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Deep AND Vein AND Thrombosis

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https://www.readbyqxmd.com/read/29234961/risk-and-incidence-of-perioperative-deep-vein-thrombosis-in-patients-undergoing-gastric-cancer-surgery
#1
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/29232246/the-role-of-fdg-pet-in-diabetic-myonecrosis-a-rare-and-underrecognized-complication-of-diabetes
#2
Guillaume Chaussé, Gad Abikhzer
A 66-year-old man with poorly controlled type 2 diabetes was admitted for acute bilateral calf pain in the context of coronary artery disease, chronic renal failure, and peripheral neuropathy. Lower-extremity Doppler ultrasound excluded deep vein thrombosis. FDG-PET was performed to exclude a suspected infection because of elevated white blood cells and inflammatory markers but normal creatinine kinase levels. PET scan demonstrated intense bilateral calf muscle and left thigh muscle uptake, which in combination with the patient's history was consistent with diabetic myonecrosis, a rare end-stage complication of diabetes...
December 11, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/29229465/diverse-management-of-isolated-calf-deep-venous-thrombosis-in-a-university-hospital
#3
Raudel Garcia, Kristan Probeck, Doreen M Elitharp, Antonios P Gasparis, Nicos Labropoulos
BACKGROUND: The management of patients with isolated deep venous thrombosis (DVT) is controversial, leading to overtreatment and undertreatment with several complications and increased cost. The aim of this study was to describe the management of isolated calf DVT (ICDVT) in a university hospital. METHODS: Data on patients with acute DVT in our hospital are prospectively entered in a database through our venous thromboembolism team. All patients had an objective diagnosis with duplex ultrasound (DU) in our accredited vascular laboratory...
December 8, 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/29229350/predictors-of-readmissions-and-reoperations-related-to-venous-thromboembolic-events-after-spine-surgery-a-single-institution-experience-with-6-869-patients
#4
Michael Cloney, Ekamjeet S Dhillon, Helena Roberts, Zachary A Smith, Tyler R Koski, Nader S Dahdaleh
BACKGROUND: Readmission and reoperation are used as hospital and surgeon quality metrics. Venous thromboembolic events (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), are a major cause of readmission, morbidity, mortality, after spine surgery. Specific procedural, perioperative, and patient characteristics may be associated with these outcomes. METHODS: We retrospectively examined records from 6869 consecutive spine surgeries at our institution...
December 8, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29227440/what-is-the-safety-and-efficacy-of-chemical-venous-thromboembolism-prophylaxis-following-vestibular-schwannoma-surgery
#5
Geoffrey C Casazza, Christian A Bowers, Joel D MacDonald, William T Couldwell, Clough Shelton, Richard K Gurgel
OBJECTIVE: The benefit of routine chemical prophylaxis use for venous thromboembolism (VTE) prevention in skull base surgery is controversial. Chemical prophylaxis can prevent undue morbidity and mortality, however there are risks for hemorrhagic complications. STUDY DESIGN: Retrospective case-control. METHODS: A retrospective chart review of patients who underwent surgery for vestibular schwannoma from 2011 to 2016 was performed. Patients were divided by receipt of chemical VTE prophylaxis...
December 7, 2017: Otology & Neurotology
https://www.readbyqxmd.com/read/29226949/thrombolysis-for-acute-upper-extremity-deep-vein-thrombosis
#6
REVIEW
Joshua Feinberg, Emil Eik Nielsen, Janus C Jakobsen
BACKGROUND: About 5% to 10% of all deep vein thromboses occur in the upper extremities. Serious complications of upper extremity deep vein thrombosis, such as post-thrombotic syndrome and pulmonary embolism, may in theory be avoided using thrombolysis. No systematic review has assessed the effects of thrombolysis for the treatment of individuals with acute upper extremity deep vein thrombosis. OBJECTIVES: To assess the beneficial and harmful effects of thrombolysis for the treatment of individuals with acute upper extremity deep vein thrombosis...
December 11, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29226883/deep-vein-thrombosis-prophylaxis-are-we-overdoing-an-asian-survey-on-trends-in-bariatric-surgery-with-a-systematic-review-of-literature
#7
Siddhartha Bhattacharya, S Saravana Kumar, Parimala Devi Kumara Swamy, C Palanivelu, P Praveen Raj
BACKGROUND: Obesity is a risk factor for deep vein thrombosis (DVT) and venous thromboembolism (VTE). VTE is the most common cause of mortality in patients undergoing bariatric surgery. There is considerable variation in practice regarding methods, dosages and duration of prophylaxis in this patient population. Most of the literature is based on Western patients and specific guidelines for Asians do not exist. METHODS: We conducted a web-based survey amongst 11 surgeons from high-volume centres in Asia regarding their DVT prophylaxis measures in patients undergoing bariatric surgery...
December 11, 2017: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/29226053/compression-stockings-and-pressure-ulcers-case-series-of-a-neglected-issue
#8
Farooq A Rathore, Faria Ahmad, Omer J Khan
Pressure ulcers develop in patients who endure long periods of immobilization, often caused by conditions such as musculoskeletal and neurological diseases. Pressure ulcers adversely affect the patient and increase caregiver burden and healthcare costs. Typical sites for these ulcers include the sacrum, trochanters, and heels; they also occur on the nape of the neck, penis, nostrils, helix of the ear, and upper back. Compression stockings are commonly used to prevent and stop the progression of venous disorders, including deep vein thrombosis, but their role in the development of pressure ulcers is not well known...
October 10, 2017: Curēus
https://www.readbyqxmd.com/read/29225327/plasma-fibrin-clot-structure-and-thromboembolism-clinical-implications
#9
Michał Ząbczyk, Anetta Undas
Fibrin formed as a result of fibrinogen polymerization is a main protein component of a clot in a test tube and intravascular thrombi in vivo. Fibrin clot structure characterized by fibers diameter and pore size differs between healthy subjects and those with thromboembolic diseases, in part due to the quality and quantity of fibrinogen and the magnitude of thrombin generation. A key measure of plasma clot structure is its permeability, reflected by the Darcy constant, Ks. Reduced Ks is a typical feature of the prothrombotic fibrin clot phenotype, which is associated with faster formation of denser fibrin mesh, relatively resistant to lysis...
December 11, 2017: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/29224973/residual-pulmonary-embolism-as-a-predictor-for-recurrence-after-a-first-unprovoked-episode-results-from-the-reverse-cohort-study
#10
Tony Wan, Marc Rodger, Wanzhen Zeng, Philippe Robin, Marc Righini, Michael J Kovacs, Melanie Tan, Marc Carrier, Susan R Kahn, Philip S Wells, David R Anderson, Isabelle Chagnon, Susan Solymoss, Mark Crowther, Richard H White, Linda Vickars, Sadri Bazarjani, Grégoire Le Gal
BACKGROUND: The optimal duration of oral anticoagulant therapy after a first, unprovoked venous thromboembolism is controversial due to tightly balanced risks and benefits of indefinite anticoagulation. Risk stratification tools may assist in decision making. OBJECTIVES: We sought to determine the relationship between residual pulmonary embolism assessed by baseline ventilation-perfusion scan after completion of 5-7months of oral anticoagulant therapy and the risk of recurrent venous thromboembolism in patients with the first episode of unprovoked pulmonary embolism...
December 7, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/29224266/-application-of-liver-three-dimensional-visualization-technologies-in-the-treatment-planning-of-hepatic-malignant-tumor
#11
P P Li, Z H Wang, G Huang, Z P Huang, Y Li, J S Ni, H Liu, C H Fang, W P Zhou
Objective: To discuss the application of three dimentional(3D)visualization technologies in treatment plan of hepatic malignant tumor. Methods: The clinical data of 300 patients with liver malignant tumor who received treatment from January 2016 to January 2017 in the Third Department of Hepatic Surgery of Eastern Hepatobiliary Surgery Hospital was retrospectively analyzed in this study, including 221 male and 79 female patients aged from 7 to 76 years with median age of 54 years. The median height was 168 cm (115-183 cm), the median weight was 65 kg (20-105 kg) and the median tumor volume was 142 ml (23-2 493 ml)...
December 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/29223985/external-validation-of-generic-and-cancer-specific-risk-stratification-tools-in-patients-with-pulmonary-embolism-and-active-cancer
#12
Erin R Weeda, Jonathan T Caranfa, Simon B Zeichner, Craig I Coleman, Elaine Nguyen, Christine G Kohn
Background: Numerous risk stratification tools exist to predict early post-pulmonary embolism (PE) mortality; however, few were specifically designed for use in patients with cancer. This study sought to evaluate the performance of 3 cancer-specific (RIETE, POMPE-C, and Font criteria) and 3 generic (Hestia, Pulmonary Embolism Severity Index [PESI], and Geneva prognostic score [GPS]) risk stratification tools for predicting 30-day post-PE mortality in patients with active cancer. Methods: We identified consecutive, adult, objectively confirmed patients with PE and active cancer presenting to our institution from November 2010 to January 2014...
December 2017: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/29222322/inferior-vena-cava-filter-use-and-patient-safety-legacy-or-science
#13
REVIEW
William Geerts, Rita Selby
There has been a dramatic increase in vena cava filter (VCF) use over the past 20 years in the absence of evidence that filters provide a net patient benefit or are required in most cases. This increase is largely attributable to the availability of retrievable filters and expanded indications, particularly as primary prophylaxis in patients thought to be at high risk of pulmonary embolism. Substantial variability in VCF use, unrelated to patient clinical factors, has been shown between hospitals, from region to region, and among various countries...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29222321/thrombectomy-and-thrombolysis-for-the-prevention-and-treatment-of-postthrombotic-syndrome
#14
REVIEW
Suresh Vedantham
Postthrombotic syndrome (PTS) is a frequent complication of lower-extremity deep vein thrombosis (DVT), occurring in approximately 40% of patients despite the use of anticoagulant therapy. PTS causes significant impairment of patients' health-related quality of life, and no evidence-based therapies have been consistently effective. Catheter-directed thrombolysis and thrombectomy have been shown to remove acute thrombus, and it has been hypothesized they could prevent or reduce PTS. However, because these procedures can be associated with complications, mainly bleeding, randomized trial data are needed to determine when they should be used...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29222260/should-we-diagnose-and-treat-distal-deep-vein-thrombosis
#15
REVIEW
Helia Robert-Ebadi, Marc Righini
Ultrasound series report that isolated distal deep vein thrombosis (DVT), also known as calf DVT, represents up to 50% of all lower-limb DVTs and, therefore, is a frequent medical condition. Unlike proximal DVT and pulmonary embolism, which have been studied extensively and for which management is well standardized, much less is known about the optimal management of isolated calf DVT. Recent data arising from registries and nonrandomized studies have suggested that most distal DVTs do not extend to the proximal veins and have an uneventful follow-up when left untreated...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29222259/controversies-in-venous-thromboembolism-to-treat-or-not-to-treat-superficial-vein-thrombosis
#16
REVIEW
Jan Beyer-Westendorf
The management of superficial vein thrombosis (SVT) is poorly defined and remains controversial overall. SVT has long been considered a benign, self-limited disease, but recent studies show that SVT carries a nonnegligible risk for recurrence, deep vein thrombosis, or pulmonary embolism. Current guidelines recommend the use of low-molecular-weight heparin or fondaparinux, but results of several surveys indicate that the majority of patients with SVT receive nonanticoagulant therapy only, which includes compression stockings or bandages, nonsteroidal anti-inflammatory drugs, topical application of heparin gel, or surgical interventions...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29222246/incidental-venous-thromboembolism-is-anticoagulation-indicated
#17
REVIEW
Marcello Di Nisio, Marc Carrier
Patients with cancer have a high risk of venous thromboembolism (VTE) and about one-half of these events are incidentally detected. The prognosis of incidental VTE appears to be similar to symptomatic events, with comparably high rates of recurrent VTE in this patient population. In the absence of major contraindications, anticoagulant treatment with low-molecular-weight heparin for 3 to 6 months is generally recommended for incidental proximal deep vein thrombosis as well as for incidental pulmonary embolism that involves multiple subsegmental or more proximal pulmonary arteries...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29219827/venous-thrombosis-and-coagulation-parameters-in-patients-with-pure-venous-malformations
#18
J van Es, N A Kappelhof, R A Douma, J C M Meijers, V E A Gerdes, C M A M van der Horst
INTRODUCTION: Venous malformations (VMs) are ubiquitous, low-flow vascular anomalies known to be occasionally painful due to thrombotic episodes within the lesion. The prevalence of superficial or deep vein thrombosis is unclear. METHODS: A cross-sectional study among outpatients aged ≥ 12 years with pure VMs was performed, quantifying the prevalence of thrombosis by screening all patients with compression ultrasonography (CUS). Additionally, we evaluated whether coagulation alterations were related to thrombosis observed with CUS...
October 2017: Netherlands Journal of Medicine
https://www.readbyqxmd.com/read/29219814/cellulitis-current-insights-into-pathophysiology-and-clinical-management
#19
D R Cranendonk, A P M Lavrijsen, J M Prins, W J Wiersinga
Cellulitis is a bacterial skin and soft tissue infection which occurs when the physical skin barrier, the immune system and/or the circulatory system are impaired. Diabetes, obesity and old age are associated with defects in all of these areas and as a result are major predisposing factors for cellulitis. In this review, we summarise current insights into the pathophysiology of cellulitis and place the Dutch guidelines on the clinical management of cellulitis of the lower extremities in perspective. Recent evidence on diagnostic strategies is discussed, the importance of which is underscored by findings that venous insufficiency, eczema, deep vein thrombosis and gout are frequently mistaken for cellulitis...
November 2017: Netherlands Journal of Medicine
https://www.readbyqxmd.com/read/29217387/individualised-versus-standard-duration-of-elastic-compression-therapy-for-prevention-of-post-thrombotic-syndrome-ideal-dvt-a-multicentre-randomised-single-blind-allocation-concealed-non-inferiority-trial
#20
Arina J Ten Cate-Hoek, Elham E Amin, Annemieke C Bouman, Karina Meijer, Lidwine W Tick, Saskia Middeldorp, Guy J M Mostard, Marije Ten Wolde, Simone M van den Heiligenberg, Sanne van Wissen, Marlène Hw van de Poel, Sabina Villalta, Erik H Serné, Hans-Martin Otten, Edith H Klappe, Ingrid M Bistervels, Mandy N Lauw, Margriet Piersma-Wichers, Paolo Prandoni, Manuela A Joore, Martin H Prins, Hugo Ten Cate
BACKGROUND: Therapy with elastic compression stockings has been the cornerstone for prevention of post-thrombotic syndrome for decades in patients after acute deep venous thrombosis. It is uncertain who benefits most from therapy, and what the optimum duration of therapy should be. We therefore aimed to assess the safety and efficacy of individualised duration of compression therapy versus the standard duration of 24 months following an initial treatment period of 6 months. METHODS: We did a multicentre, randomised, single-blind, allocation-concealed, non-inferiority trial at 12 hospitals in the Netherlands and two in Italy...
December 4, 2017: Lancet Haematology
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