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d dimer for pulmonary embolism

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https://www.readbyqxmd.com/read/28707499/performance-of-wells-score-to-predict-deep-vein-thrombosis-and-pulmonary-embolism-in-endurance-athletes
#1
Amanda L Zaleski, Beth A Taylor, Linda S Pescatello, Paul D Thompson, Craig Denegar
INTRODUCTION: There are an increasing number of reports describing deep vein thrombosis (DVT) and/or pulmonary embolism (PE) in otherwise healthy endurance athletes. The Wells score is the most commonly used clinical prediction rule to diagnose DVT/PE in clinical populations. However, the Wells score may have limited utility for recognition of DVT/PE in athletes, contributing to missed or delayed diagnosis. OBJECTIVE: We performed an analysis of the ability of the Wells score to identify DVT/PE events in athletes through a review of published case reports...
July 14, 2017: Physician and Sportsmedicine
https://www.readbyqxmd.com/read/28700164/-the-evolution-of-imaging-techniques-for-the-diagnosis-of-pulmonary
#2
Helia Robert-Ebadi, Frédéric Glauser, Sara Manzocchi Besson, Marc Blondon, Fatima Mahhou-Sennouni, Marc Righini
Modern diagnostic strategies for pulmonary embolism (PE) rely on the sequential use of clinical probability assessment, D-dimer and thoracic imaging when necessary. Computed tomography pulmonary angiography (CTPA) has become the imaging modality of choice. Diagnostic strategies using CTPA are very safe for the diagnosis of PE and have been well validated in large prospective management outcome studies. With the widespread use of CTPA, concerns regarding radiation and overdiagnosis of PE have paved the way for investigating new diagnostic modalities...
December 7, 2016: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28694415/-screening-of-deep-vein-thrombosis-prior-to-surgery-using-d-dimer-testing-and-venous-ultrasonography-of-lower-extremities
#3
Akira Joraku, Satoshi Nitta, Ken Tanaka, Daishi Ichioka, Atsushi Ikeda, Takayuki Yoshino, Shuya Kandori, Takashi Kawahara, Natsui Waku, Takahiro Kojima, Hiroyuki Nishiyama
Deep vein thrombus (DVT) in a patient awaiting surgery is a considerable source of pulmonary embolisms (PEs) during the surgical period, but screening for DVTs has not been emphasized. This retrospective study was conducted to identify factors associated with a positive D-dimer result and DVT diagnosis in order to evaluate the usefulness of DVT screening for patients awaiting surgery. A total of 1,061 patients (872 males, 189 females) underwent D-dimer testing prior to urological surgery at Tsukuba University Hospital between April 2013 and March 2016...
June 2017: Hinyokika Kiyo. Acta Urologica Japonica
https://www.readbyqxmd.com/read/28683951/diagnosis-and-exclusion-of-pulmonary-embolism
#4
Jeffrey A Kline
BACKGROUND: Failure to test for pulmonary embolism (PE) can be a lethal mistake, but PE and produces symptoms similar to many other diseases. Overtesting for PE has negative consequences. OBJECTIVES: Use published evidence to create a rationale and safe diagnostic approach for ambulatory and emergency patients with suspected PE in 2017. FINDINGS: Pulmonary embolism need not be pursued in patients with no symptoms of PE in the present or recent history (dyspnea, chest pain, cough or syncope), and always normal vital signs...
June 7, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28679334/syncope-in-a-patient-with-minimal-change-disease-without-nephrotic-range-proteinuria
#5
Wen-Fang Chiang, Jenq-Shyong Chan, Pauling Chu, Chia-Chao Wu
Introduction Pulmonary embolism is a potentially life-threatening complication of nephrotic syndrome. Syncope is rarely reported as an initial presentation of pulmonary embolism in nephrotic patients. Case presentation We describe a 35-year-old man who was taking steroids and diuretics for relapse of minimal change disease who presented after a syncopal event. The patient was hypotensive and had distended neck veins. The major laboratory findings were hypoalbuminemia with mild proteinuria. The findings on electrocardiography, chest radiography, and echocardiography and the elevated plasma D-dimer level raised suspicion of pulmonary embolism...
May 2017: Scottish Medical Journal
https://www.readbyqxmd.com/read/28676304/imaging-trends-in-acute-venous-thromboembolic-disease-2000-to-2015
#6
Isaac Wang, Matthew S Davenport, Ella A Kazerooni
PURPOSE: To measure diffusion of new knowledge and correlate imaging utilization for suspected acute venous thromboembolism (VTE) with d-dimer utilization, landmark publications, and institutional guidelines. MATERIALS: Between 2000 and 2015, the number of CT pulmonary angiograms (CTPAs), CTPA combined with indirect CT venography (CTV), ventilation-perfusion (VQ) scans, and lower extremity venous Doppler ultrasound (US) examinations were obtained for inpatients and emergency department (ED) patients and correlated with d-dimer utilization, landmark publications regarding radiation and VTE imaging, and an institutional inpatient best-practice alert requiring VTE prophylaxis assessment (2008)...
July 1, 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28671347/diagnosis-of-acute-pulmonary-embolism
#7
M Righini, H Robert-Ebadi, G Le Gal
Advances in the management of patients with suspected pulmonary embolism (PE) have improved diagnostic accuracy and made management algorithms safer, easier to use, and well standardized. These diagnostic algorithms are mainly based on the assessment of clinical pretest probability, D-dimer measurement, and imaging tests-predominantly computed tomography pulmonary angiography. These diagnostic algorithms allow safe and cost-effective diagnosis for most patients with suspected PE. In this review, we summarize signs and symptoms of PE, current existing evidence for PE diagnosis, and focus on the challenge of diagnosing PE in special patient populations, such as pregnant women, or patients with a prior VTE...
July 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28627093/characterization-of-thrombosis-in-patients-with-proteus-syndrome
#8
Kim M Keppler-Noreuil, Jay N Lozier, Julie C Sapp, Leslie G Biesecker
Patients with overgrowth and complex vascular malformation syndromes, including Proteus syndrome have an increased risk of thromboembolism. Proteus syndrome is a mosaic, progressive overgrowth disorder involving vasculature, skin, and skeleton, and caused by a somatic activating mutation in AKT1. We conducted a comprehensive review of the medical histories and hematologic evaluations of 57 patients with Proteus syndrome to identify potential risk factors for thrombosis. We found that six of ten patients, who were deceased, died secondary to deep venous thrombosis and/or pulmonary embolism...
June 19, 2017: American Journal of Medical Genetics. Part A
https://www.readbyqxmd.com/read/28623951/progressive-respiratory-distress-in-a-42-year-old-hiv-positive-woman-with-systemic-lupus-erythematosus
#9
Katongo Mutengo, Patrice Mukomena, Nason Lambwe, Owen Ngalamika
BACKGROUND: Identifying and treating the cause of pulmonary symptoms in HIV patients with underlying systemic lupus erythematosus (SLE) can be very challenging. Delays in diagnosing active SLE in HIV patients can lead to significant morbidity and even mortality. We report the case of an HIV-positive woman with SLE who presented with severe respiratory distress. CASE PRESENTATION: A 42-year-old HIV-positive woman presented with a 7-month history of anorexia, progressive dyspnoea, and a productive cough...
June 17, 2017: European Journal of Medical Research
https://www.readbyqxmd.com/read/28620755/predictive-value-of-mean-platelet-volume-for-pulmonary-embolism-recurrence
#10
Omer Araz, Fadime Sultan Albez, Elif Yilmazel Ucar, Bugra Kerget, Nafiye Yılmaz, Metin Akgun
PURPOSE: Recurrence is a major clinical problem in patients with pulmonary embolism and can affect mortality. The decision to discontinue treatment is important for recurrence and is based on patients' clinical features as well as certain blood parameters. Our aim in this study was to evaluate whether mean platelet volume (MPV) and platelet distribution width (PDW) have utility as new predictive parameters for recurrence and mortality in pulmonary embolism. MATERIALS AND METHODS: A total of 440 patients with pulmonary embolism underwent computed tomography, Doppler ultrasonography, and echocardiography before and at the conclusion of treatment...
June 15, 2017: Lung
https://www.readbyqxmd.com/read/28586697/the-diagnostic-management-of-upper-extremity-deep-vein-thrombosis-a-review-of-the-literature
#11
REVIEW
Noémie Kraaijpoel, Nick van Es, Ettore Porreca, Harry R Büller, Marcello Di Nisio
Upper extremity deep vein thrombosis (UEDVT) accounts for 4% to 10% of all cases of deep vein thrombosis. UEDVT may present with localized pain, erythema, and swelling of the arm, but may also be detected incidentally by diagnostic imaging tests performed for other reasons. Prompt and accurate diagnosis is crucial to prevent pulmonary embolism and long-term complications as the post-thrombotic syndrome of the arm. Unlike the diagnostic management of deep vein thrombosis (DVT) of the lower extremities, which is well established, the work-up of patients with clinically suspected UEDVT remains uncertain with limited evidence from studies of small size and poor methodological quality...
June 1, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28575869/the-relationship-between-tumor-markers-and-pulmonary-embolism-in-lung-cancer
#12
Wei Xiong, Yunfeng Zhao, Mei Xu, Jian Guo, Bigyan Pudasaini, Xueling Wu, Jinming Liu
BACKGROUND: Tumor markers (TMs) and D-Dimer are both hallmarks of severity and prognosis of lung cancer. Tumor markers could be related to pulmonary embolism (PE) in lung cancer. RESULTS: The number of abnormal tumor markers of lung cancer patients with pulmonary embolism (3.9 ± 1.1vs1.6 ± 0.6,P 0.005) was more than that in patients without pulmonary embolism. TMs panel (P trend < 0.001), CEA (R2 0.735, P0.003) and CYFRA21-1 (R2 0.718, P0.005) were positively correlated with D-Dimer in patients with pulmonary embolism...
June 20, 2017: Oncotarget
https://www.readbyqxmd.com/read/28569924/is-a-normal-computed-tomography-pulmonary-angiography-safe-to-rule-out-acute-pulmonary-embolism-in-patients-with-a-likely-clinical-probability-a-patient-level-meta-analysis
#13
Tom van der Hulle, Nick van Es, Paul den Exter, Josien van Es, Inge C M Mos, Renée A Douma, Marieke J H A Kruip, Marcel M C Hovens, Marije Ten Wolde, Mathilde Nijkeuter, Hugo Ten Cate, Pieter W Kamphuisen, Harry R Büller, Menno V Huisman, Erik Klok
A normal computed tomography pulmonary angiography (CTPA) remains a controversial criterion for ruling out acute pulmonary embolism (PE) in patients with a likely clinical probability. We set out to determine the risk of VTE and fatal PE after a normal CTPA in this patient category and compare these risk to those after a normal pulmonary angiogram of 1.7 % (95 %CI 1.0-2.7 %) and 0.3 % (95 %CI 0.02-0.7 %). A patient-level meta-analysis from 4 prospective diagnostic management studies that sequentially applied the Wells rule, D-dimer tests and CTPA to consecutive patients with clinically suspected acute PE...
June 1, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28557892/diagnostic-considerations-of-venous-thromboembolic-disease
#14
Sulaiman Alhassan, Jennifer Leap, Anand Popuri, Suman Yadam, Anil C Singh, Marvin Balaan
Venous thromboembolism (VTE) includes deep venous thrombosis (DVT) and pulmonary embolism (PE). The clinical presentation of VTE is nonspecific and requires confirmatory testing. The most common diagnostic tool for DVT is duplex ultrasonography since it is a noninvasive test with high accuracy. Contrast venography is considered the gold standard modality to diagnose DVT, but it is an invasive test. Magnetic resonance venography and computed tomography venography are alternative diagnostic methods for DVT, which can be helpful in certain circumstances...
July 2017: Critical Care Nursing Quarterly
https://www.readbyqxmd.com/read/28549662/simplified-diagnostic-management-of-suspected-pulmonary-embolism-the-years-study-a-prospective-multicentre-cohort-study
#15
Tom van der Hulle, Whitney Y Cheung, Stephanie Kooij, Ludo F M Beenen, Thomas van Bemmel, Josien van Es, Laura M Faber, Germa M Hazelaar, Christian Heringhaus, Herman Hofstee, Marcel M C Hovens, Karin A H Kaasjager, Rick C J van Klink, Marieke J H A Kruip, Rinske F Loeffen, Albert T A Mairuhu, Saskia Middeldorp, Mathilde Nijkeuter, Liselotte M van der Pol, Suzanne Schol-Gelok, Marije Ten Wolde, Frederikus A Klok, Menno V Huisman
BACKGROUND: Validated diagnostic algorithms in patients with suspected pulmonary embolism are often not used correctly or only benefit subgroups of patients, leading to overuse of computed tomography pulmonary angiography (CTPA). The YEARS clinical decision rule that incorporates differential D-dimer cutoff values at presentation, has been developed to be fast, to be compatible with clinical practice, and to reduce the number of CTPA investigations in all age groups. We aimed to prospectively evaluate this novel and simplified diagnostic algorithm for suspected acute pulmonary embolism...
May 23, 2017: Lancet
https://www.readbyqxmd.com/read/28522384/usefulness-of-d-dimer-testing-in-predicting-recurrence-in-elderly-patients-with-unprovoked-venous-thromboembolism
#16
Tobias Tritschler, Andreas Limacher, Marie Méan, Nicolas Rodondi, Drahomir Aujesky
BACKGROUND: Whether post-anticoagulation D-dimer levels are useful in predicting recurrence in elderly patients with unprovoked venous thromboembolism is unknown. METHODS: We followed up 157 patients aged ≥65 years with acute symptomatic, unprovoked venous thromboembolism in a prospective, multicenter cohort study. All patients completed 3-12 months of anticoagulation and then underwent quantitative D-dimer testing (enzyme-linked immunosorbent assay) 12 months after the index venous thromboembolism...
May 15, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28507573/admission-d-dimer-testing-for-differentiating-acute-aortic-dissection-from-other-causes-of-acute-chest-pain
#17
Wenlong Li, Bi Huang, Li Tian, Yanmin Yang, Weili Zhang, Xiaojian Wang, Jingzhou Chen, Kai Sun, Rutai Hui, Xiaohan Fan
INTRODUCTION: The present study aims to evaluate the utility of D-dimer testing for differentiating the causes of acute chest pain, including acute aortic dissection (AAD), pulmonary embolism (PE), acute myocardial infarction (AMI), unstable angina (UA), and other uncertain diagnoses of chest pain. MATERIAL AND METHODS: Consecutive patients admitted for acute chest pain within 24 h from symptom onset were enrolled prospectively, and plasma D-dimer levels were measured on admission...
April 1, 2017: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/28480751/ct-pulmonary-angiography-in-young-women
#18
Paul D Stein, Fadi Matta, Kate E Hughes, Mary J Hughes
The purpose was to determine whether young women in the emergency department who received computed tomographic (CT) pulmonary angiograms were evaluated to receive lower dose imaging or no imaging, recognizing that the risks of radiation are particularly high in young women. This was a retrospective cohort investigation of women aged 18 to 29 years seen for suspected acute pulmonary embolism in emergency departments of 5 regional hospitals from May 1, 2015 to April 30, 2016. Computed tomographic (CT) pulmonary angiograms were obtained in 379 young women...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/28450810/reduced-cardiac-function-and-risk-of-venous-thromboembolism-in-asian-countries
#19
REVIEW
Ruiqi Zhu, Yu Hu, Liang Tang
Patients with reduced cardiac function are thought to have a higher risk of venous thromboembolism (VTE). Additionally, they are vulnerable to complications of pulmonary embolism (PE) as well as right heart failure (HF), which in return is supposed to increase the rate of mortality. Studies focusing on VTE in heart failure patients were rare in Asian countries before the 21st century. Nowadays, more and more data are becoming available in this field in Asia. It is already known that heart failure can increase the risk of VTE, but so far a consensus on this issue has not been reached for many years, not only in Asian countries but all over the world...
2017: Thrombosis Journal
https://www.readbyqxmd.com/read/28447414/review-of-d-dimer-testing-good-bad-and-ugly
#20
REVIEW
L-A Linkins, S Takach Lapner
D-dimer assays are commonly used in clinical practice to exclude a diagnosis of deep vein thrombosis or pulmonary embolism. More recently, they have been also been used to guide patients with unprovoked venous thromboembolism (VTE) when faced with the decision to continue or stop anticoagulation after initial treatment is complete. D-dimer assays vary widely with respect to the antibody used, method of capture, instrumentation required, and calibration standard. These differences have an important influence on the operating characteristics of the assays...
May 2017: International Journal of Laboratory Hematology
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