Usefulness of predictive models of pulmonary embolism: Experience in real-world clinical practice in a regional hospital.

CONCLUSIONS: The current diagnostic models for PE lead to a large number of unnecessary explorations. The new models could reduce the number of APTC although with a minimum risk of false negatives. PMID: 31780215 [PubMed - as supplied by publisher]
Source: Medicina Clinica - Category: General Medicine Tags: Med Clin (Barc) Source Type: research

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Abstract Pulmonary embolism (PE) is a condition characterised by an obstruction of the pulmonary arterial system by one or more emboli. Advanced clinical practitioners are often faced with ruling out a diagnosis of PE in patients with non-specific symptoms such as dyspnoea and pleuritic chest pain, which can be fairly mild and therefore a diagnosis of PE easily missed. PEs can be a challenge to diagnose, especially in elderly people, since it can be difficult to differentiate their symptoms from other less serious illnesses. Widely used scoring tools are helpful to calculate a patient's probability of having a PE....
Source: British Journal of Nursing - Category: Nursing Authors: Tags: Br J Nurs Source Type: research
Conclusion: IFs were detected in the majority of patients that underwent CTPA. Most of these findings do not require follow-up or treatment. However, more than 50% of cases may require further diagnostic evaluation (40.1%) or immediate treatment (13.3%). PMID: 31875214 [PubMed]
Source: Accident and Emergency Nursing - Category: Emergency Medicine Authors: Tags: Arch Acad Emerg Med Source Type: research
Rationale: Pulmonary embolisms (PEs) are caused by emboli, which mostly originate from deep venous thrombi that travel to and suddenly block the pulmonary arteries. The emboli are usually thrombi, and right atrial myxoma emboli are rare. Patient concerns: A 55-year-old man presented with shortness of breath and syncope. We proceeded with computed tomography pulmonary angiography (CTPA) and transthoracic echocardiogram (TTE), the results of which suggested that the diagnosis was a right atrial mass. Diagnosis: A definitive diagnosis compatible with a right atrial myxoma (RAM) with tumoral pulmonary emboli after surg...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
AbstractOur knowledge about the incidence of pulmonary embolism (PE) and the performance of age adjusted D-dimers (Dd) cutoff amongst patients with lung cancer (LC) and suspected PE, remains limited. We retrospectively analyzed all clinically suspected patients who underwent computed tomography pulmonary angiography (CTPA) in a tertiary hospital during a 19  month period. Cancer diagnosis was established using ICD10 code. Eligible for Dd analysis were those tested up to 24 h prior to the scan. We analyzed 2549 patients (54.6% males, median age 68.8 years, IQR 57–78), 15.8% had active LC and 5.4% other ...
Source: Journal of Thrombosis and Thrombolysis - Category: Hematology Source Type: research
Conclusion: Although attention to thrombosis risk factors, clinical symptoms, and laboratory findings, can be helpful in screening patients with suspected PE, considering the ability of CT scan in confirming or ruling out other possible differential diagnoses, it seems that a revision should be done to lower the threshold of ordering this diagnostic modality for suspected cases. PMID: 31555771 [PubMed]
Source: Accident and Emergency Nursing - Category: Emergency Medicine Authors: Tags: Arch Acad Emerg Med Source Type: research
First description in the literature of incidental saddle pulmonary embolus diagnosed on18F ‐labelled fluoro‐2‐deoxyglucose positron emission tomography/computed tomography by seeing pulmonary infarction and right‐sided myocardial uptake. This will alert clinicians about the importance of these signs and direct emergent of further investigation and therapy. 18F ‐labelled fluoro‐2‐deoxyglucose positron emission tomography/computed tomography (18F ‐FDG PET/CT) is used extensively in the setting of cancer staging and in assessing cancer treatment response. Oncology patients have a sevenfold risk of developing p...
Source: Respirology Case Reports - Category: Respiratory Medicine Authors: Tags: Case Report Source Type: research
(Abstracted from N Engl J Med 2019;380:1139–1149) Acute pulmonary embolism is one of the leading causes of maternal death, with the overall incidence reported to be 1.72 cases per 1000 deliveries, accounting for approximately 1 death in every 100,000 deliveries. Since the D-dimer test has low specificity and sensitivity, it is common for pregnant women with suspected pulmonary embolism to undergo computed tomography (CT) pulmonary angiography or ventilation-perfusion (V/Q) scanning, both of which involve radiation exposure to the mother and fetus.
Source: Obstetrical and Gynecological Survey - Category: OBGYN Tags: OBSTETRICS: MEDICAL COMPLICATIONS OF PREGNANCY Source Type: research
AbstractPurpose of ReviewThe purpose of this article is to review the imaging findings and current imaging techniques of acute pulmonary embolism (PE) and chronic thromboembolic disease. Special considerations are also discussed, including pregnancy, congenital heart disease, lower extremity computed tomography (CT), and the isolated subsegmental PE.Recent FindingsCT pulmonary angiography and planar ventilation/perfusion (V/Q) lung scintigraphy are the primary means of evaluating pulmonary embolic disease. Magnetic resonance angiography avoids ionizing radiation and iodinated contrast in select patients. V/Q SPECT/CT provi...
Source: Current Respiratory Care Reports - Category: Respiratory Medicine Source Type: research
Authors: Kruger PC, Eikelboom JW, Douketis JD, Hankey GJ Abstract Pulmonary embolism (PE) is a potentially life-threatening condition, mandating urgent diagnosis and treatment. The symptoms of PE may be non-specific; diagnosis therefore relies on a clinical assessment and objective diagnostic testing. A clinical decision rule can determine the pre-test probability of PE. If PE is "unlikely", refer for a D-dimer test. If the D-dimer result is normal, PE can be excluded. If D-dimer levels are increased, refer for chest imaging. If PE is "likely", refer for chest imaging. Imaging with computed tomo...
Source: Medical Journal of Australia - Category: General Medicine Tags: Med J Aust Source Type: research
Conclusions: In this pilot study, we have demonstrated the feasibility and potential utility of V/Q PET/CT for the management of patients with suspected acute PE. V/Q PET/CT may be of particular relevance in cases of equivocal findings or isolated subsegmental findings on CTPA, adding further discriminatory information to allow important decision-making regarding application or withholding of treatment courses of therapeutic anticoagulation, which may confer an increased risk of bleeding. Given the other advantages of V/Q PET/CT (reduced acquisition time, low radiation dose), and with increasing availability of 68Ga-genera...
Source: Journal of Nuclear Medicine - Category: Nuclear Medicine Authors: Tags: Outcomes/Infectious Disease/Pulmonary II Source Type: research
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