ABSTRACT

Introduction Venous thromboembolism (VTE), particularly pulmonary embolism (PE), is the third highest cause of death in trauma patients who survive beyond the first day. Musculoskeletal surgery is associated with several complications, some of which may be life-threatening, including deep vein thrombosis (DVT) and PE. Objective This research aims to describe risk variables for VTE after upper extremity (UE) fracture at a single institution and estimate the incidence of PE following UE fracture. Methods The writers accessed the database via their respective universities using the International Standard Classification (ICD) codes. The medical files of patients aged 18 and older who sought treatment at our emergency department for an injury to their UE and also sought treatment at the orthopedics and traumatology clinic between the years 2013 and 2021 were manually scanned. The patients who applied to the Chest Diseases Clinic within 30 days after the trauma and were diagnosed with PE in the ICD code scan were included in the study. Results UE trauma was the cause of admission to the emergency department for 3,265 patients, and 21 of those patients (0.64%) were found to have PE. Fifteen of the patients were male, and six were female. The median age was 59 years (IQR 17). There were no deaths associated with PE. One of the patients had a scaphoid fracture, seven patients had a humerus fracture, five patients had a distal radius fracture, two patients had an acromioclavicular joint injury, one patient had a shoulder dislocation, one patient had a finger fracture, four patients had wrist crush injury. Three patients had diabetes mellitus. Five patients were active smokers. JAK-2 gene V617F mutation was detected in one patient. One patient was diagnosed with prostate cancer, and one had gastric cancer. One patient had a central venous catheter. Two patients were being treated for hypothyroidism. Two patients had hypertension. Conclusion According to the findings of our research, the probability of developing PE in the days following of an injury to the UE was found to be 0.64%. Patients with UE injuries who are active smokers and who also have diabetes, hypertension, hypothyroidism, cancer, coagulation disorder (JAK2 gene V617F mutation), or a central venous catheter may benefit from anticoagulant prophylaxis. This is because these patients are at a higher risk of developing dangerous blood clots.

PMID:37519534 | PMC:PMC10375827 | DOI:10.7759/cureus.41077

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PubMed articles on: Cancer & VTE/PE

How to Treat Today? Oral and Facial Cancer-Associated Venous Thromboembolism

Pharmaceuticals (Basel). 2023 Jul 17;16(7):1011. doi: 10.3390/ph16071011.

ABSTRACT

The exact incidence of cancer-associated venous thromboembolism (CA-VTE) in patients with oral and facial cancer (OFC) is not exactly known, and this risk is empirically considered to be low. However, this suggestion may result in disease underdiagnosis, prolong the initiation of adequate therapy, and consecutively increase CA-VTE-related morbidity and mortality. In addition, there might be specific clinical problems in the treatment of CA-VTE in patients with oral and facial cancer, such as swallowing difficulties, that might limit the possibilities of oral anticoagulation. Finally, there are limited data regarding the optimal treatment of CA-VTE in patients with oral and facial cancer, and this includes data on novel therapeutic strategies, including the use of direct oral anticoagulants. This article reviews current data on the optimal treatment strategy for CA-VTE in patients with OFC.

PMID:37513923 | PMC:PMC10385582 | DOI:10.3390/ph16071011

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PubMed articles on: Cancer & VTE/PE

Thoracic Diseases: Technique and Applications of Dual-Energy CT

Diagnostics (Basel). 2023 Jul 21;13(14):2440. doi: 10.3390/diagnostics13142440.

ABSTRACT

Dual-energy computed tomography (DECT) is one of the most promising technological innovations made in the field of imaging in recent years. Thanks to its ability to provide quantitative and reproducible data, and to improve radiologists' confidence, especially in the less experienced, its applications are increasing in number and variety. In thoracic diseases, DECT is able to provide well-known benefits, although many recent articles have sought to investigate new perspectives. This narrative review aims to provide the reader with an overview of the applications and advantages of DECT in thoracic diseases, focusing on the most recent innovations. The research process was conducted on the databases of Pubmed and Cochrane. The article is organized according to the anatomical district: the review will focus on pleural, lung parenchymal, breast, mediastinal, lymph nodes, vascular and skeletal applications of DECT. In conclusion, considering the new potential applications and the evidence reported in the latest papers, DECT is progressively entering the daily practice of radiologists, and by reading this simple narrative review, every radiologist will know the state of the art of DECT in thoracic diseases.

PMID:37510184 | PMC:PMC10378112 | DOI:10.3390/diagnostics13142440

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PubMed articles on: Cancer & VTE/PE

The use of bevacizumab in primary malignant tumors of the central nervous system: A single-center experience

Medicine (Baltimore). 2023 Jul 28;102(30):e34286. doi: 10.1097/MD.0000000000034286.

ABSTRACT

Primary central nervous system tumors rank 8 among other cancers in patients over 40 years of age. Glioblastoma is the most common primary central nervous system malignancy, accounting for 48 percent of the cases. The present study evaluates the effect of bevacizumab on the disease course in patients who received bevacizumab therapy due to primary central nervous system tumors in our clinic. The study was designed as a retrospective study. The records of patients treated between January 2000 and August 2021 were reviewed and patients who received bevacizumab therapy due to primary central nervous system tumor were included in the study to evaluate the effect of the therapy on disease course among the subgroups of patients. The study included 70 patients. Of these patients, 40 were male (57.1%) and 30 (42.9%) were female. The median duration of follow-up was 28 months (8-209 months). The median age of the patients was 47 years. The median duration of exposure to bevacizumab was 5 months (1-33 months). Forty-nine patients (71.4%) were histologically diagnosed with glioblastoma multiforme. The median progression-free survival (PFS) was 5 months (95% confidence interval 4-6). The median overall survival (OS) was 8 months (95% confidence interval 6.97-9.02). No statistically significant difference in OS or PFS was observed in any patient subgroup. The therapy was discontinued only in 2 patients (2.9%) due to side effects (1 patient with pulmonary embolism and 1 patient with intracranial hemorrhage). The present study found that the use of bevacizumab is safe in terms of side effects. No statistically significant difference in OS or PFS was observed in any patient subgroup. There is a need for studies on a larger number of patients to find out which patient subgroup benefit the most from bevacizumab therapy.

PMID:37505182 | PMC:PMC10378976 | DOI:10.1097/MD.0000000000034286

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PubMed articles on: Cancer & VTE/PE

Venous Thromboembolism and Primary Thromboprophylaxis in Perioperative Pancreatic Cancer Care

Cancers (Basel). 2023 Jul 8;15(14):3546. doi: 10.3390/cancers15143546.