https://journal.chestnet.org/article/S0012-3692(12)60129-9/pdf

Antithrombotic therapy for VTE disease: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines.

Secret History: Return of the Black Death Channel 4, 7-8pm In 1348 the Black Death swept through London, killing people within days of the appearance of their first symptoms. Exactly how many died, and why, has long been a mystery. This Secret History documentary follows experts as they pick through the evidence and reveal why the plague killed on such a scale. And they ask, what might be coming next?

Medscape

Summary Background Since December, 2019, Wuhan, China, has experienced an outbreak of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Epidemiological and clinical characteristics of patients with COVID-19 have been reported but risk factors for mortality and a detailed clinical course of illness, including viral shedding, have not been well described. Methods In this retrospective, multicentre cohort study, we included all adult inpatients (≥18 years old) with laboratory-confirmed COVID-19 from Jinyintan Hospital and Wuhan Pulmonary Hospital (Wuhan, China) who had been discharged or had died by Jan 31, 2020. Demographic, clinical, treatment, and laboratory data, including serial samples for viral RNA detection, were extracted from electronic medical records and compared between survivors and non-survivors. We used univariable and multivariable logistic regression methods to explore the risk factors associated with in-hospital death. Findings 191 patients (135 from Jinyintan Hospital and 56 from Wuhan Pulmonary Hospital) were included in this study, of whom 137 were discharged and 54 died in hospital. 91 (48%) patients had a comorbidity, with hypertension being the most common (58 [30%] patients), followed by diabetes (36 [19%] patients) and coronary heart disease (15 [8%] patients). Multivariable regression showed increasing odds of in-hospital death associated with older age (odds ratio 1·10, 95% CI 1·03–1·17, per year increase; p=0·0043), higher Sequential Organ Failure Assessment (SOFA) score (5·65, 2·61–12·23; p Interpretation The potential risk factors of older age, high SOFA score, and d-dimer greater than 1 μg/mL could help clinicians to identify patients with poor prognosis at an early stage. Prolonged viral shedding provides the rationale for a strategy of isolation of infected patients and optimal antiviral interventions in the future. Funding Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences; National Science Grant for Distinguished Young Scholars; National Key Research and Development Program of China; The Beijing Science and Technology Project; and Major Projects of National Science and Technology on New Drug Creation and Development.

Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study

Background Obesity is associated with increased mortality. Weight loss improves cardiovascular risk factors, but no prospective interventional studies have reported whether weight loss decreases overall mortality. In fact, many observational studies suggest that weight reduction is associated with increased mortality. Methods The prospective, controlled Swedish Obese Subjects study involved 4047 obese subjects. Of these subjects, 2010 underwent bariatric surgery (surgery group) and 2037 received conventional treatment (matched control group). We report on overall mortality during an average of 10.9 years of follow-up. At the time of the analysis (November 1, 2005), vital status was known for all but three subjects (follow-up rate, 99.9%). Results The average weight change in control subjects was less than ±2% during the period of up to 15 years during which weights were recorded. Maximum weight losses in the surgical subgroups were observed after 1 to 2 years: gastric bypass, 32%; vertical-banded gastropl...

/pdf/effects-of-bariatric-surgery-on-mortality-in-swedish-obese-1hxcpfu6t3.pdf

Effects of bariatric surgery on mortality in Swedish obese subjects.

https://www.chpso.org/sites/main/files/file-attachments/chest-2008-geerts-381s-453s.pdf

Prevention of Venous Thromboembolism* American College of Chest Physicians Evidence- Based Clinical Practice Guidelines (8th Edition)

Objective- Leukocyte flux contributes to thrombus formation in deep veins under pathological conditions, but mechanisms that inhibit venous thrombosis are incompletely understood. Ectonucleotide di(tri)phosphohydrolase 1 ( ENTPD1 or Cd39), an ectoenzyme that catabolizes extracellular adenine nucleotides, is embedded on the surface of endothelial cells and leukocytes. We hypothesized that under venous stasis conditions, CD39 regulates inflammation at the vein:blood interface in a murine model of deep vein thrombosis. Approach and Results- CD39-null mice developed significantly larger venous thrombi under venous stasis, with more leukocyte recruitment compared with wild-type mice. Gene expression profiling of wild-type and Cd39-null mice revealed 76 differentially expressed inflammatory genes that were significantly upregulated in Cd39-deleted mice after venous thrombosis, and validation experiments confirmed high expression of several key inflammatory mediators. P-selectin, known to have proximal involvement in venous inflammatory and thrombotic events, was upregulated in Cd39-null mice. Inferior vena caval ligation resulted in thrombosis and a corresponding increase in both P-selectin and VWF (von Willebrand Factor) levels which were strikingly higher in mice lacking the Cd39 gene. These mice also manifest an increase in circulating platelet-leukocyte heteroaggregates suggesting heterotypic crosstalk between coagulation and inflammatory systems, which is amplified in the absence of CD39. Conclusions- These data suggest that CD39 mitigates the venous thromboinflammatory response to flow interruption.

https://www.ahajournals.org/doi/pdf/10.1161/ATVBAHA.119.312407

Tuning the Thromboinflammatory Response to Venous Flow Interruption by the Ectonucleotidase CD39

Reducing venous stasis ulcers by fifty percent in 10 years: the next steps.

Objective To evaluate a gadolinium-enhanced MR angiography (Gd-MRA) imaging protocol for the assessment of thoracic vessels using double-dose gadolinium and quiet breathing An animal model was used to simulate imaging in infants and young children Material and methods Six baboons (Papio anubis), mean weight 57 kg, were sedated and intubated After the injection of double-dose Gd-DTPA (02 mmol/kg) through a peripheral vein, a coronal spoiled 3D gradient-echo volume acquisition was obtained during quiet breathing Two radiologists reviewed the images for visualization of aortic arch, brachiocephalic vessel origins, pulmonary arteries (central, upper lobe and descending branches), and pulmonary veins (upper and lower) Results Visualization was excellent for the aortic arch, brachiocephalic vessel origins, and pulmonary arteries, including the hilar branches Visualization was excellent for the lower and right upper pulmonary veins and fair for the left upper pulmonary vein There was excellent agreement between radiologists Conclusion Imaging of thoracic vessels with Gd-MRA using double gadolinium during quiet breathing was effective in our animal model The advantages of this technique include a short imaging time and depiction of vascular segments – branches of pulmonary arteries and intraparenchymal segments of pulmonary veins – not optimally visualized with other non-invasive imaging techniques

/pdf/gadolinium-enhanced-mr-angiography-gd-mra-of-thoracic-4z2ixyfw1v.pdf

Gadolinium-enhanced MR angiography (Gd-MRA) of thoracic vasculature in an animal model using double-dose gadolinium and quiet breathing

https://www.jvascsurg.org/article/0741-5214(86)90143-6/pdf

Thomas W. Wakefield

Papers

Tuning the Thromboinflammatory Response to Venous Flow Interruption by the Ectonucleotidase CD39

Reducing venous stasis ulcers by fifty percent in 10 years: the next steps.

Gadolinium-enhanced MR angiography (Gd-MRA) of thoracic vasculature in an animal model using double-dose gadolinium and quiet breathing

Arterial bypass grafts for upper extremity ischemia

Current Therapy in Vascular and Endovascular Surgery (5th Ed.)