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https://www.readbyqxmd.com/read/28483284/after-deep-vein-thrombosis-which-patients-refer-to-vascular-specialist-for-anticoagulant-withdrawal-a-delphi-study-results-between-general-practitioners-and-vascular-specialists
#1
Antonin Zoubian, Laurent Bertoletti, Paul Frappé
AIM: Deep vein thrombosis (DVT) is a potential serious common disease. Its management is, except in particular cases, on an outpatient basis. General practitioner's (GP) role usually includes the treatment risk/benefit reassessment. The treatment duration can vary and is difficult to define. The national and international guidelines do not explain clearly when to refer, or not, to a vascular specialist in order to stop treatment. The study's objective was to identify, for DVT, when a GP has to refer or not to a vascular specialist, for anticoagulant withdrawal...
May 5, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/28463936/selective-vs-nonselective-embolization-vs-no-embolization-in-pelvic-trauma-a-multicenter-retrospective-cohort-study
#2
Aimee Hymel, Sabrina Asturias, Frank Zhao, Ryan Bliss, Thea Moran, Richard H Marshall, Elizabeth Benjamin, Herb A Phelan, Peter C Krause, Geoffrey S Marecek, Claudia Leonardi, Lance Stuke, John P Hunt, Jennifer L Mooney
BACKGROUND: Traumatic hemorrhage from pelvic fractures is a significant challenge and angioembolization has become standard. Optimal treatment is undefined in two clinical scenarios. The first is in the presence of a negative angiogram. Can arterial embolization treat venous bleeding by decreasing the arterial pressure head? If the angiogram is positive, is non-selective embolization (NSE) or selective embolization (SE) better? The purpose of this study is to determine if embolization following a negative angiogram aids in hemorrhage control and when the angiogram is positive, which level of embolization is superior? METHODS: A multicenter retrospective review was conducted including blunt trauma patients with pelvic fractures who underwent angiography...
May 1, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28459751/complications-of-tibial-tuberosity-osteotomy
#3
Alex A Johnson, Andrew J Cosgarea
It is important to understand potential complications of tibial tuberosity osteotomies (TTOs) and how to avoid them. TTO is associated with a 1% to 3% rate of tibial fracture and 1% rate of nonunion. Early weight-bearing and complete detachment of the distal tuberosity may increase these risks. Painful screws requiring removal occur in 3% to 77% of cases. Use of small (3.5- mm diameter), countersunk screws reduces this risk. Recurrent instability occurs in ∼5% of cases at 5 years. The risk of deep-vein thrombosis (4%) after TTO is higher than that associated with other sports surgeries (1% to 2%)...
June 2017: Sports Medicine and Arthroscopy Review
https://www.readbyqxmd.com/read/28443568/the-compartment-syndrome-associated-with-deep-vein-thrombosis-due-to-rattlesnake-bite-a-case-report
#4
Radu Ciprian Tincu, Zoie Ghiorghiu, Dana Tomescu, Radu Alexandru Macovei
BACKGROUND: Snakebite is a health issue specific to some parts of the world, especially in the tropical area, where it produces many victims. The main clinical damage caused by snake bite involves hemotoxic, neurotoxic and myotoxic reactions. It is also established that the importance of systemic impairment varies according to individual factors and are related to organ dysfunction, shock or hypotension. We report the case of a young woman suffering from snakebite who developed deep vein thrombosis and compartment syndrome...
April 13, 2017: Balkan Medical Journal
https://www.readbyqxmd.com/read/28439954/survival-and-recurrent-venous-thromboembolism-in-patients-with-first-proximal-or-isolated-distal-deep-vein-thrombosis-and-no-pulmonary-embolism
#5
S Barco, M Corti, A Trinchero, C Picchi, C Ambaglio, S V Konstantinides, F Dentali, M Barone
BACKGROUND: A few studies focused on the risk of recurrence after first acute isolated distal deep vein thrombosis (IDDVT) compared to proximal DVT (PDVT), while the incremental risk of death has never been explored beyond the first three years after acute event. METHODS: Our single-center cohort study included patients with first symptomatic acute PDVT or IDDVT. Patients were excluded if they had concomitant pulmonary embolism (PE) or prior venous thromboembolism...
April 25, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28428437/bet-2-striking-the-right-balance-anticoagulation-and-isolated-distal-deep-vein-thrombosis
#6
Tom Jones, Dan Horner
A short-cut review was carried out to establish whether treatment of isolated distal deep vein thrombosis with therapeutic anticoagulation can reduce adverse clinical outcomes. A meta-analysis from 2011 and 11 subsequent directly relevant papers were found using the reported search strategy. Of these, 7 in total presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these best papers are tabulated...
May 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28363480/targeted-release-budesonide-versus-placebo-in-patients-with-iga-nephropathy-nefigan-a-double-blind-randomised-placebo-controlled-phase-2b-trial
#7
Bengt C Fellström, Jonathan Barratt, Heather Cook, Rosanna Coppo, John Feehally, Johan W de Fijter, Jürgen Floege, Gerd Hetzel, Alan G Jardine, Francesco Locatelli, Bart D Maes, Alex Mercer, Fernanda Ortiz, Manuel Praga, Søren S Sørensen, Vladimir Tesar, Lucia Del Vecchio
BACKGROUND: IgA nephropathy is thought to be associated with mucosal immune system dysfunction, which manifests as renal IgA deposition that leads to impairment and end-stage renal disease in 20-40% of patients within 10-20 years. In this trial (NEFIGAN) we aimed to assess safety and efficacy of a novel targeted-release formulation of budesonide (TRF-budesonide), designed to deliver the drug to the distal ileum in patients with IgA nephropathy. METHODS: We did a randomised, double-blind, placebo-controlled phase 2b trial, comprised of 6-month run-in, 9-month treatment, and 3-month follow-up phases at 62 nephrology clinics across ten European countries...
March 28, 2017: Lancet
https://www.readbyqxmd.com/read/28316124/anticoagulation-in-patients-with-isolated-distal-deep-vein-thrombosis-a-meta-analysis
#8
L Franco, M Giustozzi, G Agnelli, C Becattini
Essentials The optimal management of isolated distal deep vein thrombosis (IDDVT) is undefined. This meta-analysis aimed to assess the clinical benefit of anticoagulation for IDDVT. Anticoagulation reduced the rate of pulmonary embolism without increasing major bleeding risk. Recurrent thromboembolism was less common with more than 6 weeks vs. 6 weeks of anticoagulation. SUMMARY: Background The optimal management of patients with isolated distal deep vein thrombosis (IDDVT), concerning both the need for anticoagulation and its duration, is undefined...
March 17, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28267480/the-safety-and-efficacy-of-full-versus-reduced-dose-betrixaban-in-the-acute-medically-ill-vte-venous-thromboembolism-prevention-with-extended-duration-betrixaban-apex-trial
#9
C Michael Gibson, Rim Halaby, Serge Korjian, Yazan Daaboul, Douglas F Arbetter, Megan K Yee, Samuel Z Goldhaber, Russel Hull, Adrian F Hernandez, Shiao-Ping Lu, Olga Bandman, Janet M Leeds, Alex Gold, Robert A Harrington, Alexander T Cohen
BACKGROUND: The APEX trial assessed the safety and efficacy of extended-duration thromboprophylaxis using betrixaban versus standard dosing of enoxaparin among hospitalized, acutely ill medical patients. The 80-mg betrixaban dose was halved to 40 mg among subjects with severe renal insufficiency and those receiving a concomitant strong P-glycoprotein inhibitor. METHODS: This analysis assessed the pharmacokinetics, efficacy, and safety of full- (80 mg) and reduced-dose (40 mg) betrixaban relative to enoxaparin in the APEX trial...
March 2017: American Heart Journal
https://www.readbyqxmd.com/read/28266773/long-term-outcomes-of-cancer-related-isolated-distal-deep-vein-thrombosis-the-optimev-study
#10
J-P Galanaud, M-A Sevestre, G Pernod, C Genty, S Richelet, S R Kahn, C Boulon, H Terrisse, I Quéré, J-L Bosson
Essentials Clinical significance of cancer-related isolated distal deep vein thrombosis (iDDVT) is unknown. We studied patients with iDDVT, with and without cancer, and proximal DVT with cancer. Cancer-related iDDVT patients have a much poorer prognosis than iDDVT patients without cancer. Cancer-related iDDVT patients have a similar prognosis to cancer-related proximal DVT patients. SUMMARY: Background Isolated distal deep vein thrombosis (iDDVT) (infra-popliteal DVT without pulmonary embolism [PE]) is a frequent event and, in the absence of cancer, is usually considered to be a minor form of venous thromboembolism (VTE)...
May 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28255217/prevalence-of-acute-deep-vein-thrombosis-in-patients-with-ankle-and-foot-fractures-treated-with-nonoperative-management-a-pilot-study
#11
Edward Ho, Abdullah Omari
The prevalence of deep vein thrombosis (DVT) among patients with ankle and foot fractures in Australia treated nonsurgically is unknown. Indications for thromboprophylaxis screening and management are unclear. The primary outcome was the prevalence rate of DVT among nonsurgically managed ankle and foot fracture patients. Patients were enrolled into a prospective cross-sectional pilot study at an outpatient hospital fracture clinic. DVT risk factors and symptoms were recorded at time of recruitment followed by referral for compression duplex ultrasonography...
March 2017: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/28243107/intermittent-pneumatic-compression-devices-combined-with-anticoagulants-for-prevention-of-symptomatic-deep-vein-thrombosis-after-total-knee-arthroplasty-a-pilot-study
#12
Pengcheng Liu, Junfeng Liu, Liyang Chen, Kuo Xia, Xing Wu
OBJECTIVES: To investigate the effectiveness of intermittent pneumatic compression (IPC) devices combined with anticoagulants for the prevention of deep vein thrombosis (DVT) after total knee arthroplasty (TKA). PATIENTS AND METHODS: In total 120 patients were involved in this pilot study. Patients in the control group received 10 mg of rivaroxaban per day after surgery. In addition to the prescription of rivaroxaban, IPC devices were used in the experimental group...
2017: Therapeutics and Clinical Risk Management
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
#13
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
https://www.readbyqxmd.com/read/28132743/editor-s-choice-factors-associated-with-long-term-outcome-in-191-patients-with-ilio-femoral-dvt-treated-with-catheter-directed-thrombolysis
#14
P Foegh, L P Jensen, L Klitfod, R Broholm, N Bækgaard
OBJECTIVE: To identify factors associated with long-term treatment success after catheter-directed thrombolysis (CDT) for acute deep venous thrombosis (DVT) involving the ilio-femoral vein. MATERIAL AND METHODS: This was a non-randomised observational cohort study. From 1999 to 2013, 191 consecutive patients (203 limbs) attending a tertiary vascular centre at Gentofte University Hospital, Denmark underwent CDT. All patients had ultrasonically verified acute ilio-femoral DVT with open distal popliteal vein and calf veins...
March 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28125180/a-direct-oral-anticoagulant-as-a-cost-effective-alternative-to-warfarin-for-treatment-of-provoked-venous-thrombosis
#15
W Courtney, E Groarke, J Conway, E Conway, D Bourke, J Saunders, M Watts, D O'Keefe
In Ireland, Warfarin is the primary anticoagulant prescribed in the secondary prevention of provoked DVT. We completed a comprehensive cost analysis of a trial group of 24 patients treated with Rivaroxaban (between November 2013 and December 2014), versus a control group treated with Warfarin (between January 2008 and November 2013). The groups were matched for gender (3/7 M/F ratio), DVT type (5 proximal, 19 distal DVTs), provoking factor (20 traumatic, 4 atraumatc), and age. We calculated the cost for each group based on drug administration and clinic costs (labour, sample analysis, and additional costs)...
October 12, 2016: Irish Medical Journal
https://www.readbyqxmd.com/read/28118215/angiovac-suction-thrombectomy-complicated-by-thrombus-fragmentation-and-distal-embolization-leading-to-hemodynamic-collapse-a-case-report
#16
Timothy Del Rosario, Mafdy Basta, Shvetank Agarwal
A 35-year-old morbidly obese woman with a history of deep vein thrombosis and pulmonary embolism presented for right atrial thrombectomy via AngioVac suction system. A portion of the thrombus could not be suctioned into the AngioVac cannula, leading to fragmentation and distal embolization with hemodynamic collapse. This sequence, observed in real time under transesophageal echocardiography, also demonstrated that the clot had echocardiographic features of chronicity. A well-organized chronic clot may be more difficult to extract via this method, leading to the complication described...
April 15, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28053388/prevalence-of-deep-vein-thrombosis-in-patients-with-lower-limb-trauma
#17
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/28052946/dabigatran-related-leukocytoclastic-vasculitis
#18
Josiah An, Rohan Garje, Karolyn A Wanat, José Pablo Leone
Dabigatran is a non-vitamin K antagonist oral anticoagulant that has been approved for atrial fibrillation and prevention of venous thromboembolism. Its use has been increasing in the USA since serum drug levels do not need monitoring. To date, no significant skin side effects have been reported other than 4 cases of non-specific skin lesion and 2 cases of leukocytoclastic vasculitis (LCV), which is a small vessel inflammatory disease that presents as palpable purpura in lower extremities. We present a man aged 57 years with chronic deep vein thrombosis who developed palpable purpura, petechiae, swelling in lower extremities, torso and distal upper extremities on the third day after dabigatran initiation...
January 4, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28031644/ineffective-treatment-of-low-molecular-weight-heparin-in-obese-subject-with-traumatic-fractures-of-the-leg
#19
Egidio Imbalzano, Michele Creazzo, Giovanni Trapani, Giuseppina Lizio, Antonino Saitta
American College of Chest Physicians Evidence-Based Clinical Practice Guidelines, 9th edition, 2012, suggest no prophylaxis rather than pharmacological thromboprophylaxis in management of venous thromboembolism (VTE) risk of isolated lower leg injuries distal to knee requiring leg immobilization. Low-molecular-weight heparin (LMWH) is a class of drugs commonly used as antithrombotics in surgery and in case of prolonged bed rest and hypomobility. A 35-year-old obese man with no history of health disease (height, 170 cm; weight, 95 kg; and body mass index, 32...
December 2016: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/27987616/deep-venous-thrombosis-associated-with-caval-extension-of-iliac-stents
#20
Erin H Murphy, Blake Johns, Elliot Varney, William Buck, Arjun Jayaraj, Seshadri Raju
BACKGROUND: It is generally difficult to place an iliac vein stent precisely at the iliocaval junction with venographic control or even with intravascular ultrasound guidance. Furthermore, mechanical properties of the Wallstent (Boston Scientific, Marlborough, Mass) can predispose precisely placed stents to distal displacement or stent collapse. Our center has thus advocated extending Wallstents 3 to 5 cm into the inferior vena cava to prevent complications of missed proximal lesions or stent migration...
January 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
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