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Venous thromboembolic disease

Diren Arsoy, Nicholas J Giori, Steven T Woolson
BACKGROUND: The use of chemoprophylaxis to prevent thromboembolic disease after primary THA and TKA can be associated with postoperative bleeding complications. Mechanical prophylaxis has been studied as an alternative to chemoprophylaxis with greater safety in patients undergoing THA, but no data have been published comparing the safety of chemoprophylaxis versus mechanical methods for patients undergoing TKA. The risk of readmission resulting from bleeding and venous thromboembolism (VTE) has also not been determined for patients undergoing THA or TKA when treated with low-molecular-weight heparin (LMWH) alone compared with mechanical prophylaxis plus aspirin (ASA)...
February 2018: Clinical Orthopaedics and related Research
Ali Abdul Jabaar, J Stephen Jenkins
BACKGROUND: Beyond medical therapy, the role of endovascular approach for the management of chronic Venous Thromboembolic (VTE) disease is yet to be defined. To our knowledge, no systematic reviews or guidelines are available that provide information on how to manage this chronic condition. This paper represents the first systematic review of published reports on the use of vacuum-assisted thrombectomy (AngioVac) in treating chronic VTE disease. METHODS: A systematic review of published case-series, individual case-reports, and review articles in MEDLINE, PubMed, and Google Scholar was conducted...
February 15, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Vivan J M Baggen, Annemien E van den Bosch, Roland R van Kimmenade, Jannet A Eindhoven, Maarten Witsenburg, Judith A A E Cuypers, Frank W G Leebeek, Eric Boersma, Jolien W Roos-Hesselink
BACKGROUND: Red cell distribution width (RDW) is a standard component of the automated blood count, and is of prognostic value in heart failure and coronary heart disease. We investigated the association between RDW and cardiovascular events in patients with adult congenital heart disease (ACHD). METHODS AND RESULTS: In this prospective cohort study, 602 consecutive patients with ACHD who routinely visited the outpatient clinic were enrolled between 2011 and 2013...
March 2, 2018: International Journal of Cardiology
Robert F Łukaszuk, Krzysztof Plens, Anetta Undas
BACKGROUND: Underuse of thromboprophylaxis in hospitalized medical patients is still common worldwide. Little is known about the use of thromboprophylaxis in patients with pulmonary diseases in everyday hospital practice. OBJECTIVES: The aim of this study was to assess the use of pharmacological prophylaxis of venous thromboembolism (VTE) in real-life patients with pulmonary diseases. MATERIAL AND METHODS: In this retrospective study, 2 validated scoring systems, i...
February 2018: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
V A Levin, X Jiang, R Kagan
Menopause predisposes women to osteoporosis due to declining estrogen levels. This results in a decrease in bone mineral density (BMD) and an increase in fractures. Osteoporotic fractures lead to substantial morbidity and mortality, and are considered one of the largest public health priorities by the World Health Organization (WHO). It is therefore essential for menopausal women to receive appropriate guidance for the prevention and management of osteoporosis. The Women's Health Initiative (WHI) randomized controlled trial first proved hormonal therapy (HT) reduces the incidence of all osteoporosis-related fractures in postmenopausal women...
March 8, 2018: Osteoporosis International
Hayden N Box, Sean Shahrestani, Michael H Huo
Venous thromboembolic disease (VTED) is a major cause of morbidity and mortality after total knee arthroplasty (TKA). Current VTED prophylaxis protocols consist of early mobilization, mechanical compression devices, and pharmacologic agents. Venous phasic flow-regulated below-knee devices are generally favored, but the optimal duration and method of mechanical prophylaxis is unknown. Risk stratification models have been developed to guide pharmacologic prophylaxis. For patients with standard VTED risk profile, aspirin has become increasingly popular...
March 7, 2018: Journal of Knee Surgery
Jonathan G Stine, Blake A Niccum, Alex N Zimmet, Nicolas Intagliata, Stephen H Caldwell, Curtis K Argo, Patrick G Northup
OBJECTIVE: Patients with cirrhosis are at increased risk for venous thromboembolism (VTE) and portal vein thrombosis (PVT). Cirrhosis due to non-alcoholic steatohepatitis (NASH) appears to be particularly prothrombotic. We investigated hospitalized patients with NASH cirrhosis to determine if they are at increased risk for VTE. METHODS: Data on adult hospitalized patients with cirrhosis and VTE (deep vein thrombosis and/or pulmonary embolism) between November 1, 2010 and December 31, 2015 were obtained...
March 6, 2018: Clinical and Translational Gastroenterology
Dae Hyun Lee, Michael G Fradley
PURPOSE OF REVIEW: Multiple myeloma treatment regimens consist of proteasome inhibitors (bortezomib, carfilzomib, and ixazomib), immunomodulatory drugs (thalidomide, lenalidomide, and pomalidomide), and steroids. In this paper, we will review the pathophysiology and associated cardiotoxicities of the different multiple myeloma therapeutic modalities and present methods to mitigate the development of cardiovascular complications. RECENT FINDINGS: Although proteasome inhibitors and immunomodulatory drugs have led to significant improvements in oncologic outcomes, there is increasing evidence of serious cardiovascular side effects which may be exacerbated in the setting of underlying cardiovascular risk factors or disease...
March 6, 2018: Current Treatment Options in Cardiovascular Medicine
Daniel F Geersen, Cynthia E K Shortell
Ambulatory phlebectomy is a well-known and widely used procedure for residual symptomatic venous disease. Tumescent anesthesia complements the procedure, providing the ability to perform this intervention in a wide range of practice settings. The procedures are well tolerated by most patients, and complications are rare. They include venous thromboembolism, infection, and hematoma and are generally simple to manage. Alternative and emerging techniques of powered phlebectomy and cyanoacrylate glue are providing alternative forms for treatment and will advance the practice further...
April 2018: Surgical Clinics of North America
Ben Jacobs, Peter K Henke
Venous thromboembolism (VTE) remains a significant mortal and morbid disease. The major risks have not changed and many patients present with unprovoked VTE disease. Prevention of VTE in hospitalized patients depends on comprehensive risk factor assessment, with an individual risk score. Proper and timely prophylaxis with mechanical, pharmacologic, or both is then effective. Treatment of VTE with parenteral anticoagulation followed by either a direct oral anticoagulant or warfarin is standard to reduce risk of VTE recurrence and death...
April 2018: Surgical Clinics of North America
Hajime Ikenouchi, Naoto Sugeno, Takaaki Nakamura, Junpei Kobayashi, Ryuji Oshima, Hiroshi Kuroda, Masashi Aoki
Development of paradoxical cerebral embolism requires both unstable venous thrombosis and right-to-left shunt (RLS). Gastrointestinal endoscopy (GE) has the potential to affect intrathoracic and abdominal venous thrombi and to enhance RLS because the procedure alters intrathoracic and abdominal pressure. We describe a patient with Crohn's disease who developed paradoxical cerebral embolism after GE. Both an unstable venous thrombus in the superior vena cava and RLS through patent foramen ovale were thought to be responsible for the stroke...
February 28, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Ian C Scott, Samantha L Hider, David L Scott
Two different Janus kinase (JAK) inhibitors-baricitinib and tofacitinib-are effective and licensed in active rheumatoid arthritis (RA). There have been recent concerns about potential thromboembolic risks with these drugs. Concerns about baricitinib focus on clinical trial findings. Using all publically available data, we estimate thromboembolic risks are approximately five events per 1000 patient years with 4 mg baricitinib daily. Concerns about tofacitinib have been raised by analyses of the Federal Drug Administration Adverse Event Reporting System (FAERs)...
March 2, 2018: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
Bonnie Y Chien, Tonya Dixon, Daniel Guss, Christopher DiGiovanni
There are limited data to guide the use of venous thromboembolism disease (VTED) prophylaxis after foot and ankle surgery. Although there is general consensus that the overall risk is lower than after hip or knee replacement, subpopulations of patients may be at relatively heightened risk. Furthermore, existing data are often conflicting regarding the efficacy of prophylaxis, with little acknowledgment of the tradeoffs between VTED prophylaxis and potential complications associated with the use of such medications...
April 2018: Orthopedic Clinics of North America
Lauren N Wood, Melissa A Markowitz, Pooja S Parameshwar, Alex J Hannemann, Shellee L Ogawa, Jennifer T Anger, Karyn S Eilber
INTRODUCTION: and Objectives: Overactive bladder (OAB) imposes a significant socioeconomic burden on the healthcare system. It is a commonly held belief that increased fluid intake (eight glasses of water a day) is beneficial for one's health; however, increased fluid intake exacerbates OAB symptoms. Thus, it is imperative that clinicians appropriately educate patients for whom increased water intake may be detrimental (women with OAB), in contrast to patients with comorbidities that necessitate increased water intake (nephrolithiasis)...
February 27, 2018: Journal of Urology
Elisabetta Tedaldi, Chiara Montanari, Kenneth I Aycock, Francesco Sturla, Alberto Redaelli, Keefe B Manning
Inferior vena cava (IVC) filters have been used for over five decades as an alternative to anticoagulation therapy in the treatment of venous thromboembolic disease. However, complications associated with IVC filters remain common. Though many studies have investigated blood flow in the IVC, the effects of respiration-induced IVC collapse have not been evaluated. Our hypothesis is that IVC collapse may have an influence on IVC filter performance. Therefore, we herein investigate the hemodynamics in uncollapsed and collapsed IVC configurations using in vitro flow experiments and computational simulations...
February 24, 2018: Medical Engineering & Physics
Deisy Barrios, Luis Jara-Palomares, David Jiménez
No abstract text is available yet for this article.
February 24, 2018: Archivos de Bronconeumología
Ali Alkan, Serap Talaz
Introduction Cancer is an important risk factor for venous and arterial thromboembolic events. Treatment with chemotherapy was associated with a 6.5-fold increase in the risk of thromboembolic events. Here, we present a patient with cilioretinal artery emboli during cisplatin-based therapy. Case report A 54-year-old male patient with a diagnosis of metastatic small cell carcinoma was under cisplatin-based regimen. He presented with visual disturbance. Retinal fluorescein angiography showed multiple plaques located in cilioretinal artery and cilioretinal artery occlusion...
January 1, 2018: Journal of Oncology Pharmacy Practice
Sarah M Anderson, Bradley Beck, Susan Sterud, Robin Lockhorst, Surachat Ngorsuraches
Background Lenalidomide and pomalidomide are two immunomodulatory medications with the potential to improve outcomes for patients with multiple myeloma; however, a black box warning for venous thromboembolism exists. Purpose The purpose of this study was to assess overall adherence to guideline recommendations for anticoagulation therapy with lenalidomide and pomalidomide in multiple myeloma patients. Methods This retrospective study at an ambulatory oncology clinic utilized chart reviews from the calendar years 2013-2016...
January 1, 2018: Journal of Oncology Pharmacy Practice
Shyue-Luen Chang, Yau-Li Huang, Mei-Ching Lee, Sindy Hu, Yen-Chang Hsiao, Su-Wei Chang, Chee Jen Chang, Pei-Chun Chen
Importance: Varicose veins are common but rarely associated with serious health risks. Deep venous thrombosis (DVT), pulmonary embolism (PE), and peripheral artery disease (PAD) are also vascular diseases but associated with serious systemic effects. Little is known about the association between varicose veins and the incidence of other vascular diseases including DVT, PE, and PAD. Objective: To investigate whether varicose veins are associated with an increased risk of DVT, PE, or PAD...
February 27, 2018: JAMA: the Journal of the American Medical Association
Dražen Pulanić, Ena Ranković, Marijo Vodanović, Mario Lušić, Ana Boban, Silva Zupančić Šalek, Damir Nemet
Although venous thromboembolism (VTE) including deep venous thrombosis (DVT) and pulmonary embolism is a major health problem in the world, it is an infrequent disease among young people. It is always mandatory to look at the underlying conditions for VTE, and in young patients, inherited prothrombotic factors should also be evaluated, especially in case of unprovoked VTE. Anomalies of inferior vena cava (IVC) are very rare in the general population. In this case report we describe rare occurrence of extensive DVT in a young male patient with rare anomaly of IVC - duplication of IVC - as a predisposition factor for DVT...
June 2017: Acta Clinica Croatica
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