Rayya A. Saadiq

RIVAROXABAN COMPARED TO LOW MOLECULAR WEIGHT HEPARIN IN TREATMENT OF MALIGNANCY ASSOCIATED VENOUS THROMBOEMBOLISM

Low molecular weight heparin (LMWH) is the guideline endorsed treatment of choice for cancer associated venous thromboembolism (VTE). Rivaroxaban offers a convenient potential alternative to LMWH; however there are no data comparing either the efficacy or safety of these two therapies in this

Efficacy and safety of rivaroxaban compared to enoxaparin in treatment of cancer-associated venous thromboembolism

Low molecular weight heparin (LMWH) is the guideline‐endorsed treatment for cancer‐associated venous thromboembolism (cVTE). Study objectives were to compare the efficacy and safety of rivaroxaban and enoxaparin in cVTE.

Updates in venous thromboembolism management: evidence published in 2016

ABSTRACT The management of venous thromboembolic disease (VTE) is rapidly evolving and staying updated on practice-changing evidence can be challenging. In an attempt to alleviate this daunting task, we sought to determine the most important practice-informing articles published in 2016 relevant to the non-specialist provider managing VTE. We performed a systematic search of the literature, limiting the search to a publication date of 2016 (see Supplementary Appendix). Two reviewers screened the 3819 resulting abstracts to identify high-quality, clinically relevant publications related to VTE management. Two hundred sixteen full-text articles were considered for inclusion. The five authors used a modified Delphi method to reach consensus on inclusion of 7 articles for in-depth appraisal, following predetermined criteria of clinical relevance to non-specialist providers, potential for practice change, and strength of the evidence.

ovarian Vein Thrombosis: Incidence of Recurrent Venous Thromboembolism and Survival

OBJECTIVE To identify the risk of venous thromboembolism recurrence, major bleeding, and mortality in patients with ovarian vein thrombosis so as to better define optimal treatment strategies. METHODS Patients with ovarian vein thrombosis (1990-2015) and age- and gender-matched patients with contemporary leg deep vein thrombosis (DVT) were assessed for differences in etiology, venous thromboembolism recurrence, and survival in a case-control study. RESULTS Over the timeframe of this study, only 219 ovarian vein thrombosis cases were identified compared with 13,417 leg DVTs. Median duration of follow-up was 1.23 years (interquartile range 0.25-4.14). Pulmonary embolism was identified at presentation in 6% of patients with ovarian vein thrombosis and 16% of those with DVT (P=.001). Frequent causes of ovarian vein thrombosis included cancer, hormonal stimulation, surgery, and hospitalization. Cancer was twofold more frequent in patients with ovarian vein thrombosis (44% compared with 21%; P<.01). Despite being less frequently treated with anticoagulation (ovarian vein thrombosis 54% compared with DVT 98%, P<.001), venous thromboembolism recurrence rates were similar between groups (ovarian vein thrombosis 2.3 compared with DVT 1.8 per 100 patient-years, P=.49). A personal history of venous thromboembolism and preceding surgery was found to be an independent risk factor for venous thromboembolism recurrence among those treated with anticoagulation (hazard ratio 6.7, P=.04 and hazard ratio 13.6, P=.03, respectively). There was no significant difference in overall survival. CONCLUSION Ovarian vein thrombosis is a rare thrombotic condition with an incidence 60-fold lower compared with leg DVT in our institution. The striking association with cancer adversely affects overall survival rates in patients with ovarian vein thrombosis. Venous thromboembolism recurrence rates argue for anticoagulation with a direct oral anticoagulant or vitamin K antagonist, particularly in those with a history of venous thromboembolism.

57-Year-Old Man With Flushing and Fainting

Apreviously healthy 55-year-old man presented with a 2-month history of recurrent episodes of syncope and near syncope.Hehadrecentlylostconsciousnesswhile riding a bike, at which time hypotension was noted by emergency medical technicians. These episodes occurred on a weekly basis, lasted 15 to 20 minutes, and were primarily associated with exertion or stress. Additional symptoms includedprominentfacial flushingwiththesensationthathisearswere“on fire,”headache,nausea, abdominal discomfort, and palpitations. He reported no vomiting, diarrhea, weight loss, wheezing,dyspnea,seizurelikesymptoms,confusion, extremity weakness, or incontinence of

Testicular vein thrombosis: Incidence of recurrent venous thromboembolism and survival

Testicular vein thrombosis (TVT) etiology, recurrence, and survival were compared with lower extremity deep vein thrombosis (DVT) in order to determine whether treatment guidelines for DVT could be applied to TVT.