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Pulmonary embolus

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https://www.readbyqxmd.com/read/27914588/obesity-in-pediatric-trauma
#1
Cordelie E Witt, Saman Arbabi, Avery B Nathens, Monica S Vavilala, Frederick P Rivara
BACKGROUND/PURPOSE: The implications of childhood obesity on pediatric trauma outcomes are not clearly established. Anthropomorphic data were recently added to the National Trauma Data Bank (NTDB) Research Datasets, enabling a large, multicenter evaluation of the effect of obesity on pediatric trauma patients. METHODS: Children ages 2 to 19years who required hospitalization for traumatic injury were identified in the 2013-2014 NTDB Research Datasets. Age and gender-specific body mass indices (BMI) were calculated...
November 23, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27879533/the-angiovac-device-understanding-the-failures-on-the-road-to-success
#2
Berhane Worku, Arash Salemi, Marcus D DʼAyala, Robert F Tranbaugh, Leonard N Girardi, Iosif M Gulkarov
OBJECTIVE: Current percutaneous thromboembolectomy techniques may obviate surgical intervention in high-risk patients with iliocaval thrombus or thrombus of the right side of the heart, but typically require thrombus fragmentation and thrombolysis with associated bleeding and thromboembolic complications. The AngioVac (Angiodynamics, Latham, NY USA) device uses a percutaneous venovenous bypass circuit to aspirate intact thrombus. A review of the literature was performed with regard to the AngioVac device to determine the factors correlating with successful thrombus extraction...
November 22, 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/27873765/extensive-biatrial-thrombus-straddling-the-patent-foramen-ovale-and-traversing-into-the-left-and-right-ventricle
#3
Adil Sattar, Theingi Tiffany Win, Alex Schevchuck, Abinash Achrekar
We report an extremely rare case of an extensive biatrial thrombus straddling a patent foramen ovale (PFO) extending into the bilateral ventricles in a patient presenting with an acute embolic stroke. Our patient further developed a massive saddle pulmonary embolus (PE) with haemodynamic instability during the course of his hospitalisation. The risks of pharmacological thrombolysis or surgical thrombectomy for PE in a haemodynamically unstable patient with recent embolic stroke posed a significant therapeutic dilemma...
November 21, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27853656/risk-factors-for-venous-thromboembolism-following-thoracolumbar-surgery-analysis-of-43-777-patients-from-the-american-college-of-surgeons-national-surgical-quality-improvement-program-2005-to-2012
#4
Arjun S Sebastian, Bradford L Currier, Sanjeev Kakar, Emily C Nguyen, Amy E Wagie, Elizabeth S Habermann, Ahmad Nassr
Study Design Retrospective clinical study of a prospectively collected, national database. Objective Determine the 30-day incidence, timing, and risk factors for venous thromboembolism (VTE) following thoracolumbar spine surgery. Methods The American College of Surgeons National Surgical Quality Improvement Program Participant Use File identified 43,777 patients who underwent thoracolumbar surgery from 2005 to 2012. Multiple patient characteristics were identified. The incidence and timing (in days) of deep vein thrombosis (DVT) and pulmonary embolus (PE) were determined...
December 2016: Global Spine Journal
https://www.readbyqxmd.com/read/27851340/1705-pulmonary-embolus-masquerading-as-fulminant-liver-failure
#5
Said Chaaban, Rana Awdish, George Samuel
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27797317/prevalence-of-pulmonary-embolism-among-patients-hospitalized-for-syncope
#6
Paolo Prandoni, Anthonie W A Lensing, Martin H Prins, Maurizio Ciammaichella, Marica Perlati, Nicola Mumoli, Eugenio Bucherini, Adriana Visonà, Carlo Bova, Davide Imberti, Stefano Campostrini, Sofia Barbar
Background The prevalence of pulmonary embolism among patients hospitalized for syncope is not well documented, and current guidelines pay little attention to a diagnostic workup for pulmonary embolism in these patients. Methods We performed a systematic workup for pulmonary embolism in patients admitted to 11 hospitals in Italy for a first episode of syncope, regardless of whether there were alternative explanations for the syncope. The diagnosis of pulmonary embolism was ruled out in patients who had a low pretest clinical probability, which was defined according to the Wells score, in combination with a negative d-dimer assay...
October 20, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/27789095/deep-venous-thrombosis-prophylaxis-after-unicompartmental-knee-arthroplasty-a-prospective-study-on-the-safety-of-aspirin
#7
Tom Schmidt-Braekling, Andrew D Pearle, David J Mayman, Geoffrey H Westrich, Wenzel Waldstein, Friedrich Boettner
BACKGROUND: Although venous thromboembolism is one of the leading causes of morbidity after knee arthroplasty, little data exist on the risk of deep venous thrombosis (DVT) after unicompartmental knee arthroplasty (UKA). METHODS: We prospectively enrolled 112 patients undergoing UKA to determine the incidence of DVT utilizing aspirin 325 mg twice a day (BID) for 4 weeks postoperatively as DVT prophylaxis. The data were compared with a recent randomized controlled trial of patients undergoing total knee arthroplasty utilizing aspirin and Lovenox in conjunction with pneumatic compression devices...
September 28, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27756869/correction-of-hammertoe-deformity-with-novel-intramedullary-pip-fusion-device-versus-k-wire-fixation
#8
Seth H Richman, Marcelo Bogliolo Piancastelli Siqueira, Kirk A McCullough, Mark J Berkowitz
BACKGROUND: K-wire fixation has been the most common method of fixation for hammertoe deformity. However intramedullary devices are gaining ground in both number of available choices and in procedures performed. This study aimed to compare the outcomes of hammertoe correction performed with K-wire fixation versus a novel intramedullary fusion device (CannuLink). METHODS: A retrospective review of hammertoe correction by a single surgeon was performed from June 2011 to December 2013...
October 18, 2016: Foot & Ankle International
https://www.readbyqxmd.com/read/27752630/admission-rates-for-emergency-department-patients-with-venous-thromboembolism-and-estimation-of-the-proportion-of-low-risk-pulmonary-embolism-patients-a-us-perspective
#9
Adam J Singer, Henry C Thode, W Frank Peacock
OBJECTIVE: Introduction of target specific anticoagulants and recent guidelines encourage outpatient management of low risk patients with venous thromboembolism. We describe hospital admission rates over time for patients presenting to US emergency departments (EDs) with deep vein thrombosis (DVT) and pulmonary embolism (PE) and estimate the proportion of low-risk PE patients who could potentially be managed as outpatients. METHODS: We performed a structured analysis of the National Hospital Ambulatory Medical Care Survey (a nationally representative weighted sampling of US ED visits) database for the years 2006-2010 including all adult patients with a primary diagnosis of DVT or PE...
September 2016: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/27743740/ct-guided-drainage-of-deep-pelvic-abscesses-via-a-percutaneous-presacral-space-approach-a-clinical-report-and-review-of-the-literature
#10
Tao Peng, Liming Dong, Zhihua Zhu, Jing Cui, Qian Li, Xin Li, Heshui Wu, Chunyou Wang, Zhiyong Yang
RATIONALE AND OBJECTIVES: Some deep pelvic abscesses are not accessible through anterior or lateral approaches because of the presence of organs and structures. The objective of this study was to assess the feasibility, safety, tolerability, and efficacy of a percutaneous presacral space approach by reviewing our clinical experience and the literature. MATERIALS AND METHODS: The outcomes of 12 patients, who have undergone computed tomography (CT)-guided percutaneous presacral space drainage, were retrospectively reviewed, including demographic, clinical, and morphological data in the medical records...
October 12, 2016: Academic Radiology
https://www.readbyqxmd.com/read/27733870/chest-pain-of-uncertain-aetiology-role-of-contrast-enhanced-computed-tomography-in-the-emergency-department
#11
Firas Yassin, Chris Sawh, Pankaj Garg
There is increasing role of computed tomographic (CT) in the assessment of acute chest pain in the emergency department especially when the diagnosis is not clear. We report a case where non ECG gated contrast enhanced CT in the emergency department for rule-out of pulmonary embolus guided to the actual diagnosis, which was, acute coronary event, as evidenced by the presence of perfusion defect.
2016: Open Cardiovascular Medicine Journal
https://www.readbyqxmd.com/read/27722084/shortness-of-breath-patient-history-not-always-indicative-of-the-cause
#12
Tony S Brar, Neeka Akhavan
This is a 78 year old male with a past medical history of coronary artery disease (CAD), chronic obstructive pulmonary disease (COPD), hypertension (HTN), and gastroesophageal reflux disorder (GERD) who presented to the emergency room with worsening shortness of breath (SOB) and low-grade fevers for one week prior to admission. He was originally diagnosed with healthcare associated pneumonia (HCAP) and an acute on chronic COPD exacerbation and treated with prednisone, inhalers, ipratropium/albuterol, and broad-spectrum antibiotics...
2016: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/27714603/acute-type-a-aortic-dissection-with-mediastinal-hematoma-mimicking-massive-pulmonary-embolus
#13
Kota Talla, Adam A Dmytriw, Elsie Nguyen
No abstract text is available yet for this article.
October 6, 2016: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/27713852/delayed-cerebral-infarct-following-anterior-cervical-diskectomy-and-fusion
#14
Christopher S Graffeo, Ross C Puffer, Eelco F M Wijdicks, William E Krauss
BACKGROUND: Ischemic stroke following anterior cervical diskectomy and fusion (ACDF) is an exceedingly rare complication. There are only three previous cases focusing on this problem in the literature; here, we present the fourth case. CASE DESCRIPTION: A patient, cared for at an outside institution, developed a delayed ischemic stroke 3 days following an ACDF. This complication was attributed to carotid manipulation precipitating vascular injury in the setting of multiple comorbid vascular and coagulopathic risk factors, including previously undiagnosed carotid atherosclerosis, a prior history of pulmonary embolus requiring Warfarin anticoagulation (held perioperatively), acute dehydration, and atrial fibrillation...
2016: Surgical Neurology International
https://www.readbyqxmd.com/read/27683616/chronic-thromboembolic-pulmonary-hypertension-pregnancy-and-a-pulmonary-endarterectomy-a-rare-challenge
#15
Erika B Rosenzweig, Mauer Biscotti, Kirsten Cleary, Richard Smiley, Matthew D Bacchetta
It is well described that patients with group 1 forms of pulmonary arterial hypertension have a high risk of mortality during pregnancy and in the early postpartum period. However, to the authors' knowledge, the diagnosis and management of group 4 pulmonary hypertension due to chronic thromboembolic pulmonary hypertension (CTEPH) during pregnancy with early postpartum pulmonary endarterectomy (PEA) has not been previously reported. We report the case of a 28-year-old woman who received a diagnosis of CTEPH during her pregnancy, was managed as an inpatient by a multidisciplinary team throughout the pregnancy and early postpartum period, and underwent PEA 6 weeks after delivery...
September 2016: Pulmonary Circulation
https://www.readbyqxmd.com/read/27662063/delayed-neuraxial-hematoma-in-parturient-with-fontan-circulation-following-neuraxial-anesthesia-for-cesarean-section
#16
Chukwudi O Chiaghana, Justin M Bremer, Joshua W Sappenfield, Adam L Wendling
OBJECTIVE: Neuraxial hematoma is a rare complication of spinal or epidural anesthesia. However, variable coagulation factor defects are relatively common in patients with Fontan circulation, and may predispose such patients to either increased risk of thrombosis or coagulopathy. These defects may indirectly increase their risk of neuraxial hematoma. CASE REPORT: We report a case of delayed neuraxial hematoma after the start of full-dose anticoagulation for pulmonary embolus on a postpartum patient with Fontan physiology who had continuous spinal anesthesia for cesarean delivery 4 days earlier...
September 22, 2016: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/27659877/physiological-mechanisms-of-pulmonary-hypertension
#17
REVIEW
David H MacIver, Ismail Adeniran, Iain R MacIver, Alistair Revell, Henggui Zhang
Pulmonary hypertension is usually related to obstruction of pulmonary blood flow at the level of the pulmonary arteries (eg, pulmonary embolus), pulmonary arterioles (idiopathic pulmonary hypertension), pulmonary veins (pulmonary venoocclusive disease) or mitral valve (mitral stenosis and regurgitation). Pulmonary hypertension is also observed in heart failure due to left ventricle myocardial diseases regardless of the ejection fraction. Pulmonary hypertension is often regarded as a passive response to the obstruction to pulmonary flow...
October 2016: American Heart Journal
https://www.readbyqxmd.com/read/27642528/pulmonary-embolism-presenting-as-abdominal-pain-an-atypical-presentation-of-a-common-diagnosis
#18
Hasan Rehman, Elizabeth John, Payal Parikh
Pulmonary embolism (PE) is a frequent diagnosis made in the emergency department and can present in many different ways. Abdominal pain is an unusual presenting symptom for PE. It is essential to maintain a high degree of suspicion in these patients, as a delay in diagnosis can be devastating for the patient and confers a high risk of mortality if left untreated. Here, we report the case of a 53-year-old male who presented to the emergency department with worsening right upper quadrant abdominal pain with fevers...
2016: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/27634123/thrombotic-and-embolic-complications-associated-with-atrial-arrhythmia-after%C3%A2-fontan-operation-role-of-prophylactic-therapy
#19
Alexander C Egbe, Heidi M Connolly, Christopher J McLeod, Naser M Ammash, Talha Niaz, Vidhushei Yogeswaran, Joseph T Poterucha, Muhammad Y Qureshi, David J Driscoll
BACKGROUND: There are limited data about the risk of thrombotic and embolic complication (TEC) in adults with atrial arrhythmia after Fontan operation. OBJECTIVES: This study sought to determine the risk of TEC in this population and the role of anticoagulation therapy in TEC prevention. METHODS: This was a retrospective review of adults with atrial arrhythmia after Fontan operation who were evaluated at the Mayo Clinic between 1994 to 2014...
September 20, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27619327/pediatric-pulmonary-embolism-diagnostic-and-management-challenges
#20
Christian Lilje, Aman Chauhan, Jason P Turner, Thomas H Carson, Maria C Velez, Christopher Arcement, Joseph Caspi
A rare case of massive pulmonary embolism is presented in an oligosymptomatic teenager with predisposing factors. Computed tomography pulmonary angiography supported by three-dimensional reconstruction was diagnostic. The embolus qualified as massive by conventional anatomical guidelines, but as low risk by more recent functional criteria. Functional assessment has complemented morphologic assessment for risk stratification in adult patients. Such evidence is scarce in pediatrics. The patient underwent surgical embolectomy, followed by prophylactic anticoagulation, without further events...
September 12, 2016: World Journal for Pediatric & Congenital Heart Surgery
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