Postoperative Thromboprophylaxis With New Oral Anticoagulants is Superior to LMWH in Hip Arthroplasty Surgery: Findings from the Swedish Registry.
CONCLUSIONS: New oral anticoagulants were associated with a lower risk of symptomatic DVT and symptomatic PE in this large, registry study, and we observed no differences in the risk of bleeding, reoperation, or death between the groups. Although we were able to control for a number of potential confounding variables, we cannot ascertain the indications that drove the prescription decisions in this setting, and there were important between-group differences in terms of duration of thromboprophylaxis (new oral anticoagulants generally were used for a longer period of time after surgery). Future studies, preferably large randomized trials with pragmatic inclusion criteria, to analyze symptomatic DVT, symptomatic PE and death are needed to confirm or refute our findings. LEVEL OF EVIDENCE: Level III, therapeutic study. PMID: 31136431 [PubMed - in process]
In this study, we describe the design of PE Dx, a CDS built to support the diagnosis of pulmonary embolism (PE) in the emergency department (ED) using human factors methods. PMID: 31431589 [PubMed - in process]
In conclusion, in order for a mHealth application to be successfully implemented in a context where many digital services are already in use, it is not enough to support important activities in the current workflow. The mHealth application will need to be carefully integrated into the existing eco-system of healthcare applications to increase the chances of adoption. PMID: 31431577 [PubMed - in process]
Authors: Erlingsdottir G, Persson J, Johansson G, Larsson R, Rydenfält C Abstract The responsibilities for delivery of care in Sweden is divided between the regions and the municipalities. The regions run the hospitals and the primary care centres (PCCs) whereas the municipalities are responsible for homecare nursing and nursing homes. The homecare nurses and the doctors they need to seek advice from, thus belong to different organizations/contexts. As more patients with multi- and long-term illnesses are taken care of in their homes the workload of the homecare nurses has increased. A new healthcare agreement...
PMID: 31433699 [PubMed - in process]
Abstract While the opioid epidemic has garnered significant attention, the use of methamphetamines is growing worldwide independent of wealth or region. Following overdose and accidents, the leading cause of death in methamphetamine users is cardiovascular disease, because of significant effects of methamphetamine on vasoconstriction, pulmonary hypertension, atherosclerotic plaque formation, cardiac arrhythmias, and cardiomyopathy. In this review, we examine the current literature on methamphetamine-induced changes in cardiovascular health, discuss the potential mechanisms regulating these varied effects, and high...
PMID: 31433697 [PubMed - in process]
CONCLUSIONS The administration of tranexamic acid in two IV doses of 10-15 mg/kg to patients with total knee and hip arthroplasty has proven to be efficient. A higher efficacy of TXA was reported in TKA and due to routine administration of TXA the postoperative autotransfusion system (ORTHO P.A.S.) ceased to be used in knee replacement surgery. Key words:total hip arthroplasty, total knee arthroplasty, tranexamic acid, blood loss, allogeneic transfusion, autotransfusion, postoperative complications. PMID: 31070570 [PubMed - in process]
DiscussionSingle use of IPC device could not reach significant level of DVT prophylaxis compared to control group and only chemoprophylaxis showed significantly reduce the incidence of overall DVT following TKA. Single use of IPC device does not show effective thromboprophylaxis in a low DVT incidence population.Level of evidenceIII, case control study.
CONCLUSIONS More attention should be paid to the increased risk of wound complications and knee swelling associated with rivaroxaban, although the hidden blood loss was similar in both groups. PMID: 28174415 [PubMed - in process]
The objectives of our study were to analyze the demographic and perioperative factors of RA patients that may affect post-TKA outcomes, as well as to assess the 30-day complication rates compared to osteoarthritis patients. We retrospectively evaluated the National Surgical Quality Improvement Program (NSQIP) database from 2006 to 2012 to assess all patients who underwent a primary TKA and had a diagnosis of rheumatoid arthritis (n = 141) or primary knee osteoarthritis (n = 7125). We evaluated and compared the demographic factors, social factors, preoperative factors, operative factors, and post...