with atrial fibrillation (AF). There is no clear guidance on the use of DOACs in the significant proportion of these patients who have or will develop concomitant cancer. The occurrence of nausea and vomiting in these patients, despite implementation of guideline-recommended antiemetic strategies, is a particular concern because it may affect oral drug intake and consequently outcomes with anticoagulation therapy...
April 12, 2018: Oncologist
https://www.readbyqxmd.com/read/29649767/heparin-induced-thrombocytopenia-a-critical-appraisal-of-clinical-practice-guidelines-with-the-agree-ii-instrument
#13
Ying Wang, Zhi-Kang Ye, Ji-Feng Li, Xiang-Li Cui, Li-Hong Liu
BACKGROUND: Despite the availability of clinical practice guidelines (CPGs), the risk of death or thromboembolic complication associated with heparin-induced thrombocytopenia (HIT) remains high. Our aim was to systematically review the quality of CPGs for HIT and summarize the recommendations. METHODS: CPGs for HIT were systematically searched on PubMed, Embase, guidelines' websites, and Google up to August 6, 2017. Independently, three appraisers assessed the quality of CPGs using the Appraisal of Guidelines for Research & Evaluation II (AGREE II) instrument and extracted the data...
March 27, 2018: Thrombosis Research
https://www.readbyqxmd.com/read/29649026/evidence-review-conducted-for-the-agency-for-healthcare-research-and-quality-safety-program-for-improving-surgical-care-and-recovery-focus-on-anesthesiology-for-colorectal-surgery
#14
Kristen A Ban, Melinda M Gibbons, Clifford Y Ko, Elizabeth C Wick, Maxime Cannesson, Michael J Scott, Michael C Grant, Christopher L Wu
The Agency for Healthcare Research and Quality, in partnership with the American College of Surgeons and the Johns Hopkins Medicine Armstrong Institute for Patient Safety and Quality, has developed the Safety Program for Improving Surgical Care and Recovery (ISCR), which is a national effort to disseminate best practices in perioperative care to more than 750 hospitals across multiple procedures in the next 5 years. The program will integrate evidence-based processes central to enhanced recovery and prevention of surgical site infection, venous thromboembolic events, catheter-associated urinary tract infections with socioadaptive interventions to improve surgical outcomes, patient experience, and perioperative safety culture...
April 11, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29644411/noac-monotherapy-in-patients-with-concomitant-indications-for-oral-anticoagulation-undergoing-transcatheter-aortic-valve-implantation
#15
Nicolas A Geis, Christina Kiriakou, Emmanuel Chorianopoulos, Lorenz Uhlmann, Hugo A Katus, Raffi Bekeredjian
AIMS: Antithrombotic therapy after transcatheter aortic valve implantation (TAVI) is highly controversial and guideline recommendations are not evidence based. We assessed efficacy and safety of non-vitamin K antagonist oral anticoagulant (NOAC) monotherapy in patients with concomitant indications for OAC undergoing TAVI. METHODS: Among more than 1300 TAVI patients since 2008, 154 patients were identified who received postinterventional NOAC monotherapy. Outcomes were compared to 172 patients treated with vitamin K antagonist (VKA) monotherapy...
April 11, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/29620660/nurses-objective-knowledge-regarding-venous-thromboembolism-prophylaxis-a-national-survey-study
#16
Yu-Fen Ma, Yuan Xu, Ya-Ping Chen, Xiao-Jie Wang, Hai-Bo Deng, Yu He, Xin-Juan Wu
Venous thromboembolism (VTE) is a common vascular disorder with high mortality and morbidity. Clinical nurses are a pivotal group that can serve as first-line health care providers. Lack of knowledge about VTE is an important barrier to effective nursing performance. This study aimed to determine nurses' knowledge of VTE prophylaxis through a nationwide survey across China, to understand gaps between current knowledge, and guidelines, and to help improve clinical nursing.The survey included 5 topics with 68 items on VTE, including basic knowledge, risk assessment, basic prophylaxis, physical prophylaxis, and pharmacological prophylaxis...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29617053/efficacy-and-safety-of-rivaroxaban-compared-to-enoxaparin-in-treatment-of-cancer-associated-venous-thromboembolism
#17
Benjamin Simmons, Waldemar Wysokinski, Rayya A Saadiq, Dalene Bott-Kitslaar, Stanislav Henkin, Ana Casanegra, Charles Lenz, Paul Daniels, Haraldur Bjarnason, Emily Vargas, David Hodge, Sara J Holton, James R Cerhan, Charles Loprinzi, Robert McBane
BACKGROUND: Low molecular weight heparin (LMWH) is the guideline endorsed treatment for cancer associated venous thromboembolism (cVTE). Study objectives were to compare the efficacy and safety of rivaroxaban and enoxaparin in cVTE. METHODS: Using a cohort study design, consecutive patients with cVTE (3/1/2013-7/31/2016), enrolled in the Mayo Thrombophilia Clinic Direct Oral Anticoagulants Registry were compared to contemporary cancer patients receiving enoxaparin...
April 4, 2018: European Journal of Haematology
https://www.readbyqxmd.com/read/29614524/international-normalized-ratio-targets-for-left-sided-mechanical-valve-replacement
#18
Saurabh Gupta, Emilie P Belley-Cote, Anisha Sarkaria, Arjun Pandey, Jessica Spence, Graham McClure, Puru Panchal, Iqbal H Jaffer, Kevin An, John Eikelboom, Richard P Whitlock
BACKGROUND:  Guidelines recommend higher international normalized ratio (INR) targets for patients with mechanical valves believed to be at higher risk for thromboembolism. Higher INR targets are associated with increased bleeding risk. We performed a systematic review and meta-analysis assessing effects of lower and higher INR targets on thromboembolic and bleeding risk in patients with mechanical heart valves. METHODS:  We searched Cochrane CENTRAL, MEDLINE and EMBASE for randomized controlled trials (RCTs) evaluating lower versus higher INR targets for adults with bileaflet mechanical valves...
April 3, 2018: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/29613956/optimal-timing-of-initiation-of-thromboprophylaxis-in-spine-trauma-managed-operatively-a-nationwide-propensity-matched-analysis-of-trauma-quality-improvement-program
#19
Muhammad Zeeshan, Muhammad Khan, Terence O'Keeffe, Nina Pollack, Mohammad Hamidi, Narong Kulvatunyou, Joseph V Sakran, Lynn Gries, Bellal Joseph
INTRODUCTION: Patients with spinal trauma are at high-risk for venous-thromboembolism(VTE). Guidelines recommend prophylactic anticoagulation but they are unclear on timing of initiation of thromboprophylaxis. The aim of our study was to assess the impact of early vs late initiation of venous thromboprophylaxis in patients with spinal trauma who underwent operative intervention. METHODS: We performed a 2-year (2013-14) review of patients with isolated spine trauma (S-AIS≥3 and no other injury in another body region with AIS>2) who underwent operative intervention and received thromboprophylaxis post-operatively...
April 2, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29611483/management-of-antithrombotic-therapy-in-patients-with-coronary-artery-disease-or-atrial-fibrillation-who-underwent-abdominal-surgical-operations
#20
Dimitrios Schizas, Maria Kariori, Konstantinos Dean Boudoulas, Gerasimos Siasos, Nikolaos Patelis, Charalampos Kalantzis, Moldovan Carmen-Maria, Manolis Vavuranakis
BACKGROUND: Patients treated with antithrombotic therapy that require abdominal surgical procedures has progressively increased overtime. The management of antithrombotics during both the peri- and post- operative period is of crucial importance. METHODS: The goal of this review is to present current data concerning the management of antiplatelets in patients with coronary artery disease and of anticoagulants in patients with atrial fibrillation who had to undergo abdominal surgical operations...
April 2, 2018: Current Pharmaceutical Design
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