Better ultrasound protocols slash trauma imaging overuse

When lower extremity duplex ultrasound screening protocols for the trauma department...Read more on AuntMinnie.comRelated Reading: General practitioners accurately diagnose DVT with US Role of imaging modalities is changing for PE diagnosis Ultrasound elevates diagnosis of pulmonary embolism Can ultrasound for deep vein thrombosis cause a PE? Ultrasound screening catches embolism in cancer patients
Source: AuntMinnie.com Headlines - Category: Radiology Source Type: news

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Abstract Diagnosis of deep vein thrombosis (DVT) requires a multifaceted approach that includes clinical assessment, evaluation of pre-test probability, and objective diagnostic testing. Common symptoms and signs of DVT are pain, swelling, erythema and dilated veins in the affected limb. The pre-test probability of DVT can be assessed using a clinical decision rule that stratifies DVT into "unlikely" or "likely". If DVT is "unlikely", refer for D-dimer test. If the D-dimer level is normal, DVT can be excluded; if the D-dimer level is increased, refer for compression ultrasound. If DVT...
Source: Med J Aust - Category: General Medicine Authors: Tags: Med J Aust Source Type: research
Conclusions: Proper assessment and timely diagnosis of VTE is clinically challenging but vital to ensure appropriate and cost-effective treatment. Conventional diagnostic imaging techniques have various limitations such as being unable to differentiate acute from chronic VTE and identify underlying causes for VTE (e.g. cancer). FDG PET/CT imaging can potentially play a significant role in the detection and assessment of VTE in selected cases.
Source: Journal of Nuclear Medicine - Category: Nuclear Medicine Authors: Tags: Educational Exhibit Posters Source Type: research
This study investigates the association of statins with thrombus resolution or improvement in patients with deep venous thrombosis (DVT).MethodsA retrospective study of the electronic medical records of consecutive adult patients presenting with lower extremity DVT was performed. Patients were divided into two groups based on statin therapy (statin group) or lack thereof (nonstatin group). The two groups were compared with respect to demographics, comorbidities, and risk factors for VTE. Initial as well as all subsequent ultrasound reports were reviewed for each patient to determine extent of DVT and subsequent change in t...
Source: Journal of Vascular Surgery: Venous and Lymphatic Disorders - Category: Surgery Source Type: research
This study demonstrates that cancer patients with IDDVT have a similar rate of VTE recurrence, subsequent hospital admission, rate of major bleeding, and overall survival compared to those with proximal events. These findings, if validated, suggest that treatment of cancer-associated IDDVT should mirror treatment of proximal events.DisclosuresKhorana: Janssen: Consultancy; Bayer: Consultancy; Pfizer: Consultancy; Sanofi: Consultancy.
Source: Blood - Category: Hematology Authors: Tags: 903. Outcomes Research-Non-Malignant Hematology: Poster III Source Type: research
Conclusions: Rivaroxaban significantly reduced VTE and VTE-related death during the on-treatment period but not during the full study period; over one-third of events occurred post discontinuation of study drug. The incidence of major bleeding was low. The Khorana risk score cut-off of ≥2 identified cancer patients at high risk of thrombotic events both at baseline (4.53%) and during study (8.79% with additional 1.66% arterial events in placebo group). These results should inform future recommendations regarding thromboprophylaxis in at-risk ambulatory cancer patients.(Funded by Janssen; ClinicalTrials.gov number, NCT02...
Source: Blood - Category: Hematology Authors: Tags: Late-Breaking Abstracts Session Source Type: research
Hematological cancer has risk of venous thromboembolism of 28 fold compared to sex and age adjusted incidence in general population (JAMA 2005;293:715-722). This risk increases in patients with MM receiving dexamethasone and immunomodulatory drug. Thus, thromboprophylaxis with aspirin in low risk patients and LMWH or warfarin in high risk patients are recommended (Leukemia 2008;22:414-423). Direct oral anticoagulants are promising due to their convenience and costs-effectiveness in preventing VTE in other settings. They have not been extensively studied in myeloma therapy.From January of 2010 to December of 2017, 105 with ...
Source: Blood - Category: Hematology Authors: Tags: 332. Antithrombotic Therapy Source Type: research
BackgroundProtein disulfide isomerase (PDI) is a thiol isomerase secreted by platelets and endothelial cells and is required for thrombus formation. We previously showed that quercetin flavonoids inhibit PDI and block thrombus formation following vascular injury in a mouse model. Quercetins are present in a wide range of fruits and vegetables and epidemiologic data suggest an antithrombotic effect. Initial human studies demonstrated that the oral administration of isoquercetin reduces PDI activity in plasma. To evaluate the antithrombotic strategy of inhibiting PDI, we performed a phase II trial to evaluate the efficacy of...
Source: Blood - Category: Hematology Authors: Tags: 332. Antithrombotic Therapy: New Drugs and Technology Source Type: research
Conclusions: The goal of this Quality Assessment initiative was to evaluate the risk of recurrent VTE in cancer patients to determine if distal DVT's or subsegmental PEs had a significantly lower rate of recurrence than other VTE episodes. Our analysis indicated that the risk of recurrent VTE is not related to the size of the index thrombosed vessel. Within PE, from large, proximal index events through to subsegmental PE, the risk of recurrent VTE is comparable. Similarly, there was only a trend towards lower risk of recurrent VTE in patients with an index distal DVT, versus proximal DVT. But this association was not stati...
Source: Blood - Category: Hematology Authors: Tags: 332. Antithrombotic Therapy: Poster I Source Type: research
This study was a single-center study. From July 2016 to December 2017, all patients with lung cancer who underwent surgery in our department were enrolled into this study. Except routine preoperative examinations, lower extremity Doppler ultrasound was performed in all patients before and after surgery to determine whether there was any newly developed deep venous thrombosis (DVT). Patients did not receive any prophylactic anticoagulant therapy before and after surgery. Patients were then divided into VTE group and control group according to whether VTE occurred after operation. Baseline data, surgical related data (surger...
Source: Chinese Journal of Lung Cancer - Category: Cancer & Oncology Source Type: research
Rationale: Pulmonary tumor thrombotic microangiopathy (PTTM) is a rare but lethal complication of carcinoma, defined as non-occlusive pulmonary tumor embolism complicated by fibrocellular intimal proliferation of the small pulmonary arteries, with eventual occlusion of the pulmonary arteries. Hemodynamic deterioration caused by this condition leads to high mortality. Patient concerns: A 46-year-old woman who had undergone radiation therapy for anaplastic oligoastrocytoma and who was taking temozolomide presented with cough and palpitations. Diagnoses: A 12-lead electrocardiogram showed sinus tachycardia and SIQIII ...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
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