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Pulmonary emboli

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https://www.readbyqxmd.com/read/29436450/lesson-of-the-month-2-pulmonary-embolism-in-a-patient-on-rivaroxaban-and-concurrent-carbamazepine
#1
Thomas Burden, Charlotte Thompson, Efstathios Bonanos, Andrew Rl Medford
A 71-year-old female with a history of pulmonary embolism treated with rivaroxaban presented with acute onset shortness of breath, chest pain and palpitations. Computed tomographic pulmonary angiography (CTPA) revealed multiple bilateral pulmonary emboli. The patient was concurrently prescribed carbamazepine and was later diagnosed with recurrence of breast cancer during the admission. We discuss common drug interactions pertinent to direct oral anticoagulants (DOACs) that can increase the risk of further venous thromboembolism...
February 2018: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/29436070/microsatellite-instability-high-endocervical-serous-carcinoma-manifesting-as-pulmonary-thromboembolism-a-case-report-and-review-of-the-literature
#2
Shiori Tsuge, Chikara Ueyama, Kazuko Watanabe, Hiromi Nakamura, Akihiro Takeda
A 53-year-old obese woman was referred because of sudden onset of dyspnea and chronic vaginal bleeding. In addition to severe anemia, multiple pulmonary emboli were identified. Pelvic imaging showed an irregular-shaped mass in the region of the endocervix extending to the lower uterine segment. After successful anticoagulant therapy, followed by placement of an inferior vena cava filter, transabdominal hysterectomy and bilateral salpingo-oophorectomy were performed. An immunopathological study resulted in the diagnosis of endocervical serous carcinoma...
February 13, 2018: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/29435465/missed-massive-pulmonary-embolism-and-the-hidden-threat-of-a-distal-deep-vein-thrombosis
#3
Cynthia Wong
A 47-year-old woman presented to her GP (general practitioner) surgery with a left leg pain of 4 days duration after a recent 4-hour flight. She was taking the oral combined contraceptive pill and had no past medical history. She had a low predictive Wells score for deep vein thrombosis, but her D-dimer was positive, so she had a proximal lower limb vein ultrasound scan as per the National Institute for Clinical Excellence guidelines, which was negative. Two days later, she presented to the emergency department with a collapse and dyspnea...
January 2018: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/29429212/-the-sources-of-emboli-in-patients-with-pulmonary-embolism-diagnosed-by-autopsy
#4
H Yang, X M Xu, B M Fang
Objective: To study the sources of emboli in patients with pulmonary embolism diagnosed by autopsy, and therefore to provide help in the diagnosis and treatment of thromboembolism. Methods: We retrospectively analyzed the pathology and clinical data of 43 patients with pulmonary embolism diagnosed by autopsy from 1962 to 2012 in Beijing Hospital. Results: In patients with pulmonary embolism diagnosed by autopsy, 32.6% of the emboli came from deep veins of the lower extremities, 9.3% from the renal vein, 9.3% from the prostate sinus, 7...
February 12, 2018: Chinese Journal of Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/29416165/distal-medullary-canal-decompression-in-long-stem-hip-replacement-in-long-bone-metastasis-does-it-reduce-cardiopulmonary-complications
#5
Vivek Ajit Singh, Siamak Sarrafan, Ramesh Singh Veriah
Background: The femur is the most common long bone affected by metastatic bone disease, with 25% involving the proximal third of the femur. Long stem cemented hip replacement (LHR) is an important option for cases of impending fracture. Pulmonary embolism is a critical complication that can occur. This study evaluates the effectiveness of distal femoral canal decompression in reducing the risk of cardiopulmonary events. Materials and Methods: Thirty two patients with metastatic bone disease of the proximal femur undergoing LHR were recruited and randomized...
January 2018: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/29411299/a-rare-calr-variant-mutation-and-a-review-of-calr-in-essential-thrombocythemia
#6
Robert Diep, Ara Metjian
Essential thrombocythemia (ET) is an indolent myeloproliferative neoplasm characterized by megakaryocyte hyperplasia, thrombocytosis, thrombotic and hemorrhagic complications, and potential transformation into myelofibrosis and acute myeloid leukemia. The vast majority of cases are driven by a somatic mutation in JAK2, CALR, or MPL. CALR, a gene that codes for the calcium-binding chaperone calreticulin, is the predominant mutation in patients with non-mutated JAK2 essential thrombocythemia, accounting for 20-25% of the overall somatic mutation frequency in ET...
February 6, 2018: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29404367/paradoxical-emboli-following-a-pulmonary-embolus-in-the-presence-of-a-patent-foramen-ovale
#7
Khalid Najib, Mark Heckle, Sameh Goubran, Rhadika Mehta, Rohan Goswami, Rami N Khouzam
A paradoxical embolism is defined as a systemic arterial embolus due to passage of a venous thrombus through a right to left shunt. We describe a case of acute cerebral vascular accident (CVA), right subclavian arterial embolus, and pulmonary emboli in the setting of a large patent foramen ovale (PFO). A 74-year-old woman with multiple comorbidities presented to the emergency department with acute onset of shortness of breath, weakness, and right arm pain. She was found to have bilateral pulmonary emboli, left CVA, and a right subclavian arterial embolus on computed tomography (CT)...
January 2018: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29398969/bronchopulmonary-sequestration-as-a-cause-of-mismatched-perfusion-defect-on-single-photon-emission-computed-tomography-ventilation-perfusion-scan
#8
Michael A S Kreltszheim, Nick I Brown, Joseph C Lee
We present a 46-year-old female with pleuritic chest pain on a background of pulmonary embolism diagnosed on a single-photon emission computed tomography (SPECT) ventilation-perfusion (V/Q) imaging 3 years earlier. A SPECT V/Q scan detected a mismatched perfusion defect in the posterior basal segment of the right lower lobe, essentially unchanged from a defect identified 3 years earlier. Given the atypical finding, the patient went on to have a computed tomographic pulmonary angiogram. It revealed an intralobar bronchopulmonary sequestration as the cause of the right lower lobe mismatched perfusion defect...
January 2018: World Journal of Nuclear Medicine
https://www.readbyqxmd.com/read/29394242/pulmonary-arterial-thrombosis-in-a-murine-model-of-blunt-thoracic-trauma
#9
Ian E Brown, Robert R Rigor, Linda M Schutzman, Nasim Khosravi, Karen Chung, James A Becker, Christopher D Pivetti, Gavin T Best, Jessica C Chavez, Joseph M Galante
Pulmonary thromboembolic events cause significant morbidity and mortality after severe trauma. Clinically, these lesions are believed to be emboli arising secondary to deep venous thrombosis (DVT) in the lower extremities. Recently this notion has been challenged by clinical studies showing that pulmonary clots arise after trauma in the absence of DVT. This suggests that pulmonary blood clots arise in situ via de novo thrombosis. In the present study we characterize a murine weight-drop model of lateral blunt thoracic trauma...
February 1, 2018: Shock
https://www.readbyqxmd.com/read/29359796/the-dipep-diagnosis-of-pe-in-pregnancy-biomarker-study-an-observational-cohort-study-augmented-with-additional-cases-to-determine-the-diagnostic-utility-of-biomarkers-for-suspected-venous-thromboembolism-during-pregnancy-and-puerperium
#10
Beverley J Hunt, Kiran Parmar, Kimberley Horspool, Neil Shephard, Catherine Nelson-Piercy, Steve Goodacre
This study aimed to estimate the diagnostic utility of biomarkers for suspected venous thromboembolism (VTE) in pregnancy and the puerperium. Research nurses/midwives collected blood samples from 310 pregnant/postpartum women with suspected pulmonary emboli (PE) and 18 with diagnosed deep vein thrombosis (DVT). VTE was diagnosed using imaging, treatment and adverse outcome data. Primary analysis was limited to women with conclusive imaging (36 with VTE, 247 without). The area under the curve (AUC) for each biomarker was: activated partial thromboplastin time 0·669 (95% confidence interval 0·570-0·768), B-type natriuretic peptide 0·549 (0·453-0·645), C-reactive protein 0·542 (0·445-0·639), Clauss fibrinogen 0·589 (0·476-0·701), D-Dimer (by enzyme-linked immunosorbent assay) 0·668 (0·561-0·776), near-patient D-Dimer 0·651 (0·545-0·758), mid-regional pro-atrial natriuretic peptide 0·524 (0·418-0·630), prothrombin fragment 1 + 2 0·562 (0·462-0·661), plasmin-antiplasmin complexes 0·639 (0·536-0·742), prothombin time 0·613 (0·508-0·718), thrombin generation lag time 0·702 (0·598-0·806), thrombin generation endogenous potential 0·559 (0·437-0·681), thrombin generation peak 0·596 (0·478-0·715), thrombin generation time to peak 0·655 (0·541-0·769), soluble tissue factor 0·531 (0·424-0·638) and serum troponin 0·597 (0·499-0·695)...
January 23, 2018: British Journal of Haematology
https://www.readbyqxmd.com/read/29331855/retrievable-inferior-vena-cava-filters-in-pregnancy-risk-versus-benefit
#11
REVIEW
David A Crosby, Kevin Ryan, Niall McEniff, Patrick Dicker, Carmen Regan, Caoimhe Lynch, Bridgette Byrne
OBJECTIVE: Venous thromboembolism remains one of the leading causes of maternal mortality in the developed world. Retrievable inferior vena cava (IVC) filters have a role in the prevention of lethal pulmonary emboli when anticoagulation is contraindicated or has failed [1]. It is unclear whether or not the physiological changes in pregnancy influence efficacy and complications of these devices. The decision to place an IVC filter in pregnancy is complex and there is limited information in terms of benefit and risk to the mother...
December 21, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/29323823/atrioesophageal-fistula-a-rare-complication-of-radiofrequency-ablation
#12
Inbar Saporta, Adithya Chennamadhavuni, Michael J Dolan
75-year-old woman was admitted with fever, chills, altered mentation, and right-sided weakness. A month earlier, she had undergone catheter radiofrequency ablation for treatment of chronic atrial fibrillation. A magnetic resonance imaging scan of her brain revealed septic emboli with multiple bilateral cerebral and cerebellar infarcts, as well as extensive bilateral leptomeningeal enhancement. Blood cultures were positive for Streptococcus mitis, Rothia mucilaginosa, Streptococcus pneumonia, and Candida albicans, which suggested a connection between gastrointestinal and cardiovascular systems...
June 2017: WMJ: Official Publication of the State Medical Society of Wisconsin
https://www.readbyqxmd.com/read/29308711/express-pulmonary-micro-tumor-emboli-resulting-in-paradoxical-emboli-a-case-report
#13
Louis-Vincent Morin-Thibault, Daniel Wiseman, Michelle Fortin, Christian Couture, Steeve Provencher
No abstract text is available yet for this article.
January 1, 2018: Pulmonary Circulation
https://www.readbyqxmd.com/read/29306522/visceral-thromboses-in-pancreas-adenocarcinoma-systematic-review
#14
REVIEW
Angel Mier Hicks, Antonio DeRosa, Michael Raj, Richard Do, Kenneth H Yu, Maeve A Lowery, Anna Varghese, Eileen M O'Reilly
Within gastrointestinal malignancies, primary hepatocellular carcinoma and pancreatic ductal adenocarcinoma (PDAC) are frequently associated with visceral thromboses (VT). Thrombus formation in the portal (PVT), mesenteric (MVT), or splenic vein (SVT) system leads to portal hypertension and intestinal ischemia. VT in PDAC may convey a risk of increased distal thrombosis and poses therapeutic uncertainty regarding the role of anticoagulation. An increasing number of reports describe VT associated with PDAC. It is possible that early diagnosis of these events may help reduce morbidity and speculatively improve oncologic outcomes...
December 12, 2017: Clinical Colorectal Cancer
https://www.readbyqxmd.com/read/29298459/embolisation-for-pulmonary-arteriovenous-malformation
#15
REVIEW
Charlie C-T Hsu, Gigi Nc Kwan, Hannah Evans-Barns, Mieke L van Driel
BACKGROUND: Pulmonary arteriovenous malformations are abnormal direct connections between the pulmonary artery and pulmonary vein which result in a right-to-left shunt. They are associated with substantial morbidity and mortality mainly from the effects of paradoxical emboli. Potential complications include stroke, cerebral abscess, pulmonary haemorrhage and hypoxaemia. Embolisation is an endovascular intervention based on the occlusion of the feeding arteries the pulmonary arteriovenous malformations thus eliminating the abnormal right-to-left-shunting...
January 4, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29290408/pulmonary-emboli-and-deep-venous-thrombosis-during-adolescence
#16
Celeste Schultz, Rebecca Doran
Pulmonary emboli (PE) and deep venous thrombus (DVT) are two conditions considered to affect primarily adults. These conditions, however, can and do affect neonates, toddlers, school-age children, and adolescents. Factors contributing to the development of PE and DVT are often associated with genetic mutations in Antithrombin III, Protein C, and Protein S. This article presents a primary care case study of an adolescent who was diagnosed with and underwent treatment for bilateral PE and a DVT, and reviews the underlying primary genetic mutations, diagnostic workup, and management of his clinical condition...
December 28, 2017: Journal of Pediatric Health Care
https://www.readbyqxmd.com/read/29276710/use-of-tachycardia-in-patients-with-submassive-pulmonary-emboli-to-risk-stratify-for-early-initiation-of-thrombolytic-therapy-a-case-series-comparing-early-versus-late-thrombolytic-initiation
#17
Jordana Cheta, Ashleigh Long, Paul Marik
Pulmonary embolism (PE) represents a prevalent cause of morbidity and mortality in the United States, with approximately 600 000 cases diagnosed annually. The mortality rate for untreated PE is as high as 30%. Right ventricular (RV) dysfunction is a sign of possible adverse outcomes with right-sided heart failure being the usual cause of death from PE. There is a spectrum of clinical presentations associated with PE diagnoses, from incidental and asymptomatic to rapid hemodynamic collapse. Despite successes in identifying patients with "high-risk" PEs for aggressive thrombolytic interventions and "low-risk" PEs for outpatient anticoagulation, a significant lack of consensus exists regarding intervention modalities for PEs identified as "intermediate risk" or "submassive," defined as normotensive (systolic blood pressure ≥90 mm Hg) with acute RV dysfunction and myocardial injury...
October 2017: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/29248335/outpatient-management-of-emergency-department-patients-with-acute-pulmonary-embolism-variation-patient-characteristics-and%C3%A2-outcomes
#18
David R Vinson, Dustin W Ballard, Jie Huang, Mary E Reed, James S Lin, Mamata V Kene, Dana R Sax, Adina S Rauchwerger, David H Wang, D Ian McLachlan, Tamara S Pleshakov, Matthew A Silver, Victoria A Clague, Andrew S Klonecke, Dustin G Mark
STUDY OBJECTIVE: Outpatient management of emergency department (ED) patients with acute pulmonary embolism is uncommon. We seek to evaluate the facility-level variation of outpatient pulmonary embolism management and to describe patient characteristics and outcomes associated with home discharge. METHODS: The Management of Acute Pulmonary Embolism (MAPLE) study is a retrospective cohort study of patients with acute pulmonary embolism undertaken in 21 community EDs from January 2013 to April 2015...
December 13, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29247032/thromboembolic-risks-of-the-procedural-process-in-second-generation-cryoballoon-ablation-procedures-analysis-from-real-time-transcranial-doppler-monitoring
#19
Shinsuke Miyazaki, Tomonori Watanabe, Takatsugu Kajiyama, Jin Iwasawa, Sadamitsu Ichijo, Hiroaki Nakamura, Hiroshi Taniguchi, Kenzo Hirao, Yoshito Iesaka
BACKGROUND: Atrial fibrillation ablation is associated with substantial risks of silent cerebral events (SCEs) or silent cerebral lesions. We investigated which procedural processes during cryoballoon procedures carried a risk. METHODS AND RESULTS: Forty paroxysmal atrial fibrillation patients underwent pulmonary vein isolation using second-generation cryoballoons with single 28-mm balloon 3-minute freeze techniques. Microembolic signals (MESs) were monitored by transcranial Doppler throughout all procedures...
December 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/29237673/mycotic-pulmonary-artery-aneurysm-secondary-to-septic-emboli
#20
Kellen A Knowles, Matthew Alvin, Emily Dunn
No abstract text is available yet for this article.
December 13, 2017: BMJ Case Reports
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