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General Hematology

Review | Traumatic hemorrhage and chain of survival

21 Jun, 2023 | 13:17h | UTC

Traumatic hemorrhage and chain of survival – Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

 


RCT | Thrice-weekly oral iron shows non-inferiority and fewer gastrointestinal effects in treating iron-deficiency anemia

20 Jun, 2023 | 12:48h | UTC

A randomized controlled trial of thrice-weekly versus thrice-daily oral ferrous fumarate treatment in adult patients with iron-deficiency anemia – Ann Hematol (if the link is paywalled, try this one)

 


RCT | Avapritinib superior to placebo in reducing symptoms, mast-cell burden in indolent systemic mastocytosis patients

20 Jun, 2023 | 12:34h | UTC

Avapritinib versus Placebo in Indolent Systemic Mastocytosis – NEJM Evidence

 

Commentary on Twitter

 


Guideline | Screening and diagnosis of significant hemoglobinopathies

20 Jun, 2023 | 12:32h | UTC

Significant haemoglobinopathies: A guideline for screening and diagnosis: A British Society for Haematology Guideline – British Journal of Haematology

 


M-A | Anticoagulation options for continuous renal replacement therapy in critically ill patients

19 Jun, 2023 | 13:51h | UTC

Anticoagulation options for continuous renal replacement therapy in critically ill patients: a systematic review and network meta-analysis of randomized controlled trials – Critical Care

 


Systematic Review | Tranexamic acid likely decreases red blood cell transfusion need in hip fracture surgery

16 Jun, 2023 | 14:09h | UTC

Interventions for reducing red blood cell transfusion in adults undergoing hip fracture surgery: an overview of systematic reviews – Cochrane Library

Summary: What treatments reduce the need for a blood transfusion in adults who have broken their hip? – Cochrane Library

 


RCT | Prehospital use of tranexamic acid in severe trauma cases shows no superiority over placebo

15 Jun, 2023 | 15:16h | UTC

Prehospital Tranexamic Acid for Severe Trauma – New England Journal of Medicine (link to abstract – $ for full-text)

News Release: Shining a new light on tranexamic acid for trauma care – Monash University

 

Commentary on Twitter

 


Review | Acute graft-versus-host disease

14 Jun, 2023 | 14:20h | UTC

Acute graft-versus-host disease – Nature Reviews Disease Primers (if the link is paywalled, try this one)

 

Commentary on Twitter

 


Brief Review | Resistance to unfractionated heparin in the ICU: evaluation and management options

12 Jun, 2023 | 13:32h | UTC

Resistance to unfractionated heparin in the ICU: evaluation and management options – Intensive Care Medicine (if the link is paywalled, try this one)

 

Commentary on Twitter

 


RCT | Noninferiority shown between DOACs and LMWH for recurrent VTE prevention in cancer patients

5 Jun, 2023 | 13:50h | UTC

Summary: This unblinded, pragmatic, noninferiority randomized clinical trial aimed to assess the efficacy of direct oral anticoagulants (DOACs) against low-molecular-weight heparin (LMWH) in preventing recurrent venous thromboembolism (VTE) in patients with cancer. The study included 671 patients from 67 oncology centers, with a new clinical or radiological diagnosis of VTE.

Participants were randomly assigned to receive either a DOAC or LMWH for 6 months, and treating physicians selected and prescribed the drugs based on considerations like availability and drug-drug interactions. The primary outcome was the rate of recurrent VTE at 6 months. Findings revealed that the DOAC group had a recurrent VTE rate of 6.1% as compared to 8.8% in the LMWH group, showing noninferiority. Both groups had statistically similar rates of major bleeding and severe adverse events.

This pragmatic study included patients with advanced cancer and brain metastases, impaired performance status, and reduced liver or kidney function, making it more representative of routine oncology practice. Moreover, patient adherence to DOAC treatment was significantly higher than to LMWH. Nevertheless, the study had limitations, including the lack of blinding and underrepresentation of certain racial and ethnic groups.

In conclusion, this trial suggests that DOACs were noninferior to LMWH for preventing recurrent VTE in patients with cancer over a 6-month follow-up period, supporting the use of DOACs in this population for VTE prevention. Further research is needed to confirm these results and investigate long-term outcomes.

Article: Direct Oral Anticoagulants vs Low-Molecular-Weight Heparin and Recurrent VTE in Patients With Cancer: A Randomized Clinical Trial – JAMA (free for a limited period)

See also: Visual abstract

 

Commentary on Twitter

 


Review | Prevention of venous thromboembolism in patients with cancer

5 Jun, 2023 | 13:48h | UTC

Prevention of venous thromboembolism in patients with cancer – The BMJ

 


ASH 2023 Guidelines for management of venous thromboembolism | Thrombophilia testing

1 Jun, 2023 | 12:22h | UTC

American Society of Hematology 2023 Guidelines for Management of Venous Thromboembolism: Thrombophilia Testing – Blood Advances

 


RCT | Prophylactic platelet transfusion reduces CVC-related bleeding in patients with platelets 10-50 K/mm³

31 May, 2023 | 14:20h | UTC

Platelet Transfusion before CVC Placement in Patients with Thrombocytopenia – New England Journal of Medicine (link to abstract – $ for full-text)

News Release: Research from Amsterdam UMC shows that the bottom has been reached in restrictive blood transfusion policy – Amsterdam University Medical Centers

 

Commentary on Twitter

 


RCT | Early initiation of DOACs not statistically superior to later use in atrial fibrillation-related stroke

31 May, 2023 | 14:17h | UTC

Early versus Later Anticoagulation for Stroke with Atrial Fibrillation – New England Journal of Medicine (link to abstract – $ for full-text)

Commentaries:

ELAN: Early DOACs Safe, May Help After Ischemic Stroke in AF Patients – TCTMD

Early Versus Late Initiation of Direct Oral Anticoagulants in Post-Ischemic Stroke Patients With Atrial Fibrillation – ELAN – American College of Cardiology

 

Commentary on Twitter

 


Review | How to approach acute thrombosis and thrombocytopenia

31 May, 2023 | 14:03h | UTC

How to approach acute thrombosis and thrombocytopenia – Clinical Medicine Journal

 


Current guidelines for perioperative management and transfusion decisions in sickle cell patients

30 May, 2023 | 11:57h | UTC

Current Evidence and Rationale to Guide Perioperative Management, Including Transfusion Decisions, in Patients With Sickle Cell Disease – Anesthesia & Analgesia

 


Cohort Study | Amiodarone linked to higher bleeding risk vs. flecainide or sotalol in atrial fibrillation patients on anticoagulants

30 May, 2023 | 12:01h | UTC

Risk for Bleeding-Related Hospitalizations During Use of Amiodarone With Apixaban or Rivaroxaban in Patients With Atrial Fibrillation: A Retrospective Cohort Study – Annals of Internal Medicine (link to abstract – $ for full-text)

News Release: Amiodarone used with anticoagulant therapy linked to more bleeding-related hospitalizations than flecainide or sotalol – American College of Physicians

Commentary: Amiodarone increases bleeding compared with flecainide or sotalol in patients on anticoagulant therapy – ACP Internist

 

Commentary on Twitter

 


Guideline | Investigation and management of acute transfusion reactions

29 May, 2023 | 11:02h | UTC

Guideline on the investigation and management of acute transfusion reactions – British Journal of Haematology

 


RCT | Apixaban fails to match warfarin in preventing valve thrombosis in On-X mechanical heart valve patients

22 May, 2023 | 13:44h | UTC

Apixaban or Warfarin in Patients with an On-X Mechanical Aortic Valve – NEJM Evidence

Commentary: Apixaban or Warfarin in Patients With On-X Mechanical Aortic Valve – American College of Cardiology

 

Commentary on Twitter

 


RCT | Rivaroxaban doesn’t reduce thrombotic events, hospitalization, or death in outpatients with COVID-19

15 May, 2023 | 13:19h | UTC

Summary: The PREVENT-HD trial, a double-blind, placebo-controlled randomized study, was conducted to evaluate the effectiveness of prophylactic anticoagulation in reducing venous and arterial thrombosis, hospitalization, and death in nonhospitalized patients with symptomatic COVID-19 and at least one thrombosis risk factor. The trial took place between August 2020 and April 2022 across 14 US integrated healthcare delivery networks, with 1,284 patients enrolled and randomly assigned to receive either 10 mg of oral rivaroxaban or placebo daily for 35 days.

However, the study was terminated prematurely due to enrollment challenges and lower-than-expected event rates. The primary efficacy outcome, a composite of various hazardous events, occurred in 3.4% of the rivaroxaban group and 3.0% of the placebo group, with no significant difference between the two groups (hazard ratio, 1.16 [95% CI, 0.63–2.15]; P=0.63). No critical-site or fatal bleeding was observed, and only one patient in the rivaroxaban group experienced a major bleed.

In conclusion, rivaroxaban prescribed for 35 days in nonhospitalized patients with symptomatic COVID-19 at risk for thrombosis does not appear to reduce the composite end point of venous and arterial thrombotic events, hospitalization, and death. The study’s premature termination and lower-than-expected event rates may limit the generalizability of these findings.

Article: Rivaroxaban for Prevention of Thrombotic Events, Hospitalization, and Death in Outpatients With COVID-19: A Randomized Clinical Trial – Circulation

 

Commentary on Twitter

 


Brief Review | Coagulation support during perioperative bleeding management

15 May, 2023 | 13:01h | UTC

Coagulation support during perioperative bleeding management – Intensive Care Medicine

 

Commentary on Twitter

 


Podcast | Hypercoagulable work-up

11 May, 2023 | 11:41h | UTC

#391 Hypercoagulable Work-Up with Dr. Jean Connors – The Curbsiders

 


RCT | Single-dose intravenous iron not superior to oral iron for pregnancy anemia

8 May, 2023 | 12:52h | UTC

Ferric carboxymaltose versus standard-of-care oral iron to treat second-trimester anaemia in Malawian pregnant women: a randomised controlled trial – The Lancet

News Release: Landmark Malawi trial boosts iron levels in pregnant women – Walter and Eliza Hall Institute of Medical Research

 

Commentary from the author on Twitter

 


Cohort Study | Idiopathic CD4 Lymphocytopenia linked to increased infection risk and cancer prevalence

5 May, 2023 | 15:16h | UTC

Reappraisal of Idiopathic CD4 Lymphocytopenia at 30 Years – New England Journal of Medicine (link to abstract – $ for full-text)

 

Commentary on Twitter

 


Review | Heparin-induced thrombocytopenia

5 May, 2023 | 15:01h | UTC

Heparin-Induced Thrombocytopaenia – ICU Management & Practice

 


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