Aneurysms of the pulmonary arteries.

Dissecting aneurysms of arteries other than the aorta.

Pulmonary artery dilatation correlates with the risk of unexpected death in chronic arterial or thromboembolic pulmonary hypertension

Pulmonary arterial aneurysm. A pathologic study of five cases.

Pulmonary artery dissection in patients without underlying pulmonary hypertension

Aims: Pulmonary artery (PA) dissection is a rare event which usually occurs in patients with underlying pulmonary hypertension. We describe two patients who developed PA dissection without pre-existing pulmonary hypertension and present an extensive review of the literature.

Methods and results: In the first patient (a 59-year-old woman), acute-onset dyspnoea was initially thought to have been caused by pulmonary thrombosis, and thromboendarterectomy was performed. Histologically, pulmonary dissection without external rupture was evident, chiefly in the right main PA. In the second patient, an 85-year-old man who had hypergammaglobulinaemia of unknown cause and died from a haemorrhagic gastric ulcer, arterial dissection was detected at autopsy. There was no underlying pulmonary hypertension in either patient. Although the true reason for the development of dissection is unclear, pre-existing inflammation was considered to be related to its formation, at least in the second case.

Conclusions: A literature review indicated that idiopathic and inflammation-related PA dissection is extremely unusual. Since PA dissection is very rare, it is important to be aware of its features in order to make a correct diagnosis.

Pulmonary artery dissection in patients without underlying pulmonary hypertension

Dissecting aneurysm of the pulmonary artery.

Context: Anticoagulants are used to prevent and treat venous thromboembolism (VTE), such as deep-vein thrombosis (DVT) and pulmonary embolism (PE) in COVID-19 for better outcomes. Aim: This study aims to explore clinical outcomes and factors affecting VTE among COVID-19 patients. Settings and Design: The study design involved a retrospective cohort study. Study Methods: Hospitalized COVID-19 patients in a tertiary hospital prescribed subcutaneous (SC) anticoagulants were included. Statistical Analysis Used: Multiple logistic regression was performed to determine factors affecting VTE among subjects. Results: A total of 450 patients were included. Types of anticoagulants include fondaparinux (n = 114, 38.1%), enoxaparin (n = 113, 37.8%), and heparin (n = 72, 24.1%). 423 (94.0%) patients were discharged well, 27 (6.0%) patients were admitted to the intensive care unit (ICU). The primary outcome was the prevalence of VTE, which occurred in 19.3% (n = 87) patients, with 80 (92.0%) reporting DVT and 7 (8.0%) reporting PE. The secondary outcome, which was the average length of hospital stay was 9.9 (±4.7) days. Factors of VTE occurrence were likely in patients not prescribed SC anticoagulants compared to those prescribed with SC anticoagulants (adjusted odds ratio [aOR] 54.330, 95% confidence interval [CI]: 7.086, 416.526), treatment with fondaparinux compared to heparin (aOR 2.502, 95% CI: 1.175, 5.327), and less likely in those discharged well compared to patients in the ICU (aOR 0.139, 95% CI: 0.053, 0.361). Conclusions: Careful monitoring is required to reduce VTE risk in COVID-19 patients.

Factors of venous thromboembolism among COVID-19 patients

There is a lack of subcutaneous anticoagulant counseling tools for COVID-19 patients. This study aims to develop and validate a written counseling tool for subcutaneous anticoagulant use in COVID-19 patients. A prospective cohort study was performed with expert panels and patients. The tool was validated by hospital pharmacists using Content Validity Index (I-CVI), Scale-level-CVI (S-CVI), and Universal Acceptance (UA). Face validation by patients was determined using Item Acceptance Index (IAI), and Universal Acceptance (UA). Hospital pharmacists (n=26) were mostly female (n=18, 69.2%) and Chinese (n=20, 76.9%), with a mean age of 35.8 +/- 2.9 years. All items were assessed relevantly (n=18, 100%), I-CVIs ranging from 0.96-1.00 by hospital pharmacists. The average proportion of items, I-CVI average, (Sum of I-CVI/no. of items: 17.88/18) was reported as 0.99. S-CVI/UA (Sum of UA/no. of items: 15/18) was reported as 0.83, and S-CVI/Average (Sum of I-CVI/no. of items: 17.88/18) was reported as 0.99 indicating high content validity. Patients (n=28) involved in face validation of the construct were mostly female (n=19, 67.9%), Malay (n=46.4%), and tertiary educated (n=20, 71.4%) with a mean age of 38.0 +/- 9.8 years. All items were marked as relevant (n=18, 100%), with IAI ranging from 0.93-1.00, suggesting patients accepted each item of the construct. The average proportion of items was reported as 0.99 (Sum of IAI/no. of items: 17.82/18), indicating excellent acceptance and content comprehension among patients. The developed counseling tool is acceptable for anticoagulant education among COVID-19 patients.

https://archivepp.com/storage/files/article/243a4839-76e3-4429-ac93-d65e60f2cf43-4lYc5Oqb6hRdFbNq/archiveapp-vol14-iss2-19-24-1382.pdf

L. P. Low

Papers

Dissecting aneurysm of the pulmonary artery.

Factors of venous thromboembolism among COVID-19 patients

Development of Written Counseling Tool for Subcutaneous Anticoagulant Use in COVID-19 Patients