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Pulmonary Thromboembolism

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https://www.readbyqxmd.com/read/28106343/net-clinical-benefit-of-hospitalization-versus-outpatient-management-of-patients-with-acute-pulmonary-embolism
#1
P-M Roy, D J Corsi, M Carrier, A Theogene, C de Wit, C Dennie, G Le Gal, A Delluc, T Moumneh, M Rodger, P Wells, E Gandara
BACKGROUND: The decision to hospitalize or not patients with acute pulmonary embolism (PE) is controversial. Despite the advantages of close monitoring, hospitalization by itself may lead to in-hospital complications and potentially worsen the prognosis of PE patients. OBJECTIVES: To determine the net clinical benefit of hospitalization versus outpatient management of normotensive patients with acute pulmonary embolism (PE). METHODS: Retrospective cohort propensity score analysis (radius marching with replacement)...
January 20, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28106338/the-original-and-simplified-wells-rules-and-age-adjusted-d-dimer-testing-to-rule-out-pulmonary-embolism-an-individual-patient-data-meta-analysis
#2
Nick van Es, Noémie Kraaijpoel, Frederikus A Klok, Menno V Huisman, Paul L Den Exter, Inge C M Mos, Javier Galipienzo, Harry R Büller, Patrick M Bossuyt
BACKGROUND: The Wells score and D-dimer testing can safely rule out pulmonary embolism (PE). A simplification of the Wells score has been proposed to improve clinical applicability, but evidence on its performance is scarce. OBJECTIVES: To compare the performance of the original and simplified Wells scores alone and in combination with age-adjusted D-dimer testing. METHODS: Individual patient data from 7,268 patients with suspected PE enrolled in 6 management studies were used to evaluate the discriminatory performance of the original and simplified Wells scores...
January 20, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28100430/three-decades-later-the-fate-of-the-population-of-patients-who-underwent-the-atriopulmonary-fontan-procedure
#3
Chin Leng Poh, Diana Zannino, Robert G Weintraub, David S Winlaw, Leeanne E Grigg, Rachael Cordina, Tim Hornung, Andrew Bullock, Robert N Justo, Thomas L Gentles, Charlotte Verrall, Karin du Plessis, David S Celermajer, Yves d'Udekem
OBJECTIVE: To review our experience of patients with an atrio-pulmonary Fontan circulation to determine their long-term outcomes. METHODS AND RESULTS: A retrospective analysis of long-term follow-up data using the Australia and New Zealand Fontan Registry was performed. There were 215 patients surviving hospital discharge after an atrio-pulmonary Fontan completion. A total of 163 patients were alive at latest follow-up, with 52 deaths. Twelve patients had required heart transplantation and 95 had Fontan failure (death, transplantation, Fontan takedown, Fontan conversion, severe systemic ventricular dysfunction or NYHA≥3)...
January 7, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28100360/-end-tidal-pco-2-for-evaluation-of-severity-of-disease-in-idiopathic-pulmonary-arterial-hypertension-and-chronic-thromboembolic-pulmonary-hypertension
#4
X Shi, G L Yang, Y Chen, J Guo, W L Yang, P Yuan, S G Gong, R Jiang, Q H Zhao, L Wang, J He, T X Chen, J M Liu
Objective: To explore the difference in end tidal PCO(2) (P(ET)CO(2)) between idiopathic pulmonary arterial hypertension (IPAH) and chronic thromboembolic pulmonary hypertension (CTEPH), and to analyze the correlation between P(ET)CO(2) and the indexes of disease severity in IPAH and CTEPH patients. Methods: Data were retrieved from 68 IPAH patients and 52 CTEPH patients who all had received right-heart catheterization, pulmonary function test and cardiopulmonary exercise testing at Shanghai Pulmonary Hospital from October 2011 to October 2014...
January 12, 2017: Chinese Journal of Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/28100152/rare-iatrogenic-cardiovascular-embolization-following-dialysis
#5
Arun Sharma, Sharmila Duraisamy, Priya Jagia, Gurpreet S Gulati
Intracardiac or intrapulmonary dislodgement of dialysis catheter or guidewire coating is extremely rare. When present, it can be potentially lethal as it may get complicated by arrhythmias, myocardial or pulmonary artery rupture, valvular perforation, pulmonary thromboembolism, infarction, and infective endocarditis. Percutaneous removal should be attempted as an initial measure and is usually effective in most of the cases. We report 2 such cases, where in first patient it was the hemodialysis catheter which broke, with a large part migrating into the heart, while in second patient, it was the hydrophilic coating of the guidewire that migrated into the pulmonary arteries...
January 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28099298/low-dose-aspirin-is-effective-chemoprophylaxis-against-clinically-important-venous-thromboembolism-following-total-joint-arthroplasty-a-preliminary-analysis
#6
Javad Parvizi, Ronald Huang, Camilo Restrepo, Antonia F Chen, Matthew S Austin, William J Hozack, Jess H Lonner
BACKGROUND: Aspirin is a safe and effective prophylaxis for the prevention of venous thromboembolism following total joint arthroplasty. The optimal dose of aspirin prophylaxis is unknown. Our hypothesis was that lower-dose aspirin is as effective as higher-dose aspirin for the prevention of venous thromboembolism and is associated with fewer gastrointestinal side effects. METHODS: In a prospective, crossover study, we analyzed 4,651 primary total joint arthroplasty cases performed from July 2013 to June 2015...
January 18, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28097761/shortened-hospital-length-of-stay-and-lower-costs-associated-with-rivaroxaban-in-patients-with-pulmonary-embolism-managed-as-observation-status
#7
Erin R Weeda, W Frank Peacock, Gregory J Fermann, Christopher W Baugh, Philip S Wells, Veronica Ashton, Concetta Crivera, Peter Wildgoose, Jeff R Schein, Craig I Coleman
BACKGROUND: Unlike rivaroxaban, treatment of patients with pulmonary embolism (PE) with warfarin requires parenteral bridging and coagulation monitoring that may prolong length-of-stay (LOS) and increase hospital costs. AIMS: The aim of this study was to compare LOS, hospital costs and readmissions in PE patients managed through observation stays treated with rivaroxaban or parenterally bridged warfarin. METHODS: Premier Hospital claims data from November 2012 to March 2015 were used to identify patients with a primary diagnosis code for PE managed through an observation stay and with ≥1 claim for a PE-related diagnostic test on day 0-2...
January 2017: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/28096918/perioperative-outcomes-following-radical-prostatectomy-for-patients-with-disseminated-cancer-an-analysis-of-the-national-surgical-quality-improvement-program-database
#8
Raj Satkunasivam, Christopher J D Wallis, James Byrne, Azik Hoffman, Douglas C Cheung, Girish S Kulkarni, Avery B Nathens, Robert K Nam
INTRODUCTION: We sought to determine whether patients undergoing radical prostatectomy (RP) in the context of disseminated cancer have higher 30-day complications. METHODS: We conducted a retrospective cohort study of the National Surgical Quality Improvement Program (NSQIP) database. Men undergoing RP (from January 1, 2005 to December 31, 2014) for prostate cancer were identified and stratified by presence (n=97) or absence (n=27 868) of disseminated cancer. The primary outcome was major complications (death, re-operation, cardiac or neurologic events) within 30 days of surgery...
November 2016: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
https://www.readbyqxmd.com/read/28093377/ten-year-experience-of-retrievable-inferior-vena-cava-filters-in-a-tertiary-referral-center
#9
George Tse, Trevor Cleveland, Stephen Goode
PURPOSE: A significant proportion of patients undergoing surgery have an increased incidence of acute pulmonary embolus (PE). We analyzed all patients who had a retrievable inferior vena cava (IVC) filter placed preoperatively for PE prophylaxis and investigated the long-term outcomes of the patients who did not have their filter removed. METHODS: Patients who underwent retrievable IVC filter insertion and attempted removal were identified from the radiology information systems database in a large tertiary referral university teaching hospital...
January 17, 2017: Diagnostic and Interventional Radiology: Official Journal of the Turkish Society of Radiology
https://www.readbyqxmd.com/read/28092248/-pulmonary-thromboembolism-recent-experience-of-4-years-at-a-cardiology-hospital
#10
Erick Ramírez-Arias, Martin Rosas-Peralta, Gabriela Borrayo-Sánchez, Luis Antonio Moreno-Ruiz, Jorge Guillermo Arenas-Fonseca, Víctor Manuel Arzola-Covarrubias, Luis Efrén Santos-Martínez, Efraín Arizmendi-Uribe
It comprised a series of cases over a period of 4 years, held at the Hospital of Cardiology of the Centro Médico Nacional Siglo XXI, IMSS. From 2008 to 2011, admitted to Emergency 184 patients with suspected pulmonary embolism, of which 41 were removed; of the 143 remaining cases, only 127 patients was diagnosed with PE. The other 16 patients had other diagnoses. In 86% of patients showed electrocardiographic pattern S1Q3T3 and 39% had RBBB, in 17 (13.3%) patients there was hemodynamic instability, and in 94...
January 2017: Revista Médica del Instituto Mexicano del Seguro Social
https://www.readbyqxmd.com/read/28090468/clinical-features-and-extraintestinal-manifestations-of-crohn-disease-in-children
#11
Young Ah Lee, Peter Chun, Eun Ha Hwang, Sang Wook Mun, Yeoun Joo Lee, Jae Hong Park
PURPOSE: The aim of this study was to investigate the clinical features and extraintestinal manifestations (EIMs) of Crohn disease (CD) in Korean pediatric patients. METHODS: The medical records of 73 children diagnosed with CD were retrospectively reviewed. Data regarding baseline demographic and clinical characteristics, including CD phenotype at diagnosis based on the Montreal classification, and clinical features and course of EIMs were investigated. RESULTS: Fifty-two (71...
December 2016: Pediatric Gastroenterology, Hepatology & Nutrition
https://www.readbyqxmd.com/read/28090289/an-international-physician-survey-of-chronic-thromboembolic-pulmonary-hypertension-management
#12
Henning Gall, Ioana R Preston, Barbara Hinzmann, Sabina Heinz, David Jenkins, Nick H Kim, Irene Lang
We conducted an international study to evaluate practices in the diagnosis and management of patients with chronic thromboembolic pulmonary hypertension (CTEPH) globally across different regions. Between August and October 2012, CTEPH-treating physicians completed a 15-minute online questionnaire and provided patient record data for their 2-5 most recent patients with CTEPH. Overall, 496 physicians (Europe: 260; United States: 152; Argentina: 52; Japan: 32) completed the questionnaire and provided patient record data for 1,748 patients...
December 2016: Pulmonary Circulation
https://www.readbyqxmd.com/read/28089655/statins-and-primary-prevention-of-venous-thromboembolism-a-systematic-review-and-meta-analysis
#13
Setor K Kunutsor, Samuel Seidu, Kamlesh Khunti
BACKGROUND: Statins have been suggested to have a protective effect on venous thromboembolism (which includes deep vein thrombosis and pulmonary embolism), but the evidence is uncertain. We sought to evaluate the extent to which statins are associated with first venous thromboembolism events. METHODS: We did a systematic review and meta-analysis of observational cohort studies and randomised controlled trials (RCTs). Relevant studies that reported associations between statins and first venous thromboembolism outcomes were identified from MEDLINE, Embase, Web of Science, Cochrane Library, and a manual search of bibliographies for studies published up until July 18, 2016, and from email correspondence with investigators...
January 12, 2017: Lancet Haematology
https://www.readbyqxmd.com/read/28088580/grand-round-anticoagulation-in-chronic-liver-disease
#14
REVIEW
Ameet Dhar, Benjamin H Mullish, Mark R Thursz
In this Grand Round, we first present a case of a man with decompensated liver disease who subsequently developed a fatal pulmonary embolism, having not been prescribed prophylactic anticoagulation to prevent venous thromboembolic disease. We go on to discuss the burden of thrombotic disease in those with chronic liver disease, before a more detailed discussion regarding the current evidence, safety data, and clinical dilemmas regarding the use of anticoagulation in patients with chronic liver disease, as well as discussing potential future directions within this field...
January 11, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28079244/preoperative-multidisciplinary-program-for-bariatric-surgery-a-proposal-for-the-brazilian-public-health-system
#15
Elinton Adami Chaim, José Carlos Pareja, Martinho Antonio Gestic, Murillo Pimentel Utrini, Everton Cazzo
BACKGROUND: - Bariatric surgery has become the gold standard treatment for morbid obesity, but access to surgery remains difficult and low compliance to postoperative follow-up is common. To improve outcomes, enable access and optimize follow-up, we developed a multidisciplinary preoperative approach for bariatric surgery. OBJECTIVE: - To determine the impact of this program in the outcomes of bariatric surgery in the Brazilian public health system. METHODS: - A prospective evaluation of the individuals who underwent a preoperative multidisciplinary program for bariatric surgery and comparison of their surgical outcomes with those observed in the prospectively collected historical database of the individuals who underwent surgery before the beginning of the program...
January 2017: Arquivos de Gastroenterologia
https://www.readbyqxmd.com/read/28078350/efficacy-and-safety-of-extended-thromboprophylaxis-for-medically-ill-patients-a-meta-analysis-of-randomised-controlled-trials
#16
Francesco Dentali, Nicola Mumoli, Domenico Prisco, Andrea Fontanella, Matteo Nicola Dario Di Minno
Compelling evidence suggests that the risk of pulmonary embolism (PE) and deep-vein thrombosis (DVT) persists after hospital discharge in acutely-ill medical patients. However, no studies consistently supported the routine use of extended-duration thromboprophylaxis (ET) in this setting. We performed a meta-analysis to assess efficacy and safety of ET in acutely-ill medical patients. Efficacy outcome was defined by the prevention of symptomatic DVT, PE, venous thromboembolism (VTE) and VTE-related mortality...
January 12, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28077893/the-prediction-of-the-risk-level-of-pulmonary-embolism-and-deep-vein-thrombosis-through-artificial-neural-network
#17
Laleh Agharezaei, Zhila Agharezaei, Ali Nemati, Kambiz Bahaadinbeigy, Farshid Keynia, Mohammad Reza Baneshi, Abedin Iranpour, Moslem Agharezaei
BACKGROUND: Venous thromboembolism is a common cause of mortality among hospitalized patients and yet it is preventable through detecting the precipitating factors and a prompt diagnosis by specialists. The present study has been carried out in order to assist specialists in the diagnosis and prediction of the risk level of pulmonary embolism in patients, by means of artificial neural network. METHOD: A number of 31 risk factors have been used in this study in order to evaluate the conditions of 294 patients hospitalized in 3 educational hospitals affiliated with Kerman University of Medical Sciences...
October 2016: Acta Informatica Medica: AIM
https://www.readbyqxmd.com/read/28075625/unenhanced-and-contrast-enhanced-mr-angiography-and-perfusion-imaging-for-suspected-pulmonary-thromboembolism
#18
Yoshiharu Ohno, Takeshi Yoshikawa, Yuji Kishida, Shinichiro Seki, Nevzat Karabulut
OBJECTIVE: This article discusses the basics of unenhanced MR angiography (MRA) and MR venography (MRV), time-resolved contrast-enhanced (CE) MRA and dynamic first-pass CE perfusion MRI, and unenhanced and CE MRV, in addition to assessing the clinical relevance of these techniques for evaluating patients with suspected pulmonary thromboembolism and deep venous thrombosis. CONCLUSION: Since the 1990s, the efficacy of MRA or MRV and dynamic perfusion MRI for patients with suspected pulmonary thromboembolism and deep venous thrombosis has been evaluated...
January 11, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28073030/to-screen-or-not-to-screen-for-chronic-thromboembolic-pulmonary-hypertension-after-acute-pulmonary-embolism
#19
REVIEW
Yvonne M Ende-Verhaar, Menno V Huisman, Frederikus A Klok
Chronic thromboembolic pulmonary hypertension (CTEPH) is the most severe long term complication of acute pulmonary embolism (PE). Untreated, CTEPH is associated with a very poor prognosis and high risk of mortality, although curation can be achieved by surgical removal of the obstructive endothelialised thromboemboli from the pulmonary arteries. Early CTEPH diagnosis may improve surgical possibilities and patients outcome. Currently, early diagnosis of CTEPH is a major challenge as demonstrated by an unacceptable median diagnostic delay of over a year and as a result, surgery is impossible in 40% of patients...
January 5, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28067012/venous-thromboembolism-in-pediatric-trauma-patients-ten-year-experience-and-long-term-follow-up-in-a-tertiary-care-center
#20
Christine M Leeper, Madhav Vissa, James D Cooper, Lynn M Malec, Barbara A Gaines
BACKGROUND: Pediatric trauma patients are at high risk for development of venous thromboembolism (VTE). Our objective is to describe incidence, risk factors, and timing of development of VTE, anticoagulation complications, and long-term VTE outcomes in a critically injured pediatric population. PROCEDURE: We did a retrospective review of pediatric (0-17 years) trauma admissions to intensive care unit from 2005 to 2014. Our center employs VTE screening and prevention protocols for high-risk patients based on hypercoagulable history, age, injuries, and medical interventions...
January 9, 2017: Pediatric Blood & Cancer
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