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Pulmonary embolism diagnosis

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https://www.readbyqxmd.com/read/28077893/the-prediction-of-the-risk-level-of-pulmonary-embolism-and-deep-vein-thrombosis-through-artificial-neural-network
#1
Laleh Agharezaei, Zhila Agharezaei, Ali Nemati, Kambiz Bahaadinbeigy, Farshid Keynia, Mohammad Reza Baneshi, Abedin Iranpour, Moslem Agharezaei
BACKGROUND: Venous thromboembolism is a common cause of mortality among hospitalized patients and yet it is preventable through detecting the precipitating factors and a prompt diagnosis by specialists. The present study has been carried out in order to assist specialists in the diagnosis and prediction of the risk level of pulmonary embolism in patients, by means of artificial neural network. METHOD: A number of 31 risk factors have been used in this study in order to evaluate the conditions of 294 patients hospitalized in 3 educational hospitals affiliated with Kerman University of Medical Sciences...
October 2016: Acta Informatica Medica: AIM
https://www.readbyqxmd.com/read/28074775/axillary-artery-transection-and-bilateral-pulmonary-embolism-after-anterior-shoulder-dislocation-case-report
#2
Betty Leclerc, François Loisel, Maxime Ferrier, Mazen Al Sayed, Simon Rinckenbach, Laurent Obert
INTRODUCTION: Anterior shoulder dislocation can be associated with vascular and neurological complications. However, axillary artery injury associated with shoulder dislocation is rare and extremely rare without bone fracture. An early diagnosis of these complications allows predicting long-term functional outcomes. METHODS: This article reports the case of a 66-year-old patient who presented an anterior shoulder dislocation after a ski fall without any neurological dysfunction or pulse deficit...
2017: SICOT-J
https://www.readbyqxmd.com/read/28073030/to-screen-or-not-to-screen-for-chronic-thromboembolic-pulmonary-hypertension-after-acute-pulmonary-embolism
#3
REVIEW
Yvonne M Ende-Verhaar, Menno V Huisman, Frederikus A Klok
Chronic thromboembolic pulmonary hypertension (CTEPH) is the most severe long term complication of acute pulmonary embolism (PE). Untreated, CTEPH is associated with a very poor prognosis and high risk of mortality, although curation can be achieved by surgical removal of the obstructive endothelialised thromboemboli from the pulmonary arteries. Early CTEPH diagnosis may improve surgical possibilities and patients outcome. Currently, early diagnosis of CTEPH is a major challenge as demonstrated by an unacceptable median diagnostic delay of over a year and as a result, surgery is impossible in 40% of patients...
January 5, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28070975/progressive-dyspnea-and-signs-of-right-heart-dysfunction
#4
Stephan Staubach, Henning Strohm, Harald Mudra
A 40-year-old woman was admitted due to dyspnea and fever. Transthoracic echocardiography revealed signs of right heart volume overload and vegetations on the tricuspid valve with insufficiency. Transesophageal echocardiography showed a sinus venosus defect (SVD) with significant left-to-right shunt. Computed tomography scanning was primarily performed to rule out pulmonary embolism; however, it showed interatrial communication. Due to the concomitant tricuspid insufficiency with additional volume overload, the diagnosis of SVD was more challenging...
January 10, 2017: Echocardiography
https://www.readbyqxmd.com/read/28067012/venous-thromboembolism-in-pediatric-trauma-patients-ten-year-experience-and-long-term-follow-up-in-a-tertiary-care-center
#5
Christine M Leeper, Madhav Vissa, James D Cooper, Lynn M Malec, Barbara A Gaines
BACKGROUND: Pediatric trauma patients are at high risk for development of venous thromboembolism (VTE). Our objective is to describe incidence, risk factors, and timing of development of VTE, anticoagulation complications, and long-term VTE outcomes in a critically injured pediatric population. PROCEDURE: We did a retrospective review of pediatric (0-17 years) trauma admissions to intensive care unit from 2005 to 2014. Our center employs VTE screening and prevention protocols for high-risk patients based on hypercoagulable history, age, injuries, and medical interventions...
January 9, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28056286/-efficacy-of-treatments-in-patients-with-symptomatic-venous-thrombosis-after-knee-arthroscopic-surgery
#6
X Lu, J Qian, B Yang
Objective: To confirm the incidence of the symptomatic venous thrombosis and evaluate the efficacy of early treatments in patients with symptomatic venous thrombosis after knee arthroscopic surgery. Methods: From June 2010 to December 2015, 19 patients with symptomatic venous thrombosis hospitalized after knee arthroscopy were retrospectively analyzed by visual analogue scale (VAS) in Department of Orthopaedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College...
January 3, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28054326/what-is-the-timing-of-general-health-adverse-events-that-occur-after-total-joint-arthroplasty
#7
Daniel D Bohl, Nathaniel T Ondeck, Bryce A Basques, Brett R Levine, Jonathan N Grauer
BACKGROUND: Despite extensive research regarding risk factors for adverse events after total joint arthroplasty (TJA), there are few publications describing the timing at which such adverse events occur. QUESTIONS/PURPOSES: (1) On which postoperative day do certain adverse events occur? (2) What adverse events occur earlier after TKA than after THA? (3) For each adverse event, what proportion occurred after hospital discharge? METHODS: We screened the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) to identify all patients undergoing primary THA and primary TKA between 2005 and 2013, resulting in a study population of 124,657 patients evaluated as part of this retrospective database analysis...
January 4, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28050475/role-of-hrct-chest-in-post-stem-cell-transplant-recipients-suspected-of-pulmonary-complications
#8
Abhishek Dwivedi, R Ravi Kumar, Ajay Sharma, S K Pannu
INTRODUCTION: Stem cell transplantation is today's procedure of choice for management of various hematopoietic malignant and severe immunogenic disorders. High Resolution Computed Tomography (HRCT) is a common technique for the diagnosis of pulmonary complications in stem cell transplant recipients. There are a large number of complications which can complicate the post-transplant period. AIM: To study the role of HRCT chest in stem cell transplant patients developing pulmonary complications, detect any evidence of infection, detect clinical signs of lung infections, Graft versus Host Disease (GvHD) or other regimen related toxicities outlined earlier, detect any evidence of GvHD and correlate these clinical signs with radiological changes in the lungs...
November 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28040708/pulmonary-artery-sarcoma-mimicking-pulmonary-embolism-a-case-series
#9
Narat Srivali, Eunhee S Yi, Jay H Ryu
BACKGROUND: Pulmonary artery sarcoma (PAS) is a rare malignant neoplasm with an aggressive behavior and often difficult to distinguish from pulmonary thromboembolic disease. AIM: To assess the demographic, clinical, and radiological characteristics of PAS and clinical course. DESIGN AND METHODS: We retrospectively identified and analyzed all patients with PAS seen at Mayo Clinic in Rochester, Minnesota, between January 1, 1996 and July 31, 2015...
December 30, 2016: QJM: Monthly Journal of the Association of Physicians
https://www.readbyqxmd.com/read/28040384/circulatory-collapse-right-ventricular-dilatation-and-alveolar-dead-space-a-triad-for-the-rapid-diagnosis-of-massive-pulmonary-embolism
#10
Raúl J Gazmuri, Dimple J Patel, Rom Stevens, Shani Smith
A triad of circulatory collapse, right ventricular dilatation, and large alveolar dead space is proposed for the rapid diagnosis and treatment of massive pulmonary embolism. A 17year-old female on oral contraceptives collapsed at home becoming incoherent with shallow breathing. Paramedics initiated mechanical chest compression and transported the patient to our emergency department, arriving minimally responsive with undetectable blood pressure but having positive corneal reflexes and bradycardia with wide QRS...
December 16, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28040140/gestational-choriocarcinoma-with-renal-and-pulmonary-metastases-lacking-a-primary-uterine-origin
#11
Hao-Ming Li, Wen-Chien Hou, Yu-Ju Lai, Chien-Chang Kao, Tai-Kuang Chao, Mu-Hsien Yu, Her-Young Su
OBJECTIVE: We describe a case of gestational choriocarcinoma metastasized to the kidney and lung, which presented initially as refractory hematuria after a term pregnancy 5 years earlier. CASE REPORT: A 35-year-old woman, G2P1, with a previous history of full-term pregnancy in 2009, presented to the emergency department complaining of intermittent gross hematuria for 2 months. Abdominal computed tomography showed a suspicious arteriovenous malformation in the right kidney and a thrombus within the right renal vein...
December 2016: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28031662/hereditary-hemorrhagic-telangiectasia-and-myocardial-infarction
#12
Efrén Martínez-Quintana, Fayna Rodríguez-González, Silvia Gopar-Gopar
Hereditary hemorrhagic telangiectasia, also known as Osler-Weber-Rendu syndrome, is an autosomal dominant genetic disorder that leads to epistaxis, gastrointestinal bleeding, iron deficiency anemia, and arteriovenous malformations at the lungs, the liver, and the brain. However, due to its rarity and its unspecific findings on routine examinations, diagnosis is not easy unless suspected due to hypoxemia or paradoxical embolism. We present a case of a 46-year-old-woman with hereditary hemorrhagic telangiectasia and hypoxemia who presented a myocardial infarction secondary to paradoxical embolism through pulmonary arteriovenous malformations...
December 2016: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/28028552/venous-thromboembolic-events-in-critically-ill-traumatic-brain-injury-patients
#13
Markus B Skrifvars, Michael Bailey, Jeffrey Presneill, Craig French, Alistair Nichol, Lorraine Little, Jacques Duranteau, Olivier Huet, Samir Haddad, Yaseen Arabi, Colin McArthur, D James Cooper, Rinaldo Bellomo
PURPOSE: To estimate the prevalence, risk factors, prophylactic treatment and impact on mortality for venous thromboembolism (VTE) in patients with moderate to severe traumatic brain injury (TBI) treated in the intensive care unit. METHODS: A post hoc analysis of the erythropoietin in traumatic brain injury (EPO-TBI) trial that included twice-weekly lower limb ultrasound screening. Venous thrombotic events were defined as ultrasound-proven proximal deep venous thrombosis (DVT) or clinically detected pulmonary embolism (PE)...
December 27, 2016: Intensive Care Medicine
https://www.readbyqxmd.com/read/28018828/paradoxical-embolus-stuck-in-a-patent-foramen-ovale
#14
Zaki Kohistani, Chris Probst
In-hospital mortality rate of an embolus in transit is as high as 44.7%. In some cases, a paradoxical embolus can get stuck in a patent foramen ovale. Because of the high mortality rate, this condition should be considered as an emergency case. Echocardiography has been established as the gold standard method for the diagnosis. A negative echocardiography, however, does not rule out an embolus in transit. To rule out pulmonary embolisms, a computed tomography scan of the chest should also be performed. A cardiothoracic surgeon should be consulted immediately upon diagnosis of an embolus in transit...
December 2016: Thoracic and Cardiovascular Surgeon Reports
https://www.readbyqxmd.com/read/28012721/the-clinical-severity-of-patients-diagnosed-with-an-in-hospital-pulmonary-embolism-following-modern-elective-joint-arthroplasty-is-unrelated-to-the-location-of-emboli-in-the-pulmonary-vasculature
#15
Alejandro Gonzalez Della Valle, Alvaro Blanes Perez, Yuo-Yu Lee, Gregory R Saboeiro, Gabrielle P Konin, Yoshimi Endo, Nigel E Sharrock, Eduardo A Salvati
BACKGROUND: In the event of a postoperative pulmonary embolism (PE), it is generally believed that patients with centrally located emboli will have worse clinical symptoms than those with segmental or subsegmental ones. We studied if a relationship exists between the clinical severity at the time of PE diagnosis and the location of the emboli within the pulmonary vasculature. METHODS: All 269 patients who developed an in-hospital, computed tomography pulmonary angiography-proved, in-hospital PE following elective total hip arthroplasty or total knee arthroplasty in our institution were studied...
November 25, 2016: Journal of Arthroplasty
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
#16
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...
December 10, 2016: Thrombosis Research
https://www.readbyqxmd.com/read/28009644/imaging-of-nontraumatic-thoracic-emergencies
#17
Lauran Stöger, Cornelia Schaefer-Prokop, Bram H J Geurts
PURPOSE OF REVIEW: Acute chest symptoms form an important incentive for imaging in the emergency setting. This review discusses the radiologic features of various vascular and pulmonary diseases leading to acute respiratory distress and recent developments on important emergency radiologic examinations. RECENT FINDINGS: Recently, triple-rule-out computed tomography protocol was introduced in diagnosis of chest pain, and advancing computed tomography technology and knowledge have led to discussion on treatment of pulmonary embolism...
December 21, 2016: Current Opinion in Pulmonary Medicine
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
#18
Robert R Ehrman, John Z Gallien
We enjoyed the article by Nazerian et al., Diagnostic performance of Wells' Score combined with point-of-care lung and venous ultrasound in suspected pulmonary embolism [1]. We recognize the need to safely exclude the diagnosis of pulmonary embolism (PE) without the use of ionizing radiation through use of evidence-based clinical decision aids (CDAs). We agree that point-of-care ultrasound can play a role in the evaluation of suspected PE. This article is protected by copyright. All rights reserved.
December 22, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28008681/prediction-rule-for-diagnosis-of-pulmonary-embolism-enhanced-by-lung-and-venous-ultrasound-making-confusion-or-increasing-efficiency
#19
Giovanni Volpicelli, Simone Vanni, Cecilia Becattini, Giuseppe Francesco Sferrazza Papa, Chiara Gigli, Stefano Grifoni, Peiman Nazerian
We thank the Authors for their interest in our study [1] and the questions raised. Our response begins from their conclusion: "…we fear that uWells' may create more noise than signal in the already murky PE milieu". We find curious that two strongly evidence based applications of point-of-care ultrasound (POCUS) added to the clinical evaluation might create confusion rather than resolving challenging questions. This article is protected by copyright. All rights reserved.
December 22, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28008625/arterial-ligation-versus-embolization-in-epistaxis-management-counterintuitive-national-trends
#20
Michael J Sylvester, Sei Y Chung, Luis A Guinand, Aparna Govindan, Soly Baredes, Jean Anderson Eloy
OBJECTIVES/HYPOTHESIS: Arterial ligation and embolization are treatment modalities indicated in severe and refractory epistaxis. The purpose of this study was to examine temporal trends and compare outcomes in treatment of hospitalized epistaxis patients with ligation or embolization. METHODS: This retrospective cohort analysis utilized the 2008 to 2013 National Inpatient Sample to identify patients admitted with a primary diagnosis of epistaxis, and an associated procedure code for ligation or embolization...
December 23, 2016: Laryngoscope
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