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)

We report the case of a 28-year-old man who was admitted in an emergency because of severe abdominal pain with gastrointestinal haemorrhage and shock. Laparotomy showed infarction of the small intestine with mesenteric veins thrombosis. Severe thromboembolic complications occurred during the post-operative period: bilateral femoral deep vein thrombosis with pulmonary embolism, axillary and subclavian vein thrombosis associated with an intravenous catheter, portal hypertension related to portal vein thrombosis and cavernoma, thrombosis of the superior longitudinal sinus. Laboratory investigations performed after thrombotic episodes and repeated 5 years later evidenced a type 1 Heparin Cofactor II deficiency (HCII Ag by EID: 40 percent; functional Tollefsen's method: 60 percent). This heterozygous deficiency was also found in one of the patient's sons. This is the first reported case of HCII deficiency associated with mesenteric infarction and cerebral thrombophlebitis. The relationship between these severe venous thrombotic episodes and the HCII deficiency is discussed in relation to the dermatan sulphate-HCII couple physiology. Vascular injury may act as a triggering factor in patients with HCII deficiency.
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PMID:[Recurrent venous thromboembolism caused by heparin cofactor II deficiency. A case]. 183 93

Protein C deficiency is a known underlying risk factor for thromboembolic disease. Most commonly it presents as thrombophlebitis, deep venous thrombosis or pulmonary embolism. Less common presentations are becoming increasingly recognized now that assays for protein C are more widely available. We present two cases of mesenteric venous thrombosis who were found to have protein C deficiency.
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PMID:Mesenteric venous thrombosis due to protein C deficiency. 193 24

The diagnostic features of acute pulmonary embolism among 72 patients greater than or equal to 70 years old were evaluated and compared with characteristics of pulmonary embolism among 144 patients 40 to 69 years and 44 patients less than 40 years old. Syndromes characterized by either 1) pleuritic pain or hemoptysis, 2) isolated dyspnea, or 3) circulatory collapse were observed with comparable frequency among patients greater than or equal to 70 years old and younger patients. One of these presenting syndromes occurred in 64 (89%) of the 72 patients greater than or equal to 70 years old. Those who did not show these syndromes were identified on the basis of unexpected radiographic abnormalities, which may have been accompanied by tachypnea or a history of thrombophlebitis. Among the 72 patients greater than or equal to 70 years with pulmonary embolism, dyspnea or tachypnea (respirations greater than or equal to 20/min) occurred in 66 (92%), dyspnea or tachypnea or pleuritic pain in 68 (94%) and dyspnea or tachypnea or radiographic evidence of atelectasis or a parenchymal abnormality in 72 (100%). Complications of angiography were evaluated among patients with and without pulmonary embolism. Major complications of pulmonary angiography among patients greater than or equal to 70 years old (2 [1%] of 200) were not more frequent than among younger patients (6 [1.1%] of 562) (p = NS). However, renal failure (major or minor) was more frequent in patients greater than or equal to 70 years old than in younger patients (6 [3%] of 200 versus 4 [0.7%] of 562) (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Diagnosis of acute pulmonary embolism in the elderly. 193 45

Thrombolytic therapy has been used fairly extensively in the management of acute proximal deep-vein thrombophlebitis of the extremities, acute pulmonary embolism, and acute peripheral arterial thrombosis and embolism in addition to acute thrombotic coronary events. In the presence of acceptable indications and a favorable benefit to risk ratio, this form of therapy, when successful, has served as a useful adjunct in the management of these disorders. In deep-vein thrombophlebitis, lysis of the thrombus before permanent pathological changes (eg, organization, scarring) have occurred can prevent venous valvular dysfunction and postural venous hypertension and its complications, especially the postphlebitic syndrome. In the more severe forms of acute pulmonary embolism, thrombolytic therapy, when applied early after symptom onset, decreases morbidity and is likely to prevent a chronic increase in pulmonary vascular resistance and persistent pulmonary hypertension. In peripheral arterial thrombo-occlusive events, early restoration of flow through thrombolysis has been shown to limit ischemic damage and serve as a useful supplement to angioplasty or surgery. Thrombolytic therapy has been used less extensively in acute strokes. Here the danger of reperfusion causing bleeding into a softened area of brain undergoing infarction has slowed its evaluation for this disorder; its application to stroke remains experimental.
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PMID:Thrombolytic therapy for noncoronary diseases. 200 69

Four hundred arthroplasties with the Bateman (or universal) prosthesis were performed from June 1974 to January 1985, including 286 cases with osteoarthritis (OA) and 114 with rheumatoid arthritis (RA). Evaluation was made according to the d'Aubigne-Postel method. The follow-up period was from three to 14 years, with an average duration of eight years, five months. The results were excellent in 230 cases (172 OA, 58 RA), good in 140 (98 OA, 42 RA), fair in eight (four OA, four RA), and poor in 22 (12 OA, ten RA). Radiolucencies were present in the femoral side in 25%. Radiolucency of more than 2 mm was seen in 20 cases (5%). The complications were six cases of fracture of the plastic insert, four cases of protrusio of the acetabulum, four dislocations, eight cases of loosening of the femoral stem, one deep infection, two superficial infections, 15 cases of thrombophlebitis, one pulmonary embolism, and one death. A careful analysis of these complications and a discussion of their treatment are presented. Reoperations were performed in 20 patients (5%). The universal arthroplasty appears to be a safe and reliable procedure.
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PMID:The Bateman bipolar prosthesis in osteoarthritis and rheumatoid arthritis. A review of 400 cases. 229

Transcatheter direct-current ablation of the atrio-ventricular junction is a recently developed technique in the treatment of medically refractory supraventricular tachycardia. Twenty patients underwent this procedure between July 1987 and May 1989 and were followed-up for a mean period of 8.3 +/- 6 months (range 1-23). Indication for ablation included atrial flutter in 4 patients, atrial fibrillation in 8, atrial tachycardia in 1, atrio-ventricular nodal re-entrant tachycardia in 4, atrioventricular re-entrant tachycardia (concealed pathway) in 2, permanent junctional reciprocating tachycardia in 1. These arrhythmias were resistant to a mean of 3.3 +/- 1.7 antiarrhythmic drugs. A mean of 1.4 +/- 0.59 (range 1-3) electrical shocks, with a mean energy of 285 +/- 135J (range 200-700), were delivered during 1-2 sessions. In all patients a persistent complete atrio-ventricular block was achieved. Immediate complications included transient hypotension in 2 pts, acute pulmonary edema in 1, premature ventricular complexes in 4, non sustained ventricular tachycardia in 4, sustained ventricular tachycardia in 1. Late complications included thrombophlebitis of the right femoral vein in 2 pts; one of them died suddenly as a result of massive pulmonary embolism 10 days after the procedure. Follow-up evaluation reveals chronic complete atrio-ventricular block in all patients. Symptoms related to pre-existing arrhythmia are absent in all pts and none of them is currently taking antiarrhythmic drugs. Two patients with DDD pacing had pacemaker mediated re-entrant tachycardia and 1 patient with VVIR pacing developed a pacemaker syndrome. This experience confirms that transcatheter fulguration of atrio-ventricular junction is an effective technique. However, possible severe complications related to the procedure suggest this approach be restricted to patients with very symptomatic and drug-refractory supraventricular tachyarrhythmias.
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PMID:[Transcatheter fulguration of the atrioventricular junction in supraventricular hyperkinetic arrhythmia. Immediate and long-term results]. 232 75

Intravenous drug use patients present to the head and neck surgeon when injections are directed "in the pocket," or more appropriately, toward the internal jugular vein in the neck. The more common complications of this practice include the development of cellulitis, abscess, and venous thrombophlebitis and, potentially, pulmonary embolism and pseudoaneurysm of the carotid and subclavian arteries. Vocal cord paralysis as a result of neck injection in the intravenous drug-using population is rarely described, and a review of the literature has yielded only two reports addressing this uncommon phenomenon. During a 7 1/2-year period between October 1981 and June 1989, nine patients presented to Detroit Medical Center with hoarseness, upper-airway obstruction, or both following the injection of heroin or related substances into the neck. Otolaryngologic evaluation demonstrated unilateral or bilateral vocal cord paralysis coincident with recent neck injections. The clinical signs and symptoms, location of the injections, acute management, and subsequent complications are catalogued. Acute management of these patients consisted of airway assurance via tracheotomies when indicated and observation for the development of cellulitis, abscess, or more life-threatening neurovascular complications. Follow-up laryngeal examinations ranged from 4 months to 4 1/2 years and found no demonstrable return of vocal cord function in any of the nine patients.
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PMID:Vocal cord paralysis resulting from neck injections in the intravenous drug use population. 232 8

A 61-year-old white male with recurrent thrombophlebitis developed a painful left arm. He was initially diagnosed with superficial thrombophlebitis and treated conservatively for several days without improvement. He subsequently developed right-sided pulmonary embolism. Hypercoagulability was not present, and venography confirmed the left basilic vein as the sole thrombogenic source. Twelve to twenty percent of documented pulmonary emboli arise from deep veins of the upper extremity. To our knowledge, only one case of basilic vein thrombosis causing pulmonary embolism exists in the literature. Clinical vigilance to this uncommon entity may reduce attendant morbidity and mortality.
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PMID:A rare etiology for pulmonary embolism: basilic vein thrombosis. 235 98

Between 1963-82, 286 deaths were diagnosed after autopsy as due to pulmonary embolism at the Medico-Legal Institute of Plzen, Czechoslovakia. In almost 95% of cases, there was a massive and acute embolism of the pulmonary artery. 155 women and 131 men were involved. The average age of victims was 70 years for women and 66 for men. A thrombosis of the deep veins of the legs was found in 95% of the men and women. Unilateral or bilateral varices or their trophic complications were observed in 30% of women and 27% of men. Almost all patients were affected by arteriosclerosis, with the most serious sclerosis occurring in 32% of the women and 27% of the men. 32% of the men and 53% of the women were obese. The pulmonary embolism coexisted with another serious illness or a trauma in over 90% of cases. The deaths of 12 men and 13 women under 50 years old were studied in greater detail. In this group the cause of death was massive embolism of the pulmonary artery accompanied by deep thrombosis of the legs. The greatest differences were found in the degree of sclerosis of the arteries. Trauma preceded death in 30% of these patients. 50% of the women and 30% of the men were obese. A 32-year-old obese, nonsmoking woman originally consulted for intolerable back pains. About 8 days later she was hospitalized and died. The autopsy revealed a massive and acute pulmonary embolism with vast hemorrhagic infarcts. Thrombosis of the veins was discovered to be the source of the embolism. Microscopic examination also disclosed a venous thrombosis in the ovaries. A proliferation of elastic tissue and a visible thickening of the intima were seen in the arteries, as well as a dilatation of the lymphatic vessels. There was no indication of thrombophlebitis in the leg veins. The medical history showed that the woman had been taking an oral contraceptive (OC) for the past 3 years and continued doing so until the day before her death. The woman's gynecologist stated that 4 months before her death a routine liver examination was slightly positive and the patient was advised to discontinue her combined OC (Non-Ovlon) for 3 months. The woman felt well and disregarded the advice. Non-Ovlon contains 1 mg of norethisterone acetate and .5 mg of ethinyl estradiol.
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PMID:[Sudden death in venous diseases]. 242 70

A heterozygote protein C deficit was found in 4 members of the same family. The propositus is a 40 year old male with a clear thrombotic tendency. This included repeated thrombophlebitis of the right leg, and one episode of pulmonary embolism. Arterial thrombosis was not noted. The anticoagulant therapy undertaken by the patient appears to be of some benefit in the sense that no recurrence of thrombotic manifestations occurred. One brother and two nephews of the propositus, even though asymptomatic showed reduced levels of Protein C both as activity and antigen. The parallel reduction of Protein C activity and antigen points towards a "true" deficit of Protein C. The normal, although reduced, pattern in the crossed immunoelectrophoresis supplies further confirmation to this interpretation.
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PMID:The report of an Italian family with heterozygous protein C deficiency. 246 57


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