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Swelling of One Leg
Published in K. Gupta, P. Carmichael, A. Zumla, 100 Short Cases for the MRCP, 2020
K. Gupta, P. Carmichael, A. Zumla
Diagnosis of deep vein thrombosis is difficult on clinical grounds alone. The following tests will help make a diagnosis: Venography.Impedance plethysmography.Radio-iodine-labelled fibrinogen leg scanning.Ultrasound/arthrogram.Lymphangiogram.
Thromboembolic Disease in the Obstetric Patient: Evaluation, Diagnosis, and Treatment
Published in Hau C. Kwaan, Meyer M. Samama, Clinical Thrombosis, 2019
Similar to deep vein thrombosis, the clinical diagnosis of pulmonary embolus must be confirmed by objective tests. The best treatment is prevention. Two thirds of patients who ultimately die from pulmonary embolism do so within 30 min of the acute event,26 too soon for anticoagulants to have any effect on mortality.
Thrombolytic Therapy
Published in Genesio Murano, Rodger L. Bick, Basic Concepts of Hemostasis and Thrombosis, 2019
Genesio Murano, Rodger L. Bick
This chapter briefly summarizes the results of some clinical trials and outlines the presently accepted therapeutic regimen in the treatment of deep vein thrombosis, and massive pulmonary embolism.5-18 The use of thrombolytic agents in cerebrovascular disease, retinal venous thrombosis, myocardial infarction, arterial thrombosis, as well as the use of plasminogen in hyaline membrane disease, and the subject of chemical thrombolysis have received more limited attention (in many instances, with less encouraging results) and will not be discussed here.18-21
Pharmacological venous thromboembolism prophylaxis in elective cranial surgery: a systematic review of time of initiation, regimen and duration
Published in British Journal of Neurosurgery, 2022
Ian Tan, Anand S. Pandit, Shivani Joshi, Mehdi Khan, Zara Sayar, John-Paul Westwood, Hannah Cohen, Ahmed K. Toma
All studies included VTE and ICH as outcomes of interest. Wilhelmy et al.38 performed routine surveillance to detect postoperative ICH using computed tomography (CT) imaging, whereas the confirmation of ICH in all other studies either relied on the identification of clinical symptoms or were not specified. VTE was detected using clinical symptoms alone,37 or with further confirmation by imaging39; Wilhelmy et al.38 did not specify their method of measuring VTE occurrence. Whilst our review is focused on venous thromboembolism in the form of deep vein thrombosis and pulmonary embolism, Wilhelmy et al.38 also included patients who experienced non-venous thromboembolic events, including two patients who developed ischaemic stroke. None of the studies investigated the association between the interventions and mortality.
Managing patients on direct factor Xa inhibitors with rapid thrombelastography
Published in Scandinavian Journal of Clinical and Laboratory Investigation, 2021
Andrea Bak Kaaber, Øivind Jans, Morten H. Dziegiel, Jakob Stensballe, Pär I. Johansson
Patient demographics including age, gender, cause for XABAN prophylaxis, type of scheduled acute or subacute surgical procedure, source/localization of bleeding, administration of PCC, mortality within 30 or 90 days from hospitalization, discharge alive and stay in intensive care unit (ICU) were recorded from patient charts and entered to a dedicated study database. Furthermore, thromboembolic complications defined as deep vein thrombosis or pulmonary embolism were registered from patient charts. The need for five red blood cell (RBC) units or more from hospitalization to 24 h after the bleeding event was also recorded, and this was chosen as cut-off for a clinically relevant major bleeding condition. The need for five RBC transfusions or more indicates that the patients have lost a minimum of 30% of their total blood volume which represents a state of hemorrhagic shock.
Chylothorax in Behçet’s disease
Published in Canadian Journal of Respiratory, Critical Care, and Sleep Medicine, 2021
Sophie B. Kermelly, Marie-Ève Boucher, François Côté, François Maltais
Therapy for Behçet’s Disease mainly depends on which organ is involved and the severity of the manifestations.15,16 Currently, immunosuppression emerges as the cornerstone for the treatment with agents such as azathioprine and cyclosporine. Cyclophosphamide is the agent of choice for pulmonary involvement, such as artery aneurysms.17 Active vascular involvement requires the addition of high dose glucocorticoids to the immunosuppressive regimen. The role of anticoagulation as an adjunctive therapy for deep vein thrombosis remains unclear although it can be considered when the risk of bleeding is low. Anticoagulotherapy alone is insufficient in Behçet’s Disease since ongoing inflammation can perpetuate or create new thrombosis. The search for pulmonary artery or other arterial aneurysms must be done prior to anticoagulation since these manifestations of Behçet’s Disease can lead to fatal hemorrhage.5