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https://www.readbyqxmd.com/read/27932051/functional-and-exercise-limitations-after-a-first-episode-of-pulmonary-embolism-results-of-the-elope-prospective-cohort-study
#1
Susan R Kahn, Andrew M Hirsch, Arash Akaberi, Paul Hernandez, David R Anderson, Philip S Wells, Marc Rodger, Susan Solymoss, Michael J Kovacs, Lawrence Rudski, Avi Shimony, Carole Dennie, Christopher Rush, William H Geerts, Shawn D Aaron, John T Granton
BACKGROUND: We aimed to determine the frequency and predictors of exercise limitation after pulmonary embolism (PE), and to assess its association with health-related quality of life (HRQOL) and dyspnea. METHODS: 100 patients with acute PE were recruited at five Canadian hospitals from 2010-2013. Cardiopulmonary exercise testing (CPET) was performed at 1 and 12 months. Quality of life, dyspnea, six-minute walk distance (6MWD), residual clot burden (perfusion (Q) scan; CT pulmonary angiography (CTPA)), cardiac function (echocardiogram) and pulmonary function tests (PFT) were measured during follow-up...
December 5, 2016: Chest
https://www.readbyqxmd.com/read/27914663/outcome-of-alternative-approach-to-displaced-acetabular-fractures
#2
K S Park, C K Chan, G W Lee, H W Ahn, T R Yoon
INTRODUCTION: Anatomical reduction of displaced acetabular fracture is not without its' limitations and complications. This study is conducted to assess clinical and radiological outcomes as well as complications of treating displaced acetabular fractures with emphasis on anatomical reduction in weight-bearing area, mainly the posterior column, and imperfect reduction of the anterior column is acceptable. However, stability of both columns is mandatory. METHODS: It was a retrospective study carried out in a Level 1 arthroplasty and trauma centre...
November 27, 2016: Injury
https://www.readbyqxmd.com/read/27906870/effectiveness-of-low-molecular-weight-heparin-versus-unfractionated-heparin-to-prevent-pulmonary-embolism-following-major-trauma-a-propensity-matched-analysis
#3
James P Byrne, William Geerts, Stephanie A Mason, David Gomez, Christopher Hoeft, Ryan Murphy, Melanie Neal, Avery B Nathens
BACKGROUND: Pulmonary embolism (PE) is a leading cause of delayed mortality in patients with severe injury. While low molecular weight heparin (LMWH) is often favored over unfractionated heparin (UH) for thromboprophylaxis, evidence is lacking to demonstrate an effect on the occurrence of PE. This study compared the effectiveness of LMWH versus UH to prevent PE in patients following major trauma. METHODS: Data for adults with severe injury who received thromboprophylaxis with LMWH or UH were derived from the American College of Surgeons Trauma Quality Improvement Program (2012-2015)...
November 30, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27899519/initial-clinical-experience-using-the-two-stage-aspiration-technique-tsat-with-proximal-flow-arrest-by-a-balloon-guiding-catheter-for-acute-ischemic-stroke-of-the-anterior-circulation
#4
Hiroyuki Matsumoto, Hirokazu Nishiyama, Yoshiaki Tetsuo, Hideki Takemoto, Naoyuki Nakao
BACKGROUND: Our initial experience using the two-stage aspiration technique (TSAT) with proximal flow arrest by a balloon guiding catheter is presented. In TSAT, aspiration is applied with the 5MAX ACE and also with the 3MAX catheter with a Penumbra aspiration pump, while arresting proximal flow by balloon inflation. METHODS: In patients treated with TSAT, clinical data including National Institutes of Health Stroke Scale (NIHSS) score at admission and the modified Rankin Scale (mRS) score at discharge, as well as procedural data including the Thrombolysis in Cerebral Infarction (TICI) score, procedural time, and complications were analyzed...
November 29, 2016: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27884850/comparative-effectiveness-and-safety-of-oral-anticoagulants-for-atrial-fibrillation-in-real-world-practice-a-population-based-cohort-study-protocol
#5
Anne Holbrook, Colin Dormuth, Richard Morrow, Agnes Lee, Sue Troyan, Guowei Li, Eleanor Pullenyegum
INTRODUCTION: Anticoagulants are arguably the most important drug family of all, based on the frequency and duration of their use, and the clinical importance and frequency of benefits and harms. Several direct acting oral anticoagulants (DOACs) have recently joined warfarin for the treatment of atrial fibrillation, with a resultant significant expansion in use of oral anticoagulants (OACs). Our objectives are to compare safety and effectiveness of DOACs versus warfarin in a full population where anticoagulation management is good and to identify which types of patients do better with DOACs versus warfarin and vice versa...
November 24, 2016: BMJ Open
https://www.readbyqxmd.com/read/27873439/stand-alone-d-dimer-testing-to-rule-out-acute-pulmonary-embolism
#6
Nick van Es, Tom van der Hulle, Harry Büller, Frederikus A Klok, Menno V Huisman, Javier Galipienzo, Marcello Di Nisio
BACKGROUND: Recently, stand-alone D-dimer testing at a positivity threshold of 750 μg/L has been proposed as a safe and efficient approach to rule out acute pulmonary embolism (PE), without additional imaging, but this approach needs validation. OBJECTIVES: To evaluate stand-alone D-dimer testing at a positivity threshold of 750 μg/L to rule out PE. METHODS: Individual data from 7,268 patients with suspected PE previously enrolled in 6 prospective management studies were used...
November 22, 2016: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/27872986/prostate-zonal-volumetry-as-a-predictor-of-clinical-outcomes-for-prostate-artery-embolization
#7
André Moreira de Assis, Macello Sampaio Maciel, Airton Mota Moreira, Vanessa Cristina de Paula Rodrigues, Alberto Azoubel Antunes, Miguel Srougi, Giovanni Guido Cerri, Francisco Cesar Carnevale
PURPOSE: To determine prostate baseline zonal volumetry and correlate these findings with clinical outcomes for patients who underwent prostate artery embolization (PAE) for lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH). MATERIALS AND METHODS: This is a retrospective study that included patients treated by PAE from 2010 to 2014. Baseline and 6-month follow-up evaluations included prostate MRI with whole prostate (WP) and central gland (CG) volume measurements-as well as prostate zonal volumetry index (ZVi) calculation, defined as the CG/WP volumes relation-the International Prostate Symptom Score (IPSS), and the Quality of life (QoL) index...
November 21, 2016: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/27859891/diagnostic-performance-of-wells-score-combined-with-point-of-care-lung-and-venous-ultrasound-in-suspected-pulmonary-embolism
#8
Peiman Nazerian, Giovanni Volpicelli, Chiara Gigli, Cecilia Becattini, Giuseppe Francesco Sferrazza Papa, Stefano Grifoni, Simone Vanni
OBJECTIVE: Lung and venous ultrasound are bedside diagnostic tools increasingly used in the early diagnostic approach of suspected pulmonary embolism (PE). However, the possibility of improving the conventional prediction rule for PE by integrating ultrasound has never been investigated. METHODS: We performed lung and venous ultrasound in consecutive patients suspected of PE in four emergency departments. Conventional Wells score (Ws) was adjudicated by the attending physician, and ultrasound was performed by one of 20 investigators...
November 12, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/27843042/low-risk-of-thromboembolic-events-after-routine-administration-of-tranexamic-acid-in-hip-and-knee-arthroplasty
#9
Rune V Madsen, Christian S Nielsen, Thomas Kallemose, Henrik Husted, Anders Troelsen
BACKGROUND: The blood-conserving effect of intravenous (IV) tranexamic acid (TXA) is well-documented for total hip arthroplasty (THA) and total knee arthroplasty (TKA). However, the risk of thromboembolic (TE) events after routine use of TXA is unclear and the safety profile is debated. This retrospective study investigates patient characteristics, occurrences, and predictors of TE events after routine administration of IV TXA in THA and TKA. METHODS: Three thousand one hundred fifty-nine THA or TKA procedures performed from 2007-2013 at our institution were included...
October 20, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27832136/comparison-of-functional-outcome-and-stroke-recurrence-in-patients-with-embolic-stroke-of-undetermined-source-esus-vs-cardioembolic-stroke-patients
#10
Antonio Arauz, Eugenia Morelos, Jonathan Colín, Javier Roldán, Miguel A Barboza
BACKGROUND: Embolic stroke of undetermined source (ESUS) recurrence and functional outcome from long-term follow-up is not well delineated. The purpose of this study is to compare these functional variables between ESUS vs. cardioembolic stroke (CS) patients. METHODS: We analyzed data of consecutive ESUS and CS patients from our institutional database, from January 2003 until April 2015. The endpoints were stroke recurrence, mortality and poor clinical outcome (Modified Rankin Score 3-6), at discharge, 6 months and final follow-up...
2016: PloS One
https://www.readbyqxmd.com/read/27823686/how-well-does-physician-risk-assessment-predict-stroke-and-bleeding-in-atrial-fibrillation-results-from-the-outcomes-registry-for-better-informed-treatment-of-atrial-fibrillation-orbit-af
#11
Benjamin A Steinberg, Peter Shrader, Sunghee Kim, Laine Thomas, Gregg C Fonarow, Jack Ansell, Peter R Kowey, Daniel E Singer, Bernard J Gersh, Kenneth W Mahaffey, Eric D Peterson, Jonathan P Piccini
BACKGROUND: Assessments of stroke and bleeding risks are essential to selecting oral anticoagulation in patients with atrial fibrillation (AF). We aimed to assess outcomes according to physician assessed risk, with comparison to empirical risk scores. METHODS: This was a prospective, observational study of 9,715 outpatients with AF enrolled in ORBIT-AF, a US national registry. Stroke and bleeding risks were quantified by physician assignment, CHADS2 and CHA2DS2-VASc stroke scores, and ATRIA and HAS-BLED bleeding scores...
November 2016: American Heart Journal
https://www.readbyqxmd.com/read/27805457/laparoscopic-radiofrequency-ablation-combined-with-surgical-excision-for-exophytic-renal-angiomyolipoma-a-novel-technique-based-on-tumor-vasculature-features-of-enhancing-renal-masses-toward-hilar-off-clamping-nephron-sparing-surgery
#12
Wei Xiong, Qing Ran, Yangchun Du, Ji Lv, Fang Chen, Shan Zhong, Pu Guo, Ke Dou, Minghan Sun
OBJECTIVES: Symptomatic angiomyolipoma (AML) and asymptomatic AML larger than 4 cm in size are usually treated with nephron-sparing surgery or transarterial embolization. We used radiofrequency ablation to treat the vascular pedicle of exophytic AML with low R.E.N.A.L. nephrometry score and investigated its feasibility for hilar off-clamping nephron-sparing surgery. METHODS: Contrast-enhanced computed tomography (CT) showed enhanced, well-defined lipomatous tumors with a maximum diameter of 4-8 cm in the kidney of 15 patients...
November 2, 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/27803751/suboptimal-implementation-of-diagnostic-algorithms-and-overuse-of-computed-tomography-pulmonary-angiography-in-patients-with-suspected-pulmonary-embolism
#13
Sulaiman Alhassan, Alaa Abu Sayf, Camelia Arsene, Hicham Krayem
BACKGROUND: Majority of our computed tomography-pulmonary angiography (CTPA) scans report negative findings. We hypothesized that suboptimal reliance on diagnostic algorithms contributes to apparent overuse of this test. METHODS: A retrospective review was performed on 2031 CTPA cases in a large hospital system. Investigators retrospectively calculated pretest probability (PTP). Use of CTPA was considered as inappropriate when it was ordered for patients with low PTP without checking D-dimer (DD) or following negative DD...
October 2016: Annals of Thoracic Medicine
https://www.readbyqxmd.com/read/27797317/prevalence-of-pulmonary-embolism-among-patients-hospitalized-for-syncope
#14
Paolo Prandoni, Anthonie W A Lensing, Martin H Prins, Maurizio Ciammaichella, Marica Perlati, Nicola Mumoli, Eugenio Bucherini, Adriana Visonà, Carlo Bova, Davide Imberti, Stefano Campostrini, Sofia Barbar
Background The prevalence of pulmonary embolism among patients hospitalized for syncope is not well documented, and current guidelines pay little attention to a diagnostic workup for pulmonary embolism in these patients. Methods We performed a systematic workup for pulmonary embolism in patients admitted to 11 hospitals in Italy for a first episode of syncope, regardless of whether there were alternative explanations for the syncope. The diagnosis of pulmonary embolism was ruled out in patients who had a low pretest clinical probability, which was defined according to the Wells score, in combination with a negative d-dimer assay...
October 20, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/27792638/shorter-hospital-stays-and-lower-costs-for-rivaroxaban-compared-with-warfarin-for-venous-thrombosis-admissions
#15
Jay M Margolis, Steven Deitelzweig, Jeffrey Kline, Oth Tran, David M Smith, Brahim Bookhart, Concetta Crivera, Jeff Schein
BACKGROUND: Venous thromboembolism, including deep vein thrombosis and pulmonary embolism, results in a substantial healthcare system burden. This retrospective observational study compared hospital length of stay (LOS) and hospitalization costs for patients with venous thromboembolism treated with rivaroxaban versus those treated with warfarin. METHODS AND RESULTS: Hospitalizations for adult patients with a primary diagnosis of deep vein thrombosis or pulmonary embolism who were initiated on rivaroxaban or warfarin were selected from MarketScan's Hospital Drug Database between November 1, 2012, and December 31, 2013...
October 6, 2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/27781056/clinical-characteristics-and-one-year-outcomes-in-chinese-atrial-fibrillation-patients-with-stable-coronary-artery-disease-a-population-based-study
#16
Ying Bai, Jun Zhu, Yan-Min Yang, Yan Liang, Hui-Qiong Tan, Juan Wang, Bi Huang, Han Zhang, Xing-Hui Shao
BACKGROUND: Atrial fibrillation (AF) and coronary artery disease (CAD) often coexist, however, the clinical characteristics and the impact of stable CAD on the outcomes in Chinese patients with AF has not been well understood. METHODS: Consecutive AF patients in 20 hospitals in China from November 2008 to October 2011 were enrolled. The primary endpoints included 1-year all-cause mortality, stroke, non-central nervous system (non-CNS) embolism, and major bleeding...
August 2016: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/27779598/clinical-significance-of-computed-tomography-contrast-extravasation-in-blunt-trauma-patients-with-a-pelvic-fracture
#17
Jeremy S Juern, David Milia, Panna Codner, Marshall Beckman, Lewis Somberg, Travis Webb, John A Weigelt
INTRODUCTION: Blunt pelvic fractures can be associated with major pelvic bleeding. The significance of contrast extravasation (CE) on computed tomography (CT) is debated. We sought to update our experience with CE on CT scan for the years 2009-2014 to determine the accuracy of CE in predicting the need for angioembolization. METHODS: This is a retrospective review of the trauma registry and our electronic medical record from a Level I trauma center. Patients seen from July 1, 2009 to September 7, 2014 with blunt pelvic fractures and contrast enhanced CT were included...
October 25, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27764729/risk-stratifying-emergency-department-patients-with-acute-pulmonary-embolism-does-the-simplified-pulmonary-embolism-severity-index-perform-as-well-as-the-original
#18
David R Vinson, Dustin W Ballard, Dustin G Mark, Jie Huang, Mary E Reed, Adina S Rauchwerger, David H Wang, James S Lin, Mamata V Kene, Tamara S Pleshakov, Dana K Sax, Jordan M Sax, D Ian McLachlan, Cyrus K Yamin, Clifford J Swap, Hilary R Iskin, Ridhima Vemula, Bethany S Fleming, Andrew R Elms, Drahomir Aujesky
INTRODUCTION: The Pulmonary Embolism Severity Index (PESI) is a validated prognostic score to estimate the 30-day mortality of emergency department (ED) patients with acute pulmonary embolism (PE). A simplified version (sPESI) was derived but has not been as well studied in the U.S. We sought to validate both indices in a community hospital setting in the U.S. and compare their performance in predicting 30-day all-cause mortality and classification of cases into low-risk and higher-risk categories...
September 24, 2016: Thrombosis Research
https://www.readbyqxmd.com/read/27759843/septic-pulmonary-embolism-requiring-critical-care-clinicoradiological-spectrum-causative-pathogens-and-outcomes
#19
Deng-Wei Chou, Shu-Ling Wu, Kuo-Mou Chung, Shu-Chen Han, Bruno Man-Hon Cheung
OBJECTIVES: Septic pulmonary embolism is an uncommon but life-threatening disorder. However, data on patients with septic pulmonary embolism who require critical care have not been well reported. This study elucidated the clinicoradiological spectrum, causative pathogens and outcomes of septic pulmonary embolism in patients requiring critical care. METHODS: The electronic medical records of 20 patients with septic pulmonary embolism who required intensive care unit admission between January 2005 and December 2013 were reviewed...
October 1, 2016: Clinics
https://www.readbyqxmd.com/read/27757790/hospital-length-of-stay-and-costs-among-pulmonary-embolism-patients-treated-with-rivaroxaban-versus-parenteral-bridging-to-warfarin
#20
Erin R Weeda, Philip S Wells, W Frank Peacock, Gregory J Fermann, Christopher W Baugh, Veronica Ashton, Concetta Crivera, Peter Wildgoose, Jeff R Schein, Craig I Coleman
We sought to compare length-of-stay (LOS), total hospital costs, and readmissions among pulmonary embolism (PE) patients treated with rivaroxaban versus parenterally bridged warfarin. We identified adult PE (primary diagnostic code = 415.1x) patients in the Premier Database (11/2012-9/2015), and included those with ≥1 PE diagnostic test on days 0-2. Rivaroxaban users (allowing ≤2 days of prior parenteral therapy) were 1:1 propensity score matched to patients parenterally bridged to warfarin. LOS, total costs, and readmission for venous thromboembolism (VTE) or major bleeding within the same or subsequent 2 months were compared between cohorts...
October 18, 2016: Internal and Emergency Medicine
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