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

A large series of patients was treated for impotence with intracorporeal injections of papaverine and phentolamine with no major complications and no deaths reported. We report on a 45-year-old black man with advanced multiple sclerosis who died after such therapy. When the first self-administered injection of phentolamine and papaverine failed to produce an adequate erection the patient injected a second dose that resulted in priapism and death of massive pulmonary embolism.
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PMID:A lethal complication of papaverine-induced priapism. 198 77

We reviewed the outcome following primary definitive repair by catheter splinting in 16 patients presenting with total posterior urethral disruption following pelvic injury. There were two deaths in the early post-operative period due to pulmonary embolism associated with other serious injuries. Five patients were judged to have a significant stricture at the site of injury, but all proved amenable to management with endoscopic treatment or periodic dilatation. None required a urethroplasty. The two cases with stress incontinence were related to concomitant injury of the bladder neck. Impotence persisted in 2 or 5 patients followed for longer than 12 months. Complications from catheter traction were not seen using the system of light interrupted traction described. A case is made for primary management by catheter splinting of such urethral injuries.
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PMID:Disrupting injuries of the membranous urethra--the case for early surgery and catheter splinting. 665 45

Staging pelvic lymphadenectomy (PLND) was performed in 210 prostatic cancer patients (mean age 67 years, clinical stage T0-T3 M0). A radical retropubic prostatectomy was subsequently performed in 54 men, ten of whom also received postoperative radiotherapy due to positive surgical margins. Ninety-eight patients were treated with external beam radiation alone (70 Gy in 35 fractions) and the remaining 58 received endocrine therapy. The complications of PLND alone (156 patients), consisted of wound infection in eight patients, hematoma or lymphocele in seven, venous thrombosis in three, and cardiac infarction in one patient. Early side-effects of radiotherapy included mild to moderate proctitis and/or cystitis in 57 patients. One year after completion of therapy, 48 of the irradiated men had proctitis, but only six had severe symptoms. Four patients developed radiation cystitis and two urethral stricture. Following prostatectomy (54 patients), two patients died in pulmonary embolism and another one developed a deep venous thrombosis. Hematoma occurred in five patients. Of the 42 surviving patients who did not receive postoperative radiotherapy, eight developed anastomotic strictures and four had severe stress incontinence. Only five were fully potent one year after surgery. Eight of the ten patients receiving radiotherapy after prostatectomy developed side-effects from the intestine and/or the urinary bladder. Two of them became totally incontinent. One developed a severe hemorrhagic cystitis necessitating urinary diversion. All ten were impotent after treatment.
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PMID:Morbidity of pelvic lymphadenectomy, radical retropubic prostatectomy and external radiotherapy in patients with localised prostatic cancer. 781 68

We report a case of Cushing's syndrome due to ACTH-independent macro-nodular adrenal hyperplasia (AIMAH). The patient, a 51-year-old man, had been suffering from poorly controlled arterial hypertension for the previous 6 years and he complained of progressive weight gain, gynecomastia and impotence. Physical examination revealed classic cushingoid features. Endocrine basal assessment showed increased urinary free cortisol (264-600 micrograms/24 hr). Urinary steroid profile showed an increase of total 17-hydroxycorticosteroids (17-OHCS: 23 mg/24 hr), with a threefold increase of tetrahydrocortisol (THF:9.66 mg/24 hr) and of tetrahydrocorticosterone (THB: 1.35 mg/24 hr). Tetrahydrodesossicortisol was only slightly elevated (THS:0.67 mg/24 hr) and tetrahydrodesossicorticosterone was at the inferior limit of the normal range (THDOC: 0.03 mg/24 hr). Total 17-ketosteroids were decreased (17-KS: 3 mg/24 hr). Plasma cortisol level was elevated and without circadian rhythm (26-29 micrograms/dl in the morning, 26-28 micrograms/dl at 24:00 h). DHEAs and free testosterone levels were significantly reduced (106 ng/dl and 3.9 pg/ml respectively). ACTH was undetectable and unresponsive to CRH. Both dexamethasone and octreotide failed to suppress plasma cortisol levels. Abdomen computed tomography scan demonstrated bilaterally enlarged multinodular adrenal glands. Cerebral magnetic resonance revealed no alteration of the pituitary gland. The patient underwent bilateral adrenalectomy. On macroscopic examination, adrenal glands were occupied by multiple yellow nodules and their compressive weight was 190 g, with left adrenal heavier than the right one (120 g and 70 g respectively). Histologically, nodular lesions were predominantly composed of large clear cells, with small foci of "hybrid" cells and adipose tissue metaplasia. Reticularis zone was atrophic. In the immediate post-operatory course pulmonary embolism occurred, despite prophylaxis with low molecular weight heparin. After having recovered from this complication, the patient showed progressive regression of cushingoid status. The findings of increased THF/THS and THB/THDOC ratios were in agreement with a relative hyperfunction of 11-beta-hydroxylase "in vivo", which might have contributed to the hypercortisolism, in addition to the marked increase of secernent adrenal mass.
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PMID:An unusual case of Cushing's syndrome due to ACTH-independent macronodular adrenal hyperplasia. 1274 99

Radical cystectomy is the standard treatment for muscle-invasive bladder cancer. Today, most patients can undergo substitution enteroplasty following cystectomy. Recto-colic urinary diversions and cutaneous ureterostomy are now uncommon. An ileal conduit (Bricker) may be proposed to patients with urethral involvement, as well as to elderly patients and to women who are at a high risk of severe urine leakage following enteroplasty. Thanks to progress in anesthesia, surgical techniques and intensive care, cystectomy with substitution enteroplasty is now a routine procedure. For localized bladder cancer (pT2N0M0 stage), this intervention is associated with a 10-year survival rate of about 80%. The mean length of stay in the intensive care unit varies between 1 and 7 days, and the mean total hospital stay ranges from 10 to 13 days. Early complications, which occur in less than 30% of cases, are mainly medical; the most common are cardiovascular complications, pulmonary embolism, disorientation and urinary tract and pulmonary infections. Late complications are less common and are mainly surgical; they include uretero-ileal stenoses (-10% of cases), uretero-ileal stenosis (4%), and intestinal obstruction (4%). Urinary and sexual disorders are frequent after radical cystectomy and substitution enteroplasty. Early postoperative incontinence occurs in more than 50% of cases but often responds to physiotherapy. In contrast, most male patients remain impotent. Simple transurethral resection of the prostate with cystectomy may be used instead of radical cystoprostatectomy in order to reduce the risks of incontinence and impotence, but this approach is controversial, as some authors have reported an increased risk of recurrence and metastasis.
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PMID:[Indications and current results of substitution enteroplasty following radical cystectomy]. 1611 85