Our objective is to investigate if PE is diagnosed according to clinical practice guidelines. Materials and methods: Retrospective study of clinically suspected PE in the emergency department between January 2010 and December 2012. A D-dimer value bigger than = 500 ng/ml was considered positive. PE was diagnosed on the basis of the multislice computed tomography angiography and, to a lesser extent, with other imaging techniques. The CPS used was the revised Geneva scoring system. Results: There was 3,924

cases of suspected PE (56% female). Diagnosis was determined in 360 patients (9.2%) and the incidence was 30.6 cases per 100,000 inhabitants/year. Sensitivity and the negative predictive value of the D-dimer test were 98.7% and 99.2% respectively. CPS was calculated in only 24 cases (0.6%) and diagnostic algorithms were not followed in 2,125 patients (54.2%): learn more in 682 (17.4%) because clinical probability could not be estimated and in 482 (37.6%), 852(46.4%) and 109(87.9%) with low, intermediate and high clinical probability, respectively, because the diagnostic algorithms

for these probabilities were not applied. Conclusions: CPS are rarely calculated in the diagnosis of PE and the diagnostic algorithm is rarely used in clinical practice. This may result in procedures with potential significant side effects being unnecessarily performed or to a high risk of underdiagnosis. (C) 2013 SEPAR. Published by Elsevier Espana, S.L. All rights reserved.”
“As a peculiar folk medicinal

plant, Acanthopanax brachypus was widely selleck used to Cyclopamine treat various diseases in China. At present, however, there is not a good quality standard for its quality evaluation. In this study, on the basis of the validation tests of precision, stability and repeatability, the chromatographic fingerprint of A. brachypus was established by using gas chromatography (GC)-flame ionization detector (FID) and GC-MS techniques, as well as computer aided similarity evaluation system. Thirty-two different batches of samples collected from the different producing regions and the different parts of A. brachypus were studied. The results showed that the dominant constituents of all oils were monoterpenes and sesquiterpenes, as well as oxygenated monoterpenes and sesquiterpenes. The fingerprinting profiles were found to be consistent for the fresh stem bark acquired from various production areas, 48 common peaks were determined, but the relative abundance of peaks was varied. beta-Pinene, linalool, p-cymene, spathulenol, camphene, endo-borneol, verbenone, beta-caryophyllene, gamma-terpinene, germacrene-D, camphor, beta-thujone and beta-cadinene were the main constituents of the fresh stem bark oil. Except for the leaf, the chemical components among different medicinal parts of fresh plant were inconsistent with the stem bark. Besides, the varieties and relative levels of chemical components in the fresh stem bark were more abundant than in the dry counterpart.