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https://www.readbyqxmd.com/read/27894155/increased-lower-extremity-venous-stasis-may-contribute-to-deep-venous-thrombosis-formation-after-microsurgical-breast-reconstruction-an-ultrasonographic-study
#1
Arash Momeni, Michael G Tecce, Michael A Lanni, Shagun Aggarwal, Christopher Pannucci, Stephen J Kovach, Suhail K Kanchwala, Liza C Wu, Joseph M Serletti
Background Despite guideline-compliant prophylaxis, an increased rate of deep venous thrombosis (DVT) formation has been reported following autologous versus implant-based breast reconstruction. We hypothesized that tight abdominal fascia closure might decrease lower extremity venous return and promote venous stasis. Methods An observational crossover study of patients who underwent autologous breast reconstruction using transverse rectus abdominis musculocutaneous/deep inferior epigastric artery perforator flaps was conducted...
November 28, 2016: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/27870674/impact-of-hospital-employed-physician-assistants-on-a-level-ii-community-based-orthopaedic-trauma-system
#2
Peter L Althausen, Steven Shannon, Brianne Owens, Daniel Coll, Michael Cvitash, Minggen Lu, Timothy J O'Mara, Timothy J Bray
OBJECTIVES: The American Academy of Orthopedic Surgeons and the Orthopedic Trauma Association have released guidelines for the provision of orthopedic trauma services such as adequate stipends, designated operating rooms, ancillary staff, and guaranteed reimbursement for indigent care. One recommendation included a provision for hospital-based physician assistants (PAs). Given current reimbursement arrangements, PA collections for billable services may not meet their salary and benefit expenses...
December 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27808636/non-pharmacological-interventions-for-the-prevention-of-venous-thromboembolism-a-literature-review
#3
Esther Hanison, Kevin Corbett
AIM: To assess the relative clinical efficacy of different forms of non-pharmacological prophylaxis, intermittent pneumatic compression and graduated compression stockings in reducing the incidence of venous thromboembolism (VTE) in patients hospitalised following acute stroke. METHOD: This was a thematic synthesis of literature retrieved from a structured bibliographic search of: Medline, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Summon, British Nursing Index, NHS Evidence, Internurse...
October 19, 2016: Nursing Standard
https://www.readbyqxmd.com/read/27757740/design-and-%C3%AE-testing-of-an-electronic-rounding-tool-certainp-to-improve-process-of-care-in-pediatric-intensive-care-unit
#4
Manasi Hulyalkar, Stephen J Gleich, Rahul Kashyap, Amelia Barwise, Harsheen Kaur, Yue Dong, Lei Fan, Srinivas Murthy, Grace M Arteaga, Sandeep Tripathi
Increasing process complexity in the pediatric intensive care unit (PICU) can lead to information overload resulting in missing pertinent information and potential errors during morning rounds. An efficient model using a novel electronic rounding tool was designed as part of a broader critical care decision support system-checklist for early recognition and treatment of acute illness and injury in pediatrics (CERTAINp). We aimed to evaluate its impact on improving the process of care during rounding. Prospective pre- and post-interventional data included: team performance baseline assessment, patient safety discussion, guideline adherence, rounding time, and a survey of Residents' and Nurses' perception using a Likert scale...
October 18, 2016: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/27752630/admission-rates-for-emergency-department-patients-with-venous-thromboembolism-and-estimation-of-the-proportion-of-low-risk-pulmonary-embolism-patients-a-us-perspective
#5
Adam J Singer, Henry C Thode, W Frank Peacock
OBJECTIVE: Introduction of target specific anticoagulants and recent guidelines encourage outpatient management of low risk patients with venous thromboembolism. We describe hospital admission rates over time for patients presenting to US emergency departments (EDs) with deep vein thrombosis (DVT) and pulmonary embolism (PE) and estimate the proportion of low-risk PE patients who could potentially be managed as outpatients. METHODS: We performed a structured analysis of the National Hospital Ambulatory Medical Care Survey (a nationally representative weighted sampling of US ED visits) database for the years 2006-2010 including all adult patients with a primary diagnosis of DVT or PE...
September 2016: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/27685687/dvt-presentations-to-an-emergency-department-a-study-of-guideline-based-care-and-decision-making
#6
D A Lillis, C Lloyd, S Kelada, P O'Kelly, S Kelly, P Gilligan
Pre-test probability scoring and blood tests for deep venous thrombosis (DVT) assessment are sensitive but not specific leading to increased demands on radiology services. 385 patients presenting to an Emergency Department with suspected DVT were studied to explore our actual work up of patients with possible DVT relating to risk stratification, further investigation and follow up. Of the 205 patients with an initially negative scan, 36 (17.6%) were brought for review to the Emergency Department Consultant clinic...
February 19, 2016: Irish Medical Journal
https://www.readbyqxmd.com/read/27633687/an-analysis-of-deep-vein-thrombosis-in-burn-patients-part-ii-a-randomized-and-controlled-study-of-thrombo-prophylaxis-with-low-molecular-weight-heparin
#7
Rajeev B Ahuja, Priya Bansal, Gaurav S Pradhan, Manju Subberwal
INTRODUCTION: Morbidity and mortality from venous thrombo-embolism (VTE) remains a significant problem for trauma and medical patients and there are established guidelines for prophylaxis in these patients. However, the efficacy and safety of VTE prophylaxis in thermally injured patients continue to be elusive as it has never been studied in a prospective, randomized fashion. Selective use of VTE prophylaxis, for high risk patients, is practiced by some burn units even if objective evidence is lacking for majority of risk factors enunciated in burn patients...
September 12, 2016: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/27600864/combined-intermittent-pneumatic-leg-compression-and-pharmacological-prophylaxis-for-prevention-of-venous-thromboembolism
#8
Stavros K Kakkos, Joseph A Caprini, George Geroulakos, Andrew N Nicolaides, Gerard Stansby, Daniel J Reddy, Ioannis Ntouvas
BACKGROUND: It is generally assumed by practitioners and guideline authors that combined modalities (methods of treatment) are more effective than single modalities in preventing venous thromboembolism (VTE), defined as deep vein thrombosis (DVT) or pulmonary embolism (PE), or both. This is an update of the review first published in 2008. OBJECTIVES: The aim of this review was to assess the efficacy of combined intermittent pneumatic leg compression (IPC) and pharmacological prophylaxis versus single modalities in preventing venous thromboembolism...
September 7, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27552459/concomitant-venous-thrombosis-and-pulmonary-embolism-after-hip-arthroscopy-in-a-patient-with-heterozygous-factor-v-leiden-deficiency
#9
Raveesh D Richard, Brooke E Maloney, Glen T Feltham
As hip arthroscopy becomes more prevalent, it is imperative to identify potential risks associated with this procedure. In this article, we report a case of deep vein thrombosis (DVT) and pulmonary embolism that developed after hip arthroscopy in a moderate-risk patient with heterozygous factor V Leiden deficiency. The patient concomitantly developed DVT and pulmonary embolism during a 5-day course of treatment with subcutaneous enoxaparin. The American College of Chest Physicians and American Academy of Orthopaedic Surgeons guidelines on postarthroplasty DVT prophylaxis do not address thromboprophylaxis in hip arthroscopy...
July 2016: American Journal of Orthopedics
https://www.readbyqxmd.com/read/27549352/deep-vein-thrombosis-in-arthroscopic-surgery-and-chemoprophylaxis-recommendation-in-an-asian-population
#10
Kuei Siong Andy Yeo, Wen Siang Kevin Lim, Yee Han Dave Lee
INTRODUCTION: There are currently no guidelines supporting the use of routine chemoprophylaxis to prevent deep vein thrombosis (DVT) in arthroscopic surgery. Studies and meta-analysis show opposing views on its routine use in arthroscopy. This study aimed to examine the incidence of DVT in a prospective cohort of knee arthroscopy and knee arthroplasty patients, and to analyse the risk factors contributing to DVT. METHODS: All patients scheduled to undergo knee arthroscopy or arthroplasty over a two-year period were included...
August 2016: Singapore Medical Journal
https://www.readbyqxmd.com/read/27483722/surgical-treatment-of-postpartum-iliofemoral-deep-vein-thrombosis-case-reports
#11
I Cazan, Cristina Strobescu, Genoveva Baroi, Simona Cazan, G Lefter, R F Popa
The writing committee for Antithrombotic Therapy for Venous Thromboembolic Disease of the 2008 ACCP guidelines made the following recommendations for thrombus removal strategies in patients with deep vein thrombosis (DVT): open surgical thrombectomy is recommended in patients with acute iliofemoral DVT to reduce symptoms and post-thrombotic morbidity; whenever available, catheter-directed thrombolysis is preferred to surgical venous thrombectomy, the risk of hemorrhage being diminished; surgical venous thrombectomy is recognized to be efficient in cases where catheter-directed thrombolysis is unavailable or the patients are not suitable candidates for such a procedure...
April 2016: Revista Medico-chirurgicală̆ a Societă̆ţ̜ii de Medici ş̧i Naturaliş̧ti Din Iaş̧i
https://www.readbyqxmd.com/read/27482017/systematic-review-of-aspirin-for-thromboprophylaxis-in-modern-elective-total-hip-and-knee-arthroplasty
#12
D G G Wilson, W E C Poole, S K Chauhan, B A Rogers
AIMS: There is uncertainty regarding the optimal means of thromboprophylaxis following total hip and knee arthroplasty (THA, TKA). This systematic review presents the evidence for acetylsalicylic acid (aspirin) as a thromboprophylactic agent in THA and TKA and compares it with other chemoprophylactic agents. MATERIALS AND METHODS: A search of literature published between 2004 and 2014 was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines...
August 2016: Bone & Joint Journal
https://www.readbyqxmd.com/read/27471223/multi-faceted-implementation-strategy-to-increase-use-of-a-clinical-guideline-for-the-diagnosis-of-deep-venous-thrombosis-in-primary-care
#13
Anna E C Kingma, Henk F van Stel, Ruud Oudega, Karel G M Moons, Geert-Jan Geersing
BACKGROUND: A clinical decision rule (CDR), combined with a negative D-dimer test, can safely rule out deep venous thrombosis (DVT) in primary care. This strategy is recommended by guidelines, yet uptake by GPs is low. OBJECTIVE: To evaluate a multi-faceted implementation strategy aimed at increased use of the guideline recommended CDR plus D-dimer test in primary care patients with suspected DVT. METHODS: This multi-faceted implementation strategy consisted of educational outreach visits, financial reimbursements and periodical newsletters...
July 28, 2016: Family Practice
https://www.readbyqxmd.com/read/27441307/repeat-duplex-ultrasound-scanning-in-suspected-deep-vein-thrombosis-dvt-putting-the-onus-back-on-the-referring-clinician
#14
Bryan Renton, S Thiru, C P Griffin
Duplex scanning is utilised by many departments in the investigation of suspected DVT. NICE Guideline CG144 recommended repeat scanning for patients in whom the initial Wells score was 'likely' in the presence of a raised D-Dimer, following a normal first scan. Following implementation of this recommendation in our department there was a dramatic rise in the number of repeat scans being undertaken, all of which were negative for DVT. Introduction of an electronic message to the report, placing the onus back on the referring clinician to arrange repeat scan if deemed appropriate resulted in a fall in the number of scans being undertaken without impacting on patient outcome...
2016: Acute Medicine
https://www.readbyqxmd.com/read/27372555/use-of-a-pneumatic-tourniquet-in-total-knee-arthroplasty-increases-the-risk-of-distal-deep-vein-thrombosis-a-prospective-randomized-study
#15
Noriaki Mori, Shoichi Kimura, Tomohiro Onodera, Norimasa Iwasaki, Izumi Nakagawa, Takeshi Masuda
BACKGROUND: There has been controversy regarding the incidence of deep vein thrombosis (DVT) after total knee arthroplasty (TKA) with or without the use of a tourniquet. The aim of this randomized, prospective study was to clarify the effects of tourniquet use on DVT in TKA. METHODS: The subjects were 109 patients scheduled to undergo TKA from April 2008 to March 2009 before the establishment of the American Association of Orthopedic Surgeons (AAOS) practice guidelines...
October 2016: Knee
https://www.readbyqxmd.com/read/27284271/clinical-benefit-of-graduated-compression-stockings-for-prevention-of-venous-thromboembolism-after-total-knee-arthroplasty-post-hoc-analysis-of-a-phase-3-clinical-study-of-edoxaban
#16
Takeshi Fuji, Satoru Fujita, Tetsuya Kimura, Kei Ibusuki, Kenji Abe, Shintaro Tachibana, Mashio Nakamura
BACKGROUND: Guidelines from the Japanese Circulation Society recommend prophylaxis with anticoagulation plus intermittent pneumatic compression or graduated compression stockings (GCS) among patients at the highest risk for developing venous thromboembolism (VTE). However, the benefits of concomitant GCS use for patients undergoing total knee arthroplasty (TKA) and receiving anticoagulation remain unknown. In this study, the efficacy of GCS plus anticoagulation compared with anticoagulation alone was evaluated among patients undergoing TKA...
2016: Thrombosis Journal
https://www.readbyqxmd.com/read/27179058/in-hospital-management-and-follow-up-treatment-of-venous-thromboembolism-focus-on-new-and-emerging-treatments
#17
Joshua D Lenchus, Michelle Biehl, Jorge Cabrera, Alice Gallo de Moraes, Cameron Dezfulian
Venous thromboembolism (VTE), encompassing pulmonary embolism (PE) and deep venous thrombosis (DVT), is a major cause of morbidity and mortality of particular relevance for intensivists and hospitalists. Acute VTE is usually managed with parenteral unfractionated heparin or low-molecular-weight heparin, followed by an oral vitamin K antagonist. Data are lacking for optimal treatment of less common occurrences, such as upper extremity DVT, and for approaches such as thrombolysis for PE associated with early signs of hemodynamic compromise or inferior vena cava filters when anticoagulation is contraindicated...
May 13, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27161717/po-30-changes-in-soluble-cd106-and-cd54-serum-levels-during-chemotherapy-treatment-for-multiple-myeloma
#18
J Hall, M A Adesanya, L A Madden, A Maraveyas
INTRODUCTION: IMiD-based regimens are now widely considered standard of care in the treatment of Multiple myeloma (MM) patients (Kumar et al., 2008). One of the major adverse events noted in many MM clinical studies in patients treated with combination regimens including Thalidomide (Thal), Lenanlidomide (Len) and dexamethasone or chemotherapy was the development of hrombosis (Carrier et al., 2011). AIM: We have postulated that one mechanism for venous thromboembolism (VTE) occurrence may be through chemotherapy damage to endothelium (Date et al...
April 2016: Thrombosis Research
https://www.readbyqxmd.com/read/27161673/oc-01-clinical-history-of-cancer-patients-with-isolated-distal-deep-vein-thrombosis-a-multicenter-cohort-study
#19
F Dentali, S Pegoraro, S Barco, M N D di Minno, D Mastroiacovo, F Pomero, C Lodigiani, F Bagna, M Sartori, G Barillari, N Mumoli, M Napolitano, S Passamonti, R Benedetti, W Ageno, M Di Nisio
INTRODUCTION: Isolated distal deep vein thrombosis (IDDVT) accounts for one-fourth to one-half of all deep vein thrombosis (DVT) of the leg. Patients with IDDVT are frequently treated for a shorter period of time compared to patients with proximal DVT and/or pulmonary embolism (PE) due to a perceived lower risk of recurrence. About 10-20% of patients with venous thromboembolic events (VTEs) have concomitant cancer. Guidelines recommend long-term anticoagulant treatment in this group of patients due to their high risk of VTE recurrence...
April 2016: Thrombosis Research
https://www.readbyqxmd.com/read/27067973/incidental-venous-thromboembolic-events-in-cancer-patients-what-we-know-in-2016
#20
Howard A Liebman, Casey O'Connell
Cancer patients are at high risk of venous thromboembolism (VTE). Previous reports on the epidemiology and incident of thrombotic complications in cancer patients are based upon documented symptomatic events. However, the frequent use of contrast enhanced computerized tomography for cancer staging has documented a high incidence of unsuspected venous thrombosis (DVT), pulmonary embolism (PE) and abdominal visceral thrombosis in cancer patients. Recent studies focusing on the findings of incidental PE when compared to symptomatic PE find no significant difference in pulmonary distribution of clots, incidence of VTE recurrence or survival in these patients...
April 2016: Thrombosis Research
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