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Pulmonary embolism guide

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https://www.readbyqxmd.com/read/29310336/removal-of-a-subdermal-contraceptive-implant-implanon-nxt-that-migrated-to-the-axilla-by-c-arm-guidance-a-case-report-and-review-of-the-literature
#1
Ji Ung Park, Han Sol Bae, Seung Mi Lee, Jaehoon Bae, Jeong Woo Park
RATIONALE: To report the distant migration of a subdermal contraceptive implant and to suggest that C arm-guided technique is one of the feasible options for removal of the device migrated to the axilla. PATIENT CONCERNS: A 41-year-old multipara with tingling sensation in the left axilla was referred for removal of an Implanon NXT which could not be palpated by physical examination or detected by ultrasound scanning. Finally, the device was detected by computed tomography and found migrating to the left axilla...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29301470/risk-of-complications-of-ultrasound-guided-renal-biopsy-for-adult-and-pediatric-patients-with-systemic-lupus-erythematosus
#2
Y S Sun, I T Sun, H K Wang, A H Yang, C Y Tsai, C J Huang, D F Huang, C C Lai
Objective The objective of this paper is to identify the risk of complications of real-time ultrasound-guided renal biopsy in adult and pediatric patients with systemic lupus erythematosus (SLE). Materials and methods This retrospective study examined outcomes of 296 renal biopsy procedures in 275 SLE patients. Imaging-confirmed symptomatic hematoma was regarded as a major complication when intervention (blood transfusion, angiographic embolization, or surgery) was required or as a minor complication otherwise...
January 1, 2018: Lupus
https://www.readbyqxmd.com/read/29299093/systemic-air-embolism-after-percutaneous-lung-biopsy-a-manageable-complication
#3
Lucas Fiore, Nathan Elie Frenk, Guilherme Lopes Pinheiro Martins, Publio Cesar Cavalcante Viana, Marcos Roberto de Menezes
CT-guided percutaneous biopsy is a resourceful and widely used tool to evaluate pulmonary nodules that frequently avoids costly and unnecessary surgeries. Severe complications occur in less than 1% of cases and include gas embolism, which is rarely documented. We report a case of gas embolism after transthoracic biopsies and discuss the pathophysiology and the benefits of early diagnosis and proper management.
June 2017: Journal of Radiology Case Reports
https://www.readbyqxmd.com/read/29285876/metabolomic-analysis-of-92-pulmonary-embolism-patients-from-a-nested-case-control-study-identifies-metabolites-associated-with-adverse-clinical-outcomes
#4
O A Zeleznik, E M Poole, S Lindstrom, P Kraft, A Van Hylckama Vlieg, J A Lasky-Su, L B Harrington, K Hagan, J Kim, B A Parry, N Giordano, C Kabrhel
BACKGROUND: Patients with acute pulmonary embolism (PE) exhibit wide variation in clinical presentation and outcomes. Our understanding of the pathophysiologic mechanisms differentiating low-risk and high-risk PE is limited, so current risk-stratification efforts often fail to predict clinical deterioration and are insufficient to guide management. OBJECTIVES: To improve our understanding of the physiology differentiating low-risk from high-risk PE, we conducted the first-ever high-throughput metabolomics analysis (843 named metabolites) comparing PE patients across risk strata within a nested case-control study...
December 29, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/29224973/residual-pulmonary-embolism-as-a-predictor-for-recurrence-after-a-first-unprovoked-episode-results-from-the-reverse-cohort-study
#5
Tony Wan, Marc Rodger, Wanzhen Zeng, Philippe Robin, Marc Righini, Michael J Kovacs, Melanie Tan, Marc Carrier, Susan R Kahn, Philip S Wells, David R Anderson, Isabelle Chagnon, Susan Solymoss, Mark Crowther, Richard H White, Linda Vickars, Sadri Bazarjani, Grégoire Le Gal
BACKGROUND: The optimal duration of oral anticoagulant therapy after a first, unprovoked venous thromboembolism is controversial due to tightly balanced risks and benefits of indefinite anticoagulation. Risk stratification tools may assist in decision making. OBJECTIVES: We sought to determine the relationship between residual pulmonary embolism assessed by baseline ventilation-perfusion scan after completion of 5-7months of oral anticoagulant therapy and the risk of recurrent venous thromboembolism in patients with the first episode of unprovoked pulmonary embolism...
December 7, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/29215781/clinical-prediction-rules-for-mortality-in-patients-with-pulmonary-embolism-and-cancer-to-guide-outpatient-management-a-meta-analysis
#6
E Nguyen, J Caranfa, G H Lyman, N M Kuderer, C Stirbis, M Wysocki, C I Coleman, E R Weeda, C G Kohn
Essentials Clinical prediction rules (CPRs) can stratify patients with pulmonary embolism (PE) and cancer. A meta-analysis was done to assess prognostic accuracy in CPRs for mortality in these patients. Eight studies evaluating ten CPRs were included in this study. CPRs should continue to be used with other patient factors for mortality risk stratification. SUMMARY: Background Cancer treatment is commonly complicated by pulmonary embolism (PE), which remains a leading cause of morbidity and mortality in these patients...
December 7, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/29203261/preoperative-computed-tomography-guided-pulmonary-lesion-marking-in-preparation-for-fluoroscopic-wedge-resection-rates-of-success-complications-and-pathology-outcomes
#7
Babatunde Olaiya, Charles A Gilliland, Seth D Force, Felix G Fernandez, Manu S Sancheti, William C Small
PURPOSE: In this study, we describe our experience of lesion marking with fiducial markers (FM) and microcoils (MC) facilitating same-day surgical wedge resection, including success rates, pathology outcomes, and complications. We also explored patient/nodular characteristics associated with developing complications. MATERIALS AND METHODS: An IRB-approved single-institutional retrospective study of 136 patients who had 148 pulmonary nodules was conducted. All patients had CT-guided pulmonary nodule labeling with either FM (121) or MC (15) patients with plan for same-day fluoroscopic-guided wedge resection...
November 6, 2017: Current Problems in Diagnostic Radiology
https://www.readbyqxmd.com/read/29201914/acute-right-ventricular-dysfunction-in-intensive-care-unit
#8
REVIEW
Juan C Grignola, Enric Domingo
The role of the left ventricle in ICU patients with circulatory shock has long been considered. However, acute right ventricle (RV) dysfunction causes and aggravates many common critical diseases (acute respiratory distress syndrome, pulmonary embolism, acute myocardial infarction, and postoperative cardiac surgery). Several supportive therapies, including mechanical ventilation and fluid management, can make RV dysfunction worse, potentially exacerbating shock. We briefly review the epidemiology, pathophysiology, diagnosis, and recommendations to guide management of acute RV dysfunction in ICU patients...
2017: BioMed Research International
https://www.readbyqxmd.com/read/29088950/neurosurgical-applications-of-viscoelastic-hemostatic-assays
#9
Svetlana Kvint, James Schuster, Monisha A Kumar
Patients taking antithrombotic agents are very common in neurosurgical practice. The perioperative management of these patients can be extremely challenging especially as newer agents, with poorly defined laboratory monitoring and reversal strategies, become more prevalent. This is especially true with emergent cases in which rapid reversal of anticoagulation is required and the patient's exact medical history is not available. With an aging patient population and the associated increase in diseases such as atrial fibrillation, it is expected that the use of these agents will continue to rise in coming years...
November 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/29076888/role-of-perfusion-defects-at-follow-up-lung-scan-in-predicting-recurrences-after-a-first-episode-of-symptomatic-pulmonary-embolism-a-retrospective-analysis
#10
Liliana Villari, Roberta Pancani, Ferruccio Aquilini, Letizia Marconi, Laura Carrozzi, Antonio Palla, Alessandro Celi
The optimal duration of anticoagulant therapy after a first episode of unprovoked pulmonary thromboembolism is not fully defined. The identification of patients more prone to recurrence would be useful in this context but is currently relatively unreliable. Perfusion lung scan (PLS) is an established approach for the follow-up of patients with pulmonary embolism to identify recurrences and to help in the diagnosis of chronic thromboembolic pulmonary hypertension. The aim of the study was to investigate the potential role of residual perfusion defects at follow-up perfusion scans in predicting pulmonary embolism recurrences...
October 25, 2017: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/29017434/transesophageal-echocardiogram-guided-stent-placement-in-superior-vena-cava-syndrome-secondary-to-granulomatous-lung-disease-a-case-series-and-literature-review
#11
REVIEW
Kaiwen Sun, Rishi Batra, Nicholas W Markin, Melissa Suh, Iraklis I Pipinos, Ellen K Roberts, Jason N Mactaggart, B Timothy Baxter
Obstruction of the superior vena cava (SVC) is an uncommon, but potentially life-threatening condition due to likely development of edema in the head and neck and potential respiratory compromise. Less than half of those affected by SVC syndrome survive more than a year. Obstruction can be from neoplasms or secondary to benign disease. Treatment for most cases of symptomatic SVC syndrome involves placement of a stent to relieve the stenosis. Serious complications such as stent migration, pulmonary embolism, and cardiac tamponade can occur in 5% to 10% of cases, and inadequate imaging of the SVC-atrial junction by fluoroscopy contributes to these problems...
November 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28970039/clinical-conundrums-in-antithrombotic-therapy-management-a-delphi-consensus-panel
#12
Paolo Colonna, Felicita Andreotti, Walter Ageno, Vittorio Pengo, Niccolò Marchionni
BACKGROUND: Anticoagulants are recommended for the prevention of stroke/systemic embolism for most patients with atrial fibrillation (AF) and for the treatment of patients with venous thromboembolism (VTE). Regulatory-driven randomized trials, however, typically exclude extreme patient scenarios involving, for instance, severe bleeding, ischaemic risk, frailty or renal impairment, despite their common occurrence in clinical practice. Uncertainty in the management of such cases leads to a high degree of variability in therapeutic approaches...
December 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28951500/predictors-of-venous-thromboembolism-and-early-mortality-in-lung-cancer-results-from-a-global-prospective-study-cantarisk
#13
Nicole M Kuderer, Marek S Poniewierski, Eva Culakova, Gary H Lyman, Alok A Khorana, Ingrid Pabinger, Giancarlo Agnelli, Howard A Liebman, Eric Vicaut, Guy Meyer, Frances A Shepherd
BACKGROUND: Patients with lung cancer are known to be at increased risk for venous thromboembolism (VTE). Venous thromboembolism is associated with increased risk for early mortality. However, there have been no studies performing a comprehensive assessment of risk factors for VTE or early mortality in lung cancer patients undergoing systemic chemotherapy in a global real-world setting. MATERIALS AND METHODS: CANTARISK is a prospective, global, noninterventional cohort study including patients with lung cancer initiating a new cancer therapy...
September 26, 2017: Oncologist
https://www.readbyqxmd.com/read/28925655/pleuritic-chest-pain-sorting-through-the-differential-diagnosis
#14
Brian V Reamy, Pamela M Williams, Michael Ryan Odom
Pleuritic chest pain is characterized by sudden and intense sharp, stabbing, or burning pain in the chest when inhaling and exhaling. Pulmonary embolism is the most common serious cause, found in 5% to 21% of patients who present to an emergency department with pleuritic chest pain. A validated clinical decision rule for pulmonary embolism should be employed to guide the use of additional tests such as d-dimer assays, ventilation-perfusion scans, or computed tomography angiography. Myocardial infarction, pericarditis, aortic dissection, pneumonia, and pneumothorax are other serious causes that should be ruled out using history and physical examination, electrocardiography, troponin assays, and chest radiography before another diagnosis is made...
September 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/28844809/-pulmonary-embolism-as-a-presentation-of-nephrotic-syndrome
#15
C Fraisse, M Nouvier, S Lainez, P Nesme, S Ernesto, G Devouassoux
BACKGROUND: Nephrotic syndrome (NS) in adults is defined by proteinuria>3g/24h or 50mg/kg/d, hypoproteinemia<60g/24h and hypoalbuminemia<30g/L. The final diagnosis is guided by the histopathology evidence when a renal biopsy is possible. The consequences of NS are multiple: high blood pressure, undernutrition, infections and a hypercoagulable state. OBSERVATION: We report the case of a patient presenting with thromboembolic disease, occurring in the absence of other thromboembolic risk factors, which revealed NS with spontaneously favorable evolution...
September 2017: Revue des Maladies Respiratoires
https://www.readbyqxmd.com/read/28843329/safety-and-feasibility-of-the-transcatheter-approach-to-create-a-reverse-potts-shunt-in-children-with-idiopathic-pulmonary-arterial-hypertension
#16
Younes Boudjemline, Aleksander Sizarov, Sophie Malekzadeh-Milani, Cristian Mirabile, Marien Lenoir, Diala Khraiche, Marilyne Lévy, Damien Bonnet
BACKGROUND: The reversed Potts shunt improves right ventricular (RV) function in patients with suprasystemic pulmonary arterial hypertension (PAH). The proximity of the left pulmonary artery (LPA) to the descending aorta (DAo) permits the creation of a transcatheter connection. We sought to assess the safety, feasibility, and hemodynamic efficacy of the transcatheter Potts shunt (TPS) in children. METHODS: The TPS procedure was performed using radiofrequency energy for vessel perforation and deployment of a covered stent to connect the DAo and LPA...
September 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28835184/physician-failure-to-stratify-patients-hospitalized-with-acute-pulmonary-embolism
#17
Mitchell D Jacobs, Allison Greco, Umer Mukhtar, Jonathan Dunn, Michael L Scharf
OBJECTIVES: In 2011, the AHA recommended risk stratification of patients with acute pulmonary embolism (PE). Failure to risk stratify may cause under recognition of intermediate-risk PE and its attendant short- and long-term consequences. We sought to determine if patients hospitalized with acute PE were appropriately risk stratified according to the 2011 AHA Scientific Statement within our hospital system and whether differences exist in adherence to risk stratification by hospital or treating hospital service...
August 30, 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/28805341/treatment-options-for-severe-pulmonary-embolism-during-pregnancy-and-the-postpartum-period-a-systematic-review
#18
G Martillotti, F Boehlen, H Robert-Ebadi, N Jastrow, M Righini, M Blondon
Essentials The evidence on how to manage life-threatening pregnancy-related pulmonary embolism (PE) is scarce. We systematically reviewed all available cases of (sub)massive PE until December 2016. Thrombolysis in such severe PE was associated with a high maternal survival (94%). The major bleeding risk was much greater in the postpartum (58%) than antepartum period (18%). SUMMARY: Background Massive pulmonary embolism (PE) during pregnancy or the postpartum period is a rare but dramatic event...
October 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28801217/evaluation-of-unplanned-hospital-readmissions-after-major-urologic-inpatient-surgery-in-the-era-of-accountable-care
#19
Benjamin V Stone, Matthew R Cohn, Nicholas M Donin, Michael Schulster, James S Wysock, Danil V Makarov, Marc A Bjurlin
OBJECTIVE: To provide a multi-institutional analysis of clinical factors predicting unplanned hospital readmission after major inpatient urologic surgery. MATERIALS AND METHODS: The American College of Surgeons National Surgical Quality Improvement Program is a risk-adjusted data collection mechanism for analyzing clinical outcomes data including 30-day perioperative readmissions and complications. We identified 23,108 patients who underwent major inpatient urologic surgery from 2011 to 2012...
November 2017: Urology
https://www.readbyqxmd.com/read/28791850/the-contribution-of-clinical-assessments-to-the-diagnostic-algorithm-of-pulmonary-embolism
#20
Onur Turan, Deniz Turgut, Turkan Gunay, Erkan Yilmaz, Ayse Turan, Atila Akkoclu
BACKGROUND: Pulmonary thromboembolism (PE) is a major disease in respiratory emergencies. Thoracic CT angiography (CTA) is an important method of visualizing PE. Because of the high radiation and contrast exposure, the method should be performed selectively in patients in whom PE is suspected. OBJECTIVES: The aim of the study was to identify the role of clinical scoring systems utilizing CTA results to diagnose PE. MATERIAL AND METHODS: The study investigated 196 patients referred to the hospital emergency service in whom PE was suspected and CTA performed...
March 2017: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
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