Latest & greatest articles for pulmonary embolism

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Top results for pulmonary embolism

141. Is long-term Rivaroxaban superior to Warfarin in pulmonary embolism at 6 months?

Is long-term Rivaroxaban superior to Warfarin in pulmonary embolism at 6 months? BestBets: Is long-term Rivaroxaban superior to Warfarin in pulmonary embolism at 6 months? Is long-term Rivaroxaban superior to Warfarin in pulmonary embolism at 6 months? Report By: Chris Morgan - Medical Student Y5 Search checked by Rick Body - Consultant in Emergency Medicine Institution: University of Manchester, Manchester, UK Original institution: Manchester Royal Infirmary Date Submitted: 21st October 2015 (...) Date Completed: 21st October 2015 Last Modified: 21st October 2015 Status: Green (complete) Three Part Question In [patients with proven pulmonary embolism (PE)] is [Rivaroxaban better than warfarin] at [reducing mortality and recurrence of venous thromboembolism at 6 months]? Clinical Scenario A 52-year-old lady has presented to the Emergency Department with a suspected PE. This is confirmed by CT pulmonary angiography (CTPA). Consequently she requires anticoagulation. Hospital guidelines suggest

2015 BestBETS

142. Thrombolytic therapy for pulmonary embolism. (Abstract)

Thrombolytic therapy for pulmonary embolism. Thrombolytic therapy (powerful anticoagulation drugs) is usually reserved for patients with clinically serious or massive pulmonary embolism (PE). Evidence suggests that thrombolytic agents may dissolve blood clots more rapidly than heparin and reduce the death rate associated with PE. However, there are still concerns about the possible risk of adverse effects of thrombolytic therapy, such as major or minor haemorrhages. This is the second update (...) pulmonary embolism compared with heparin. Furthermore, thrombolytic therapies included in the review were heterogeneous. Thrombolytic therapy may be helpful in reducing the recurrence of pulmonary emboli but may cause more major and minor haemorrhagic events and stroke. More high quality double blind RCTs assessing safety and cost-effectiveness are required.

2015 Cochrane

143. Evaluation of Patients With Suspected Acute Pulmonary Embolism: Best Practice Advice From the Clinical Guidelines Committee of the American College of Physicians. Full Text available with Trip Pro

Evaluation of Patients With Suspected Acute Pulmonary Embolism: Best Practice Advice From the Clinical Guidelines Committee of the American College of Physicians. Pulmonary embolism (PE) can be a severe disease and is difficult to diagnose, given its nonspecific signs and symptoms. Because of this, testing patients with suspected acute PE has increased dramatically. However, the overuse of some tests, particularly computed tomography (CT) and plasma d-dimer measurement, may not improve care (...) for this paper is all clinicians; the target patient population is all adults, both inpatient and outpatient, suspected of having acute PE.Clinicians should use validated clinical prediction rules to estimate pretest probability in patients in whom acute PE is being considered.Clinicians should not obtain d-dimer measurements or imaging studies in patients with a low pretest probability of PE and who meet all Pulmonary Embolism Rule-Out Criteria.Clinicians should obtain a high-sensitivity d-dimer measurement

2015 Annals of Internal Medicine

144. Fibrinolysis for patients with intermediate-risk pulmonary embolism

Fibrinolysis for patients with intermediate-risk pulmonary embolism PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?

2015 PedsCCM Evidence-Based Journal Club

145. Edoxaban for treating and for preventing deep vein thrombosis and pulmonary embolism

Edoxaban for treating and for preventing deep vein thrombosis and pulmonary embolism Edo Edoxaban for treating and for pre xaban for treating and for prev venting enting deep v deep vein thrombosis and pulmonary ein thrombosis and pulmonary embolism embolism T echnology appraisal guidance Published: 26 August 2015 nice.org.uk/guidance/ta354 © NICE 2018. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and-conditions#notice-of- rights).Y Y our responsibility our (...) , to advance equality of opportunity and to reduce health inequalities. Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible. Deep vein thrombosis, pulmonary embolism (treatment, secondary prevention) - edoxaban tosylate (TA354) © NICE 2018. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions

2015 National Institute for Health and Clinical Excellence - Technology Appraisals

146. Do patients with a clinically suspected subsegmental pulmonary embolism need anticoagulation therapy?

Do patients with a clinically suspected subsegmental pulmonary embolism need anticoagulation therapy? BestBets: Do patients with a clinically suspected subsegmental pulmonary embolism need anticoagulation therapy? Do patients with a clinically suspected subsegmental pulmonary embolism need anticoagulation therapy? Report By: Chris Morgan, Hyun Choi - TBC Institution: University of Manchester, Manchester, UK and Emergency Department, Lewisham and Greenwich NHS Trust, London, UK Date Submitted (...) : 26th August 2015 Last Modified: 26th August 2015 Status: Green (complete) Three Part Question In [a symptomatic patient with an isolated subsegmental pulmonary embolism] does [anticoagulation therapy or no treatment] lead to [lower rates of mortality and recurrent venous thromboembolism?] Clinical Scenario A 62-year-old gentleman attends your Emergency Department with shortness of breath and chest pain. You suspect a pulmonary embolism (PE) and request a CT pulmonary angiogram. The radiologist

2015 BestBETS

147. Validation of a Model for Identification of Patients at Intermediate to High Risk for Complications Associated With Acute Symptomatic Pulmonary Embolism (Abstract)

Validation of a Model for Identification of Patients at Intermediate to High Risk for Complications Associated With Acute Symptomatic Pulmonary Embolism For patients with acute symptomatic pulmonary embolism (PE), the Bova score classifies their risk for PE-related complications within 30 days after diagnosis. The original Bova score was derived from 2,874 normotensive patients with acute PE who participated in one of six prospective PE studies.We retrospectively assessed the validity

2015 EvidenceUpdates

148. Six Months vs Extended Oral Anticoagulation After a First Episode of Pulmonary Embolism: The PADIS-PE Randomized Clinical Trial. Full Text available with Trip Pro

Six Months vs Extended Oral Anticoagulation After a First Episode of Pulmonary Embolism: The PADIS-PE Randomized Clinical Trial. The optimal duration of anticoagulation after a first episode of unprovoked pulmonary embolism is uncertain.To determine the benefits and harms of an additional 18-month treatment with warfarin vs placebo, after an initial 6-month nonrandomized treatment period on a vitamin K antagonist.Randomized, double-blind trial (treatment period, 18 months; median follow-up, 24 (...) months); 371 adult patients who had experienced a first episode of symptomatic unprovoked pulmonary embolism (ie, with no major risk factor for thrombosis) and had been treated initially for 6 uninterrupted months with a vitamin K antagonist were randomized and followed up between July 2007 and September 2014 in 14 French centers.Warfarin or placebo for 18 months.The primary outcome was the composite of recurrent venous thromboembolism or major bleeding at 18 months after randomization. Secondary

2015 JAMA Controlled trial quality: predicted high

149. Comparison of Wells and Revised Geneva Rule to Assess Pretest Probability of Pulmonary Embolism in High-Risk Hospitalized Elderly Adults (Abstract)

Comparison of Wells and Revised Geneva Rule to Assess Pretest Probability of Pulmonary Embolism in High-Risk Hospitalized Elderly Adults To assess and compare the diagnostic power for pulmonary embolism (PE) of Wells and revised Geneva scores in two independent cohorts (training and validation groups) of elderly adults hospitalized in a non-emergency department.Prospective clinical study, January 2011 to January 2013.Unit of Internal Medicine inpatients, University of Catania, Italy.Elderly

2015 EvidenceUpdates

150. Ultrasound-enhanced, catheter-directed thrombolysis for pulmonary embolism

Ultrasound-enhanced, catheter-directed thrombolysis for pulmonary embolism Ultr Ultrasound-enhanced, catheter-directed asound-enhanced, catheter-directed thrombolysis for pulmonary embolism thrombolysis for pulmonary embolism Interventional procedures guidance Published: 26 June 2015 nice.org.uk/guidance/ipg524 Y Y our responsibility our responsibility This guidance represents the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement (...) thrombolysis for pulmonary embolism raises no major safety concerns over those of catheter-directed thrombolysis (CDT) alone. With regard to efficacy, evidence of any enhancement of thrombolysis over CDT alone is inadequate in quality © NICE 2018. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 1 of 8and quantity. Therefore this procedure should only be used with special arrangements for clinical governance, consent and audit

2015 National Institute for Health and Clinical Excellence - Interventional Procedures

151. Apixaban for the treatment and secondary prevention of deep vein thrombosis and/or pulmonary embolism

Apixaban for the treatment and secondary prevention of deep vein thrombosis and/or pulmonary embolism Apixaban for the treatment and Apixaban for the treatment and secondary pre secondary prev vention of deep v ention of deep vein ein thrombosis and/or pulmonary embolism thrombosis and/or pulmonary embolism T echnology appraisal guidance Published: 4 June 2015 nice.org.uk/guidance/ta341 © NICE 2018. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and-conditions (...) due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible. Apixaban for the treatment and secondary prevention of deep vein thrombosis and/or pulmonary embolism (TA341) © NICE 2018. All rights reserved

2015 National Institute for Health and Clinical Excellence - Technology Appraisals

152. Dabigatran (Pradaxa) in deep vein thrombosis and pulmonary embolism

Dabigatran (Pradaxa) in deep vein thrombosis and pulmonary embolism Prescrire IN ENGLISH - Spotlight ''In the June issue of Prescrire International: Dabigatran (Pradaxa°) in deep vein thrombosis and pulmonary embolism'', 1 June 2015 {1} {1} {1} | | > > > In the June issue of Prescrire International: Dabigatran (Pradaxa°) in deep vein thrombosis and pulmonary embolism Spotlight Every month, the subjects in Prescrire’s Spotlight. 100 most recent :  |   |   |   |  (...)  |   |   |   |   |  Spotlight In the June issue of Prescrire International: Dabigatran (Pradaxa°) in deep vein thrombosis and pulmonary embolism FREE DOWNLOAD In the New Products section of the June issue: compared with adjusted-dose warfarin, dabigatran provides no tangible advantages for patients with pulmonary embolism or deep vein thrombosis. Warfarin remains the standard drug. Full text available for free download. Summary The anticoagulant dabigatran

2015 Prescrire

153. Prognostic value of troponins in acute nonmassive pulmonary embolism: A meta-analysis. (Abstract)

Prognostic value of troponins in acute nonmassive pulmonary embolism: A meta-analysis. The objective of our meta-analysis is to update the evidence on the prognostic value of elevated troponin levels in patient with acute normotensive pulmonary embolism (PE). We did a systematic literature review of database, including Pubmed, EMBASE, and Cochrane. Studies were included if those were done on normotensive patients with acute PE and serum troponin assay was done. The primary end point was short

2015 Heart & lung : the journal of critical care

154. Should we use an age adjusted D-dimer threshold in managing low risk patients with suspected pulmonary embolism?

Should we use an age adjusted D-dimer threshold in managing low risk patients with suspected pulmonary embolism? BestBets: Should we use an age adjusted D-dimer threshold in managing low risk patients with suspected pulmonary embolism? Should we use an age adjusted D-dimer threshold in managing low risk patients with suspected pulmonary embolism? Report By: Dr Tom Jaconelli - Registrar in Emergency Medicine Search checked by Dr Steven Crane - Consultant in Emergency Medicine Institution: York (...) District Hospital, York, UK Date Submitted: 26th December 2014 Date Completed: 6th May 2015 Last Modified: 6th May 2015 Status: Green (complete) Three Part Question In [patients with signs and symptoms of pulmonary embolism who are deemed low risk] is a [age adjusted D-dimer sensitive enough] compared to a standard D-dimer to [safely exclude pulmonary embolism]? Clinical Scenario A70 year old man presents with pleuritic chest pain. A D-dimer taken at triage is mildly elevated from the standard positive

2015 BestBETS

155. Treatment of pulmonary embolism with rivaroxaban: outcomes by simplified Pulmonary Embolism Severity Index score from a post hoc analysis of the EINSTEIN PE study Full Text available with Trip Pro

Treatment of pulmonary embolism with rivaroxaban: outcomes by simplified Pulmonary Embolism Severity Index score from a post hoc analysis of the EINSTEIN PE study The objective was to assess adverse outcomes in relation to the simplified Pulmonary Embolism Severity Index (PESI) score in patients treated with rivaroxaban or standard therapy in the phase III EINSTEIN PE study and to evaluate the utility of the simplified PESI score to identify low-risk pulmonary embolism (PE) patients.A post hoc

2015 EvidenceUpdates Controlled trial quality: uncertain

156. Effect of a retrievable inferior vena cava filter plus anticoagulation vs anticoagulation alone on risk of recurrent pulmonary embolism: a randomized clinical trial. Full Text available with Trip Pro

Effect of a retrievable inferior vena cava filter plus anticoagulation vs anticoagulation alone on risk of recurrent pulmonary embolism: a randomized clinical trial. Although retrievable inferior vena cava filters are frequently used in addition to anticoagulation in patients with acute venous thromboembolism, their benefit-risk ratio is unclear.To evaluate the efficacy and safety of retrievable vena cava filters plus anticoagulation vs anticoagulation alone for preventing pulmonary embolism (...) recurrence in patients presenting with acute pulmonary embolism and a high risk of recurrence.Randomized, open-label, blinded end point trial (PREPIC2) with 6-month follow-up conducted from August 2006 to January 2013. Hospitalized patients with acute, symptomatic pulmonary embolism associated with lower-limb vein thrombosis and at least 1 criterion for severity were assigned to retrievable inferior vena cava filter implantation plus anticoagulation (filter group; n = 200) or anticoagulation alone

2015 JAMA Controlled trial quality: predicted high

157. Pulmonary Embolism (PE): Diagnosis

Pulmonary Embolism (PE): Diagnosis © 2015 Thrombosis Canada Page 1 of 1 PULMONARY EMBOLISM (PE): DIAGNOSIS OBJECTIVE: To provide a diagnostic approach to patients with suspected acute pulmonary embolism (PE). BACKGROUND: Venous thromboembolism (VTE) is a common disease, affecting approximately 1-2 in 1,000 adults per year. Approximately one third of first VTE presentations are due to PE while the remainder is due to deep vein thrombosis (DVT). The diagnosis of PE has increased significantly (...) such as SPECT V/Q, has high sensitivity and specificity in patients with a normal chest X-ray who do not have significant lung disease. V/Q scanning should be considered in patients with renal insufficiency, contrast allergy and in young patients with a normal chest X-ray. © 2015 Thrombosis Canada Page 3 of 3 FIGURE 1: SUGGESTED DIAGNOSTIC ALGORITHM FOR SUSPECTED PULMONARY EMBOLISM * Consideration for thrombolysis without diagnostic test confirmation should be made if the patient has a high clinical

2015 Thrombosis Interest Group of Canada

158. Thrombolysis for pulmonary embolism and risk of all-cause mortality, major bleeding, and intracranial hemorrhage: a meta-analysis

Thrombolysis for pulmonary embolism and risk of all-cause mortality, major bleeding, and intracranial hemorrhage: a meta-analysis PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?

2015 PedsCCM Evidence-Based Journal Club

159. Predictive value of the heart-type fatty acid-binding protein and the Pulmonary Embolism Severity Index in patients with acute pulmonary embolism in the emergency department Full Text available with Trip Pro

Predictive value of the heart-type fatty acid-binding protein and the Pulmonary Embolism Severity Index in patients with acute pulmonary embolism in the emergency department Heart-type fatty acid-binding protein (h-FABP), sensitive troponins, natriuretic peptides, and clinical scores such as the Pulmonary Embolism Severity Index (PESI) are candidates for risk stratification of patients with acute pulmonary embolism (PE). The aim was to compare their respective prognostic values to predict

2015 EvidenceUpdates

160. Do patients with an asymptomatic sub-segmental pulmonary embolism need anticoagulation therapy?

Do patients with an asymptomatic sub-segmental pulmonary embolism need anticoagulation therapy? BestBets: Do patients with an asymptomatic sub-segmental pulmonary embolism need anticoagulation therapy? Do patients with an asymptomatic sub-segmental pulmonary embolism need anticoagulation therapy? Report By: Hyun Choi - CT3 Search checked by Christopher Morgan - Institution: Central Manchester University Hospitals NHS Foundation Trust, University Of Manchester Date Submitted: 27th November 2010 (...) Date Completed: 5th January 2015 Last Modified: 5th January 2015 Status: Green (complete) Three Part Question [In an asymptomatic patient with small subsegmental pulmonary embolism] does [anticoagulation therapy or no treatment] lead to [reduced mortality and a lower rate of recurrent venous thromboembolism?] Clinical Scenario A 49 year old male, who was previously fit and well, attended the Emergency Department as a trauma patient after being involved in a road traffic collision. He underwent

2015 BestBETS