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https://www.readbyqxmd.com/read/28780771/low-molecular-weight-heparin-for-prevention-of-venous-thromboembolism-in-patients-with-lower-limb-immobilization
#1
REVIEW
Aniek Ag Zee, Kelly van Lieshout, Maaike van der Heide, Loes Janssen, Heinrich Mj Janzing
BACKGROUND: Immobilization of the lower limb is a risk factor for venous thromboembolism (VTE). Low molecular weight heparins (LMWHs) are anticoagulants, which might be used in adult patients with lower-limb immobilization to prevent deep venous thrombosis (DVT) and its complications. This is an update of the review first published in 2008. OBJECTIVES: To assess the effectiveness of low molecular weight heparin for the prevention of venous thromboembolism in patients with lower-limb immobilization in an ambulatory setting...
August 6, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28762665/external-validation-of-the-dash-prediction-rule-a-retrospective-cohort-study
#2
A Tosetto, S Testa, I Martinelli, D Poli, B Cosmi, C Lodigiani, W Ageno, V De Stefano, A Falanga, I Nichele, O Paoletti, P Bucciarelli, E Antonucci, C Legnani, E Banfi, F Dentali, F Bartolomei, L Barcella, G Palareti
BACKGROUND: The DASH prediction model has been proposed as a guide to identify patients at low risk of recurrence of venous thromboembolism (VTE), but has never been validated in an independent cohort. AIMS: To validate the calibration and discrimination of the DASH prediction model. We were also willing to evaluate the DASH score in a predefined patient subgroup aged >65 years. METHODS: Patients with a proximal unprovoked DVT or PE, who received a full course of VKA or DOAC (>3 months) and having D-Dimer measured after treatment withdrawal were eligible...
August 1, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28732457/long-term-recurrence-of-venous-thromboembolism-after-short-term-treatment-of-symptomatic-isolated-distal-deep-vein-thrombosis-a-cohort-study
#3
Marco P Donadini, Francesco Dentali, Samuela Pegoraro, Fulvio Pomero, Chiara Brignone, Luigina Guasti, Luigi Steidl, Walter Ageno
Isolated distal deep vein thrombosis (IDDVT) is a common clinical manifestation of venous thromboembolism (VTE). However, there are only scant and heterogeneous data available on the long-term risk of recurrent VTE after IDDVT, and the optimal therapeutic management remains uncertain. We carried out a retrospective cohort study of consecutive patients diagnosed with symptomatic IDDVT between 2004 and 2011, according to a predefined short-term treatment protocol (low molecular weight heparin (LMWH) for 4-6 weeks)...
July 1, 2017: Vascular Medicine
https://www.readbyqxmd.com/read/28692467/intravenous-tranexamic-acid-bolus-plus-infusion-is-not-more-effective-than-a-single-bolus-in-primary-hip-arthroplasty-a-randomized-controlled-trial
#4
Paul J Zufferey, Julien Lanoiselée, Céline Chapelle, Dmitry B Borisov, Jean-Yves Bien, Pierre Lambert, Rémi Philippot, Serge Molliex, Xavier Delavenne, Béatrice Deygas, Mathilde Donnat, Juanita Techer, Laurent Tordella, Jean-Noël Fort, Nicolas Barbe, Julie Gavory, Sylvie Passot, Laetitia Burnol, Stéphanie Seve
BACKGROUND: Preoperative administration of the antifibrinolytic agent tranexamic acid reduces bleeding in patients undergoing hip arthroplasty. Increased fibrinolytic activity is maintained throughout the first day postoperation. The objective of the study was to determine whether additional perioperative administration of tranexamic acid would further reduce blood loss. METHODS: This prospective, double-blind, parallel-arm, randomized, superiority study was conducted in 168 patients undergoing unilateral primary hip arthroplasty...
July 10, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28676651/age-related-diagnostic-value-of-d-dimer-testing-and-the-role-of-inflammation-in-patients-with-suspected-deep-vein-thrombosis
#5
Jürgen H Prochaska, Bernd Frank, Markus Nagler, Heidrun Lamparter, Gerhard Weißer, Andreas Schulz, Lisa Eggebrecht, Sebastian Göbel, Natalie Arnold, Marina Panova-Noeva, Iris Hermanns, Antonio Pinto, Stavros Konstantinides, Hugo Ten Cate, Karl J Lackner, Thomas Münzel, Christine Espinola-Klein, Philipp S Wild
Previous reports have investigated the impact of age on D-Dimer testing in elderly individuals with suspected deep vein thrombosis (DVT), but data on the age-related diagnostic value of D-dimer in a sample covering a broad age range are limited. The present study determined age-specifically the diagnostic accuracy of D-dimer and compared it to C-reactive protein (CRP), a marker of inflammation, in 500 patients with suspected DVT from the VTEval project (NCT02156401). Sensitivity of D-dimer was lower in patients < 60 years in comparison to patients ≥ 60 years (∆-16...
July 4, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28659542/asymptomatic-lower-extremity-deep-vein-thrombosis%C3%A3-clinical-characteristics-management-strategies-and-long-term-outcomes
#6
Yugo Yamashita, Hiroki Shiomi, Takeshi Morimoto, Tomoya Yoneda, Chinatsu Yamada, Takeru Makiyama, Takao Kato, Naritatsu Saito, Satoshi Shizuta, Koh Ono, Takeshi Kimura
BACKGROUND: The prognosis of asymptomatic deep vein thrombosis (DVT) is uncertain and there is no consensus on the necessity of detection and treatment.Methods and Results:We retrospectively evaluated 300 patients with asymptomatic lower extremity DVT screened from 4,514 consecutive patients on ultrasound at Kyoto University Hospital between January 2010 and September 2015. The subjects had concomitant active cancer in 40%, unprovoked DVT in 59%, and distal DVT in 70%. The cumulative 5-year incidences of symptomatic recurrent venous thromboembolism (VTE); major bleeding; and all-cause death were 14...
June 27, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28639418/clinical-course-of-isolated-distal-deep-vein-thrombosis-in-patients-with-active-cancer-a-multicenter-cohort-study
#7
F Dentali, S Pegoraro, S Barco, M N D di Minno, D Mastroiacovo, F Pomero, C Lodigiani, F Bagna, M Sartori, G Barillari, N Mumoli, M Napolitano, S M Passamonti, R Benedetti, W Ageno, M Di Nisio
Essentials Isolated distal deep vein thrombosis (IDDVT) is frequently associated with cancer. No study has specifically evaluated the long-term clinical course of cancer-associated IDDVT. Patients with cancer-associated IDDVT are at very high risk of symptomatic recurrence and death. We observed low rates of major bleeding during anticoagulation. SUMMARY: Background Although isolated distal deep vein thrombosis (IDDVT) is frequently associated with cancer, no study has specifically evaluated the long-term clinical course of IDDVT in this setting...
June 21, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28635085/venous-thromboembolism-management-in-northeast-melbourne-how-does-it-compare-to-international-guidelines-and-data
#8
Hui Yin Lim, Chong Chyn Chua, Mark Tacey, Matthew Sleeman, Geoffrey Donnan, Harshal Nandurkar, Prahlad Ho
BACKGROUND: Venous thromboembolism (VTE) is a major cause of morbidity and mortality with significant heterogeneity in its management, both within our local practice and international guidelines. AIMS: To provide a holistic evaluation of "real-world" Australian experience in the warfarin era, including how we compare to international guidelines. METHODS: Retrospective evaluation of VTE from July 2011 to December 2012 at two major hospitals in Melbourne, Australia...
June 21, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28541021/predictors-of-active-cancer-thromboembolic-outcomes-mortality-associated-with-calf-deep-vein-thrombosis
#9
Juan P Salazar Adum, Harry E Fuentes, Benjamin B Lind, Alfonso J Tafur, Joseph A Caprini
BACKGROUND: Venous thromboembolism (VTE) is a leading cause of mortality in patients with cancer. Outcomes, including mortality data, in the cancer population are limited in those with calf deep vein thrombosis (CDVT) compared to individuals with proximal deep vein thrombosis. AIM: To assess the prognosis among patients with active cancer and CDVT. METHODS: Single institution inception cohort of cancer-associated CDVT patients who presented with thrombosis distal to popliteal level confirmed objectively by ultrasound...
May 24, 2017: International Angiology: a Journal of the International Union of Angiology
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
#10
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 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
#11
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
#12
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
#13
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
#14
S Barco, M Corti, A Trinchero, C Picchi, C Ambaglio, S V Konstantinides, F Dentali, M Barone
Essentials The long-term risk of recurrence and death after distal deep vein thrombosis (DVT) is uncertain. We included subjects with first proximal or isolated distal DVT (IDDVT) and no pulmonary embolism. The risk of symptomatic and asymptomatic recurrence is lower after IDDVT (vs. proximal). IDDVT may be associated with a lower long-term risk of death, especially after unprovoked DVT. SUMMARY: Background A few studies have focused on the risk of recurrence after first acute isolated distal deep vein thrombosis (IDDVT) compared with proximal DVT (PDVT), whereas the incremental risk of death has never been explored beyond the first 3 years after acute event...
July 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
#15
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
#16
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
#17
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...
June 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
#18
RANDOMIZED CONTROLLED TRIAL
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
#19
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
#20
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
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