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Pulmonary embolism guide

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https://www.readbyqxmd.com/read/27920857/aortic-air-embolus-following-pulmonary-tumor-radiofrequency-ablation
#1
Roger Stimpson, Suhag Patel, Rohan Shah, Junjian Huang, Sumit Chhadia, Vivek Yedavalli, Mark Saker
Aortic air embolism following a computed tomography (CT) guided percutaneous transthoracic procedure is a rare occurrence, but one that can have dire consequences. We present a case of a 48-year old female diagnosed with aortic air embolism during percutaneous radiofrequency ablation of a pulmonary mass. A large amount of intra-aortic air can be seen on the CT images just before the patient suffered acute cardiac arrest. Although this is a rare occurrence, recognition and management of this complication is important for physicians who perform any percutaneous transthoracic procedures...
December 2016: Radiology case reports
https://www.readbyqxmd.com/read/27913507/diagnosis-of-suspected-venous-thromboembolism
#2
Clive Kearon
The primary goal of diagnostic testing for venous thromboembolism (VTE) is to identify all patients who could benefit from anticoagulant therapy. Test results that identify patients as having a ≤2% risk of VTE in the next 3 months are judged to exclude deep vein thrombosis (DVT) or pulmonary embolism (PE). Clinical evaluation, with assessment of: (1) clinical pretest probability (CPTP) for VTE; (2) likelihood of important alternative diagnoses; and (3) the probable yield of D-dimer and various imaging tests, guide which tests should be performed...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27912200/is-cha2ds2-vasc-appropriate-for-hyperthyroid-patients-with-atrial-fibrillation-implications-of-adding-a-transesophageal-echocardiography-evaluation
#3
Marcus Vinicius Leitão de Souza, Patricia de Fátima Dos Santos Teixeira, Mario Vaisman, Sergio Salles Xavier
BACKGROUND: Anticoagulation remains a controversial issue among hyperthyroid patients with atrial fibrillation (AF). We aimed to evaluate the prevalence of the thrombogenic milieu (TM), detected using transesophageal echocardiography (TEE), among patients with AF related to hyperthyroidism, and to correlate these findings with the clinical embolic risk classification (CHA2DS2-VASc). METHODS: CHA2DS2-VASc score, thyroid hormonal status, time since hyperthyroidism diagnosis, transthoracic echocardiography (TTE) and TEE were assessed in 47 consecutive patients aged between 18 and 65years with AF related to hyperthyroidism...
November 10, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27869512/controversies-in-the-management-of-cancer-associated-thrombosis
#4
Marc Carrier, Paolo Prandoni
Cancer associated thrombosis (CAT) is a frequent complication among cancer patients. It is associated with increased morbidity, mortality, and psychological burden. Areas covered: Low-molecular-weight heparin monotherapy for the initial 6 months is considered the standard of care for the acute and long-term management of CAT. For patients at high risk of recurrent CAT (e.g. active cancer or still undergoing anticancer therapy) beyond the initial 6 months of treatment, continuation of anticoagulation therapy for secondary prevention is usually recommended...
November 21, 2016: Expert Review of Hematology
https://www.readbyqxmd.com/read/27849664/perioperative-pharmacological-thromboprophylaxis-in-patients-with-cancer-a-systematic-review-and-meta-analysis
#5
Qiang Guo, Bin Huang, Jichun Zhao, Yukui Ma, Ding Yuan, Yi Yang, Xiaojiong Du
OBJECTIVE: To compare the relative effects between pharmacological thromboprophylaxis and no anticoagulation. BACKGROUND: The efficacy and safety of pharmacological thromboprophylaxis in cancer patients undergoing surgery need to be quantified to guide management. METHODS: We searched multiple electronic databases (up to March 31, 2016) for trials of cancer patients undergoing surgery that assessed the relative benefits and harms of perioperative pharmacological thromboprophylaxis...
November 15, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27822904/a-new-prognostic-strategy-for-adult-patients-with-acute-pulmonary-embolism-eligible-for-outpatient-therapy
#6
Federico Angriman, Fernando J Vazquez, Pierre Marie Roy, Gregoire Le Gal, Marc Carrier, Esteban Gandara
We sought to derive a parsimonious predictive model to identify a subgroup of patients that will experience a low number of adverse events within 14 days of the diagnosis of pulmonary embolism. Retrospective cohort study of adult patients with acute pulmonary embolism at the Ottawa Hospital between 2007 and 2012. Primary outcome was defined as the composite of all-cause mortality, recurrent venous thromboembolism and major bleeding within 14 days. Multivariate logistic regression models were fit to model the occurrence of the primary outcome so as to guide either outpatient therapy or early discharge after initial admission...
November 7, 2016: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/27796581/treatment-of-accidental-perianal-injection-of-topical-thrombin-with-intravenous-antithrombin
#7
Vance G Nielsen, Samata R Paidy, Whitney McLeod, Alexandra Fox, Valentine N Nfonsam
While topical thrombin application can markedly improve surgical hemostasis, rapid absorption of thrombin can result in pulmonary embolism and death. We report a case of accidental interstitial infiltration of topical thrombin after hemorrhoidectomy that was treated with administration of human antithrombin and heparin anticoagulation. Except for a marked decrease in antithrombin activity from super normal to normal values, the patient exhibited no laboratory or clinical signs of pulmonary embolism, thrombin mediated consumptive loss of procoagulants, or regional thrombosis...
October 28, 2016: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/27783380/common-pitfalls-in-point-of-care-ultrasound-a-practical-guide-for-emergency-and-critical-care-physicians
#8
REVIEW
Pablo Blanco, Giovanni Volpicelli
BACKGROUND: Point-of-care ultrasonography (POCUS) is a widely used tool in emergency and critical care settings, useful in the decision-making process as well as in interventional guidance. While having an impressive diagnostic accuracy in the hands of highly skilled operators, inexperienced practitioners must be aware of some common misinterpretations that may lead to wrong decisions at the bedside. OBJECTIVES: This article provides a revision list of common POCUS misdiagnoses usually found in practice and offers useful tips to recognize and avoid them...
December 2016: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/27699156/diagnosis-and-treatment-of-lower-extremity-deep-vein-thrombosis-korean-practice-guidelines
#9
Seung-Kee Min, Young Hwan Kim, Jin Hyun Joh, Jin Mo Kang, Ui Jun Park, Hyung-Kee Kim, Jeong-Hwan Chang, Sang Jun Park, Jang Yong Kim, Jae Ik Bae, Sun Young Choi, Chang Won Kim, Sung Il Park, Nam Yeol Yim, Yong Sun Jeon, Hyun-Ki Yoon, Ki Hyuk Park
Lower extremity deep vein thrombosis is a serious medical condition that can result in death or major disability due to pulmonary embolism or post-thrombotic syndrome. Appropriate diagnosis and treatment are required to improve symptoms and salvage the affected limb. Early thrombus clearance rapidly resolves symptoms related to venous obstruction, restores valve function and reduces the incidence of post-thrombotic syndrome. Recently, endovascular treatment has been established as a standard method for early thrombus removal...
September 2016: Vascular Specialist International
https://www.readbyqxmd.com/read/27696084/safe-and-effective-use-of-rivaroxaban-for-treatment-of-cancer-associated-venous-thromboembolic-disease-a-prospective-cohort-study
#10
Simon Mantha, Eva Laube, Yimei Miao, Debra M Sarasohn, Rekha Parameswaran, Samantha Stefanik, Gagandeep Brar, Patrick Samedy, Jonathan Wills, Stephen Harnicar, Gerald A Soff
Low-molecular weight heparin (LMWH) has been the standard of care for treatment of venous thromboembolism (VTE) in patients with cancer. Rivaroxaban was approved in 2012 for the treatment of pulmonary embolism (PE) and deep vein thrombosis (DVT), but no prior studies have been reported specifically evaluating the efficacy and safety of rivaroxaban for cancer-associated thrombosis (CAT). Under a Quality Assessment Initiative (QAI), we established a Clinical Pathway to guide rivaroxaban use for CAT and now report a validation analysis of our first 200 patients...
September 30, 2016: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/27620305/symptomatology-clinical-presentation-and-basic-work-up-in-patients-with-suspected-pulmonary-embolism
#11
Poul Henning Madsen, Søren Hess
Basic knowledge of pulmonary embolism is relevant to most practicing physicians. Many medical specialties care for patients with increased risk of pulmonary embolism, why recognition of relevant symptoms, a thorough medical history, assessment of the clinical condition of the patient and possibly referral to a relevant facility should be a part of the skills of all clinicians. Sudden onset dyspnea, chest pain, syncope and hemoptysis are essential symptoms of pulmonary embolism, and in most of these patients basic investigations like arterial blood gas analysis, electrocardiogram, chest x-ray and biochemical analyses are appropriate...
September 13, 2016: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/27604617/12th-winfocus-world-congress-on-ultrasound-in-emergency-and-critical-care
#12
Yahya Acar, Onur Tezel, Necati Salman, Erdem Cevik, Margarita Algaba-Montes, Alberto Oviedo-García, Mayra Patricio-Bordomás, Mustafa Z Mahmoud, Abdelmoneim Sulieman, Abbas Ali, Alrayah Mustafa, Ihab Abdelrahman, Mustafa Bahar, Osama Ali, H Lester Kirchner, Gregor Prosen, Ajda Anzic, Paul Leeson, Maryam Bahreini, Fatemeh Rasooli, Houman Hosseinnejad, Gabriel Blecher, Robert Meek, Diana Egerton-Warburton, Edina Ćatić Ćuti, Stanko Belina, Tihomir Vančina, Idriz Kovačević, Nadan Rustemović, Ikwan Chang, Jin Hee Lee, Young Ho Kwak, Do Kyun Kim, Chi-Yung Cheng, Hsiu-Yung Pan, Chia-Te Kung, Ela Ćurčić, Ena Pritišanac, Ivo Planinc, Marijana Grgić Medić, Radovan Radonić, Abiola Fasina, Anthony J Dean, Nova L Panebianco, Patricia S Henwood, Oliviero Fochi, Moreno Favarato, Ezio Bonanomi, Ivan Tomić, Youngrock Ha, Hongchuen Toh, Elizabeth Harmon, Wilma Chan, Cameron Baston, Gail Morrison, Frances Shofer, Angela Hua, Sharon Kim, James Tsung, Isa Gunaydin, Zeynep Kekec, Mehmet Oguzhan Ay, Jinjoo Kim, Jinhyun Kim, Gyoosung Choi, Dowon Shim, Ji-Han Lee, Jana Ambrozic, Katja Prokselj, Miha Lucovnik, Gabrijela Brzan Simenc, Asta Mačiulienė, Almantas Maleckas, Algimantas Kriščiukaitis, Vytautas Mačiulis, Andrius Macas, Sharad Mohite, Zoltan Narancsik, Hugon Možina, Sara Nikolić, Jan Hansel, Rok Petrovčič, Una Mršić, Simon Orlob, Markus Lerchbaumer, Niklas Schönegger, Reinhard Kaufmann, Chun-I Pan, Chien-Hung Wu, Sarah Pasquale, Stephanie J Doniger, Sharon Yellin, Gerardo Chiricolo, Maja Potisek, Borut Drnovšek, Boštjan Leskovar, Kristine Robinson, Clara Kraft, Benjamin Moser, Stephen Davis, Shelley Layman, Yusef Sayeed, Joseph Minardi, Irmina Sefic Pasic, Amra Dzananovic, Anes Pasic, Sandra Vegar Zubovic, Ana Godan Hauptman, Ana Vujaklija Brajkovic, Jaksa Babel, Marina Peklic, Vedran Radonic, Luka Bielen, Peh Wee Ming, Nur Hafiza Yezid, Fatahul Laham Mohammed, Zainal Abidin Huda, Wan Nasarudin Wan Ismail, W Yus Haniff W Isa, Hashairi Fauzi, Praveena Seeva, Mohd Zulfakar Mazlan
A1 Point-of-care ultrasound examination of cervical spine in emergency departmentYahya Acar, Onur Tezel, Necati SalmanA2 A new technique in verifying the placement of a nasogastric tube: obtaining the longitudinal view of nasogastric tube in addition to transverse view with ultrasoundYahya Acar, Necati Salman, Onur Tezel, Erdem CevikA3 Pseudoaneurysm of the femoral artery after cannulation of a central venous line. Should we always use ultrasound in these procedures?Margarita Algaba-Montes, Alberto Oviedo-García, Mayra Patricio-BordomásA4 Ultrasound-guided supraclavicular subclavian vein catheterization...
September 2016: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/27595470/us-guided-direct-puncture-retrograde-thoracic-duct-access-lymphangiography-and-embolization-feasibility-and-efficacy
#13
Carlos J Guevara, Kristy L Rialon, Raja S Ramaswamy, Seung K Kim, Michael D Darcy
PURPOSE: To describe technical details, success rate, and advantages of direct puncture of the thoracic duct (TD) under direct ultrasound (US) guidance at venous insertion in the left neck. MATERIALS AND METHODS: All patients who underwent attempted thoracic duct embolization (TDE) via US-guided retrograde TD access in the left neck were retrospectively reviewed. Indications for lymphangiography were iatrogenic chyle leak, pulmonary lymphangiectasia, and plastic bronchitis...
December 2016: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/27581130/comparison-of-inferior-vena-cava-filters-placed-at-the-bedside-via-intravenous-ultrasound-ivus-guidance-versus-fluoroscopic-guidance
#14
Suvranu Ganguli, Beau M Hawkins, Farhad Abtahian, Mazen S Abu-Fadel, Thomas G Walker, Cheryl MacKay, Michael R Jaff, Ido Weinberg
OBJECTIVES: To compare utilization, procedural outcomes, complications and long-term patient outcomes associated with bedside placement of inferior vena cava filters (IVCF) using intravascular ultrasound (IVUS) and fluoroscopic placement of IVCF. BACKGROUND: IVCF are usually placed under fluoroscopic-guidance in dedicated angiography suites. Bedside placement of IVCF is possible in patients not suitable for transportation, but data regarding their use are limited...
August 28, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27567411/detection-of-pulmonary-embolism-in-high-risk-children
#15
Kara E Hennelly, Marc N Baskin, Michael C Monuteuax, Joel Hudgins, Eugene Kua, Ashlee Commeree, Rotem Kimia, Edward Y Lee, Amir Kimia, Mark I Neuman
OBJECTIVE: To evaluate 2 commonly used adult-based pulmonary embolism (PE) algorithms in pediatric patients and to derive a pediatric-specific clinical decision rule to evaluate children at risk for PE, given the paucity of data to guide diagnostic imaging in children for whom PE is suspected. STUDY DESIGN: We performed a single-center retrospective study among 561 children <22 years of age undergoing either D-dimer testing or radiologic evaluation (computed tomography or ventilation-perfusion scan) in the emergency department setting for concern of PE...
November 2016: Journal of Pediatrics
https://www.readbyqxmd.com/read/27522970/combined-coil-embolization-and-foam-sclerotherapy-for-the-management-of-varicose-veins
#16
Ahmed Kayssi, George Oreopoulos, Kong T Tan, Jeffrey Jaskolka
BACKGROUND: We propose a novel technique for endovenous treatment of varicose veins (VVs) using combined coil embolization and foam sclerotherapy of the great saphenous vein (GSV). METHODS: A retrospective case-series analysis on patients undergoing fluoroscopically guided coil embolization of the GSV and foam sclerotherapy of the GSV and below-knee varices at a single Canadian center. RESULTS: Twenty-two patients underwent the procedure on 23 legs...
August 12, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27495809/does-surgeon-experience-impact-the-risk-of-complications-after-bernese-periacetabular-osteotomy
#17
Eduardo N Novais, Patrick M Carry, Lauryn A Kestel, Brian Ketterman, Christopher M Brusalis, Wudbhav N Sankar
BACKGROUND: Bernese periacetabular osteotomy (PAO) is a technically challenging procedure with potential risk for major complications and a previously reported steep learning curve. However, the impact of contemporary hip preservation fellowships on the learning curve of PAO has not been established. QUESTIONS/PURPOSES: (1) What was the frequency of major complications during the PAO learning curve of two surgeons who recently graduated from hip preservation fellowships? (2) Is increasing level of experience associated with the risk of a complication and with operative time, a possible surrogate measure of surgical performance? METHODS: We retrospectively studied 81 PAOs performed by one of two surgeons who recently graduated from a hip preservation fellowship during their first 4 years of practice in two institutions...
August 5, 2016: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/27458485/ultrasound-guided-foam-sclerotherapy-of-great-saphenous-vein-with-2-polidocanol-one-year-follow-up-results
#18
Jacek Kurnicki, Marcin Osęka, Robert Tworus, Zbigniew Gałązka
INTRODUCTION: Ultrasound-guided foam sclerotherapy (UGFS) of varicose veins is a useful treatment option. It is a relatively safe method in the case of limited, small varicose veins. In theory, a justified concern could be raised that the injection of an active drug into the large superficial venous vessels may potentially cause life-threatening consequences. AIM: To assess the safety and efficacy of UGFS using a 2% solution of polidocanol (Aethoxysklerol 2%) in the case of great saphenous vein incompetence...
2016: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
https://www.readbyqxmd.com/read/27433417/a-case-of-oncocytic-adrenocortical-neoplasm-of-borderline-uncertain-malignant-potential
#19
Mina Shenouda, Linda G Brown, Krista L Denning, Toni Pacioles
Oncocytic neoplasms are tumors composed predominantly or exclusively of oncocytes (large polygonal cells with granular eosinophilic cytoplasm due to abnormal mitochondrial accumulation). These tumors are frequently reported in the thyroid, kidneys, and salivary glands. However, they are distinctly rare in the adrenal cortex. Oncocytic adrenocortical neoplasms (OAN) are classified regarding their biological behavior by their histological features according to the Lin-Weiss-Bisceglia system (LWB). Here, we report a case of OAN of borderline or uncertain malignant potential (BMP) with subsequently identified papillary thyroid carcinoma (PTC)...
2016: Curēus
https://www.readbyqxmd.com/read/27402385/swyer-james-macleod-syndrome-mimicking-an-acute-pulmonary-embolism-a-report-of-six-adult-cases-and-a-retrospective-analysis
#20
Recep Akgedik, Harun Karamanlı, İlknur Aytekin, Ali Bekir Kurt, Hasan Öztürk, Canan Eren Dağlı
BACKGROUND AND AIM: In patients with pulmonary embolism (PE), a pulmonary radiograph may reveal oligemic fields (the Westermark sign) associated with sites of occlusion of the pulmonary arteries, interruption or loss of the artery line (the knuckle sign), and even unilateral hyperlucency attributable to reduced overall lung vascularity. In Swyer-James-Macleod Syndrome (SJMS), which develops as a result of bronchiolitis obliterans, unilateral hyperlucency is evident because of emphysema and hypoplasia of the pulmonary artery and its branches...
July 12, 2016: Clinical Respiratory Journal
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