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Elevated Risk of Venous Thromboembolism in People Living with HIV. Viruses 2022; 14:v14030590. [PMID: 35336997 PMCID: PMC8955815 DOI: 10.3390/v14030590] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 03/06/2022] [Indexed: 11/16/2022] Open
Abstract
Human immunodeficiency virus (HIV) has been generally considered as a highly adaptive and rapidly evolving virus. It still constitutes a major public health problem all over the world despite an effective outcome in the prevention and reversal of the development and prognosis by using antiretroviral therapy. The salient question lies in the more frequent emergence of a series of comorbidities along with the prolongation of the life, which deeply affects the survival in such group. Venous thromboembolism (VTE) has been recognized to be the third most common cardiovascular condition within people living with HIV (PWH). In terms of its mechanism of action, the occurrence of VTE is quite multifactorial and complex in HIV. Prior exploration concerning the etiology of VTE in PWH identifies general, disease-specific, and miscellaneous factors for explaining its occurrence and development. VTE has constituted an important role in PWH and may increase its all-cause mortality. Therefore, it is quite necessary to understand VTE from the following aspects of epidemiology, pathophysiology, molecular mechanisms, and therapeutic interventions so as to balance the risks and benefits of anticoagulation and optimize corresponding treatment.
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Spiegl HR, Estepp JH, Li C, Gil S, Gosain A, Murphy AJ, Davidoff AM. Risk for deep venous thrombosis in pediatric cancer patients undergoing surgery. J Pediatr Surg 2021; 56:2360-2363. [PMID: 33722369 DOI: 10.1016/j.jpedsurg.2021.01.047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 01/25/2021] [Accepted: 01/26/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE Cancer is a well-established risk factor for deep venous thrombosis (DVT). We sought to assess the incidence of DVT in pediatric cancer patients undergoing select surgical procedures at our institution and to identify additional factors associated with DVT development. METHODS We performed a retrospective review of cancer patients who underwent select surgical procedures and developed a DVT within 30 days of their operation from 2000 to 2018 at our institution. Catheter-associated DVTs were excluded from this analysis. Major oncologic operations were selected. RESULTS From 2000 to 2018, 3031 major oncologic operations were performed following which 14 symptomatic DVTs occurred, for an overall incidence of 0.46%. Procedures associated with post-operative DVT included: mass biopsy (7), pulmonary wedge resection (2), inguinal lymph node excision (1), colectomy (1), nephrectomy (1), lower extremity limb-sparing revision (1), and femur resection (1). CONCLUSIONS Our data suggest that surgery does not put children with cancer at significant risk for DVT. Given the low incidence of perioperative DVT, routine pharmacologic prophylaxis for children with cancer undergoing surgery does not seem warranted. LEVEL OF EVIDENCE II.
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Affiliation(s)
- Hannah R Spiegl
- Department of Surgery, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105, United States
| | - Jeremie H Estepp
- Department of Hematology, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105, United States
| | - Chen Li
- Department of Biostatistics, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105, United States
| | - Sebastian Gil
- Department of Surgery, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105, United States
| | - Ankush Gosain
- Department of Surgery, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105, United States; Department of Surgery, University of Tennessee Health Science Center, 910 Madison Ave, Memphis, TN 38163, United States; Division of Pediatric Surgery, LeBonheur Children's Hospital, 848 Adams Ave, Memphis, TN 38103, United States
| | - Andrew J Murphy
- Department of Surgery, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105, United States; Department of Surgery, University of Tennessee Health Science Center, 910 Madison Ave, Memphis, TN 38163, United States; Division of Pediatric Surgery, LeBonheur Children's Hospital, 848 Adams Ave, Memphis, TN 38103, United States
| | - Andrew M Davidoff
- Department of Surgery, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105, United States; Department of Surgery, University of Tennessee Health Science Center, 910 Madison Ave, Memphis, TN 38163, United States; Division of Pediatric Surgery, LeBonheur Children's Hospital, 848 Adams Ave, Memphis, TN 38103, United States.
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Nicholson M, Chan N, Bhagirath V, Ginsberg J. Prevention of Venous Thromboembolism in 2020 and Beyond. J Clin Med 2020; 9:jcm9082467. [PMID: 32752154 PMCID: PMC7465935 DOI: 10.3390/jcm9082467] [Citation(s) in RCA: 71] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 07/18/2020] [Accepted: 07/27/2020] [Indexed: 02/06/2023] Open
Abstract
Venous thromboembolism (VTE) is the third most common cause of vascular mortality worldwide and comprises deep-vein thrombosis (DVT) and pulmonary embolism (PE). In this review, we discuss how an understanding of VTE epidemiology and the results of thromboprophylaxis trials have shaped the current approach to VTE prevention. We will discuss modern thromboprophylaxis as it pertains to genetic risk factors, exogenous hormonal therapies, pregnancy, surgery, medical hospitalization, cancer, and what is known thus far about VTE in COVID-19 infection.
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Shin JA, Lee JY, Kim KM, Yoon JH, Lee JW, Lee C. A huge right ventricular thrombosis and pulmonary thromboembolism in a child with acute lymphoblastic leukemia. Pediatr Blood Cancer 2020; 67:e28347. [PMID: 32379393 DOI: 10.1002/pbc.28347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 04/01/2020] [Accepted: 04/02/2020] [Indexed: 11/09/2022]
Affiliation(s)
- Ju Ae Shin
- Department of Pediatrics, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Jae Young Lee
- Department of Pediatrics, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Kyung Min Kim
- Department of Pediatrics, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Ji Hong Yoon
- Department of Pediatrics, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Jae-Wook Lee
- Department of Pediatrics, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Cheul Lee
- Department of Thoracic and Cardiovascular Surgery, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
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Park ES, Choi HS, Lee KS, Kim SW, Lee JM. Venous Thromboembolism in Children and Young Adults in Korea: Analysis of the Korean Health Insurance Review and Assessment Service Database. J Korean Med Sci 2019; 34:e316. [PMID: 31858756 PMCID: PMC6926097 DOI: 10.3346/jkms.2019.34.e316] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 10/28/2019] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Venous thromboembolism (VTE) is very rare in childhood. Nevertheless, its incidence has increased recently. This study aimed to identify risk factors for developing thrombosis in childhood cancers and other childhood diseases through the Korean Health Insurance Review and Assessment Service database. METHODS Data were extracted from the Korean Health Insurance Review and Assessment Service database. Children and young adults from 1 month to 29 years of age were eligible, and 21,747 cases of VTE between January 2008 and December 2016 were identified. RESULTS The VTE incidence was high in children younger than 1 year of age. After 1 year of age, its incidence decreased rapidly and gradually increased. The VTE incidence for children between 0 and 1 year of age was 10.23-fold higher than that for those between 1 and 5 years of age. Annual VTE incidence increased by year. The age-standardized annual incidence rates were 9.98 per 100,000 population in 2008 and 22.53 per 100,000 population in 2016. The age-standardized annual incidence rate increased 2.25-fold during the 8 years. The lower extremity was the most common site of venous thrombosis. CONCLUSION The incidence of VTE in a population younger than 30 years was 13.11 per 100,000 persons in Korea. We found a bimodal age distribution of the VTE incidence with peaks at infancy and again after 16 years. The incidence of portal vein thrombosis was high in infants, and infection and malignancy were the most common comorbidities in patients with VTE.
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Affiliation(s)
- Eun Sil Park
- Department of Pediatrics, College of Medicine, Gyeongsang National University, Jinju, Korea
| | - Hyoung Soo Choi
- Department of Pediatrics, Seoul National University Bundang Hospital, College of Medicine, Seoul National University, Seongnam, Korea
| | - Kyeong Soo Lee
- Department of Preventive Medicine and Public Health, College of Medicine, Yeungnam University, Daegu, Korea
| | - Sang Won Kim
- Medical Research Center, College of Medicine, Yeungnam University, Daegu, Korea
| | - Jae Min Lee
- Department of Pediatrics, College of Medicine, Yeungnam University, Daegu, Korea.
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Ting M, Rodriguez M, Gowda ST, Anders M, Qureshi AM, Grimes A. Cardiovascular recurrence of high-grade osteosarcoma presenting as atrial thrombosis and pulmonary embolism: A case report and review of the pediatric literature. Pediatr Hematol Oncol 2019; 36:244-251. [PMID: 31179809 DOI: 10.1080/08880018.2019.1624902] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
In the era of neoadjuvant and adjuvant chemotherapy, extrapulmonary involvement by high-grade osteosarcoma (HGOS) is rare. Importantly however, HGOS metastasis in the form of cardiovascular tumor thrombus portends a dismal prognosis. Thus, prompt and accurate identification of tumor thrombus is crucial. We report here two unique cases of recurrent HGOS, presenting as thrombotic events, in order to increase awareness and index of suspicion among practitioners regarding this presentation. Additionally, we review 14 previously reported pediatric cases of cardiovascular metastatic HGOS.
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Affiliation(s)
- Michelle Ting
- a Division of Pediatric Hematology and Oncology, Department of Pediatrics, Texas Children's Hospital and Baylor College of Medicine , Houston , Texas
| | - Marco Rodriguez
- b Division of Pediatric Cardiology, Department of Pediatrics, Texas Children's Hospital and Baylor College of Medicine , Houston , Texas
| | - Srinath T Gowda
- c Division of Pediatric Cardiology, Department of Pediatrics, Texas Children's Hospital and Baylor College of Medicine , Houston , Texas
| | - Marc Anders
- d Division of Pediatric Critical Care Medicine, Department of Pediatrics, Texas Children's Hospital and Baylor College of Medicine , Houston , Texas
| | - Athar M Qureshi
- e Division of Pediatric Cardiology, Department of Pediatrics, Texas Children's Hospital and Baylor College of Medicine , Houston , Texas
| | - Amanda Grimes
- f Division of Pediatric Hematology and Oncology, Department of Pediatrics, Texas Children's Hospital and Baylor College of Medicine , Houston , Texas
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