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Thromboembolism guidelines

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https://www.readbyqxmd.com/read/29441513/evaluation-of-indications-for-reduced-dose-noacs-in-hospitalized-atrial-fibrillation-patients
#1
Olga Jelonek, Iwona Gorczyca, Michał Bączek, Paweł Kośmider, Beata Wożakowska-Kapłon
BACKGROUND: Prevention of thromboembolic complications is a priority in patients with atrial fibrillation (AF). The use of non-vitamin K antagonist oral anticoagulants (novel oral anticoagulants, NOAC) is more common, and some patients have indications for a reduced dose of NOAC. AIM: The aim of the study was to evaluate the frequency of NOACs being prescribed to AF patients and to compare the groups of AF patients receiving standard and reduced doses of NOACs. METHODS: The study was conducted in a population of 1,327 patients diagnosed with AF and hospitalized at an institution of the highest referral level in cardiology in years 2015-2016...
February 14, 2018: Kardiologia Polska
https://www.readbyqxmd.com/read/29433369/postpartum-thromboprophylaxis-in-a-multireligious-cohort-a-retrospective-review-of-indications-and-uptake
#2
Hian Yan Voon, Ming Cheng Chai, Ling Yien Hii, Rafaie Amin, Haris Njoo Suharjono
Strategies to prevent mortality from obstetric venous thromboembolism begin with identification, risk stratification and subsequently, implementation of prophylactic measures. We sought to identify the burden of pharmacologic thromboprophylaxis in postpartum women, including the main clinical indications and its uptake in a multireligious population, with Islam as the official religion. A total of 2514 deliveries between 1st January to 31st December 2016, across three centres in Malaysia were reviewed retrospectively from hospital-based registries...
February 12, 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29432374/development-of-an-outpatient-guideline-for-optimal-anticoagulation-bridging-in-patients-with-durable-mechanical-circulatory-support
#3
Amy A Levesque, Jessica M Rimsans, Katelyn W Sylvester, Erin N Lyons, Katie A Frankel, Lara L Coakley, Maryclare Hickey, Krystin A Montoya, Mandeep R Mehra, Michael M Givertz, Garrick C Stewart, Jean M Connors
Patients with durable mechanical circulatory support are at increased risk of thromboembolic and bleeding complications. Current guidelines recommend that these patients receive chronic anticoagulation with warfarin to maintain a target international normalized ratio (INR) as specified by device manufacturers. Limited data exist regarding management of subtherapeutic INRs in this setting. To standardize clinical practice at our institution, we assembled a multidisciplinary task force including members from various specialties to develop a guideline for managing subtherapeutic INRs that incorporates published data and expert opinion...
March 2018: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/29427461/thromboembolism-prophylaxis-in-patients-with-philadelphia-negative-myeloproliferative-neoplasms-clinical-practice-among-nordic-specialists
#4
O W Bjerrum, J Samuelsson, W Ghanima, M Kauppila, C L Andersen
BACKGROUND: Patients with Philadelphia chromosome-negative myeloproliferative neoplasms (MPNs) have higher risks of developing thromboembolisms compared to the general population. International guidelines on the management of MPNs therefore include recommendations concerning thromboembolism prophylaxis. In clinical practice strict adherence to guidelines may be challenging and dependent on factors such as physician experience, outpatient clinic setting and access to therapy, however, no data exist on physician adherence or patient compliance to thromboembolism prophylaxis in MPNs...
February 10, 2018: European Journal of Haematology
https://www.readbyqxmd.com/read/29415816/-impact-of-the-2009-afssaps-guidelines-on-the-management-of-venous-thromboembolic-disease-in-emergency-department-before-after-study
#5
L De Massari, Y Jamilloux, J-C Lega, A Sigal, X Jacob, K Tazarourte, K Mensah, P Sève
INTRODUCTION: The French Agency for Health Safety of Products published recommendations of good practices (RGP) for the treatment of venous thromboembolic disease in 2009. Four of these recommendations apply to the initial management of the disease, with the objective of this study is to determine whether the development and diffusion of the four RGP has had an impact on the practice. METHODS: A retrospective before/after study comparing 132 patients treated in emergency department of the Civil Hospices of Lyon for pulmonary embolism (PE) and/or deep venous thrombosis (DVT) in 2008-2009 ("before") and 153 patients in 2010-2011 ("after")...
February 4, 2018: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/29410171/how-fragile-are-clinical-trial-outcomes-that-support-the-chest-clinical-practice-guidelines-for-venous-thromboembolism
#6
Elizabeth Edwards, Cole Wayant, Jonathan Besas, Justin Chronister, Matt Vassar
BACKGROUND: Venous thromboembolism (VTE) remains a health concern for global populations. Clinical practice guidelines are necessary to guide physicians in the prophylaxis and treatment of VTE. METHODS: Our investigation assessed the robustness of the underlying evidence in 21 randomized controlled trials (RCTs) used to support treatment recommendations in the 2016 CHEST Guideline and Expert Panel Report on Antithrombotic Therapy for VTE Disease. We calculated the fragility index and fragility quotient for qualifying outcomes within RCTs...
February 1, 2018: Chest
https://www.readbyqxmd.com/read/29409308/a-prospective-multicenter-study-evaluating-bleeding-risk-after-endoscopic-ultrasound-guided-fine-needle-aspiration-in-patients-prescribed-antithrombotic-agents
#7
Kazumichi Kawakubo, Kei Yane, Kazunori Eto, Hirotoshi Ishiwatari, Nobuyuki Ehira, Shin Haba, Ryusuke Matsumoto, Keisuke Shinada, Hiroaki Yamato, Taiki Kudo, Manabu Onodera, Toshinori Okuda, Yoko Taya-Abe, Shuhei Kawahata, Kimitoshi Kubo, Yoshimasa Kubota, Masaki Kuwatani, Hiroshi Kawakami, Akio Katanuma, Michihiro Ono, Tsuyoshi Hayashi, Minoru Uebayashi, Naoya Sakamto
Background/Aims: Although the risk of bleeding after endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is low, the safety of EUS-FNA in patients prescribed antithrombotic agents is unclear. Therefore, this study evaluated the incidence of bleeding after EUS-FNA in those patients. Methods: Between September 2012 and September 2015, patients who were prescribed antithrombotic agents underwent EUS-FNA at 13 institutions in Japan were prospectively enrolled in the study...
February 8, 2018: Gut and Liver
https://www.readbyqxmd.com/read/29408946/poor-adherence-to-risk-stratification-guidelines-results-in-overuse-of-venous-thromboembolism-prophylaxis-in-hospitalized-older-adults
#8
Juliessa M Pavon, Richard J Sloane, Carl F Pieper, Cathleen S Colón-Emeric, Harvey J Cohen, David Gallagher, Miriam C Morey, Midori McCarty, Thomas L Ortel, Susan N Hastings
No abstract text is available yet for this article.
February 6, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29404935/the-effect-of-obesity-on-anti-xa-concentrations-in-bariatric-patients
#9
W Schijns, M J Deenen, E O Aarts, J Homan, I M C Janssen, F J Berends, K A H Kaasjager
BACKGROUND: Morbidly obese patients are at increased risk to develop venous thromboembolism (VTE), especially after bariatric surgery. Adequate postoperative thrombosis prophylaxis is of utmost importance. It is assumed that morbidly obese patients need higher doses of low molecular weight heparin (LMWH) compared to normal-weight patients; however, current guidelines based on relative efficacy in obese populations are lacking. OBJECTIVES: First, we will evaluate the relationship between body weight descriptors and anti-Xa activity prospectively...
February 5, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29399521/thrombosis-in-cancer-patients-etiology-incidence-and-management
#10
REVIEW
Rahul A Sheth, Andrew Niekamp, Keith B Quencer, Fadi Shamoun, Martha-Gracia Knuttinen, Sailendra Naidu, Rahmi Oklu
Venous thromboembolism (VTE) is the second most common cause of mortality in cancer patients. The mechanisms of cancer-associated thrombosis (CAT), much like cancer itself, are multi-factorial and incompletely understood. Cancer type, stage, tumor-derived factors and genetics all affect CAT risk. Furthermore, cancer therapies as well as the indwelling vascular devices through which these therapies are delivered can increase the risk for CAT. In this review, we summarize mechanisms of hypercoagulability in cancer patients, patterns of thrombosis associated with cancer, current guidelines for the diagnosis and management of CAT, and important considerations regarding the placement of implantable vascular devices in the care of cancer patients with VTE...
December 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/29390512/venous-thromboembolism-related-to-cytomegalovirus-infection-a-case-report-and-literature-review
#11
Amar H Kelkar, Kavitha S Jacob, Eman B Yousif, John J Farrell
RATIONALE: Herein, we present a case of seemingly unprovoked portal vein thrombosis (PVT) occurring in the context of an acute cytomegalovirus (CMV) infection and prolonged debilitating fatigue. PATIENT CONCERNS: A 46-year-old male airline pilot presented with a 2 week history of abdominal pain, nausea, vomiting, watery diarrhea, and daily recurrent fevers. This was in the context of progressive, debilitating fatigue for 3 months forcing the patient to leave his job...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29388467/emerging-therapeutics-in-pulmonary-hypertension
#12
Matthew K Hensley, Andrea Levine, Mark T Gladwin, Yen-Chun Lai
Pulmonary hypertension (PH) is a progressive and often fatal illness presenting with nonspecific symptoms of dyspnea, lower extremity edema, and exercise intolerance. Pathologically, endothelial dysfunction leads to abnormal intimal and smooth muscle proliferation along with reduced apoptosis, resulting in increased pulmonary vascular resistance (PVR) and elevated pulmonary pressures. PH is subdivided into five WHO groups based on the disease pathology and specific cause. While there are FDA-approved medications for the treatment of pulmonary arterial hypertension (PAH, Group 1 PH), as well as for chronic thromboembolic pulmonary hypertension (CTEPH, Group 4 PH), the morbidity and mortality remain high...
February 1, 2018: American Journal of Physiology. Lung Cellular and Molecular Physiology
https://www.readbyqxmd.com/read/29385248/guideline-quick-view-venous%C3%A2-thromboembolism
#13
(no author information available yet)
No abstract text is available yet for this article.
February 2018: AORN Journal
https://www.readbyqxmd.com/read/29384974/efficacy-and-safety-of-tranexamic-acid-in-total-hip-replacement-a-prisma-compliant-meta-analysis-of-25-randomized-controlled-trials
#14
Jianxi Zhu, Yong Zhu, Pengfei Lei, Min Zeng, Weiping Su, Yihe Hu
BACKGROUND: Hip osteoarthritis is one of the most prevalent musculoskeletal degenerative diseases in elderly. Total hip arthroplasty (THA) is the most effective surgical treatment for end stage hip osteoarthritis. Tranexamic acid (TA) is a potent drug to reduce surgical blood loss in surgery, therefore, as a potential drug for application in THA. OBJECTIVES: To identify the combined efficacy of TA administration in THA. A meta-analysis including 25 randomized controlled trials was conducted for generating synthesized effects...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29382561/optimal-timing-of-initiation-of-thromboprophylaxis-after-nonoperative-blunt-spinal-trauma-a-propensity-matched-analysis
#15
Muhammad Khan, Faisal Jehan, Terence O'Keeffe, Mohammad Hamidi, Michael Truitt, Muhammad Zeeshan, Lynn Gries, Andrew Tang, Bellal Joseph
BACKGROUND: Patients with spinal trauma have the highest risk of a venous thromboembolism. While anticoagulation is recommended, its optimal timing is not well-defined. We aimed to assess the impact of early initiation of thromboprophylaxis in spinal trauma patients who were managed non-operatively. STUDY DESIGN: A 2-year (2013-2014) analysis of all isolated spinal-trauma patients managed non-operatively who received thromboprophylaxis in the TQIP. Patients were divided into two groups based on timing of initiation of thromboprophylaxis: Early (<48hours) and Late (≥48hours), and were matched in a 1:1 ratio using propensity score matching for demographics, admission vitals, injury severity, level of spine-injury and type of prophylaxis...
January 27, 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29382016/fatal-pulmonary-thromboembolism-after-achilles-tendon-open-repair-a-rare-case-report
#16
Dong Il Chun, Sanghyeon Lee, Sung Hun Won, Jaeho Cho
RATIONALE: The operative procedure for Achilles tendon rupture is relatively simple, but venous thromboembolism is serious complication with a high incidence after Achilles tendon rupture. However, the guideline for thromboprophylaxis in Achilles tendon rupture is unclear. PATIENT CONCERNS: The patient was 32-year-old male and underwent Achilles tendon open repair surgery. He was healthy and there are no abnormal findings other than Achilles tendon rupture. At 3 weeks after operation, the episode of loss of consciousness with convulsive movement occurred...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29381974/stroke-risks-and-patterns-of-warfarin-therapy-among-atrial-fibrillation-patients-post-radiofrequency-ablation-a-real-world-experience
#17
Juan Zhang, Xingpeng Liu, Xiaoqing Liu, Xiandong Yin, Yanjiang Wang, Xiaoying Lu, Xinchun Yang
We assessed the thromboembolic risks of atrial fibrillation (AF) patients who had undergone radiofrequency ablation (RFA) using the CHADS2-VASc risk scoring system and further investigated the patterns of warfarin use for thromboprophylaxis according to patient thromboembolic risk scores.In this study, we analyzed the stroke risks of patients who had undergone RFA for AF at our hospital between March 2014 and June 2016 using the CHADS2, CHADS2-VASc, and Hypertension, Abnormal renal/liver function, Stroke, Bleeding history or predisposition, Labile international normalized ratio, Elderly (> 65 years) (HAS-BLED) scoring systems...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29377971/patterns-and-predictors-of-short-term-peripherally-inserted-central-catheter-use-a-multicenter-prospective-cohort-study
#18
David Paje, Anna Conlon, Scott Kaatz, Lakshmi Swaminathan, Tanya Boldenow, Steven J Bernstein, Scott A Flanders, Vineet Chopra
BACKGROUND: The guidelines for peripherally inserted central catheters (PICCs) recommend avoiding insertion if the anticipated duration of use is =5 days. However, short-term PICC use is common in hospitals. We sought to identify patient, provider, and device characteristics and the clinical outcomes associated with short-term PICCs. METHODS: Between January 2014 and June 2016, trained abstractors at 52 Michigan Hospital Medicine Safety (HMS) Consortium sites collected data from medical records of adults that received PICCs during hospitalization...
February 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29372247/association-of-intracerebral-hemorrhage-among-patients-taking-non-vitamin-k-antagonist-vs-vitamin-k-antagonist-oral-anticoagulants-with-in-hospital-mortality
#19
Taku Inohara, Ying Xian, Li Liang, Roland A Matsouaka, Jeffrey L Saver, Eric E Smith, Lee H Schwamm, Mathew J Reeves, Adrian F Hernandez, Deepak L Bhatt, Eric D Peterson, Gregg C Fonarow
Importance: Although non-vitamin K antagonist oral anticoagulants (NOACs) are increasingly used to prevent thromboembolic disease, there are limited data on NOAC-related intracerebral hemorrhage (ICH). Objective: To assess the association between preceding oral anticoagulant use (warfarin, NOACs, and no oral anticoagulants [OACs]) and in-hospital mortality among patients with ICH. Design, Setting, and Participants: Retrospective cohort study of 141 311 patients with ICH admitted from October 2013 to December 2016 to 1662 Get With The Guidelines-Stroke hospitals...
January 25, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29369958/epidural-hematoma-following-cessation-of-a-direct-oral-anticoagulant-a-case-report
#20
Jessica E Burjorjee, Rachel Rooney, Melanie Jaeger
OBJECTIVE: In this case report, we describe a case of epidural hematoma following epidural analgesia in a patient with recent cessation of a direct oral anticoagulant (DOAC). CASE REPORT: An 89-year-old woman requiring upper abdominal surgery presented with multiple comorbidities, including a prior cerebrovascular accident resulting in a left-sided hemiparesis and atrial fibrillation requiring anticoagulation with rivaroxaban. In accordance with our departmental guidelines at the time of procedure, rivaroxaban was discontinued 4 days preoperatively...
January 24, 2018: Regional Anesthesia and Pain Medicine
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