1138: Diagnosing pulmonary embolism in pregnancy: a cost-minimization analysis

The optimal approach to diagnosing pulmonary embolism (PE) in pregnancy is uncertain. Two studies published in the last year (Righini and YEARS) have recommended using D-dimer as an initial screening tool. In the Righini protocol, this was followed by compression ultrasound (CUS), CT pulmonary angiography (CTPA) and ventilation-perfusion scan (V/Q) as needed. The aim of this study was to determine which strategy for diagnosis of PE is least costly in pregnant women presenting with clinically suspected PE and a low-intermediate probability revised Geneva score.
Source: American Journal of Obstetrics and Gynecology - Category: OBGYN Authors: Tags: Poster Session V Source Type: research

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RARITAN, NJ, March 28, 2020 – The Janssen Pharmaceutical Companies of Johnson &Johnson today announced the VOYAGER PAD study met its primary efficacy and principal safety endpoints, demonstrating the XARELTO® (rivaroxaban) vascular dose (2.5 mg twice daily) plus aspirin (100 mg once daily) was superior to aspirin alone in reducing the risk of major adverse limb and cardiovascular (CV) events by 15 percent in patients with symptomatic peripheral artery disease (PAD) after lower-extremity revascularization, with similar rates of TIMI[1] major bleeding. VOYAGER PAD is the only study to show a significant benefit...
Source: Johnson and Johnson - Category: Pharmaceuticals Tags: Innovation Source Type: news
RARITAN, N.J., March 20, 2020 – The Janssen Pharmaceutical Companies of Johnson &Johnson announced today that it will unveil late-breaking data from its leading cardiovascular and metabolism portfolio during the virtual American College of Cardiology’s 69th Annual Scientific Session together with the World Congress of Cardiology (ACC.20/WCC) on March 28-30, 2020. Notably, four late-breaking abstracts for XARELTO® (rivaroxaban) will be presented, including data from the Phase 3 VOYAGER PAD study in patients with symptomatic peripheral artery disease (PAD) after lower-extremity revascularization.Click to ...
Source: Johnson and Johnson - Category: Pharmaceuticals Source Type: news
Maurine Stuart credits the Affordable Care Act (ACA) for saving her family. In 2014, Stuart was diagnosed with HELLP syndrome, a rare disease that causes heart, liver and lymphatic problems. As a result, she was unable to continue working full time—which meant losing her employer-sponsored health insurance. But thankfully, she says, that same year, her home state of West Virginia opted in to the 2010 Affordable Care Act’s Medicaid-coverage expansion, and she qualified. Over the next few years, as bad news kept rolling in, ACA protections continued to keep Stuart’s family afloat. When Stuart was diagnosed ...
Source: TIME: Health - Category: Consumer Health News Authors: Tags: Uncategorized Source Type: news
Abstract Point-of-care ultrasonography (POCUS) is performed by a physician at the bedside and is standard practice in obstetric, emergency, and musculoskeletal medicine. When compared with formal sonography, POCUS is equivalent in screening for abdominal aortic aneurysm and as accurate in diagnosing deep venous thrombosis. POCUS has high accuracy for diagnosing pneumonia and detecting acute decompensated heart failure but is less accurate than computed tomography for identifying pulmonary embolism. POCUS confirmation of intrauterine pregnancy rules out an ectopic pregnancy. In the third trimester of high-risk preg...
Source: American Family Physician - Category: Primary Care Authors: Tags: Am Fam Physician Source Type: research
Publication date: March 2020Source: The Lancet Haematology, Volume 7, Issue 3Author(s): Stuart L Cohen, Chinara Feizullayeva, John A McCandlish, Pina C Sanelli, Thomas McGinn, Benjamin Brenner, Alex C Spyropoulos
Source: The Lancet Haematology - Category: Hematology Source Type: research
Authors: Nourollahpour Shiadeh M, Cassinerio E, Modarres M, Zareiyan A, Hamzehgardeshi Z, Behboodi Moghadam Z Abstract β-thalassaemia major (BTM) has a high prevalence worldwide and is associated with considerable morbidity and mortality. The aim of this review is to provide an illustrative overview of the reproductive health and pregnancy related issues in females with β-thalassaemia. A literature search was performed in four international databases (1980-2018) to identify the potentially relevant articles. Common reproductive health disorders are hypo-gonadotrophic hypogonadism, infertility, delayed or ...
Source: Journal of Obstetrics and Gynaecology - Category: OBGYN Tags: J Obstet Gynaecol Source Type: research
Publication date: Available online 22 January 2020Source: Revista Española de Cardiología (English Edition)Author(s): Ernesto Valero, Jessika González-D’Gregorio, Nieves Carbonell, Mónica García-Simón, José Ferreres, Juan Sanchis
Source: Revista Espanola de Cardiologia - Category: Cardiology Source Type: research
Authors: Sucker C Abstract Venous thromboembolisms and pulmonary embolisms are one of the main causes of morbidity and mortality in pregnancy. The increased risk of thrombotic events caused by the physiological changes during pregnancy alone does not justify any medical antithrombotic prophylaxis. However, if there are also other risk factors such as a history of thromboses, hormonal stimulation as part of fertility treatment, thrombophilia, increased age of the pregnant woman, severe obesity or predisposing concomitant illnesses, the risk of thrombosis should be re-evaluated - if possible by a coagulation speciali...
Source: Geburtshilfe und Frauenheilkunde - Category: OBGYN Tags: Geburtshilfe Frauenheilkd Source Type: research
PERIPARTUM CARDIAC complications account for 41% of all maternal deaths in the United States.1 In parturients with cardiogenic shock from peripartum cardiomyopathy, amniotic fluid embolism, and pulmonary emboli, mechanical circulatory support (MCS) devices are increasingly used. Such devices include intra-aortic balloon pumps (IABP), veno-venous and veno-arterial extracorporeal membrane oxygenation (ECMO), left ventricular assist devices, and paracorporeal ventricular assist devices (PVAD).2-4 Respiratory syndromes exacerbated by pregnancy, such as influenza-induced acute respiratory distress syndrome, are also potentially...
Source: Journal of Cardiothoracic and Vascular Anesthesia - Category: Anesthesiology Authors: Tags: Original Research Source Type: research
AbstractPurposeThe purpose of this study is to determine the rates of CT pulmonary angiography (CTPA) interpreted as limited and severely limited in pregnant patients suspected for pulmonary embolism (PE), and to evaluate factors that influence these rates.MethodsThis is a retrospective study with CTPA for evaluation of PE in pregnancy across a large health system from 2006 to 2017. CTPA was classified as limited from the radiology report with a subset of those studies classified as severely limited. Bivariate and multivariate analysis was performed for limited and severely limited rates with maternal age and patient size ...
Source: Emergency Radiology - Category: Emergency Medicine Source Type: research
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