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Acute pulmonary embolism

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https://www.readbyqxmd.com/read/28708723/preliminary-results-can-dual-energy-computed-tomography-help-distinguish-cardiogenic-pulmonary-edema-and-acute-interstitial-lung-disease
#1
Hitoshi Takeuchi, Shigeru Suzuki, Haruhiko Machida, Takuya Ishikawa, Eiko Ueno
OBJECTIVE: We compared iodine concentration in pulmonary ground-glass opacity on iodine density images of contrast-enhanced chest dual-energy computed tomography (DECT) between patients with cardiogenic pulmonary edema (CPE) and acute interstitial lung disease (AILD). METHODS: Five of 12 patients who underwent contrast-enhanced chest DECT to exclude pulmonary embolism were clinically diagnosed with CPE and 7, with AILD. We compared the mean CT value on monochromatic images at 65 keV and iodine concentration on iodine density images between the affected and normal areas...
July 13, 2017: Journal of Computer Assisted Tomography
https://www.readbyqxmd.com/read/28705229/brugada-syndrome-in-a-patient-with-amyotrophic-lateral-sclerosis-a-case-report
#2
Anusha Battineni, Rohit Gummi, Naresh Mullaguri, Raghav Govindarajan
BACKGROUND: Amyotrophic lateral sclerosis is a fatal neuromuscular disorder characterized by progressive death of the upper and lower motor neurons in the central nervous system. Patients with this disease die mostly as a result of respiratory failure; however, owing to prolonged survival through assisted ventilation, cardiovascular causes are increasingly responsible for mortality. We report what is to the best of our knowledge the first case of type 2 Brugada syndrome causing ventricular tachyarrhythmia and cardiac arrest in a patient with upper limb onset amyotrophic lateral sclerosis...
July 14, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28704383/predicting-in-hospital-death-during-acute-presentation-with-pulmonary-embolism-to-facilitate-early-discharge-and-outpatient-management
#3
Jerrett K Lau, Vincent Chow, Alex Brown, Leonard Kritharides, Austin C C Ng
BACKGROUND: Pulmonary embolism continues to be a significant cause of death. The aim was to derive and validate a risk prediction model for in-hospital death after acute pulmonary embolism to identify low risk patients suitable for outpatient management. METHODS: A confirmed acute pulmonary embolism database of 1,426 consecutive patients admitted to a tertiary-center (2000-2012) was analyzed, with odd and even years as derivation and validation cohorts respectively...
2017: PloS One
https://www.readbyqxmd.com/read/28699943/dosing-accuracy-of-direct-oral-anticoagulants-in-an-academic-medical-center
#4
Janice Schwartz, Steve Merrill, Noelle de Leon, Ashley Thompson, Margaret Fang
BACKGROUND/OBJECTIVE: Direct-acting oral anticoagulants (DOACs) are increasingly used to prevent or treat thromboembolism. We conducted a study to compare how well initial DOAC prescribing for adult inpatients adhered to dosing recommendations approved by the US Food and Drug Administration (FDA). DESIGN: Retrospective analysis. SETTING: Single academic medical center, July 1, 2014 to June 30, 2015. PATIENTS: 508 adult inpatients...
July 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28698258/comparison-of-fatal-or-irreversible-events-with-extended-duration-betrixaban-versus-standard-dose-enoxaparin-in-acutely-ill-medical-patients-an-apex-trial-substudy
#5
C Michael Gibson, Serge Korjian, Gerald Chi, Yazan Daaboul, Purva Jain, Douglas Arbetter, Samuel Z Goldhaber, Russel Hull, Adrian F Hernandez, Renato D Lopes, Alex Gold, Alexander T Cohen, Robert A Harrington
BACKGROUND: Extended-duration betrixaban showed a significant reduction in venous thromboembolism in the APEX trial (Acute Medically Ill VTE Prevention With Extended Duration Betrixaban Study). Given the variable clinical impact of different efficacy and safety events, one approach to assess net clinical outcomes is to include only those events that are either fatal or cause irreversible harm. METHODS AND RESULTS: This was a post hoc analysis of the APEX trial-a multicenter, double-blind, randomized controlled trial comparing extended-duration betrixaban versus standard-of-care enoxaparin...
July 11, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28696852/imaging-of-pregnancy-related-vascular-complications
#6
R Scooter Plowman, Cylen Javidan-Nejad, Constantine A Raptis, Douglas S Katz, Vincent M Mellnick, Sanjeev Bhalla, Patricia Cornejo, Christine O Menias
Pregnancy results in substantial hemodynamic and prothrombotic changes that form the foundation for downstream vascular complications, both during pregnancy and in the postpartum period. In addition, several important risk factors, including older patient age, diabetes, and smoking, can increase the risk for vascular-related pregnancy complications. Because radiologists often play an important role in evaluation of the pregnant patient, understanding the pathophysiology of vascular-related complications in pregnancy and their imaging appearances is essential for diagnostic accuracy...
July 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/28694415/-screening-of-deep-vein-thrombosis-prior-to-surgery-using-d-dimer-testing-and-venous-ultrasonography-of-lower-extremities
#7
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/28690295/high-frequency-of-acute-adverse-cardiovascular-events-after-lung-transplantation-in-patients-with-pulmonary-arterial-hypertension-receiving-preoperative-long-term-intravenous-prostacyclin
#8
Satoshi Akagi, Takahiro Oto, Motomu Kobayashi, Kentaroh Miyoshi, Seiichiro Sugimoto, Masaomi Yamane, Kazufumi Nakamura, Toshihiro Sarashina, Shinichiro Miyoshi, Hiroshi Ito
Adverse cardiovascular events after lung transplantation (LT) increase the mortality in patients with pulmonary arterial hypertension (PAH). Long-term intravenous prostacyclin is the usual treatment in severe patients with PAH, but it may increase the risk of hemorrhage due to its antiplatelet aggregation effect or thrombocytopenia. We investigated the impact of length of intravenous prostacyclin therapy on acute adverse cardiovascular events including hemorrhagic complication after LT. We retrospectively compared the incidence of adverse events (death, intrathoracic hematoma and bleeding, cardiac congestion or shock, cerebral infarction and pulmonary embolism) within 30 days after LT between no/short-term (median 0...
July 10, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28683900/derivation-and-validation-of-a-novel-prediction-model-to-identify-low-risk-patients-with-acute-pulmonary-embolism
#9
Muthiah Subramanian, Sowmya Gopalan, Srinivasan Ramadurai, Preetam Arthur, Mukund A Prabhu, Rajesh Thachathodiyl, Kumaraswamy Natarajan
Accurate identification of low-risk patients with acute pulmonary embolism (PE) who may be eligible for outpatient treatment or early discharge can have substantial cost-saving benefit. The purpose of this study was to derive and validate a prediction model to effectively identify patients with PE at low risk of short-term mortality, right ventricular dysfunction, and other nonfatal outcomes. This study analyzed data from 400 consecutive patients with acute PE. We derived and internally validated our prediction rule based on clinically significant variables that are routinely available at initial examination and that were categorized and weighted using coefficients in the multivariate logistic regression...
May 30, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28683557/weekend-versus-weekday-admission-and-in-hospital-mortality-for-pulmonary-embolism-a-14-year-retrospective-study-on-the-national-hospital-database-of-italy
#10
Massimo Gallerani, Ugo Fedeli, Marco Pala, Alfredo De Giorgi, Fabio Fabbian, Roberto Manfredini
We assessed the association between weekday (WD) or weekend (WE) admission and mortality for patients hospitalized with acute pulmonary embolism (PE). Weekend included holidays. We analyzed hospital administrative data of all patients discharged with a diagnosis of PE extracted from the Italian Health Ministry database (January 2001 to December 2014). A total of 265 035 hospitalizations with a diagnosis of PE were retrieved, in which PE was the primary diagnosis in 198 565 (74.9%); 200 166 (75.5%) patients were admitted on WD and 64 869 (24...
January 1, 2017: Angiology
https://www.readbyqxmd.com/read/28682884/microarray-expression-profile-of-circular-rnas-in-chronic-thromboembolic-pulmonary-hypertension
#11
Ran Miao, Ying Wang, Jun Wan, Dong Leng, Juanni Gong, Jifeng Li, Yan Liang, Zhenguo Zhai, Yuanhua Yang
BACKGROUND: Chronic thromboembolic pulmonary hypertension (CTEPH) is a rare but debilitating and life-threatening complication of acute pulmonary embolism. Circular RNAs (circRNAs), presenting as covalently closed continuous loops, are RNA molecules with covalently joined 3'- and 5'-ends formed by back-splicing events. circRNAs may be significant biological molecules to understand disease mechanisms and to identify biomarkers for disease diagnosis and therapy. The aim of this study was to investigate the potential roles of circRNAs in CTEPH...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28680172/direct-oral-anticoagulants-and-vitamin-k-antagonists-for-treatment-of-deep-venous-thrombosis-and-pulmonary-embolism-in-the-outpatient-setting-comparative-economic-evaluation
#12
Abdullah S Al Saleh, Patrick Berrigan, David Anderson, Sudeep Shivakumar
BACKGROUND: To date, there have been few economic evaluations, from a Canadian perspective, of direct oral anticoagulants (DOACs) for the prevention of recurrent venous thromboembolism (VTE) in patients with acute unprovoked VTE. As a result, there is a lack of consensus about which treatment strategy should be adopted in the clinical setting. OBJECTIVES: To assess the cost-effectiveness of currently approved anti-coagulant options, in terms of cost per quality-adjusted life-year (QALY) gained, for the prevention of recurrent VTE in patients with unprovoked events managed on an outpatient basis...
May 2017: Canadian Journal of Hospital Pharmacy
https://www.readbyqxmd.com/read/28678793/timing-of-femoral-shaft-fracture-fixation-following-major-trauma-a-retrospective-cohort-study-of-united-states-trauma-centers
#13
James P Byrne, Avery B Nathens, David Gomez, Daniel Pincus, Richard J Jenkinson
BACKGROUND: Femoral shaft fractures are common in major trauma. Early definitive fixation, within 24 hours, is feasible in most patients and is associated with improved outcomes. Nonetheless, variability might exist between trauma centers in timeliness of fixation. Such variability could impact outcomes and would therefore represent a target for quality improvement. We evaluated variability in delayed fixation (≥24 hours) between trauma centers participating in the American College of Surgeons (ACS) Trauma Quality Improvement Program (TQIP) and measured the resultant association with important clinical outcomes at the hospital level...
July 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28676304/imaging-trends-in-acute-venous-thromboembolic-disease-2000-to-2015
#14
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/28675998/cardiovascular-and-pulmonary-manifestations-of-systemic-lupus-erythematosus
#15
M B Urowitz, Konstantinos Tselios
BACKGROUND: Systemic lupus erythematosus (SLE) is characterized by various clinical manifestations and immunologic abnormalities. Among clinical manifestations, cardiovascular and respiratory system involvement is increasingly recognized as critical for patients' prognosis. OBJECTIVE: Heart involvement, most commonly presents with pericarditis. However, valvular disease and less often myocarditis may be detected. METHOD: Accelerated atherosclerosis is currently considered as one of the most important co-morbidities of SLE with cardiovascular events being one of the leading causes of death at relatively young ages...
July 4, 2017: Current Rheumatology Reviews
https://www.readbyqxmd.com/read/28675082/predictors-of-mid-term-prognosis-and-adverse-factors-in-acute-pulmonary-embolism
#16
Xin Liu, Suchi Chang, Cuiping Fu, Zhirong Huo, Jing Zhou, Chengying Liu, Shanqun Li, Aijun Sun
BACKGROUND: To explore the differences in short and middle term adverse factors of pulmonary embolism (PE) outcome. METHODS: This was a single-center retrospective study of inpatients admitted from Zhongshan Hospital, Fudan University, with first-time PE. Clinical data were collected from patients with objectively confirmed PE, and a 2-year follow up was conducted. RESULTS: The sample contained 310 patients with PE, ranging in age from 18 to 86 years old (mean 63...
July 1, 2017: Therapeutic Advances in Respiratory Disease
https://www.readbyqxmd.com/read/28673674/is-ct-angiography-of-the-pulmonary-arteries-indicated-in-patients-with-high-clinical-probability-of-pulmonary-embolism
#17
L Martínez Montesinos, J M Plasencia Martínez, J M García Santos
When a diagnostic test confirms clinical suspicion, the indicated treatment can be administered. A problem arises when the diagnostic test does not confirm the initially suspected diagnosis; when the suspicion is grounded in clinically validated predictive rules and is high, the problem is even worse. This situation arises in up to 40% of patients with high suspicion for acute pulmonary embolism, raising the question of whether CT angiography of the pulmonary arteries should be done systematically. This paper reviews the literature about this issue and lays out the best evidence about the relevant recommendations for patients with high clinical suspicion of acute pulmonary embolism and negative findings on CT angiography...
June 30, 2017: Radiología
https://www.readbyqxmd.com/read/28673474/new-developments-and-future-challenges-of-nuclear-medicine-and-molecular-imaging-for-pulmonary-embolism
#18
Pierre-Yves Le Roux, Philippe Robin, Pierre-Yves Salaun
Although widely validated, current tests for pulmonary embolism (PE) diagnosis, i.e. computed tomography pulmonary angiography (CTPA) and V/Q planar scintigraphy, have some limitations. Drawbacks of CTPA include the radiation dose, some contra indications and a rising concern about a possible overdiagnosis/overtreatment of PE. On the other hand, V/Q planar scintigraphy has a high rate of non-diagnostic tests responsible for complex diagnostic algorithms. Since the PIOPED study, imaging equipment and radiopharmaceuticals have greatly evolved allowing the introduction of techniques that improve imaging of lung ventilation and perfusion...
June 27, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28671347/diagnosis-of-acute-pulmonary-embolism
#19
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/28667815/pulmonary-thromboembolism-in-an-emergency-hospital-are-our-patients-different
#20
Ana Maria Balahura, Andrada Guţă, Vlad Mihalcea, Emma Weiss, Maria Dorobanţu, Daniela Bartoş, Elisabeta Bădilă, Gheorghe Andrei Dan
INTRODUCTION: Pulmonary embolism (PTE) represents a medical emergency and is the third most common cause of mortality after myocardial infarction and stroke. The purpose of this study was to describe the characteristics and management of patients with PTE admitted in a referral emergency hospital in Romania. MATERIAL AND METHODS: We retrospectively reviewed all cases of PTE diagnosed in one of the largest emergency hospitals in Bucharest during a 2-year period (January 2014 - December 2016)...
June 27, 2017: Romanian Journal of Internal Medicine, Revue Roumaine de Médecine Interne
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