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Browsing by Author "Maldonado, Sarina Masso"
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Item Current Management of Acute Pulmonary Embolism(AME Publishing Company, 2020) Martinez Licha, Carlos R.; McCurdy, Chelsea M.; Maldonado, Sarina Masso; Lee, Lawrence S.; Medicine, School of MedicinePurpose: Acute pulmonary embolism (PE) remains a significant cause of morbidity and requires prompt diagnosis and management. While non-surgical approaches have supplanted surgery as primary treatment, surgical pulmonary embolectomy (SPE) remains a vital option for select patients. We review the current management of acute PE, with a focus on surgical therapy. Methods: A PubMed search was performed to identify literature regarding PE and treatment. Results were filtered to include the most comprehensive publications over the past decade. Results: PE is stratified based on presenting hemodynamic status or degree of mechanical pulmonary arterial occlusion. Although systemic or catheter-guided fibrinolysis is the preferred first-line treatment for the majority of cases, patients who are not candidates should be considered for SPE. Studies demonstrate no mortality benefit of thrombolysis over surgery. Systemic anticoagulation is a mainstay of treatment regardless of intervention approach. Following surgical embolectomy, direct oral anticoagulants (DOACs) have been shown to reduce recurrence of thromboembolism. Conclusions: Acute PE presents with varying degrees of clinical stability. Patients should be evaluated in the context of various available treatment options including medical, catheter-based, and surgical interventions. SPE is a safe and appropriate treatment option for appropriate patients.Item Video visits for isotretinoin patients are perceived as safe, effective, and convenient(UC Davis, 2021) Hekman, Daniel; Maldonado, Sarina Masso; Wolverton, Jay; Rahnama-Moghadam, Sahand; Dermatology, School of Medicine