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Acute pulmonary embolism

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https://www.readbyqxmd.com/read/29331359/quantitative-ct-evaluation-of-small-pulmonary-vessels-in-patients-with-acute-pulmonary-embolism
#1
Shin Matsuoka, Akiyuki Kotoku, Tsuneo Yamashiro, Shoichiro Matsushita, Atsuko Fujikawa, Kunihiro Yagihashi, Yasuo Nakajima
RATIONALE AND OBJECTIVES: The objective of this study was to investigate the correlation between the computed tomography (CT) cross-sectional area (CSA) of small pulmonary vessels and the CT obstruction index in patients with acute pulmonary embolism (PE) and the correlation between the changes in these measurements after anticoagulant therapy. MATERIALS AND METHODS: Fifty-two patients with acute PE were selected for this study. We measured the CSA less than 5 mm2 on coronal reconstructed images to obtain the percentage of the CSA (%CSA < 5)...
January 10, 2018: Academic Radiology
https://www.readbyqxmd.com/read/29328448/association-between-ace2-ace-balance-and-pneumocyte-apoptosis-in-a-porcine-model-of-acute-pulmonary-thromboembolism-with-cardiac-arrest
#2
Hong-Li Xiao, Lian-Xing Zhao, Jun Yang, Nan Tong, Le An, Qi-Tong Liu, Miao-Rong Xie, Chun-Sheng Li
Acute pulmonary embolism (APE) is frequently reported in patients with cardiac arrest (CA) in emergency care. Pneumocyte apoptosis is commonly observed in the lungs following an APE. An important pathological mechanism evoking apoptosis during a lipopolysaccharide‑induced acute lung injury is the angiotensin‑converting enzyme 2 (ACE2)/ACE imbalance. The present study uses a porcine model to examine the anti‑apoptotic effects of captopril on APE‑CA and the return of spontaneous circulation (ROSC). Pigs were randomly assigned into four groups: Control, APE‑CA, ROSC‑saline, and ROSC‑captopril...
January 12, 2018: Molecular Medicine Reports
https://www.readbyqxmd.com/read/29322296/catheter-directed-ultrasound-facilitated-fibrinolysis-in-obese-patients-with-massive-and-submassive-pulmonary-embolism
#3
Brett J Carroll, Samuel Z Goldhaber, Ping-Yu Liu, Gregory Piazza
Obesity is a well-established risk factor for pulmonary embolism (PE). However, treatment of PE in obese patients is challenging because of limited outcomes data, especially with advanced therapies such as catheter-based fibrinolysis. We assessed the efficacy and safety of ultrasound-facilitated, catheter-directed fibrinolysis in obese patients with submassive and massive PE enrolled in the SEATTLE II Trial. Eligible patients had a right ventricular-to-left ventricular (RV/LV) diameter ratio ≥ 0.9 on chest computed tomography (CT)...
January 10, 2018: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29320796/prevalence-and-risk-factors-of-acute-pulmonary-embolism-in-patients-with-lung-cancer-surgery
#4
Yu-Ping Li, Lei Shen, Wei Huang, Xue-Fei Hu, Dong Xie, Jian Yang, Xiao Song, Yan-Feng Zhao, Chao-Jie Zhou, Ge-Ning Jiang
Acute pulmonary embolism (PE) is one of the serious complications with high mortality after thoracic surgery. The authors aimed to determine the prevalence of PE events and evaluate additional risk factors for PE in patients with lung cancer surgery. Patients underwent lung cancer resections during January 2012 to July 2015 and had 30-day postoperative follow-up were included. Those with incomplete or miscoded data were excluded. The number of postoperative PE events was recorded retrospectively. Analyses were used to evaluate risk factors of PE during the hospitalization...
January 10, 2018: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/29319365/the-prognostic-value-of-mid-regional-pro-adrenomedullin-in-the-evaluation-of-acute-dyspnea
#5
Justin J Choi, Matthew W McCarthy
Acute dyspnea is a common chief complaint among patients who visit an emergency room and presents diagnostic challenges for clinicians in both identifying the etiology and determining the clinical severity. The study of biomarkers in the prognostication and risk stratification of these patients has been increasing, including the investigation of the prognostic value for mid-regional pro-adrenomedullin (MR-proADM). Areas Covered: In this review, the authors cover what is known about MR-proADM testing in patients presenting with acute dyspnea and the supporting evidence of its prognostic value in common conditions in medical patients with acute dyspnea, including acute heart failure, community acquired pneumonia, acute exacerbation of chronic obstructive pulmonary disease, and acute pulmonary embolism...
January 10, 2018: Expert Review of Molecular Diagnostics
https://www.readbyqxmd.com/read/29305675/efficacy-and-safety-of-outpatient-treatment-with-direct-oral-anticoagulation-in-pulmonary-embolism
#6
REVIEW
R Ghazvinian, A Gottsäter, J L Elf
Anticoagulant treatment of acute pulmonary embolism (PE) has traditionally been hospital-based. The lesser need for monitoring with the increasingly used direct acting oral anticoagulants (DOAC) in comparison to warfarin potentially facilitates outpatient treatment of PE with these drugs. This study aimed to evaluate efficacy and safety of outpatient treatment of PE with DOAC. We extracted data from the Swedish quality registry for patients on oral anticoagulation (AuriculA) for all 245 patients in the southernmost hospital region in Sweden (1...
January 5, 2018: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29305026/beyond-submassive-acute-pulmonary-embolism-seeing-clearly-beyond-the-clouds
#7
EDITORIAL
Janet M C Ngu, Fraser D Rubens
No abstract text is available yet for this article.
November 8, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29304932/patient-friendly-summary-of-the-acr-appropriateness-criteria-acute-chest-pain-suspected-pulmonary%C3%A2-embolism
#8
Andrea Borondy Kitts
No abstract text is available yet for this article.
January 2018: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29304524/amino-fucoidan-as-a-vector-for-rtpa-induced-fibrinolysis-in-experimental-thrombotic-events
#9
Radouane Ghebouli, Stephane Loyau, Murielle Maire, Pierre Saboural, Jean-Philippe Collet, Martine Jandrot-Perrus, Didier Letourneur, Frédéric Chaubet, Jean-Baptiste Michel
Acute ischaemic stroke, myocardial infarction and pulmonary embolism are the main causes of mortality and morbidity worldwide. Thrombolysis by intravenous injection of recombinant tissue plasminogen activator (rtPA) remains the most common non-interventional treatment to recanalize occluded vessels. However, this procedure is limited by significant drawbacks, including high doses and bleeding complications. Recent studies showed that fucoidan targets the intraluminal thrombus in vivo. We have developed a chimaera covalently linking fucoidan, able to target platelets within the thrombus, to dilysine, able to non-covalently bind rtPA...
January 2018: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/29304488/factors-associated-with-elevated-cardiac-troponin-levels-in-patients-with-acute-pulmonary-thromboembolism
#10
Samad Ghaffari, Nariman Sepehrvand, Leili Pourafkari, Reza Hajizadeh, Elnaz Javanshir, Mehdi Nadiri, Nader D Nader
PURPOSE: We aimed to investigate the factors that are associated with increased cardiac troponin I (cTnI) leakage in the acute pulmonary embolism (PTE) setting and their alignment with patient outcome. METHODS: Adult patients with a diagnosis of PTE were enrolled in this prospective cohort study. The primary endpoint of interest was major adverse cardio-pulmonary events (MACPE), defined as the composite of in-hospital all-cause mortality, need for thrombolysis and mechanical ventilation and surgical embolectomy during index hospitalization...
December 29, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29302461/warfarin-anticoagulation-in-acute-type-a-aortic-dissection-survivors-watas
#11
Yskert von Kodolitsch, Oliver Wilson, Helke Schüler, Axel Larena-Avellaneda, Tilo Kölbel, Sabine Wipper, Fiona Rohlffs, Christian Behrendt, E Sebastian Debus, Jens Brickwedel, Evaldas Girdauskas, Christian Detter, Alexander M Bernhardt, Jürgen Berger, Stefan Blankenberg, Hermann Reichenspurner, Tamer Ghazy, Klaus Matschke, Ralf-Thorsten Hoffmann, Norbert Weiss, Adrian Mahlmann
Background: Early survivors of acute type A aortic dissection (AAAD) remain at risk for late death and late aortic events. However, the frequency and long-term effects of warfarin anticoagulation on long-term outcome in post-surgical AAAD survivors have not been elucidated. Methods: Two tertiary care centers performed a retrospective observational cohort study of warfarin anticoagulation in AAAD in 243 persons with early survival of surgical repair (WATAS). Serial postoperative tomographic imaging was available in 106 persons...
December 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/29302122/rvad-support-in-the-setting-of-submassive-pulmonary-embolism
#12
Antonio Salsano, Elena Sportelli, Guido Maria Olivieri, Nicola Di Lorenzo, Silvia Borile, Francesco Santini
Patients with submassive pulmonary embolism (PE), although normotensive, are characterized by right ventricular (RV) dysfunction and elevated levels of biomarkers of cardiac damage. The best treatment option in these cases is still a subject of debate and the use of thrombolysis in submassive PE remains controversial. A 57-year-old Caucasian male with unprovoked PE, normal blood pressure, and elevated troponin I values was referred to the cardiovascular department. In view of the presence of a right atrium thrombus, the patient underwent surgical embolectomy under extracorporeal circulation, with the extraction of a huge thrombus together with fragmented thrombi from both pulmonary arteries...
December 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/29298088/echocardiogram-in-the-evaluation-of-hemodynamically-stable-acute-pulmonary-embolism-national-practices-and-clinical-outcomes
#13
David M Cohen, Michael Winter, Peter K Lindenauer, Allan J Walkey
RATIONALE: Societal guideline recommendations vary with regard to the role of routine trans-thoracic echocardiography (TTE) to screen for right ventricular strain in patients with hemodynamically-stable, acute pulmonary embolism (PE). OBJECTIVE: To characterize national patterns in use of early TTE for the evaluation of patients with hemodynamically-stable, acute PE, and determine associations between TTE use and patient outcomes. METHODS: Retrospective cohort study using Premier, Inc...
January 3, 2018: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29296166/multimodal-imaging-for-the-assessment-of-a-cardiac-mass-a-case-of-primary-cardiac-sarcoma
#14
Benjamin Abels, Steffen Pfeiffer, Jana Stix, Johannes Schwab
We present a case of an 85-year-old patient who underwent clinical work-up for chronic heart failure, acute coronary syndrome, and pulmonary embolism, until she was diagnosed with a cardiac mass that was histologically identified as sarcoma. The aim of this educational case report is to raise awareness of cardiac masses and to point out diagnostic hints towards a cardiac tumor on chest X-ray, coronary angiography, echocardiography, and chest CT. Moreover, the vital role of cardiac magnetic resonance for the diagnosis of a cardiac mass is highlighted...
November 2017: Journal of Radiology Case Reports
https://www.readbyqxmd.com/read/29296060/short-term-outcomes-of-transcatheter-closure-of-secundum-atrial-septal-defect-in-children-and-adolescents-an-experience-of-two-centers-in-upper-egypt
#15
Safaa H Ali, Amal El Sisi, Duaa M Raafat, Salah-Eldin Amry, Sharaf E D Mahamoud
Background: The aim of this study was to evaluate the acute and short-term outcomes of transcatheter closure of secundum atrial septal defect (ASD) in children and adolescents in the first 4-year experience in two institutional centers in Upper Egypt. Methods: This was a retrospective cohort study including 135 children and adolescents who underwent ASD closure between April 2012 and May 2016. A review of the acute and short-term outcomes and adverse events was performed...
January 2018: Journal of the Saudi Heart Association
https://www.readbyqxmd.com/read/29295847/how-i-use-catheter-directed-interventional-therapy-to-treat-patients-with-venous-thromboembolism
#16
Suresh Vedantham, Akhilesh K Sista
Patients who present with severe manifestations of acute venous thromboembolism (VTE) are at higher risk for premature death and long-term disability. In recent years, catheter-based interventional procedures have shown strong potential to improve clinical outcomes in selected VTE patients. However, physicians continue to be routinely faced with challenging decisions that pertain to the utilization of these risky and costly treatment strategies, and there is a relative paucity of published clinical trials with sufficient rigor and directness to inform clinical practice...
January 2, 2018: Blood
https://www.readbyqxmd.com/read/29291427/pulmonary-embolism-care-standards-in-2018
#17
REVIEW
Ariel Borohovitz, Mitchell D Weinberg, Ido Weinberg
Pulmonary embolism (PE) is a leading cause of cardiovascular mortality worldwide. Clinical presentation can be diverse, and clinicians should have a high index of suspicion regarding the diagnosis. Evaluation should include detailed history of possible risk factors, physical examination and laboratory tests that would support the diagnosis and help risk-stratify patients. Finally, a dedicated imaging study should be performed in order to make a definitive diagnosis. Decisions regarding short-term, immediate, treatment are dictated by PE risk category...
December 29, 2017: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/29287491/acute-pulmonary-embolism-after-arthroscopic-glenoid-labral-repair-and-subacromial-decompression-case-report-and-review-of-the-literature
#18
Michelle Yagnatovsky, Amos Z Dai, Michael Zacchilli, Laith M Jazrawi
A 29-year-old female with a history of polycystic ovary syndrome (PCOS) on combined oral contraceptives presents with an acute, CT confirmed pulmonary embolus of the right lower lobe one week following arthroscopic labral repair of the right shoulder. The patient's risk factors including obesity, oral contraceptive use, PCOS, and surgical positioning are discussed.
December 21, 2017: Physician and Sportsmedicine
https://www.readbyqxmd.com/read/29285876/metabolomic-analysis-of-92-pulmonary-embolism-patients-from-a-nested-case-control-study-identifies-metabolites-associated-with-adverse-clinical-outcomes
#19
O A Zeleznik, E M Poole, S Lindstrom, P Kraft, A Van Hylckama Vlieg, J A Lasky-Su, L B Harrington, K Hagan, J Kim, B A Parry, N Giordano, C Kabrhel
BACKGROUND: Patients with acute pulmonary embolism (PE) exhibit wide variation in clinical presentation and outcomes. Our understanding of the pathophysiologic mechanisms differentiating low-risk and high-risk PE is limited, so current risk-stratification efforts often fail to predict clinical deterioration and are insufficient to guide management. OBJECTIVES: To improve our understanding of the physiology differentiating low-risk from high-risk PE, we conducted the first-ever high-throughput metabolomics analysis (843 named metabolites) comparing PE patients across risk strata within a nested case-control study...
December 29, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/29284886/monitored-anesthesia-care-for-the-acute-ischemic-stroke-patient-with-end-stage-pulmonary-disease
#20
Kevin C Lee, Brian C Lee, Steven E Miller
The majority of patients who suffer acute ischemic stroke (AIS) from large vessel occlusion are at a significant risk for disability or death. Because patients on veno-arterial extracorporeal membrane oxygenation (VA ECMO) are therapeutically anticoagulated, intravenous recombinant tissue plasminogen activator is contraindicated. For AIS management, these patients must undergo emergent intra-arterial therapy. Presented is a patient on VA ECMO who subsequently suffered a large vessel embolic stroke requiring emergent surgical intervention...
October 2017: Anesthesia, Essays and Researches
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