What Are the Parameters That Should Inform Gestalt as a Clinical Decision Strategy for Pulmonary Embolism?

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.
Source: The American Journal of Medicine - Category: General Medicine Authors: Tags: Letter Source Type: research

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We report a 36-year-old woman in Iran who sought care for left shoulder pain and cough 5 days after a scheduled cesarean section. Acute pulmonary embolism and coronavirus disease were diagnosed. Physicians should be aware of the potential for these concurrent conditions in postpartum women. PMID: 32396506 [PubMed - indexed for MEDLINE]
Source: Emerging Infectious Diseases - Category: Infectious Diseases Authors: Tags: Emerg Infect Dis Source Type: research
Written by Pendell MeyersA man in his sixties with no prior history of CAD presented with fluctuating central chest pain that started the night before presentation, then went away, then woke him up from sleep the morning of presentation. The pain was 10/10 on arrival, with SOB. Although he also had some nasal drip and sore throat, he had no cough or fevers (this occurred during peak COVID).Here is his triage ECG:What do you think?Normal P-waves would have upright morphology in the inferior leads (especially lead II) and usually biphasic (up-down) morphology in V1. These p-waves are negative in almost all leads except for a...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
We present a case of primary pulmonary arterial sarcoma (PPAS) treated with endostatin (endostar) injection and radiotherapy  discuss the diagnosis, clinical manifestations, and pathology of PPAS. The patient complained of cough with sputum, fever, and chest pain with hemoptysis. Numerous nodules were observed in the computed tomography (CT) scan. The patient was diagnosed with pulmonary embolism (PE) by computed tomography pulmonary angiography (CTPA). The pathology and immunohistochemistry results indicated soft tissue sarcomas, indicative of angiosarcoma. The nodules shrunk after 5 courses of endostatin and one cou...
Source: Saudi Medical Journal - Category: Middle East Health Tags: Saudi Med J Source Type: research
Authors: Xu H, Yang W, Wu C Abstract A case of primary pulmonary arterial sarcoma (PPAS) treated with Endostar injection and radiotherapy and discuss the diagnosis, clinical characteristics, and pathology of PPAS. The patient complained of cough, sputum, fever, and chest pain with hemoptysis. Numerous nodules were seen in the computed tomography scan. The patient was diagnosed as pulmonary embolism (PE) by computed tomography pulmonary angiography. The pathology and immunohistochemistry results indicated soft tissue sarcomas, indicative of angiosarcoma. The nodules shrunk after 5 courses of endostatin and one cours...
Source: Saudi Medical Journal - Category: Middle East Health Tags: Saudi Med J Source Type: research
Abstract A COVID-19-positive patient presented with pleuritic chest pain and cough and was found to have acute pulmonary embolisms (APEs). There has been an increase in observational reports of venous thromboembolic events in patients who are positive for COVID-19, especially in the setting of elevated inflammatory markers. The possibility of COVID-19 as an independent risk factor for APEs should be further explored in this novel pandemic. PMID: 32670476 [PubMed - in process]
Source: Methodist DeBakey Cardiovascular Journal - Category: Cardiology Authors: Tags: Methodist Debakey Cardiovasc J Source Type: research
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
Authors: Underner M, Peiffer G, Perriot J, Jaafari N Abstract Cocaine can be responsible for many psychiatric and/or somatic disorders. The aim of this systematic literature review of data was to expose relations between cocaine use and pulmonary complications. Cocaine can be responsible for acute respiratory symptoms (cough, black sputum, hemoptysis, dyspnea, wheezing, chest pain) and for various pulmonary disorders including barotrauma (pneumothorax, pneumomediastinum, subcutaneous emphysema, pneumopericardium), airway damage, asthma, bronchiolitis obliterans with organizing pneumonia, acute pulmonary edema, alve...
Source: Revue des Maladies Respiratoires - Category: Respiratory Medicine Tags: Rev Mal Respir Source Type: research
Pulmonary thromboembolism (PE) causes high morbidity and mortality. Due to limited information about the disease in our country, information from others must often be used. That is why we conducted a prospective observational study on the epidemiology of PE treated in a high complexity hospital from Colombia.A search of the scientific literature was carried out finding several initiatives and only two previous local ones. A review of the risk factors, clinical presentation, diagnostic process, treatment, complications and prognosis of the disease was used to construct the tool for data collection in the RedCap program. Bet...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Pulmonary embolism Source Type: research
We present our 4 years experience on this subject. SUBJECTS AND METHODS: We retrospectively studied 2178 lung perfusion scintigraphies (LPS). Of them 1846 were performed to patients suspected for APE admitted to the emergency departments of the University Polyclinic of Bari and examined immediately by our Nuclear Medicine Department. Contingency tables and odds ratio (OR) were used to estimate the relation between symptoms, risk factors, D-dimers dosage, other imaging diagnostic tools and LPS results. RESULTS: Lung perfusion scintigraphy was positive for APE in 309/1846 (16.7%) patients which then were treated succ...
Source: Hellenic Journal of Nuclear Medicine - Category: Nuclear Medicine Tags: Hell J Nucl Med Source Type: research
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