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Latest & greatest articles for pulmonary embolism
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Blood and Clots Series: My patient has a pulmonaryembolism. Should I screen them for cancer? Blood and Clots Series: My patient has a pulmonaryembolism. Should I screen them for cancer? - CanadiEM Blood and Clots Series: My patient has a pulmonaryembolism. Should I screen them for cancer? In , by Eric Tseng March 20, 2018 All the content from the Blood & Clots series can be found . CanMEDS Roles addressed: Expert, Leader Case Description An 83 year old female presents for follow-up after
Prognostic role of neutrophils to lymphocytes ratio in patients with acute pulmonaryembolism: a systematic review and meta-analysis of the literature. The prognostic assessment of patients with acute pulmonaryembolism (PE) is essential to drive its management. The search for new prognostic factors is a central issue for a more accurate estimate of short-term adverse events. Circulating neutrophils/lymphocytes ratio (NLR) has been suggested as prognostic biomarker for different cardiovascular
Systematic review and meta-analysis of outcomes of patients with subsegmental pulmonaryembolism with and without anticoagulation treatment. This systematic review addresses the controversy over the decision to anticoagulate patients with subsegmental pulmonaryembolism (SSPE).We searched Ovid MEDLINE, PubMed, Embase, the Cochrane Library, Scopus, Web of Science, ClinicalTrials.gov, Google Scholar, and bibliographies in March 2017. Two authors reviewed and retained papers with symptomatic (...) patients who underwent computerized tomographic pulmonary angiography and had sufficient information to determine SSPE; decision to treat (or not) with systemic anticoagulation; and outcomes of bleeding, venous thromboembolism (VTE) recurrence, and death. Papers were assessed for selection and publication bias and heterogeneity, with Eggers and the inconsistency indexes (I2 ).From 1,512 papers screened, we included 14 studies comprising 15,563 patients for full-length review and analysis. Pooled data
Effect of the PulmonaryEmbolism Rule-Out Criteria on Subsequent Thromboembolic Events Among Low-Risk Emergency Department Patients: The PROPER Randomized Clinical Trial. The safety of the pulmonaryembolism rule-out criteria (PERC), an 8-item block of clinical criteria aimed at ruling out pulmonaryembolism (PE), has not been assessed in a randomized clinical trial.To prospectively validate the safety of a PERC-based strategy to rule out PE.A crossover cluster-randomized clinical (...) that was not initially diagnosed. The noninferiority margin was set at 1.5%. Secondary end points included the rate of computed tomographic pulmonary angiography (CTPA), median length of stay in the emergency department, and rate of hospital admission.Among 1916 patients who were cluster-randomized (mean age 44 years, 980 [51%] women), 962 were assigned to the PERC group and 954 were assigned to the control group. A total of 1749 patients completed the trial. A PE was diagnosed at initial presentation in 26 patients
Clinical prediction rules for mortality in patients with pulmonaryembolism and cancer to guide outpatient management: a meta-analysis Essentials Clinical prediction rules (CPRs) can stratify patients with pulmonaryembolism (PE) and cancer. A meta-analysis was done to assess prognostic accuracy in CPRs for mortality in these patients. Eight studies evaluating ten CPRs were included in this study. CPRs should continue to be used with other patient factors for mortality risk (...) stratification.Background Cancer treatment is commonly complicated by pulmonaryembolism (PE), which remains a leading cause of morbidity and mortality in these patients. Some guidelines recommend the use of clinical prediction rules (CPRs) to help clinicians identify patients at low risk of mortality and therefore guide care. Objective To determine and compare the accuracy of available CPRs for identifying cancer patients with PE at low risk of mortality. Methods A literature search of Medline and Scopus (January 2000
, SPECT/CT, Single-Photon, Tomography Scanners, V/Q scan, Wells, X-Ray Computed, cardiac echo, d-dimer, lung embolism, pulmonaryembolism rule out criteria, thoracic ultrasound, ventilation-perfusion scan, ventilation/perfusion scan Optimal Use Report In Brief PUBLISHED : March 2018 Optimal Use Report Recommendations PUBLISHED : March 2018 Optimal Use Report Infographic PUBLISHED : August 2018 Optimal Use Report Science Report PUBLISHED : January 2018 Optimal Strategies for the Diagnosis of Acute (...) Optimal Strategies for the Diagnosis of Acute PulmonaryEmbolism Optimal Strategies for the Diagnosis of Acute PulmonaryEmbolism | CADTH.ca Find the information you need Optimal Strategies for the Diagnosis of Acute PulmonaryEmbolism Optimal Strategies for the Diagnosis of Acute PulmonaryEmbolism Published on: March 1, 2018 Project Number: OP0528-000 Product Line: Research Type: Other Diagnostics Result type: Report Pulmonaryembolism (PE) is a blockage of one of the arteries in the lung
PulmonaryembolismPulmonaryembolism - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search Pulmonaryembolism Last reviewed: February 2019 Last updated: July 2018 Summary Pulmonaryembolism (PE) is a life-threatening condition resulting from dislodged thrombi occluding the pulmonary vasculature; right heart failure and cardiac arrest may ensue if not aggressively treated. Symptoms include chest pain, dyspnoea, and a sense (...) , and hypercoagulability. These factors are collectively known as Virchow's triad. Cervantes J, Rojas G. Virchow's legacy: deep vein thrombosis and pulmonaryembolism. World J Surg. 2005;29 Suppl 1:S30-4. http://www.ncbi.nlm.nih.gov/pubmed/15818472?tool=bestpractice.com Approximately 51% of deep venous thrombi will embolise to the pulmonary vasculature, resulting in a PE. Huisman MV, Büller HR, ten Cate JW, et al. Unexpected high prevalence of silent pulmonaryembolism in patients with deep venous thrombosis. Chest
Interventions to Reduce the Overuse of Imaging for PulmonaryEmbolism: A Systematic Review. Imaging use in the diagnostic workup of pulmonaryembolism (PE) has increased markedly in the last 2 decades. Low PE prevalence and diagnostic yields suggest a significant problem of overuse.The purpose of this systematic review is to summarize the evidence associated with the interventions aimed at reducing the overuse of imaging in the diagnostic workup of PE in the emergency department and hospital
Clinical Value of Ultrasonography in Diagnosis of PulmonaryEmbolism in Critically Ill Patients Pulmonaryembolism (PE) is a clinical emergency that will increase the mortality if complicated with unstable hemodynamics. Because of its nonspecific clinical symptoms, it's a great challenge to make a PE diagnosis. The golden standard to diagnose PE is computed tomography of pulmonary artery (CTPA), but a diagnosis of PE also composed of evaluation of PE risk factors, possibilities, and risk (...) stratification. Ultrasonography may detect right ventricle strain related to hemodynamic change, intravascular thrombosis, thrombosis in right heart or pulmonary arteries, pulmonary infarction, and local pleural effusion. Combination of ultrasound and traditional PE possibility evaluation score may further improve the pretest probability of CTPA. A comprehensive ultrasonography may sometimes rule out PE and may disclose other causes for the clinical situations. A heart-lung-vessel-integrated multiorgan
Global incidence and case fatality rate of pulmonaryembolism following major surgery: a protocol for a systematic review and meta-analysis of cohort studies. Pulmonaryembolism (PE) is a life-threatening condition common after major surgery. Although the high incidence (0.3-30%) and mortality rate (16.9-31%) of PE in patients undergoing major surgical procedures is apparent from findings of contemporary observational studies, there is a lack of a summary and meta-analysis data
No added value of the age-adjusted D-dimer cut-off to the YEARS algorithm in patients with suspected pulmonaryembolism Essentials Imaging is warranted in the majority of patients to confirm or rule out pulmonaryembolism (PE). The age-adjusted D-dimer (ADJUST) reduced the number of required imaging tests in patients ≥ 50 years. The YEARS algorithm was designed to improve the efficiency in patients with suspected PE. There was no added value of implementing ADJUST in the YEARS algorithm in our (...) cohort.Background The YEARS algorithm was designed to simplify the diagnostic work-up of pulmonaryembolism (PE) and to reduce the number of necessary computed tomography pulmonary angiography (CTPA) scans. An alternative strategy to reduce the number of CTPAs is the age-adjusted D-dimer cut-off (ADJUST) in patients aged 50 years or older. We aimed to investigate whether a combination of both diagnostic strategies might save additional CTPAs. Methods The YEARS algorithm consists of three items (clinical signs
Comparison between CT and MRI in the assessment of pulmonaryembolism: A meta-analysis. Besides pulmonary arteriography, a number of imaging techniques, such as magnetic resonance imaging (MRI) and computed tomography (CT), were adopted in the detection of identifying pulmonaryembolism (PE). However, the contrast of sensitivity and specificity in these methods was studied little in a statistical way. To compare the effects of MRI and CT, this study used a series of methods to analyze data
Efficacy and safety outcomes of recanalisation procedures in patients with acute symptomatic pulmonaryembolism: systematic review and network meta-analysis. We aimed to review the efficacy and safety of recanalisation procedures for the treatment of PE.We searched PubMed, the Cochrane Library, EMBASE, EBSCO, Web of Science and CINAHL databases from inception through 31 July 2015 and included randomised clinical trials that compared the effect of a recanalisation procedure versus each other
Incremental diagnostic quality gain of CTA over V/Q scan in the assessment of pulmonaryembolism by means of a Wells score Bayesian model: results from the ACDC collaboration. Our objective was to evaluate the diagnostic value of computed tomography angiography (CTA) and ventilation perfusion (V/Q) scan in the assessment of pulmonaryembolism (PE) by means of a Bayesian statistical model.Wells criteria defined pretest probability. Sensitivity and specificity of CTA and V/Q scan for PE were (...) no significant difference (p = 0.8745, p = 0.9841 respectively).This Bayesian model demonstrated a superiority of CTA when compared to V/Q scan for the diagnosis of pulmonaryembolism. Low-risk patients are recognized to have a superior overall comparative gain favoring CTA.
Blood and Clots Quizlet 1: Oral Contraceptives and PulmonaryEmbolism Blood and Clots Quizlet 1: Oral Contraceptives and PulmonaryEmbolism - CanadiEM Blood and Clots Quizlet 1: Oral Contraceptives and PulmonaryEmbolism In , by Eric Tseng October 27, 2017 Hello Blood & Clots/CanadiEM community! Before we post our blog series on thrombosis and bleeding, we encourage you to test your initial knowledge by going through a few brief case scenarios. These cases were originally posted as part of our (...) ”. On examination, Maria is a well-appearing, average sized young woman. Her vitals reveal T=37C, HR 85, BP 110/90, RR 15, SpO2 99% RA. Head and neck exam is normal. Cardiorespiratory examination is normal and there is no jugular venous distension. The chest pain is not reproducible with palpation or movement. She does endorse mild bilateral calf pain that she attributes to running. ECG performed at triage shows NSR and no signs of S1Q3T3 or RBBB. Question 1: What is the pre-test probability for pulmonary
Prevalence of pulmonaryembolism in patients presenting with syncope. A systematic review and meta-analysis. Syncope is a common clinical presentation and establishing an etiology is often challenging. Pulmonaryembolism (PE) has been thought to be an uncommon cause but a recent report suggested otherwise.To establish the prevalence of PE in patients presenting with syncope to the emergency department (ED) and in hospitalized patients.We systematically searched Medline, CINAHL, EMBASE, LILACS
Inferior Vena Cava Filters to Prevent PulmonaryEmbolism: Systematic Review andÂ Meta-Analysis. Inferior vena cava (IVC) filters are widely used for prevention of pulmonaryembolism (PE). However, uncertainty persists about their efficacy and safety.The authors conducted a systematic review and meta-analysis of the published reports on the efficacy and safety of IVC filters.The authors searched PubMed, the Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov through October 3
Approaches to Diagnosing Acute PulmonaryEmbolism in Canada: current practice, challenges, and availability of testing Approaches to Diagnosing Acute PulmonaryEmbolism in Canada: current practice, challenges, and availability of testing | CADTH.ca Find the information you need Approaches to Diagnosing Acute PulmonaryEmbolism in Canada: current practice, challenges, and availability of testing Approaches to Diagnosing Acute PulmonaryEmbolism in Canada: current practice, challenges (...) , and availability of testing Published on: September 8, 2017 Project Number: ES0307-000 Product Line: Result type: Report CADTH undertook an environmental scan to identify and summarize information regarding pulmonaryembolism (PE) imaging in Canada. The scan described current practice, challenges, and enablers in diagnosing PE, and the availability of tests, scans, and tools for diagnosing PE. The key objectives of this environmental scan were as follows: Identify current practice related to diagnostic