Podcasts about venous thromboembolism

Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances, discusses a recently published original research paper on A Comparison of Outcomes With Apixaban, Rivaroxaban, and Warfarin for Atrial Fibrillation and/or Venous Thromboembolism.

Antithrombotic Therapy in VTE

Francis Couturaud joins Chloe Wilson of The Lancet to discuss the RENOVE trial, which looks at assessing the efficacy and safety of reduced-dose versus full-dose direct oral anticoagulants in patients in whom extended anticoagulation has been indicated.Read the full paper: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)02842-3/fulltext?dgcid=buzzsprout_icw_podcast_generic_lancetContinue this conversation on social!Follow us today at...https://twitter.com/thelancethttps://instagram.com/thelancetgrouphttps://facebook.com/thelancetmedicaljournalhttps://linkedIn.com/company/the-lancethttps://youtube.com/thelancettv

A New Podcast from Obstetrics & Gynecology, featuring members from the Editorial Team and contributing authors, each month as they highlight the latest research and practice updates in the field. This episode features an interview Dr. Ann M. Bruno, author of “Postpartum Pharmacologic Thromboprophylaxis and Venous Thromboembolism in a U.S. Cohort.”

Venous Thromboembolism (VTE) is a condition where blood clots form in a blood vessel. As serious as heart attacks and strokes, VTE is the most common cause of preventable death in hospitalized patients. Interventional Radiologist Scott Perrin, MD, discusses the dangers of the disease and what can be done to treat deep vein thrombosis (DVT) and pulmonary embolism (PE).You can also watch the video recording on our Vimeo channel here.For more health tips & news you can use from experts you trust, sign up for Sarasota Memorial's monthly digital newsletter, Healthe-Matters.

Dr Dawn Swan joins us to discuss current knowledge and future perspectives on the possible association between air pollution and venous thromboembolism.Read the full article:https://www.thelancet.com/journals/lanhae/article/PIIS2352-3026(24)00291-6/fulltext?dgcid=buzzsprout_icw_podcast_general_lanhaeContinue this conversation on social!Follow us today at...https://twitter.com/thelancethttps://instagram.com/thelancetgrouphttps://facebook.com/thelancetmedicaljournalhttps://linkedIn.com/company/the-lancethttps://youtube.com/thelancettv

Dr Leslie Skeith joins us to discuss the PARTUM pilot trial, comparing low-dose aspirin versus placebo in postpartum venous thromboembolism.Continue this conversation on social!Follow us today at...https://twitter.com/thelancethttps://instagram.com/thelancetgrouphttps://facebook.com/thelancetmedicaljournalhttps://linkedIn.com/company/the-lancethttps://youtube.com/thelancettv

Commentary by Dr. Tzu-Fei Wang.

Pulmonary emboli in Trauma patients is, unfortunately, an established and not uncommon complication we must deal with. Today, we welcome one of our own Trauma Surgeons, Dr Brent Emigh, MD to the Podcast to discuss VTE occurance and prophylaxis in Trauma patients. Article with more information on PE in Trauma patients is HERE Article mentioned on IVC filters can be accessed HERE If anyone has comments on this episode or suggestions for topics please feel free to reach out to me at kenneth_lynch@brown.edu

Dr. Bob Kay from CHLA joins the show to discuss his recent research on access to hip reconstruction surgery for neuromuscular patients in the Los Angeles area. The Lightning Round discussion spans numerous hip topics including hip preservation surgery and Perthes as well as recent studies on MPFL reconstruction. Your hosts are Carter Clement from Children's Hospital of New Orleans, Josh Holt from Iowa, and Tyler McDonald from University of South Alabama. Music by A. A. Aalto.   References: X-Ray Adventures: https://www.amazon.com/X-ray-Adventures-Carter-Clement/dp/B0D9C5CRTF 1) Timely Hip Surgery Access in Children with Cerebral Palsy: Unaffected by Social Disadvantage at a Large Urban Safety Net Hospital. Wimmer et al. JPO, Oct 2024. PMID: 39350583. 2) Exploring the Experiences and Expectations of Adolescent Females Undergoing Periacetabular Osteotomy. Luck et al. JPO, Aug 2024. PMID: 39171434. 3) Risk of Venous Thromboembolism in Adolescents Undergoing Pelvic Osteotomy: Insights From a Propensity-matched Retrospective Cohort Study. Mittal et al. JPO, Oct 2024. PMID: 39363394. 4) Prevalence and Risk Factors for Stiffness Following Open Reduction for Developmental Dysplasia of the Hip. Desai et al. JPO, Nov-Dec 2024. PMID: 39021118. 5) Adherence to Wide-Abduction Brace Treatment is Associated With Improved Hip Abduction and Radiographic Outcomes in Legg-Calvé-Perthes Disease. Prasadh et al. JPO, Nov-Dec 2024. PMID: 39187945. 6) Medial Patellofemoral Ligament Reconstruction in Adolescents: What Parents Care About. Culpepper et al. JPO, Aug 2024. PMID: 39171383. 7) Medial Patellofemoral Ligament Reconstruction Improves Patella Alta. Yang et al. JPO, Sep 2024. PMID: 39279747.

Show notes at pharmacyjoe.com/episode943. In this episode, I'll discuss the risk factors associated with the development of venous thromboembolism in ICU patients. The post 943: Risk Factors Associated With the Development of Venous Thromboembolism in ICU Patients appeared first on Pharmacy Joe.

In this week's episode we'll discuss minimal residual disease as an intermediate clinical endpoint for multiple myeloma. Then, we'll learn about IPSS-R downstaging before transplant in MDS. Finally we'll hear about the connection between hereditary angioedema and venous thromboembolism. Featured Articles:EVIDENCE meta-analysis: evaluating minimal residual disease as an intermediate clinical endpoint for multiple myeloma Does IPSS-R down-staging before transplantation improve the prognosis of patients with Myelodysplastic Neoplasms? Increased risk of venous thromboembolism [or VTE] in young and middle-aged individuals with hereditary angioedema: a family study

I'm thrilled to welcome the incredible Dr. Tabatha Barber, known as the Gutsy Gynecologist, to Well Beyond 40. Dr. Tabatha's journey is nothing short of inspiring—she became a mother at 17, dropped out of high school, and overcame immense challenges to become a renowned medical doctor and functional gynecologist. Her story is a testament to perseverance and faith, offering a powerful message to women in their 40s and beyond who are navigating their own life transitions. Dr. Tabatha shares her personal experience with menopause and how it has informed her compassionate approach to patient care. She emphasizes the importance of understanding hormone balance and addresses common myths and misconceptions about hormone replacement therapy (HRT). As someone who has treated thousands of patients and gone through menopause herself, Dr. Tabatha brings a wealth of real-world experience and practical advice. Her unique combination of conventional and functional medicine allows her to provide holistic care that truly meets the needs of women in midlife. One key takeaway from our conversation is Dr. Tabatha's emphasis on the critical role of estrogen in women's health. She debunks the long-standing fear surrounding HRT and highlights the significant benefits of hormone therapy, such as improved heart health, bone density, and overall vitality. Dr. Tabatha's insights are backed by her thorough understanding of medical research and her firsthand experience, making her advice both credible and relatable. A particularly powerful moment in our discussion is when Dr. Tabatha recounts her own sudden drop in estrogen levels and the profound impact it had on her mood and well-being. This personal story underscores the importance of recognizing and addressing hormonal changes with appropriate medical support, rather than resorting to antidepressants which can exacerbate symptoms. For actionable advice and a deeper understanding of how to navigate hormonal changes during menopause, be sure to listen to the full episode. FULL show notes: https://jjvirgin.com/drtabatha Estrogen Matters by Avrum Bluming: https://amzn.to/3wVcmTK  YourLabwork: https://yourlabwork.com/jj-virgin/  ACOG: Postmenopausal Estrogen Therapy Route of Administration and Risk of Venous Thromboembolism: https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2013/04/postmenopausal-estrogen-therapy-route-of-administration-and-risk-of-venous-thromboembolism  Get Dr. Barber's FREE Guide: The Gutsy Gynecologist's Guide to Balancing Your Hormones Naturally Episode Sponsors:  Try Timeline: https://www.timelinenutrition.com/shop?rfsn=7082975.4b75243 Use code JJ10 for 10% off all products Go to qualialife.com/VIRGINWELLNESS now to try Qualia Senolytic backed by a 100 day money back guarantee, and use promo code VIRGINWELLNESS to get 15% off!  

At AOFAS Annual Meeting 2023 in Louisville, Kentucky, host Nicholas Strasser, MD, discusses with Jitendra Mangwani, MBBS, MS(Orth), FRCS(Tr&Orth), the IFFAS Award Finalist paper “UK Foot and Ankle Thrombo-Embolism Audit (UK-FATE) – A multicentre prospective study of Venous Thromboembolism in Foot and Ankle Surgery.” To claim CME credit, click here or listen in the free ConveyMED app: Apple Store or Google Play   CME credit is free to AOFAS members and $25 for non-members. 

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/CGE865. CME/MOC/AAPA/IPCE credit will be available until February 28, 2025.REVIVE Initiative: Reinforcing Evidence-Based Principles Against Cancer-Associated Venous Thromboembolism In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an educational grant from the Bristol Myers Squibb and Pfizer Alliance.Disclosure PolicyAll relevant conflicts of interest have been mitigated prior to the commencement of the activity.Faculty/Planner DisclosuresChair/PlannerAlok A. Khorana, MD, FACP, FASCO, has a financial interest/relationship or affiliation in the form of:Consultant and/or Advisor for Anthos Therapeutics; Bayer Corporation; Bristol Myers Squibb; Pfizer; and Sanofi.Planning Committee and Reviewer DisclosuresPlanners, independent reviewers, and staff of PVI, PeerView Institute for Medical Education, do not have any relevant financial relationships related to this CE activity unless listed below.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/CGE865. CME/MOC/AAPA/IPCE credit will be available until February 28, 2025.REVIVE Initiative: Reinforcing Evidence-Based Principles Against Cancer-Associated Venous Thromboembolism In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an educational grant from the Bristol Myers Squibb and Pfizer Alliance.Disclosure PolicyAll relevant conflicts of interest have been mitigated prior to the commencement of the activity.Faculty/Planner DisclosuresChair/PlannerAlok A. Khorana, MD, FACP, FASCO, has a financial interest/relationship or affiliation in the form of:Consultant and/or Advisor for Anthos Therapeutics; Bayer Corporation; Bristol Myers Squibb; Pfizer; and Sanofi.Planning Committee and Reviewer DisclosuresPlanners, independent reviewers, and staff of PVI, PeerView Institute for Medical Education, do not have any relevant financial relationships related to this CE activity unless listed below.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/CGE865. CME/MOC/AAPA/IPCE credit will be available until February 28, 2025.REVIVE Initiative: Reinforcing Evidence-Based Principles Against Cancer-Associated Venous Thromboembolism In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an educational grant from the Bristol Myers Squibb and Pfizer Alliance.Disclosure PolicyAll relevant conflicts of interest have been mitigated prior to the commencement of the activity.Faculty/Planner DisclosuresChair/PlannerAlok A. Khorana, MD, FACP, FASCO, has a financial interest/relationship or affiliation in the form of:Consultant and/or Advisor for Anthos Therapeutics; Bayer Corporation; Bristol Myers Squibb; Pfizer; and Sanofi.Planning Committee and Reviewer DisclosuresPlanners, independent reviewers, and staff of PVI, PeerView Institute for Medical Education, do not have any relevant financial relationships related to this CE activity unless listed below.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/CGE865. CME/MOC/AAPA/IPCE credit will be available until February 28, 2025.REVIVE Initiative: Reinforcing Evidence-Based Principles Against Cancer-Associated Venous Thromboembolism In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an educational grant from the Bristol Myers Squibb and Pfizer Alliance.Disclosure PolicyAll relevant conflicts of interest have been mitigated prior to the commencement of the activity.Faculty/Planner DisclosuresChair/PlannerAlok A. Khorana, MD, FACP, FASCO, has a financial interest/relationship or affiliation in the form of:Consultant and/or Advisor for Anthos Therapeutics; Bayer Corporation; Bristol Myers Squibb; Pfizer; and Sanofi.Planning Committee and Reviewer DisclosuresPlanners, independent reviewers, and staff of PVI, PeerView Institute for Medical Education, do not have any relevant financial relationships related to this CE activity unless listed below.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/CGE865. CME/MOC/AAPA/IPCE credit will be available until February 28, 2025.REVIVE Initiative: Reinforcing Evidence-Based Principles Against Cancer-Associated Venous Thromboembolism In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an educational grant from the Bristol Myers Squibb and Pfizer Alliance.Disclosure PolicyAll relevant conflicts of interest have been mitigated prior to the commencement of the activity.Faculty/Planner DisclosuresChair/PlannerAlok A. Khorana, MD, FACP, FASCO, has a financial interest/relationship or affiliation in the form of:Consultant and/or Advisor for Anthos Therapeutics; Bayer Corporation; Bristol Myers Squibb; Pfizer; and Sanofi.Planning Committee and Reviewer DisclosuresPlanners, independent reviewers, and staff of PVI, PeerView Institute for Medical Education, do not have any relevant financial relationships related to this CE activity unless listed below.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/CGE865. CME/MOC/AAPA/IPCE credit will be available until February 28, 2025.REVIVE Initiative: Reinforcing Evidence-Based Principles Against Cancer-Associated Venous Thromboembolism In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an educational grant from the Bristol Myers Squibb and Pfizer Alliance.Disclosure PolicyAll relevant conflicts of interest have been mitigated prior to the commencement of the activity.Faculty/Planner DisclosuresChair/PlannerAlok A. Khorana, MD, FACP, FASCO, has a financial interest/relationship or affiliation in the form of:Consultant and/or Advisor for Anthos Therapeutics; Bayer Corporation; Bristol Myers Squibb; Pfizer; and Sanofi.Planning Committee and Reviewer DisclosuresPlanners, independent reviewers, and staff of PVI, PeerView Institute for Medical Education, do not have any relevant financial relationships related to this CE activity unless listed below.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/CGE865. CME/MOC/AAPA/IPCE credit will be available until February 28, 2025.REVIVE Initiative: Reinforcing Evidence-Based Principles Against Cancer-Associated Venous Thromboembolism In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an educational grant from the Bristol Myers Squibb and Pfizer Alliance.Disclosure PolicyAll relevant conflicts of interest have been mitigated prior to the commencement of the activity.Faculty/Planner DisclosuresChair/PlannerAlok A. Khorana, MD, FACP, FASCO, has a financial interest/relationship or affiliation in the form of:Consultant and/or Advisor for Anthos Therapeutics; Bayer Corporation; Bristol Myers Squibb; Pfizer; and Sanofi.Planning Committee and Reviewer DisclosuresPlanners, independent reviewers, and staff of PVI, PeerView Institute for Medical Education, do not have any relevant financial relationships related to this CE activity unless listed below.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/CGE865. CME/MOC/AAPA/IPCE credit will be available until February 28, 2025.REVIVE Initiative: Reinforcing Evidence-Based Principles Against Cancer-Associated Venous Thromboembolism In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an educational grant from the Bristol Myers Squibb and Pfizer Alliance.Disclosure PolicyAll relevant conflicts of interest have been mitigated prior to the commencement of the activity.Faculty/Planner DisclosuresChair/PlannerAlok A. Khorana, MD, FACP, FASCO, has a financial interest/relationship or affiliation in the form of:Consultant and/or Advisor for Anthos Therapeutics; Bayer Corporation; Bristol Myers Squibb; Pfizer; and Sanofi.Planning Committee and Reviewer DisclosuresPlanners, independent reviewers, and staff of PVI, PeerView Institute for Medical Education, do not have any relevant financial relationships related to this CE activity unless listed below.

Asavari and Rachel discuss common postop complications, workup, and management with Olivia de Bear, MPAS, PA-C. 0:30: Olivia de Bear Bio 1:01 Case 1: 52yo woman s/p TLH and bilateral salpingectomy with low urine output 11:06 Case 2: 58yo woman s/p ex lap, TAH, BSO, pelvic mass removal, and staging procedures for ovarian cancer with intolerance of PO intake, nausea, and emesis 20:11 Case 3: 62yo with newly diagnosed endometrial cancer s/p TLH, BSO, and sentinel lymph nodes with new-onset dyspnea Transcript: bit.ly/gynpostop References: Postop oliguria differential Brackmann voiding trial Acute abdominal series Review of postop fever w's MD Calc Caprini Score ACOG Practice Bulletin no. 232: Prevention of Venous Thromboembolism in Gynecologic Surgery Enhanced recovery after surgery (ERAS®) society guidelines for gynecologic oncology: Addressing implementation challenges - 2023 update⁠

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Commentary by Dr. Tzu-Fei Wang

  “So much of this is just knowing what is their diagnosis, what medications are they on, what could be the root cause of this—where is their disease to begin with? There's really a lot of differential diagnosis and workup that has to be thought about, you know, when you're dealing with shortness of breath and pulmonary toxicities,” Beth Sandy, MSN, CRNP, OCN®, thoracic medical oncology nurse practitioner at the Abramson Cancer Center at the University of Pennsylvania in Philadelphia, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a discussion about just a few of the pulmonary toxicities oncology nurses may encounter in patients receiving pharmaceutical cancer treatments. This episode is part of a series on cancer symptom management basics; the rest are linked below.  You can earn free NCPD contact hours after listening to this episode and completing the evaluation linked below.   Music Credit: “Fireflies and Stardust” by Kevin MacLeod  Licensed under Creative Commons by Attribution 3.0  Earn 0.75 contact hours of nursing continuing professional development (NCPD), which may be applied to the nursing practice, oncology nursing practice, symptom management, palliative care, supportive care, or treatment.ILNA categories, by listening to the full recording and completing an evaluation at myoutcomes.ons.org by January 19, 2026. 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.  Learning outcome: The learner will report an increase in knowledge of pulmonary complications from cancer treatment.   Episode Notes  Complete this evaluation for free NCPD.   Oncology Nursing Podcast Cancer Symptom Management Basics series  ONS Voice articles: Pneumonitis With Immunotherapy Treatment Hematologic Cancers Have Higher Long-Term Risk of Clots and Bleeding  Clinical Journal of Oncology Nursing articles: Durvalumab Immunotherapy: Nursing Management of Immune-Related Adverse Events During the Journey of Patients With Stage III Non-Small Cell Lung Cancer Heart and Lung Complications: Assessment and Prevention of Venous Thromboembolism and Cardiovascular Disease in Patients With Multiple Myeloma Chronic Obstructive Pulmonary Disease: Clinical Implications for Patients With Lung Cancer  Oncology Nursing Forum article: Multifactorial Model of Dyspnea in Patients With Cancer  ONS book: Understanding and Managing Oncologic Emergencies: A Resource for Nurses (third edition)  ONS Symptom Interventions and Guidelines™: Dyspnea  To discuss the information in this episode with other oncology nurses, visit the ONS Communities.    To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library.  To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org.  Highlights From Today's Episode  “Your lungs are what is needed to have the gas exchange within your bloodstream. So, when we inhale, we're inhaling oxygen, and we need that gas exchange to occur in the alveoli, which are the tiny, little bubble-like structures within the periphery of the lungs. And they're communicating with tiny, itty-bitty little blood vessels. And that's where the gas exchange occurs, where you get rid of the carbon dioxide from the blood and you get oxygen to the blood. And what ends up happening is there is, for whatever reason it may be, that gas exchange can't occur, and that can result in so many different forms from different toxicities, whether there's an inflammation causing the alveoli not to work correctly, whether there's an obstruction where there's literally something obstructing the air getting into the lungs, or whether there's compression from an external source like a fusion or something like that that is pressing against the lungs where that gas exchange cannot occur.” TS 2:36  “Pulmonary embolism, I'll tell you, is one of the most common things that we see in cancer. As a matter of fact, often patients are diagnosed with cancer because they present with a pulmonary embolism into the E.R. (emergency room) and there's really not a lot of reasons why healthy-otherwise patients develop a PE [pulmonary embolism]. So, we start looking for cancer. So, just having cancer in general puts you in that hypercoagulable state. . . . And then, being on chemotherapy increases that risk.” TS 6:38  “I think we need to really make sure that they're compliant. We need to make sure they're not having bleeding. Are you having significant bruising anywhere? Are you having unprovoked nosebleeds? And by that, I mean, I always tell people, ‘Were you just sitting watching TV and it started dripping?' versus, ‘Oh, I blew my nose and some blood came out.' Okay, well, that is probably pretty common side effect of this and should stop quickly.” TS 12:06  “The problem is the majority of these patients have metastatic disease or an incurable cancer. So, we prefer not to stop it [PE medication] in those patients because if you think about it, their risk comes from the cancer. And we're not getting rid of that if they have metastatic disease. I think for those patients with metastatic disease, as long as they're tolerating it, they're not having bleeding events, we will typically tend to just keep them on it.” TS 13:09  “The main difference with the targeted therapies is it tends to be worse, and it's not something that you can rechallenge. And I think that's kind of one of the most important things to think about here. In immunotherapy, it's like, okay, it's T-cell mediated; we gave you corticosteroids; it calmed itself down. And a lot of times we can rechallenge, and we don't necessarily see it again. Whereas with targeted therapies, you have to be much more cautious. If you look at the package inserts for the EGFR and ALK inhibitors, most of them are going to tell you this is not something you ever rechallenge. Any kind of symptomatic pneumonitis, you're going to permanently discontinue the drug. Because if you give it again, it's going to recur in a pretty bad way, where corticosteroids may not even be helpful again even if you rechallenge them.” TS 17:52  “What can happen in cancer, typically, thoracic cancers—so lung cancer, mesothelioma for sure, thymic cancers like thymomas and thymic carcinomas—often will have pleural effusion or pleural disease as well. But when cancer cells get into that fluid, there's irritation which causes an increase in the amount of fluid there. And then what happens is when that space, that pleural space, is now enlarged with fluid or engorged with fluid, a few things occur here. Patients are short of breath because it's a pressure gradient there. So, you're trying to inhale against this fluid-filled cavity that's making it hard. So, often patients will describe it as it feels like someone's giving you a really tight hug and they won't stop.” TS 21:59  “There is another procedure called a talc pleurodesis, where you can have a procedure where you inject some powder in there that will kind of dry it up. The downside of that is that it kind of fuses the pleura to the lung, so there can be some complications there, some pain, and decreased lung function just from doing that, but it can be an easy fix that you certainly don't want to have an indwelling catheter there.” TS 25:11  “So, patients need to know, if they are short of breath at all, call us; let us know. The other thing that's important is know with their baseline vital signs are, especially their pulse ox. You know, some people, their pulse oximetry may be in the low 90s or upper 80s at baseline. We need to know that because there's a big difference if a patient has, you know, they're living at 99% versus 91% normally. Because if they come in and they live at 99 and they're 91, that's a huge drop. But if they come in and they were 91 to begin with and they're 90, that's not a big difference. So, we really do need to make sure we know what their baseline is before they're starting any treatments.” TS 29:18  “This is not something that you want to downplay. You can't sit there and say, you know, ‘Oh, they smoke a lot, so it's probably that.' Or, ‘They have this type of cancer, so it's probably that.' I think this is something that you have to take shortness of breath seriously, and you have to work up and understand and know your patient. But for the most part, this is not something you're going to just triage to the next day or to a few days later. You're going to need some kind of urgent intervention or workup to be done pretty quickly.” TS 32:54  “I think the biggest misconception is that they can't be treated even if they're severe. Most of these things can be reversed. Part of it is just diagnosing it at first and then going from there and starting the appropriate treatment strategy.” TS 33:29 

Can a blood test identify patients at high risk for suicide? Find out about this and more in today's PV Roundup podcast.

For this year's review, Bob Harrington and Mike Gibson revisit the major cardiology conferences -- from ACC in New Orleans to AHA in Philly. This podcast is intended for healthcare professionals only. To read a transcript or to comment, visit: https://www.medscape.com/author/bob-harrington ACC 2023 Top Trials - Bempedoic Acid Cuts CV Events in Statin-Intolerant Patients: CLEAR Outcomes https://www.medscape.com/viewarticle/989100 - Bempedoic Acid and Cardiovascular Outcomes in Statin-Intolerant Patients - Phase 2b Randomized Trial of the Oral PCSK9 Inhibitor MK-0616 https://www.jacc.org/doi/10.1016/j.jacc.2023.02.018 ACC/WCC 2023 Collection Page https://www.medscape.com/viewcollection/36966 ESC 2023 Top Trials - Wegovy Scores HFpEF Benefits in People With Obesity https://www.medscape.com/viewarticle/995844 - Semaglutide in Patients with Heart Failure with Preserved Ejection Fraction and Obesity https://www.nejm.org/doi/full/10.1056/NEJMoa2306963 - Acoramidis Shows Encouraging Results in ATTR Cardiomyopathy https://www.medscape.com/viewarticle/995883 ESC 2023 Collection Page https://www.medscape.com/viewcollection/36988 AHA 2023 Top Trials - Semaglutide 'A New Pathway' to CVD Risk Reduction: SELECT https://www.medscape.com/viewarticle/998373 - Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes https://www.nejm.org/doi/full/10.1056/NEJMoa2307563 - Bariatric Surgery is Associated With Improved Coronary Microvascular Function and Cardiorespiratory Fitness in Patients With Ischemia and Non-Obstructive Coronary Arteries https://www.ahajournals.org/doi/10.1161/circ.148.suppl_1.18949 - Angioplasty Finally Proven Beneficial in Stable Angina: ORBITA-2 https://www.medscape.com/s/viewarticle/998375 - A Placebo-Controlled Trial of Percutaneous Coronary Intervention for Stable Angina https://www.nejm.org/doi/full/10.1056/NEJMoa2310610 - Impressive Bleeding Profile With Factor XI Inhibitor in AF: AZALEA https://www.medscape.com/viewarticle/998418 - Promising First Results With DNA Editing to Lower LDL https://www.medscape.com/s/viewarticle/998719 - Single Injection Reduces Blood Pressure for 6 Months: KARDIA-1 https://www.medscape.com/viewarticle/998666 AHA 2023 Collection Page https://www.medscape.com/viewcollection/37277 Other Mentions - N-of-1 Trial of a Statin, Placebo, or No Treatment to Assess Side Effects https://www.nejm.org/doi/full/10.1056/NEJMc2031173 - Rimonabant: From RIO to Ban https://doi.org/10.1155%2F2011%2F432607 - Percutaneous coronary intervention in stable angina (ORBITA): a double-blind, randomised controlled trial https://doi.org/10.1016/S0140-6736(17)32714-9 - Asundexian Phase 3 AF Study Halted for Lack of Efficacy https://www.medscape.com/viewarticle/998665 - Challenges in the Design and Interpretation of Noninferiority Trials https://www.nejm.org/doi/full/10.1056/nejmra1510063 - Milvexian for the Prevention of Venous Thromboembolism https://www.nejm.org/doi/full/10.1056/NEJMoa2113194 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine Hear John Mandrola, MD's summary and perspective on the top cardiology news each week, on This Week in Cardiology https://www.medscape.com/twic Questions or feedback, please contact news@medscape.net

Dr. Zhong Zheng provides an overview of his study, "Association of Estimated Glomerular Filtration Rate and Albuminuria with Venous Thromboembolism," on behalf of his colleagues.

Guidelines in Practice: Prevention of Venous Thromboembolism by AORNJournal

Visit my Patreon page for a detailed summary of these guidelines with links, graphics, and more!#DoNoHarmTakeNoShitFind me on InstagramMidwife Collaborator ProgramEnroll in the Born Free MethodJoin the waitlist for Clear+Free: Your Holistic Solution to Persistent HPV(Looking for my other podcast? Go HERE for The Holistic OBGYN)**Medical Disclaimer: The Holistic OBGYN Podcast is an educational program. No information conveyed through this podcast should be construed as medical advice. These conversations are available to the public for educational and entertainment purposes only.

"The primary safety and primary efficacy endpoints—which were preset in consideration with the FDA and all the societies—were met. You look at what we did, what we said, and using those definitions, filters are safe and effective."—Matthew S. Johnson, MD, FSIR, PRESERVE Principal InvestigatorHost Warren Krackov, MD, FSIR, speaks with PRESERVE (Predicting the Safety and Effectiveness of Inferior Vena Cava Filters) Trial Principal Investigator Matthew S. Johnson, MD, FSIR, about the lessons learned from the trial's initial data, his collaboration with vascular surgery and others in the study, and more. Related resources:Predicting the safety and effectiveness of Inferior Vena Cava Filters (PRESERVE): Outcomes at 12 months (Journal of Vascular and Interventional Radiology, April 2023)SIR/SVS Press Release on PRESERVE (Feb. 23, 2023)"Session recap: The SIR/SVS PRESERVE Trial" (SIR Today, March 6, 2023)Episode 10: The ongoing evolution of IVC filters (June 30, 2020)Note: This episode was recorded on Aug. 8, 2023.Support the show

This episode covers deep vein thrombosis and venous thromboembolism.Written notes can be found at https://zerotofinals.com/medicine/haematology/dvt/ or in the haematology section of the 2nd edition of the Zero to Finals medicine book.The audio in the episode was expertly edited by Harry Watchman.

Commentary by Dr. Candice Silversides

STUDIES REFERENCE IN THE EPISODE   SWITCHING FROM TOFACITINIB TO BARICITINIB   Kazmi A et al (starts at 12:33). Switching between tofacitinib and baricitinib in alopecia areata: A review of clinical response. J Am Acad Dermatol. 2023 Apr 4;S0190-9622(23)00532-7.     RITLECITINIB IN ADOLESCENTS   Hordinsky M et al (starts at 21:31). Efficacy and safety of ritlecitinib in adolescents with alopecia areata: Results from the ALLEGRO phase 2b/3 randomized, double-blind, placebo-controlled trial. Pediatr Dermatol. 2023 Jul 17.     RISK OF INFECTIONS, CANCER, HEART DISEASE AND BLOOD CLOTS IN AT/AU   George P et al (starts at 36:08). Incidence Rates of Infections, Malignancies, Thromboembolism, and Cardiovascular Events in an Alopecia Areata Cohort from a US Claims Database., Dermatol Ther (Heidelb). 2023 Aug; 13(8): 1733–1746.     Schneeweiss MC et al (starts at 37:36). Incidence of Venous Thromboembolism in Patients With Dermatologist-Diagnosed Chronic Inflammatory Skin Diseases. JAMA Dermatol. 2021 Jul 1;157(7):805-816.     MARKERS OF VENOUS THROMBOEMBOLISM IN ALOPECIA AREATA   Sudnik W et al (starts at 57:40) . The role of selectins in alopecia areata. Postepy Dermatol Alergol. 2015 Feb;32(1):27-32.   Shakoei S et al (starts at 58:23). Coagulation status in patients with alopecia areata: a cross-sectional study. Ital J Dermatol Venerol. 2021 Oct;156(5):588-592.   Waśkiel-Burnat A et al (starts at 59:30). Markers of Venous Thromboembolism Risk in Patients with Alopecia Areata: Is There Anything to Worry about? Dermatol Ther (Heidelb). 2023 Aug;13(8):1847-1855.     HABIT REPLACEMENT THERAPY FOR TRICHOTILLOMANIA   Moritz S et al (starts at 1:04:34). Self-Help Habit Replacement in Individuals With Body-Focused Repetitive Behaviors: A Proof-of-Concept Randomized Clinical Trial.  JAMA Dermatol. 2023 Jul 19;e232167.   LINK TO VIDEO on HRT DEMONSTRATION https://clinical-neuropsychology.de/habit-replacement-en/#sthash.J6iQiYRi.dpuf    

Speaker: Prof. Petra Stute. Topic: “Did you know!” Taking oral estradiol has increased risk of venous thromboembolism but not with transdermal estradiol This podcast was sponsored by Besin Healthcare

How do concomitant meds affect antidepressant response? Find out about this and more in today's PV Roundup podcast.

Description: Dr. Maya Graham interviews Drs. Jasmin Jo, Craig Horbinski and David Schiff about their recent manuscript entitled: "Epidemiology, biology and management of venous thromboembolism in gliomas: an interdisciplinary review", published online in Neuro-Oncology in April 2023. Read Paper

In this JCO Article Insights episode, Emily Zabor summarizes two original articles from the June 1st, 2023 Journal of Clinical Oncology issue: “A Clinical Genetic Risk Score for Predicting Cancer-Associated Venous Thromboembolism: A Development and Validation Study Involving Two Independent Prospective Cohorts”  by Muñoz et al,  and “Derivation and Validation of Clinical Risk Assessment Model for Cancer Associated Thrombosis in Two Unique Healthcare Systems” by Li et al, as well as the accompanying editorial “Fine Tuning Venous Thromboembolism Risk Prediction in Patients with Cancer” by Jean Marie Connors. The original reports describe the development and validation of two new risk prediction models for venous thromboembolism in cancer patients and the editorial puts them into context of existing tools. TRANCRIPT  The guest on this podcast episode has no disclosures to declare. Emily Zabor: Welcome to JCO Article Insights for the June 1st, 2023 issue of JCO. I'm your host, Emily Zabor, JCO Biostatistics Editorial Fellow. Today, I will be providing summaries of three articles.  The first article, titled “A Clinical Genetic Risk Score for Predicting Cancer-Associated Venous Thromboembolism: A Development and Validation Study Involving Two Independent Prospective Cohorts” by Andres Muñoz and colleagues, describes the development and validation of a risk score for venous thromboembolism in oncology patients based on both clinical and genetic features, called the ONCOTHROMB score. In developing this model, the authors sought to address the fact that venous thromboembolism is among the leading causes of death among patients with cancer. Whereas hospitalized cancer patients are typically treated with thromboprophylaxis, outpatient treatment with thromboprophylaxis is only suggested for patients at high risk for venous thromboembolism identified according to the Khorana score.  The authors sought to determine whether incorporation of known genetic risk factors along with clinical factors would result in improved predictive accuracy. The risk score was developed in a cohort of 364 patients and was validated in an external cohort of 263 patients. The primary outcome of interest was venous thromboembolism within six months of a cancer diagnosis. The authors used logistic regression with backward selection with a p-value threshold of 0.25 to first select the genetic variants to include in the genetic risk score and then to separately select the clinical features to incorporate. Then the genetic risk score and clinical features were combined into a single multivariable logistic regression model, and backward selection was performed again.  The final model included nine genetic variants, tumor site, TNM stage, and a BMI of greater than 25. In the validation data, the ONCOTHROMB score using a threshold selected with the Youden index resulted in an AUC of 0.686 as compared to an AUC of 0.577 for the Khorana score with a threshold of 3. The ONCOTHROMB score had statistically significantly higher sensitivity, whereas the Khorana score had statistically significantly higher specificity. The authors conclude that the ONCOTHROMB score demonstrated improved predictive ability and should be investigated further in clinical trials.  The second article, titled “Derivation and Validation of Clinical Risk Assessment Model for Cancer Associated Thrombosis in Two Unique Healthcare Systems” by Ang Li and colleagues, describes the development and validation of a risk assessment model for venous thromboembolism, pulmonary embolism, and lower-extremity deep vein thrombosis in oncology patients undergoing systemic therapy. The authors developed this model to address the increased morbidity and mortality associated with venous thromboembolism among cancer patients and the fact that risk reduction for use of thromboprophylaxis as well as the efficacy-safety trade-off, and cost-effectiveness have been shown to be higher among patients selected as high risk for venous thromboembolism.  The primary outcome was venous thromboembolism within six months of treatment initiation. In the development data set, the authors used lasso-penalized logistic regression analysis to shrink some of the covariates to zero as a form of variable selection, then a multivariable logistic regression model was fit to the remaining covariates and those with an estimated odds ratio greater than 1.2 or less than 0.8 were retained in the final model. A linear risk score was created from the resulting beta coefficients. The risk assessment model was developed in a cohort of 9769 patients and validated in an external cohort of 79,517 patients. The final model included eleven factors: cancer subtype, pre-therapy BMI greater than or equal to 35, pre-therapy white blood cell count greater than 11, pre-therapy hemoglobin less than 10, pre-therapy platelet greater than or equal to 350, cancer staging 3 to 4, targeted or endocrine monotherapy, lifetime history of venous thromboembolism, history of paralysis and immobility in the last 12 months, recent hospitalization lasting greater than three days in the last three months, and Asian Pacific Islander race.   The final linear risk score was stratified into six categories and then dichotomized based on overall venous thromboembolism incidence of 7%, resulting in about half of the patient population being classified as high risk for venous thromboembolism. In the validation data, the model was associated with a c-statistic of 0.68 as compared to 0.6 for the Khorana score with a threshold of 2. Sensitivity analyses demonstrated that the model had similar discrimination in subgroups according to age, sex, and race-ethnicity. The authors conclude that their new risk assessment model has the potential to improve patient selection for thromboprophylaxis. The third and final article titled “Fine Tuning Venous Thromboembolism Risk Prediction in Patients with Cancer” by Jean Marie Connors, is an editorial accompanying the two previously summarized articles. Dr. Connors emphasizes that venous thromboembolism is the second leading cause of death in cancer patients, second only to cancer itself, and that while treatment with thromboprophylaxis has been shown to significantly reduce the occurrence of venous thromboembolism in randomized controlled trials, since the overall risk of venous thromboembolism is so low, treating all patients would result in significant overtreatment. Therefore, prediction tools are needed and many have been developed, with the Khorana score being the most widely used because it is the best validated and easy to calculate.   Dr. Connors observes that in the risk assessment model by Li and colleagues, more granularity is added to the  Khorana score by stratifying gastrointestinal cancer subtypes and by adding aggressive NHL, myeloma, brain tumors, and sarcoma, and also incorporates additional cancer-specific and patient-specific risk factors. But while this risk assessment model reclassified approximately 25% of patients in both the development and validation sets, as compared to the Khorana score, there was only modest improvement in discrimination. With the c-index improving from 0.65 to 0.71 in the development set and from 0.6 to 0.68 in the validation set from the Khorana score to the new risk assessment model.   On the other hand, the ONCOTHROMB score developed by Muñoz and colleagues contains fewer clinical features as compared to the Khorana score but adds a genetic risk score based on eleven genetic variants. The Khorana score performed quite poorly in both the development and validation data in this study, with AUCs of just 0.58 and 0.56, so improvements to 0.781 and 0.720 were relatively large. Connors notes that prospective validation of both scores is still needed, especially of the ONCOTHROMB score in more diverse populations, as allele frequencies can vary widely and the studied populations were predominantly Western European. Connors cautions that there is still a need to demonstrate mortality benefit from venous thromboembolism prophylaxis and that the risk of bleeding and other complications must be properly weighed against the benefits.  That concludes this episode on the articles “A Clinical Genetic Risk Score for Predicting Cancer-Associated Venous Thromboembolism: A Development and Validation Study Involving Two Independent Prospective Cohorts” and “Derivation and Validation of Clinical Risk Assessment Model for Cancer Associated Thrombosis in Two Unique US Healthcare Systems,” and the associated editorial, “Fine Tuning Venous Thromboembolism Risk Prediction in Patients with Cancer.” Thank you for listening and please tune in for the next issue of JCO Article Insights.  The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions.   Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. Like, share, and subscribe so you never miss an episode and leave a rating or review.  Editorial:   Fine Tuning Venous Thromboembolism Risk Prediction in Patients With Cancer Derivation and Validation of a Clinical Risk Assessment Model for Cancer-Associated Thrombosis in Two Unique US Health Care Systems A Clinical-Genetic Risk Score for Predicting Cancer-Associated Venous Thromboembolism: A Development and Validation Study Involving Two Independent Prospective Cohorts Original Report:   Find more articles from the June 1 issue  

In this episode Johnny and Kyle talk with two authors, Dr. Ellen Hillegass and Dr. Kathleen Lukaszewicz, of the recent Clinical Practice Guideline covering PT management of Venous Thromboembolism. This was such an enjoyable and educational chat! We know you will enjoy it... Link to the paper: https://pubmed.ncbi.nlm.nih.gov/35567347/ Link to the pocket guide: https://www.guidelinecentral.com/shop/venous-thromboembolism/ Link to the app: https://apps.apple.com/us/app/guideline-central/id567695579

Management of Perimenopause and Menopause   Evaluation and Credit:  https://www.surveymonkey.com/r/MedChat53   Target Audience             This activity is targeted toward primary care and geriatric healthcare providers and advanced providers.   Statement of Need  This program will provide the latest clinical guidelines and treatment options for the management of menopause. One research study indicated that 50% of patients delayed seeking treatment for 6-months despite having bothersome symptoms. Providers should be up-to-date on the latest recommendations for the management of patients experiencing perimenopause and menopause.   Objectives  At the conclusion of this offering, the participant will be able to:  Define perimenopause and menopause. List the symptoms associated with perimenopause and menopause. Discuss strategies and considerations for the effective management of menopausal symptoms.   Moderator Monalisa Tailor, M.D. Internal Medicine Norton Community Medical Associates Norton Healthcare Louisville, Kentucky   Speaker Kris Barnsfather, M.D. Obstetrician Gynecologist Women's Care Physicians of Louisville Louisville, Kentucky   Moderator, Speaker and Planner Disclosures   The speaker, planners and moderator of this activity do not have any relevant relationships to disclose.    Commercial Support   There was no commercial support for this activity.    Physician Credits Accreditation  Norton Healthcare is accredited by the Kentucky Medical Association to provide continuing medical education for physicians.     Designation  Norton Healthcare designates this enduring material for a maximum of 0.75 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.   Nursing Credits Norton Healthcare Institute for Education and Development is approved with distinction as a provider of nursing continuing professional development by the South Carolina Nurses Association, an accredited approver by the American Nurses Credentialing Center's Commission on Accreditation. This continuing professional development activity has been approved for 0.75 contact hours. In order for nursing participants to obtain credits, they must claim attendance by attesting to the number of hours in attendance.     For more information related to nursing credits, contact Sally Sturgeon, DNP, RN, SANE-A, AFN-BC at (502) 446-5889 or sally.sturgeon@nortonhealthcare.org.   Resources for Additional Study: Postmenopausal Estrogen Therapy Route of Administration and Risk of Venous Thromboembolism https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2013/04/postmenopausal-estrogen-therapy-route-of-administration-and-risk-of-venous-thromboembolism   Should we be prescribing testosterone to perimenopausal and menopausal women? A guide to prescribing testosterone for women in primary care https://pubmed.ncbi.nlm.nih.gov/32217602/   Treatment and resource utilization for menopausal symptoms in the United States: a retrospective review of real-world evidence from US electronic health records  https://pubmed.ncbi.nlm.nih.gov/36576444/     Norton Healthcare, a not for profit health care system, is a leader in serving adult and pediatric patients throughout Greater Louisville, Southern Indiana, the commonwealth of Kentucky and beyond. Five Louisville hospitals provide inpatient and outpatient general care as well as specialty care including heart, neuroscience, cancer, orthopedic, women's and pediatric services. A strong research program provides access to clinical trials in a multitude of areas. More information about Norton Healthcare is available at NortonHealthcare.com.     Date of Original Release |June 2023; Information is current as of the time of recording.  Course Termination Date | June 2025 Contact Information | Center for Continuing Medical, Provider and Nursing Education; (502) 446-5955 or cme@nortonhealthcare.org  

ICU patients are at high risk for venous thromboembolism, and the majority of patients require prophylaxis. The challenging therapy is thrombocytopenia. Join host Geoff Wall, as he evaluates the results of a new study evaluating the clinical thresholds for chemical prophylaxis.The GameChangerThe majority of ICU patients eligible for VTE prophylaxis do not receive it. Different clinicians use different thresholds to initiate or stop prophylaxis. The database study discussed provides a potential evidence-based threshold.Show Segments00:00 - Introductions00:47 - VTE Prophylaxis Background09:34 - Looking at the Study18:42 - The GameChanger: A Potential Threshold for Chemical Prophylaxis22:15 - Connecting to Practice: Applicability26:13 - Closing RemarksHostGeoff Wall, PharmD, BCPS, FCCP, CGPProfessor of Pharmacy Practice, Drake UniversityInternal Medicine/Critical Care, UnityPoint HealthReferences and ResourcesAssociation between Early Venous Thromboembolism Prophylaxis, Bleeding Risk, and Venous Thromboembolism among Critically Ill Patients with Thrombocytopenia. Redeem your CPE hereCPE (Pharmacist)Get a membership & earn CE for GameChangers Podcast episodes (30 mins/episode)Pharmacists: Get a membershipCE InformationLearning ObjectivesUpon successful completion of this knowledge-based activity, participants should be able to:1. Discuss the history and use of VTE prophylaxis in the ICU2. Describe the results of the Pang et al study discussed and its applicability to ICU patients0.05 CEU/0.5 HrUAN: 0107-0000-23-134-H01-PInitial release date: 04/10/2023Expiration date: 04/10/2024Additional CPE details can be found here.Follow CEimpact on Social Media:LinkedInInstagramDownload the CEimpact App for Free Continuing Education + so much more!

Efficacy and Safety of Intensive Versus Nonintensive Supplemental Insulin With a Basal-Bolus Insulin Regimen in Hospitalized Patients With Type 2 Diabetes: A Randomized Clinical Study | Diabetes Care | American Diabetes Association (diabetesjournals.org)   randomized noninferiority study from Emory University, 224 hospitalized patients with longstanding type 2 diabetes  Both groups received basal/bolus insulin; both the starting dose and subsequent changes were specified by the study protocol. Additional premeal SSI was added to scheduled premeal bolus doses.randomized to either intensive SSI (at BG >140 mg/dL) or nonintensive SSI (at BG >260 mg/dL) before meals and at bedtime.  Mean baseline glycosylated hemoglobin (HbA1c) was 9%, and 60% of patients were using insulin at home. Patients with a presenting glucose level of >400 mg/dL or diabetic ketoacidosis were excluded.  Outcome---Mean daily BG level, hypoglycemia, severe hyperglycemia, percent of BGs in the target range (70–180 mg/dL), and the amount of total, basal, or prandial insulin used did not differ between groups. However, significantly fewer patients in the nonintensive group than in the intensive group received SSI (34% vs. 91%).   COMMENTAlthough this is a single-center study, its results are persuasive and suggest that a less-intense SSI regimen can achieve similar glucose outcomes in hospitalized patients with type 2 diabetes who are receiving basal/bolus insulin. It also could decrease nursing treatment burden. As we move slowly toward more continuous glucose monitoring in hospitals, reducing use of SSI is another opportunity to achieve similar results with less staff burden and more patient comfort.  Comparative Effectiveness and Safety Between Apixaban, Dabigatran, Edoxaban, and Rivaroxaban Among Patients With Atrial Fibrillation: A Multinational Population-Based Cohort Study: Annals of Internal Medicine: Vol 175, No 11 (acpjournals.org) In a retrospective study, investigators accessed five electronic health databases from Europe and the U.S. to compare >500,000 new DOAC users with newly diagnosed atrial fibrillation. Follow up varied from 1.5 to 4.5 years.   In propensity score–adjusted analyses, patients who received apixaban had significantly less gastrointestinal (GI) bleeding did those who received any of the other three drugs (hazard ratios, 0.7–0.8). This result was consistent among older patients and those with chronic kidney disease (CKD). Risk for stroke or other systemic embolism, intracranial hemorrhage, and all-cause mortality did not differ significantly among DOACs.    COMMENTThis is the largest comparison of individual DOACs, and it demonstrates similar efficacy among all agents. Although apixaban was associated with less GI bleeding, absolute percentages of GI bleeds ranged from ≈2% to ≈3.5% for all DOACs; therefore, apixaban's statistically significant safety benefit might amount to marginal clinical benefit for any individual patient. I might turn to apixaban for patients at high risk for GI bleeding (and those with CKD), but all DOACs remain reasonable options for preventing thromboembolism in most patients with atrial fibrillation. Ellenbogen MI et al. Safety and effectiveness of apixaban versus warfarin for acute venous thromboembolism in patients with end-stage kidney disease: A national cohort study. J Hosp Med 2022 Oct; 17:809. (https://doi.org/10.1002/jhm.12926. opens in new tab)  . In an industry-funded retrospective study, investigators used a national database (years, 2014–2018) and propensity score–adjusted analysis to compare outcomes among >11,500 patients with ESRD and newly diagnosed VTE who received either apixaban or warfarin.Only 2% of patients received apixaban in 2014, but 47% received apixaban in 2018.during the 6 months following initiation of therapy, apixaban — compared with warfarin  associated with significantly lower incidence of major bleeding (10% vs. 14%), including intracranial bleeding (1.8% vs. 2.5%) and gastrointestinal bleeding (8.6% vs. 10.4%). Recurrent VTE and all-cause mortality were similar in the two groups.   VTE and creatine clearence less than 30 then I think apixaban is the drug of choice—I would like to see this study don't with afib and done with exclusively

Janus kinase inhibitor therapy and venous thromboembolism risk factors by AORNJournal

Identifying validated venous thromboembolism risk assessment tools by AORNJournal

Communicating venous thromboembolism and bleeding risk after surgery by AORNJournal

Timing of the preoperative venous thromboembolism risk assessment by AORNJournal

This episode covers venous thromboembolism in pregnancy.Written notes can be found at https://zerotofinals.com/obgyn/antenatal/vte/ or in the antenatal care section of the Zero to Finals obstetrics and gynaecology book.The audio in the episode was expertly edited by Harry Watchman.

Show notes at pharmacyjoe.com/episode702. In this episode, I'll discuss the risk factors associated with the development of venous thromboembolism in ICU patients. The post 702: Risk Factors Associated With the Development of Venous Thromboembolism in Critically Ill Patients appeared first on Pharmacy Joe.

Show notes at pharmacyjoe.com/episode702. In this episode, I ll discuss the risk factors associated with the development of venous thromboembolism in ICU patients. The post 702: Risk Factors Associated With the Development of Venous Thromboembolism in ICU Patients appeared first on Pharmacy Joe.