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Advances in Experimental Medicine and... 2017Venous thromboembolism (VTE) is a common medical condition, particularly after surgical interventions. Many studies have shown that development of VTE, including both... (Review)
Review
Venous thromboembolism (VTE) is a common medical condition, particularly after surgical interventions. Many studies have shown that development of VTE, including both deep vein thrombosis (DVT) and pulmonary embolism (PE), is more common in surgical patients with cancer than in patients without cancer. This chapter focuses on VTE in brain tumor patients, including their pathogenesis, presentation, diagnosis, and treatment. Topics discussed included a brief overview of VTE followed by an in-depth discussion of the VTE risks brain tumor patients face in the post-operative period. We conclude with a summary of various recommendations on VTE prophylaxis and a discussion of the controversial nature of VTE chemoprophylaxis for patients undergoing transcranial operations for brain tumors.
Topics: Anticoagulants; Brain Neoplasms; Heparin; Humans; Intermittent Pneumatic Compression Devices; Neurosurgical Procedures; Practice Guidelines as Topic; Pulmonary Embolism; Risk Factors; Stockings, Compression; Venous Thromboembolism; Venous Thrombosis
PubMed: 27628002
DOI: 10.1007/5584_2016_117 -
Disaster Medicine and Public Health... Feb 2023Among natural disasters, earthquake is associated with heavy fatalities and financial damages, causing considerable mortality. The complications resulting from getting... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
Among natural disasters, earthquake is associated with heavy fatalities and financial damages, causing considerable mortality. The complications resulting from getting trapped in rubble, secondary traumas, obligation to reside in temporary shelters, along with other factors such as limited mobility, stress, and dehydration, predispose earthquake survivors to Deep Vein Thrombosis (DVT). The aim of the present study is to investigate the rate of DVT after an earthquake using a systematic review and meta-analysis.
METHODS
To perform the present study, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was used. The protocol of this review study has been registered in the International Perspective Register of Systematic Review (PROSPERO) with the code of CRD42021290375. Credible data resources including PubMed, Scopus, Web of Science, Science Direct, Google Scholar, Magiran, SID, and Embase were used for extracting relevant studies. Random effect model was used to perform the meta-analysis. I was ritualized to investigate heterogeneity across the studies. Publication bias of studies was evaluated using the Begg test.
RESULTS
In this study, 267 primary studies were identified and extracted. After removing the duplicate ones and the screening, eventually 1 final studies were chosen for the meta-analysis. Based on the meta-analysis results, the total rate of DVT was 9.07% (95% confidence interval [CI]: 7.32-10.81; I = 97.9%; = 0<0.001). Analysis of DVT in the subgroups of the general population and patient survivors were 11.43% (95% CI: 9.06-13.79; I = 98%; = 0<0.001) and 2.51% (95% CI: 0.04-4.63; I = 77.7%; = 0.001). Also, based on the Begg test, the publication bias in the chosen studies was not considerable.
CONCLUSIONS
DVT rate in earthquake survivors is higher compared with other disasters, and over time it finds a growing trend. After earthquake, the focus of rescue and health-care teams is on individuals with observable injuries and damages. Because DVT is first asymptomatic but has fatal consequences, including pulmonary embolism and sudden death, it should be incorporated in health's status assessment of earthquake-stricken people as well as screening and diagnostic programs of health-care providers.
Topics: Humans; Venous Thrombosis; Earthquakes; Pulmonary Embolism; Disasters
PubMed: 36785532
DOI: 10.1017/dmp.2022.268 -
European Journal of Preventive... May 2022
Topics: Aorta; Consensus; Humans; Neoplasms; Peripheral Vascular Diseases; Pulmonary Circulation; Vascular Diseases; Venous Thrombosis; Ventricular Function, Right
PubMed: 34463767
DOI: 10.1093/eurjpc/zwab117 -
American Family Physician Mar 2017Pulmonary embolism and deep venous thrombosis are the two most important manifestations of venous thromboembolism (VTE), which is the third most common life-threatening...
Pulmonary embolism and deep venous thrombosis are the two most important manifestations of venous thromboembolism (VTE), which is the third most common life-threatening cardiovascular disease in the United States. Anticoagulation is the mainstay of VTE treatment. Most patients with deep venous thrombosis or low-risk pulmonary embolism can be treated in the outpatient setting with low-molecular-weight heparin and a vitamin K antagonist (warfarin) or direct-acting oral anticoagulants. Inpatient treatment of VTE begins with parenteral agents, preferably low-molecular-weight heparin. Unfractionated heparin is used if a patient is hemodynamically unstable or has severe renal insufficiency, high bleeding risk, hemodynamic instability, or morbid obesity. Direct-acting oral anticoagulants are an alternative; however, concerns include cost and use of reversing agents (currently available only for dabigatran, although others are in development). If warfarin, dabigatran, or edoxaban is used, low-molecular-weight or unfractionated heparin must be administered concomitantly for at least five days and, in the case of warfarin, until the international normalized ratio becomes therapeutic for 24 hours. Hemodynamically unstable patients with a low bleeding risk may benefit from thrombolytic therapy. An inferior vena cava filter is not indicated for patients treated with anticoagulation. Current guidelines recommend anticoagulation for a minimum of three months. Special situations, such as active cancer and pregnancy, require long-term use of low-molecular-weight or unfractionated heparin. Anticoagulation beyond three months should be individualized based on a risk/benefit analysis. Symptomatic distal deep venous thrombosis should be treated with anticoagulation, but asymptomatic patients may be monitored with serial imaging for two weeks and treated only if there is extension.
Topics: Anticoagulants; Education, Medical, Continuing; Heparin; Humans; Pulmonary Embolism; United States; Venous Thrombosis; Warfarin
PubMed: 28290648
DOI: No ID Found -
Digestive Diseases and Sciences May 2024Acute pancreatitis is an acute inflammatory condition of the pancreas that has not only local but systemic effects as well. Venous thrombosis is one such complication... (Review)
Review
Acute pancreatitis is an acute inflammatory condition of the pancreas that has not only local but systemic effects as well. Venous thrombosis is one such complication which can give rise to thrombosis of the peripheral vasculature in the form of deep vein thrombosis, pulmonary embolism, and splanchnic vein thrombosis. The prevalence of these complications increases with the severity of the disease and adds to the adverse outcomes profile. With better imaging and awareness, more cases are being detected, although many at times it can be an incidental finding. However, it remains understudied and strangely, most of the guidelines on the management of acute pancreatitis are silent on this aspect. This review offers an overview of the incidence, pathophysiology, symptomatology, diagnostic work-up, and management of venous thrombosis that develops in AP.
Topics: Humans; Venous Thrombosis; Pancreatitis; Acute Disease
PubMed: 38600412
DOI: 10.1007/s10620-024-08418-5 -
Journal of Vascular Surgery. Venous and... Mar 2020Venous thromboembolism (VTE) is a common disease with potentially devastating and long-term sequelae, such as pulmonary embolism and post-thrombotic syndrome (PTS).... (Review)
Review
OBJECTIVE
Venous thromboembolism (VTE) is a common disease with potentially devastating and long-term sequelae, such as pulmonary embolism and post-thrombotic syndrome (PTS). Given the mortality risk, prevalence of VTE, and limited access to diagnostic imaging, clinically relevant biomarkers for diagnosis and prognostication are needed. Therefore, this review aimed to summarize the data on clinically applicable biomarkers that best indicate acute VTE and chronic PTS.
METHODS
We reviewed the medical and scientific literature from 2001 to 2019 for VTE biomarkers. Randomized controlled trials, meta-analyses, and review articles were included. Primary basic research papers with no clinical applicability, opinion papers, institutional guidelines, and case reports were excluded.
RESULTS
We highlight the diagnostic value of D-dimer alongside other promising biomarkers, including cellular adhesion molecules, P-selectin, cytokines (interleukins 6 and 10), fibrin monomer complexes, and coagulation factors (factor VIII).
CONCLUSIONS
High-sensitivity D-dimer remains the most clinically established VTE biomarker. Current research endeavors are under way to identify more precise biomarkers of VTE and PTS.
Topics: Animals; Biomarkers; Fibrin Fibrinogen Degradation Products; Humans; Inflammation Mediators; Postthrombotic Syndrome; Predictive Value of Tests; Prognosis; Risk Factors; Venous Thromboembolism; Venous Thrombosis
PubMed: 32067731
DOI: 10.1016/j.jvsv.2019.09.008 -
Phlebology Jul 2017Postthrombotic syndrome is the most common complication after deep venous thrombosis. Postthrombotic syndrome is a debilitating disease and associated with decreased... (Review)
Review
Postthrombotic syndrome is the most common complication after deep venous thrombosis. Postthrombotic syndrome is a debilitating disease and associated with decreased quality of life and high healthcare costs. Postthrombotic syndrome is a chronic disease, and causative treatment options are limited. Prevention of postthrombotic syndrome is therefore very important. Not all patients develop postthrombotic syndrome. Risk factors have been identified to try to predict the risk of developing postthrombotic syndrome. Age, gender, and recurrent deep venous thrombosis are factors that cannot be changed. Deep venous thrombosis location and extent seem to predict severity of postthrombotic syndrome and are potentially suitable as patient selection criteria. Residual thrombosis and reflux are known to increase the incidence of postthrombotic syndrome, but are of limited use. More recently developed treatment options for deep venous thrombosis, such as new oral factor X inhibitors and catheter-directed thrombolysis, are available at the moment. Catheter-directed thrombolysis shows promising results in reducing the incidence of postthrombotic syndrome after deep venous thrombosis. The role of new oral factor X inhibitors in preventing postthrombotic syndrome is still to be determined.
Topics: Administration, Oral; Adult; Algorithms; Anticoagulants; Catheterization; Factor X; Female; Humans; Incidence; Lower Extremity; Male; Postthrombotic Syndrome; Risk Factors; Thrombolytic Therapy; Venous Thrombosis
PubMed: 27251397
DOI: 10.1177/0268355516652010 -
Orthopaedic Surgery Aug 2022Deep venous thrombosis (DVT) has been characterized by a disorder of venous return caused by abnormal blood clotting in deep veins. It often occurs in the lower limbs... (Review)
Review
Deep venous thrombosis (DVT) has been characterized by a disorder of venous return caused by abnormal blood clotting in deep veins. It often occurs in the lower limbs and is a common complication in orthopaedics. Therefore, relevant professional organizations domestic and overseas had formulated and constantly updated relevant guidelines to prevent the occurrence of DVT. According to the management strategy of the guidelines, the incidence of DVT can be significantly reduced. However, due to the variety of fractures types, the guidelines cannot expound precautions and characteristics of DVT for all fracture types at present, and there are other related unresolved problems. For example, there is still a lack of consistent optimal strategies for the management of DVT following isolated lower extremity fractures with a higher incidence. The best anticoagulant strategies for patients with upper limb fractures, pediatric fractures, and those combined with other injuries are rarely described in orthopaedic guidelines, but such fractures are common in clinical orthopaedics. The long-term complications after DVT, such as post-thrombotic syndrome, are not well-understood. In the absence of clear guidance, orthopaedic surgeons often resort to empiric anticoagulation or conservative treatment, so the prevention effects of DVT are inconsistent. The purpose of this review is to summarize the characteristics of DVT events after isolated lower extremity fractures and to discuss the unsolved issues in the guidelines by reviewing the previous literature and tracing the history of DVT discovery, to provide more scientific and comprehensive recommendations for the prediction and prevention of DVT.
Topics: Anticoagulants; Child; Fractures, Bone; Humans; Incidence; Lower Extremity; Retrospective Studies; Risk Factors; Venous Thrombosis
PubMed: 35633091
DOI: 10.1111/os.13306 -
Neurological Research Nov 2023Venous thromboembolism is one of the causes of sudden death in Parkinson's Disease (PD). Few studies have investigated the correlation between PD and deep venous...
INTRODUCTION
Venous thromboembolism is one of the causes of sudden death in Parkinson's Disease (PD). Few studies have investigated the correlation between PD and deep venous thrombosis (DVT). This study aimed to investigate the frequency of DVT in PD patients prospectively.
MATERIAL AND METHOD
Demographic characteristics of 37 PD patients without known risk factors for DVT, disease duration, Hoehn-Yahr (H - Y) stage, oxygen saturation (SpO2) and heart rate values with pulse oximetry, use of assistive devices, waist and knee circumference measurements, and modified Medical Research Council (mMRC) dyspnea score was recorded. Both legs were evaluated for thrombus by Doppler venous ultrasound (US).
RESULTS
With the H-Y stage of the disease duration, a positive correlation was determined between the H-Y stage and mMRC. Disease duration was negatively correlated with BMI and positively correlated with the need for assistance. Assistive device use was positively associated with age and mMRC. DVT was detected in only one patient. When our patients' files were reviewed after 1.5 years, one patient was hospitalized with the diagnosis of submassive pulmonary embolism.
CONCLUSION
Attention should be paid to the development of DVT in elderly patients with advanced stages of PD, progression in the H-Y stage, use of assistive devices, and progression in dyspnea scoring. There is also a need for studies on the benefit of DVT prophylaxis in PD patients with a high risk of venous thromboembolism.
Topics: Humans; Aged; Venous Thromboembolism; Venous Thrombosis; Incidence; Parkinson Disease; Pulmonary Embolism; Risk Factors; Dyspnea; Retrospective Studies
PubMed: 37699515
DOI: 10.1080/01616412.2023.2257441 -
The American Journal of the Medical... Aug 2018Postthrombotic syndrome is a common long-term complication of proximal lower extremity deep venous thrombosis, which not only significantly affects the quality of life... (Review)
Review
Postthrombotic syndrome is a common long-term complication of proximal lower extremity deep venous thrombosis, which not only significantly affects the quality of life of patients but also imposes a substantial financial burden on our healthcare system. Due to limited awareness and inability of physicians to recognize and treat this condition early, its prevalence is steadily increasing. In this article, we review the pathophysiology, the risk factors involved, diagnostic workup, and the various management options available to treat this condition.
Topics: Humans; Postthrombotic Syndrome; Quality of Life; Risk Factors
PubMed: 29779730
DOI: 10.1016/j.amjms.2018.03.004