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Pulmonary embolus

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https://www.readbyqxmd.com/read/29109889/a-case-report-on-vt-from-tv-dvt-and-pe-from-prolonged-television-watching
#1
Alan Lucerna, James Espinosa, Lindsey Ackley, Philip Carhart, Douglas Stranges, Risha Hertz
Pulmonary embolus (PE) and deep vein thrombosis are diagnoses that are commonly made in the emergency department. Well known risk factors for thromboembolic events include immobility, malignancy, pregnancy, surgery, and acquired or inherited thrombophilias, obesity, cigarette smoking, and hypertension. We present a case of a 59-year-old female who watched TV and developed leg swelling and was found to have PE and DVT.
2017: Case Reports in Pulmonology
https://www.readbyqxmd.com/read/29090256/pulseless-electrical-activity-during-general-anesthesia-induction-in-patients-with-amyotrophic-lateral-sclerosis
#2
Tae Min You, Seungoh Kim
Pulseless electrical activity (PEA) is a clinical condition characterized by unresponsiveness and lack of palpable pulse in the presence of organized cardiac electrical activity and is caused by a profound cardiovascular insult (e.g., severe prolonged hypoxia or acidosis, extreme hypovolemia, or flow-restricting pulmonary embolus). Amyotrophic lateral sclerosis (ALS) is a disease that is characterized by progressive degeneration of all levels of the motor nervous system. Damage to the respiratory system and weakness of the muscles may increase the likelihood of an emergency situation occurring in patients with ALS while under general anesthesia...
September 2017: J Dent Anesth Pain Med
https://www.readbyqxmd.com/read/29054227/life-threatening-cardiac-perforation-after-posterior-spondylodesis
#3
Michaela Andrä, Harald Baumer, Florian Mittergradnegger, Michael Laschitz, Tadej Petek, Wolfgang Wandschneider
This reports presents a case of a 62-year-old woman with hemorrhagic hypovolemic shock, respiratory distress, and pericardial effusion secondary to right atrial perforation caused by a cement embolus after dorsal spondylodesis. Despite optimal intensive care support for a supposed pulmonary embolism, the patient's condition markedly deteriorated. On delayed embolus recognition by contrast-enhanced computed tomography and transesophageal echocardiography, she had to undergo cardiac surgery. Cardiac involvement is a rare but important complication, with few cases described after vertebroplasty and none after spondylodesis...
November 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29037361/a-novel-surgical-approach-to-symptomatic-left-renal-vein-aneurysm
#4
Anthony Rios, Pouria Parsa, John Eidt, Gregory Pearl
Visceral venous aneurysms are uncommon and renal vein aneurysms are among the rarest in this subset. Renal vein aneurysms are frequently asymptomatic, but patients may present with flank pain or hematuria. Complications of untreated visceral venous aneurysms include thrombus formation and, very rarely, rupture. Treatment of renal vein aneurysms ranges from watchful waiting to surgical repair. We describe a patient with renal vein aneurysm presenting with recurrent pulmonary embolus with no other identifiable source...
November 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/29035980/incidence-of-symptomatic-pulmonary-embolus-and-deep-vein-thrombosis-after-knee-arthroscopy-in-the-pediatric-and-adolescent-population
#5
Brian C Lau, Jason Jagodzinski, Nirav K Pandya
OBJECTIVE: The incidence of deep venous thrombosis (DVT) and pulmonary embolism (PE) after pediatric knee arthroscopy is unknown. The purpose of this study was to determine the incidence of venous thromboembolism (VTE) after knee arthroscopy in the pediatric and adolescent population in a high-volume center. DESIGN: Retrospective cohort study. SETTING: Tertiary care children's hospital. PATIENTS: All patients who underwent arthroscopy of the knee for a sports-related injury by 2 surgeons were reviewed...
October 10, 2017: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
https://www.readbyqxmd.com/read/28989798/how-to-train-radiology-residents-to-diagnose-pulmonary-embolism-using-a-dedicated-mri-protocol
#6
Anna Nordgren Rogberg, Sven Nyrén, Eli Westerlund, Peter Lindholm
BACKGROUND: In recent years, magnetic resonance imaging (MRI) has been suggested as an alternative to computed tomography angiography (CTA) to diagnose pulmonary embolism (PE). In previous studies, only senior radiologists have been evaluated as reviewers. PURPOSE: To investigate if radiology residents can be trained to review MRI regarding PE and to determine the learning curve effects. MATERIAL AND METHODS: Four residents independently went through a training program consisting of 70 participants that had undergone steady-state free precession MRI...
September 2017: Acta Radiologica Open
https://www.readbyqxmd.com/read/28987675/influence-of-spectral-detector-ct-based-monoenergetic-images-on-the-computer-aided-detection-of-pulmonary-artery-embolism
#7
Jan Robert Kröger, Tilman Hickethier, Gregor Pahn, Felix Gerhardt, David Maintz, Alexander C Bunck
OBJECTIVE: To evaluate the influence of monoenergetic reconstructions using a spectral detector CT (SDCT) on the computer aided detection (CAD) of pulmonary artery embolism (PAE) on CT pulmonary angiography (CTPA) and CT in venous contrast phase (CTV). MATERIAL AND METHODS: A retrospective data base search identified 15 patients with CTPA and 18 patients with CTV and diagnosis of PAE. For these patients, monoenergetic (monoE) images at different energy levels or with a fixed attenuation in the pulmonary artery were generated and independently analyzed using a commercially available computer aided detection (CAD) tool...
October 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/28982549/achieving-a-3-star-society-of-thoracic-surgery-lobectomy-ranking-by-using-continuing-process-improvement-lean-methodology-and-root-cause-analysis
#8
Robert J Cerfolio, Douglas J Minnich, Benjamin Wei, Caroline Watson, Malcolm M DeCamp
Our purpose is to identify the metrics used by the Society of Thoracic Surgeons (STS) to rank lobectomy and to show our process to improve. This is a review of our STS data for lobectomy and our results using the process of root cause analysis and lean methodology to improve our outcomes. The STS metrics are 30-day mortality, pneumonia, adult respiratory distress syndrome, bronchopleural fistula, pulmonary embolus, initial ventilator support greater than 48 hours, reintubation and respiratory failure, tracheostomy, myocardial infarction, or unexpected return to the operating room...
August 18, 2017: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28922451/low-medical-morbidity-and-mortality-after-acute-courses-of-electroconvulsive-therapy-in-a-population-based-sample
#9
D M Blumberger, D P Seitz, N Herrmann, J G Kirkham, R Ng, C Reimer, P Kurdyak, A Gruneir, M J Rapoport, Z J Daskalakis, B H Mulsant, S N Vigod
BACKGROUND: To determine event rates for specific medical events and mortality among individuals receiving electroconvulsive therapy (ECT). METHOD: Population-based cohort study using health administrative data of acute ECT treatments delivered in Ontario, Canada, from 2003 to 2011. We measured the following medical event rates, per 10 000 ECT treatments, up to 7 and 30 days post-treatment: stroke, seizure, acute myocardial infarction, arrhythmia, pneumonia, pulmonary embolus, deep vein thrombosis, gastrointestinal bleeding, falls, hip fracture, and mortality...
September 18, 2017: Acta Psychiatrica Scandinavica
https://www.readbyqxmd.com/read/28904659/-pulmonary-embolism-at-the-university-hospital-campus-of-lome-togo-a-retrospective-study-about-51-cases
#10
Soulemane Pessinaba, Yaovi Dodzi Molba Atti, Soodougoua Baragou, Machihude Pio, Yaovi Afassinou, Mohamed Kpélafia, Edem Goeh-Akué, Findibé Damorou
INTRODUCTION: This study provides an analysis of the evolutionary, clinical and epidemiological aspects of pulmonary embolism at the University Hospital Campus of Lome. METHODS: We conducted a retrospective, analytic and descriptive study over a period of 39 months (November 1 , 2011- January 31, 2015). All the medical records of patients hospitalized for PE in the Department of Cardiology at the University Hospital Campus were analyzed. RESULTS: The prevalence of PE was 3...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28891912/postoperative-complications-affecting-survival-after-cardiac-arrest-in-general-surgery-patients
#11
Minjae Kim, Guohua Li
BACKGROUND: Postoperative cardiac arrest is uncommon but associated with a high mortality risk in general surgery patients and is often preceded by postoperative complications. The relationships between previous complications and mortality after cardiac arrest in general surgery patients have not been completely evaluated. METHODS: retrospective, observational cohort of general surgery in patients with cardiac arrest occurring after postoperative day (POD) #0 (and up to POD #30) was obtained from the 2012-2013 American College of Surgeons National Surgical Quality Improvement Program...
September 7, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28869115/wound-discharge-after-pharmacological-thromboprophylaxis-in-lower-limb-arthroplasty
#12
Christopher W Jones, S Spasojevic, G Goh, Z Joseph, D J Wood, Piers J Yates
BACKGROUND: The benefits vs risk of pharmacological prophylaxis for thromboembolic disease in orthopedic patients remain controversial. Pharmacological thromboprophylaxis regimes are commonly used in this patient group. Few studies specifically examine wound complications attributable to this therapy. In this prospective trial, we investigated the effect of various regimens on postoperative wounds. METHODS: A prospective, observational, multicenter study involving patients undergoing elective hip or knee arthroplasty was undertaken...
August 3, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28854070/first-in-human-phase-i-study-of-the-tamoxifen-metabolite-z-endoxifen-in-women-with-endocrine-refractory-metastatic-breast-cancer
#13
Matthew P Goetz, Vera J Suman, Joel M Reid, Don W Northfelt, Michael A Mahr, Andrew T Ralya, Mary Kuffel, Sarah A Buhrow, Stephanie L Safgren, Renee M McGovern, John Black, Travis Dockter, Tufia Haddad, Charles Erlichman, Alex A Adjei, Dan Visscher, Zachary R Chalmers, Garrett Frampton, Benjamin R Kipp, Minetta C Liu, John R Hawse, James H Doroshow, Jerry M Collins, Howard Streicher, Matthew M Ames, James N Ingle
Purpose Endoxifen is a tamoxifen metabolite with potent antiestrogenic activity. Patients and Methods We performed a phase I study of oral Z-endoxifen to determine its toxicities, maximum tolerated dose (MTD), pharmacokinetics, and clinical activity. Eligibility included endocrine-refractory, estrogen receptor-positive metastatic breast cancer. An accelerated titration schedule was applied until moderate or dose-limiting toxicity occurred, followed by a 3+3 design and expansion at 40, 80, and 100 mg per day...
October 20, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28839904/uk-practice-in-the-prevention-of-central-venous-catheter-associated-thrombosis-in-adults-on-home-parenteral-nutrition
#14
L Macdougall, J Hanley, C Mountford, N P Thompson
BACKGROUND: Maintaining central access is imperative for the delivery of home parenteral nutrition (HPN) in those with intestinal failure. Methods to reduce central venous catheter infection are well recognised; however, the prevention of line thrombosis is less well studied. METHODS: This paper reviews the current evidence and reports a survey of current practice within the UK. Using an electronic survey, respondents were asked to detail their use of anticoagulation in different patient groups and the type of anticoagulation used...
July 2017: Frontline Gastroenterology
https://www.readbyqxmd.com/read/28838508/postpneumonectomy-bronchopleural-fistula-closure-with-biologic-mesh-and-diaphragm-flap
#15
Usman Ahmad, Maryna Chumakova, Siva Raja, David P Mason, Sudish C Murthy
A 77-year-old man with clinical stage II squamous cell carcinoma underwent right intrapericardial pneumonectomy. After an initially uneventful course he was readmitted with right-sided empyema, bronchopleural fistula, and pulmonary embolus. This was managed with initial resuscitation and anticoagulant agents, followed by debridement and closure of the fistula with biologic mesh reinforced with a pedicled diaphragm muscle flap.
September 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28806210/risk-stratification-for-major-postoperative-complications-in-patients-undergoing-intra-abdominal-general-surgery-using-latent-class-analysis
#16
Minjae Kim, Melanie M Wall, Guohua Li
BACKGROUND: Preoperative risk stratification is a critical element in assessing the risks and benefits of surgery. Prior work has demonstrated that intra-abdominal general surgery patients can be classified based on their comorbidities and risk factors using latent class analysis (LCA), a model-based clustering technique designed to find groups of patients that are similar with respect to characteristics entered into the model. Moreover, the latent risk classes were predictive of 30-day mortality...
August 10, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28767504/echocardiography-in-the-evaluation-of-pulmonary-embolism
#17
Tanya Dutta, William H Frishman, Wilbert S Aronow
Pulmonary embolism is a major cause of mortality. Acute pulmonary embolism also encompasses a wide clinical spectrum of severity, ranging from asymptomatic silent disease to hemodynamic instability and shock. Echocardiography is a useful modality to improve treatment strategies for pulmonary embolus. Echocardiography plays a role in risk stratification at the time of diagnosis. The evaluation of the right ventricle (RV) has evolved over time. RV variables evaluated by echocardiography include RV size, RV/left ventricular ratio, RV fractional area of change, tricuspid annular plane systolic excursion, RV systolic pressure, and RV Tei index...
November 2017: Cardiology in Review
https://www.readbyqxmd.com/read/28765479/early-intracardiac-thrombus-and-pulmonary-embolus-after-trauma
#18
Neel Desai, Julia Heid, Andrew Leitch
Here, we present the case of a patient with the findings of an early intracardiac thrombus and a pulmonary embolus after major trauma. A large clot was identified extending from the inferior vena cava into the right atrium and ventricle in the setting of preserved right ventricular function. Post-traumatic intracardiac thrombus is extremely rare and no comparable cases have previously been described in the absence of a congenital heart defect and obvious myocardial injury. Best practice afterpost-traumatic intracardiac thrombus is not well established but we found that early inferior vena cava filter placement and treatment with therapeutic coagulation resulted in clinical improvement, resolution of the thrombus and no further emboli...
July 31, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28755257/two-way-interaction-effects-of-perioperative-complications-on-30-day-mortality-in-general-surgery
#19
Minjae Kim, Guohua Li
BACKGROUND: Multiple perioperative complications increase mortality risk, and certain complications synergistically increase this risk to a greater degree than might be expected if the complications were independent, but these effects are not well established. METHODS: This is a retrospective cohort study of 422,827 intraabdominal general surgery patients (American College of Surgeons National Surgical Quality Improvement Program 2005-2011). Eight complications were evaluated: acute respiratory failure (ARF), acute kidney injury (AKI), sepsis/septic shock, stroke, cardiac arrest (CA), myocardial infarction (MI), deep vein thrombosis/pulmonary embolus, and transfusion...
July 28, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28742015/topical-tranexamic-acid-reduces-transfusion-rates-in-simultaneous-bilateral-total-knee-arthroplasty-a-retrospective-case-series
#20
COMPARATIVE STUDY
Christopher Kim, Sam S Park, Herman S Dhotar, Anthony V Perruccio, Michael G Zywiel, J Roderick Davey
BACKGROUND: Topical tranexamic acid (TA) has been reported to be effective in reducing postoperative bleeding and transfusions after total knee arthroplasty (TKA). The main objective of this study was to retrospectively assess the effectiveness and safety of topical TA administration in patients undergoing simultaneous bilateral TKA. METHODS: We conducted a retrospective chart review of consecutive cohorts of patients undergoing simultaneous bilateral TKA. We compared the patients who received TA with patients from a similar time frame who did not receive TA...
September 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
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