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https://www.readbyqxmd.com/read/29334497/deep-vein-thrombosis-and-venous-thromboembolism-in-trauma
#1
Keith J Ruskin
PURPOSE OF REVIEW: Deep vein thrombosis (DVT) and pulmonary embolus are major causes of hospital-related morbidity and mortality, and are recognized as complications in patients with traumatic injury. Despite the significant morbidity and mortality associated with DVTs, prophylaxis and treatment are still not well understood and remain the subject of research and debate. RECENT FINDINGS: Elements of the patient's history and physical examination, along with thromboelastography, can be used to predict patients who are at greatest risk of DVT and venous thromboembolism (VTE)...
January 12, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29324334/rivaroxaban-versus-warfarin-for-the-prevention-of-post-thrombotic-syndrome
#2
K K Utne, A Dahm, H S Wik, L P Jelsness-Jørgensen, P M Sandset, W Ghanima
INTRODUCTION: Despite treatment of acute deep vein thrombosis (DVT) with low molecular weight heparin and warfarin, up to 50% of patients develop post-thrombotic syndrome (PTS). Our aims were to assess whether treatment of DVT with rivaroxaban would reduce the rate of subsequent PTS and improve health-related quality of life (HRQoL) as compared to conventional anticoagulation with low molecular weight heparin (LMWH)/warfarin. MATERIALS AND METHODS: Consecutive patients with an objectively confirmed DVT diagnosed between 2011 and 2014 and treated with either rivaroxaban or warfarin were included in this study 24 (±6) months after DVT...
January 8, 2018: Thrombosis Research
https://www.readbyqxmd.com/read/29318176/venous-thromboembolism-within-professional-american-sport-leagues
#3
Meghan Bishop, Matthew Astolfi, Eric Padegimas, Peter DeLuca, Sommer Hammoud
Background: Numerous reports have described players in professional American sports leagues who have been sidelined with a deep vein thrombosis (DVT) or a pulmonary embolism (PE), but little is known about the clinical implications of these events in professional athletes. Purpose: To conduct a retrospective review of injury reports from the National Hockey League (NHL), Major League Baseball (MLB), the National Basketball Association (NBA), and the National Football League (NFL) to take a closer look at the incidence of DVT/PE, current treatment approaches, and estimated time to return to play in professional athletes...
December 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29315455/home-versus-in-patient-treatment-for-deep-vein-thrombosis
#4
REVIEW
Richard Othieno, Emmanuel Okpo, Rachel Forster
BACKGROUND: Deep vein thrombosis (DVT) occurs when a blood clot blocks blood flow through a vein, which can occur after surgery, after trauma, or when a person has been immobile for a long time. Clots can dislodge and block blood flow to the lungs (pulmonary embolism (PE)), causing death. DVT and PE are known by the term venous thromboembolism (VTE). Heparin (in the form of unfractionated heparin (UFH)) is a blood-thinning drug used during the first three to five days of DVT treatment...
January 9, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29300003/effects-of-inhalation-anesthesia-vs-total-intravenous-anesthesia-tiva-vs-spinal-epidural-anesthesia-on-deep-vein-thrombosis-after-total-knee-arthroplasty
#5
Lu-Yang Zhou, Wei Gu, Yun Liu, Zheng-Liang Ma
BACKGROUND The objective of the present study was to evaluate the varying efficacy of general anesthesia (GA), combined spinal-epidural anesthesia (CSEA), and total intravenous anesthesia (TIVA) on the occurrence of deep vein thrombosis (DVT) following total knee arthroplasty (TKA). MATERIAL AND METHODS From July 2013 to May 2015, a total of 197 cases of patients who had undergone TKA treatment at either the Drum Tower Hospital or Nanjing General Hospital of Nanjing Military Command were recruited to participate in the study...
January 4, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/29295847/how-i-use-catheter-directed-interventional-therapy-to-treat-patients-with-venous-thromboembolism
#6
Suresh Vedantham, Akhilesh K Sista
Patients who present with severe manifestations of acute venous thromboembolism (VTE) are at higher risk for premature death and long-term disability. In recent years, catheter-based interventional procedures have shown strong potential to improve clinical outcomes in selected VTE patients. However, physicians continue to be routinely faced with challenging decisions that pertain to the utilization of these risky and costly treatment strategies, and there is a relative paucity of published clinical trials with sufficient rigor and directness to inform clinical practice...
January 2, 2018: Blood
https://www.readbyqxmd.com/read/29290408/pulmonary-emboli-and-deep-venous-thrombosis-during-adolescence
#7
Celeste Schultz, Rebecca Doran
Pulmonary emboli (PE) and deep venous thrombus (DVT) are two conditions considered to affect primarily adults. These conditions, however, can and do affect neonates, toddlers, school-age children, and adolescents. Factors contributing to the development of PE and DVT are often associated with genetic mutations in Antithrombin III, Protein C, and Protein S. This article presents a primary care case study of an adolescent who was diagnosed with and underwent treatment for bilateral PE and a DVT, and reviews the underlying primary genetic mutations, diagnostic workup, and management of his clinical condition...
December 28, 2017: Journal of Pediatric Health Care
https://www.readbyqxmd.com/read/29279522/comparison-of-direct-oral-anticoagulants-and-warfarin-in-the-treatment-of-deep-venous-thrombosis-in-the-chronic-phase
#8
Shingo Wakakura, Fumihiko Hara, Tadashi Fujino, Asami Hamai, Hiroshi Ohara, Takayuki Kabuki, Masahiko Harada, Takanori Ikeda
We assessed the efficacy and safety of direct oral anticoagulants (DOACs) for the treatment of deep venous thrombosis (DVT) in the chronic phase through comparison with conventional warfarin therapy.A total of 807 consecutive patients who were diagnosed with having DVT in the chronic phase were included (484 patients to warfarin therapy and 323 patients to DOAC therapy). The condition of leg veins was assessed 3 to 6 months after starting the therapies by ultrasound examination. Major bleeding and mortality during the therapies were followed-up...
December 27, 2017: International Heart Journal
https://www.readbyqxmd.com/read/29275595/-clinical-efficacy-of-rivaroxaban-in-prevention-and-treatment-of-postoperative-deep-vein-thrombosis-for-severe-traumatic-brain-injury
#9
Z L Zhang, W M Liu, Y Zhang, G H Wang, C Yan, H Q Wang, Q B Huang
Objective: To explore the clinical efficacy of rivaroxaban in the prevention and treatment of postoperative deep vein thrombosis (DVT) for severe traumatic brain injury (sTBI). Methods: Patients with sTBI who met the inclusion criteria were enrolled in this study, including 119 males (75.8%) and 38 females (24.2%), aged (38.75 ± 11.98) years old. DVT was prevented and treated according to the DVT screening and anticoagulation regimen. Intermittent venous compression was used on all of the patients to prevent DVT, and D-dimer dynamic monitoring and regular ultrasound were performed to screen for DVT...
December 5, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29242187/altered-plasma-clot-properties-increase-the-risk-of-recurrent-deep-vein-thrombosis-a-cohort-study
#10
Joanna Cieslik, Sandra Mrozinska, Elzbieta Broniatowska, Anetta Undas
It has been demonstrated that fibrin clots generated from plasma samples obtained from patients with prior thromboembolic events are denser and less susceptible to lysis. Such a prothrombotic fibrin clot phenotype has been suggested as a new risk factor for venous thromboembolism, but its prognostic value is unclear. To assess whether abnormal clot properties can predict recurrent deep-vein thrombosis (DVT), we studied 320 consecutive patients aged 18 to 70 years following the first-ever DVT. Plasma clot properties were evaluated after 3 months of anticoagulant treatment since the index event...
December 14, 2017: Blood
https://www.readbyqxmd.com/read/29229465/diverse-management-of-isolated-calf-deep-venous-thrombosis-in-a-university-hospital
#11
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/29225244/trousseau-s-syndrome-causing-refractory-deep-venous-thrombosis
#12
Shoko Mizoguchi, Toshiki Sawai, Atsuya Hirota, Shigetada Yamamoto, Hiroshi Nakajima, Katsutoshi Makino, Kojiro Takase, Masaaki Ito
A 66-year-old man, who had been diagnosed with deep venous thrombosis (DVT), and who was treated with a vitamin K antagonist (VKA) and who had undergone the implantation of an inferior vena cava filter, was admitted due to an exacerbation of DVT. VKA was administered again; however, the patient's DVT worsened. Further examinations revealed colon cancer, which led to a diagnosis of Trousseau's syndrome. The regression of the thrombi was confirmed after the administration of heparin and the resection of the tumors...
December 8, 2017: Internal Medicine
https://www.readbyqxmd.com/read/29222321/thrombectomy-and-thrombolysis-for-the-prevention-and-treatment-of-postthrombotic-syndrome
#13
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
#14
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/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
#15
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
https://www.readbyqxmd.com/read/29216693/a-comparative-study-in-patients-with-fractures-of-the-lower-limbs-between-rivaroxaban-versus-enoxaparin-and-its-impact-on-bone-healing-time
#16
P Peláez-Damy, A Torres-Gómez, F Mas-Celis, M Martínez-Villalobos
BACKGROUND: Each year it is estimated in the United States an approximate of 8 million fractures; 5 to 10% develop delayed union or absence of periosteal new bone. There are several factors that can cause delay in fracture healing, among the well known, is the use of prophylactic antithrombotic therapy for deep vein thrombosis (DVT). DVT appears in 40 to 60% of the patients undergoing orthopedic surgery without prophylactic antithrombotic therapy. The goal of this study was to assess whether there is a difference in time of bone healing in lower limb fractures (femur and tibia) comparing rivaroxaban to enoxaparin as the prophylactic antithrombotic management...
July 2017: Acta Ortopédica Mexicana
https://www.readbyqxmd.com/read/29214507/comparison-of-once-daily-bemiparin-with-twice-daily-enoxaparin-for-acute-deep-vein-thrombosis-a-multicenter-open-label-randomized-controlled-trial
#17
Igor A Suchkov, Javier Martinez-Gonzalez, Sebastian M Schellong, Toni Garbade, Michela Falciani
BACKGROUND: Individuals with deep vein thrombosis (DVT) have an increased risk of pulmonary embolism (PE), death, and long-term thrombotic complications. OBJECTIVES: To evaluate the efficacy and safety of bemiparin once daily versus enoxaparin twice daily in the treatment of acute DVT, and to establish therapeutic non-inferiority of bemiparin. PATIENTS AND METHODS: This multicenter, randomized, open-label, active-controlled phase III clinical trial enrolled patients with acute proximal DVT confirmed by complete compression ultrasound (CCUS)...
December 6, 2017: Clinical Drug Investigation
https://www.readbyqxmd.com/read/29202213/rivaroxaban-for-preventing-venous-thromboembolism-in-high-risk-ambulatory-patients-with-cancer-rationale-and-design-of-the-cassini-trial
#18
Alok A Khorana, Saroj Vadhan-Raj, Nicole M Kuderer, Ted Wun, Howard Liebman, Gerald Soff, Chandra Belani, Eileen M O'Reilly, Robert McBane, John Eikelboom, C V Damaraju, Karen Beyers, Flavia Dietrich, Ajay K Kakkar, Hanno Riess, Renata D'Alpino Peixoto, Gary H Lyman
Venous thromboembolism (VTE) is a frequent complication of cancer associated with morbidity, mortality, increased hospitalizations and higher health care costs. Cancer patients at increased risk for VTE can be identified using a validated risk assessment score, and the incidence of VTE can be reduced in high-risk settings using anticoagulation. Rivaroxaban is a potent, oral, direct, factor Xa inhibitor approved for the prevention and treatment of thromboembolic events, including VTE. CASSINI is a double-blind, randomized, parallel-group, multicentre study comparing rivaroxaban with placebo in adult ambulatory patients with various cancers who are initiating systemic cancer therapy and are at high risk of VTE (Khorana score ≥ 2)...
November 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/29200147/pediatric-deep-venous-thrombosis-associated-with-staphylococcal-infections-single-institutional-experience
#19
Divyaswathi Citla Sridhar, Ossama M Maher, Nidra I Rodriguez
Deep venous thrombosis (DVT) has been previously reported in children with methicillin-resistant Staphylococcus aureus (MRSA). This study reviews our institutional experience by evaluating characteristics and outcomes of children with DVT and staphylococcal infections. Retrospective clinical data from 16 pediatric patients with DVT and staphylococcal infections over a 5-year period was obtained via medical record abstraction. Sixteen patients with a median age at diagnosis of 8 years were included. The most common infection encountered was osteomyelitis (56%)...
December 1, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/29199766/pentasaccharides-for-the-treatment-of-deep-vein-thrombosis
#20
REVIEW
Gustavo Ms Brandao, Daniela R Junqueira, Hamilton A Rollo, Marcone L Sobreira
BACKGROUND: Standard treatment of deep vein thrombosis (DVT) is based on antithrombotic therapy, initially with parenteral administration of unfractionated heparin or low molecular weight heparins (LMWH) for five to seven days, then subsequent long-term therapy with oral vitamin K antagonists (e.g. warfarin). Pentasaccharides are novel anticoagulants that may be favourable over standard therapy due to their predictable effect, no need for frequent monitoring or re-dosing, and few known drug interactions...
December 2, 2017: Cochrane Database of Systematic Reviews
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