This study explores the diagnostic value of combining the Padua score with the thrombotic biomarker tissue plasminogen activator inhibitor-1(tPAI-1)for assessing the risk of deep vein thrombosis(DVT)in patients with p...This study explores the diagnostic value of combining the Padua score with the thrombotic biomarker tissue plasminogen activator inhibitor-1(tPAI-1)for assessing the risk of deep vein thrombosis(DVT)in patients with pulmonary heart disease.These patients often exhibit symptoms similar to venous thrombosis,such as dyspnea and bilateral lower limb swelling,complicating differential diagnosis.The Padua Prediction Score assesses the risk of venous thromboembolism(VTE)in hospitalized patients,while tPAI-1,a key fibrinolytic system inhibitor,indicates a hypercoagulable state.Clinical data from hospitalized patients with cor pulmonale were retrospectively analyzed.ROC curves compared the diagnostic value of the Padua score,tPAI-1 levels,and their combined model for predicting DVT risk.Results showed that tPAI-1 levels were significantly higher in DVT patients compared to non-DVT patients.The Padua score demonstrated a sensitivity of 82.61%and a specificity of 55.26%at a cutoff value of 3.The combined model had a significantly higher AUC than the Padua score alone,indicating better discriminatory ability in diagnosing DVT risk.The combination of the Padua score and tPAI-1 detection significantly improves the accuracy of diagnosing DVT risk in patients with pulmonary heart disease,reducing missed and incorrect diagnoses.This study provides a comprehensive assessment tool for clinicians,enhancing the diagnosis and treatment of patients with cor pulmonale complicated by DVT.Future research should validate these findings in larger samples and explore additional thrombotic biomarkers to optimize the predictive model.展开更多
Objective:To explore the clinical effect of preventive nursing intervention on deep venous thrombosis rate,nursing satisfaction and average hospitalization time after treatment of lung cancer.Methods:Chinese databases...Objective:To explore the clinical effect of preventive nursing intervention on deep venous thrombosis rate,nursing satisfaction and average hospitalization time after treatment of lung cancer.Methods:Chinese databases(Wanfang,Weipu and China Knowledge Network)and English databases(Pubmed,Cochrane and Scopus)were searched and read references for relevant research.Statistical analysis was performed using Review Manager 5.3.The odds ratio(OR)and the mean difference(MD)were used as the combined effect values of the comparison groups.Sensitivity analysis was performed by changing the effect model or excluding the literature with a large weight ratio,and the symmetry of the funnel plot was observed for publication bias test.Results:A total of 14 Chinese studies included.Compared with routine nursing intervention,preventive nursing intervention could significantly reduce the rate of deep vein thrombosis after lung cancer treatment[OR=0.16(0.10,0.23)],improve nursing satisfaction[OR=6.42(3.32,12.41)]and shorten the average hospital stay[MD=-7.41(-8.16,-6.65)],without heterogeneous existing.And regardless of whether the lung cancer patient was undergoing resection or chemotherapy,the effect of preventive nursing intervention to reduce the rate of deep vein thrombosis was very significant.Conclusion:Preventive nursing intervention is beneficial to patients with lung cancer,which can significantly reduce the formation rate of deep vein thrombosis,which is worthy of clinical promotion.展开更多
The etiology of deep vein thrombosis（DVT） is still not elucidated nowadays.Based on the accordance between DVT incidence and the anemophilous pollen concentration in the air,we proposed the hypothesis that allergic ...The etiology of deep vein thrombosis（DVT） is still not elucidated nowadays.Based on the accordance between DVT incidence and the anemophilous pollen concentration in the air,we proposed the hypothesis that allergic reaction induced by anemophilous pollen may cause ＂idiopathic＂ DVT,and proinflammatory factors may play an important role in the thrombosis process.展开更多
Deep vein thrombosis (DVT) is one or more blood clots formed inside the deep vein in the body resulting in complete or partial blockage of blood flow through the affected vein. Upper Extremity DVT (UEDVT) accounts for...Deep vein thrombosis (DVT) is one or more blood clots formed inside the deep vein in the body resulting in complete or partial blockage of blood flow through the affected vein. Upper Extremity DVT (UEDVT) accounts for 5% - 10% of all cases of DVTs. Previously it was thought to be a rare disorder. However in recent years with the advent of various indwelling intravenous devices, hypercoagulable state like COVID-19, secondary UEDVT did not remain infrequent presentation anymore. Though primary UEDVT, also known as Effort Thrombosis, that takes place without any underlying obvious pathology is a rare form till now. We presented a case of 46 years female who presented to the emergency with complaints of progressively increasing pain (7 days) and swelling (3 days) of her right forearm since last 7 days following strenuous and heavy work by her dominant/ right hand during the period of festival. She initially ignored her condition because of the Durga Puja festival. As her symptoms deteriorated she eventually had to attend the emergency department. Eventually an urgent ultrasonography color Doppler was done on emergency basis which diagnosed underlying DVT of her right brachial vein. She was managed with low molecular weight heparin, urgent fasciotomy owning to her impending compartment syndrome. Other tests ruled out any secondary underlying pathology. She improved and discharged without any complications on oral anticoagulant. Exigent events in her history were trauma followed by fall on her right elbow 2 months back and then presenting signs & symptoms commencing at the same region following strenuous, tedious activities over 7 days and consequential effort thrombosis of her right brachial vein. All of that compelled us to ruminate on rare differentials of her presentation and eventually come to this rare diagnosis. The author hence brought this pedagogic case to the readers, especially emergency & primary care physicians and emphasised the importance of being intuitive about rare but deadly differentials which come from proficiency & experience in the field of medicine.展开更多
基金Sichuan Province Medical Research Project Plan(Project No.S21113)。
文摘This study explores the diagnostic value of combining the Padua score with the thrombotic biomarker tissue plasminogen activator inhibitor-1(tPAI-1)for assessing the risk of deep vein thrombosis(DVT)in patients with pulmonary heart disease.These patients often exhibit symptoms similar to venous thrombosis,such as dyspnea and bilateral lower limb swelling,complicating differential diagnosis.The Padua Prediction Score assesses the risk of venous thromboembolism(VTE)in hospitalized patients,while tPAI-1,a key fibrinolytic system inhibitor,indicates a hypercoagulable state.Clinical data from hospitalized patients with cor pulmonale were retrospectively analyzed.ROC curves compared the diagnostic value of the Padua score,tPAI-1 levels,and their combined model for predicting DVT risk.Results showed that tPAI-1 levels were significantly higher in DVT patients compared to non-DVT patients.The Padua score demonstrated a sensitivity of 82.61%and a specificity of 55.26%at a cutoff value of 3.The combined model had a significantly higher AUC than the Padua score alone,indicating better discriminatory ability in diagnosing DVT risk.The combination of the Padua score and tPAI-1 detection significantly improves the accuracy of diagnosing DVT risk in patients with pulmonary heart disease,reducing missed and incorrect diagnoses.This study provides a comprehensive assessment tool for clinicians,enhancing the diagnosis and treatment of patients with cor pulmonale complicated by DVT.Future research should validate these findings in larger samples and explore additional thrombotic biomarkers to optimize the predictive model.
基金Key R&D projects in social development in Shaanxi province(2017SF-003)New technology new business of Xijing hospital(No.XJGX15H01)
文摘Objective:To explore the clinical effect of preventive nursing intervention on deep venous thrombosis rate,nursing satisfaction and average hospitalization time after treatment of lung cancer.Methods:Chinese databases(Wanfang,Weipu and China Knowledge Network)and English databases(Pubmed,Cochrane and Scopus)were searched and read references for relevant research.Statistical analysis was performed using Review Manager 5.3.The odds ratio(OR)and the mean difference(MD)were used as the combined effect values of the comparison groups.Sensitivity analysis was performed by changing the effect model or excluding the literature with a large weight ratio,and the symmetry of the funnel plot was observed for publication bias test.Results:A total of 14 Chinese studies included.Compared with routine nursing intervention,preventive nursing intervention could significantly reduce the rate of deep vein thrombosis after lung cancer treatment[OR=0.16(0.10,0.23)],improve nursing satisfaction[OR=6.42(3.32,12.41)]and shorten the average hospital stay[MD=-7.41(-8.16,-6.65)],without heterogeneous existing.And regardless of whether the lung cancer patient was undergoing resection or chemotherapy,the effect of preventive nursing intervention to reduce the rate of deep vein thrombosis was very significant.Conclusion:Preventive nursing intervention is beneficial to patients with lung cancer,which can significantly reduce the formation rate of deep vein thrombosis,which is worthy of clinical promotion.
文摘The etiology of deep vein thrombosis（DVT） is still not elucidated nowadays.Based on the accordance between DVT incidence and the anemophilous pollen concentration in the air,we proposed the hypothesis that allergic reaction induced by anemophilous pollen may cause ＂idiopathic＂ DVT,and proinflammatory factors may play an important role in the thrombosis process.
文摘Deep vein thrombosis (DVT) is one or more blood clots formed inside the deep vein in the body resulting in complete or partial blockage of blood flow through the affected vein. Upper Extremity DVT (UEDVT) accounts for 5% - 10% of all cases of DVTs. Previously it was thought to be a rare disorder. However in recent years with the advent of various indwelling intravenous devices, hypercoagulable state like COVID-19, secondary UEDVT did not remain infrequent presentation anymore. Though primary UEDVT, also known as Effort Thrombosis, that takes place without any underlying obvious pathology is a rare form till now. We presented a case of 46 years female who presented to the emergency with complaints of progressively increasing pain (7 days) and swelling (3 days) of her right forearm since last 7 days following strenuous and heavy work by her dominant/ right hand during the period of festival. She initially ignored her condition because of the Durga Puja festival. As her symptoms deteriorated she eventually had to attend the emergency department. Eventually an urgent ultrasonography color Doppler was done on emergency basis which diagnosed underlying DVT of her right brachial vein. She was managed with low molecular weight heparin, urgent fasciotomy owning to her impending compartment syndrome. Other tests ruled out any secondary underlying pathology. She improved and discharged without any complications on oral anticoagulant. Exigent events in her history were trauma followed by fall on her right elbow 2 months back and then presenting signs & symptoms commencing at the same region following strenuous, tedious activities over 7 days and consequential effort thrombosis of her right brachial vein. All of that compelled us to ruminate on rare differentials of her presentation and eventually come to this rare diagnosis. The author hence brought this pedagogic case to the readers, especially emergency & primary care physicians and emphasised the importance of being intuitive about rare but deadly differentials which come from proficiency & experience in the field of medicine.
