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Pulmonary embolism diagnosis

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https://www.readbyqxmd.com/read/28331932/pulmonary-embolism-and-in-situ-pulmonary-artery-thrombosis-in-paediatrics-a-systematic-review
#1
Madhvi Rajpurkar, Tina Biss, Ernest Amankwah, Denise Martinez, Suzan Williams, C Heleen Van Ommen, Neil A Goldenberg
Data on paediatric pulmonary embolism (PE) are scarce. We sought to systematically review the current literature on childhood PE and conducted a search on paediatric PE via PubMed (1946-2013) and Embase (1980-2013). There was significant heterogeneity in reported data. Two patterns were noted: classic thromboembolic PE (TE-PE) and in situ pulmonary artery thrombosis (ISPAT). Mean age of presentation for TE-PE was 14.86 years, and 51 % of cases were males. The commonest method for diagnosis of TE-PE was contrast CT with angiography (74 % of patients)...
March 23, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28330686/imaging-of-acute-and-chronic-thromboembolic-disease-state-of-the-art
#2
REVIEW
A Ruggiero, N J Screaton
Acute pulmonary embolism (PE) is a life-threatening condition that requires prompt diagnosis and treatment. Recent advances in imaging allow acute and rapid recognition even by the non-specialist radiologist. Most acute emboli resolve on anticoagulation without sequelae; however, some emboli fail to fully resolve becoming endothelialised with the development of chronic thromboembolic disease (CTED). Increased pulmonary vascular resistance arising from CTED may lead to chronic thromboembolic pulmonary hypertension (CTEPH) a debilitating disease affecting up to 5% of survivors of acute PE...
March 19, 2017: Clinical Radiology
https://www.readbyqxmd.com/read/28306332/contrast-enhanced-pulmonary-mra-for-the-primary-diagnosis-of-pulmonary-embolism-current-state-of-the-art-and-future-directions
#3
Donald G Benson, Mark L Schiebler, Michael D Repplinger, Christopher J François, Thomas M Grist, Scott B Reeder, Scott K Nagle
Computed tomographic pulmonary angiography (CTPA) is currently considered the imaging standard of care for the diagnosis of pulmonary embolism (PE). Recent advances in contrast enhanced pulmonary magnetic resonance angiography (MRA) techniques have led to increased use of this modality for the detection of PE in the proper clinical setting. This review is intended to provide an introduction to the state of the art techniques used in pulmonary MRA for the detection of PE and to discuss possible future directions for this modality...
March 17, 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/28302245/amniotic-fluid-embolism
#4
Tayyab Mohyuddin, Shahbaz Sarwar, Dawar Ayyaz
We report a case of 34-year patient who had uncomplicated elective caesarean-section. Postoperatively, she developed sudden hypotension, bradycardia, dyspnea and disseminated intravascular coagulation (DIC), all signs associated with amniotic fluid embolism (AFE). Echocardiogram showed signs of acutely increased right ventricular after load including McConell's sign, i.e. right ventricular dilatation, segmental hypokinesia (mid-right ventricular) and hypercontractile right ventricular apex and overall right ventricular dysfunction...
March 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28300866/thrombotic-risk-according-to-serpinc1-genotype-in-a-large-cohort-of-subjects-with-antithrombin-inherited-deficiency
#5
Martine Alhenc-Gelas, Genevieve Plu-Bureau, Justine Hugon-Rodin, Véronique Picard, Marie-Helene Horellou
Inherited quantitative (type I) or qualitative (type II) antithrombin deficiency (ATD) due to mutations in the SERPINC1 gene is a well-known risk factor for venous thromboembolism. ATD may also increase risk for arterial thrombosis. Few studies have investigated risk for thrombosis according to mutations. We addressed this topic in a large retrospective cohort study of 540 heterozygous carriers of SERPINC1 mutations and compared risk for first venous or arterial thrombosis associated with carrying of different type II or type I mutations...
March 16, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28298559/the-risk-of-deep-venous-thrombosis-and-pulmonary-embolism-in-primary-sj%C3%A3-gren-syndrome-a-general-population-based-study
#6
J Antonio Aviña-Zubieta, Michael Jansz, Eric C Sayre, Hyon K Choi
OBJECTIVE: To estimate the future risk and time trends of venous thromboembolism (VTE) in individuals with newly diagnosed primary Sjögren syndrome (pSS) in the general population. METHODS: Using a population database that includes all residents of British Columbia, Canada, we created a study cohort of all patients with incident SS and up to 10 controls from the general population matched for age, sex, and entry time. We compared incidence rates (IR) of pulmonary embolism (PE), deep vein thrombosis (DVT), and VTE between the 2 groups according to SS disease duration...
March 15, 2017: Journal of Rheumatology
https://www.readbyqxmd.com/read/28292995/-a-case-of-stage-iv-breast-cancer-with-long-term-survival-by-chemotherapy-developing-pulmonary-tumor-thrombotic-microangiopathy-during-the-treatment-course
#7
Kana Kobayashi, Akari Murakami, Saaya Komatsu, Kanako Nishiyama, Michiko Yamashita, Wakana Sugimori, Yoshiaki Kamei, Hiroaki Asai, Akiyoshi Ogimoto, Kazuo Honda, Yasutsugu Takada
Pulmonary tumor thrombotic microangiopathy(PTTM)caused by pulmonary artery microscopic tumor emboli and fibrocellular and/or fibromuscular proliferation leads to progressive pulmonary hypertension and respiratory failure.The prognosis is extremely poor and most patients die shortly after onset.We report a patient with Stage IV breast cancer and long-term survival who developed PTTM during chemotherapy treatment.A 63-year-old woman with multiple metastases in her cerebellum, bone, lung, and lymph node after left breast conserving surgery started to experience dyspnea and malaise 7 years after the surgery...
March 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28292566/impact-of-anticoagulation-in-elderly-patients-with-pulmonary-embolism-that-undergo-ivc-filter-placement-a-retrospective-cohort-study
#8
John M Falatko, Bhavinkumar Dalal, Lihua Qu
BACKGROUND: Anticoagulation is the primary treatment for pulmonary embolism (PE). Inferior vena cava (IVC) filters are an adjunctive intervention to prevent recurrent pulmonary embolism. Long-term outcomes in elderly patients with contraindications to anticoagulation after IVC filter placement for prevention of recurrent pulmonary embolism have yet to be assessed. MATERIALS AND METHODS: Patients ≥60years of age, that had an IVC filter placed between January 1st, 2008 and February 2nd, 2013, with a primary diagnosis of pulmonary embolism, were included...
February 28, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28290856/-chronic-heart-failure-with-preserved-systolic-function-and-reversible-dilatation-of-cardiac-chambers
#9
O V Blagova, S V Volkov, A V Nedostup, A O Korobkov, I V Mostovoy, N G Sergushina, N V Gagarina, E A Mershina
Diagnosis of dilation (D) cardiomyopathy (CMP) requires exclusion not only of inflammatory and genetically determined forms but also of some rare diseases. This 51 year old patient with history of moderate arterial hypertension approached a cardiologist because of new onset atrial fibrillation and dyspnea. Echocardiography detected dilation of all cardiac chambers with relatively preserved ejection fraction, causing suspicion of DCMP. Among conditions excluded were coronary atherosclerosis, congenital heart defect with left to right shunt, primary pulmonary hypertension, pulmonary embolism, hypertensive heart, tachycardia induced CMP, arrhythmogenic right ventricular dysplasia, noncompaction myocardium...
June 2016: Kardiologiia
https://www.readbyqxmd.com/read/28289555/gender-differences-in-post-traumatic-stress
#10
Maria Grazia Modena, Daniele Pettorelli, Giulia Lauria, Elisa Giubertoni, Erminio Mauro, Valentina Martinotti
Acute stress can trigger cardiovascular events and disease. The earthquake is an "ideal" natural experiment for acute and chronic stress, with impact mainly on the cardiovascular system. On May 20th and 29th, 2012, two earthquakes of magnitude 5.9° to 6.4° on the Richter scale, hit the province of Modena and Reggio Emilia, an area of the north-center of Italy never considered at seismic risk. The purpose of our study was to assess whether there were gender-specific differences in stress-induced incidence of cardiovascular events and age of patients who arrived at the Emergency Departments (ED) of the three main teaching hospitals of the University of Modena and Reggio Emilia...
2017: BioResearch Open Access
https://www.readbyqxmd.com/read/28289497/interventional-therapy-for-pulmonary-embolism
#11
Alan B Lumsden, Erik Suarez
Patients with pulmonary embolism (PE) present with highly variable clinical symptoms and often have accompanying comorbidities. Timely diagnosis and treatment are critical to help prevent recurrence and increased morbidity/mortality. While open surgical thrombectomy was once reserved only for those with massive PE and hemodynamic compromise, it has been reevaluated with a focus on careful patient selection and early intervention. Lately, there has been increased interest in catheter-based interventions and in combining these with an open surgical component to decrease the magnitude of the intervention-for example, direct placement of large-bore thrombectomy devices directly into the right ventricle via sternotomy or subxiphoid approaches...
October 2016: Methodist DeBakey Cardiovascular Journal
https://www.readbyqxmd.com/read/28288526/performance-of-khorana-risk-score-for-prediction-of-venous-thromboembolism-in-patients-with-hepatocellular-carcinoma
#12
Y Wang, B M Attar, H E Fuentes, J Yu, Huiyuan Zhang, A J Tafur
Cancer-associated venous thromboembolism (VTE) is one of the leading causes of mortality and morbidity among patients with malignancy. The Khorana risk score (KRS) is currently the best validated risk assessment model to stratify risks of VTE development in ambulatory patients with cancer. In the current study, we assessed the performance of KRS in patients with hepatocellular carcinoma (HCC). We retrospectively analyzed patients with diagnosis of HCC (screened by International Classification of Diseases [ ICD-9] and ICD-10 code, confirmed with radiographic examination and/or histopathology) at a large public hospital over 15 years (January 2000 through July 2015)...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/28280082/bumpy-road-to-the-diagnosis-of-polycythaemia-vera
#13
Rita de Sousa Gameiro, Ana Rodrigues, Fernando Martos Gonçalves, José Pimenta da Graça
Polycythaemia vera (PV) is the most common myeloproliferative neoplasm, characterised by increased red cell mass that can present as an unspecified symptom or a thrombohaemorrhagic event. Its diagnosis is based on the presence of erythrocytosis, the identification of the Janus kinase 2 mutation and bone marrow aspirate or biopsy alterations. The challenge of this disease lies on the treatment approach. Its cornerstone is phlebotomy, but depending on the vascular risk, it can include cytoreductive agents, low-dose aspirin or even anticoagulation...
March 9, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28279993/clinical-characteristics-associated-with-diagnostic-delay-of-pulmonary-embolism-in-primary-care-a-retrospective-observational-study
#14
Janneke M T Hendriksen, Marleen Koster-van Ree, Marcus J Morgenstern, Ruud Oudega, Roger E G Schutgens, Karel G M Moons, Geert-Jan Geersing
OBJECTIVES: To evaluate the extent of delay in the diagnosis of pulmonary embolism (PE) in primary care, and to identify determinants that are associated with such diagnostic delay. DESIGN: Retrospective observational study. SETTING: 6 primary care practices across the Netherlands. PARTICIPANTS: Data from patients with an objectively confirmed diagnosis of PE (International Classification of Primary Care (ICPC) code K93) up to June 2015 were extracted from the electronic medical records...
March 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/28268789/perspective-imaging-of-flow-in-arterial-model-obtained-with-continuous-wave-doppler-focusing-technique
#15
Ryo Nagaoka, Katsuhiro Sasaki, Seiichi Zama, Masaaki Nagone, Hiroshi Nagai, Yasuhito Takeuchi, Yoshifumi Saijo
Flowing emboli in the circulatory system cause fatal diseases such as stroke or pulmonary embolism. Conventional transcranial Doppler ultrasound for detection of emboli requires precise positioning by experienced examiner. In the present study, an easier emboli detection device by visualizing perspective view of blood vessel is proposed. The perspective image was obtained with continuous wave (CW) Doppler ultrasound from 2-dimensional array probe. CW Doppler signal from each element was focused by novel beam forming algorithm to obtain en face images at arbitrary depth to form perspective image...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28267709/predicting-serious-complications-in-patients-with-cancer-and-pulmonary-embolism-using-decision-tree-modelling-the-epiphany-index
#16
A Carmona-Bayonas, P Jiménez-Fonseca, C Font, F Fenoy, R Otero, C Beato, J M Plasencia, M Biosca, M Sánchez, M Benegas, D Calvo-Temprano, D Varona, L Faez, I de la Haba, M Antonio, O Madridano, M P Solis, A Ramchandani, E Castañón, P J Marchena, M Martín, F Ayala de la Peña, V Vicente
BACKGROUND: Our objective was to develop a prognostic stratification tool that enables patients with cancer and pulmonary embolism (PE), whether incidental or symptomatic, to be classified according to the risk of serious complications within 15 days. METHODS: The sample comprised cases from a national registry of pulmonary thromboembolism in patients with cancer (1075 patients from 14 Spanish centres). Diagnosis was incidental in 53.5% of the events in this registry...
March 7, 2017: British Journal of Cancer
https://www.readbyqxmd.com/read/28267465/assessment-of-right-ventricular-function-in-acute-pulmonary-embolism
#17
Deisy Barrios, Raquel Morillo, José Luis Lobo, Rosa Nieto, Ana Jaureguizar, Ana K Portillo, Esther Barbero, Covadonga Fernandez-Golfin, Roger D Yusen, David Jiménez
The optimal approach to assess right ventricular (RV) function in patients with acute symptomatic pulmonary embolism (PE) lacks clarity. METHODS: This study aimed to evaluate the optimal approach to assess RV function in normotensive patients with acute symptomatic PE. Outcomes assessed through 30-days after the diagnosis of PE included all-cause mortality and complicated course. RESULTS: Eight hundred forty-eight patients were enrolled. Multidetector computed tomography (MDCT) and transthoracic echocardiography agreed on the presence or absence of RV overload in 449 (53%) patients...
March 2017: American Heart Journal
https://www.readbyqxmd.com/read/28262522/a-clinically-meaningful-interpretation-of-the-prospective-investigation-of-pulmonary-embolism-diagnosis-pioped-scintigraphic-data
#18
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
#19
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/28260214/polydactylous-transverse-erythronychia-report-of-a-patient-with-multiple-horizontal-red-bands-affecting-the-fingernails
#20
Carina Chang, Bryce D Beutler, Philip R Cohen
INTRODUCTION: Redness of the nail plate-erythronychia-is a common condition involving one or multiple digits. It may affect the entire nail or present as longitudinal red bands that extend from the proximal nail fold to the distal tip of the nail plate. Rarely, red bands may traverse the nail bed horizontally. Although erythronychia is often idiopathic, it has also been associated with amyloidosis, Darier's disease, lichen planus, and various other cutaneous conditions. We describe the clinical features of a 64-year-old Caucasian man who presented with transverse and longitudinal erythronychia affecting his fingernails...
March 4, 2017: Dermatology and Therapy
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