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Pulmonary embolism prophylaxis

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https://www.readbyqxmd.com/read/28645996/treatment-of-suspected-pulmonary-embolism-in-a-morbidly-obese-patient
#1
Viviene Heitlage, Mary Beth Borgstadt, Lisa Carlson
PURPOSE: A case highlighting challenges with enoxaparin dosage and monitoring in obese patients is presented. SUMMARY: A morbidly obese 22-year-old Caucasian female (height, 168 cm; weight, 322 kg; body mass index [BMI], 114 kg/m(2)) who presented to the emergency department with acute-onset dyspnea and hypoxia was empirically initiated on enoxaparin for suspected pulmonary embolism at the institution's standard maximum dosage (160 mg subcutaneously every 12 hours)...
July 1, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28634095/comparative-effectiveness-and-safety-of-drug-prophylaxis-for-prevention-of-venous-thromboembolism-after-total-knee-arthroplasty
#2
Guy Cafri, Elizabeth W Paxton, Yuexin Chen, Craig T Cheetham, Michael K Gould, Janet Sluggett, Stefano A Bini, Monti Khatod
BACKGROUND: Rates of venous thromboembolism in contemporary studies of primary total knee arthroplasty (TKA) have been reported to be as high as 3.5%. Although drug prophylaxis is effective, the best option among these regimens is not well established. The purpose of this study was to evaluate the comparative effectiveness and safety of aspirin, low-molecular-weight heparin, synthetic pentasaccharide factor Xa inhibitors, and vitamin K antagonist. METHODS: Data were from a US total joint replacement registry, with 30,499 patients receiving unilateral TKA from May 16, 2006, to December 31, 2013...
May 31, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28622843/fatal-pulmonary-embolism-following-elective-total-knee-replacement-using-aspirin-in-multi-modal-prophylaxis-a-12year-study
#3
C Quah, E Bayley, N Bhamber, P Howard
BACKGROUND: The National Institute for Health and Clinical Excellence (NICE) has issued guidelines on which thromboprophylaxis regimens are suitable following lower limb arthroplasty. Aspirin is not a recommended agent despite being accepted in orthopaedic guidelines elsewhere. We assessed the incidence of fatal pulmonary embolism (PE) and all-cause mortality following elective primary total knee replacement (TKR) with a standardised multi-modal prophylaxis regime in a large teaching district general hospital...
June 13, 2017: Knee
https://www.readbyqxmd.com/read/28610546/neuromuscular-electrical-stimulation-for-the-prevention-of-venous-thromboembolism
#4
Raveena Ravikumar, Katherine J Williams, Adarsh Babber, Hayley M Moore, Tristan Ra Lane, Joseph Shalhoub, Alun H Davies
Objective Venous thromboembolism, encompassing deep vein thrombosis and pulmonary embolism, is a significant cause of morbidity and mortality, affecting one in 1000 adults per year. Neuromuscular electrical stimulation is the transcutaneous application of electrical impulses to elicit muscle contraction, preventing venous stasis. This review aims to investigate the evidence underlying the use of neuromuscular electrical stimulation in thromboprophylaxis. Methods The Medline and Embase databases were systematically searched, adhering to PRISMA guidelines, for articles relating to electrical stimulation and thromboprophylaxis...
January 1, 2017: Phlebology
https://www.readbyqxmd.com/read/28608277/-oral-anticoagulation-using-coumarins-an-update
#5
REVIEW
Christoph Sucker, Jens Litmathe
Vitamin K antagonists (VKA) are used for the prophylaxis and treatment of thrombotic and thromboembolic events. Most important indications are venous thrombosis and pulmonary embolism, atrial fibrillation, and mechanical heart-valve replacement. Hence they are from high relevance for the neurologist and his daily praxis in cardio-neurological routine. Here, we give an overview about VKA with focus on mode of action, indications and efficacy, practical aspects of treatment, side effects, and monitoring.
June 12, 2017: Wiener Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28579397/meta-analysis-of-heparin-therapy-for-preventing-venous-thromboembolism-in-acute-spinal-cord-injury
#6
REVIEW
Yang Liu, Hong Xu, Feifei Liu, Zenghui Lv, Shunli Kan, Guangzhi Ning, Shiqing Feng
OBJECTIVE: Venous thromboembolism (VTE) is a frequent complication in patients with acute spinal cord injury (SCI) and may have serious consequences. This study aimed to assess the efficacy and safety of heparin and low-molecular-weight heparin (LMWH) venous thromboprophylaxis in patients with acute SCI. METHODS: PubMed, Web of Science, EMBASE and the Cochrane library were searched from January 1980 to August 2016. The primary outcome was the incidence of VTE. Secondary outcomes included the incidences of Deep-vein thrombosis (DVT), pulmonary embolism (PE) and major bleeding...
June 1, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28569372/venous-thromboembolism-prophylaxis-after-tka-aspirin-warfarin-enoxaparin-or-factor-xa-inhibitors
#7
Abiram Bala, James I Huddleston, Stuart B Goodman, William J Maloney, Derek F Amanatullah
BACKGROUND: There is considerable debate regarding the ideal agent for venous thromboembolism (VTE) prophylaxis after TKA. Numerous studies and meta-analyses have yet to provide a clear answer and often omit one or more of the commonly used agents such as aspirin, warfarin, enoxaparin, and factor Xa inhibitors. QUESTIONS/PURPOSES: Using a large database analysis, we asked: (1) What are the differences in VTE incidence in primary TKA after administration of aspirin, warfarin, enoxaparin, or factor Xa inhibitors? (2) What are the differences in bleeding risk among these four agents? (3) How has use of these agents changed with time? METHODS: We queried a combined Humana and Medicare database between 2007 and Quarter 1 of 2016, and identified all primary TKAs performed using ICD-9 and Current Procedural Terminology codes...
May 31, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28495498/venous-thromboembolism-in-patients-with-pemphigus-a-cohort-study
#8
Yael Anne Leshem, Lihi Atzmony, Israel Dudkiewicz, Emmilia Hodak, Daniel Mimouni
BACKGROUND: Venous thromboembolism (VTE) has been reported to be a significant cause of death in patients with pemphigus. OBJECTIVE: We sought to assess the incidence and characteristics of VTE in patients with pemphigus. METHODS: A retrospective study following a cohort of 172 patients with newly diagnosed pemphigus for the development of VTE was conducted. RESULTS: Over a mean follow-up time of 4 years, 10 patients (6%) had development of VTE at a median of 4 months from pemphigus diagnosis...
May 8, 2017: Journal of the American Academy of Dermatology
https://www.readbyqxmd.com/read/28492861/vena-cava-filter-use-in-trauma-and-rates-of-pulmonary-embolism-2003-2015
#9
Alan D Cook, Brian W Gross, Turner M Osler, Katelyn J Rittenhouse, Eric H Bradburn, Steven R Shackford, Frederick B Rogers
Importance: Vena cava filter (VCF) placement for pulmonary embolism (PE) prophylaxis in trauma is controversial. Limited research exists detailing trends in VCF use and occurrence of PE over time. Objective: To analyze state and nationwide temporal trends in VCF placement and PE occurrence from 2003 to 2015 using available data sets. Design, Setting, and Participants: A retrospective trauma cohort study was conducted using data from the Pennsylvania Trauma Outcome Study (PTOS) (461 974 patients from 2003 to 2015), the National Trauma Data Bank (NTDB) (5 755 095 patients from 2003 to 2014), and the National (Nationwide) Inpatient Sample (NIS) (24 449 476 patients from 2003 to 2013) databases...
May 10, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28465845/bilateral-pulmonary-embolism-after-a-short-haul-flight-in-a-man-with-multiple-risk-factors-including-sickle-cell-trait
#10
Kamille Abdool, Kanterpersad Ramcharan, Antonio J Reyes, Nadiene Lutchman, Adrian Alexander
We report a case of pulmonary embolism (PE) in an Afro-Caribbean man following a short commercial flight of less than 5,000 kilometers (Km) in economy class with a 1-month interval between journeys. He had an elevated body mass index (BMI) and sickle cell trait (SCT) with hyperhomocysteinemia. No other preexisting source of venous thrombosis was found. We posit that venous thromboembolism (VTE) and/or PE may have been a complication of SCT in an individual with other multiple risk factors. We discuss the possible interaction of these risk factors for VTE and/or PE and the implications for travelers at risk...
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/28440519/-prevention-diagnosis-and-treatment-of-perioperative-complications-of-bariatric-and-metabolic-surgery
#11
Haifu Wu, Ming Zhong, Di Zhou, Chenye Shi, Heng Jiao, Wei Wu, Xinxia Chang, Jing Cang, Hua Bian
Surgical operation in treating obesity and type 2 diabetes is popularizing rapidly in China. Correct prevention and recognition of perioperation-related operative complications is the premise of ensuring surgical safety. Familiar complications of the operation include deep venous thrombosis, pulmonary artery embolism, anastomotic bleeding, anastomotic fistula and marginal ulcer. The prevention of deep venous thrombosis is better than treatment. The concrete measures contain physical prophylaxis (graduated compression stocking and intermittent pneumatic compression leg sleeves) and drug prophylaxis (unfractionated heparin and low molecular heparin), and the treatment is mainly thrombolysis or operative thrombectomy...
April 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28439702/a-comparison-of-apixaban-and-dabigatran-etexilate-for-thromboprophylaxis-following-hip-and-knee-replacement-surgery
#12
Adriane Mayer, Philipp Schuster, Bernd Fink
INTRODUCTION: Patients who have undergone hip or knee replacement surgery are exposed to a high risk of developing a post-operative venous thromboembolus and so have a need for an effective, medication-based, thrombosis prophylaxis. New orally active anticoagulants have been available for a few years now. These specific substances directly block either thrombin (e.g., dabigatran etexilate) or Factor Xa (e.g., apixaban). It is not clear whether there are any efficacy differences between these two substances because there have never been any head-to-head studies carried out...
April 24, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28432715/complications-of-pregnancy-and-labor-in-women-with-klippel-trenaunay-syndrome-a-nationwide-cross-sectional-study
#13
S E R Horbach, M M Lokhorst, C E U Oduber, S Middeldorp, J A M van der Post, C M A M van der Horst
OBJECTIVE: To evaluate complications of pregnancy, including thromboembolism, in women with extensive vascular malformations associated with Klippel-Trenaunay Syndrome (KTS). DESIGN: Nationwide cross-sectional study. SETTING: Two tertiary expert centers and the Dutch Klippel-Trenaunay patient organization. SAMPLE: Adult women with KTS. METHODS: Patients with KTS were invited to participate in a comprehensive online survey about their obstetric history...
April 22, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28431186/unfractionated-heparin-versus-low-molecular-weight-heparins-for-avoiding-heparin-induced-thrombocytopenia-in-postoperative-patients
#14
REVIEW
Daniela R Junqueira, Liliane M Zorzela, Edson Perini
BACKGROUND: Heparin-induced thrombocytopenia (HIT) is an adverse drug reaction presenting as a prothrombotic disorder related to antibody-mediated platelet activation. It is a paradoxical immune reaction resulting in thrombin generation in vivo, which leads to a hypercoagulable state and the potential to initiate venous or arterial thrombosis. A number of factors are thought to influence the incidence of HIT including the type and preparation of heparin (unfractionated heparin (UFH) or low molecular weight heparin (LMWH)) and the heparin-exposed patient population, with the postoperative patient population at higher risk...
April 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28427109/traveler-s-diarrhea-vision-abnormalities-and-unsteady-gait-in-a-young-woman
#15
Tobias Mühling, Felix Gundling, Thomas Helmberger, Wolfgang Schepp
We report on the course of disease in a young woman, originally admitted with suspected refractory infectious tropical traveler's diarrhea. However, symptoms did not resolve upon either symptomatic or subsequent antibiotic therapy. When neurologic deterioration was observed, imaging studies revealed a dramatic series of thromboembolic events, including intracranial hemorrhage caused by extensive sinus vein thrombosis as well as thrombi of the right cardiac ventricle. Colonic mucosal biopsy samples finally led to the histologic diagnosis of ulcerative colitis...
April 2017: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/28426561/unfractionated-heparin-versus-low-molecular-weight-heparin-for-venous-thromboembolism-prophylaxis-in-trauma
#16
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...
July 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28424139/lethal-trauma-pulmonary-embolism-is-a-black-swan-event-in-patients-at-risk-for-deep-vein-thrombosis-an-evidence-based-review
#17
REVIEW
C Michael Dunham, Gregory S Huang
We delineated the incidence of trauma patient pulmonary embolism (PE) and risk conditions by performing a systematic literature review of those at risk for deep vein thrombosis (DVT). The PE proportion was 1.4 per cent (95% confidence interval = 1.2-1.6) in at-risk patients. Of 10 conditions, PE was only associated with increased age (P < 0.01) or leg injury (P < 0.01; risk ratio = 1.6). As lower extremity DVT (LEDVT) proportions increased, mortality proportions (P = 0.02) and hospital stay (P = 0.0002) increased, but PE proportions did not (P = 0...
April 1, 2017: American Surgeon
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
#18
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...
June 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28366316/abo-blood-group-is-a-predictor-for-the-development-of-venous-thromboembolism-after-total-joint-arthroplasty
#19
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/28366145/-inflammatory-bowel-disease-and-pulmonary-embolism-because-of-3-cases
#20
REVIEW
Betül Abanoz, Arif Mansur Coşar, Müge Erbay, Savaş Özsu, Yılmaz Bülbül
Thromboembolic complications are an important cause of morbidity and mortality in inflammatory bowel diseases (IBD). Thromboembolic events are observed more frequently during acute flare of the disease, especially patients received steroid therapy. Increase in awareness and especially anticoagulation prophylaxis in these patients are extremely important. In this article, three cases with diagnosed pulmonary thromboembolism (PE) were presented accompanied by the current literature.
December 2016: Tüberküloz Ve Toraks
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