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)

The specificity of the action of low-molecular-weigh heparin promotes its prevention use in ophthalmological surgery, where any hemorrhage, even if not of vital consequence, can reduce and even cancel out the results of the surgery. Consequently, we subjected 63 patients (21 male, 42 female) aged 54 to 93 to preventive treatment with Fraxiparine (CY 216) as per the conventional indications of risk factors: essentially venous insufficiency [23], varicose veins [29], a history of phlebitis [20] or pulmonary embolism [12]. A first group of 31 patients (protocol P 1) was given the first injection 2 hours prior to surgery (D 0). A second group of 32 patients (P 2) was given the injection at 10 p.m. on the eve of surgery (D-1). P 1 and P 2 were given CY 216 (0.3 ml, one injection at 6 a.m.) each day from D 1 to D 7 (and 7 patients from P 1 until D 10). The type of surgery concerned was: cataract [46], retinal detachment [11], glaucoma [3]; fifteen patients had already undergone surgery and 6 were given CY 216 twice. P 2 was compared with a control group T of 20 patients (7 male, 13 females, mean age 71.8) in the same department given calcium heparin sc (3 x 0.2 ml daily, D 1 to D 7). In P 1 and P 2, as well as in the T group, no clinical thromboembolic complications were observed. Tolerance, however, differed. In P 1: 2 cases of hyphema and one of choroidal hematoma. In P 2: no significant hemorrhage.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Tolerability in ophthalmologic surgery of CY 216 in preventing venous thrombosis of the leg]. 285 75

In eight of 14 patients who were deficient in protein S and who belonged to two unrelated families thrombosis presented as thrombophlebitis in seven and deep vein thrombosis in six, complicated by pulmonary embolism in four and leg ulcers in two. In four patients superficial thrombophlebitis preceded deep vein thrombosis by one to 11 years. Post-thrombotic varicose veins and venous insufficiency had developed in four patients. In three of those and in a fourth patient symptomatic superficial thrombophlebitis, deep vein thrombosis, and pulmonary embolism did not recur while they were taking oral anticoagulant treatment for six to 12 years. The anticoagulation intensity corresponded to international normalised ratio values of over 2.5. It is concluded that the benefits of anticoagulant treatment for patients with congenital thrombotic disease are great, and thus it is necessary to make an early diagnosis and treat patients at risk of developing thrombosis.
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PMID:Effectiveness of long term oral anticoagulation treatment in preventing venous thrombosis in hereditary protein S deficiency. 295 50

The question of knowing to what extent varices occur more frequently in obese, rather than in non-obese, patients is answered variously in the epidemiological studies carried out. But if pathological venous conditions originate in, or are aggravated by, obesity, the question is raised: to what extent is the venous circulation modified by obesity? The authors discuss the factors at play in venous circulation in the obese patient. The effect of super alimentation on the venous system is demonstrated in the autopsy statistics on the occurrence of fatal pulmonary embolism, compared with the general nutrition index.
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PMID:[The physiology and physiopathology of the venous system in the obese]. 322 92

Fatal pulmonary embolism is a major cause of postoperative death. When no prophylaxis is given in general surgery, it has a frequency of about 1%. Apart from the immediate risk to life, one must also consider the late sequelae of extensive deep vein thrombosis--swelling of the legs, varicose veins, ulceration and other trophic changes which represent an equally distressing situation. Recently, three large-scale surveys have been published, where the data of over 100 randomized controlled clinical trials of prophylaxis against venous thromboembolism has been analysed. The purpose of this talk is to provide an overview of the currently available prophylactic methods analysed in these surveys, with an aim to define a policy for preventing venous thromboembolism, with particular emphasis on the surgical patients. There is evidence suggesting that the frequency of fatal pulmonary embolism can be reduced by such prophylactic remedies as low-dose heparin, dextran, the combination of dihydroergotamine plus heparin, and low molecular weight heparin.
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PMID:Current recommendations in prevention of thrombosis in surgery. 333 8

The incidence of deep-vein thrombosis was studied in 146 consecutive Korean patients who had a cementless total hip replacement with a porous-coated anatomic prosthesis. All of the patients had discontinued taking aspirin, aspirin-containing compounds, or other antiplatelet medications fourteen days before admission to the hospital for the operation. Deep-vein thrombosis was diagnosed by roentgenographic venography, and pulmonary embolism, by perfusion lung-scanning. There was an unusually low incidence (10 per cent) of deep-vein thrombosis in this series. In contrast to other reports, we did not identify a relationship between deep-vein thrombosis and so-called risk factors such as advanced age, number of venous valves (more than five) in the lower extremity, abnormal coagulation-assay data, certain diseases, or preoperative limitation of mobility. In addition, hypertension, blood group, surgical approach, and choice of cemented or cementless total hip replacement did not seem to affect the incidence of deep-vein thrombosis. There was a low incidence of deep-vein thrombosis in patients in whom obesity, prolonged immobilization postoperatively, varicose veins, and hyperlipemia were not factors.
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PMID:Low incidence of deep-vein thrombosis after cementless total hip replacement. 339 86

Denver type peritoneo-venous (PV) shunting for intractable ascites was performed in 16 patients also treated with endoscopic injection sclerotherapy (ST) for variceal haemorrhage. Indications, timing and results of shunt insertion are detailed and discussed. Serial ST for eradication of varices could be completed in 10 patients a median of 7 months before PV shunting. The postoperative risk of bleeding was increased four times, i.e. the number of GI bleedings per month of follow-up, was 0.05 and 0.21 (p less than 0.05) respectively, before and after shunt operation. Two patients experienced their first variceal bleeding and 6 patients rebled during a median follow-up of 3 months after PV shunting. The Denver shunt succeeded in resolving ascites clinically in 13 patients within 7 days with a median decrease in weight of 10 kg, parallel to increased urinary output and reduced serum-creatinine. Three patients did not benefit from the shunt procedure due to terminal neoplastic disease (one patient), and severe hepatorenal failure, although the shunts were proven patent. Serious complications included clinically important consumptive coagulopathy, DIC-syndrome (two patients), myocardial infarction (one), pulmonary embolism (three), and sepsis following intervention of obstruction (one).
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PMID:Peritoneo-venous shunting and endoscopic sclerotherapy in patients with portal hypertension. 349 19

The author gives original information on the situation in Czechoslovakia regarding the treatment of varicose veins. The prevalence of varicose veins is 20%, the incidence is more than 1% in the adult population. Heredity accounts for 75% of these cases. In one year, only 35 to 129 patients are operated for varicose veins in a department of Clinical Surgery. The serious complications were analysed over a period of 10 years: there were 37 cases of pulmonary embolism and 10 deaths out of 95,000 operations for varices. The long-term results, that is from 5 - 15 years, were considered to be satisfactory in more than 90% of the cases operated. In Czechoslovakia, sclerotherapy is still a complementary method. However, the good results of sclerosing varices have been proven by the statistics issued by the phlebological clinics set up by the Czech Dermatological Association.
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PMID:[Current treatment of varices of the lower extremities in Czechoslovakia]. 370 40

A traumatic venous aneurysm within the greater saphenous vein occurred in a 15-year-old hockey player. The patient had early diagnosis and surgical excision of the lesion. Venous aneurysm is a rare clinical entity and a pathologic curiosity in the absence of varicose veins. It can lead to serious complications, such as pulmonary embolism, portal hypertension, and rupture. Early diagnosis with the use of venography and surgical excision of the lesion can prevent major complications.
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PMID:Traumatic venous aneurysm. Case report. 382 5

A case is reported of a 39-year-old woman who had postoperative pulmonary embolism after taking combined oral contraceptives from 1967 to 1970. Her related history included birth of 2 large infants, phlebitis, and varicosities. Her operation for retroverted uterus and tubal sterilization was followed the next day by a severe pulmonary embolism treated with heparin. This treatment resulted in a pelvic hematoma, abundant metrorrhagia, and anemia requiring 4 transfusions. 4 months later she developed jaundice due to hepatitis virus B, which potentiated the effect of the antiprothrombin treatment and precipitated 2 new pelvic masses, fever, and metrorrhagia. She was given hysterectomy, which revealed bilateral hematosalpinx, probably related to endometriosis. 1 year later she was in good health, but her serum lipids were found high in the alpha- and pre-beta-lipoprotein bands. A delay of 2 months between stopping oral contraceptives and surgery is recommended.
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PMID:[Postoperative thromboembolic accident observed during estro-progestative treatment. Apropos of a case]. 516 37

The treatment of choice in acute iliofemoral venous thrombosis is still controversial. This prospective randomized study compares the results of conventional anticoagulation of 32 patients with the results obtained in 31 patients undergoing acute thrombectomy combined with a temporary arteriovenous fistula and anticoagulation. Early complications were few in both treatment groups, and significant pulmonary embolism developed in only one conservatively treated patient. At 6-month follow-up in all surviving patients, leg swelling, varicose veins, and venous claudication were more frequent after conservative treatment. Only 7% (2 of 27) of these patients were completely free from postthrombotic symptoms compared with 42% (10 of 24) of the operated patients (p less than 0.005). Contrast phlebography demonstrated an excellent venous outflow through the iliofemoral segment in 35% (9 of 26) of the conservatively treated and in 76% (16 of 21) of the operated patients (p less than 0.025). Open femoropopliteal veins with competent valves were recorded in 26% (7 of 27) in the conservative group and in 52% (12 of 23) in the thrombectomy group (p less than 0.05). Thus thrombectomy combined with arteriovenous fistula decreases early symptoms and preserves venous outflow and valvular function better than conservative treatment. This procedure is therefore recommended for young patients with acute iliofemoral thrombosis to avoid development of incapacitating postthrombotic sequelae.
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PMID:Thrombectomy with temporary arteriovenous fistula: the treatment of choice in acute iliofemoral venous thrombosis. 638 92


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