Vascular disease caused by the formation of a blood clot inside a blood vessel
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This episode covers: Cardiology This Week: A concise summary of recent studies Non-bacterial thrombotic endocarditis Managing cardiovascular risk in transgender people Milestones: RAVEL Host: Perry Elliott Guests: Kyle Klarich, Christian Delles Want to watch that episode? Go to: https://esc365.escardio.org/event/1800 Disclaimer: ESC TV Today is supported by Bristol Myers Squibb. This scientific content and opinions expressed in the programme have not been influenced in any way by its sponsor. This programme is intended for health care professionals only and is to be used for educational purposes. The European Society of Cardiology (ESC) does not aim to promote medicinal products nor devices. Any views or opinions expressed are the presenters' own and do not reflect the views of the ESC. Declarations of interests: Stephan Achenbach, Christian Delles, Kyle Klarich and Nicolle Kraenkel have declared to have no potential conflicts of interest to report. Carlos Aguiar has declared to have potential conflicts of interest to report: personal fees for consultancy and/or speaker fees from Abbott, AbbVie, Alnylam, Amgen, AstraZeneca, Bayer, BiAL, Boehringer-Ingelheim, Daiichi-Sankyo, Ferrer, Gilead, GSK, Lilly, Novartis, Novo Nordisk, Pfizer, Sanofi, Servier, Takeda, Tecnimede. Davide Capodanno has declared to have potential conflicts of interest to report: Bristol Myers Squibb, Daiichi Sankyo, Sanofi Aventis, Novo Nordisk, Terumo. Perry Elliott has declared to have potential conflicts of interest to report: consultancies for Pfizer, BMS, Cytokinetics, AstraZeneca, Forbion. Steffen Petersen has declared to have potential conflicts of interest to report: consultancy for Circle Cardiovascular Imaging Inc. Calgary, Alberta, Canada. Emma Svennberg has declared to have potential conflicts of interest to report: Abbott, Astra Zeneca, Bayer, Bristol-Myers, Squibb-Pfizer, Johnson & Johnson.
In this episode, we review the high-yield topic of Thrombotic Thrombocytopenic Purpura (TTP) from the Hematology section. Follow Medbullets on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficial Twitter: www.twitter.com/medbullets
In this episode, we review the high-yield topic Thrombotic Thrombocytopenic Purpura (TTP) from the Heme section at Medbullets.com Follow Medbullets on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficial Twitter: www.twitter.com/medbullets Linkedin: https://www.linkedin.com/company/medbullets
In this episode of “Lab Medicine Rounds,” Justin Kreuter, M.D., interviews Ewa Wysokinska, M.D., an assistant professor of medicine and consultant in the Division of Hematology and Medical Oncology at Mayo Clinic in Florida, to talk about clinical updates in thrombotic thrombocytopenic purpura.
In this episode, Dr. Paul Lewis discusses best practices for thoracentesis. He shares insights on using image guidance, managing complex effusions, and managing complications such as pneumothorax and hemothorax. Dr. Lewis is an interventional radiologist at the University of Pittsburgh Medical Center. --- CHECK OUT OUR SPONSOR Laborie RenovaRP Centesis System https://www.laborie.com/product/renovarp-products/ --- SYNPOSIS Dr. Lewis also speaks on patient selection, procedural techniques, equipment choices, and other troubleshooting tips. Additionally, the doctors cover procedural nuances such as bilateral thoracentesis and patient positioning and highlight the efficiency of the RenovaRP Centesis System. --- TIMESTAMPS 00:00 - Introduction 06:07 - Thoracentesis Procedure Walkthrough 16:49 - Equipment Used 22:14 - Troubleshooting 30:56 - Post-Procedural Care 36:12 - Complications 48:07 - Helpful Resources --- RESOURCES Prospective comparison between a peristaltic pump and vacuum containers for paracentesis: Time, resources and safety: https://pubmed.ncbi.nlm.nih.gov/38042055/ Paracentesis: Faster and easier using the RenovaRP® pump: https://pubmed.ncbi.nlm.nih.gov/35548901/ Society of Interventional Radiology Consensus Guidelines for the Periprocedural Management of Thrombotic and Bleeding Risk in Patients Undergoing Percutaneous Image-Guided Interventions—Part II: Recommendations: https://www.jvir.org/article/S1051-0443(19)30407-5/fulltext The Impact of Gravity vs Suction-driven Therapeutic Thoracentesis on Pressure-related Complications: The GRAVITAS Multicenter Randomized Controlled Trial: https://pubmed.ncbi.nlm.nih.gov/31711990/
In this episode, Dr. Paul Lewis discusses best practices for thoracentesis. He shares insights on using image guidance, managing complex effusions, and managing complications such as pneumothorax and hemothorax. Dr. Lewis is an interventional radiologist at the University of Pittsburgh Medical Center. --- CHECK OUT OUR SPONSOR Laborie RenovaRP Centesis System https://www.laborie.com/product/renovarp-products/ --- SYNPOSIS Dr. Lewis also speaks on patient selection, procedural techniques, equipment choices, and other troubleshooting tips. Additionally, the doctors cover procedural nuances such as bilateral thoracentesis and patient positioning and highlight the efficiency of the RenovaRP Centesis System. --- TIMESTAMPS 00:00 - Introduction 06:07 - Thoracentesis Procedure Walkthrough 16:49 - Equipment Used 22:14 - Troubleshooting 30:56 - Post-Procedural Care 36:12 - Complications 48:07 - Helpful Resources --- RESOURCES Prospective comparison between a peristaltic pump and vacuum containers for paracentesis: Time, resources and safety: https://pubmed.ncbi.nlm.nih.gov/38042055/ Paracentesis: Faster and easier using the RenovaRP® pump: https://pubmed.ncbi.nlm.nih.gov/35548901/ Society of Interventional Radiology Consensus Guidelines for the Periprocedural Management of Thrombotic and Bleeding Risk in Patients Undergoing Percutaneous Image-Guided Interventions—Part II: Recommendations: https://www.jvir.org/article/S1051-0443(19)30407-5/fulltext The Impact of Gravity vs Suction-driven Therapeutic Thoracentesis on Pressure-related Complications: The GRAVITAS Multicenter Randomized Controlled Trial: https://pubmed.ncbi.nlm.nih.gov/31711990/
This week on Medmastery's Cardiology Digest, we're peeling back the layers of three enlightening studies that are pushing the boundaries of what we know about cardiac care. STUDY #1: First, we revisit the use of an everyday medication to check if it's doing more harm than good in the elderly. Aspirin, long touted for its preventative benefits, is under scrutiny for its role in anemia. Should we rethink the use of aspirin in primary prevention, especially among the older population? McQuilten, ZK, Thao, LTP, Pasricha, S-R, et al. 2023. Effect of low-dose aspirin versus placebo on incidence of anemia in the elderly: A secondary analysis of the Aspirin in Reducing Events in the Elderly trial. Ann Intern Med. 7: 913–921. (https://www.acpjournals.org/doi/10.7326/M23-0675) STUDY #2: Then, we shift focus to a comparison of approaches to mitral valve repair: the less-invasive minithoracotomy versus the conventional median sternotomy. Patient outcomes and success rates are put under the microscope, so we can tease apart what truly makes a difference in the final result. Is it the size of the incision or the skill of the hands making it? Akowuah, EF, Maier, RH, Hancock, HC, et al. 2023. Minithoracotomy vs conventional sternotomy for mitral valve repair: A randomized clinical trial. JAMA. 22: 1957–1966. (https://jamanetwork.com/journals/jama/fullarticle/2805908) STUDY #3: Lastly, we wrap up with an insightful discussion on compression stockings after acute DVT, to see if they can prevent post-thrombotic syndrome. Do we have enough evidence to make confident recommendations on the real benefits and drawbacks of compression wearables? And how long should patients use them? We delve into the practical aspects of incorporating the findings of this paper into patient care. Meng, J, Liu, W, Wu, Y, et al. Is it necessary to wear compression stockings and how long should they be worn for preventing post thrombotic syndrome? A meta-analysis of randomized controlled trials. Thromb Res. 225: 79–86. (https://www.thrombosisresearch.com/article/S0049-3848(23)00090-7/fulltext) Join us as we dig into the actionable insights from these studies, so we can all better optimize our patients' outcomes! Learn more with these courses: Cardiac MRI Essentials: https://www.medmastery.com/courses/cardiac-mri-essentials Echo Masterclass—The Valves: https://www.medmastery.com/courses/echo-masterclass-valves Show notes: Visit us at https://www.medmastery.com/podcasts/cardiology-podcast.
In this week's episode we'll discuss eculizumab in stem cell transplant-associated thrombotic microangiopathy. Then, we'll learn about reclassifying malignant monocytosis, these newly classified cases have distinct mutational and transcriptional profiles. Finally, we'll hear about targeting the tissue factor coagulation initiation complex prevents antiphospholipid antibody development.Articles featured in this episode: A prospective multi-institutional study of eculizumab to treat high-risk stem cell transplantation–associated TMA Comparing malignant monocytosis across the updated WHO and ICC classifications of 2022 Treatment outcomes of complement protein C5 inhibition in 509 UK patients with paroxysmal nocturnal hemoglobinuria
Ready Player One? In our latest episode, Dr. Keith Brunt (Dalhousie University) interviews lead author Dr. Joanne DiFrancisco-Donoghue (New York Institute of Technology) and expert Dr. Saurabh Thosar (Oregon Health and Science University Hospital) about a new article published in the AJP-Heart and Circ Call for Papers on Exercise, Physical Activity, and Cardiovascular Health. DiFrancisco-Donoghue et al. raise an important question about the risk for college level e-sport athletes, professionals, and recreational gamers to develop deep vein thromboses. Using Doppler ultrasound recordings of blood flow velocity and volume, the authors found a decrease in both measures when e-sport play was interrupted with a 6-minute walk. DiFrancisco-Donoghue and co-authors found a similar decrease when e-sport athletes wore compression sleeves during play. Could either a break in play for a brief walk or wearing compression stockings help e-sport athletes avoid the risk of deep vein thrombosis caused by prolonged sitting? What effects might this have on executive function, improvement in game play, and for that matter, sleep? If you are a recreational gamer or hoping to go professional, a casual e-sports spectator, or even an active member of the military sitting for prolonged periods of time, you don't want to miss this engaging and enlightening episode! Listen now. Joanne DiFrancisco-Donoghue, Kelly Borges, Timothy Li, Olivia Ballone, Hallie Zwibel, and Peter C. Douris Reducing thrombotic risks in video gamers: investigating the benefits of walking and compression sleeves on blood hemodynamics Am J Physiol Heart Circ Physiol, published February 8, 2024. DOI: 10.1152/ajpheart.00669.2023 I Spy Physiology Blog by Erica Roth How Can Walking and Wearing Socks Help Video Gamers?
Commentary by Dr. Candice Silversides
The CLOT Conversation Hosts (Dr Jameel Abdulrehman and Dr Maha Othman) discuss Post-Thrombotic Syndrome and the TILE study with two of the authors of the recently published paper, Tinzaparin Lead-in to Prevent the Post-Thrombotic syndrome study protocol, Dr Jean-Phillippe Galanaud and Dr Ilia Makedonov. In the interview the authors discuss the latest research on PTS and the rationale for the TILE study.Dr Jean-Philippe Galanaud is a General Internal Medicine specialist and Thrombosis Physician. He works as a staff physician in the Department of Medicine at Sunnybrook Health Sciences Centre in Toronto; He is associate Professor of Medicine at the University of Toronto.His areas of expertise in research are in the field of the post thrombotic syndrome and of distal DVT; He is currently conducting, with Susan Kahn from McGill, 2 multicentre studies in the field of PTS; 1 on the prevention of post thrombotic syndrome with LMWH (The Tile study) and 1 on the treatment of post thrombotic syndrome with venoactive drugs (The MUFFIN study)AndDr Makedonov completed medical school at the University of Toronto, followed by internal medicine residency in Ottawa. He took a keen interest in thrombosis, doing a fellowship at Sunnybrook and receiving a grant from CanVECTOR. He research has focused on the post thrombotic syndrome as well as distal DVT and cerebral venous sinus thrombosis. He runs a thrombosis clinic at the Southlake Regional Health Centre. He has a broad clinical practice, including peri-partum and cancer associated VTE. In his spare time , he bikes and sails. He hopes to one day own a dog. Reference: Makedonov I, Kahn S, Abdulrehman J, et al. TILE pilot trial study protocol: Tinzaparin Lead-in to Prevent the Post-Thrombotic syndrome study protocol. BMJ Open 2023;13:e064715. doi:10.1136/ bmjopen-2022-064715 Follow us on twitter: @thrombosiscan Check out our website: https://thrombosiscanada.caSupport the showhttps://thrombosiscanada.caTake a look at our healthcare professional and patient resources, videos and publications on thrombosis from the expert members of Thrombosis Canada
On today's podcast we'll discuss high-risk cytogenetic abnormalities in solitary bone plasmacytomas. Then, we'll consider complement activation in vaso-occlusive pain episodes and how targeting C5a generation inhibited those effects. Finally we'll explore the genetics of platelet reactivity and how researchers used this data to develop a genetic score that was associated with risk of thrombotic diseases.
Welcome to "ACR Convergence on Air" (ACoA)! Our daily coverage of ACR Convergence 2023! First up: what is thrombotic microangiopathy (TMA) and what is its significance for rheumatology? How does TMA present in clinic and what are the challenges in diagnosing it? Chief of the Division of Hematology and Medical Director of the Clinical Coagulation and the Platelet Antibody Laboratories at Duke University, Dr. Thomas Ortel, joins us on the show to explain this and more from his presentation here at Convergence 2023
Looking for more information on this topic? Check out the Thrombotic Microangiopathies brick. If you enjoyed this episode, we'd love for you to leave a review on Apple Podcasts. It helps with our visibility, and the more med students (or future med students) listen to the podcast, the more we can provide to the future physicians of the world. Follow USMLE-Rx at: Facebook: www.facebook.com/usmlerx Blog: www.firstaidteam.com Twitter: https://twitter.com/firstaidteam Instagram: https://www.instagram.com/firstaidteam/ YouTube: www.youtube.com/USMLERX Learn how you can access over 150 of our bricks for FREE: https://usmlerx.wpengine.com/free-bricks/ from our Musculoskeletal, Skin, and Connective Tissue collection, which is available for free. Learn more about Rx Bricks by signing up for a free USMLE-Rx account: www.usmle-rx.com You will get 5 days of full access to our Rx360+ program, including nearly 800 Rx Bricks. After the 5-day period, you will still be able to access over 150 free bricks, including the entire collections for General Microbiology and Cellular and Molecular Biology.
Title: Cardiology Grand Rounds: Lessons Learned from DOAC's and the New Factor XI Anti-thrombotic Therapies Being Studied Speaker: Manesh R. Patel, MD Chief, Division of Cardiology Co-Director, Duke Heart Center Duke Clinical Research Institute Duke University, Durham, NC Disclosures: Research Grants: PACIFIC-AF: Bayer, Janssen, Heartflow, Idorsia, NHLBI, Novartis Advisory Board/Consulting: Bayer, Janssen, Heartflow, Medscape Objectives: •Understand the Net-Benefit of Warfarin and then NOACs in AFib •Understand the use of NOACs and limitations •Understand the Factor XI therapy and promise in A. Fib
Christoph Licht, MD, FRCPC, FASN - Recognizing the Signs: Expert Insights to Guide the Timely Diagnosis of Thrombotic Microangiopathies
We are happy to be joined this week once again by Dr Tom Skinner, Haematology SpR. Dr Skinner is going to give us a brief summary of diagnosis and management of a rare but life threatening haematological emergency, TTP. Enjoy listening.
Join us for an in-depth conversation with Dr Lucia Caiano and Dr Tzu-Fei Wang, two of the authors of a review exploring the potential role of statins in preventing post-thrombotic syndrome (PTS), a frequent long-term complication of deep vein thrombosis (DVT). They dive into their systematic review and meta-analysis, discussing the intriguing findings drawn from 1971 screened records. The interview reveals their insightful interpretations of data, including the possible 22% reduction of PTS incidence with statin use. Yet, they also acknowledge the limitations seen in randomized controlled trials (RCTs). The conversation offers an invaluable opportunity to better understand the challenges of PTS prevention, the promising role of statins, and the crucial need for larger RCTs to confirm these findings. Don't miss this chance to gain expert insights into this rapidly developing field of medical research.Contact us on Twitter:@ThrombosisCan@TzufeiWangRef:Caiano L, Drury T, Zahrai A, Wang TF, Siegal DM, Rodger MA, Fournier K, Delluc A. Role of statins in the prevention of post-thrombotic syndrome after a deep venous thrombosis event: a systematic review and meta-analysis. Journal of Thrombosis and Haemostasis. 2022 Dec 22.Support the showhttps://thrombosiscanada.caTake a look at our healthcare professional and patient resources, videos and publications on thrombosis from the expert members of Thrombosis Canada
Commentary by Dr. Valentin Fuster
Looking for more information on this topic? Check out the Thrombotic Disorders: Foundations and Frameworks brick. If you enjoyed this episode, we'd love for you to leave a review on Apple Podcasts. It helps with our visibility, and the more med students (or future med students) listen to the podcast, the more we can provide to the future physicians of the world. Follow USMLE-Rx at: Facebook: www.facebook.com/usmlerx Blog: www.firstaidteam.com Twitter: https://twitter.com/firstaidteam Instagram: https://www.instagram.com/firstaidteam/ YouTube: www.youtube.com/USMLERX Learn how you can access over 150 of our bricks for FREE: https://usmlerx.wpengine.com/free-bricks/ from our Musculoskeletal, Skin, and Connective Tissue collection, which is available for free. Learn more about Rx Bricks by signing up for a free USMLE-Rx account: www.usmle-rx.com You will get 5 days of full access to our Rx360+ program, including nearly 800 Rx Bricks. After the 5-day period, you will still be able to access over 150 free bricks, including the entire collections for General Microbiology and Cellular and Molecular Biology.
MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021. Originally released: December 28, 2017 In this week's clinical case, Dr. John Baird (Stanford) shares the story of a patient he's been following who's experienced a neurologic complication of her hematologic illness. Check it out. Produced by James E Siegler. Music by Chris Zabriskie, Ian Southerland, Julie Maxwell, Jason Shaw, and Rafael Archangel. Voiceover by Erika Mejia. BrainWaves' podcasts and online content are intended for medical education only and should not be used for routine clinical decision-making. REFERENCES Bakshi R, Shaikh ZA, Bates VE, Kinkel PR. Thrombotic thrombocytopenic purpura: brain CT and MRI findings in 12 patients. Neurology 1999;52(6):1285-8. PMID 10214762 George JN. Clinical practice. Thrombotic thrombocytopenic purpura. N Engl J Med 2006;354(18):1927-35. PMID 16672704 George JN, Nester CM. Syndromes of thrombotic microangiopathy. N Engl J Med 2014;371(7):654-66. PMID 25119611 Goel R, Ness PM, Takemoto CM, Krishnamurti L, King KE, Tobian AA. Platelet transfusions in platelet consumptive disorders are associated with arterial thrombosis and in-hospital mortality. Blood 2015;125(9):1470-6. PMID 25588677 We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode's original release date.
Don't miss our latest podcast interview with Dr Joseph Shaw and Dr Tzu-Fei Wang who discuss insights from their single-center retrospective cohort study, which included 264 patients with nonvalvular AF and Cancer undergoing 302 periprocedural interruptions. Learn about the primary endpoints, which were the 30-day risks of arterial thromboembolism and major bleeding, and the results that showed relatively low risk for these complications when patients were managed according to commonly applied perioperative management recommendations. Tune in now to gain valuable knowledge on this important topic.Aziz, Joseph, et al. "Thrombotic and Bleeding Outcomes Following the Perioperative Interruption of Anticoagulation Among Patients with Non-Valvular Atrial Fibrillation and Active Cancer." Journal of Thrombosis and Haemostasis (2022).Follow us on TwitterDr Shaw: @JRand083Dr Wang: @TzufeiWang@thrombosiscanada.cawww.thrombosiscanada.caSupport the showhttps://thrombosiscanada.caTake a look at our healthcare professional and patient resources, videos and publications on thrombosis from the expert members of Thrombosis Canada
ESC TV Today brings you concise analysis from the world's leading experts, so you can stay on top of what's happening in your field quickly. This episode covers: Cardiology This Week: A concise summary of recent studies Cardiac involvement in Fabry's Disease Anti-thrombotic therapy post PCI: DAPT in 2023 Mythbusters: Powernap for heart health Host: Rick Grobbee Guests: Perry Elliott, Nicolle Kraenkel, Roxana Mehran and Franz Weidinger Want to watch that episode? Go to: https://esc365.escardio.org/event/896 Disclaimer This programme is intended for health care professionals only and is to be used for educational purposes. The European Society of Cardiology (ESC) does not aim to promote medicinal products nor devices. Any views or opinions expressed are the presenters' own and do not reflect the views of the ESC. Declarations of interests Stephan Achenbach, Rick Grobbee, Nicolle Kraenkel and Franz Weidinger have declared to have no potential conflicts of interest to report. Carlos Aguiar has declared to have potential conflicts of interest to report: personal fees for consultancy and/or speaker fees from Abbott, Alnylam, Amgen, AstraZeneca, Bayer, Boehringer-Ingelheim, Daiichi-Sankyo, Ferrer, Gilead, Lilly, Novartis, Pfizer, Sanofi, Servier, Tecnimede. Davide Capodanno has declared to have potential conflicts of interest to report: Sanofi, Daiichi Sankyo, Terumo, Medtronic, Chiesi. Perry Elliott has declared to have potential conflicts of interest to report: consultancies for Sanofi. Roxana Mehran has declared to have potential conflicts of interest to report: institutional research payments from Abbott, Abiomed, Alleviant Medical, Amgen, AM-Pharma, Arena, AstraZeneca, Atricure, Bayer, Biosensors, Biotronik, Boston Scientific, Bristol-Myers Squibb, CardiaWave, CeloNova, Chiesi, Concept Medical, CSL Behring, Cytosorbents, Daiichi Sankyo, Element Science, Faraday, Filterlex Medical, Humacyte, Idorsia Pharmaceuticals, Janssen, Mediasphere, Medtelligence, Medtronic, Novartis, OrbusNeich, Penumbra, PhaseBio, Philips, Pi-Cardia, PLx Pharma, Protembis, RenalPro, RM Global, Shockwave, Vivasure, Zoll; personal fees from Cine-Med Research, Ionis Pharmaceuticals, Novartis, Novo Nordisk, Vectura, WebMD; Equity
In this final episode in the Vascular Surgery series from Surgical Readings from SRGS, host Rick Greene, MD, FACS, and vascular surgeon Girma Tefera, MD, FACS, review key data on the etiology, diagnosis, and management of varicose veins. Dr. Tefera outlines endoluminal ablation, foam injection, and traditional approaches of ligation and stripping. The discussion current guidance for compression treatment and strategies for successful wound care and management. Learn more about Selected Readings in General Surgery, an American College of Surgeons publication that highlights highly relevant and practice-changing information from the world's most prominent medical journals. #SurgicalReadings #SRGS
In this interview, two of the authors of the paper Direct oral anticoagulants vs vitamin-K antagonists in thrombotic antiphospholipid syndrome: meta-analysis of randomized controlled trials, Dr Jean Connors and Dr Benhood Bikdeli, provide listeners with an overview of their systematic review and meta-analysis that evaluated the efficacy and safety of direct oral anticoagulants (DOACs) compared to vitamin K antagonists (VKAs) in patients with thrombotic antiphospholipid syndrome. The authors searched through three databases (PubMed, EMBASE, and Cochrane Central Register of Controlled Trials) and found four eligible randomized controlled trials with a total of 472 patients. Our podcast guests discuss the results of the study and the clinical implications. About our guests:Dr Jean M Connors: Jean M. Connors, MD is a hematology attending at Brigham and Women's Hospital and Dana-Farber Cancer Institute; the Medical Director of the Anticoagulation Management Services, and the Hemostatic Antithrombotic Stewardship Program; and an Associate Professor of Medicine at Harvard Medical School. She received a medical degree from The Johns Hopkins University in Baltimore, completed her residency in internal medicine at Beth Israel Deaconess Medical Center in Boson, as well as fellowships in transfusion medicine and hematology & oncology from Brigham and Women's Hospital.Dr. Connors is an Associate Editor for the Journal of Thrombosis and Haemostasis and the Journal of the American College of Cardiology: Basic to Translational Science. She is a member of or holds a leadership role in many professional societies, including ASH and ISTH. She has participated in numerous clinical trials for patients with venous thrombosis in cancer, and anticoagulation questions in general.Dr Benhood Bikdeli:Behnood Bikdeli, MD, MS is a clinician-investigator, with training in cardiology and in vascular medicine who is particularly interested in thrombotic diseases. He is an Associate Physician in the Division of Cardiovascular Medicine at Brigham and Women's Hospital, an Instructor in Medicine at Harvard Medical School, and an investigator at Yale Center for Outcomes Research and Evaluation (CORE). His research has been funded by the NIH, the American Heart Association, Brigham and Women's Hospital and others. Dr Bikdeli has coauthored over 180 publications, which have been published in journals including Lancet, JAMA, JAMA Internal Medicine, Circulation, Journal of the American College of Cardiology, the British Medical Journal, and others. Dr. Bikdeli was the lead author of two international consensus documents related to thrombosis in COVID-19, is the joint principal investigator of the INSPIRATION/ INSPIRATION-S randomized controlled trial, and is an Associate Editor for Thrombosis Research. Ref:Khairani, C. D., Bejjani, A., Piazza, G., Jimenez, D., Monreal, M., Chatterjee, S., ... & Bikdeli, B. (2022). Direct oral anticoagulants vs vitamin-K antagonists in thrombotic antiphospholipid syndrome: meta-analysis of randomized controlled trials. Journal of the American College of Cardiology.Follow us on Twitter:@thrombosiscan@connors_mdSupport the showhttps://thrombosiscanada.caTake a look at our healthcare professional and patient resources, videos and publications on thrombosis from the expert members of Thrombosis Canada
Commentary by Dr. Valentin Fuster
TTP is a life-threatening rare blood disorder requiring rapid diagnosis and treatment. Dr Eng Soo Yap and patient advocate, Ms Lisa Foster, help us understand more about the two main types of TTP, immune-mediated TTP (iTTP) and congenital TTP (cTTP), and the overall impact it has on the patient.See omnystudio.com/listener for privacy information.
CME credits: 1.25 Valid until: 23-11-2023 Claim your CME credit at https://reachmd.com/programs/cme/rivaroxaban-to-reduce-the-risk-of-major-venous-and-arterial-thrombotic-events-hospitalization-and-death-in-medically-ill-outpatients-with-covid-19-primary-results-of-the-prevent-hd-randomized-clinical-trial/14429/ In this program, expert faculty review and discuss real-world applications of the latest, practice-changing data across different therapeutic areas within cardiovascular medicine presented at the American Heart Association Scientific Session 2022.
“Once patients come out on the other side, nursing care involves understanding how to triage their disease: If they call you with concerns, how would you address those concerns? How would you find out if there's something going on? Just given how acute the onset is, a lot of these patients have some post-traumatic stress disorder, so there's a lot of worried-well conversations, and in outpatients you need to figure out how to coordinate future care given their history of thrombotic thrombocytopenia purpura (TTP),” ONS member Amanda Weatherford, MSN, RN, OCN®, clinical nurse coordinator at Fred Hutchinson Cancer Center in Seattle, WA, told Jaime Weimer, MSN, RN, AGCNS-BC, AOCNS®, oncology clinical specialist at ONS in a conversation about nursing considerations to manage TTP. This episode is part of a series about oncologic emergencies; the others are linked in the episode notes. You can earn free NCPD contact hours after listening to this episode by completing the evaluation linked below. Music Credit: “Fireflies and Stardust” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at myoutcomes.ons.org by November 18, 2024. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center's Commission on Accreditation. Upon completion of this activity, participants will report an increase in knowledge of thrombotic thrombocytopenia purpura. Episode Notes Complete this evaluation for free NCPD. Previous Oncology Nursing Podcast episodes on oncologic emergencies ONS book: Understanding and Managing Oncologic Emergencies: A Resource for Nurses (third edition) ONS courses: Oncologic Emergencies Treatment and Symptom Management—Oncology RN Essentials in Oncologic Emergencies for the Advanced Practice Provider ONS Huddle Cards™ American Society of Hematology National Organization for Rare Diseases To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From Today's Episode “Immune or acquired thrombotic thrombocytopenia purpura (TTP) is the most common. It's 95% of all the cases. It is what we as nurses are most likely to encounter in our practice.” Timestamp (TS) 03:29 “TTP can show up in cancer and also as the result of chemotherapy and medications. They say it's either a system of malignancy or a consequence of treatment, and it has also shown up in patients who are post allogenic stem cell transplants.” TS 07:05 “Once you suspect that TTP is into play, you would immediately start the patient on plasma exchange or plasma pheresis, daily or twice daily, and also on high-dose steroids. You do that until you start to see improvement in platelet counts and some of the other hemolysis markers, like LDH.” TS 11:26 “Once patients come out on the other side, nursing care involves understanding how to triage their disease: If they call you with concerns, how would you address those concerns? How would you find out if there's something going on? Just given how acute the onset is, a lot of these patients have some post-traumatic stress disorder, so there's a lot of worried-well conversations, and in outpatients you need to figure out how to coordinate future care given their history of TTP.” TS 14:58 “In patients with cancer, TTP is either a symptom of disease or caused by the treatment. So, you could potentially just have a new patient with cancer and, along with this major, acute crisis that they've had, so dealing with a cancer diagnosis and having had TTP. Or trying to figure out if it was medication. How do we resolve that? Are we able to find a different drug and switch to a different regiment, or do we continue to give it because it's the only therapy? And do we have to continue to be on the lookout for relapse?” TS 17:47
In this next installment of our Back to the Basics series, Drs. Aaron Fritts and Chris Beck discuss their techniques, considerations, and tips for ensuring safe and high quality renal biopsies. The CE experience for this Podcast is powered by CMEfy - click here to reflect and earn credits: https://earnc.me/bYgmZk --- CHECK OUT OUR SPONSORS Laurel Road for Doctors https://www.laurelroad.com/healthcare-banking/ RADPAD® Radiation Protection https://www.radpad.com/ --- SHOW NOTES First, the doctors discuss indications and contraindications for biopsy. In the outpatient setting, the doctors have noticed that proteinuria is the most common reason for referral, followed by lupus nephritis. For inpatients, acute unexplained kidney failure is an additional indication. It is important to talk with nephrologists to weigh the risks and benefits of renal biopsy, especially if the patient has a coagulopathy, is experiencing uncontrolled hypertension, or is too unstable to lay prone on the table. The SIR Guidelines app is a useful tool to risk stratify patients. In terms of imaging, CT or ultrasound can be used, although they each have unique advantages. Ultrasound allows for real-time guidance and the ability to use the probe to hold pressure on the kidney to prevent bleeding. On the other hand, CT allows for better imaging in patients with larger body habitus and allows the patients to lay prone. Dr. Fritts emphasizes that the best imaging modality is the one that the operator is most comfortable with, since this will ensure maximal safety for the patient. One helpful tip when planning a biopsy is to avoid needle entry into the paraspinal muscles, since this could change the trajectory of the needle and cause pain. Both doctors prefer to use moderate sedation if the patient can tolerate it. This sedation usually has the added benefit of facilitating an intra-procedural blood pressure dip, which protects against bleeding when biopsying hypertensive patients. Since sedation can alter breathing patterns, starting sedation early (before scanning the patient) can be helpful in establishing a steady breathing pattern before the procedure starts. Dr. Beck also recommends checking blood pressure while the patient is in pre-operative care, in order to predict whether or not they might require additional intra-procedural antihypertensive medications such as hydralazine, labetalol, or clonidine. Since blood pressure control is a cornerstone of a safe procedure, each doctor has their own safety threshold for blood pressure. Then, the doctors discuss different types and sizes of biopsy needles. While a 16G needle can obtain better diagnostic samples, the 18G needle might have a lower risk of bleeding complications. The doctors also share their preferred brands of needles. The episode concludes with tips for surveilling patients in the post-procedural period and dealing with bleeding complications. Dr. Beck describes his protocol for re-scanning patients to check for large hematomas and keeping them under observation for at least three hours. If there is a large hematoma, emergency embolization must be performed. --- RESOURCES SIR Guidelines App: https://apps.apple.com/us/app/sir-guidelines/id1552455529 SIR Consensus Guidelines for the Periprocedural Management of Thrombotic and Bleeding Risk in Patients Undergoing Percutaneous Image-Guided Interventions: https://www.jvir.org/article/S1051-0443(19)30407-5/fulltext 18G BioPince Biopsy Needle: https://www.argonmedical.com/products/biopince-full-core-biopsy-instrument Bard Mission Biopsy Needle: https://www.bd.com/en-us/products-and-solutions/products/product-families/mission-disposable-core-biopsy-instrument Temno Biopsy Needle: https://www.merit.com/peripheral-intervention/biopsy/soft-tissue-biopsy/temno-evolution-biopsy-device/
KaShena L. Kennedy, PharmD (Twitter: @KaShenaKennedy) reviews and identifies the pathophysiology, clinical manifestations, and diagnostic criteria for TA-TMA in pediatric patients, differentiates risk factors associated with TA-TMA and discusses prophylactic treatment in pediatric patients and explores treatment and emerging therapy options of TA-TMA in pediatric patients. For more pharmacy content, follow Mayo Clinic Pharmacy Residency Programs @MayoPharmRes or the host, Garrett E. Schramm, Pharm.D., @garrett_schramm on Twitter! You can also connect with the Mayo Clinic's School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.
Thrombotic microangiopathies are uncommon disorders, and can result in significant patient morbidity. With the introduction of effective new therapies, the outlook for those suffering from these diseases is increasingly optimistic. Elie Azoulay is a professor of medicine, intensivist and board member of the French National Reference Centre for Thrombotic Microangiopathies. See omnystudio.com/listener for privacy information.
In this episode, Dr. Yeh is joined by lead author Danielle C. Sutzko, MD, MS, from the University of Alabama at Birmingham, and senior author Andrea T. Obi, MD, FACS, from the University of Michigan, both vascular surgeons. They discuss their recent work on outcomes associated with direct oral anticoagulant and vitamin K antagonist use after lower extremity bypass. Learn more about the Journal of the American College of Surgeons, a monthly peer-reviewed journal publishing original contributions on all aspects of surgery, including scientific articles, collective reviews, experimental investigations, and more. #JACSOperativeWord
Editor's Summary by Kirsten Bibbins-Domingo, PhD, MD, MAS, Editor in Chief of JAMA, the Journal of the American Medical Association, for the August 16, 2022 issue.
CME credits: 1.75 Valid until: 12-08-2023 Claim your CME credit at https://reachmd.com/programs/cme/thrombotic-risk-and-ivh-is-there-something-more-to-pnh/14302/ tbd
Welcome to the Sterile Technique Podcast! It's the podcast about Surgical Technology. Whether you are a CST or CSFA, this podcast helps you earn CE credits and improve your surgery skills in the OR. This episode discusses the cover article of the July 2022 issue of The Surgical Technologist, which is the official journal of the Association of Surgical Technologists (AST). The article is titled, "Immuno-Thrombotic Complications of COVID-19: Implications for Timing of Surgery and Anticoagulation". "Scrub in" at steriletpodcast.com and on Twitter, @SterileTPodcast (twitter.com/SterileTPodcast). This podcast is a Dybas Media production. Sound effects adapted from GarageBand and sindhu.tms at https://freesound.org/people/sindhu.tms/sounds/169065/ and licensed courtesy of https://creativecommons.org/licenses/by-nc/3.0/.
Darryl Earl Clack is a former American football running back in the National Football League for the Dallas Cowboys. He also was a member of the Toronto Argonauts in the Canadian Football League. He played college football at Arizona State University. After his playing days, Clack went to the University of Texas at El Paso earning a B.A. in Kinesiology and Sports Studies. He moved around the business world for a time and settled into the banking business as vice president at Compass Bank in Tempe, Arizona, not far from the Arizona State University campus. After banking he accumulated over 15 years of extensive experience in management and leadership at various companies including Cox Communications. He then earned an M.A. in Organizational Management from the University of Phoenix and was in his first year of working towards a Ph.D. when he fell ill to Thrombotic thrombocytopenic purpura (TTP), a rare autoimmune blood disorder. In addition to TTP, in July 2016, he learned of his early-stage dementia diagnose, due to years of trauma to the head from playing football. These traumatic events, three months apart, prompted Darryl to write the book "Hear My Story Before I Forget" and start a foundation to bring awareness to TTP and brain injuries. Although he is no longer playing ball, he keeps his hand in the game as President and co-founder of SportMetric, along with co-founders Josh Jakubczak and Darius Perry, a company emphasizing education, community involvement, and athletics for the youth. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app Support this podcast: https://anchor.fm/dadcastco/support
Emergencies happen in hematology and oncology. This is a fact. But how do we manage these emergencies? Look no further. In this episode, we talk all about our fourth hematologic emergency: thrombotic thrombocytopenic purpura (TTP). Thrombotic thrombocytopenic purpura (TTP):- Be sure to check out episode 009 on thrombocytopenia for a general approach and differential!- New anemia and thrombocytopenia should raise concerns for TTP! Workup: - Peripheral smear - concern for schistocytes. Look at this first! Example of these cells from ASH image bank here- ADAMTS13 level - always draw ASAP before any intervention- Repeat CBC- Reticulocyte count - will have elevated retic count- Citrated platelet count - CMP- PT, PTT, INR- Fibrinogen- Haptoglobin - LDH- Viral serologies Clinical manifestations: - Fever, Anemia, Thrombocytopenia, Renal (AKI), Altered Mental Status- If you see this - the patient is in bad shapeMechanism:- Tiny blood clots form in the body, causing platelet shearing- Loss of ADAMTS13 - This protein normally is responsible for chopping up von Willebrand's factor (vWF)- In the absence of ADAMTS13, vWF multimers are extra long, therefore interacting with platelets/collagen more and causing activation of platelets and clotting system- This causes red blood cell shearing due to small vessel microthrombi (brain, kidneys, heart)- Cytokine release causes fevers Management:- Do not reflexively transfuse platelets; can make situation worse - PLASMIC Score: helps to stratify likelihood of TTP; MDCalc link (https://www.mdcalc.com/plasmic-score-ttp)Treatment: - Plasma exchange: replacing ADATMS13-deficient plasma with ADAMTS13-rich plasma- This is different than plasmapheresis, where we replace plasma with albumin- Steroids: 1mg/kg prednisone daily to stop auto-antibody (against ADAMTS13) production- Confirm with ADAMTS13 levels; if
The thrombotic antiphospholipid syndrome (TAPS) is associated with atypical thromboembolic events and/or recurrent pregnancy loss. Patients with TAPS are at very high risk of recurrent thrombotic events and require indefinite therapy. Warfarin therapy is very challenging to manage in this patient population and requires frequent monitoring. Thus a direct oral anticoagulant would be a welcomed alternative to warfarin by many patients with TAPS. But are they effective? Guest Authors: Leslie Walters, PharmD, BCACP and Jennifer Carie, PharmD, BCACP, BC-ADM Music by Good Talk
Today's episode will focus on Thrombotic Thrombocytopenic Purpura or TTP. This will include the high yield facts on mechanism, presentation, diagnostic work-up, and treatment of TTP, and also discuss Hemolytic Uremic Syndrome (HUS).
Ticagrelor and secondary prevention in CCS
In this episode, we review the high-yield topic of Thrombotic Thrombocytopenic Purpura (TTP) from the Heme section. Follow Medbullets on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficial Twitter: www.twitter.com/medbullets
Looking for more information on this topic? Check out the Thrombotic Disorders: Foundations and Frameworks brick. If you enjoyed this episode, we'd love for you to leave a review on Apple Podcasts. It helps with our visibility, and the more med students (or future med students) listen to the podcast, the more we can provide to the future physicians of the world. Follow USMLE-Rx at: Facebook: www.facebook.com/usmlerx Blog: www.firstaidteam.com Twitter: https://twitter.com/firstaidteam Instagram: https://www.instagram.com/firstaidteam/ YouTube: www.youtube.com/USMLERX Learn how you can access over 150 of our bricks for FREE: https://usmlerx.wpengine.com/free-bricks/ from our Musculoskeletal, Skin, and Connective Tissue collection, which is available for free. Learn more about Rx Bricks by signing up for a free USMLE-Rx account: www.usmle-rx.com You will get 5 days of full access to our Rx360+ program, including nearly 800 Rx Bricks. After the 5-day period, you will still be able to access over 150 free bricks, including the entire collections for General Microbiology and Cellular and Molecular Biology.
Ticagrelor in preventing post-ACS thrombotic events
Welcome to the emDOCs.net podcast! Join us as we review our high-yield posts from our website emDOCs.net. Today on the emDOCs cast with Brit Long, MD (@long_brit), we cover a deadly microangiopathic hemolytic anemia: thrombotic thrombocytopenic purpura. To continue to make this a worthwhile podcast for you to listen to, we appreciate any feedback and comments you may have for us. Please let us know!Subscribe to the podcast on one of the many platforms below:Apple iTunesSpotifyGoogle Play
In this episode, we discuss the mechanism , contraindications, dose, and other considerations in the use of Caplacizumab for TTP
In this episode, we review the high-yield topic of Thrombotic Thrombocytopenic Purpura (TTP) from the Hematology section. Follow Medbullets on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficial Twitter: www.twitter.com/medbullets --- Send in a voice message: https://anchor.fm/medbulletsstep1/message
The Elective Rotation: A Critical Care Hospital Pharmacy Podcast
Show notes at pharmacyjoe.com/episode646. In this episode, I’ll discuss a possible syndrome that might herald vaccine-induced immune thrombotic thrombocytopenia. The post 646: Does vaccine-induced immune thrombotic thrombocytopenia have a "pre-VITT syndrome" ? appeared first on Pharmacy Joe.
TTP is a life-threatening, hematologic emergency that can be a challenge to recognize clinically. In this episode, Andrew discusses the pathophysiology and features of this condition, before diving into workup and, most importantly, management.
The difficulties in diagnosing TTP