Current guidelines state that patients over 40 years of age with a first unprovoked pulmonary embolism should be offered limited screening for possible cancer and considered for intensive screening (abdomino-pelvic computed tomography and mammography), despite no evidence for the latter. The aim of this study was to evaluate the clinical utility and cost of intensive screening in routine clinic...

BACKGROUND Randomized trials and meta-analyses have reached conflicting conclusions regarding the risk benefit ratio of thrombolytic therapy or anticoagulant therapy in patients with moderate pulmonary embolism. To investigate the effect of initial thrombolysis and anticoagulant therapy in patients with moderate pulmonary embolism, we performed an updated meta-analysis. METHODS We searched th...

OBJECTIVE To validate all diagnostic prediction models for ruling out pulmonary embolism that are easily applicable in primary care. DESIGN Systematic review followed by independent external validation study to assess transportability of retrieved models to primary care medicine. SETTING 300 general practices in the Netherlands. PARTICIPANTS Individual patient dataset of 598 patients with...

OBJECTIVES To assess the likelihood ratios of diagnostic strategies for pulmonary embolism and to determine their clinical application according to pretest probability. DATA SOURCES Medline, Embase, and Pascal Biomed and manual search for articles published from January 1990 to September 2003. STUDY SELECTION Studies that evaluated diagnostic tests for confirmation or exclusion of pulmonary...

A recent reporti indicates an exceedingly high incidence rate (73 percent) of negative pulmonary arteriograms in patients with suspected pulmonary embolism. All of these patients had a “suitable clinical history,” hypoxemia and positive perfusion scans. In view of this apparent failure of clinical evaluation and noninvasive tests, it was concluded that overdiagnosis and overtreatment can be avo...

Orthopaedic patients are at particularly high risk for pulmonary embolism. There has been a trend recently toward overdiagnosis of pulmonary embolism; thus, evaluation of the nature of a clinically relevant pulmonary embolism is needed, as is assessment of the timing, risks, and outcomes of therapeutic anticoagulation in surgical patients. Recent literature shows the incidence of pulmonary embo...

Pulmonary embolism is a serious complication, which is well known in patients undergoing total hip or total knee arthroplasty or lower extremity fracture surgery. But, there are few literatures concerning pulmonary embolism after upper extremity surgery. Pulmonary embolism after minor upper extremity fracture surgery is extremely rare. We report a case of 66-year-old female patient that develop...

Pulmonary embolism is one of the leading causes of cardiovascular related death beside myocardial infarction and stroke. Contrary to stroke and myocardial infarction, diagnosis of pulmonary embolism is considered to be much more difficult and complicated compare with the treatment once diagnosis is confirmed. Multiple diagnostic studies including clinical scoring, serum biomarker and diagnostic...

The Authors Reply It is very well known that the mortality in acute pulmonary embolism patients presenting with cardiac arrest is very high. One of the aims of our manuscript is to emphasize that thrombolytic therapy is a lifesaving choice of treatment even in resuscitated massive pulmonary embolism patients. The other aims of our manuscript are to highlight the fact that massive pulmonary embo...