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

A patient is described, with a history of pain in the neck, followed by a slowly progressive loss of muscle strength in both arms, followed by tetraplegia. Medical history included laryngectomy with partial hypopharyngectomy preceded by radiotherapy, because of carcinoma. X-ray of the cervical spine was suggestive for metastases. The patient died as a consequence of massive pulmonary embolism and at autopsy the cause of the neurological deficit turned out to be vertebral osteomyelitis and epidural abscess due to mucormycosis.
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PMID:Vertebral osteomyelitis and epidural abcess due to mucormycosis, a case report. 22 96

Oesophageal perforations associated with cervical fractures occur from a variety of injuries. Fractures of the cervical spine, blunt trauma and penetrating injuries such as gunshot wounds, knives and missiles, perforate the cervical oesophagus. This retrospective study consists of 24 patients with an oesophageal perforation and cervical fracture. Motor vehicle accidents were responsible for 54% of the oesophageal perforations. The other oesophageal injuries were related to anterior spine surgery, gunshot wounds and sports-related activities. The clinical features related to these injuries included the obvious signs of an oesophageal perforation as well as fever of unknown origin, leukocytosis and unexplained persistent tachycardia. A variety of techniques was used to establish the diagnosis. All the patients had treatment for the cervical fracture and 20 patients required surgical repair of the oesophagus. The most common oesophageal complications were stricture of the oesophagus (54%) and oesophageal diverticulum (10%). The other complications were atelectasis, pneumonia, tracheobronchitis, pulmonary embolism, cervical osteomyelitis, cervical abscess, mediastinitis, septicemia and cervical fistulae. These patients have a serious life-threatening illness that may be difficult to diagnose and treat.
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PMID:Oesophageal trauma in patients with spinal cord injury. 128 44

Ten cases of right-sided infective endocarditis (IE) were recorded in a retrospective study over a 5 year period (1984-88). In 8 cases, IE complicated known congenital heart disease. One patient was followed up for rhumatic valvular disease and in the remaining case, IE seemed to have occurred on a normal valve. The inclusion criteria were based on the clinical signs: prolonged pyrexia, the finding of a new murmur or a change on cardiac auscultation, and eventually, the occurrence of a complication (7 cases). The commonest complications were right ventricular failure and pulmonary embolism. A portal of entry was found in 5 cases: dental infection in 3 cases, osteomyelitis in 1 case and an abscess on the right leg in 1 case. Blood cultures were positive in 5 cases and grew a staphylococcus aureus on each occasion. Two-dimensional echocardiography showed vegetations in 9 cases. The short-term outcome was satisfactory. There were no fatalities and 5 patients underwent surgery.
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PMID:[Infectious endocarditis of the right heart. Apropos of 10 cases]. 204 21

Deep venous thromboses in the lower extremities were observed in three boys aged 8, 10, and 12 years. In one case, it must have originated from circulatory depression during diabetic ketoacidosis. In two children, osteomyelitis was detected in the proximity; they developed septic pulmonary embolism. Osteomyelitis and septic arthritis as possible cause or consequence should be actively looked for in septic thromboembolism.
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PMID:[Pelvic and femoral vein thrombosis in childhood]. 314 16

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

A review of all (1279) total hip arthroplasties in the Province of Manitoba, Canada, from 1973 to 1978 demonstrates an increase in the number of operations except in the very elderly. Six-week operative mortality was decreased from 2.4% to .6%, and time spent in the hospital has decreased from 54 to 40 days. Utilization of medical services by patients before and after surgery, as recorded by the Manitoba Health Services Commission, enables identification of all serious postoperative complications. Two years after surgery, 95.2% of patients were alive, and 16% had a contralateral hip arthroplasty. Fourteen patients (2.7%) required revision surgery within two years; 20 patients (4%) were readmitted to the hospital with other surgical complications, including trochanteric bursitis, osteomyelitis, pulmonary embolism, and so forth. Visits to physicians for arthritis-related problems and to chiropractors decreased in the two years after surgery compared with the two years before.
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PMID:Hip arthroplasty surgery in Manitoba: 1973-1978. 404 87

The frequency of pulmonary embolism was investigated in a 10-year period from 1971 to 1982. During this time approximately 30 000 operations in 60 000 surgical and medical patients were performed. In seven patients, six boys and one girl, pulmonary embolism was diagnosed. This includes six patients with septic embolism, arising in three cases from subacute endocarditis, in two from osteomyelitis of the humerus and in one from coxitis. Only in one patient, a boy who was operated for perforated appendicitis, pulmonary embolism resulted as a complication of left-sided ileofemoral thrombosis. In three boys with osteomyelitis and coxitis, staph. aureus was found locally as well as in blood culture and in sputum. Prophylactic anticoagulation is recommended by the authors in all children over 10 years who were immobilized due to a septic process.
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PMID:[Pulmonary embolism in childhood]. 663 41

External skeletal fixation is a well-known tool in the management of infection of long bones. However, the application of external skeletal fixation in the treatment of spinal infection has not been previously reported. We have used percutaneous external spinal fixation (PESF) for the treatment of osteomyelitis of the spine in 23 patients since 1981. The treatment consists of percutaneous vertebral biopsy for bacteriologic diagnosis, installation of a suction/irrigation system into the intervertebral disk space, and posterior stabilization (and reduction if indicated) with an external fixator placed percutaneously. This treatment was conceived in 15 patients as definitive treatment. One patient died due to pulmonary embolism. In 12 patients, the infection healed without further operative treatment. Preoperative kyphosis averaged 15 degrees (range 0-30 degrees). At follow-up, kyphotic deformity also averaged 15 degrees (range 0-30 degrees). Two patients required anterior debridement and bone grafting because of progression of bony destruction. In eight patients, PESF was performed emergently, followed by planned anterior debridement and interbody grafting. The treatment was successful in all patients. All fusions healed. Preoperative kyphosis averaged 18 degrees (range 0-40 degrees). At follow-up, kyphotic deformity averaged 10 degrees (range 0-22 degrees). Our present indications are listed below and comprise pyogenic and tuberculous osteomyelitis of the spine localized between T3 and S1. The procedure is an alternative to conservative or more invasive operative treatment modalities in the following conditions: (a) painful lesions of the spine with minimal bone loss, not amenable to efficient orthotic stabilization (thoracic spine from T3 to T9, lumbosacral junction, elderly patients, or presence of deleterious general conditions); (b) osteomyelitis of the spine from T3 to S1, when emergency decompression of the spine is mandatory because of neurologic deterioration due to the kyphotic deformity or to a noncapsulated epidural abscess and anterior decompression is not possible emergently; (c) pyogenic osteomyelitis of the spine at L5/S1, when operative treatment is indicated. In addition, percutaneous insertion of external skeletal fixation is indicated in the presence of infected wounds, making internal posterior stabilization unsuitable (e.g., after open decompression of epidural abscess, postoperative infections).
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PMID:Treatment of osteomyelitis of the spine using percutaneous suction/irrigation and percutaneous external spinal fixation. 791 42

Between 1988 and 1991, 40 Wagner SL femoral revision stems were implanted at the Orthopaedic Departments of the University of Basel and of the Kantonsspital Liestal, Switzerland. The indications were: 27 cases of extensive bone resorption and destruction of the proximal prosthetic bed, seven periprosthetic fractures, two Girdle-stone situations after removal of infected total hip arthroplasty (THA), 1 case each of primary arthroplasty for congenital dysplasia of the hip, failed osteosynthesis of a pertrochanteric fracture, subtrochanteric femoral fracture and femoral fracture with subsequent osteomyelitis. The average follow-up time was 47 months. The average age of the patients was 70 years (range 37-85 years). The average preoperative hip score was 32 points, postoperative 78 points. We noted to severe complications such as thrombosis, pulmonary embolism or nerve injury. No case of early infection has occurred to date. Four hips required further revision, one after a haematogenous infection of the prosthesis 2 years after implantation, one 4 weeks after surgery because of a stem which was significantly undersized compared with the medullary canal of the femur. Two hips were revised after 3 and 4 years, respectively, for continuous subsidence and loosening in the medullary canal. Both revisions were successfully achieved using a femoral component of larger diameter. We recommend the Wagner SL femoral revision stem, not as a routine procedure to treat loosening, but for patients with severe femoral bone resorption after THA or periprosthetic fractures, those in the Girdlestone situation and geriatric patients with pertrochanteric or subtrochanteric fractures.
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PMID:Three-to 7-year results with the uncemented SL femoral revision prosthesis. 912 70

Osteoplastic flap of the frontal sinus, described by Macbeth over 40 years ago, still is the best surgical approach for the diagnosis and definitive treatment of chronic disease. Forty-seven patients were treated with this technique between 1978 and 1995. The conditions treated were, by order of frequency: 16 fronto-ethmoidal mucocele, 12 osteoma, 12 hypertrophic sinusitis, and less frequent disorders, such as osteomyelitis (2), fibrous histiocytoma (2), tuberculosis (1), frontal fracture (1) and dilated pneumosinus (1). The surgical approach was coronal in 28 patients, brow in 18 and hemicoronal in 3. In some cases, other approaches were associated: 13 lateral rhinotomy, 6 sublabial and 1 intranasal. Nasofrontal duct obstruction was found in 89% of cases and erosion of one or more sinus walls in 70%. Intraoperative complications included 4 small dural tears, 1 with leakage of cerebrospinal fluid. Postoperative complications included 4 frontal deformity, 2 persistent frontal anesthesia, 1 supraorbital nerve neuralgia, 1 post-anticoagulant epistaxis and 1 death from pulmonary embolism.
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PMID:[Osteoplastic frontal sinus flap. Study of 47 cases]. 971 27


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