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cancer associated venous thromboembolic disease

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
Yohei Hisada, Charlotte Thålin, Staffan Lundström, Håkan Wallén, Nigel Mackman
INTRODUCTION: Increased levels of circulating tissue factor (TF)-positive microvesicles (MVs) may increase the risk of thrombosis. Indeed, TF-positive MVs are detected in plasma of patients with various types of diseases. In this study, we measured levels of MV TF activity in non-cancer severely ill patients and cancer patients. METHODS: We used an in-house MV TF activity assay to measure MV TF activity. RESULTS: MV TF activity was significantly increased in a population of cancer patients but not in a population of non-cancer severely ill patients compared with healthy controls...
March 7, 2018: Thrombosis Research
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
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
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
Naima B Benelhaj, Ann Hutchinson, Anthony M Maraveyas, Julie D Seymour, Muhammad Waqas Ilyas, Miriam J Johnson
BACKGROUND: Cancer-associated thrombosis is common. Recommended treatment is daily injected low-molecular-weight heparin for 6 months. Most studies focus on prophylaxis and treatment; few have explored the patients' experience. AIMS: To identify and synthesise the available literature concerning patients' experience of cancer-associated thrombosis. DESIGN: Systematic literature review and qualitative thematic synthesis. DATA SOURCE: MEDLINE, Embase, CINAHL, PsycINFO (until 10/2016; limited to English) were searched...
February 1, 2018: Palliative Medicine
Megan K Phelps, Tracy E Wiczer, H Paige Erdeljac, Kelsey R Van Deusen, Kyle Porter, Gary Philips, Tzu-Fei Wang
Introduction Low-molecular-weight heparins are the standard treatment for cancer-associated thrombosis. Recently, direct oral anticoagulants are a new option for thrombosis treatment; however, data supporting the use of direct oral anticoagulants for cancer-associated thrombosis are limited. Objectives The primary objective of this study was to determine the rate of recurrent cancer-associated thrombosis and major bleeding within 6 months of starting either low-molecular-weight heparin or direct oral anticoagulant for treatment of cancer-associated thrombosis...
January 1, 2018: Journal of Oncology Pharmacy Practice
Fadwa Ali, Sadeer G Al-Kindi, Jacqueline J Blank, Carrie Y Peterson, Kirk A Ludwig, Timothy J Ridolfi
BACKGROUND: The risk of postoperative venous thromboembolism is high in patients with colon cancer and IBD. Although The American Society of Colon and Rectal Surgeons suggests posthospital prophylaxis after surgery in patients with colon cancer, there are no such recommendations for patients with IBD. OBJECTIVE: This study aims to analyze the incidence and risk factors for postoperative venous thromboembolism. DESIGN: This was a retrospective review using the Explorys platform...
March 2018: Diseases of the Colon and Rectum
Rahmi Oklu, Rahul A Sheth, Keith H K Wong, Amin H Jahromi, Hassan Albadawi
Background: A single center, prospective tissue-based study was conducted to investigate an association between neutrophil extracellular traps (NETs) and venous thromboembolic disease in patients with malignancy. Methods: Plasma was collected from 65 patients in which 27 were cancer patients and 38 were age-matched non-cancer patients. Plasma NETs, circulating free DNA (cfDNA), DNase-1, endonuclease-G, endonuclease activity and thrombin-antithrombin III (TAT) complex levels was quantified...
December 2017: Cardiovascular Diagnosis and Therapy
Hung-Kai Huang, Chew-Teng Kor, Ching-Pei Chen, Hung-Te Chen, Po-Ta Yang, Chen-Dao Tsai, Ching-Hui Huang
Background: Venous thromboembolism (VTE) is a sex-specific disease that has different presentations between men and women. Women with uterine leiomyoma can present with VTE without exhibiting the traditional risk factors. We investigated the relationship between a history of uterine leiomyoma and the risk of VTE using the National Health Insurance Research Database (NHIRD). Methods: We conducted a retrospective, nationwide, population-based case-control study using the NHIRD...
January 2018: Acta Cardiologica Sinica
John Simes, Kristy P Robledo, Harvey D White, David Espinoza, Ralph A Stewart, David R Sullivan, Tanja Zeller, Wendy Hague, Paul J Nestel, Paul P Glasziou, Anthony C Keech, John Elliott, Stefan Blankenberg, Andrew M Tonkin
Background -D-dimer, a degradation product of cross-linked fibrin, is a marker for hypercoagulability and thrombotic events. Moderately elevated levels of D-dimer are associated with the risk of venous and arterial events in patients with vascular disease. We assessed the role of D-dimer levels in predicting long-term vascular outcomes, cause-specific mortality, and new cancers in the LIPID trial in the context of other risk factors. Methods -LIPID randomized patients to placebo or pravastatin 40 mg/day 5-38 months after myocardial infarction or unstable angina...
January 24, 2018: Circulation
A Theron, C Biron-Andreani, S Haouy, L Saumet, M Saguintah, E Jeziorski, N Sirvent
The survival rate of children with cancer is now close to 80 %, as a result of continuous improvement in diagnostic and treatment procedures. Prevention and treatment of treatment-associated complications is now a major challenge. Thromboembolic venous disease, due to multifactorial pathogenesis, is a frequent complication (up to 40 % asymptomatic thrombosis in children with cancer), responsible for significant morbidity. Predominantly in children with acute lymphoblastic leukemia, lymphoma, or sarcoma, thromboembolic disease justifies primary prophylaxis in certain populations at risk, whether genetic or environmental...
January 8, 2018: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
Lingjing Chen, Sandra Eloranta, Anna Martling, Ingrid Glimelius, Martin Neovius, Bengt Glimelius, Karin E Smedby
AIM: A population-based cohort and four randomized trials enriched with long-term register data were used to clarify if radiotherapy in combination with rectal cancer surgery is associated with increased risks of cardiovascular disease (CVD). METHODS: We identified 14,901 rectal cancer patients diagnosed 1995-2009 in Swedish nationwide registers, of whom 9227 were treated with preoperative radiotherapy. Also, we investigated 2675 patients with rectal cancer previously randomized to preoperative radiotherapy or not followed by surgery in trials conducted 1980-1999...
January 3, 2018: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Gerald Gartlehner, Sheila V Patel, Cynthia Feltner, Rachel Palmieri Weber, Rachel Long, Kelly Mullican, Erin Boland, Linda Lux, Meera Viswanathan
Importance: Postmenopausal status coincides with increased risks for chronic conditions such as heart disease, osteoporosis, cognitive impairment, or some types of cancers. Previously, hormone therapy was used for the primary prevention of these chronic conditions. Objective: To update evidence for the US Preventive Services Task Force on the benefits and harms of hormone therapy in reducing risks for chronic conditions. Data Sources: MEDLINE, Cochrane Library, EMBASE, and trial registries from June 1, 2011, through August 1, 2016...
December 12, 2017: JAMA: the Journal of the American Medical Association
Ingrid Pabinger, Julia Riedl
Data on specific studies in cancer patients using direct oral anticoagulants (DOACs) for the prevention and treatment of venous thromboembolism (VTE) are still scarce. For preventing VTE with DOACs, current experience is still very limited, so definite conclusions cannot yet be drawn. However, DOACs have so far been compared with vitamin K antagonists (VKAs) in patients with acute VTE in 5 studies, and several hundreds of patients included in these studies had either active cancer, a history of cancer, or a new occurrence of cancer during the course of disease...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
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...
January 2018: Thrombosis Research
Rishi J Desai, Joshua J Gagne, Joyce Lii, Jun Liu, Sonia Friedman, Seoyoung C Kim
BACKGROUND: Inflammatory bowel disease (IBD) increases the risk of venous thromboembolism (VTE) by 2 to 3 times. We compared the reduction in risk of incident VTE associated with use of tumour necrosis factor-α (TNF-α) inhibitors versus nonbiologic immunomodulatory agents in patients with IBD. METHODS: This observational cohort study used data from public (Medicaid, 2000-2010; Medicare, 2007-2013) and private (Optum Clinformatics, 2004-2013) health insurance programs in the United States...
November 27, 2017: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
Deisy Barrios, Raquel Morillo, Ina Guerassimova, Esther Barbero, Héctor Escobar-Morreale, Alexander T Cohen, Cecilia Becattini, Victor Tapson, Roger Yusen, David Jimenez
BACKGROUND: We sought to examine sex-related differences in the characteristics and outcome in patients presenting with acute symptomatic pulmonary embolism (PE). METHODS: We conducted a retrospective cohort study of 2,096 patients diagnosed with acute PE. The characteristics were recorded at presentation. Treatment was at the discretion of patients' physicians. The primary study outcome, all-cause mortality, and the secondary outcomes of PE-specific mortality, recurrent venous thromboembolism, and major bleeding were assessed during the first month of follow-up after PE diagnosis...
2017: PloS One
L Ek, E Gezelius, B Bergman, P O Bendahl, H Anderson, J Sundberg, M Wallberg, U Falkmer, S Verma, M Belting
Background: Coagulation activation and venous thromboembolism (VTE) are hallmarks of malignant disease and represent a major cause of morbidity and mortality in cancer. Coagulation inhibition with low molecular weight heparin (LMWH) may improve survival specifically in small cell lung cancer (SCLC) patients by preventing VTE and tumor progression; however, randomized trials with well-defined patient populations are needed to obtain conclusive data. The aim of RASTEN was to investigate the survival effect of LMWH enoxaparin in a homogenous population of SCLC patients...
November 2, 2017: Annals of Oncology: Official Journal of the European Society for Medical Oncology
Senem Maral, Sule Mine Bakanay, Imdat Dilek
: Acquired hemophilia A (AHA) which presents with spontaneous severe intramuscular, mucosal and/or subcutaneous bleeding is a rare bleeding disorder. Even 50% of AHA patients are defined as idiopathic; 10% of cases are related with malignancy. Here, we present a case of AHA in a 43-year-old lady who was diagnosed with malignancy and venous thromboembolism on vena cava 2 years ago. To the best of our knowledge, this is the first report in literature presented with both acquired hemophilia and thrombosis associated with malignancy...
January 2018: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
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