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https://www.readbyqxmd.com/read/29223985/external-validation-of-generic-and-cancer-specific-risk-stratification-tools-in-patients-with-pulmonary-embolism-and-active-cancer
#1
Erin R Weeda, Jonathan T Caranfa, Simon B Zeichner, Craig I Coleman, Elaine Nguyen, Christine G Kohn
Background: Numerous risk stratification tools exist to predict early post-pulmonary embolism (PE) mortality; however, few were specifically designed for use in patients with cancer. This study sought to evaluate the performance of 3 cancer-specific (RIETE, POMPE-C, and Font criteria) and 3 generic (Hestia, Pulmonary Embolism Severity Index [PESI], and Geneva prognostic score [GPS]) risk stratification tools for predicting 30-day post-PE mortality in patients with active cancer. Methods: We identified consecutive, adult, objectively confirmed patients with PE and active cancer presenting to our institution from November 2010 to January 2014...
December 2017: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/29222322/inferior-vena-cava-filter-use-and-patient-safety-legacy-or-science
#2
REVIEW
William Geerts, Rita Selby
There has been a dramatic increase in vena cava filter (VCF) use over the past 20 years in the absence of evidence that filters provide a net patient benefit or are required in most cases. This increase is largely attributable to the availability of retrievable filters and expanded indications, particularly as primary prophylaxis in patients thought to be at high risk of pulmonary embolism. Substantial variability in VCF use, unrelated to patient clinical factors, has been shown between hospitals, from region to region, and among various countries...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29222321/thrombectomy-and-thrombolysis-for-the-prevention-and-treatment-of-postthrombotic-syndrome
#3
REVIEW
Suresh Vedantham
Postthrombotic syndrome (PTS) is a frequent complication of lower-extremity deep vein thrombosis (DVT), occurring in approximately 40% of patients despite the use of anticoagulant therapy. PTS causes significant impairment of patients' health-related quality of life, and no evidence-based therapies have been consistently effective. Catheter-directed thrombolysis and thrombectomy have been shown to remove acute thrombus, and it has been hypothesized they could prevent or reduce PTS. However, because these procedures can be associated with complications, mainly bleeding, randomized trial data are needed to determine when they should be used...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29222260/should-we-diagnose-and-treat-distal-deep-vein-thrombosis
#4
REVIEW
Helia Robert-Ebadi, Marc Righini
Ultrasound series report that isolated distal deep vein thrombosis (DVT), also known as calf DVT, represents up to 50% of all lower-limb DVTs and, therefore, is a frequent medical condition. Unlike proximal DVT and pulmonary embolism, which have been studied extensively and for which management is well standardized, much less is known about the optimal management of isolated calf DVT. Recent data arising from registries and nonrandomized studies have suggested that most distal DVTs do not extend to the proximal veins and have an uneventful follow-up when left untreated...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29222259/controversies-in-venous-thromboembolism-to-treat-or-not-to-treat-superficial-vein-thrombosis
#5
REVIEW
Jan Beyer-Westendorf
The management of superficial vein thrombosis (SVT) is poorly defined and remains controversial overall. SVT has long been considered a benign, self-limited disease, but recent studies show that SVT carries a nonnegligible risk for recurrence, deep vein thrombosis, or pulmonary embolism. Current guidelines recommend the use of low-molecular-weight heparin or fondaparinux, but results of several surveys indicate that the majority of patients with SVT receive nonanticoagulant therapy only, which includes compression stockings or bandages, nonsteroidal anti-inflammatory drugs, topical application of heparin gel, or surgical interventions...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29222246/incidental-venous-thromboembolism-is-anticoagulation-indicated
#6
REVIEW
Marcello Di Nisio, Marc Carrier
Patients with cancer have a high risk of venous thromboembolism (VTE) and about one-half of these events are incidentally detected. The prognosis of incidental VTE appears to be similar to symptomatic events, with comparably high rates of recurrent VTE in this patient population. In the absence of major contraindications, anticoagulant treatment with low-molecular-weight heparin for 3 to 6 months is generally recommended for incidental proximal deep vein thrombosis as well as for incidental pulmonary embolism that involves multiple subsegmental or more proximal pulmonary arteries...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29221750/secondary-surgical-site-infection-after-coronary-artery-bypass-grafting-a-multi-institutional-prospective-cohort-study
#7
Brian C Gulack, Katherine A Kirkwood, Wei Shi, Peter K Smith, John H Alexander, Sandra G Burks, Annetine C Gelijns, Vinod H Thourani, Daniel Bell, Ann Greenberg, Seth D Goldfarb, Mary Lou Mayer, Michael E Bowdish
OBJECTIVE: To analyze patient risk factors and processes of care associated with secondary surgical-site infection (SSI) after coronary artery bypass grafting (CABG). METHODS: Data were collected prospectively between February and October 2010 for consenting adult patients undergoing CABG with saphenous vein graft (SVG) conduits. Patients who developed a deep or superficial SSI of the leg or groin within 65 days of CABG were compared with those who did not develop a secondary SSI...
December 5, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29219827/venous-thrombosis-and-coagulation-parameters-in-patients-with-pure-venous-malformations
#8
J van Es, N A Kappelhof, R A Douma, J C M Meijers, V E A Gerdes, C M A M van der Horst
INTRODUCTION: Venous malformations (VMs) are ubiquitous, low-flow vascular anomalies known to be occasionally painful due to thrombotic episodes within the lesion. The prevalence of superficial or deep vein thrombosis is unclear. METHODS: A cross-sectional study among outpatients aged ≥ 12 years with pure VMs was performed, quantifying the prevalence of thrombosis by screening all patients with compression ultrasonography (CUS). Additionally, we evaluated whether coagulation alterations were related to thrombosis observed with CUS...
October 2017: Netherlands Journal of Medicine
https://www.readbyqxmd.com/read/29219814/cellulitis-current-insights-into-pathophysiology-and-clinical-management
#9
D R Cranendonk, A P M Lavrijsen, J M Prins, W J Wiersinga
Cellulitis is a bacterial skin and soft tissue infection which occurs when the physical skin barrier, the immune system and/or the circulatory system are impaired. Diabetes, obesity and old age are associated with defects in all of these areas and as a result are major predisposing factors for cellulitis. In this review, we summarise current insights into the pathophysiology of cellulitis and place the Dutch guidelines on the clinical management of cellulitis of the lower extremities in perspective. Recent evidence on diagnostic strategies is discussed, the importance of which is underscored by findings that venous insufficiency, eczema, deep vein thrombosis and gout are frequently mistaken for cellulitis...
November 2017: Netherlands Journal of Medicine
https://www.readbyqxmd.com/read/29217387/individualised-versus-standard-duration-of-elastic-compression-therapy-for-prevention-of-post-thrombotic-syndrome-ideal-dvt-a-multicentre-randomised-single-blind-allocation-concealed-non-inferiority-trial
#10
Arina J Ten Cate-Hoek, Elham E Amin, Annemieke C Bouman, Karina Meijer, Lidwine W Tick, Saskia Middeldorp, Guy J M Mostard, Marije Ten Wolde, Simone M van den Heiligenberg, Sanne van Wissen, Marlène Hw van de Poel, Sabina Villalta, Erik H Serné, Hans-Martin Otten, Edith H Klappe, Ingrid M Bistervels, Mandy N Lauw, Margriet Piersma-Wichers, Paolo Prandoni, Manuela A Joore, Martin H Prins, Hugo Ten Cate
BACKGROUND: Therapy with elastic compression stockings has been the cornerstone for prevention of post-thrombotic syndrome for decades in patients after acute deep venous thrombosis. It is uncertain who benefits most from therapy, and what the optimum duration of therapy should be. We therefore aimed to assess the safety and efficacy of individualised duration of compression therapy versus the standard duration of 24 months following an initial treatment period of 6 months. METHODS: We did a multicentre, randomised, single-blind, allocation-concealed, non-inferiority trial at 12 hospitals in the Netherlands and two in Italy...
December 4, 2017: Lancet Haematology
https://www.readbyqxmd.com/read/29217335/rivaroxaban-and-apixaban-for-initial-treatment-of-acute-venous-thromboembolism-of-atypical-location
#11
Dawid T Janczak, Malgorzata K Mimier, Robert D McBane, Patrick S Kamath, Benjamin S Simmons, Dalene M Bott-Kitslaar, Charles J Lenz, Emily R Vargas, David O Hodge, Waldemar E Wysokinski
OBJECTIVES: To assess the outcome of direct oral anticoagulants (DOACs), specifically Xa inhibitors: rivaroxaban and apixaban, for the treatment of venous thromboembolism (VTE) of atypical location (VTE-AL), portal, mesenteric, hepatic, splenic, gonadal, renal, and cerebral veins, prospectively collected data of Mayo Thrombophilia Clinic Registry were used. METHODS: Patients with acute VTE-AL treated with DOACs, enrolled between March 1, 2013, and February 1, 2017, were compared with patients with VTE of typical location (VTE-TL: deep vein thrombosis of extremities and/or pulmonary embolism) receiving DOACs and with patients with VTE-AL treated with enoxaparin...
December 4, 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29216693/a-comparative-study-in-patients-with-fractures-of-the-lower-limbs-between-rivaroxaban-versus-enoxaparin-and-its-impact-on-bone-healing-time
#12
P Peláez-Damy, A Torres-Gómez, F Mas-Celis, M Martínez-Villalobos
BACKGROUND: Each year it is estimated in the United States an approximate of 8 million fractures; 5 to 10% develop delayed union or absence of periosteal new bone. There are several factors that can cause delay in fracture healing, among the well known, is the use of prophylactic antithrombotic therapy for deep vein thrombosis (DVT). DVT appears in 40 to 60% of the patients undergoing orthopedic surgery without prophylactic antithrombotic therapy. The goal of this study was to assess whether there is a difference in time of bone healing in lower limb fractures (femur and tibia) comparing rivaroxaban to enoxaparin as the prophylactic antithrombotic management...
July 2017: Acta Ortopédica Mexicana
https://www.readbyqxmd.com/read/29216634/lysine-restriction-affects-feed-intake-and-amino-acid-metabolism-via-gut-microbiome-in-piglets
#13
Jie Yin, Hui Han, Yuying Li, Zhaojin Liu, Yurong Zhao, Rejun Fang, Xingguo Huang, Jie Zheng, Wenkai Ren, Fei Wu, Gang Liu, Xin Wu, Kai Wang, Liping Sun, Chunyong Li, Tiejun Li, Yulong Yin
BACKGROUND/AIMS: Our previous reports suggested that dietary supplementation with lysine influenced intestinal absorption and metabolism of amino acids. In this study, we further investigated the effect of lysine restriction (30%) on feed intake and we also tested the hypothesis that gut microbiome contributed to the potential mechanism of lysine restriction-mediated feeding behavior. Here, we profiled gut microbial communities by sequencing 16S ribosomal ribonucleic acid (rRNA) genes from gut samples as well as growth performance, serum hormones, and intestinal lysine transport in a piglet model...
December 6, 2017: Cellular Physiology and Biochemistry
https://www.readbyqxmd.com/read/29216479/diagnosis-of-deep-vein-thrombosis-recurrence-ultrasound-criteria
#14
REVIEW
Mario Maufus, Antoine Elias, Marie-Thérèse Barrellier, Gilles Pernod
INTRODUCTION: Recurrent deep vein thrombosis (DVT) is often suspected in patients after anticoagulant drug withdrawal. The clinical signs can be confused with the onset of post-thrombotic syndrome. For these reasons, diagnosis of DVT recurrence must rely on an accurate method. MATERIALS AND METHODS: In order to assess this challenging clinical issue, we performed an overview of the literature regarding ultrasound criteria for the diagnosis of recurrent DVT through a Medline search, which included articles published from January 1, 1980 to February 20, 2017...
November 14, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/29215498/postoperative-deep-vein-thrombosis-pulmonary-embolism-and-myocardial-infarction-complications-after-therapeutic-anticoagulation-in-the-patient-with-spine-trauma
#15
Brian Shiu, Elizabeth Le, Ehsan Jazini, Tristan B Weir, Timothy Costales, Nicholas Caffes, Ebrahim Paryavi, Nathan O'Hara, Daniel E Gelb, Eugene Y Koh, Steven C Ludwig
STUDY DESIGN: A retrospective review (2001-2014) was conducted using prospectively collected data at a level I trauma center. OBJECTIVE: We sought to determine the incidence and characteristics of complications occurring secondary to therapeutic anticoagulation in adult spine trauma patients. SUMMARY OF BACKGROUND DATA: Numerous studies have assessed prophylactic anticoagulation after spine surgery, but none has investigated the risks of therapeutic doses of anticoagulation for treatment of postoperative thromboembolic events...
December 5, 2017: Spine
https://www.readbyqxmd.com/read/29214507/comparison-of-once-daily-bemiparin-with-twice-daily-enoxaparin-for-acute-deep-vein-thrombosis-a-multicenter-open-label-randomized-controlled-trial
#16
Igor A Suchkov, Javier Martinez-Gonzalez, Sebastian M Schellong, Toni Garbade, Michela Falciani
BACKGROUND: Individuals with deep vein thrombosis (DVT) have an increased risk of pulmonary embolism (PE), death, and long-term thrombotic complications. OBJECTIVES: To evaluate the efficacy and safety of bemiparin once daily versus enoxaparin twice daily in the treatment of acute DVT, and to establish therapeutic non-inferiority of bemiparin. PATIENTS AND METHODS: This multicenter, randomized, open-label, active-controlled phase III clinical trial enrolled patients with acute proximal DVT confirmed by complete compression ultrasound (CCUS)...
December 6, 2017: Clinical Drug Investigation
https://www.readbyqxmd.com/read/29212126/thrombus-burden-of-deep-vein-thrombosis-and-its-association-with-thromboprophylaxis-and-d-dimer-measurement-insights-from-the-apex-trial
#17
Gerald Chi, Samuel Z Goldhaber, Russell D Hull, Adrian F Hernandez, Mathieu Kerneis, Fahad Al Khalfan, Alexander T Cohen, Robert A Harrington, C Michael Gibson
No abstract text is available yet for this article.
December 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/29211671/pharmacomechanical-catheter-directed-thrombolysis-for-deep-vein-thrombosis
#18
Suresh Vedantham, Samuel Z Goldhaber, Jim A Julian, Susan R Kahn, Michael R Jaff, David J Cohen, Elizabeth Magnuson, Mahmood K Razavi, Anthony J Comerota, Heather L Gornik, Timothy P Murphy, Lawrence Lewis, James R Duncan, Patricia Nieters, Mary C Derfler, Marc Filion, Chu-Shu Gu, Stephen Kee, Joseph Schneider, Nael Saad, Morey Blinder, Stephan Moll, David Sacks, Judith Lin, John Rundback, Mark Garcia, Rahul Razdan, Eric VanderWoude, Vasco Marques, Clive Kearon
BACKGROUND: The post-thrombotic syndrome frequently develops in patients with proximal deep-vein thrombosis despite treatment with anticoagulant therapy. Pharmacomechanical catheter-directed thrombolysis (hereafter "pharmacomechanical thrombolysis") rapidly removes thrombus and is hypothesized to reduce the risk of the post-thrombotic syndrome. METHODS: We randomly assigned 692 patients with acute proximal deep-vein thrombosis to receive either anticoagulation alone (control group) or anticoagulation plus pharmacomechanical thrombolysis (catheter-mediated or device-mediated intrathrombus delivery of recombinant tissue plasminogen activator and thrombus aspiration or maceration, with or without stenting)...
December 7, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/29211373/-deep-vein-thrombosis-in-uncommon-localisations
#19
Andreas Erdmann, Barbara Ney, Salah Dine Qanadli, Luca Calanca, Lucia Mazzolai
Venous thromboembolism (VTE) with its two components, deep vein thrombosis (DVT) and pulmonary embolism (PE), is a common disease with an incidence of 0,75‑2,69/1000. Deep vein thrombosis is localized in unusual sites in about 10 %, and rare DVT's have specific symptoms and risk factors. Uncommon DVT's are often related to local factors, inflammation, cancer, hematologic diseases and thrombophilia. Their diagnostic workup is less straightforward than in suspected VTE of lower limbs and PE, and rare DVT's are often unexpected findings of imaging studies...
December 6, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29207652/iqca-tavv-to-explore-the-effect-of-p-selectin-gpiib-iiia-il-2-il-6-and-il-8-on-deep-venous-thrombosis
#20
Jianhui Wu, Haimei Zhu, Guodong Yang, Yuji Wang, Yaonan Wang, Shurui Zhao, Ming Zhao, Shiqi Peng
Deep vein thrombosis (DVT) associates with considerable morbidity, functional disability and mortality. Due to the lack of suitable inhibitor the correlation of various factors in DVT onset remains unknown. In this context we analyzed the structure of anti-platelet aggregation agent, P-selectin down-regulator, GPIIb/IIIa down-regulator and anti-inflammatory agent, thereby designed N-(3S-1,2,3,4-tetrahydroisoquinoline-3-carbonyl)- Thr-Ala-Arg-Gly-Asp(Val)-Val (IQCA-TAVV) as an inhibitor of DVT to receive evaluations...
October 31, 2017: Oncotarget
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