Isolated and early-onset cerebral fat embolism syndrome in a multiply injured patient: a rare case
Fat embolism syndrome (FES) is a rare complication that can occur between 12 and 72 h after the initial insult. Isolated cerebral FES without pulmonary symptoms is rarer. Early fracture fixation might prevent ...
Both acute myocardial infarction and acute pulmonary embolism are distinct medical urgencies while they may conincide. Leriche ’s syndrome is a relatively rare aortoiliac occlusive disease characterized by clau...
To examine the safety of therapeutic-dose anticoagulation during catheter-directed thrombolysis (CDT) for acute pulmonary embolism (PE).
We present a contemporary review summarizing the different catheter directed interventions currently available for acute PE, their indications, technical considerations, clinical effectiveness, complication rates and long-term outcomes.Expert opinion: For intermediate high-risk PE patients without a contraindication for thrombolysis, CDIs should be considered in patients at risk for clinical decompensation. For high risk PE patients with a major contraindication to thrombolytic therapy, suction thrombectomy can be considered in places with appropriate clinical and technical expertise. PMID: 31937150 [PubMed - as supplied by publisher]
The limitations of clinical decision rules1 are exemplified by the performance of the Wells criteria in primary care.2 The latter study enrolled 598 patients in whom the general practitioner considered that pulmonary embolism might be present. Suspicion of pulmonary embolism was based on the presence of 1 or more of the following symptoms: unexplained (sudden) dyspnea, deterioration in existing dyspnea, pleuritic pain, and unexplained cough. After recording the Wells score, the primary care doctor was required to refer the patient to secondary care for further evaluation.
In their review, St üssi-Helbling et al identify myths and realities related to evaluating patients with suspected acute pulmonary embolism.1 We agree that the clinical gestalt of experienced physicians has proven noninferior to standardized prediction scores but disagree that it is a subjective assessment enabling th e physician to make clinical decisions. Although important, we contend experience alone is insufficient for gestalt development. Here, we shed light on the path toward diagnostic expertise to illuminate gestalt acquisition.
Conclusions: Cannula-associated deep vein thrombosis after venovenous extracorporeal membrane oxygenation is a frequent complication. This plead for a systematic vascular axis imaging after venovenous extracorporeal membrane oxygenation. Thrombocytopenia is associated with a reduction in the occurrence of thrombotic events.
In routine clinical practice, in most countries, patients with pulmonary embolism (PE) are hospitalized for clinical surveillance and to start anticoagulant treatment. Clinical trials and guidelines suggest that patients with stable PE can be safely treated as outpatients. This shift in management may increase general practitioners' (GP) role in PE early management. However, GP opinion regarding PE home treatment has never been assessed.
Conclusion: Aneurysmal lesions are severe complications in BD. Pathergy reaction, arterial stenosis or occlusion, and arterial thrombosis are the risk factors of aneurysmal lesions in BD. Achieving BD remission and performing surgical or interventional procedures are both important in the treatment of these patients. PMID: 31930152 [PubMed - in process]
We present a retrospective review of 104 patients with an oncologic diagnosis who received intraoperative tranexamic acid during orthopedic surgery. Overall, complication rates were low, including deep vein thrombosis (1.0%), pulmonary embolism (4.8%), stroke (0%), and myocardial infarction (0%). This preliminary evidence shows that antifibrinolytics such as tranexamic acid may be considered perioperatively in oncology patients without increased risk of thromboembolic events; however, further prospective trials are encouraged.
Abstract Acute pulmonary embolism (PE) is one of the major causes of in-hospital mortality, and the short term PE prognosis is strongly related to its haemodynamic consequences. Therefore, a stepwise risk stratification approach has been proposed using a combination of clinical data, imaging, and biochemical markers, to define risk an early adverse outcome. Patients should be managed according to PE severity: some of them require urgent primary reperfusion, for most patients anticoagulation alone is sufficient, and selected low risk patients are potential candidates for early discharge and continuation...