Thrombosis research
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Thrombosis research · Apr 2016
Comparative StudyAccuracy of point of care coagulometers compared to reference laboratory measurements in patients on oral anticoagulation therapy.
Vitamin K antagonists (VKA) are widely prescribed throughout the world. Patients on VKA therapy require international normalized ratio (INR) monitoring of venous blood to ensure the response remains within the therapeutic window. Point-of-care devices (POC-INR) can safely and easily monitor VKA efficacy but need to be evaluated in practice. The aim of this study was to assess the precision and accuracy of a new POC-INR (Qlab) compared to the laboratory plasma technique and the CoaguChek-XS system. ⋯ This study suggests that the Qlab has accuracy limitations with clinical consequences. New POC-INR devices require careful evaluation prior to clinical implementation.
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Thrombosis research · Apr 2016
ReviewIncidental venous thromboembolic events in cancer patients: what we know in 2016.
Cancer patients are at high risk of venous thromboembolism (VTE). Previous reports on the epidemiology and incident of thrombotic complications in cancer patients are based upon documented symptomatic events. ⋯ Recent studies focusing on the findings of incidental PE when compared to symptomatic PE find no significant difference in pulmonary distribution of clots, incidence of VTE recurrence or survival in these patients. Based upon these studies, current guidelines recommend treatment for incidental PE as recommended for symptomatic PE.
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Thrombosis research · Apr 2016
Hypercoagulable state as demonstrated by thromboelastometry in hemoglobin E/beta-thalassemia patients: Association with clinical severity and splenectomy status.
Patients with hemoglobin E/beta-thalassemia disease (E/β) are at risk of thromboembolism. Rotational thromboelastometry (ROTEM®) can be used to determine a hypercoagulable state. The objective was to describe the hemostatic and thromboelastometric changes in pediatric patients with E/β with different clinical severity, in comparison with healthy children as controls. ⋯ Hypercoagulable state was demonstrated by ROTEM® in patients with E/β with severe disease and who were previously splenectomized. The hypercoagulable state was associated with the higher numbers of PLT rather than the decrease of PC, PS, and AT.
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Thrombosis research · Apr 2016
Inferior vena cava filters in patients with cancer and venous thromboembolism (VTE): patterns of use and outcomes.
Few studies have evaluated the use and outcomes of inferior vena cava filters (IVCF) insertion in cancer patients with deep venous thrombosis (DVT) or pulmonary embolism (PE). ⋯ An IVCF was placed in approximately 20% of acute VTE patients with cancer and use varied widely between hospitals and cancer types. Most patients did not have a contraindication for anticoagulation. There was no benefit in short-term mortality or risk of PE; there was increased risk of DVT and subsequent bleeding.
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Thrombosis research · Apr 2016
OC-12 - Peri operative venous thromboembolism prophylaxis in gynaecological cancer patients. A survey of current practice.
Gynaecological cancer is associated with some of the highest rates of venous thromboembolism (VTE) with some subtypes of ovarian cancer associated with rates as high as 20%. VTE prophylaxis is an important part of post-operative management in gynaecological cancer patient care. Despite the evidence base and guidelines recommending extended VTE prophylaxis for patients undergoing major cancer surgery, adherence to best practice guidelines has been found to be low. ⋯ In conclusion, the adherence to current guidelines for VTE prophylaxis in the peri-operative period for gynaecological oncology patients is still poor. Awareness needs to be raised in order to decrease the morbidity/mortality of VTE in this high risk group of patients. The adoption of multidiscplinary approach to manage gynaecological cancer patients, which includes the involvment of thrombosis specialist, may reduce post operative VTE rates and improve cancer care.