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Concept: Venous thrombosis

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Guidelines and clinical practice vary considerably with respect to thrombosis prophylaxis during plaster cast immobilization of the lower extremity. Identifying patients at high risk for the development of venous thromboembolism (VTE) would provide a basis for considering individual thromboprophylaxis use and planning treatment studies. The aims of this study were (1) to investigate the predictive value of genetic and environmental risk factors, levels of coagulation factors, and other biomarkers for the occurrence of VTE after cast immobilization of the lower extremity and (2) to develop a clinical prediction tool for the prediction of VTE in plaster cast patients.

Concepts: Epidemiology, Blood, Thrombosis, Warfarin, Hematology, Thrombus, Vein, Venous thrombosis

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Venous thromboembolism (VTE) is a common disease where known genetic risk factors explain only a small portion of the genetic variance. Then, the analysis of intermediate phenotypes, such as thrombin generation assay, can be used to identify novel genetic risk factors that contribute to VTE.

Concepts: Scientific method, Blood, Thrombosis, Warfarin, Hematology, Vein, Deep vein, Venous thrombosis

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What treatments for lower extremity superficial thrombophlebitis are associated with lower rates of venous thromboembolic events (VTE), major bleeding, and superficial venous thrombosis extension?

Concepts: Blood, Thrombosis, Bleeding, Vein, Deep vein thrombosis, Venous thrombosis

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Herein, we report a case of a 27-year-old man with Ebstein’s anomaly and a history of unexplained recurrent venous thrombosis despite adequate anticoagulation. After surgical correction of the Ebstein’s anomaly, the venous thromboembolic events did not recur. This case demonstrates the possible etiopathogenesis of Ebstein’s anomaly in causing recurrent venous thromboembolism, which is likely caused through impedance of venous blood flow.Our objective in presenting this particular case is to highlight the possible association between Ebstein’s anomaly and venous thrombosis.

Concepts: Blood, Stroke, Thrombosis, Warfarin, Hematology, Vein, Anticoagulant, Venous thrombosis

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Acute mesenteric ischemia poses a diagnostic challenge due to nonspecific clinical clues and lack of awareness owing to its rarity. Ischemia due to mesenteric venous thrombosis has a good prognosis compared to arterial cause and can be managed conservatively with early diagnosis. The portomesenteric venous system is an unusual site of thrombosis in patients with protein S deficiency, and its thrombosis is an uncommon cause of acute mesenteric ischemia.

Concepts: Blood, Blood vessel, Thrombosis, Vein, Hepatic portal vein, Portal venous system, Venous thrombosis

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: Postoperative venous thromboembolism has a poor prognosis in patients with cancer. We aimed to investigate the utility of thromboelastometry in detecting the risk of postoperative venous thromboembolism in patients with cholangiocarcinoma. We prospectively included patients submitted to liver resection for cholangiocarcinoma at our hospital between May 2011 and July 2014. Patients undergoing major hepatectomy for adult living donor transplantation in the same time period served as a control group. Thromboelastometry was performed before anesthesia. Postoperative venous thrombotic events were recorded in the 6 months after surgery. Twenty-seven patients with cholangiocarcinoma and 17 living-donor liver transplantation patients were included. Maximum clot firmness and its derivative parameter G, pointed to hypercoagulability in patients with cholangiocarcinoma, whereas all parameters were within normal ranges in controls. Six postoperative thrombotic events were recorded: four portal vein thrombosis and two deep venous thrombosis, all in patients with cholangiocarcinoma. Patients with cholangiocarcinoma who displayed thrombotic complications showed a nonsignificant trend to more pronounced hypercoagulability compared with those without. The results suggest that first, in patients with cholangiocarcinoma, despite standard thromboprophylaxis, thrombotic events remain a substantial problem, and, second, thromboelastometry may be useful in identifying patients with cholangiocarcinoma at risk of postoperative venous thromboembolism. Large prospective studies are warranted to confirm these results.

Concepts: Stroke, Thrombosis, Hematology, Vein, Deep vein thrombosis, Deep vein, Portal vein thrombosis, Venous thrombosis

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To measure diffusion of new knowledge and correlate imaging utilization for suspected acute venous thromboembolism (VTE) with d-dimer utilization, landmark publications, and institutional guidelines.

Concepts: Blood, Thrombosis, Hematology, Vein, Deep vein, Knowledge management, Venous thrombosis

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To investigate the association between thrombomodulin c.1418C>T polymorphism and venous thrombosis.

Concepts: Blood, Thrombosis, Hematology, The Association, Vein, Deep vein thrombosis, Deep vein, Venous thrombosis

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To review whether the incidence of catheter-associated venous thromboses was higher in patients receiving IV dihydroergotamine compared to lidocaine.

Concepts: Vein, Deep vein thrombosis, Venous thrombosis