oalib
Search Results: 1 - 10 of 100 matches for " "
All listed articles are free for downloading (OA Articles)
Page 1 /100
Display every page Item
The Absolute Risk of Venous Thrombosis after Air Travel: A Cohort Study of 8,755 Employees of International Organisations  [PDF]
Saskia Kuipers,Suzanne C Cannegieter ,Saskia Middeldorp,Luc Robyn,Harry R Büller,Frits R Rosendaal
PLOS Medicine , 2007, DOI: 10.1371/journal.pmed.0040290
Abstract: Background The risk of venous thrombosis is approximately 2- to 4-fold increased after air travel, but the absolute risk is unknown. The objective of this study was to assess the absolute risk of venous thrombosis after air travel. Methods and Findings We conducted a cohort study among employees of large international companies and organisations, who were followed between 1 January 2000 and 31 December 2005. The occurrence of symptomatic venous thrombosis was linked to exposure to air travel, as assessed by travel records provided by the companies and organisations. A long-haul flight was defined as a flight of at least 4 h and participants were considered exposed for a postflight period of 8 wk. A total of 8,755 employees were followed during a total follow-up time of 38,910 person-years (PY). The total time employees were exposed to a long-haul flight was 6,872 PY. In the follow-up period, 53 thromboses occurred, 22 of which within 8 wk of a long-haul flight, yielding an incidence rate of 3.2/1,000 PY, as compared to 1.0/1,000 PY in individuals not exposed to air travel (incidence rate ratio 3.2, 95% confidence interval 1.8–5.6). This rate was equivalent to a risk of one event per 4,656 long-haul flights. The risk increased with exposure to more flights within a short time frame and with increasing duration of flights. The incidence was highest in the first 2 wk after travel and gradually decreased to baseline after 8 wk. The risk was particularly high in employees under age 30 y, women who used oral contraceptives, and individuals who were particularly short, tall, or overweight. Conclusions The risk of symptomatic venous thrombosis after air travel is moderately increased on average, and rises with increasing exposure and in high-risk groups.
Travel-Related Venous Thrombosis: Results from a Large Population-Based Case Control Study (MEGA Study)  [PDF]
Suzanne C Cannegieter,Carine J. M Doggen,Hans C van Houwelingen,Frits R Rosendaal
PLOS Medicine , 2006, DOI: 10.1371/journal.pmed.0030307
Abstract: Background Recent studies have indicated an increased risk of venous thrombosis after air travel. Nevertheless, questions on the magnitude of risk, the underlying mechanism, and modifying factors remain unanswered. Methods and Findings We studied the effect of various modes and duration of travel on the risk of venous thrombosis in a large ongoing case-control study on risk factors for venous thrombosis in an unselected population (MEGA study). We also assessed the combined effect of travel and prothrombotic mutations, body mass index, height, and oral contraceptive use. Since March 1999, consecutive patients younger than 70 y with a first venous thrombosis have been invited to participate in the study, with their partners serving as matched control individuals. Information has been collected on acquired and genetic risk factors for venous thrombosis. Of 1,906 patients, 233 had traveled for more than 4 h in the 8 wk preceding the event. Traveling in general was found to increase the risk of venous thrombosis 2-fold (odds ratio [OR] 2.1; 95% confidence interval [CI] 1.5–3.0). The risk of flying was similar to the risks of traveling by car, bus, or train. The risk was highest in the first week after traveling. Travel by car, bus, or train led to a high relative risk of thrombosis in individuals with factor V Leiden (OR 8.1; 95% CI 2.7–24.7), in those who had a body mass index of more than 30 kg/m2 (OR 9.9; 95% CI 3.6–27.6), in those who were more than 1.90 m tall (OR 4.7; 95% CI 1.4–15.4), and in those who used oral contraceptives (estimated OR > 20). For air travel these synergistic findings were more apparent, while people shorter than 1.60 m had an increased risk of thrombosis after air travel (OR 4.9; 95% CI 0.9–25.6) as well. Conclusions The risk of venous thrombosis after travel is moderately increased for all modes of travel. Subgroups exist in which the risk is highly increased.
The association between air travel and deep vein thrombosis: Systematic review & meta-analysis
Yaser Adi, Sue Bayliss, Andrew Rouse, R S Taylor
BMC Cardiovascular Disorders , 2004, DOI: 10.1186/1471-2261-4-7
Abstract: A comprehensive search was undertaken (Data bases searched were: MEDLINE, EMBASE, Cochrane Library) for studies that estimated both the incidence and the risk of DVT in air travellers relative to non-air travellers.In total 254 studies were identified but only six incidence studies and four risk studies met inclusion criteria justifying their use in a systematic review. Incidence of symptomatic DVT ranged from (0%) in one study to (0.28%) which was reported in pilots over ten years. The incidence of asymptomatic DVT ranged from (0%) to (10.34%). Pooled odds ratios for the two case control studies examining the risk of DVT following air travel were 1.11 (95% CI: 0.64–1.94). Pooled odds ratios for all models of travel including two studies of prolonged air travel (more than three hours) were 1.70 (95% CI: 0.89–3.22).We found no definitive evidence that prolonged (more than 3-hours) travel including air travel, increases the risk of DVT. There is evidence to suggest that flights of eight hours or more increase the risk of DVT if additional risk factors exist.The link between air flight and the development of deep vein thrombosis (DVT) and subsequent pulmonary embolism (PE) – so called 'thromboembolic disease'- was first suggested in 1954 by a report describing DVT in a doctor after a 14-hour flight [1]. Since then there has been a massive increase in the popularity of air travel. More than 1.5 billion people travel each year and the International Civil Association Organisation (ICAO) estimates that this figure will rise to over 2 billion by 2005 [2]. Even a small increased risk of venous thromboembolic events (VTE) associated with air travel will cause a substantial number of VTE. Therefore this topic is a matter of public health concern. Much has been written in the medical and popular press about the link between air travel and the development of deep vein thrombosis (DVT) and pulmonary embolism [3-6]. Not surprisingly this has led to an increase in reports of what h
Air travel and venous thromboembolism
Mendis,Shanthi; Yach,Derek; Alwan,Ala;
Bulletin of the World Health Organization , 2002, DOI: 10.1590/S0042-96862002000500012
Abstract: abstract: there has recently been increased publicity on the risk of venous thrombosis after long-haul flights. this paper reviews the evidence base related to the association between air travel and venous thromboembolism. the evidence consists only of case reports, clinical case-control studies and observational studies involving the use of intermediate end-points, or expert opinion. some studies have suggested that there is no clear association, whereas others have indicated a strong relationship. on the whole it appears that there is probably a link between air travel and venous thrombosis. however, the link is likely to be weak, mainly affecting passengers with additional risk factors for venous thromboembolism. the available evidence is not adequate to allow quantification of the risk. there are insufficient scientific data on which to base specific recommendations for prevention, other than that leg exercise should be taken during travel. further studies are urgently needed in order to identify prospectively the incidence of the condition and those at risk.
Air travel and venous thromboembolism  [cached]
Mendis Shanthi,Yach Derek,Alwan Ala
Bulletin of the World Health Organization , 2002,
Abstract: ABSTRACT: There has recently been increased publicity on the risk of venous thrombosis after long-haul flights. This paper reviews the evidence base related to the association between air travel and venous thromboembolism. The evidence consists only of case reports, clinical case-control studies and observational studies involving the use of intermediate end-points, or expert opinion. Some studies have suggested that there is no clear association, whereas others have indicated a strong relationship. On the whole it appears that there is probably a link between air travel and venous thrombosis. However, the link is likely to be weak, mainly affecting passengers with additional risk factors for venous thromboembolism. The available evidence is not adequate to allow quantification of the risk. There are insufficient scientific data on which to base specific recommendations for prevention, other than that leg exercise should be taken during travel. Further studies are urgently needed in order to identify prospectively the incidence of the condition and those at risk.
Portal Vein Thrombosis after Splenectomy  [PDF]
Mohamed Al Saeed
Egyptian Journal of Hospital Medicine , 2012,
Abstract: Background and Aim of the work: Splenectomy is a common operation but it carries the danger of many postoperative complications. One of the most important complications is the portal vein thrombosis (PVT), which may be fatal due to development of bowel ischemia and severe portal hypertension. Due to the effect of hypobaric hypoxia and higher liability for thrombosis encountered in high altitude areas, PVT may represent an actual problem in Taif province. The aim of this retrospective study is to detect the incidence, pattern of presentation, laboratory, radiological and results of treatment of cases of PVT following splenectomy.Methods: In this study, we reviewed all cases of splenectomy performed in King Abdul Aziz Specialist Hospital, Taif, Saudi Arabia from January 2007 to January 2012. Cases of PVT following splenectomy were analyzed for incidence, pattern of presentation, laboratory, radiological and results of treatment. Results: This study involved 50 patients (40 males and 10 females) admitted in the surgical department of King Abdul Aziz Specialist Hospital, Taif, Saudi Arabia from January 2007 to January 2012. Eight cases of Portal vein thrombosis (16%) out of 50 splenectomies were identified. These 8 patients included: 4/10 of the patients (40%) suffering from myeloproliferative (MP), 3 of them (75%) had spleen weight greater than 3,000 g, 3/12 (25%) of the hemolytic anemia patients, and 1/10 of the patients (10%) operated upon for Hypersplenism. All patients had splenomegaly with mean weight of 1540 Gms (range 460 to 3850 g). Presenting symptoms included; anorexia in 7/8 cases (87.5%), abdominal pain in 6 (75%), and in all cases there was elevation in D-Dimer level, leukocyte and platelet counts. All diagnoses were made by contrast-enhanced computed tomography scan, and anticoagulation was initiated immediately. One/8 patients (12.5%) died from progressive liver cell failure; the others are alive with no clinical sequalae at a mean follow up of 27 months.CONCLUSIONS: PVT is a relatively common complication of splenectomy in patients with Splenomegaly, especially in Taif and related districts in which there is already a higher incidence of thrombotic disorders. The surgeon has to be with high index of suspicion, for early diagnosis by contrast-enhanced computed tomography, and prompt anticoagulation for successful outcome.
Fatal portal thrombosis after laparoscopic Nissen fundoplication
García Díaz,R. A.; Rodríguez-Sanjuán,J. C.; Domínguez Díez,R. A.; García-Barón Pórtoles,A.; Trugeda Carrera,M. S.; Torre Carrasco,F. de la; Gómez-Fleitas,M.;
Revista Espa?ola de Enfermedades Digestivas , 2005, DOI: 10.4321/S1130-01082005000900007
Abstract: portal and mesenteric vein thrombosis is a very uncommon complication of laparoscopic surgery, especially after anti-reflux procedures. we report the case of a twenty-year-old man with a history of alcohol and cocaine consumption. a nissen fundoplication was performed. the patient received a single 20-mg dose of enoxaparin (clexane?, aventis pharma, spain) two hours before surgery for antithrombotic prophylaxis. on the seventh postoperative day the patient had a portal and mesenteric venous thrombosis, which was confirmed at laparotomy, with both extensive small-intestine necrosis and partial colon necrosis. despite anticoagulant therapy, the patient died 24 hours later. surgical findings were confirmed at necropsy. portal and mesenteric venous thrombosis is an uncommon but severe and even fatal complication after laparoscopic anti-reflux surgery. when other pro-thrombotic, predisposing conditions such as laparoscopic surgery and cocaine consumption are present, the usual prophylactic doses of low molecular weight heparin might not be sufficient to protect against this life-threatening complication.
Cerebral Venous Sinus Thrombosis After Spinal Anesthesia: Case Report
Neslihan YüCEL,Feride Sinem AKGüN,Yusuf Kenan TEK?N,Sibel ALTINAYAR
Turkish Journal of Emergency Medicine , 2011,
Abstract: Cerebral venous sinus thrombosis is a rare clinical disorder which frequently shows up as prolonged headache unresponsive to standard therapies following spinal anesthesia. In this study, a 24 years old male presenting to our emergency department (ED) after many visits to other ED with headache which started following spinal anesthesia underwent fifteen days ago and being diagnosed with cerebral sinus venous thrombosis upon the evaluations is reported.
Expatriates ill after travel: Results from the Geosentinel Surveillance Network  [cached]
Lim Poh-Lian,Han Pauline,Chen Lin H,MacDonald Susan
BMC Infectious Diseases , 2012, DOI: 10.1186/1471-2334-12-386
Abstract: Background Expatriates are a distinct population at unique risk for health problems related to their travel exposure. Methods We analyzed GeoSentinel data comparing ill returned expatriates with other travelers for demographics, travel characteristics, and proportionate morbidity (PM) for travel-related illness. Results Our study included 2,883 expatriates and 11,910 non-expatriates who visited GeoSentinel clinics ill after travel. Expatriates were more likely to be male, do volunteer work, be long-stay travelers (>6 months), and have sought pre-travel advice. Compared to non-expatriates, expatriates returning from Africa had higher proportionate morbidity (PM) for malaria, filariasis, schistosomiasis, and hepatitis E; expatriates from the Asia-Pacific region had higher PM for strongyloidiasis, depression, and anxiety; expatriates returning from Latin America had higher PM for mononucleosis and ingestion-related infections (giardiasis, brucellosis). Expatriates returning from all three regions had higher PM for latent TB, amebiasis, and gastrointestinal infections (other than acute diarrhea) compared to non-expatriates. When the data were stratified by travel reason, business expatriates had higher PM for febrile systemic illness (malaria and dengue) and vaccine-preventable infections (hepatitis A), and volunteer expatriates had higher PM for parasitic infections. Expatriates overall had higher adjusted odds ratios for latent TB and lower odds ratios for acute diarrhea and dermatologic illness. Conclusions Ill returned expatriates differ from other travelers in travel characteristics and proportionate morbidity for specific diseases, based on the region of exposure and travel reason. They are more likely to present with more serious illness.
The incidence of late stent thrombosis after successful cypher stent implantation
Amir Aslani,MB Sharifkazemi,M Zamirian
Iranian Cardiovascular Research Journal , 2007,
Abstract: Background: Stent thrombosis is a rare but devastating complication ofcoronary stent implantation. Coronary stent deployment is associated with a lowincidence of acute and sub-acute thrombosis. However, late stent thrombosis hasbeen recognized clinically. The aim of this prospective study was to evaluatethe incidence of late stent thrombosis in patients receiving sirolimus-elutingstents.Patients and Methods: One hundred patients (132 lesions) who underwentimplantation of sirolimus eluting stents were selected. All patients werepre-medicated with 325 mg of aspirin, which was continued indefinitely.Anti-thrombotic regimens, including intravenous heparin and a loading dose ofclopidogrel (300 mg) were given in the catheterization laboratory andclopidogrel 75 mg/day was continued for at least 6 months. In patients allergicto clopidogrel, ticlopidine at a dose of 250 mg twice daily was prescribed as asubstitute. Late stent thrombosis was defined as myocardial infarctioncharacterized by anginal symptoms with ST-elevation on the electrocardiogram andcreatine kinase-MB elevation >3 times the upper limit of normal withangiographic documentation of partial or total stent occlusion more than 30 daysafter sirolimus eluting stent implantation (while the stented segment was theculprit lesion).Results: Complete 2 year follow-up was available for all patients.Between 30 days to 2 years after sirolimus-eluting stent implantation, 2patients (2%) experienced late stent thrombosis at a mean time of 420 days(range 360 to 480).Conclusions: This study reports a very late stent thrombosis after 20months of sirolimus eluting stent implantation and 15 months after cessation ofclopidogrel treatment, despite continued aspirin administration. This study alsoimplies the possible need for long term antiplatelet therapy among patientsreceiving sirolimus eluting stents.
Page 1 /100
Display every page Item


Home
Copyright © 2008-2017 Open Access Library. All rights reserved.