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Pulmonary embolism guide

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https://www.readbyqxmd.com/read/28457630/non-invasive-thrombolysis-using-microtripsy-in-a-porcine-deep-vein-thrombosis-model
#1
Xi Zhang, Jonathan J Macoskey, Kimberly Ives, Gabe E Owens, Hitinder S Gurm, Jiaqi Shi, Matthew Pizzuto, Charles A Cain, Zhen Xu
Histotripsy is a non-invasive therapeutic technique that uses ultrasound generated from outside the body to create controlled cavitation in targeted tissue, and fractionates it into acellular debris. We have developed a new histotripsy approach, termed microtripsy, to improve targeting accuracy and to avoid collateral tissue damage. This in vivo study evaluates the safety and efficacy of microtripsy for non-invasive thrombolysis in a porcine deep vein thrombosis model. Acute thrombi were formed in left femoral veins of pigs (∼35 kg) by occluding the vessel using two balloon catheters and infusing with thrombin...
July 2017: Ultrasound in Medicine & Biology
https://www.readbyqxmd.com/read/28447414/review-of-d-dimer-testing-good-bad-and-ugly
#2
REVIEW
L-A Linkins, S Takach Lapner
D-dimer assays are commonly used in clinical practice to exclude a diagnosis of deep vein thrombosis or pulmonary embolism. More recently, they have been also been used to guide patients with unprovoked venous thromboembolism (VTE) when faced with the decision to continue or stop anticoagulation after initial treatment is complete. D-dimer assays vary widely with respect to the antibody used, method of capture, instrumentation required, and calibration standard. These differences have an important influence on the operating characteristics of the assays...
May 2017: International Journal of Laboratory Hematology
https://www.readbyqxmd.com/read/28417266/guided-longer-pulses-from-a-diagnostic-ultrasound-and-intraclot-microbubble-enhanced-catheter-directed-thrombolysis-in-vivo
#3
Shunji Gao, Qiong Zhu, Xiaoxiao Dong, Zhong Chen, Zheng Liu, Feng Xie
The mechanism of ultrasound thrombolysis (UT) is generally attributed to cavitation. The insufficiency of microbubbles (MB) to serve as cavitation nuclei in the vessel-obstructing thrombi significantly reduces the effectiveness of UT. Taking advantage of the widely performed catheter-directed therapy (CDT), in a thrombo-embolized rabbit IVC model with a simultaneous catheter directed rt-PA thrombolysis procedure, guided moderate mechanical index longer pulses from a modified diagnostic ultrasound transducer, combined with an intraclot infusion of MB, significantly accelerated the thrombolysis process...
April 17, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28347676/treating-multiple-myeloma-patients-with-oral-therapies
#4
REVIEW
Shaji K Kumar, Ravi Vij, Stephen J Noga, Deborah Berg, Lonnie Brent, Lawrence Dollar, Ajai Chari
Recent advances have highlighted the importance of long-term, continuous treatment in multiple myeloma (MM) to improve survival. However, treatment burden continues to negatively impact the real-world duration of MM therapy, and strategies to limit the adverse impact of treatment on patient quality of life are therefore particularly important. Oral MM therapies include the immunomodulatory drugs lenalidomide, thalidomide, and pomalidomide; the alkylating agents melphalan and cyclophosphamide; the histone deacetylase inhibitor panobinostat; the corticosteroids prednisone and dexamethasone; and the proteasome inhibitor ixazomib...
March 7, 2017: Clinical Lymphoma, Myeloma & Leukemia
https://www.readbyqxmd.com/read/28314711/validating-the-herdoo2-rule-to-guide-treatment-duration-for-women-with-unprovoked-venous-thrombosis-multinational-prospective-cohort-management-study
#5
MULTICENTER STUDY
Marc A Rodger, Gregoire Le Gal, David R Anderson, Jeannot Schmidt, Gilles Pernod, Susan R Kahn, Marc Righini, Patrick Mismetti, Clive Kearon, Guy Meyer, Antoine Elias, Tim Ramsay, Thomas L Ortel, Menno V Huisman, Michael J Kovacs
Objective To prospectively validate the HERDOO2 rule (Hyperpigmentation, Edema, or Redness in either leg; D-dimer level ≥250 μg/L; Obesity with body mass index ≥30; or Older age, ≥65 years), which states that women with none or one of the criteria can safely discontinue anticoagulants after short term treatment.Design Prospective cohort management study.Setting 44 secondary or tertiary care centres in seven countries.Participants Of 3155 consecutive eligible participants with a first unprovoked venous thromboembolism (VTE, proximal leg deep vein thrombosis or pulmonary embolism) who completed 5-12 months of short term anticoagulant treatment, 370 declined to participate, leaving 2785 enrolled participants...
March 17, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28277229/intraventricular-air-embolism-complicating-computed-tomography-guided-pulmonary-aspiration-biopsy
#6
Agustin Dietrich, Analía Vargas, David E Smith, Alberto Domenech
No abstract text is available yet for this article.
October 27, 2016: Archivos de Bronconeumología
https://www.readbyqxmd.com/read/28265126/achieving-multidisciplinary-collaboration-for-the-creation-of-a-pulmonary-embolism-response-team-creating-a-team-of-rivals
#7
REVIEW
Christopher Kabrhel
Pulmonary embolism response teams (PERTs) have recently been developed to streamline care for patients with life-threatening pulmonary embolism (PE). PERTs are unique among rapid response teams, in that they bring together a multidisciplinary team of specialists to care for a single disease for which there are novel treatments but few comparative data to guide treatment. The PERT model describes a process that includes activation of the team; real-time, multidisciplinary consultation; communication of treatment recommendations; mobilization of resources; and collection of research data...
March 2017: Seminars in Interventional Radiology
https://www.readbyqxmd.com/read/28263791/accuracy-of-point-of-care-focused-echocardiography-in-predicting-outcome-of-resuscitation-in-cardiac-arrest-patients-a-systematic-review-and-meta-analysis
#8
REVIEW
Po-Yang Tsou, Jeantte Kurbedin, Yueh-Sheng Chen, Eric H Chou, Meng-Tse Gabriel Lee, Matthew Chien-Hung Lee, Matthew Huei-Ming Ma, Shyr-Chyr Chen, Chien-Chang Lee
OBJECTIVE: We aim to summarize current evidence on the value of point-of-care (POC) focused echocardiography in the assessment of short-term survival in patients with cardiac arrest. METHODS: PubMed and EMBASE were searched from inception to July 2016 for eligible studies that evaluated the utility of POC echocardiography in patients with cardiac arrest. Modified QUADAS was used to appraise the quality of included studies. A random-effect bivariate model and a hierarchical summary receiving operating curve were used to summarize the performance characteristics of focused echocardiography...
March 2, 2017: Resuscitation
https://www.readbyqxmd.com/read/28259825/soft-tissue-neoplasms-causing-apparent-venous-thoracic-outlet-syndrome
#9
Aleem K Mirza, Ian J Barrett, Animesh Rathore, Bassem T Elhassan, Peter S Rose, Thomas Shives, Thomas C Bower
Venous thoracic outlet syndrome (vTOS) usually results from compression of the subclavian vein classically as a result of narrowing of the costoclavicular space. We report 2 rare cases of soft tissue neoplasms resulting in apparent vTOS. The first case is a 46-year-old female with a 2-year history of intermittent unilateral shoulder pain, who was initially diagnosed with intervertebral disk herniation. Cervical fusion was performed; however, her symptoms progressed and she additionally developed paresthesias and venous congestion...
March 1, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28258976/congenital-pulmonary-lymphangiectasia
#10
Shi-Min Yuan
Congenital pulmonary lymphangiectasia (CPL) is a rare but fatal disease, usually having an onset from the first few hours to days after birth. Inconsistent nomenclatures were used for CPL in the past decades. Patients often present with intractable respiratory failure, hydrops fetalis and even sudden death. The etiologies of CPL remain unclear. Previous hypotheses suggested that CPL might be caused by conditions preventing normal regression of the lymphatics after the 18th-20th week of gestation. Up-to-date biological studies on lymphatic development, lymphatic valve formation and occurrence of hydrops fetalis revealed possible causative relations with mutations of genes of the vascular endothelial growth factor receptor (VEGFR), RAS/MAPK, PI3K/AKT and NF-κB signaling pathways...
March 4, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28251012/ectopic-thyroid-tissue-in-the-mediastinum-characterized-by-histology-and-functional-imaging-with-i-123-spect-ct
#11
Jed Hummel, Jason Wachsmann, Kelley Carrick, Orhan K Oz, Dana Mathews, Fangyu Peng
Ectopic thyroid tissue is a rare entity and when discovered it is typically along the pathway of embryologic migration of the thyroid. We present a case of incidental finding of ectopic thyroid tissue within mediastinum in a 61-year-old female patient with a history of total thyroidectomy for thyroiditis and nodules. The patient presented to emergency room with cough and right chest pain and underwent a chest computed tomographic angiogram (CTA) to exclude pulmonary embolism as part of chest pain workup. One right paratracheal mediastinal soft tissue nodule was visualized on the images of CTA...
2017: Case Reports in Radiology
https://www.readbyqxmd.com/read/28250929/ambiguous-presentation-of-mycobacterium-avium-complex-associated-rasmussen-aneurysm
#12
Hsin-Wei Chiu, Shu-Hung Kuo, Ruay-Sheng Lai, Ming-Ting Wu, Hsiu-Fu Wu
A 77-year-old man with a progressively dry cough (two months duration) was admitted with hemoptysis. Chest computed tomography (CT) revealed left lingular lobe consolidation and one thick-walled cavity lesion over the left lower lobe, which was accompanied by satellite micro-nodules in a tree-in-bud pattern. CT-guided biopsy confirmed mycobacterial infection, and subsequent culture yielded Mycobacterium avium complex (MAC). Unremitting hemoptysis was present despite treatment (14 days) with ethambutol, rifampin, clarithromycin, and streptomycin...
May 2017: Respirology Case Reports
https://www.readbyqxmd.com/read/28247199/cost-effectiveness-of-genotype-guided-warfarin-dosing-in-patients-with-mechanical-heart-valve-replacement-under-the-fee-for-service-system
#13
Dong-Jin Kim, Ho-Sook Kim, Minkyung Oh, Eun-Young Kim, Jae-Gook Shin
BACKGROUND: Although studies assessing the cost effectiveness of genotype-guided warfarin dosing for the management of atrial fibrillation, deep vein thrombosis, and pulmonary embolism have been reported, no publications have addressed genotype-guided warfarin therapy in mechanical heart valve replacement (MHVR) patients or genotype-guided warfarin therapy under the fee-for-service (FFS) insurance system. OBJECTIVE: The aim of this study was to evaluate the cost effectiveness of genotype-guided warfarin dosing in patients with MHVR under the FFS system from the Korea healthcare sector perspective...
February 28, 2017: Applied Health Economics and Health Policy
https://www.readbyqxmd.com/read/28216527/usefulness-of-intraoperative-cone-beam-ct-images-on-video-assisted-thoracic-surgery
#14
Harutaka Hisano, Tohru Sakuragi, Yoshinobu Kakiuchi, Satoshi Takita, Yuuji Takeda, Shigeki Morita, Hiroyuki Irie
For the resection of pulmonary ground glass opacity (GGO) or non-palpable nodule on video-assisted thoracic surgery (VATS), preoperative computed tomography (CT)-guided VATS marker pricking is usually performed. Recently, air embolisms after VATS marker pricking have been reported to be serious problems. The purpose of this study was to evaluate the usefulness of intraoperative cone beam CT images on VATS to avoid preoperative VATS marker pricking. The CT number of the both GGO and nodule indicate the range from -200 to -800 HU in general...
2017: Nihon Hoshasen Gijutsu Gakkai Zasshi
https://www.readbyqxmd.com/read/28197281/prediction-of-symptomatic-embolism-in-filipinos-with-infective-endocarditis-using-the-embolic-risk-french-calculator
#15
Jaime Alfonso M Aherrera, Maria Teresa B Abola, Maria Margarita O Balabagno, Lauro L Abrahan, Jose Donato A Magno, Paul Ferdinand M Reganit, Felix Eduardo R Punzalan
BACKGROUND: Cardioembolic events are life-threatening complications of infective endocarditis (IE). The embolic risk French calculator estimates the embolic risk in IE computed on admission. Variables in this tool include age, diabetes, atrial fibrillation, prior embolism, vegetation length, and Staphylococcus aureus on culture. A computed risk of > 7% was considered high in the development of this tool. Knowledge of this risk applied in our local setting is important to guide clinicians in preventing such catastrophic complications...
August 2016: Cardiology Research
https://www.readbyqxmd.com/read/28135040/lipid-levels-and-risk-of-recurrent-venous-thrombosis-results-from-the-mega-follow-up-study
#16
V M Morelli, W M Lijfering, F R Rosendaal, S C Cannegieter
Essentials The role of lipid levels in the risk of recurrent venous thrombosis is unclear. Lipids were assessed in patients with a first venous thrombosis (n = 2106) followed for 6.9 years. Lipids were not associated with recurrence, overall or in patients with unprovoked first events. Testing lipid levels is not useful to identify patients at an increased risk of recurrence. SUMMARY: Background Knowledge of risk factors for recurrent venous thrombosis may guide decisions on duration of anticoagulation...
April 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28119956/analysis-of-clinical-factors-affecting-the-rates-of-fatal-pulmonary-embolism-and-bleeding-in-cancer-patients-with-venous-thromboembolism
#17
Javier Trujillo-Santos, Francisco Martín Martos, Carme Font, Dominique Farge-Bancel, Vladimir Rosa, Alicia Lorenzo, Manuel Barrón, Manuel Alejandro Lorente, José María Pedrajas, Manuel Monreal
BACKGROUND: In cancer patients with symptomatic venous thromboembolism (VTE) (deep-vein thrombosis (DVT) and/or pulmonary embolism (PE)), clinical factors that influence the benefit-risk balance of anticoagulation need to be identified so treatment intensity and duration can be optimally adjusted for the individual patient. METHODS: Using clinical data for cancer patients with VTE obtained from the RIETE registry, we compared how rates of fatal PE and fatal bleeding during and after anticoagulation vary depending on patients' clinical characteristics...
January 2017: Heliyon
https://www.readbyqxmd.com/read/28054326/what-is-the-timing-of-general-health-adverse-events-that-occur-after-total-joint-arthroplasty
#18
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/28046769/su-g-iep4-15-ultrasound-imaging-of-absorbable-inferior-vena-cava-filters-for-proper-placement
#19
T Mitcham, R Bouchard, A Melancon, M Eggers, M Melancon
PURPOSE: Inferior vena cava filters (IVCFs) are used in patients with a high risk of pulmonary embolism in situations when the use of blood thinning drugs would be inappropriate. These filters are implanted under x-ray guidance; however, this provides a dose of ionizing radiation to both patient and physician. B-mode ultrasound (US) imaging allows for localization of certain implanted devices without radiation dose concerns. The goal of this study was to investigate the feasibility of imaging the placement of absorbable IVCFs using US imaging to alleviate the dosage concern inherent to fluoroscopy...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28009644/imaging-of-nontraumatic-thoracic-emergencies
#20
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...
March 2017: Current Opinion in Pulmonary Medicine
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