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Deep vein thrombosis and pulmonary embolism

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https://www.readbyqxmd.com/read/29773423/management-of-giant-embryonic-vein-in-klippel-tr%C3%A3-naunay-syndrome
#1
Animesh Rathore, Peter Gloviczki, Haraldur Bjarnason
Klippel-Trénaunay syndrome is a rare mixed malformation characterized by congenital varicose veins, low-flow venous and lymphatic malformations, hypertrophy of soft tissue and bone, and capillary malformations. A 35-year-old man with a diagnosis of Klippel-Trénaunay syndrome presented to the clinic with significant pain and swelling in the left leg. Initial conservative management with compression therapy failed. He was then managed surgically with preoperative placement of an inferior vena cava filter (because of a history of deep venous thrombosis and pulmonary embolism), followed by resection of the lateral embryonic vein, ligation of large perforators, and excision of smaller varicosities...
May 14, 2018: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/29767472/the-impact-of-real-world-cardiovascular-related-pharmacogenetic-testing-in-an-insured-population
#2
Jennifer Billings, Patrick N Racsa, Kristine Bordenave, Charron L Long, Jeffrey J Ellis
BACKGROUND: Pharmacogenomics is intended to help clinicians provide the right drug to the right patient at an appropriate dose. However, limited evidence of clinical utility has slowed uptake of pharmacogenomic testing (PGT). OBJECTIVE: To evaluate the impact of real-world cardiovascular (CV)-related PGT on clinical outcomes, healthcare resource utilisation (HCRU) and cost in a large, heterogeneous population. METHODS: Individuals with Medicare Advantage Prescription Drug, Medicaid, or commercial coverage between 1/1/2011 and 9/30/2015 and ≥1 atherosclerotic CV-related diagnosis were identified...
May 16, 2018: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/29760845/ruling-out-pulmonary-embolism-in-patients-with-high-pretest-probability
#3
Murtaza Akhter, Jeffrey Kline, Bikash Bhattarai, Mark Courtney, Christopher Kabrhel
Introduction: The American College of Emergency Physicians guidelines recommend more aggressive workup beyond imaging alone in patients with a high pretest probability (PTP) of pulmonary embolism (PE). However, the ability of multiple tests to safely rule out PE in high PTP patients is not known. We sought to measure the ability of negative computed tomography pulmonary angiography (CTPA) along with negative D-dimer to rule out PE in these high-risk patients. Methods: We analyzed data from a previous prospective observational study conducted in 12 emergency departments (ED)...
May 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29757786/management-of-venous-thromboembolism-with-non-vitamin-k-oral-anticoagulants-a-review-for-nurse-practitioners-and-pharmacists
#4
Michelle Schmerge, Sally Earl, Carol Kline
BACKGROUND AND PURPOSE: Venous thromboembolism (VTE), comprising deep-vein thrombosis and pulmonary embolism, is associated with significant morbidity and mortality. Non-vitamin K oral anticoagulants (NOACs), including apixaban, betrixaban, dabigatran, edoxaban, and rivaroxaban, are as effective and safe as vitamin K antagonists (VKAs) for primary prophylaxis, treatment, and/or secondary prevention of VTE and present significant advantages in convenience of use. This review provides guidance to nurse practitioners (NPs) and pharmacists on NOAC usage for the management of VTE and examines how traditional anticoagulation clinics can adapt to cater to patients on NOACs...
April 2018: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/29753382/may-thurner-syndrome
#5
Yub Raj Sedhai, Reshma Golamari, Aliaksei Salei, Joseph Alukal, Soney Basnyat, Sunil Pathak, Santosh Timalsina, Subtain Zia, Suraj Malhan, Priyanka T Bhatacharya
This single-center, retrospective review identified 6 patients (n = 6, 100% female) treated by endovascular therapy for May-Thurner syndrome from June 2013 to September 2015. Patients consisted of 3 African American, 2 Caucasian and 1 Asian; mean age was 53.50 ± 8.31 years, range: 39-63 years. Clinical presentations consisted of left lower extremity deep vein thrombosis in 4, left lower extremity deep vein thrombosis with pulmonary embolism in 1 and pulmonary embolism with left common iliac vein thrombosis in 1 patient...
May 2018: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/29746227/comparison-of-an-oral-factor-xa-inhibitor-with-low-molecular-weight-heparin-in-patients-with-cancer-with-venous-thromboembolism-results-of-a-randomized-trial-select-d
#6
Annie M Young, Andrea Marshall, Jenny Thirlwall, Oliver Chapman, Anand Lokare, Catherine Hill, Danielle Hale, Janet A Dunn, Gary H Lyman, Charles Hutchinson, Peter MacCallum, Ajay Kakkar, F D Richard Hobbs, Stavros Petrou, Jeremy Dale, Christopher J Poole, Anthony Maraveyas, Mark Levine
Purpose Venous thromboembolism (VTE) is common in patients with cancer. Long-term daily subcutaneous low molecular weight heparin has been standard treatment for such patients. The purpose of this study was to assess if an oral factor Xa inhibitor, rivaroxaban, would offer an alternative treatment for VTE in patients with cancer. Patient and Methods In this multicenter, randomized, open-label, pilot trial in the United Kingdom, patients with active cancer who had symptomatic pulmonary embolism (PE), incidental PE, or symptomatic lower-extremity proximal deep vein thrombosis (DVT) were recruited...
May 10, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/29745099/incidence-and-risk-assessment-of-venous-thromboembolism-in-cancer-patients-admitted-to-intensive-care-unit-for-postoperative-care
#7
Jia-Xuan Xu, Jun Dong, Hong Ren, Xiao-Jie Chen, Yong Yang, Ren-Xiong Chen, Guo-Dong Wang, Hong-Zhi Wang
PURPOSE: Cancer patients undergoing surgery are at high risk of venous thromboembolism (VTE). The occurrence of VTE in Chinese cancer patients admitted to intensive care unit (ICU) for postoperative care is poorly characterized. This study was designed to investigate the incidence of VTE in this population and to evaluate the utility of the Caprini score in risk stratification. METHODS: 2127 consecutive adult patients admitted to a 10-bed surgical ICU (SICU) in a tertiary care academic hospital during a 4-year period (January 1, 2013 - December 31, 2016) were enrolled...
January 2018: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
https://www.readbyqxmd.com/read/29729658/effect-of-intermittent-pneumatic-compression-on-preventing-deep-vein-thrombosis-among-stroke-patients-a-systematic-review-and-meta-analysis
#8
Dongdong Zhang, Fenfen Li, Xiaotian Li, Ganqin Du
BACKGROUND: Deep vein thrombosis (DVT) and subsequent pulmonary embolism (PE) are common complications of stroke. However, the effect of intermittent pneumatic compression (IPC) for patients after stroke is uncertain. OBJECTIVES: To assess the effectiveness and safety of IPC in reducing the risk of DVT, PE, and mortality in stroke patients. METHODS: We searched leading medical databases including Medline, EMBASE, Cochrane Library, Wanfang, CNKI, and CBM, from inception to June 2, 2017...
May 5, 2018: Worldviews on Evidence-based Nursing
https://www.readbyqxmd.com/read/29727761/systematic-review-and-meta-analyses-of-tranexamic-acid-use-for-bleeding-reduction-in-prostate-surgery
#9
REVIEW
Marcelo A Longo, Bárbara T Cavalheiro, Getúlio R de Oliveira Filho
BACKGROUND: Prostate cancer and benign prostatic hyperplasia have an increased incidence with aging. The most effective treatments are radical prostatectomy and transurethral resection of the prostate. To reduce perioperative bleeding in these surgeries, an approach is the use of tranexamic acid (TXA). Studies show that TXA is effective in reducing the blood loss and the need for transfusion in cardiac, orthopedic, and gynecological surgeries. In prostate surgeries, its efficacy and safety have not been established yet...
May 1, 2018: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29723672/tranexamic-acid-versus-aminocaproic-acid-for-blood-management-after-total-knee-and-total-hip-arthroplasty-a-systematic-review-and-meta-analysis
#10
REVIEW
Qiuliang Liu, Peishuo Geng, Longyan Shi, Qi Wang, Pengliang Wang
OBJECTIVE: To compare the efficacy and safety of tranexamic acid and aminocaproic acid for reducing blood loss and transfusion requirements after total knee and total hip arthroplasty. METHODS: We conduct electronic searches of Medline (1966-2017.11), PubMed (1966-2017.11), Embase (1980-2017.11), ScienceDirect (1985-2017.11) and the Cochrane Library (1900-2017.11). The primary outcomes, including total blood loss, hemoglobin decline and transfusion requirements...
April 30, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29720096/celiac-crisis-a-rare-and-profound-presentation-of-celiac-disease-a-case-report
#11
Elizabeth Ann Forrest, Mark Wong, Srinivasa Nama, Siddharth Sharma
BACKGROUND: Celiac crisis is a life-threatening manifestation of celiac disease and is rare in adults, with only a handful of cases documented worldwide and mostly in children. CASE PRESENTATION: A profoundly emaciated 43-year-old female presented with profuse diarrhoea, shortness of breath, left leg swelling with ulceration and immobility (Body Mass Index (BMI) = 14.7 kg/m2 ). The patient had normal anion-gap metabolic acidosis (pH = 7.16) with persisting hypokalemia, hyponatremia, hypomagnesemia and hypophosphatemia...
May 2, 2018: BMC Gastroenterology
https://www.readbyqxmd.com/read/29719492/design-and-rationale-of-the-non-interventional-edoxaban-treatment-in-routine-clinical-practice-in-patients-with-venous-thromboembolism-in-europe-etna-vte-europe-study
#12
Alexander T Cohen, Cihan Ay, Philippe Hainaut, Hervé Décousus, Ulrich Hoffmann, Sean Gaine, Michiel Coppens, Pedro Marques da Silva, David Jimenez Castro, Beatrice Amann-Vesti, Bernd Brüggenjürgen, Pierre Levy, Julio Lopez Bastida, Eric Vicaut, Petra Laeis, Eva-Maria Fronk, Wolfgang Zierhut, Thomas Malzer, Peter Bramlage, Giancarlo Agnelli
Background: Venous thromboembolism (VTE, including deep vein thrombosis [DVT] and pulmonary embolism [PE]) has an annual incidence rate of 104-183 per 100,000 person-years. After a VTE episode, the two-year recurrence rate is about 17%. Consequently, effective and safe anticoagulation is paramount. Edoxaban is a direct oral anticoagulant (DOAC) approved VTE treatment. Current safety and efficacy data are derived from clinical trials, and information about treatment durations beyond 12 months are not available...
2018: Thrombosis Journal
https://www.readbyqxmd.com/read/29709665/symptomatic-venous-thromboembolism-is-associated-with-inferior-survival-among-patients-undergoing-nephrectomy-with-inferior-vena-cava-tumor-thrombectomy-for-renal-cell-carcinoma
#13
Paras H Shah, R Houston Thompson, Stephen A Boorjian, Christine M Lohse, Timothy D Lyon, Raymond C Shields, David Froehling, Bradley C Leibovich, Boyd R Viers
PURPOSE: To investigate the incidence and survival impact of symptomatic venous thromboembolism after nephrectomy with inferior vena cava tumor thrombectomy. METHODS: A retrospective review was performed of 183 patients undergoing nephrectomy with inferior vena cava tumor thrombectomy (Level I-IV) between 2000 and 2010 for renal cell carcinoma. Postoperative venous thromboembolism was defined as symptomatic bland thrombus or embolism confirmed with imaging. Cumulative incidence of venous thromboembolism was estimated using the Kaplan-Meier method...
April 27, 2018: Journal of Urology
https://www.readbyqxmd.com/read/29708541/deep-vein-thrombosis-induced-by-stasis-in-mice-monitored-by-high-frequency-ultrasonography
#14
Ryan N Rys, Mark D Blostein, Catherine A Lemarié
Venous thrombosis is a common condition affecting 1 - 2% of the population, with an annual incidence of 1 in 500. Venous thrombosis can lead to death through pulmonary embolism or results in the post-thrombotic syndrome, characterized by chronic leg pain, swelling, and ulceration, or in chronic pulmonary hypertension resulting in significant chronic respiratory compromise. This is the most common cardiovascular disease after myocardial infarction and ischemic stroke and is a clinical challenge for all medical disciplines, as it can complicate the course of other disorders such as cancer, systemic disease, surgery, and major trauma...
April 13, 2018: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29707339/effect-of-low-molecular-weight-heparin-on-venous-thromboembolism-disease-in-thoracotomy-patients-with-cancer
#15
Jun Dong, Jia Wang, Yuan Feng, Li-Ping Qi, Hua Fang, Guo-Dong Wang, Zhou-Qiao Wu, Hong-Zhi Wang, Yue Yang, Qing Li
Background: Much attention has been given to venous thromboembolism (VTE) disease, and many guidelines for prophylaxis have been published. However, there are few published data on patients who underwent thoracotomy. This study is to compare the effect of low molecular weight heparin (LMWH) combined mechanical approaches with mechanical approaches alone in prevention of VTE in the post thoracotomy cancer patients. Methods: This study used a prospective, randomized-controlled design...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29707297/atrial-fibrillation-is-related-to-lower-incidence-of-deep-venous-thrombosis-in-patients-with-pulmonary-embolism
#16
Khalid Bin Waleed, Xumin Guan, Xintao Li, Yiheng Yang, Zhao Wang, Xiaomeng Yin, Zhengyan Wang, Jianghai Liu, Lianjun Gao, Dong Chang, Xianjie Xiao, Rongfeng Zhang, Gary Tse, Yunlong Xia
Background: Atrial fibrillation (AF) is an established risk factor of left atrial thrombosis and systemic embolism. Traditionally pulmonary embolism (PE) is a recognized complication of deep vein thrombosis (DVT). However, whether AF is responsible for right atrial thrombosis and leads to PE has not been examined. Methods: We retrospectively analyzed medical records of patients with confirmed diagnosis of PE with AF (study group) from 2002-2015. Patients with PE without AF, matched by age and sex, served as controls (control group)...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29703562/d-dimer-levels-in-vte-patients-with-distal-and-proximal-clots
#17
Adam J Singer, Hui Zheng, Samuel Francis, Gregory J Fermann, Anne Marie Chang, Blair A Parry, Nick Giordano, Christopher Kabrhel
OBJECTIVES: There is growing evidence that venous thromboembolism (VTE) patients with distal clots (distal calf deep vein thrombosis [DVT] and sub-segmental pulmonary embolism [PE]) may not routinely benefit from anticoagulation. We compared the D-dimer levels in VTE patients with distal and proximal clots. METHODS: We conducted a multinational, prospective observational study of low-to-intermediate risk adult patients presenting to the emergency department (ED) with suspected VTE...
April 21, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29703470/apixaban-for-the-prevention-of-venous-thromboembolism-in-high-risk-ambulatory-cancer-patients-receiving-chemotherapy-rational-and-design-of-the-avert-trial
#18
Miriam Kimpton, Philip S Wells, Marc Carrier
Patients with active cancer have a heightened risk of venous thromboembolism (VTE). This risk is further increased by the initiation of chemotherapy. Although previous studies have suggested that the use of parenteral thromboprophylaxis in all ambulatory cancer patients receiving chemotherapy significantly decreases the rate of VTE, current clinical practice guidelines do not recommend routine use of thromboprophylaxis in this patient population. A major criticism of these studies has been the inclusion of patients at lower risk for VTE, which may have diluted the potential beneficial effect of the parenteral thromboprophylaxis...
April 2018: Thrombosis Research
https://www.readbyqxmd.com/read/29701703/molecular-and-clinical-issues-about-the-risk-of-venous-thromboembolism-in-older-patients-a-focus-on-parkinson-s-disease-and-parkinsonism
#19
REVIEW
Claudio Tana, Fulvio Lauretani, Andrea Ticinesi, Beatrice Prati, Antonio Nouvenne, Tiziana Meschi
Venous thromboembolism (VTE) is a common and potentially life-threatening condition which includes both deep-vein thrombosis (DVT) and pulmonary embolism (PE). VTE has a significant clinical and epidemiological impact in the elderly, and its incidence increases to more than 1% per year in older patients, suggesting the presence of specific age-related risk factors in this population. Immobilization seems to predominate as the main cause in patients admitted for medical acute illness in medicine wards, and there is evidence of a high risk in older patients with immobilization resulting from advanced forms of Parkinson’s disease (PD), regardless of the presence of an acute medical condition...
April 26, 2018: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29692193/incidence-of-clinically-suspected-venous-thromboembolism-in-british-indian-patients
#20
B M Siddiqui, M S Patel, S Rudge, A Best, J Mangwani
Introduction Venous thromboembolism (VTE) remains a major public health issue around the world. Ethnicity is known to alter the incidence of VTE. To our knowledge, there are no reports in the literature investigating the incidence of VTE in British Indians. The aim of this study was to investigate the rates of symptomatic VTE in British Indian patients in the UK. Methods Patients referred to our institution between January 2011 and August 2013 with clinically suspected VTE were eligible for inclusion in the study...
May 2018: Annals of the Royal College of Surgeons of England
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