Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0034065 (pulmonary embolism)
 14,979 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The case histories of the 49 patients who died in a series of 165 patients admitted to the Medical Unit between 1958 and 1984 with polyarteritis nodosa (PAN) were reviewed. The causes of death of the 29 men and 20 women, mean age 51.44 +/- 7.4 years, were classified into 6 groups. Infection accounted for 26.5% (13/49) of deaths, the initial site of infection being pulmonary, complicated by septicaemia in 6 cases. Cardiovascular events were responsible for death in 24.4% (11/49): terminal cardiac failure (4 cases), myocardial infarction (1 case), ventricular tachycardia (1 case), stroke (1 case), pulmonary embolism (2 cases), fulminant hemoptysis (1 case). Gastrointestinal complications were the cause of death in 16.3% (8/49): ischemic necrosis (5 cases), acute pancreatitis (2 cases), oesophageal ulceration (1 case). Renal failure was observed in 10.2% (5/49), all occurring before 1972: acute renal failure (3 cases), chronic renal failure (2 cases). Cancer was the cause of death in 10.2% (5/49): primary bronchial carcinoma (2 cases), laryngeal carcinoma (1 case), carcinoma of the vulva (1 case), bone metastases (1 case). Finally, 14.2% (7/49) could not be classified in the preceding groups. Sudden death occurred in 3 patients, shock in 1 patient, multivisceral PAN in 2 patients and anaphylactic shock in 1 patient. Three of the 12 patients who had post-mortem studies had signs of progressive vasculitis. The results are compared with other reports in the literature and the pathogenic mechanisms are discussed. The infections and cardiovascular deaths occurred early or late and were not related to the state of the activity of the vasculitis. Immunosuppressive treatment seems to play an important role in their pathogenesis.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[Causes of death in systemic vasculitis of polyarteritis nodosa. Analysis of a series of 165 patients]. 290 28

We report four patients with a protracted history of acute pancreatitis complicated by infected pseudocysts or abscesses. Ultrasonography showed that each patient had cholelithiasis. Endoscopic biliary sphincterotomy was performed resulting in the release of stones, gravel, or pus in all four cases. Three of the patients had successful percutaneous abscess drainage, and one patient was drained surgically. The abscesses all resolved, but one patient died suddenly of acute pulmonary embolism. The other three patients are well. We recommend this combined approach to pancreatic abscess drainage because, if there is obstruction to the flow of pancreatic juice at the ampulla of Vater, it is likely that the pancreatitis and abscess will fail to resolve.
 ...
PMID:The combination of endoscopic sphincterotomy and percutaneous abscess drainage in the management of complicated biliary pancreatitis. 295 Jan 6

Endoscopic sphincterotomy (ES) was attempted in 409 patients with common bile duct stone(s) (CBDS). The mean age of patients was 72.0 +/- 0.8 years (m +/- SEM); 47 p. 100 presented risk factors; 57 p.100 had previously been cholecystectomized while 43 p. 100 had not. On an average, patients in the former group were older (80 +/- 0.7 years) than in the latter 65.4 +/- 1.0 years, p less than 0.001). The procedure was successful in 98 p. 100 of the patients, after a standard ES in 78.5 p. 100 or after different technical artifices in 21.5 p. 100. The vacuity of the CBD was obtained in 96.5 p. 100 of the cases. During the first month after the ES, 13 p. 100 of the patients had complications and 4 p. 100 died; 37 complications (9 p. 100) were related to the ES and were responsible for death in 4 patients: 18 episodes of bleeding at the site of ES, 7 acute pancreatitis, 6 cholangitis, 4 retroperitoneal perforations and 2 other complications. The occurrence of these complications was closely related to the technique of ES being more frequent after technical artifices than after a standard ES (p less than 0.001). On the other hand, these complications occurred independently of the age of patients or of previous cholecystectomy. Seventeen complications (4 p. 100) did not depend directly on ES and were responsible for death in 14 patients (3 p. 100): pneumopathy, pulmonary embolism.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[Results of endoscopic sphincterotomy in common bile duct lithiasis]. 397 27

The authors sent questionnaires to the members of the French speaking Gynecology and Obstetrics societies and received 216 replies, of which 129 covering 86,700 patients are summarized here. There were 53 cases of phlebitis, 4 of pulmonary embolism, 2 of acute hypertension, 1 of hypotension, 1 of cerebral thrombosis, 1 of retinal hemorrhage, 1 of facial paralysis and 1 of acute pancreatitis and mesenteric infarction. If the 57 cases of phlebitis and pulmonary embolism are grouped, the frequency is 6.5 per 1000, which is not sufficiently greater than 2 per 1000 found by Drill in nonpregnant women, to incrimin ate the pill. The frequency of morbidity from phlebitis and thromboembo lism in this survey may be artificially low because most respondents wer e gynecologists; some women with these disorders may have consulted other physicians.
 ...
PMID:[Survey of vascular accidents caused by oral contraceptives]. 540 35

The development of laparoscopic cholecystectomy is only justified if it can ensure the good results obtained by laparotomy. The purpose of this work is to study all complications which occurred in a homogeneous group of patients. From May 1988 to January 1993, we operated on 2006 patients by laparoscopy (724 men and 1282 women) with a mean age of 50.6 years. Signs of stones in the common bile duct were noted in 4.1% and acute cholecystitis was detected in 12.5%. A conversion to normal laparotomy was necessary in 2.1% of patients. All complications were systematically investigated restrospectively in any patient hospitalised for more than five days. Residual stones in the common bile duct were not taken into consideration when they were not complications obviously related to the operation. We observed five intraoperative complications (4 hemorrhages, 1 ileum puncture) and 40 postoperative complications (25 non biliary and 15 biliary). The 25 non biliary complications consisted of: 1 death by pulmonary embolism, 9 hemorrhages, 4 cases of acute pancreatitis, 4 subphrenic abscesses, 2 colon punctures, 2 parietal complications, 1 ulcer perforation, 1 myocardial infarction and 1 phlebitis. The 15 biliary complications consisted of: 3 lateral punctures of the common bile duct, 9 fistulas of the cystic duct (4 with a residual stone in the common bile duct and 5 without), 2 punctures of an abnormal right hepatic duct, one of which was treated by "Roux en Y loop" intestinal diversion, and a late stenosis of the common bile duct.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[Complications of celioscopic cholecystectomy in 2006 patients]. 773 88

The results of 100 consecutive autopsy studies performed since the introduction and use of cyclosporine (1984 to 1991) in patients who died less than 2.5 months after cardiac transplantation were analysed to try to prevent this type of lethal damage. The lesions were complex but the causes of death may be classified as follows: 44 infections (20 aspergillosis, with 13 septicaemias and 7 predominantly pulmonary complications, 15 severe lung infections, 9 other infections including 7 pyogenic mediastino-pericarditis), 12 acute myocardial rejects, 14 pulmonary arteriolitis reflecting the fact that pulmonary resistances affect the results of cardiac transplantation, 13 non-infectious pericarditis, 17 immediate postoperative deaths (incompetent graft, DIVC). In the discussion, the authors underline the importance of pericardial damage, the direct cause of death in 13 cases but also present in most cases of infection when sometimes clinically confused with the diagnosis of "acute reject". Acute pancreatitis (over 10% of cases) were often labelled "septicaemic shock". Pulmonary involvement is one of the commonest complications related to infection and changes due to passive pulmonary hypertension related to the causal preoperative disease, by silent pulmonary embolism during the 3 months of cardiac failure before surgery and DIVC. Infection was the cause of death in nearly half of the early fatalities, and aspergillosis was particularly common whereas systematic prevention with sulfadoxine-pyrimethamine has eliminated pneumocystosis for example. The management of immuno-depression varies from centre to centre and this is also a factor in the incidence of anatomical complications.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[Early fatal lesions after cardiac transplantation. Results of 100 autopsies]. 833 96

The present article analyzes the indications for sphincterotomy in the Surgical Department of the University of Murcia, postoperative morbidity and mortality and the long term clinical situation of the patient after a follow-up period averaging 5.8 years. During a ten year period, a total of 2,610 patients underwent operation for biliary lithiasis, with exploratory choledochotomy indicated in 591 (22.6 percent). Surgical exploration of the bile duct finished with sphincterotomy in 135 (22.9 percent); 52 percent of these patients were less than 60 years old. The most frequent preoperative diagnosis was choledocholithiasis (33.3 percent) and cholelithiasis with crises of acute pancreatitis (30.3 percent). If we divide the ten years of the study into two five year periods, we noted a statistically significant decrease (p < 0.001) in the percentage of sphincterotomies compared with the number of choledochotomies performed during the second period. The rate of intra-abdominal complications was 5.1 percent; four intra-abdominal abscesses, one hemorrhaging at the level of the sphincterotomy and two instances of postoperative pancreatitis. Mortality in the series was 1.4 percent (two patients)--one with postoperative pancreatitis that developed torpidly and one with pulmonary embolism. Six years after the operation, 72.9 percent of the patients are still asymptomatic and the remaining patients have some type of symptoms--15.8 percent presented with dyspeptic syndrome; 2.0 percent had crises of colicky pain, and 5.9 percent required hospital admission for cholangitis. All of the patients with symptoms underwent endoscopy and ultrasonographic exploration of the bile duct. There were no pathologic findings in the biliary tree of patients who had dyspeptic syndrome or colicky pain, and all of the patients with cholangitis had a papillary stenosis and required endoscopic sphincterotomy or reoperation.
 ...
PMID:Long term results of surgical sphincterotomy in the treatment of choledocholithiasis. 843 96

From January 1988 through October 1997, 167 cardiac transplants were performed. 1246 endomyocardial biopsies (EMBs) from 138 cardiac allograft recipients were investigated and graded according to the Working Formulation (WF) criteria. The specimens were inadequate in 44 EMBs (3.5%), while 598 (48%) showed no rejection. The grade of rejection was: mild (grade 1A and 1B) in 531 EMBs (42.6%), mild/moderate (grade 2) in 38 (3.1%), and moderate (grade 3A and 3B) in 35 (2.8%). The indications for transplantation were: dilated cardiomyopathy (46.1%); ischemic disease (37.1%); valvular disease (12%); hypertrophic cardiomyopathy (1.8%); myocarditis (1.2%); congenital cardiopathy (0.6%), restrictive cardiomyopathy (0.6%) and chronic rejection (0.6%). The most reliable histologic feature of acute rejection was the myocyte necrosis or damage in presence of pironinophilic mononuclear cell infiltrate, so our protocol requires multifocal or diffuse myocyte damage (rejection grade 3A and 3B) to perform an additional treatment, which was required in 35 cases (2.8%). An intermediate grade mild/moderate 2, was introduced from the WF to classify the EMBs in which the myocyte necrosis was scant or not clear; this grade in our series generally resolves without any additional treatment; in order to monitor the rejection another EMB was performed 5 days after in these patients. The EMBs showed also the following lesions other than acute rejection: Quilty A (79 patients; 57.25%), Quilty B (24 pts; 17.39%), early ischemic necrosis (43 pts; 31.15%) and late ischemic necrosis (5 pz; 3.62%). Quilty B and late ischemic necrosis were correlated with acute rejection (grade 2), furthermore the patients with graft vascular disease showed 3 or more episodes of acute rejection. These findings confirm the relationship between acute and chronic rejection. Furthermore, a relationship between chronic rejection (4 pts) and infection from hepatitis C (antibodies positive 3 pts/4) and cytomegalovirus (antibodies positive 4 pts/4) was found in our series. In the follow-up period (117 months), a 30.72% death rate was recorded; the main causes of death were: early failure of the transplanted heart (30 pts) in 4 of them associated with pulmonary hypertension, infections (6 pts), sudden death (4 pts), graft's vasculopathy (4 pts), acute pancreatitis (1 pts) pulmonary embolism (1 pts), lung (1 pts) and ovary (1 pts) carcinoma, acute rejection (1 pts), others (2 pts). In the early period (< 1 month), the most frequent cause of death was the early failure of the transplanted heart, while in the late period (> 1 year) the chronic rejection following by sudden death and tumours. The actuarial survival curve drops to 83.13% after the first post-operative month, abates to 75.30 at the end of the first year, and progressively decreases to 70.48% at the end of the fifth follow-up year. The mortality rate was 38.7% in pts transplanted for ischemic disease and 24.7% for dilated cardiomyopathy. Cardioplegia seems to play an important role in the success of the heart transplant.
 ...
PMID:[Pathology of heart transplantation.(Morphological study of 1246 endomyocardial biopsies from 167 transplanted hearts). Causes of early, intermediate, and late deaths]. 1048 68

The authors present a particular case of an acute pancreatitis. The disease developed in a young male patient following cholelithiasis and cholecystectomy. The inflammation affected the outer layers of the pancreas as a mantle and it caused widespread fat necrosis. Necrectomy for septic state was conducted to improve the condition, but the patient died of pulmonary embolism. Unexpectedly big necrotic areas of fat necrosis and abscess were found at autopsy.
 ...
PMID:[Acute pancreatitis with few symptoms and extensive necrosis]. 1147 36

In patients operated on for severe acute pancreatitis (SAP), the factors determining outcome remain unclear. From 1986 to 1998 a total of 340 patients with a diagnosis of SAP and in need of operative treatment were admitted to the intensive care unit (ICU) of a university hospital and a secondary care hospital. The mean APACHE II score on the day of admission was 16.1 (range 8-35). All patients required operative therapy. Among the 340 patients, 270 (79.4%) had to be reoperated: 196 patients (72.6%) underwent operative revisions on demand, and 74 (27.4%) patients had preplanned reoperation. The overall mortality was 39.1% (133 patients). Septic organ failure in 126 patients (37.1%) and myocardial infarction or pulmonary embolism in 7 patients (2%) were the causes of death. The patient's age (p < 0.0002), APACHE II scores at admission (p < 0.0001), presence or development of (single or multiple) organ failure (p < 0.002), infection (p < 0.02) and extent (p < 0.04) of pancreatic necrosis, and surgical control of local necrosis (p < 0.0001) significantly determined survival. SAP that requires surgical treatment is associated with high in-hospital mortality. Surgical control of local necrosis is the precondition for survival. Advanced age of the patient, high APACHE II score at admission, development of organ failure, and the extent and infection of pancreatic necrosis influence the outcome.
 ...
PMID:Surgical treatment for severe acute pancreatitis: extent and surgical control of necrosis determine outcome. 1191 Apr 83


1 2 3 Next >>