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

Lung perfusion scintigraphy can make arterial embolic obstruction visible because the uptake of microspheres labelled with 99mTc is lower than normal in the corresponding lobes, segments or subsegments. The sensitivity for pulmonary embolism is high (up to 98%). The specificity of a positive finding increases with additional investigations: infiltrative and space occupying lesions can be seen on the chest X-ray, and broncho-obstructive diseases with concomitant perfusion defects can be identified with the help of ventilation scintigraphy using 133Xe. In view of its high sensitivity and specificity, its low cost, low risk with practically no discomfort for the patient, and standardized techniques not dependent on the skill of the examiner, lung scintigraphy can replace pulmonary angiography in nearly all circumstances. It should be noted, however, that late sequelae--after thrombolysis and recanalization have taken place and when atelectases or pneumonia may dominate--may blur the scintigraphy findings. Thus, patients must be sent for lung scintigraphy as soon as suspicion of pulmonary embolism arises.
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PMID:[Nuclear medical diagnosis of pulmonary embolism]. 652 99

The authors have studied the CK isozyme pattern in the pericardial fluid of 100 cadavers autopsied in the Anatomic Forensic Institute of Granada. The samples were classified into several groups according to the cause of death: --Multiple trauma with thoracic contusion --Pneumonia and pulmonary embolism --Mechanical asphyxia --Cranio-cerebral trauma --Acute haemorrhage --Myocardial infarction --Others. The results showed that the CK isozyme pattern of pericardial fluid provides useful postmortem information of cardiac "status", adding to the diagnostic potential of CK isozymes.
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PMID:The postmortem determination of CK isozymes in the pericardial fluid in various causes of death. 661 58

Results of extensive follow-up for weight loss and complications in 150 consecutive patients who underwent a standardized gastric exclusion procedure have been presented. A comparative review of the literature has also been presented. All patients were followed for up to 6 years (mean 27.8 months). Only one patient was lost to follow-up. Complications during this period occurred in 54.7 percent of our patients. These were mainly postsurgical biliary disease and ventral hernias. Our recent experience has suggested that the latter complications could have been prevented. The absence of pulmonary embolism, pneumonia, and stomal ulcer in our series, as well as the low incidence of perforations, thrombophlebitis, and stomal and pouch complications suggest that the occurrence of these complications can be minimized as well. Patients in this series lost an average of 75 percent of their excess weight, 38 percent of their original weight, and stabilized at 30 percent above their ideal body weight. Ninety percent of the weight loss occurred in the first 12 months. Eighty percent of the patients, however, continued to lose weight 18 months postoperatively and 40 percent lost weight up to 24 months postoperatively. Weight loss has been maintained from 2 to 5 years. In conclusion, analysis of available data has demonstrated that careful patient selection, attention to technical detail, and close follow-up are of paramount importance for providing successful results and minimizing complications in the morbidly obese population who undergo gastric exclusion surgery.
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PMID:Complications and weight loss in 150 consecutive gastric exclusion patients. Critical review. 663 65

After gastric restrictive procedures in morbidly obese persons, the reported morbidity is 15 per cent, and mortality is 1 per cent. Pulmonary embolism continues to be the most serious complication. Gastric perforations must be recognized early and treated promptly, as must the common postoperative complications: pneumonia, atelectasis, and wound infection.
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PMID:Complications of gastric restrictive operations in morbidly obese patients. 664 66

Analysis of early deaths after stroke is important, since some deaths may be preventable. Previous studies have relied on retrospective and often incomplete clinical data, for comparison with pathological findings. The present study is based on 1073 consecutive stroke patients admitted to an intensive care stroke unit from a well-defined population. There were 212 deaths within the first 30 days, yielding a mortality rate of 20%. Clinical, radiological, and laboratory data were collected prospectively according to a standardized protocol. Autopsies were performed on 90 of the 212 patients, and CT scanning on a further 27. Early mortality after stroke exhibits a bimodal distribution. One peak occurs during the first week, and a second during the second and third weeks. The majority of deaths in the first week are due to transtentorial herniation. Of these, deaths due to hemorrhage usually occur within the first three days, whilst deaths due to infarction peak between the third and sixth day post ictus. After the first week, deaths due to relative immobility (pneumonia, pulmonary embolism and sepsis) predominate, peaking towards the end of the second week. Cardiac deaths occur throughout the first month, and unfortunately account for many deaths in patients with small functional deficits.
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PMID:Early mortality following stroke: a prospective review. 672 78

A number of medical disciplines are involved in the diagnosis and therapy of thoracic pain. The origin may be somatic or visceral. Individual diseases are discussed in particular such as myalgia epidemica, intercostal neuralgia, herpes zoster, pleuritis and pneumonia, pulmonary embolism, pneumothorax, mediastinal emphysema, mediastinitis, pulmonary hypertension and the hyperventilation syndrome. Differential diagnosis is also referred to.
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PMID:[Pulmological aspects of diagnosis of thoracic pain (author's transl)]. 677 86

Three patients with Boerhaave syndrome were successfully managed with nonoperative treatment. The diagnosis was delayed 5 days in one patient and 10 days in the other two. None of the patients appeared septic. Their conditions had been misdiagnosed as myocardial infarction, pneumonia and pulmonary embolism. Treatment consisted of intravenous hyperalimentation and administration of antacids and antibiotics. Cimetidine was also used in one patient. Two patients were discharged 14 days after diagnosis and the third on the 20th hospital day. Follow-up barium swallows showed complete healing in 2 months in all three patients. Conservative management of spontaneous esophageal perforation is feasible when (1) the perforation is already 5 days old, (2) there are no signs of severe sepsis, (3) esophageal barium study shows a wide-mouthed cavity draining freely back into the esophagus, and (4) the pleural space is not contaminated. When the diagnosis is made promptly, surgical therapy remains the treatment of choice, and patients managed conservatively who show signs of sepsis should be operated on without hesitation. Follow-up esophageal evaluation should be performed to confirm complete healing and to evaluate underlying disease.
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PMID:Boerhaave syndrome. Successful conservative management in three patients with late presentation. 678 84

We evaluated reflection and absorption indexes of ultrasound as well as Doppler estimates of intrapulmonary blood flow for diagnosing pulmonary embolism. The pulmonary reflection coefficient (PRC), coefficient of tissue attenuation (alpha R) and range-gated blood Doppler signals were studied in 25 patients with pulmonary embolism, 19 with pneumonia, nine with atelectasis, 20 with congestive heart failure, 20 with chronic obstructive lung disease and 10 normal subjects. The PRC was significantly diminished in pulmonary embolism, pneumonia and atelectasis, but was not altered by underlying chronic obstructive lung disease or congestive heart failure. The alpha R in pulmonary embolism was 1.03 +/- 0.04 db/MHz cm, significantly lower than that for pneumonia, 1.48 +/- 0.03 db/MHz cm (p less than 0.001), but not significantly different from that for atelectasis, 0.95 +/- 0.05 db/MHz cm. Doppler signals indicating blood flow in the affected area of lung were present in only two of 25 patients with pulmonary embolism, compared with seven of nine with atelectasis and 17 of 19 with pneumonia. The combined use of PRC, alpha R and blood Doppler signals correctly diagnosed pulmonary embolism in 23 of 25 patients. Thus, ultrasound offers a reliable noninvasive method for diagnosis of pulmonary embolism.
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PMID:Echocardiographic tissue characterization and range-gated Doppler ultrasound for the diagnosis of pulmonary embolism. 684 26

An experiment was designed to determine whether or not acute pneumococcal pneumonia in dogs is associated with intravascular thrombosis, or with angiographic features distinguishable from pulmonary embolism. In dogs with normal baseline chest radiographs and perfusion scans, pneumonia was produced by transbronchial instillation of type III pneumococcus. After 2 days, perfusion scans demonstrated discrete appropriate defects. In vivo magnification pulmonary arteriography, postmortem pulmonary arteriography, and histologic examination disclosed no evidence of thrombi.
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PMID:Subselective magnification angiography of experimental pneumonia. 685 Jul 6

A 54-year-old man presenting with symptoms and signs of pulmonary embolism demonstrated gallium-67 accumulation within the right lower lung field in the region of a pulmonary embolism with effusion. An associated infectious process was ruled out. This is contrary to the usual clinical experience and identifies a potential pitfall in the use of gallium-67 as an aid in the differential diagnosis of pulmonary embolism and pneumonitis.
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PMID:Positive gallium-67 scintigraphy associated with pulmonary embolism. 687 9


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