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Venous embolism

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https://www.readbyqxmd.com/read/28550192/comparison-of-risk-prediction-scores-for-venous-thromboembolism-in-cancer-patients-a-prospective-cohort-study
#1
Nick van Es, Marcello Di Nisio, Gabriela Cesarman, Ankie Kleinjan, Hans-Martin Otten, Isabelle Mahé, Ineke T Wilts, Desirée C Twint, Ettore Porreca, Oscar Arrieta, Alain Stépanian, Kirsten Smit, Michele De Tursi, Suzanne M Bleker, Patrick M Bossuyt, Rienk Nieuwland, Pieter W Kamphuisen, Harry R Büller
In ambulatory patients with solid cancer, routine thromboprophylaxis to prevent venous thromboembolism is not recommended. Several risk prediction scores to identify cancer patients at high risk of venous thromboembolism have been proposed, but their clinical usefulness remains a matter of debate. We evaluated and directly compared the performance of the Khorana, Vienna, PROTECHT, and CONKO scores in a multinational, prospective cohort study. Patients with advanced cancer were eligible if they were planned for chemotherapy or had started chemotherapy in the previous 3 months...
May 26, 2017: Haematologica
https://www.readbyqxmd.com/read/28549662/simplified-diagnostic-management-of-suspected-pulmonary-embolism-the-years-study-a-prospective-multicentre-cohort-study
#2
Tom van der Hulle, Whitney Y Cheung, Stephanie Kooij, Ludo F M Beenen, Thomas van Bemmel, Josien van Es, Laura M Faber, Germa M Hazelaar, Christian Heringhaus, Herman Hofstee, Marcel M C Hovens, Karin A H Kaasjager, Rick C J van Klink, Marieke J H A Kruip, Rinske F Loeffen, Albert T A Mairuhu, Saskia Middeldorp, Mathilde Nijkeuter, Liselotte M van der Pol, Suzanne Schol-Gelok, Marije Ten Wolde, Frederikus A Klok, Menno V Huisman
BACKGROUND: Validated diagnostic algorithms in patients with suspected pulmonary embolism are often not used correctly or only benefit subgroups of patients, leading to overuse of computed tomography pulmonary angiography (CTPA). The YEARS clinical decision rule that incorporates differential D-dimer cutoff values at presentation, has been developed to be fast, to be compatible with clinical practice, and to reduce the number of CTPA investigations in all age groups. We aimed to prospectively evaluate this novel and simplified diagnostic algorithm for suspected acute pulmonary embolism...
May 23, 2017: Lancet
https://www.readbyqxmd.com/read/28546279/impact-of-residual-pulmonary-obstruction-on-the-long-term-outcome-of-patients-with-pulmonary-embolism
#3
Raffaele Pesavento, Lucia Filippi, Antonio Palla, Adriana Visonà, Carlo Bova, Marco Marzolo, Fernando Porro, Sabina Villalta, Maurizio Ciammaichella, Eugenio Bucherini, Giovanni Nante, Sandra Battistelli, Maria Lorenza Muiesan, Giampietro Beltramello, Domenico Prisco, Franco Casazza, Walter Ageno, Gualtiero Palareti, Roberto Quintavalla, Simonetta Monti, Nicola Mumoli, Nello Zanatta, Roberto Cappelli, Marco Cattaneo, Valentino Moretti, Francesco Corà, Mario Bazzan, Angelo Ghirarduzzi, Anna Chiara Frigo, Massimo Miniati, Paolo Prandoni
The impact of residual pulmonary obstruction on the outcome of patients with pulmonary embolism is uncertain.We recruited 647 consecutive symptomatic patients with a first episode of pulmonary embolism, with or without concomitant deep venous thrombosis. They received conventional anticoagulation, were assessed for residual pulmonary obstruction through perfusion lung scanning after 6 months and then were followed up for up to 3 years. Recurrent venous thromboembolism and chronic thromboembolic pulmonary hypertension were assessed according to widely accepted criteria...
May 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28545858/hemocoagulase-combined-with-microbubble-enhanced-ultrasound-cavitation-for-augmented-ablation-of-microvasculature-in-rabbit-vx2-liver-tumors
#4
Qian Yang, Peng Tang, Guangbin He, Shuping Ge, Liwen Liu, Xiaodong Zhou
We investigated a new method for combining microbubble-enhanced ultrasound cavitation (MEUC) with hemocoagulase (HC) atrox. Our goal was to induce embolic effects in the vasculature and combine these with an anti-angiogenic treatment strategy. Fourteen days after being implanted with a single slice of the liver VX2 tumor, rabbits were randomly divided into five groups: (i) a control group injected intra-venously with saline using a micropump; (ii) a group given only an injection of HC; (iii) a group treated only with ultrasound cavitation; (iv) a group treated with MEUC; (v) a group treated with MEUC + HC...
May 22, 2017: Ultrasound in Medicine & Biology
https://www.readbyqxmd.com/read/28544422/assessment-of-clinically-relevant-bleeding-as-a-surrogate-outcome-for-major-bleeding-validation-by-meta-analysis-of-randomized-controlled-trials
#5
S Laporte, C Chapelle, L Bertoletti, E Ollier, P Zufferey, J-C Lega, A Merah, H Décousus, S Schulman, G Meyer, M Cucherat, P Mismetti
BACKGROUND: Clinically relevant bleeding (CRB), comprising major bleeding and clinically relevant non-major bleeding, has been used as a surrogate for major bleeding in most anticoagulant trials, but its validity for estimating compromise between thrombotic and bleeding events has never been assessed. METHODS: We systematically reviewed randomized phase III trials comparing new anticoagulants with standard of care for venous thromboembolism prevention following major orthopedic surgery, venous thromboembolism (VTE) treatment, or stroke and systemic embolism prevention in atrial fibrillation (AF), and reporting both major bleeding and CRB rates...
May 20, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28544026/immobilization-and-high-platelet-count-are-associated-with-thromboembolic-complications-in-heparin-induced-thrombocytopenia
#6
Juliane Bolbrinker, Edeltraut Garbe, Antonios Douros, Matthias Huber, Elisabeth Bronder, Andreas Klimpel, Frank Andersohn, Oliver Meyer, Abdulgabar Salama, Reinhold Kreutz
PURPOSE: Immune-mediated heparin-induced thrombocytopenia (HIT type II, HIT) is a potentially serious adverse drug reaction characterized by an increased risk of venous and arterial thrombosis. This study aimed to identify risk factors associated with the development of these complications. METHODS: Our study cohort included patients with HIT assembled in our pharmacovigilance center by reports from 51 collaborating hospitals in Berlin, Germany. To identify risk factors for thromboembolic complications, patients with thromboembolic events (cases) were compared to those without thromboembolic events (controls) in a case-control design...
May 24, 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/28542789/annotation-developing-a-national-programme-for-vte-prevention
#7
Lara N Roberts, Mike Durkin, Roopen Arya
The National Venous Thromboembolism Prevention Programme was launched in England, in 2010. Its central objective was to reduce morbidity and mortality from preventable deep vein thrombosis and pulmonary embolism through introduction of a comprehensive systematic approach. The cornerstone of the programme was the introduction of mandatory documented risk assessment for venous thromboembolism, supported by national thromboprophylaxis guidance. Despite widespread uptake of risk assessment, measuring the impact of the national programme on outcomes has proved challenging...
May 23, 2017: British Journal of Haematology
https://www.readbyqxmd.com/read/28541021/predictors-of-active-cancer-thromboembolic-outcomes-mortality-associated-with-calf-deep-vein-thrombosis
#8
Juan P Salazar Adum, Harry E Fuentes, Benjamin B Lind, Alfonso J Tafur, Joseph A Caprini
BACKGROUND: Venous thromboembolism (VTE) is a leading cause of mortality in patients with cancer. Outcomes, including mortality data, in the cancer population are limited in those with calf deep vein thrombosis (CDVT) compared to individuals with proximal deep vein thrombosis. AIM: To assess the prognosis among patients with active cancer and CDVT. METHODS: Single institution inception cohort of cancer-associated CDVT patients who presented with thrombosis distal to popliteal level confirmed objectively by ultrasound...
May 24, 2017: International Angiology: a Journal of the International Union of Angiology
https://www.readbyqxmd.com/read/28540661/diagnostic-accuracy-of-focused-cardiac-and-venous-ultrasound-examinations-in-patients-with-shock-and-suspected-pulmonary-embolism
#9
Peiman Nazerian, Giovanni Volpicelli, Chiara Gigli, Alessandro Lamorte, Stefano Grifoni, Simone Vanni
Evaluating the diagnostic performance of focused cardiac ultrasound (US) alone and combination with venous US in patients with shock and suspected pulmonary embolism (PE). Consecutive adult patients with shock and suspected PE, presenting to two Italian emergency departments, were included. Patients underwent cardiac and venous US at presentation with the aim of detecting right ventricular (RV) dilatation and proximal deep venous thrombosis (DVT). Final diagnosis of PE was based on a second level diagnostic test or autopsy...
May 24, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28540347/interdisciplinary-management-of-head-and-neck-vascular-anomalies-clinical-presentation-diagnostic-findings-and-minimalinvasive-therapies
#10
REVIEW
Maliha Sadick, Walter A Wohlgemuth, Roland Huelse, Bettina Lange, Thomas Henzler, Stefan O Schoenberg, Haneen Sadick
OBJECTIVES: Vascular anomalies are included in the 30 000 rare diseases worldwide affecting less than 5/10 000 people. Depending on their morphology and biological properties, they can cause varied disorders with organ involvement. Almost 60% of vascular anomalies have a predilection for the head and neck region in children. Clinical and scientific effort to establish interdisciplinary management concepts for vascular anomalies is increasing worldwide. METHODS: Especially in the head and neck region, clinical impairment and organ dysfunction is associated with cosmetic issues that may represent a physical and psychological issue for the patient...
2017: European Journal of Radiology Open
https://www.readbyqxmd.com/read/28540132/more-risks-and-complications-for-elective-spine-surgery-in-morbidly-obese-patients
#11
REVIEW
Nancy E Epstein
BACKGROUND: The vast majority of studies emphasize the greater morbidity/mortality for elective spine surgery in morbidly obese patients. METHODS: This review focuses on the increased morbidity/mortality of performing elective spinal operations in morbidly obese patients. There are two definitions of morbid obesity; a body mass index (BMI) of equal to or greater than 35 plus two major comorbid factors (e.g., hypertension, diabetes, etc.) or a BMI (morbidly obese III) of =≥40 kg/m(2)...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28538271/pulmonary-transplant-salvage-using-ultrasound-assisted-thrombolysis-of-subacute-occlusive-main-pulmonary-artery-embolus
#12
John R Spratt, Prashant Shrestha, Gabriel Loor, Jagadish M Patil, Marshall I Hertz, Gosta B Pettersson, Michael S Rosenberg
A 53-year-old woman who underwent bilateral lung transplantation 14 months before presented with 2 to 3 weeks of severe exertional dyspnea. Workup revealed a complete embolic occlusion of her left main pulmonary artery related to a femoral deep venous thrombosis. The occlusion did not respond to systemic anticoagulation, and a trial of catheter-directed thrombolysis was pursued. Flow to the left lower lobe was restored after 2 days of thromobolytic therapy. The patient is alive and well at more than 1 year of follow-up...
May 19, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28530488/the-effect-of-angiojet-rheolytic-thrombectomy-in-the-endovascular-treatment-of-lower-extremity-deep-venous-thrombosis
#13
Mert Dumantepe, Ibrahim Uyar
Objective To evaluate the clinical safety and effectiveness of percutaneous rheolytic thrombectomy in patients with acute lower extremity deep venous thrombosis. Method Sixty-eight consecutive patients with acute massive lower extremity deep venous thrombosis were included in this retrospective study. A percutaneous rheolytic thrombectomy device (Angiojet ® Rheolytic thrombectomy catheter, Boston Scientific, Marlborough, MA, USA) was used in all patients in an angiography suite through ipsilateral popliteal vein access...
January 1, 2017: Phlebology
https://www.readbyqxmd.com/read/28528624/root-cause-analysis-of-adverse-events-in-an-outpatient-anticoagulation-management-consortium
#14
Christopher M Graves, Brian Haymart, Eva Kline-Rogers, Geoffrey D Barnes, Linda K Perry, Denise Pluhatsch, Nannette Gearhart, Helen Gikas, Noelle Ryan, Brian Kurtz
BACKGROUND: A number of factors can lead to adverse events (AEs) in patients taking warfarin. Performing a root cause analysis (RCA) of serious AEs is one systematic way of determining the causes of these events. METHODS: Multidisciplinary teams were formed at Michigan Anticoagulation Quality Improvement Initiative (MAQI(2)) sites with organized anticoagulation management services (AMS). Medical records from patients who suffered serious AEs (major bleed, embolic stroke, venous thromboembolism) were reviewed, and AMS staff were interviewed to determine the root cause using the "5 Whys" technique...
June 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28527240/recurrent-deep-vein-thrombosis-after-the-first-venous-thromboembolism-event-a-single-institution-experience
#15
Mohammad Asim, Hassan Al-Thani, Ayman El-Menyar
BACKGROUND We investigated the frequency, clinical presentation, risk factors, and outcome after the first deep vein thrombosis (DVT) event. MATERIAL AND METHODS A retrospective study was conducted for patients with DVT between 2008 and 2012 with a 1-year follow-up. Patients were divided into 2 groups: single vs. recurrent DVT (RDVT). RESULTS Of the 6420 patients screened for DVT, 662 (10.3%) had DVT. RDVT constituted 22% of cases. A single event was more frequent in left lower limb DVT (p=0.01), while RDVT cases had more bilateral DVT (p=0...
May 20, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28526929/analytical-management-of-patients-undergoing-oral-anticoagulant-therapy-could-have-a-strong-impact-on-clinical-outcomes-a-follow-up-study
#16
Vincenzo De Iuliis, Sebastiano Ursi, Gianfranco Vitullo, Irma Griffo, Antonio Marino, Marika Caruso, Francesco Cipollone, Sabrina Capodifoglio, Veronica Breda, Elena Toniato, Alfonso Pennelli, Pio Conti, Stefano Martinotti
INTRODUCTION: Oral anticoagulant therapy, such as vitamin K antagonists (VKAs), is prominent for the prevention of cerebral ischemic stroke or systemic embolism and all-cause mortality in patients with atrial fibrillation, venous thromboembolism, and mechanical or biological valve. VKA treatment requires monitoring of the international normalized ratio (INR) in order to maintain it in a therapeutic range, avoiding side effects, the main and most significant of which is bleeding. The aim of the present study was to evaluate the event rates of several clinical composite outcomes, such as bleeding, thromboembolic events, and all-cause death...
May 19, 2017: Cardiology and Therapy
https://www.readbyqxmd.com/read/28524790/cognard-type-v-intracranial-dural-arteriovenous-fistula-presenting-in-a-pediatric-patient-with-rapid-progressive-myelopathy
#17
Walter J Jermakowicz, Alexander G Weil, Artyom Vlasenko, Sanjiv Bhatia, Toba N Niazi
Cognard Type V dural arteriovenous fistulas (dAVFs) are a unique type of cranial vascular malformation characterized by congestion of the perimedullary venous system that may lead to devastating spinal cord pathology if left untreated. The authors present the first known case of a pediatric patient diagnosed with a Type V dAVF. A 14-year-old girl presented with a 3-week history of slowly progressive unilateral leg weakness that quickly progressed to bilateral leg paralysis, sphincter dysfunction, and complete sensory loss the day of her presentation...
May 19, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28524005/rivaroxaban-metabolism-pharmacologic-properties-and-drug-interactions
#18
Tomas Kvasnicka, Ivana Malikova, Zuzana Zenahlikova, Karolína Kettnerova, Radka Brzezkova, Tomas Zima, Jan Ulrych, Jan Briza, Ivan Netuka, Jan Kvasnicka
BACKGROUND: Rivaroxaban represents a selective direct inhibitor of activated coagulation factor X (FXa) having peroral bioavailability and prompt onset of action. OBJECTIVE: The absorbtion of rivaroxaban is quick, reaching maximum plasma concentration 2-4 hours following its administration. Peroral bioavailability is high (80-100 %) and pharmacokinetic variability is considered to be moderate (coefficient of variation 30-40 %). This review discusses the properties, drug interactions, pharmacokinetics and clinical indications of rivaroxaban...
May 18, 2017: Current Drug Metabolism
https://www.readbyqxmd.com/read/28522384/usefulness-of-d-dimer-testing-in-predicting-recurrence-in-elderly-patients-with-unprovoked-venous-thromboembolism
#19
T Tritschler, A Limacher, M Méan, N Rodondi, D Aujesky
BACKGROUND: Whether post-anticoagulation D-dimer levels are useful in predicting recurrence in elderly patients with unprovoked venous thromboembolism is unknown. METHODS: We followed-up 157 patients aged ≥65 years with acute symptomatic unprovoked venous thromboembolism in a prospective multicenter cohort study. All patients completed 3-12 months of anticoagulation and then underwent quantitative D-dimer testing (ELISA, VIDAS DD) 12 months after the index venous thromboembolism...
May 15, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28512699/an-open-label-crossover-study-of-the-pharmacokinetics-of-the-60-mg-edoxaban-tablet-crushed-and-administered-either-by-a-nasogastric-tube-or-in-apple-puree-in-healthy-adults
#20
Kenneth Duchin, Anil Duggal, George J Atiee, Motonori Kidokoro, Tadanobu Takatani, Nicole Lazarus Shipitofsky, Ling He, George Zhang, Tarundeep Kakkar
BACKGROUND: Edoxaban is an orally active, direct factor Xa inhibitor indicated to reduce the risk of stroke and systemic embolism in non-valvular atrial fibrillation and for the treatment of venous thromboembolism. OBJECTIVES: This study assessed the pharmacokinetics, safety, and tolerability of the edoxaban 60-mg tablet crushed and administered via a nasogastric tube in a water suspension or orally mixed in apple puree. METHODS: This phase 1, open-label, crossover study randomized 30 healthy adults to receive three edoxaban treatment regimens (oral 60-mg edoxaban tablet, or 60-mg edoxaban tablet crushed and administered via a nasogastric tube or orally in apple puree) in one of six treatment sequences...
May 17, 2017: Clinical Pharmacokinetics
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