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DVT AND trauma

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https://www.readbyqxmd.com/read/28900890/high-level-of-venous-thromboembolism-in-critically-ill-trauma-patients-despite-early-and-well-driven-thromboprophylaxis-protocol
#1
S R Hamada, C Espina, T Guedj, R Buaron, A Harrois, S Figueiredo, J Duranteau
BACKGROUND: Venous thromboembolism (VTE) is one of the most common preventable causes of in-hospital death in trauma patients surviving their injuries. We assessed the prevalence, incidence and risk factors for deep venous thrombosis (DVT) and pulmonary embolism (PE) in critically ill trauma patients, in the setting of a mature and early mechanical and pharmacological thromboprophylaxis protocol. METHODS: This was a prospective observational study on a cohort of patients from a surgical intensive care unit of a university level 1 trauma centre...
September 12, 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28891535/doppler-sonographic-evaluation-of-venogenic-extremity-swellings-analysis-of-170-patients-from-kano-nigeria
#2
A Ismail, A M Tabari, K Isyaku
INTRODUCTION: Deep venous thrombosis (DVT) is a serious problem that can potentially lead to many complications including life-threatening pulmonary arterial thrombosis. Screening and confirmation of the diagnosis are critical in the care of this condition. OBJECTIVES: The objective of this study was to evaluate the role of Doppler sonography in diagnosing DVT and to illustrate the pattern in 170 suspected cases from our local environment. MATERIALS AND METHODS: This study was conducted at our department over 18 months...
August 2017: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/28865588/the-effect-of-active-toe-movement-atom-on-calf-pump-function-and-deep-vein-thrombosis-in-patients-with-acute-foot-and-ankle-trauma-treated-with-cast-a-prospective-randomized-study
#3
Ben A Hickey, Andrew Cleves, Raza Alikhan, Neil Pugh, Len Nokes, Anthony Perera
BACKGROUND: Patients with foot and ankle trauma treated with cast are advised to perform toe movements to prevent venous thromboembolism (VTE). Our aim was to determine the effect of active toe movement on asymptomatic deep vein thrombosis (DVT) and venous calf pump function. METHODS: Patients aged 18-60 years with acute foot and ankle trauma requiring below knee non weight bearing cast were randomized to intervention (regular active toe movement) or control groups (n=100)...
September 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28863205/bruises-on-the-ears-and-body
#4
Diana M Sarmiento, Thomas F Northrup, Yu Wah
Over the course of a month, this 34-year-old woman had sought care at our facility--and another--on 3 separate occasions for painful bruises (visits #1 and #3) and deep vein thrombosis (visit #2). The bruises first appeared acutely on her arms, prompting her first visit to our ED and leading to a hospital stay. Several weeks later, the patient developed new bruise-like lesions on her earlobes, face, trunk, and lower extremities. In between these 2 visits, the patient was seen in another ED (and admitted) for right upper extremity DVT and was started on enoxaparin, followed by warfarin...
September 2017: Journal of Family Practice
https://www.readbyqxmd.com/read/28863078/the-prevalence-of-chronic-deep-venous-thrombosis-in-trauma-implications-for-hospitals-and-patients
#5
Kathleen A Cannon, Jayraan Badiee, James D Wallace, Jason B Brill, Michael J Sise, Vishal Bansal, C Beth Sise, Steven R Shackford
INTRODUCTION: Deep venous thrombosis (DVT) is considered a preventable complication in trauma patients. Hospitals risk financial penalties for DVT rates above accepted benchmarks. These penalties do not apply to chronic DVT which develop prior to admission. Lower-extremity duplex ultrasound (LEDUS) can detect characteristics of thrombus chronicity, allowing differentiation of chronic from acute DVT. The objective of this study was to determine the prevalence of chronic DVT in hospitalized trauma patients...
August 31, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28808595/a-case-of-superficial-femoral-arteriovenous-fistula-and-severe-venous-stasis-ulceration-managed-with-an-iliac-extender-prosthesis
#6
Nicole Ilonzo, Selena Goss, Chun Yang, Michael Dudkiewicz
Most femoral artery arteriovenous fistulas occur as a result of percutaneous interventions. However, arteriovenous fistulas can occur in the setting of trauma, with resultant consequences such as heart failure, steal syndrome, or venous insufficiency. Indications for endovascular repair in this setting are limited to patients who are at too high risk for anesthesia, have a hostile groin, or would not survive significant bleeding. We report the case of a traumatic femoral arteriovenous fistula, causing severe venous insufficiency and arteriomegaly, in a 58-year-old male, with history of traumatic gunshot wound complicated by popliteal DVT...
2017: Case Reports in Vascular Medicine
https://www.readbyqxmd.com/read/28742784/treatment-and-complications-of-patients-with-ipsilateral-acetabular-and-femur-fractures-a-multicenter-retrospective-analysis
#7
Justin M Hire, Preston J Boyer, Heidi Israel, Lisa K Cannada, Hassan Mir, Jason Halvorson, Gregory J Della Rocca, Bryan Ming, Brian Mullis, Chetan Deshpande
OBJECTIVES: The purpose of this study was to review the treatment of ipsilateral acetabular and femur fracture patients to provide descriptive demographic data, injury pattern classification, treatment and evaluate the complication profile reflective of current practices. STUDY DESIGN: Multicenter retrospective cohort. SETTING: Eight Level 1 Trauma Centers. PATIENTS/PARTICIPANTS: 101 patients met inclusion criteria. INTERVENTION: Surgical treatment of both the acetabular and femur fracture...
July 24, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28736179/venous-thromboembolism-in-burn-patients-is-not-prevented-by-chemoprophylaxis
#8
Sheena Sikora, Anthony Papp
BACKGROUND: Venous thromboembolisms (VTE) including deep venous thrombosis and pulmonary embolism are serious complications following burn trauma. There are inconsistencies in the literature regarding thromboembolic prevention strategies and data suggests that complications occur despite chemoprophylaxis. OBJECTIVE: To determine the prevalence of deep venous thromboembolism and pulmonary embolism in burn patients who are actively being treated with VTE prophylaxis and to determine factors that help predict which anti-coagulated patients are at risk for VTE and may benefit from further treatment...
July 20, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28721003/patient-compliance-with-venous-thromboembolism-prophylaxis-vte
#9
John Ross Blackwell, Parag Raval, John-Patrick Quigley, Amit Patel, Donald McBride
Venous thromboembolic disease (VTE) comprises pulmonary embolism (PE) and deep vein thrombosis (DVT), and causes morbidity and mortality, particularly in trauma and orthopaedic patients. Prevalence of 0.9% and 1.2% respectively are reported, with mortality rates up to 13.8%. Chemical thromboprophylactic agents including low molecular weight heparin (LMWH) are considered cost effective in reducing VTE risk. Evidence for anti-platelets including Aspirin for VTE prophylaxis is less compelling and is not supported as monotherapy...
April 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28697017/risk-factors-for-deep-vein-thrombosis-and-pulmonary-embolism-after-traumatic-injury-a-competing-risks-analysis
#10
Jan-Michael Van Gent, Richard Y Calvo, Ashley L Zander, Erik J Olson, C Beth Sise, Michael J Sise, Steven R Shackford
BACKGROUND: Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), is typically reported as a composite measure of the quality of trauma center care. Given recent data suggesting post-injury DVT and PE are distinct clinical processes, a better understanding may result from analyzing them as independent, competing events. Using competing risks analysis, we evaluated our hypothesis that the risk factors and timing of post-injury DVT and PE are different...
July 8, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28642012/evaluation-of-a-device-combining-an-inferior-vena-cava-filter-and-a-central-venous-catheter-for-preventing-pulmonary-embolism-among-critically-ill-trauma-patients
#11
Victor F Tapson, Joshua P Hazelton, John Myers, Claudia Robertson, Ramyar Gilani, Julie A Dunn, Marko Bukur, Martin A Croce, Ann Peick, Sonlee West, Lawrence Lottenberg, Jay Doucet, Preston R Miller, Bruce Crookes, Rajesh R Gandhi, Chasen A Croft, Anthony Manasia, Brian A Hoey, Howard Lieberman, Oscar D Guillamondegui, Victor Novack, Gregory Piazza, Samuel Z Goldhaber
PURPOSE: To evaluate efficacy and safety of a novel device that combines an inferior vena cava (IVC) filter and central venous catheter (CVC) for prevention of pulmonary embolism (PE) in critically ill patients. MATERIALS AND METHODS: In a multicenter, prospective, single-arm clinical trial, the device was inserted at the bedside without fluoroscopy and subsequently retrieved before transfer from the intensive care unit (ICU). The primary efficacy endpoint was freedom from clinically significant PE or fatal PE 72 hours after device removal or discharge, whichever occurred first...
June 20, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28598908/the-rate-of-deep-vein-thrombosis-doubles-in-trauma-patients-with-hypercoagulable-thromboelastography
#12
Jason B Brill, Jayraan Badiee, Ashley L Zander, James D Wallace, Paul R Lewis, Michael J Sise, Vishal Bansal, Steven R Shackford
BACKGROUND: Venous thromboembolism (VTE) in trauma can occur in patients at low risk. Conventional coagulation tests do not predict VTE. Studies investigating thromboelastography (TEG) for VTE risk are conflicting and have not included routine surveillance to detect deep vein thrombosis (DVT). We undertook a prospective study of TEG to evaluate its utility in predicting VTE. METHODS: We conducted a prospective cohort study on all adult trauma patients admitted to our Level I trauma center from 2013 to 2015...
September 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28598905/military-use-of-txa-in-combat-trauma-does-it-matter
#13
Jeffrey T Howard, Zsolt T Stockinger, Andrew P Cap, Jeffrey A Bailey, Kirby R Gross
BACKGROUND: Tranexamic acid (TXA) has been previously reported to have a mortality benefit in civilian and combat-related trauma, and was thus added to the Joint Theater Trauma System Damage Control Resuscitation Clinical Practice Guideline. As part of ongoing system-wide performance improvement, the use of TXA has been closely monitored. The goal was to evaluate the efficacy and safety of TXA use in military casualties and provide additional guidance for continued use. METHODS: A total of 3,773 casualties were included in this retrospective, observational study of data gathered from a trauma registry...
June 9, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28556184/the-utility-of-on-site-ultrasound-screening-in-population-at-high-risk-for-deep-venous-thrombosis-in-temporary-housing-after-the-great-east-japan-earthquake
#14
Muneichi Shibata, Hiroshi Chiba, Kazuhiro Sasaki, Shinsaku Ueda, Osamu Yamamura, Kazuhiko Hanzawa
BACKGROUND: To evaluate the diagnostic performance of ultrasonography for screening of a population at risk for deep vein thrombosis (DVT) in a post-disaster setting. METHODS: Ultrasonography was applied as a screening technique to the residents of a temporary housing facility who were displaced following the Great East Japan Earthquake. Thirty DVT screening sessions were held from April 2013 to June 2015. Individuals were invited to participate if they were identified as "high risk" for DVT, defined as those with low activity levels, a history of lower limb trauma, baseline lower limb pain or swelling, a cancer-bearing status, or a history of venous thromboembolic event...
May 29, 2017: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/28494041/innovative-single-tooth-replacement-with-an-individual-root-analog-hybrid-implant-in-the-esthetic-zone-case-report
#15
Reza Saeidi Pour, Peter Randelzhofer, Daniel Edelhoff, Otto Prandtner, Caroline Freitas Rafael, Anja Liebermann
The goal of this study was to explore an innovative approach to single-tooth replacement using an individually custom-fabricated, root-analog, hybrid dental implant, in the esthetic zone, to avoid the microgap and micromovements between the implant and abutment. Moreover, the use of burs to prepare the implant recipient site is not necessary in this technique, reducing the bone removal, heating, and trauma. The process requires capturing accurate root geometry through combined computer-aided design/computer-assisted manufacturing (CAD/CAM) and a three-dimensional (3D) visualization (digital volume tomography [DVT]) of the tooth in situ, which might result in reduced remodeling after insertion...
May 2017: International Journal of Oral & Maxillofacial Implants
https://www.readbyqxmd.com/read/28487103/the-high-risk-polytrauma-patient-and-inferior-vena-cava-filter-use
#16
Onur Berber, Aswin Vasireddy, Obi Nzeako, Adel Tavakkolizadeh
OBJECTIVES: The aim of this study was to assess the impact on practice of vena cava filter insertion guidelines (Eastern Association for the Surgery of Trauma: practice management guidelines). DESIGN: The study was performed at a level 1 trauma centre with data from the 'Trauma Audit and Research Network' cross-referenced to hospital data. RESULTS: A total of 1138 specific 'high-risk' major trauma patients were identified over a 6-year period...
April 20, 2017: Injury
https://www.readbyqxmd.com/read/28474980/risk-of-deep-venous-thrombosis-in-elective-neurosurgical-procedures-a-prospective-doppler-ultrasound-based-study-in-children-12-years-of-age-or-younger
#17
Andrea G Scherer, Ian K White, Kashif A Shaikh, Jodi L Smith, Laurie L Ackerman, Daniel H Fulkerson
OBJECTIVE The risk of venous thromboembolism (VTE) from deep venous thrombosis (DVT) is significant in neurosurgical patients. VTE is considered a leading cause of preventable hospital deaths and preventing DVT is a closely monitored quality metric, often tied to accreditation, hospital ratings, and reimbursement. Adult protocols include prophylaxis with anticoagulant medications. Children's hospitals may adopt adult protocols, although the incidence of DVT and the risk or efficacy of treatment is not well defined...
July 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28429334/thrombolysis-of-deep-vein-thrombosis-and-inhibiting-chemotaxis-of-macrophage-by-mcp-1-blockage
#18
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
#19
COMPARATIVE STUDY
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...
July 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
#20
REVIEW
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
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