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)

A 10-year analysis of 113 cases of staphylococcal endocarditis seen in two Washington, D.C., hospitals is presented. 96% of the cases occurred in parenteral drug addicts, but 4% complicated septicemia from known foci of infection. Coagulase positive staphylococcus was responsible for 97% of the infection, and the rest were caused by coagulase negative staphyloccus. Except in four patients with previously known cardiac murmurs, infection occurred on normal valves in these patients. Infection was isolated to the tricuspid valve in 71%, to the mitral valve in 6% and to the aortic valve in 3.5% of our cases; and more than one cardiac valve was affected in the remaining patients. All patients were treated with antibiotics based on bacterial sensitivity testing. The mortality from isolated tricuspid endocarditis was 5%, from isolated mitral endocarditis 33%, and from isolated aortic valve endocarditis 100%. The overall mortality was 18%. The better prognosis documented for acute tricuspid endocarditis is related to the much less severe haemodynamic consequences of acute tricuspid regurgitation, and the probably milder consequences of septic pulmonary embolism compared with coronary or cerebral embolism.
 ...
PMID:Staphylococcal endocarditis: clinical observations on 113 patients. 9 45

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...
 ...
PMID:Chronic Q fever. 94 Sep 18

Two types of postoperative complications should be distinguished, i.e. early complications including a lethality within 30 days and delayed complications which may occur after several years. In the period between 8/1985 and 12/1987 216 operations were carried out on patients with bronchial carcinoma. The operative lethality rate was 2.3%. The most frequently performed operation was lobectomy with 59% followed by pneumonectomy including extended pneumonectomy with 17.5%. 57.7% of patients with bronchial carcinomata were resected in the early stage I and II, and 26.4% of patients in stage IIIa. Squamous cell carcinomata occurred most frequently, with an incidence of 41%. Of the common postoperative complications cardiac arrhythmia was to be found most often (27%). Pulmonary embolism developed in 5% of all cases, cerebral complications in 3.7%, wound infections in 2.3% and post-operative haemorrhages in 1.3%. Bronchus stump insufficiency and dehiscence of suture were found in 2.2%, and pleural empyema in 4.2% of the complications directly resulting from the operation. Only 6 of 9 patients had suffered an persistent bronchopleural fistula lasting 7 days. Infections of the respiratory tree were identified in 18.3% and pneumonia in only 8.3% of cases. Delayed empyemas and bronchus fistulas belong in the category of delayed complications. The risk of deformation of the vertebral column caused by processes of involution in the cavity of pneumonectomy should be kept in mind following pneumonectomy. A distinction shall be made between the postthoracotomy syndrome an classical intercostal neuralgia, which has a sharply defined clinical picture and may be treated by operative neurolysis or resection of the nerve.
 ...
PMID:[Early and late postoperative complications in thoracic surgery interventions]. 187 91

Since 1985 organ donors are routinely tested for the presence of HIV-antibodies, but prior to that time several patients acquired HIV-infection from grafts. In May 1984 a 65-year-old woman on hemodialysis received a cadaver kidney graft from a young iv drug addict. The transplant functioned perfectly with cyclosporin A immunosuppression. Retrospectively, 22 days after surgery HIV antigen was detected. At this time only a faint band of anti-p24 antibodies was found in the Western blot. Two years after surgery splenomegaly was found in the apparently healthy patient. During the third year thrombocytes fell and she developed lymphadenopathy and constitutional symptoms. Up to this time the immunological parameters were in the range of 10 healthy renal transplant patients with cyclosporin A treatment. In the 4th year T-lymphocytes dropped to values below 200 and the patient developed Pneumocystis carinii pneumonia. A few months later a pulmonary node, which later proved to be a B-cell lymphoma, appeared. Slightly less than 5 years after transplantation the patient died from clinically diagnosed pulmonary embolism. The progression of the HIV-Infection in this patient and in one of 18 patients in published reports show that the incubation period is several years shorter in renal transplant patients than in those who acquire HIV from blood products.
 ...
PMID:[HIV infection caused by kidney transplant: case report and review of 18 published cases]. 267 39

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

During the last three decades it has become clear that removal of the spleen, for any reason, is not a benign procedure. In both adults and children splenectomy places the patient at significantly higher risk of overwhelming infection, compared to the normal population. The risk of the post-splenectomy septic syndrome is lifelong and is not eliminated by the administration of polyvalent pneumococcal vaccine. Thus far, the reported rate of overwhelming sepsis in asplenic individuals has ranged from 2.5-13.5%. As more long-term follow-up data become available, it is likely that the true incidence will be 5-10%. In addition to this late complication, splenectomy increases the frequency of adverse events, including death, in the immediate postoperative period. Infections, particularly pulmonary and abdominal sepsis, constitute the majority of the complications. The mortality rate from postoperative sepsis is substantial. Atelectasis, pancreatitis/fistula, pulmonary embolism and bleeding at the operative site are also relatively common occurrences following splenic removal. These alarming statistics have spurred surgeons to change their attitudes concerning splenectomy for trauma, both accidental and iatrogenic. Nonoperative management of hemodynamically stable patients with isolated splenic injury and splenorrhaphy in patients requiring laparotomy are now firmly entrenched in the surgical armamentarium. Patients in whom splenectomy is necessary are given polyvalent pneumococcal vaccine and are instructed to seek early medical attention for febrile illnesses. Splenic autotransplantation and lifelong prophylactic antibiotic therapy have been used in some centers, but their clinical value remains to be proven.
 ...
PMID:Complications of splenectomy. 332 38

A number of radiologic features on chest X-ray may aid in diagnosis and management of the patient with legionella infection. The infiltrates in legionnaires' disease frequently progress despite initiation of appropriate antibiotic therapy. Pleural effusion is common and occasionally seen even in the absence of lung field infiltrates. Pleural-based infiltrates associated with pleuritic pain may mimic pulmonary embolism. Circumscribed peripheral densities are commonly seen in immunosuppressed patients. Cavitation is also a prominent feature in this patient group and may develop during clinical improvement. Radiographic severity does not correlate with clinical outcome. Resolution of infiltrates may be slow, and the tendency for delayed clearing should be considered before initiating further invasive diagnostic investigation. Infections due to Tatlockia (Legionella) micdadei and Legionella bozemanii are more commonly reported in immunocompromised hosts; the radiographic manifestations are similar to those seen in Legionella pneumophila infection in the immunosuppressed.
 ...
PMID:The radiologic manifestations of Legionella pneumonia. 332 94

A patient with dyspnea, skin rash, hypoxemia and mononucleosis was shown to have acute cytomegalovirus infection. The chest X-ray was normal, but the lung scan showed perfusion defects. Although pulmonary embolism cannot be ruled out, it seems likely that the CMV infection was responsible for the abnormalities observed.
Infection
PMID:Cytomegalovirus infection with perfusion defects on the lung scan. 609 77

Maternal mortality was examined in a semi-urban Nigerian community over a 10-year period. Maternal mortality was defined as death occurring as the direct result of childbearing and measured per 1000 births. Abortions at below 20 weeks gestation were excluded. From 1966 to 1975, there were 90 maternal deaths out of 13,182, a rate of 6.8/1000. The hospital records of the Baptist Medical Center, located in the western part of Nigeria, were carefully reviewed and cross-checked with obstetric statistical records. Only 13 of the deaths occurred in hospitalized patients. 78 (80%) were due to direct obstetric causes; 12% were from nonobstetric causes. Anemia due to blood loss was the leading casue of death, accounting for 30, or 33%, of the deaths. Anemia, with or without congestive heart failure accounted for 7 deaths. Infection was responsible for 5 deaths. Ruptured uterus, preeclampsia, and eclampsia occurred in equal percentages, 10-11%. Indirect obstetric deaths, such as sudden death, accounted for 10 deaths. 50% of these were anesthetic deaths; the remainder were due to pulmonary embolism. Sickle cell intrapartum crisis was the cause of 1 death. Associated causes included featured pneumonia, nephritis, hepatitis, meningitis, enteritis, and cerebrovascular accident. Parity ranged from 0-11. 25 babies were salvaged in this series. Prevention continues to be the cornerstone in improving maternal mortality figures in developing countries. The Baptist Medical Center's model for providing maternal care is described briefly and is identified as responsible for the encouraging decline in the maternal mortality rate.
 ...
PMID:Maternal mortality in a semi-urban Nigerian community. 720 76

During the last three years many cases of Legionnaires' disease have been reported. Several cases reported had underlying disorders such as immunity deficiencies, or were undergoing immunosuppressive therapy. In this report we describe a previously healthy young man who acquired Legionnaires' disease and recovered after ampicillin-gentamicin treatment. During recovery he developed a lower leg thrombosis followed by pulmonary embolism.
Infection 1980
PMID:Case of Legionnaires' disease with deep venous thrombosis. 741 78


1 2 3 Next >>