No abstract

The clinical management of portal vein thrombosis (PVT) remains ambiguous due to its heterogeneous presentations and its associations with liver disease, malignancy, and hypercoagulable states. The natural history and clinical outcome of PVT are highly variable, dependent upon size, extent and degree of the thrombotic occlusion, as well as the physiological impact of patient comorbidities. While existing clinical guidelines consistently recommend low molecular weight heparin or vitamin K antagonist anticoagulation in cirrhotic patients with symptomatic acute PVT, management of asymptomatic and chronic PVT may need to be determined on a case-by-case basis, factoring in the state of underlying liver disease. In general, patients with PVT and underlying malignancy should be anticoagulated to alleviate symptoms and prevent recurrences that could disrupt the cancer management. However, existing clinical data does not support routine anticoagulation of cirrhotic patients with asymptomatic PVT in the absence of underlying cancer. While low molecular weight heparin and vitamin K antagonist remain the most commonly used agents in PVT, an emerging body of clinical evidence now suggests that direct-acting oral anticoagulants may be used safely and effectively in PVT. As such, direct-acting oral anticoagulants may offer a more convenient anticoagulation alternative for PVT management in future practice.

No abstract

We introduce a stationary model for gas flow based on simplified isothermal Euler equations in a non-cycled pipeline network. Especially the problem of the feasibility of a random load vector is analyzed. Feasibility in this context means the existence of a flow vector meeting these loads, which satisfies the physical conservation laws with box constraints for the pressure. An important aspect of the model is the support of compressor stations, which counteract the pressure loss caused by friction in the pipes. The network is assumed to have only one influx node; all other nodes are efflux nodes. With these assumptions the set of feasible loads can be characterized analytically. In addition we show the existence of optimal solutions for some optimization problems with probabilistic constraints. A numerical example based on real data completes this paper.

Most respondents perform CT angiography in pregnant patients suspected of having pulmonary embolism, but their policies and practices vary considerably.