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Daniel Horner Kerstin Hogg Richard Body Steve Jones Michael J. Nash Kevin Mackway‐Jones 《British journal of haematology》2014,164(3):422-430
International guidance has recently recommended serial proximal compression ultrasound (CUS) as first line imaging for suspected deep vein thrombosis (DVT). Single whole‐leg CUS is a routine alternative diagnostic strategy that can reduce repeated attendances and identify alternative pathology. We conducted a prospective observational cohort study. Consecutive ambulatory, adult patients with suspected DVT and negative or inconclusive whole‐leg CUS had anticoagulation withheld and were followed for 3 months. The primary outcome was a predefined clinically relevant adverse event rate. Secondary outcomes included technical failure, alternative diagnoses and all cause mortality. 212 patients agreed to participate and completed follow up. One patient was subsequently diagnosed with an isolated distal DVT. The adverse event rate was thus 1/212, 0·47% (95% confidence interval [CI] 0·08–2·62). Technical imaging failure occurred in 11·3% of cases (95% CI 7·7–16·3). Several potential predictors of an inconclusive result were identified on multivariate analysis. 150 (70·8%) patients were provided with a documented alternative diagnosis. Patients who have anticoagulation withheld following a negative or inconclusive whole‐leg CUS for suspected DVT have a low rate of adverse events. Technical failure remains an issue: several factors were significantly associated with inconclusive results and may warrant an alternative diagnostic approach. 相似文献
986.
George W. Rebok PhD Karlene Ball PhD Lin T. Guey PhD Richard N. Jones ScD Hae‐Young Kim DrPH Jonathan W. King PhD Michael Marsiske PhD John N. Morris PhD Sharon L. Tennstedt PhD Frederick W. Unverzagt PhD Sherry L. Willis PhD for the ACTIVE Study Group 《Journal of the American Geriatrics Society》2014,62(1):16-24
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Kristjan Paulson Anna Serebrin Pascal Lambert Julie Bergeron Janeve Everett Andrea Kew David Jones Salah Mahmud Catherine Meloche Mitchell Sabloff Ismail Sharif John Storring Donna Turner Matthew D. Seftel 《British journal of haematology》2014,166(5):660-666
Timely diagnosis and care are major determinants of the outcome in acute promyelocytic leukaemia (APL), a malignancy whose incidence may be increasing. The Canadian Cancer Registry (CCR) and health system represent valuable settings to study APL epidemiology. We analysed the CCR, which contains data on all Canadians with APL. To provide clinical information lacking in the CCR, we obtained data from five leukaemia referral centres during a similar time period. Between 1993 and 2007, there were 399 APL in Canada. Age‐standardized incidence was 0·083/100 000 and was stable over time. The early death (ED) rate was 21·8% (10·6% in patients <50 years old and 35·5% for those aged >50 years), with no improvement over time. Five‐year overall survival (OS) was 54·6% (73·3% in patients <50 years; 29·1% older patients). In the referral cohort, 131 patients were diagnosed between 1999 and 2010. ED was 14·6% and 2‐year OS was 76·5%. Within this cohort, ED and OS improved over time, although advanced patient age remained an adverse determinant of OS. In Canada, APL incidence is unexpectedly low and temporally stable. ED was higher than reported in clinical trials, but similar to reports from other registries. In contrast, ED was lower in referral centres and improved with time. 相似文献
989.
Karin G. Stenkula Maria Lindahl Jitka Petrlova Jonathan Dalla-Riva Olga Göransson Samuel W. Cushman Ewa Krupinska Helena A. Jones Jens O. Lagerstedt 《Diabetologia》2014,57(4):797-800