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d dimer for pulmonary embolism

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https://www.readbyqxmd.com/read/28331932/pulmonary-embolism-and-in-situ-pulmonary-artery-thrombosis-in-paediatrics-a-systematic-review
#1
Madhvi Rajpurkar, Tina Biss, Ernest Amankwah, Denise Martinez, Suzan Williams, C Heleen Van Ommen, Neil A Goldenberg
Data on paediatric pulmonary embolism (PE) are scarce. We sought to systematically review the current literature on childhood PE and conducted a search on paediatric PE via PubMed (1946-2013) and Embase (1980-2013). There was significant heterogeneity in reported data. Two patterns were noted: classic thromboembolic PE (TE-PE) and in situ pulmonary artery thrombosis (ISPAT). Mean age of presentation for TE-PE was 14.86 years, and 51 % of cases were males. The commonest method for diagnosis of TE-PE was contrast CT with angiography (74 % of patients)...
March 23, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28314711/validating-the-herdoo2-rule-to-guide-treatment-duration-for-women-with-unprovoked-venous-thrombosis-multinational-prospective-cohort-management-study
#2
Marc A Rodger, Gregoire Le Gal, David R Anderson, Jeannot Schmidt, Gilles Pernod, Susan R Kahn, Marc Righini, Patrick Mismetti, Clive Kearon, Guy Meyer, Antoine Elias, Tim Ramsay, Thomas L Ortel, Menno V Huisman, Michael J Kovacs
Objective To prospectively validate the HERDOO2 rule (Hyperpigmentation, Edema, or Redness in either leg; D-dimer level ≥250 μg/L; Obesity with body mass index ≥30; or Older age, ≥65 years), which states that women with none or one of the criteria can safely discontinue anticoagulants after short term treatment.Design Prospective cohort management study.Setting 44 secondary or tertiary care centres in seven countries.Participants Of 3155 consecutive eligible participants with a first unprovoked venous thromboembolism (VTE, proximal leg deep vein thrombosis or pulmonary embolism) who completed 5-12 months of short term anticoagulant treatment, 370 declined to participate, leaving 2785 enrolled participants...
March 17, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28295882/identifying-atrial-fibrillation-in-outpatients-initiating-oral-anticoagulants-based-on-medico-administrative-data-results-from-the-french-national-healthcare-databases
#3
Cécile Billionnet, François Alla, Éric Bérigaud, Antoine Pariente, Géric Maura
PURPOSE: Identifying atrial fibrillation (AF) in outpatients treated with oral anticoagulants (OACs) from claims databases is challenging when the outpatient indication is not available, as OACs are also prescribed for deep vein thrombosis/pulmonary embolism (DVT/PE) that may be treated in the ambulatory setting. An algorithm was developed to identify AF in outpatients initiating OAC from medico-administrative data. METHODS: Among patients initiating OAC in 2013 in the French healthcare databases, those treated for orthopaedic indications were excluded...
March 14, 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/28267480/the-safety-and-efficacy-of-full-versus-reduced-dose-betrixaban-in-the-acute-medically-ill-vte-venous-thromboembolism-prevention-with-extended-duration-betrixaban-apex-trial
#4
C Michael Gibson, Rim Halaby, Serge Korjian, Yazan Daaboul, Douglas F Arbetter, Megan K Yee, Samuel Z Goldhaber, Russel Hull, Adrian F Hernandez, Shiao-Ping Lu, Olga Bandman, Janet M Leeds, Alex Gold, Robert A Harrington, Alexander T Cohen
BACKGROUND: The APEX trial assessed the safety and efficacy of extended-duration thromboprophylaxis using betrixaban versus standard dosing of enoxaparin among hospitalized, acutely ill medical patients. The 80-mg betrixaban dose was halved to 40 mg among subjects with severe renal insufficiency and those receiving a concomitant strong P-glycoprotein inhibitor. METHODS: This analysis assessed the pharmacokinetics, efficacy, and safety of full- (80 mg) and reduced-dose (40 mg) betrixaban relative to enoxaparin in the APEX trial...
March 2017: American Heart Journal
https://www.readbyqxmd.com/read/28262243/pitfalls-in-the-diagnostic-management-of-pulmonary-embolism-in-pregnancy
#5
Cécile Tromeur, Liselotte M van der Pol, Frederikus A Klok, Francis Couturaud, Menno V Huisman
Women are at increased risk of venous thromboembolism (VTE) during pregnancy and VTE remains one of the main causes of maternal mortality in developed countries (Konstantinides SV, et al. Eur Heart J 2014; 35(43):3033-69, 69a-69k). Although an accurate diagnosis of acute pulmonary embolism (PE) in pregnant patients is thus of crucial importance, the diagnostic management of suspected PE is challenging for this specific patient category. As D-dimer levels increase physiologically throughout pregnancy, the optimal D-dimer threshold to rule out PE during pregnancy remains unknown...
March 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28246560/saddle-pulmonary-embolism-with-thrombus-in-transit-across-a-patent-foramen-ovale
#6
Fitzgerald Shepherd, Ashley White-Stern, Oloruntobi Rahaman, Damian Kurian, Karen Simon
This is the case of a 25-year-old obese man who presented with acute shortness of breath, chest pain, and palpitations. Of note, he lives a sedentary lifestyle and was recently hospitalized for incision and drainage of a left foot abscess. On presentation he was tachypnoeic, tachycardiac, and hypoxic but blood pressure was stable. Laboratory studies were significant for elevated D-dimer and mildly increased troponin. On further investigation he was found to have a saddle pulmonary embolism with massive clot burden...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28214153/arrhythmogenic-right-ventricular-dysplasia-atypical-clinical-presentation
#7
José Marçalo, Luiz Menezes Falcão
A 67-year-old man was admitted to our hospital after episodes of syncope preceded by malaise and diffuse neck and chest discomfort. No family history of cardiac disease was reported. Laboratory workup was within normal limits, including D-dimers, serum troponin I and arterial blood gases. The electrocardiogram showed sinus rhythm with T-wave inversion in leads V1 to V3. Computed tomography angiography to investigate pulmonary embolism showed no abnormal findings. Transthoracic echocardiography (TTE) displayed massive enlargement of the right ventricle with intact interatrial septum and no pulmonary hypertension...
March 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/28206731/thrombus-resolution-and-right-ventricular-functional-recovery-using-ultrasound-accelerated-thrombolysis-in-acute-massive-and-submassive-pulmonary-embolism
#8
Evren Ozcinar, Mehmet Cakici, Nur Dikmen Yaman, Cagdas Baran, Anar Aliyev, Bahadir Inan, Serkan Durdu, Ahmet R Akar, Mustafa Sirlak
BACKGROUND: This study aims to evaluate the efficacy and safety of ultrasound-accelerated catheter- directed thrombolysis (UACDT) in the treatment of massive and submassive pulmonary embolism (PE). METHODS: We conducted a prospective, observational cohort study of consequtive patients with massive or submassive PE treated with low-dose UACDT using EKOS EkoSonic® system at single center from May 2014 until April 2015. Overall, thirty-eight patients (median age, 64...
February 15, 2017: International Angiology: a Journal of the International Union of Angiology
https://www.readbyqxmd.com/read/28197219/factors-determining-altered-perfusion-after-acute-pulmonary-embolism-assessed-by-quantified-single-photon-emission-computed-tomography-perfusion-scan
#9
Marc Meysman, Hendrik Everaert, Walter Vincken
AIM OF THE STUDY: The aim of the study was to analyze the evolution of perfusion (Q)-defects in patients treated for acute pulmonary embolism (PE), correlation with baseline parameters and evaluation of recurrence risk. METHODS: This is a single-center prospective observational cohort study in symptomatic normotensive PE. Comparison of the ventilation/perfusion single-photon emission computed tomography (V/Q-SPECT) acquired at baseline with a quantified SPECT (Q-SPECT) repeated at 1 week and 6 months...
January 2017: Annals of Thoracic Medicine
https://www.readbyqxmd.com/read/28190568/predictable-factors-of-deep-venous-thrombosis-in-patients-undergoing-spine-surgery
#10
Terumasa Ikeda, Hiroshi Miyamoto, Kazuki Hashimoto, Masao Akagi
BACKGROUND: DVT is one of the major postoperative complications of joint replacement surgery of the lower extremity which can cause catastrophic complications such as pulmonary embolism. However, little is known about the incidence of DVT after spine surgery. The purpose of this study was to examine predictable factors of DVT after spine surgery. METHODS: This study included 194 patients who underwent spine surgery (104 males, 90 females, mean age 65.7 years). Postoperative DVT was detected using duplex ultrasonography (DUS)...
February 9, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/28116533/negative-d-dimer-testing-excludes-pulmonary-embolism-in-non-high-risk-patients-in-the-emergency-department
#11
John B Harringa, Rebecca L Bracken, Scott K Nagle, Mark L Schiebler, Michael S Pulia, James E Svenson, Michael D Repplinger
PURPOSE: The purpose of this study was to assess the ability of d-dimer testing to obviate the need for cross-sectional imaging for patients at "non-high risk" for pulmonary embolism (PE). METHODS: This is a retrospective study of emergency department patients at an academic medical center who underwent cross-sectional imaging (MRA or CTA) to evaluate for PE from 2008 to 2013. The primary outcome was the NPV of d-dimer testing when used in conjunction with clinical decision instruments (CDIs = Wells', Revised Geneva, and Simplified Revised Geneva Scores)...
January 24, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/28075426/age%C3%A2-adjusted-plasma-d%C3%A2-dimer-levels-in-suspected-acute-pulmonary-embolism-a-retrospective-single%C3%A2-center-study
#12
Marta Kozłowska, Magdalena Pływaczewska, Michał Ciurzyński, Szymon Pacho, Marzanna Paczyńska, Zenon Truszewski, Maciej Kostrubiec, Anna Wyzgał, Piotr Palczewski, Marcin Koć, Dorota Matuszewicz, Piotr Pruszczyk
INTRODUCTION The conventional D‑dimer threshold (CDD) is characterized by high sensitivity and low specificity in diagnosing acute pulmonary embolism (PE) in older patients. A higher cut‑off level for D‑dimer has been proposed, aiming at increasing the specificity while maintaining high sensitivity. It is calculated by multiplying the patient's age in years by a coefficient of 10 (YADD10). OBJECTIVES The aim of this study was to validate the clinical value of YADD10 in patients with suspected acute PE and to optimize this threshold to achieve increased specificity paired with high sensitivity...
January 10, 2017: Pol Arch Intern Med
https://www.readbyqxmd.com/read/28039291/can-recombinant-human-thrombomodulin-increase-survival-among-patients-with-severe-septic-induced-disseminated-intravascular-coagulation-a-single-centre-open-label-randomised-controlled-trial
#13
Akiyoshi Hagiwara, Noriko Tanaka, Tatsuki Uemura, Wataru Matsuda, Akio Kimura
OBJECTIVE: To determine whether treatment with recombinant human thrombomodulin (rhTM) increases survival among patients with severe septic-induced disseminated intravascular coagulation (DIC). DESIGN: Single-centre, open-label, randomised controlled trial. SETTING: Single tertiary hospital. PARTICIPANT: 92 patients with severe septic-induced DIC. INTERVENTIONS: Patients with DIC scores ≥4, as defined by the Japanese Association of Acute Medicine, were diagnosed with DIC...
December 30, 2016: BMJ Open
https://www.readbyqxmd.com/read/28002070/retrospective-validation-of-the-pulmonary-embolism-rule-out-criteria-rule-in-pe-unlikely-patients-with-suspected-pulmonary-embolism
#14
Steven Crane, Tom Jaconelli, Mazin Eragat
INTRODUCTION: Patients presenting to emergency departments (EDs) with suspected pulmonary embolism (PE) can be risk stratified and those who are deemed to be at low risk for PE usually undergo D-dimer testing. A negative D-dimer in this low-risk group rules out PE with a high degree of certainty because of its high sensitivity. The D-dimer is, however, a poorly specific test and positive results often lead to unnecessary radiological imaging (notably computed tomography pulmonary angiography)...
December 19, 2016: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/27991422/volumetric-capnography-in-the-exclusion-of-pulmonary-embolism-at-the-emergency-department-a-pilot-study
#15
Timon M Fabius, Michiel M Eijsvogel, Ivo van der Lee, Marjolein G J Brusse-Keizer, Frans H de Jongh
The analysis of the [Formula: see text] in expired air as a function of the exhaled volume (volumetric capnography) might result in a more specific exclusion tool for pulmonary embolism (PE) in addition to the Wells-score and D-dimer. A novel combination of volumetric capnography parameters ([Formula: see text]) should be decreased in PE and could possibly be used to decrease the number of requested computed tomography pulmonary angiograms (CTPA). Volumetric capnography measurements were performed on consecutive patients seen in the emergency department for which, due to suspected PE (due to increased D-dimer level or Wells-score), a CTPA was ordered...
December 17, 2016: Journal of Breath Research
https://www.readbyqxmd.com/read/27979674/a-treatment-strategy-using-subcutaneous-fondaparinux-followed-by-oral-rivaroxaban-is-effective-for-treating-acute-venous-thromboembolism
#16
Takayuki Kabuki, Rine Nakanishi, Shinji Hisatake, Takahiro Fujii, Shintaro Dobashi, Shingo Wakakura, Shunsuke Kiuchi, Tadashi Fujino, Takanori Ikeda
BACKGROUND: The factor Xa inhibitors have been widely used for the treatment and prevention of venous thromboembolism (VTE). However, the efficacy of factor Xa inhibitors in Japanese patients with VTE has not been well examined. In this study, we investigated the effect of the sequential use of two factor Xa inhibitors in patients with acute VTE. METHODS: We conducted an observational study of 87 consecutive patients diagnosed with VTE. As an initial treatment, we administered subcutaneous fondaparinux to the patients for 7-10 days, and then switched to oral rivaroxaban...
December 12, 2016: Journal of Cardiology
https://www.readbyqxmd.com/read/27966438/never-ignore-extremely-elevated-d-dimer-levels-they-are-specific-for-serious-illness
#17
T Schutte, A Thijs, Y M Smulders
BACKGROUND: D-dimer is routinely measured as part of the clinical diagnosis algorithms for venous thromboembolism (VTE). In these algorithms, low D- dimer cut-off values are used to generate a dichotomous test result that is sensitive, but very non-specific for VTE. A consequence of any test dichotomisation is loss of information that is hidden in the continuous spectrum of results. For D-dimer, the information conveyed by extremely elevated results may be particularly relevant. Our aim was to assess the differential diagnosis of extremely elevated D-dimer levels in a hospital setting...
December 2016: Netherlands Journal of Medicine
https://www.readbyqxmd.com/read/27966013/choice-of-marker-for-assessment-of-rv-dysfunction-in-acute-pulmonary-embolism-nt-probnp-pulmonary-artery-systolic-pressure-mean-arterial-pressure-or-blood-pressure-index
#18
H Ates, I Ates, H Kundi, F M Yilmaz
BACKGROUND: We aimed to examine the value of NT-proBNP, pulmonary artery systolic pressure (PASP), blood pressure index (BPI), and mean arterial pressure (MAP) in the determination of right ventricular dysfunction (RVD) in patients with acute pulmonary embolism (APE). PATIENTS AND METHODS: A total of 547 patients diagnosed with APE were included in the study. Demographic characteristics and comorbid conditions of patients were recorded in patient files. For blood pressure measurement, a calibrated digital blood pressure monitor was used at regular intervals...
December 13, 2016: Herz
https://www.readbyqxmd.com/read/27941007/age-adjusted-d-dimer-excludes-pulmonary-embolism-and-reduces-unnecessary-radiation-exposure-in-older-adults-retrospective-study
#19
Jennifer Nobes, Claudia-Martina Messow, Mohammed Khan, Petr Hrobar, Chris Isles
BACKGROUND: Patients in whom a diagnosis of pulmonary embolism (PE) is suspected and whose D-dimers are elevated frequently require CT pulmonary angiogram (CTPA) for diagnosis. Because D-dimer rises with age, an age-adjusted D-dimer threshold may prevent unnecessary radiation exposure from CTPA in older patients. OBJECTIVE: To determine the efficacy and safety of implementing an age-adjusted D-dimer threshold to exclude PE. DESIGN, SETTINGS AND PATIENTS: Retrospective comparison of conventional and age-adjusted D-dimer thresholds in 1000 consecutive patients who had both D-dimer and CTPA...
December 9, 2016: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/27939016/diagnosing-pulmonary-embolisms-the-clinician-s-point-of-view
#20
A Carrillo Alcaraz, A López Martínez, F J Sotos Solano
Pulmonary thromboembolism is common and potentially severe. To ensure the correct approach to the diagnostic workup of pulmonary thromboembolism, it is essential to know the basic concepts governing the use of the different tests available. The diagnostic approach to pulmonary thromboembolism is an example of the application of the conditional probabilities of Bayes' theorem in daily practice. To interpret the available diagnostic tests correctly, it is necessary to analyze different concepts that are fundamental for decision making...
December 7, 2016: Radiología
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