Journal of thrombosis and haemostasis : JTH
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J. Thromb. Haemost. · Sep 2009
Review Meta AnalysisSafety of ruling out acute pulmonary embolism by normal computed tomography pulmonary angiography in patients with an indication for computed tomography: systematic review and meta-analysis.
Several outcome studies have ruled out acute pulmonary embolism (PE) by normal computed tomography pulmonary angiography (CTPA). We performed a meta-analysis in order to determine the safety of this strategy in a specific group of patients with a strict indication for CTPA, that is, 'likely' or 'high' clinical probability for PE, an elevated D-dimer concentration, or both. ⋯ A normal CTPA result alone can safely exclude PE in all patients in whom CTPA is required to rule out this disease. There is no need for additional ultrasonography to rule out VTE in these patients.
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J. Thromb. Haemost. · Sep 2009
Chronic venous insufficiency is associated with elevated level of circulating microparticles.
Chronic venous insufficiency (CVI) results when the veins in the legs no longer pump blood back to the heart effectively. Microparticles (MPs) are small membrane vesicles released by several circulating and vascular cells upon activation or apoptosis. ⋯ The findings indicate that CVI is accompanied by an enhanced release of EMPs and PMPs that contribute to altered dysfunctional response of the venous wall.
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J. Thromb. Haemost. · Sep 2009
Multicenter StudyEffect of anti-platelet factor-4/heparin antibody induction on early saphenous vein graft occlusion after coronary artery bypass surgery.
Antibodies to complexes of heparin and platelet factor 4 (PF4) are capable of causing heparin-induced thrombocytopenia (HIT). Recent evidence suggests that anti-PF4/heparin antibodies may be prothrombogenic even in the absence of thrombocytopenia and clinically-recognized HIT. ⋯ Induction of anti-PF4/heparin antibodies, even those capable of heparin-dependent platelet activation, is not independently associated with early SVG occlusion or adverse clinical outcomes after CABG surgery.
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J. Thromb. Haemost. · Sep 2009
Prophylaxis of venous thromboembolism in the US: improving hospital performance.
Venous thromboembolism (VTE) prevention has been recognized as the most important practice for improving patient safety in hospitals. To be effective, VTE prophylaxis must be appropriately prescribed with respect to type, dose and duration. ⋯ Multifaceted, active, quality improvement initiatives have been developed and shown to successfully increase the appropriate prescribing of VTE prophylaxis in patients at risk. By increasing the use of appropriate VTE prophylaxis in at-risk patients, the disease burden of hospital-acquired VTE and its resulting complications can be reduced.