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d dimer for pulmonary embolism

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https://www.readbyqxmd.com/read/29146682/magnitude-of-soluble-st2-as-a-novel-biomarker-for-acute-aortic-dissection
#1
Yuan Wang, Xin Tan, Hai Gao, Hui Yuan, Rong Hu, Lixin Jia, Junming Zhu, Lizhong Sun, Hongjia Zhang, Lianjun Huang, Dong Zhao, Pei Gao, Jie Du
Background -Misdiagnosis of acute aortic dissection (AAD) can lead to significant morbidity and death. Soluble ST2 (sST2) is a cardiovascular injury-related biomarker. The extent to which sST2 is elevated in AAD and whether sST2 can discriminate AAD from other causes of sudden-onset severe chest pain is unknown. Methods -We measured plasma concentrations of sST2 (R&D systems assay) in 1360 patients, including 1027 participants in the retrospective discovery set and 333 patients with initial suspicion of AAD enrolled in the prospective validation cohort...
November 16, 2017: Circulation
https://www.readbyqxmd.com/read/29117965/diagnostic-accuracy-of-the-d-dimer-in-children
#2
Jessica Kanis, Cassandra L Hall, Jonathan Pike, Jeffrey A Kline
BACKGROUND: We sought to measure the diagnostic accuracy of D-dimer in children with suspected pulmonary embolism (PE). METHODS: We queried our electronic medical record for quantitative D-dimer values obtained in all children ages 5-17 over 10 years in our 10-hospital system. Patients who had a D-dimer obtained in the evaluation of PE underwent supervised chart review to extract baseline demographics (age, sex, ethnicity), medical history, laboratory data and imaging results...
November 8, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/29117964/clinical-characteristics-of-children-evaluated-for-suspected-pulmonary-embolism-with-d-dimer-testing
#3
Jessica Kanis, Jonathan Pike, Cassandra L Hall, Jeffrey A Kline
BACKGROUND: We sought to determine clinical variables in children tested for suspected pulmonary embolism (PE) that predict PE+ outcome for the development of paediatric PE prediction rule. METHODS: Data were collected by query of a laboratory database for D-dimer from January 2004 to December 2014 for a large multicentre hospital system and the radiology database for pulmonary vascular imaging in children aged 5-17. Using explicit, predefined methods, trained abstractors, determined if D-dimer was sent in the evaluation of PE and then recorded predictor data which was tested for association with PE+ outcome using univariate techniques...
November 8, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/29100817/edoxaban-improves-acute-venous-thromboembolism-while-preserving-protein-c-and-protein-s-levels
#4
Hiromu Yamazaki, Shusuke Yagi, Yuta Torii, Rie Amano, Yasuyuki Oomichi, Teruaki Sangawa, Daiju Fukuda, Muneyuki Kadota, Takayuki Ise, Rie Ueno, Tomoya Hara, Kenya Kusunose, Tomomi Matsuura, Takeshi Tobiume, Koji Yamaguchi, Hirotsugu Yamada, Takeshi Soeki, Tetsuzo Wakatsuki, Masashi Akaike, Masataka Sata
BACKGROUND: It is well known that warfarin inhibits the synthesis of vitamin K-dependent anticoagulants, including thrombin, protein C and S, and factor Xa, leading, paradoxically, to an initial hypercoagulable state. Edoxaban, a direct inhibitor of activated factor X is widely used for the treatment of acute venous thromboembolism (VTE). However, the effect of edoxaban on circulating coagulation factors, in patients with acute VTE, remains unknown. METHODS AND RESULTS: We enrolled 57 patients with acute VTE with/without pulmonary embolism treated with edoxaban (n=37) or warfarin (n=20) in a clinical setting...
October 31, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/29078111/markers-of-coagulation-activation-inflammation-and-fibrinolysis-as-predictors-of-poor-outcomes-after-pediatric-venous-thromboembolism-a-systematic-review-and-meta-analysis
#5
REVIEW
Ayesha Zia, Joy Russell, Ravi Sarode, Surendranath R Veeram, Shellie Josephs, Kendra Malone, Song Zhang, Janna Journeycake
BACKGROUND: Sequelae of venous thromboembolism (VTE) in children include recurrence, development of post thrombotic syndrome (PTS) when venous return from a limb is affected and chronic thromboembolic pulmonary hypertension (CTEPH) after pulmonary embolism. Identification of laboratory-based risk factors may be useful for individualized risk assessment for VTE sequelae. Coagulation activation and inflammation may contribute to their pathophysiology. We performed a systematic review to investigate the association between biomarkers of coagulation activation, inflammation and fibrinolysis and adverse VTE outcomes in children and young adults...
October 7, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/29077155/utility-of-biochemical-markers-and-rvd-lvd-ratio-in-acute-pulmonary-embolism-risk-classification-in-emergency-department
#6
M O Ay, N Kozaci, M Avci, B Cekic, N Cerit, O Keskin, A Celik
OBJECTIVE: We aimed to determine the efficacy of troponin I, D-dimer, and lactate levels and right ventricular diameter (RVD)/left ventricular diameter (LVD) ratio on pulmonary computed tomography angiography (PCTA) in the risk classification of patients who were diagnosed with acute pulmonary embolism (APE) in Emergency Department (ED). PATIENTS AND METHODS: Patients who were diagnosed as having APE by PCTA in ED were included in this retrospective study. Patients were grouped as high-risk (undergoing cardiopulmonary resuscitation or given thrombolytic therapy), moderate-risk (with non-high-risk and positive ECO findings) and low risk (others)...
October 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29055608/qualitative-study-to-understand-ordering-of-ct-angiography-to-diagnose-pulmonary-embolism-in-the-emergency-room-setting
#7
Soterios Gyftopoulos, Silas W Smith, Emma Simon, Masha Kuznetsova, Leora I Horwitz, Danil V Makarov
PURPOSE: To better understand the decision making behind the ordering of CT pulmonary angiography (CTPA) for the diagnosis of pulmonary embolism (PE) in the emergency department. METHODS: We conducted semistructured interviews with our institution's emergency medicine (EM) providers and radiologists who read CTPAs performed in the emergency department. We employed the Theoretical Domains Framework-a formal, structured approach used to better understand the motivations and beliefs of physicians surrounding a complex medical decision making-to categorize the themes that arose from our interviews...
October 18, 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29049229/neck-to-shoulder-pain-as-an-unusual-presentation-of-pulmonary-embolism-in-a-patient-with-cervical-spinal-cord-injury-a-case-report
#8
Dong Gyu Lee, Min Cheol Chang
RATIONALE: Information on referred pain can be helpful for diagnosing diseases of the visceral organs. Here, the authors report a patient with cervical spinal cord injury (SCI) who had referred pain at the right side from the neck to shoulder, as a presentation of pulmonary embolism (PE). PATIENT CONCERNS: A 55-year-old man with complete tetraplegia, due to cervical SCI after C5 and C6 vertebral body fracture, complained of right neck-to-shoulder pain (numerical scale rating: 6)...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29044295/clinical-decision-rules-for-pulmonary-embolism-in-hospitalized-patients-a-systematic-literature-review-and-meta-analysis
#9
Anne R Bass, Kara G Fields, Rie Goto, Gregory Turissini, Shirin Dey, Linda A Russell
Background Clinical decision rules (CDRs) for pulmonary embolism (PE) have been validated in outpatients, but their performance in hospitalized patients is not well characterized. Objectives The goal of this systematic literature review was to assess the performance of CDRs for PE in hospitalized patients. Methods We performed a structured literature search using Medline, EMBASE and the Cochrane library for articles published on or before January 18, 2017. Two authors reviewed all titles, abstracts and full texts...
October 10, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/29043850/age-adjusted-d-dimer-cut-off-in-the-diagnostic-strategy-for-deep-vein-thrombosis-a-systematic-review
#10
Mads Nybo, Anne-Mette Hvas
BACKGROUND: Studies have indicated that use of an age-adjusted D-dimer cut-off value for patients above 50 years increases utility of the diagnostic strategy for pulmonary embolism. Evidence for the same approach regarding diagnosis of deep vein thrombosis (DVT) is, however, unclear. MATERIALS AND METHODS: A systematic literature review was conducted following the PRISMA Statement guideline to gather the existing knowledge on the use of an age-adjusted D-dimer cut-off in the diagnostic strategy for DVT...
October 18, 2017: Scandinavian Journal of Clinical and Laboratory Investigation
https://www.readbyqxmd.com/read/29017215/-pulmonary-embolism-despite-rivaroxaban-in-an-obese-patient
#11
Thomas Schuh, Claudia Stöllberger
Introduction Rivaroxaban, an oral factor Xa inhibitor, is approved for therapy of venous thromboembolism. It is unclear whether the standard dose for patients with a body mass index (BMI) > 40 kg/m(2) is sufficient. History The 45-year-old patient was admitted because of increasing respiratory distress. She had a history of pulmonary embolism 30 months before the admission, a factor V Leiden mutation and several hospitalisations due to dermatomycoses. The patient briefly took phenprocoumon which was changed to 20 mg rivaroxaban due to a lack of adherence...
October 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28990745/diagnostic-value-of-circulating-microrna-27a-b-in-patients-with-acute-pulmonary-embolism
#12
Qian Wang, Junfen Ma, Zhiyun Jiang, Fan Wu, Jiedan Ping, Liang Ming
BACKGROUND: Circulating microRNAs (miRNAs) have been increasingly suggested as biomarkers for numerous diseases. The aims of this study were to evaluate the expression of plasma miR-27a/b in patients with acute pulmonary embolism (APE) and determine the possibility of miR-27a/b as diagnostic biomarkers for APE. METHODS: 78 APE patients diagnosed by computed tomographic pulmonary angiography (CTPA) and 70 age and gender matched normal volunteers were included in this study...
October 9, 2017: International Angiology: a Journal of the International Union of Angiology
https://www.readbyqxmd.com/read/28980454/incidence-risk-factors-and-outcomes-of-central-venous-catheter-related-thromboembolism-in-breast-cancer-patients-the-caveccas-study
#13
Philippe Debourdeau, Marc Espié, Sylvie Chevret, Joseph Gligorov, Antoine Elias, Pierre François Dupré, Kristell Desseaux, Issa Kalidi, Stephane Villiers, Sylvie Giachetti, Corinne Frere, Dominique Farge
Previous epidemiologic studies investigating central venous catheter (CVC)-related venous thromboembolism (CRT) were conducted in heterogenous cancer populations and data in breast cancer (BC) remain limited. To investigate the Doppler ultrasound (DUS)-CRT incidence, risk factors and outcomes in BC, we designed a prospective, multicenter cohort of nonmetastatic invasive BC patients undergoing insertion of a CVC for chemotherapy. All patients underwent double-blind DUS before, 7, 30, and 90 days after CVC insertion and a 6 months clinical follow-up...
November 2017: Cancer Medicine
https://www.readbyqxmd.com/read/28976338/false-positive-perfusion-ventilation-spect-study-for-pulmonary-embolism-in-a-patient-with-fontan-circulation
#14
Emmanouil Panagiotidis
Fontan circulation is the consequence of an operation that results in the flow of systemic venous blood to the lungs without passing through a ventricle. An 18-year old man with a history of congenital heart disease surgically treated with Fontan circulation, presented with pleuritic chest pain and a raised D-dimer level. Perfusion/ventilation SPECT was performed to exclude the possibility of pulmonary embolism (PE) that showed unilateral reduced perfusion of the left lung with a mismatched right upper lobe defect, suspicious of PE...
October 3, 2017: Molecular Imaging and Radionuclide Therapy
https://www.readbyqxmd.com/read/28941051/no-added-value-of-the-age-adjusted-d-dimer-cut-off-to-the-years-algorithm-in-patients-with-suspected-pulmonary-embolism
#15
L M van der Pol, T van der Hulle, Y W Cheung, A T A Mairuhu, C G Schaar, L M Faber, M Ten Wolde, H M A Hofstee, M M C Hovens, M Nijkeuter, R C J van Klink, M J H A Kruip, S Middeldorp, M V Huisman, F A Klok
BACKGROUND: The YEARS algorithm was designed to simplify the diagnostic work-up of pulmonary embolism (PE) and to reduce the number of necessary computed tomography pulmonary angiography (CTPA) scans. An alternative strategy to reduce the number of CTPAs is the age-adjusted D-dimer cut-off (ADJUST) in patients aged 50 years or older. We aimed to investigate whether a combination of both diagnostic strategies might save additional CTPAs. METHODS: The YEARS algorithm consists of three items (clinical signs of deep venous thrombosis, hemoptysis, "PE most likely diagnosis") with simultaneous D-dimer testing using a pre-test dependent threshold...
September 22, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28935434/diagnosis-of-venous-thromboembolism-in-pregnancy
#16
Wee-Shian Chan
The diagnosis of deep vein thrombosis (DVT) and pulmonary embolism (PE) during pregnancy still relies on objective imaging. Ancillary testing such as clinical prediction rules and D-dimer testing may have a role in excluding both DVT and PE in these pregnant patients even as we await results from prospective management studies. The anatomical distribution of DVT in pregnancy differs from those in non-pregnant patient with a greater propensity for proximal iliac vein thrombosis. Using leg ultrasonography with compression maneuvers from the femoral vein to popliteal vein and doppler assessment of the iliac vein in a single examination, appears adequate in most pregnant women with suspected DVT, in excluding DVT...
September 5, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28925904/factors-associated-with-pulmonary-embolism-recurrence-and-the-benefits-of-long-term-anticoagulant-therapy
#17
Javier Anniccherico, Jose-Luis Alonso-Martinez, Mirem Urbieta, Jorge Rojo Alvaro, Ione Villar-Garcia
BACKGROUND: Venous thromboemboli tend to recur. However, the causative factors underlying pulmonary embolism recurrence are not well defined. AIMS: To explore the factors associated with pulmonary embolism recurrence. PATIENTS AND METHODS: Patients diagnosed with pulmonary emboli between 2004 and 2013 at our institution were enrolled. Duration of anticoagulant therapy, new episodes of venous thromboembolism, and deaths were recorded. RESULTS: Pulmonary embolism was diagnosed in 528 patients (median age: 76 years, interquartile range [IQR]: 16; male: 45%)...
September 18, 2017: Cardiovascular & Hematological Disorders Drug Targets
https://www.readbyqxmd.com/read/28925655/pleuritic-chest-pain-sorting-through-the-differential-diagnosis
#18
Brian V Reamy, Pamela M Williams, Michael Ryan Odom
Pleuritic chest pain is characterized by sudden and intense sharp, stabbing, or burning pain in the chest when inhaling and exhaling. Pulmonary embolism is the most common serious cause, found in 5% to 21% of patients who present to an emergency department with pleuritic chest pain. A validated clinical decision rule for pulmonary embolism should be employed to guide the use of additional tests such as d-dimer assays, ventilation-perfusion scans, or computed tomography angiography. Myocardial infarction, pericarditis, aortic dissection, pneumonia, and pneumothorax are other serious causes that should be ruled out using history and physical examination, electrocardiography, troponin assays, and chest radiography before another diagnosis is made...
September 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/28857400/predictive-value-of-symptoms-signs-and-biomarkers-on-computer-tomography-pulmonary-angiogram-results
#19
Anver Sethwala, Xiaojie Wang, Emma E Sturm, Kate L Collins, Ronan O'Donnabhain, N Deborah Friedman
BACKGROUND: Pulmonary embolism (PE) is associated with significant morbidity and mortality. PE is a heterogeneous entity causing a wide variety of clinical presentations, making it imperative to establish which clinical symptoms, signs and biomarkers can influence the pre-test probability of PE to aid clinicians and reduce over testing. AIMS: The objective of this study was to analyse the clinical parameters used by clinicians to order a Computer Tomography Pulmonary Angiogram (CTPA), and establish which were associated with the presence of PE...
August 30, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28813774/pulmonary-embolism-caused-by-popliteal-vein-aneurysm-a-case-report
#20
Kevin Marquez, Kalyan Chakravarthy Potu, Chad Laurich, Randall Lamfers
In this case report, we describe an unusual episode of bilateral submassive pulmonary embolism (PE) caused by a popliteal vein aneurysm (PVA). The development of PE stems from many risk factors including obesity (BMI³ 30 kg/m2), hypertension, cigarette smoking (greater than 25 cigarettes per day), increasing age, surgery, immobility, malignancy, and inherited thrombophilia. A PVA is a rare but significant cause of PE. A 28-year-old male presented to the emergency department with progressive shortness of breath...
March 2017: South Dakota Medicine: the Journal of the South Dakota State Medical Association
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