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Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care

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Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
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Skeletal muscle relaxants are used to relax muscle tone and alleviate painful muscle contractions. However, the choice of skeletal muscle relaxants depends on the duration of the surgical procedure in order to minimize potential side effects. Skeletal muscle relaxants like neuromuscular blocking agents [NMBAs] are commonly employed as adjuvants alongside general anesthetics in clinical settings. NMBAs are also used to maintain controlled ventilation during surgery of the larynx or pharynx...
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Pulmonary embolism (PE) occurs when a thrombus, fat or air embolus, amniotic fluid, or tumor tissue blocks one or more pulmonary arteries. These blockages originate in the venous system or the right side of the heart.EtiologyPE primarily arises from deep vein thrombosis (DVT) and other hypercoagulable states, such as inherited thrombophilias. Additional etiological factors include venous stasis, commonly seen in obesity, and endothelial injury from surgery and trauma. Less common causes include...
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Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
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Directly acting muscle relaxants like dantrolene and botulinum toxin (BoNT) have distinct mechanisms and applications. Dantrolene, a hydantoin derivative, acts on the ryanodine receptor (RYR1) in skeletal muscle cells. RYR1 are calcium channels present at the sarcoplasmic reticulum membrane. In response to excitation, they release calcium ions from the sarcoplasmic reticulum to the cytosol. Calcium promotes actin-myosin-mediated contraction of muscles.
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Musculoskeletal Embolotherapy.

T F Barge1, M W Little2

  • 1University Department of Radiology, Royal Berkshire NHS Foundation Trust, Reading, UK.

Cardiovascular and Interventional Radiology
|November 9, 2022
PubMed
Summary
This summary is machine-generated.

Transcatheter embolisation shows promise for managing musculoskeletal pain, particularly in knee osteoarthritis. Further high-quality research is needed to confirm its efficacy and safety for various painful conditions.

Keywords:
EmbolisationJointsMusculoskeletal

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Area of Science:

  • Interventional Radiology
  • Musculoskeletal Medicine
  • Pain Management

Background:

  • Musculoskeletal (MSK) conditions cause significant pain and disability.
  • Current treatments for MSK pain can be limited or difficult.
  • Transcatheter embolisation is an emerging minimally invasive treatment option.

Purpose of the Study:

  • To review the pathophysiology and mechanism of action of transcatheter embolisation for MSK pain.
  • To discuss the technical aspects and embolic agents used in the procedure.
  • To evaluate the current clinical outcomes, adverse effects, and future research directions.

Main Methods:

  • Literature review of studies on transcatheter embolisation for MSK conditions.
  • Analysis of evidence regarding mechanism of action, technical considerations, and clinical results.
  • Appraisal of existing data on efficacy and safety, including adverse events.

Main Results:

  • Transcatheter embolisation is being explored for knee osteoarthritis, adhesive capsulitis, and tendinopathies.
  • Early results suggest potential benefits, but most studies are open-label and non-randomised.
  • A need exists for high-quality, randomised controlled trials to validate efficacy.

Conclusions:

  • Transcatheter embolisation is a developing technique for MSK pain management.
  • Further robust evidence is required to establish its role in clinical practice.
  • Future research should focus on high-quality trials to assess efficacy and safety.