Latest & greatest articles for pulmonary embolism

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Top results for pulmonary embolism

241. Computed tomographic pulmonary angiography vs ventilation-perfusion lung scanning in patients with suspected pulmonary embolism: a randomized controlled trial. Full Text available with Trip Pro

Computed tomographic pulmonary angiography vs ventilation-perfusion lung scanning in patients with suspected pulmonary embolism: a randomized controlled trial. Ventilation-perfusion (V(dot)Q(dot) lung scanning and computed tomographic pulmonary angiography (CTPA) are widely used imaging procedures for the evaluation of patients with suspected pulmonary embolism. Ventilation-perfusion scanning has been largely replaced by CTPA in many centers despite limited comparative formal evaluations (...) and concerns about CTPA's low sensitivity (ie, chance of missing clinically important pulmonary embuli).To determine whether CTPA may be relied upon as a safe alternative to V(dot)Q(dot scanning as the initial pulmonary imaging procedure for excluding the diagnosis of pulmonary embolism in acutely symptomatic patients.Randomized, single-blinded noninferiority clinical trial performed at 4 Canadian and 1 US tertiary care centers between May 2001 and April 2005 and involving 1417 patients considered likely

2007 JAMA Controlled trial quality: predicted high

242. Thrombolytic Therapy for Submassive Pulmonary Embolism?

embolism. Suspecting pulmonary embolism, you order computed tomography angiogram of the thorax, which reveals diffuse bilateral pulmonary emboli. It is now 2 am and you call for a helicopter to have the patient transported to a tertiary care facility. The physician on duty at the receiving hospital asks why you have not given thrombolytics yet; he refers to a recent article in a prominent journal that recommends administration of alteplase to patients with submassive pulmonary embolism. You have (...) since its introduction 40 years ago. x 2 Barrit, D.W. and Jordan, S.C. Anticoagulant drugs in the treatment of pulmonary embolism: a controlled trial. Lancet . 1960 ; 1 : 1309–1312 | | | , x 3 Goldhaber, S.Z. Contemporary pulmonary embolism thrombolysis. Chest . 1995 ; 107 : 45S–51S | | Thrombolysis has been shown to provide improvements in hemodynamic status and pulmonary imaging results compared to heparin. x 4 Dalla-Volta, S., Palla, A., Santolicandro, A. et al. Alteplase combined with heparin

2007 Evidence-Based Emergency Medicine

243. Anticoagulation for three versus six months in patients with deep vein thrombosis or pulmonary embolism, or both: randomised trial. Full Text available with Trip Pro

Anticoagulation for three versus six months in patients with deep vein thrombosis or pulmonary embolism, or both: randomised trial. To determine the optimum duration of oral anticoagulant therapy after an episode of deep vein thrombosis or pulmonary embolism, or both.Multicentre, prospective, randomised study with follow-up for one year.46 hospitals in United Kingdom.Patients aged > or =18 with deep vein thrombosis or pulmonary embolism, or both.Three (n=369) or six months (n=380 (...) ) of anticoagulation with heparin for five days accompanied and followed by warfarin, with a target international normalised ratio of 2.0-3.5.Death from deep vein thrombosis or pulmonary embolism; failure to resolve, extension, recurrence of during treatment; recurrence after treatment; and major haemorrhage during treatment.In the patients allocated to three months' treatment two died from deep vein thrombosis or pulmonary embolism during or after treatment, compared with three in the six month group. During

2007 BMJ Controlled trial quality: predicted high

244. The value of clinical features in the diagnosis of acute pulmonary embolism: systematic review and meta-analysis

The value of clinical features in the diagnosis of acute pulmonary embolism: systematic review and meta-analysis Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.

2007 DARE.

245. No difference in risk for thrombocytopenia during treatment of pulmonary embolism and deep venous thrombosis with either low-molecular-weight heparin or unfractionated heparin: a metaanalysis

No difference in risk for thrombocytopenia during treatment of pulmonary embolism and deep venous thrombosis with either low-molecular-weight heparin or unfractionated heparin: a metaanalysis Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.

2007 DARE.

246. Catheter-tip embolectomy in the management of acute massive pulmonary embolism

Catheter-tip embolectomy in the management of acute massive pulmonary embolism Catheter-tip embolectomy in the management of acute massive pulmonary embolism Catheter-tip embolectomy in the management of acute massive pulmonary embolism Skaf E, Beemath A, Siddiqui T, Janjua M, Patel N R, Stein P D CRD summary This review assessed the efficacy and safety of catheter-tip devices in patients with acute massive pulmonary embolism. The authors suggested that aspiration, fragmentation, and rheolytic (...) techniques could be useful in the management of acute massive pulmonary embolism. These conclusions have to be viewed with caution given the small size and poor quality of the studies included. Authors' objectives To review the evidence on the efficacy and safety of catheter-tip devices in patients with acute massive pulmonary embolism (PE). Searching MEDLINE and the Cochrane Library were searched; the search terms were reported. The reference lists of relevant articles and reviews were checked

2007 DARE.

247. Venous thromboembolism: reducing the risk of venous thromboembolism (deep vein thrombosis and pulmonary embolism) in inpatients undergoing surgery

Venous thromboembolism: reducing the risk of venous thromboembolism (deep vein thrombosis and pulmonary embolism) in inpatients undergoing surgery Venous thromboembolism: reducing the risk of venous thromboembolism (deep vein thrombosis and pulmonary embolism) in inpatients undergoing surgery Venous thromboembolism: reducing the risk of venous thromboembolism (deep vein thrombosis and pulmonary embolism) in inpatients undergoing surgery National Institute for Health and Clinical Excellence (...) 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 National Institute for Health and Clinical Excellence. Venous thromboembolism: reducing the risk of venous thromboembolism (deep vein thrombosis and pulmonary embolism) in inpatients undergoing surgery. London: National Institute for Health and Clinical Excellence (NICE). Clinical Guideline 46. 2007 Authors' objectives

2007 Health Technology Assessment (HTA) Database.

248. Influence of age on the cost-effectiveness of diagnostic strategies for suspected pulmonary embolism Full Text available with Trip Pro

Influence of age on the cost-effectiveness of diagnostic strategies for suspected pulmonary embolism Influence of age on the cost-effectiveness of diagnostic strategies for suspected pulmonary embolism Influence of age on the cost-effectiveness of diagnostic strategies for suspected pulmonary embolism Righini M, Nendaz M, Le Gal G, Bounameaux H, Perrier A 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 assessed the cost-effectiveness of four diagnostic strategies for suspected pulmonary embolisms in patients of various ages. The authors concluded that the strategies that included the D-dimer test resulted in cost savings, which were reduced after the age of 80 years. This study had some limitations, especially in its

2007 NHS Economic Evaluation Database.

249. Effectiveness and cost-effectiveness of thrombolysis in submassive pulmonary embolism Full Text available with Trip Pro

Effectiveness and cost-effectiveness of thrombolysis in submassive pulmonary embolism Effectiveness and cost-effectiveness of thrombolysis in submassive pulmonary embolism Effectiveness and cost-effectiveness of thrombolysis in submassive pulmonary embolism Perlroth D J, Sanders G D, Gould M K 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. Health technology Two treatments for patients with submassive pulmonary embolism (PE) and right ventricular dysfunction (RVD) were studied. The treatments were alteplase plus heparin (thrombolysis) versus heparin alone. Patients treated with heparin alone received an intravenous bolus of 5,000 units of unfractionated heparin followed by an initial infusion of 1,000 units per hour adjusted to maintain

2007 NHS Economic Evaluation Database.

250. Multidetector computed tomography for acute pulmonary embolism. Full Text available with Trip Pro

Multidetector computed tomography for acute pulmonary embolism. The accuracy of multidetector computed tomographic angiography (CTA) for the diagnosis of acute pulmonary embolism has not been determined conclusively.The Prospective Investigation of Pulmonary Embolism Diagnosis II trial was a prospective, multicenter investigation of the accuracy of multidetector CTA alone and combined with venous-phase imaging (CTA-CTV) for the diagnosis of acute pulmonary embolism. We used a composite (...) , and nondiagnostic if clinical probability was discordant. CTA-CTV was inconclusive in 87 of 824 patients because the image quality of either CTA or CTV was poor. The sensitivity of CTA-CTV for pulmonary embolism was 90 percent, and specificity was 95 percent. CTA-CTV was also nondiagnostic with a discordant clinical probability.In patients with suspected pulmonary embolism, multidetector CTA-CTV has a higher diagnostic sensitivity than does CTA alone, with similar specificity. The predictive value of either CTA

2006 NEJM

251. Risk of deep vein thrombosis and pulmonary embolism after acute infection in a community setting. (Abstract)

Risk of deep vein thrombosis and pulmonary embolism after acute infection in a community setting. Acute infection increases the risk of arterial cardiovascular events, but effects on venous thromboembolic disease are less well established. Our aim was to investigate whether acute infections transiently increase the risk of venous thromboembolism.We used the self-controlled case-series method to study the risk of first deep vein thrombosis (DVT) (n=7278) and first pulmonary embolism (PE) (n=3755

2006 Lancet

252. Review: no evidence exists that thrombolysis is better than heparin for reducing the risk of recurrent pulmonary embolism and death Full Text available with Trip Pro

Review: no evidence exists that thrombolysis is better than heparin for reducing the risk of recurrent pulmonary embolism and death Review: no evidence exists that thrombolysis is better than heparin for reducing the risk of recurrent pulmonary embolism and death | Evidence-Based Nursing 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 use cookies, please see our (...) . Log in using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? Search for this keyword Search for this keyword Main menu Log in using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? You are here Review: no evidence exists that thrombolysis is better than heparin for reducing the risk of recurrent pulmonary embolism and death

2006 Evidence-Based Nursing

253. Review: thrombolytic treatment does not reduce the risk of recurrent pulmonary embolism and death more than heparin Full Text available with Trip Pro

Review: thrombolytic treatment does not reduce the risk of recurrent pulmonary embolism and death more than heparin Review: thrombolytic treatment does not reduce the risk of recurrent pulmonary embolism and death more than heparin | 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 use cookies, please see our . Log in using your username (...) and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? Search for this keyword Search for this keyword Main menu Log in using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? You are here Review: thrombolytic treatment does not reduce the risk of recurrent pulmonary embolism and death more than heparin Article Text Therapeutics Review: thrombolytic

2006 Evidence-Based Medicine

254. Pulmonary embolism in patients with unexplained exacerbation of chronic obstructive pulmonary disease: prevalence and risk factors. (Abstract)

Pulmonary embolism in patients with unexplained exacerbation of chronic obstructive pulmonary disease: prevalence and risk factors. Diagnosis of pulmonary embolism (PE) is difficult in patients with chronic obstructive pulmonary disease (COPD) and exacerbation.To evaluate PE in patients with COPD and exacerbation of unknown origin and explore factors associated with PE.Prospective cohort study.University-affiliated hospital in France.211 consecutive patients, all current or former smokers

2006 Annals of Internal Medicine

255. Appropriateness of diagnostic management and outcomes of suspected pulmonary embolism. (Abstract)

Appropriateness of diagnostic management and outcomes of suspected pulmonary embolism. International guidelines include several strategies for diagnosing pulmonary embolism with confidence, but little is known about how these guidelines are implemented in routine practice.To evaluate the appropriateness of diagnostic management of suspected pulmonary embolism and the relationship between diagnostic criteria and outcome.Prospective cohort study with a 3-month follow-up.116 emergency departments (...) in France and 1 in Belgium.1529 consecutive outpatients with suspected pulmonary embolism.Appropriateness of diagnostic criteria according to international guidelines; incidence of thromboembolic events during follow-up.Diagnostic management was inappropriate in 662 (43%) patients: 36 of 429 (8%) patients with confirmed pulmonary embolism and 626 of 1100 (57%) patients in whom pulmonary embolism was ruled out. Independent risk factors for inappropriate management were age older than 75 years (adjusted

2006 Annals of Internal Medicine

256. Prediction of pulmonary embolism in the emergency department: the revised Geneva score. (Abstract)

Prediction of pulmonary embolism in the emergency department: the revised Geneva score. Diagnosis of pulmonary embolism requires clinical probability assessment. Implicit assessment is accurate but is not standardized, and current prediction rules have shortcomings.To construct a simple score based entirely on clinical variables and independent from physicians' implicit judgment.Derivation and external validation of the score in 2 independent management studies on pulmonary embolism (...) diagnosis.Emergency departments of 3 university hospitals in Europe.Consecutive patients admitted for clinically suspected pulmonary embolism.Collected data included demographic characteristics, risk factors, and clinical signs and symptoms suggestive of venous thromboembolism. The variables statistically significantly associated with pulmonary embolism in univariate analysis were included in a multivariate logistic regression model. Points were assigned according to the regression coefficients. The score

2006 Annals of Internal Medicine

257. Effectiveness of managing suspected pulmonary embolism using an algorithm combining clinical probability, D-dimer testing, and computed tomography. Full Text available with Trip Pro

Effectiveness of managing suspected pulmonary embolism using an algorithm combining clinical probability, D-dimer testing, and computed tomography. Previous studies have evaluated the safety of relatively complex combinations of clinical decision rules and diagnostic tests in patients with suspected pulmonary embolism.To assess the clinical effectiveness of a simplified algorithm using a dichotomized clinical decision rule, D-dimer testing, and computed tomography (CT) in patients (...) with suspected pulmonary embolism.Prospective cohort study of consecutive patients with clinically suspected acute pulmonary embolism, conducted in 12 centers in the Netherlands from November 2002 through December 2004. The study population of 3306 patients included 82% outpatients and 57% women.Patients were categorized as "pulmonary embolism unlikely" or "pulmonary embolism likely" using a dichotomized version of the Wells clinical decision rule. Patients classified as unlikely had D-dimer testing

2006 JAMA

258. CTA vs. CTA/CTV for Pulmonary Embolism

CTA vs. CTA/CTV for Pulmonary Embolism CTA vs. CTA/CTV for Pulmonary Embolism « Sinai EM Journal Club Emergency Medicine Discussion Forum CTA vs. CTA/CTV for Pulmonary Embolism Annals was mostly about airway this month, and felt a little sparse (Levitan showed that BURP and cricoid pressure worsen the view compared to bimanual laryngoscopy– stop the presses! Also, a letter to the editor advocated for the mnemonic LEMONS over LEMON — the extra S is for O2 saturation, which of course you might (...) of the PIOPED II study is that although multidetector (mainly four-slice) CTA is more sensitive than singledetector imaging, it still misses small, peripheral subsegmental clots that are better detected by ventilation–perfusion scintigraphy or classic pulmonary angiography." Surely, this statement is crazy/invalid. If a CT scan is missing small peripheral subsegmental clots (which is indeed possible), how would we know that fact? Remember that 57% of the positive PE-diagnoses in the PIOPED II study were

2006 Sinai EM Journal Club

259. Diagnosis of deep vein thrombosis and pulmonary embolism in pregnancy: a systematic review

Diagnosis of deep vein thrombosis and pulmonary embolism in pregnancy: a systematic review Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.

2006 DARE.

260. Diagnosis of pulmonary embolism with CT pulmonary angiography: a systematic review Full Text available with Trip Pro

Diagnosis of pulmonary embolism with CT pulmonary angiography: a systematic review Diagnosis of pulmonary embolism with CT pulmonary angiography: a systematic review Diagnosis of pulmonary embolism with CT pulmonary angiography: a systematic review Hogg K, Brown G, Dunning J, Wright J, Carley S, Foex B, Mackway-Jones K CRD summary The authors concluded that there was insufficient evidence to determine the accuracy of computed tomographic (CT) pulmonary angiography for diagnosing pulmonary (...) embolism (PE), but negative CT in combination with negative examination for deep vein thrombosis can exclude PE. This was a well-conducted and clearly reported review and the conclusions, though based on a small number of patients, are likely to be reliable. Authors' objectives To assess the diagnostic accuracy of computed tomographic (CT) pulmonary angiography and the prognostic value of a negative result in the diagnosis of pulmonary embolism (PE). Searching MEDLINE and EMBASE were searched from

2006 DARE.