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https://www.readbyqxmd.com/read/29567899/autopsy-findings-in-an-atypical-case-of-occult-massive-fatal-pulmonary-embolism-in-a-backdrop-of-hyperhomocysteinemia
#1
Pratibha Misra, Arijit Kumar Ghosh, Aneeta Jassar
A 43-year-old apparently healthy male presented with fever and presyncope. He was suspected to have massive pulmonary thromboembolism based on the clinico-biochemical profile. Despite aggressive thrombolytic therapy, he succumbed to his illness within 12 h of admission. Postmortem examination showed massive pulmonary thromboembolism and hyperhomocysteinemia with low high-density lipoproteins (HDL) cholesterol with antemortem blood sample. Herein, we report autopsy findings in a rare case of a young male with occult massive pulmonary thromboembolism without deep vein thrombosis, who had an atypical clinical presentation and was found to have underlying hyperhomocysteinemia and decreased HDLc...
January 2018: Indian Journal of Pathology & Microbiology
https://www.readbyqxmd.com/read/29524978/t4-urothelial-carcinoma-in-undiagnosed-closed-bladder-exstrophy-in-a-post-menopausal-female
#2
Brian J McArdle, Patricia Vidal, Sarah P Psutka, Courtney M P Hollowell
It is rare to see an adult presenting with exstrophy of the bladder. Malignant conversion in exstrophy occurs in 4%, with adenocarcinoma as the most common histopathology. We report the first case of metastatic high grade urothelial carcinoma with squamous and sarcomatoid differentiation arising from undiagnosed, closed bladder exstrophy in a female at advanced age with associated bilateral deep vein thrombosis and clot retention. The patient developed clinical progression of disease despite neoadjuvant gemcitabine-cisplatin and salvage (or palliative) radiotherapy...
February 2018: Canadian Journal of Urology
https://www.readbyqxmd.com/read/29479925/the-use-of-inferior-vena-cava-filters-before-surgery-in-women-with-ovarian-cancer-with-the-initial-symptom-of-deep-venous-thrombosis-case-report-and-review-of-literature
#3
Višnja Nesek Adam, Antonia Bulić, Aleksandra Jokić, Nedžad Osmančević, Martina Matolić, Gordana Brozović
Venous thromboembolism is a frequent complication of gynecologic cancer, and may be the first symptom of occult malignant disease. Although anticoagulation therapy remains the standard of care in patients presenting with acute venous thromboembolism, inferior vena cava filters are an important alternative when anticoagulants are contraindicated or ineffective. We report a case of a 69-year-old woman who presented with left leg swelling secondary to deep venous thrombosis before the diagnosis of ovarian cancer...
September 2017: Acta Clinica Croatica
https://www.readbyqxmd.com/read/29360741/a-patient-centered-approach-to-guide-follow-up-and-adjunctive-testing-and-treatment-after-first-rib-resection-for-venous-thoracic-outlet-syndrome-is-safe-and-effective
#4
Colin P Ryan, Nicolas J Mouawad, Patrick S Vaccaro, Michael R Go
Controversies in the treatment of venous thoracic outlet syndrome (VTOS) have been discussed for decades, but still persist. Calls for more objective reporting standards have pushed practice towards comprehensive venous evaluations and interventions after first rib resection (FRR) for all patients. In our practice, we have relied on patient-centered, patient-reported outcomes to guide adjunctive treatment and measure success. Thus, we sought to investigate the use of thrombolysis versus anticoagulation alone, timing of FRR following thrombolysis, post-FRR venous intervention, and FRR for McCleery syndrome (MCS) and their impact on patient symptoms and return to function...
January 23, 2018: Diagnostics
https://www.readbyqxmd.com/read/29245061/risk-and-prognosis-of-cancer-after-upper-extremity-deep-venous-thrombosis-a-population-based-cohort-study
#5
Kasper Adelborg, Erzsébet Horváth-Puhó, Jens Sundbøll, Paolo Prandoni, Anne Ording, Henrik Toft Sørensen
INTRODUCTION: The association between lower-extremity venous thrombosis and cancer is well-established. However, the extent to which upper-extremity deep venous thrombosis (U-DVT) is a marker of cancer and a prognostic factor for all-cause mortality remains poorly understood. We examined the risk of cancer after a diagnosis of U-DVT compared with cancer risk in the general population. MATERIALS AND METHODS: Using Danish nationwide population-based medical registries, we identified all patients with first-time U-DVT during 1980-1993 and 2000-2013...
January 2018: Thrombosis Research
https://www.readbyqxmd.com/read/29202544/-the-460th-case-lower-extremity-edema-positive-fecal-occult-blood
#6
Y D Sun, J L Zhao, P Zhang, Q Wang, M T Li
An 61-year-old woman presenting deep vein thrombosis and persistent positive anticardiolipin antibodies was diagnosed as antiphospholipid syndrome and treated with low molecular weight heparin. Before and after anticoagulant therapy, continuous positive fecal occult-blood was found asymptomatically. Colonoscopy confirmed rectal cancer. Antiphospholipid autoantibodies are non-specially positive in some malignances, especially in elder onset patients. Thus, routine screening of malignancies is strongly suggested...
December 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/29199711/venous-thromboembolism-in-cancer-patients-magnitude-of-problem-approach-and-management
#7
REVIEW
G Singh, A K Rathi, K Singh, D Sharma
Cancer is hypercoagulable state. Patients with cancer are at high risk to develop venous thromboembolism (VTE). Relative risk of developing VTE is approximately seven times higher in patients with active cancer. The incidence of occult malignancy is 7%-12% in patients with idiopathic deep vein thrombosis (DVT). However, little research has been focused on cancer with thromboembolism. Lowmolecularweight heparin most frequently used pharmacologic agents as recommended by established guidelines. The aim was to evaluate the magnitude of problem in cancer patients and treatment option as per established guidelines...
January 2017: Indian Journal of Cancer
https://www.readbyqxmd.com/read/29161683/out-of-the-blue-finger-ischaemia-and-occult-colorectal-cancer
#8
Ami Schattner
A woman aged 66 years with a history of unprovoked deep venous thrombosis (DVT) presented with persistent digital ischaemic changes of 2 of her right hand fingers. Physical examination was otherwise normal and extensive laboratory and imaging studies were unremarkable. A history of unprovoked DVT and the current episode of digital ischaemia prompted concern for underlying occult malignancy. Repeated history-taking revealed a strongly positive family history suggesting an occult colorectal cancer. Colonoscopy with biopsy revealed adenocarcinoma...
March 8, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28751848/anmco-position-paper-long-term-follow-up-of-patients-with-pulmonary-thromboembolism
#9
Carlo D'Agostino, Pietro Zonzin, Iolanda Enea, Michele Massimo Gulizia, Walter Ageno, Piergiuseppe Agostoni, Michele Azzarito, Cecilia Becattini, Amedeo Bongarzoni, Francesca Bux, Franco Casazza, Nicoletta Corrieri, Michele D'Alto, Nicola D'Amato, Andrea Maria D'Armini, Maria Grazia De Natale, Giovanni Di Minno, Giuseppe Favretto, Lucia Filippi, Valentina Grazioli, Gualtiero Palareti, Raffaele Pesavento, Loris Roncon, Laura Scelsi, Antonella Tufano
Venous thromboembolism (VTE), including pulmonary embolism and deep venous thrombosis, is the third most common cause of cardiovascular death. The management of the acute phase of VTE has already been described in several guidelines. However, the management of the follow-up (FU) of these patients has been poorly defined. This consensus document, created by the Italian cardiologists, wants to clarify this issue using the currently available evidence in VTE. Clinical and instrumental data acquired during the acute phase of the disease are the cornerstone for planning the FU...
May 2017: European Heart Journal Supplements: Journal of the European Society of Cardiology
https://www.readbyqxmd.com/read/28616050/occult-cancer-in-patients-with-deep-vein-thrombosis-in-a-general-hospital-at-mexico-city-a-pilot-study
#10
Christian O Ramírez-Serrano Torres, Edgardo Román-Guzmán, Carlos-Manuel Ortiz-Mendoza
BACKGROUND: We aimed to explore the frequency of occult cancer in patients with deep-vein thrombosis (DVT) at a general hospital in Mexico City. MATERIALS AND METHODS: From March 2012 to February 2015, all patients with primary DVT of lower extremities attended in the emergency department of our hospital were studied. Initially, all patients were evaluated with clinical history, physical examination, basic laboratories, abdominal ultrasound, chest X-ray, and duplex venous ultrasonography...
2017: Journal of Research in Medical Sciences: the Official Journal of Isfahan University of Medical Sciences
https://www.readbyqxmd.com/read/28275022/correction-out-of-the-blue-finger-ischaemia-and-occult-colorectal-cancer
#11
(no author information available yet)
Schattner A. Out of the blue finger ischaemia and occult colorectal cancer. BMJ Case Rep 2017 (Epub ahead of print 8 Mar 2017). doi:10.1136/bcr-2016-218779 The correct title of the article is: Out of the blue—finger ischaemia and occult colorectal cancer.
March 8, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/27994217/desmoid-fibromatosis-presenting-as-deep-venous-thrombosis-a-case-report-and-discussion
#12
Lisa M Marks, Susan J Neuhaus
BACKGROUND Venous thromboembolism (VTE), comprising deep vein thrombosis (DVT) and pulmonary embolism (PE), is a common, serious cardiovascular event. Predisposing factors include genetic disorders, immobility, and underlying malignancy. Soft tissue tumors are by contrast rare, but should be included in the differential etiology of DVT, especially when the patient is young and has few thrombotic risk factors. CASE REPORT We present a 40-year-old patient whose initial diagnosis was spontaneous DVT of the lower leg, treated conventionally...
December 20, 2016: American Journal of Case Reports
https://www.readbyqxmd.com/read/27771600/deep-venous-thrombosis-as-the-single-sign-of-unexpected-metastatic-urinary-tract-cancer-in-a-patient-with-a-history-of-cutaneous-melanoma-a-case-report
#13
Joachim Mikkelsen, Steen Henrik Matzen
INTRODUCTION: Cancer is a recognized risk factor of venous thromboembolism (VTE) as it induces a prothrombotic state through various mechanisms of activation of coagulation. Recognizing occult cancer as a risk factor is equally important. In patients with no known thromboembolic risk factors, utilizing PET/CT as a screening tool may be considered in order to reveal occult malignancy associated with otherwise unexplainable VTE. METHODS: This case report has been reported in line with the SCARE criteria...
2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27455158/timing-of-chemical-thromboprophylaxis-and-deep-vein-thrombosis-in-major-colorectal-surgery-a-randomized-clinical-trial
#14
RANDOMIZED CONTROLLED TRIAL
Karen N Zaghiyan, Harry C Sax, Emily Miraflor, David Cossman, Willis Wagner, James Mirocha, Bruce Gewertz, Phillip Fleshner
OBJECTIVE: To identify the optimal timing of perioperative chemical thromboprophylaxis (CTP) and incidence of occult preoperative deep vein thrombosis (OP-DVT) in patients undergoing major colorectal surgery. BACKGROUND: There is limited Level 1 data regarding the optimal timing of CTP in major colorectal surgery and the incidence of OP-DVT remains unclear. Both issues influence the occurrence of venous thromboembolism (VTE) and may impact Medicare reimbursement because of penalties for hospital-acquired conditions...
October 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27268941/an-algorithmic-approach-to-management-of-venous-thromboembolism
#15
Prajwal Dhakal, Krishna Gundabolu, Vijaya R Bhatt
Venous thromboembolism (VTE) is associated with significant morbidity and mortality. Factors such as the presence of transient risk factors for VTE, risk of bleeding, and location of deep vein thrombosis (DVT) determine the duration of anticoagulation. Extended anticoagulation is offered to patients with unprovoked pulmonary embolism (PE) or proximal DVT and a low risk of bleeding. Anticoagulation for 3 months is advised in patients with provoked DVT or PE, high risk of bleeding, and isolated distal or upper extremity DVT...
September 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/27264137/ovarian-malignancy-unmasked-by-venous-gangrene-in-a-patient-on-warfarin-therapy-a-case-report
#16
Amgad Said, Justin Keasberry
BACKGROUND: Venous gangrene complicating deep vein thrombosis in the context of anticoagulation use in patients with gynecologic malignancy is rarely reported. We report an unusual presentation of venous gangrene of the lower limbs associated with warfarin therapy in a 53-year-old woman from the Cook Islands with an occult ovarian cancer. CASE PRESENTATION: A 53-year-old woman of Cook Islands origin presented with exertional dyspnea, rapid atrial fibrillation, bilateral lower limb edema, and painful digital ischemia of her hallux...
June 6, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27257452/massive-gas-gangrene-secondary-to-occult-colon-carcinoma
#17
Andrew S Griffin, Matthew D Crawford, Rajan T Gupta
Gas gangrene is a rare but often fatal soft-tissue infection. Because it is uncommon and the classic symptom of crepitus does not appear until the infection is advanced, prompt diagnosis requires a high index of suspicion. We present a case report of a middle-aged man who presented with acute onset lower-extremity pain that was initially thought to be due to deep vein thrombosis. After undergoing workup for pulmonary embolism, he was found to have massive gas gangrene of the lower extremity secondary to an occult colon adenocarcinoma and died within hours of presentation from multisystem organ failure...
June 2016: Radiology Case Reports
https://www.readbyqxmd.com/read/27237325/investigation-of-unprovoked-venous-thromboembolism-a-case-for-a-tempered-approach
#18
T I Hussain, J A Stephenson, B Das, S Naqvi, R Verma, D Barnes
AIM: To investigate and review the diagnostic yield for occult malignancy in patients who underwent abdominopelvic computed tomography (CT) after the diagnosis of unprovoked venous thromboembolism (VTE) with reference to the guidelines set by The National Institute for Health and Clinical Excellence (NICE). MATERIALS AND METHODS: We retrospectively reviewed all unprovoked VTE diagnosed within a large teaching hospital over a period of 21 months for subsequent imaging investigations and cancer diagnoses...
October 2016: Clinical Radiology
https://www.readbyqxmd.com/read/27161696/po-08-venous-thrombosis-and-cancer-about-an-algerian-series
#19
M Berrah-Bennaceur, A Berrah, M Arrada
INTRODUCTION: Venous thromboembolism (VTE) and cancer is an association with increasing progression and poor prognosis. It always raises many issues including the question what is the exact incidence of occult cancer in a VTE? Is there a simple biological marker with a predictive value of this combination? Can we define a strategy thromboprophylaxis in cancer patients? AIM: To try to answer these questions we conducted a prospective study. MATERIALS AND METHODS: We collected 140 patients with VTE, 70 of neoplastic origin ( group A) and 70 of other etiologies (Group B)...
April 2016: Thrombosis Research
https://www.readbyqxmd.com/read/27073982/impact-of-d-dimer-for-prediction-of-incident-occult-cancer-in-patients-with-unprovoked-venous-thromboembolism
#20
Donghee Han, Bríain ó Hartaigh, Ji Hyun Lee, In-Jeong Cho, Chi Young Shim, Hyuk-Jae Chang, Geu-Ru Hong, Jong-Won Ha, Namsik Chung
BACKGROUND: Unprovoked venous thromboembolism (VTE) is related to a higher incidence of occult cancer. D-dimer is clinically used for screening VTE, and has often been shown to be present in patients with malignancy. We explored the predictive value of D-dimer for detecting occult cancer in patients with unprovoked VTE. METHODS: We retrospectively examined data from 824 patients diagnosed with deep vein thrombosis or pulmonary thromboembolism. Of these, 169 (20...
2016: PloS One
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