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Management of venous thromboembolism in athletes. Blood Rev 2020; 47:100780. [PMID: 33229140 DOI: 10.1016/j.blre.2020.100780] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 09/05/2020] [Accepted: 10/15/2020] [Indexed: 11/22/2022]
Abstract
Venous thromboembolism (VTE) is a common condition with high associated morbidity and mortality. Athletes have unique VTE risk factors compared with the general population, and may have a higher than anticipated risk of thrombosis. Anticoagulant treatment poses additional challenges in athletes, as these individuals usually wish to return to sporting activities without delay. In addition, those athletes who engage in contact sports may have bleeding complications with extended anticoagulation. In this paper, we discuss VTE risk factors in athletes, the impact of exertion on haemostasis, measures which could be adopted to mitigate VTE risks in these highly active individuals and options to deal with bleeding risks from anticoagulation during injury-prone sporting activities.
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Borrelli A, Botto A, Maurella C, Falco S, Pagani E, Miniscalco B, Tarducci A, Bruno B. Thromboelastometric assessment of hemostasis in newborn Piemontese calves. J Vet Diagn Invest 2017; 29:293-297. [DOI: 10.1177/1040638716688044] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
We investigated possible age-related differences in coagulation profiles in bovine species by means of rotational thromboelastometric (ROTEM) analysis. We evaluated hemostasis by ROTEM in newborn Piemontese calves at birth (T0), 8 d (T8), and 15 d (T15) of age and compared the ROTEM results obtained in 16 newborn calves with 28 adult Piemontese cattle. Hemostasis was evaluated using standard coagulation tests and ROTEM analysis, obtaining in-TEM, ex-TEM, and fib-TEM profiles. Statistically significant differences in the ROTEM profiles of newborn calves were found between T0 and T8 and between T0 and T15 ( p < 0.05) but not between T8 and T15. Differences between ROTEM profiles of calves and adults were statistically significant at T0 ( p < 0.05) but no differences were found at T15 ( p < 0.05). Hence, ROTEM reference intervals for adult cattle can be used to evaluate profiles in Piemontese calves ≥8 d of age.
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Affiliation(s)
- Antonio Borrelli
- Department of Veterinary Science, University of Turin, Turin, Italy (Borrelli, Botto, Falco, Pagani, Miniscalco, Tarducci, Bruno)
- Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle D’Aosta, Italy (Maurella)
| | - Angelica Botto
- Department of Veterinary Science, University of Turin, Turin, Italy (Borrelli, Botto, Falco, Pagani, Miniscalco, Tarducci, Bruno)
- Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle D’Aosta, Italy (Maurella)
| | - Cristiana Maurella
- Department of Veterinary Science, University of Turin, Turin, Italy (Borrelli, Botto, Falco, Pagani, Miniscalco, Tarducci, Bruno)
- Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle D’Aosta, Italy (Maurella)
| | - Sara Falco
- Department of Veterinary Science, University of Turin, Turin, Italy (Borrelli, Botto, Falco, Pagani, Miniscalco, Tarducci, Bruno)
- Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle D’Aosta, Italy (Maurella)
| | - Elena Pagani
- Department of Veterinary Science, University of Turin, Turin, Italy (Borrelli, Botto, Falco, Pagani, Miniscalco, Tarducci, Bruno)
- Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle D’Aosta, Italy (Maurella)
| | - Barbara Miniscalco
- Department of Veterinary Science, University of Turin, Turin, Italy (Borrelli, Botto, Falco, Pagani, Miniscalco, Tarducci, Bruno)
- Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle D’Aosta, Italy (Maurella)
| | - Alberto Tarducci
- Department of Veterinary Science, University of Turin, Turin, Italy (Borrelli, Botto, Falco, Pagani, Miniscalco, Tarducci, Bruno)
- Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle D’Aosta, Italy (Maurella)
| | - Barbara Bruno
- Department of Veterinary Science, University of Turin, Turin, Italy (Borrelli, Botto, Falco, Pagani, Miniscalco, Tarducci, Bruno)
- Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle D’Aosta, Italy (Maurella)
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Sommerey CC, Williams TL, McCrone I, Ruiz-Ferreras A, Freeman D, Archer J. Thromboelastography in healthy dairy cows. J Dairy Sci 2014; 97:5474-80. [PMID: 24997666 DOI: 10.3168/jds.2014-7909] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2014] [Accepted: 06/02/2014] [Indexed: 11/19/2022]
Abstract
Thromboelastography is a whole blood-based coagulation assay that can be used to investigate hypocoagulability and hypercoagulability, as seen with thromboembolic diseases and disseminated intravascular coagulation. Numerous coagulopathies due to different causes are reported in cows. The objective was to establish reference intervals for thromboelastography using the TEG 5000 (Haemonetics GmbH, Munich, Germany) with citrated whole blood samples and kaolin activation in dairy cows and to investigate possible thromboelastographic changes between cows in different lactation periods. An additional objective was to test the stability of samples for up to 100h. Sixty blood samples from healthy Holstein-Friesian cows were examined. The samples were allocated to 3 different lactation groups (≤30 d postcalving, 31-99 d postcalving, ≥100 d postcalving). Thromboelastography was performed by using the TEG 5000 analyzer with citrated whole blood samples with kaolin activation. The calculated reference intervals were as follows: reaction time=2.2 to 6.2min, coagulation time=0.8 to 2.0min, angle α=58.2 to 81.8°, maximum amplitude=64.3 to 89.2mm, and clot rigidity=9.2 to 41.2 dyn/cm(2). The 3 different lactation groups showed no significant differences in TEG parameters. No significant difference was seen in samples stored for up to 48h at room temperature, which indicates that delays in processing samples, such as those arising during transit, are not an issue.
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Affiliation(s)
- Cora-Costanze Sommerey
- Department of Veterinary Medicine, University of Cambridge, Cambridge CB3 0ES, United Kingdom.
| | - Tim L Williams
- Department of Veterinary Medicine, University of Cambridge, Cambridge CB3 0ES, United Kingdom
| | - Ian McCrone
- Department of Veterinary Medicine, University of Cambridge, Cambridge CB3 0ES, United Kingdom
| | - Aran Ruiz-Ferreras
- Department of Veterinary Medicine, University of Cambridge, Cambridge CB3 0ES, United Kingdom
| | - Dan Freeman
- Department of Veterinary Medicine, University of Cambridge, Cambridge CB3 0ES, United Kingdom
| | - Joy Archer
- Department of Veterinary Medicine, University of Cambridge, Cambridge CB3 0ES, United Kingdom
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