Should You Treat This Acutely Ill Medical Inpatient With Venous Thromboembolism Chemoprophylaxis?: Grand Rounds Discussion From Beth Israel Deaconess Medical Center.

Discussion From Beth Israel Deaconess Medical Center. Ann Intern Med. 2020 Apr 07;172(7):484-491 Authors: Kanjee Z, Bauer KA, Breu AC, Burns R Abstract Venous thromboembolism (VTE), which includes both deep venous thrombosis and pulmonary embolism, is a common and potentially fatal condition. Medical inpatients are at high risk for VTE because of immobility as well as acute and chronic illness. Several randomized trials demonstrated that chemoprophylaxis, or low-dose anticoagulation, prevents VTE in selected medical inpatients. The 2018 American Society of Hematology clinical practice guideline on prophylaxis for hospitalized and nonhospitalized medical patients conditionally recommends chemoprophylaxis for non-critically ill medical inpatients, leaving much to the discretion of the treating physician. Here, 2 experts, a hematologist and a hospitalist, reflect on the care of a woman hospitalized with a rheumatologic disorder. They consider the risks and benefits of chemoprophylaxis, discuss VTE risk stratification, and recommend which patients should receive chemoprophylaxis and with which agents. PMID: 32252085 [PubMed - as supplied by publisher]
Source: Annals of Internal Medicine - Category: Internal Medicine Authors: Tags: Ann Intern Med Source Type: research

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CONCLUSION: Using propensity score-matched analysis we showed that pharmacological thromboprophylaxis after EVLA seems to be equally effective with 3 days or 10 days of treatment with a similar success rate and safety profile. Undoubtedly, a large randomised control trial, ideally including a group without pharmacological thromboprophylaxis, is needed to draw more definitive conclusions on the optimal duration of pharmacological post-EVLA thromboprophylaxis. PMID: 31869428 [PubMed - in process]
Source: Swiss Medical Weekly - Category: General Medicine Authors: Tags: Swiss Med Wkly Source Type: research
Introduction: Venous thromboembolism (VTE), defined as deep venous thrombosis (DVT) and pulmonary embolism (PE), is a cause of significant morbidity and mortality worldwide, with an overall incidence of about 10,000,000 cases per year. The majority of VTEs are believed to be attributable to genetic factors. Yet, the five established heritable thrombophilias of factor V Leiden (FVL), prothrombin (PT) gene mutation, antithrombin (AT) deficiency, protein C (PC) deficiency, and protein S (PS) deficiency comprise only a small portion of VTEs, suggesting that further genetic factors contributing to VTE risk are unrecognized. In ...
Source: Blood - Category: Hematology Authors: Tags: 331. Pathophysiology of Thrombosis: Poster II Source Type: research
Venous thromboembolism (VTE) consists of deep vein thrombosis (DVT) and pulmonary embolism (PE), and it is the number one preventable complication of death among patients during their hospital stay [1 –3]. VTE is often caused by venous stasis, hypercoagulability, and endothelial injury, or the triad of Virchow [4]. Owing to burn victims’ immobility, repeated operations, and recurrent use of indwelling venous catheters, they have a high risk of VTE complications. The lowest frequency of thromb oembolic complications has been reported as 0.25% through routine administration of prophylactic heparin [5]; however, t...
Source: Burns : Journal of the International Society for Burn Injuries - Category: Cosmetic Surgery Authors: Source Type: research
Conclusion: Majority of plastic surgeons practice DVT prophylaxis routinely and consider multiple criteria such as percentage of burns, age, lower limb involvement, the degree of burns and associated co-morbidities for starting the LMWH.
Source: Indian Journal of Plastic Surgery - Category: Cosmetic Surgery Authors: Source Type: research
Conclusions NPWT may be employed in a fashion similar to the standard incisional application. With this technique, serial flap examination remains possible and is not associated with pedicle compression or increased rates of flap loss. Interestingly, no splints were utilized with the VAC device which itself may serve as a relative immobilizer of an extremity. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text
Source: Journal of Reconstructive Microsurgery - Category: Surgery Authors: Tags: Original Article Source Type: research
By ANISH KOKA, MD The idea that payment should be linked to the value lies at the heart of most of the transactions we participate in on a daily basis. Yet, value based payment in healthcare has seemingly run into very rocky waters as of late.  It is at this precarious time that stakeholders representing large employers and other purchasers of health care’ took to the Harvard Business Review to write in defense of value based payment reform.  The authors pepper their article with cherry picked ‘successes’ of the value movement and urge the country to forge ahead on the current path.  The pi...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: Uncategorized Value-Based Payment Source Type: blogs
Sulfur mustard (SM) is a chemical warfare agent. When inhaled, SM causes significant injury to the respiratory tract. Although the mechanism involved in acute airway injury after SM inhalation has been well described previously, the mechanism of SM's contr...
Source: SafetyLit - Category: International Medicine & Public Health Tags: Burns, Electricity, Explosions, Fire, Scalds Source Type: news
Conclusions Chemoprophylaxis does not prevent VTEs. Burn severity predisposes to venous thromboembolic complications.
Source: Burns - Category: Dermatology Source Type: research
Cardiovascular disease (CVDs) is the leading cause of death and major cause of disability worldwide [1,2]. An estimated 17.5 million people died from CVDs in 2012, representing 31% of all global deaths. Of these deaths, an estimated 7.4 million were due to coronary heart disease and 6.7 million were due to stroke. CVDs are a group of disorders of the heart and blood vessels and include coronary heart disease with or without heart failure, dysrhythmias, cardiomyopathy; cerebrovascular disease including aneurysmal diseases; peripheral arterial disease; rheumatic heart disease – damage to the heart muscle and heart valv...
Source: Burns : Journal of the International Society for Burn Injuries - Category: Cosmetic Surgery Authors: Source Type: research
Conclusion With a moderate risk of developing DVT (8%) and a complication rate of only 2% with chemoprophylaxis, we feel that routine prophylaxis has the potential to decrease the incidence of VTE, without associated complications, in the moderate to high risk category. Graphical abstract
Source: Burns - Category: Dermatology Source Type: research
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