Thromboprophylaxis in ambulatory lung cancer treatment.

Clin J Oncol Nurs. 2013 Feb 1;17(1):74-9

Authors: Cavaliere L

Abstract
Venous thromboembolism (VTE), including deep vein thrombosis and pulmonary embolism, are common problems experienced by patients with lung cancer that can impact treatment plans, prognoses, and survival. Patients with lung cancer are at greatest risk for development of VTE in the ambulatory care treatment setting. Literature does exist on VTE management for medical and surgical oncology inpatients, as well as clinical guidelines for inpatient prophylaxis; however, published evidence is lacking on outpatient risk and thromboprophylaxis in medical oncology outpatients, particularly patients with lung cancer. Because patients with lung cancer treated in the ambulatory setting have established risks for VTE, they may benefit from thromboprophylaxis. Clinical guidelines for outpatient thromboprophylaxis direct the clinical practice for thromboprophylaxis in lung cancer treatment. The purpose of the current article is to explore the VTE risks associated with ambulatory lung cancer treatment and to review the recommended guidelines for thromboprophylaxis to guide clinical decision making for patients with lung cancer.

PMID: 23372099 [PubMed - in process]

Related Articles

Idiopathic pulmonary fibrosis complicated by acute thromboembolic disease: chest X-ray, HRCT and multi-detector row CT angiographic findings.

J Thorac Dis. 2013 Feb;5(1):82-6

Authors: Camera L, Campanile F, Imbriaco M, Ippolito R, Sirignano C, Santoro C, Galderisi M, Salvatore M

Abstract
Idiopathic pulmonary fibrosis (IPF) is a chronic diffuse interstitial disease characterized by a predominant reticular pattern of involvement of the lung parenchyma which can be well documented by High Resolution Computed Tomography (HRCT). While almost half of the patients with IPF may develop pulmonary arterial hypertension, the occurrence of superimposed acute thrombo-embolic disease is rare.We describe a case of an 87 yrs old female who was found to have IPF complicated by acute pulmonary thrombo-embolism during the clinical and radiological investigation of a rapidly worsening dyspnea. While chest x-ray findings were initially considered consistent with a congestive heart failure, a bed side echocardiography revealed findings suggestive of pulmonary arterial hypertension and right ventricular failure with enlargement of both right cavities and associated valvular regurgitations. An acute thrombo-embolic disease was initially ruled out by a perfusion lung scintigraphy and subsequently confirmed by contrast-enhanced multi-detector CT which showed an embolus at the emergency of the right inter-lobar artery with associated signs of chronic pulmonary hypertension. However, unenhanced scans performed with both conventional and high resolution techniques also depicted a reticular pattern of involvement of lung parenchyma considered suggestive of IPF despite a atypical upper lobe predominance. IPF was later confirmed by further clinical, serological and instrumental follow-up.

PMID: 23372953 [PubMed]

Related Articles

Medical emergencies: pulmonary embolism and acute severe asthma.

Anaesthesia. 2013 Jan;68 Suppl 1:102-16

Authors: Somasundaram K, Ball J

Abstract
In this, the second of two articles covering specific medical emergencies, we discuss the definitions, epidemiology, pathophysiology, acute and chronic management of pulmonary embolus and acute severe asthma.

PMID: 23210560 [PubMed - indexed for MEDLINE]

The Prevalence of Wheezing and its Association with Body Mass Index and Abdominal Obesity in Children.

J Asthma. 2013 Jan 31;

Authors: Silva RD, Assis AM, Goncalves MS, Fiaccone RL, Matos SM, Barreto ML, Pinto ED, Silva LA, Rodrigues LC, Alcantara-Neves NM

Abstract
Objective. To evaluate the relative importance of body mass index (BMI) and abdominal obesity in the prevalence of wheezing in Brazilian children. Materials and methods. This is a cross-sectional study of male and female students, 6-12 years old, from the public elementary schools of São Francisco do Conde, Bahia, Northeast Brazil. Reports of wheezing in the past 12 months were collected using a questionnaire from the International Study of Asthma and Allergies in Childhood Program (ISAAC) phase III, adapted to Portuguese. Anthropometric, demographic, and socioeconomic information was collected. Multivariate logistic regression analyses were used to assess the associations of interest. Results. Of the children surveyed, 10.6% reported wheezing. Excess weight was observed in 16.2%, 10.5%, and 7.9% of the sample, measured by BMI, waist circumference (WC), and the waist-to-height ratio (WHtR), respectively. The percentage of patients with wheezing attributable to BMI ≥ 85th percentile (8.2%) slightly exceeded those identified with abdominal obesity, WC  ≥ 80th percentile (7.3%) and WHtR  > 0.5 (7.1%). Conclusion. The results suggest that an excess of fat deposits, either in the abdominal region or elsewhere in the body, increased the risk of wheezing. Since obesity is an important public health problem worldwide, control of this problem may partially reduce the occurrence of wheezing in youth.

PMID: 23368279 [PubMed - as supplied by publisher]