Emergency medicine journal : EMJ
-
A short-cut review was carried out to establish whether treatment of isolated distal deep vein thrombosis with therapeutic anticoagulation can reduce adverse clinical outcomes. A meta-analysis from 2011 and 11 subsequent directly relevant papers were found using the reported search strategy. ⋯ The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these best papers are tabulated. It is concluded that patients diagnosed with isolated distal deep vein thrombosis should be individually risk assessed and treated according to their risk of thrombotic complication, bleeding with anticoagulation and personal preference.
-
A short-cut review was carried out to establish whether thrombolysis in addition to therapeutic anticoagulation could be of benefit in submassive (intermediate risk) pulmonary embolism (PE). 64 directly relevant papers were found using the reported search strategy. Of these, three presented the best evidence to answer the clinical question. ⋯ It is concluded that there is insufficient evidence to support the routine use of adjuvant thrombolytic therapy at any dose for patients with submassive PE. Carefully selected patients with a low bleeding risk who attribute high importance to functional outcome may stand to benefit.
-
Injuries to the foot are a common cause for presentation to the emergency department, and imaging is often used to aid in the diagnosis. The foot can be divided into three distinct anatomic regions: the forefoot, midfoot and hindfoot. ⋯ We provide pearls to radiographic interpretation and discuss prognostic implications and classification systems. Part 1 addresses forefoot injuries, part 2 reviews midfoot injuries and part 3 covers the hindfoot.