Interventions for implementation of thromboprophylaxis in hospitalized patients at risk for venous thromboembolism.

CONCLUSIONS: We reviewed RCTs that implemented a variety of system-wide strategies aimed at improving thromboprophylaxis in hospitalized patients. We found increased prescription of prophylaxis associated with alerts and multifaceted interventions, and increased prescription of appropriate prophylaxis associated with alerts. While multifaceted interventions were found to be less effective than alerts, a multifaceted intervention with an alert was more effective than one without an alert. Alerts, particularly computer alerts, were associated with a reduction in symptomatic VTE at three months, although there were not enough studies to pool computer alerts and human alerts results separately.Our analysis was underpowered to assess the effect on mortality and safety outcomes, such as bleeding.The incomplete reporting of relevant study design features did not allow complete assessment of the certainty of the evidence. However, the certainty of the evidence for improvement in outcomes was judged to be better than for our previous review (low- to moderate-certainty evidence, compared to very low-certainty evidence for most outcomes). The results of our updated review will help physicians, hospital administrators, and policy makers make practical decisions about adopting specific system-wide measures to improve prescription of thromboprophylaxis, and ultimately prevent VTE in hospitalized patients. PMID: 29687454 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research

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This study aimed to evaluate the effect of poly(dimethylsiloxane) on the mechanical properties of chitosan-alginate (CA) polyelectrolyte complexes (PECs) with potential application as wound dressing biomaterials. For that purpose, different amounts of poly(dimethylsiloxane) were incorporated during the formulation of the PECs. Results showed that the highest tensile strength was observed when using 0.1 g of poly(dimethylsiloxane) per gram of PEC (CAS10). This formulation was also non-hemolytic, capable of inducing thrombus formation to potentially reduce bleeding, and additionally presented high stability when exposed to...
Source: Materials Science and Engineering: C - Category: Materials Science Source Type: research
Authors: Tantry U, Chaudhary R, Kubica J, Bliden K, Gurbel PA Abstract INTRODUCTION: All oral P2Y12 receptor blockers are associated with some degree of delayed onset and offset of pharmacodynamic (PD) effects in patients with acute coronary syndromes (ACS) undergoing percutaneous coronary intervention (PCI). Although intravenous glycoprotein IIb/IIIa inhibitors are associated with rapid onset of action, they are also associated with delayed offset and other limitations such as elevated bleeding risk and thrombocytopenia. Areas covered: In this review, the authors focus on cangrelor, an intravenous, reversible P2Y1...
Source: Expert Opinion on Pharmacotherapy - Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research
Objective: Non-selective β-blockers (NSBBs) are used in liver cirrhosis (LC) to prevent variceal bleeding because they decrease portal pressure. A main risk factor for the development of portal vein thrombosis (PVT) in LC is decreased portal vein inflow velocity. The aim of our study was to examine retrospectively the inci dence of PVT and its correlation with the use of β-blockers in a cohort of LC patients. Subjects and Methods: Data from 230 LC patients (90% Child-Pugh class A), who had been followed up for at least 5 years, were reviewed. Diagnosis of PVT was made by ultrasound. The presence of PVT was evalua...
Source: Medical Principles and Practice - Category: Internal Medicine Source Type: research
ConclusionsHAPR was infrequently present in a large registry of patients undergoing PCI. There was no clear relationship between HAPR and 2-year clinical outcomes. Investigation of antiplatelet regimens without aspirin after DES implantation are ongoing and should inform future management of patients undergoing PCI.
Source: American Heart Journal - Category: Cardiology Source Type: research
Abstract Varan B, Yakut K, Harman A. Transcatheter retrieval of embolized catheter using venovenous loop in a neonate. Turk J Pediatr 2018; 60: 113-115. Umbilical venous catheters are reliable in providing adequate medical care for premature babies however complications include infections, bleeding, thrombosis, catheter occlusion and migration of a piece of catheter to other parts in the body. Here, we present a case with migration of a piece of umbilical venous catheter which has been trapped between hepatic vein and right upper pulmonary vein causing apnea episodes, recurrent respiratory symptoms, need for mecha...
Source: The Turkish Journal of Pediatrics - Category: Pediatrics Authors: Tags: Turk J Pediatr Source Type: research
ors Venous thromboembolism (VTE) complicates the clinical course of approximately 5–10% of all cancer patients. Anticoagulation of the cancer patient often presents unique challenges as these patients have both a higher risk of recurrent VTE and a higher risk of bleeding than patients without cancer. Although low molecular weight heparins (LMWH) are the standard of care for the management of cancer-associated VTE, their use requires once or twice daily subcutaneous injections, which can be a significant burden for many cancer patients who often require a long duration of anticoagulation. The direct oral antic...
Source: Cancers - Category: Cancer & Oncology Authors: Tags: Review Source Type: research
Objective: Non-selective β-blockers (NSBBs) are used in liver cirrhosis (LC) to prevent variceal bleeding because they decrease portal pressure. A main risk factor for the development of portal vein thrombosis (PVT) in LC is decreased portal vein inflow velocity. The aim of our study was to examine retrospectively the inci dence of PVT and its correlation with the use of β-blockers in a cohort of LC patients. Subjects and Methods: Data from 230 LC patients (90% Child-Pugh class A), who had been followed up for at least 5 years, were reviewed. Diagnosis of PVT was made by ultrasound. The presence of PVT was evalua...
Source: Medical Principles and Practice - Category: Internal Medicine Source Type: research
Publication date: Available online 14 August 2018Source: Cor et VasaAuthor(s): Štefan Volovár, Radka Tancošová, Richard RokytaAbstractOral anticoagulation therapy is used in patients with various diagnoses to reduce the risk of thromboembolic events or to induce a hypocoagulation state to facilitate dissolution of a thrombus. In clinical practice we often encounter anticoagulated patients, many of whom have been diagnosed with nonvalvular atrial fibrillation. Each year a significant number of these patients undergo a medical procedure, which, in some cases, requires temporary discontinuation of ...
Source: Cor et Vasa - Category: Cardiology Source Type: research
Publication date: September 2018Source: Archives of Cardiovascular Diseases Supplements, Volume 10, Issues 3–4Author(s): Anne Moreau de Bellaing, Fanny Bajolle, Ayman Haydar, Pascal Vouhé, Damien BonnetIntroductionSystemic atrioventricular mechanical valve replacement (SAVR) in children is challenging particularly in the youngest because of poor long-term outcomes.MethodsWe reviewed the clinical and surgical records of 96 children who underwent SAVR procedures (n = 110) in Necker hospital between 2000 and 2017. The median age and the median weight at first operation were respectively 3.1 years (range...
Source: Archives of Cardiovascular Diseases Supplements - Category: Cardiology Source Type: research
RBCs are the most abundant circulating cells in humans and typically comprise 35% to 45% of the blood volume (hematocrit). Anemia is associated with an increase in bleeding, and epidemiological studies have shown an association between an elevated hematocrit and thrombosis. RBCs may contribute to hemostasis and thrombosis via mechanisms that include platelet margination leading to an increase in the near-wall platelet concentration, blood viscosity, thrombin generation, and platelet activation. In this issue of the JCI, Klatt et al. report that binding of the Fas ligand FasL on the surface of platelets to its cognate recep...
Source: Journal of Clinical Investigation - Category: Biomedical Science Authors: Source Type: research
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