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Query: UMLS:C0034065 (pulmonary embolism)
 14,979 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Four patients with primary disease in the chest are discussed, each coming to laparotomy. The final postoperative diagnoses were empyema, pulmonary tuberculosis, pulmonary embolism and bacterial endocarditis. These cases well illustrate the real risk of confusing an acute chest condition with an acute abdomen.
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PMID:Chest disease presenting as an acute abdomen. 45 25

Sixteen cases of chronic Q fever are described. In eight there was a history of exposure to infection from farms or farm products. All had valvular heart disease, involving the mitral valve in nine and the aortic valve in seven. Infection occurred on a prosthetic valve in two patients. Arterial embolism was common. Venous thrombosis occured in three patients, and pulmonary embolism occurred in three other patients. Complement fixing antibodies to phase 1 antigen were found in a titre of 1:200 or greater in all except two patients. In one of these post-mortem examination revealed rickettsial bodies in mitral valve vegetations, and in the other Coxiella burneti was isolated from heart valve tissue. The majority presented with infective endocarditis but two presented primarily with liver disease. All patients had evidence of liver involvement and in one this led to death from cirrhosis. Abnormal tests of liver function, particularly hyperglobulinaemia, raised alkaline phsophatase and abnormal bromsulphthalein retention were found in all patients. Hepatic histology was abnormal in all eight patients in whom it was studied. The commonest features were mononuclear cell infiltration of the portal tracts and prominence of the sinusoidal Kupffer cells. Patchy focal necrosis of parenchymal cells, granulomata, fatty change, and eosinophilia of the sinusoidal walls were also noted in several patients and cirrhosis developed in one. Six patients had a purpuric rash, and in 12 there was thrombocytopenia. It is suggested that the presence of hepatomegaly and liver involvement and thrombocytopenia may help to differentiate Q fever endocarditis from bacterial endocarditis. Raised serum IgM and IgA levels occured frequently, but with only a moderate dominance of IgM. Sheep cell agglutination and latex fixation tests for rheumatoid factor were occasionally positive. Several features of the disease suggest the possibility that immune-complex mechanisms may play a role in chronic Q fever. Treatment was with prolonged courses of tetracycline usually combined with lincomycin. Seven patients underwent valve replacement surgery for haemodynamic reasons. Five patients died; two from heart failure, one from cirrhosis, one seven days after valve replacement and one from intraperitoneal haemorrhage following percutaneous liver biopsy. Three patients have survived for more than five years, and another six for more than three and a half years after diagnosis. Of these nine patients, three received medical therapy alone and six required valve replacement as well. Antibiotics have been discontinued in four patients who have had valve surgery and three others. Six patients had received antibiotics for continuous periods varying from 29-62 months. In the period after stopping therapy varying from 15-21 months, no relapse has occured. A seventh patient, who had received antibiotics for four months prior to valve replacement, has survived 43 months after the withdrawal of antibiotics...
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PMID:Chronic Q fever. 94 Sep 18

Medical complications associated with narcotic addiction include bacterial endocarditis, pneumonia, pulmonary embolism and renal disease. Renal disorders associated with pentazocine abuse are rarely reported. They vary with method of administration, dosage, and duration of abuse. We describe a 33-year-old male addict, using intravenous pentazocine for 6 years. He has nephrotic syndrome with a rapid deterioration of renal function to a uremic stage within 3 weeks. The laboratory data includes: IgG 1270 mg/dl, IgA 369mg/dl, IgM 326mg/dl, C'3 65.2 mg/dl, C'4 16.3 mg/dl, and serum soluble interleukin-2 receptor level (sIL-2R) greater than 6000U/ml. A renal biopsy revealed membranoproliferative glomerulonephritis (MPGN) type I with tubulointerstitial nephritis. Immunofluorescent (IF) study revealed granular deposition of C'3 and IgM in mesangium and the glomerular capillary wall. The pathogenesis of glomerular disease in drug addicts is discussed, and the literature reviewed.
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PMID:Pentazocine addict nephropathy: a case report. 131 15

We describe two patients suffering from bacterial endocarditis with tricuspid valve envolvement. Both had pulmonary embolism, revealed by scintigraphic lung perfusion examination. The diagnosis was made by transthoracic echocardiography in one patient and transoesophageal echocardiography in the other. Both received therapy with antibiotics and heparin given intravenously. In one patient the vegetation disappeared. We discuss the epidemiology, diagnosis and treatment of the condition, with special focus on the possible role of heparin.
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PMID:[Tricuspid valve endocarditis with pulmonary embolism]. 221 13

This report reviews the present status of cardiovascular surgery in West Africa and highlights some of the constraints of development in this field.Rheumatic heart disease is still endemic in the tropics, where it constitutes about 20 percent of all cases of cardiovascular disease (CVD) in Nigeria. Endomyocardial fibrosis is a disease of unknown etiology accounting for 10 to 20 percent of cases. Purulent pericarditis is a common complication of pyomyositis and osteomyelitis found in 5 percent of patients. Chronic constrictive pericarditis is a sequela of infective pericarditis found in 5 percent of all cases of CVD. Calcification is found in 30 percent of cases and pericardiectomy can be performed successfully without cardiopulmonary bypass. Infective endocarditis is equally rare, occurring in 2.5 percent of cases; it is a common source of septic emboli to coronary artery and a very difficult disease to treat in the West African environment.Ischemic heart disease is relatively uncommon, accounting for less than 0.5 percent of patients. The rarity of the disease in black Africans has been attributed to dietary habits and environment rather than to racial and psychosocial factors. Congenital heart disease accounts for 5 percent of all cases of CVD in this review. Ventricular septal defect and patent ductus arteriosus are the most common acyanotic defects, while tetralogy of Fallot and transposition of the great arteries are the most common cyanotic defects.Vascular diseases are uncommon in this series, with traumatic injuries accounting for most of the cases. Abdominal aortic aneurysms, peripheral occlusive vascular disease, and atherosclerotic aortic aneurysms are quite rare. This review further confirms the rarity of deep venous thrombosis and pulmonary embolism in Africans.
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PMID:The status of cardiovascular surgery in West Africa. 331 74

Ten terminal uremic patients seen over the period of one and one-half years have been kept alive by repeated hemodialysis using a modification of the Seattle system, carried out for the most part by nurses and technicians. All the patients had creatinine clearance values below 5 ml./min., and blood urea nitrogen values which ranged between 156 and 453 mg. % before beginning the first dialysis.Selection was based on their ability to co-operate with and to tolerate the regimen. Nine patients were fully rehabilitated.The major complications were those related to shunt-site infections, including septicemia, bacterial endocarditis, septic arthritis, septic pulmonary embolism and mycotic aneurysm.Nevertheless, all patients except one were rehabilitated and resumed their full-time occupations and have continued to lead happy and useful lives.
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PMID:Chronic hemodialysis for terminal renal failure. 590 68

In order to determine whether endocardial lesions that developed in relation to an indwelling catheter in the right heart had any significance or characteristics, a study with clinicopathologic correlations was performed in which a total of 57 hearts were found to have right heart endocardial lesions at necropsy. Some of our findings fall within the range of results of various similar studies, e.g., clinical backgrounds and incidence in which these lesions occur. However, others do not; pulmonary embolism was preexisting and coexisting rather than attributable to the heart lesions. Right heart lesions occur significantly more often (P less than 0.01) in patients who received a right heart catheter than those who did not. The morphologic features of these endocardial lesions are sufficiently characteristic to indicate not only that an intracardiac catheter had been present but even what type of catheter it was. Infective endocarditis was found in seven catheterized patients. This process has a tendency to involve valves transmurally, indicating possible need for prosthetic valve replacement if any patients were to survive the underlying disease. Traumatic perforation of the endocardium was uncommon. With the aid of careful indications and strict adherence to guidelines, the risk of fatality from these lesions is extremely unlikely.
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PMID:Right heart catheter lesions: any significance? 646 78

he recent advances in surgical treatment of congenital heart disease, permits the survival of those cases to adult life. Infective endocarditis in the childhood is becoming increasingly important. We studied 32 cases in the pediatric cardiology ward at the INC between 1977 and 1981. There was a male predominance of 62.5%. Rheumatic heart disease (40.7%), congenital heart disease (15.6%) and postoperative cases (43.7%) were the underlying conditions. There was an average time of 43 days delay from the first symptom to diagnosis. Blood cultures were taken in 29 cases (90.6%). Only half of them were positive. Staphylococcus and streptococcus were the commonest isolates. Peripheral and pulmonary embolism (11 cases-34.4%) were the most frequent complications. In those cases with negative blood culture the most successful antibiotic combination was ampicillin or oxacillin plus aminoglucosides (56%). There were 17 deaths (53%).
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PMID:[Infectious endocarditis in children]. 674 35

The following observations were made on a series of 15 cases of bacterial endocarditis on congenital cardiac lesions admitted between 1971 and 1980, in 13 patients aged 6 to 48 years old (average 21 yrs old): --The low but constant incidence of endocarditis--The majority of causal lesions were ventricular septal defects of Fallot's tetralogy--The portal of entry diagnosed in 2/3 of cases was usually dental--The causal organism was a streptococcus in 80% of cases--The long period of pyrexia before, the diagnosis of endocarditis was made--M mode, and above all, 2D echo detected vegetations in half the cases where it was performed--The gravity of the immediate prognosis due to a 25% mortality and a high incidence of complications--Early complications present in 2/3 of cases were dominated by true "oslerian" lesions, cardiac failure, cerebral complications, pulmonary embolism and early relapse. --The relatively good secondary prognosis.
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PMID:[Bacterial endocarditis in congenital heart diseases]. 681 69

Infective endocarditis was diagnosed in a 15-yr-old patient following closure of a patent ductus arteriosus several weeks previously. Pulmonic valve vegetations were detected by both M-mode and two-dimensional echocardiograms. The serial echocardiographic examinations revealed the emergence of a vegetation on the pulmonic valve, a marked decrease in its size subsequent to pulmonary embolism, reemergence of a vegetation upon relapse of the disease and its resolution 4 mo later. The echocardiographic findings and their correlation to the various stages of the disease are described.
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PMID:Serial two-dimensional echocardiography in infective endocarditis of the pulmonic valve. 683 49


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