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Deep vein thrombosis

Antonio Meštrović, Ivan Žaja, Žarko Ardalić, Pavle Vrebalov-Cindro, Ivan Šustić, Marko Puljiz, Andre Bratanić, Damir Bonacin
Crohn's disease and ulcerative colitis (UC) patients have an increased risk for thromboembolic complications, the most common of them are deep venous thrombosis and pulmonary embolism. Other locations and genetic mutations of coagulation factors are not so common in these patients. Here we present a case of a young woman with exacerbation of previously diagnosed mild UC complicated by multiple thrombotic incidents due to MTHFR gene mutation.
May 2018: Case Reports in Gastroenterology
Yong Tae Kim, Min Wook Kang, Joon Kyu Lee, Young Min Lee, Joong Il Kim
BACKGROUND: Blood loss and deep vein thrombosis (DVT) are important complications after total knee arthroplasty (TKA). Topical tranexamic acid (TXA) effectively reduces wound bleeding but may elevate the risk of DVT. In contrast, rivaroxaban potently prevents DVT but has been associated with bleeding complications. The simultaneous use of topical TXA and rivaroxaban in TKA has not been much investigated. METHODS: A retrospective cohort study was conducted with two consecutive groups of patients who underwent TKA...
July 18, 2018: BMC Musculoskeletal Disorders
Timothy Wen, Jason D Wright, Dena Goffman, Mary E D'Alton, William J Mack, Frank J Attenello, Alexander M Friedman
BACKGROUND: There is limited data on when postpartum readmissions for thromboembolism occur after delivery hospitalizations on a population basis in the United States. OBJECTIVE: To characterize risk factors for and timing of postpartum venous thromboembolism (VTE) readmission after delivery hospitalization discharge. STUDY DESIGN: The Healthcare Cost and Utilization Project's Nationwide Readmissions Database for calendar years 2013 and 2014 was used to perform a retrospective cohort study evaluating risk for readmission for venous thromboembolism within 60 days of discharge from a delivery hospitalization...
July 11, 2018: American Journal of Obstetrics and Gynecology
Byron C Drumheller, Deborah M Stein, Thomas M Scalea
BACKGROUND: Correction of hypothermia is a key component of the resuscitation of critically injured patients with hemorrhagic shock who require damage control surgery. External rewarming methods may not be sufficient in this population, while extracorporeal techniques lack widespread feasibility. Intravascular catheter-based temperature modulation is increasingly being employed in different critically ill patient populations but has not been described as part of a damage control resuscitation strategy in trauma patients...
July 8, 2018: Injury
Bobby Daly, Kevin Nicholas, Dmitriy Gorenshteyn, Stefania Sokolowski, Lior Gazit, Lynn Adams, Jennie Matays, Lauren L Katzen, Yeneat O Chiu, Han Xiao, Rori Salvaggio, Abigail Baldwin-Medsker, Kimberly Chow, Judith Nelson, Mikel Ross, Kenneth K Ng, Alice Zervoudakis, Wendy Perchick, Diane L Reidy, Brett A Simon, Isaac Wagner
PURPOSE: The Centers for Medicare & Medicaid Services (CMS) identifies suboptimal management of treatment toxicities as a care gap and proposes the measurement of hospital performance on the basis of emergency department visits for 10 common symptoms. Current management strategies do not address symptom co-occurrence. METHODS: We evaluated symptom co-occurrence in three patient cohorts that presented to a cancer hospital urgent care center in 2016. We examined both the CMS-identified symptoms and an expanded clinician-identified set defined as symptoms that could be safely managed in the outpatient setting if identified early and managed proactively...
July 17, 2018: Journal of Oncology Practice
Gjam Boon, L F van Dam, F A Klok, M V Huisman
Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), is the third most frequent cardiovascular disease besides myocardial infarction and stroke. Since DVT may cause life-threatening conditions, treatment should be started as soon as possible. This comprises certain challenges in special populations. Areas covered: In cancer-associated VTE, current treatment is different from non-cancer VTE due to disease-related interventions and higher bleeding risks. In treatment of patients with extensive DVT, the role of catheter-directed thrombolysis has been investigated in two randomised trials but results do not yield a recommendation for standard thrombolysis...
July 17, 2018: Expert Review of Hematology
Pedro L Mercado, Daniel H Liberto, Julia Udaquiola, Patricio Cieri, Roberto L Vagni, Pablo Lobos, Juan M Moldes Larribasa
Inferior Vena Cava (IVC) is composed of three segments from different embryological origin. Its lack of fusion originates a wide spectrum of anomalies of the IVC. These malformations are present in 0.07-8.7% of the population. It is generally diagnosed as an incidental finding in adult life. It represents between 5 and 9.5% of idiopathic deep vein thrombosis in patients younger than 30 years old without associated risk factors. We present a case of a term newborn with prenatal diagnosis of ascites during the 20th week of gestation...
August 1, 2018: Archivos Argentinos de Pediatría
Ina Isabella Høiland, Robin Amanda Liang, Kristian Hindberg, Nadezhda Latysheva, Ole-Lars Brekke, Tom Eirik Mollnes, John-Bjarne Hansen
INTRODUCTION: Deep vein thrombosis (DVT) originates in the valvular sinuses of large veins in a local milieu characterized by stasis and severe hypoxia. This may induce complement- and coagulation activation, which potentially increases the risk of venous thromboembolism (VTE). The aim of the present study was to investigate whether the activity of the complement pathways, the level of mannose-binding lectin (MBL) and tissue-factor (TF) induced thrombin generation were associated with risk of unprovoked VTE...
June 30, 2018: Thrombosis Research
F Dentali, S Barco, S Pegoraro, M N D Di Minno, D Mastroiacovo, F Pomero, C Lodigiani, F Bagna, M Sartori, G Barillari, N Mumoli, M Napolitano, S M Passamonti, R Benedetti, W Ageno, M Di Nisio
After acute proximal deep vein thrombosis (DVT) the thrombotic mass decreases, especially during the first months of anticoagulation. The persistence of residual vein obstruction (RVO) may predict future recurrence in patients with cancer-associated DVT. We aimed to evaluate the proportion of patients with RVO after an episode of cancer associated isolated distal DVT (IDDVT), to identify variables associated with RVO, and to provide initial evidence of its association with recurrent VTE. We performed a post-hoc analysis of a multicenter cohort study of patients with isolated cancer-associated acute IDDVT...
July 16, 2018: Journal of Thrombosis and Thrombolysis
Alejandro González-Castro, María Ortiz-Lasa, Julia García-Reyero, Ainara Azueta
Wünderlich syndrome, or spontaneous retroperitoneal hematoma, secondary to spontaneous rupture of the iliac vein is a rare clinical entity and a medical emergency. Often the aetiology is difficult to identify and different hypotheses have been proposed, such as the presence of hormonal, inflammatory and/or mechanical factors. It may be important to assess the presence of a factor that triggered the deep vein thrombosis and secondary rupture of the iliac vein and retroperitoneal hematoma. We present a case where venous thrombosis could have caused rupture of the iliac vein and we discuss the entity in light of the current literature...
July 2018: Revista Española de Patología
Sylvana Ml de Mik, Fabienne E Stubenrouch, Dink A Legemate, Ron Balm, Dirk T Ubbink
Objective To reach consensus on which complications of varicose vein treatments physicians consider major or minor, in order to standardize the informed consent procedure and improve shared decision-making. Methods Using the e-Delphi method, expert physicians from 10 countries were asked to rate complications as "major" or "minor" on a 5-point Likert scale. Reference articles from a Cochrane review on varicose veins were used to compose the list of complications. Results Participating experts reached consensus on 12 major complications: allergic reaction, cellulitis requiring intravenous antibiotics/intensive care, wound infection requiring debridement, hemorrhage requiring blood transfusion/surgical intervention, pulmonary embolism, skin necrosis requiring surgery, arteriovenous fistula requiring repair, deep venous thrombosis, lymphocele, thermal injury, transient ischemic attack/stroke, and permanent discoloration...
January 1, 2018: Phlebology
Dale Ding, Padmini Sekar, Charles J Moomaw, Mary E Comeau, Michael L James, Fernando Testai, Matthew L Flaherty, Anastasia Vashkevich, Bradford B Worrall, Daniel Woo, Jennifer Osborne
BACKGROUND: Patients with spontaneous intracerebral hemorrhage (ICH) are predisposed to venous thromboembolic (VTE) complications, such as deep vein thrombosis and pulmonary embolism. OBJECTIVE: To evaluate, in a multicenter, retrospective cohort study, the rate of VTE complications in ICH patients during acute hospitalization, identify potential risk factors, and assess their association with functional outcome. METHODS: We retrospectively analyzed prospectively collected data from 19 centers and 41 sites that participated in the Ethnic/Racial Variations of Intracerebral Hemorrhage study, from August 2010 to February 2016...
July 13, 2018: Neurosurgery
Shuqiu Chen, Guiya Jiang, Ning Liu, Hua Jiang, Lijie Zhang, Chao Sun, Bin Xu, Xiaowen Zhang, Yu Yang, Jing Liu, Weidong Zhu, Ming Chen
PURPOSE: We discuss the safety and perioperative outcomes of a 2-week interval between prostate biopsy and laparoscopic radical prostatectomy (LRP). MATERIALS AND METHODS: We retrospectively reviewed the medical records of 182 patients with prostate cancer (PCa) who underwent transperitoneal LRP 2 weeks after prostate biopsy between 2012 and 2015. We evaluated the following perioperative outcomes: operative time, estimated blood loss (EBL), infection, conversion to open surgery, positive surgery margins (PSM), and complications...
July 14, 2018: Urology Journal
Ann M Borzecki, Qi Chen, William O'Brien, Michael Shwartz, Peter A Najjar, Kamal M F Itani, Amy K Rosen
BACKGROUND: Studies disagree whether surveillance bias is associated with perioperative venous thromboembolism (VTE) performance measures. A prior VA study used a chart-based outcome; no studies have used the fully specified administrative data-based AHRQ Patient Safety Indicator, PSI-12, as their primary outcome. If surveillance bias were present, we hypothesized that inpatient surveillance rates would be associated with higher PSI-12 rates, but with lower post-discharge VTE rates. METHODS: Using VA data, we examined Pearson correlations between hospital-level VTE imaging rates and risk-adjusted PSI-12 rates and post-discharge VTE rates...
July 4, 2018: American Journal of Surgery
Malgorzata M Bala, Elżbieta Paszek, Wiktoria Lesniak, Dorota Wloch-Kopec, Katarzyna Jasinska, Anetta Undas
BACKGROUND: Antiphospholipid syndrome (APS) is an autoimmune disease characterised by the presence of antiphospholipid (aPL) antibodies that have prothrombotic activity. Antiphospholipid antibodies are associated with an increased risk of pregnancy complications (recurrent miscarriage, premature birth, intrauterine growth retardation) and thrombotic events (both arterial and venous). The most common thrombotic events include brain ischaemia (stroke or transient ischaemic attack) and deep vein thrombosis...
July 13, 2018: Cochrane Database of Systematic Reviews
Ismet Tolu, Mehmet Sedat Durmaz
Objective: The aim of this study was to reveal the frequency and impact of perforating venous insufficiency (PVI) in chronic venous insufficiency (CVI) of lower extremity (LE). Materials and Methods: Between 2012 and 2017, a total of 1154 patients [781 females (67.68%) and 373 males (32.32%), 228 (19.76%) unilateral and 926 (80.24%) bilateral LE] were examined using Doppler ultrasound (US). A total of 2080 venous systems of LEs [31.4% male (n=653) and 68.6% female (n=1427); 1056 left LEs (50...
June 2018: Eurasian Journal of Medicine
Jean-Marie Januel, Patrick S Romano, Chantal M Couris, Phil Hider, Hude Quan, Cyrille Colin, Bernard Burnand, William A Ghali
BACKGROUND: Routinely collected hospital data provide increasing opportunities to assess the performance of health care systems. Several factors may, however, influence performance measures and their interpretation between countries. OBJECTIVE: We compared the occurrence of in-hospital venous thromboembolism (VTE) in patients undergoing hip replacement across 5 countries and explored factors that could explain differences across these countries. METHODS: We performed cross-sectional studies independently in 5 countries: Canada; France; New Zealand; the state of California; and Switzerland...
July 11, 2018: Medical Care
Tomoyuki Naito, Hiroki Hayashi, Takeru Kashiwada, Yoshinobu Saito, Shinji Abe, Kaoru Kubota, Akihiko Gemma
A 41-year-old woman presented complaining of cough and purpura for one month. On her first visit, a blood test demonstrated peripheral blood eosinophilia, but chest radiography showed no abnormalities. However, 2 days after the first visit, she went to the emergency room because of fever and right-sided chest pain. Contrast-enhanced computed tomography of the chest showed pulmonary embolism and air space consolidation. Thrombosis was present in the popliteal vein. Bronchoscopy revealed alveolar hemorrhage and increased eosinophils in the bronchoalveolar lavage fluid, and a skin biopsy demonstrated a perivascular eosinophilic infiltrate...
2018: Respiratory Medicine Case Reports
Daniele Morosetti, Eliseo Picchi, Antonello Calcagni, Feliciana Lamacchia, Armando Ugo Cavallo, Alessio Bozzi, Adriano Lacchè, Gianluigi Sergiacomi
We reported the cases of two adult male patients who were admitted to our emergency room with abdominal pain and dyspnea caused by gallstones and pulmonary embolism respectively. During the radiological investigations, as collateral findings, we found two anomalous development of the inferior vena cava. These conditions affect about 4% of population and, although asymptomatic or mildly symptomatic, are associated with thrombotic manifestations as deep vein thrombosis and pulmonary embolism. The prompt recognition of these anomalies is necessary in order to prevent the complications associated with these conditions and to set the best therapy for patients...
August 2018: Radiology Case Reports
Robert H Blackwell, Anai N Kothari, Arpeet Shah, William Gang, Marcus L Quek, Fred A Luchette, Robert C Flanigan, Paul C Kuo, Gopal N Gupta
Objective: To describe the long-term incidence of adhesive bowel obstruction following major urologic surgery, and the effect of early surgery on perioperative outcomes. Methods: The Healthcare Cost and Utilization Project State Inpatient Databases for California and Florida (2006-2011) were used to identify major urologic oncologic surgery patients. Subsequent adhesive bowel obstruction admissions were identified and Kaplan-Meier time-to-event analysis was performed...
June 2018: Current Urology
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