Abstract：
OBJECTIVE:To determine the sensitivity and specificity of a quantitative plasma fibrin D-dimer latex immunoassay (LIA) for the diagnosis of acute pulmonary embolism. SUBJECTS AND METHODS:Study subjects were Mayo Clinic Rochester inpatients and outpatients with suspected acute pulmonary embolism; all had undergone quantitative D-dimer LIA testing and multidetector-row computed tomographic (CT) angiography between August 3, 2001, and November 10, 2003. Multidetector-row CT angiography was the diagnostic reference standard. RESULTS:Of 1355 CT studies, 208 (15%) were positive for acute pulmonary embolism. Median D-dimer levels were significantly higher for patients with acute pulmonary embolism (1425 ng/mL) than for patients without (500 ng/mL) (P<.001). The highest specificity that optimizes sensitivity for acute pulmonary embolism was achieved by using a discriminant value of 300 ng/mL, which yielded a sensitivity of 0.94 (95% confidence interval [CI], 0.89-0.97), a specificity of 0.27 (95% CI, 0.25-0.30), and a negative predictive value of 0.96 (95% CI, 0.93-0.98). CONCLUSION:The quantitative D-dimer LIA with a discriminant value of 300 ng/mL had high sensitivity and high negative predictive value but low specificity for the diagnosis of acute pulmonary embolism. On the basis of these results, we believe that a negative quantitative D-dimer LIA result and a low pretest probability of thromboembolism together are sufficient to exclude acute pulmonary embolism.
journal_name
Mayo Clin Procjournal_title
Mayo Clinic proceedingsauthors
Froehling DA,Daniels PR,Swensen SJ,Heit JA,Mandrekar JN,Ryu JH,Elkin PLdoi
10.4065/82.5.556subject
Has Abstractpub_date
2007-05-01 00:00:00pages
556-60issue
5eissn
0025-6196issn
1942-5546pii
S0025-6196(11)61278-0journal_volume
82pub_type
杂志文章abstract：:Constrictive pericarditis frequently poses a diagnostic challenge because of its varied manifestations. Accurate diagnosis is essential, however, because surgical decortication may yield excellent clinical results. Although new diagnostic procedures have helped the clinician to diagnose constrictive pericarditis, the ...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/s0025-6196(12)60850-7
更新日期：1985-06-01 00:00:00
abstract：:Catastrophic infarcts of the cerebral hemisphere often involve occlusion of the middle cerebral artery. In approximately 50% of these patients, consciousness declines because of brain swelling. Management includes prevention of further systemic complications, and recent studies have suggested that decompressive hemicr...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,评审
doi：10.4065/75.9.945
更新日期：2000-09-01 00:00:00
abstract：OBJECTIVE:In this report, our goal was to summarize the current knowledge of the biochemical basis for the impaired DNA synthesis and neuropathy associated with vitamin B12 deficiency. MATERIAL AND METHODS:We reviewed the pertinent literature and our clinical experience with cobalamin deficiency. RESULTS:Studies have...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,评审
doi：10.1016/s0025-6196(12)61046-5
更新日期：1994-02-01 00:00:00
abstract：OBJECTIVE:To examine the ability of 4 published osteoporosis risk indices to identify women with low bone density. SUBJECTS AND METHODS:Subjects included postmenopausal women 45 years and older consecutively recruited from US clinics, women from general practice centers in The Netherlands (age range, 50-80 years), wom...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.4065/77.7.629
更新日期：2002-07-01 00:00:00
abstract：:Tinnitus, a common complaint, reportedly affects more than 37 million Americans. Most often, it is associated with a sensorineural hearing loss in the high-frequency range. Tinnitus, however, is a symptom and not a disease. Complacency about this symptom complex may cause physicians to overlook a severe underlying pat...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,评审
doi：10.1016/s0025-6196(12)60521-7
更新日期：1991-06-01 00:00:00
abstract：:Extending a study of the period 1935-1964, we determined the incidence rates of leukemia in Olmsted County during the decade 1965-1974. In this decade, the overall crude annual incidence rate was 9.5 per 100,000. The ratio of males to females was 2.4 to 1; and the incidence rate was significantly higher among males th...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：
更新日期：1978-11-01 00:00:00
abstract：OBJECTIVE:To investigate the impact of obesity and underweight on adverse in-hospital outcomes in pulmonary embolism (PE). PATIENTS AND METHODS:Patients diagnosed as having PE based on International Statistical Classification of Diseases and Related Health Problems, 10th Revision, German Modification code I26 in the G...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/j.mayocp.2019.04.035
更新日期：2019-10-01 00:00:00
abstract：:Multiple regression analysis were used to investigate the relationship between blood pressure and age, sex, relative weight, antihypertensive medication, diabetes mellitus, diet (low-salt, low-cholesterol, and weight-reducing regimens), cigarette smoking, coffee drinking, and aerobic exercise among a stratified random...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/s0025-6196(12)65532-3
更新日期：1988-07-01 00:00:00
abstract：:A patient simulator has been developed for training, certification, modeling, and demonstrating problems in the management of critical-care patients. The Critical Care & Hemodynamic Monitoring Training System consists of a personal computer, software, and a replica of a human torso designed to enable students to pract...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/s0025-6196(12)65158-1
更新日期：1990-07-01 00:00:00
abstract：:Drugs that target G protein-coupled receptors (GPCRs) represent the primary treatment strategy for patients with acute and chronic pain; however, there is substantial individual variability in both the efficacy and adverse effects associated with these drugs. Variability in drug responses is due, in part, to individua...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,评审
doi：10.1016/j.mayocp.2015.06.010
更新日期：2015-08-01 00:00:00
abstract：OBJECTIVE:To ascertain the usefulness of bone marrow and cerebrospinal fluid (CSF) examinations in identifying or predicting relapse in children with acute lymphoblastic leukemia (ALL) before discontinuation of chemotherapy. MATERIAL AND METHODS:We retrospectively reviewed the medical records of 113 children with ALL ...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.4065/71.9.854
更新日期：1996-09-01 00:00:00
abstract：:A 4 1/2-year-old girl is described in whom the portal vein is absent and the venous return from the gastrointestinal tract, spleen, and pancreas is through the left renal vein into the inferior vena cava. She had a hepatoblastoma, which was treated surgically by right hepatic lobectomy. Regeneration occurred in the re...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：
更新日期：1979-01-01 00:00:00
abstract：:Use of amiodarone, an investigational antidysrhythmic agent, has been associated with cases of pulmonary toxicity. The mechanism of amiodarone pulmonary toxicity is unknown, and recommendations for the assessment and treatment of patients with this condition continue to evolve. In two patients with clinically diagnose...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/s0025-6196(12)60983-5
更新日期：1985-09-01 00:00:00
abstract：OBJECTIVE:To assess whether dietary supplements that are herbal and/or animal-derived products, marketed for enhancing metabolism or promoting energy, "adrenal fatigue," or "adrenal support," contain thyroid or steroid hormones. METHODS:Twelve dietary adrenal support supplements were purchased. Pregnenolone, androsten...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/j.mayocp.2017.10.019
更新日期：2018-03-01 00:00:00
abstract：:Abdominal apoplexy is a clinical entity characterized by spontaneous intraperitoneal hemorrhage from rupture of a visceral vessel. We describe a 34-year-old man who presented with abdominal apoplexy due to rupture of an ileocolic aneurysm. Subsequent biochemical and genetic analysis confirmed the diagnosis of Ehlers-D...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.4065/77.8.861
更新日期：2002-08-01 00:00:00
abstract：:Risedronate sodium is a pyridinyl bisphosphonate effective for treatment and prevention of postmenopausal and glucocorticoid-induced osteoporosis. Some bisphosphonates have been associated with upper gastrointestinal (GI) tract adverse effects. The objective of this study was to determine the frequency of upper GI tra...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,meta分析
doi：10.4065/77.3.262
更新日期：2002-03-01 00:00:00
abstract：:Susac syndrome (retinocochleocerebral vasculopathy) is a syndrome of unknown pathogenesis. The triad of multifocal encephalopathy, visual loss, and hearing loss is caused by microangiopathy of the brain, retina, and cochlea. The illness tends to be monophasic, and to our knowledge, recurrence after years of remission ...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.4065/76.9.958
更新日期：2001-09-01 00:00:00
abstract：OBJECTIVE:To evaluate the rate of and potential risk factors for bloodstream infections (BSIs) using data from the REVEAL (Registry to Evaluate Early and Long-term Pulmonary Arterial Hypertension [PAH] Disease Management) REGISTRY(®), which provides current information about patients with PAH. PATIENTS AND METHODS:Pat...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,多中心研究
doi：10.1016/j.mayocp.2012.05.014
更新日期：2012-09-01 00:00:00
abstract：:In the last 20 years, the treatment of mood disorders has advanced immeasurably. We now have relatively safe and effective agents for the treatment of depression and mania. This review discusses two types of agents that elevate mood--tricyclic antidepressants and monoamine oxidase inhibitors--including the indications...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,评审
doi：
更新日期：1979-05-01 00:00:00
abstract：UNLABELLED:Cirrhosis and liver cancer, the main causes of liver-related morbidity and mortality, result from defective repair of liver injury. This article summarizes rapidly evolving knowledge about liver myofibroblasts and progenitors, the 2 key cell types that interact to orchestrate effective repair, because deregu...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/j.mayocp.2013.10.009
更新日期：2014-01-01 00:00:00
abstract：:Stereotactic ventralis lateralis thalamotomy can be performed in selected patients with medically intractable parkinsonian tremor and rigidity. New technology, including computed tomography-based stereotaxis and microelectrode recording techniques, provides a data base for precise localization of thalamic lesions tail...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/s0025-6196(12)65215-x
更新日期：1987-08-01 00:00:00
abstract：:The clinical impact of the association between oral contraceptive (OC) use and breast cancer risk is important given that OCs are the most commonly prescribed contraceptive agent and that more than a quarter of a million women are diagnosed as having breast cancer in the United States annually. Substantial changes to ...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,评审
doi：10.4065/83.1.86
更新日期：2008-01-01 00:00:00
abstract：:Q fever, a zoonosis caused by Coxiella burnetii, is seen throughout the world. Recent reports suggest that its incidence in the United States is increasing, with more than 30 cases reported in the US military. The disease has many acute and chronic manifestations. Endocarditis is the most common form of chronic diseas...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章,评审
doi：10.4065/83.5.574
更新日期：2008-05-01 00:00:00
abstract：OBJECTIVE:To assess the association between exercise capacity and the risk of developing atrial fibrillation (AF). PATIENTS AND METHODS:A symptom-limited exercise tolerance test was conducted to assess exercise capacity in 5962 veterans (mean age, 56.8±11.0 years) from the Veterans Affairs Medical Center, Washington, ...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/j.mayocp.2016.03.002
更新日期：2016-05-01 00:00:00
abstract：OBJECTIVE:To describe 3 patients who presented with chest pain and intermittent Q waves on the electrocardiogram (ECG) and were subsequently found to have latent preexcitation. PATIENTS AND METHODS:During a span of 8 years, 3 patients were evaluated because of atypical chest pain and pathologic Q waves in the inferior...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.4065/78.7.840
更新日期：2003-07-01 00:00:00
abstract：:Since 1980, impressive progress in the treatment of solid tumors has altered the practice of pediatric surgical oncology. Because these advances have been balanced by both liberal and conservative viewpoints, an accurate reassessment of traditional approaches has been possible. Noteworthy alterations in chemotherapy, ...
journal_title：Mayo Clinic proceedings
pub_type： 临床试验,杂志文章
doi：10.1016/s0025-6196(12)61929-6
更新日期：1986-04-01 00:00:00
abstract：OBJECTIVE:To verify preliminary studies on patients with melanoma exposed to β-blockers that suggested a reduced risk of disease recurrence and death. PATIENTS AND METHODS:Data were obtained from all consecutive patients diagnosed as having melanoma between January 1, 1993, and December 31, 2009, at the Department of ...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/j.mayocp.2013.09.001
更新日期：2013-11-01 00:00:00
abstract：OBJECTIVE:To document our evolving surgical management of colonoscopic perforation and examine factors crucial to the improvement of patient care. DESIGN:We conducted a computer-based retrospective analysis of medical records (1980 through 1995). MATERIAL AND METHODS:Among 57,028 colonoscopic procedures performed, 43...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/S0025-6196(11)63592-1
更新日期：1997-08-01 00:00:00
abstract：:In this report, we describe 13 cases of primary neurofibrosarcoma of the skin. The tumor presumably arises from small cutaneous nerves, is locally aggressive, and has a potential for metastasis. Characteristic histopathologic features include proliferating atypical spindle cells with slender wavy and pointed nuclei; h...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/s0025-6196(12)65011-3
更新日期：1990-02-01 00:00:00
abstract：OBJECTIVE:To evaluate the frequency and appropriateness of nil per os (nothing by mouth) (NPO) orders and determine the number of meals missed because of these orders among hospitalized patients. PATIENTS AND METHODS:We retrospectively analyzed inpatient NPO orders at an academic institution in the United States. The ...
journal_title：Mayo Clinic proceedings
pub_type： 杂志文章
doi：10.1016/j.mayocp.2015.07.013
更新日期：2015-09-01 00:00:00
