A Multicenter, Open-label, Prospective Randomized Controlled Trial to evaluate the Effect of Low-Molecular-Weight Heparin on Prevention of Venous Thromboembolism after Laparoscopic Surgery
Ontology highlight
ABSTRACT:
DISEASE(S): Gastric Or Colorectal Cancer Patients Planned To Receive Laparoscopic Surgery
PROVIDER: 2625294 | ecrin-mdr-crc |
REPOSITORIES: ECRIN MDR
Similar Datasets
Project description:Interventions: Enoxaparin group Subcutaneous injection of enoxaparin 2000U twice daily (postoperative day 2 to discharge) Intermittent pneumatic compression (IPC) prophylaxis (after surgery to postoperative day 1)
Control group IPC prophylaxis alone (after surgery to postoperative day 1)
Primary outcome(s): Incidence of venos thromboembolism until postoperative day 28
Study Design: Parallel Randomized
| 2633931 | ecrin-mdr-crc
Project description:Overall, only limited evidence exists regarding the clinical benefit of antithrombotic prophylaxis after laparoscopic surgery for cancer. Four studies reported on the incidence of venous thromboembolism (VTE) after laparoscopic surgery for cancer. These studies differ concerning study design, site of cancer, regimens for antithrombotic prophylaxis and reported incidence of VTE.
The aim of this multicenter, randomized study is to assess the clinical benefit of extended (4 weeks) compared to short (one week) heparin prophylaxis after laparoscopic surgery for colorectal cancer.
| 2124630 | ecrin-mdr-crc
Project description:Primary objectives: To assess the efficacy and safety of postdischarge extended (3 weeks) antithrombotic prophylaxis with rivaroxaban compared to placebo after planned laparoscopic surgery for colorectal cancer in patients who had received antithrombotic prophylaxis with LMWH during the hospital stay for 7±2 days
Primary endpoints: The primary study outcome is a composite of symptomatic objectively confirmed VTE, asymptomatic ultrasonography-confirmed DVT or VTE-related death at 28±2 days from planned laparoscopic surgery for colorectal cancer in patients randomized to rivaroxaban or placebo.Pulmonary embolism will be diagnosed in the presence of:- intraluminal filling defect at computed tomography angiography or pulmonary angiography- high probability perfusion defect at perfusion lung scan with mismatch area compared to chest X Ray.Deep vein thrombosis will be diagnosed in the presence of:- an uncompressible vein segment in the deep vein of the lower limbs as assessed by complete compression ultrasonography examination
| 2535176 | ecrin-mdr-crc
Project description:Coagulopathy is a hallmark finding in patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and is associated with an increased risk of death from venous and arterial thromboembolic complications. SARS-CoV-2 infection can lead to microvascular thrombosis that contributes to acute lung injury and respiratory failure. The molecular mechanisms leading to thrombosis in Coronavirus disease 2019 (COVID19) patients are poorly understood. Here, we study a role of the procoagulant neutrophil extracellular traps (NETs)/Factor XII (FXII) axis in COVID19-associated thromboembolism.
2021-08-20 | PXD020216 | Pride
Project description:Coagulopathy is a hallmark finding in patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and is associated with an increased risk of death from venous and arterial thromboembolic complications. SARS-CoV-2 infection can lead to microvascular thrombosis that contributes to acute lung injury and respiratory failure. The molecular mechanisms leading to thrombosis in Coronavirus disease 2019 (COVID19) patients are poorly understood. Here, we study a role of the procoagulant neutrophil extracellular traps (NETs)/Factor XII (FXII) axis in COVID19-associated thromboembolism.
2021-08-20 | PXD020279 | Pride
Project description:Interventions: Once daily fondaparinux (2.5mg or 1.5mg) for 4 to 8 days after 24 hours of surgery
Intermittent pneumatic compression according to the institutional guidelines
Primary outcome(s): Incidence of venous thromboembolism (VTE)
Study Design: Parallel Randomized
| 2623843 | ecrin-mdr-crc
Project description:<p><b>Overview:</b><br/> <u>Our overall long-term goal is to determine risk factors for the complex (multifactorial) disease, venous thromboembolism (<b>VTE</b>), that will allow physicians to stratify individual patient risk and target VTE prophylaxis to those who would benefit most.</u> In this genome-wide association case-control study (1300 cases and 1300 controls) we hope to identify susceptibility variants for VTE.</p> <p>Mutations within genes encoding for important components of the anticoagulant, procoagulant, fibrinolytic, and innate immunity pathways are risk factors for VTE. We hypothesize that other genes within these four pathways or within other pathways also are VTE disease-susceptibility genes. Therefore, we performed a genome wide association (GWA) screen and analysis using the Illumina 660W platform to identify SNPs within 1,300 clinic-based, non-cancer VTE cases primarily from Minnesota and the upper Midwest USA, and 1300 clinic-based, unrelated controls frequency-matched on patient age, gender, myocardial infarction/stroke status and state of residence.</p> <p>This is a subset of a slightly larger candidate gene study using 1500 case-control pairs to identify haplotype-tagging SNPs (<b>ht</b>-SNPs) in a large set of candidate genes (n~750) within the anticoagulant, procoagulant, fibrinolytic, and innate immunity pathways.</p> <p><b>Study Populations.</b><br/> <b><u>Cases</u>.</b> VTE cases were consecutive Mayo Clinic outpatients with objectively-diagnosed deep vein thrombosis (DVT) and/or pulmonary embolism (PE) residing in the upper Midwest and referred by Mayo Clinic physician to the Mayo Clinic Special Coagulation Laboratory for clinical diagnostic testing to evaluate for an acquired or inherited thrombophilia, or to the Mayo Clinic Thrombophilia Center. Any person contacted to be a control but discovered to have had a VTE was evaluated for inclusion as a case. Cases were primarily residents from Minnesota, Wisconsin, Iowa, Michigan, Illinois, North or South Dakota, Nebraska, Kansas, Missouri and Indiana. A DVT or PE was categorized as objectively diagnosed when (a) confirmed by venography or pulmonary angiography, or pathology examination of thrombus removed at surgery, or (b) if at least one non-invasive test (compression duplex ultrasonography, lung scan, computed tomography scan, magnetic resonance imaging) was positive. A VTE was defined as: <ol> <li>Proximal leg deep vein thrombosis (DVT), which includes the common iliac, internal iliac, external iliac, common femoral, superficial [now termed "femoral"] femoral, deep femoral [sometimes referred to as "profunda" femoral] and/or popliteal veins. (Note: greater and lesser saphenous veins, or other superficial or perforator veins, were not included as proximal or distal leg DVT).</li> <li>Distal leg DVT (or "isolated calf DVT"), which includes the anterior tibial, posterior tibial and/or peroneal veins. (Note: gastrocnemius, soleal and/or sural [e.g., "deep muscular veins" of the calf] vein thrombosis was not included as distal leg DVT).</li> <li>Arm DVT, which includes the axillary, subclavian and/or innominate (brachiocephalic) veins. (Note: jugular [internal or external], cephalic and brachial vein thrombosis was not included in "arm DVT").</li> <li>Hepatic, portal, splenic, superior or inferior mesenteric, and/or renal vein thrombosis. (Note: ovarian, testicular, peri-prostatic and/or pelvic vein thrombosis was not included).</li> <li>Cerebral vein thrombosis (includes cerebral or dural sinus or vein, saggital sinus or vein, and/or transverse sinus or vein thrombosis).</li> <li>Inferior vena cava (IVC) thrombosis</li> <li>Superior vena cava (SVC) thrombosis</li> <li>Pulmonary embolism</li> </ol> </p> <p>Patients with VTE related to active cancer, antiphospholipid syndrome, inflammatory bowel disease, vasculitis, a rheumatoid or other autoimmune disorder, a vascular anomaly (e.g., Klippel-Trénaunay syndrome, etc.), heparin-induced thrombocytopenia, or a mechanical cause for DVT (e.g., arm DVT or SVC thrombosis related to a central venous catheter or transvenous pacemaker, portal and/or splenic vein thrombosis related to liver cirrhosis, IVC thrombosis related to retroperitoneal fibrosis, etc.), with hemodialysis arteriovenous fistula thrombosis, or with prior liver or bone marrow transplantation were excluded. </p> <p><b><u>Controls</u>.</b> A Mayo Clinic outpatient control group was prospectively recruited for this study. Controls were frequency-matched on the age group (18-29, 30-39, 40-49, 50-59, 60-69, 70-79, and 80+ years), sex, myocardial infarction/stroke status, and state of residence distribution of the cases. We selected clinic-based controls using a controls' database of persons undergoing general medical examinations in the Mayo Clinic Departments of General Internal Medicine or Primary Care Internal Medicine. Additionally persons undergoing evaluation at the Mayo Clinic Sports Medicine Center, and the Department of Family Medicine were screened for inclusion as controls.</p> <p>This study is part of the Gene Environment Association Studies initiative (GENEVA, <a href="http://www.genevastudy.org" target="_blank">http://www.genevastudy.org</a>) funded by the trans-NIH Genes, Environment, and Health Initiative (GEI). The overarching goal is to identify novel genetic factors that contribute to venous thrombosis through large-scale genome-wide association studies of 1,300 clinic-based, VTE cases and 1300 clinic-based, unrelated controls. Genotyping was performed at the Johns Hopkins University Center for Inherited Disease Research (CIDR). Data cleaning and harmonization were done at the GEI-funded GENEVA Coordinating Center at the University of Washington.</p>
| phs000289 | dbGaP
Project description:A key challenge in aging research is to extend lifespan in tandem with slowing down functional decline so that the life with good health (healthspan) can be extended. Here, we show that clearance of a small number of cells, which highly express p21Cip1 (p21high), starting from 20 months improves cardiac and metabolic function, and extends both median and maximum lifespan in mice. Importantly, by assessing health and physical function of these mice monthly until death, we show that clearance of p21high cells improves physical function at all remaining stages of life, suggesting morbidity compression and healthspan extension. Mechanistically, p21high cells encompass several cell types, with a conserved pro-inflammatory signature. Clearance of p21high cells reduces inflammation, and rejuvenates transcriptomic signatures of various tissues to younger states. These findings demonstrate the feasibility of morbidity compression in mice, and indicate p21high cells as a therapeutic target for healthy aging.
2024-06-13 | GSE269660 | GEO
Project description:Many patients who are diagnosed with coronavirus disease 2019 (COVID-19) suffer from venous thromboembolic complications despite the use of stringent anticoagulant prophylaxis. Studies on the exact mechanism(s) underlying thrombosis in COVID-19 are limited as animal models commonly used to study venous thrombosis pathophysiology (i.e. rats and mice) are naturally not susceptible to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Ferrets are susceptible to SARS-CoV-2 infection, successfully used to study virus transmission, and were previously used to study activation of coagulation and thrombosis during influenza virus infection. Here, we used plasma and lung material from SARS-CoV-2-inoculated ferrets to explore their use in studying COVID-19-associated changes in coagulation and thrombosis. Lungs of ferrets inoculated intranasally with SARS-CoV-2 demonstrated alveolar septa that were mildly expanded by macrophages, and diffuse interstitial histiocytic pneumonia. However, no macroscopical or microscopical evidence of vascular thrombosis in the lungs of SARS-CoV-2-inoculated ferrets was found. Longitudinal plasma profiling using a mass spectrometry-based approach revealed minor differences in plasma protein profiles in SARS-CoV-2-inoculated ferrets up to 2 weeks post-infection. Apart from fibrinogen, the majority of plasma coagulation factors were stable and demonstrated a low coefficient of variation. We conclude that while ferrets are an essential and well-suited animal model to study SARS-CoV-2 transmission, their use to study SARS-CoV-2-related changes relevant to thrombotic disease is limited.
2022-07-19 | PXD027582 | Pride
Project description:Atherosclerosis is the preliminary cause of coronary artery disease, one of the diseases that ac-count for the largest number of fatal mortalities. Physical activity is an effective strategy to restrain atherosclerosis from deterioration. Evidence indicated that the changes of proteomic profile is highly associated with the atherosclerosis development, but the mechanism behind the exercise for atherosclerosis amelioration has not yet been investigated from the proteomics perspective. Hence, the proteomic profiles could further elucidate the systematic effects of exercise interven-tion on ApoE knockout atherosclerotic model and high fat diet intervention. In current study, Apoeem1Narl/Narl mice were randomly allocated into a normal diet (ND), western diet (WD) and WD with 12 weeks exercise intervention (WD EX) groups. The plasm proteome between WD and WD EX demonstrate the significant difference, and ten major pathways, including cardiovascular disease (CVD)–hematological disease, cellular compromise–inflammatory response, protein synthesis, connective tissue disorders, cellular movement–immune cell tracking, inflammatory response, etc., were generated by the IPA analysis. The fourteen proteins (PROS, PROZ, C2, F5, C5, SERPINA 10, FGB, FGG, CFB, F12, CRP, CFHR1, HABP2, and PPIA) critically involved in CVD–hematological disease pathway showed significant difference among groups. The PROS, F5, C5, FGG, and CFB levels associated with thrombosis and atherosclerosis induced by WD were significantly decreased by exercise intervention in WD EX. Furthermore, the F5 and FGG were well-demonstrated the important roles for thrombosis of atherosclerotic pathogenesis but the complement factor C5 in the development of atherosclerosis is not fully understood. In current study, the exercise could significantly alleviate the significantly elevated C5 and inflammation induced by WD group in accordance to amelioration of atherosclerosis. Therefore, exercise could mitigate chemotaxis through the modulation of the C5 level and innate immunity, thereby alle-viating the pathogenesis of atherosclerosis in western-diet induced obese mice.
2022-04-04 | PXD030951 | Pride