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https://www.readbyqxmd.com/read/28436558/adverse-effects-of-pegaspargase-in-pediatric-patients-receiving-doses-greater-than-3-750%C3%A2-iu
#1
Rachel Lebovic, Natalie Pearce, Laura Lacey, James Xenakis, Cassidy B Faircloth, Patrick Thompson
BACKGROUND: Increased toxicities have been identified with higher doses of pegaspargase (PEG-ASP) in adults. This has led to routine use of a dose cap of 3,750 IU for adult acute lymphoblastic leukemia (ALL) patients in most institutions. In pediatric ALL patients, PEG-ASP is not capped. There is concern at our institution that larger doses may result in increased rates of adverse effects and that increased monitoring may be warranted in pediatric patients receiving doses greater than 3,750 IU...
April 24, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28430759/evaluation-of-guidelines-for-injured-children-at-high-risk-for-venous-thromboembolism-a-prospective-observational-study
#2
Rachel M Landisch, Sheila J Hanson, Laura D Cassidy, Kristin Braun, Rowena C Punzalan, David M Gourlay
BACKGROUND: Pharmacologic prophylaxis for venous thromboembolism (VTE) is a widely accepted practice in adult trauma patients to prevent associated morbidity and mortality. However, VTE prophylaxis has not been standardized in injured pediatric patients. Our institution identified factors potentially associated with a high risk of VTE in critically injured children that led to prospective implementation of VTE prophylaxis guidelines. We hypothesize that the guidelines are accurate in predicting children at risk for VTE...
May 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28427508/review-of-current-evidence-available-for-guiding-optimal-enoxaparin-prophylactic-dosing-strategies-in-obese-patients-actual-weight-based-vs-fixed
#3
REVIEW
Zikai He, Hana Morrissey, Patrick Ball
BACKGROUND: The current debate over the optimal Enoxaparin prophylactic dosing strategies in obese patients centre around whether it should be based on the actual weight of the patient (i.e. weight-based), or at an artificially fixed amount, as it is the case in Australia (40mg daily). The vast majority of the evidence available today is laboratory-based, measuring serum Antifactor-Xa activities as a marker for physiological response. AIM: The aim of the parent study is to compare the clinical outcomes for obese patients who received fixed doses of enoxaparin compared to those who received weight-based doses within the licensed dosage recommendations...
May 2017: Critical Reviews in Oncology/hematology
https://www.readbyqxmd.com/read/28426561/unfractionated-heparin-versus-low-molecular-weight-heparin-for-venous-thromboembolism-prophylaxis-in-trauma
#4
Benjamin N Jacobs, Anne H Cain-Nielsen, Jill L Jakubus, Judy N Mikhail, John J Fath, Scott E Regenbogen, Mark R Hemmila
BACKGROUND: Venous thromboembolism (VTE) is a common complication in trauma patients. Pharmacologic prophylaxis is utilized in trauma patients to reduce their risk of a VTE event. The Eastern Association for the Surgery of Trauma guidelines recommend use of low molecular weight heparin (LMWH) as the preferred agent in these patients. However, there is literature suggesting that unfractionated heparin (UFH) is an acceptable, and less costly, alternative VTE prophylaxis agent with equivalent efficacy in trauma patients...
April 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28426451/quality-of-care-and-outcomes-among-hospitalized-inflammatory-bowel-disease-patients-a-multicenter-retrospective-study
#5
Geoffrey C Nguyen, Sanjay K Murthy, Brian Bressler, Mindy C W Lam, Ali Alali, Asmae Toumi, Jason Reinglas, Adam Rampersad, Adam V Weizman, Waqqas Afif
BACKGROUND: Half of patients with inflammatory bowel disease (IBD) require hospitalization. We sought to characterize inpatient quality indicators of care and outcomes during IBD-related hospitalizations at 4 major IBD referral centers in Canada. METHODS: We conducted a multicenter retrospective cohort study of patients with IBD admitted from 2011 to 2013 to tertiary centers in Toronto, Montreal, Ottawa, and Vancouver. We assessed the following inpatient indicators of care: pharmacological venous thromboembolism (VTE) prophylaxis, Clostridium difficile testing, and medical rescue therapy for steroid-refractory ulcerative colitis (UC)...
May 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28424324/preventing-venous-thromboembolism-in-ambulatory-cancer-patients-the-onkotev-study
#6
Chiara Alessandra Cella, Giovanni Di Minno, Chiara Carlomagno, Michele Arcopinto, Anna Maria Cerbone, Elide Matano, Antonella Tufano, Florian Lordick, Biagio De Simone, Katja Sibylle Muehlberg, Dario Bruzzese, Laura Attademo, Claudia Arturo, Marta Sodano, Roberto Moretto, Ersilia La Fata, Sabino De Placido
BACKGROUND: The efficacy of risk model scores to predict venous thromboembolism (VTE) in ambulatory cancer patients is under investigation, aiming to stratify on an individual risk basis the subset of the cancer population that could mostly benefit from primary thromboprophylaxis. MATERIALS AND METHODS: We prospectively assessed 843 patients with active cancers, collecting clinical and laboratory data. We screened all the patients with a duplex ultrasound (B-mode imaging and Doppler waveform analysis) of the upper and lower limbs to evaluate the right incidence of VTE (both asymptomatic and symptomatic)...
April 19, 2017: Oncologist
https://www.readbyqxmd.com/read/28412908/news-in-the-indications-of-non-vitamin-k-oral-anticoagulants-according-to-the-guidelines-of-the-american-college-of-chest-physicians-2016
#7
Gabriela Cesarman Maus, Guillermo Jose Ruiz Argüelles
Antithrombotic guidelines published by the Chest Journal, the official publication of the American College of Chest Physicians (ACCP), are continuously updated as clinically relevant information accumulates. The Evidence-Based Clinical Practice Guidelines on antithrombotic therapy and prevention of thrombosis were published in 2012. This year, the topic that has been updated pertains to antithrombotic therapy, specifically addressing prophylaxis and treatment of venous thromboembolic (VTE) disease. In this paper, I focus on these guidelines regarding the indications or lack thereof for the use of Non-vitamin K-antagonist Oral Anticoagulants (NOACS), also referred to as Direct-acting Oral Anticoagulants (DOACS)...
April 13, 2017: Current Drug Metabolism
https://www.readbyqxmd.com/read/28411291/automating-venous-thromboembolism-risk-calculation-using-electronic-health-record-data-upon-hospital-admission-the-automated-padua-prediction-score
#8
Pierre Elias, Raman Khanna, Adams Dudley, Jason Davies, Ronald Jacolbia, Kara McArthur, Andrew D Auerbach
BACKGROUND: Venous thromboembolism (VTE) risk scores assist providers in determining the relative benefit of prophylaxis for individual patients. While automated risk calculation using simpler electronic health record (EHR) data is feasible, it lacks clinical nuance and may be less predictive. Automated calculation of the Padua Prediction Score (PPS), requiring more complex input such as recent medical events and clinical status, may save providers time and increase risk score use. OBJECTIVE: We developed the Automated Padua Prediction Score (APPS) to auto-calculate a VTE risk score using EHR data drawn from prior encounters and the first 4 hours of admission...
April 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28402864/meta-analysis-on-anticoagulation-and-prevention-of-thrombosis-and-mortality-among-patients-with-lung-cancer
#9
H E Fuentes, D M Oramas, L H Paz, A I Casanegra, A S Mansfield, A J Tafur
BACKGROUND: Venous thromboembolism (Wickham et al., 2012 [1]) is a leading cause of morbidity and mortality among patients with cancer; however, primary thromboprophylaxis is not routinely recommended. We performed a systematic review and meta-analysis of randomized control trials (RCTs) to measure the impact of primary VTE prevention and its effect on mortality among patients with lung cancer. METHODS: With assistance from a master librarian, we searched Ovid, Scopus, DARE, CINAHL, MEDLINE, EMBASE, EBM reviews-Cochrane database of systematic reviews, EBM reviews-ACP journal, and EBM Reviews-Databases for relevant studies following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines...
April 1, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28402497/systematic-review-of-safety-and-cost-effectiveness-of-venous-thromboembolism-prophylaxis-strategies-in-patients-undergoing-craniotomy-for-brain-tumor
#10
Hanna Algattas, Dushyant Damania, Ian DeAndrea-Lazarus, Kristopher T Kimmell, Nicholas F Marko, Kevin A Walter, G Edward Vates, Babak S Jahromi
BACKGROUND: Studies have evaluated various strategies to prevent venous thromboembolism (VTE) in neuro-oncology patients, without consensus. OBJECTIVE: To perform a systematic review with cost-effectiveness analysis (CEA) of various prophylaxis strategies in tumor patients undergoing craniotomy to determine the safest and most cost-effective prophylaxis regimen. METHODS: A literature search was conducted for VTE prophylaxis in brain tumor patients...
April 11, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28397505/-current-recommendations-for-the-prevention-and-treatment-of-venous-thromboembolism-in-cancer-patients
#11
J Halámková, M Penka
About 20% of patients suffer from venous thromboembolism (VTE) during oncology disease. Active cancer, along with cancer therapy, increases the risk of VTE, especially in the first 6 months after diagnosis. Most often VTE accompanies haematological malignancies and CNS tumours, and gastrointestinal, breast, lung, ovary and uterine cancer. The presence of distant metastases, together with the implantation of a central venous catheter, increases the risk even more. A cancer patient also has a 2-5× higher risk of recurrence of VTE during anticoagulant therapy than patients without a malignancy, as well as a 2-6× higher risk of serious bleeding...
2017: Klinická Onkologie: Casopis Ceské a Slovenské Onkologické Spolecnosti
https://www.readbyqxmd.com/read/28392450/efficacy-and-safety-of-thromboembolism-prophylaxis-with-fondaparinux-in-japanese-colorectal-cancer-patients-undergoing-laparoscopic-surgery-a-phase-ii-study
#12
Katsuji Tokuhara, Hideyuki Matsushima, Yosuke Ueyama, Kazuyoshi Nakatani, Kazuhiko Yoshioka, Masanori Kon
PURPOSE: We aimed to assess the safety and efficacy of fondaparinux (FPNX) for patients undergoing laparoscopic colorectal surgery (LAC). METHODS: Patients scheduled for LAC received once-daily subcutaneous injections of FPNX 1.5-2.5 mg for 4-8 days. The primary endpoint was the incidence of bleeding events. The secondary endpoint was the incidence of deep vein thrombosis (DVT) and pulmonary embolism (PE). RESULTS: Among 128 patients evaluable for efficacy, 119 patients were administered FPNX...
April 6, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28379461/current-practice-trends-for-use-of-early-venous-thromboembolism-prophylaxis-after-intracerebral-hemorrhage
#13
Laurel J Cherian, Eric E Smith, Lee H Schwamm, Gregg C Fonarow, Phillip J Schulte, Ying Xian, Jingjing Wu, Shyam K Prabhakaran
BACKGROUND: Venous thromboembolism (VTE) is common after intracerebral hemorrhage (ICH). Guidelines recommend early VTE prophylaxis. OBJECTIVE: To determine characteristics associated with early chemoprophylaxis (CP) after ICH in the Get With The Guidelines-Stroke registry. METHODS: In this observational cohort study, we identified patients with ICH between January 1, 2009 and September 30, 2013, who (1) were non-ambulatory and/or not comfort care measures by hospital day 2; (2) were not transferred to another acute care facility; and (3) had known VTE prophylaxis status at end of hospital day 2...
April 4, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28371250/a-decision-model-to-estimate-a-risk-threshold-for-venous-thromboembolism-prophylaxis-in-hospitalized-medical-patients
#14
P Le, K A Martinez, M A Pappas, M B Rothberg
BACKGROUND: Venous thromboembolism (VTE) is a common preventable condition in medical inpatients. Thromboprophylaxis is recommended for inpatients who are not at low risk of VTE, but no specific risk threshold for prophylaxis has been defined. OBJECTIVE: To determine a threshold for prophylaxis based on risk of VTE. PATIENTS/METHODS: We constructed a decision model with a decision-tree following patients for 3 months after hospitalization, and a lifetime Markov model with 3-month cycles...
March 31, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28366422/efficacy-and-safety-of-postoperative-anticoagulation-prophylaxis-with-enoxaparin-in-patients-undergoing-pancreatic-surgery-a-prospective-trial-and-literature-review
#15
Daisuke Hashimoto, Shigeki Nakagawa, Naoki Umezaki, Takanobu Yamao, Yuki Kitano, Kensuke Yamamura, Takayoshi Kaida, Kota Arima, Katsunori Imai, Yo-Ichi Yamashita, Akira Chikamoto, Hideo Baba
BACKGROUND: /Objectives: Enoxaparin is low-molecular-weight heparin that is used for postoperative thromboprophylaxis. The purpose of this study was to evaluate the efficacy and safety of enoxaparin after pancreatic resection. We additionally carried out a literature review regarding venous thromboembolism (VTE) and postoperative bleeding mainly after hepatobiliary-pancreatic surgery. METHODS: This was a prospective, single-arm study. Patients aged 20-79 years who planned to undergo pancreatic resection followed by postoperative anticoagulation therapy with enoxaparin were enrolled from 2013 to 2016...
March 29, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28366316/abo-blood-group-is-a-predictor-for-the-development-of-venous-thromboembolism-after-total-joint-arthroplasty
#16
Jared M Newman, Matthew V Abola, Alexandra Macpherson, Alison K Klika, Wael K Barsoum, Carlos A Higuera
BACKGROUND: The study's purpose was to determine if there is an association between ABO blood group and the development of symptomatic venous thromboembolism (VTE) after total joint arthroplasty (TJA). METHODS: A total of 28,025 patients who underwent primary TJA at a single health care system from 2000 to 2014 were retrospectively reviewed from electronic records. Patients who experienced a symptomatic VTE were identified. A multivariate regression model adjusted for known potential risk factors, including age, gender, body mass index, surgery type, previous VTE, smokers, rheumatologic diseases, malignancy, hypercoagulable state, and VTE prophylaxis, was developed to test the association of ABO blood group and postoperative VTE...
March 2, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28360495/the-incidence-of-deep-vein-thrombosis-and-pulmonary-embolism-after-fracture-of-the-tibia-an-analysis-of-the-national-trauma-databank
#17
Ronald Auer, John Riehl
Controversy exists regarding the routine use of chemical prophylaxis in isolated lower extremity fractures. The incidence of VTE in specific fracture locations in the lower extremity is largely unknown, and represents key information necessary to determine the need for prophylaxis. A large cross-sectional study using the National Trauma Databank was performed evaluating for the incidence and risk factors of VTE in isolated tibia fractures. The overall incidence of DVT and PE are extremely low in cases of isolated tibia fractures, which brings into doubt a role for routine use of chemical prophylaxis for these fractures...
January 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28349046/venous-thromboembolism-in-critical-illness-and-trauma-pediatric-perspectives
#18
REVIEW
Ranjit S Chima, Sheila J Hanson
Critically ill children and those sustaining severe traumatic injuries are at higher risk for developing venous thromboembolism (VTE) than other hospitalized children. Multiple factors including the need for central venous catheters, immobility, surgical procedures, malignancy, and dysregulated inflammatory state confer this increased risk. As well as being at higher risk of VTE, this population is frequently at an increased risk of bleeding, making the decision of prophylactic anticoagulation even more nuanced...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28342641/procedure-specific-risks-of-thrombosis-and-bleeding-in-urological-cancer-surgery-systematic-review-and-meta-analysis
#19
REVIEW
Kari A O Tikkinen, Samantha Craigie, Arnav Agarwal, Philippe D Violette, Giacomo Novara, Rufus Cartwright, Richard Naspro, Reed A C Siemieniuk, Bassel Ali, Leyla Eryuzlu, Johanna Geraci, Judi Winkup, Daniel Yoo, Michael K Gould, Per Morten Sandset, Gordon H Guyatt
CONTEXT: Pharmacological thromboprophylaxis involves balancing a lower risk of venous thromboembolism (VTE) against a higher risk of bleeding, a trade-off that critically depends on the risks of VTE and bleeding in the absence of prophylaxis (baseline risk). OBJECTIVE: To provide estimates of the baseline risk of symptomatic VTE and bleeding requiring reoperation in urological cancer surgery. EVIDENCE ACQUISITION: We identified contemporary observational studies reporting symptomatic VTE or bleeding after urological procedures...
March 22, 2017: European Urology
https://www.readbyqxmd.com/read/28338589/managing-hip-fracture-and-lower-limb-surgery-in-the-emergency-setting-potential-role-of-non-vitamin-k-antagonist-oral-anticoagulants
#20
William Fisher
Trauma, immobilization, and subsequent surgery of the hip and lower limb are associated with a high risk of developing venous thromboembolism (VTE). Individuals undergoing hip fracture surgery (HFS) have the highest rates of VTE among orthopedic surgery and trauma patients. The risk of VTE depends on the type and location of the lower limb injury. Current international guidelines recommend routine pharmacological thromboprophylaxis based on treatment with heparins, fondaparinux, dose-adjusted vitamin K antagonists and acetylsalicylic acid for patients undergoing emergency HFS; however, not all guidelines recommend pharmacological prophylaxis for patients with lower limb injuries...
March 23, 2017: Journal of Trauma and Acute Care Surgery
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