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Pulmonary embolus

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https://www.readbyqxmd.com/read/28430391/analysis-of-pulmonary-embolus-size-at-the-time-of-recurrence-compared-with-presentation-a-single-centre-retrospective-study
#1
W Thomas, O Firth, M Besser, M Beveridge, T Baglin
BACKGROUND: the size of recurrent pulmonary embolus (PE) in relation to a prior event could be a factor in deciding whether to continue anticoagulation. There is no published data on this subject to help with counselling patients. OBJECTIVES: to determine whether size of a first PE predicts the size at recurrence. PATIENTS AND METHODS: retrospective cohort study of consecutive patients over 25 months, at a single tertiary centre, with recurrent PE...
April 21, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28401718/compliance-to-clinical-pathways-in-the-management-of-suspected-pulmonary-embolus-are-there-cost-implications
#2
Ata Rehman, Eric Yelf, Jacqueline Pearson, Wilf Yeo
This study investigated the cost implications of poor compliance to established guidelines for management of suspected pulmonary embolism (PE) in two NSW public hospitals. A retrospective audit showed that the prevalence of PE overall was 9.9% (4.3% in the low-risk groups) in 436 patients. An estimated total of $32 454 (14%) was spent on unnecessary tests.
April 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28369826/increased-incidence-of-vte-in-sickle-cell-disease-patients-risk-factors-recurrence-and-impact-on-mortality
#3
Ann Brunson, Amy Lei, Aaron S Rosenberg, Richard H White, Theresa Keegan, Ted Wun
Previous reports show increased incidence of venous thromboembolism [VTE, deep-vein thrombosis (DVT) and pulmonary embolus (PE)] in sickle cell disease (SCD) patients but did not account for frequency of hospitalization. We determined the incidence of VTE in a SCD cohort versus matched controls. For SCD patients, risk factors for incident VTE, recurrence and the impact on mortality were also determined. Among 6237 patients with SCD, 696 patients (11·2%) developed incident-VTE: 358 (51·6%) had PE (±DVT); 179 (25·7%) had lower-extremity DVT only and 158 (22·7%) had upper-extremity DVT...
April 3, 2017: British Journal of Haematology
https://www.readbyqxmd.com/read/28367009/trauma-patients-warrant-upper-and-lower-extremity-venous-duplex-ultrasound-surveillance
#4
Alonso Andrade, Alan H Tyroch, Susan F McLean, Jody Smith, Alex Ramos
BACKGROUND: Due to the high incidence of thromboembolic events (deep venous thrombosis [DVT] and pulmonary embolus [PE]) after injury, many trauma centers perform lower extremity surveillance duplex ultrasounds. We hypothesize that trauma patients are at a higher risk of upper extremity DVTs (UEDVTs) than lower extremity DVTs (LEDVTs), and therefore, all extremities should be evaluated. MATERIALS AND METHODS: A retrospective chart and trauma registry review of Intensive Care Unit trauma patients with upper and LEDVTs detected on surveillance duplex ultrasound from January 2010 to December 2014 was carried out...
April 2017: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/28364812/coagulopathy-before-and-after-liver-transplantation-from-the-hepatic-to-the-systemic-circulatory-systems
#5
REVIEW
Jonathan G Stine, Patrick G Northup
The hemostatic environment in patients with cirrhosis is a delicate balance between prohemostatic and antihemostatic factors. There is a lack of effective laboratory measures of the hemostatic system in patients with cirrhosis. Many are predisposed to pulmonary embolus, deep vein thrombosis, and portal vein thrombosis in the pretransplantation setting. This pretransplantation hypercoagulable milieu seems to extend for at least several months post-transplantation. Patients with nonalcoholic fatty liver disease, inherited thrombophilia, portal hypertension in the absence of cirrhosis, and hepatocellular carcinoma often require individualized approach to anticoagulation...
May 2017: Clinics in Liver Disease
https://www.readbyqxmd.com/read/28357505/identification-of-left-ventricle-failure-on-pulmonary-artery-cta-diagnostic-significance-of-decreased-aortic-left-ventricle-enhancement
#6
Abhishek Chaturvedi, Joel P Thompson, Katherine Kaproth-Joslin, Susan K Hobbs, Karl Q Schwarz, Vijay K Krishnamoorthy, Apeksha Chaturvedi, Timothy Baran
PURPOSE: This study aimed to identify findings on non-ECG-gated CT pulmonary angiography (CTPA) indicating decreased left ventricle (LV) systolic function, later confirmed by echocardiogram. METHODS: After obtaining institutional review board approval, review was performed of emergency department (ED) patients who had CTPA and follow-up echocardiogram within 48 h, over 18 months. Patients with pulmonary embolus, suboptimal CTPA, arrhythmias or pericardial tamponade were excluded...
March 29, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/28339655/what-should-we-do-when-a-small-pulmonary-embolus-is-diagnosed-unexpectedly
#7
J Thachil
No abstract text is available yet for this article.
February 17, 2017: QJM: Monthly Journal of the Association of Physicians
https://www.readbyqxmd.com/read/28331450/pulmonary-thromboendarterectomy-for-pulmonary-hypertension-before-considering-transplant
#8
Hannah Kooperkamp, Inder Mehta, David Fary, Michael Bates
BACKGROUND: In cases of chronic thromboembolic pulmonary hypertension (CTEPH), referral for possible surgical intervention is important because surgery can be curative. Surgery necessitates cardiopulmonary bypass and deep circulatory arrest with pulmonary thrombectomy and bilateral endarterectomy (PTE). If surgery fails, lung transplant is the next best surgical option. Medical treatment is also an important adjunct. CASE REPORT: A 35-year-old female presented 3 months after a pulmonary embolus was found to be completely occluding her left pulmonary artery...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/28281739/cerebral-micro-embolization-during-pulmonary-vein-isolation-relation-to-post-ablation-silent-cerebral-ischemia
#9
Edina Nagy-Baló, Mihran Martirosyan, Gábor Sándorfi, Orsolya Hajas, Levente Lánczi, Ervin Berényi, Lilla Ladányi, Alexandra Kiss, István Édes, Zoltán Csanádi
BACKGROUND: High incidences of silent cerebral ischemia (SCI) have been revealed by diffusion-weighted magnetic resonance imaging (DW MRI) after pulmonary vein isolation (PVI) for atrial fibrillation. A high number of mostly gaseous micro-embolic signals (MESs) was detected by transcranial Doppler (TCD) during PVI. In this investigation the possible relationship between MESs detected intraoperatively by TCD and new SCI on DW MRI post-ablation is reported. METHODS: 27 consecutive atrial fibrillation patients (6 female, age median: 64 interquartile range: 13...
March 10, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/28268789/perspective-imaging-of-flow-in-arterial-model-obtained-with-continuous-wave-doppler-focusing-technique
#10
Ryo Nagaoka, Katsuhiro Sasaki, Seiichi Zama, Masaaki Nagone, Hiroshi Nagai, Yasuhito Takeuchi, Yoshifumi Saijo
Flowing emboli in the circulatory system cause fatal diseases such as stroke or pulmonary embolism. Conventional transcranial Doppler ultrasound for detection of emboli requires precise positioning by experienced examiner. In the present study, an easier emboli detection device by visualizing perspective view of blood vessel is proposed. The perspective image was obtained with continuous wave (CW) Doppler ultrasound from 2-dimensional array probe. CW Doppler signal from each element was focused by novel beam forming algorithm to obtain en face images at arbitrary depth to form perspective image...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28226983/perspective-imaging-of-flow-in-arterial-model-obtained-with-continuous-wave-doppler-focusing-technique
#11
Ryo Nagaoka, Katsuhiro Sasaki, Seiichi Zama, Masaaki Nagone, Hiroshi Nagai, Yasuhito Takeuchi, Yoshifumi Saijo, Ryo Nagaoka, Katsuhiro Sasaki, Seiichi Zama, Masaaki Nagone, Hiroshi Nagai, Yasuhito Takeuchi, Yoshifumi Saijo, Yoshifumi Saijo, Hiroshi Nagai, Katsuhiro Sasaki, Masaaki Nagone, Seiichi Zama, Ryo Nagaoka, Yasuhito Takeuchi
Flowing emboli in the circulatory system cause fatal diseases such as stroke or pulmonary embolism. Conventional transcranial Doppler ultrasound for detection of emboli requires precise positioning by experienced examiner. In the present study, an easier emboli detection device by visualizing perspective view of blood vessel is proposed. The perspective image was obtained with continuous wave (CW) Doppler ultrasound from 2-dimensional array probe. CW Doppler signal from each element was focused by novel beam forming algorithm to obtain en face images at arbitrary depth to form perspective image...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28209484/successful-provision-of-inter-hospital-extracorporeal-cardiopulmonary-resuscitation-for-acute-post-partum-pulmonary-embolism
#12
C McDonald, J Laurie, S Janssens, C Zazulak, P Kotze, K Shekar
Mortality during pregnancy in a well-resourced setting is rare, but acute pulmonary embolism is one of the leading causes. We present the successful use of extracorporeal cardiopulmonary resuscitation (eCPR) in a 22-year old woman who experienced cardiopulmonary collapse following urgent caesarean section in the setting of a sub-massive pulmonary embolus. Resources and personnel to perform eCPR were not available at the maternity hospital and were recruited from an adjacent pediatric hospital. Initial care used low blood flow extracorporeal membrane oxygenation (ECMO) with pediatric ECMO circuitry, which was optimized when the team from a nearby adult cardiac hospital arrived...
May 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28197281/prediction-of-symptomatic-embolism-in-filipinos-with-infective-endocarditis-using-the-embolic-risk-french-calculator
#13
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/28187807/neuropulmonology
#14
REVIEW
A Balofsky, J George, P Papadakos
Neuropulmonology refers to the complex interconnection between the central nervous system and the respiratory system. Neurologic injury includes traumatic brain injury, hemorrhage, stroke, and seizures, and in each there are far-reaching effects that can result in pulmonary dysfunction. Systemic changes can induce impairment of pulmonary function due to changes in the core structure and function of the lung. The conditions and disorders that often occur in these patients include aspiration pneumonia, neurogenic pulmonary edema, and acute respiratory distress syndrome, but also several abnormal respiratory patterns and sleep-disordered breathing...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28159870/a-17-year-old-with-chest-pain
#15
Ankoor Y Shah, Megan Jamison, Hansel J Otero, Lawrence Jung, Lowell H Frank, Michael F Guerrera, A Yasmine Kirkorian
A 17-year-old male subject with a history of deep venous thrombosis presented with acute unilateral severe chest pain. His examination was nonspecific, and vital signs were normal. His initial laboratory evaluation revealed mild thrombocytopenia, elevated troponin levels, and critically elevated activated partial thromboplastin time. A computed tomography angiogram of the chest revealed a pulmonary embolus, and anticoagulation therapy was initiated. His course was complicated by the development of multiple thrombi and respiratory failure...
March 2017: Pediatrics
https://www.readbyqxmd.com/read/28156464/short-course-radiation-for-palliation-of-squamous-cell-carcinoma-of-an-unknown-primary-of-the-head-and-neck
#16
William M Mendenhall
62 Background: The purpose of this study was to examine the treatment patterns used for palliative radiotherapy for squamous cell carcinoma of an unknown primary of the head and neck and to compare the acute toxicity and tumor response for these patients for the most common dose-fractionation regimens. METHODS: Patients with biopsy-proven squamous cell carcinoma of an unknown primary with cervical lymphadenopathy were included who were treated with radiation therapy with palliative intent at a single institution between 1966 and 2015 (N = 45)...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28138441/cardiac-papillary-fibroelastoma-the-need-for-a-timely-diagnosis
#17
Srikanth Yandrapalli, Bella Mehta, Pratik Mondal, Tanush Gupta, Pallavi Khattar, John Fallon, Randy Goldberg, Sachin Sule, Wilbert S Aronow
Cardiac papillary fibroelastomas (CPFs) are the second most common primary cardiac tumors and the most common cardiac valvular tumors. Although they are histologically benign and usually asymptomatic, CPFs can lead to serious and life-threatening complications like myocardial infarction, stroke, pulmonary embolus, cardiac arrest etc. CPFs represent a rare entity in clinical medicine and literature regarding their management is limited. We report two cases which illustrate such complications arising from undiagnosed CPFs on the aortic valve...
January 16, 2017: World Journal of Clinical Cases
https://www.readbyqxmd.com/read/28127832/does-this-patient-need-telemetry-an-analysis-of-telemetry-ordering-practices-at-an-academic-medical-center
#18
Stephanie Chen, Sonali Palchaudhuri, Amber Johnson, Jeff Trost, Ileana Ponor, Sammy Zakaria
INTRODUCTION: The American Heart Association and Choosing Wisely campaign recommend guideline-based usage of telemetry. Inappropriate use leads to increased costs, alarm fatigue, and inefficient nursing care. This study assesses provider ordering practices for telemetry at a US-based academic hospital. METHODS: This retrospective study includes all telemetry orders in the medicine and progressive care units from April 2014 to March 2015. Indications were grouped into categories per American Heart Association guidelines...
January 27, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28111746/saddle-pulmonary-embolism-with-paradoxical-coronary-artery-embolism-through-a-patent-foramen-ovale
#19
Amber L Achesinski, Wendy M Gunther, Catherine B Pearman
A 35-year-old male patient was found in cardiac arrest in his vehicle, with no apparent injuries after a minor motor vehicle collision. The decedent was found to have a saddle pulmonary embolus with a thromboembolus impacted across a patent foramen ovale and a paradoxical embolism in the circumflex coronary artery, as well as significant clotting in the deep veins of both lower extremities. There were no risk factors in his history to explain the deep venous thrombosis; family history suggested the possibility of an unrecognized clotting disorder...
May 2017: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/28106717/air-embolism-diagnosis-clinical-management-and-outcomes
#20
Colin J McCarthy, Sasan Behravesh, Sailendra G Naidu, Rahmi Oklu
Air embolism is a rare but potentially fatal complication of surgical procedures. Rapid recognition and intervention is critical for reducing morbidity and mortality. We retrospectively characterized our experience with air embolism during medical procedures at a tertiary medical center. Electronic medical records were searched for all cases of air embolism over a 25-year period; relevant medical and imaging records were reviewed. Sixty-seven air embolism cases were identified; the mean age was 59 years (range, 3-89 years)...
January 17, 2017: Diagnostics
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