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Pulmonary embolus

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https://www.readbyqxmd.com/read/28209484/successful-provision-of-inter-hospital-extracorporeal-cardiopulmonary-resuscitation-for-acute-post-partum-pulmonary-embolism
#1
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...
January 9, 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
#2
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
#3
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
#4
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...
February 3, 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
#5
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
#6
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
#7
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
#8
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...
January 23, 2017: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/28106717/air-embolism-diagnosis-clinical-management-and-outcomes
#9
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
https://www.readbyqxmd.com/read/28093377/ten-year-experience-of-retrievable-inferior-vena-cava-filters-in-a-tertiary-referral-center
#10
George Tse, Trevor Cleveland, Stephen Goode
PURPOSE: A significant proportion of patients undergoing surgery have an increased incidence of acute pulmonary embolus (PE). We analyzed all patients who had a retrievable inferior vena cava (IVC) filter placed preoperatively for PE prophylaxis and investigated the long-term outcomes of the patients who did not have their filter removed. METHODS: Patients who underwent retrievable IVC filter insertion and attempted removal were identified from the radiology information systems database in a large tertiary referral university teaching hospital...
January 17, 2017: Diagnostic and Interventional Radiology: Official Journal of the Turkish Society of Radiology
https://www.readbyqxmd.com/read/28052051/deep-inferior-epigastric-perforator-versus-free-transverse-rectus-abdominis-myocutaneous-flap-complications-and-resource-utilization
#11
Yasmina Zoghbi, David J Gerth, Jun Tashiro, Samuel Golpanian, Seth R Thaller
INTRODUCTION: Abdominal based breast reconstruction exists in a continuum from pedicled transverse rectus abdominis myocutaneous (TRAM) flap to deep inferior epigastric perforator (DIEP) free flap. DIEP flap has the advantage of complete rectus abdominis sparing during harvest, thus decreasing donor site morbidity. Aim of this study is to determine whether the surgical advantages of the DIEP flap impact postoperative outcomes versus the free TRAM flap (fTRAM). METHODS: We reviewed the Nationwide Inpatient Sample database (2010-2011) for all cases of DIEP and fTRAM breast reconstruction...
November 3, 2016: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28028005/releasing-the-brakes-on-the-fibrinolytic-system-in-pulmonary-emboli-unique-effects-of-plasminogen-activation-and-%C3%AE-2-antiplasmin-inactivation
#12
Satish Singh, Aiilyan K Houng, Guy L Reed
BACKGROUND: -In patients with hemodynamically significant pulmonary embolism, physiologic fibrinolysis fails to dissolve thrombi acutely and recombinant tissue plasminogen activator (r-tPA) therapy may be required, despite its bleeding risk. To examine potential mechanisms, we analyzed the expression of key fibrinolytic molecules in experimental pulmonary emboli, assessed the contribution of α2-antiplasmin to fibrinolytic failure and compared the effects of plasminogen activation and α2-antiplasmin-inactivation on experimental thrombus dissolution and bleeding...
December 27, 2016: Circulation
https://www.readbyqxmd.com/read/28018828/paradoxical-embolus-stuck-in-a-patent-foramen-ovale
#13
Zaki Kohistani, Chris Probst
In-hospital mortality rate of an embolus in transit is as high as 44.7%. In some cases, a paradoxical embolus can get stuck in a patent foramen ovale. Because of the high mortality rate, this condition should be considered as an emergency case. Echocardiography has been established as the gold standard method for the diagnosis. A negative echocardiography, however, does not rule out an embolus in transit. To rule out pulmonary embolisms, a computed tomography scan of the chest should also be performed. A cardiothoracic surgeon should be consulted immediately upon diagnosis of an embolus in transit...
December 2016: Thoracic and Cardiovascular Surgeon Reports
https://www.readbyqxmd.com/read/28018495/postoperative-venous-thromboembolism-in-patients-undergoing-endovenous-laser-and-radiofrequency-ablation-of-the-saphenous-vein
#14
Nobuhisa Kurihara, Masayuki Hirokawa, Takashi Yamamoto
Objective: Endovenous laser ablation (EVLA) and radiofrequency ablation (RFA) are safe and effective treatments for varicose veins caused by saphenous reflux. Deep venous thrombosis (DVT) and endovenous heat-induced thrombosis (EHIT) are known complications of these procedures. The purpose of this article is to investigate the incidence of postoperative DVT and EHIT in patients undergoing EVLA and RFA. Methods: The patients were assessed by clinical examination and venous duplex ultrasonography before operation and at 24-72 hours, 1 month, and 1 year follow-up after operation...
2016: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/28017313/percutaneous-pulmonary-embolus-mechanical-thrombectomy
#15
Deepali Nivas Tukaye, Michael McDaniel, Henry Liberman, Yelena Burkin, Wissam Jaber
No abstract text is available yet for this article.
December 1, 2016: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28009735/mock-pages-are-a-valid-construct-for-assessment-of-clinical-decision-making-and-interprofessional-communication
#16
Margaret L Boehler, Cathy J Schwind, Stephen J Markwell, Rebecca M Minter
IMPORTANCE: Answering pages from nurses about patients in need of immediate attention is one of the most difficult challenges a resident faces during their first days as a physician. A Mock Page program has been developed and adopted into a national surgical resident preparatory curriculum to prepare senior medical students for this important skill. OBJECTIVE: The purpose of this study is to assess standardized mock page cases as a valid construct to assess clinical decision making and interprofessional communication skills...
January 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28009035/unilateral-hypertransparency-on-chest-radiograph-the-congenital-poland-syndrome
#17
Ioannis Tomos, Andriana I Papaioannou, Aikaterini Vlami, Vasiliki Apollonatou, Effrosyni D Manali, Spyros A Papiris
Unilateral hypertransparent hemithorax requires a particular diagnostic approach as it can be the result of diverse pulmonary diseases, including pneumothorax, large pulmonary embolus, unilateral large bullae, mucous plag, airway obstruction and contralateral pleural effusion. Congenital syndromes with chest wall abnormalities, are rare, but often underdiagnosed causes. Poland Syndrome consists of such a rare, congenital anomaly and is characterized by the absence of the pectoralis major muscle and upper limb ipsilateral abnormalities...
2016: Adv Respir Med
https://www.readbyqxmd.com/read/27979032/prevalence-and-outcome-of-thrombotic-and-embolic-complications-in-adults-after-fontan-operation
#18
Alexander C Egbe, Heidi M Connolly, Talha Niaz, Vidhushei Yogeswaran, Nathaniel W Taggart, Muhammad Y Qureshi, Joseph T Poterucha, Arooj Razzaq Khan, David J Driscoll
: There are limited studies of thrombotic and embolic complications (TEC) in the adult Fontan population. The purpose of the study was to determine the prevalence, risk factors, and outcomes of TECs in this population. METHODS: Retrospective review of adults with a previous Fontan operation, with follow-up at Mayo Clinic, 1994-2014. Systemic TEC was defined as intracardiac thrombus, ischemic stroke, or systemic arterial embolus. Nonsystemic TEC was defined as Fontan conduit/right atrial thrombus or pulmonary embolus...
January 2017: American Heart Journal
https://www.readbyqxmd.com/read/27930576/hyperthyroidism-secondary-to-hysterosalpingography-an-extremely-rare-complication-a-case-report
#19
Guotao Ma, Rui Mao, Haixin Zhai
RATIONALE: Hysterosalpingography (HSG), a standard procedure for the evaluation of women with infertility and repetitive pregnancy loss, is associated with complications such as uterine perforation, infection, allergic reactions, syncope, hemorrhage and shock, and pulmonary or retinal embolus. However, hyperthyroidism has not been reported as one of its complications. PATIENT CONCERNS AND DIAGNOSES: We report the case of a 33-year-old euthyroid woman who presented to our hospital with palpitation, hand tremor, fatigue, and excessive sweating after HSG...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27926655/maternal-morbidity-after-previable-prelabor-rupture-of-membranes
#20
Sarah K Dotters-Katz, Alexis Panzer, Matthew R Grace, Marcela C Smid, J Adeolu Keku, Catherine J Vladutiu, Kim A Boggess, Tracy A Manuck
OBJECTIVE: To identify risk factors for maternal morbidity after previable prelabor rupture of membranes (PROM). METHODS: We conducted a case-control study of singleton and twin pregnancies complicated by previable PROM (14.0-22.9 weeks of gestation) at a single tertiary care referral institution, 2000-2015. Pregnancies complicated by fetal anomalies, previable PROM within 2 weeks of chorionic villus sampling or amniocentesis, and those with contraindications to expectant management (eg, chorioamnionitis) were excluded...
January 2017: Obstetrics and Gynecology
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