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Pulmonary embolism diagnosis

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https://www.readbyqxmd.com/read/28440519/-prevention-diagnosis-and-treatment-of-perioperative-complications-of-bariatric-and-metabolic-surgery
#1
Haifu Wu, Ming Zhong, Di Zhou, Chenye Shi, Heng Jiao, Wei Wu, Xinxia Chang, Jing Cang, Hua Bian
Surgical operation in treating obesity and type 2 diabetes is popularizing rapidly in China. Correct prevention and recognition of perioperation-related operative complications is the premise of ensuring surgical safety. Familiar complications of the operation include deep venous thrombosis, pulmonary artery embolism, anastomotic bleeding, anastomotic fistula and marginal ulcer. The prevention of deep venous thrombosis is better than treatment. The concrete measures contain physical prophylaxis (graduated compression stocking and intermittent pneumatic compression leg sleeves) and drug prophylaxis (unfractionated heparin and low molecular heparin), and the treatment is mainly thrombolysis or operative thrombectomy...
April 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28439321/embolization-of-a-bronchial-artery-aneurysm-in-a-chronic-obstructive-pulmonary-disease-copd-patient-with-non-massive-hemoptysis
#2
Ignazio Salamone, Marco Cavallaro, Carmela Visalli, Mariano Velo, Ugo Barbaro, Karol Galletta, Filippo Andò
BACKGROUND: Bronchial artery aneurysm (BAA) is a rare condition with a reported prevalence of less than 1% of all selective bronchial arterial angiograms. Despite its low incidence, BAA represents a potential cause of hemoptysis. CASE REPORT: We describe the case of a 63-year-old man suffering from chronic obstructive pulmonary disease (COPD), who presented with non-massive hemoptysis. CT angiography revealed a single bronchial artery aneurysm of 9 mm in diameter, abutting the esophageal wall...
2017: Polish Journal of Radiology
https://www.readbyqxmd.com/read/28427109/traveler-s-diarrhea-vision-abnormalities-and-unsteady-gait-in-a-young-woman
#3
Tobias Mühling, Felix Gundling, Thomas Helmberger, Wolfgang Schepp
We report on the course of disease in a young woman, originally admitted with suspected refractory infectious tropical traveler's diarrhea. However, symptoms did not resolve upon either symptomatic or subsequent antibiotic therapy. When neurologic deterioration was observed, imaging studies revealed a dramatic series of thromboembolic events, including intracranial hemorrhage caused by extensive sinus vein thrombosis as well as thrombi of the right cardiac ventricle. Colonic mucosal biopsy samples finally led to the histologic diagnosis of ulcerative colitis...
April 2017: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/28427005/diagnostic-accuracy-of-magnetic-resonance-imaging-in-patients-with-suspected-pulmonary-embolism-a-bivariate-meta-analysis
#4
REVIEW
Alessandro Squizzato, Fulvio Pomero, Attilio Allione, Roberto Priotto, Nicoletta Riva, Menno V Huisman, Frederikus A Klok, Paul D Stein, Luigina Guasti, Luigi Fenoglio, Francesco Dentali, Walter Ageno
BACKGROUND: Computed tomographic pulmonary angiography (CTPA) has simplified the diagnostic approach to patients with clinically suspected pulmonary embolism (PE), but alternative imaging tests are still advocated. We aimed to systematically assess the diagnostic accuracy of magnetic resonance imaging (MRI) for PE diagnosis. METHODS: Studies evaluating the diagnostic accuracy of MRI for the diagnosis of PE were systematically searched in the PubMed and EMBASE databases (up to May 2016)...
April 7, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28422842/the-role-of-renoscintigraphy-and-surgery-in-the-management-of-page-kidney-a-case-report
#5
Yu-Li Chiu, Chin Hu, Sin-Di Lee, Po-Yin Chen, Cheng-Pin Wang
RATIONALE: Page kidney is an uncommon condition that hypertension occurs secondary to microvascular ischemia and alternation of small-vessel hemodynamics due to external compression of renal parenchyma and activation of the renin-angiotensin-aldosterone system. There are no specific guidelines for the management of Page kidney in the literatures. PATIENT CONCERNS: A 17-year-old teenager who had Fontan procedure for tricuspid and pulmonary atresia in early childhood suffered from sudden onset of severe left flank pain during cardiac catheterization procedure...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28413775/an-interesting-case-of-mycoplasma-pneumonia-associated-multisystem-involvement-and-diffuse-alveolar-hemorrhage
#6
Rashmi Mishra, Edison Cano, Sindhaghatta Venkatram, Gilda Diaz-Fuentes
Severe mycoplasma pneumonia is a rare entity with only 0.5-2% of cases having a fulminant course. We present a 74-year-old woman with hypertension, diabetes mellitus and remote history of marginal zone B-cell lymphoma admitted with abdominal pain and diarrhea of 1-2 days associated with body-aches, dyspnea, dry cough and weight loss for 2-3 weeks. On physical exam, she was febrile, tachypneic, tachycardic and hypoxic on room air. Chest examination revealed diffuse crackles and end-expiratory wheezes. Laboratory tests showed anemia, acute-on-chronic kidney injury and hyaline casts and epithelial cells in the urine analysis...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28412719/combined-measurement-of-factor-xiii-and-d-dimer-is-helpful-for-differential-diagnosis-in-patients-with-suspected-pulmonary-embolism
#7
Ning Tang, Ziyong Sun, Dengju Li, Jun Yang, Shiyu Yin, Qing Guan
BACKGROUND: D-dimer has been used to rule out pulmonary embolism (PE). Based on previous reports of decreased concentrations of coagulation factor XIII (FXIII) in venous thromboembolism, and no change in FXIII concentration in patients with acute cardiovascular disease, we evaluated the benefit of simultaneously measuring D-dimer and FXIII concentrations for diagnosing PE. METHODS: In this prospective single-center study, we enrolled 209 patients initially suspected of having PE, and measured their D-dimer and FXIII concentrations...
April 17, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28411120/effectiveness-and-safety-of-rivaroxaban-and-warfarin-in-patients-with-unprovoked-venous-thromboembolism-a-propensity-matched-nationwide-cohort-study
#8
Torben B Larsen, Flemming Skjøth, Jette N Kjældgaard, Gregory Y H Lip, Peter B Nielsen, Mette Søgaard
BACKGROUND: Deep vein thrombosis (DVT) and pulmonary embolism are collectively known as venous thromboembolism (VTE), which is a common vascular disease and a major cause of morbidity and mortality worldwide. We compare effectiveness and safety of rivaroxaban versus warfarin in a prospective cohort of routine care patients with incident unprovoked VTE. METHODS: In this propensity-matched cohort study, we linked nationwide Danish health registries to identify all patients with a first hospital diagnosis of unprovoked VTE who were new users of rivaroxaban or warfarin...
April 11, 2017: Lancet Haematology
https://www.readbyqxmd.com/read/28410589/lung-involvement-in-childhood-onset-granulomatosis-with-polyangiitis
#9
REVIEW
Giovanni Filocamo, Sofia Torreggiani, Carlo Agostoni, Susanna Esposito
Granulomatosis with polyangiitis is an ANCA-associated systemic vasculitis with a low incidence in the pediatric population. Lung involvement is a common manifestation in children affected by granulomatosis with polyangiitis, both at disease's onset and during flares. Its severity is variable, ranging from asymptomatic pulmonary lesions to dramatic life-threatening clinical presentations such as diffuse alveolar haemorrhage. Several radiologic findings have been described, but the most frequent abnormalities detected are nodular lesions and fixed infiltrates...
April 14, 2017: Pediatric Rheumatology Online Journal
https://www.readbyqxmd.com/read/28410584/case-crossover-study-to-examine-the-change-in-postpartum-risk-of-pulmonary-embolism-over-time
#10
Grégoire Ficheur, Alexandre Caron, Jean-Baptiste Beuscart, Laurie Ferret, Yu-Jin Jung, Charles Garabedian, Régis Beuscart, Emmanuel Chazard
BACKGROUND: Although the current guidelines recommend anticoagulation up until 6 weeks after delivery in women at high risk of venous thromboembolism (VTE), the risk of VTE may extend beyond 6 weeks. Our objective was to estimate the risk of a pulmonary embolism in successive 2-week intervals during the postpartum period. METHODS: In a population-based, case-crossover study, we analyzed the French national inpatient database from 2007 to 2013 (n = 5,517,680 singleton deliveries)...
April 14, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28406123/utilization-of-glial-fibrillary-acidic-protein-and-galectin-3-in-the-diagnosis-of-cerebral-infarction-patients-with-normal-cranial-tomography
#11
E Ekingen, M Yilmaz, M Yildiz, M Atescelik, M C Goktekin, M Gurger, O D Alatas, M Basturk, N Ilhan
OBJECTIVE: It was aimed to determine whether levels of glial fibrillary acidic protein (GFAP) and Galectin-3 contribute to the diagnosis of cerebral infarction in clinically suspected ischemic stroke patients with normal computerized cranial tomography (CCT) in the emergency department. MATERIALS AND METHODS: In this study, patients above the age of 18 years who presented to emergency department of Firat University between December 2011-November 2012 and were diagnosed with cerebral infarction were included...
April 2017: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/28405830/low-yield-of-ventilation-and-perfusion-imaging-for-the-evaluation-of-pulmonary-embolism-after-indeterminate-ct-pulmonary-angiography
#12
Brian R Curtis, Mougnyan Cox, Michael Poplawski, Andrej Lyshchik
PURPOSE: Ventilation and perfusion (VQ) imaging is common following suboptimal CT pulmonary angiogram (CTPA) for pulmonary embolism (PE) evaluation; however, the results of this diagnostic pathway are unclear. The purpose of our study is to determine the incidence of PE diagnosed on VQ scans performed in patients with suboptimal CTPAs. METHODS: One hundred twenty-two suboptimal CTPAs with subsequent VQ scans within 1 week were retrospectively identified. VQ reports utilizing modified ​prospective investigation of pulmonary embolism diagnosis (PIOPED) and prospective investigative study of acute pulmonary embolism diagnosis (PISAPED) criteria were evaluated for presence of PE; intermediate probability, high probability, and PE present were considered PE positive...
April 12, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/28405675/the-management-of-acute-venous-thromboembolism-in-clinical-practice-results-from-the-european-prefer-in-vte-registry
#13
Alexander T Cohen, Anselm K Gitt, Rupert Bauersachs, Eva-Maria Fronk, Petra Laeis, Patrick Mismetti, Manuel Monreal, Stefan N Willich, Peter Bramlage, Giancarlo Agnelli
Venous thromboembolism (VTE) is a significant cause of morbidity and mortality in Europe. Data from real-world registries are necessary, as clinical trials do not represent the full spectrum of VTE patients seen in clinical practice. We aimed to document the epidemiology, management and outcomes of VTE using data from a large, observational database. PREFER in VTE was an international, non-interventional disease registry conducted between January 2013 and July 2015 in primary and secondary care across seven European countries...
April 13, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28400247/quality-of-life-dyspnea-and-functional-exercise-capacity-following-a-first-episode-of-pulmonary-embolism-results-of-the-elope-cohort-study
#14
Susan R Kahn, Arash Akaberi, John T Granton, David R Anderson, Philip S Wells, Marc A Rodger, Susan Solymoss, Michael J Kovacs, Lawrence Rudski, Avi Shimony, Carole Dennie, Chris Rush, Paul Hernandez, Shawn D Aaron, Andrew M Hirsch
BACKGROUND: We aimed to evaluate health-related quality of life (QOL), dyspnea and functional exercise capacity during the year following the diagnosis of a first episode of pulmonary embolism. METHODS: Prospective multicenter cohort study of 100 patients with acute pulmonary embolism recruited at 5 Canadian hospitals from 2010-2013. We measured the outcomes QOL (by SF-36 and PEmb-QOL measures), dyspnea (by the University of California San Diego Shortness of Breath Questionnaire (SOBQ)) and six-minute walk distance at Baseline, 1, 3, 6, and 12 months after acute pulmonary embolism...
April 8, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28399929/xanthogranulomatous-pyelonephritis-presenting-as-acute-pleuritic-chest-pain-a-case-report
#15
Justin Chow, Rameez Kabani, Kirstie Lithgow, Magdalena A Sarna
BACKGROUND: Xanthogranulomatous pyelonephritis is a rare and serious manifestation of chronic kidney inflammation that can be life-threatening if not recognized and treated appropriately, often with antibiotics and surgery. Affected patients are most commonly females in their fifth or sixth decade of life with a background of obstructive uropathy, nephrolithiasis, or recurrent urinary tract infections who present with vague nonspecific symptoms. CASE PRESENTATION: A 43-year-old woman of Russian ethnicity with a history of nephrolithiasis presented to our emergency department with new left-sided pleuritic chest pain amid a 6-week history of constitutional symptoms including fevers, night sweats, and 7 kg of weight loss...
April 12, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28390832/utility-of-the-simplified-wells-and-revised-geneva-scores-to-exclude-pulmonary-embolism-in-femur-fracture-patients
#16
Youn-Jung Kim, Dae-Hee Choi, Eu Sun Lee, Seung Mok Ryoo, Shin Ahn, Chang Hwan Sohn, Dong-Woo Seo, Kyoung Soo Lim, Won Young Kim
OBJECTIVES: The diagnosis of acute pulmonary embolism (PE) in trauma patients is challenging. This study evaluated the diagnostic value of simplified Wells and simplified revised Geneva scores to predict PE in femur fracture patients in emergency department (ED). METHODS: All consecutive adult patients with femur fractures and elevated D-dimer levels (>0.5μg/mL) who underwent CTPA within 72h of injury from January 2010 to December 2014 were included. The simplified Wells and simplified revised Geneva scores were applied to evaluate the clinical probability of PE...
March 14, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28383022/high-sensitivity-assays-for-troponin-in-patients-with-cardiac-disease
#17
REVIEW
Dirk Westermann, Johannes Tobias Neumann, Nils Arne Sörensen, Stefan Blankenberg
Troponin is a widely used biomarker in patients with cardiac disease. The use of troponin is well established in patients with suspected acute myocardial infarction (AMI), but troponin measurement is also used in other acute and nonacute settings. In patients with suspected AMI, early decision-making is crucial to allow rapid treatment and further diagnostic evaluation. Current guidelines recommend serial measurements of troponin with a cut-off concentration at the 99th percentile to triage patients in the emergency department...
April 6, 2017: Nature Reviews. Cardiology
https://www.readbyqxmd.com/read/28375909/syncope
#18
William P Cheshire
PURPOSE OF REVIEW: Syncope is a prevalent syndrome with diverse causes, which have in common a sudden transient failure of the autonomic nervous system to maintain blood pressure against the force of gravity at a level sufficient for cerebral perfusion. Neurally mediated syncope is an episodic phenomenon in which autonomic nervous system function is normal the rest of the time. Although relatively benign, syncope increases the risk for injury from falling and can substantially impair patients' quality of life...
April 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28373261/how-we-treat-central-venous-access-device-related-upper-extremity-dvt
#19
Anita Rajasekhar, Michael B Streiff
Central venous access device (CVAD)-related thrombosis (CRT) is a common complication among patients requiring central venous access as part of their medical care. Complications of CRT include pulmonary embolism, recurrent deep venous thrombosis, loss of central venous access and post-thrombotic syndrome. Patient, device and treatment-related factors can influence the risk of CRT. Despite numerous randomized controlled trials, the clinical benefit of pharmacologic thromboprophylaxis for prevention of CRT remains to be established...
April 3, 2017: Blood
https://www.readbyqxmd.com/read/28370558/an-unexpected-tumor-causing-right-ventricular-obstruction
#20
Jorge Padilla-Ibarra, Hugo Rodríguez Zanella, Roberto Cano Zarate, Erick Alexánderson-Rosas
A 58-year-old male with a history of a soft tissue sarcoma in remission presented with a 2 weeks history of progressive dyspnea. Transthoracic echocardiography showed right ventricular dilation; right ventricular systolic pressure (RVSP) of 110 mm Hg, and a lobulated mass in the right ventricular outflow tract (RVOT) causing obstruction. Microbubble contrast was administered showing perfusion within the mass, which suggested malignancy. A CT pulmonary angiogram (CTPA) confirmed the presence of the mass in the RVOT without evidence of pulmonary embolism...
March 30, 2017: Echocardiography
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