scholarly journals State-of-Art in the Age Determination of Venous Thromboembolism: A Systematic Review

Diagnostics ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. 2397
Author(s):  
Nicola Di Fazio ◽  
Giuseppe Delogu ◽  
Costantino Ciallella ◽  
Martina Padovano ◽  
Federica Spadazzi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Venous Thromboembolism ◽  
Age Determination ◽  
Time Geography ◽  
Vein Thrombosis ◽  
Immunohistochemical Markers ◽  
Bias Risk ◽  
Immunohistochemical Techniques ◽  
Meta Analyses

Venous thromboembolism (VTE), consisting of deep vein thrombosis (DVT) and pulmonary embolism (PE), requires a forensic age determination to ascertain their causal relationship with recent events, such as trauma or medical treatment. The main objective of this systematic review is to identify the current state-of-the-art immunohistochemical methods for age determination of fatal VTE. A literature search was performed through different databases, according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Within the study, we have selected only cases represented by deceased patients for DVT and/or PTE in which thromboembolic material was collected during an autoptic examination and then subjected to a histological and an immunohistochemical investigation. Studies based on animal models were not included. We assessed bias risk. A database-based search produced a total of 19 articles. After excluding duplicate items from the selection, 14 articles were reviewed. Ten articles were excluded because they did not meet the inclusion criteria. The results have pointed out 4 studies that were included in the present analysis for a total of 157 samples of DVT and 171 PTE samples. These were analyzed using traditional histological and immunohistochemical techniques. The results must be interpreted with a critical eye because of their heterogeneity in terms of time, geography, and study design. The present review highlights the importance of associating specific immunohistochemical markers with a histological analysis for the timing of DVT/PTE fatal events. Further future experiences will hopefully endorse actual knowledge on the subject to increase the accuracy in the assessment of thrombus-embolus age.

504 Venous Thromboembolism Chemoprophylaxis in Burn Patients: A Literature Review and Single-institution Experience

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S88-S89
Author(s):  
Alice Liu ◽  
Raquel Minasian ◽  
Ellen Maniago ◽  
Justin Gillenwater ◽  
Warren L Garner ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Retrospective Studies ◽  
Factor Xa ◽  
Cost Effective ◽  
Incidence Rates ◽  
Endothelial Damage ◽  
Burn Patients ◽  
Vein Thrombosis ◽  
Routine Monitoring ◽  
Meta Analyses

Abstract Introduction Hospitalized burn patients meet the criteria for Virchow’s triad (endothelial damage, hypercoagulability, and stasis), predisposing them to venous thromboembolism (VTE). While the cost, morbidity, and mortality of VTE suggest a need for prevention in this population, unreliable reported VTE rates, variable and complicated prophylaxis regimens, and risks associated with chemoprophylaxis have prevented the establishment of a universal protocol. This paper reviews the thromboprophylaxis practices both in the literature and at our own institution. Methods A systematic review was conducted according to Preferred Reported Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines identifying studies pertaining to VTE chemoprophylaxis in burn patients. Additionally, medical records of patients admitted to an American Burn Association-verified burn center between June 2015 and June 2019 were retrospectively reviewed for patient demographics, chemoprophylaxis, and presence of VTE defined as either deep vein thrombosis (DVT) or pulmonary embolism (PE). Results 35 studies met inclusion criteria. In the 11 studies that reported VTE incidence, rates ranged widely from 0.27 to 23.3%. The two largest retrospective studies (n = 33,637 and 36,638) reported a VTE incidence of 0.61% and a DVT incidence of 0.8% in populations with unknown or inconsistently recorded chemoprophylaxis. Throughout the literature, prevention protocols were mixed, though a trend toward using dose-adjusted subcutaneous low molecular weight heparin based on serum anti-factor Xa level was noted. At our institution, 1440 patients were admitted over four years. At-risk patients received a simple chemoprophylaxis regimen of 5000U of subcutaneous unfractionated heparin every eight hours. No routine monitoring tests were performed to limit cost. Ten cases of DVT and two cases of PE were identified with an incidence of 0.69% and 0.14%, respectively, and a total VTE incidence of 0.83%. One patient developed heparin-induced thrombocytopenia (0.07%). There were no other heparin-associated complications. Conclusions VTE incidence rates reported in the literature are wide-ranging and poorly capture the effect of any one chemoprophylaxis regimen in the burn population. Our center uses a single, safe, and cost-effective protocol with a VTE rate comparable to that of large national retrospective studies. Applicability of Research to Practice VTE continues to represent a threat to the burn population. While simple and safe chemoprophylaxis regimens exist, the optimal prevention protocol remains elusive.

scholarly journals COVID-19 and Venous Thromboembolism: A Meta-analysis of Literature Studies

2020 ◽  
Vol 46 (07) ◽  
pp. 763-771 ◽  
Author(s):  
Alessandro Di Minno ◽  
Pasquale Ambrosino ◽  
Ilenia Calcaterra ◽  
Matteo Nicola Dario Di Minno
Keyword(s):  
Venous Thromboembolism ◽  
Wide Spectrum ◽  
Meta Analysis ◽  
Z Score ◽  
Thromboembolic Complications ◽  
Vein Thrombosis ◽  
Clinical Presentations ◽  
Meta Analyses ◽  
Detailed Search ◽  
Deep Vein

AbstractCoronavirus disease 2019 (COVID-19) may have a wide spectrum of clinical presentations, leading in some cases to a critical condition with poor long-term outcomes and residual disability requiring post-acute rehabilitation. A major concern in severe COVID-19 is represented by a concomitant prothrombotic state. However, contrasting data are available about the prevalence of venous thromboembolism (VTE), including deep vein thrombosis (DVT) and/or pulmonary embolism (PE). A detailed search on the association of COVID-19 with thromboembolic complications was conducted in the main electronic databases (PubMed, Web of Science, and Scopus) according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The weighted mean prevalence (WMP) with 95% confidence interval (95% CI) was calculated with the random-effects model. Twenty studies enrolling 1,988 COVID-19 patients were included. The WMP of VTE was 31.3% (95% CI: 24.3–39.2%). The WMP of DVT was 19.8% (95% CI: 10.5–34.0%), whereas the WMP of PE was 18.9% (95% CI: 14.4–24.3%). Similar results were obtained when specifically analyzing studies on patients admitted to intensive care units and those on patients under antithrombotic prophylaxis. Regression models showed that an increasing age was associated with a higher prevalence of VTE (Z-score: 3.11, p = 0.001), DVT (Z-score: 2.33, p = 0.002), and PE (Z-score: 3.03, p = 0.002), while an increasing body mass index was associated with an increasing prevalence of PE (Z-score = 2.01, p = 0.04). Male sex did not impact the evaluated outcomes. The rate of thromboembolic complications in COVID-19 patients is definitely high. Considering the risk of fatal and disabling complications, adequate screening procedures and antithrombotic strategies should be implemented.

Histological criteria for age determination of fatal venous thromboembolism

2017 ◽  
Vol 132 (3) ◽  
pp. 775-780 ◽  
Author(s):  
Valeria Maffeis ◽  
Lorenzo Nicolè ◽  
Claudio Rago ◽  
Ambrogio Fassina
Keyword(s):  
Venous Thromboembolism ◽  
Age Determination ◽  
Histological Criteria

scholarly journals Venous Thromboembolism in Hospitalized Critical and Noncritical COVID-19 Patients: A Systematic Review and Meta-analysis

TH Open ◽  
2021 ◽  
Vol 05 (03) ◽  
pp. e286-e294
Author(s):  
Eman M. Mansory ◽  
Suthan Srigunapalan ◽  
Alejandro Lazo-Langner
Keyword(s):  
Systematic Review ◽  
Intensive Care Unit ◽  
Venous Thromboembolism ◽  
Meta Analysis ◽  
Icu Patients ◽  
Systematic Screening ◽  
Screening Analysis ◽  
Vein Thrombosis ◽  
Novel Coronavirus ◽  
Deep Vein

Abstract Introduction Venous thromboembolism (VTE) has been observed as a frequent complication in patients with severe novel coronavirus disease 2019 (COVID-19) infection requiring hospital admission. Aim This study was aimed to evaluate the epidemiology of VTE in hospitalized intensive care unit (ICU) and non-ICU patients. Materials and Methods PubMed was searched up to November 13, 2020, and updated in December 12, 2020. We included studies that evaluated the epidemiology of VTE, including pulmonary embolism (PE) and/or deep vein thrombosis (DVT), in patients with COVID-19. Results A total of 91 studies reporting on 35,017 patients with COVID-19 was included. The overall frequency of VTE in all patients, ICU and non-ICU, was 12.8% (95% confidence interval [CI]: 11.103–14.605), 24.1% (95% CI: 20.070–28.280), and 7.7% (95% CI: 5.956–9.700), respectively. PE occurred in 8.5% (95% CI: 6.911–10.208), and proximal DVT occurred in 8.2% (95% CI: 6.675–9.874) of all hospitalized patients. The relative risk for VTE associated with ICU admission was 2.99 (95% CI: 2.301–3.887, p <0.001). DVT and PE estimated in studies that adopted some form of systematic screening were higher compared with studies with symptom-triggered screening. Analysis restricted to studies in the 5th quintile of sample size reported significantly lower VTE estimates. Conclusion This study confirmed a high risk of VTE in hospitalized COVID-19 patients, especially those admitted to the ICU. Nevertheless, sensitivity analysis suggests that previously reported frequencies of VTE in COVID-19 might have been overestimated.

scholarly journals The Effectiveness of Drying on Residual Droplets, Microorganisms, and Biofilms in Gastrointestinal Endoscope Reprocessing: A Systematic Review

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Hefeng Tian ◽  
Jiao Sun ◽  
Shaoning Guo ◽  
Xuanrui Zhu ◽  
Han Feng ◽  
...  
Keyword(s):  
Systematic Review ◽  
Biofilm Formation ◽  
Microbial Growth ◽  
Assessment Tool ◽  
Current Status ◽  
Drying Methods ◽  
Bias Risk ◽  
The Status ◽  
Meta Analyses ◽  
Gastrointestinal Endoscope

Background. Despite endoscope reprocessing, residual droplets remain in gastrointestinal endoscope working channels. Inadequate drying of gastrointestinal endoscope working channels may promote microbial reproduction and biofilm formation, increasing the risk of infection in patients. This review was designed to provide the current status of gastrointestinal endoscope drying, emphasize the importance of gastrointestinal endoscope drying, and evaluate the effectiveness of different drying methods of gastrointestinal endoscope in reducing residual droplets and microbial growth risk. Methods. A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting checklist. The PubMed, Web of Science, Medline, EMBASE, EBSCO, CNKI, CQVIP, and Wanfang Data databases were searched from 2010 to 2020 to identify eligible articles focused on methods of gastrointestinal endoscope drying and the status of endoscope drying. The following key points were analyzed: type of intervention, amount of residual droplets, major microbial types, and effectiveness of biofilm intervention. JBI quality assessment tool was used to determine bias risk for inclusion in the article. Results. This review included twelve articles. Two of the articles reported lack of drying of gastrointestinal endoscopes while the other ten reported residual droplets, microbial growth, and biofilm formation after different methods of drying. Four articles reported 0 to 4.55 residual droplets; four articles reported that the main microbial types were cocci and bacilli, most commonly Staphylococcus, Escherichia coli, Bacillus maltophilia, and Pseudomonas aeruginosa; and two reported that drying could effectively reduce biofilm regeneration. The type of intervention is as follows: automatic endoscopy reprocessor (AER), manual compressed air drying, and the Dri-Scope Aid for automatic drying and drying cabinet. Conclusions. While endoscope reprocessing may not always be effective, an automatic endoscope reprocessor plus the Dri-Scope Aid with automatic drying over 10 min or storage in a drying cabinet for 72 h may be preferred.

scholarly journals Serological Parameters and Vascular Investigation for a Better Assessment in DVT during Pregnancy—A Systematic Review

Medicina ◽  
2021 ◽  
Vol 57 (2) ◽  
pp. 160
Author(s):  
Catalina Filip ◽  
Demetra Gabriela Socolov ◽  
Elena Albu ◽  
Cristiana Filip ◽  
Roxana Serban ◽  
...  
Keyword(s):  
Systematic Review ◽  
Deep Vein Thrombosis ◽  
Venous Thromboembolism ◽  
Correct Diagnosis ◽  
Thrombotic Event ◽  
Vein Thrombosis ◽  
Major Consequence ◽  
Life Threatening ◽  
The Right ◽  
Deep Vein

Pregnancy and the postpartum period represent a condition characterized by a thrombotic predisposition. The majority of pregnant women do not face acute or severe thrombotic events. In general, mild inconveniences such as leg swelling or moderately painful thrombotic events (phlebitis) are encountered. However, when pregnancy is associated with inherited or acquired deficits that affect homeostasis, the risk of acute or even life-threatening events can increase significantly. The major consequence is the loss of the fetus or the venous thromboembolism that endangers the mother’s life. Venous thromboembolism is caused by deep vein thrombosis, therefore timely detection and especially the assessment of the extent of the thrombotic event are crucial. In this paper we have summarized the most important paraclinical investigations. The study emphasizes the importance of selecting the methods of investigation. The right choice allows establishing a correct diagnosis and individualizing the treatment.

Abstract P227: Diabetes Mellitus and Venous Thromboembolism: A Systematic Review and Meta-analysis

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Elizabeth J Bell ◽  
Aaron R Folsom ◽  
Pamela L Lutsey ◽  
Elizabeth Selvin ◽  
Mary Cushman ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Systematic Review ◽  
Venous Thromboembolism ◽  
Observational Studies ◽  
Meta Analysis ◽  
Diabetes Mellitus Type 1 ◽  
Vein Thrombosis ◽  
Increased Risk ◽  
Study Heterogeneity ◽  
Control Of Diabetes

Introduction: Reported associations of diabetes with venous thromboembolism (VTE) are inconsistent. We conducted a systematic review and meta-analysis to quantify the association between diabetes mellitus (type 1 or 2) and VTE (deep vein thrombosis or pulmonary embolism). Methods: A systematic review of observational studies was conducted using PubMed, Web of Science, and CINAHL through Dec 31, 2012. Additional studies were identified by contacting experts and through manual review of reference lists of review articles and articles eligible for the present study. We abstracted information on relative risk (RR) estimates and pooled these data using a random-effects model. We queried authors of papers that did not adjust for important confounders to request controlled RR estimates. Results: We identified 10 studies (N participants: 240,940; 7 cohort, 3 case-control: Heit, Lidegaard, and Poulter) which provided RRs adjusted for age and BMI (Figure), and 8 additional studies which did not adjust for these confounders (N participants = 150,205). The pooled RR for the association of diabetes with VTE in the 10 studies was 1.18 (95% CI, 1.03-1.34). The test for heterogeneity was not significant (I 2 = 23.8%, p = 0.22). Amongst the 10 studies, smaller studies tended to have lower RR estimates: Both the Begg and Egger tests were significant (p = 0.02 and 0.01, respectively). The other 8 studies showed evidence of significant between-study heterogeneity (I 2 = 75.5%, p <0.0001), making a pooled estimate inappropriate. Conclusions: Diabetes is associated with an 18% increased risk of VTE in observational studies after accounting for age and obesity. Possible explanations for the association of diabetes with VTE include increased hypercoagulability or vascular damage caused by the metabolic derangements of diabetes or increased exposure to VTE risk factors in individuals with diabetes. Further research is needed to elucidate the mechanisms of this association and whether improved control of diabetes is associated with reduced VTE risk.

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