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Pulmonary Thromboembolism

Sarasa Isobe, Masaharu Kataoka, Takashi Kawakami, Keiichi Fukuda
BACKGROUND: The correlation between serum adiponectin concentration and hemodynamics or certain metabolic markers in patients with chronic thromboembolic pulmonary hypertension (CTEPH) is unknown.Methods and Results:We enrolled 30 CTEPH patients who underwent interventional therapy of balloon pulmonary angioplasty or pulmonary endarterectomy. Serum adiponectin concentrations positively correlated with B-type natriuretic peptide (BNP) concentrations, pulmonary vascular resistance, and mean pulmonary arterial pressure...
March 21, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
Nicolas Coquoz, Daniel Weilenmann, Daiana Stolz, Vladimir Popov, Andrea Azzola, Jean-Marc Fellrath, Hans Stricker, Alberto Pagnamenta, Sebastian Ott, Silvia Ulrich, Sandor Györik, Jérôme Pasquier, John-David Aubert
Chronic thromboembolic pulmonary hypertension (CTEPH) is a severe complication of pulmonary embolism (PE). Its incidence following PE is debated. An active screening for CTEPH in patients with acute PE is yet to be recommended.This prospective, multicentre, observational study (INPUT on PE; ISRCTN61417303) included patients with acute PE from 11 centres in Switzerland from March 2009 to November 2016. Screening for possible CTEPH was performed at 6, 12 and 24 months using a step-wise algorithm that included a dyspnoea phone-based survey, transthoracic echocardiography, right heart catheterisation and radiologic confirmation of CTEPH...
March 21, 2018: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
C F Song, H Li, B Tian, S Chen, J B Miao, Y L Fu, B You, Q R Chen, T Li, X X Hu, W Q Zhang, B Hu
Objective: To evaluate the incidence of postoperative venous thromboembolism (VTE) after thoracic surgery and its characteristic. Methods: This was a single-center, prospective cohort study. Patients undergoing major thoracic surgeries between July 2016 and March 2017 at Department of Thoracic Surgery, Beijing Chaoyang Hospital Affiliated to Capital Medical University were enrolled in this study. Besides the routine examination, all patients were screened for deep venous thrombosis (DVT) by using noninvasive duplex lower-extremity ultrasonography after surgery...
April 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
John O DeLancey, Eddie Blay, D Brock Hewitt, Kathryn Engelhardt, Karl Y Bilimoria, Jane L Holl, David D Odell, Anthony D Yang, Jonah J Stulberg
BACKGROUND: Adverse postoperative outcomes related to smoking are well established, yet current smokers continue to be offered elective surgery in the US. It is unknown whether patients undergoing low-risk, elective procedures, who actively smoke experience increased risk of complications. We sought to determine the increased burden of complications following elective hernia repair procedures in patients identified as current smokers. METHODS: We identified patients undergoing elective incisional, inguinal, umbilical, or ventral hernia repair from 2011 to 2014 using the American College of Surgeons National Surgical Quality Improvement Project (ACS NSQIP) database...
March 6, 2018: American Journal of Surgery
Jia-Xuan Xu, Jun Dong, Hong Ren, Xiao-Jie Chen, Yong Yang, Ren-Xiong Chen, Guo-Dong Wang, Hong-Zhi Wang
PURPOSE: The occurrence of venous thromboembolism (VTE) in Chinese cancer patients admitted to intensive care unit (ICU) for postoperative care is poorly characterized. This study was designed to investigate the incidence of VTE in this polulation and to evaluate the utility of the Caprini score in risk stratification. METHODS: We conducted a retrospective cohort study of 2127 consecutive adult patients admitted to a 10-bed surgical ICU in a tertiary care academic hospital during a 4-year period (January 1,2013 to December 31,2016)...
January 2018: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
Chunmeng Chen, Chong Jiang, Lin Li
Retroperitoneal pleomorphic liposarcoma (RPLS) is the least common but the most aggressive subtype of liposarcoma. We herein report a case of tumor embolism (TE) to the inferior vena cava (IVC) and pulmonary arteries in a 54 years old woman with RPLS. The case suggests that fusion fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (18 F-FDG PET/CT) can accurately detect occult TE. It also illustrates the usefulness of computed tomography (CT) and high18 F-FDG uptake by PET/CT imaging for diagnosing such findings as filling defect in the veins and beaded pulmonary arteries as TE...
March 20, 2018: Hellenic Journal of Nuclear Medicine
Benedetta Vanini, Valentina Grazioli, Antonio Sciortino, Maurizio Pin, Vera N Merli, Anna Celentano, Ilaria Parisi, Catherine Klersy, Lucia Petrucci, Maurizio Salati, Pierluigi Politi, Andrea M D'Armini
BACKGROUND: In this prospective, single-center, observational study, we investigated the association between repeated short periods of circulatory arrest with moderate hypothermia during pulmonary endarterectomy (PEA) in patients with chronic thromboembolic pulmonary hypertension (CTEPH) and different neuropsychological dimensions. METHODS: We examined 70 patients with CTEPH, >18 to 80 years of age, who had been treated with PEA. Neuropsychological testing was performed...
February 19, 2018: Journal of Heart and Lung Transplantation
Gang Zheng, Qian Tang, Ping Shang, Xiao-Yun Pan, Hai-Xiao Liu
Arthroscopic knee surgery is the most commonly performed orthopedic procedure worldwide and whether thromboprophylaxis should be undertaken after knee arthroscopy is still controversial. To evaluate the efficacy of thromboprophylaxis for deep venous thrombosis (DVT) and venous thromboembolism (VTE) after knee arthroscopic surgery. A meta-analysis was conducted using data from eight randomized trials (4148 patients) to compare thromboprophylaxis with placebo or no prophylactic treatment in patients undergoing knee arthroscopy...
March 16, 2018: Journal of Thrombosis and Thrombolysis
Fernando A Angarita, Sergio A Acuna, Erin Cordeiro, Ahmad Elnahas, Subir Sutradhar, Timothy Jackson, Tulin D Cil
PURPOSE: Postoperative complication rates for elderly women undergoing breast cancer surgery have not been well studied. We describe the postoperative complication rates of elderly (≥ 70 years) women with breast cancer and compare them with young (40-69 years) women. METHODS: Data were extracted from the National Surgical Quality Improvement Program database (2004-2014). We included women with invasive breast cancer who underwent surgery. Outcomes were 30-day postoperative morbidity and mortality (complications), which were compared between young and elderly women...
March 15, 2018: Breast Cancer Research and Treatment
Julio Sandoval
Despite advances in drug therapy, pulmonary hypertension-particularly arterial hypertension (PAH)-remains a fatal disease. Untreatable right heart failure (RHF) from PAH eventually ensues and remains a significant cause of death in these patients. Lowering pulmonary input impedance with different PAH-specific drugs is the obvious therapeutic target in RHF due to chronically increased afterload. However, potential clinical gain can also be expected from attempts to unload the right heart and increase systemic output...
March 12, 2018: Revista Española de Cardiología
Luke S Howard
Acute pulmonary embolism (PE) is a relatively common cardiopulmonary emergency that is a major cause of hospitalization and morbidity and is the primary cause of mortality associated with venous thromboembolism (VTE). During the last decade, one of the biggest changes in the management of PE has been the approval of four non-vitamin K antagonist oral anticoagulants (NOACs; apixaban, dabigatran, edoxaban and rivaroxaban) for the treatment of PE and deep vein thrombosis and secondary prevention of VTE. Areas covered: This article reviews the evolving management of PE in the NOAC era and addresses three fundamental questions: who should receive NOACs over conventional heparin/vitamin K antagonist regimens for the treatment of acute PE; whether patients should be treated as inpatients or outpatients; and how long patients should be treated to reduce the risk of recurrence? Expert commentary: The management of PE is changing...
March 15, 2018: Expert Review of Respiratory Medicine
Pei-Hsun Sung, Hsin-Ju Chiang, Yao-Hsu Yang, John Y Chiang, Chi-Jen Chen, Hon-Kan Yip, Mel S Lee
PURPOSE: Endothelial dysfunction is a risk factor for osteonecrosis of femoral head (ONFH) and venous thromboembolism (VTE) [defined as deep venous thrombosis (DVT) or pulmonary embolism (PE)]. However, the risk of unprovoked VTE in non-traumatic ONFH patients remains unclear. METHODS: We investigated the relationship between ONFH and VTE using Taiwan National Health Insurance Research Database (NHIRD). Between 1997 and 2010, a total of 1514 non-traumatic ONFH patients were identified from 1,000,000 general populations after excluding initially concomitant diagnoses of DVT and PE, and subjects undergoing lower limb surgery within one year since enrollment...
March 14, 2018: International Orthopaedics
Hideki Miwa, Nobuhiro Tanabe, Takayuki Jujo, Fumiaki Kato, Rie Anazawa, Keiko Yamamoto, Akira Naito, Hajime Kasai, Rintaro Nishimura, Rika Suda, Toshihiko Sugiura, Seiichiro Sakao, Keiichi Ishida, Masahisa Masuda, Koichiro Tatsumi
BACKGROUND: Several new treatments for chronic thromboembolic pulmonary hypertension (CTEPH) have appeared in recent years, which have led to changes in the treatment algorithm. Changes in survival rates and prognostic factors, however, have not been estimated so far.Methods and Results:Two hundred and eighty patients were diagnosed with CTEPH at Chiba University Hospital between June 1986 and June 2016. Survival rate was investigated by date of treatment initiation (group 1, 1986-1998; group 2, 1999-2008; group 3, 2009-2016)...
March 13, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
Jacob C Easaw, Susan McCall, Adrian Azim
Stable cancer patients diagnosed with a pulmonary embolus or deep vein thrombosis are commonly referred to the emergency department for management. This practice strains an already overburdened emergency department and is associated with long wait times and poor disease/injection education for patients. This pilot study sought to determine if stable cancer patients with newly diagnosed cancer-associated thrombosis could be effectively managed by community-based pharmacists who followed an evidence-based protocol to prescribe and initiate low-molecular weight heparin therapy...
January 1, 2018: Journal of Oncology Pharmacy Practice
Nitin Agarwal, Georgios A Zenonos, Prateek Agarwal, Frank J Walch, Eileen Roach, Sandra J Stokes, Robert M Friedlander, Peter C Gerszten
BACKGROUND: Pharmacological prophylaxis for venous thromboembolism (VTE) in the neurosurgical population is still a matter of debate, as the risk-to-benefit ratio is not well defined. OBJECTIVE: To further evaluate the risk-to-benefit ratio of VTE prophylaxis (VTEP) for all neurosurgical procedures. METHODS: A prospective evaluation was performed after the initiation of a VTEP protocol for 11 436 patients undergoing neurosurgical procedures over 24 mo...
March 9, 2018: Neurosurgery
Andre M Samuel, Pablo J Diaz-Collado, Raj J Gala, Matthew L Webb, Adam M Lukasiewicz, Bryce A Basques, Daniel D Bohl, Han Jo Kim, Jonathan N Grauer
STUDY DESIGN: Retrospective cohort study OBJECTIVE.: To determine the rate of venous thromboembolism event (VTE) and risk factors for their occurrence in patients with vertebral fractures. SUMMARY OF BACKGROUND DATA: Deep vein thrombosis or pulmonary embolism (VTE) events are a significant source of potentially preventable morbidity and mortality in trauma patients. In patients with traumatic vertebral fractures, a common high-energy injury sometimes resulting in spinal cord injury, there is debate about what factors may be associated with such VTEs...
March 13, 2018: Spine
Maria Anna Bazmpani, Georgios Arsos, Paul Zarogoulidis, Argyrios Doumas, Theodoros Dimitroulas, George Sianos, Stavros Hadjimiltiades, Konstantinos Kouskouras, Eckhard Mayer, Haralambos Karvounis, George Giannakoulas
No abstract text is available yet for this article.
January 1, 2018: Pulmonary Circulation
Cristiana Bulato, Elena Campello, Sabrina Gavasso, Sara Maggiolo, Daniela Tormene, Paolo Simioni
A 7-years-old child who developed unprovoked deep vein thrombosis (DVT) and pulmonary embolism (PE) was tested for inherited thrombophilia. Protein C (PC) antigen level (87 %) and PC coagulometric and amidolytic activities (12 % and 11 %, respectively) were consistent with a homozygous PC type IIA phenotype.The patient was carrier of two heterozygous missense mutations causing p.Arg32Cys substitution associated with a type I PC defect ("null allele", from the paternal side) and p.Gly433Ser substitution responsible for a type IIA PC defect (from the maternal side)...
February 2018: Hämostaseologie
Frederikus A Klok, Stefano Barco
In addition to among others major bleeding from anticoagulant therapy and recurrent venous thromboembolism (VTE), patients who survived acute pulmonary embolism (PE) face an increased risk of chronic functional limitations and decreased quality of life. In recent years, this latter complications have been better framed within the evolving definition of "post-PE syndrome" of which chronic thromboembolic pulmonary hypertension (CTEPH) represents the most extreme presentation. The post-PE syndrome in all its aspects is a frequent and clinically relevant long-term complication of PE but -except for CTEPH- has been largely understudied...
February 2018: Hämostaseologie
Kentaro Minami, Koji Kumagai, Yoshinao Sugai, Kohki Nakamura, Shigeto Naito, Shigeru Oshima
A 19-year-old man was referred due to sudden onset of right foot pain and chest discomfort. Contrast-enhanced computed tomography revealed massive thrombi in the right pulmonary artery and femoral vein. The patient's father had experienced multiple recurrences of venous thromboembolism (VTE) and was diagnosed with inherited antithrombin deficiency by a genetic examination. The patient was administered the oral factor Xa inhibitor rivaroxaban (30 mg). After seven days, the thrombus disappeared. Rivaroxaban (15 mg) was continued for 6 months with no recurrence, indicating the efficacy of this factor Xa inhibitor for the treatment and prevention of VTE in patients with antithrombin deficiency...
March 9, 2018: Internal Medicine
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