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Latest & greatest articles for pulmonary embolism
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Predictive value of the high-sensitivity troponin T assay and the simplified pulmonaryembolism severity index in hemodynamically stable patients with acute pulmonaryembolism: a prospective validation study The new, high-sensitivity troponin T (hsTnT) assay may improve risk stratification of normotensive patients with acute pulmonaryembolism (PE). We externally validated the prognostic value of hsTnT, and of the simplified PulmonaryEmbolism Severity Index (sPESI), in a large multicenter
Oral rivaroxaban for the treatment of symptomatic pulmonaryembolism. A fixed-dose regimen of rivaroxaban, an oral factor Xa inhibitor, has been shown to be as effective as standard anticoagulant therapy for the treatment of deep-vein thrombosis, without the need for laboratory monitoring. This approach may also simplify the treatment of pulmonary embolism.In a randomized, open-label, event-driven, noninferiority trial involving 4832 patients who had acute symptomatic pulmonaryembolism (...) % CI, 0.31 to 0.79; P=0.003). Rates of other adverse events were similar in the two groups.A fixed-dose regimen of rivaroxaban alone was noninferior to standard therapy for the initial and long-term treatment of pulmonaryembolism and had a potentially improved benefit-risk profile. (Funded by Bayer HealthCare and Janssen Pharmaceuticals; EINSTEIN-PE ClinicalTrials.gov number, NCT00439777.).
Rivaroxaban for the treatment of deep vein thrombosis and prevention of recurrent deep vein thrombosis and pulmonaryembolism (TA261) Overview | Rivaroxaban for the treatment of deep vein thrombosis and prevention of recurrent deep vein thrombosis and pulmonaryembolism | Guidance | NICE Rivaroxaban for the treatment of deep vein thrombosis and prevention of recurrent deep vein thrombosis and pulmonaryembolism Technology appraisal guidance [TA261] Published date: 25 July 2012 Share Guidance (...) on rivaroxaban (Xarelto) for treating deep vein thrombosis and preventing a pulmonaryembolism or another deep vein thrombosis in adults. Guidance development process Is this guidance up to date? . We found nothing new that affects the recommendations in this guidance. Next review : This guidance will be reviewed if there is new evidence that is likely to affect the recommendations. Your responsibility The recommendations in this guidance represent the view of NICE, arrived at after careful consideration
Risk of pulmonaryembolism in patients with autoimmune disorders: a nationwide follow-up study from Sweden. Some autoimmune disorders have been linked to venous thromboembolism. We examined whether there is an association between autoimmune disorders and risk of pulmonary embolism.We followed up all individuals in Sweden without previous hospital admission for venous thromboembolism and with a primary or secondary diagnosis of an autoimmune disorder between Jan 1, 1964, and Dec 31, 2008 (...) , for hospital admission for pulmonaryembolism. We obtained data from the MigMed2 database, which has individual-level information about all registered residents of Sweden. The reference population was the total population of Sweden. We calculated standardised incidence ratios (SIRs) for pulmonaryembolism, adjusted for individual variables, including age and sex.535,538 individuals were admitted to hospital because of an autoimmune disorder. Overall risk of pulmonaryembolism during the first year after
Clinical decision rules for excluding pulmonaryembolism: a meta-analysis Clinical decision rules for excluding pulmonaryembolism: a meta-analysis Clinical decision rules for excluding pulmonaryembolism: a meta-analysis Lucassen W, Geersing GJ, Erkens PM, Reitsma JB, Moons KG, Buller H, van Weert HC CRD summary This review concluded that clinical decision rules or Gestalt could safely exclude pulmonaryembolism, when combined with sensitive D-dimer testing. Standardised decision rules were (...) recommended over Gestalt. The review was generally well conducted, but the conclusions and implications for practice seem to be too strong for the evidence presented. Authors' objectives To compare the failure rates of standard clinical assessment (Gestalt) and clinical decision rules, when used in combination with D-dimer testing, to diagnose pulmonaryembolism in adults with suspected pulmonaryembolism. Searching MEDLINE and EMBASE were searched for articles published in English, French, German
Clinical Decision Rules for Excluding PulmonaryEmbolism: A Meta-analysis. Clinical probability assessment is combined with d-dimer testing to exclude pulmonaryembolism (PE).To compare the test characteristics of gestalt (a physician's unstructured estimate) and clinical decision rules for evaluating adults with suspected PE and assess the failure rate of gestalt and rules when used in combination with d-dimer testing.Articles in MEDLINE and EMBASE in English, French, German, Italian, Spanish
Multidetector computed tomography for acute pulmonaryembolism: diagnosis and risk stratification in a single test In patients with acute pulmonaryembolism (PE), right ventricular dysfunction at echocardiography is associated with increased in-hospital mortality. The aims of this study in patients with acute PE were to identify a sensitive and simple criterion for right ventricular dysfunction at multidetector computed tomography (MDCT) using echocardiography as the reference standard
Ventilation/perfusion scintigraphy (using Technegas) versus computed tomography pulmonary angiography for the diagnosis of pulmonaryembolism in hospitalized patients: a review of the clinical and cost-effectiveness Ventilation/perfusion scintigraphy (using Technegas) versus computed tomography pulmonary angiography for the diagnosis of pulmonaryembolism in hospitalized patients: a review of the clinical and cost-effectiveness Ventilation/perfusion scintigraphy (using Technegas) versus (...) computed tomography pulmonary angiography for the diagnosis of pulmonaryembolism in hospitalized patients: a review of the clinical and cost-effectiveness Canadian Agency for Drugs and Technologies in Health Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation Canadian Agency for Drugs and Technologies in Health. Ventilation/perfusion scintigraphy
Performance of 4 Clinical Decision Rules in the Diagnostic Management of Acute PulmonaryEmbolism: A Prospective Cohort Study. Several clinical decision rules (CDRs) are available to exclude acute pulmonaryembolism (PE), but they have not been directly compared.To directly compare the performance of 4 CDRs (Wells rule, revised Geneva score, simplified Wells rule, and simplified revised Geneva score) in combination with d-dimer testing to exclude PE.Prospective cohort study.7 hospitals
Current evidence does not support the use of a negative D-dimer to rule out suspected pulmonaryembolism in pregnancy. BestBets: Current evidence does not support the use of a negative D-dimer to rule out suspected pulmonaryembolism in pregnancy. Current evidence does not support the use of a negative D-dimer to rule out suspected pulmonaryembolism in pregnancy. Report By: Sivanthi Sivanadarajah - Speciality Trainee in Emergency Medicine Search checked by Daniel Horner - Research Fellow (...) Institution: Manchester Royal Infirmary Date Submitted: 27th October 2004 Date Completed: 9th March 2011 Last Modified: 10th March 2011 Status: Green (complete) Three Part Question In [a clinically well pregnant patient with a suspected PulmonaryEmbolism] is [a negative D-dimer sensitive enough] to [exclude PulmonaryEmbolism] Clinical Scenario A patient attends the emergency department (ED) with atraumatic pleuritic chest pain. She is 12 weeks pregnant with no other medical history. A junior doctor has
Cost-effectiveness of lower extremity compression ultrasound in emergency department patients with a high risk of hemodynamically stable pulmonaryembolism Cost-effectiveness of lower extremity compression ultrasound in emergency department patients with a high risk of hemodynamically stable pulmonaryembolism Cost-effectiveness of lower extremity compression ultrasound in emergency department patients with a high risk of hemodynamically stable pulmonaryembolism Ward MJ, Sodickson A, Diercks (...) angiogram for patients with suspected pulmonaryembolism in the emergency department. The selective strategy was less expensive and more beneficial than universal CT, for patients with a high pre-test probability of pulmonaryembolism. The cost-effectiveness framework was conventional, but the sources of clinical evidence were not extensively described. The authors’ conclusions seem robust. Type of economic evaluation Cost-utility analysis Study objective This study examined the cost-effectiveness
The shock index and the simplified PESI for identification of low-risk patients with acute pulmonaryembolism We compared the test characteristics of the shock index (SI) and the simplified pulmonaryembolism severity index (sPESI) for predicting 30-day outcomes in a cohort of 1,206 patients with objectively confirmed pulmonaryembolism (PE). The primary outcome of the study was all-cause mortality. The secondary outcome was nonfatal symptomatic recurrent venous thromboembolism (VTE
Quality Improvement Guidelines for the Performance of Inferior Vena Cava Filter Placement for the Prevention of PulmonaryEmbolism STANDARDS OF PRACTICE Quality Improvement Guidelines for the Performance of Inferior Vena Cava Filter Placement for the Prevention of PulmonaryEmbolism Drew M. Caplin, MD, Boris Nikolic, MD, MBA, Sanjeeva P. Kalva, MD, Suvranu Ganguli, MD, Wael E.A. Saad, MD, and Darryl A. Zuckerman, MD, for the Society of Interventional Radiology Standards of Practice Committee (...) ABBREVIATIONS DVT deep vein thrombosis, IVC inferior vena cava, PE pulmonaryembolism PREAMBLE The membership of the Society of Interventional Radiology (SIR) Stan- dards of Practice Committee represents experts in a broad spectrum of interventional procedures from both the private and academic sectors of medicine. Generally Standards of Practice Committee members dedicate the vast majority of their professional time to performing interventional procedures; as such they represent a valid broad expert
Evaluation of Suspected PulmonaryEmbolism In Pregnancy: An Official ATS/STR Clinical Practice Guideline American Thoracic Society Documents AnOf?cialAmericanThoracicSociety/Societyof ThoracicRadiologyClinicalPracticeGuideline: EvaluationofSuspectedPulmonaryEmbolism InPregnancy Ann N. Leung, Todd M. Bull, Roman Jaeschke, Charles J. Lockwood, Phillip M. Boiselle, Lynne M. Hurwitz, Andra H. James, Laurence B. McCullough, Yusuf Menda, Michael J. Paidas, Henry D. Royal, Victor F. Tapson, Helen T (...) . Winer-Muram, Frank A. Chervenak, Dianna D. Cody, Michael F. McNitt-Gray, Christopher D. Stave, and Brandi D. Tuttle,on behalf of the ATS/STR Committee on PulmonaryEmbolism in Pregnancy THIS OFFICIAL CLINICAL PRACTICE GUIDELINE OF THE AMERICAN THORACIC SOCIETY (ATS) AND THESOCIETY OFTHORACIC RADIOLOGY(STR) WAS APPROVED BY THEATS BOARD OF DIRECTORS,MARCH 2011 AND BY THE STR, MAY 2011 THIS CLINICAL PRACTICE GUIEDLINE HAS BEEN FORMALLY ENDORSED BY THE AMERICAN COLLEGE OF OBSTETRICIANS ANDGYNECOLOGISTS
Outpatient versus inpatient treatment for patients with acute pulmonaryembolism: an international, open-label, randomised, non-inferiority trial. Although practice guidelines recommend outpatient care for selected, haemodynamically stable patients with pulmonaryembolism, most treatment is presently inpatient based. We aimed to assess non-inferiority of outpatient care compared with inpatient care.We undertook an open-label, randomised non-inferiority trial at 19 emergency departments (...) in Switzerland, France, Belgium, and the USA. We randomly assigned patients with acute, symptomatic pulmonaryembolism and a low risk of death (pulmonaryembolism severity index risk classes I or II) with a computer-generated randomisation sequence (blocks of 2-4) in a 1:1 ratio to initial outpatient (ie, discharged from hospital ≤24 h after randomisation) or inpatient treatment with subcutaneous enoxaparin (≥5 days) followed by oral anticoagulation (≥90 days). The primary outcome was symptomatic, recurrent
Cost-effective diagnostic strategies in patients with a high, intermediate, or low clinical probability of pulmonaryembolism Cost-effective diagnostic strategies in patients with a high, intermediate, or low clinical probability of pulmonaryembolism Cost-effective diagnostic strategies in patients with a high, intermediate, or low clinical probability of pulmonaryembolism Lee JA, Zierler BK, Liu CF, Chapko MK Record Status This is a critical abstract of an economic evaluation that meets (...) the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. CRD summary This study examined the cost-effectiveness of strategies, including rapid quantitative D-dimer assays, lower extremity venous duplex ultrasound, ventilation and perfusion scans, and multislice computed tomography (CT) angiography, to diagnose pulmonaryembolism in patients
Computer-aided detection of pulmonaryembolism Computer-aided detection of pulmonaryembolism Computer-aided detection of pulmonaryembolism Record Status This is a bibliographic record of a published health technology assessment. No evaluation of the quality of this assessment has been made for the HTA database. Citation Computer-aided detection of pulmonaryembolism. Lansdale: HAYES, Inc.. Directory Publication. 2011 Authors' conclusions Computer-aided detection (CAD) systems utilize computer (...) -based algorithms to identify pulmonaryembolism (PE) in radiographic images. CAD systems are used as stand-alone devices or as tools to help radiologists more accurately diagnose patients suspected of PE. Final publication URL The report may be purchased from: Indexing Status Subject indexing assigned by CRD MeSH Algorithms; Pulmonary Artery; PulmonaryEmbolism; Radiographic Image Interpretation, Computer-Assisted; Tomography, X-Ray Computed Language Published English Country of organisation United
Acute pulmonaryembolism. 21067400 2010 11 30 2018 05 09 1533-4406 363 20 2010 11 11 The New England journal of medicine N. Engl. J. Med. Acute pulmonaryembolism. 1974; author reply 1974-5 10.1056/NEJMc1009061 Lazar Harold L HL Farber Harrison W HW eng Letter Comment United States N Engl J Med 0255562 0028-4793 AIM IM N Engl J Med. 2010 Jul 15;363(3):266-74 20592294 Acute Disease Embolectomy Hemorrhage chemically induced Humans PulmonaryEmbolism drug therapy mortality surgery Risk