Database : MEDLINE
Search on : upper and extremity and deep and vein and thrombosis [Words]
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[PMID]: 29522873
[Au] Autor:Mahmoud O; Vikatmaa P; Räsänen J; Peltola E; Sihvo E; Vikatmaa L; Lappalainen K; Venermo M
[Ad] Address:Department of Vascular Surgery, Helsinki University Hospital and Institute of Clinical Medicine, Faculty of Medicine, University of Helsinki, Finland; Department of Vascular Surgery, Assiut University Hospital, Faculty of Medicine, Assiut University, Egypt.
[Ti] Title:Catheter-Directed Thrombolysis vs. Pharmacomechanical Thrombectomy for Upper Extremity Deep Venous Thrombosis: Cost-Effectiveness Analysis.
[So] Source:Ann Vasc Surg;, 2018 Mar 06.
[Is] ISSN:1615-5947
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:BACKGROUND AND AIMS: We compared the immediate and one-year results as well as total hospital costs between catheter-directed thrombolysis (CDT) and pharmacomechanical thrombolysis (PMT) in the treatment of symptomatic upper extremity deep venous thrombosis (UEDVT). MATERIAL AND METHODS: From 2006 to 2013, 55 patients with UEDVT were treated with either CDT or PMT at Helsinki University Hospital. Of them, 43 underwent thoracoscopic rib resection later in order to relieve phlebography-confirmed vein compression. This patient cohort was prospectively followed up with repeated phlebographies. CDT was performed to 24 patients and 19 had PMT with a Trellis™ device. Clinical evaluation and vein patency assessment were performed with either phlebography or ultrasound one year after the thrombolysis. Primary outcomes were immediate technical success, one-year vein patency, and costs of the initial treatment. RESULTS: The immediate overall technical success rate, defined as recanalization of the occluded vein and removal of the fresh thrombus, was 91.7% in the CDT group, and 100% in the PMT group (n.s.). The median thrombolytic time was significantly longer in CDT patients than PMT patients (21.1 hours vs. 0.33 hours, P<0.00001). There were no procedure-related complications. The one-year primary assisted patency rate was similar in both groups (91.7% and 94.7%, respectively). There were no recurrences of clinical DVT. The hospital costs for the acute period were significantly lower in the PMT group than the CDT group (medians 11,476 € and 5,975 € in the in the CDT and PMT group, respectively (P<0.00001)). CONCLUSIONS: The clinical results of the treatment of UEDVT with CDT or PMT were similar. However, PMT required shorter hospital stay and less intensive surveillance, leading to lower total costs.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:Publisher

  2 / 929 MEDLINE  
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[PMID]: 29481925
[Au] Autor:Vincent Cawley O; Walsh AS; Asghar I; Desmarowitz HU; Antoniou GA
[Ad] Address:Department of Vascular and Endovascular Surgery, The Royal Oldham Hospital, Pennine Acute Hospitals NHS Trust, Manchester, UK. Electronic address: olicawley@gmail.com.
[Ti] Title:Arterial injury in the upper limb resulting from dog bite.
[So] Source:Ann Vasc Surg;, 2018 Feb 23.
[Is] ISSN:1615-5947
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:Dog bites in the upper limbs have particular significance, as despite the small size of the puncture wounds, penetration is deep, causing serious injuries to deeper structures. There is currently very little data relating to upper extremity dog bite arterial injury. We present the case of a 32-year-old man who sustained a dog bite injury to his right arm, leading to direct puncture and spasm of the brachial artery. He was successfully treated with a jump bypass graft to the right brachial artery, with the use of the reversed ipsilateral cephalic vein as a conduit. We identified 34 cases in the literature reporting upper limb arterial injury secondary to dog bite. Twenty-two cases in the literature detailed axillo-brachial artery damage (65%), 24% radial artery, 3% ulnar artery and 9% combined. Presentation was most commonly with diminished pulses found in at least 45% of the patients. Arterial thrombosis occurred in 29% of cases of single artery injury, transection in 15%, intimal tear in 9% of cases and undisclosed in 44%. Management most commonly included interposition graft (47%) and primary repair (20%), while 15% did not undergo surgical intervention, 9% underwent ligation and 3% were treated with thromboembolectomy. Follow up data for these patients is scarce, with some experiencing residual neurological deficit. This report highlights the importance of prompt recognition and treatment of vascular injury following dog bite in order to attain an optimal outcome and minimise complications.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180226
[Lr] Last revision date:180226
[St] Status:Publisher

  3 / 929 MEDLINE  
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[PMID]: 28459919
[Au] Autor:Noyes AM; Dickey J
[Ad] Address:Department of Medicine, Division of Cardiology, Warren Alpert Medical School of Brown University, Providence, RI.
[Ti] Title:The Arm is Not the Leg: Pathophysiology, Diagnosis, and Management of Upper Extremity Deep Vein Thrombosis.
[So] Source:R I Med J (2013);100(5):33-36, 2017 May 01.
[Is] ISSN:2327-2228
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Upper extremity deep venous thrombosis (UEDVT) involves thrombosis of the deep veins of the arm as they enter the thorax. They are increasing in frequency, largely due to the rising use of central venous catheters and implantable cardiac devices, and represent more than 10% of all DVT cases, Upper extremity deep venous thrombosis has been historically misunderstood when compared to lower extremity deep vein thrombosis (LEDVT). Their associated disease states may carry devastating complications, with mortality rates often higher than that of LEDVT. Thus, education on recognition, classification and management is critical to avoid long-term sequelae and mortality from UEDVT. [Full article available at http://rimed.org/rimedicaljournal-2017-05.asp].
[Mh] MeSH terms primary: Upper Extremity Deep Vein Thrombosis/diagnosis
Upper Extremity Deep Vein Thrombosis/therapy
[Mh] MeSH terms secundary: Humans
Upper Extremity Deep Vein Thrombosis/physiopathology
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1802
[Cu] Class update date: 180221
[Lr] Last revision date:180221
[Js] Journal subset:IM
[Da] Date of entry for processing:170502
[St] Status:MEDLINE

  4 / 929 MEDLINE  
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[PMID]: 29390472
[Au] Autor:Wang K; Sun W; Shi X
[Ad] Address:Department of Parenteral and Enteral Nutrition, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
[Ti] Title:Upper extremity deep vein thrombosis after migration of peripherally inserted central catheter (PICC): A case report.
[So] Source:Medicine (Baltimore);96(51):e9222, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:INTRODUCTION: Peripherally inserted central venous catheters (PICC) are widely used in cancer patients and ultrasound-guided PICC insertion could improve success rate. The tip position of the catheter should be located at the border of lower one-third of the superior vena cava (SVC) and cavo-atrial junction. The migration is malposition at the late stage after PICCs were inserted, and catheter malposition was associated with thrombosis and other complications.After patient's informed consent, we report a case of a 66-year-old male with twice catheter migrations resulting in thrombosis after being diagnosed with cardiac cancer. CONCLUSION: The correct position of the catheter tip can ensure the normal use of PICC and reduce the complications. For the migrated catheter, it should be removed as soon as possible, and when thrombosis has been developed, standard anticoagulant therapy should be given.
[Mh] MeSH terms primary: Anticoagulants/administration & dosage
Catheterization, Peripheral/adverse effects
Central Venous Catheters/adverse effects
Foreign-Body Migration/complications
Upper Extremity Deep Vein Thrombosis/etiology
Upper Extremity Deep Vein Thrombosis/therapy
[Mh] MeSH terms secundary: Aged
Catheterization, Peripheral/methods
Device Removal
Equipment Failure
Follow-Up Studies
Foreign-Body Migration/diagnostic imaging
Heart Neoplasms/diagnosis
Heart Neoplasms/drug therapy
Humans
Male
Risk Assessment
Treatment Outcome
Ultrasonography, Doppler, Color/methods
Upper Extremity Deep Vein Thrombosis/diagnostic imaging
[Pt] Publication type:CASE REPORTS; JOURNAL ARTICLE
[Nm] Name of substance:0 (Anticoagulants)
[Em] Entry month:1802
[Cu] Class update date: 180214
[Lr] Last revision date:180214
[Js] Journal subset:AIM; IM
[Da] Date of entry for processing:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009222

  5 / 929 MEDLINE  
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[PMID]: 29429212
[Au] Autor:Yang H; Xu XM; Fang BM
[Ad] Address:Department of Respiratory and Critical Care Medicine, Beijing Hospital, Beijing 100730, China.
[Ti] Title:[The sources of emboli in patients with pulmonary embolism diagnosed by autopsy].
[So] Source:Zhonghua Jie He He Hu Xi Za Zhi;41(2):86-89, 2018 Feb 12.
[Is] ISSN:1001-0939
[Cp] Country of publication:China
[La] Language:chi
[Ab] Abstract:To study the sources of emboli in patients with pulmonary embolism diagnosed by autopsy, and therefore to provide help in the diagnosis and treatment of thromboembolism. We retrospectively analyzed the pathology and clinical data of 43 patients with pulmonary embolism diagnosed by autopsy from 1962 to 2012 in Beijing Hospital. In patients with pulmonary embolism diagnosed by autopsy, 32.6% of the emboli came from deep veins of the lower extremities, 9.3% from the renal vein, 9.3% from the prostate sinus, 7.0% from the venous plexus around the prostate, 7.0% from the hepatic vein and 7.0% from the submucosal vein of the bladder. Other sources included the right atrium 4.7%, portal vein 4.7%, pancreatic peripheral vein 4.7%, prostate, heart, esophageal vein 4.7%, right common iliac vein 2.3%, right upper limb brachial vein 2.3%. No source of emboli was found in 4.7% patients with pulmonary embolism. Non-lower extremity deep vein emboli accounted for 60.5%. Only 9.3% of the cases were diagnosed with pulmonary embolism with deep vein thrombosis before death. There was a wide range of sources of emboli in patients with pathologically proven pulmonary embolism. Although the deep veins of lower extremities are the most common, more than 60% of the emboli came from the renal vein, prostate vein, hepatic vein and other abdominal or pelvic veins, the heart, and the upper extremity deep veins. In addition to the lower extremity deep veins, other sources of emboli should be actively examined when the patient was diagnosed with acute pulmonary embolism.
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180212
[Lr] Last revision date:180212
[St] Status:In-Process
[do] DOI:10.3760/cma.j.issn.1001-0939.2018.02.003

  6 / 929 MEDLINE  
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[PMID]: 29388461
[Au] Autor:Samoila G; Twine CP; Williams IM
[Ad] Address:Cardiff and Vale University Health Board , UK.
[Ti] Title:The infraclavicular approach for Paget-Schroetter syndrome.
[So] Source:Ann R Coll Surg Engl;100(2):83-91, 2018 Feb.
[Is] ISSN:1478-7083
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:Introduction Paget-Schroetter syndrome is a rare effort thrombosis of the axillary-subclavian vein, mainly occurring in young male patients. Current management involves immediate catheter directed thrombolysis, followed by surgical decompression of the subclavian vein. This has been invariably performed using a transaxillary or supraclavicular approach. However, the subclavian vein crosses the first rib anteriorly just behind the manubrium and can also be accessed via an infraclavicular incision. Methods MEDLINE and Embase™ were searched for all studies on outcomes in patients undergoing infraclavicular first rib resection for treatment of Paget-Schroetter syndrome. Measured outcomes included freedom from reintervention, secondary patency and symptom resolution. Studies on neurogenic, arterial and iatrogenic venous thoracic outlet syndrome were not included. Findings Six studies (involving 268 patients) were eligible. The overall secondary venous patency rate was 98.5%. There was freedom from reintervention in 89.9% of cases and among those patients with reocclusion, 84.0% had chronic thrombosis (symptom duration >14 days), with 76.2% having a venous segment stenosis of >2cm. Only 3 of the 27 patients remained occluded despite reintervention. The infraclavicular approach provides excellent exposure to the subclavian vein and allows reconstruction when required. Moreover, this approach enables complete resection of the extrinsic compression that precipitated the initial thrombotic event, with excellent long-term patency rates. In conclusion, the infraclavicular route may have significant advantages compared with the transaxillary or supraclavicular approaches for successful and durable treatment of Paget-Schroetter syndrome.
[Mh] MeSH terms primary: Decompression, Surgical/methods
Subclavian Vein/surgery
Upper Extremity Deep Vein Thrombosis/surgery
[Mh] MeSH terms secundary: Adult
Female
Humans
Male
Thoracic Outlet Syndrome/surgery
Thrombolytic Therapy/methods
Upper Extremity Deep Vein Thrombosis/diagnosis
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1802
[Cu] Class update date: 180209
[Lr] Last revision date:180209
[Js] Journal subset:IM
[Da] Date of entry for processing:180202
[St] Status:MEDLINE
[do] DOI:10.1308/rcsann.2017.0154

  7 / 929 MEDLINE  
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[PMID]: 29408616
[Au] Autor:Chopra V; Kaatz S; Grant P; Swaminathan L; Boldenow T; Conlon A; Bernstein SJ; Flanders SA
[Ad] Address:The Division of Hospital Medicine, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI; Patient Safety Enhancement Program and Center for Clinical Management Research, VA Ann Arbor Health Care System, Ann Arbor, MI; the Michigan Hospital Medicine Safety Consortium,
[Ti] Title:Risk of Venous Thromboembolism Following Peripherally Inserted Central Catheter Exchange: an Analysis of 23,000 Hospitalized Patients.
[So] Source:Am J Med;, 2018 Jan 31.
[Is] ISSN:1555-7162
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Catheter exchange over a guidewire is frequently performed for malfunctioning peripherally inserted central catheters (PICCs). Whether such exchanges are associated with venous thromboembolism is not known. METHODS: We performed a retrospective cohort study to assess the association between PICC exchange and risk of thromboembolism. Adult hospitalized patients that received a PICC during clinical care one of 51 hospitals participating in the Michigan Hospital Medicine Safety consortium were included. The primary outcome was hazard of symptomatic venous thromboembolism (radiographically confirmed upper-extremity deep vein thrombosis and pulmonary embolism) in those that underwent PICC exchange vs. those that did not. RESULTS: Of 23,010 patients that underwent PICC insertion in the study, 589 patients (2.6%) experienced a PICC exchange. Almost half of all exchanges were performed for catheter dislodgement or occlusion. A total of 480 patients (2.1%) experienced PICC-associated deep vein thrombosis. The incidence of deep vein thrombosis was greater in those that underwent PICC exchange vs. those that did not (3.6% vs. 2.0%, p<0.001). Median time to thrombosis was shorter among those that underwent exchange compared vs. those that did not (5 vs. 11 days, p=0.02). Following adjustment, PICC exchange was independently associated with two-fold greater risk of thrombosis (hazard ratio [HR]=1.98, 95%CI=1.37-2.85) vs. no exchange. The effect size of PICC exchange on thrombosis was second in magnitude to device lumens (HR=2.06 [95%CI=1.59-2.66] and HR=2.31 [95%CI=1.6-3.33] for double- and triple lumen devices, respectively). CONCLUSION: Guidewire exchange of PICCs may be associated with increased risk of thrombosis. As some exchanges may be preventable, consideration of risks and benefits of exchanges in clinical practice is needed.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180206
[Lr] Last revision date:180206
[St] Status:Publisher

  8 / 929 MEDLINE  
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[PMID]: 29226949
[Au] Autor:Feinberg J; Nielsen EE; Jakobsen JC
[Ad] Address:Copenhagen Trial Unit, Centre for Clinical Intervention Research, Department 7812, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, Copenhagen, Denmark, 2100.
[Ti] Title:Thrombolysis for acute upper extremity deep vein thrombosis.
[So] Source:Cochrane Database Syst Rev;12:CD012175, 2017 12 11.
[Is] ISSN:1469-493X
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: About 5% to 10% of all deep vein thromboses occur in the upper extremities. Serious complications of upper extremity deep vein thrombosis, such as post-thrombotic syndrome and pulmonary embolism, may in theory be avoided using thrombolysis. No systematic review has assessed the effects of thrombolysis for the treatment of individuals with acute upper extremity deep vein thrombosis. OBJECTIVES: To assess the beneficial and harmful effects of thrombolysis for the treatment of individuals with acute upper extremity deep vein thrombosis. SEARCH METHODS: The Cochrane Vascular Information Specialist (CIS) searched the Specialised Register (29 March 2017), the Cochrane Central Register of Controlled Trials (CENTRAL; 2017, Issue 2), and three trial registries (World Health Organization International Clinical Trials Registry, ClinicalTrials.gov, and ISRCTN registry) for ongoing and unpublished studies. We additionally searched the registries of the European Medical Agency and the US Food and Drug Administration (December 2016). SELECTION CRITERIA: We planned to include randomised clinical trials irrespective of publication type, publication date and language that investigated the effects of thrombolytics added to anticoagulation, thrombolysis versus anticoagulation, or thrombolysis versus any other type of medical intervention for the treatment of acute upper extremity deep vein thrombosis. DATA COLLECTION AND ANALYSIS: Two review authors independently screened all records to identify those that met inclusion criteria. We planned to use the standard methodological procedures expected by Cochrane. We planned to use trial domains to assess the risks of systematic error (bias) in the trials. We planned to conduct trial sequential analyses to control for the risk of random errors and to assess the robustness of our conclusions. We planned to consider a P value of 0.025 or less as statistically significant. We planned to assess the quality of the evidence using the GRADE approach. Our primary outcomes were severe bleeding, pulmonary embolism, and all-cause mortality. MAIN RESULTS: We found no trials eligible for inclusion. We also identified no ongoing trials. AUTHORS' CONCLUSIONS: There is currently insufficient evidence from which to draw conclusion on the benefits or harms of thrombolysis for the treatment of individuals with acute upper extremity deep vein thrombosis as an add-on therapy to anticoagulation, alone compared with anticoagulation, or alone compared with any other type of medical intervention. Large randomised clinical trials with a low risk of bias are warranted. They should focus on clinical outcomes and not solely on surrogate measures.
[Mh] MeSH terms primary: Thrombolytic Therapy/methods
Upper Extremity Deep Vein Thrombosis/drug therapy
[Mh] MeSH terms secundary: Acute Disease
Humans
[Pt] Publication type:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T; REVIEW
[Em] Entry month:1801
[Cu] Class update date: 180123
[Lr] Last revision date:180123
[Js] Journal subset:IM
[Da] Date of entry for processing:171212
[St] Status:MEDLINE
[do] DOI:10.1002/14651858.CD012175.pub2

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[PMID]: 29353683
[Au] Autor:Dronkers CEA; Klok FA; van Haren GR; Gleditsch J; Westerlund E; Huisman MV; Kroft LJM
[Ad] Address:Department of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: C.E.A.Dronkers@lumc.nl.
[Ti] Title:Diagnosing upper extremity deep vein thrombosis with non-contrast-enhanced Magnetic Resonance Direct Thrombus Imaging: A pilot study.
[So] Source:Thromb Res;163:47-50, 2018 Jan 10.
[Is] ISSN:1879-2472
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Diagnosing upper extremity deep vein thrombosis (UEDVT) can be challenging. Compression ultrasonography is often inconclusive because of overlying anatomic structures that hamper compressing veins. Contrast venography is invasive and has a risk of contrast allergy. Magnetic Resonance Direct Thrombus Imaging (MRDTI) and Three Dimensional Turbo Spin-echo Spectral Attenuated Inversion Recovery (3D TSE-SPAIR) are both non-contrast-enhanced Magnetic Resonance Imaging (MRI) sequences that can visualize a thrombus directly by the visualization of methemoglobin, which is formed in a fresh blood clot. MRDTI has been proven to be accurate in diagnosing deep venous thrombosis (DVT) of the leg. The primary aim of this pilot study was to test the feasibility of diagnosing UEDVT with these MRI techniques. MRDTI and 3D TSE-SPAIR were performed in 3 pilot patients who were already diagnosed with UEDVT by ultrasonography or contrast venography. In all patients, UEDVT diagnosis could be confirmed by MRDTI and 3D TSE-SPAIR in all vein segments. In conclusion, this study showed that non-contrast MRDTI and 3D TSE-SPAIR sequences may be feasible tests to diagnose UEDVT. However diagnostic accuracy and management studies have to be performed before these techniques can be routinely used in clinical practice.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180122
[Lr] Last revision date:180122
[St] Status:Publisher

  10 / 929 MEDLINE  
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[PMID]: 29245061
[Au] Autor:Adelborg K; Horváth-Puhó E; Sundbøll J; Prandoni P; Ording A; Sørensen HT
[Ad] Address:Department of Clinical Epidemiology, Aarhus University Hospital, Denmark. Electronic address: kade@clin.au.dk.
[Ti] Title:Risk and prognosis of cancer after upper-extremity deep venous thrombosis: A population-based cohort study.
[So] Source:Thromb Res;161:106-110, 2018 01.
[Is] ISSN:1879-2472
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:INTRODUCTION: The association between lower-extremity venous thrombosis and cancer is well-established. However, the extent to which upper-extremity deep venous thrombosis (U-DVT) is a marker of cancer and a prognostic factor for all-cause mortality remains poorly understood. We examined the risk of cancer after a diagnosis of U-DVT compared with cancer risk in the general population. MATERIALS AND METHODS: Using Danish nationwide population-based medical registries, we identified all patients with first-time U-DVT during 1980-1993 and 2000-2013. Cancer incidence was ascertained using data from the Danish Cancer Registry. We computed standardized incidence ratios (SIRs) calculated as the observed number of cancers relative to the expected number based on national incidence rates by sex, age, and calendar year. We created a matched comparison cohort of cancer patients without U-DVT, to assess the impact of U-DVT on all-cause mortality. RESULTS: Among 1087 patients with U-DVT, 232 patients subsequently were diagnosed with cancer, corresponding to an overall SIR of 1.69 (95% confidence interval, 1.48-1.92). During the first 6months following U-DVT, the absolute risk of any cancer was 5.4%, corresponding to a 13-fold elevated SIR. During the subsequent 6-12months and >12months, the SIR remained 2-fold and 1.3-fold elevated, respectively. U-DVT was a prognostic factor for all-cause mortality in patients with lung, prostate, and colorectal cancer during the first 6months of follow-up. CONCLUSION: U-DVT was a marker of cancer. The clinical utility of searching for occult cancer in patients with U-DVT remains unknown.
[Pt] Publication type:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Entry month:1712
[Cu] Class update date: 180119
[Lr] Last revision date:180119
[St] Status:In-Process


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