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deep vein thrombosis prophylaxis

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https://www.readbyqxmd.com/read/28634095/comparative-effectiveness-and-safety-of-drug-prophylaxis-for-prevention-of-venous-thromboembolism-after-total-knee-arthroplasty
#1
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/28612028/chronic-kidney-dysfunction-can-increase-the-risk-of-deep-vein-thrombosis-after-total-hip-and-knee-arthroplasty
#2
Qiangqiang Li, Bingyang Dai, Yao Yao, Kai Song, Dongyang Chen, Qing Jiang
BACKGROUND: Deep vein thrombosis (DVT) is one of the major complications of total joint arthroplasty (TJA). Chronic kidney dysfunction (CKD) has proven to promote a proinflammatory and prothrombotic state and is prevalent among patients undergoing TJA. The purpose of this study is to identify whether CKD increase the risk of DVT following TJA. METHODS: In a retrospective study, 1274 patients who underwent primary TJA were studied. CKD is graded in 5 stages. Univariate and multivariate analysis were used to identify the association of CKD and its severity with postoperative DVT...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28610546/neuromuscular-electrical-stimulation-for-the-prevention-of-venous-thromboembolism
#3
Raveena Ravikumar, Katherine J Williams, Adarsh Babber, Hayley M Moore, Tristan Ra Lane, Joseph Shalhoub, Alun H Davies
Objective Venous thromboembolism, encompassing deep vein thrombosis and pulmonary embolism, is a significant cause of morbidity and mortality, affecting one in 1000 adults per year. Neuromuscular electrical stimulation is the transcutaneous application of electrical impulses to elicit muscle contraction, preventing venous stasis. This review aims to investigate the evidence underlying the use of neuromuscular electrical stimulation in thromboprophylaxis. Methods The Medline and Embase databases were systematically searched, adhering to PRISMA guidelines, for articles relating to electrical stimulation and thromboprophylaxis...
January 1, 2017: Phlebology
https://www.readbyqxmd.com/read/28598908/the-rate-of-deep-vein-thrombosis-doubles-in-trauma-patients-with-hypercoagulable-thromboelastography
#4
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...
June 9, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28579397/meta-analysis-of-heparin-therapy-for-preventing-venous-thromboembolism-in-acute-spinal-cord-injury
#5
REVIEW
Yang Liu, Hong Xu, Feifei Liu, Zenghui Lv, Shunli Kan, Guangzhi Ning, Shiqing Feng
OBJECTIVE: Venous thromboembolism (VTE) is a frequent complication in patients with acute spinal cord injury (SCI) and may have serious consequences. This study aimed to assess the efficacy and safety of heparin and low-molecular-weight heparin (LMWH) venous thromboprophylaxis in patients with acute SCI. METHODS: PubMed, Web of Science, EMBASE and the Cochrane library were searched from January 1980 to August 2016. The primary outcome was the incidence of VTE. Secondary outcomes included the incidences of Deep-vein thrombosis (DVT), pulmonary embolism (PE) and major bleeding...
June 1, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28557893/prophylaxis-for-venous-thromboembolism
#6
Kiet Ma, Sulaiman Alhassan, Rihab Sharara, Meilin Young, Anil C Singh, Eric Bihler
Venous thromboembolisms are major risk factors for many of our hospitalized patients. These events, however, can be prevented with prophylactic measurements when administered appropriately and on a timely basis. As patients are admitted, discharged, transferred, and scheduled for procedures on an hourly basis, anticoagulation and deep vein thrombosis prophylaxis are held or discontinued in anticipation for possible procedures. This results in delay of care and intervals where patients may not be covered with any prophylactic measurements...
July 2017: Critical Care Nursing Quarterly
https://www.readbyqxmd.com/read/28557787/warfarin-personalized-dosage-re-compounding-for-a-more-suitable-therapy-and-better-compliance
#7
Tommaso Pellagatti, Marco Ternelli, Davide Frascio, Ruggero Bettini
Warfarin is still the most prescribed oral anticoagulant prescribed for the prophylaxis and treatment of thromboembolic events such as stroke, heart attack, embolism, and deep vein thrombosis. It is administered orally in the form of sodium salt as a tablet with a typical strength of 5 mg. The molecule has a narrow therapeutic index. As a consequence, the dosage must be individualized for each patient based on the patient response in terms of time of coagulation. Thus, warfarin represents an example of a drug whose dose needs to be tailored to individual requirements that are often changing and, therefore, constitute a paramount illustration of personalized medicine...
May 2017: International Journal of Pharmaceutical Compounding
https://www.readbyqxmd.com/read/28516316/venous-thromboembolism-after-nephrectomy-incidence-timing-and-associated-risk-factors-from-a-national-multi-institutional-database
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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...
June 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
#18
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
#19
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
#20
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
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