Database : MEDLINE
Search on : Pulmonary and Embolism [Words]
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[PMID]: 29099425
[Au] Autor:Grobben RB; van Waes JAR; Leiner T; Peelen LM; de Borst GJ; Vogely HC; Grobbee DE; Doevendans PA; van Klei WA; Nathoe HM; CHASE Investigators
[Ad] Address:From the Departments of *Cardiology, †Anesthesiology, ‡Radiology, §Epidemiology, Julius Center for Health Sciences and Primary Care, ‖Vascular Surgery, and ¶Orthopedic Surgery, University Medical Center Utrecht, Utrecht, the Netherlands.
[Ti] Title:Unexpected Cardiac Computed Tomography Findings in Patients With Postoperative Myocardial Injury.
[So] Source:Anesth Analg;, 2017 Nov 01.
[Is] ISSN:1526-7598
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Postoperative myocardial injury (PMI) is a strong predictor of mortality after noncardiac surgery. PMI is believed to be attributable to coronary artery disease (CAD), yet its etiology is largely unclear. We aimed to quantify the prevalence of significant CAD in patients with and without PMI using coronary computed tomography angiography (CCTA). METHODS: This prospective cohort study included patients of 60 years or older without a history of cardiac disease and with and without PMI after intermediate- to high-risk noncardiac surgery. PMI was defined as any serum troponin I level ≥60 ng/L on the first 3 postoperative days. Main exclusion criteria were known cardiac disease and postoperative ischemic symptoms or electrocardiography abnormalities. Noninvasive imaging consisted of a postoperative CCTA. Main outcome was CAD defined as >50% coronary stenosis on CCTA. RESULTS: The analysis included 66 patients. Median peak troponin levels in the PMI (n = 46) and control group (n = 20) were 150 (interquartile range, 120-298) vs 15 (interquartile range, 10-31) ng/L (P < .01). CAD was found in 23 patients with PMI (50%) versus 3 without PMI (15%; relative risk, 3.3; 95% confidence interval, 1.1-9.8). Remarkably, pulmonary embolism was present in 15 patients with PMI (33%) versus in 4 without PMI (20%; relative risk, 1.6; 95% confidence interval, 0.6-4.3). None of the patients died within 30 days. CONCLUSIONS: In patients without a history of cardiac disease, PMI after noncardiac surgery was associated with CAD. In addition, a clinically silent pulmonary embolism was found in one-third of patients with PMI. This urges further research to improve clinical workup using imaging and may have important clinical implications.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1711
[Cu] Class update date: 171103
[Lr] Last revision date:171103
[St] Status:Publisher
[do] DOI:10.1213/ANE.0000000000002580

  2 / 48532 MEDLINE  
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[PMID]: 29097743
[Au] Autor:Ji QY; Wang MF; Su CM; Yang QF; Feng LF; Zhao LY; Fang SY; Zhao FH; Li WM
[Ad] Address:Department of Respiratory, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, Zhejiang, 322100, China.
[Ti] Title:Clinical symptoms and related risk factors in pulmonary embolism patients and cluster analysis based on these symptoms.
[So] Source:Sci Rep;7(1):14887, 2017 Nov 02.
[Is] ISSN:2045-2322
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:Pulmonary embolism (PE) remains largely underdiagnosed due to nonspecific symptoms. This study aims to evaluate typical symptoms of PE patients, their related predictors, and to differentiate typical clusters of patients and principal components of PE symptoms. Clinical data from a total of 551 PE patients between January 2012 and April 2016 were retrospectively reviewed. PE was diagnosed according to the European Society of Cardiology Guidelines. Logistic regression models, system clustering method, and principal component analysis were used to identify potential risk factors, different clusters of the patients, and principal components of PE symptoms. The most common symptoms of PE were dyspnea, cough, and tachypnea in more than 60% of patients. Some combined chronic conditions, laboratory and clinical indicators were found to be related to these clinical symptoms. Our study also suggested that PE is associated with a broad list of symptoms and some PE patients might share similar symptoms, and some PE symptoms were usually cooccurrence. Based on ten symptoms generated from our sample, we classified the patients into five clusters which represent five groups of PE patients during clinical practice, and identified four principal components of PE symptoms. These findings will improve our understanding of clinical symptoms and their potential combinations which are helpful for clinical diagnosis of PE.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1711
[Cu] Class update date: 171103
[Lr] Last revision date:171103
[St] Status:In-Data-Review
[do] DOI:10.1038/s41598-017-14888-7

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[PMID]: 29097086
[Au] Autor:Schomburg J; Krishna S; Soubra A; Cotter K; Fan Y; Brown G; Konety B
[Ad] Address:Department of Urology, University of Minnesota, Minneapolis, MN.
[Ti] Title:Extended outpatient chemoprophylaxis reduces venous thromboembolism after radical cystectomy.
[So] Source:Urol Oncol;, 2017 Oct 30.
[Is] ISSN:1873-2496
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:PURPOSE: Venous thromboembolism (VTE), including deep venous thrombosis (DVT) and pulmonary embolism, is a common cause of morbidity and mortality after radical cystectomy. The purpose of our study was to evaluate the utility of extended outpatient chemoprophylaxis against VTE after radical cystectomy-with a focus on any reduction in the incidence of VTE, including DVT and pulmonary embolism. MATERIALS AND METHODS: Beginning in April 2013, we prospectively instituted a policy of extending inpatient VTE prophylaxis with subcutaneous heparin/enoxaparin for 30 days postoperatively. For this study, we reviewed the electronic medical records of all patients who underwent radical cystectomy at our institution from January 2012 through December 2015. The experimental group (n = 79) received extended outpatient chemoprophylaxis against VTE; the control group (n = 51) received no chemoprophylaxis after discharge. The primary outcome was the 90-day incidence of VTE. The secondary outcomes included the overall complication rate, the hemorrhagic complication rate, as well as the rate of readmission within 30 days of hospital discharge. RESULTS: The experimental group experienced a significantly lower rate of DVT (5.06%), assessed as of 90 days postoperatively, than the control group (17.6%): a relative risk reduction of 71.3% (P = 0.021). We found no significant differences in secondary outcomes between the 2 groups, including the overall complication rate (54.4% vs. 68.6%), the hemorrhagic complication rate (3.7% vs. 2.0%), and the readmission rate (21.5% vs. 29.4%). CONCLUSION: Extended outpatient chemoprophylaxis significantly reduced the incidence of VTE.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1711
[Cu] Class update date: 171103
[Lr] Last revision date:171103
[St] Status:Publisher

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[PMID]: 29096931
[Au] Autor:Scagliola R
[Ad] Address:Cardiovascular Disease Unit, IRCCS AOU San Martino - IST, Department of Internal Medicine, University of Genova, Genova, Italy. Electronic address: risca88@live.it.
[Ti] Title:ST-elevation in massive acute pulmonary embolism during hemodynamic instability.
[So] Source:J Electrocardiol;, 2017 Oct 19.
[Is] ISSN:1532-8430
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Electrocardiogram (ECG) is one of the first procedures performed in the initial assessment of patients with suspected pulmonary embolism (PE), although one of its main advantages is in suspecting alternative clinical conditions, including acute coronary syndrome (ACS). ST-elevation remains an uncommon ECG pattern in PE. Cardiac ultrasound can help to the differential diagnosis from ACS and to a fast detection of acute right ventricle (RV) overload. In the presence of hemodynamic instability, with ECG signs of RV strain and concomitant ST-elevation, massive PE should be suspected as shown in the present case report.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1711
[Cu] Class update date: 171103
[Lr] Last revision date:171103
[St] Status:Publisher

  5 / 48532 MEDLINE  
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[PMID]: 29096902
[Au] Autor:Aubry P; Demian H; Brochet E; Juliard JM
[Ad] Address:Département de cardiologie, groupe hospitalier Bichat-Claude-Bernard, Assistance publique-Hôpitaux de Paris, 46, rue Henri-Huchard, 75018 Paris, France; Service de cardiologie, centre hospitalier de Gonesse, 95500 Gonesse, France. Electronic address: pcaubry@yahoo.fr.
[Ti] Title:Embolie paradoxale : mythe ou réalité ? [Paradoxical embolism: Myth or reality?]
[So] Source:Ann Cardiol Angeiol (Paris);, 2017 Oct 30.
[Is] ISSN:1768-3181
[Cp] Country of publication:France
[La] Language:fre
[Ab] Abstract:Paradoxical embolism should be suspected in front of a clinical phenomenon of thromboembolism associated with an anatomical right-to-left shunt. Others potential cardiac sources of thromboembolism must be ruled out. Strokes constitute the most frequent clinical manifestations of paradoxical embolism. Right-to-left left shunts are in connection with intracardiac defects (atrial septal defect and patent foramen ovale) or pulmonary arteriovenous malformations. The probability that a discovered PFO is stroke-related can be evaluated by a score. Therapeutic approaches for secondary prevention of recurrent stroke include antithrombotic and/or percutaneous treatments. The choice strategy begins to be clearer with the recent results of randomized controlled studies.
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1711
[Cu] Class update date: 171103
[Lr] Last revision date:171103
[St] Status:Publisher

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[PMID]: 29096812
[Au] Autor:Weitz JI; Fredenburgh JC; Eikelboom JW
[Ad] Address:Department of Medicine, McMaster University, Hamilton, Ontario, Canada; Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, Ontario, Canada; Thrombosis and Atherosclerosis Research Institute, McMaster University, Hamilton, Ontario, Canada. Electronic address: weitzj@taari.ca.
[Ti] Title:A Test in Context: D-Dimer.
[So] Source:J Am Coll Cardiol;70(19):2411-2420, 2017 Nov 07.
[Is] ISSN:1558-3597
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:D-dimer is a soluble fibrin degradation product that results from ordered breakdown of thrombi by the fibrinolytic system. Numerous studies have shown that D-dimer serves as a valuable marker of activation of coagulation and fibrinolysis. Consequently, D-dimer has been extensively investigated for the diagnosis of venous thromboembolism (VTE) and is used routinely for this indication. In addition, D-dimer has been evaluated for determining the optimal duration of anticoagulation in VTE patients, for diagnosing and monitoring disseminated intravascular coagulation, and as an aid in the identification of medical patients at high risk for VTE. Thus, quantification of D-dimer levels serves an important role in guiding therapy. This review: 1) describes how D-dimer is generated; 2) reviews the assays used for its detection; and 3) discusses the role of D-dimer determination in these various conditions.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1711
[Cu] Class update date: 171103
[Lr] Last revision date:171103
[St] Status:In-Process

  7 / 48532 MEDLINE  
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[PMID]: 29096745
[Au] Autor:Wei H; Ma X
[Ad] Address:Department of Spinal surgery, China-Japan Friendship Hospital, Beijing, China.
[Ti] Title:Application of unilateral multiple channels approach in percutaneous vertebroplasty for osteoporotic vertebral fractures.
[So] Source:Cell Mol Biol (Noisy-le-grand);63(10):69-73, 2017 Oct 31.
[Is] ISSN:1165-158X
[Cp] Country of publication:France
[La] Language:eng
[Ab] Abstract:This study aimed to investigate the application valuable of percutaneous vertebroplasty (PVP) with unilateral multiple channels approach in osteoporotic vertebral fractures patients. A retrospective review was conducted on 685 consecutive patients with osteoporotic vertebral fracture from March 2003 to October 2012. Among them, 82 cases were given PVP procedure by unilateral multiple channels approach. The timing of surgery, bone cements injection, and complications were analyzed. By using the X-ray film, the distribution of cement was detected and scored. The visual analogue scale (VAS) score and Oswestry disability index (ODI) system were used to evaluate the pain relief and improvement of daily activity function after operation. The excellent and good rate of cement distribution was 98.8% (98/99). Before surgery, the VAS score was 2.5±0.43. After surgery, the VAS score was significantly decreased to 2.0±0.33 at 1 h. Before surgery, ODI was 40.94±2.72. ODI was significantly decreased at 1 month after surgery (9.64±2.60) and at the final follow-up (7.77±2.15).  No spine or nerve injury, bone cement leakage, pulmonary embolism, pneumothorax, bleeding or infection occurred intraoperatively. Thus, the PVP with unilateral multiple channels approach effectively relieve the pain and improve the functional activity, without occurrence of complications.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1711
[Cu] Class update date: 171103
[Lr] Last revision date:171103
[St] Status:In-Process
[do] DOI:10.14715/cmb/2017.63.10.11

  8 / 48532 MEDLINE  
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[PMID]: 29096590
[Au] Autor:Sammel AM; Fung S; Omari A
[Ad] Address:1 St Vincent's Hospital Sydney, Sydney, Australia.
[Ti] Title:Non-thrombotic pulmonary artery embolism - Don't forget the differential.
[So] Source:Vasc Med;:1358863X17739145, 2017 Nov 01.
[Is] ISSN:1477-0377
[Cp] Country of publication:England
[La] Language:eng
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1711
[Cu] Class update date: 171103
[Lr] Last revision date:171103
[St] Status:Publisher
[do] DOI:10.1177/1358863X17739145

  9 / 48532 MEDLINE  
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[PMID]: 29093471
[Au] Autor:Lee W; Lee S; Choi J; Park JH; Kim KM; Jee JG; Bae JS
[Ad] Address:College of Pharmacy, CMRI, Research Institute of Pharmaceutical Sciences, BK21 Plus KNU Multi-Omics based Creative Drug Research Team, Kyungpook National University, Daegu, 41566, Republic of Korea.
[Ti] Title:Antithrombotic properties of JJ1, a potent and novel thrombin inhibitor.
[So] Source:Sci Rep;7(1):14862, 2017 Nov 01.
[Is] ISSN:2045-2322
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:The development of new anticoagulants is an important goal for the improvement of thrombosis treatment. Recent studies have suggested the importance of thrombin inhibitors in the modulation of thromboembolic disorders. The aim of this study was to discover a new small-molecule thrombin inhibitor. In this study, the compound JJ1, which has a novel scaffold, was selected by structure-based docking simulation to determine its potential inhibitory activity against thrombin. JJ1 was shown to inhibit the catalytic activity of human α-thrombin with a K of 0.019 µM by direct binding to the active site and with at least 10,000-fold selectivity relative to that reported for the inhibition of other biologically important serine proteases. JJ1 prolonged clotting times (activated partial thromboplastin time and prothrombin time) and inhibited the activity and production of thrombin. Furthermore, it inhibited thrombin-catalyzed fibrin polymerization and platelet aggregation. Similar to its in vitro antithrombotic activities, JJ1 showed enhanced antithrombotic effects in an in vivo pulmonary embolism and arterial thrombosis model. It also exhibited anticoagulant effects in mice. Collectively, these results demonstrated that JJ1 was a potent, direct, and selective thrombin inhibitor that may be useful in the management of various thrombotic disorders.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1711
[Cu] Class update date: 171102
[Lr] Last revision date:171102
[St] Status:In-Data-Review
[do] DOI:10.1038/s41598-017-13868-1

  10 / 48532 MEDLINE  
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[PMID]: 29093435
[Au] Autor:Giofrè MC; Napoli F; La Rosa D; Caruso A; Laganà N; Orlando Settembrini L; Saitta A; Versace AG
[Ad] Address:Department of Clinical and Experimental Medicine, Azienda Ospedaliera Universitaria - Policlinico "G. Martino", Messina, Italy.
[Ti] Title:Recurrent Thrombosis: A Case of Hereditary Thromboembolism.
[So] Source:Am J Case Rep;18:1157-1159, 2017 Nov 02.
[Is] ISSN:1941-5923
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND Thrombophilia is a predisposition to thrombosis. Genetic causes include antithrombin III, protein C, protein S, factor V Leiden, prothrombin 20210A allele, and MTHFR mutations. Other genetic factors causing thrombosis and pulmonary embolism have been identified in recent studies, including 4G/4G polymorphism of the PAI-1 gene. CASE REPORT A patient with a personal and family history of recurrent thrombosis and pulmonary embolism was admitted to our Internal Medicine Department. After the most common acquired risk factors for thromboembolism were ruled out, the patient and her family members underwent genetic diagnostic testing. These tests showed homozygous 4G/4G polymorphism of the PAI-1 gene in 14 subjects, homozygous 4G/4G polymorphism of the PAI-1 gene and C677T/A1298C polymorphism of the MTHFR gene in 4 subjects, and heterozygous 4G/4G polymorphism of the PAI-1 gene and C677T/A1298C polymorphism of the MTHFR gene in 3 subjects. Afterwards, we initiated the administration of Rivaroxaban, with beneficial results. CONCLUSIONS No thrombotic recurrence has been observed in the patient since 2014. This case report shows the efficacy and superiority of Rivaroxaban over traditional anticoagulants in the treatment of hereditary thrombophilia. Further studies are clearly needed before Rivaroxaban can be recommended as a standard treatment in patients with inherited thrombophilia.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1711
[Cu] Class update date: 171102
[Lr] Last revision date:171102
[St] Status:In-Process


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