Latest & greatest articles for pulmonary embolism

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Top results for pulmonary embolism

141. Thrombolysis for pulmonary embolism and risk of all-cause mortality, major bleeding, and intracranial hemorrhage: a meta-analysis. (Full text)

Thrombolysis for pulmonary embolism and risk of all-cause mortality, major bleeding, and intracranial hemorrhage: a meta-analysis. Thrombolytic therapy may be beneficial in the treatment of some patients with pulmonary embolism. To date, no analysis has had adequate statistical power to determine whether thrombolytic therapy is associated with improved survival, compared with conventional anticoagulation.To determine mortality benefits and bleeding risks associated with thrombolytic therapy (...) compared with anticoagulation in acute pulmonary embolism, including the subset of hemodynamically stable patients with right ventricular dysfunction (intermediate-risk pulmonary embolism).PubMed, the Cochrane Library, EMBASE, EBSCO, Web of Science, and CINAHL databases from inception through April 10, 2014.Eligible studies were randomized clinical trials comparing thrombolytic therapy vs anticoagulant therapy in pulmonary embolism patients. Sixteen trials comprising 2115 individuals were identified

2014 JAMA PubMed

142. Deep venous thrombosis and pulmonary embolism: initial treatment

Deep venous thrombosis and pulmonary embolism: initial treatment Prescrire IN ENGLISH - Spotlight: Archive ''Deep venous thrombosis and pulmonary embolism: initial treatment'', 1 April 2013 {1} {1} {1} | | > > > Deep venous thrombosis and pulmonary embolism: initial treatment Spotlight: Archives Every month, the subjects in Prescrire’s Spotlight. 2013 :  |   |  Spotlight Archives Deep venous thrombosis and pulmonary embolism: initial treatment Patients suffering from deep venous (...) thrombosis are exposed in the short term to a risk of pulmonary embolism, which is often fatal. A low-molecular-weight heparin (LMWH) injected subcutaneously is the first-line anticoagulant for this condition. Patients suffering from deep venous thrombosis are exposed to a more serious risk of pulmonary embolism when the thrombosis is above the knee rather than below. Deep venous thrombosis sometimes causes local after-effects such as leg pains, varicose veins, oedema, and sometimes skin ulcers

2014 Prescrire

143. Deep venous thrombosis and pulmonary embolism: prevention of recurrences

Deep venous thrombosis and pulmonary embolism: prevention of recurrences Prescrire IN ENGLISH - Spotlight ''Deep venous thrombosis and pulmonary embolism: prevention of recurrences '', 1 May 2013 {1} {1} {1} | | > > > Deep venous thrombosis and pulmonary embolism: prevention of recurrences Spotlight Every month, the subjects in Prescrire’s Spotlight. 100 most recent :  |   |   |   |   |   |   |   |   |  Spotlight Deep (...) venous thrombosis and pulmonary embolism: prevention of recurrences FEATURED REVIEW After the initial phase of treatment for deep venous thrombosis or pulmonary embolism, the goal is to prevent recurrences, which can be fatal. In practice, it is best to choose between low-molecular weight heparin (LMWH) and warfarin, on a case-by-case basis. Full review (5 pages) available for download by subscribers. Abstract In patients with deep venous thrombosis or pulmonary embolism , initial treatment with low

2014 Prescrire

144. Increased risks of deep vein thrombosis and pulmonary embolism in sjogren syndrome: a nationwide cohort study (PubMed)

Increased risks of deep vein thrombosis and pulmonary embolism in sjogren syndrome: a nationwide cohort study Studies of the risks of deep vein thrombosis (DVT) and pulmonary embolism (PE) in patients with Sjögren syndrome (SS) in Asia are scant. We evaluated the effect of SS on the incidences of DVT and PE in a nationwide, population-based cohort in Taiwan.We identified patients in Taiwan diagnosed with SS between 1998 and 2008 in the Catastrophic Illness Patient Database and the National

2014 EvidenceUpdates

145. Derivation and validation of multimarker prognostication for normotensive patients with acute symptomatic pulmonary embolism (PubMed)

Derivation and validation of multimarker prognostication for normotensive patients with acute symptomatic pulmonary embolism Not all patients with acute pulmonary embolism (PE) have a high risk of an adverse short-term outcome.This prospective cohort study aimed to develop a multimarker prognostic model that accurately classifies normotensive patients with PE into low and high categories of risk of adverse medical outcomes.The study enrolled 848 outpatients from the PROTECT (PROgnosTic valuE (...) of Computed Tomography) study (derivation cohort) and 529 patients from the Prognostic Factors for Pulmonary Embolism (PREP) study (validation cohort). Investigators assessed study participants for a 30-day complicated course, defined as death from any cause, hemodynamic collapse, and/or adjudicated recurrent PE.A complicated course occurred in 63 (7.4%) of the 848 normotensive patients with acute symptomatic PE in the derivation cohort and in 24 patients (4.5%) in the validation cohort. The final model

2014 EvidenceUpdates

146. Anticoagulant treatment for subsegmental pulmonary embolism. (PubMed)

Anticoagulant treatment for subsegmental pulmonary embolism. Acute pulmonary embolism (PE) is a common cause of death, accounting for 50,000 to 200,000 deaths annually. It is the third most common cause of mortality among the cardiovascular diseases, after coronary artery disease and stroke.The advent of multi-detector computed tomographic pulmonary angiography (CTPA) has allowed better assessment of PE regarding visualisation of the peripheral pulmonary arteries, increasing its rate (...) PEs. However, the clinical significance in patients and their prognosis have to be studied to evaluate whether anticoagulation therapy is required.To assess the effectiveness and safety of anticoagulation therapy versus no intervention in patients with isolated subsegmental pulmonary embolism (SSPE) or incidental SSPE.The Cochrane Peripheral Vascular Diseases Group Trials Search Co-ordinator searched the Specialised Register (last searched October 2013) and CENTRAL (2013, Issue 9). MEDLINE, EMBASE

2014 Cochrane

147. Rivaroxaban - Thromboembolic events (venous), pulmonary embolism

Rivaroxaban - Thromboembolic events (venous), pulmonary embolism Common Drug Review CDEC Meetings: October 16, 2013; January 15, 2013; March 19, 2014 Notice of Final Recommendation — March 26, 2014 Page 1 of 6 © 2014 CADTH CDEC FINAL RECOMMENDATION RIVAROXABAN (Xarelto — Bayer Inc.) New Indication: Pulmonary Embolism Recommendation: CDEC recommends that rivaroxaban be listed for the treatment of VTE (DVT and PE) and prevention of recurrent DVT and PE, for a duration of up to six months (...) ; the treatment of VTE (DVT and PE) and prevention of recurrent DVT and PE; and the prevention of stroke and systemic embolism in patients with atrial fibrillation, in whom anticoagulation is appropriate. Note: The Canadian Drug Expert Committee (CDEC) previously reviewed rivaroxaban for the treatment of deep vein thrombosis (DVT) in patients without symptomatic pulmonary embolism (PE) (see CDEC Final Recommendation, August 12, 2012). The current CDEC recommendation is for the new indication of treatment

2014 Canadian Agency for Drugs and Technologies in Health - Common Drug Review

148. Timely diagnosis of pulmonary artery tumor embolism by ultrasound-guided transbronchial needle aspiration (Full text)

Timely diagnosis of pulmonary artery tumor embolism by ultrasound-guided transbronchial needle aspiration Pulmonary artery tumor embolism (PATE) is a rare disease without an established diagnostic method. In an autopsy series, however, the incidence of PATE was relatively high, between 3% and 26% in patients with a solid tumor. Here we report a case of a patient with a massive PATE from hepatocellular carcinoma diagnosed safely and promptly by endobronchial ultrasound-guided transbronchial

2014 Thoracic cancer PubMed

149. CHA2DS2-VASc score is directly associated with the risk of pulmonary embolism in patients with atrial fibrillation (PubMed)

CHA2DS2-VASc score is directly associated with the risk of pulmonary embolism in patients with atrial fibrillation The risk stratification score, which includes Congestive heart failure, Hypertension, Age ≥ 75 [doubled], Diabetes, Stroke [doubled]- Vascular disease, Age 65-74, and Sex category [female] (CHA2DS2-VASc), is used to predict stroke in atrial fibrillation. However, whether high CHA2DS2-VASc score carries a higher risk of pulmonary embolism remains unknown. We aimed to investigate (...) the association between the severity of CHA2DS2-VASc score and the incidence of pulmonary embolism.A total of 73,541 adults with atrial fibrillation diagnosed before January 1, 2012, and no history of pulmonary embolism, were retrospectively identified from the computerized database of the Clalit Health Services, which is the largest not-for-profit health maintenance organization in Israel. The CHA2DS2-VASc score was calculated for each subject at study entry. The cohort was followed for the first occurrence

2014 EvidenceUpdates

150. Low-molecular weight heparins versus warfarin for the long-term prevention or treatment of deep vein thrombosis or pulmonary embolism: a review of the clinical and cost-effectiveness

Low-molecular weight heparins versus warfarin for the long-term prevention or treatment of deep vein thrombosis or pulmonary embolism: a review of the clinical and cost-effectiveness Low-molecular weight heparins versus warfarin for the long-term prevention or treatment of deep vein thrombosis or pulmonary embolism: a review of the clinical and cost-effectiveness Low-molecular weight heparins versus warfarin for the long-term prevention or treatment of deep vein thrombosis or pulmonary embolism (...) : a review of the clinical and cost-effectiveness CADTH 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 CADTH. Low-molecular weight heparins versus warfarin for the long-term prevention or treatment of deep vein thrombosis or pulmonary embolism: a review of the clinical and cost-effectiveness. Ottawa: Canadian Agency for Drugs and Technologies

2014 Health Technology Assessment (HTA) Database.

151. Thrombolytics for Submassive Pulmonary Embolism

Thrombolytics for Submassive Pulmonary Embolism Emergency Medicine > Journal Club > Archive > September 2014 Toggle navigation September 2014 Thrombolytics for Submassive Pulmonary Embolism Vignette You are working a day shift in your ED when you meet a generally healthy 55 year old male who acutely developed chest pain and shortness of breath at home. He tells you that he underwent an orthopedic procedure 10 days prior. He is tachycardic and has an oxygen saturation of 94% on room air. You (...) ventricle with Slattened septal motion, McConnell’s sign of right ventricle apical hyperkinesis, and tricuspid regurgitation consistent with right ventricular dysfunction in the context of an acute pulmonary embolism. Given the relatively young age of the patient and his previously normal cardiac function, you consider whether to offer thrombolytic therapy given the degree of right ventricular dysfunction seen on ECHO. However, the patient has a SBP > 110 and is on room-­‐air, and hence does not meet

2014 Washington University Emergency Medicine Journal Club

152. Fibrinolysis for patients with intermediate-risk pulmonary embolism. (Full text)

Fibrinolysis for patients with intermediate-risk pulmonary embolism. The role of fibrinolytic therapy in patients with intermediate-risk pulmonary embolism is controversial.In a randomized, double-blind trial, we compared tenecteplase plus heparin with placebo plus heparin in normotensive patients with intermediate-risk pulmonary embolism. Eligible patients had right ventricular dysfunction on echocardiography or computed tomography, as well as myocardial injury as indicated by a positive test (...) , which was hemorrhagic (P=0.003). By day 30, a total of 12 patients (2.4%) in the tenecteplase group and 16 patients (3.2%) in the placebo group had died (P=0.42).In patients with intermediate-risk pulmonary embolism, fibrinolytic therapy prevented hemodynamic decompensation but increased the risk of major hemorrhage and stroke. (Funded by the Programme Hospitalier de Recherche Clinique in France and others; PEITHO EudraCT number, 2006-005328-18; ClinicalTrials.gov number, NCT00639743.).

2014 NEJM PubMed

153. Diagnosis and Management of Acute Pulmonary Embolism

Diagnosis and Management of Acute Pulmonary Embolism ESC GUIDELINES 2014 ESC Guidelines on the diagnosis and management of acute pulmonary embolism The Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (ESC) Endorsed by the European Respiratory Society (ERS) Authors/Task Force Members: Stavros V. Konstantinides * (Chairperson) (Germany/ Greece), Adam Torbicki * (Co-chairperson) (Poland), Giancarlo Agnelli (Italy), Nicolas Danchin (...) classi?cation of pulmonary embolism severity . . .3039 3. Diagnosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3039 3.1 Clinical presentation . . . . . . . . . . . . . . . . . . . . . . . .3039 3.2 Assessment of clinical probability . . . . . . . . . . . . . . . .3040 3.3 D-dimer testing . . . . . . . . . . . . . . . . . . . . . . . . . . .3040 3.4 Computed tomographic pulmonary angiography . . . . . .3042 3.5 Lung scintigraphy

2014 European Society of Cardiology

154. Outpatient versus inpatient treatment in patients with pulmonary embolism: a meta-analysis (Full text)

Outpatient versus inpatient treatment in patients with pulmonary embolism: a meta-analysis Our aim was to study the safety of outpatient treatment in low risk patients with acute pulmonary embolism compared with inpatient treatment, the current clinical standard. We searched Medline, Web of Science, Cochrane and EMBASE databases and included studies on outpatient treatment of pulmonary embolism. The outcomes were 3-month recurrent venous thromboembolism, major bleeding and all-cause mortality (...) discharge patients and 1.0% (0.39-2.8%) in inpatients. The pooled incidence of mortality was 1.9% (0.79-4.6%) in outpatients, 2.3% (1.1-5.1%) in early discharge patients and 0.74% (0.04-11%) in inpatients. Incidences of recurrent venous thromboembolism, major bleeding and, after correction for malignancies, mortality were comparable between outpatients, patients discharged early and inpatients. We conclude that home treatment or early discharge of selected low-risk patients with pulmonary embolism

2013 EvidenceUpdates PubMed

155. Imaging for the Diagnosis of Pulmonary Embolism in Pregnant Women

Imaging for the Diagnosis of Pulmonary Embolism in Pregnant Women BestBets: Imaging for the Diagnosis of Pulmonary Embolism in Pregnant Women Imaging for the Diagnosis of Pulmonary Embolism in Pregnant Women Report By: Simon Bordeleau - Emergency medicine PGY-4 Institution: Laval University, Quebec, Canada Date Submitted: 21st December 2012 Date Completed: 17th April 2013 Last Modified: 17th April 2013 Status: Green (complete) Three Part Question In [Pregnancy with pulmonary embolism (...) ], is [Computed-Tomographic pulmonary angiography better than Ventilation (V) –Perfusion (Q) scintigraphy] for [detection of pulmonary embolism]? Clinical Scenario A 27-year-old female presents to the emergency department with shortness of breath. She is 26 weeks pregnant. The lower limbs Doppler ultrasound is negative. You must perform another diagnostic test to eliminate a pulmonary embolism. You wonder which test is the most appropriate for this patient: a Computed-Tomographic pulmonary angiography

2013 BestBETS

156. Changes in PESI scores predict mortality in intermediate-risk patients with acute pulmonary embolism (Full text)

Changes in PESI scores predict mortality in intermediate-risk patients with acute pulmonary embolism Although the Pulmonary Embolism Severity Index (PESI) accurately identifies 35% of patients with acute pulmonary embolism (PE) as being low risk, some patients deemed high risk by the PESI on admission might be treated safely in the outpatient environment. This retrospective cohort study included a total of 304 consecutive patients with acute PE, classified at the time of hospital admission

2013 EvidenceUpdates PubMed

157. Can selected patients with newly diagnosed pulmonary embolism be safely treated without hospitalization? A systematic review (PubMed)

Can selected patients with newly diagnosed pulmonary embolism be safely treated without hospitalization? A systematic review Omitting inpatient therapy for emergency department patients with newly diagnosed pulmonary embolism occurs infrequently in the United States. We seek to describe the safety of initial outpatient management of these patients and their demographics, comorbidities, risk stratification, treatment, and outcomes.We identified studies from searches of MEDLINE, EMBASE, and other (...) databases from inception through March 22, 2012. We supplemented this with a search of conference proceedings and consultation with experts. We selected prospective studies of adults with acute, symptomatic, objectively confirmed pulmonary embolism who were discharged home without hospitalization. All contributing studies explicitly defined inclusion and exclusion criteria plus objectively confirmed outcome measures: recurrent thromboembolism, major hemorrhage, and mortality. Two investigators

2013 EvidenceUpdates

158. Submassive pulmonary embolism. (PubMed)

Submassive pulmonary embolism. The US Surgeon General estimates that 100,000 to 180,000 deaths occur annually from acute pulmonary embolism (PE) in the United States. The case of Ms A, a 60-year-old woman with acute PE and right ventricular dysfunction (submassive PE), illustrates the clinical challenge of identifying this high-risk patient population and determining when more aggressive immediate therapy should be pursued in addition to standard anticoagulation. The clinical examination (...) , electrocardiogram, cardiac biomarkers, chest computed tomography, and echocardiography can be used to risk stratify patients with acute PE. Current options for more aggressive intervention in the treatment of patients with acute PE who are at increased risk of an adverse clinical course include systemic fibrinolysis, pharmacomechanical catheter-directed therapy, surgical pulmonary embolectomy, and inferior vena cava filter insertion. Determination of the optimal duration of anticoagulation and lifestyle

2013 JAMA

159. Cohort study: Pretest probability assessment combined with point-of-care D-dimer testing allows primary care physicians to rule out pulmonary embolism

Cohort study: Pretest probability assessment combined with point-of-care D-dimer testing allows primary care physicians to rule out pulmonary embolism Pretest probability assessment combined with point-of-care D-dimer testing allows primary care physicians to rule out pulmonary embolism | BMJ Evidence-Based Medicine We use cookies to improve our service and to tailor our content and advertising to you. You can manage your cookie settings via your browser at any time. To learn more about how we (...) physicians to rule out pulmonary embolism Article Text Diagnosis Cohort study Pretest probability assessment combined with point-of-care D-dimer testing allows primary care physicians to rule out pulmonary embolism Christopher Kabrhel Statistics from Altmetric.com Commentary on: Geersing GJ , Erkens PM , Lucassen WA , et al . Safe exclusion of pulmonary embolism using the Wells rule and qualitative D-dimer testing in primary care: prospective cohort study. Context A Bayesian combination of pretest

2013 Evidence-Based Medicine (Requires free registration)

160. Cohort: Thrombolytic therapy with or without a vena cava filter results in a lower case fatality rate in unstable patients with acute pulmonary embolism

Cohort: Thrombolytic therapy with or without a vena cava filter results in a lower case fatality rate in unstable patients with acute pulmonary embolism Thrombolytic therapy with or without a vena cava filter results in a lower case fatality rate in unstable patients with acute pulmonary embolism | BMJ Evidence-Based Medicine We use cookies to improve our service and to tailor our content and advertising to you. You can manage your cookie settings via your browser at any time. To learn more (...) rate in unstable patients with acute pulmonary embolism Article Text Online articles Cohort Thrombolytic therapy with or without a vena cava filter results in a lower case fatality rate in unstable patients with acute pulmonary embolism Marie Méan 1 , Said A Ibrahim 2,3 Statistics from Altmetric.com Commentary on: Stein PD , Matta F . Thrombolytic therapy in unstable patients with acute pulmonary embolism: saves lives but underused . Context Acute pulmonary embolism (PE) is a major health problem

2013 Evidence-Based Medicine (Requires free registration)