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

The authors report 12 cases of pulmonary embolism with misleading signs and discuss the difficulty in diagnosis: 1) the frequency of incomplete forms; 2) lack of specificity of the clinical and paraclinical picture of pulmonary embolism which may simulate pulmonary or heart disease; 3) difficulties in interpretation of the signs of pulmonary embolism in cases of prior heart or pulmonary disease.
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PMID:[Misleading pulmonary emboliu]. 19 95

Authors have reported ECG signs of pulmonary embolism caused by lymphography injected contrast oil. Signs indicative of transitory right ventricular strain were observed in the ECG in 17 of 30 clinically symptom-free patients.
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PMID:[ECG signs of pulmonary embolism caused by lymphography injected contrast oil (author's transl)]. 20 25

Natural history of pulmonary embolism observed during a 4-year period in a non-discriminayory Department of Internal Medicine, with reference to 7,843 admissions : 2 per cent of patients, 9 per cent of deaths, 22 per cent of post-mortem examinations. Value of various paraclinical examinations, more especially ECG, lung scintigraphy and determination of blood gases.
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PMID:[Pulmonary embolism in general medicine. Characteristics and diagnostic elements]. 21 May 9

Fifty-nine patients with ovarian carcinoma were studied with particular reference to abnormalities of the coagulation mechanism. The notable findings were the high incidence of episodic thrombocytosis (73%) and the relation of these peaks of thrombocytosis to periods of expected maximum tumour break-down. The incidence of pulmonary embolism for the series was 44%, with the majority occurring in the group demonstrating significant thrombocytosis; in this latter group, pulmonary embolism constituted the major cause of death. The abnormalities in coagulation are discussed, together with pragmatic significance and methods of control.
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PMID:The hypercoagulable state and pulmonary embolism in patients with ovarian carcinoma. 21 29

A consecutive series of 101 pituitary tumours treated in the 10 year period 1968-78 has been examined, giant lesions being excluded. There were 48 female cases and 53 male, women predominating in the ratio of three to two in the age group 40-50 years and men showing a slight predominance in the age group 50-60 years. Most cases presented with visual deterioration which in 22 cases had been present for between one and two years, and in a further 22 for an even longer period, between two and 10 years. All patients underwent subfrontal craniotomy with mainly radical excision of the tumour followed by radiotherapy. The operative mortality was 0.99%. A system of grading of visual field defect has been described and used to compare preoperatively visual loss with postoperative visual recovery. Fifty-six per cent of cases returned to normal vision over the first two years, and a further 37% showed appreciable improvement in visual fields or acuity or both. Six per cent of cases showed no improvement in visual fields, and one patient died of postoperative deep vein thrombosis and pulmonary embolism. The degree of visual improvement has been correlated with the extent of visual defect, length of visual complaint, and size of the tumour. The importance of central and peripheral visual field analysis is emphasised yet again.
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PMID:Transcranial management of pituitary tumours with suprasellar extension. 21 70

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

A summary of what is currently known about the negative side effects associated with oral contraceptive usage is presented, and recommendations for prescribing OCs (oral contraceptives) are made. According to the results of several investigations, 2-18% of all women who take OCs develop hypertension. For most of these women the effects are mild; however, for some the increase in blood pressure is marked and results in renal damage. Several studies demonstrate that the risk of peripheral venous thrombosis and pulmonary embolism is enhanced for women who use OCs compared to nonusers. The risk is somewhat reduced for those who take low estrogen OCs. Women aged 30-39, who take OCs, are 3 times more likely to suffer a myocardial infarction than those who do not use OCs. This risk is markedly increased among OC users who either smoke or suffer from hypertension, diabetes, or hypercholesterolemia. OC users have a 9.5 times greater risk of thrombolic stroke and a 2.0 times greater risk of hemorrhagic stroke than nonusers. For women over 27 years of age, OC usage is associated with the development of benign hepatic adenoma. This risk increases markedly with duration of pill use and is greater for women who take pills containing mestranol compared to those who take pills containing ethinyl estradiol. Occasionally cases of pulmonary hypertension, peripheral arterial occlusion, mesenteric vascular insufficiency, Budd-Chiari syndrome, and noninflammatory cholestatic liver injury are reported among OC users. Recommendations are: 1) women with thromboembolic disorders and women over 34 years old, who smoke or who are obese or hypertensive should be advised to consider other forms of contraception; 2) prescriptions should be written for a 6 month supply and renewed only after a follow-up visit; 3) women who experience elevated blood pressure readings should be advised to discontinue usage; 4) serum triglyceride and cholesterol should be checked every 6 months; and 5) consider the use of low dose heparin for OC users who are recovering from trauma or surgery or who are confined to bed for long periods of time.
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PMID:A review: adverse effects of oral contraceptives. 22 69

We have recently described a new method for measuring distributions of ventilation-perfusion ratios (VA/Q) based on inert gas elimination. Here we report the initial application of the method in normal dogs and in dogs with pulmonary embolism, pulmonary edema, and pneumonia. Characteristic distributions appropriate to the known effects of each lesion were observed. Comparison with traditional indices of gas exchange revealed that the arterial PO2 calculated from the distributions agreed well with measured values, as did the shunts indicated by the method and by the arterial PO2 while breathing 100 per cent 02. Also the Bohr dead space closely matched the dispersion of ventilation in realtion to VA/Q. Assumptions made in the method were critically evaluated and appear justified. These include the existence of a steady state of gas exchange, an alveolar-end-capillary diffusion equilibration, and the fact that all of the observered VA/Q inequality occurs between gas exchange units in parallel. However, theoretical analysis suggests that the method can detect failure of diffusion equilbration across the blood-gas barrier should it exist. These results suggest that the method is well-suited to clinical investigation of patients with pulmonary disease.
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PMID:Distribution of ventilation-perfusion ratios in dogs with normal and abnormal lungs. 23 70

Pulmonary embolism is unique among cardiorespiratory diseases because of its high frequency of both overdiagnosis and underdiagnosis. The lack of specific and consistent clinical, laboratory, roentgen, and electrocardiographic features lead to this paradox. While the lung scan may be diagnostic in selected cases, the pulmonary angiogram is the most accurate method of demonstrating emoboli short of operative or pathological examination.
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PMID:Pulmonary embolism: dilemmas in diagnosis and therapy. 25 22

Twenty-two patients from our surgical intensive care ward were, after unsuccessful treatment outside, treated with a combination of antibiotics including 6-[(R)-2-[3-methylsulfonyl-2-oxo-imidazolidine-1-carboxamido]-2-phenyl-acetamido]-penicillanic acid sodium salt (mezlocillin, Baypen) as a beta-lactam antibiotic. The infection was cured in 16 and improved in 2 patients. Three cases of infection with Serratia did not respond to treatment and antibacterial efficacy was unassessable in another case. Four patients died of shock lung (2), pulmonary embolism (1) or Candida-induced septicaemia (1) after cure of the infection. The daily dose of mezlocillin was 3 x 5 g, given as an i.v. short-term infusion. Diarrhoea (1) and petechiae (1) were observed as side effects probably attributable to mezlocillin. In none of the patients was a discontinuation of treatment necessary. Owing to its broad spectrum of action (covering both gram-positive and gram-negative microorganisms and anaerobes) and its consistently strong molar action, mezlocillin is well suited as a beta-lactam combination component for intensive care patients. At the end of this study in vitro resistant strains appeared. Therefore mezlocillin with its very valuable properties should be given only to critically selected cases.
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PMID:[Antibiotic therapy of infections in patients under surgical intensive care, in particular with mezlocillin (author's transl)]. 26 72


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