Management of venous thrombo-embolism: an update

Venous thrombo-embolism is the third most frequent acute cardiovascular syndrome after myocardial infarction and stroke. Recently published landmark trials paved the way for significant progress in the management of the disease and provided the evidence for the ESC Pulmonary Embolism (PE) Guidelines 2014 update. Risk stratification strategies for non-high-risk PE continue to evolve, with an increasing emphasis on clinical prediction rules and right ventricular (RV) assessment on computed tomographic pulmonary angiography. In the field of anticoagulation treatment, pharmacogenetic testing for vitamin K antagonists on top of clinical parameters was not found to offer a significant benefit during the initiation phase; on the other hand, dosing based on the patient's clinical data seems superior to fixed loading regimens. The phase 3 trial programme of new oral anticoagulants in the treatment of venous thrombo-embolism has been completed, and the results indicate that these agents are at least as effective and probably cause less major bleeding than currently standard treatment. A multicentre prospective phase 4 trial will determine whether early discharge and out-of-hospital treatment of low-risk PE with the oral factor Xa inhibitor rivaroxaban is feasible, effective, and safe. For intermediate-risk PE defined on the basis of imaging tests and laboratory biomarkers, the bleeding risks of full-dose thrombolytic treatment appear too high to justify its use, unless clinical signs o...
Source: European Heart Journal - Category: Cardiology Authors: Tags: Frontiers in cardiovascular medicine Source Type: research

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Conclusion: The FHS can favor the care and control of SAH in Brazil. Thus, it must receive investments that guarantee its effectiveness.
Source: Revista Brasileira de Epidemiologia - Category: Epidemiology Source Type: research
ABSTRACT: Introduction: In high-income countries, persons of high socioeconomic status (SES) have a lower cardiovascular risk. However, in middle and low-income countries, the results are controversial. Objective: To evaluate the association between family income and cardiovascular risk factors in young adults. Methods: A total of 2,063 individuals of a birth cohort initiated in 1978/79 in the city of Ribeir ão Preto, Brazil, were evaluated at age of 23/25 years. Cardiovascular risk factors (hypertension, sedentary lifestyle, smoking, low high-density lipoprotein (HDL)-cholesterol, high low-density lipoprotein (LDL)...
Source: Revista Brasileira de Epidemiologia - Category: Epidemiology Source Type: research
Conclusion: The findings, such as the inverse relationship with tuberculosis treatment discontinuation in the group of people with comorbidity, reinforce the importance of integrated actions in health services to change the scenario of this challenging comorbidity.
Source: Revista Brasileira de Epidemiologia - Category: Epidemiology Source Type: research
Authors: Rathi V, Ish P, Singh G, Tiwari M, Goel N, Gaur SN Abstract Non-anemic iron deficiency has been studied in heart failure, but studies are lacking in chronic obstructive pulmonary disease (COPD). The potential clinical implications of association of iron deficiency with the severity of COPD warrant research in this direction. This was an observational, cross-sectional study on patients with COPD to compare disease severity, functional status and quality of life in non-anemic patients with COPD between two groups - iron deficient and non-iron deficient. Stable non-anemic COPD with no cause of bleeding were e...
Source: Monaldi Archives for Chest Disease - Category: Respiratory Medicine Tags: Monaldi Arch Chest Dis Source Type: research
This study aims to further characterise the LALV and proposes a novel classification for its relation to other veins.Dissection of the LRV system, including the left suprarenal vein (LSV), left gonadal vein (LGV) and LALV, was performed in 38 cadavers. Their drainage points into the LRV were recorded, and measurements taken of the distances from these points to the junction of the LRV and inferior vena cava (IVC).The position of the LRV in relation to the aorta was anterior in 35 cases (92%), entirely posterior in 1 case (3%), and circumaortic in 2 cases (5%). Duplication of the LSV and LGV occurred in 6 (16%) and 10 (27%)...
Source: The Surgeon - Category: Surgery Source Type: research
Publication date: Available online 20 February 2020Source: Journal of Vascular Surgery: Venous and Lymphatic DisordersAuthor(s): Arash Fereydooni, Naiem NassiriAbstractThe lateral marginal vein is an anomalous clinical entity found in association with Klippel-Trénaunay and other PIK3CA-related overgrowth syndromes. Although it is reported to affect 
Source: Journal of Vascular Surgery: Venous and Lymphatic Disorders - Category: Surgery Source Type: research
No abstract available
Source: Annals of Surgery - Category: Surgery Tags: BRIEF CLINICAL REPORTS Source Type: research
No abstract available
Source: Annals of Surgery - Category: Surgery Tags: BRIEF CLINICAL REPORTS Source Type: research
Publication date: Available online 20 February 2020Source: Respiratory InvestigationAuthor(s): Yasuhiro Nakajima, Toshiyuki Minami, Hirotoshi Ishigaki, Eirou Sakai, Ryo Takahashi, Takashi Yokoi, Kozo Kuribayashi, Takashi KijimaAbstractA superior vena cava (SVC) aneurysm is a rare disease that can be confused with upper mediastinal tumor. A 57-year-old female visited our hospital regarding an abnormal shadow in her mediastinum on a chest X-ray. Upon closer examinations, which included three-dimensional computed tomography, we diagnosed it as a SVC aneurysm. Since her SVC aneurysm was regarded as fusiform type at low risk of...
Source: Respiratory Investigation - Category: Respiratory Medicine Source Type: research
Publication date: Available online 20 February 2020Source: Diagnostic and Interventional ImagingAuthor(s): A. David, E. Frampas, F. Douane, C. Perret, F. Leaute, D. Cantarovich, G. Karam, J. BranchereauAbstractPancreas transplantation exposes to high rates of complications, either vascular (thrombosis, stenosis, pseudoaneurysm, arteriovenous fistula) or nonvascular (fluid collection, graft rejection). With advances in percutaneous and endovascular techniques, interventional radiologists are increasingly involved in the management of these complications. In this article, we review the anatomical considerations relevant to p...
Source: Diagnostic and Interventional Imaging - Category: Radiology Source Type: research
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