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https://www.readbyqxmd.com/read/28429334/thrombolysis-of-deep-vein-thrombosis-and-inhibiting-chemotaxis-of-macrophage-by-mcp-1-blockage
#1
Z-W Wang, J-J Wang, J-Z Zhang, Z-J Xue, J Miao, L Li, W-X Hu
OBJECTIVE: Deep vein thrombosis (DVT) is one common vascular complication after trauma or surgery. Macrophage plays an important role in recanalization of thrombosis and monocyte chemotactic protein 1 (MCP-1) has a potent chemotactic role for macrophage. This study investigated the role of MCP-1 and macrophage in DVT thrombolysis. MATERIALS AND METHODS: DVT mice model was established for evaluating thrombosis grades, and divided into DVT, DVT + MCP-1 recombinant protein, and DVT + MCP-1 neutralizing antibody groups...
April 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28426561/unfractionated-heparin-versus-low-molecular-weight-heparin-for-venous-thromboembolism-prophylaxis-in-trauma
#2
Benjamin N Jacobs, Anne H Cain-Nielsen, Jill L Jakubus, Judy N Mikhail, John J Fath, Scott E Regenbogen, Mark R Hemmila
BACKGROUND: Venous thromboembolism (VTE) is a common complication in trauma patients. Pharmacologic prophylaxis is utilized in trauma patients to reduce their risk of a VTE event. The Eastern Association for the Surgery of Trauma guidelines recommend use of low molecular weight heparin (LMWH) as the preferred agent in these patients. However, there is literature suggesting that unfractionated heparin (UFH) is an acceptable, and less costly, alternative VTE prophylaxis agent with equivalent efficacy in trauma patients...
April 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28424139/lethal-trauma-pulmonary-embolism-is-a-black-swan-event-in-patients-at-risk-for-deep-vein-thrombosis-an-evidence-based-review
#3
C Michael Dunham, Gregory S Huang
We delineated the incidence of trauma patient pulmonary embolism (PE) and risk conditions by performing a systematic literature review of those at risk for deep vein thrombosis (DVT). The PE proportion was 1.4 per cent (95% confidence interval = 1.2-1.6) in at-risk patients. Of 10 conditions, PE was only associated with increased age (P < 0.01) or leg injury (P < 0.01; risk ratio = 1.6). As lower extremity DVT (LEDVT) proportions increased, mortality proportions (P = 0.02) and hospital stay (P = 0.0002) increased, but PE proportions did not (P = 0...
April 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28416153/a-critical-review-of-patient-safety-indicators-attributed-to-trauma-surgeons
#4
Nicole Fox, Rebecca Willcutt, Adrienne Elberfeld, John Porter, Anthony J Mazzarelli
BACKGROUND: The Agency for Health Care Research and Quality (AHRQ) developed patient safety indicators (PSIs) to identify events with a high likelihood of representing medical error. The purpose of this study was to validate PSIs attributed to trauma surgeons and compare validated PSIs to performance improvement (PI) and morbidity and mortality (M&M) data. We hypothesized that PSIs are not an indicator of quality of care in trauma. METHODS: PSI's attributed to trauma surgeons (n=9) at our institution were reviewed (Jan-Dec 2015)...
April 1, 2017: Injury
https://www.readbyqxmd.com/read/28383471/clinical-practice-guideline-adherence-during-operation-inherent-resolve
#5
Timothy P Plackett, Darren C Cherry, Gerald Delk, Steven Satterly, Jared Theler, Derek McVay, Jacqueline Moore, Stacy A Shackelford
BACKGROUND: The Joint Trauma System (JTS) Clinical Practice Guidelines (CPGs) contributed to the decrease in battlefield morality over the past 15 years. However, it is unknown to what degree the guidelines are being followed in current military operations. METHODS: A retrospective review was performed of all patients treated at three separate US Army Role II facilities during the first ten months of Operation Inherent Resolve in Iraq. Charts were reviewed for patient demographics, clinical care, and outcomes...
April 5, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28367009/trauma-patients-warrant-upper-and-lower-extremity-venous-duplex-ultrasound-surveillance
#6
Alonso Andrade, Alan H Tyroch, Susan F McLean, Jody Smith, Alex Ramos
BACKGROUND: Due to the high incidence of thromboembolic events (deep venous thrombosis [DVT] and pulmonary embolus [PE]) after injury, many trauma centers perform lower extremity surveillance duplex ultrasounds. We hypothesize that trauma patients are at a higher risk of upper extremity DVTs (UEDVTs) than lower extremity DVTs (LEDVTs), and therefore, all extremities should be evaluated. MATERIALS AND METHODS: A retrospective chart and trauma registry review of Intensive Care Unit trauma patients with upper and LEDVTs detected on surveillance duplex ultrasound from January 2010 to December 2014 was carried out...
April 2017: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/28360495/the-incidence-of-deep-vein-thrombosis-and-pulmonary-embolism-after-fracture-of-the-tibia-an-analysis-of-the-national-trauma-databank
#7
Ronald Auer, John Riehl
Controversy exists regarding the routine use of chemical prophylaxis in isolated lower extremity fractures. The incidence of VTE in specific fracture locations in the lower extremity is largely unknown, and represents key information necessary to determine the need for prophylaxis. A large cross-sectional study using the National Trauma Databank was performed evaluating for the incidence and risk factors of VTE in isolated tibia fractures. The overall incidence of DVT and PE are extremely low in cases of isolated tibia fractures, which brings into doubt a role for routine use of chemical prophylaxis for these fractures...
January 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28110934/-posttraumatic-thromboembolic-complications-incidence-risk-factors-pathophysiology-and-prevention
#8
M Bahloul, K Regaieg, K Chtara, O Turki, N Baccouch, A Chaari, M Bouaziz
Venous thromboembolism (VTE) remains a major challenge in critically ill patients. Subjects admitted in intensive care unit (ICU), in particular trauma patients, are at high-risk for both deep vein thrombosis (DVT) and pulmonary embolism (PE). The rate of symptomatic PE in injured patients has been reported previously ranging from 1 to 6%. The high incidence of posttraumatic venous thromboembolic events is well known. In fact, major trauma is a hypercoagulable state. Several factors placing the individual patient at a higher risk for the development of DVT and PE have been suggested: high ISS score, meningeal hemorrhage and spinal cord injuries have frequently been reported as a significant risk factor for VTEs after trauma...
January 19, 2017: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/28108019/goal-directed-enoxaparin-dosing-provides-superior-chemoprophylaxis-against-deep-vein-thrombosis
#9
Tammy R Kopelman, Jarvis W Walters, James N Bogert, Usmaan Basharat, Paola G Pieri, Karole M Davis, Asia N Quan, Sydney J Vail, Melissa A Pressman
INTRODUCTION: Optimal enoxaparin dosing for deep venous thrombosis (DVT) prophylaxis remains elusive. Prior research demonstrated that trauma patients at increased risk for DVT based upon Greenfield's risk assessment profile (RAP) have DVT rates of 10.8% despite prophylaxis. The aim of this study was to determine if goal directed prophylactic enoxaparin dosing to achieve anti-Xa levels of 0.3-0.5IU/ml would decrease DVT rates without increased complications. MATERIALS AND METHODS: Retrospective review of trauma patients having received prophylactic enoxaparin and appropriately timed anti-Xa levels was performed...
November 3, 2016: Injury
https://www.readbyqxmd.com/read/28067012/venous-thromboembolism-in-pediatric-trauma-patients-ten-year-experience-and-long-term-follow-up-in-a-tertiary-care-center
#10
Christine M Leeper, Madhav Vissa, James D Cooper, Lynn M Malec, Barbara A Gaines
BACKGROUND: Pediatric trauma patients are at high risk for development of venous thromboembolism (VTE). Our objective is to describe incidence, risk factors, and timing of development of VTE, anticoagulation complications, and long-term VTE outcomes in a critically injured pediatric population. PROCEDURE: We did a retrospective review of pediatric (0-17 years) trauma admissions to intensive care unit from 2005 to 2014. Our center employs VTE screening and prevention protocols for high-risk patients based on hypercoagulable history, age, injuries, and medical interventions...
January 9, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28053388/prevalence-of-deep-vein-thrombosis-in-patients-with-lower-limb-trauma
#11
Chirag S Kapoor, Ashit K Mehta, Krunal Patel, Paresh P Golwala
INTRODUCTION: Venous thrombo-embolism (VTE), which consists of deep vein thrombosis (DVT) and pulmonary embolism, is a potentially fatal condition. According to Western literature, DVT of lower limb veins is one of the most common complications following surgeries for lower limb. Few studies have been published from India on the subject and little is known about the true prevalence of the DVT and hence there are no clear guidelines regarding the prophylaxis for DVT for Indian patients...
October 2016: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/27870674/impact-of-hospital-employed-physician-assistants-on-a-level-ii-community-based-orthopaedic-trauma-system
#12
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/27779597/abnormalities-in-fibrinolysis-at-the-time-of-admission-are-associated-with-deep-vein-thrombosis-mortality-and-disability-in-a-pediatric-trauma-population
#13
Christine M Leeper, Matthew D Neal, Christine McKenna, Jason L Sperry, Barbara A Gaines
BACKGROUND: Abnormalities in fibrinolysis are common and associated with increased mortality in injured adults. While hyperfibrinolysis (HF) and fibrinolysis shutdown (SD) are potential prognostic indicators and treatment targets in adults, these derangements are not well described in a pediatric trauma cohort. METHODS: This was a prospective analysis of highest level trauma activations in subjects aged 0 to 18 years presenting to our academic center between June 1, 2015, and July 31, 2016, with admission rapid thrombelastograph...
January 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27692532/retrievable-inferior-vena-cava-filters-in-trauma-patients-prevalence-and-management-of-thrombus-within-the-filter
#14
Y Pan, J Zhao, J Mei, M Shao, J Zhang, H Wu
OBJECTIVE: The incidence of thrombus was investigated within retrievable filters placed in trauma patients with confirmed DVT at the time of retrieval and the optimal treatment for this clinical scenario was assessed. A technique called "filter retrieval with manual negative pressure aspiration thrombectomy" for management of filter thrombus was introduced and assessed. METHODS: The retrievable filters referred for retrieval between January 2008 and December 2015 were retrospectively reviewed to determine the incidence of filter thrombus on a pre-retrieval cavogram...
December 2016: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27664391/early-thrombin-formation-capacity-in-trauma-patients-and-association-with-venous-thromboembolism
#15
Stacy A Voils, Stephen J Lemon, Janeen Jordan, Paul Riley, Reginald Frye
Incidence of venous thromboembolism (VTE) in adult trauma patients is high despite mechanical and pharmacologic prophylaxis. We hypothesized that thrombin formation capacity as measured by calibrated automated thrombogram (CAT) is increased early in hospitalization and is associated with the development of VTE. METHODS: We conducted a prospective study in adult, critically ill trauma patients. Plasma was generated from whole blood samples collected within the first 3days of hospital admission...
November 2016: Thrombosis Research
https://www.readbyqxmd.com/read/27639819/an-analysis-of-deep-vein-thrombosis-in-burn-patients-part-1-comparison-of-d-dimer-and-doppler-ultrasound-as-screening-tools
#16
COMPARATIVE STUDY
Rajeev B Ahuja, Priya Bansal, Gaurav S Pradhan, Manju Subberwal
INTRODUCTION: The high prevalence of deep vein thrombosis (DVT) reported in prospective studies and the unreliability of clinical diagnosis mandates prospective screening for DVT in burn patients. Our study seeks to compare D-dimer and Doppler ultrasound (DUS) in search for a practical, inexpensive and a reliable screening tool. METHODS: One hundred burn patients (inclusion criteria: 30-60% TBSA burn, >18 years of age, admitted within 48h of burn) were computer randomized into two equal groups...
December 2016: Burns: Journal of the International Society for Burn Injuries
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
#17
RANDOMIZED CONTROLLED TRIAL
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...
December 2016: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/27627722/f11-rs2289252t-and-rs2036914c-polymorphisms-increase-the-activity-of-factor-xi-in-post-trauma-patients-with-fractures-despite-thromboprophylaxis
#18
Nan Song, Ai-Xian Tian, Jian-Min Zhang, Hong-Qiang Jiang, Jia-Cheng Zang, Xin-Long Ma
OBJECTIVE: To evaluate the association between F11 rs2289252, rs2036914 polymorphisms and the activity of clotting factor XI in post-trauma patients with fractures receiving routine anticoagulation therapy for deep venous thrombosis (DVT). METHODS: A case-control study involving 110 consecutive post-trauma patients with fractures and DVT in our hospital was conducted from April 2014 to October 2015; these patients comprised a DVT group. Another 40 sex- and age-matched patients with fractures but without DVT served as controls...
August 2016: Orthopaedic Surgery
https://www.readbyqxmd.com/read/27611117/-post-thrombotic-panic-syndrome-a-thematic-analysis-of-the-experience-of-venous-thromboembolism
#19
Rachael Hunter, Sarah Lewis, Simon Noble, Jaynie Rance, Paul D Bennett
OBJECTIVES: Venous thromboembolism (VTE, including deep vein thrombosis [DVT] and pulmonary embolism [PE]) is a serious, potentially traumatic, life-threatening condition and a major cause of mortality and morbidity. The aim of this study was to explore the patients' experiences of VTE and its psychosocial impact. METHODS: Audio-recorded semistructured interviews with a purposive sample of 12 participants who had experienced a first-time DVT or PE within the previous 6 months...
February 2017: British Journal of Health Psychology
https://www.readbyqxmd.com/read/27600864/combined-intermittent-pneumatic-leg-compression-and-pharmacological-prophylaxis-for-prevention-of-venous-thromboembolism
#20
REVIEW
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
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