The diagnosis and management of pulmonary embolism.

The diagnosis and management of pulmonary embolism. Br J Nurs. 2020 Jan 09;29(1):22-26 Authors: Toplis E, Mortimore G 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. The Wells score is the most widely used pre-test clinical probability indicator of PE used in the UK, which scores the patient's probability of having a PE based on their risk factors. The D-dimer test is a relatively simple investigation to rule out venous thromboembolism (VTE) but can be raised for various reasons other than PE. Computed tomography pulmonary angiography (CTPA) is regarded as the gold standard imaging modality for investigation of acute PE but ventilation-perfusion (VQ) scans can be used as an alternative imaging technique for diagnosing PE in those where CTPA is contraindicated. Thrombolysis is underused in clinical practice due to the fear of adverse bleeding events. Patients without a massive or sub-massive ...
Source: British Journal of Nursing - Category: Nursing Authors: Tags: Br J Nurs Source Type: research

Related Links:

Publication date: March 2020Source: Journal of Vascular Surgery: Venous and Lymphatic Disorders, Volume 8, Issue 2Author(s): Daniel Myers, Patrick Lester, Reheman Adili, Angela Hawley, Laura Durham, Veronica Dunivant, Garrett Reynolds, Kiley Crego, Zoe Zimmerman, Suman Sood, Robert Sigler, William Fogler, John Magnani, Michael Holinstat, Thomas WakefieldAbstractObjectiveThere is an inter-relationship between thrombosis and inflammation. Previously, we have shown the importance of P-selectin in thrombogenesis and thrombus resolution in many preclinical animal models. The role of E-selectin has been explored in rodent models...
Source: Journal of Vascular Surgery: Venous and Lymphatic Disorders - Category: Surgery Source Type: research
Authors: Gong M, Zhao B, He X, Gu J, Chen G Abstract The aim of the present study was to investigate whether the rescue of thrombolysis with the recombinant tissue plasminogen activator (rt-PA) alteplase was an effective and safe therapeutic option in patients who did not respond to urokinase. Between February 2016 and February 2017, 26 patients with deep venous thrombosis (DVT) underwent rescue thrombolysis with alteplase. Unsuccessful thrombolysis with urokinase was defined as a lack of improvement in the degree of thrombotic removal with a lysis rate 3 million units of total urokinase, or>7 days infusion dura...
Source: Experimental and Therapeutic Medicine - Category: General Medicine Tags: Exp Ther Med Source Type: research
We present a case of a 68-year-old Hispanic female with a history of factor VII deficiency who presented with shortness of breath, chest pain, and palpitations and was found to have pulmonary embolism. Our patient did not have any of the above-mentioned thrombotic risk factors. Our case and review of the literature show that factor VII deficiency does not provide protection against thrombosis. PMID: 31590173 [PubMed - as supplied by publisher]
Source: Acta Haematologica - Category: Hematology Authors: Tags: Acta Haematol Source Type: research
r M Abstract OBJECTIVE: Fast track concepts are used to reduce the risk of perioperative and postoperative complications after total knee arthroplasty. INDICATIONS: The described concepts are used for patients with indications for the implantation of a total knee prosthesis. CONTRAINDICATIONS: Contraindications for fast track concepts are aged patients, dementia, American Society of Anesthesiologists (ASA) grade IV and implantation of large revision or tumor prostheses. Contraindications for tranexamic acid are bleeding in the urinary tract, caution in cases of known epilepsy, individual risk assessment ...
Source: Operative Orthopadie und Traumatologie - Category: Orthopaedics Authors: Tags: Oper Orthop Traumatol Source Type: research
Abstract Diagnosis of deep vein thrombosis (DVT) requires a multifaceted approach that includes clinical assessment, evaluation of pre-test probability, and objective diagnostic testing. Common symptoms and signs of DVT are pain, swelling, erythema and dilated veins in the affected limb. The pre-test probability of DVT can be assessed using a clinical decision rule that stratifies DVT into "unlikely" or "likely". If DVT is "unlikely", refer for D-dimer test. If the D-dimer level is normal, DVT can be excluded; if the D-dimer level is increased, refer for compression ultrasound. If DVT...
Source: Med J Aust - Category: General Medicine Authors: Tags: Med J Aust Source Type: research
Conclusion: Our findings describe the most reported risk factors for preventability of oral anticoagulant-induced bleedings. These factors may be useful for targeting interventions to improve pharmacovigilance activities in our regional territory and to reduce the burden of medication errors and inappropriate prescription. Introduction Oral anticoagulant therapy is widely used for the prevention of stroke and systemic embolism in patients with atrial fibrillation, or for the prevention and treatment of deep vein thrombosis and pulmonary embolism (Raj et al., 1994; Monaco et al., 2017). Oral anticoagulants can be di...
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
Individuals share about 99.97 percent of their DNA and only the remaining 0.03 percent is responsible for the differences in skin, hair or eye color, height, shoe size or sunspots. Scientists discovered somewhat recently that our bodies also metabolize drugs differently so it would make sense to prescribe medications based on the knowledge hidden in our DNA. In some cases, physicians already do that. Here’s what you need to know about pharmacogenomics and the future of prescription drugs. It’s all in your genes Why do some people eat creamy French cakes all the time, only do sports when they have to run after t...
Source: The Medical Futurist - Category: Information Technology Authors: Tags: Future of Pharma Genomics Medical Professionals Patients Researchers DNA dna testing drugs genetics Health Healthcare Innovation medication pharmacogenetics pharmacogenomics precision health precision medicine technology Source Type: blogs
A 77-year-old man with a history of coronary artery bypass grafting, deep vein thrombosis, and pulmonary embolism presented with acute-onset epigastric pain and bright red hematemesis. Medications included rivaroxaban and low-dose aspirin. He had no history of abdominal surgery. He was hemodynamically stable on admission. Initial laboratory tests included hemoglobin 10.8 g/dL, platelet count 201,000/mm3, creatinine 1.47 mg/dL, and prothrombin time 29.4 seconds.
Source: Clinical Gastroenterology and Hepatology - Category: Gastroenterology Authors: Tags: Electronic image of the month Source Type: research
(CNN) — In what researchers are calling “the largest genetic study ever performed” on varicose vein disease, a Stanford University School of Medicine study found a person’s height to be a significant risk factor for developing varicose veins. “We not only found an association between height and varicose veins, but the genetic studies we did showed a causal link,” said cardiologist and study author Dr. Nicholas Leeper, an associate professor of surgery and cardiovascular medicine at Stanford. “That suggests that the genes and pathways that drive human height are also likely to be ca...
Source: WBZ-TV - Breaking News, Weather and Sports for Boston, Worcester and New Hampshire - Category: Consumer Health News Authors: Tags: Health News Local TV Varicose Veins Source Type: news
Authors: Shimomura M, Kochi M, Hinoi T, Egi H, Adachi T, Kobayashi T, Tashiro H, Ohdan H Abstract Pharmacological prophylaxis was not routinely administrated following gastroenterological surgery because of concerns about bleeding complications. We tried to establish the original risk classification to determine the indication for pharmacological prophylaxis for selected patients at high risk of venous thromboembolism (VTE). One hundred and fifty-six consecutive patients who underwent lower abdominal elective surgery were divided into three groups (highest, high, and low risk groups) based on the original risk clas...
Source: Hiroshima Journal of Medical Sciences - Category: General Medicine Tags: Hiroshima J Med Sci Source Type: research
More News: Angiography | Bleeding | Coumadin | CT Scan | Nurses | Nursing | Pain | Pain Management | Perfusion | PET Scan | Pulmonary Thromboembolism | Thrombosis | UK Health | Warfarin