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Pulmonary embolism diagnosis

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https://www.readbyqxmd.com/read/29778034/early-discharge-of-patients-with-pulmonary-embolism-in-daily-clinical-practice-a-prospective-observational-study-comparing-clinical-gestalt-and-clinical-rules
#1
Simone Vanni, Cecilia Becattini, Peiman Nazerian, Carlo Bova, Valerio Teodoro Stefanone, Ludovica Anna Cimini, Gabriele Viviani, Cosimo Caviglioli, Michela Sanna, Giuseppe Pepe, Stefano Grifoni
OBJECTIVES: To estimate the efficiency and safety of clinicians' gestalt in the identification of patients with pulmonary embolism (PE) candidates for early discharge and to compare the efficiency and safety of clinical gestalt with that of the Pulmonary Embolism Severity Index (PESI), the simplified PESI (sPESI) and the Hestia criteria (HC). METHODS: Consecutive adult patients presenting to the emergency department of four Italian hospitals with confirmed diagnosis of PE were included...
May 8, 2018: Thrombosis Research
https://www.readbyqxmd.com/read/29775966/an-enigmatic-case-presentation-of-budd-chiari-syndrome-with-pulmonary-embolism-an-unusual-syndrome-with-an-uncommon-complication
#2
A M Al-Sharydah, A H Al-Abdulwahhab, H A Abu AlOla
INTRODUCTION: In patients with a hypercoagulable state, such as patients with pulmonary embolism and/or Budd-Chiari syndrome, the complications from multiple gene mutations are more numerous than those from a single mutation. The authors present a woman with no major prior medical history who presented with pulmonary embolism and Budd-Chiari syndrome; this enigmatic co-occurrence has never been solely reported without underlying aetiology in a patient without prior medical conditions...
May 3, 2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29773479/emergency-department-diagnosis-of-septic-pulmonary-embolism-due-to-infectious-endocarditis-using-bedside-ultrasound
#3
Jason Arthur, Juvenal Havyarimana, Ashley Booth Norse
BACKGROUND: Septic pulmonary embolism (SPE) is a rare disorder caused by metastasis of infectious thrombi to the lungs. Most commonly, this occurs as a result of infectious endocarditis. This clinical entity may easily be confused for more common and less mortal diagnoses such as pneumonia, bronchitis, or pulmonary embolism. CASE REPORT: A 47-year-old woman presented in respiratory distress with a complaint of cough productive of rusty sputum, shortness of breath, and pleuritic chest pain...
May 14, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29773423/management-of-giant-embryonic-vein-in-klippel-tr%C3%A3-naunay-syndrome
#4
Animesh Rathore, Peter Gloviczki, Haraldur Bjarnason
Klippel-Trénaunay syndrome is a rare mixed malformation characterized by congenital varicose veins, low-flow venous and lymphatic malformations, hypertrophy of soft tissue and bone, and capillary malformations. A 35-year-old man with a diagnosis of Klippel-Trénaunay syndrome presented to the clinic with significant pain and swelling in the left leg. Initial conservative management with compression therapy failed. He was then managed surgically with preoperative placement of an inferior vena cava filter (because of a history of deep venous thrombosis and pulmonary embolism), followed by resection of the lateral embryonic vein, ligation of large perforators, and excision of smaller varicosities...
May 14, 2018: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/29767472/the-impact-of-real-world-cardiovascular-related-pharmacogenetic-testing-in-an-insured-population
#5
Jennifer Billings, Patrick N Racsa, Kristine Bordenave, Charron L Long, Jeffrey J Ellis
BACKGROUND: Pharmacogenomics is intended to help clinicians provide the right drug to the right patient at an appropriate dose. However, limited evidence of clinical utility has slowed uptake of pharmacogenomic testing (PGT). OBJECTIVE: To evaluate the impact of real-world cardiovascular (CV)-related PGT on clinical outcomes, healthcare resource utilisation (HCRU) and cost in a large, heterogeneous population. METHODS: Individuals with Medicare Advantage Prescription Drug, Medicaid, or commercial coverage between 1/1/2011 and 9/30/2015 and ≥1 atherosclerotic CV-related diagnosis were identified...
May 16, 2018: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/29762842/the-role-of-commonly-used-clinical-indicators-in-the-diagnosis-of-acute-heart-failure
#6
X-L Wang, J-M Lei, Y Yuan, L Feng, Y Ning, Y-F Liu
OBJECTIVE: Acute heart failure (AHF) is one of the most commonly seen clinical cases, with a high rate of re-hospitalization and mortality. AHF can be divided into two categories based on the systolic function of the left ventricle, which are heart failure with reduced ejection fraction (HFREF) and heart failure with preserved ejection fraction (HFPEF). Pathogenesis and treatment of the two are quite different. In this article we attempted to explore the value of combined use of clinical and laboratory indicators in the differential diagnosis of AHFREF and AHFPEF...
April 2018: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29762047/imaging-of-suspected-pulmonary-embolism-and-deep-venous-thrombosis-in-obese-patients
#7
Vincent Cascio, Man Hon, Linda B Haramati, Animesh Gour, Peter Spiegler, Sanjeev Bhalla, Douglas Katz
Obesity is a growing problem around the world, and radiology departments frequently encounter difficulties related to large patient size. Diagnosis and management of suspected venous thromboembolism, in particular deep venous thrombosis (DVT) and pulmonary embolism (PE), are challenging even in some lean patients, and can become even more complicated in the setting of obesity. Many obstacles must be overcome to obtain imaging examinations in obese patients with suspected PE and/or DVT, and to ensure that these examinations are of sufficient quality to diagnose or exclude thromboembolic disease, or to establish an alternative diagnosis...
May 15, 2018: British Journal of Radiology
https://www.readbyqxmd.com/read/29760849/acute-pulmonary-embolism-in-emergency-department-patients-despite-therapeutic-anticoagulation
#8
Michelle Y Liu, Dustin W Ballard, Jie Huang, Adina S Rauchwerger, Mary E Reed, Sean C Bouvet, David R Vinson
Introduction: Emergency department (ED) patients with acute pulmonary embolism (PE) despite therapeutic anticoagulation at the time of diagnosis are uncommonly encountered and present a diagnostic and management challenge. Their characterization and outcomes are poorly described. We sought to describe the prevalence and characteristics of therapeutically anticoagulated patients among a population of patients with acute PE in a community setting and to describe treatment changes and 30-day outcomes...
May 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29760834/a-case-series-of-two-patients-presenting-with-pericardial-effusion-as-first-manifestation-of-non-small-cell-lung-cancer-with-braf-mutation-and-expression-of-pd-l1
#9
Muhammad Mufti, Steven Ching, Sassan Farjami, Sharareh Shahangian, Serap Sobnosky
Lung cancer is the number one cause of cancer-related deaths in the United States. Involvement of pericardium occurs once cancer has progressed to stage IV which can cause massive effusion in the pericardial sac. This can lead to cardiac tamponade which can be fatal very quickly if untreated. The following is a two patient case series in which both patients presented with large pericardial effusion. The first patient sought medical attention due to new onset palpitations and was found to have hemorrhagic pericardial effusion and pulmonary embolism (PE)...
April 2018: World Journal of Oncology
https://www.readbyqxmd.com/read/29752323/effectiveness-and-safety-of-rivaroxaban-in-patients-with-cancer-associated-venous-thrombosis
#10
Christine G Kohn, Gary H Lyman, Jan Beyer-Westendorf, Alex C Spyropoulos, Thomas J Bunz, William L Baker, Daniel Eriksson, Anna-Katharina Meinecke, Craig I Coleman
Background: Although not designated as guideline-recommended first-line anticoagulation therapy, patients are receiving rivaroxaban for the treatment and secondary prevention of cancer-associated venous thrombosis (CAT). We sought to estimate the cumulative incidence of recurrent venous thromboembolism (VTE), major bleeding, and mortality/hospice care in patients with CAT treated with outpatient rivaroxaban in routine practice. Methods: Using US MarketScan claims data from January 2012 through June 2015, we identified adults with active cancer (using SEER program coding) who had ≥1 primary hospitalization or emergency department discharge diagnosis code for VTE (index event) and received rivaroxaban as their first outpatient anticoagulant within 30 days of the index VTE...
May 2018: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/29749991/pulmonary-embolism-as-a-rare-complication-of-liver-hydatid-cyst-report-of-two-cases
#11
Omar Toumi, Randa Salem, Sadok Ben Jabra, Ghedira Abdesslem, Faouzi Noomen, Abdel Aziz Hamdi
Hydatid cyst is a helminth infection. The rupture of a hepatic hydatid cyst in inferior vena cava is a rare and lethal complication. Pulmonary embolism is the commonest manifestation. The diagnosis of hydatid cyst is made by histopathological or serological examination, and imaging may suggest the probability of hydatid cyst. Surgical treatment should be performed with caution and always under vascular control. We present two cases of hydatid cyst ruptured into the inferior vena cava. The patients also presented with dyspnea, hemoptysis, and intermittent cough at the time of admission...
March 2018: Iranian Journal of Medical Sciences
https://www.readbyqxmd.com/read/29747728/management-of-obstructive-sleep-apnea-in-pregnancy
#12
REVIEW
Jennifer E Dominguez, Linda Street, Judette Louis
The spectrum of sleep-disordered breathing (SDB) ranges from mild snoring to obstructive sleep apnea, the most severe form of SDB. Current recommendations are to treat these women with continuous positive airway pressure despite limited data. SDB in early and mid-pregnancy is associated with preeclampsia and gestational diabetes. Pregnant women with a diagnosis of obstructive sleep apnea at delivery were at significantly increased risk of having cardiomyopathy, congestive heart failure, pulmonary embolism, and in-hospital death...
June 2018: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/29737640/acute-pulmonary-embolism-focus-on-the-clinical-picture
#13
REVIEW
Doralisa Morrone, Vincenzo Morrone
Acute pulmonary embolism (APE) is characterized by numerous clinical manifestations which are the result of a complex interplay between different organs; the symptoms are therefore various and part of a complex clinical picture. For this reason, it may not be easy to make an immediate diagnosis. This is a comprehensive review of the literature on all the various clinical pictures in order to help physicians to promptly recognize this clinical condition, remembering that our leading role as cardiologists depends on and is influenced by our knowledge and working methods...
May 2018: Korean Circulation Journal
https://www.readbyqxmd.com/read/29737426/elevated-factor-viii-increases-the-risk-of-cerebral-venous-thrombosis-a-case-control-study
#14
Loes Vecht, Susanna M Zuurbier, Joost C M Meijers, Jonathan M Coutinho
BACKGROUND: Elevated factor VIII (FVIII) is a risk factor for leg-vein thrombosis and pulmonary embolism. We assessed whether elevated FVIII is also a risk factor for cerebral venous thrombosis (CVT). METHODS: We performed a matched case-control study. We assessed patients with CVT, as cases, admitted between July 2006 and December 2016. The controls were healthy hospital-staff employees matched for age (within 5 years) and sex. FVIII activity was measured at least 3 months after CVT diagnosis...
May 8, 2018: Journal of Neurology
https://www.readbyqxmd.com/read/29734231/cost-effectiveness-analysis-of-routine-venous-doppler-ultrasound-for-diagnosis-of-deep-venous-thrombosis-at-admission-to-inpatient-rehabilitation
#15
Shanti M Pinto, Mohamed Yassin, Gary Galang
OBJECTIVE: 1. Identify whether timing of venous thromboembolism (VTE) diagnosis is associated with differences in patient outcomes. 2. Perform a cost-effectiveness analysis of routine venous Doppler ultrasound at admission to inpatient rehabilitation (IPR), taking into account costs associated with prolonged IPR length of stay (LOS) and development of pulmonary embolism (PE). DESIGN: This was a retrospective cohort study of 2312 consecutive patient discharges from a single IPR facility over an 18-month period...
May 4, 2018: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/29728431/a-miraculous-recovery-bartonella-henselae-infection-following-a-red-ant-bite
#16
Pramod K Guru, Anjali Agarwal, Ashley Fritz
Infections caused by the Bartonella species are responsible for the human diseases collectively called 'bartonellosis'. The clinically important human infections are mostly caused by the three species (eg, B. bacilliformis, B. quintana and B. henselae ) of Bartonella out of the many progressively increasing identified species. Bartonella henselae transmitted by the arthropod vector, fleas, after cat bite is responsible for the rare multisystem cat scratch disease in humans. We present an extremely rare case of B...
May 4, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29724918/management-appropriateness-and-outcomes-of-patients-with-acute-pulmonary-embolism
#17
David Jimenez, Behnood Bikdeli, Deisy Barrios, Raquel Morillo, Rosa Nieto, Ina Guerassimova, Alfonso Muriel, Luis Jara-Palomares, Lisa Moores, Victor Tapson, Roger D Yusen, Manuel Monreal
Background: Studies have not well defined the impact of adherence to published guidelines on the outcomes of patients with acute pulmonary embolism ( PE ). Methods: In this prospective cohort study of patients admitted to a respiratory department (N=2096), we evaluated whether patients with PE had better outcomes if they were acutely managed according to international guidelines. Outcomes consisted of all-cause mortality, PE-related mortality, recurrent venous thromboembolism ( VTE ), and major bleeding events during the first month of follow-up after diagnosis...
May 3, 2018: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/29721920/acquired-peripheral-pulmonary-artery-aneurysms-morphological-spectrum-of-disease-and-multidetector-computed-tomography-angiography-findings-cases-series-and-literature-review
#18
REVIEW
Tullio Valente, Ahmad Abu-Omar, Giacomo Sica, Alfredo Clemente, Massimo Muto, Giorgio Bocchini, Salvatore Cappabianca, Gaetano Rea
BACKGROUND: Acquired peripheral or intraparenchymal pulmonary artery aneurysms (PPAA) are rare entities but are important to recognize because of the associated morbidity. Hemoptysis is their principal complication and is a potentially fatal condition. PURPOSE: To illustrate the causes, multidetector CT angiography (MDCTA) findings and differential diagnosis of acquired PPAA. MATERIALS AND METHODS: The institutional review boards approved this study...
May 2, 2018: La Radiologia Medica
https://www.readbyqxmd.com/read/29720096/celiac-crisis-a-rare-and-profound-presentation-of-celiac-disease-a-case-report
#19
Elizabeth Ann Forrest, Mark Wong, Srinivasa Nama, Siddharth Sharma
BACKGROUND: Celiac crisis is a life-threatening manifestation of celiac disease and is rare in adults, with only a handful of cases documented worldwide and mostly in children. CASE PRESENTATION: A profoundly emaciated 43-year-old female presented with profuse diarrhoea, shortness of breath, left leg swelling with ulceration and immobility (Body Mass Index (BMI) = 14.7 kg/m2 ). The patient had normal anion-gap metabolic acidosis (pH = 7.16) with persisting hypokalemia, hyponatremia, hypomagnesemia and hypophosphatemia...
May 2, 2018: BMC Gastroenterology
https://www.readbyqxmd.com/read/29713422/pulmonary-embolism-from-cement-augmentation-of-the-vertebral-body
#20
REVIEW
Jose Manuel Fernando Ignacio, Katrina Hannah Dizon Ignacio
Pulmonary cement embolism (PCE) can follow cement augmentation procedures for spine fractures due to osteoporosis, traumatic injuries, and painful metastatic lesions. PCE is underreported and it is likely that many cases remain undiagnosed. Risk factors for PCE have been identified, which can help alert clinicians to patients likely to develop the condition, and there are recommended techniques to reduce its incidence. Most patients with PCE are asymptomatic or only develop transient symptoms, although a few may exhibit florid cardiorespiratory manifestations which can ultimately be fatal...
April 2018: Asian Spine Journal
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