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)

This study is an analysis of the reasons for hospitalisation for respiratory diseases in 1985 in the eleven departments of pneumology (SP) and departments of Internal Medicine (SMI) in the public hospitals in Paris. As well as epidemiological data systematically gathered on the discharge of the patients the number of stays for respiratory diseases, the mean duration of stay (DMS), sex, age and place of residence of the patients were studied. 59 diagnostic codes were considered as covering the overall pattern of respiratory pathology (OMS) classification at 3 levels 9th revision). Amongst those 24 were regrouped into 7 pathological groups considered as characteristic of the discipline of pneumology: asthma, chronic airflow obstruction (BPCO), malignant tumours of the respiratory tract, pulmonary embolism, respiratory infections, sarcoidosis and tuberculosis. There were 30,877 inpatient stays for respiratory disease identified, representing 6.6% of all hospitalisations in the medical service of the public hospitals. 41.1% of stays were in SP and 24% in SMI. 78% of the stays in SP were for respiratory diseases against 10-15% in SMI. In SP asthma represented an average of 11% of all hospitalisations for respiratory disease, BPCO was 13%, cancer 35% and pulmonary embolism 4%, sarcoidosis 2%, respiratory infections 8% and tuberculosis 8%; great variation were noted according to the different units which enabled a hospital profile to be identified and which gave the general orientation of a particular service. In SMI this profile was different: there was a smaller percentage of cancer cases and a higher level of infectious disease. The mean stay was shorter in SP than in SMI (10.4 v 13.8 days) for respiratory cases overall and whatever pathology that was studied.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[Hospitalizations for diseases of the respiratory system at public assistance hospitals in Paris in 1985]. 260 16

The aim of prophylaxis in venous thromboembolism is firstly to prevent fatal pulmonary embolism and secondly to reduce the morbidity associated with deep vein thrombosis and the post-phlebitic limb. Particularly high-risk groups are identifiable and include those over 60 years of age undergoing major surgery, patients with malignancy and those undergoing hip operations. Low-dose subcutaneous heparin (5000 U s.c. commenced two hours preoperatively and continued eight to twelve hourly until the patient is fully mobile) is unequivocally effective in preventing deep vein thrombosis in medical and surgical patients and, most importantly, significantly reduces the incidence of fatal postoperative pulmonary embolism and total mortality. Furthermore, in established deep vein thrombosis, low-dose heparin limits proximal clot propagation, which is the prelude to pulmonary embolism. Despite this, surveys have demonstrated an alarming deficiency amongst clinicians in the application of measures to prevent venous thromboembolism. Heparin prophylaxis carries a small risk of increased bleeding complications, mostly evidenced by the frequency of wound haematoma rather than major haemorrhage. Low molecular heparin fragments (e.g. Fragmin, Choay, Enoxaprin) are now emerging as useful alternative agents, having the advantage of once daily administration and yet providing similar efficacy in the prevention of deep vein thrombosis. However, protection against fatal pulmonary embolism has yet to be demonstrated. Mechanical methods of prophylaxis designed to counteract venous stasis, such as graduated elastic compression stockings, are also beneficial in protection against deep vein thrombosis but by themselves do not achieve such consistently good prophylaxis as low-dose heparin. However, clinical trials with combinations of mechanical methods and low-dose heparin indicate that this may be the optimum approach to very high-risk patients. In the presence of established acute deep vein thrombosis, anticoagulant therapy is the mainstay in preventing pulmonary embolism. Vena caval interruption procedures should be reserved for patients in whom anticoagulation is contraindicated or for those who develop recurrent pulmonary embolism despite adequate anticoagulation.
 ...
PMID:Prevention of venous thromboembolism. 266 85

A prospective randomized trial was organized at the Institut Gustave-Roussy to assess the reliability of classical external catheters (CE) versus totally implanted access systems (TI) for delivering intravenous chemotherapy for a duration of at least 6 months. The analysis was performed on the 96 patients whose implantation succeeded (CE 46, TI 50). Failure was defined as loss of ability to function (followed by removal) within the 6-month period of the survey. Patients dying with functional catheters were considered as censored (15 cases) at the time of death. Twenty-four access systems were removed. The removal-free curves differ significantly (P less than 0.001), favoring the TI access systems. The main reasons for removal were: catheter fall (CE6, (TI 0), migration (CE 1, TI 1), infection (CE 5, TI 1), thrombotic occlusion (CE 1, TI 0) and venous complications (CE 1 thrombosis plus 1 pulmonary embolism, TI 1 thrombosis). In addition, a survey by questionnaire demonstrated a significantly better patient activity rate (P = 0.02) and hygiene (P less than 0.001) in the TI group. This prospective randomized study demonstrates that totally implanted access systems are more reliable, safer and better tolerated than classical external catheters for solid tumor patients undergoing intravenous chemotherapy for longer than 6 months.
Eur J Cancer Clin Oncol 1989 Jun
PMID:Classical external indwelling central venous catheter versus totally implanted venous access systems for chemotherapy administration: a randomized trial in 100 patients with solid tumors. 266 37

Seven patients with metastatic colorectal cancer have been treated with a regimen involving an 120-hour continuous infusion of rIL-2, 3 x 10(6) mu/m2. Entry restrictions included a Karnofsky index of greater than or equal to 80%, and a measurable lesion. One patient died of peritonitis secondary to bowel perforation at the site of the unresected tumour. One patient abandoned treatment following a pulmonary embolism during the first rIL-2 infusion. Other side effects included, pyrexia, rigors, nausea, hypotension, oliguria, weight gain, thrombocytopenia, neuropsychiatric symptoms and prerenal renal failure. Two patients have shown a greater than 50% regression in the size of their tumours and 3 have stable disease. The use of 'humanized' monoclonal antibodies together with mononuclear cells from patients receiving IL-2 infusions may provide a useful way of killing tumour cells which are resistant to lysis by LAK cells.
Cancer Treat Rev 1989 Jun
PMID:A phase-II trial of recombinant interleukin-2 and 5-FU chemotherapy in patients with metastatic colorectal carcinoma. 267 Feb 12

Thrombophlebitis is defined as thrombotic inflammation of a previously healthy superficial vein, varicophlebitis as that occurring in varicosities. The latter appears responsible for the majority of thrombotic venous occlusions. In contrast to venous thrombosis, the thrombotic involvement of deep veins, thrombophlebitis usually resolves without sequel and, in general, thrombophlebitis nor varicophlebitis are associated with the risk of pulmonary embolism. The clinical presentation of thrombophlebitis is that of a tender, hardened superficial vein which, in the presence of inflammation, may be very painful. The lower extremities are most frequently involved. Differential diagnostic considerations include bacterial cellulitis and lymphangitis. The cause of thrombophlebitis, which is rare without precipitating factors, may be a mechanical lesion such as kinking of the vein or trauma to the wall of the vein as well as other primary disease such as auto-immune afflictions, endangiitis obliterans or malignancy; in particular, with localization in the area of the rump, with concomitant occurrence in various regions or extending phlebitis, paraneoplastic syndromes and hemoblastoses should be ruled out. Rarely, phlebitis may be associated with tuberculosis and syphilis. Thrombophlebitis may be caused iatrogenically by improper application of chemical substances which cause damage to the venous walls as well as by indwelling catheters or cannulas. This form can progress to sepsis and pulmonary embolism may be incurred. Varicophlebitis, in contrast, accounts for about 90% of all cases of phlebitis and can be regarded as a typical late complication of varicosities in the superficial venous system.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[Pathogenesis, diagnosis and therapy of thrombophlebitis and varicophlebitis]. 268 Aug 51

To investigate the present status of pulmonary embolism as a cause of death in a general hospital patient population, a 5-year retrospective study of all autopsy reports and associated hospital records was undertaken. Pulmonary embolism was thought to be the cause of death in 239 of 2388 autopsies performed (10%): 15% of these patients were aged less than 60 years and 68% did not have cancer. Of these patients, 83% had deep-vein thrombosis (DVT) in the legs at autopsy, of whom only 19% had symptoms of DVT before death. Only 3% of patients who had DVT at autopsy had undergone an investigation for such before death. Twenty-four per cent of patients who died from pulmonary embolism had undergone surgery a mean of 6.9 days before. Screening tests for DVT should be applied widely in the hospital population.
 ...
PMID:Autopsy proven pulmonary embolism in hospital patients: are we detecting enough deep vein thrombosis? 271 16

Twenty-six cases of excavated pulmonary masses are reported. In 18 cases malignancy was proven by transparietal needle aspiration. A false-negative result was due to the needle being introduced too centrally and bringing pus, whereas the tumour was an epidermoid carcinoma. The seven non-malignant lesions consisted of abscess in 4 cases, tuberculosis in 1 case and pulmonary embolism in 2 cases. The sensitivity and specificity of the technique were similar to those observed in large series of transparietal needle aspiration of solid masses. Using thin needles and extemporaneous cytology reduced the number of complications: haemothorax 6 percent, haemoptysis 0.4 percent. The authors conclude that in excavated pulmonary masses transparietal needle aspiration provides a diagnosis of malignancy when the radiological and clinical courses and bronchial fibroscopy are inconclusive. Transparietal needle aspiration avoids the need for other investigations, such as exploratory thoracotomy, thereby reducing the cost of diagnosis.
 ...
PMID:[Transthoracic puncture and excavated pulmonary lesion. Diagnostic contribution and value of the extemporaneous cytologic test]. 271 26

Deep vein thrombosis (DVT) of the arm unrelated to central venous cannulation is an uncommon occurrence in patients with malignancy. The author reports six cases encountered in a large county hospital over an 8-year period. Three of the patients had gastric carcinoma, esophageal adenocarcinoma, and testicular carcinoma, respectively. These neoplasms have not been previously reported to be associated with DVT of the arm. Three episodes of DVT resulted from venous compression by the tumor, and a hypercoagulable state may have contributed to the pathogenesis of DVT in the other three cases. Venography is required for confirmation of the diagnosis; however, a computed tomographic scan with contrast media may be a valuable adjunct. A review of the literature indicated that the incidence of pulmonary embolism is significant in these patients. Therefore, anticoagulation within 7 days of clinical onset is recommended.
Cancer 1989 Jul 15
PMID:Deep vein thrombosis of the arm associated with malignancy. 273 99

Contrary to deep venous thrombosis of the lower extremity, subclavian vein thrombosis (SVT) is rather rare. Although the problem has been known for more than 100 years, the rarity of its incidence accounts for the persistent uncertainty concerning the indication and modalities of acute therapy as well as the long-term course. In the majority of 96 patients observed between 1976 and 1983 SVT was due to central venous catheter, neoplasm and thoracic outlet syndrome. 2 of 96 patients developed pulmonary embolism. 45 patients without malignancy were available for follow-up studies. Acute therapy included anticoagulation in 27, fibrinolysis in 10 and rib resection in 8 cases. The mean follow-up averaged 6.3 years and confirmed a favorable course independent of the acute therapy modality. There were none of the trophic alterations so often found in the lower extremity and no patient was unable to work as a consequence of SVT. However, minor late sequelae occurred quite frequently: slight symptoms in one third, and minor incapacity for sport in 25% of the cases. 75% of the patients showed clinical signs of stasis, such as venous bypass circulation, edema and/or cyanosis. The average post-thrombotic score (1.3 out of a possible 4) confirms the minor significance of the findings. A rather important reduction in venous backflow was found by plethysmography in 4% of the patients. We favor immediate anticoagulation, mainly to cover the risk of pulmonary embolism. This should be continued for at least 3 months in order to prevent early recurrence of thrombosis.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[Etiology and long-term course of subclavian vein thrombosis with reference to acute therapy]. 274 Aug 79

Forty-eight patients with carcinoma of the renal pelvis were treated between 1976 and 1986. 77% (n = 37) underwent nephrectomy; 4% (n = 2) open biopsy; 8% (n = 4) organ-preserving surgery, and 11% (n = 5) were treated conservatively. Major complications associated with the nephrectomies included: hemorrhage (11%); pulmonary embolism (5%); abscess (5%); ileus (5%), and pneumonia (5%). There was no postoperative mortality. Grade-III carcinoma, advanced tumor stage (T4N+M1), and generalized urothelial cancer worsened the prognosis. Such patients might benefit from adjuvant therapy.
 ...
PMID:Therapy and prognosis of carcinoma of the renal pelvis. 276 96


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>