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https://www.readbyqxmd.com/read/29339844/the-risk-of-deep-vein-thrombosis-in-total-joint-patients-compared-to-orthopaedic-trauma-patients-need-for-new-prevention-guidelines
#1
Michelle Shen, Norele J Cutrera, Ashley C Dodd, Christopher Wallace, Frank R Avilucea, Craig Melbourne, Alex A Jahangir, Hassan H Mir, William T Obremskey, Manish K Sethi
Background: The development of Deep Vein Thrombosis (DVT) is a major concern following orthopaedic surgery. No study has yet to compare the rate and risk factors for DVT between total joint and orthopaedic trauma patients. To evaluate if DVT prophylaxis for trauma should differ from total joints, we explored the rate and risk factors for DVT between both cohorts. Methods: Using a CPT code search from 2005 to 2013 in the ACS-NSQIP database, 150,657 orthopaedic total joint patients and 44,594 orthopaedic trauma patients were identified...
November 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/29338966/family-history-of-venous-thromboembolism-predicts-the-diagnosis-of-acute-pulmonary-embolism-in-the-emergency-department
#2
Christopher Kelly, Chad Agy, Margaret Carlson, Jacob Steenblik, Joseph Bledsoe, Stephen Hartsell, Troy Madsen
BACKGROUND: Pulmonary embolism (PE) clinical decision rules do not consider a patient's family history of venous thromboembolism (VTE). We evaluated whether a family history of VTE predicts acute PE in the emergency department (ED). METHODS: Over a 5.5-year study period, we enrolled a prospective convenience sample of patients presenting to an academic emergency department with chest pain and/or shortness of breath. We defined a family history of VTE as a first-degree relative with previous PE or deep vein thrombosis (DVT)...
January 6, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29334497/deep-vein-thrombosis-and-venous-thromboembolism-in-trauma
#3
Keith J Ruskin
PURPOSE OF REVIEW: Deep vein thrombosis (DVT) and pulmonary embolus are major causes of hospital-related morbidity and mortality, and are recognized as complications in patients with traumatic injury. Despite the significant morbidity and mortality associated with DVTs, prophylaxis and treatment are still not well understood and remain the subject of research and debate. RECENT FINDINGS: Elements of the patient's history and physical examination, along with thromboelastography, can be used to predict patients who are at greatest risk of DVT and venous thromboembolism (VTE)...
January 12, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29329472/impact-of-thrombus-sidedness-on-presentation-and-outcomes-of-patients-with-proximal-lower-extremity-deep-vein-thrombosis
#4
Behnood Bikdeli, Babak Sharif-Kashani, Bavand Bikdeli, Reina Valle, Conxita Falga, Antoni Riera-Mestre, Lucia Mazzolai, Peter Verhamme, Philip S Wells, Juan Francisco Sánchez Muñoz Torrero, Luciano Lopez-Jiménez, Manuel Monreal
Small studies have suggested differences in demographics and outcomes between left- and right-sided deep vein thrombosis (DVT), and also unilateral versus bilateral DVT. We investigated the clinical presentation and outcomes of patients with DVT based on thrombus sidedness. The authors used the data from the Registro Informatizado Enfermedad TromboEmbólica (RIETE) database (2001-2016) to identify patients with symptomatic proximal lower-extremity DVT. Main outcomes included cumulative 90-day symptomatic pulmonary embolism (PE) and 1-year mortality...
January 12, 2018: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/29325797/consequences-of-retained-defibrillator-and-pacemaker-leads-following-heart-transplantation-an-underrecognized-problem
#5
Luise Holzhauser, Teruhiko Imamura, Hemal M Nayak, Nitasha Sarswat, Gene Kim, Jayant Raikhelkar, Sara Kalantari, David Onsager, Tae Song, Takeyoshi Ota, Valluvan Jeevanandam, Gabriel Sayer, Nir Uriel
BACKGROUND: Cardiovascular implantable electronic devices (CIED) are common in patients undergoing heart transplantation (HT) and complete removal is not always possible at the time of transplant. METHODS: We retrospectively assessed the frequency of retained CIED leads and clinical consequences in consecutive HT patients from 2013-2016. Clinical outcomes included bacteremia, upper extremity deep venous thrombosis (UEDVT), lead migration and inability to perform MRI...
January 8, 2018: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/29325504/platelet-to-lymphocyte-ratio-neutrophil-to-lymphocyte-ratio-and-platelet-indices-in-patients-with-acute-deep-vein-thrombosis
#6
Liang Ming, Zhiyun Jiang, Junfen Ma, Qian Wang, Fan Wu, Jiedan Ping
BACKGROUND: Inflammation is associated with an increased risk of thrombotic events and complete blood count (CBC) is an easily measured test. The purpose of this study was to evaluate the value of CBC relative parameters including mean platelet volume (MPV), platelet-to-lymphocyte ratio (PLR), mean platelet volume-to-lymphocyte ratio (MPVLR), and neutrophil-to-lymphocyte ratio (NLR) for patients with acute deep vein thrombosis (DVT). PATIENTS AND METHODS: A total of 115 patients with unprovoked DVT of the lower extremities and 105 controls were recruited in this study...
January 12, 2018: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/29324334/rivaroxaban-versus-warfarin-for-the-prevention-of-post-thrombotic-syndrome
#7
K K Utne, A Dahm, H S Wik, L P Jelsness-Jørgensen, P M Sandset, W Ghanima
INTRODUCTION: Despite treatment of acute deep vein thrombosis (DVT) with low molecular weight heparin and warfarin, up to 50% of patients develop post-thrombotic syndrome (PTS). Our aims were to assess whether treatment of DVT with rivaroxaban would reduce the rate of subsequent PTS and improve health-related quality of life (HRQoL) as compared to conventional anticoagulation with low molecular weight heparin (LMWH)/warfarin. MATERIALS AND METHODS: Consecutive patients with an objectively confirmed DVT diagnosed between 2011 and 2014 and treated with either rivaroxaban or warfarin were included in this study 24 (±6) months after DVT...
January 8, 2018: Thrombosis Research
https://www.readbyqxmd.com/read/29321050/plasminogen-activator-inhibitor-1-a-risk-factor-for-deep-vein-thrombosis-after-total-hip-arthroplasty
#8
Ju Tang, Wei Zhu, Xiaoliang Mei, Zhenxiang Zhang
BACKGROUND: The onset of deep vein thrombosis (DVT) in patients after total hip arthroplasty (THA) may expand or enlarge and subsequently lead to significant mortality. The objective of this study was to investigate potential risk factors for DVT in patients after THA. METHODS: Eligible patients with hip joint diseases who were scheduled for unilateral primary THA at our hospital were prospectively included into this study. The demographic and clinical features, preoperative plasma biomarkers were detailed, recorded, and compared...
January 10, 2018: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29320959/factor-v-leiden-paradox-in-a-middle-aged-swedish-population-a-prospective-study
#9
Bengt Zöller, Olle Melander, Peter J Svensson, Gunnar Engström
Few prospective studies have examined the factor V paradox: factor V Leiden (FVL) is a stronger risk factor for deep venous thrombosis (DVT) than for pulmonary embolism (PE). The present study, to the best of our knowledge, is the first population-based study aimed to examine the relationship between FVL and incidence of venous thromboembolism (VTE), DVT and PE in a prospective cohort study of middle-aged Swedish individuals. FVL was determined in 4890 subjects (aged 46-68 years, 57% women) from the general population without previous VTE or cancer, who participated in the Malmö Diet and Cancer study between 1991 and 1994...
January 1, 2018: Vascular Medicine
https://www.readbyqxmd.com/read/29318176/venous-thromboembolism-within-professional-american-sport-leagues
#10
Meghan Bishop, Matthew Astolfi, Eric Padegimas, Peter DeLuca, Sommer Hammoud
Background: Numerous reports have described players in professional American sports leagues who have been sidelined with a deep vein thrombosis (DVT) or a pulmonary embolism (PE), but little is known about the clinical implications of these events in professional athletes. Purpose: To conduct a retrospective review of injury reports from the National Hockey League (NHL), Major League Baseball (MLB), the National Basketball Association (NBA), and the National Football League (NFL) to take a closer look at the incidence of DVT/PE, current treatment approaches, and estimated time to return to play in professional athletes...
December 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29315455/home-versus-in-patient-treatment-for-deep-vein-thrombosis
#11
REVIEW
Richard Othieno, Emmanuel Okpo, Rachel Forster
BACKGROUND: Deep vein thrombosis (DVT) occurs when a blood clot blocks blood flow through a vein, which can occur after surgery, after trauma, or when a person has been immobile for a long time. Clots can dislodge and block blood flow to the lungs (pulmonary embolism (PE)), causing death. DVT and PE are known by the term venous thromboembolism (VTE). Heparin (in the form of unfractionated heparin (UFH)) is a blood-thinning drug used during the first three to five days of DVT treatment...
January 9, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29311570/a-systematic-review-and-meta-analysis-of-the-topical-administration-of-fibrin-sealant-in-total-hip-arthroplasty
#12
Zhihu Zhao, Xinlong Ma, Jianxiong Ma, Xiaolei Sun, Fengbo Li, Jianwei Lv
Patients who undergo total hip arthroplasty (THA) may experience a large amount of blood loss. The objective of our study is to include randomized controlled trials (RCTs) and compare the clinical outcomes of fibrin sealant (FS) versus placebo after a THA. In October 2015, we searched the following databases: Medline, Embase, PubMed, the Cochrane Controlled Trials Register, Web of Science, the China National Knowledge Infrastructure, the China Wanfang database and Google Scholar. Finally, seven studies that included 679 patients met the inclusion criteria...
January 8, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29310137/diagnosis-of-venous-thromboembolism-20-years-of-progress
#13
Philip S Wells, Ryma Ihaddadene, Aiofe Reilly, Melissa Anne Forgie
Many guidelines suggest incorporating clinical assessment, imaging, and D-dimer testing into diagnostic algorithms in patients with suspected deep venous thrombosis (DVT) and pulmonary embolism (PE). This special article reviews the evidence supporting the use of algorithms and their individual components for diagnosis of upper- and lower-extremity DVT and PE in adults, including pregnant women. The authors identified evidence through several electronic database searches to April 2017, evaluated the robustness of selected evidence, assessed whether diagnostic approaches that do not use algorithms are acceptable, and identified knowledge gaps that require further research...
January 9, 2018: Annals of Internal Medicine
https://www.readbyqxmd.com/read/29309713/routine-preoperative-venous-doppler-screening-is-not-effective-in-preventing-thromboembolic-events-after-total-joint-arthroplasty
#14
Morteza Meftah, Peter B White, Ahmed Siddiqi, Vinayak S Perake, Ira H Kirschenbaum
Despite advances in thromboprophylaxis, the relationship between preexisting deep venous thromboses (DVTs) and postoperative thromboembolic complications is not fully established. The aim of this study was to assess the utility of selective and nonselective preoperative lower extremity venous Doppler screening protocols as tools in reducing the incidence of thromboembolic events (DVT/pulmonary embolism [PE]) after total joint arthroplasty. In the 2-year period from August 2013 to August 2015, a total of 455 consecutive elective primary total joint arthroplasties were identified from the authors' database...
January 8, 2018: Orthopedics
https://www.readbyqxmd.com/read/29306580/comparison-of-the-accuracy-of-emergency-department-performed-point-of-care-ultrasound-pocus-in-the-diagnosis-of-lower-extremity-deep-vein-thrombosis
#15
Jorge Pedraza García, Joaquín Valle Alonso, Pedro Ceballos García, Francisca Rico Rodríguez, Miguel Ángel Aguayo López, María Del Carmen Muñoz-Villanueva
BACKGROUND: Compression ultrasonography is the most effective diagnostic tool in the emergency department (ED) for the diagnosis of deep vein thrombosis (DVT). It has been demonstrated to be highly accurate and cost-effective. OBJECTIVE: The objective of this study was to determine the accuracy of emergency physicians who performed three-point compression ultrasound (US) for suspected above-knee DVT within the context of using Wells score and D-dimer. METHOD: This was a prospective diagnostic test assessment of three-point ultrasound conducted in a district general hospital of patients who presented to the ED with suspected DVT of the lower limb...
January 3, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29304541/rationale-design-and-methodology-of-the-computerized-registry-of-patients-with-venous-thromboembolism-riete
#16
Behnood Bikdeli, David Jimenez, Mayra Hawkins, Salvador Ortíz, Paolo Prandoni, Benjamin Brenner, Hervé Decousus, Frederick A Masoudi, Javier Trujillo-Santos, Harlan M Krumholz, Manuel Monreal
Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), is a preventable cause of in-hospital death, and one of the most prevalent vascular diseases. There is a lack of knowledge with regards to contemporary presentation, management and outcomes of patients with VTE. Many clinically important subgroups (including the elderly, those with recent bleeding and pregnant patients) have been under-represented in clinical trials. Furthermore, design of clinical trials is challenging in some scenarios, such as in those with hemodynamically unstable PE...
January 2018: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/29300003/effects-of-inhalation-anesthesia-vs-total-intravenous-anesthesia-tiva-vs-spinal-epidural-anesthesia-on-deep-vein-thrombosis-after-total-knee-arthroplasty
#17
Lu-Yang Zhou, Wei Gu, Yun Liu, Zheng-Liang Ma
BACKGROUND The objective of the present study was to evaluate the varying efficacy of general anesthesia (GA), combined spinal-epidural anesthesia (CSEA), and total intravenous anesthesia (TIVA) on the occurrence of deep vein thrombosis (DVT) following total knee arthroplasty (TKA). MATERIAL AND METHODS From July 2013 to May 2015, a total of 197 cases of patients who had undergone TKA treatment at either the Drum Tower Hospital or Nanjing General Hospital of Nanjing Military Command were recruited to participate in the study...
January 4, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/29299477/novel-venous-thromboembolic-disease-vted-prophylaxis-for-total-knee-arthroplasty-aspirin-and-fish-oil
#18
Peter M Bonutti, Nipun Sodhi, Yatindra H Patel, Assem A Sultan, Anton Khlopas, Morad Chughtai, Frank R Kolisek, Nick Williams, Michael A Mont
Background: Despite the demonstrated success of multiple anticoagulation therapies for post-operative prophylaxis of thromboembolic disease in lower extremity arthroplasties, each modality comes with a unique set of limitations. Thus, the ideal anticoagulation medication which provides adequate therapy with minimal cost, complications, or added patient work is yet to be defined. One promising novel thrombophylactic supplement is fish oil, as many preliminary clinical trials have demonstrated a protective effect of fish oil against thrombosis in multiple clinical settings...
December 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29297660/overview-of-venous-thromboembolism
#19
Haley M Phillippe
Venous thromboembolism (VTE) describes the diagnoses of deep vein thrombosis (DVT) or pulmonary embolism (PE). DVT is the formation of thrombi in the deep veins, most commonly the large veins of the legs or pelvis. PE develops when thrombi dislodge from clots in vein walls and travel through the heart to pulmonary arteries. In many patients, the presenting manifestation of PE is sudden death. VTE may be categorized as provoked or unprovoked. This categorization influences the risk of recurrent VTE and duration of anticoagulation therapy...
December 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/29296053/nonfatal-pulmonary-embolism-associated-with-the-use-of-compression-stockings-in-the-lithotomy-position-after-spinal-anesthesia
#20
I-Wen Chen, Cheuk-Kwan Sun, Jen-Yin Chen, Chien-Ming Lin, Kuo-Chuan Hung
A 73-year-old male (height, 156 cm; body weight, 51 kg), without a history of cardiovascular disease or thromboembolic events, was scheduled for transurethral resection of the prostate under spinal anesthesia. Spinal anesthesia was administered with hyperbaric bupivacaine, resulting in an upper anesthetic level of T6. Before surgery, compression stockings were applied to both lower limbs, and the patient was placed in the lithotomy position. Approximately 15 min later, he complained of intolerable chest tightness, followed by tachycardia (heart rate, 110 beats/min) and desaturation (oxygen saturation [SaO2], 90%)...
October 2017: Ci Ji Yi Xue za Zhi, Tzu-chi Medical Journal
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