检索结果-南通市图书馆

Saddle Pulmonary Embolism is not a sign of high-risk deterioration in non-high-risk patients: A propensity score-matched study

在线全文

学校读者我要写书评

暂无评论

World Journal of Emergency Medicine 2021年第4期12卷 261-267页

作者： Dong Jia Chao Ji Min Zhao Department of Emergency Medicine Shengjing Hospital of China Medical UniversityShenyang 110004China Department of Clinical Epidemiology Shengjing Hospital of China Medical UniversityShenyang 110004China

BACKGROUND: There is controversy regarding whether saddle main pulmonary artery(MPA) embolism represents a high risk of deterioration in non-high-risk acute Pulmonary Embolism(PE) patients. This study aims to address this issue by conducting a propensity score matching(PSM) study.METHODS: A total of 727 non-high-risk acute PE patients were retrospectively evaluated. We evaluated the Bova score and risk stratification to examine the risk of deterioration. Deterioration defined as any adverse event within 30 days after admission. Computed tomographic pulmonary angiography was used to identify the embolism type. All patients were matched into four subgroups by PSM according to age, sex, Bova score, and risk stratification:(1) MPA and non-MPA embolism;(2) non-saddle MPA and non-MPA embolism;(3) saddle MPA and non-saddle MPA embolism;(4) saddle MPA and non-MPA embolism. Correlations were analyzed using Cox regression analysis, and deterioration risk was compared between subgroups using Kaplan-Meier analysis.RESULTS: Cox regression analysis revealed that MPA embolism was correlated with deterioration, regardless of whether saddle MPA embolism was included or excluded. Saddle MPA embolism was not correlated with deterioration, regardless of comparison with non-saddle MPA embolism or non-MPA embolism. Patients with MPA and non-saddle MPA embolism presented a high risk for deterioration(logrank test=5.23 and 4.70, P=0.022 and 0.030, respetively), while patients with saddle MPA embolism were not at a high risk of deterioration(log-rank test=1.20 and 3.17, P=0.729 and 0.077, respetively).CONCLUSIONS: Saddle MPA embolism is not indicative of a high risk of deterioration in nonhigh-risk acute PE patients.

关键词： Main pulmonary artery Pulmonary Embolism Computerized tomography pulmonary arteriography

Role of Pulmonary Embolism Response Team in patients with intermediate-and high-risk Pulmonary Embolism:a concise review and preliminary experience from China

在线全文

学校读者我要写书评

暂无评论

Journal of Geriatric Cardiology 2020年第8期17卷 510-518页

作者： Ying LIANG Shao-Ping NIE Xiao WANG Ashley Thomas Elizabeth Thompson Guan-Qi ZHAO Jing HAN Jing WANG Mark J D Griffiths Emergency&Critical Care Center Beijing Anzhen HospitalCapital Medical UniversityBeijingChina Peri-Operative Medicine Barts Health NHS Trust LondonUK

Intermediate-and high-risk Pulmonary Embolism(PE)is a life-threatening medical emergency with high morbidity and mortality.Many of the treatment options for PE involve clinicians from multiple disciplines.Pulmonary Embolism Response Teams(PERTs)have been developed to coordinate the multidisciplinary team of clinicians to streamline the decision making process and develop individualised treatment plans in a timely fashion.The first PERT was established in 2012 and subsequently multiple centres worldwide have introduced this model for the management of intermediate-and high-risk PE.In this review,we evaluate the organisational structure and algorithms of different PERT services and compare data from pre-and post-PERT services to determine the impact of PERT on outcomes.We consider the cost and time implications of this multidisciplinary 24-hour service and suggest areas for further research and review.

关键词： Multidisciplinary Pulmonary Embolism Pulmonary Embolism Response Team

Combined MR Imaging for Pulmonary Embolism and Deep Venous Thrombosis by Contrast-enhanced MR Volume Interpolated Body Examination

在线全文

学校读者我要写书评

暂无评论

Current Medical Science 2020年第1期40卷 192-198页

作者： Qing FU Ding-xi LIU Xiang-chuang KONG Zi-qiao LEI Department of Radiology Union HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430022China Hubei Province Key Laboratory of Molecular Imaging Wuhan 430022China

MR pulmonary angiography(MRPA)combined with indirect MR venography(MRV)was attempted by using 3D contrast-enhanced MR volume interpolated body examination(VIBE)sequence.Agreement rate for deep venous thrombosis(DVT)detection between MRV and duplex sonography(DUS)was evaluated;the potential of this method for venous thromoembolism(VTE)was also investigated.Thirty-four patients with DUS-identified DVT were enrolled in this study.MRI was performed after a single administration of Gadopentetate dimeglumine.Fatsuppressed 3D VIBE was applied for visualizing pulmonary arteries,abdominal veins,pelvic and leg veins,ranging from lung apex to ankle level.Two radiologists observed the MR images in consensus,recorded the location and number of emboli.MRV images were assessed based on per-vein segment.The agreement rate between MRV and DUS for venous segment-to-segment comparison was analyzed by Wilcoxon rank sum test.All the patients were diagnosed as having DV 1 by MRV.MRV detected 55 more venous segments with thrombi than DUS based on per-vein segment analysis.Twenty-three patients with Pulmonary Embolism(PE)were detected by MRPA.Twenty-one patients underwent both pulmonary CT angiography and MRPA,and consistency for PE detection was 100%.Total examination time of the combined MR protocol was 7 min for each patient.The contrast-enhanced VIBE sequence proves to be a feasible and reliable method for VTE diagnosis in one-stop MR scanning procedure,and contrast-enhanced VIBE performs better to depict DVT than DUS on per-vein segment basis.

关键词： magnetic resonanee imaging Pulmonary Embolism deep venous thrombosis venous thromoembolism

Value of Coronary Sinus During Computed Tomography pulmonary Angiography for Predicting pulmonary Hypertension in Patients with Acute Pulmonary Embolism

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Cardiology Discovery 2023年第2期3卷 78-84页

作者： Chuang Zhang Qian Xin Hongling Xu Xiangyu Wang Zhiqiang Yan Shengtao Sun Xiangmin Shi Mei Tian Department of Cardiology The Sixth Medical Center of People’s Liberation Army General HospitalBeijing 100048China Department of Cardiology The Eighth Medical Center of People’s Liberation Army General HospitalBeijing 100091China Department of Radiology The Eighth Medical Center of People’s Liberation Army General HospitalBeijing 100091China Department of Radiology The Sixth Medical Center of People’s Liberation Army General HospitalBeijing 100048China.

Objective:Computed tomography pulmonary angiography(CTPA)parameters are valuable for predicting pulmonary hypertension(PH)in patients with Pulmonary Embolism(PE).However,few studies have used the coronary sinus ostium area(CSOA),derived from CTPA,to detect PH.This study aimed to compare the prognostic values of the CSOA,coronary sinus ostium diameter(CSOD),and right ventricular(RV)/left ventricular(LV)ratio for PH.Methods:This study retrospectively analyzed 78 patients(mean age,(51.94±12.33)years;53.8%male)with acute PE confirmed by CTPA at the Sixth and Eighth Medical Centers of the People’s Liberation Army General Hospital between June 2018 and June 2020.Patients were categorized into 2 groups using a pulmonary artery systolic pressure(PASP)cut-off of 30 mmHg.CTPA parameters were compared between these groups.Results:Patients with PASP>30 mmHg(n=22)had a larger CSOA,CSOD,RV diameter,RV/LV ratio,and inferior vena cava diameter compared with patients with PASP≤30 mmHg(n=56).The CSOA had an area under the receiver-operating characteristic curve(AUC,0.84;95%confidence interval(CI),0.74–0.94;P30 mmHg.

关键词： Angiography Computed tomography Coronary sinus Diagnosis Pulmonary Embolism pulmonary hypertension Right ventricle

Pulmonary Embolism in Pregnancy: UltrasoundAssisted Catheter-Directed Thrombolytic Therapy for the Treatment of a pulmonary Embolus—A Case Report

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Maternal-Fetal Medicine 2022年第3期4卷 229-232页

作者： Michael G.Baracy Jr Olumide Olotu Phillip Marchese Marc Gosselin Shyla Vengalil Department of Obstetrics and Gynecology Ascension St.John HospitalDetroitMichigan 48236USA School of Medicine St.Georges UniversityTrue BlueGrenada Department of Interventional Cardiology Ascension St.John HospitalDetroitMichigan 48236USA Department of Maternal Fetal Medicine Ascension St.John HospitalDetroitMichigan 48236USA.

In the United States,Pulmonary Embolism(PE)accounts for approximately 10%of all pregnancy related deaths.The standard treatment for a patient with high-risk PE is systemic thrombolysis.Systemic thrombolysis in pregnancy is associated with the risk of maternal hemorrhage and fetal complications,including spontaneous abortion,preterm delivery,and fetal bleeding.Currently,there is limited evidence for a standardized approach for the treatment and management of intermediate-and high-risk PEs in pregnancy.A 36-year-old gravida 3 para 2002 woman at 31+1weeks of gestation with a history of deep vein thrombosis in her prior pregnancy presented with shortness of breath.A computed tomography angiogram revealed a large pulmonary embolus with a saddle component that extended into the bilateral upper and lower lobes and into the secondary and tertiary pulmonary branches.A subsequent bedside echocardiogram demonstrated a dilated right ventricle with severely reduced right ventricular systolic function.The patient was successfully treated with bilateral ultrasound-assisted catheter-directed thrombolysis.She subsequently delivered a healthy male infant at term.Reported cases of ultrasound-assisted catheter-directed thrombolysis in pregnant patients is limited.Our case demonstrates that localized thrombolysis is a viable treatment option for life-threatening PE in pregnancy.Catheterdirected thrombolysis can be efficacious in treating intermediate-and high-risk PEs in pregnancy while simultaneously reducing the risk of bleeding complications.

关键词： Pulmonary Embolism Catheter-directed thrombolysis Pregnancy Ultrasound-assisted catheter-directed thrombolysis Venous thromboembolism

Misdiagnosis of primary intimal sarcoma of the pulmonary artery as chronic Pulmonary Embolism: A case report

在线全文

学校读者我要写书评

暂无评论

World Journal of Clinical Cases 2020年第5期8卷 986-994页

作者： Ping Lu Bei-Bei Yin Department of Cardiac Surgery The First Affiliated Hospital of Shandong First Medical UniversityJinan 250014Shandong ProvinceChina Department of Oncology The First Affiliated Hospital of Shandong First Medical UniversityJinan 250014Shandong ProvinceChina

BACKGROUND Primary intimal sarcoma of the pulmonary artery is a rare malignant tumor originating from the pulmonary artery,which has a low incidence rate and is easily misdiagnosed as Pulmonary Embolism.There is no standard protocol for the treatment of primary intimal sarcoma of the pulmonary artery.CASE SUMMARY This study reports a patient with primary intimal sarcoma of the pulmonary artery who was admitted to our hospital in 2017.The clinical characteristics,diagnosis,treatment and outcome of the patient were retrospectively analyzed.The patient was a Chinese Han male aged 44 years.He had three consecutive episodes of syncope,and was thus admitted to a local hospital.Computed tomography pulmonary angiography showed multiple lesions with abnormal densities in the pulmonary trunk,left pulmonary artery,mediastinum and pericardium,which were consistent with recurrence after tumor resection.He underwent surgery,and was pathologically diagnosed with intimal sarcoma of the pulmonary artery.He relapsed 3 mo after surgery,and apatinib was administered.His condition was stable after 4 mo,with tolerable and controllable adverse reactions.He subsequently died 19 mo after surgery.CONCLUSION Primary intimal sarcoma of the pulmonary artery has no specific clinical or imaging manifestations.The diagnosis of this disease depends on histopathology and immunohistochemistry,and has a poor clinical prognosis.Surgical treatment is currently a favorable option for primary intimal sarcoma of the pulmonary artery,and targeted therapy may provide new insights for the development of effective treatment methods.

关键词： Intimal sarcoma pulmonary artery Pulmonary Embolism Misdiagnosis Case report

Contribution of Quick Sequential Organ Failure Assessment Score Combined with Electrocardiography in Risk Stratification of Patients with Acute Pulmonary Embolism

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Chinese Medical Journal 2018年第20期131卷 2395-2401页

作者： Fei Teng Yun-Xia Chen Xin-Hua He Shu-Bin Guo Department of Emergency Beijing Chao-Yang Hospital Capital Medical University Beijing 100020 China Department of Infection and Microbiology Beijing Chao-Yang Hospital Capital Medical University Beijing 100020 China

Background： The quick Sequential Organ Failure Assessment （qSOFA） score emerged recently. We investigated its contribution to risk stratification in acute Pulmonary Embolism （PE） by combining with electrocardiography （ECG）. Methods： Acute PE patients diagnosed in Beijing Chao-Yang Hospital, Capital Medical University, from 2008 to 2018 were retrospectively studied and divided into high- and low-risk groups by imaging and biomarkers. The ECG scores consisted oftachycardia, McGinn-White sign （S1Q3T3）, right bundle branch block, and T-wave inversion of leads V1-V3. A new combination of qSOFA scores and ECG scores by logistic regression for predicting high-risk stratification patients with acute PE was evaluated by a receiver operating characteristic curve. Results： Totally 1318 patients were enrolled, including 271 in the high-risk group and 1047 in the low-risk group. A combination predictive scoring system named qSOFA-ECG = qSOFA score ＋ ECG score was created. The optimal cutoffvalue for qSOFA-ECG was 2, and the sensitivity, specificity, positive predictive value, and negative predictive value were 81.5%, 72.3%, 43.2%, and 93.8%, respectively. For predicting high-risk stratification and reperfusion therapy, the qSOFA-ECG is superior to PE Severity Index （PESI） and simplified PESI. Conclusions： The qSOFA score contributes to identify acute PE patients with potentially hemodynamic decompensation that need monitoring and possible reperfusion therapy at the emergency department arrival when used in combination with ECG score.

关键词： Electrocardiography Emergency Pulmonary Embolism Quick Sequential Organ Failure Assessment

Pulmonary Embolism in Patients with Acute Exacerbation of Chronic Obstructive pulmonary Disease

在线全文

学校读者我要写书评

暂无评论

Chinese Medical Journal 2018年第14期131卷 1732-1737页

作者： Yao-Qian Cao Li-Xia Dong Jie Cao Department of Respiratory General Hospital Tianjin Medical University Tianjin 300052 China

Objective： In most cotintries, nearly 6% of the adults are suffering from chronic obstructive pulmonary disease （COPD）. which puts a huge economic burden on the society. Moreover, COPD has been considered as an independent risk factor for Pulmonary Embolism （PE）. In this review, we summarized the existing evidence that demonstrates the associations between COPD exacerbation and PE from various aspects, including epidemiology, pathophysiological changes, risk factors, clinical features, management, and prognosis. Data Sources： We searched the terms ＂chronic obstructive pulmonary disease,＂＂＇Pulmonary Embolism,＂＂exacerbations,＂ and ＂＇thromboembolic＂ in PubMed database and collected the results up to April 2018. The language was limited to English. Study Selection： We thoroughly examined the titles and abstracts of all studies that met our search strategy. The data from prospective studies, meta-analyses, retrospective studies, and recent reviews were selected for preparing this review. Results： The prevalence of PE in patients with COPD exacerbation varied a lot among different studies, mainly due to the variations in race, sample size, study design, research setting, and enrollment criteria. Overall, whites and African Americans showed significantly higher prevalence of PE than Asian people, and the hospitalized patients showed higher prevalence of PE compared to those who were evaluated in emergency department. PE is easily overlooked in patients with COPD exacerbation due to the similar clinical symptoms. However, several factors have been identified to contribute to the increased risk of PE during COPD exacerbation. Obesity and lower limb asymmetry were described as independent predictors for PE. Moreover, due to the high risk of PE, thromboprophylaxis has been used as an important treatment for hospitalized patients with COPD exacerbation. Conclusions： According to the previous studies, COPD patients with PE experienced an increased risk of death and prolonged length of hospital stay. Therefore, the thromboem

关键词： Acute Exacerbations Chronic Obstructive pulmonary Disease Pulmonary Embolism

Pulmonary Embolism with chronic obstructive pulmonary disease

在线全文

学校读者我要写书评

暂无评论

Chronic Diseases and Translational Medicine 2021年第3期7卷 149-156页

作者： Ruohan Yang Guiqing Liu Chaosheng Deng Institute of Respiratory Disease Fujian Medical UniversityDivision of Respiratory and Critical Care MedicineFirst Affiliated Hospital of Fujian Medical UniversityFuzhouFujian350005China The Hammersmith Hospital London W120NNUnited Kingdom

Chronic obstructive pulmonary disease (COPD) is a common, preventable, and treatable disease. The incidence of COPD is growing annually in China, and it is a significant and growing public health burden. Multivariate analysis showed that COPD was one of the independent risk factors for the occurrence of Pulmonary Embolism (PE),and the incidence of PE was significantly higher in COPD patients than in normal subjects. However, PE is often overlooked in patients with acute exacerbation of COPD (AECOPD) because there are many similarities in clinical symptoms between PE and AECOPD, which are difficult to distinguish, resulting in the failure of timely treatment and poor prognosis. Therefore, it is of great significance to understand the clinical manifestations, diagnosis, and treatment of COPD combined with PE for making a more accurate diagnosis, providing timely and effective treatment, and improving the prognosis of such patients.

关键词： Chronic obstructive pulmonary disease Pulmonary Embolism Acute exacerbation