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Byline: Jianpeng. Wang, Xishan. Li, Fengjie. Wang, Degang. Shi, Jiren. Zhang Background: Portal vein tumor thrombus (PVTT) remains a poor prognostic factor occurring in about 10%-40% of patients with hepatocellular [...]

A thorough review of current and classic literature was completed to distinguish the influence of bedrest or ambulation on patient treatment outcomes with confirmed deep vein thrombosis., Deep vein thrombosis (DVT) is a "major public health problem" (Galson, 2008, p. 9) impacting the entire nation and affecting as many as 350,000 people yearly. Recognizing DVT and pulmonary [...]

Background: The optimal duration of oral anticoagulant therapy in patients with deep venous thrombosis (DVT) of the lower extremities remains uncertain. Objective: To assess whether tailoring the duration of anticoagulation on the basis of the persistence of residual thrombi on ultrasonography reduces the rate of recurrent venous thromboembolism (VTE) compared with the administration of conventional fixed-duration treatment in adults with proximal DVT. Design: Parallel, randomized trial from 1999 to 2006. Trained physicians who assessed outcomes were blinded to patient assignment status, but patients and providers were not. Setting: 9 university or hospital centers in Italy. Patients: 538 consecutive outpatients with a first episode of acute proximal DVT at completion of an uneventful 3-month period of anticoagulation. Intervention: Patients were randomly assigned (stratified by center and secondary vs. unprovoked DVT by using a computer-generated list that was accessible only to a trial nurse) to fixed-duration anticoagulation (no further anticoagulation for secondary thrombosis and an extra 3 months for unprovoked thrombosis) or flexible-duration, ultrasonography-guided anticoagulation (no further anticoagulation in patients with recanalized veins and continued anticoagulation in all other patients for up to 9 months for secondary DVT and up to 21 months for unprovoked thrombosis). For the primary outcome assessment, 530 patients completed the trial. Measurements: The rate of confirmed recurrent VTE during 33 months of follow-up. Results: Overall, 46 (17.2%) of 268 patients allocated to fixed-duration anticoagulation and 32 (11.9%) of 270 patients allocated to flexible-duration anticoagulation developed recurrent VTE (adjusted hazard ratio [HR], 0.64 [95% Cl, 0.39 to 0.99]). For patients with unprovoked DVT, the adjusted HR was 0.61 (Cl, 0.36 to 1.02) and 0.81 (Cl, 0.32 to 2.06) for those with secondary DVT. Major bleeding occurred in 2 (0.7%) patients in the fixed-duration group and 4 (1.5%) patients in the flexible-duration group (P = 0.67). Limitations: The trial lacked a double-blind design. The sample size was not powered to detect differences in bleeding between groups and to detect effectiveness of the intervention in the subgroups of patients with unprovoked and secondary DVT. Patients with previous thromboembolism, permanent risk factors for thrombosis, and thrombophilic abnormalities other than factor V Leiden and prothrombin mutation were excluded. Conclusion: Tailoring the duration of anticoagulation on the basis of ultrasonography findings reduces the rate of recurrent VTE in adults with proximal DVT. Primary Funding Source: None.

* Spontaneous superficial venous thrombophlebitis (SVTP) confers a 10-fold risk of developing DVT within 6 months compared with controls. * Absolute risk of DVT following SVTP, however, is just 2.7%, [...]

Warfarin is one of the common drugs used in the treatment of deep vein thrombosis, pulmonary embolism and atrial fibrillation with stroke. Warfarin-associated intracerebral hemorrhage (ICH) has become common in the last decades contributing to 19% of intracerebral bleeds. We report a case with deep vein thrombosis that developed acute onset neurosurgical deterioration secondary to left subdural hematoma. Burr hole evacuation was done with correction of the coagulopathy. Keywords: Subdural Hematoma | Deep Vein Thrombosis | Pulmonary Embolism | Warfarin, Introduction Warfarin is one of the common drugs used in the treatment of deep vein thrombosis, pulmonary embolism, mechanical heart valves and chronic atrial fibrillation with stroke. The incidence of [...]

Deep vein thrombosis (DVT) is reported to be common among patients undergoing surgery for gastrointestinal cancer. In this study we present a case with ipsilateral upper and lower extremities deep venous thrombosis developed after surgery for gastrointestinal malignancy. Development of DVT is clearly associated with decreased survival because DVT reflects the presence of a biologically aggressive cancer. Correct diagnosis and treatment of DVT are crucial. Keywords: Upper extremity | lower extremity | deep vein thrombosis | gastrointestinal malignancy., Introduction Venous thromboembolism (VTE), manifested as either deep venous thrombosis (DVT) or pulmonary embolism (PE), is an extremely common medical problem, occurring either in isolation or as a complication of [...]

Cerebral venous sinus thrombosis (CVST) is a rare and potentially fatal condition. A 23-year-old man was admitted to the emergency department of Maresal Cakmak Military Hospital, Erzurum two times in one week for epileptiform seizures. As noncontrast head computed tomography (CT) scan was normal, he was first diagnosed with epilepsy. Magnetic resonance imaging (MRI) and magnetic resonance venography (MRV) showed the thrombus in the right transverse sinus, right straight sinus, and superior sagittal sinus. CVST should be considered for the differential diagnosis of patients who were admitted to the emergency department with epilepsy or epileptiform seizures and both MRI and MRV should be used for the diagnosis. Keywords: Emergency department | cerebral venous sinus thrombosis | magnetic resonance imaging | magnetic resonance venography | epileptiform seizure, Introduction Cerebral venous sinus thrombosis (CVST) is a rare and potentially fatal condition (1). CVST presents with a wide spectrum of symptoms including headache, nausea, vomiting, papilla edema, focal neurological [...]

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.amjmed.2008.12.023 Byline: Russell D. Hull (a), Graham F. Pineo (a), Rollin Brant (b), Jane Liang (a), Roy Cook (a), Susan Solymoss (c), Man-Chiu Poon (a), Gary Raskob (d) Keywords: Deep vein thrombosis; Leg ulcer; Post-thrombotic syndrome; Tinzaparin; Warfarin Abstract: Home-LITE compared long-term treatment at home with tinzaparin or usual care in terms of efficacy, safety, patients' treatment satisfaction, incidence of post-thrombotic syndrome, and associated venous leg ulcers. Author Affiliation: (a) University of Calgary, Calgary, AB, Canada (b) University of British Columbia, Vancouver, BC, Canada (c) McGill University, Montreal, QC, Canada (d) College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City Article Note: (footnote) Funding: The study was supported by grants from the Medical Research Council (now Canadian Institutes for Health Research) and industry (LEO Pharma A/S Ltd., Ballerup, Denmark). Additional funding was provided by Pharmion and Dupont Pharmaceuticals. LEO Pharma provided the study drug and drug safety monitoring. The industry sponsors did not have any influence on the design or analysis of the study. The protocol was designed by 3 investigators. The Thrombosis Research Unit, University of Calgary, coordinated the study and carried out the data management and administrative duties. Statistical analysis was carried out independently of the industry sponsors by Rollin F. Brant, PhD, Department of Community Health Sciences, University of Calgary, Canada., Conflict of Interest: R. Hull has received grants/research support from Bayer Pharmaceuticals Corporation, LEO Pharma Inc., and sanofi-aventis; been a consultant for LEO Pharma, Inc., Pfizer Inc., and GlaxoSmithKline, and sat on advisory boards for Pfizer Inc. and sanofi-aventis. Graham Pineo is a consultant or advisory board member (or both): sanofi-aventis, Pfizer, and steering committee member for sanofi-aventis. Susan Solymoss has received honoraria from Pfizer and LEO-Pharma. Jane Liang, Man-Chiu Poon, Roy Cook, and Rollin Brant have no conflict of interest to declare. Gary Raskob receives consultant income or honoraria (or both) from the following companies: GlaxoSmithKline, Pfizer, and sanofi-aventis., Authorship: All authors had access to the data and contributed to/critically reviewed drafts of the manuscript.

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.amjmed.2006.06.046 Byline: Frederick A. Spencer (a)(b), Cathy Emery (a), Darleen Lessard (a), Robert J. Goldberg (a) Keywords: Deep vein thrombosis; Incidence; Population-based; Upper extremity Abstract: The purpose of this study was to examine the magnitude, risk factors, management strategies, and outcomes in a population-based investigation of patients with upper, as compared with lower, extremity deep vein thrombosis diagnosed in 1999. Author Affiliation: (a) Department of Medicine, University of Massachusetts Medical School, Worcester (b) Department of Medicine, McMaster University Medical Center, Hamilton, Ont, Canada. Article Note: (footnote) This study was supported by a grant from the National Heart, Lung, and Blood Institute (R01-HL70283), Bethesda, Md.

Table of Contents Abstract Case Report Discussion References Abstract Hip pain is a common problem in children; most common being irritable hip, Perthe's disease, transient synovitis, trauma, and rarely septic [...]

Bacchus Vascular's Trellis-8 system cleared for treating DVT By HOLLAND JOHNSON Medical Device Daily Associate Managing Editor Bacchus Vascular (Santa Clara, California) reported the recent FDA 510(k) clearance of its [...]

Senior nurse specialists have warned that hospital nurses need to be given adequate training in the prevention of venous thromboembolism (VTE) in order to reduce the risk posed to patients. The UK Department of Health is also planning to undertake several initiatives in 2020-11 to educate nurses regarding VTE and help prevent mortality from preventable VTE.

SAN DIEGO -- Proximal deep vein thrombosis was confirmed to be more likely to cause death in hospitalized patients than distal deep vein thrombosis, based on data from a large [...]