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  1. AU="Maraveyas, A"
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  1. Artikel: Rare Gastric Diverticulum Mimicking Adrenal Abscess on Computed Tomography.

    Maraveyas, Alexander

    Cureus

    2024  Band 16, Heft 3, Seite(n) e55796

    Abstract: Gastric diverticula are a rare phenomenon that is typically asymptomatic and encountered incidentally. Due to the relative proximity between the gastric diverticula and the left adrenal gland, they may mimic adrenal masses on computed tomography (CT). ... ...

    Abstract Gastric diverticula are a rare phenomenon that is typically asymptomatic and encountered incidentally. Due to the relative proximity between the gastric diverticula and the left adrenal gland, they may mimic adrenal masses on computed tomography (CT). For this reason, the preferred diagnostic methods for gastric diverticula are upper gastrointestinal series or direct visualization on endoscopy. The present report describes an unusual case of a gastric diverticulum mimicking an abscess of the adrenal gland with the apparent spread of infection to the left lower lobe of the lung.
    Sprache Englisch
    Erscheinungsdatum 2024-03-08
    Erscheinungsland United States
    Dokumenttyp Case Reports
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.55796
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  2. Artikel ; Online: Latest advances in preventing thromboembolic disease in the ambulatory oncology patient.

    Maraveyas, Anthony

    Thrombosis research

    2020  Band 191 Suppl 1, Seite(n) S91–S98

    Abstract: Venous thromboembolism (VTE) is often cited as a major cause of death and morbidity in cancer patients. Even a non-lethal VTE causes distress and is commonly perceived by patients as a set-back in the cancer journey and a threat to the cancer treatment. ... ...

    Abstract Venous thromboembolism (VTE) is often cited as a major cause of death and morbidity in cancer patients. Even a non-lethal VTE causes distress and is commonly perceived by patients as a set-back in the cancer journey and a threat to the cancer treatment. It is also known that the risk of VTE varies between cancers (cancer-related risk factors), between patients (patient-related risk factors), and also within the cancer journey of a single patient. Risk can increase during treatments like surgery and chemotherapy and decline during remission. Neither the low molecular weight heparins nor the vitamin K analogues have gained an established role in thromboprevention guidance other than in 'the high risk' patient, who remains a rather ambiguous entity. The recently published randomised studies of rivaroxaban and apixaban in moderate- to high-risk thrombosis patients, assigned by the Khorana Risk Score, has seen the inclusion of direct oral anticoagulants (DOACs) in recent guidelines (e.g. the American Society of Clinical Oncology 2019 guidelines) for this indication. The ease of administration and the demonstrated greater patient adherence to oral agents has heightened the expectation that a practice-changing thromboprevention study in cancer patients should be realizable. However, key unmet needs that pose familiar challenges remain and as yet do not have satisfactory solutions. Anticoagulants carry risks of bleeding that are higher in the cancer population. There is therefore the challenge of sufficient risk reduction of VTE from the intervention balanced against the number of patients that may be harmed from bleeding. There is also the challenge of penetrating the risk threshold beyond which oncologists would deem thromboprevention a clinically meaningful praxis. Thus, identifying the high-risk groups of patients or targeting the length or timing of the thromboprevention to when the risks are highest are major questions that remain the subject of ongoing research. Notably all this is taking place against a backdrop of changing therapeutics for many cancers (e.g. targeted agents, checkpoint inhibitors and combinations) and their assorted impact on VTE incidence. In this review, past data for the ambulatory cancer patient are summarised, the latest evidence for the direct oral anticoagulants apixaban and rivaroxaban are analysed and the challenges of identifying the high-risk patients that have the greater chance of benefiting from thromboprophylaxis are discussed.
    Mesh-Begriff(e) Administration, Oral ; Anticoagulants/therapeutic use ; Humans ; Medical Oncology ; Neoplasms/complications ; Neoplasms/drug therapy ; Rivaroxaban/therapeutic use ; Venous Thromboembolism/drug therapy ; Venous Thromboembolism/etiology ; Venous Thromboembolism/prevention & control
    Chemische Substanzen Anticoagulants ; Rivaroxaban (9NDF7JZ4M3)
    Sprache Englisch
    Erscheinungsdatum 2020-07-04
    Erscheinungsland United States
    Dokumenttyp Journal Article ; Review
    ZDB-ID 121852-9
    ISSN 1879-2472 ; 0049-3848
    ISSN (online) 1879-2472
    ISSN 0049-3848
    DOI 10.1016/S0049-3848(20)30404-7
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  3. Artikel ; Online: Cancer-associated venous thrombosis in adults (second edition): A British Society for Haematology Guideline.

    Alikhan, Raza / Gomez, Keith / Maraveyas, Anthony / Noble, Simon / Young, Annie / Thomas, Mari

    British journal of haematology

    2024  

    Abstract: A shared decision on the most appropriate agent for the treatment of cancer-associated thrombosis should consider the following factors, which should be reassessed as patients continue along their cancer care pathway: risk of bleeding; tumour site; ... ...

    Abstract A shared decision on the most appropriate agent for the treatment of cancer-associated thrombosis should consider the following factors, which should be reassessed as patients continue along their cancer care pathway: risk of bleeding; tumour site; suitability of oral medications; potential for drug-drug interactions; and patient preference and values regarding choice of drug. Continuing anticoagulation beyond 6 months in patients with cancer-associated venous thromboembolism and active cancer is recommended.
    Sprache Englisch
    Erscheinungsdatum 2024-04-25
    Erscheinungsland England
    Dokumenttyp Journal Article
    ZDB-ID 80077-6
    ISSN 1365-2141 ; 0007-1048
    ISSN (online) 1365-2141
    ISSN 0007-1048
    DOI 10.1111/bjh.19414
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  4. Artikel ; Online: An overlooked mimic? Autoimmune myelofibrosis-A scoping review of the literature.

    Amel Riazat-Kesh, Yosef Joseph Rene / Maraveyas, Alexander / Martin, Lily / Tremblay, Douglas

    European journal of haematology

    2023  Band 111, Heft 5, Seite(n) 706–714

    Abstract: Background and objectives: Autoimmune myelofibrosis (AIMF) is a rare cause of bone marrow fibrosis (BMF) occurring in the presence or absence of a defined autoimmune disease (secondary or primary AIMF, sAIMF/pAIMF, respectively). Unlike primary ... ...

    Abstract Background and objectives: Autoimmune myelofibrosis (AIMF) is a rare cause of bone marrow fibrosis (BMF) occurring in the presence or absence of a defined autoimmune disease (secondary or primary AIMF, sAIMF/pAIMF, respectively). Unlike primary myelofibrosis (PMF), AIMF responds well to immunosuppressive therapy with a benign clinical course. Diagnostic criteria for AIMF in opposition to PMF have been lacking, though recent work has helped better characterise molecular and pathological features of AIMF, improving diagnostic precision.
    Methods: Using a modern clinical and pathophysiological understanding of AIMF, we apply scoping review methodology and rigorous case-criteria to retrospectively analyse the case literature. We examine its patient-population, describing patient-associated factors, presentation, bone marrow pathology, genetics, treatment and outcomes.
    Results: Fifty-five studies were identified, describing 139 AIMF patients. Patients were mostly young females (~4:1 ratio female:male, median age 40.8 years) and typically presented with cytopenias. Splenomegaly was rare. sAIMF was more common than pAIMF (~3:1 ratio), and most cases responded well to immunosuppressive therapy.
    Conclusions: Our results strengthen the emerging picture of AIMF's patient population, natural history and response to treatment. Further work should continue to use reproducible diagnostic criteria, and explore AIMF's pathophysiology, response to different therapies, and sequelae over larger timescales, as well as differences between pAIMF, sAIMF and PMF.
    Mesh-Begriff(e) Humans ; Male ; Female ; Adult ; Primary Myelofibrosis/diagnosis ; Primary Myelofibrosis/therapy ; Primary Myelofibrosis/complications ; Retrospective Studies ; Bone Marrow/pathology ; Autoimmune Diseases/diagnosis ; Autoimmune Diseases/therapy ; Autoimmune Diseases/complications ; Immunosuppression Therapy
    Sprache Englisch
    Erscheinungsdatum 2023-07-29
    Erscheinungsland England
    Dokumenttyp Review ; Journal Article
    ZDB-ID 392482-8
    ISSN 1600-0609 ; 0902-4441
    ISSN (online) 1600-0609
    ISSN 0902-4441
    DOI 10.1111/ejh.14064
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  5. Artikel ; Online: Cancer patients' experiences of the diagnosis and treatment of incidental pulmonary embolism (a qualitative study).

    Benelhaj, Naima E / Hutchinson, Ann / Maraveyas, Anthony / Johnson, Miriam J

    PloS one

    2022  Band 17, Heft 10, Seite(n) e0276754

    Abstract: Background: The diagnosis of symptomatic cancer-associated thrombosis often causes distress and alarm for patients, especially for those unaware of the risk, or the signs and symptoms to look out for. There are few data about cancer patients' ... ...

    Abstract Background: The diagnosis of symptomatic cancer-associated thrombosis often causes distress and alarm for patients, especially for those unaware of the risk, or the signs and symptoms to look out for. There are few data about cancer patients' experiences of incidentally diagnosed pulmonary embolism (IPE), where lack of warning (recognised signs, symptoms) may cause delayed diagnosis and aggravate distress.
    Objectives: To explore cancer patients' experience of the diagnosis of and living with incidental pulmonary embolism treated with anticoagulation.
    Methods: A qualitative study using modified grounded theory approach. Semi-structured interviews were conducted as part of a mixed- methods prospective observational survey study of consenting patients with IPE. Data were subjected to thematic analysis. The qualitative findings are presented.
    Findings: Eleven participants were interviewed (mean age 68.3 years, range 38-82 years; various forms of cancer and stages). Three major themes and one cross-cutting theme were generated. Theme (1): IPE is experienced in the context of cancer and concomitant comorbidities. Issues are understood in the shadow of-and often overshadowed by-current serious illness. Theme (2): Being diagnosed with IPE. Misattribution to cancer or other comorbidities caused delay in help-seeking and diagnosis. Theme (3): Coping with anticoagulation. Participants' incorporated anticoagulation treatment and its effects into their daily routine with acceptance and stoicism. Finally, the cross-cutting theme relates to a lack of information and uncertainty, contributing to distress throughout the experience.
    Conclusion: The diagnosis of IPE was upsetting and unexpected. Expert and timely information was valued by those with IPE. Education called for about the increased risk of cancer-associated thrombosis and the signs and symptoms to be aware of.
    Mesh-Begriff(e) Humans ; Adult ; Middle Aged ; Aged ; Aged, 80 and over ; Pulmonary Embolism/diagnosis ; Pulmonary Embolism/drug therapy ; Pulmonary Embolism/complications ; Neoplasms/complications ; Neoplasms/diagnosis ; Qualitative Research ; Adaptation, Psychological ; Anticoagulants/therapeutic use
    Chemische Substanzen Anticoagulants
    Sprache Englisch
    Erscheinungsdatum 2022-10-25
    Erscheinungsland United States
    Dokumenttyp Observational Study ; Journal Article
    ZDB-ID 2267670-3
    ISSN 1932-6203 ; 1932-6203
    ISSN (online) 1932-6203
    ISSN 1932-6203
    DOI 10.1371/journal.pone.0276754
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  6. Artikel ; Online: Deficient DNA mismatch repair and persistence of SARS-CoV-2 RNA shedding: a case report of hereditary nonpolyposis colorectal cancer with COVID-19 infection.

    Haque, Farzana / Lillie, Patrick / Haque, Farhana / Maraveyas, Anthony

    BMC infectious diseases

    2021  Band 21, Heft 1, Seite(n) 854

    Abstract: Background: Several independent risk factors have been reported to influence viral shedding following COVID-19 infection, but the influence of host-related molecular factors has not yet been described. We report a case of a cancer patient with Lynch ... ...

    Abstract Background: Several independent risk factors have been reported to influence viral shedding following COVID-19 infection, but the influence of host-related molecular factors has not yet been described. We report a case of a cancer patient with Lynch syndrome (hereditary nonpolyposis colorectal cancer, HNPCC) who manifested SARS-CoV-2 PCR (polymerase chain reaction) positivity for at least 54 days after contracting mild COVID-19 illness. We propose that deficient mismatch repair (MMR) may play a role in the prolonged SARS-CoV-2 RNA shedding.
    Case presentation: A patient with Lynch syndrome was under surveillance for metastatic adenocarcinoma after completing palliative chemotherapy in October 2019. Between the period of April 2020 to June 2020, he was admitted multiple times to address several clinical needs mainly related to his underlying malignancy. These included progressive disease observed in the aortocaval lymph nodes leading to recurrent episodes of upper gastrointestinal bleeding, dehydration resulting in acute kidney injury and a short-lived episode of pyrexia. A SARS-CoV-2 PCR of the nasopharyngeal swab (NPS) was positive at his initial admission with mild COVID-19 symptoms. He remained positive on subsequent admissions when tested routinely for SARS-CoV-2 without demonstrating any apparent clinical features of COVID-19 infection. The MMR pathway, a component of DNA damage response (DDR), is impaired in Lynch syndrome due to an inherited genetic mutation. This pathway is also required for viral clearance from the host cells following certain RNA viral infections like influenza virus and other coronaviridae. Here we provide a current understanding of the importance of DDR deficiencies in the clearance of RNA virus and suggest how this may play a similar role in the clearance of COVID-19, as evident in our case that demonstrated persistent positivity.
    Conclusion: The importance of understanding the scientific basis of extended viral shedding during the COVID-19 pandemic is now centre-stage in the establishment of robust track and trace services to allow the recovery and function of societies and economies. This patient with Lynch syndrome recovered from infection but had prolonged viral positivity, which might merit further investigation to better understand the effect of this condition on infection duration and outcome.
    Mesh-Begriff(e) COVID-19 ; Colorectal Neoplasms, Hereditary Nonpolyposis/complications ; Colorectal Neoplasms, Hereditary Nonpolyposis/genetics ; DNA Mismatch Repair ; Humans ; Male ; Pandemics ; RNA, Viral ; SARS-CoV-2 ; Virus Shedding
    Chemische Substanzen RNA, Viral
    Sprache Englisch
    Erscheinungsdatum 2021-08-21
    Erscheinungsland England
    Dokumenttyp Case Reports ; Journal Article
    ZDB-ID 2041550-3
    ISSN 1471-2334 ; 1471-2334
    ISSN (online) 1471-2334
    ISSN 1471-2334
    DOI 10.1186/s12879-021-06500-1
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  7. Artikel ; Online: Tissue factor-bearing microparticles and inflammation: a potential mechanism for the development of venous thromboembolism in cancer.

    Date, K / Ettelaie, C / Maraveyas, A

    Journal of thrombosis and haemostasis : JTH

    2017  Band 15, Heft 12, Seite(n) 2289–2299

    Abstract: Cancer is associated with an increased risk of venous thromboembolism (VTE); the exact mechanisms for the induction of VTE remain to be fully elucidated, but it is widely acknowledged that tissue factor (TF)-bearing microparticles (TF-MPs) may play a ... ...

    Abstract Cancer is associated with an increased risk of venous thromboembolism (VTE); the exact mechanisms for the induction of VTE remain to be fully elucidated, but it is widely acknowledged that tissue factor (TF)-bearing microparticles (TF-MPs) may play a significant role. However, TF-MPs have yet to be accepted as a genuine biomarker for cancer-associated VTE, as the presence of elevated TF-MP levels is not always accompanied by thrombosis; interestingly, in certain cases, particularly in pancreatic cancer, VTE seems to be more likely in the context of acute inflammation. Although several potential mechanisms for the development of VTE in cancer have been postulated, this review explores the homeostatic disruption of TF-MPs, as the main reservoir of bloodborne TF, in the context of cancer and inflammation, and considers the abrogated responses of the activated endothelium and mononuclear phagocyte system in mediating this disruption.
    Mesh-Begriff(e) Biomarkers/blood ; Blood Coagulation ; Cell-Derived Microparticles/metabolism ; Female ; Homeostasis ; Humans ; Inflammation/blood ; Inflammation/complications ; Male ; Models, Biological ; Neoplasms/blood ; Neoplasms/complications ; Phagocytes/metabolism ; Risk Factors ; Thromboplastin/metabolism ; Venous Thromboembolism/blood ; Venous Thromboembolism/etiology
    Chemische Substanzen Biomarkers ; Thromboplastin (9035-58-9)
    Sprache Englisch
    Erscheinungsdatum 2017-11-08
    Erscheinungsland England
    Dokumenttyp Journal Article ; Review
    ZDB-ID 2112661-6
    ISSN 1538-7836 ; 1538-7933
    ISSN (online) 1538-7836
    ISSN 1538-7933
    DOI 10.1111/jth.13871
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  8. Artikel ; Online: Venous thromboembolism in cancer patients: ESMO Clinical Practice Guideline.

    Falanga, A / Ay, C / Di Nisio, M / Gerotziafas, G / Jara-Palomares, L / Langer, F / Lecumberri, R / Mandala, M / Maraveyas, A / Pabinger, I / Sinn, M / Syrigos, K / Young, A / Jordan, K

    Annals of oncology : official journal of the European Society for Medical Oncology

    2023  Band 34, Heft 5, Seite(n) 452–467

    Mesh-Begriff(e) Humans ; Venous Thromboembolism/epidemiology ; Venous Thromboembolism/etiology ; Venous Thromboembolism/therapy ; Anticoagulants/therapeutic use ; Risk Factors ; Neoplasms/complications ; Neoplasms/epidemiology ; Neoplasms/therapy
    Chemische Substanzen Anticoagulants
    Sprache Englisch
    Erscheinungsdatum 2023-01-10
    Erscheinungsland England
    Dokumenttyp Practice Guideline ; Research Support, Non-U.S. Gov't ; Journal Article
    ZDB-ID 1025984-3
    ISSN 1569-8041 ; 0923-7534
    ISSN (online) 1569-8041
    ISSN 0923-7534
    DOI 10.1016/j.annonc.2022.12.014
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  9. Artikel ; Online: PO-27 - Thrombin generation in pancreatic cancer and multiple myeloma with use of calibrated automated thrombography.

    Adesanya, M A / Maraveyas, A / Madden, L A

    Thrombosis research

    2016  Band 140 Suppl 1, Seite(n) S186

    Abstract: Introduction: The calibrated automated thrombography (CAT) assay is emerging as a reliable tool for real time estimation of thrombin generation (TG) potential. As a time-dependent colorimetric assessment of thrombin quantity generated per sample, it ... ...

    Abstract Introduction: The calibrated automated thrombography (CAT) assay is emerging as a reliable tool for real time estimation of thrombin generation (TG) potential. As a time-dependent colorimetric assessment of thrombin quantity generated per sample, it measures the amount of thrombin-cleaved fluorogenic substrate produced, and so is regarded as a better overall indicator of the clotting efficiency and function of the haemostatic process than one stage clotting-time based assays.
    Aim: We already recognise that the pathways underlying the thrombotic phenotype for different malignancies may be driven by different factors of the coagulation cascade with TG has a common denominator. Two such malignancies with high venous thromboembolism (VTE) incidence are Multiple myeloma (MM) and Pancreatic cancer (PC). Understanding the underlying variations in these two distinct cancer models using patient samples and cell lines might potentially allow individual approaches to identifying thrombotic risk and relevant prevention strategies.
    Materials and methods: Citrated blood samples were taken from healthy controls, pre-surgical pancreatic cancer and pre-chemotherapy multiple myeloma patients enrolled into ongoing clinical trials. The clotting ability was tested using platelet free plasma (PPP) on a one-step clotting time-based (CT) assay and the TG profiles were evaluated on a Thrombinoscope™ software (Thrombinoscope BV, Maastricht, Netherlands). Solid tumour cells of pancreatic cancer and malignant haematological cell lines were used at various cell concentrations for the CAT assay, which was performed with the addition of platelet-free control plasma or control plasma deficient in coagulation factors VII and XII.
    Results: At TF concentration conditions of 1 pmol/L, the peak height of thrombin generated on thrombogram curves strongly correlated with CT of patient samples. Compared to healthy controls, pancreatic cancer had higher thrombin peaks (P), shorter lag times (LG), and an overall stronger TG profile than MM. Pancreatic cancer cell lines exhibited higher concentration-dependent TG profiles in control plasma than haematological cell lines, with higher peaks, endogenous thrombin potential (ETP), shorter lag times (LG) and faster times-to-peak (ttPeak).
    Conclusions: This study demonstrates that the CAT assay is a useful predictor of the thrombotic phenotype in cancer patients as it gives a more comprehensive overall coagulation profile than one stage CT-based assays. It shows that for patient samples and cell lines, the similarities and differences that exists in the TG potential, significantly depends on specific coagulation factors present in the intrinsic or extrinsic arms of the clotting cascade.
    Sprache Englisch
    Erscheinungsdatum 2016-04
    Erscheinungsland United States
    Dokumenttyp Journal Article
    ZDB-ID 121852-9
    ISSN 1879-2472 ; 0049-3848
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    ISSN 0049-3848
    DOI 10.1016/S0049-3848(16)30160-8
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  10. Artikel ; Online: Practical treatment guidance for cancer-associated thrombosis - Managing the challenging patient: A consensus statement.

    Musgrave, Kathryn M / Power, Kieron / Laffan, Mike / O'Donnell, James S / Thachil, Jecko / Maraveyas, Anthony

    Critical reviews in oncology/hematology

    2022  Band 171, Seite(n) 103599

    Abstract: Cancer-associated thrombosis (CAT) is a leading cause of death amongst people with cancer. Treatment decisions have become increasingly complex with the introduction of direct oral anticoagulants and existing guidelines are limited to evidence from ... ...

    Abstract Cancer-associated thrombosis (CAT) is a leading cause of death amongst people with cancer. Treatment decisions have become increasingly complex with the introduction of direct oral anticoagulants and existing guidelines are limited to evidence from patients meeting stringent trial-entry criteria. To assist decision making for healthcare professionals managing CAT in challenging 'real-world' situations, an expert working group of clinicians from oncology, haematology and pharmacology convened over a series of virtual meetings between September 2020 and January 2021 to catalogue the most challenging clinical problems and define consensus recommendations. Clinical problems were divided amongst the group members according to their areas of expertise, with each reviewing the literature and writing their recommendations. Using a web-based file-sharing platform, each contribution was reviewed until consensus was reached. Each clinical problem is discussed; these include managing gastrointestinal impairment, renal impairment, liver impairment, increased risk of bleeding, extremes of body weight, drug interactions, anticoagulation beyond the initial six months and managing recurrent thrombosis. A user-friendly, practical, colour-coded algorithm was produced to help guide clinical decision-making in CAT. Red highlights decision steps where shared decision making, such as with the multi-disciplinary team, is recommended. Amber steps reflect uncertainty of existing evidence. Multiple amber steps per patient warrant increased caution. Making anticoagulation decisions in people with cancer is challenging; it is important that healthcare providers can discuss where there is a lack of evidence and ensure that patient preference is given priority. This algorithm and consensus recommendations are a useful tool to guide these complex discussions.
    Mesh-Begriff(e) Anticoagulants/therapeutic use ; Clinical Decision-Making ; Consensus ; Humans ; Neoplasms/drug therapy ; Neoplasms/therapy ; Thrombosis/drug therapy ; Thrombosis/therapy
    Chemische Substanzen Anticoagulants
    Sprache Englisch
    Erscheinungsdatum 2022-01-19
    Erscheinungsland Netherlands
    Dokumenttyp Journal Article ; Review
    ZDB-ID 605680-5
    ISSN 1879-0461 ; 0737-9587 ; 1040-8428
    ISSN (online) 1879-0461
    ISSN 0737-9587 ; 1040-8428
    DOI 10.1016/j.critrevonc.2022.103599
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