جستجوی مقالات مرتبط با کلیدواژه "dvt" در نشریات گروه "پزشکی"

Venous thromboembolism is a prevalent global health concern that includes 2 primary clinical manifestations: deep vein thrombosis and pulmonary embolism. In patients with heart failure, disruptions in homeostasis result from diminished cardiac output and malfunctioning cardiac chambers, leading to blood stasis. Consequently, these homeostatic abnormalities accelerate the activation of the coagulation system and fibrin formation, rendering patients with heart failure more susceptible to venous thromboembolism. This case report involves a 57-year-old woman presenting with shortness of breath following moderate exertion, such as sweeping and walking 100 meters, over the past month. The symptoms were alleviated by rest, and the patient occasionally experienced orthopnea, accompanied by pain and difficulty walking in the preceding week. The examination of the left lower extremity revealed edema, tenderness, erythema, venectasia around the left femur, and positive Homan’s and Pratt’s signs. Doppler imaging disclosed complete thrombosis in the popliteal veins and the left common femoral vein, partial thrombosis in the superficial femoral veins (the great saphenous vein), and subcutaneous edema in the left femur and lower extremity. Computed tomography findings for the thoracic region indicated pulmonary embolism at the bifurcation of the pulmonary artery, extending to the right and left pulmonary artery branches in the axial view. (Iranian Heart Journal 2024; 25(3): 85-91)

The evaluation of VTE risk using risk assessment scales for each hospitalized patient is recommended by the National Institute for Health and Care Excellence. The purpose of this study was to compare the predictive accuracy of two common assessment scales, the Autar and Padua deep vein thrombosis (DVT) risk assessment scales.  

This prospective cohort study was  conducted on 228 ICU hospitalized patients. The risk of VTE was estimated using the Autar and Padua scales during the first 48 hours after admission. The predictive accuracy of the above two risk assessment scales for VTE in ICU patients was compared based on the area under the receiver operating curve (ROC).   

Results of ROC analysis indicated the area under the curve (AUC) values for the Autar (0.61 ± 0.05) and Pauda (0.53 ± 0.06). Log-rank test showed no difference in AUCs (P = 0.19). Moreover, the accuracy of the Autar scale  and Padua obtained 24% and 14% respectively. Both scales had 100% sensitivity but their specificity was low (Autar 14% and Padua 3%). The positive likelihood ratios (LR+) were 1.17 for Autar and 1.03 for Padua. The negative likelihood ratios (LR-)  were 0 for Autar and 0.89 for Padua. Inter-rater agreement values obtained 0.99 and 0.95 respectively for the the Autar and Padua scales.   

The AUC, accuracy, and LR+ of the Autar risk assessment scale were higher than the Padua scale in predicting VTE. However, both scales had excellent reliability, high sensitivity and low specificity. It is recommended that the risk of VTE is recorded by the Autar scale for patients admitted to ICUs. It can help the healthcare team in the use of prophylaxis for those that are at high risk for VTE.

Pregnant women appear to be more severely affected by COVID-19. Coagulopathy is known as one of the most challenging effects of COVID-19, and the effects of acute airway diseases resulting from the coronavirus on pregnant mothers and their fetuses can be dangerous. Two women who where pregnant suffering from coagulopathy (one of them with disseminated intravascular coagulation (DIC) and the other one with hypercoagulation) and COVID-19 infection are reported in this study. During hospitalization due to severe vaginal bleeding and placental detachment, cesarean section was performed on the first caseand because of acute severe DIC, she received a massive transfusion. The second patient  epigastric pain and tachycardia. COVID-19 might have a variety of effects on pregnancy outcome, from vascular and placental involvement to respiratory involvement; there is an association between the coronavirus and hyper-coagulopathy state and coagulopathy like DIC.

Menopause is one of the risk factors for deep vein thrombosis (DVT) that may increase its likelihood after coronary artery bypass graft surgery (CABG). Hence, it is essentially advised to prevent DVT. In this regard, the purpose of this study was to investigate the effects of simple exercise with and without physiotherapy on DVT prevention in postmenopausal women requiring CABG.

This quasi-experimental study was carried out on 34 patients in Tabriz Shahid Madani hospital from 1 March to the end of July 2019. It is noteworthy that participants were selected based on a random sampling method. The experimental group, namely, the exercise group (n=17) did cardiovascular exercises for 40 minutes the day before the surgery. However, the other group received physiotherapy for each leg for 15 minutes in addition to cardiovascular exercise. Then, DVT diagnosis blood tests, clinical examinations, and Doppler sonography were performed and recorded in all participants’ portfolios. The obtained data were analyzed using SPSS software, and the SPSS tests included Kolmogorov-Smirnov, paired t test, and independent t-test at the significance level of 0.05.

The results of intra-group DVT and blood tests before and after the intervention revealed a statistically significant difference in terms of complete blood count, hemoglobin, hematocrit (P≤0.05). However, no statistically significant differences were reported considering the other variables (P≥0.11). Finally, in the case of inter-group variations, a comparison of the results of the two groups represented no statistically significant difference in any of the studied variables (P≥0.15).

In general, a light exercise session either with or without physiotherapy did not have any positive effects on DVT prevention in postmenopausal women in need of CABG.

Deep vein thrombosis (DVT) and pulmonary embolism (PTE) are known as venous thromboembolism (VTE). DVT occurs when a thrombus (a blood clot) forms in deep veins of the body, usually in the lower extremities. It can cause swelling or leg pain, but sometimes may occur with no symptoms. Awareness of DVT is the best way to prevent the VTE. Patients with trauma are at increased risk of DVT and subsequent PE because of coagulopathy in patients with multiple trauma, DVT prophylaxis is essential but the VTE prophylaxis strategy is controversial for the trauma patients. The risk factors for VTE includes pelvic and lower extremity fractures, and head injury.

Low plasma level of vitamin D is linked to the increased risk of cardiovascular diseases such as hypertension, diabetes, dyslipidemia and peripheral vascular diseases. Vitamin D deficiency is a worldwide problem that involves Iranian population. To the best of our knowledge, this was the first investigation on venous thromboembolism (VTE) subjects that assessed the correlation of vitamin D level with plasma P-selectin, hs-CRP, and risk factors of thrombosis. In this prospective study, patients with diagnosis of acute deep vein thrombosis and or pulmonary eboembolism were enrolled. All patients’ clinical data, demographics and risk factors of thrombosis were evaluated. Plasma level of P-selectin and hs-CRP were measured by ELISA method. Radio immune assay method was used to determine plasma level of 25-hydroxy vitamin D. In this study, 60 subjects were included. The mean ± SD plasma 25-hydroxy vitamin D level (25(OH) D) of participants was 21.4 ± 14.6 ng/mL. The vitamin D deficiency was reported in 60% of patients. No significant relation was found between the plasma 25(OH)D level and P-selectin and hs-CRP. In multiple regression analysis, there was a significant relationship between the level of 25(OH)D and the patients’ age (beta = 0.452; p = 0.001), diabetes (beta = 0.280; p = 0.036) and positive family history of cardiovascular diseases (beta = 0.373; p = 0.003). Vitamin D deficiency is a frequent problem in Iranian VTE patients. Moreover, Plasma level of vitamin D is not associated with increase level of P-selectin and hs-CRP in VTE patients.