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https://www.readbyqxmd.com/read/28228310/comparison-of-pesi-echocardiogram-ctpa-and-nt-probnp-as-risk-stratification-tools-in-patients-with-acute-pulmonary-embolism
#1
A Vamsidhar, D Rajasekhar, V Vanajakshamma, A Y Lakshmi, K Latheef, C Siva Sankara, G Obul Reddy
OBJECTIVE: The aim of this study is to prospectively assess the diagnostic accuracy of pulmonary embolism severity index, echocardiogram, computed tomography pulmonary angiogram (CTPA), and N-terminal pro b-type natriuretic peptide (NT-proBNP) for predicting adverse events in acute pulmonary embolism patients. METHODS: Thirty consecutive acute pulmonary embolism patients were included in this study. Combined adverse events consisted of in-hospital death or use of escalation of care including cardiopulmonary resuscitation, mechanical ventilation, vasopressor therapy, or secondary thrombolysis during hospital stay...
January 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/28212259/robotic-rectal-resection-with-a-single-docking-technique-thanks-to-the-rotation-of-the-r3-arm
#2
Benedetta Pesi, Mario Annecchiarico, Stefano Amore Bonapasta, Alessandro Nerini, Federico Perna, Lapo Bencini, Michele Di Marino, Andrea Coratti
BACKGROUND: Robotic surgery for rectal resection presents some advantages compared with the traditional technique; however, it also presents some limitations, especially due to the multiple changes of surgical fields. We describe a new technique to perform low-anterior resection using single docking with the rotation of the third arm and our perioperative results. MATERIALS AND METHODS: A total of 31 patients who underwent low-anterior rectal robotic resection with single-docking technique using robotic daVinci SI (Surgical Intuitive System) were included in the study...
February 20, 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28187372/symptom-overreporting-and-dissociative-experiences-a-qualitative-review
#3
REVIEW
H Merckelbach, I Boskovic, D Pesy, M Dalsklev, S J Lynn
We discuss a phenomenon that has received little attention to date in research on dissociative phenomena, namely that self-reports of these phenomena overlap with the tendency to overendorse eccentric items. We review the literature documenting the dissociation-overreporting link and then briefly discuss various interpretations of this link: (1) overreporting is an artifact of measuring dissociative symptoms; (2) dissociative psychopathology engenders overreporting of eccentric symptoms through fantasy proneness or impairments in internal monitoring; (3) an overreporting response style as is evident in malingerers, for example, promotes reports of dissociative symptoms...
February 7, 2017: Consciousness and Cognition
https://www.readbyqxmd.com/read/28183418/clinical-characteristics-of-coexisting-pulmonary-thromboembolism-in-patients-with-respiratory-tuberculosis
#4
Hyeyoung Park, Seung-Ick Cha, Jae-Kwang Lim, Kyung Nyeo Jeon, Seung-Soo Yoo, Jaehee Lee, Shin-Yup Lee, Chang-Ho Kim, Jae-Yong Park
OBJECTIVES: Data regarding coexisting pulmonary thromboembolism (PTE) in patients with tuberculosis are limited. The aim of this study was to investigate the clinical features of coexisting PTE in patients with respiratory tuberculosis. METHODS: Clinical parameters were retrospectively compared between the tuberculosis group (PTE and coexisting respiratory tuberculosis) and unprovoked or provoked group selected from a single institution in South Korea, a country that has an intermediate tuberculosis burden...
February 2017: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/28149705/secondary-ion-mass-spectrometry-analysis-of-renal-cell-carcinoma-with-electrospray-droplet-ion-beams
#5
Satoshi Ninomiya, Kentaro Yoshimura, Lee Chuin Chen, Sen Takeda, Kenzo Hiraoka
Tissue samples from renal cell carcinoma patients were analyzed by electrospray droplet ion beam-induced secondary ion mass spectrometry (EDI/SIMS). Positively- and negatively-charged secondary ions were measured for the cancerous and noncancerous regions of the tissue samples. Although specific cancerous species could not be found in both the positive and negative secondary ion spectra, the spectra of the cancerous and noncancerous tissues presented different trends. For instance, in the m/z range of 500-800 of the positive secondary ion spectra for the cancerous tissues, the intensities for several m/z values were lower than those of the m/z+2 peaks (indicating one double bond loss for the species), whereas, for the noncancerous tissues, the inverse trend was obtained...
2017: Mass Spectrometry
https://www.readbyqxmd.com/read/28106343/net-clinical-benefit-of-hospitalization-versus-outpatient-management-of-patients-with-acute-pulmonary-embolism
#6
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/28099957/results-of-surgical-salvage-treatment-for-anal-canal-cancer-a-retrospective-analysis-with-overview-of-the-literature
#7
Benedetta Pesi, Stefano Scaringi, Carmela Di Martino, Giacomo Batignani, Francesco Giudici, Damiano Bisogni, Francesco Tonelli, Paolo Bechi
BACKGROUND AND AIM: Chemoradiotherapy (CRT) is the gold standard treatment for anal cancer, which permits the maintenance of the anal function. However, about 30-40% of patients develop local disease progression, for which surgery represents a good salvage therapy. The aim of this study is to evaluate survival and morbidity rate in patients who undergo salvage surgery in our single institution, with an overview of the literature. METHODS: A retrospective study was carried out on patients who underwent surgical treatment of anal canal cancer after failure of CRT...
January 19, 2017: Digestive Surgery
https://www.readbyqxmd.com/read/28066591/relationship-between-polycythemia-and-in-hospital-mortality-in-chronic-obstructive-pulmonary-disease-patients-with-low-risk-pulmonary-embolism
#8
Lu Guo, Aamer Rasheed Chughtai, Hongli Jiang, Lingyun Gao, Yan Yang, Yang Yang, Yuejian Liu, Zhenliang Xie, Weimin Li
BACKGROUNDS: Pulmonary embolism (PE) is frequent in subjects with chronic obstructive pulmonary disease (COPD) and associated with high mortality. This multi-center retrospective study was performed to investigate if secondary polycythemia is associated with in-hospital mortality in COPD patients with low-risk PE. METHODS: We identified COPD patients with proven PE between October, 2005 and October, 2015. Patients in risk classes III-V on the basis of the PESI score were excluded...
November 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28052963/symptoms-signs-suspicion-and-setting-a%C3%A2-pesi-score-for-cancer-associated-pulmonary-embolism
#9
EDITORIAL
Florian Posch, Cihan Ay
No abstract text is available yet for this article.
January 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28012721/the-clinical-severity-of-patients-diagnosed-with-an-in-hospital-pulmonary-embolism-following-modern-elective-joint-arthroplasty-is-unrelated-to-the-location-of-emboli-in-the-pulmonary-vasculature
#10
Alejandro Gonzalez Della Valle, Alvaro Blanes Perez, Yuo-Yu Lee, Gregory R Saboeiro, Gabrielle P Konin, Yoshimi Endo, Nigel E Sharrock, Eduardo A Salvati
BACKGROUND: In the event of a postoperative pulmonary embolism (PE), it is generally believed that patients with centrally located emboli will have worse clinical symptoms than those with segmental or subsegmental ones. We studied if a relationship exists between the clinical severity at the time of PE diagnosis and the location of the emboli within the pulmonary vasculature. METHODS: All 269 patients who developed an in-hospital, computed tomography pulmonary angiography-proved, in-hospital PE following elective total hip arthroplasty or total knee arthroplasty in our institution were studied...
November 25, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28007362/best-clinical-practice-controversies-in-outpatient-management-of-acute-pulmonary-embolism
#11
Brit Long, Alex Koyfman
BACKGROUND: Pulmonary embolism (PE) is a common condition managed in the emergency department (ED), with a wide range of morbidity and mortality. Patients are classically admitted for treatment and monitoring of anticoagulation. OBJECTIVE: We sought to evaluate the controversy concerning outpatient therapy for patients with acute PE and investigate the feasibility, safety, and efficacy of outpatient management. DISCUSSION: Patients with venous thromboembolism have historically been admitted for treatment and monitoring for concern of worsening disease or side effects of anticoagulation (bleeding)...
December 19, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27997739/is-oxygen-saturation-variable-of-simplified-pulmonary-embolism-severity-index-reliable-for-identification-of-patients-suitable-for-outpatient-treatment
#12
Serhat Erol, Aslıhan Gürün Kaya, Fatma Arslan Ciftçi, Aydın Çiledağ, Elif Şen, Akın Kaya, Gökhan Çelik, İsmail Savaş
INTRODUCTION: The pulmonary embolism severity index (PESI) or simplified version (sPESI) are widely validated risk scores for the identification of eligible patients for outpatient treatment. Saturation is one of these criteria. For this metric, saturation of 90% or greater is assigned zero points. However, 90% saturation does not always exclude hypoxemic respiratory failure. OBJECTIVE: The aims of this study were first was to define corresponding partial arterial oxygen pressure (PaO2 ) values according to saturation in pulmonary embolism (PE) patients, and the second was to define a target saturation that can exclude hypoxemic respiratory failure and enable secure discharge of PE patients from emergency departments...
December 20, 2016: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/27939428/perceived-exertion-is-as-effective-as-the-perceptual-strain-index-in-predicting-physiological-strain-when-wearing-personal-protective-clothing
#13
David N Borg, Joseph T Costello, Aaron J Bach, Ian B Stewart
OBJECTIVE: The perceptual strain index (PeSI) has been shown to overcome the limitations associated with the assessment of the physiological strain index (PSI), primarily the need to obtain a core body temperature measurement. The PeSI uses the subjective scales of thermal sensation and perceived exertion (RPE) to provide surrogate measures of core temperature and heart rate, respectively. Unfortunately, thermal sensation has shown large variability in providing an estimation of core body temperature...
February 1, 2017: Physiology & Behavior
https://www.readbyqxmd.com/read/27890156/physiological-and-perceptual-effects-of-a-cooling-garment-during-simulated-industrial-work-in-the-heat
#14
RANDOMIZED CONTROLLED TRIAL
Cory L Butts, Cody R Smith, Matthew S Ganio, Brendon P McDermott
OBJECTIVE: Evaluate physiological and perceptual responses using a phase change cooling (PCC) garment during simulated work in the heat. METHODS: Twenty males wearing compression undergarments, coverall suit, gloves, and hard-hat, completed two randomly assigned trials (with PCC inserts or control, CON) of simulated industrial tasks in the heat (34.2 ± 0.05 °C, 54.7 ± 0.3%RH). Trials consisted of two 20 min work bouts, a maximum performance bout, and 10 min of recovery...
March 2017: Applied Ergonomics
https://www.readbyqxmd.com/read/27791486/perception-or-reality-can-thermal-perceptions-inform-management-of-firefighters-in-the-heat
#15
Anthony Walker, Ben Rattray, Matt Brearley
Accurately assessing the physiological status of firefighters during work in the heat is critical to ensuring their safety. Evaluating core temperatures (Tc) in the field is problematic due to cost and limitations in technology and accuracy. As such, fire services rely on individual perceptions of wellbeing. The present study aimed to establish whether perceptual responses measured using the perceptual strain index (PeSI), calculated from rate of perceived exertion (RPE) and thermal sensation (TS), could reliably predict the physiological strain (PSI) encountered by experienced firefighters working in a hot environment...
October 28, 2016: Journal of Occupational and Environmental Hygiene
https://www.readbyqxmd.com/read/27764729/risk-stratifying-emergency-department-patients-with-acute-pulmonary-embolism-does-the-simplified-pulmonary-embolism-severity-index-perform-as-well-as-the-original
#16
David R Vinson, Dustin W Ballard, Dustin G Mark, Jie Huang, Mary E Reed, Adina S Rauchwerger, David H Wang, James S Lin, Mamata V Kene, Tamara S Pleshakov, Dana K Sax, Jordan M Sax, D Ian McLachlan, Cyrus K Yamin, Clifford J Swap, Hilary R Iskin, Ridhima Vemula, Bethany S Fleming, Andrew R Elms, Drahomir Aujesky
INTRODUCTION: The Pulmonary Embolism Severity Index (PESI) is a validated prognostic score to estimate the 30-day mortality of emergency department (ED) patients with acute pulmonary embolism (PE). A simplified version (sPESI) was derived but has not been as well studied in the U.S. We sought to validate both indices in a community hospital setting in the U.S. and compare their performance in predicting 30-day all-cause mortality and classification of cases into low-risk and higher-risk categories...
December 2016: Thrombosis Research
https://www.readbyqxmd.com/read/27760781/biomarkers-for-clinical-decision-making-in-the-management-of-pulmonary-embolism
#17
REVIEW
Evangelos Giannitsis, Hugo A Katus
BACKGROUND: Pulmonary embolism (PE) is associated with high all-cause and PE-related mortality and requires individualized management. After confirmation of PE, a refined risk stratification is particularly warranted among normotensive patients. Previous prognostic models favored combinations of echocardiography or computed tomography suggestive of right ventricular (RV) dysfunction together with biomarkers of RV dysfunction (natriuretic peptides) or myocardial injury (cardiac troponins) to identify candidates for thrombolysis or embolectomy...
January 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/27693164/-outpatient-management-of-pulmonary-embolism-diagnosed-in-emergency-services
#18
E Dubie, G Pouzet, E Bohyn, C Meunier, A Wuyts, S Chateigner Coelsch, P Lesage, C Morvan, L Belle, G Vanzetto
In the emergency department, the management of patients with pulmonary embolism depends on the early mortality risk. Outpatient care is possible in low-risk patients. We present the existing scores and the strategy proposed by the North Alps Emergency Network, which uses the simplified PESI score (Pulmonary Embolism Severity Index) to select those low-risk patients, candidates for early discharge.
November 2016: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/27666953/role-of-work-uniform-in-alleviating-perceptual-strain-among-construction-workers
#19
Yang Yang, Albert Ping-Chuen Chan
This study aims to examine the benefits of wearing a new construction work uniform in real-work settings. A field experiment with a randomized assignment of an intervention group to a newly designed uniform and a control group to a commercially available trade uniform was executed. A total of 568 sets of physical, physiological, perceptual, and microclimatological data were obtained. A linear mixed-effects model (LMM) was built to examine the cause-effect relationship between the Perceptual Strain Index (PeSI) and heat stressors including wet bulb globe temperature (WBGT), estimated workload (relative heart rate), exposure time, trade, workplace, and clothing type...
February 7, 2017: Industrial Health
https://www.readbyqxmd.com/read/27652375/optimizing-clinical-decision-support-in-the-electronic-health-record-clinical-characteristics-associated-with-the-use-of-a-decision-tool-for-disposition-of-ed-patients-with-pulmonary-embolism
#20
Dustin W Ballard, Ridhima Vemula, Uli K Chettipally, Mamata V Kene, Dustin G Mark, Andrew K Elms, James S Lin, Mary E Reed, Jie Huang, Adina S Rauchwerger, David R Vinson
OBJECTIVE: Adoption of clinical decision support (CDS) tools by clinicians is often limited by workflow barriers. We sought to assess characteristics associated with clinician use of an electronic health record-embedded clinical decision support system (CDSS). METHODS: In a prospective study on emergency department (ED) activation of a CDSS tool across 14 hospitals between 9/1/14 to 4/30/15, the CDSS was deployed at 10 active sites with an on-site champion, education sessions, iterative feedback, and up to 3 gift cards/clinician as an incentive...
September 21, 2016: Applied Clinical Informatics
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