Significant improvement has been achieved in diagnostic accuracy, validation of probability scores, and standardized treatment algorithms for patients with suspected acute pulmonary embolism. These developments have provided the tools for a safe and cost-effective management for most of these patients. In our experience, however, the presence of medical myths and ongoing controversies seem to hinder the implementation of these tools in everyday clinical practice. This review provides a selection of such dilemmas and controversies and discusses the published evidence beyond them. By doing so, we try to overcome these dilemmas and suggest pragmatic approaches guided by the available evidence and current guidelines.
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http://dx.doi.org/10.1016/j.amjmed.2019.01.011 | DOI Listing |
BMC Ophthalmol
January 2025
Department of Retina and Vitreous, Narayana Nethralaya, #121/C, 1st R Block, Chord Road, Rajaji Nagar, Bengaluru, Karnataka, 560010, India.
Background: Accurate localization of premacular hemorrhages (PMHs) is crucial as treatment strategies vary significantly based on whether the hemorrhage resides within the vitreous gel, subhyaloid space, or beneath the internal limiting membrane (ILM). This report outlines the clinical features, diagnostic findings, and treatment outcomes in a patient diagnosed with a PMH secondary to suspected Valsalva retinopathy.
Methods: This is a retrospective interventional case report.
BMC Neurol
January 2025
Department of Neurosurgery, Gifu University Graduate School of Medicine, 1-1, Yanagido, Gifu, 501-1194, Japan.
Background: Tyrosine kinase inhibitors (TKIs) improve prognosis in chronic myeloid leukemia (CML). Nilotinib and ponatinib, second- and third-generation TKIs, respectively, have been reported to cause adverse vascular occlusive events such as myocardial infarction and peripheral arterial disease. However, little is known about the risk of cerebral infarction associated with severe cerebrovascular stenosis, which is a late complication of TKIs.
View Article and Find Full Text PDFCardiovasc Revasc Med
December 2024
Department of Cardiology, Tel Aviv Sourasky Medical Center, affiliated with the School of Medicine, Tel Aviv University, Israel.
Background: Angina with non-obstructive coronary artery disease (ANOCA) is commonly observed in patients with stable angina undergoing coronary angiography. Current guidelines recommend non-invasive stress testing as the first step in diagnosing coronary microvascular disease (CMD). This study aims to evaluate the diagnostic value of non-invasive stress testing in patients invasively diagnosed with CMD.
View Article and Find Full Text PDFBMJ Case Rep
January 2025
Critical Care Medicine, Metropolitan Bokutoh Hospital, Tokyo, Japan.
Cardiogenic shock with bradycardia due to beta-blockers is well-documented; however, this condition in association with arotinolol is unreported. We present a case of cardiogenic shock resulting from delayed arotinolol clearance caused by bile duct obstruction. A man in his 60s presented to our hospital with jaundice.
View Article and Find Full Text PDFBMJ Open Qual
January 2025
Division of Cardiovascular Sciences, The University of Manchester, Manchester, UK.
Introduction: Stroke is a leading cause of mortality and morbidity, demanding prompt and accurate identification. However, prehospital diagnosis is challenging, with up to 50% of suspected strokes having other diagnoses. A prehospital video triage (PHVT) system was piloted in Greater Manchester to improve prehospital diagnostic accuracy and appropriate conveyance decisions.
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