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well's score embolism

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https://www.readbyqxmd.com/read/28262522/a-clinically-meaningful-interpretation-of-the-prospective-investigation-of-pulmonary-embolism-diagnosis-pioped-scintigraphic-data
#1
Paul Cronin, Ben A Dwamena
RATIONALE AND OBJECTIVES: Pulmonary embolism (PE) is a common condition associated with significant morbidity and mortality. Diagnostic test characteristics reported in terms of sensitivity and specificity are difficult to translate at the clinical level. More relevant measures are likelihood ratios (LRs), which can convert a pretest into a posttest probability. The aim of our study was to calculate the LRs and posttest probabilities for multiple-level test result for ventilation/perfusion (V/Q) lung scintigraphy and for perfusion scintigraphy combined with chest radiography using modified Prospective Investigation of Pulmonary Embolism Diagnosis (PIOPED) II and the Prospective Investigative Study of Pulmonary Embolism Diagnosis (PISAPED) criteria for each clinical probability level for the most commonly used clinical prediction rules (CPR) using the PIOPED data...
March 2, 2017: Academic Radiology
https://www.readbyqxmd.com/read/28262243/pitfalls-in-the-diagnostic-management-of-pulmonary-embolism-in-pregnancy
#2
Cécile Tromeur, Liselotte M van der Pol, Frederikus A Klok, Francis Couturaud, Menno V Huisman
Women are at increased risk of venous thromboembolism (VTE) during pregnancy and VTE remains one of the main causes of maternal mortality in developed countries (Konstantinides SV, et al. Eur Heart J 2014; 35(43):3033-69, 69a-69k). Although an accurate diagnosis of acute pulmonary embolism (PE) in pregnant patients is thus of crucial importance, the diagnostic management of suspected PE is challenging for this specific patient category. As D-dimer levels increase physiologically throughout pregnancy, the optimal D-dimer threshold to rule out PE during pregnancy remains unknown...
March 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28260470/american-society-of-anesthesiologists-classification-versus-ariscat-risk-index-predicting-pulmonary-complications-following-renal-transplant
#3
Elif Kupeli, Balam Er Dedekarginoglu, Gaye Ulubay, Fusun Oner Eyuboglu, Mehmet Haberal
OBJECTIVES: Patients with chronic renal failure are prone to pulmonary complications. Renal transplant recipients should undergo complete preoperative evaluation to determine risk of postoperative pulmonary complications. The American Society of Anesthesiologists classification and the Assess Respiratory Risk in Surgical Patients in Catalonia risk index correlate well with incidence of postoperative pulmonary complications. Here, we compared their accuracy in predicting pulmonary complications following renal transplant...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28236025/incremental-diagnostic-quality-gain-of-cta-over-v-q-scan-in-the-assessment-of-pulmonary-embolism-by-means-of-a-wells-score-bayesian-model-results-from-the-acdc-collaboration
#4
Laila Cochon, Kaitlin McIntyre, José M Nicolás, Amado Alejandro Baez
OBJECTIVE: Our objective was to evaluate the diagnostic value of computed tomography angiography (CTA) and ventilation perfusion (V/Q) scan in the assessment of pulmonary embolism (PE) by means of a Bayesian statistical model. METHODS: Wells criteria defined pretest probability. Sensitivity and specificity of CTA and V/Q scan for PE were derived from pooled meta-analysis data. Likelihood ratios calculated for CTA and V/Q were inserted in the nomogram. Absolute (ADG) and relative diagnostic gains (RDG) were analyzed comparing post- and pretest probability...
February 24, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/28196379/pulmonary-embolism-and-atrial-fibrillation-two-sides-of-the-same-coin-a-systematic-review
#5
Behnood Bikdeli, Maen D Abou Ziki, Gregory Y H Lip
Pulmonary embolism (PE) is a common, potentially fatal thrombotic disease. Atrial fibrillation (AF), the most common arrhythmia, may also lead to thromboembolic complications. Although initially appearing as distinct entities, PE and AF may coexist. The direction and extent of this association has not been well characterized. We performed a search of PubMed, Scopus, and the Cochrane Database of Systematic Reviews for publications that reported coexisting AF in patients with PE, or vice versa, to provide a systematic overview of pathophysiological and epidemiological aspects of this association (last search: October 13, 2016)...
February 14, 2017: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/28195823/clinical-safety-of-bariatric-arterial-embolization-preliminary-results-of-the-beat-obesity-trial
#6
Clifford R Weiss, Olaguoke Akinwande, Kaylan Paudel, Lawrence J Cheskin, Brian Holly, Kelvin Hong, Aaron M Fischman, Rahul S Patel, Eun J Shin, Kimberley E Steele, Timothy H Moran, Kristen Kaiser, Amie Park, David M Shade, Dara L Kraitchman, Aravind Arepally
Purpose To conduct a pilot prospective clinical trial to evaluate the feasibility, safety, and short-term efficacy of bariatric embolization, a recently developed endovascular procedure for the treatment of obesity, in patients with severe obesity. Materials and Methods This is an institutional review board- and U.S. Food and Drug Administration-approved prospective physician-initiated investigational device exemption study. This phase of the study ran from June 2, 2014, to August 4, 2015. Five severely obese patients (four women, one man) who were 31-49 years of age and who had a mean body mass index of 43...
February 14, 2017: Radiology
https://www.readbyqxmd.com/read/28131928/treatment-strategies-for-intracranial-mirror-aneurysms
#7
Wen-Xin Wang, Zhe Xue, Lin Li, Chen Wu, Yan-Yang Zhang, Xin Lou, Lin Ma, Zheng-Hui Sun
OBJECTIVE: Intracranial mirror aneurysms are clinically rare and uncommonly reported in the literature. Therefore, the present study evaluated a series of mirror aneurysm cases with respect to the clinical features of the patients and the treatment strategies that were used. METHODS: This study retrospectively reviewed and systematically analyzed the clinical features, imaging data, treatment methods, and treatment outcomes of 68 cases of mirror aneurysms (a total of 70 pairs) that were admitted to our department between November 2007 and May 2016...
January 25, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28116533/negative-d-dimer-testing-excludes-pulmonary-embolism-in-non-high-risk-patients-in-the-emergency-department
#8
John B Harringa, Rebecca L Bracken, Scott K Nagle, Mark L Schiebler, Michael S Pulia, James E Svenson, Michael D Repplinger
PURPOSE: The purpose of this study was to assess the ability of d-dimer testing to obviate the need for cross-sectional imaging for patients at "non-high risk" for pulmonary embolism (PE). METHODS: This is a retrospective study of emergency department patients at an academic medical center who underwent cross-sectional imaging (MRA or CTA) to evaluate for PE from 2008 to 2013. The primary outcome was the NPV of d-dimer testing when used in conjunction with clinical decision instruments (CDIs = Wells', Revised Geneva, and Simplified Revised Geneva Scores)...
January 24, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/28110934/-posttraumatic-thromboembolic-complications-incidence-risk-factors-pathophysiology-and-prevention
#9
M Bahloul, K Regaieg, K Chtara, O Turki, N Baccouch, A Chaari, M Bouaziz
Venous thromboembolism (VTE) remains a major challenge in critically ill patients. Subjects admitted in intensive care unit (ICU), in particular trauma patients, are at high-risk for both deep vein thrombosis (DVT) and pulmonary embolism (PE). The rate of symptomatic PE in injured patients has been reported previously ranging from 1 to 6%. The high incidence of posttraumatic venous thromboembolic events is well known. In fact, major trauma is a hypercoagulable state. Several factors placing the individual patient at a higher risk for the development of DVT and PE have been suggested: high ISS score, meningeal hemorrhage and spinal cord injuries have frequently been reported as a significant risk factor for VTEs after trauma...
January 19, 2017: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/28106343/net-clinical-benefit-of-hospitalization-versus-outpatient-management-of-patients-with-acute-pulmonary-embolism
#10
P-M Roy, D J Corsi, M Carrier, A Theogene, C de Wit, C Dennie, G Le Gal, A Delluc, T Moumneh, M Rodger, P Wells, E Gandara
Essentials Clinical benefit of hospitalization vs. outpatient treatment in pulmonary embolism (PE) is unknown. We performed a propensity matched cohort study of hemodynamically stable PE patients. Regardless of the risk assessment, hospitalized patients had the highest rate of adverse event. If confirmed, ambulatory care of normotensive PE patients may be preferred whenever possible. SUMMARY: Background The decision to hospitalize or not patients with acute pulmonary embolism (PE) is controversial...
January 20, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28106338/the-original-and-simplified-wells-rules-and-age-adjusted-d-dimer-testing-to-rule-out-pulmonary-embolism-an-individual-patient-data-meta-analysis
#11
N van Es, N Kraaijpoel, F A Klok, M V Huisman, P L Den Exter, I C M Mos, J Galipienzo, H R Büller, P M Bossuyt
Essentials Evidence for the simplified Wells rule in ruling out acute pulmonary embolism (PE) is scarce. This was a post-hoc analysis on data from 6 studies comprising 7268 patients with suspected PE. The simplified Wells rule combined with age-adjusted D-dimer testing may safely rule out PE. Given its ease of use, the simplified Wells rule is to be preferred over the original Wells rule. SUMMARY: Background The Wells score and D-dimer testing can safely rule out pulmonary embolism (PE)...
January 20, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28101125/preventive-transarterial-embolization-in-upper-nonvariceal-gastrointestinal-bleeding
#12
Aleksejs Kaminskis, Aina Kratovska, Sanita Ponomarjova, Anna Tolstova, Maksims Mukans, Solvita Stabiņa, Raivis Gailums, Andrejs Bernšteins, Patricija Ivanova, Viesturs Boka, Guntars Pupelis
BACKGROUND: Transarterial embolization (TAE) is a therapeutic option for patients with a high risk of recurrent bleeding after endoscopic haemostasis. The aim of our prospective study was a preliminary assessment of the safety, efficacy, and clinical outcomes following preventive TAE in patients with non-variceal acute upper gastrointestinal bleeding (NVUGIB) with a high risk of recurrent bleeding after endoscopic haemostasis. METHODS: Preventive visceral angiography and TAE were performed after endoscopic haemostasis on patients with NVUGIB who were at a high risk of recurrent bleeding (PE+ group)...
2017: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/28100857/-clinical-features-and-findings-in-patients-with-unruptured-intracranial-aneurysms-aged-%C3%A2-80-years
#13
Tetsuhiro Kamo, Naoki Akioka, Daina Kashiwazaki, Masaki Koh, Naoya Kuwayama, Satoshi Kuroda
OBJECTIVE: It is difficult to decide whether to treat unruptured intracranial aneurysm(UIA)in elderly patients aged ≥80 years because they have potentially shorter life expectancy and risks related to treatment. Here, we report the results of the treatment of patients aged ≥80 years. METHODS: A retrospective review was performed in patients who underwent surgical or endovascular treatment between April 2012 and December 2015 at our institution. RESULTS: Between April 2012 and December 2015 we treated 130 UIA patients who presented with 145 aneurysms and 12 patients who presented with 14 aneurysms, who were aged ≥80 years...
January 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/28097761/shortened-hospital-length-of-stay-and-lower-costs-associated-with-rivaroxaban-in-patients-with-pulmonary-embolism-managed-as-observation-status
#14
Erin R Weeda, W Frank Peacock, Gregory J Fermann, Christopher W Baugh, Philip S Wells, Veronica Ashton, Concetta Crivera, Peter Wildgoose, Jeff R Schein, Craig I Coleman
BACKGROUND: Unlike rivaroxaban, treatment of patients with pulmonary embolism (PE) with warfarin requires parenteral bridging and coagulation monitoring that may prolong length-of-stay (LOS) and increase hospital costs. AIMS: The aim of this study was to compare LOS, hospital costs and readmissions in PE patients managed through observation stays treated with rivaroxaban or parenterally bridged warfarin. METHODS: Premier Hospital claims data from November 2012 to March 2015 were used to identify patients with a primary diagnosis code for PE managed through an observation stay and with ≥1 claim for a PE-related diagnostic test on day 0-2...
January 2017: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/28091770/relevance-of-surgery-in-patients-with-non-variceal-upper-gastrointestinal-bleeding
#15
S Dango, T Beißbarth, E Weiss, A Seif Amir Hosseini, D Raddatz, V Ellenrieder, J Lotz, B M Ghadimi, A Beham
INTRODUCTION: Upper GI bleeding remains one of the most common emergencies with a substantial overall mortality rate of up to 30%. In severe ill patients, death does not occur due to failure of hemostasis, either medical or surgical, but mainly from comorbidities, treatment complications, and decreased tolerated blood loss. Management strategies have changed dramatically over the last two decades and include primarily endoscopic intervention in combination with acid-suppressive therapy and decrease in surgical intervention...
January 14, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28078379/chitosan-sodium-tetradecyl-sulfate-hydrogel-characterization-and-preclinical-evaluation-of-a-novel-sclerosing-embolizing-agent-for-the-treatment-of-endoleaks
#16
Fatemeh Zehtabi, Vincent Dumont-Mackay, Ahmed Fatimi, Antony Bertrand-Grenier, Hélène Héon, Gilles Soulez, Sophie Lerouge
PURPOSE: To compare the efficacy of an embolization agent with sclerosing properties (made of chitosan and sodium tetradecyl sulfate, CH-STS) with a similar embolization agent but without sclerosing properties (made of chitosan, CH) in treating endoleaks in a canine endovascular aneurysm repair model. METHODS: Two chitosan-based radiopaque hydrogels were prepared, one with STS and one without STS. Their rheological, injectability, and embolizing properties were assessed in vitro; afterwards, their efficacy in occluding endoleaks was compared in a canine bilateral aneurysm model reproducing type I endoleaks (n = 9 each)...
January 11, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28066591/relationship-between-polycythemia-and-in-hospital-mortality-in-chronic-obstructive-pulmonary-disease-patients-with-low-risk-pulmonary-embolism
#17
Lu Guo, Aamer Rasheed Chughtai, Hongli Jiang, Lingyun Gao, Yan Yang, Yang Yang, Yuejian Liu, Zhenliang Xie, Weimin Li
BACKGROUNDS: Pulmonary embolism (PE) is frequent in subjects with chronic obstructive pulmonary disease (COPD) and associated with high mortality. This multi-center retrospective study was performed to investigate if secondary polycythemia is associated with in-hospital mortality in COPD patients with low-risk PE. METHODS: We identified COPD patients with proven PE between October, 2005 and October, 2015. Patients in risk classes III-V on the basis of the PESI score were excluded...
November 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28011405/platelet-to-lymphocyte-ratio-as-a-novel-marker-of-in-hospital-and-long-term-adverse-outcomes-among-patients-with-acute-pulmonary-embolism-a-single-center-large-scale-study
#18
Elif Hande Ozcan Cetin, Mehmet Serkan Cetin, Ugur Canpolat, Ahmet Akdi, Dursun Aras, Ahmet Temizhan, Sinan Aydogdu
BACKGROUND: The interaction of platelets with leukocytes is a well-known process both in progression and prognosis of acute pulmonary embolism (PE). Recently, platelet to lymphocyte ratio (PLR) is emerged as an indirect inflammatory indicator which was shown to be associated with adverse cardiovascular events in various clinical conditions, including acute PE. However, the long-term prognostic value of PLR in acute PE has not been investigated thoroughly. Therefore, we aimed to assess the impact of PLR on both in-hospital and long-term adverse outcomes in acute PE...
February 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28009228/microsurgery-for-spetzler-ponce-class-a-and-b-arteriovenous-malformations-utilizing-an-outcome-score-adopted-from-gamma-knife-radiosurgery-a-prospective-cohort-study
#19
Michael K Morgan, Markus K Hermann Wiedmann, Marcus A Stoodley, Gillian Z Heller
OBJECTIVE The purpose of this study was to adapt and apply the extended definition of favorable outcome established for Gamma Knife radiosurgery (GKRS) to surgery for brain arteriovenous malformations (bAVMs). The aim was to derive both an error around the point estimate and a model incorporating angioarchitectural features in order to facilitate comparison among different treatments. METHODS A prospective microsurgical cohort was analyzed. This cohort included patients undergoing embolization who did not proceed to microsurgery and patients denied surgery because of perceived risk of treatment...
December 23, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28008692/a-response-to-diagnostic-performance-of-wells-score-combined-with-point-of-care-lung-and-venous-ultrasound-in-suspected-pulmonary-embolism
#20
Robert R Ehrman, John Z Gallien
No abstract text is available yet for this article.
December 22, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
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