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deep vein thrombosis prophylaxis

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https://www.readbyqxmd.com/read/28516316/venous-thromboembolism-after-nephrectomy-incidence-timing-and-associated-risk-factors-from-a-national-multi-institutional-database
#1
Brian J Jordan, Richard S Matulewicz, Brian Trihn, Shilajit Kundu
PURPOSE: To evaluate the rate of venous thromboembolism (VTE) after nephrectomy with specific focus on event timing and location (before or after hospital discharge) in order to identify modifiable risk factors and establish benchmarks for preventive interventions. METHODS: Using the ACS-NSQIP database, we identified patients undergoing nephrectomy from 2006 to 2012. Patients were analyzed in two cohorts: collectively and by surgical approach [open vs. lap/robotic (MIS)]...
May 17, 2017: World Journal of Urology
https://www.readbyqxmd.com/read/28492861/vena-cava-filter-use-in-trauma-and-rates-of-pulmonary-embolism-2003-2015
#2
Alan D Cook, Brian W Gross, Turner M Osler, Katelyn J Rittenhouse, Eric H Bradburn, Steven R Shackford, Frederick B Rogers
Importance: Vena cava filter (VCF) placement for pulmonary embolism (PE) prophylaxis in trauma is controversial. Limited research exists detailing trends in VCF use and occurrence of PE over time. Objective: To analyze state and nationwide temporal trends in VCF placement and PE occurrence from 2003 to 2015 using available data sets. Design, Setting, and Participants: A retrospective trauma cohort study was conducted using data from the Pennsylvania Trauma Outcome Study (PTOS) (461 974 patients from 2003 to 2015), the National Trauma Data Bank (NTDB) (5 755 095 patients from 2003 to 2014), and the National (Nationwide) Inpatient Sample (NIS) (24 449 476 patients from 2003 to 2013) databases...
May 10, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28479182/sex-disparity-in-stroke-quality-of-care-in-a-community-based-study
#3
Mollie McDermott, Lynda D Lisabeth, Jonggyu Baek, Eric E Adelman, Nelda M Garcia, Erin Case, Morgan S Campbell, Lewis B Morgenstern, Darin B Zahuranec
BACKGROUND: Studies have suggested that women may receive lower stroke quality of care (QOC) than men, although population-based studies at nonacademic centers are limited. We investigated sex disparities in stroke QOC in the Brain Attack Surveillance in Corpus Christi Project. METHODS: All ischemic stroke patients admitted to 1 of 6 Nueces County nonacademic hospitals between February 2009 and June 2012 were prospectively identified. Data regarding compliance with 7 performance measures (PMs) were extracted from the medical records...
May 4, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28439702/a-comparison-of-apixaban-and-dabigatran-etexilate-for-thromboprophylaxis-following-hip-and-knee-replacement-surgery
#4
Adriane Mayer, Philipp Schuster, Bernd Fink
INTRODUCTION: Patients who have undergone hip or knee replacement surgery are exposed to a high risk of developing a post-operative venous thromboembolus and so have a need for an effective, medication-based, thrombosis prophylaxis. New orally active anticoagulants have been available for a few years now. These specific substances directly block either thrombin (e.g., dabigatran etexilate) or Factor Xa (e.g., apixaban). It is not clear whether there are any efficacy differences between these two substances because there have never been any head-to-head studies carried out...
April 24, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28432715/complications-of-pregnancy-and-labor-in-women-with-klippel-trenaunay-syndrome-a-nationwide-cross-sectional-study
#5
S E R Horbach, M M Lokhorst, C E U Oduber, S Middeldorp, J A M van der Post, C M A M van der Horst
OBJECTIVE: To evaluate complications of pregnancy, including thromboembolism, in women with extensive vascular malformations associated with Klippel-Trenaunay Syndrome (KTS). DESIGN: Nationwide cross-sectional study. SETTING: Two tertiary expert centers and the Dutch Klippel-Trenaunay patient organization. SAMPLE: Adult women with KTS. METHODS: Patients with KTS were invited to participate in a comprehensive online survey about their obstetric history...
April 22, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28431186/unfractionated-heparin-versus-low-molecular-weight-heparins-for-avoiding-heparin-induced-thrombocytopenia-in-postoperative-patients
#6
REVIEW
Daniela R Junqueira, Liliane M Zorzela, Edson Perini
BACKGROUND: Heparin-induced thrombocytopenia (HIT) is an adverse drug reaction presenting as a prothrombotic disorder related to antibody-mediated platelet activation. It is a paradoxical immune reaction resulting in thrombin generation in vivo, which leads to a hypercoagulable state and the potential to initiate venous or arterial thrombosis. A number of factors are thought to influence the incidence of HIT including the type and preparation of heparin (unfractionated heparin (UFH) or low molecular weight heparin (LMWH)) and the heparin-exposed patient population, with the postoperative patient population at higher risk...
April 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28427109/traveler-s-diarrhea-vision-abnormalities-and-unsteady-gait-in-a-young-woman
#7
Tobias Mühling, Felix Gundling, Thomas Helmberger, Wolfgang Schepp
We report on the course of disease in a young woman, originally admitted with suspected refractory infectious tropical traveler's diarrhea. However, symptoms did not resolve upon either symptomatic or subsequent antibiotic therapy. When neurologic deterioration was observed, imaging studies revealed a dramatic series of thromboembolic events, including intracranial hemorrhage caused by extensive sinus vein thrombosis as well as thrombi of the right cardiac ventricle. Colonic mucosal biopsy samples finally led to the histologic diagnosis of ulcerative colitis...
April 2017: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/28426561/unfractionated-heparin-versus-low-molecular-weight-heparin-for-venous-thromboembolism-prophylaxis-in-trauma
#8
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
#9
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
https://www.readbyqxmd.com/read/28392450/efficacy-and-safety-of-thromboembolism-prophylaxis-with-fondaparinux-in-japanese-colorectal-cancer-patients-undergoing-laparoscopic-surgery-a-phase-ii-study
#10
Katsuji Tokuhara, Hideyuki Matsushima, Yosuke Ueyama, Kazuyoshi Nakatani, Kazuhiko Yoshioka, Masanori Kon
PURPOSE: We aimed to assess the safety and efficacy of fondaparinux (FPNX) for patients undergoing laparoscopic colorectal surgery (LAC). METHODS: Patients scheduled for LAC received once-daily subcutaneous injections of FPNX 1.5-2.5 mg for 4-8 days. The primary endpoint was the incidence of bleeding events. The secondary endpoint was the incidence of deep vein thrombosis (DVT) and pulmonary embolism (PE). RESULTS: Among 128 patients evaluable for efficacy, 119 patients were administered FPNX...
April 6, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28381322/efficacy-and-safety-of-an-intravenous-c1-inhibitor-concentrate-for-long-term-prophylaxis-in-hereditary-angioedema
#11
Timothy Craig, Ralph Shapiro, Arthur Vegh, James W Baker, Jonathan A Bernstein, Paula Busse, Markus Magerl, Inmaculada Martinez-Saguer, Marc A Riedl, William Lumry, Debora Williams-Herman, Jonathan Edelman, Henrike Feuersenger, Thomas Machnig, Mikhail Rojavin
BACKGROUND: The plasma-derived, pasteurized, nanofiltered C1-inhibitor concentrate (pnfC1-INH) is approved in the United States as an intravenous (IV) on-demand treatment for hereditary angioedema (HAE) attacks, and, in Europe, as on demand and short-term prophylaxis. OBJECTIVE: This analysis evaluated Berinert Patient Registry data regarding IV pnfC1-INH used as long-term prophylaxis (LTP). METHODS: The international registry (2010-2014) collected prospective and retrospective usage, dosing, and safety data on individuals who used pnfC1-INH for any reason...
March 1, 2017: Allergy & Rhinology
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
#12
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/28343749/manual-calf-massage-and-passive-ankle-motion-reduce-the-incidence-of-deep-vein-thromboembolism-after-total-hip-arthroplasty
#13
Norio Imai, Tomoyuki Ito, Ken Suda, Dai Miyasaka, Naoto Endo
BACKGROUND: Venous thromboembolism is one of the general complications following total hip arthroplasty, wherein various preventive treatments have been recommended. Several studies reported that venous thromboembolism incidence after total hip arthroplasty was similar in patients who were administered prophylaxis with a conventional mechanical procedure alone, and those who were administered pharmacological anticoagulation therapy. Therefore, the optimum methods of prophylaxis are still controversial...
March 24, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/28325458/chronic-subdural-hematoma-icu-management
#14
REVIEW
Jeremy T Ragland, Kiwon Lee
Patients with cSDH presenting with new or worsening neurological deficits, especially if they are debilitating and adversely affecting quality of life require urgent medical and surgical attention. Neurological and neurosurgical critical care team need to stabilize the patient by reversing any underlying coagulopathy states in order to prevent further hematoma expansion.In the event of brain herniation and presumed ICP elevation and CPP compromise, step-wise ICP management should be instituted promptly.Seizure prophylaxis treatment is reasonable...
April 2017: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/28314981/time-trends-in-incidence-rates-of-venous-thromboembolism-in-a-large-cohort-recruited-from-the-general-population
#15
Nadia Arshad, Trond Isaksen, John-Bjarne Hansen, Sigrid K Brækkan
Changes in the incidence of venous thromboembolism (VTE) during the last two decades have not been extensively studied. Therefore, we studied time trends in the incidence rates (IRs) of deep vein thrombosis (DVT) and pulmonary embolism (PE) in a cohort of 26,855 subjects, aged 25-97 years, enrolled in the Tromsø study in 1994/1995. The subject were followed-up throughout 2012, and all symptomatic, objectively confirmed, incident VTEs were identified using multiple sources (hospital discharge-, radiology procedure- and autopsy registry) and validated by review of medical records...
March 17, 2017: European Journal of Epidemiology
https://www.readbyqxmd.com/read/28286820/deep-vein-thrombosis-among-intensive-care-unit-patients-an-epidemiologic-study
#16
MirMohammad Miri, Reza Goharani, Mohammad Sistanizad
INTRODUCTION: Deep vein thrombosis (DVT) is a major cause of morbidity and mortality in intensive care unit (ICU) patients despite use of prophylactic anticoagulant therapy. The aim of the present study was to determine the incidence of DVT among medical and surgical ICU patients. METHODS: In this cross sectional study, patients older than 18 years who were hospitalized in the ICU of Imam Hossein educational Hospital, Tehran, Iran, for ≥ 2 days, during August 2008 to July 2011 were evaluated regarding DVT incidence...
2017: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/28214760/genotyping-analysis-of-protein-s-tokushima-k196e-and-the-involvement-of-protein-s-antigen-and-activity-in-patients-with-recurrent-pregnancy-loss
#17
Yasushi Matsukawa, Eriko Asano, Tomohide Tsuda, Hiroyuki Kuma, Tamao Kitaori, Kinue Katano, Yasuhiko Ozaki, Mayumi Sugiura-Ogasawara
OBJECTIVE: Preston et al. indicated that Protein S (PS) deficiency was associated with stillbirths but not miscarriages. The PS-Tokushima missense variant was reported to serve as a genetic risk factor for deep vein thrombosis in the Japanese population. A previous cross-sectional study showed no increase in the prevalence of PS-Tokushima in patients with recurrent early pregnancy loss or in patients with intra uterine fetal death and/or fetal growth restriction. There has been limited number of prospective studies examining the pregnancy outcome in patients with both a PS deficiency and recurrent pregnancy loss (RPL)...
February 8, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28214257/a-comparison-of-two-dosing-regimens-of-asa-following-total-hip-and-knee-arthroplasties
#18
Michael J Feldstein, Sara L Low, Antonia F Chen, Laura A Woodward, William J Hozack
BACKGROUND: The purpose of this study was to compare short-term side effects of aspirin (ASA) 325 mg vs ASA 81 mg orally twice daily (PO BID) when used as thromboembolic prophylaxis following primary total joint arthroplasty. METHODS: A 1-year prospective cohort study was performed on 643 primary unilateral total joint arthroplasty patients operated on by a single surgeon. Two hundred eighty-two patients were administered ASA 325 mg PO BID and 361 patients were administered ASA 81 mg PO BID for 1 month...
January 24, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28196814/racial-ethnic-disparities-in-acute-stroke-care-in-the-florida-puerto-rico-collaboration-to-reduce-stroke-disparities-study
#19
Ralph L Sacco, Hannah Gardener, Kefeng Wang, Chuanhui Dong, Maria A Ciliberti-Vargas, Carolina M Gutierrez, Negar Asdaghi, W Scott Burgin, Olveen Carrasquillo, Enid J Garcia-Rivera, Ulises Nobo, Sofia Oluwole, David Z Rose, Michael F Waters, Juan Carlos Zevallos, Mary Robichaux, Salina P Waddy, Jose G Romano, Tatjana Rundek
BACKGROUND: Racial-ethnic disparities in acute stroke care can contribute to inequality in stroke outcomes. We examined race-ethnic disparities in acute stroke performance metrics in a voluntary stroke registry among Florida and Puerto Rico Get With the Guidelines-Stroke hospitals. METHODS AND RESULTS: Seventy-five sites in the Florida Puerto Rico Stroke Registry (66 Florida and 9 Puerto Rico) recorded 58 864 ischemic stroke cases (2010-2014). Logistic regression models examined racial-ethnic differences in acute stroke performance measures and defect-free care (intravenous tissue plasminogen activator treatment, in-hospital antithrombotic therapy, deep vein thrombosis prophylaxis, discharge antithrombotic therapy, appropriate anticoagulation therapy, statin use, smoking cessation counseling) and temporal trends...
February 14, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28185212/economic-evaluations-of-new-oral-anticoagulants-for-the-prevention-of-venous-thromboembolism-after-total-hip-or-knee-replacement-a-systematic-review
#20
REVIEW
James Brockbank, Sorrel Wolowacz
BACKGROUND: Total hip replacement (THR) and total knee replacement (TKR) surgeries are being performed with increasing regularity and are associated with a high risk of developing a venous thromboembolism (VTE). New oral anticoagulants (NOACs) may be more effective at preventing VTEs but are associated with more bleeding events versus traditional anticoagulants. OBJECTIVE: The objective of this systematic review was to identify published economic analyses of NOACs for primary VTE prophylaxis following THR and TKR surgeries, and to summarise the modelling techniques used and the cost-effectiveness results...
May 2017: PharmacoEconomics
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