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d dimer for pulmonary embolism

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https://www.readbyqxmd.com/read/29341511/age-adjusted-d-dimer-for-exclusion-of-pulmonary-embolism-a-retrospective-cohort-study
#1
D Monks, A Neill, D Barton, A Moughty, A McFeely, A Timmons, S Hatton, D McMorrow
D-Dimer (DD) will increase with age and recent studies have shown the upper limit of normal can be raised in those who are low risk and over 50. We studied age adjusted D-dimer (AADD) levels to assess whether pulmonary embolism (PE) could be safely excluded. This study analysed the Emergency Department (ED) Computed Tomographic Pulmonary Angiography (CTPA) requests. There were 756 requests. The parameters studied were; age, DD value, calculated AADD, CT result and Simplified Geneva Score (SGS). The primary outcome was the diagnostic performance of AADD...
August 8, 2017: Irish Medical Journal
https://www.readbyqxmd.com/read/29332446/lung-cancer-complicated-with-asymptomatic-pulmonary-embolism-clinical-analysis-of-84-patients
#2
Guangsheng Li, Yuechuan Li, Shuping Ma
BACKGROUND AND OBJECTIVE: Pulmonary embolism is potentially life-threatening in patients with lung cancer, but the clinical studies on patients with lung cancer having asymptomatic pulmonary embolism were barely reported. METHODS: Clinical data of patients with lung cancer were obtained from the Department of Respiratory and Critical Care Medicine of Tianjin Chest Hospital during July 2012 and June 2015 and were reviewed retrospectively. A total of 28 patients with lung cancer having pulmonary embolism (LP group) were enrolled, and another 56 cases with lung cancer alone (LC group) were enrolled as controls...
December 2017: Technology in Cancer Research & Treatment
https://www.readbyqxmd.com/read/29324936/the-impact-of-lung-perfusion-scintigraphy-in-the-emergency-management-of-patients-with-suspected-pulmonary-embolism
#3
Cristina Ferrari, Alessandra Cimino, Giacomo Bianco, Francesca Iuele, Alessandra Di Palo, Margherita Fanelli, Artor Niccoli-Asabella, Giuseppe Rubini
OBJECTIVE: Pulmonary Embolism (PE) is an emergency condition that requires immediate treatment. As the symptoms and the risk factors are nonspecific, PE differential diagnosis is often required. Even if angio-CT is considered the gold standard for PE diagnosis, the frequent allergic condition and/or chronic renal failure of patients make, in most cases, not possible the use of contrast enhancement in emergency with even more increasing use of Lung Perfusion Scintigraphy (LPS), as a simple and fast examination with no preparation/contraindication...
September 2017: Hellenic Journal of Nuclear Medicine
https://www.readbyqxmd.com/read/29321409/pulmonary-embolism-caused-by-intravenous-leiomyosarcoma-of-the-lower-limb
#4
Soichiro Kado, Masahide Goto, Hidetsugu Yamao, Toru Tsukada, Masataka Sato, Yoshifumi Uekusa
Pulmonary embolism (PE) is usually caused by thrombosis or tumor. We report the long-term survival of a patient with PE due to a leiomyosarcoma in the deep vein. A 71-year-old woman complained of dyspnea and swelling of the left lower limb. Computed tomography revealed filling defects in the pulmonary arteries and deep vein. She was diagnosed with PE caused by venous thrombosis and treated with anticoagulant therapy. Her symptoms were prolonged, and D-dimer tests remained negative. Biopsy of the substance in the deep vein revealed leiomyosarcoma...
January 11, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29310357/risk-profile-management-and-outcomes-of-patients-with-venous-thromboembolism-attended-in-spanish-emergency-departments-the-espheria-registry
#5
Sonia Jimenez, Pedro Ruiz-Artacho, Marta Merlo, Coral Suero, Albert Antolin, José Ramón Casal, Marta Sanchez, Alejandra Ortega-Duarte, Mar Genis, Pascual Piñera
The objective of this study was to determine the clinical profile of and diagnostic and therapeutic approach to patients with venous thromboembolism (VTE) in Spanish Emergency Departments (EDs). Risk factors, adherence to clinical practice guidelines, and outcomes were also evaluated.Patients with VTE diagnosed in 53 Spanish EDs were prospectively and consecutively included. Demographic data, comorbidities, risk factors for VTE, index event characteristics, hemorrhagic risk, and mortality were evaluated. Adherence to clinical practice guidelines was assessed based on clinical probability scales, requests for determination of D-dimer, use of anticoagulant treatment before confirmation of diagnosis, and assessment of bleeding and prognostic risk...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29296053/nonfatal-pulmonary-embolism-associated-with-the-use-of-compression-stockings-in-the-lithotomy-position-after-spinal-anesthesia
#6
I-Wen Chen, Cheuk-Kwan Sun, Jen-Yin Chen, Chien-Ming Lin, Kuo-Chuan Hung
A 73-year-old male (height, 156 cm; body weight, 51 kg), without a history of cardiovascular disease or thromboembolic events, was scheduled for transurethral resection of the prostate under spinal anesthesia. Spinal anesthesia was administered with hyperbaric bupivacaine, resulting in an upper anesthetic level of T6. Before surgery, compression stockings were applied to both lower limbs, and the patient was placed in the lithotomy position. Approximately 15 min later, he complained of intolerable chest tightness, followed by tachycardia (heart rate, 110 beats/min) and desaturation (oxygen saturation [SaO2], 90%)...
October 2017: Ci Ji Yi Xue za Zhi, Tzu-chi Medical Journal
https://www.readbyqxmd.com/read/29286428/stenosis-of-the-inferior-vena-cava-a-murine-model-of-deep-vein-thrombosis
#7
Holly Payne, Alexander Brill
Deep vein thrombosis (DVT) and its devastating complication, pulmonary embolism, are a severe health problem with high mortality. Mechanisms of thrombus formation in veins remain obscure. Lack of mobility (e.g., after surgery or long-haul flights) is one of the main factors leading to DVT. The pathophysiological consequence of the lack of mobility is blood flow stagnation in venous valves. Here, a model is described that mimics such flow disturbance as a thrombosis-driving factor. In this model, partial flow restriction (stenosis) in the inferior vena cava (IVC) is created...
December 22, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29275595/-clinical-efficacy-of-rivaroxaban-in-prevention-and-treatment-of-postoperative-deep-vein-thrombosis-for-severe-traumatic-brain-injury
#8
Z L Zhang, W M Liu, Y Zhang, G H Wang, C Yan, H Q Wang, Q B Huang
Objective: To explore the clinical efficacy of rivaroxaban in the prevention and treatment of postoperative deep vein thrombosis (DVT) for severe traumatic brain injury (sTBI). Methods: Patients with sTBI who met the inclusion criteria were enrolled in this study, including 119 males (75.8%) and 38 females (24.2%), aged (38.75 ± 11.98) years old. DVT was prevented and treated according to the DVT screening and anticoagulation regimen. Intermittent venous compression was used on all of the patients to prevent DVT, and D-dimer dynamic monitoring and regular ultrasound were performed to screen for DVT...
December 5, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29201906/age-adjusted-d-dimer-in-the-prediction-of-pulmonary-embolism-does-a-normal-age-adjusted-d-dimer-rule-out-pe
#9
Jacob Ortiz, Rabia Saeed, Christopher Little, Saul Schaefer
Risk assessment for pulmonary embolism (PE) currently relies on physician judgment, clinical decision rules (CDR), and D-dimer testing. There is still controversy regarding the role of D-dimer testing in low or intermediate risk patients. The objective of the study was to define the role of clinical decision rules and D-dimer testing in patients suspected of having a PE. Records of 894 patients referred for computed tomography pulmonary angiography (CTPA) at a University medical center were analyzed. The clinical decision rules overall had an ROC of approximately 0...
2017: BioMed Research International
https://www.readbyqxmd.com/read/29170316/19%C3%A2-accuracy-of-biomarkers-for-venous-thromboembolism-in-pregnancy-the-diagnosis-of-pulmonary-embolism-in-pregnancy-dipep-biomarker-study
#10
Steve Goodacre, Beverley Hunt, Kiran Parmar, Neil Shephard, Kimberley Horspool
OBJECTIVE: To estimate the accuracy of biomarkers for venous thromboembolism (VTE) in pregnant and postpartum women with suspected pulmonary embolism (PE). DESIGN: Observational cohort study augmented with additional cases with VTE. SETTING: Emergency departments and maternity units at eleven prospectively recruiting sites. PARTICIPANTS: Pregnant or postpartum women presenting with suspected PE or diagnosed DVT. INTERVENTIONS: Research nurses/midwives collected a blood sample from women with suspected PE or diagnosed DVT and data relating to diagnostic imaging, treatment and adverse outcomes...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29160572/rapid-on-site-evaluation-of-routine-biochemical-parameters-to-predict-right-ventricular-dysfunction-in-and-the-prognosis-of-patients-with-acute-pulmonary-embolism-upon-admission-to-the-emergency-room
#11
Dong Jia, Fan Liu, Qin Zhang, Guang-Qiao Zeng, Xue-Lian Li, Gang Hou
INTRODUCTION: Patients with acute pulmonary embolism(APE)who present with right ventricular dysfunction (RVD) have a worse prognosis. This study aimed to evaluate the value of routine biochemical parameters in predicting RVD and 30-day mortality in patients with APE. METHODS: We retrospectively collected the clinical data for 154 enrolled patients, including the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), D-dimer, cardiac troponin I (cTnI), and N-terminal pro-brain natriuretic peptide (NT-proBNP)...
November 21, 2017: Journal of Clinical Laboratory Analysis
https://www.readbyqxmd.com/read/29146682/magnitude-of-soluble-st2-as-a-novel-biomarker-for-acute-aortic-dissection
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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 19, 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
#19
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
#20
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...
November 2017: Thrombosis and Haemostasis
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