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N Engl J Med 2019 02;380(8):720-728

From the Department of Hematology and Medical Oncology, Taussig Cancer Institute and Case Comprehensive Cancer Center, Cleveland Clinic, Cleveland (A.A.K.); the Department of Medicine, Memorial Sloan Kettering Cancer Center (G.A.S., E.M.O.), and Weill Cornell Medical College (G.A.S., E.M.O.), New York; the Thrombosis Research Institute and University College London, London (A.K.K.); University of Texas M.D. Anderson Cancer Center, Houston (S.V.-R.), and U.S. Oncology Research-Texas Oncology, Tyler (H.A.Y.) - both in Texas; the Department of Medicine, Charité Universitätsmedizin Berlin, Berlin (H.R.); the Division of Hematology-Oncology, University of California Davis School of Medicine, Sacramento (T.W.), and the Keck School of Medicine, University of Southern California, Los Angeles (H.A.L.); the Division of Hematology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore (M.B.S.); the University of Washington School of Medicine (D.A.G., N.M.K., G.H.L.), Advanced Cancer Research Group (N.M.K.), and Fred Hutchinson Cancer Research Center (G.H.L.), Seattle; Penn State Cancer Institute, Milton S. Hershey Medical Center, Hershey, PA (C.P.B.); the Department of Cancer Pharmacology, Levine Cancer Institute, Atrium Health, Charlotte, NC (J.N.P.); Janssen Scientific Affairs, Titusville (P.W., P.B., S.K.), and Janssen Research and Development, Raritan (U.V.) - both in New Jersey; the Department of Medicine, McMaster University, Hamilton, ON, Canada (J.E.); the Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN (R.M.); and the Division of Hematology-Oncology, Beth Israel Deaconess Medical Center, Boston (K.A.B.).

Background: Ambulatory patients receiving systemic cancer therapy are at varying risk for venous thromboembolism. However, the benefit of thromboprophylaxis in these patients is uncertain.

Methods: In this double-blind, randomized trial involving high-risk ambulatory patients with cancer (Khorana score of ≥2, on a scale from 0 to 6, with higher scores indicating a higher risk of venous thromboembolism), we randomly assigned patients without deep-vein thrombosis at screening to receive rivaroxaban (at a dose of 10 mg) or placebo daily for up to 180 days, with screening every 8 weeks. Read More

JMIR Hum Factors 2019 Feb 20;6(1):e10245. Epub 2019 Feb 20.

Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY, United States.

Background: Successful clinical decision support (CDS) tools can help use evidence-based medicine to effectively improve patient outcomes. However, the impact of these tools has been limited by low provider adoption due to overtriggering, leading to alert fatigue. We developed a tracking mechanism for monitoring trigger (percent of total visits for which the tool triggers) and adoption (percent of completed tools) rates of a complex CDS tool based on the Wells criteria for pulmonary embolism (PE). Read More

Vasa 2019 Feb 20:1-8. Epub 2019 Feb 20.

2 Angio-Center-Vascular Medicine Romania, Targu Mures, Romania.

Iliac vein compression syndrome (May-Thurner syndrome - MTS) is an anatomically variable clinical condition in which the left common iliac vein is compressed between the right common iliac artery and the underlying spine. This anatomic variant results in an increased incidence of left iliac or iliofemoral vein thrombosis. It predominantly affects young women in the second or third decades of life with preponderance during pregnancy or oral contraceptive use. Read More

Biomed Pharmacother 2019 Feb 19;112:108595. Epub 2019 Feb 19.

Department of Anesthesiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China. Electronic address:

This study was designed to investigate the inflammatory responses in fat embolism syndrome (FES) and the relationship of ALX/FPR2 receptors and lipoxin A (LXA) in FES models. In this model, lung injury score, lung tissue wet-to-dry (W/D) ratio and total protein concentration in bronchoalveolar lavage fluid (BALF) were increased compared with those of the control group. Meanwhile, the number of leukocytes and neutrophils was significantly increased in the FES group, as was the myeloperoxidase (MPO) activity and mRNA expression. Read More

Thromb Res 2019 Feb 15;176:85-94. Epub 2019 Feb 15.

Department of Pulmonary and Critical Care Medicine, Sir Run Run Shaw Hospital, Medical School of Zhejiang University, Hangzhou, China. Electronic address:

Introduction: Acute pulmonary embolism (APE) is a cardiovascular disease with high morbidity and mortality. Although the anatomical obstruction of the pulmonary vascular bed initiates APE, recent studies have suggested that vasoconstrictors in the renin-angiotensin system (RAS) play a role in the severity of APE.

Materials And Methods: We performed a 5-year retrospective clinical study to analyze the key RAS components in APE patients, including angiotensin converting enzyme (ACE), ACE2, angiotensin II (Ang II) and angiotensin 1-7(Ang(1-7)). Read More

Eur Radiol 2019 Feb 19. Epub 2019 Feb 19.

Klinik und Hochschulambulanz für Radiologie, Charité - Universitätsmedizin Berlin Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Germany.

Objective: The aim of this study was to compare the age-dependent diagnostic performance of clinical scores and D-dimer testing to identify patients with suspected pulmonary embolism (PE).

Methods: Consecutive patients with suspected PE referred from the emergency department for computed tomography pulmonary angiography (CTPA) were retrospectively evaluated. Diagnostic scores (classic Wells score (WS), modified WS, simplified WS, revised Geneva score (GS), simplified GS, and YEARS score) were calculated from medical records. Read More

Am J Case Rep 2019 Feb 20;20:224-227. Epub 2019 Feb 20.

Department of General Medicine/Family and Community Medicine, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.

BACKGROUND Intramural hematoma of the esophagus (IHE), a rare manifestation of acute mucosal injuries of the esophagus, can be caused by trauma such as endoscopic surgeries. Coagulation disorders increase the risk of IHE. The most common location of IHE is in the distal esophagus. Read More

BMJ Open 2019 Feb 19;9(2):e024805. Epub 2019 Feb 19.

Department of Clinical Psychology, Swansea University, Swansea, UK.

Objectives: Venous thromboembolism (VTE) is a serious, potentially traumatic, life-threatening condition and a major cause of mortality and morbidity. The aim of this study was to obtain detailed understandings of the impact of VTE and examine individual's experiences over the first year since a first-time VTE.

Design: A longitudinal qualitative interview study using inductive thematic analysis. Read More

Vasc Endovascular Surg 2019 Feb 19:1538574419831488. Epub 2019 Feb 19.

1 Division of Vascular Surgery, Indiana University School of Medicine, Indianapolis, IN, USA.

We present a case of a 58-year-old otherwise healthy women who presented with left lower extremity deep venous thrombosis and was found to have pulmonary embolism along with a ruptured left internal iliac vein. Our patient was hemodynamically stable upon presentation; therefore, a staged approach was undertaken. Initially, an inferior vena cava filter was placed and the patient was slowly advanced to therapeutic anticoagulation and subsequently discharged. Read More

Thromb Res 2019 Feb 13;176:79-84. Epub 2019 Feb 13.

Department of Medicine, University of Ottawa, Ottawa Hospital Research Institute, Ottawa, Canada.

Background: Unprovoked venous thromboembolism (VTE) may be the first manifestation of an underlying cancer. We aimed to assess the period prevalence of occult cancer detection stratified by VTE location (deep vein thrombosis [DVT], pulmonary embolism [PE] or both) and the anatomical relationship between occult cancer and VTE.

Methods: Post-hoc analysis of a systematic review and individual patient data meta-analysis of adults with unprovoked VTE with at least 12 months of follow-up. Read More

N Engl J Med 2019 02 18. Epub 2019 Feb 18.

From the College of Medicine, King Saud Bin Abdulaziz University for Health Sciences (Y.M.A., S.J.A., S.A.I.A., A.A.-D.), the Departments of Intensive Care (Y.M.A., S.J.A., S.A.I.A., A.A.-D.) and Emergency Medicine, (S.J.A.), Ministry of National Guard Health Affairs, Military Medical Services, Ministry of Defense (Y. Mandourah), the Department of Intensive Care Services, Prince Sultan Military Medical City (G.A.A.), the Department of Pulmonary and Critical Care Medicine, King Fahad Medical City (M.A., H.L.), Critical Care Medicine Department, King Faisal Specialist Hospital and Research Center (H.H.), and the Department of Biostatistics and Bioinformatics (J.J.) and Research Office (L.Y.A.), King Abdullah International Medical Research Center (Y.M.A., S.J.A., S.A.I.A., A.A.-D.), Riyadh, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, and the Intensive Care Department, Ministry of National Guard Health Affairs (F.A.-H.), and Critical Care Section, Department of Medicine, King Faisal Specialist Hospital and Research Center (I.K.), Jeddah, the Department of Emergency and Critical Care Medicine, College of Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University (M.S.A.), Dammam, the Department of Critical Care Medicine, King Khalid University, Asir Central Hospital (A.A.B.), Abha, and King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, and the Intensive Care Division, Department of Medicine, King Abdulaziz Hospital (A.A.A.), Al Ahsa - all in Saudi Arabia; St. Michael's Hospital, Li Ka Shing Knowledge Institute (K.E.A.B.), the Department of Medicine, Sinai Health System (S.M.), and Interdepartmental Division of Critical Care Medicine, University of Toronto (K.E.A.B, S. M.) - all in Toronto; the George Institute for Global Health (S.F.), the Department of Intensive Care Medicine, Centre for Applied Medical Research, St. Vincent's Hospital (H.B.), and the University of New South Wales, Sydney (S.F., H.B.), and Intensive Care Department, Gosford Hospital, Gosford, NSW (A.G.) - all in Australia; and the Department of Anesthesiology and Critical Care, King George's Medical University, Lucknow (Z.A.), and Institute of Critical Care and Anesthesiology, Medanta-The Medicity, Gurgaon (Y. Mehta) - both in India.

Background: Whether adjunctive intermittent pneumatic compression in critically ill patients receiving pharmacologic thromboprophylaxis would result in a lower incidence of deep-vein thrombosis than pharmacologic thromboprophylaxis alone is uncertain.

Methods: We randomly assigned patients who were considered adults according to the local standards at the participating sites (≥14, ≥16, or ≥18 years of age) within 48 hours after admission to an intensive care unit (ICU) to receive either intermittent pneumatic compression for at least 18 hours each day in addition to pharmacologic thromboprophylaxis with unfractionated or low-molecular-weight heparin (pneumatic compression group) or pharmacologic thromboprophylaxis alone (control group). The primary outcome was incident (i. Read More

Ugeskr Laeger 2019 Feb;181(7)

If anticoagulant therapy is stopped, the risk of recurrence after unprovoked venous thromboembolism is high. After anticoagulant treatment for at least three months, the indication for prolonging therapy should be decided after thorough evaluation of individual risk factors for recurrence and bleeding. Clinical parameters, imaging modalities and D-dimer levels can guide this decision. Read More

Rev Med Inst Mex Seguro Soc 2019 Jan 28;56(5):478-485. Epub 2019 Jan 28.

Instituto Mexicano del Seguro Social, Hospital de Cardiología, Departamento de Hipertensión Pulmonar y Función Ventricular Derecha. Ciudad de México, México

Background: Currently the options for treatment of chronic thromboembolic pulmonary hypertension can be pulmonary endarterectomy, pulmonary angioplasty and pharmacological treatment.

Objective: To show the feasibility of performing pulmonary endarterectomy in a cardiology hospital.

Methods: From December 2013 to June 2014 a serie of consecutive cases was studied according to the guidelines of the Fifth World Symposium of Pulmonary Hypertension. Read More

J Med Imaging Radiat Sci 2019 Mar 4;50(1):62-67. Epub 2018 Dec 4.

Department of Medical Imaging, Princess Alexandra Hospital, Brisbane, Australia.

Introduction: Optimal opacification of the pulmonary vasculature is a fundamental factor of a diagnostic quality computed tomography pulmonary angiogram (CTPA). This retrospective study examined the feasibility of utilising a noise-optimised monoenergetic reconstruction of the dual-energy computed tomography pulmonary angiogram (DE-CTPA) as an additional protocol to increase vessel opacification.

Method: The study involved a retrospective analysis of 129 patients, 69 males (average age 58 years), 60 females (average age 56 years) who underwent a DE-CTPA at a tertiary referral hospital. Read More

J Med Case Rep 2019 Feb 19;13(1):37. Epub 2019 Feb 19.

Cardiac Imaging Laboratory, Department of Cardiology, Hospital Universitario de Canarias, Ofra s/n, La Cuesta, 38320, La Laguna, Tenerife, Spain.

Background: Approximately half of pulmonary embolism cases are diagnosed in an emergency context. The classic symptoms of pulmonary embolism are absent in intensive care unit patients who are under sedation and on mechanical ventilation. In this scenario, after the development of sudden, severe hypotension, pulmonary embolism must be considered and included in a differential diagnosis according to the cause of admission. Read More

Thromb Res 2019 Feb 13;176:46-53. Epub 2019 Feb 13.

Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark; Danish Center for Clinical Health Services Research, Department of Clinical Medicine, Aalborg University and Aalborg University Hospital, Denmark. Electronic address:

Background: Venous thromboembolism (VTE) has major clinical and public health impact. However, only sparse data on calendar time trends in incidence from unselected populations reflecting current clinical practice are available.

Objectives: To examine temporal trends in the incidence and characteristics of patients hospitalized with first-time VTE in Denmark between 2006 and 2015. Read More

Clin Pract Cases Emerg Med 2019 Feb 4;3(1):11-12. Epub 2019 Jan 4.

University of California, Irvine, Department of Emergency Medicine, Orange, California.

A 95-year-old female with a history of dementia and atrial fibrillation (not on anticoagulation) presented to the emergency department (ED) by ambulance from her skilled nursing facility due to hypoxia. Point-of-care ultrasound was performed, and showed evidence of a large mobile thrombus in the right ventricle on apical four-chamber view. Further evidence of associated right heart strain was seen on the corresponding parasternal short-axis view. Read More

Perfusion 2019 Feb 17:267659119830014. Epub 2019 Feb 17.

3 Department of Anaesthesiology and Intensive Medicine, Aalborg University Hospital, Aalborg, Denmark.

Introduction:: In massive pulmonary embolism (PE) with circulatory collapse or with cardiac arrest, treatment can be difficult. Often, the diagnosis is unclear, and the time to treatment is crucial. Our institution has had an out-of-hospital team intended for the treatment of accidental hypothermia with extra corporeal membrane oxygenation (ECMO) since 2004. Read More

Expert Rev Hematol 2019 Feb 18. Epub 2019 Feb 18.

a Haemorrhagic and Thrombotic Diseases Unit, Department of Medicine (DIMED), Padova University Hospital , Italy.

Introduction: Fifty-three years after the first description of an inherited prothrombotic condition (antithrombin deficiency), our knowledge on hereditary and acquired causes of hypercoagulability that can predispose carriers to venous thromboembolism (VTE) has greatly improved. Areas covered: Main causes of hereditary thrombophilia are summarized alongside new prothrombotic mutations recently discovered. The main causes of acquired thrombophilia, and namely, antiphospholipid antibody syndrome and hyperhomocysteinemia, are also discussed together with other common acquired prothrombotic states characterized by an increase of procoagulant factors and/or a decrease of natural anticoagulants. Read More

Expert Rev Hematol 2019 Feb 16. Epub 2019 Feb 16.

a Johns Hopkins School of Medicine , Baltimore , MD , USA.

Introduction: Venous thromboembolism (VTE) is a common comorbid condition found in sickle cell disease (SCD) and is associated with increased mortality for adults with SCD. The pathophysiology that leads to the thrombophilic state in SCD has been previously reviewed; however, evidence-based guidelines to aid in diagnosis, prevention and management of VTE are lacking. Areas covered: This review article will cover the pathophysiology underlying the hypercoagulable state, the epidemiology of VTE, and management strategies of VTE in SCD. Read More

Lancet Haematol 2019 Feb 13. Epub 2019 Feb 13.

Murdoch Children's Research Institute and Department of Paediatrics, The University of Melbourne, Royal Children's Hospital, Parkville, VIC 3052, Australia. Electronic address:

Lancet Haematol 2019 Feb 13. Epub 2019 Feb 13.

Division of Haematology/Oncology, Department of Paediatrics, The Hospital for Sick Children, Toronto, ON, Canada. Electronic address:

Background: Little is known about severe pulmonary embolism in children. We aimed to report pulmonary embolism outcomes, identify risk factors for unfavourable outcomes, and evaluate the discriminative ability of two clinical-severity indices in children.

Methods: In this retrospective cohort study, we included consecutive patients aged 18 years or younger with acute pulmonary embolism, objectively diagnosed radiologically or pathologically, between Jan 1, 2000, and Dec 31, 2016, from two Canadian paediatric hospitals (The Hospital for Sick Children, Toronto, ON, and the Children's Hospital of Eastern Ontario, Ottawa, ON). Read More

JACC Cardiovasc Interv 2019 Feb 7. Epub 2019 Feb 7.

Division of Cardiology, Department of Medicine, Columbia University Medical Center, New York, New York. Electronic address:

J Neurosurg Spine 2019 Feb 15:1-13. Epub 2019 Feb 15.

Departments of1Neurosurgery.

OBJECTIVEThe Michigan Spine Surgery Improvement Collaborative (MSSIC) is a statewide, multicenter quality improvement initiative. Using MSSIC data, the authors sought to identify 90-day adverse events and their associated risk factors (RFs) after cervical spine surgery.METHODSA total of 8236 cervical spine surgery cases were analyzed. Read More

Respir Investig 2019 Feb 12. Epub 2019 Feb 12.

Long Beach VA Health Care System, Long Beach, CA, USA. Electronic address:

Background: Obesity is associated with many cardiovascular risk factors. This study aimed to evaluate the independent association between obesity and pulmonary embolism.

Methods: We used the International Classification of Diseases, Ninth Revision, Codes for obesity and pulmonary embolism from the Nationwide Inpatient Sample database. Read More

Eur J Intern Med 2019 Feb 13. Epub 2019 Feb 13.

Department of Cardiology, Cardiology I, University Medical Center Mainz (Johannes Gutenberg-University Mainz), Mainz, Germany.

Aims: Syncope is a common phenomenon in the general population. Although most of the causes are of benign origin, some comorbidities are accompanied by high mortality. We aimed to compare the in-hospital mortality of patients with syncope related to different comorbities and investigate the impact of syncope in patients with atrial fibrillation/flutter (AF). Read More

Anasthesiol Intensivmed Notfallmed Schmerzther 2019 Feb 15;54(2):90-106. Epub 2019 Feb 15.

With focused transthoracic echocardiography (TTE) we rapidly and non-invasively receive up-to-date information on a patient's hemodynamic status. These can subsequently influence our therapy and thus our risk management. Postoperatively, TTE has proved its worth as an examination method in the recovery room and in the intensive care unit to promptly diagnose life-threatening causes of circulatory depression. Read More

Thromb Res 2019 Feb 4;176:27-29. Epub 2019 Feb 4.

Wingate University School of Pharmacy, Clinical Pharmacy Specialist, Internal Medicine, Wake Forest Baptist Health, 515 N Main St, Wingate, NC 28174, United States of America. Electronic address:

Clin Chim Acta 2019 Feb 12;492:78-83. Epub 2019 Feb 12.

Clinic of Cardiology and Emergency Internal Medicine, Military Medical Academy, Belgrade, Serbia; School of Medicine, University of Defense, Belgrade, Serbia. Electronic address:

Factors associated with provoked PE may influence a biomarker's predictive value for the primary outcome. The aim of this study was to investigate the value of BNP, cTnI, CRP and D-Dimer measurements taken soon after hospital admission for the prediction of 30-day PE-caused death in patients with spontaneous versus provoked PE.Data were extracted from a pool of 726 consecutive PE patients enrolled in the multicenter Serbian PE registry. Read More

JAMA Netw Open 2019 Feb 1;2(2):e188332. Epub 2019 Feb 1.

Division of General Internal and Emergency Medicine, University Department of Medicine, Kantonsspital Aarau, Aarau, Switzerland.

Importance: In 2012, hospital reimbursement in Switzerland changed from a fee-for-service per diem system to a diagnosis-related group (SwissDRG) system. Whether this change in reimbursement is associated with harmful implications for quality of care and patient outcomes remains unclear.

Objective: To examine the association of the SwissDRG implementation with length of hospital stay (LOS), in-hospital mortality, and 30-day readmission rates in the overall adult inpatient population and stratified by 5 individual diagnoses. Read More

Cancer Med 2019 Feb 14. Epub 2019 Feb 14.

Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark.

Background: Rivaroxaban could be an attractive alternative to low molecular weight heparin for the treatment of cancer-associated venous thromboembolism (VTE) but the safety and effectiveness remain unclear. We examined risk of recurrent VTE and major bleeding associated with rivaroxaban treatment of cancer-associated VTE.

Methods: Through linkage of nationwide Danish registries, we identified all adults with cancer-associated VTE initiating treatment with rivaroxaban, 2012-2017. Read More

Diabetes 2019 Feb 14. Epub 2019 Feb 14.

Fraternal Order of Eagles Diabetes Research Center and Division of Endocrinology and Metabolism, Carver College of Medicine, University of Iowa

Patients with type 1 diabetes mellitus (T1DM) have increased thrombosis and platelet activation. The mechanisms for platelet hyperactivation in diabetes are incompletely understood. T1DM is accompanied by hyperglycemia, dyslipidemia, and increased inflammation, in addition to an altered hormonal milieu. Read More

J Vasc Surg Venous Lymphat Disord 2019 Feb 11. Epub 2019 Feb 11.

Raymond G. Murphy VA Medical Center, Albuquerque, NM.

Objective: Vascular laboratory (VL) venous duplex ultrasound is the "gold standard" for diagnosis of lower extremity deep venous thrombosis (DVT), which is linked to many morbid conditions. Decreasing night and weekend use of VL services in the emergency department (ED) represents a potentially viable means of reducing costs as skilled personnel must remain on call and receive a wage premium when activated. We investigated the effects of workflow changes that required ED providers to use a computerized decision-making tool, integrated into the electronic medical record, to calculate a Wells score for each patient considered for an after-hours venous duplex ultrasound study for suspected DVT. Read More

Am Surg 2019 Jan;85(1):e63-e65

Arthritis Res Ther 2019 Feb 14;21(1):57. Epub 2019 Feb 14.

The University of Melbourne, 41 Victoria Parade Fitzroy, Melbourne, Victoria, 3065, Australia.

Background: Up to 12% of patients with systemic sclerosis (SSc) have anti-neutrophil cytoplasmic antibodies (ANCA). However, the majority of these patients do not manifest ANCA-associated vasculitis (AAV) and the significance of ANCA in these patients is unclear. The aim of this study is to determine the prevalence of ANCA in a well-characterised SSc cohort and to examine the association between ANCA and SSc clinical characteristics, other autoantibodies, treatments and mortality. Read More

Respir Res 2019 Feb 14;20(1):34. Epub 2019 Feb 14.

Division of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation, Viale Golgi 19, 27100, Pavia, Italy.

Background: After successful pulmonary endoarterectomy (PEA), patients may still suffer from exercise limitation, despite normal pulmonary vascular resistance. We sought to assess the proportion of these patients after the extension of PEA to frail patients, and the determinants of exercise limitation.

Methods: Out of 553 patients treated with PEA from 2008 to 2016 at our institution, a cohort of 261 patients was followed up at 12 months. Read More

Ann Vasc Surg 2019 Feb 11. Epub 2019 Feb 11.

Department of Vascular and Endovascular Surgery, University Hospital Frankfurt am Main, Germany. Electronic address:

Hughes-Stovin syndrome is a disorder characterized by deep vein thrombosis and pulmonary artery aneurysms with potentially life-threatening complications. The case of a 22-year-old Moroccan male patient, presenting with signs of sepsis of unclear etiology, is presented here. CT scan revealed thrombosis of the inferior vena cava up to the hepatic veins, thrombosis of both common iliac veins and a thrombus in the right atrium. Read More

Ann Thorac Surg 2019 Feb 11. Epub 2019 Feb 11.

Department of Echocardiograph, Asia Heart Hospital, Wuhan, P.R. China. Electronic address:

Impending paradoxical embolism (IPDE) is the presence of a thrombus in the patent foramen ovale (PFO). Usually, IPDE is diagnosed by echocardiography or an Multislice computer tomography (MSCT) scan and is performed during the evaluation of a patient presenting with suspected pulmonary embolism (PE). We report two patients who presented with IPDE and were successfully treated with cardiac surgery and thrombolytic therapy. Read More

Expert Rev Med Devices 2019 Feb 14:1-4. Epub 2019 Feb 14.

c Department of Intensive Care , Erasme Hospital, Université libre de Bruxelles , Brussels , Belgium.

Introduction: Pulmonary embolism is common in critical care patients and carries significant morbidity and mortality. Concurrent risk of severe bleeding in this population may prohibit anticoagulation. Areas covered: The Angel Catheter device is a central venous catheter combined with an inferior vena cava filter inserted at the bedside for pulmonary embolism prevention. Read More

Clin Spine Surg 2019 Feb 12. Epub 2019 Feb 12.

Weill Cornell Medicine.

Study Design: This was a retrospective cohort study.

Objectives: The main objectives of this study were to identify epidemiological trends, differences, and complications in patients undergoing surgical treatment for single-level cervical radiculopathy (SLCR).

Summary Of Background Data: SLCR that fails nonoperative management is effectively treated with either anterior cervical discectomy and fusion (ACDF), cervical disc replacement (CDR), or posterior cervical foraminotomy (PCF). Read More

Clin Orthop Relat Res 2019 Mar;477(3):533-535

M. Maltenfort, Statistician, Children's Hospital of Philadelphia, Department of Biomedical Health Informatics, Philadelphia, PA, USA.

Am Surg 2019 Jan;85(1):e63-e65

Int J Mol Sci 2019 Feb 12;20(3). Epub 2019 Feb 12.

Department of Thoracic Surgery, University Hospital Zurich, 8091 Zurich, Switzerland.

Chronic Thromboembolic Pulmonary Hypertension (CTEPH) is a debilitating disease, for which the underlying pathophysiological mechanisms have yet to be fully elucidated. Occurrence of a pulmonary embolism (PE) is a major risk factor for the development of CTEPH, with non-resolution of the thrombus being considered the main cause of CTEPH. Polymorphisms in the α-chain of fibrinogen have been linked to resistance to fibrinolysis in CTEPH patients, and could be responsible for development and disease progression. Read More

J Clin Endocrinol Metab 2019 Feb 12. Epub 2019 Feb 12.

Department of Obstetrics and Gynecology, David Geffen School of Medicine, University of California Los Angeles (UCLA), Los Angeles, CA.

Context: Ovarian hyperandrogenism from polycystic ovarian syndrome (PCOS) and hyperinsulinemia from insulin resistance are modulators of ovarian follicle development. We report a PCOS woman with hyperandrogenism and severe insulin resistance from metabolic syndrome who received long-term GnRH analog therapy preceding bilateral salpingo-oophorectomy for massive ovarian enlargement. Ovarian histological examination showed proliferating granulosa cells within antral follicles coexistent with serous cystadenofibromas, demonstrating a unique link between hyperinsulinemia and granulosa cell mitogenesis. Read More

Insights Imaging 2019 Feb 13;10(1):18. Epub 2019 Feb 13.

Radiology Department, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY, 10065, USA.

Pulmonary embolus (PE) is the third most common cause of cardiovascular death with more than 600,000 cases occurring in the USA per year. About 45% of patients with acute PE will have acute right ventricular failure, and up to 3.8% of patients will develop chronic thromboembolic pulmonary hypertension (CTEPH) with progressive, severe, chronic heart failure. Read More

J Bras Pneumol 2019 Feb 11;45(1):e20180297. Epub 2019 Feb 11.

. Divisão de Emergências Clínicas, Departamento de Clínica Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto (SP) Brasil.

Eur J Case Rep Intern Med 2018 27;5(9):000938. Epub 2018 Sep 27.

Emergency Department, Hospital of Braga/Medical School of University of Minho, Braga, Portugal.

Pulmonary embolism (PE) is the most serious and life-threatening clinical presentation of venous thromboembolism, and difficult to diagnose. Triple point-of-care-ultrasonography (POCUS) of the lung, heart and leg veins is a multiorgan approach that may help to evaluate patients suspected of having PE, in combination with existing protocols and computed tomographic pulmonary angiography (CTPA). We present the case of a 26-year-old man with sudden onset of dyspnoea and swelling of the leg with a Well's score of 9. Read More

Eur J Case Rep Intern Med 2018 28;5(8):000899. Epub 2018 Aug 28.

Department of Radiology, University Hospital Kerry, Tralee, Ireland.

May-Thurner syndrome (MTS) usually presents as acute or chronic deep vein thrombosis (DVT) in patients. A 49-year-old woman presented with left lower limb DVT, which was followed by a diagnosis of MTS on a background of polycystic ovary syndrome (PCOS) and hypothyroidism. MTS is more common among women in the second to fourth decades of life. Read More

Eur J Case Rep Intern Med 2018 31;5(1):000713. Epub 2018 Jan 31.

Consultant in Haematology and General Internal Medicine, AlKhums General Hospital, Libya.

This case demonstrates the therapeutic challenges encountered when managing an acute pulmonary embolism in a cancer patient with thrombocytopenia. A 64-year-old man with a history of lung cancer receiving chemotherapy was admitted to Walsall Manor Hospital with haemodynamic instability consistent with a pulmonary embolism, proven on computed tomographic pulmonary angiogram. His platelet count was noted to be 35×10/l (chemotherapy-induced thrombocytopenia). Read More

Blood Adv 2019 Feb;3(3):489-498

Division of Pediatric Pathology, Department of Pathology.

Tissue factor pathway inhibitor (TFPI) is a serine protease with multiple anticoagulant activities. The Kunitz1 (K1) domain of TFPI binds the active site of factor VIIa and is required for inhibition of tissue factor (TF)/factor VIIa catalytic activity. Mice lacking TFPI K1 domain die in utero. Read More