D R Anderson's research while affiliated with Dalhousie University and other places
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Publications (45)
Background
The postthrombotic syndrome (PTS) is a frequent chronic complication of deep vein thrombosis (DVT).Objective
In the BioSox study we investigated whether inflammation markers predict the risk of PTS after DVT.Methods
We measured C-reactive protein (CRP), intercellular adhesion molecule (ICAM)-1, interleukin (IL)-6 and IL-10, at baseline,...
To assess the accuracy of the Wells rule for excluding deep vein thrombosis and whether this accuracy applies to different subgroups of patients.
Meta-analysis of individual patient data.
Authors of 13 studies (n=10 002) provided their datasets, and these individual patient data were merged into one dataset.
Studies were eligible if they enrolled c...
Post-thrombotic syndrome (PTS) is the most frequent complication of deep vein thrombosis (DVT). Its diagnosis is based on clinical characteristics. However, symptoms and signs of PTS are non-specific, and could result from concomitant primary venous insufficiency (PVI) rather than DVT. This could bias evaluation of PTS.
Using data from the REVERSE...
Background: Risk factors for post-thrombotic syndrome (PTS) remain poorly understood.
Objectives: In this multinational multicenter study, we evaluated whether subtherapeutic warfarin anticoagulation was associated with the development of PTS.
Methods: Patients with a first unprovoked deep venous thrombosis (DVT) received standard anticoagulation f...
Post-thrombotic syndrome (PTS) is the most frequent complication of a deep vein thrombosis (DVT). International guidelines recommend assessing PTS with the Villalta scale, a clinical measure that incorporates venous symptoms and signs in the leg ipsilateral to a DVT. However, these signs and symptoms are not specific for PTS and their prevalence an...
Comparisons of overall costs and resource utilization associated with anticoagulation management are important as new alternatives to warfarin are introduced. The aim of the present study was to assess total costs of warfarin-based anticoagulation in different health care models.
Physician- or pharmacist-managed hospital- or community-based antic...
Multiple-detectors computed tomographic pulmonary angiography (CTPA) has a higher sensitivity for pulmonary embolism (PE) within the subsegmental pulmonary arteries as compared with single-detector CTPA. Multiple-detectors CTPA might increase the rate of subsegmental PE diagnosis. The clinical significance of subsegmental PE is unknown. We sought t...
Deep vein thrombosis (DVT) can be safely and reliably excluded in patients with a low clinical probability and a negative D-dimer result but the accuracy and utility of such a strategy is unclear in elderly patients.
We sought to compare the performance of the Wells pretest probability (PTP) model and D-dimer testing between patients of different a...
Central venous catheters in patients with cancer are associated with development of deep vein thrombosis (DVT); however, there is no accepted standard treatment.
To assess the safety and effectiveness of a management strategy for central venous catheter-related DVT in cancer patients consisting of dalteparin and warfarin without the need for line r...
Although hormone replacement therapy (HRT) is associated with an increased risk of deep vein thrombosis (DVT), it is not clear if the risk differs in users of combined estrogen-progestin HRT and estrogen-only HRT.
We prospectively studied postmenopausal women with suspected DVT in whom HRT use status was ascertained and who subsequently had objecti...
The post-thrombotic syndrome is a chronic, poorly understood complication of deep venous thrombosis (DVT).
To evaluate predictors of the post-thrombotic syndrome, including intensity of long-term anticoagulation, and to assess the impact of the post-thrombotic syndrome on quality of life.
The setting was 13 Canadian hospitals and one US hospital. O...
When warfarin is interrupted for surgery, low-molecular-weight heparin is often used as bridging therapy. However, this practice has never been evaluated in a large prospective study. This study was designed to assess the efficacy and safety of bridging therapy with low-molecular-weight heparin initiated out of hospital.
This was a prospective, mul...
The risk of recurrence is lower after treatment of an episode of venous thromboembolism associated with a transient risk factor, such as recent surgery, than after an episode associated with a permanent, or no, risk factor. Retrospective analyses suggest that 1 month of anticoagulation is adequate for patients whose venous thromboembolic event was...
Suspected deep vein thrombosis (DVT) is a common problem facing emergency physicians. Timely diagnostic testing must be performed to accurately identify patients with DVT. The purpose of this study was to evaluate the safety and effectiveness of a management strategy that combined consideration of clinical pretest probability and a d-dimer test to...
The limitations of the current diagnostic standard, ventilation-perfusion lung scanning, complicate the management of patients with suspected pulmonary embolism. We previously demonstrated that determining the pretest probability can assist with management and that the high negative predictive value of certain D -dimer assays may simplify the diagn...
The management of patients presenting to hospital emergency departments with suspected deep vein thrombosis (DVT) is problematic because urgent diagnostic imaging capability is sometimes unavailable. Experienced physicians using clinical skills alone can classify patients with suspected DVT into low-, moderate-, and high-probability categories.
To...
The low specificity of ventilation-perfusion lung scanning complicates the management of patients with suspected pulmonary embolism.
To determine the safety of a clinical model for patients with suspected pulmonary embolism.
Prospective cohort study.
Five tertiary care hospitals.
1239 inpatients and outpatients with suspected pulmonary embolism.
A...
Clinical trials evaluating antithrombotic therapy for the treatment of deep vein thrombosis require that the diagnosis is confirmed by objective testing prior to patient entry into the study. Two basic approaches may then be taken for defining endpoints to assess the efficacy of antithrombotic treatment. In the first approach, the diagnostic test i...
Objectives:
We recently demonstrated the utility of a clinical model combined with ultrasonography to assist the diagnostic approach in patients with suspected deep-vein thrombosis (DVT). In this study we also sought to demonstrate that the model is useful with impedance plethysmography, a less accurate and less utilized diagnostic test. The origi...
Background Low-molecular-weight heparin is known to be safe and effective for the initial Treatment of patients with proximal deep-vein thrombosis. However, its application to patients with pulmonary embolism or previous episodes of thromboembolism has not been studied. Methods We randomly assigned 1021 patients with symptomatic venous thromboembol...
Typically the serological diagnosis of alloimmune haemolytic disease of the newborn (HDN) includes a positive direct antiglobulin test on the infant's red cells, and the presence of an IgG red cell alloantibody in both maternal and cord sera. HDN with a negative direct antiglobulin test has been reported with anti-A and anti-B, but not with other r...
The clinical diagnosis of deep-vein thrombosis is generally thought to be unreliable. From experience, we hypothesised that this widely held view might be incorrect. We developed a clinical model and prospectively tested its ability in three tertiary care centres to stratify symptomatic outpatients with suspected deep-vein thrombosis into groups wi...
The anticoagulant activity of warfarin sodium is monitored by the prothrombin time (PT). The introduction of a portable PT monitor has raised the possibility that patients could reduce the inconvenience of anticoagulant therapy by measuring their PT at home. We performed this study to determine the feasibility and accuracy of home use of the portab...
The use of subcutaneous heparin, the therapy of choice for women requiring anticoagulant prophylaxis during pregnancy, is problematic because of the discomfort produced by repeated injections. An indwelling subcutaneous Teflon catheter that can be left in place for 1 week recently became available for use as an entry port for parenteral therapy. Si...
To determine whether thrombolytic therapy reduces the rate of death or complications in patients with acute pulmonary embolism and whether a particular thrombolytic regimen is more effective than others.
The key words "fibrinolytic agents," "plasminogen activators," "streptokinase," "urokinase" and "pulmonary embolism" were used to search MEDLINE f...
In order to determine the efficacy and safety of ancrod, a rapid acting defibrinogenating drug, for patients with heparin-induced thrombocytopenia, 11 consecutive patients who required anticoagulant therapy because of venous thromboembolism and who developed acute heparin-induced thrombocytopenia or had a history of heparin-induced thrombocytopenia...
In order to determine the efficacy and safety of ancrod, a rapid acting defibrinogenating drug, for patients with heparin-induced thrombocytopenia, 11 consecutive patients who required anticoagulant therapy because of venous thromboembolism and who developed acute heparin-induced thrombocytopenia or had a history of heparin-induced thrombocytopenia...
In order to determine the efficacy and safety of ancrod, a rapid acting defibrinogenating drug, for patients with heparin-induced thrombocytopenia, 11 consecutive patients who required anticoagulant therapy because of venous thromboembolism and who developed acute heparin-induced thrombocytopenia or had a history of heparin-induced thrombocytopenia...
Citations
... [39] Anderson demonstrated in patients undergoing TKA or THA who received 5 days of prophylactic treatment with rivaroxaban, there was no significant difference in the rate of VTE between extended prophylaxis with aspirin or rivaroxaban. [40] There are various etiologies for patients undergoing lower limb joint arthroplasty surgery. We can see keywords such as arthritis and hip fracture in Cluster 4, and the risk of thrombosis may differ in patients with joint replacement with different causes. ...
![[object Object]](https://i1.rgstatic.net/ii/profile.image/276890087641091-1443027149481_Q64/Michael-Dunbar.jpg)
... While active cancer is an established and major risk factor for VTE in the general population but accounts for a minority of VTE events in APS when paraneoplastic APL are excluded. According to the ISTH proposals, cancer is active if the following situations: the disease has not received potentially curative treatment or there is evidence that treatment has not been curative (recurrence or progression) (20), "Men continue and HERDOO2" (21). They have not been tested in the context of APS and cannot be used for APS patients. ...
![[object Object]](https://i1.rgstatic.net/ii/profile.image/278444597366786-1443397773209_Q64/Marc-Rodger.jpg)
![[object Object]](https://i1.rgstatic.net/ii/profile.image/413919714791424-1475697558836_Q64/Susan-Kahn-3.jpg)
... Despite being recognized as a potentially life-threatening condition, relatively little has been reported about retroperitoneal and rectus sheath hemorrhage since its first description approximately 60 years ago [18]. Next to associations with anticoagulant therapy, hemodialysis, trauma, surgery, and/or underlying vascular pathologies, spontaneous occurrences without precipitating factors have been reported and are expected to increase in an aging population receiving anticoagulants for various indications, including atrial fibrillation, acute coronary syndrome, or deep vein thrombosis [2,4,18,19]. A well-known complication of anticoagulation therapy, acute hemorrhage has been described with incidences of 0.6 to 6.6% in the retroperitoneum and adominal wall [2,3]. ...
![[object Object]](https://i1.rgstatic.net/ii/profile.image/272374952099857-1441950657957_Q64/Jack-Hirsh.jpg)
... ryzyko po?rednie, natomiast je?li liczba punkt?w jest wi?ksza lub r?wna 3 ? istnieje du?e prawdopodobie?stwo zakrzepicy [13,14] Druga cz??? skali Wellsa przedstawia ocen? prawdopodobie?stwa wyst?pienia zatorowo?ci ...
... Thus, the goal of treatment of acute DVT should not only be prevention of early and fatal pulmonary embolism but also be restoration of blood flow to diminish the sequelae of PTS [30]. According to previous studies, there were some risks factors which facilitated to PTS and may be independent of the presentation of thrombosis, including location of DVT, patients' age, sex, body mass index, thrombophilia and D-dimer levels [5,29,[31][32][33][34][35][36]. While most iliofemoral vein thrombosis combined with IVCS was not well taken into considered in these studies. ...
![[object Object]](https://i1.rgstatic.net/ii/profile.image/272453561745432-1441969399645_Q64/Jeffrey-Ginsberg.jpg)
... When a single (previously published) prediction model is available, typical research aims include the following: @BULLET To validate and summarize the model's performance across various study populations, settings , and domains. For example, Geersing and colleagues used an IPD-MA to examine the predictive accuracy of the Wells rule for diagnosing deep vein thrombosis (DVT) across different subgroups of suspected patients [17]. @BULLET To tailor (update) the model to specific populations or settings. ...
![[object Object]](https://i1.rgstatic.net/ii/profile.image/272421374656555-1441961725974_Q64/Geert-Jan-Geersing.jpg)
... PECAM-1, also denoted CD 31, is a cell surface receptor protein expressed on endothelial cells which has important roles in inflammation, angiogenesis, and thrombus resolution [13,14]. Intracellular adhesion molecule 1 (ICAM-1), also named CD 54, is another adhesion molecule which is involved in thrombosis and the development of post-thrombotic syndromes (PTS) [15,16]. Vascular cell adhesion molecule 1 (VCAM-1) is essential for leukocyte recruitment and the development of arteriosclerosis. ...
... When emergency physicians employ POCUS for a lower-extremity DVT diagnosis, the reported sensitivity and specificity are 93%-95% and 90%-96%, respectively. 168,169 In cases of suspected DVT, the Wells criteria (Table 15) are employed to estimate pre-test probability, followed by the application of D-dimer and ultrasonography of the lower extremity, as shown in Figure 8. 157,170 If technicians are unavailable for whole-leg ultrasonography, particularly during nights or holidays, two-region ultrasonography is valuable for short-term therapeutic decision-making. However, as mentioned earlier, it is essential to conduct follow-up examinations. ...
... Accurate lower extremity DVT diagnosis and treatment are critical due to the risk of potentially fatal PE. While tools like the Wells score and D-dimer tests aid in assessing DVT risk [26,27], imaging, particularly ultrasound, is crucial for confirming suspicions [28]. Despite being the preferred diagnostic method, its implementation is often delayed due to the requirement for trained specialists. ...
... Wells score that was first created by Wells et al in 2000 could be the first PE risk score globally recognized. 13, 14 Wells score was validated in a series of studies 9,10 and frequently applied in large-scale international clinical trials, 15,16 as well as incorporated into the PEGeD strategy. 17 Despite this, a controversial issue regarding Wells score is that it has a subjective item which is "pulmonary embolism is the most likely diagnosis," thereby it is not highly favored by ESC guidelines 2 and a latest authoritative state-of-the-art review of VTE. ...
