Maureen Meade

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..This test has an anatomic component to locate DVT and a functional component to differentiate acute (newly formed) thrombus from inactive (old) thrombus...

..Few studies have assessed the effect of prothrombotic blood abnormalities on the risk of deep vein thrombosis (DVT) with hormone replacement therapy (HRT)...

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..Data source Comprehensive search of electronic databases (Medline, Embase, CINAHL, Cochrane Central Register of Controlled Trials) until July 2010, supplemented by review of conference abstracts and contact with content experts...

..within the context of how the quality of anticoagulation control affects warfarin efficacy and safety; and 3) to consider which patients with chronic atrial fibrillation should receive and which may not need to receive dabigatran...

..Although hormone replacement therapy (HRT) is associated with an increased risk of deep vein thrombosis (DVT), it is not clear if the risk differs in users of combined estrogen-progestin HRT and estrogen-only HRT...

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..To identify patients with deep vein thrombosis (DVT) for whom in-hospital treatment should be considered...

..1; 95% CI: 0.2-4.9). In patients who present with submassive PE, an elevated cTnI occurs in about one in seven patients and is associated with a 3.5-fold increased risk of all-cause death...

..In patients who require bridging anticoagulation with LMWH, a residual anticoagulant effect from LMWH is detected in 1 of 6 patients, and receiving therapeutic-dose LMWH is the strongest predictor of such an effect...

..Additional research is needed to develop a validated risk stratification model for hospitalized medical patients that can help identify patients who would benefit most from anticoagulant prophylaxis...

..hormone replacement therapy? Does the presence of thrombophilia influence the risk for venous thromboembolism in hormone replacement therapy users? Should hormone replacement therapy be temporarily interrupted around the time of surgery?..

..The overall objective of this review is to provide a practical approach relating to perioperative anticoagulation which can be used in everyday clinical practice...

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..To challenge this premise, we evaluated if deep vein thrombosis (DVT) prophylaxis with dalteparin sodium confers an excessive anticoagulant effect in critically ill patients with severe renal insufficiency...

..In patients with venous thromboembolism (VTE), 15-20% will have prevalent cancer when VTE is diagnosed but little is known about such patients' long-term risk, time course and predictors of new cancer...

..The long-term risk for fatal pulmonary embolism (PE) after treatment of venous thromboembolism (VTE) may be an important factor in the decision to discontinue this treatment...

..Recent observations in patients with atrial fibrillation who are receiving warfarin suggest that concomitant treatment with a 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor (statin) decreases the risk for bleeding...

..Ximelagatran is a novel direct thrombin inhibitor that can be administered as a fixed oral dose, without the need for anticoagulant monitoring...

..This review focuses on anticoagulant prophylaxis in such patients, including reasonable approaches for using low-molecular-weight heparins as thromboprophylaxis...

..However, questions remain about the utility of measuring d-dimer in clinical practice...

..The objective of this article is to provide an evidence-based but practical approach relating to these 2 key issues in a manner than can be applied to everyday clinical practice...

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..The objectives of this review are to focus on practical issues relating to perioperative anticoagulation and the implementation of a perioperative anticoagulation management approach that can be used in everyday clinical practice...

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..Additionally, self-monitoring is limited to patients who have the cognitive and physical capabilities to perform the technique required for the portable coagulometer...

..We performed a prospective cohort study to determine the prevalence of elevated cardiac troponin I (cTnI) levels in patients with submassive pulmonary embolism...

..Additional studies are needed to determine the long-term (>1 year) efficacy and safety of antihypertensive and anti-obesity management strategies in the overweight and obese hypertensive patient...

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..We investigated the efficacy and safety of a standardized periprocedural anticoagulation regimen with low-molecular-weight heparin...

..The objective of the present study was to evaluate the prevalence, incidence and predictors of DVT and the incidence of bleeding in intensive care unit (ICU) patients with estimated creatinine clearance <30 ml/min...

..Further research is needed to evaluate the risks and benefits of more intense venous thromboembolism prophylaxis...

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..The 4Ts score (Thrombocytopenia, Timing of thrombocytopenia, Thrombosis, and oTher reason) might identify individual patients at risk of having this disorder...

..The objective of the present survey is to identify the patient factors and radiologic features of lower limb DVT that intensivists consider more or less likely to make a DVT clinically important in ICU patients...

..Its additional goals were to evaluate the suitability of the exclusion criteria and to document the range of research activities that precede accrual of patients into a trial to plan multisite management...

..To survey physicians' anticoagulation preferences in patients with chronic atrial fibrillation who are undergoing elective surgery...

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..We aimed to test the efficacy and safety of oral rivaroxaban for the prevention of venous thromboembolism after total knee arthroplasty...

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..Warfarin reduces the risk of stroke in patients with atrial fibrillation but increases the risk of hemorrhage and is difficult to use. Dabigatran is a new oral direct thrombin inhibitor...

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..The objective of this study was to determine if RBC transfusions or RBC storage age predicts incident DVT in medical or surgical intensive care unit (ICU) patients...

..We sought to determine whether systemic corticosteroids reduce hospital mortality from these illnesses...

..We conducted a systematic review to determine whether anticoagulant prophylaxis reduces the risk of asymptomatic DVT compared to no prophylaxis in at-risk hospitalized medical patients...

..The risk of cardiovascular events among patients with atrial fibrillation is high. We evaluated whether irbesartan, an angiotensin-receptor blocker, would reduce this risk...

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..We performed a systematic review and meta-analysis of randomized controlled trials comparing these 2 treatment strategies (combined aspirin-OAC therapy vs OAC therapy alone) to assess the therapeutic benefits and risks...

..001). DISCUSSION: Our findings support the routine use of capillary blood testing, using a portable monitor, for the management of patients in outpatient anticoagulation clinics...

..Underutilization of anticoagulant prophylaxis may be due to lack of evidence that prophylaxis prevents clinically important outcomes in hospitalized medical patients at risk for venous thromboembolism...

..The objectives of this study were to examine the time from submission to approval, to analyze predictors of approval time, and to describe the scope of conditions from REBs evaluating an international thromboprophylaxis trial...

..Semiquantitative dipyridamole myocardial perfusion scintigraphy may provide better estimates of perioperative cardiac risk than nonquantitative scintigraphy...

..These findings highlight the need for randomized controlled trials to compare the efficacy of different routes of administration of vitamin K for warfarin-associated coagulopathy...

..0 to 2.5, is effective in suppressing coagulation activation, and therefore, might be effective in preventing thromboembolism...

..To determine if the location of deep vein thrombosis is a predictor of recurrent venous thromboembolism during the initial 3 months of anticoagulant therapy...

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..In patients who require warfarin interruption before surgery and have an elevated international normalized ratio (INR) before surgery, low-dose vitamin K may normalize the INR in time for surgery...

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..The perioperative management of anticoagulation in patients who are having implantation of a pacemaker or implantable cardioverter defibrillator (ICD) is a common clinical problem in which best clinical practise is not established...

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..Excessive anticoagulation due to warfarin use is associated with hemorrhage. Subcutaneously administered vitamin K has not been evaluated for the treatment of warfarin-associated coagulopathy, yet it is widely used...

..Drug and food interactions are frequently cited as causes of adverse events with warfarin. We provide an updated systematic overview of the quality, clinical effect, and importance of these reported interactions...

..The purpose of this study was to measure and compare clinical characteristics and outcomes of patients with validated symptomatic PE and isolated DVT in a New England community...

..Such disagreements can cause tension and moral distress among families and clinicians...

..To determine the stated practices of clinicians in weaning critically ill adults from invasive ventilation...

..Cyclooxygenase-2 selective NSAIDs such as celecoxib may be less likely to promote gastrointestinal bleeding; however, there are concerns that they could potentiate the anticoagulation effect of warfarin...

..To evaluate the effect of continuing warfarin therapy on the bleeding risk of patients undergoing elective dental surgical procedures...

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..However, it may be possible to safely perform some procedures, such as coronary angiography with or without percutaneous coronary intervention (PCI), without VKA interruption...

..Although LMWH and UFH are self-administered by >90% of patients, factors that may be important to patients such as differences in pain and ecchymosis have not been explored...

..Methods for predicting risk for recurrence may identify low-risk patients who are less likely to benefit from prolonged anticoagulation...

..Coadministered clopidogrel, other drugs that affect hemostasis, and increasing age conferred an increased bleeding risk...

..Additional studies to further clarify the management of these patients are warranted...

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..Warfarin is a commonly used anticoagulant in North America. Several generic formulations have been approved, raising concern over the safety and efficacy of these products compared with brand-name Coumadin...

..The issue of therapeutic equivalence has been a source of controversy in Canada since the approval of generic warfarin products in 2000...

..In patients who are receiving warfarin therapy and require cataract surgery, it may be possible to continue warfarin in the perioperative period but the safety of this management strategy has not been systematically evaluated...

..To compare a strategy of combination therapy with a strategy of monotherapy with broad-spectrum antibiotics for suspected late ventilator-associated pneumonia...

..In oral contraceptive users who develop venous thrombosis in the absence of other risk factors, clinicians should consider investigations for an underlying prothrombotic biochemical disorder...

..SLOS is a treatable genetic condition that may be difficult to diagnose in its mildest form because of nonspecific clinical markers (two- to three-toe webbing, short upturned nose, and micrognathia)...

..However, before further high quality research can be performed in this area, information such as current practice and associated event rates is required...

..Some patients develop fatigue while taking warfarin, but causality is uncertain...

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..In order to reconcile the above-mentioned paradoxes, we propose a model based on a higher than observed carrier frequency of the most common mutation and on very high fetal loss of homozygotes for that mutation...

..Larger studies will be required to determine if the use of oral vitamin K, for example in patients who are temporarily discontinuing warfarin to undergo interventional procedures, is safe and effective...