Latest & greatest articles for pulmonary embolism

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Top results for pulmonary embolism

181. Accuracy of very low pretest probability estimates for pulmonary embolism using the method of attribute matching compared with the wells score

Accuracy of very low pretest probability estimates for pulmonary embolism using the method of attribute matching compared with the wells score 20370742 2010 04 07 2010 08 09 2010 04 07 1553-2712 17 2 2010 Feb Academic emergency medicine : official journal of the Society for Academic Emergency Medicine Acad Emerg Med Accuracy of very low pretest probability estimates for pulmonary embolism using the method of attribute matching compared with the Wells score. 133-41 10.1111/j.1553-2712.2009.00648 (...) evaluation for suspected pulmonary embolism (PE). The criterion standard to exclude VTE required no evidence of PE or deep venous thrombosis (DVT) within 45 days of enrollment. To estimate pretest probabilities, a computer program selected, from a large reference database of patients previously evaluated for PE, patients who matched 10 predictor variables recorded for each current test patient. The authors compared the outcome frequency of having VTE [VTE(+)] in patients with a pretest probability

EvidenceUpdates2010

182. Potential of an age adjusted D-dimer cut-off value to improve the exclusion of pulmonary embolism in older patients: a retrospective analysis of three large cohorts.

Potential of an age adjusted D-dimer cut-off value to improve the exclusion of pulmonary embolism in older patients: a retrospective analysis of three large cohorts. OBJECTIVES: In older patients, the the D-dimer test for pulmonary embolism has reduced specificity and is therefore less useful. In this study a new, age dependent cut-off value for the test was devised and its usefulness with older patients assessed. DESIGN: Retrospective multicentre cohort study. SETTING: General and teaching (...) hospitals in Belgium, France, the Netherlands, and Switzerland. Patients 5132 consecutive patients with clinically suspected pulmonary embolism. INTERVENTION: Development of a new D-dimer cut-off point in patients aged >50 years in a derivation set (data from two multicentre cohort studies), based on receiver operating characteristics (ROC) curves. This cut-off value was then validated with two independent validation datasets. MAIN OUTCOME MEASURES: The proportion of patients in the validation

BMJ2010 Full Text: Link to full Text with Trip Pro

183. Vena caval filters for the prevention of pulmonary embolism.

Vena caval filters for the prevention of pulmonary embolism. BACKGROUND: Pulmonary emboli (PE) can have potentially fatal consequences. Inferior vena caval filters (VCFs) are metal alloy devices that mechanically trap fragmented thromboemboli from the deep leg veins en route to the pulmonary circulation. Filters are designed to be introduced (and in the case of retrievable filters, removed) percutaneously. Although their deployment seems of theoretical benefit, their clinical efficacy (...) and adverse event profile is unclear.This is an update of a Cochrane review first published in 2007. OBJECTIVES: To examine evidence for the effectiveness of VCFs in preventing pulmonary embolism (PE). Secondary outcomes were mortality, distal (to filter) thrombosis, and filter-related complications. SEARCH STRATEGY: The Cochrane Peripheral Vascular Diseases Group searched their Specialised Register (last searched October 2009) and the Cochrane Central Register of Controlled Trials (CENTRAL

Cochrane2010

184. Safety of excluding acute pulmonary embolism based on an unlikely clinical probability by the Wells rule and normal D-dimer concentration: a meta-analysis

Safety of excluding acute pulmonary embolism based on an unlikely clinical probability by the Wells rule and normal D-dimer concentration: a meta-analysis Safety of excluding acute pulmonary embolism based on an unlikely clinical probability by the Wells rule and normal D-dimer concentration: a meta-analysis Safety of excluding acute pulmonary embolism based on an unlikely clinical probability by the Wells rule and normal D-dimer concentration: a meta-analysis Pasha SM, Klok FA, Snoep JD, Mos (...) IC, Goekoop RJ, Rodger MA, Huisman MV CRD summary This review concluded that acute pulmonary embolism could be safely excluded in patients with an “unlikely” Wells clinical decision rule (4 or less points) and normal D-dimer test, and that anticoagulant treatment could safely be withheld. Given the potential for missed studies, clinical differences between studies and lack of power of the meta-analysis, the conclusions should be treated with caution. Authors' objectives To determine the negative

DARE.2010

185. Natriuretic peptides and troponins in pulmonary embolism: a meta-analysis

Natriuretic peptides and troponins in pulmonary embolism: a meta-analysis 19525265 2009 09 29 2009 10 29 2015 11 19 1468-3296 64 10 2009 Oct Thorax Thorax Natriuretic peptides and troponins in pulmonary embolism: a meta-analysis. 869-75 10.1136/thx.2008.110965 The role of biomarkers such as B-type natriuretic peptides (BNP and NT-proBNP) and troponins in risk stratification of acute pulmonary embolism (APE) is still debated. A meta-analysis was performed to assess the association between raised (...) . Lega J-C JC Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec (Hôpital Laval), Québec, G1V 4G5 Canada. Lacasse Y Y Lakhal L L Provencher S S eng Journal Article Meta-Analysis Research Support, Non-U.S. Gov't Review 2009 06 11 England Thorax 0417353 0040-6376 0 Biomarkers 0 Natriuretic Peptides 0 Troponin IM Thorax. 2009 Oct;64(10):832-3 19786711 Biomarkers blood Humans Natriuretic Peptides blood Pulmonary Embolism blood mortality ROC Curve Troponin blood

EvidenceUpdates2010

187. Troponin-based risk stratification of patients with acute nonmassive pulmonary embolism: systematic review and metaanalysis

Troponin-based risk stratification of patients with acute nonmassive pulmonary embolism: systematic review and metaanalysis 19465511 2009 10 07 2009 11 17 2009 10 07 1931-3543 136 4 2009 Oct Chest Chest Troponin-based risk stratification of patients with acute nonmassive pulmonary embolism: systematic review and metaanalysis. 974-82 10.1378/chest.09-0608 Controversy exists regarding the usefulness of troponin testing for the risk stratification of patients with acute pulmonary embolism (PE). We (...) conducted an updated systematic review and a metaanalysis of troponin-based risk stratification of normotensive patients with acute symptomatic PE. The sources of our data were publications listed in Medline and Embase from 1980 through April 2008 and a review of cited references in those publications. We included all studies that estimated the relation between troponin levels and the incidence of all-cause mortality in normotensive patients with acute symptomatic PE. Two reviewers independently

EvidenceUpdates2009

188. Pulmonary embolism in pregnancy.

Pulmonary embolism in pregnancy. Pulmonary embolism (PE) is the leading cause of maternal mortality in the developed world. Mortality from PE in pregnancy might be related to challenges in targeting the right population for prevention, ensuring that diagnosis is suspected and adequately investigated, and initiating timely and best possible treatment of this disease. Pregnancy is an example of Virchow's triad: hypercoagulability, venous stasis, and vascular damage; together these factors lead (...) to an increased incidence of venous thromboembolism. This disorder is often suspected in pregnant women because some of the physiological changes of pregnancy mimic its signs and symptoms. Despite concerns for fetal teratogenicity and oncogenicity associated with diagnostic testing, and potential adverse effects of pharmacological treatment, an accurate diagnosis of PE and a timely therapeutic intervention are crucial. Appropriate prophylaxis should be weighed against the risk of complications and offered

Lancet2009

189. Thrombolysis Compared With Heparin for the Initial Treatment of Pulmonary Embolism: A Meta-Analysis of the Randomized Controlled Trials

Thrombolysis Compared With Heparin for the Initial Treatment of Pulmonary Embolism: A Meta-Analysis of the Randomized Controlled Trials PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?

PedsCCM Evidence-Based Journal Club2009

191. Short term effect of recombinant tissue plasminogen activator in patients with hemodynamically stable acute pulmonary embolism: results of a meta-analysis involving 464 patients

Short term effect of recombinant tissue plasminogen activator in patients with hemodynamically stable acute pulmonary embolism: results of a meta-analysis involving 464 patients Short term effect of recombinant tissue plasminogen activator in patients with hemodynamically stable acute pulmonary embolism: results of a meta-analysis involving 464 patients Short term effect of recombinant tissue plasminogen activator in patients with hemodynamically stable acute pulmonary embolism: results (...) of a meta-analysis involving 464 patients Tardy B, Venet C, Zeni F, Coudrot M, Guyomarc'h S, Mismetti P CRD summary This review found that in patients with haemodynamically stable pulmonary embolus, recombinant tissue plasminogen activator did not reduce rates of objective recurrent pulmonary embolism or pulmonary embolism-related mortality compared to heparin. The review was limited by the small amount of evidence available and questionable study quality. The authors’ conclusions may require cautious

DARE.2009

192. Catheter-directed therapy for the treatment of massive pulmonary embolism: systematic review and meta-analysis of modern techniques

Catheter-directed therapy for the treatment of massive pulmonary embolism: systematic review and meta-analysis of modern techniques Catheter-directed therapy for the treatment of massive pulmonary embolism: systematic review and meta-analysis of modern techniques Catheter-directed therapy for the treatment of massive pulmonary embolism: systematic review and meta-analysis of modern techniques Kuo WT, Gould MK, Louie JD, Rosenberg JK, Sze DY, Hofmann LV CRD summary This review concluded (...) that catheter-directed therapy was a relatively safe and effective alternative treatment for acute massive pulmonary embolism. Given that the appropriateness of pooling was unclear and that study quality was not assessed, the authors' conclusions may not be reliable. Authors' objectives To investigate the efficacy and safety of modern catheter-directed therapy as an alternative treatment for massive pulmonary embolism. Searching MEDLINE and EMBASE were searched for studies in all languages, from January

DARE.2009

193. Safety of ruling out acute pulmonary embolism by normal computed tomography pulmonary angiography in patients with an indication for computed tomography: systematic review and meta-analysis

Safety of ruling out acute pulmonary embolism by normal computed tomography pulmonary angiography in patients with an indication for computed tomography: systematic review and meta-analysis Safety of ruling out acute pulmonary embolism by normal computed tomography pulmonary angiography in patients with an indication for computed tomography: systematic review and meta-analysis Safety of ruling out acute pulmonary embolism by normal computed tomography pulmonary angiography in patients (...) with an indication for computed tomography: systematic review and meta-analysis Mos IC, Klok FA, Kroft LJ, De Roos A, Dekkers OM, Huisman MV CRD summary This review found that a normal computed tomography pulmonary angiography result alone can safely exclude pulmonary embolism in patients at moderate or high risk of disease; there was no need for additional ultrasonography to exclude venous thromboembolism in these patients. The conclusions were supported by the data presented and are likely to be reliable

DARE.2009

194. A meta-analysis of bed rest versus early ambulation in the management of pulmonary embolism, deep vein thrombosis, or both

A meta-analysis of bed rest versus early ambulation in the management of pulmonary embolism, deep vein thrombosis, or both A meta-analysis of bed rest versus early ambulation in the management of pulmonary embolism, deep vein thrombosis, or both A meta-analysis of bed rest versus early ambulation in the management of pulmonary embolism, deep vein thrombosis, or both Aissaoui N, Martins E, Mouly S, Weber S, Meune C CRD summary The authors' conclusion reflected the evidence presented, that early (...) ambulation of patients was not associated with a higher risk of progression of deep vein thrombosis, new pulmonary embolism or death. Due to the inclusion of small studies and absence of detail on their quality, some of caution is warranted when considering the reliability of this conclusion. Authors' objectives To evaluate early ambulation compared with bed rest, in addition to anticoagulation treatment, in managing patients with deep vein thrombosis and pulmonary embolism. Searching The Cochrane

DARE.2009

195. Thrombolysis for patients with pulmonary embolism, right ventricular dysfunction or pulmonary hypertension, and normal blood pressure

Thrombolysis for patients with pulmonary embolism, right ventricular dysfunction or pulmonary hypertension, and normal blood pressure application/octet-stream

Monash Health Evidence Reviews2009

196. Outpatient treatment and early discharge of symptomatic pulmonary embolism: a systematic review

Outpatient treatment and early discharge of symptomatic pulmonary embolism: a systematic review Outpatient treatment and early discharge of symptomatic pulmonary embolism: a systematic review Outpatient treatment and early discharge of symptomatic pulmonary embolism: a systematic review Squizzato A, Galli M, Dentali F, Ageno W CRD summary This review concluded that subgroups of stable patients may be safely treated at home for pulmonary embolism with a well-defined management programme (...) , but the quality of this evidence was inadequate and further research was warranted. There were several methodological weaknesses in the included studies and some potential for bias in the review, but the authors’ conclusions seem suitably cautious. Authors' objectives To assess the safety of outpatient treatment and early discharge of symptomatic pulmonary embolism. Searching PubMed and EMBASE were searched up to January 2008 for publications without language restrictions. Search terms were reported

DARE.2009

197. VIDAS D-dimer in combination with clinical pre-test probability to rule out pulmonary embolism: a systematic review of management outcome studies

VIDAS D-dimer in combination with clinical pre-test probability to rule out pulmonary embolism: a systematic review of management outcome studies VIDAS D-dimer in combination with clinical pre-test probability to rule out pulmonary embolism: a systematic review of management outcome studies VIDAS D-dimer in combination with clinical pre-test probability to rule out pulmonary embolism: a systematic review of management outcome studies Carrier M, Righini M, Karami Djurabi R, Huisman MV, Perrier (...) A, Wells PS, Rodger M, Wuillemin WA, Le Gal G CRD summary This review assessed the combined negative VIDAS D-dimer result and a non-high pre-test probability to exclude pulmonary embolism. The authors concluded that this method can safely and effectively exclude pulmonary embolism in outpatients with a suspected event. This was a largely well-conducted review, although a lack of clarity regarding study quality limited the interpretation of reliability. Authors' objectives To assess efficacy and safety

DARE.2009

198. Transthoracic sonography for the detection of pulmonary embolism: a meta-analysis

Transthoracic sonography for the detection of pulmonary embolism: a meta-analysis Transthoracic sonography for the detection of pulmonary embolism: a meta-analysis Transthoracic sonography for the detection of pulmonary embolism: a meta-analysis Niemann T, Egelhof T, Bongartz G CRD summary The authors concluded that transthoracic ultrasound was a diagnostic alternative for special clinical settings in the work-up of suspected pulmonary embolism. These conclusions should be interpreted with some (...) caution as no details on clinical settings in which studies were conducted were provided, there was a possibility of missed studies and there were limitations in the quality assessment. Authors' objectives To determine the diagnostic accuracy of transthoracic ultrasound for diagnosis of pulmonary embolism. Searching PubMed and EMBASE were searched from 1990 to 2006 for studies published in English, German or French. Reference lists of retrieved articles were screened. Study selection Studies

DARE.2009

199. Clinical Practice Guideline for the prevention of venous thromboembolism (deep vein thrombosis and pulmonary embolism) in patients admitted to Australian hospitals (2009)

Clinical Practice Guideline for the prevention of venous thromboembolism (deep vein thrombosis and pulmonary embolism) in patients admitted to Australian hospitals (2009)

National Health and Medical Research Council2009

200. Simplification of the revised geneva score for assessing clinical probability of pulmonary embolism

Simplification of the revised geneva score for assessing clinical probability of pulmonary embolism 18955643 2008 10 28 2008 11 25 2009 04 08 1538-3679 168 19 2008 Oct 27 Archives of internal medicine Arch. Intern. Med. Simplification of the revised Geneva score for assessing clinical probability of pulmonary embolism. 2131-6 10.1001/archinte.168.19.2131 The revised Geneva score is a fully standardized clinical decision rule (CDR) in the diagnostic workup of patients with suspected pulmonary embolism (...) (PE). The variables of the decision rule have different weights, which could lead to miscalculations in an acute setting. We have validated a simplified version of the revised Geneva score. Data from 1049 patients from 2 large prospective diagnostic trials that included patients with suspected PE were used and combined to validate the simplified revised Geneva score. We constructed the simplified CDR by attributing 1 point to each item of the original CDR and compared the diagnostic accuracy

EvidenceUpdates2008