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Inside Out: Bone Marrow Necrosis and Fat Embolism

  Neurologic symptoms initially attributed to infection were ultimately the result of a devastating hematologic condition. The patient, a 57-year-old woman, was rushed to the emergency department for somnolence and slurred speech. She had experienced low back pain during the preceding week. Her medical history was notable for a ventriculoperitoneal shunt placed several years ago […]

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Unnecessary Hospitalizations for Pulmonary Embolism: Impact on US Health Care Costs

  Each year, more than 350,000 patients are treated for pulmonary embolism in US hospitals. Recent reports indicate that the majority of these patients do not have to be hospitalized: they can be safely treated at home, which will result in a tremendous decrease in our health care costs. One of the first reports that […]

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Adherence to PIOPED II Investigators’ Recommendations for Computed Tomography Pulmonary Angiography

Non-adherence to recommendations for CT pulmonary angiography is common and exposes patients to increased risks, including potential false positive diagnoses of pulmonary embolism. Abstract  Background  Computed tomography (CT) pulmonary angiography use has increased dramatically, raising concerns for patient safety. Adherence to recommendations and guidelines may protect patients. We measured adherence to the recommendations of Prospective […]

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Chasing Pulmonary Emboli

Chasing Pulmonary Emboli: Let’s Agree on One Big Thing Clinical practice guidelines can be great. It’s nice to have guidelines for the diagnosis, management, and long-term care objectives for basically every condition known to medicine. Clinical practice guidelines are supposed to be the foundation of 21st century evidence-based medicine. But clinicians frequently do not follow […]

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Thrombolytics & Vena Cava Filters

Thrombolytics and Vena Cava Filters Decrease Mortality in Patients with Unstable Pulmonary Embolism Standard anticoagulant therapy is very effective in patients with pulmonary embolism who are hemodynamically stable. Hospital mortality is in the range of 5% or less.(1) However, in patients with shock secondary to massive pulmonary embolism, mortality ranges from 30% to 50%.2 A […]

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