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Deep venous thrombosis

Christopher D Witiw, Fabrice Smieliauskas, John E O'Toole, Michael G Fehlings, Richard G Fessler
BACKGROUND: Surgery for cervical radiculopathy is often approached by either anterior cervical discectomy and fusion (ACDF) or posterior cervical foraminotomy (PCF). ACDF is more common; however, recent single center studies suggest comparable efficacy and significant cost savings with PCF in appropriately selected patients. OBJECTIVE: To compare utilization, adverse events, and costs for each approach from a national perspective. METHODS: Adults undergoing single level ACDF or PCF for cervical radiculopathy were included from a US commercial health insurance claims database spanning 2003 to 2014...
March 14, 2018: Neurosurgery
Yaseen Arabi, Fahad Al-Hameed, Karen E A Burns, Sangeeta Mehta, Sami Alsolamy, Mohammed Almaani, Yasser Mandourah, Ghaleb A Almekhlafi, Ali Al Bshabshe, Simon Finfer, Mohammed Alshahrani, Imran Khalid, Yatin Mehta, Atul Gaur, Hassan Hawa, Hergen Buscher, Zia Arshad, Hani Lababidi, Abdulsalam Al Aithan, Jesna Jose, Sheryl Ann I Abdukahil, Lara Y Afesh, Maamoun Dbsawy, Abdulaziz Al-Dawood
BACKGROUND: The Pneumatic CompREssion for Preventing VENous Thromboembolism (PREVENT) trial evaluates the effect of adjunctive intermittent pneumatic compression (IPC) with pharmacologic thromboprophylaxis compared to pharmacologic thromboprophylaxis alone on venous thromboembolism (VTE) in critically ill adults. METHODS/DESIGN: In this multicenter randomized trial, critically ill patients receiving pharmacologic thromboprophylaxis will be randomized to an IPC or a no IPC (control) group...
March 15, 2018: Trials
Luke S Howard
Acute pulmonary embolism (PE) is a relatively common cardiopulmonary emergency that is a major cause of hospitalization and morbidity and is the primary cause of mortality associated with venous thromboembolism (VTE). During the last decade, one of the biggest changes in the management of PE has been the approval of four non-vitamin K antagonist oral anticoagulants (NOACs; apixaban, dabigatran, edoxaban and rivaroxaban) for the treatment of PE and deep vein thrombosis and secondary prevention of VTE. Areas covered: This article reviews the evolving management of PE in the NOAC era and addresses three fundamental questions: who should receive NOACs over conventional heparin/vitamin K antagonist regimens for the treatment of acute PE; whether patients should be treated as inpatients or outpatients; and how long patients should be treated to reduce the risk of recurrence? Expert commentary: The management of PE is changing...
March 15, 2018: Expert Review of Respiratory Medicine
Pei-Hsun Sung, Hsin-Ju Chiang, Yao-Hsu Yang, John Y Chiang, Chi-Jen Chen, Hon-Kan Yip, Mel S Lee
PURPOSE: Endothelial dysfunction is a risk factor for osteonecrosis of femoral head (ONFH) and venous thromboembolism (VTE) [defined as deep venous thrombosis (DVT) or pulmonary embolism (PE)]. However, the risk of unprovoked VTE in non-traumatic ONFH patients remains unclear. METHODS: We investigated the relationship between ONFH and VTE using Taiwan National Health Insurance Research Database (NHIRD). Between 1997 and 2010, a total of 1514 non-traumatic ONFH patients were identified from 1,000,000 general populations after excluding initially concomitant diagnoses of DVT and PE, and subjects undergoing lower limb surgery within one year since enrollment...
March 14, 2018: International Orthopaedics
Masoumeh Shohani, Akram Mansouri, Siros Norozi, Naser Parizad, Milad Azami
Background: There is not enough studies to determine the frequency of using the prophylaxis against deep venous thrombosis (DVT) based on the American College of Chest Physician's (ACCP) guidelines in Iran. Thus, providing such statistics is essential to improve thromboprophylaxis in hospital. The present study aimed to determine the frequency of using the prophylaxis against DVT based on ACCP guidelines in patients hospitalized in surgical wards in one of teaching hospital in Ilam, Iran...
2018: International Journal of Preventive Medicine
Jacob C Easaw, Susan McCall, Adrian Azim
Stable cancer patients diagnosed with a pulmonary embolus or deep vein thrombosis are commonly referred to the emergency department for management. This practice strains an already overburdened emergency department and is associated with long wait times and poor disease/injection education for patients. This pilot study sought to determine if stable cancer patients with newly diagnosed cancer-associated thrombosis could be effectively managed by community-based pharmacists who followed an evidence-based protocol to prescribe and initiate low-molecular weight heparin therapy...
January 1, 2018: Journal of Oncology Pharmacy Practice
Nitin Agarwal, Georgios A Zenonos, Prateek Agarwal, Frank J Walch, Eileen Roach, Sandra J Stokes, Robert M Friedlander, Peter C Gerszten
BACKGROUND: Pharmacological prophylaxis for venous thromboembolism (VTE) in the neurosurgical population is still a matter of debate, as the risk-to-benefit ratio is not well defined. OBJECTIVE: To further evaluate the risk-to-benefit ratio of VTE prophylaxis (VTEP) for all neurosurgical procedures. METHODS: A prospective evaluation was performed after the initiation of a VTEP protocol for 11 436 patients undergoing neurosurgical procedures over 24 mo...
March 9, 2018: Neurosurgery
Andre M Samuel, Pablo J Diaz-Collado, Raj J Gala, Matthew L Webb, Adam M Lukasiewicz, Bryce A Basques, Daniel D Bohl, Han Jo Kim, Jonathan N Grauer
STUDY DESIGN: Retrospective cohort study OBJECTIVE.: To determine the rate of venous thromboembolism event (VTE) and risk factors for their occurrence in patients with vertebral fractures. SUMMARY OF BACKGROUND DATA: Deep vein thrombosis or pulmonary embolism (VTE) events are a significant source of potentially preventable morbidity and mortality in trauma patients. In patients with traumatic vertebral fractures, a common high-energy injury sometimes resulting in spinal cord injury, there is debate about what factors may be associated with such VTEs...
March 13, 2018: Spine
Muharrem Yunce, Ashwyn Sharma, Evan Braunstein, Michael B Streiff, Ying Wei Lum
RATIONALE: Thoracic outlet syndrome (TOS) is a rare cause of upper extremity deep vein thrombosis (UEDVT). The treatment usually involves catheter directed thrombolysis followed by systemic anticoagulation. Surgical decompression is frequently recommended after anticoagulation for definitive therapy. PATIENT CONCERNS: We report two cases of UEDVT secondary to venous TOS with important clinical presentations. DIAGNOSES: Venous TOS. INTERVENTIONS: One patient was initially treated conservatively but had a recurrent UEDVT...
March 2018: Medicine (Baltimore)
Zhen-En Lin, Hong Zheng, Xue-Sheng Chen, Zhao-Hui Li
OBJECTIVE: To analysis the outcome of modified closure bone setting manipulation for the treatment of femoral neck fracture. METHODS: From January 2012 to December 2012, 47 cases of femoral neck fracture were treated and included 25 males and 22 females with an average age of (44.58±10.32) years old ranging from 23 to 61 years old. All patients had a history of trauma, hip pain and movement limited, limb shortening extorsion deformity, X-ray showed fracture between femoral head and femoral neck basic...
February 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Cristiana Bulato, Elena Campello, Sabrina Gavasso, Sara Maggiolo, Daniela Tormene, Paolo Simioni
A 7-years-old child who developed unprovoked deep vein thrombosis (DVT) and pulmonary embolism (PE) was tested for inherited thrombophilia. Protein C (PC) antigen level (87 %) and PC coagulometric and amidolytic activities (12 % and 11 %, respectively) were consistent with a homozygous PC type IIA phenotype.The patient was carrier of two heterozygous missense mutations causing p.Arg32Cys substitution associated with a type I PC defect ("null allele", from the paternal side) and p.Gly433Ser substitution responsible for a type IIA PC defect (from the maternal side)...
February 2018: Hämostaseologie
Jian Huang, Peng Zhang, Dawei Wang
Coagulation changes after total knee arthroplasty (TKA) can provide evidence for optimization of timing of perioperative anticoagulation medicine. To evaluate the changes, 50 patients with knee osteoarthritis or rheumatoid arthritis were recruited for the study and underwent thrombelastography tests pre-, 6 hours, 12 hours, and 24 hours after TKA surgery and Doppler ultrasound examination 20 to 24 hours after surgery. The results have shown prolonged clotting time ( R value) at 6 and 12 hours, while shortened at 24 hours...
January 30, 2018: Journal of Knee Surgery
Andrew Bromley, Anna Plitt
Venous thromboembolism (VTE), which includes both deep vein thrombosis and pulmonary embolism (PE), is a very common disorder with high risk for recurrence and is associated with significant morbidity and mortality. The non-vitamin K oral anticoagulants (NOACs), which include dabigatran, rivaroxaban, apixaban, and edoxaban, have been shown to be noninferior to conventional anticoagulant therapy for the prevention of recurrent VTE and are associated with more favorable bleeding risk. Evidence from the treatment of VTE with traditional therapy (low molecular weight heparin and vitamin K antagonists) implies that extended or indefinite treatment reduces risk of recurrence...
March 10, 2018: Cardiology and Therapy
O Mahmoud, P Vikatmaa, J Räsänen, E Peltola, E Sihvo, L Vikatmaa, K Lappalainen, M Venermo
BACKGROUND AND AIMS: We compared the immediate and one-year results as well as total hospital costs between catheter-directed thrombolysis (CDT) and pharmacomechanical thrombolysis (PMT) in the treatment of symptomatic upper extremity deep venous thrombosis (UEDVT). MATERIAL AND METHODS: From 2006 to 2013, 55 patients with UEDVT were treated with either CDT or PMT at Helsinki University Hospital. Of them, 43 underwent thoracoscopic rib resection later in order to relieve phlebography-confirmed vein compression...
March 6, 2018: Annals of Vascular Surgery
Michitaka Funayama, Taketo Takata, Akihiro Koreki, Satoyuki Ogino, Masaru Mimura
OBJECTIVE: Although catatonia can occur secondary to a general medical condition, catatonia itself has been known to lead to various medical compolications. Although case reports on the association of catatonia with subsequent medical complications have been documented, no comprehensive large-scale study has been performed. To investigate specific medical complications following catatonia, we conducted a retrospective cohort study of specific medical complications of schizophrenia patients with catatonia...
March 8, 2018: Psychosomatic Medicine
Zi-Jian Li, Min-Wei Zhao, Lin Zeng
Background: Total knee arthroplasty (TKA) is the most frequently performed procedure in treating advanced knee osteoarthritis. Excessive perioperative blood loss can sometimes lead to postoperative anemia. Tranexamic acid (TXA) is a potent fibrinolysis inhibitor which has been extensively used at the surgical incision and closure to lower overall blood loss in adult reconstruction surgery. Our previous study suggested that about two-thirds of the total blood loss (TBL) came from hidden blood loss (HBL) on postoperative days 1 and 2...
March 20, 2018: Chinese Medical Journal
K H Lee, L Cavanaugh, H Leung, F Yan, Z Ahmadi, B H Chong, F Passam
INTRODUCTION: Neutrophil extracellular traps (NETs) are networks of extracellular fibres produced from neutrophil DNA with a pathogenic role in infection, thrombosis and other conditions. Reliable assays for measuring NETs are desirable as novel treatments targeting NETs are being explored for the treatment of these conditions. We compare a whole blood flow cytometry method with serum assays to measure NETs-associated markers in patients with sepsis and thrombosis. METHODS: Patients with deep venous thrombosis (n = 25), sepsis (n = 21) and healthy controls (n = 23) were included in the study...
March 9, 2018: International Journal of Laboratory Hematology
Davide Imberti, Cecilia Becattini, Enrico Bernardi, Giuseppe Camporese, Claudio Cuccia, Francesco Dentali, Damiano Paretti
Despite the availability of updated guidelines for the diagnosis and treatment of venous thromboembolism (VTE), the management of this disorder in clinical practice is often not standardized, given the different degree of compliance with official recommendations by the various involved specialists. The aim of this consensus paper, as a result of a board of experts in thromboembolism, is to define strategies to improve the quality of patients' care and the efficiency of healthcare resources utilization, by means of: (a) analysis of the guidelines for diagnosis and treatment of VTE; (b) analysis of diagnostic and therapeutic algorithms currently used in clinical practice by different specialists; (c) agreement on a common algorithm for diagnosis and treatment of VTE in different clinical settings; (d) definition of the possible role of the new oral anticoagulant agents (NOAC), such as rivaroxaban, based on their potential benefits for both acute and chronic therapy...
March 8, 2018: Internal and Emergency Medicine
William J Yoon, Pegge Halandras, Bernadette Aulivola, Paul Crisostomo
INTRODUCTION & OBJECTIVES: Cancer patients demonstrate increased risk for venous thromboembolism (VTE), VTE recurrence, and anticoagulation-associated bleeding. Pharmacomechanical thrombolysis and thrombectomy (PMT) improves venous patency, venous valve function, and quality of life in patients with acute iliofemoral deep venous thrombosis (DVT). It remains unknown whether pharmacomechanical thrombolysis can be used safely in patients with active cancer. We hypothesized that perioperative and short-term outcomes of pharmacomechanical iliofemoral DVT thrombolysis would not differ between patients with cancer and those without cancer...
March 5, 2018: Annals of Vascular Surgery
Haiyang Wang, Xiaotong Qi, Yikuan Chen, Jianming Sun
PURPOSE: To compare the clinical efficacy and safety of catheter-directed thrombolysis (CDT) using the anterior tibial vein approach and popliteal vein approach for acute lower-extremity deep venous thrombosis (LEDVT). MATERIALS AND METHODS: From March 2014 to October 2015, 63 patients with unilateral acute extensive LEDVT were enrolled in this study: 36 patients received CDT via the popliteal vein approach (PVA) group, and 27 patients received CDT via the anterior tibial vein approach (ATVA) group...
March 5, 2018: Annals of Vascular Surgery
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