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Pathophysiology and Clinical Evaluation of the Patient with Acute Heart Failure
Published in Andreas P. Kalogeropoulos, Hal A. Skopicki, Javed Butler, Heart Failure, 2023
Georgios Bakosis, Vasiliki Bistola, Eftyhia Polyzogopoulou, John Parissis
Hematologic parameters (complete blood count) may reveal anemia or underlying infection. Arterial blood gas is particularly helpful to assess respiratory or metabolic acidosis in cases with persistent respiratory distress,52 although serum lactate is considered to be a good prognosticator of outcome in shock.53 D-dimer testing is indicated in patients with suspected acute pulmonary embolism.
Methodology and Clinical Implementation of Ventilation/Perfusion Tomography for Diagnosis and Follow-up of Pulmonary Embolism and Other Pulmonary Diseases
Published in Michael Ljungberg, Handbook of Nuclear Medicine and Molecular Imaging for Physicists, 2022
Before performing imaging tests, it is recommended to estimate the clinical probability for PE [7]. Usually, a Wells score is applied. The measurement of D-dimer – a breakdown product of cross-linked fibrin clot – is widely used in the investigative workup of patients with suspected venous thromboembolism. However, D-dimer has a low specificity (40%) because a number of conditions, other than venous thromboembolism, may cause it to be elevated: For example, acute myocardial infarction, stroke, inflammation, active cancer, and pregnancy. The specificity declines even further with age and, in the elderly, may reach only 10 per cent [8]. Due to the low predictive value, a positive quantitative D-dimer test does not modify the pre-test probability. A negative quantitative D-dimer test combined with a low clinical probability is associated with a low risk of thromboembolic disease. At moderate to high pre-test clinical probability, D-dimer has no incremental value.
Paper 1
Published in Aalia Khan, Ramsey Jabbour, Almas Rehman, nMRCGP Applied Knowledge Test Study Guide, 2021
Aalia Khan, Ramsey Jabbour, Almas Rehman
The following are true about British Thoracic Society (BTS) guide lines on pulmonary emboli (PE) except which one? A negative D-dimer reliably excludes a PE.Isotope scanning is the recommended initial radiological investigation for non-massive PE.All patients with a possible PE need to have their probability assessed and recorded.D-dimer tests should only be considered following assessment of clinical probability.Computed tomography pulmonary angiography (CTPA) is the recom mended initial radiological investigation for non-massive PE.
Post COVID-19 Retinal Evaluation Using Optical Coherence Tomography Angiography: A Case Control Study
Published in Ocular Immunology and Inflammation, 2023
Ramy Emad Nageeb Louz, Mohamad Amr Salah Eddin, Tamer A. Macky, Doaa Ahmed Abdelrahman Tolba
The patients’ laboratory investigations showed: Lymphopenia in 23 cases (51.1%).CRP ranged from (0.51) mg/ml to (105) mg/ml with an average level of 23.08 ± 29.47 mg/ml and elevated in 26 cases (57.8%) (Normal value: 0–6 mg/L).Serum ferritin ranged from (6) ng/ml to (601) ng/ml with an average level of 195.82 ± 155.24 ng/ml.D-dimer ranged from (0.20) μg/ml to (0.89) μg/ml with an average level of 0.40 ± 0.19 μg/ml.
The predictive utility of atherosclerosis-related risk factors as predictors of the prognosis of idiopathic sudden sensorineural hearing loss in older adults
Published in Acta Oto-Laryngologica, 2023
Zhi-Ting Chen, Yichen Guo, Jing Zhang, Xiaobing Huang, Jianhong Wang
D-dimer is a key atherosclerosis-related biomarker generated by the degradation of cross-linked fibrin and serum or plasma D-dimer concentrations reflect coagulatory function and systemic fibrinolytic system activation 23, with higher D-dimer levels indicating a higher level of thrombotic activity that is associated with the degree of thrombosis and several other pathophysiological characteristics. D-dimer levels are impacted by infections, cerebrovascular disease, venous thrombosis, and other factors [15]. Previously, D-dimer levels were found to be of value when attempting to predict the incidence of acute ischemic stroke and total stroke, particularly in cases of cardioembolic stroke, in addition to offering insight into acute coronary syndrome prognosis, intracranial large vessel occlusion, and cerebral reperfusion [16,17]. Mechanistically, how atherosclerosis relates to levels of D-dimer has yet to be fully clarified. Just as a previous study suggests, D-dimer may be associated with the oxidized phospholipids on apolipoprotein B-100 (OxPL-apoB), which are in turn related to the inflammatory cytokine IL-6 [18]. Zhou et al. have thus speculated that D-dimer may contribute to poor prognostic outcomes through inflammatory pathways due to increases in IL-6 levels and a concomitant increase in overall inflammation [17]. Whether this is the case, however, and how plasma D-dimer levels relate to other important ISSNHL-related inflammatory biomarkers including NLR, PLR, and cytokine levels thus warrant further Exploration [6].
Safety evaluation of long-term temperature controlled whole-body thermal treatment in female Aachen minipig
Published in International Journal of Hyperthermia, 2021
Marcia Weber Carneiro, Luigi Brancato, Britta Wylleman, Eke van Zwol, Liesbet Conings, Peter Vueghs, Ivana Gorbaslieva, Johan Van den Bossche, Oleg Rudenko, Michel Janicot, John-Paul Bogers
As illustrated in Figure 5, levels of thrombocytes dropped after WBTT procedures but remained stable and within the normal range after some days, for most of the minipigs. Together with the observed parallel rise of D-dimer (also known as fragment D-dimer or fibrin degradation fragment) concentration, this could be the result of disseminated coagulation. D-dimer is one of the protein fragments produced when a blood clot gets dissolved in the body. Therefore, D-dimer testing is classically performed to help rule out clotting (thrombotic) episodes and to help diagnose conditions related to thrombosis [42,43]. However, there was no clear sign of clotting in any histologically investigated organ, and all functions and parameters (including thrombocyte levels) recovered quickly after the experiment. In MP3 and more pronounced in MP2, the drop-in thrombocyte counts already started during the warmup phase. The mirror image is consistently observed in the D-dimer concentration changes, which increase from the start of the experiment, and then back to baseline after ∼1 week. Potentially the thrombocyte count and D-dimer concentration changes are the results of intravascular physical intervention (i.e. animal handling operations and surgical placement of catheters and temperature sensors) potentially enhanced by thermal treatment, as the changes observed in MP4 (normothermia, 37 °C for 8 h) are less pronounced on these parameters.