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https://www.readbyqxmd.com/read/28650573/factors-associated-with-thromboembolic-events-following-cytoreductive-surgery-and-hyperthermic-intraperitoneal-chemotherapy
#1
Amihai Rottenstreich, Yosef Kalish, Geffen Kleinstern, Almog Ben Yaacov, Joseph Dux, Aviram Nissan
BACKGROUND AND OBJECTIVES: We investigated the risk factors, incidence, and role of thromboprophylaxis in the development of thrombosis following cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS/HIPEC). METHODS: We reviewed data of patients with CRS/HIPEC in three hospitals. RESULTS: Overall, 192 patients underwent CRS/HIPEC during 2007-2016. Mechanical (thigh-length pneumatic compression stockings) and pharmacologic thromboprophylaxis (40 mg enoxaparin daily, starting 12 h before surgery until discharge) was provided for all patients; and 116 (60...
June 26, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28645996/treatment-of-suspected-pulmonary-embolism-in-a-morbidly-obese-patient
#2
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/28640322/effectiveness-and-safety-of-rivaroxaban-versus-warfarin-for-treatment-and-prevention-of-recurrence-of-venous-thromboembolism
#3
Craig I Coleman, Craig Coleman, Thomas J Bunz, Alexander G G Turpie
The efficacy and safety or rivaroxaban versus enoxaparin/vitamin K antagonist for treatment and prevention recurrence of venous thromboembolism (VTE) was demonstrated in the randomised EINSTEIN trials. We assessed the effectiveness and safety of rivaroxaban versus warfarin in VTE patients managed in routine practice. Using US MarketScan claims from 1/2012-6/2015, we included adults with a primary diagnosis of deep vein thrombosis (DVT) or pulmonary embolism (PE) during a hospitalisation/emergency department visit, newly-initiated on rivaroxaban or warfarin within 30-days after the VTE and with ≥180-days of continuous medical/prescription benefits prior to the VTE (baseline)...
June 22, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28634095/comparative-effectiveness-and-safety-of-drug-prophylaxis-for-prevention-of-venous-thromboembolism-after-total-knee-arthroplasty
#4
Guy Cafri, Elizabeth W Paxton, Yuexin Chen, Craig T Cheetham, Michael K Gould, Janet Sluggett, Stefano A Bini, Monti Khatod
BACKGROUND: Rates of venous thromboembolism in contemporary studies of primary total knee arthroplasty (TKA) have been reported to be as high as 3.5%. Although drug prophylaxis is effective, the best option among these regimens is not well established. The purpose of this study was to evaluate the comparative effectiveness and safety of aspirin, low-molecular-weight heparin, synthetic pentasaccharide factor Xa inhibitors, and vitamin K antagonist. METHODS: Data were from a US total joint replacement registry, with 30,499 patients receiving unilateral TKA from May 16, 2006, to December 31, 2013...
May 31, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28630388/spontaneous-liver-rupture-associated-with-anticoagulant-therapy-a-case-report
#5
Marco Clementi, Sara Colozzi, Stefano Guadagni, Beatrice Pessia, Federico Sista, Mario Schietroma, Andrea Della Penna, Gianfranco Amicucci
Spontaneous hepatic rupture without underlying liver diseases is uncommon entity. We report a rare case of spontaneous rupture of liver hematoma in patient treated with warfarin end enoxaparin sodium because of pulmonary embolism. Two day after admission the patient complained generalized abdominal pain and hemodynamic instability. The abdominal US and TC scan revealed free fluid and lesion at right liver lobe. The patient, despite intravenous fluid support and blood transfusion, was hemodinamically instable and urgent laparotomy was needed...
January 20, 2017: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/28622941/pre-hospital-ticagrelor-in-st-segment-elevation-myocardial-infarction-in-the-french-atlantic-population
#6
Guillaume Cayla, Frédéric Lapostolle, Patrick Ecollan, Olivier Stibbe, Jean Francois Benezet, Patrick Henry, Christopher J Hammett, Jens Flensted Lassen, Robert F Storey, Jur M Ten Berg, Christian W Hamm, Arnoud W Van't Hof, Gilles Montalescot
BACKGROUND: ATLANTIC was a randomized study comparing pre- and in-hospital treatment with a ticagrelor loading dose (LD) in ongoing ST-segment elevation myocardial infarction (STEMI). We sought to compare patient characteristics and clinical outcomes in France with other countries participating in ATLANTIC. METHODS: The population comprised 1862 patients, 660 (35.4%) from France and 1202 from 12 other countries. The main endpoints were reperfusion (≥70% ST-segment elevation resolution) and TIMI flow grade 3 before (co-primary endpoints) and after percutaneous coronary intervention (PCI)...
June 9, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28622843/fatal-pulmonary-embolism-following-elective-total-knee-replacement-using-aspirin-in-multi-modal-prophylaxis-a-12year-study
#7
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/28618257/is-a-therapeutic-anticoagulation-window-needed-for-delivery-when-using-prophylactic-low-molecular-weight-heparin-during-pregnancy-a-retrospective-monocentric-study
#8
Assila Roueli, Elsa Cesario, Julien Amsellem, Antoine Agman, Danièle Vauthier-Brouzes, Jacky Nizard
OBJECTIVES: The aim of the study was to evaluate the usefulness of therapeutic window for delivery for patients under prophylactic anticoagulation by low molecular weight heparin (LMWH) by comparing those who had a planned delivery versus those who delivered spontaneously. STUDY DESIGN: This retrospective monocentric study included pregnant patients with prophylactic anticoagulation (one injection per day of enoxaparin 4000UI), who delivered after 24 weeks of gestation...
June 1, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28616032/dose-dependent-neuroprotective-effect-of-enoxaparin-on-cold-induced-traumatic-brain-injury
#9
Ilknur Keskin, M Yalcin Gunal, Nilufer Ayturk, Ulkan Kilic, Mehmet Ozansoy, Ertugrul Kilic
Recent evidence exists that enoxaparin can reduce brain injury because of its anticoagulant activity. To investigate the potential therapeutic effect of enoxaparin on cold-induced traumatic brain injury, at 20 minutes after modeling, male BALB/c mouse models of cold-induced traumatic brain injury were intraperitoneally administered 3 and 10 mg/kg enoxaparin or isotonic saline solution. Twenty-four hours later, enoxaparin at 10 mg/kg greatly reduced infarct volume, decreased cell apoptosis in the cortex and obviously increased serum level of total antioxidant status...
May 2017: Neural Regeneration Research
https://www.readbyqxmd.com/read/28611833/open-label-phase-i-clinical-study-to-assess-the-safety-and-efficacy-of-cilostazol-in-patients-undergoing-internal-carotid-artery-stent-placement
#10
Ameer E Hassan, Haralabos Zacharatos, Mikayel Grigoryan, Wondwossen G Tekle, Amir Khan, Farhan Siddiq, Gustavo J Rodriguez, Ramachandra Tummala, Bharathi Jagadeesan, M Fareed K Suri, Adnan I Qureshi
BACKGROUND: One-month dual antiplatelet treatment, with aspirin and clopidogrel, following internal carotid artery stent placement is the current standard of care to prevent in-stent thrombosis. Cilostazol, an antiplatelet drug, has been demonstrated to have a safety profile comparable to aspirin and clopidogrel. OBJECTIVE: To evaluate the safety and clinical efficacy of cilostazol and aspirin therapy following internal carotid artery stent placement up to 1 month postprocedure...
March 2017: Interventional Neurology
https://www.readbyqxmd.com/read/28609556/prevention-of-livedoid-vasculopathy-recurrence-by-prolonged-administration-of-rivaroxaban
#11
Ch Drerup, T Goerge
A 49-year-old man with known livedoid vasculopathy presented with recurrent painful (VAS 8/10) ulceration and necrosis on the foot (Figure 1). He was formerly treated with prostacyclin infusions, acetylsalicylic acid, intravenous immunoglobulins, different systemic antibiotics and a skin grafting. At admission an antithrombotic therapy with enoxaparin (Clexane(®) ) in a dose of 1 mg/ kg bodyweight (100 mg) once daily was initiated. This article is protected by copyright. All rights reserved.
June 13, 2017: Journal of the European Academy of Dermatology and Venereology: JEADV
https://www.readbyqxmd.com/read/28608312/cost-effectiveness-analysis-of-rivaroxaban-for-treatment-of-deep-vein-thrombosis-and-pulmonary-embolism-in-greece
#12
George Gourzoulidis, Georgia Kourlaba, John Kakisis, Mitiadis Matsagkas, George Giannakoulas, Konstantinos I Gourgoulianis, Theodoros Vassilakopoulos, Nikos Maniadakis
BACKGROUND AND OBJECTIVE: Venous thromboembolism (VTE), comprising deep-vein thrombosis (DVT) and pulmonary embolism (PE), is a major healthcare concern that results in substantial morbidity and mortality with great economic burden for healthcare systems. Hence, the need for effective and efficient treatment of patients with VTE is important for both clinical and economic reasons. The objective of this study was to evaluate the cost effectiveness of rivaroxaban compared to standard of care (SoC) with enoxaparin followed by dose-adjusted vitamin-K antagonists for the treatment of DVT and PE in Greece...
June 12, 2017: Clinical Drug Investigation
https://www.readbyqxmd.com/read/28605879/a-rct-study-of-rivaroxaban-low-molecular-weight-heparin-and-sequential-medication-regimens-for-the-prevention-of-venous-thrombosis-after-internal-fixation-of-hip-fracture
#13
Yilun Tang, Kunzheng Wang, Zhibin Shi, Pei Yang, Xiaoqian Dang
The guidelines for the prevention of venous thromboembolism in orthopedic surgeries have reached a consensus on the postoperative conventional anticoagulation. However, the choice of anticoagulant drugs is yet controversial. The use of the drug rivaroxaban is expensive. Since the compliance of patients with low-molecular-weight heparin is considerably low, a cost-effective, efficacious and convenient anticoagulant program is essential. The present study investigated the efficacy, safety, patient compliance, and cost-effectiveness of low-molecular-weight heparin with sequential Rivaroxaban anticoagulant therapy in patients with a hip fracture, following internal fixation...
August 2017: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/28604246/is-portomesenteric-vein-thrombosis-after-laparoscopic-sleeve-gastrectomy-related-to-short-course-prophylaxis-of-thromboembolism-a-monocentric-retrospective-analysis-about-an-infrequent-but-not-rare-complication-and-review-of-the-literature
#14
Francesco Caruso, Giovanni Cesana, Laura Lomaglio, Stefano Cioffi, Francesca Ciccarese, Matteo Uccelli, Stefano Olmi
BACKGROUND: Portomesenteric vein thrombosis (PMVT) is considered a rare and potentially fatal complication of bariatric surgery. Laparoscopic sleeve gastrectomy (LSG) is one of the most performed bariatric procedures in the world. PMVT in LSG was first reported in 2009 by Berthet et al. in a thrombophilic patient. No data exist regarding the real prevalence of this complication specifically after LSG. METHODS: We examined retrospectively all the clinical records of patients who underwent LSG for morbid obesity from January 2011 to December 2016...
June 12, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28596666/enoxaparin-induced-skin-lesions-in-pregnancy-a-rare-but-clinically-recognizable-association
#15
Sumeet Prakash Mirgh, Abhay A Bhave
We report the case of a 29 year old pregnant female who experienced itching with erythematous plaques on prophylactic enoxaparin for recurrent fetal losses. These lesions generalized on rechallenge but erythema and itching gradually resolved after 4 weeks of discontinuation. Cutaneous adverse events with heparin have been reported (Villanueva et al. in Actas Dermosifiliogr 103:816-819, 2012; Neloska et al. in Acta Dermatovenerol Croat 23:223-224, 2015; Maldonado et al. in Clin Exp Dermatol 37:707-711, 2012; Schindewolf et al...
June 2017: Indian Journal of Hematology & Blood Transfusion
https://www.readbyqxmd.com/read/28591361/doppler-velocimetry-in-fetal-rats-exposed-to-enoxaparin-and-unfractionated-heparin-ufh-during-pregnancy
#16
Flavio Renato de Almeida Senefonte, Ricardo Dutra Aydos, Vanessa Marcon de Oliveira, Marco Antonio Costa Bósio, Ernesto Antonio Figueiró-Filho
Purpose: To evaluate the effects of enoxaparin and unfractionated heparin (UFH) administered in prophylactic and therapeutic doses on fetal vessels in healthy pregnant Wistar rats, according to Doppler velocimetry measurements. Methods: Fifty animals were assigned to one of five groups: controls (saline), prophylactic and therapeutic enoxaparin (1 and 2 mg/kg/day, respectively), and prophylactic and therapeutic UFH (72 and 400 UI/kg/day, respectively). Uterine horns were examined by ultrasound for identification of live fetuses...
May 2017: Acta Cirúrgica Brasileira
https://www.readbyqxmd.com/read/28581881/prevalence-and-clinical-intentions-of-antithrombotic-therapy-on-discharge-to-hospice-care
#17
Christina A Kowalewska, Brie N Noble, Erik K Fromme, Mary Lynn McPherson, Kristi N Grace, Jon P Furuno
BACKGROUND: There are no guidelines for antithrombotic therapy on admission to hospice care. Antithrombotic therapy may offer some benefit in these patients, but is also associated with well-described risks. OBJECTIVE: We quantified the frequency and characteristics of patients prescribed antithrombotic therapy on discharge from acute care to hospice care. DESIGN: Retrospective cohort study. Settings/Subjects: Adult (age> = 21 years) patients discharged from acute care to hospice care between January 1, 2010 and June 30, 2014...
June 5, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28574956/identifying-high-alert-medications-in-a-university-hospital-by-applying-data-from-the-medication-error-reporting-system
#18
Lotta Tyynismaa, Anni Honkala, Marja Airaksinen, Kenneth Shermock, Lasse Lehtonen
OBJECTIVES: To facilitate safe use of high-alert medications, lists of medications posing higher risks for medication errors (MEs) and harmful effects have been compiled. These lists can be general or reflect clinical practices in specific settings. Less common has been to compile a hospital-specific list applying data from the organization's ME reporting system. Our objective was to demonstrate a method for compiling such a high-alert medication list in a university hospital. METHODS: Of the eighteen 136 MEs reported during 2007 to 2013, ME reports with medications coded as a contributing factor to the incident were included (n = 249)...
June 1, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28569372/venous-thromboembolism-prophylaxis-after-tka-aspirin-warfarin-enoxaparin-or-factor-xa-inhibitors
#19
Abiram Bala, James I Huddleston, Stuart B Goodman, William J Maloney, Derek F Amanatullah
BACKGROUND: There is considerable debate regarding the ideal agent for venous thromboembolism (VTE) prophylaxis after TKA. Numerous studies and meta-analyses have yet to provide a clear answer and often omit one or more of the commonly used agents such as aspirin, warfarin, enoxaparin, and factor Xa inhibitors. QUESTIONS/PURPOSES: Using a large database analysis, we asked: (1) What are the differences in VTE incidence in primary TKA after administration of aspirin, warfarin, enoxaparin, or factor Xa inhibitors? (2) What are the differences in bleeding risk among these four agents? (3) How has use of these agents changed with time? METHODS: We queried a combined Humana and Medicare database between 2007 and Quarter 1 of 2016, and identified all primary TKAs performed using ICD-9 and Current Procedural Terminology codes...
May 31, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28543543/cardiac-implantable-electronic-device-hematomas-risk-factors-and-effect-of-prophylactic-pressure-bandaging
#20
Youlin Koh, Nicholas E Bingham, Natalie Law, Dustin Le, Justin A Mariani
BACKGROUND: Cardiac implantable electronic device (CIED) hematomas are associated with many adverse outcomes. We examined the incidence and risk factors associated with hematoma formation post-CIED implantation, and explored the preventative effect of prophylactic pressure bandaging (PPB) in a large tertiary center. METHODS: 1,091 devices were implanted during October 2011-December 2014. Clinically significant hematomas (CSH) were those that necessitated prolonged admission, including those due to reoperation, and clinically suspicious hematomas were swellings noted by medical/nursing staff...
May 23, 2017: Pacing and Clinical Electrophysiology: PACE
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