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https://www.readbyqxmd.com/read/28800668/-epidemiology-risk-factors-and-risk-stratification-of-venous-thromboembolism-in-pregnancy-and-the-puerperium
#1
Panagiotis Tsikouras, Georg-Friedrich von Tempelhoff, Werner Rath
Venous thromboembolism (VTE) remains a leading cause of direct maternal deaths in the developed countries. The incidence of VTE has increased significantly during the past two decades. The absolute risk of VTE is estimated 0.6-2.2 per 1000 deliveries. Compared with age-matched non-pregnant women, the daily risk of VTE is increased 7- to 10-fold for antepartum VTE, but it is 15- to 35-fold for postpartum VTE. The incidence of pulmonary embolism (PE) during the first 6 weeks postpartum is nearly 15-fold higher compared to the incidence in pregnancy, and remains significantly increased up to 12 weeks postpartum...
August 2017: Zeitschrift Für Geburtshilfe und Neonatologie
https://www.readbyqxmd.com/read/28794825/interventional-radiology-treatment-for-pulmonary-embolism
#2
REVIEW
Miguel A De Gregorio, Jose A Guirola, Celia Lahuerta, Carolina Serrano, Ana L Figueredo, William T Kuo
Venous thromboembolism (VTE) is an illness that has a potentially life-threatening condition that affects a large percentage of the global population. VTE with pulmonary embolism (PE) is the third leading cause of death after myocardial infarction and stroke. In the first three months after an acute PE, there is an estimated 15% mortality among submassive PE, and 68% mortality in massive PE. Current guidelines suggest fibrinolytic therapy regarding the clinical severity, however some studies suggest a more aggressive treatment approach...
July 28, 2017: World Journal of Radiology
https://www.readbyqxmd.com/read/28780343/the-role-of-heparin-lead-in-in-the-real-world-management-of-acute-venous-thromboembolism-the-prefer-in-vte-registry
#3
Rupert Bauersachs, Giancarlo Agnelli, Anselm K Gitt, Manuel Monreal, Patrick Mismetti, Stefan N Willich, Petra Laeis, Eva-Maria Fronk, Peter Bramlage, Alexander T Cohen
INTRODUCTION: The appropriate strategy for initiating oral anticoagulant (OAC) therapy after an acute venous thromboembolism (VTE) depends on the intermediate-term anticoagulant to be used. While heparin bridging to vitamin K antagonists (VKA) is required, the direct oral anticoagulants (DOAC) rivaroxaban (30mg/day) and apixaban (10mg/day) can be initiated directly without parenteral anticoagulation. The objective was to evaluate OAC initiation patterns in clinical practice. MATERIALS AND METHODS: PREFER in VTE was an international, non-interventional registry conducted between January 2013 and August 2015...
July 28, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28765760/study-design-of-general-general-practitioners-and-embolism-prevention-in-nvaf-patients-treated-with-rivaroxaban-real-life-evidence-a-multicenter-prospective-cohort-study-in-primary-care-physicians-to-investigate-the-effectiveness-and-safety-of-rivaroxaban-in
#4
Kengo Kusano, Masaharu Akao, Hikari Tsuji, Kunihiko Matsui, Shinya Hiramitsu, Yutaka Hatori, Hironori Odakura
BACKGROUND: Rivaroxaban, a direct oral anticoagulant (DOAC), has become available for stroke prevention in patients with non-valular atrial fibrillation (NVAF). However, little is known about its effectiveness and safety when prescribed by general practitioners in real-life settings. METHODS: GENERAL is a multicenter, prospective, non-interventional observational study of patients receiving rivaroxaban for NVAF in daily clinical practice prescribed specifically by general practitioners...
August 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28751848/anmco-position-paper-long-term-follow-up-of-patients-with-pulmonary-thromboembolism
#5
Carlo D'Agostino, Pietro Zonzin, Iolanda Enea, Michele Massimo Gulizia, Walter Ageno, Piergiuseppe Agostoni, Michele Azzarito, Cecilia Becattini, Amedeo Bongarzoni, Francesca Bux, Franco Casazza, Nicoletta Corrieri, Michele D'Alto, Nicola D'Amato, Andrea Maria D'Armini, Maria Grazia De Natale, Giovanni Di Minno, Giuseppe Favretto, Lucia Filippi, Valentina Grazioli, Gualtiero Palareti, Raffaele Pesavento, Loris Roncon, Laura Scelsi, Antonella Tufano
Venous thromboembolism (VTE), including pulmonary embolism and deep venous thrombosis, is the third most common cause of cardiovascular death. The management of the acute phase of VTE has already been described in several guidelines. However, the management of the follow-up (FU) of these patients has been poorly defined. This consensus document, created by the Italian cardiologists, wants to clarify this issue using the currently available evidence in VTE. Clinical and instrumental data acquired during the acute phase of the disease are the cornerstone for planning the FU...
May 2017: European Heart Journal Supplements: Journal of the European Society of Cardiology
https://www.readbyqxmd.com/read/28721321/correlation-of-ventilation-perfusion-v-q-scan-results-as-compared-with-clinical-probability-of-pulmonary-embolism-in-african-american-population
#6
Fasil Tiruneh, Ahmad Awan, Nicole Hunt, Nahom Tegegn, Daniel Larbi
Introduction Current guidelines suggest the use of the more specific Wells' score could safely reduce the number of unnecessary scans. There is a lack of research to support whether these guidelines apply to the African American population. This study aims to evaluate the correlation of clinical pretest probability of pulmonary embolism (PE) with ventilation-perfusion (V/Q) scan results in a predominantly African American population and to test whether current guidelines based on studies conducted in other populations hold true in this group...
June 14, 2017: Curēus
https://www.readbyqxmd.com/read/28686913/guidance-for-the-diagnosis-of-pulmonary-embolism-during-pregnancy-consensus-and-controversies
#7
REVIEW
Tony Wan, Leslie Skeith, Alan Karovitch, Marc Rodger, Grégoire Le Gal
Pulmonary embolism (PE) is one of the leading causes of maternal mortality despite a low incidence of PE during pregnancy. Several challenges surround the diagnosis of PE in pregnant women and the existing clinical guidelines provide weak recommendations on selecting the appropriate investigations for suspected PE in pregnancy. The purpose of this narrative review is to compare and contrast the recommendations of current clinical guidelines and review the evidence underpinning the recommendations on the evaluation of suspected PE in pregnancy...
June 23, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28680366/fatal-pulmonary-embolism-following-splenectomy-in-a-patient-with-evan-s-syndrome-case-report-and-review-of-the-literature
#8
Varun Monga, Seth M Maliske, Usha Perepu
BACKGROUND: Evans syndrome (ES) is a rare disease characterized by simultaneous or sequential development of autoimmune hemolytic anemia (AIHA) and immune thrombocytopenia (ITP) with or without immune neutropenia. Splenectomy is one of the treatment options for disease refractory to medical therapy. Venous thromboembolism (VTE) following splenectomy for hematological diseases has an incidence of 10%. CASE PRESENTATION: Here we describe a case report of a young patient hospitalized with severe hemolytic anemia with Hgb 4...
2017: Thrombosis Journal
https://www.readbyqxmd.com/read/28679020/a-cross-study-analysis-evaluating-the-effects-of-food-on-the-pharmacokinetics-of-rivaroxaban-in-clinical-studies
#9
Liping Zhang, Gary Peters, Lloyd Haskell, Purve Patel, Partha Nandy, Kenneth Todd Moore
US prescribing guidelines recommend that 15- and 20-mg doses of rivaroxaban be administered with food for the treatment of deep vein thrombosis (DVT) and pulmonary embolism (PE) and for reduction in the risk of recurrence of DVT and PE. In addition, the US prescribing guidelines recommend these doses be administered with an evening meal to reduce the risk of stroke and systemic embolism in patients with nonvalvular atrial fibrillation (AF). The purpose of this model-based cross-study comparison was to examine the impact of food, with regard to both meal timing and content, on the pharmacokinetics (PK) of rivaroxaban, using data collected during its clinical development...
July 5, 2017: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28678793/timing-of-femoral-shaft-fracture-fixation-following-major-trauma-a-retrospective-cohort-study-of-united-states-trauma-centers
#10
James P Byrne, Avery B Nathens, David Gomez, Daniel Pincus, Richard J Jenkinson
BACKGROUND: Femoral shaft fractures are common in major trauma. Early definitive fixation, within 24 hours, is feasible in most patients and is associated with improved outcomes. Nonetheless, variability might exist between trauma centers in timeliness of fixation. Such variability could impact outcomes and would therefore represent a target for quality improvement. We evaluated variability in delayed fixation (≥24 hours) between trauma centers participating in the American College of Surgeons (ACS) Trauma Quality Improvement Program (TQIP) and measured the resultant association with important clinical outcomes at the hospital level...
July 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28676304/imaging-trends-in-acute-venous-thromboembolic-disease-2000-to-2015
#11
Isaac Wang, Matthew S Davenport, Ella A Kazerooni
PURPOSE: To measure diffusion of new knowledge and correlate imaging utilization for suspected acute venous thromboembolism (VTE) with d-dimer utilization, landmark publications, and institutional guidelines. MATERIALS: Between 2000 and 2015, the number of CT pulmonary angiograms (CTPAs), CTPA combined with indirect CT venography (CTV), ventilation-perfusion (VQ) scans, and lower extremity venous Doppler ultrasound (US) examinations were obtained for inpatients and emergency department (ED) patients and correlated with d-dimer utilization, landmark publications regarding radiation and VTE imaging, and an institutional inpatient best-practice alert requiring VTE prophylaxis assessment (2008)...
July 1, 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28666174/safety-feasibility-and-patient-reported-outcome-measures-of-outpatient-treatment-of-pulmonary-embolism
#12
Stefan Walen, Bianca Katerberg, Martijn F Boomsma, Jan Willem K van den Berg
BACKGROUND: Despite growing evidence on safe and feasible outpatient treatment for acute pulmonary embolism (PE), the majority of patients is still treated in an inpatient setting. This is probably due to a lack of clear guidelines on this subject. OBJECTIVES: To evaluate safety and patient reported outcome measures (PROM) on outpatient treatment of acute PE. METHODS: We conducted a prospective cohort study. 250 patients presenting with acute PE and Pulmonary Embolism Severity Index (PESI) class I or II were enrolled...
June 23, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28645996/treatment-of-suspected-pulmonary-embolism-in-a-morbidly-obese-patient
#13
Viviene Heitlage, Mary Beth Borgstadt, Lisa Carlson
PURPOSE: A case highlighting challenges with enoxaparin dosage and monitoring in obese patients is presented. SUMMARY: A morbidly obese 22-year-old Caucasian female (height, 168 cm; weight, 322 kg; body mass index [BMI], 114 kg/m(2)) who presented to the emergency department with acute-onset dyspnea and hypoxia was empirically initiated on enoxaparin for suspected pulmonary embolism at the institution's standard maximum dosage (160 mg subcutaneously every 12 hours)...
July 1, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28635085/venous-thromboembolism-management-in-northeast-melbourne-how-does-it-compare-to-international-guidelines-and-data
#14
Hui Yin Lim, Chong Chyn Chua, Mark Tacey, Matthew Sleeman, Geoffrey Donnan, Harshal Nandurkar, Prahlad Ho
BACKGROUND: Venous thromboembolism (VTE) is a major cause of morbidity and mortality with significant heterogeneity in its management, both within our local practice and international guidelines. AIMS: To provide a holistic evaluation of "real-world" Australian experience in the warfarin era, including how we compare to international guidelines. METHODS: Retrospective evaluation of VTE from July 2011 to December 2012 at two major hospitals in Melbourne, Australia...
June 21, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28624000/aneurysms-of-the-azygos-vein
#15
REVIEW
Maximilian Kreibich, Matthias Siepe, Jochen Grohmann, Gregor Pache, Friedhelm Beyersdorf
OBJECTIVE: Azygos vein aneurysms (AVAs) are uncommon and infrequently diagnosed. When confronted with a patient presenting with an AVA, physicians can rely on only a few case reports after an extensive literature search. To date, no guideline, no rule, and no review on the optimal treatment strategy for these patients exist. METHODS: A PubMed and MEDLINE database search for papers and case reports describing AVA was performed. Cases from our own institutions were also reviewed...
July 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28622843/fatal-pulmonary-embolism-following-elective-total-knee-replacement-using-aspirin-in-multi-modal-prophylaxis-a-12year-study
#16
C Quah, E Bayley, N Bhamber, P Howard
BACKGROUND: The National Institute for Health and Clinical Excellence (NICE) has issued guidelines on which thromboprophylaxis regimens are suitable following lower limb arthroplasty. Aspirin is not a recommended agent despite being accepted in orthopaedic guidelines elsewhere. We assessed the incidence of fatal pulmonary embolism (PE) and all-cause mortality following elective primary total knee replacement (TKR) with a standardised multi-modal prophylaxis regime in a large teaching district general hospital...
June 13, 2017: Knee
https://www.readbyqxmd.com/read/28612276/clinical-risk-stratification-of-acute-pulmonary-embolism-comparing-the-usefulness-of-cta-obstruction-score-and-pulmonary-perfusion-defect-score-with-dual-energy-ct
#17
Wei-Fang Kong, Yu-Ting Wang, Long-Lin Yin, Hong Pu, Ke-Yan Tao
To compare the ability of CT angiography (CTA) obstruction score and perfusion defect score on dual energy CT perfusion imaging (DEPI) for clinical risk stratification of patients with acute pulmonary embolism (PE). 55 patients diagnosed as acute PE either by CTA or DEPI were retrospectively enrolled. Patients were grouped into high-, intermediate-, and low-risk groups in accordance to the renewed guidelines of 2014. Consistency between DEPI and CTA in diagnosis of PE were assessed. Correlations between CT parameters and right-to-left ventricular (RV/LV) diameter ratio were evaluated...
June 13, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28610546/neuromuscular-electrical-stimulation-for-the-prevention-of-venous-thromboembolism
#18
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/28603413/identifying-the-heterogeneity-of-copd-by-v-p-spect-a-new-tool-for-improving-the-diagnosis-of-parenchymal-defects-and-grading-the-severity-of-small-airways-disease
#19
M Bajc, Y Chen, J Wang, X Y Li, W M Shen, C Z Wang, H Huang, A Lindqvist, X Y He
INTRODUCTION: Airway obstruction and possible concomitant pulmonary diseases in COPD cannot be identified conventionally with any single diagnostic tool. We aimed to diagnose and grade COPD severity and identify pulmonary comorbidities associated with COPD with ventilation/perfusion single-photon emission computed tomography (V/P SPECT) using Technegas as the functional ventilation imaging agent. METHODS: 94 COPD patients (aged 43-86 years, Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages I-IV) were examined with V/P SPECT and spirometry...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28599856/-bilateral-pulmonary-embolism-mimicking-acute-chest-syndrome-in-an-adolescent-with-sickle-cell-disease
#20
P Mornand, F Chalard, A-S Romain, M Rohr, C Paluel-Marmont, A Niakaté, B Quinet, E Grimprel, M-H Odièvre-Montanié
Pulmonary embolism is a life-threatening and potentially lethal disease. Its incidence in children with sickle cell disease is probably underestimated and pediatric case reports in the literature are rare. Moreover, symptoms can mimic an acute chest syndrome. We report on the case of a 17-year-old boy with SS sickle cell disease, admitted for chest pain with dyspnea and tachycardia. Pulmonary angiography revealed a partial bilateral obstructive pulmonary embolism. We did not find any deep venous thrombosis or thrombophilia...
June 6, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
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