• Title/Summary/Keyword: Total DVT

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Deep Vein Thrombosis Prophylaxis after Total Hip Arthroplasty in Asian Patients

  • Kim, Jun-Shik
    • Hip & pelvis
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    • v.30 no.4
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    • pp.197-201
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    • 2018
  • In Western patient populations, the reported incidence of imaging-demonstrated deep vein thrombosis (DVT) after total hip arthroplasty (THA) is as high as 70% without prophylaxis. The reported rates of symptomatic pulmonary embolism (PE) after THA in recent studies range from 0.6% to 1.5%, and the risk of fatal PE ranges from 0.11% to 0.19% in the absence of prophylaxis. Predisposing factors to DVT in western patients include advanced age, previous venous insufficiency, osteoarthritis, obesity, hyperlipidemia, dietary and genetic factors. However, Asian patients who have undergone THA have a strikingly low prevalence of DVT and virtually no postoperative PE. Some authors suggest low clinical prothrombotic risk factors and the absence of some DVT-related genetic factors in Asian patient populations decrease the risk of DVT, PE or both. In Korea, the prevalence of DVT after THA without thromboprophylaxis have ranges from 6.8% to 43.8%, and asymptomatic PE have ranges from 0% to 12.9%; there have been only two reported cases of fatal PE. Deep-wound infections resulting from postoperative hematomas or prolonged wound drainage have been reported with routine thromboprophylaxis. The prevalence of DVT differs varies based on patient ethnicity. Guidelines for the use of thromboprophylaxis were altered and focus on the potential value of outcomes compared with possible complications (e.g., bleeding).

Nurses' Knowledge and Compliance on Deep Vein Thrombosis (일 지역 병원간호사의 심부정맥혈전증에 관한 지식과 간호수행)

  • Choi, Dong-Ok;Min, Hye-Sook
    • Journal of Korean Critical Care Nursing
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    • v.4 no.1
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    • pp.75-87
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    • 2011
  • Purpose: This study was done to investigate the DVT-related knowledge and compliance of hospital nurses. Methods: A survey questionnaire was administrated to a convenience sample of 367 nurses working at 3 university hospitals and 4 general hospitals located in Busan. Results: The mean score of DVT-related knowledge was $16.86{\pm}$3.40$ points out of 26, with a percentage of correct answers of 64.8%. The mean score of DVT-related compliance was $21.40{\pm}6.42$ points out of 32. There was a significant correlation between hospital nurses' DVTrelated knowledge and compliance (r=.309, p=.000). The factors for predicting hospital nurses' DVT-related compliance included knowledge of treatment and care areas, the subcategories of DVT knowledge (${\beta}$=.214), knowledge of the area of risk factors (${\beta}$=.105), whether to perform DVT prevention and treatment based on protocols (${\beta}$=.193), the existence of DVT protocols (${\beta}$=.168) and the degree of interest in DVT (${\beta}$=.102) and the total explanatory power of these was 21.3%. Conclusion: To improve compliance on preventing DVT effectively, it is necessary to improve nurses' DVT-related knowledge and interest in DVT through appropriate education. And, it is necessary to develop standardized protocols and guidelines.

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Breeding Process and Agronomic Traits for New Burley Tobacco Variety, KB 301 (버어리종 고 DVT 계통 KB 301의 육성경과 및 농경적 특성)

  • 조천준;정석훈;배성국;최상주;김도연
    • Journal of the Korean Society of Tobacco Science
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    • v.24 no.2
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    • pp.130-132
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    • 2002
  • The new burley tobacco variety, KB 301, was developed by the cross combination ’(Ky 17 x TI 1068)F$_4$ x TC 613’. The modified pedigree breeding method was used in the selection procedures. The agronomic traits and chemical constituents of KB 301 were very similar to those of Burley 21. But KB 301 had significantly higher content of total DVT than Burley 21. KB 301 was also resistant to black shank, TMV and PVY.

Deep Vein Thrombosis after Total Knee Replacement in a Patient undergoing Korean Medical Rehabilitation (슬관절 전치환술 후 한방재활치료 중 발생한 심부정맥 혈전증 보고)

  • Kim, Chang-Gon;Koh, Nak-Yong;Ko, Youn-Suk;Lee, Jung-Han
    • Journal of Korean Medicine Rehabilitation
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    • v.25 no.2
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    • pp.197-203
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    • 2015
  • Objectives The objective of this study is to report the deep vein thrombosis (DVT) after total knee replacement (TKR) in a patient undergoing Korean medical rehabilitation. Methods A female patient who had total knee replacement (TKR) was treated by Korean medical rehabilitation with protocol. After fifteen days treatment, deep vein thrombosis (DVT) was suspected. Therefore, CT venography was performed. Results After Korean medical rehabilitation, pain was decreased. But also occurred deep vein thrombosis (DVT) as a complication. Conclusions We present a case of deep vein thrombosis (DVT) after total knee replacement (TKR) in a patient undergoing Korean medical rehabilitation. There is a limit that this study hasn't sufficient number of cases. Further studies will be needed.

A New D-dimer Cutoff Value to Improve the Exclusion of Deep Vein Thrombosis in Cancer Patients

  • Chen, Chong;Li, Gang;Liu, Yun-De;Gu, Ya-Jun
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.4
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    • pp.1655-1658
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    • 2014
  • Objective: To find a more appropriate alternative to D-dimer cutoff value for the diagnosis of deep vein thrombosis (DVT) in cancer patients. Methods: A total of 711 cancer patients with symptoms suspicious of DVT were included in the study. D-dimer levels were assessed using ELISA. All patients were subjected to imaging procedures. Results: Among 711 patients with cancer, 466 (65.5%) were females and 245 (34.5%) were males, with an average age of $57.3{\pm}13.23$ years. The mean age in the DVT group was significantly higher than in the non-DVT group (P<0.05). The D-dimer levels of the DVT group were significantly higher than those of the non-DVT group (P<0.05). The incidence rate of DVT varied significantly according to cancer type (P<0.05). Increasing age and lung cancer were significantly correlated with D-dimer levels (P<0.05), and a one-year increase in age was associated with a 14.28 ng/ml increase in the D-dimer value. The optimal cutoff point for D-dimer was found to be 981 ng/ml, with a sensitivity of 86.4%, specificity of 79.4%, and accuracy of 82.6%. If the D-dimer cutoff point was set to 981ng/ml, the specificity would increase from 61.8% to 85.5% without loss of sensitivity in patients aged 40 years or younger. In patients aged more than 40 years, the new cutoff almost doubled the specificity with slightly reduced sensitivity. Conclusion: In cancer patients, a new cutoff value of 981 ng/ml effectively improved the exclusion of DVT, especially for patients aged more than 40 years.

Incidence and Clinical Characteristic of Venous Thromboembolism in Gynecologic Oncology Patients attending King Chulalongkorn Memorial Hospital over a 10 Year Period

  • Oranratanaphan, S;Termrungruanglert, W;Khemapech, N
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.15
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    • pp.6705-6709
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    • 2015
  • Background: Venous thromboembolisms (VTEs) constitute a group of diseases including deep vein thrombosis (DVT) and pulmonary embolism (PE). They regarded as the second leading cause of death in cancer patients and several studies have confirmed that VTEs have a negative impact on survival and recurrent rate in both ovarian and endometrial cancer cases. The incidence of VTEs differs worldwide and depends on several risk factors including race, underlying disease, lifestyle, body weight, BMI and genetic risk factors. There is heterogeneity of DVT rates between Asian and Western countries. This study was conducted in order to evaluate the character and incidence of VTEs in gynecologic oncology patients in King Chulalongkorn Memorial Hospital over a 10 year period. Materials and Methods: A retrospective chart review was performed with VTEs defined as objective diagnosis of acute DVT or PE with typical symptoms and signs. Diagnoses were approved byan internist and/or confirmed with imaging studies. Data from both outpatient and inpatient sessions of the affected cases from January 2004 to December 2013 were extracted. General characteristics of the patients were collected with details of the diseases, types of cancer, stage, date of diagnosis of cancer, operative data, treatment outcome, progression free survival and overall survival. Results: Thirty cases of VTEs were identified in a total 2,316 gynecologic oncology cases. The incidence of symptomatic VTEs in total gynecologic oncology patients in our institution is 1.295%. The incidence of VTEs in ovarian cancer patients in our institution was 5.9%. Duration for VTE detection ranged from 13 months before diagnosis of cancer to 33 months after diagnosis of cancer. Most of the VTE cases were detected in ovarian cancer patients (60%). The most common cell type was adenocarcinoma (moderately to poorly differentiated) which accounted for 26.7% of the cases. The second most common cell type was clear cell carcinoma with 23.3% of the cases. Thirty percent of VTE cases developed before cancer was diagnosed, 20% were diagnosed at the same time as cancer detection and fifty percent developed after cancer was diagnosed. Median disease free survival of the gynecologic oncology patients with VTE was 7.5 months. Median overall survival (OS) was 12 months. Median progession free survivals of DVT and PE groups were 11.5 and 5.5 months, respectively. OS of DVT and PE was 12.0 and 11.5 months respectively. Conclusions: The incidence of VTE in Asian countries is believed to be lower than in European or Western countries. From our retrospective review, the incidence of VTEs in all types of gynecologic oncology was 1.295%, much lower than reported in the West. The reason for the lower incidence may genetic differences. Another factor is that VTE in this review was symptomatic, which is less than asymptomatic VTE. More than half of VTEs in this study developed in ovarian cancer patients. The results are compatible with earlier reports that among gynecologic malignancies, the incidence of VTE is highest in ovarian cancer.

Treatment of Deep Venous Thromboses of Lower Leg with Thrombolysis (혈전용해술을 이용한 하지 심부정맥 혈전증의 치료)

  • 이재원
    • Journal of Chest Surgery
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    • v.34 no.9
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    • pp.711-715
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    • 2001
  • Background: Deep venous thrombosis(DVT) is a curable disease when it is appropriately treated in the early stages of onset. The long term follow up of chronic DVT shows poor prognosis with serious complications such as venous valvular insufficiency, venous claudication, venous ulcer and leg swelling. Thrombolytic therapy is a very active treatment that delivers thrombolytic agents via catheter to the target thrombi. The aim of this study is to evaluate the effect of catheter directed thrombolysis using urokinase to acute DVT. Material and Method: We studied 5 patients, who were diagnosed as acute DVT and had no contraindication for selective hemolysis using urokinase. Result: All the patients were successfully recanalized. Total infusion time of urokinase was 2.0$\pm$0.6 days, and the amount was 5.9$\pm$2.45 million IU. In 4 patients, who were diagnosed as May-Therner syndrome, we performed the balloon angioplasty and inserted the stent at the stenotic portion. There were minor complications such as hematuria, hematoma at puncture site, and all of them are self limited. Conclusion: Catheter induced thrombolysis is an effective treatment in acute DVT.

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Composition of Leaf Surface Lipid in Flue-cured Tobacco and Their Changes during Flue-curing (황색종 잎담배의 엽면지질 성분 조성 및 건조중 변화)

  • 지상운;김도연;이문용;김영희;신승구
    • Journal of the Korean Society of Tobacco Science
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    • v.19 no.1
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    • pp.57-63
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    • 1997
  • The composition of leaf surface lipid in Flue-cured tobacco and their changes during curing was investigated. The flue-cured variety, Nicotiana tabacum cv. NC 82 was cultivated at Eumsung experiment station in 1996. The samples of riced leaves with different stalk Position(Lugs, Cutter, Leaf and Tips) and different curing stage at half yellowing(24hr), yellowing(48 hr) , color axing(72 hr), midrib drying(96 hr) and cured(120 hr) were collected for analysis of leaf surface lipid. $\alpha$ - and $\beta$ - 4, 8, 13-Duvatriene-1, 3-diol($\alpha$, $\beta$-DVT) were major components in leaf surface lipid extracted with methylene chloride and sugar ester was detected slightly DVT content was increased with ascending stalk position, but increasing trend of total hydrocarbon was not observed. While DVT was decreased throughout curing of tobacco leaves, hydrocarbon content did not show significant change during curing process. Twenty-two duvane compounds were detected by capillary GC in duvane fraction isolated from leaf surface lipid and of which 11 compounds were identified by GC-MS. These compounds were decreased with curing in all stalk position.

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Anatomic total shoulder arthroplasty with a nonspherical humeral head and inlay glenoid: 90-day complication profile in the inpatient versus outpatient setting

  • Andrew D. Posner;Michael C. Kuna;Jeremy D. Carroll;Eric M. Perloff;Matthew J. Anderson;Ian D. Hutchinson;Joseph P. Zimmerman
    • Clinics in Shoulder and Elbow
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    • v.26 no.4
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    • pp.380-389
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    • 2023
  • Background: Total shoulder arthroplasty (TSA) with a nonspherical humeral head component and inlay glenoid is a successful bone-preserving treatment for glenohumeral arthritis. This study aimed to describe the 90-day complication profile of TSA with this prosthesis and compare major and minor complication and readmission rates between inpatient- and outpatient-procedure patients. Methods: A retrospective review was performed of a consecutive cohort of patients undergoing TSA with a nonspherical humeral head and inlay glenoid in the inpatient and outpatient settings by a single surgeon between 2017 and 2022. Age, sex, body mass index, American Society of Anesthesiologists (ASA) score, Charlson Comorbidity Index (CCI), and 90-day complication and readmission rates were compared between inpatient and outpatient groups. Results: One hundred eighteen TSAs in 111 patients were identified. Mean age was 64.9 years (range, 39-90) and 65% of patients were male. Ninety-four (80%) and 24 (20%) patients underwent outpatient and inpatient procedures, respectively. Four complications (3.4%) were recorded: axillary nerve stretch injury, isolated ipsilateral arm deep venous thrombosis (DVT), ipsilateral arm DVT with pulmonary embolism requiring readmission, and gastrointestinal bleed requiring readmission. There were no reoperations or other complications. Outpatients were younger with lower ASA and CCI scores than inpatients; however, there was no difference in complications (1/24 vs. 3/94, P=1.00) or readmissions (1/24 vs. 1/94, P=0.37) between these two groups. Conclusions: TSA with a nonspherical humeral head and inlay glenoid can be performed safely in both inpatient and outpatient settings. Rates of early complications and readmissions were low with no difference according to surgical setting. Level of evidence: IV.

Frequency, Clinical Pattern and Outcome of Thrombosis in Cancer Patients in Saudi Arabia

  • Aleem, Aamer;Diab, Abdul Rahman Al;Alsaleh, Khalid;Algahtani, Farjah;Alsaeed, Eyad;Iqbal, Zafar;El-Sherkawy, Mohamed Sherif
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.4
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    • pp.1311-1315
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    • 2012
  • Objectives: Thrombotic risk is increased in patients with cancer and there are important implications for those who suffer a venous thromboembolism (VTE). We undertook this study to determine the frequency, clinical patterns, and outcome of VTE in Saudi patients with cancer. Methods: Cancer (solid tumors and lymphoma) patients who developed VTE from January 2004 to January 2009 were studied retrospectively. Demographics and clinical characteristics related to thrombosis and cancer were evaluated. Results: A total of 701 patients with cancer were seen during the study period. VTE was diagnosed in 47 (6.7%) patients (median age 52, range 18-80 years). Lower limb DVT was the most common type, seen in 47% patients, followed by PE in 19%, and 19% patients had both DVT & PE. Thrombosis was symptomatic in 72% patients while it was an incidental finding on routine workup in 28%. Cancer and VTE were diagnosed at the same time in 38% of patients, and 47% patients developed VTE during the course of disease after the cancer diagnosis. The majority of VTE post cancer diagnoses occurred during the first year (median 4 months, range 1-14). Additional risk factors for VTE were present in 22 (47%) patients and 14 (30%) of these patients were receiving chemotherapy at the time of thrombosis. Only 5 (10.6%) patients were receiving thrombo-prophylaxis at the time of VTE diagnosis. Most common types of tumors associated with thrombosis were breast cancer, non-Hodgkin's lymphoma and lung cancer. The majority of the affected patients (79%) had advanced stage of cancer. After a median follow-up of 13 (range 0.5-60) months, 38 (81%) patients had died. There was no difference in the mortality of patients with symptomatic or asymptomatic thrombosis (82% vs 78.6%). Conclusions: Thrombotic complications can develop in a significant number of patients with cancer, and almost half of the patients have additional risk factors for VTE. Thrombosis is usually associated with advanced disease and can be asymptomatic in more than a quarter of cases. Thromboprophylaxis in cancer patients is under-utilized. Community based studies are needed to accurately define the extent of this problem and to develop effective prophylactic strategies.