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)

Sixty-two living related kidney donors were nephrectomized during a 10-year period. The overall complication rate was 40%, most complications being minor. Among the major complications was one patient with pulmonary embolism and three patients with hepatitis. One female donor suffered a psychoneurotic reaction following rejection of the donated kidney and she is still away from work, more than 2 years later. The other 61 donors were back to work within 2 to 18 (mean 8) weeks. The mean serum creatinine livels increased from 0.95 preoperatively to 1.15 mg/100 ml at the followup examination, which took place between 6 months and 9 years after nephrectomy. The mean increase in serum creatinine was higher in donors above 50 years of age (P less than 0.02). The mean creatinine clearance of the whole group decreased from 111 to 90 ml/min. The mean increase in size of the remaining kidney was 22%. Donor nephrectomy is a safe procedure with few serious complications and the prognosis for the recipient is excellent. Therefore, we consider transplantation from a family member to be the treatment of choice in terminal uremia.
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PMID:Living related kidney donors: complications and long-term renal function. 63 86

Renal vein thrombosis caused the nephrotic syndrome in a patient with morbid obesity. Pulmonary embolism occurred initially, but not after anticoagulants were administered. Surviving for three years, the patient died of profound uremia and hyperosmolar coma. At autopsy, membranous glomerular changes were found. Conclusive exclusion of renal vein thrombosis in the morbidly obese patient with nephrotic syndrome appears advisable.
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PMID:Thrombosis of the renal veins and vena cava. Occurrence in morbid obesity. 124 31

Hemoptysis in systemic lupus erythematosus (SLE) may occur in up to 17% of cases. The vast majority of the cases are secondary to bacterial, tuberculosis or opportunistic infections. Also uremia, pulmonary embolism and lung hemorrhage must be considered. The majority of the above referred entities are usually alarming events in any patient with SLE. In contrast, we describe a patient with inactive SLE, who developed hemoptysis secondary to Paragonimus sp., which was treated "easily" with praziquantel. Fluke infection must be considered in the differential diagnosis of hemoptysis in SLE.
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PMID:Paragonimiasis: an infrequent but treatable cause of hemoptysis in systemic lupus erythematosus. 231 24

Heparin has been used in clinical practice since 1936 as anticoagulant for: the treatment of thromboembolic disorders, the prevention of deep vein thrombosis and pulmonary embolism and the maintenance of blood fluidity in extracorporal circuits. Its use in these indications has been complicated by an increased risk of hemorrhage such as major bleeding during the treatment of pulmonary embolism and wound hematoma after surgery. Bleeding problems associated with the use of heparin in extracorporal circuits are the following: hemorrhages after cardiopulmonary bypass, serious hemorrhagic complications in patients treated with hemodialysis during acute renal failure and in patients on chronic intermittent hemodialysis and increased occult blood loss from the gastrointestinal tract and from other sites. The precise contribution of the use of heparin to the enhanced bleeding in these conditions has not yet been established. The effects on platelets, coagulation factors and/or fibrinolytic activity by the exposure of blood to foreign surfaces together with uremia present in hemodialysis patients may also contribute to abnormalities in clinical hemostasis. Recently heparin fractions and a heparinoid of low molecular weight (LMW) have been developed because of their potential to diminish the hazard of hemorrhage while retaining their antithrombotic properties. Preliminary reports from pilot studies have confirmed the increased efficacy in preventing deep vein thrombosis (DVT) of some of the new LMW heparin(oid)s; however, improved safety with regard to bleeding still needs to be shown. The use of LMW heparins and of a new LMW heparinoid in acute and chronic hemodialysis has also been shown to be effective.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Heparin and its biocompatibility. 243 41

By activating plasminogen into plasmin, which in turn dissolves fibrin, fibrinolytic agents can dissolve pathologic thrombi. Streptokinase, a fibrinolytic agent derived from group C beta-hemolytic streptococci, is antigenic and can elicit allergic reactions. Urikinase, a fibrinolytic agent obtained by purification from human urine or from human fetal kidney cell culture, is not antigenic, and for this reason can be used repeatedly, if needed, whereas streptokinase cannot be used for retreatment within six months of a course of therapy. Either agent can be introduced into the circulation systemically (intravenously) or locally (via catheter). The indications for systemic therapy include deep-vein thrombosis, pulmonary embolism, and arterial thrombosis and embolism. The indications for local therapy include acute myocardial infarction, arterial thrombosis and embolism, and the clearing of occluded arteriovenous cannulae and access shunts. Contraindications include an actively bleeding lesion, a vascular intracranial disorder, or uncontrolled hypertension; relative contraindications include pregnancy; a recent wound, fracture, surgery, or deep closed biopsy; or a general contraindication to anticoagulation, such as coagulopathy, uremia, or severe liver disease. During thrombolytic therapy, invasive procedures, intramuscular injections, and the use of other anticoagulant or antiplatelet agents should be avoided. Measurement of fibrinogen levels, the titer of fibrin/fibrinogen degradation product, or thrombin time can be used to monitor therapy.
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PMID:Fibrinolysis and its current usage. 634 82

Out of 279 cases of elective radical colonic surgery 109 complicated cases are dealt with. Most of them (66%) were caused by infection. The postoperative mortality came up to 10%. Three quarters of the postoperative deaths were caused by septicaemia and gastrointestinal bleeding. Some of the complications can be effectively cured. Others like peritonitis, anaerobic septicaemia, pulmonary embolism and uraemia have a high mortality rate and will in future require better methods of prevention and therapy.
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PMID:[Complications of 279 elective radical colonic operations and results of their management (author's transl)]. 697 30

In 1096 cases of death (autopsy rate 63.8%) the accuracy of clinical diagnoses was investigated by comparing clinical diagnoses with recorded autopsy findings. -- In 81.3% of the cases the primary disease had been determined correctly. In more than half of these cases the immediate cause of death or an additional disease contributing to death had not been correctly identified. In 16% of the cases the diagnosis proved to be inadequate. -- In 2.6% of all cases the primary disease, cause of death and accompanying illnesses were misdiagnosed. Most of these patients had stayed in the hospital for a much shorter time than the rest of the patients. -- Among conditions clinically diagnosed as cirrhosis of the liver, pulmonary embolism, myocardial infarction, cerebral hemorrhage, and malignant tumors -- pulmonary embolism was by far the most frequent condition to go unrecognized, i.e. in 50% of th cases in which it was present. Primary liver cell carcinoma proved to be the malignant tumor most frequently not identified by clinical studies. -- Four clinical diagnoses (shock, septicemia, diabetes mellitus and uremia) were often unsupported by morphological findings. Yet there were 13 clinically undiagnosed cases of septicemia in which findings at post mortem examination revealed this condition. These cases also underline the importance of autopsies.
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PMID:Autopsy and clinical diagnosis. 1879 61

A study of maternal deaths due to septic abortion from 1973-77 in India found the incidence of septic abortion to be 6.6% of all spontaneous abortion in the L.N.J.P. Hospital. The total maternal deaths were 81 and deaths due to septic abortion were 17. The death rate due to septic abortions remained constant during the 5-year period. The majority of cases were married and belonged to the urban population. Of a total 6418 medically terminated pregnancies, 190 were septic abortions. The causes of death were generalised peritonitis (4); septicaemia (4); uraemia (2); endotoxic shock (2); uterine perforation with peritonitis (2); pelvic abcess and pulmonary embolism (1); and tetanus (2). In view of the high number of septic abortion deaths, medically terminated pregnancy services should be reapprised. Preventive contraception would alleviate most of the potential dangers of septic abortion.
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PMID:Septic abortions: 5 years review. 1233 18

Oral anticoagulants are commonly used drugs in patients with CKD and patients with ESKD to treat atrial fibrillation to reduce stroke and systemic embolism. Some of these drugs are used to treat or prevent deep venous thrombosis and pulmonary embolism in patients with CKD who undergo knee and hip replacement surgeries. Warfarin is the only anticoagulant that is approved for use by the Food and Drug Administration in individuals with mechanical heart valves. Each oral anticoagulant affects the coagulation profile in the laboratory uniquely. Warfarin and apixaban are the only anticoagulants that are Food and Drug Administration approved for use in patients with CKD and patients with ESKD. However, other oral anticoagulants are commonly used off label in this patient population. Given the acquired risk of bleeding from uremia, these drugs are known to cause increased bleeding events, hospitalization, and overall morbidity. Each anticoagulant has unique pharmacologic properties of which nephrologists need to be aware to optimally manage patients. In addition, nephrologists are increasingly asked to aid in the management of adverse bleeding events related to oral anticoagulant use in patients with CKD and patients with ESKD. This article summarizes the clinical pharmacology of these drugs and identifies knowledge gaps in the literature related to their use.
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PMID:Clinical Pharmacology of Oral Anticoagulants in Patients with Kidney Disease. 3090 1

Classic "bread-and-butter" appearance of fibrinous pericarditis had been described in rheumatic disease and other immunologic diseases such as systemic lupus erythematosus, post-myocardial infarct, uremia, tuberculosis, radiation effects, bacterial, and viral etiology. In most of the described cases, pericarditis occurs as a delayed complication. We present a case of a 21-year-old white woman who was seen in the emergency department to rule out pulmonary embolism for shortness of breath, chest pain, and lightheadedness. The autopsy showed a collection of serous fluid into the pericardial sac with bread-and-butter appearance. Microscopically, the pericardium showed acute inflammation with fibrinous exudates. Sections of the heart showed areas of lymphocytic infiltration with acute fibrinous inflammation of the pericardium. Vasculitis was seen in small blood vessels in the heart and was negative in other organs. No granuloma or necrotizing lesion was seen in microscopic sections of all organs including the heart, ruling out rheumatologic disease. The present study highlights the quest and design of an algorithm for a nonrheumatic disorder as the cause of pericarditis. Molecular studies were performed on heart tissue blocks for identification of cardiotropic viruses. Human parvovirus B19 was isolated from heart tissue blocks. The present case study highlights on updates in pathophysiology and diagnostic criteria for myocarditis along with the use of new molecular techniques for detection of idiopathic cardiomyopathies in a medical examiner setup.
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PMID:Nonrheumatoid Fibrinous Pericarditis: A Medical Examiner Algorithm for the Diagnosis of Viral Myocarditis and Use of Molecular Diagnostic Techniques. 3028 28


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