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Acute embolism pulmonary

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https://www.readbyqxmd.com/read/29222261/symptomatic-subsegmental-pulmonary-embolism-to-treat-or-not-to-treat
#1
REVIEW
Marc Carrier, Fredrikus A Klok
The introduction of computed tomographic pulmonary angiography and its recent increasing availability has led to a significant rise in its use to help clinicians diagnose acute pulmonary embolism (PE). This has led to a significant increase in the incidence of PE diagnoses. Simultaneously, the case fatality rate of acute PE has been decreasing and no significant change in its mortality has been noted, suggesting that the additional PE diagnoses are less severe and these patients might not benefit from anticoagulation therapy...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29217343/patent-foramen-ovale-in-patients-with-pulmonary-embolism-a-prognostic-factor-on-ct-pulmonary-angiography
#2
Meng Zhang, Stephanie Tan, Vishal Patel, Benjamin A Zalta, Anna Shmukler, Jeffrey M Levsky, Vineet R Jain, Nada M Shaban, Linda B Haramati
BACKGROUND: Patent foramen ovale (PFO) in patients with acute pulmonary embolism (PE) represents a risk factor for mortality, but this has not been evaluated for CT pulmonary angiography (CTPA). The purpose of the present study was to assess the relationship between PFO and mortality in patients with acute PE diagnosed on CTPA. MATERIALS AND METHODS: This retrospective study included 268 adults [173 women, mean age 61 (range 22-98) years] diagnosed with acute PE on non-ECG-gated 64-slice CTPA in 2012 at our medical center...
December 2, 2017: Journal of Cardiovascular Computed Tomography
https://www.readbyqxmd.com/read/29217335/rivaroxaban-and-apixaban-for-initial-treatment-of-acute-venous-thromboembolism-of-atypical-location
#3
Dawid T Janczak, Malgorzata K Mimier, Robert D McBane, Patrick S Kamath, Benjamin S Simmons, Dalene M Bott-Kitslaar, Charles J Lenz, Emily R Vargas, David O Hodge, Waldemar E Wysokinski
OBJECTIVES: To assess the outcome of direct oral anticoagulants (DOACs), specifically Xa inhibitors: rivaroxaban and apixaban, for the treatment of venous thromboembolism (VTE) of atypical location (VTE-AL), portal, mesenteric, hepatic, splenic, gonadal, renal, and cerebral veins, prospectively collected data of Mayo Thrombophilia Clinic Registry were used. METHODS: Patients with acute VTE-AL treated with DOACs, enrolled between March 1, 2013, and February 1, 2017, were compared with patients with VTE of typical location (VTE-TL: deep vein thrombosis of extremities and/or pulmonary embolism) receiving DOACs and with patients with VTE-AL treated with enoxaparin...
December 4, 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29214507/comparison-of-once-daily-bemiparin-with-twice-daily-enoxaparin-for-acute-deep-vein-thrombosis-a-multicenter-open-label-randomized-controlled-trial
#4
Igor A Suchkov, Javier Martinez-Gonzalez, Sebastian M Schellong, Toni Garbade, Michela Falciani
BACKGROUND: Individuals with deep vein thrombosis (DVT) have an increased risk of pulmonary embolism (PE), death, and long-term thrombotic complications. OBJECTIVES: To evaluate the efficacy and safety of bemiparin once daily versus enoxaparin twice daily in the treatment of acute DVT, and to establish therapeutic non-inferiority of bemiparin. PATIENTS AND METHODS: This multicenter, randomized, open-label, active-controlled phase III clinical trial enrolled patients with acute proximal DVT confirmed by complete compression ultrasound (CCUS)...
December 6, 2017: Clinical Drug Investigation
https://www.readbyqxmd.com/read/29212594/-false-positive-troponin-i-due-to-heterophile-antibodies
#5
Henrik Nørlund, Ann Bovin
The troponin I (TnI) level is essential in the diagnosis of acute myocardial infarction, but may be elevated by other cardial and non-cardial causes. We report a 32-year-old pregnant woman admitted to hospital because of chest pain and dyspnoea. TnI levels were significantly elevated, although there was no suspicion of acute coronary syndrome or myocarditis, and supplementary diagnostics excluded pulmonary embolism. The TnI level was found to be falsely elevated due to immunoassay interference. We stress the need to be aware of the possibility of false positive TnI, especially during pregnancy...
December 4, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/29212130/dabigatran-after-short-heparin-anticoagulation-for-acute-intermediate-risk-pulmonary-embolism-rationale-and-design-of-the-single-arm-peitho-2-study
#6
Frederikus A Klok, Walter Ageno, Stefano Barco, Harald Binder, Benjamin Brenner, Daniel Duerschmied, Klaus Empen, Pompilio Faggiano, Joachim H Ficker, Nazzareno Galiè, Alexandre Ghuysen, Matthias Held, Nadine Heydenreich, Menno V Huisman, David Jiménez, Matija Kozak, Irene M Lang, Mareike Lankeit, Thomas Münzel, Antoniu Petris, Piotr Pruszczyk, Kurt Quitzau, Sebastian Schellong, Kai-Helge Schmidt, Branislav S Stefanovic, Franck Verschuren, Anamaria Wolf-Puetz, Guy Meyer, Stavros V Konstantinides
No abstract text is available yet for this article.
December 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/29206697/perioperative-pulmonary-thromboembolism-current-concepts-and-treatment-options
#7
David M Ruohoniemi, Akhilesh K Sista, Charles F Doany, Paul M Heerdt
PURPOSE OF REVIEW: Anesthesiologists are familiar with pulmonary emboli prophylaxis paradigms and many have witnessed acute intraoperative embolization. Clinicians must balance conservative anticoagulation and aggressive intervention in perioperative submassive pulmonary emboli, yet the bulk of the literature excludes surgery as a relative contraindication. This review will summarize the current treatment options for acute pulmonary emboli, drawing attention to special considerations in perioperative submassive pulmonary emboli, and discuss right ventricular monitoring to improve assessment of intervention efficacy...
December 4, 2017: Current Opinion in Anaesthesiology
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/29201371/giant-thrombosed-saphenofemoral-junction-aneurysm-a-case-report
#9
Vladimir Cojocari, Vasile Culiuc, Florin Bzovii, Dumitru Casian, Eugen Gutu
Introduction: Although saphenofemoral junction aneurysms are not so rare, only scarce of the published cases reported thrombosis of the aneurysmal sac and saphenous trunk. Presentation of case: A 65-year-old male with varicose disease, developed acute ascending superficial vein thrombosis of the left greater saphenous vein, involving the 6-cm saphenofemoral junction aneurysm. The patient underwent common femoral vein thrombectomy, aneurysm removal, and greater saphenous vein excision with uneventful postoperative course...
2017: SAGE Open Medical Case Reports
https://www.readbyqxmd.com/read/29198735/outpatient-therapy-for-acute-symptomatic-pulmonary-embolism-diagnosed-in-the-emergency-department-time-to-improve-the-evidence-base
#10
EDITORIAL
David Jiménez, Roger D Yusen
No abstract text is available yet for this article.
November 26, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/29196412/a-phase-1-trial-of-vadastuximab-talirine-as-monotherapy-in-patients-with-cd33-positive-acute-myeloid-leukemia-aml
#11
Eytan M Stein, Roland B Walter, Harry P Erba, Amir T Fathi, Anjali S Advani, Jeffrey E Lancet, Farhad Ravandi, Tibor Kovacsovics, Daniel J DeAngelo, Dale Bixby, Stefan Faderl, Anand P Jillella, Phoenix Ho, Megan M O'Meara, Baiteng Zhao, Charles Biddle-Snead, Anthony S Stein
Vadastuximab talirine (SGN-CD33A, 33A) is an antibody-drug conjugate consisting of pyrrolobenzodiazepine dimers linked to a monoclonal antibody targeting CD33, which is expressed in the majority of acute myeloid leukemia (AML) patients. This phase 1 study (clinicaltrials.gov NCT01902329) evaluated the safety, pharmacokinetics, and preliminary activity of vadastuximab talirine and determined the recommended monotherapy dose in patients with relapsed or refractory AML. Additional expansion cohorts tested vadastuximab talirine in specific subpopulations of relapsed AML, and in a cohort of older, treatment-naïve patients...
December 1, 2017: Blood
https://www.readbyqxmd.com/read/29187254/acute-disseminated-melioidosis-giving-rise-to-pneumonia-and-renal-abscesses-complicated-with-thrombotic-thrombocytopenic-purpura-in-a-post-partum-woman-a-case-report
#12
Piyumi Sachindra Alwis Wijewickrama, Rohini Weerakoon
BACKGROUND: Melioidosis is an established endemic infection in Sri Lanka, caused by Burkholderia pseudomallei, a gram negative bacterium distributed in saprophytes in soil and surface water. Main mode of transmission is via percutaneous inoculation. Pneumonia is the most common presentation in acute disease. CASE PRESENTATION: We report a 33 year old previously healthy Sinhalese female with an occupational exposure to surface water in paddy fields, who was on postpartum day 6 following an uncomplicated pregnancy and delivery via an elective caesarian section...
November 29, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/29182657/accuracy-and-reproducibility-of-ct-right-to-left-ventricular-diameter-measurement-in-patients-with-acute-pulmonary-embolism
#13
Yvonne M Ende-Verhaar, Lucia J M Kroft, Inge C M Mos, Menno V Huisman, Frederikus A Klok
BACKGROUND: Right ventricular (RV) dysfunction caused by acute pulmonary embolism (PE) is associated with poor short- and long-term prognosis. RV dilatation as a proxy for RV dysfunction can be assessed by calculating the right-to-left ventricle diameter (RV/LV) ratio on standard computed tomography pulmonary angiography (CTPA) images. It is unknown whether dedicated training is required to accurately and reproducibly measure RV/LV ratio therefore we aimed to assess these parameters in residents in internal medicine without experience in CTPA reading...
2017: PloS One
https://www.readbyqxmd.com/read/29182088/perinatal-maternal-mortality-in-sickle-cell-anemia-two-case-reports-and-review-of-the-literature
#14
Sanaa Rizk, Elizabeth D Pulte, David Axelrod, Samir K Ballas
As outcomes of patients with sickle cell anemia improve and survival into adulthood with good quality of life and expectation of long-term survival becomes more common, challenges have developed, including issues related to reproduction. Pregnancy is frequently complicated in patients with sickle cell anemia with mortality up to 4.0%. Here we report maternal perinatal mortality in two women with sickle cell anemia who died post-partum due to acute chest syndrome (ACS), caused by bone marrow fat embolism and review the literature pertinent to this subject...
November 28, 2017: Hemoglobin
https://www.readbyqxmd.com/read/29179902/mediastinal-epipericardial-fat-necrosis-an-overlooked-and-little-known-cause-of-acute-chest-pain-mimicking-acute-coronary-syndrome
#15
Gabriela Gayer
Necrosis of the fat adjacent to the heart, referred to as pericardial fat necrosis, epipericardial fat necrosis, and mediastinal fat necrosis, is a rare, self-limited condition. It presents as a sudden onset of severe chest pain that mimics symptoms of pulmonary embolism and acute coronary syndrome. Computed tomography (CT) findings are quite typical and consist of a round- or oval-shaped mass-like lesion containing soft tissue and fat density components in the cardiophrenic space. Lack of familiarity with this condition has led in the past to surgical interventions to remove the mass-like mediastinal fat necrosis...
December 2017: Seminars in Ultrasound, CT, and MR
https://www.readbyqxmd.com/read/29178987/time-to-threshold-as-a-new-indicator-of-circulatory-state-and-prognosis-in-patients-with-pulmonary-embolism
#16
Andreas Gunter Bach, Bettina-Maria Taute, Alexey Surov
BACKGROUND: Bolus tracking is commonly applied in computed tomography pulmonary angiography. The time that it takes for contrast to reach a predefined threshold in the pulmonary artery is called time to threshold (TTT). TTT could be associated with the circulatory state, and ultimately with prognosis in patients with PE. AIM: The purpose of the present study was to examine the correlation of TTT with embolus burden, radiological and clinical parameters of circulatory state, and ultimately with 30-day mortality...
November 16, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/29175770/catheter-based-therapies-in-acute-pulmonary-embolism
#17
Jacob Schultz, Asger Andersen, Christopher Kabrhel, Jens Erik Nielsen-Kudsk
AIMS: To provide a systematic review of catheter-based therapies of acute pulmonary embolism. METHODS AND RESULTS: Studies published in peer-reviewed journals before February 2017 were included and categorized according to the mechanism of thrombus removal: fragmentation, rheolytic therapy, aspiration or catheter-directed thrombolysis. Strengths, challenges and the level of evidence of each device were evaluated. We found 16 different catheter-based therapies for acute PE; all but one being used off-label...
November 28, 2017: EuroIntervention
https://www.readbyqxmd.com/read/29171210/pericardial-esophageal-fistula-complicating-atrial-fibrillation-ablation-successfully-resolved-after-pericardial-drainage-with-conservative-management
#18
Jeong Min Seo, Jong Sung Park, Sang Seok Jeong
A 40-year-old male patient underwent radiofrequency catheter ablation for symptomatic paroxysmal atrial fibrillation (AF). Although pulmonary vein (PV) isolation was successfully completed without acute complications, the patient began complaining of sustained retrosternal pain. Seventeen days after ablation, the patient visited the emergency room with fever and severe chest pain with pericarditis-like features. Chest computed tomography (CT) revealed clustered air bubbles in the pericardial space. Esophagography confirmed leakage of contrast agent into the pericardial space but not into the left atrium...
November 2017: Korean Circulation Journal
https://www.readbyqxmd.com/read/29169908/increased-risk-and-severity-of-unprovoked-venous-thromboembolism-with-clustering-cardiovascular-risk-factors-for-atherosclerosis-results-of-the-remotev-registry
#19
S Gaertner, E-M Cordeanu, C Mirea, A-S Frantz, C Auger, P Bilbault, P Ohlmann, V Schini-Kerth, D Stephan
BACKGROUND: The role of cardiovascular risk factors (CVRF) for atherosclerosis in venous thromboembolic disease (VTE) is controversial. The aim of this study was to evaluate the impact of CVRF and their cumulative effects on the occurrence of unprovoked VTE, severity, recurrence and survival. METHODS AND RESULTS: This is a prospective cohort from the REMOTEV registry including all consecutively hospitalized patients for acute symptomatic VTE. From November 2013 to December 2016, 515 patients with 6months follow-up (FU) were selected for the analysis...
November 21, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/29169886/a-potential-diagnostic-pitfall-in-acute-chest-pain-massive-pulmonary-embolism-mimicking-acute-st-elevation-myocardial-infarction
#20
Ya-Wen Lu, Yi-Lin Tsai, Chun-Chin Chang, Po-Hsun Huang
BACKGROUND: Pulmonary embolism (PE) represents a clinical challenge for clinicians because of nonspecific presentations, including dyspnea, chest pain, and tachycardia. The immediate 12-lead electrocardiogram (ECG) is commonly used to facilitate differential diagnosis of acute chest pain. Although relative rare, massive pulmonary embolism could induce ST segment elevation and mimic acute myocardial infarction. CASE PRESENTATION: We present a challenging scenario that ECG showed ST segment elevation, nevertheless, urgent coronary angiogram revealed non-obstructive coronary artery disease...
November 20, 2017: American Journal of Emergency Medicine
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