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Venous thromboprophylaxis

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https://www.readbyqxmd.com/read/29244199/secondary-prevention-of-recurrent-venous-thromboembolism-after-initial-oral-anticoagulation-therapy-in-patients-with-unprovoked-venous-thromboembolism
#1
REVIEW
Lindsay Robertson, Su Ern Yeoh, Ahmad Ramli
BACKGROUND: Currently, little evidence is available on the length and type of anticoagulation used for extended treatment for prevention of recurrent venous thromboembolism (VTE) in patients with unprovoked VTE who have completed initial oral anticoagulation therapy. OBJECTIVES: To compare the efficacy and safety of available oral therapeutic options (aspirin, warfarin, direct oral anticoagulants (DOACs)) for extended thromboprophylaxis in adults with a first unprovoked VTE, to prevent VTE recurrence after completion of an acceptable initial oral anticoagulant treatment period, as defined in individual studies...
December 15, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29234961/risk-and-incidence-of-perioperative-deep-vein-thrombosis-in-patients-undergoing-gastric-cancer-surgery
#2
Tomohiro Osaki, Hiroaki Saito, Yoji Fukumoto, Yusuke Kono, Yuki Murakami, Yuji Shishido, Hirohiko Kuroda, Tomoyuki Matsunaga, Kengo Sato, Yasuaki Hirooka, Yoshiyuki Fujiwara
BACKGROUND AND PURPOSE: Venous thromboembolism (VTE) is a potentially fatal perioperative complication. Understanding the risk factors for deep vein thrombosis (DVT) and initiating appropriate prophylaxis is pivotal for reducing the risk of VTE. The purpose of this study was to clarify the perioperative risk factors for DVT in patients undergoing surgery for gastric cancer. METHODS: We reviewed the findings of lower limb ultrasonography performed in 160 patients who underwent gastrectomy for gastric cancer...
December 12, 2017: Surgery Today
https://www.readbyqxmd.com/read/29229126/prophylactic-enoxaparin-doses-may-be-inadequate-in-patients-undergoing-abdominal-cancer-surgery
#3
Joel M Baumgartner, Shonté McKenzie, Shanna Block, Todd W Costantini, Andrew M Lowy
BACKGROUND: The incidence of venous thromboembolism has increased in patients following cancer surgery despite the increased use of prophylactic anticoagulants, suggesting standard doses may be inadequate. We sought to determine the adequacy of enoxaparin prophylaxis in patients undergoing abdominal cancer surgery. METHODS: Peak and trough anti-Xa levels were measured in patients receiving enoxaparin thromboprophylaxis (40 mg daily or 30 mg twice daily, at the surgeon's discretion) after undergoing open abdominal cancer surgery at a single institution...
January 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29226697/update-on-the-use-of-direct-oral-anticoagulants-for-the-prevention-and-treatment-of-thromboembolism
#4
Anna Jacobs, Rajesh Kabra, Pranab Das, Carrie S Oliphant
Following publication of our review article 4 years ago, there has been an uptake in the use of nonvitamin K oral antagonists, also known as direct oral anticoagulants. The most recent Xa inhibitors to receive approval are edoxaban, which has been approved for use in both atrial fibrillation and venous thromboembolism prevention and betrixaban, which has been approved in the USA for extended thromboprophylaxis in the medically ill population. Additional analyses of certain types of atrial fibrillation patients have now become available...
December 11, 2017: Future Cardiology
https://www.readbyqxmd.com/read/29224364/new-anticoagulants-for-venous-thromboembolism-and-atrial-fibrillation-what-the-future-holds
#5
Gerasimos Dimitropoulos, S M Zubair Rahim, Alexandra Sophie Moss, Gregory Y H Lip
Introduction The field of anticoagulation has seen impressive progress over the last decade. The introduction of the Non Vitamin K Oral Anticoagulants (NOACs) has revolutionized practice surrounding thromboprophylaxis, treatment of thromboembolic disease and stroke prevention in atrial fibrillation (AF). However, the search for the "holy grail" of anticoagulation, an agent that combines optimal efficacy with minimal bleeding diathesis, continues. Areas covered In this paper we aim to summarize the current evidence from pre-clinical studies and early phase clinical trials, presenting the pharmacodynamic and pharmacokinetic properties as well as the safety and efficacy profiles of the most important antithrombotic agents in development...
December 9, 2017: Expert Opinion on Investigational Drugs
https://www.readbyqxmd.com/read/29220427/steroid-but-not-biological-therapy-elevates-the-risk-of-venous-thromboembolic-events-in-inflammatory-bowel-disease-a-meta-analysis
#6
Patricia Sarlos, Kata Szemes, Peter Hegyi, Andras Garami, Imre Szabo, Anita Illes, Margit Solymar, Erika Petervari, Aron Vincze, Gabriella Par, Judit Bajor, Jozsef Czimmer, Orsolya Huszar, Peter Varju, Nelli Farkas
Background and aim: Inflammatory bowel disease [IBD] is associated with 1.5- to 3-fold increased risk of venous thromboembolic events [VTE]. The aim of this study was to determine the risk of VTE in IBD as a complication of systemic corticosteroids and anti-tumor necrosis factor alpha [TNFα] therapies. Methods: A systematic review and meta-analysis was conducted, which conforms to the Preferred Reporting Items for Systematic Reviews and Meta-analyses [PRISMA] statement...
December 6, 2017: Journal of Crohn's & Colitis
https://www.readbyqxmd.com/read/29207321/a-multi-institutional-registry-of-pediatric-hospital-acquired-thrombosis-cases-the-children-s-hospital-acquired-thrombosis-chat-project
#7
Julie Jaffray, Arash Mahajerin, Guy Young, Neil Goldenberg, Lingyun Ji, Richard Sposto, Amy Stillings, Emily Krava, Brian Branchford
BACKGROUND: Pediatric hospital-acquired venous thromboembolism (HA-VTE) rates have increased dramatically. To achieve generalizable knowledge in the derivation and validation of HA-VTE risk factors and risk prediction models and inform future risk-stratified prevention strategies, multi-institutional studies are needed. OBJECTIVES: This paper presents an investigator-initiated, multicenter pediatric case-cohort study designed to identify risk factors for HA-VTE to create a HA-VTE risk prediction model...
December 1, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/29199711/venous-thromboembolism-in-cancer-patients-magnitude-of-problem-approach-and-management
#8
REVIEW
G Singh, A K Rathi, K Singh, D Sharma
Cancer is hypercoagulable state. Patients with cancer are at high risk to develop venous thromboembolism (VTE). Relative risk of developing VTE is approximately seven times higher in patients with active cancer. The incidence of occult malignancy is 7%-12% in patients with idiopathic deep vein thrombosis (DVT). However, little research has been focused on cancer with thromboembolism. Lowmolecularweight heparin most frequently used pharmacologic agents as recommended by established guidelines. The aim was to evaluate the magnitude of problem in cancer patients and treatment option as per established guidelines...
January 2017: Indian Journal of Cancer
https://www.readbyqxmd.com/read/29198736/venous-thromboembolic-complications-to-hysterectomy-for-benign-disease-a-nationwide-cohort-study
#9
Henriette Strøm Kahr, Ole Thorlacius-Ussing, Ole Bjarne Christiansen, Regitze Kuhr Skals, Christian Torp-Pedersen, Aage Knudsen
STUDY OBJECTIVE: To estimate the risk of venous thromboembolic complications following abdominal, laparoscopic and vaginal hysterectomy when performed for benign disorders. DESIGN: Nationwide cohort study (Canadian Task Force Classification II-2). SETTING: Data from Danish national registers on all women undergoing hysterectomy for benign conditions in the period 1996-2015. PATIENTS: Women aged 18 and above who underwent hysterectomy for benign disease were stratified into 3 groups according to hysterectomy approach: abdominal, laparoscopic or vaginal...
November 30, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29190255/relation-of-antifactor-xa-peak-levels-and-venous-thromboembolism-after-trauma
#10
Charles A Karcutskie, Arjuna Dharmaraja, Jaimin Patel, Sarah A Eidelson, Arch G Martin, Edward B Lineen, Nicholas Namias, Carl I Schulman, Kenneth G Proctor
BACKGROUND: No previous studies have established the optimal antifactor Xa (anti-Xa) level to guide thromboprophylaxis (TPX) dosing with enoxaparin in trauma patients. We hypothesize that achieving 0.2-0.4 IU/mL anti-Xa will decrease venous thromboembolism (VTE) rates after trauma. METHODS: This was a retrospective review of 194 intensive care unit patients sustaining blunt or penetrating trauma from January 2015 to March 2017. All received initial enoxaparin (30 mg BID subcutaneous) and mechanical devices for TPX...
December 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29184861/efficacy-and-safety-of-venous-thromboembolism-prophylaxis-with-fondaparinux-in-women-at-risk-after-cesarean-section
#11
Ryuji Kawaguchi, Shoji Haruta, Hiroshi Kobayashi
Objectives: Cesarean section is associated with an increased risk for venous thromboembolism (VTE). The safety and efficacy of primary prophylaxis of fondaparinux, a synthetic sulfated pentasaccharide heparin analog, in women at risk after cesarean section is uncertain. Methods: This was a retrospective study of 295 cases of pregnant women presenting to a tertiary referral center of Nara, Japan, to evaluate the usefulness of thromboprophylaxis with fondaparinux after cesarean delivery between 2011 and 2012...
November 2017: Obstetrics & Gynecology Science
https://www.readbyqxmd.com/read/29171776/extended-thromboprophylaxis-in-the-acutely-ill-medical-patient-after-hospitalization-a-paradigm-shift-in-post-discharge-thromboprophylaxis
#12
Charles E Mahan, Allison E Burnett, Megan Fletcher, Alex C Spyropoulos
Venous thromboembolism (VTE) is a significant healthcare burden with approximately 900,000 events annually in the United States, over half of which are healthcare-associated. This number is anticipated to double by 2050. Group prophylaxis strategies confined to the inpatient setting appear to have minimal impact on the reduction of post-discharge VTE in medically ill patients due to shortened lengths of stay and a heterogenous population that includes patients at low risk for VTE. In accordance with current guideline recommendations, very few (<5%) medically ill patients are discharged with extended prophylaxis, which potentially creates a clinical gap for at-risk patients as VTE risk has been shown to persist for up to 90 days...
November 24, 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/29164026/a-clinical-practice-guideline-for-the-management-of-patients-with-acute-spinal-cord-injury-recommendations-on-the-type-and-timing-of-anticoagulant-thromboprophylaxis
#13
Michael G Fehlings, Lindsay A Tetreault, Bizhan Aarabi, Paul Anderson, Paul M Arnold, Darrel S Brodke, Anthony S Burns, Kazuhiro Chiba, Joseph R Dettori, Julio C Furlan, Gregory Hawryluk, Langston T Holly, Susan Howley, Tara Jeji, Sukhvinder Kalsi-Ryan, Mark Kotter, Shekar Kurpad, Brian K Kwon, Ralph J Marino, Allan R Martin, Eric Massicotte, Geno Merli, James W Middleton, Hiroaki Nakashima, Narihito Nagoshi, Katherine Palmieri, Anoushka Singh, Andrea C Skelly, Eve C Tsai, Alexander Vaccaro, Jefferson R Wilson, Albert Yee, James S Harrop
Introduction: The objective of this study is to develop evidence-based guidelines that recommend effective, safe and cost-effective thromboprophylaxis strategies in patients with spinal cord injury (SCI). Methods: A systematic review of the literature was conducted to address key questions relating to thromboprophylaxis in SCI. Based on GRADE (Grading of Recommendation, Assessment, Development and Evaluation), a strong recommendation is worded as "we recommend," whereas a weaker recommendation is indicated by "we suggest...
September 2017: Global Spine Journal
https://www.readbyqxmd.com/read/29164021/efficacy-safety-and-timing-of-anticoagulant-thromboprophylaxis-for-the-prevention-of-venous-thromboembolism-in-patients-with-acute-spinal-cord-injury-a-systematic-review
#14
REVIEW
Paul M Arnold, James S Harrop, Geno Merli, Lindsay G Tetreault, Brian K Kwon, Steve Casha, Katherine Palmieri, Jefferson R Wilson, Michael G Fehlings, Haley K Holmer, Daniel C Norvell
Study Design: Systematic review. Objectives: The objective of this study was to answer 5 key questions: What is the comparative effectiveness and safety of (1a) anticoagulant thromboprophylaxis compared to no prophylaxis, placebo, or another anticoagulant strategy for preventing deep vein thrombosis (DVT) and pulmonary embolism (PE) after acute spinal cord injury (SCI)? (1b) Mechanical prophylaxis strategies alone or in combination with other strategies for preventing DVT and PE after acute SCI? (1c) Prophylactic inferior vena cava filter insertion alone or in combination with other strategies for preventing DVT and PE after acute SCI? (2) What is the optimal timing to initiate and/or discontinue anticoagulant, mechanical, and/or prophylactic inferior vena cava filter following acute SCI? (3) What is the cost-effectiveness of these treatment options? Methods: A systematic literature search was conducted to identify studies published through February 28, 2015...
September 2017: Global Spine Journal
https://www.readbyqxmd.com/read/29147590/paroxysmal-nocturnal-hemoglobinuria-in-pregnancy-a-dilemma-in-treatment-and-thromboprophylaxis
#15
Arpan Patel, Athira Unnikrishnan, Martina Murphy, Robert Egerman, Sarah Wheeler, Ashley Richards, John Wingard
Paroxysmal nocturnal hemoglobinuria (PNH) is a hematologic disorder characterized by an acquired somatic mutation in the phosphatidylinositol glycan class A gene which leads to a higher risk for increased venous and arterial thrombosis. Current treatment for PNH includes eculizumab. Pregnant patients who have PNH have higher risk for thrombosis and hemorrhage with both pregnancy and their underlying PNH. Treatment frequently poses conundrum. The safety and efficacy of eculizumab during pregnancy and breast feeding have not been extensively studied and contraception has been recommended due to potential for teratogenicity...
2017: Case Reports in Hematology
https://www.readbyqxmd.com/read/29144543/primary-thromboprophylaxis-in-individuals-without-cancer-admitted-to-a-geriatric-palliative-care-unit
#16
Adam J Gurau, Anna Berall, Jurgis Karuza, Giulia-Anna Perri
BACKGROUND/OBJECTIVES: The prevalence of individuals with advanced noncancer disease is increasing on palliative care units (PCUs), but there are no current guidelines to direct venous thromboembolism (VTE) prophylaxis decisions in these individuals. The aim of this study was to compare primary VTE prophylaxis in elderly adults with advanced noncancer diagnoses with that of those with advanced cancer on a dedicated geriatric PCU. DESIGN: Single-center retrospective chart review...
November 16, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29137835/venous-thromboembolism-risk-and-prophylaxis-in-the-portuguese-hospital-care-setting-the-arte-study
#17
Daniel Ferreira, Joaquim Abreu de Sousa, Paulo Felicíssimo, Ana França
INTRODUCTION: Venous thromboembolism (VTE) is a relatively common complication during hospital stay and determination of VTE risk is critical to choosing the best prophylactic strategy for each patient. OBJECTIVES: In the present study we studied the risk profile for VTE in hospitalized patients in a group of hospitals in Portugal. METHODS: Based on an open cohort of 4248 patients hospitalized in surgical, internal medicine, orthopedic or oncology departments, we determined thromboembolic risk at admission by applying a new score, modified from the Caprini and Khorana scores...
November 11, 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/29127473/colorectal-cancer-and-thrombosis
#18
P A Rees, H W Clouston, S Duff, C C Kirwan
SIGNIFICANCE: Colorectal cancer (CRC), results in a hypercoagulable state which manifests clinically as venous thromboembolism (VTE), often presenting as a deep vein thrombosis (DVT) or pulmonary embolism (PE). The consequences of VTE in CRC can be devastating, resulting in long-term morbidity and are a frequent cause of death, even amongst those who would have otherwise had a favourable cancer prognosis. The incidence of VTE in all cancers is increasing, whilst the exact incidence of VTE in CRC is likely to be underestimated...
November 10, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/29121664/does-preoperative-mechanical-prophylaxis-have-additional-effectiveness-in-preventing-postoperative-venous-thromboembolism-in-elderly-patients-with-hip-fracture-retrospective-case-control-study
#19
Ji-Hoon Nam, Dae-Hwan Kim, Je-Hyun Yoo, Ji-Hyo Hwang, Jun-Dong Chang
BACKGROUND: Elderly patients undergoing hip fracture surgery (HFS) are at increased risk of postoperative venous thromboembolism (VTE). To reduce this risk, combined postoperative mechanical and chemical thromboprophylaxis has been routinely performed after HFS in these patients. This retrospective case-control study was conducted to evaluate the additional effectiveness of preoperative mechanical thromboprophylaxis for the prevention of VTE following HFS in elderly patients. METHODS: Of 539 consecutive patients aged 70 years or older undergoing HFS, 404 (control group) did not receive preoperative mechanical thromboprophylaxis, while 135 (study group) received mechanical thromboprophylaxis using an intermittent pneumatic compression device and graduated compression stockings from the time of admission until surgery...
2017: PloS One
https://www.readbyqxmd.com/read/29118862/thromboprophylaxis-and-mortality-among-patients-who-developed-venous-thromboembolism-in-seven-major-hospitals-in-saudi-arabia
#20
Fahad M Al-Hameed, Hasan M Al-Dorzi, Abdulelah I Qadhi, Amira Shaker, Farjah H Al-Gahtani, Fawzi F Al-Jassir, Galila F Zahir, Tarig S Al-Khuwaitir, Mohammed H Addar, Mohamed S Al-Hajjaj, Mohamed A Abdelaal, Essam Y Aboelnazar
INTRODUCTION: Venous thromboembolism (VTE) during hospitalization is a serious and potentially fatal condition. Despite its effectiveness, evidence-based thromboprophylaxis is still underutilized in many countries including Saudi Arabia. OBJECTIVE OF THE STUDY: Our objectives were to determine how often hospital-acquired VTE patients received appropriate thromboprophylaxis, VTE-associated mortality, and the percentage of patients given anticoagulant therapy and adherence to it after discharged...
October 2017: Annals of Thoracic Medicine
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