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Pulmonary embolism treatment

Rachel Rosovsky, Yuchiao Chang, Kenneth Rosenfield, Richard Channick, Michael R Jaff, Ido Weinberg, Thoralf Sundt, Alison Witkin, Josanna Rodriguez-Lopez, Blair A Parry, Savannah Harshbarger, Praveen Hariharan, Christopher Kabrhel
Multidisciplinary pulmonary embolism response teams (PERTs) are being implemented to improve care of patients with life-threatening PE. We sought to determine how the creation of PERT affects treatment and outcomes of patients with serious PE. A pre- and post-intervention study was performed using an interrupted time series design, to compare patients with PE before (2006-2012) and after (2012-2016) implementation of PERT at a university hospital. T-tests, Chi square tests and logistic regression were used to compare outcomes, and multivariable regression were used to adjust for differences in PE severity...
September 21, 2018: Journal of Thrombosis and Thrombolysis
Piotr Skrzypczyk, Małgorzata Mizerska-Wasiak, Anna Ofiara, Michał Szyszka, Jagoda Kułagowska, Agnieszka Biejat, Michał Brzewski, Beata Kucińska, Bożena Werner, Małgorzata Pańczyk-Tomaszewska
Thromboembolic complications are found in 2-3% of children with nephrotic syndrome (NS); this increased risk is caused by hypovolemia, hemoconcentration, increased number and activity of platelets, hyperfibrinogenemia and loss of coagulation inhibitors. Risk is even higher in case of additional factors e.g. congenital thrombophilia. CASE REPORT: Girl with NS aged 17 11/12 years was admitted to hospital due to respiratory tract infection with cough and back pain. NS started 9 months earlier and she had two bouts of disease, and was treated only with prednisone (current dose - 60 mg/48h)...
September 21, 2018: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
Sara P Myers, Matthew E Kutcher, Matthew R Rosengart, Jason L Sperry, Andrew B Peitzman, Joshua B Brown, Matthew D Neal
BACKGROUND: Tranexamic acid (TXA) is used as a hemostatic adjunct for hemorrhage control in the injured patient and reduces early preventable death. But the risk of venous thromboembolism (VTE) has been incompletely explored. Previous studies investigating the effect of TXA on VTE vary in their findings. We performed a propensity matched analysis to investigate the association between TXA and VTE following trauma, hypothesizing that TXA is an independent risk factor for VTE. METHODS: This retrospective study queried trauma patients presenting to a single level I trauma center from 2012 to 2016...
September 19, 2018: Journal of Trauma and Acute Care Surgery
Dezhi Li, Li Xu, Dianjie Lin, Shujuan Jiang, Saran Feng, Ling Zhu
Acute pulmonary embolism (PE) is a most dangerous complication that needs prompt treatment to reduce potentially death. There are many well-known prognostic factors indicate the morbidity and mortality in various thromboembolic events. Persistent eosinophilia in peripheral blood can lead to tissue infiltration and even organ damage, but the urgent event of thromboembolism in pulmonary provoked by eosinophil eosinophilia in idiopathic hypereosinophilic syndrome (HES) is relative an unusual presentation. In this paper, we present two cases of patients with multiple PE and deep vein thrombosis secondary to the idiopathic HES...
2018: Respiratory Medicine Case Reports
Kyle H Cichos, Jessica L Churchill, Sierra G Phillips, Shawna L Watson, Gerald McGwin, Elie S Ghanem, Brent A Ponce
INTRODUCTION: Hip fractures and metabolic syndrome (MetS) are becoming major global healthcare burdens as populations age. This study sought to determine the impact of MetS in hip fracture patients on perioperative outcomes following operative fixation or arthroplasty. METHODS: Data from the 2004-2014 Nationwide Inpatient Sample was used to select 3,348,207 discharges with hip fracture. MetS patients were identified by having at least 3 of 4 component comorbidities: hypertension, dyslipidemia, obesity, and diabetes...
September 8, 2018: Injury
Alessandra Iaccarino, Giacomo Frati, Leonardo Schirone, Wael Saade, Elio Iovine, Mizar D'Abramo, Antonio De Bellis, Sebastiano Sciarretta, Ernesto Greco
Massive pulmonary embolism (PE) is a severe condition that can potentially lead to death caused by right ventricular (RV) failure and the consequent cardiogenic shock. Despite the fact thrombolysis is often administrated to critical patients to increase pulmonary perfusion and to reduce RV afterload, surgical treatment represents another valid option in case of failure or contraindications to thrombolytic therapy. Correct risk stratification and multidisciplinary proactive teams are critical factors to dramatically decrease the mortality of this global health burden...
August 2018: Journal of Thoracic Disease
Irene Schmidtmann, Stavros Konstantinides, Harald Binder
In clinical trials with patients in a critical state, death may preclude measurement of a quantitative endpoint of interest, and even early measurements, for example for intention-to-treat analysis, may not be available. For example, a non-negligible proportion of patients with acute pulmonary embolism will die before 30 day measurements on the efficacy of thrombolysis can be obtained. As excluding such patients may introduce bias, alternative analyses, and corresponding means for sample size calculation are needed...
September 19, 2018: Biometrical Journal. Biometrische Zeitschrift
S Javed Zaidi, Lorene Schweig, Dhaval Patel, Alexander Javois, Javeed Akhter
INTRODUCTION: Hemoptysis in children is an uncommon presenting symptom but can be life-threatening if massive. Cardiac catheterization and coil embolization of aorto-pulmonary collateral vessels (APCs) is uncommon in pediatric hemoptysis patients without congenital heart disease. METHODS: We present a series of seven infants (≤12 months of age) with hemoptysis, all of whom underwent cardiac catheterization to look for and intervene upon APCs, if found. Only those patients who underwent both bronchoscopy as well as cardiac catheterization from January 1995 to January 2015 were included in this retrospective review...
September 18, 2018: Pediatric Pulmonology
Josef S Smolen, Mark C Genovese, Tsutomu Takeuchi, David L Hyslop, William L Macias, Terence Rooney, Lei Chen, Christina L Dickson, Jennifer Riddle Camp, Tracy E Cardillo, Taeko Ishii, Kevin L Winthrop
OBJECTIVE: Baricitinib is an oral, once-daily selective Janus kinase (JAK1/JAK2) inhibitor for adults with moderately to severely active rheumatoid arthritis (RA). We evaluated baricitinib's safety profile through 288 weeks (up to September 1, 2016) with an integrated database [8 phase III/II/Ib trials, 1 longterm extension (LTE)]. METHODS: The "all-bari-RA" group included patients who received any baricitinib dose. Placebo comparison was based on the 6 studies with 4 mg and placebo up to Week 24 ("placebo-4 mg" dataset)...
September 15, 2018: Journal of Rheumatology
Gregory A Magee, Matthew G Bartley, Anastasia Plotkin, Jeniann A Yi, Natalia O Glebova
Perforation of inferior vena cava (IVC) filter struts is a common incidental finding on postoperative computed tomography (CT) scans that is not associated with bleeding or major complications. However, in rare circumstances it can be associated with hemorrhage requiring immediate removal. We present a case of a 62-year-old man who developed abdominal pain and right lower extremity weakness two weeks after treatment of a pulmonary embolism with IVC filter placement and anticoagulation. A CT scan revealed a large right-sided retroperitoneal hematoma with active extravasation from the IVC filter struts that had perforated the IVC wall...
September 12, 2018: Annals of Vascular Surgery
Alina Wilkowska, Hanna Kujawska-Danecka, Adam Hajduk
Venous thromboembolism (VTE) is a frequent dangerous complication occurring during hospital treatment with total annual incidence of 70-200 per 100,000 citizens. Venous thromboembolism includes deep vein thrombosis (DVT) and pulmonary embolism (PE). Pulmonary embolism is responsible for about 10% of hospitalization-related deaths and is the most common avoidable reason for deaths in hospitals. Psychiatric inpatients are particularly vulnerable to an increased risk of VTE due to their limited mobility, the use of restraints, catatonia, communication difficulties, and the use of antipsychotics...
June 30, 2018: Psychiatria Polska
Rie Kure, Natsumi Uehara, Kazuaki Inoue, Tomomi Kogiso, Kazuhisa Kodama, Makiko Taniai, Katsutoshi Tokushige, Masayuki Nakano, Hiroto Egawa, Masakazu Yamamoto
Here, we describe a 42-year-old male patient with late-onset hepatic failure (LOHF) due to acute-onset autoimmune hepatitis. At first, his response to steroid therapy was good, but hepatitis relapsed during steroid pulse therapy. Deterioration of liver function caused LOHF, and LOHF has a poor prognosis, particularly when it is complicated by infection. Systemic infection by Staphylococcus aureus resulted in a skin rash and septic pulmonary embolism, and is an absolute contraindication for liver transplantation (LT)...
September 14, 2018: Clinical Journal of Gastroenterology
Sonja Kroep, Ling-Hsiang Chuang, Alexander Cohen, Pearl Gumbs, Ben van Hout, Manuel Monreal, Stefan N Willich, Anselm Gitt, Rupert Bauersachs, Giancarlo Agnelli
Venous thromboembolism (VTE) is often accompanied by co-morbidities, which complicate and confound data interpretation concerning VTE-related mortality, costs and quality of life. We aimed to assess the contribution of co-morbidities to the burden of VTE. The PREFER in VTE registry, across seven European countries, documented and followed acute VTE patients over 12 months. Patients with co-morbidities were grouped in major co-morbidity groups: cancer, cardiovascular (CV) comorbidity (other than VTE), CV risks, venous, renal, liver, respiratory, bone and joint diseases, and lower extremity paralysis...
September 14, 2018: Journal of Thrombosis and Thrombolysis
Mroawan Amoury, Frank Noack, Kathleen Kleeberg, Dietrich Stoevesandt, Burghart Lehnigk, Steffi Bethge, Viktoria Heinze, Axel Schlitt
Introduction: Pulmonary embolism (PE) is a life-threatening disease; in Germany, therefore, rehabilitation after PE is recommended in patients with intermediate- and high-risk PE. However, no prospective data on PE after inpatient rehabilitation have been published so far. Patients and methods: For this monocentric study, 70 patients with PE were prospectively recruited between November 2013 and November 2014 after giving written informed consent. This study was approved by the ethics committee of the Medical Association of Saxony-Anhalt...
2018: Vascular Health and Risk Management
Marek Roik, Dominik Wretowski, Michał Machowski, Michał Ciurzyński, Marcin Krakowian, Piotr Pruszczyk
No abstract text is available yet for this article.
2018: Kardiologia Polska
Philips G Michael, Georgios Antoniades, Anca Staicu, Shahid Seedat
A pulmonary glue embolism is an unusual but potentially life-threatening complication following the treatment of variceal bleeding, especially in patients with large varices requiring large volumes of sclerosant. Other contributory factors include the rate of injection and ratio of the constituent components of the sclerosant (i.e. n-butyl-cyanoacrylate and lipiodol). This condition may be associated with a delayed onset of respiratory compromise. Therefore, a high degree of clinical suspicion is essential in patients with unexplained cardiorespiratory decline during or following endoscopic sclerotherapy...
May 2018: Sultan Qaboos University Medical Journal
Yupeng Li, Yu Shang, Wenwen Wang, Shangwei Ning, Hong Chen
Pulmonary embolism (PE) is gradually considered to be the third most common disease in the vascular disease category. Lung cancer is the most frequently diagnosed cancer and the leading cause of cancer death among males worldwide. Although initially appearing as distinct entities, lung cancer is a great risk factor for the development of PE. Pulmonary embolism is common in lung cancer patients, with a pooled incidence of 3.7%, and unsuspected pulmonary embolism (UPE) is also non-negligible with a rough rate ranging from 29...
2018: Journal of Cancer
Stefan N Willich, Ling-Hsiang Chuang, Ben van Hout, Pearl Gumbs, David Jimenez, Sonja Kroep, Rupert Bauersachs, Manuel Monreal, Giancarlo Agnelli, Alexander Cohen
OBJECTIVES: Pulmonary embolism (PE) is associated with a substantial economic burden. However evidence from patients in Europe is scarce. The aim of this study was to report the impacts of PE on healthcare resource utilization (HCRU) and return to work using the PREFER in VTE registry. METHODS: The PREFER in VTE registry was a prospective, observational, multicenter study in seven European countries, aiming to provide data concerning treatment patterns, HCRU, mortality, quality of life and work-loss...
February 16, 2018: Thrombosis Research
David Graham, Qi Xuan Wu, Ian Gilligan, Raiz Ismail, Mark Walker
OBJECTIVE: Late life depression (LLD) may have a significant vascular component. While this organic basis remains controversial it would explain the refractory nature of LLD. Moreover, depression is a risk factor for venous thrombus embolism (VTE). This paper aims to describe two elderly patients with LLD who developed and were treated for pulmonary embolism (PE). METHODS: Two cases of elderly patients who developed PE while they were undergoing inpatient treatment for depression are presented...
September 10, 2018: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
Prakash Chand Negi, Kunal Mahajan, Vivek Rana, Sachin Sondhi, Nitin Mahajan, Sanjay Rathour, Ritesh Verma, Ashish Dhiman, Munish Dev, Shivani Rao, Sanjeev Asotra, Rajeev Bhardwaj, Neeraj Ganju, Arvind Kandoria, Rajeev Merwaha, Rajesh Sharma, Nirmal Kolte, Ravi Kumar V, Prince Kumar Paul, Davinder Pal Singh
BACKGROUND: Despite the high prevalence of rheumatic heart disease (RHD) in developing countries such as India, data on characteristics, complications, and treatment practices are lacking. The HP-RHD (Himachal Pradesh Rheumatic Heart Disease) registry aimed at reporting these parameters in patients with RHD from a northern state of India. METHODS: A total of 2,005 consecutive patients of RHD were enrolled over a period of 6 years (2011 to 2016) in the present study...
September 6, 2018: Global Heart
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