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)

Fifty-two deep venous thromboses and 35 pulmonary emboli were treated by Streptokinase administered in accordance with a standard protocol. Radiological examinations revealed total lysis of clots in 22 cases, partial lysis in 42 and failure in 23. The latter more commonly involved venous clots than pulmonary emboli. Early treatment was more effective (21 total lyses out of 22) than late treatment. However, in venous thrombosis, late treatment may give partial lysis and free important venous junctions. With standard treatment, lysis was biologically correct in 70 p. 100 of cases. It was inadequate in 20 p 100 of cases and nil in 10 p. 100 of cases. The results could thus have been improved by treatment established and adjusted in the light of laboratory results. The extent of the thrombosis played an important role. Total lysis was obtained in 9 out of 10 cases of localised deep venous thrombosis. In pulmonary embolism there was an average gain of approximately 30 p. 100 in obstructed surface area. However, in these latter cases, it is important to take into account not only the pulmonary surface area obstructed but also the origin of the clots.
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PMID:[Streptokinase in the treatment of deep venous thrombosis and pulmonary embolism]. 3 Nov 16

In a study of 112 patients undergoing elective major surgery clinical and haemostatic data was followed in connection with a double-blind investigation on the effect of subcutaneous low-dose heparin prophylaxis. None of the patients developed severe thromboembolism but according to lung photoscanning and leg scanning 41 of the patients had deep vein thrombosis and/or pulmonary embolism. Clinically thromboembolism appeared within 4 days after operation. In 22 patients with epidural anaesthesia the incidence of thromboembolism was lower than in the patients with general anaesthesia. The extension of the operation was positively correlated to a higher incidence of thromboembolism. The surgical trauma was reflected in most of the routine haemostatic laboratory parameters, hiding possible minor changes caused by subclinical thromboembolic complications. The low doses of heparin could only be detected with more sensitive methods. A comparison of sodium and calcium heparin administered subcutaneously revealed no significant differences.
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PMID:Clinical and haemostatic parameters related to thromboembolism and low-dose heparin prophylaxis in major surgery. 5 29

In a prospective controlled randomised trial, the prophylactic value of warfarin sodium (in doses aimed at maintaining a "Thrombotest" value of 10% and given from the day of admission until independent mobility had been achieved or for 3 mo, whichever was the sooner) was assessed in 160 elderly patients who had sustained a fracture of the femoral neck. Treatment significantly reduced the frequency of deep venous thrombosis (D.V.T.), whether indicated by the 125I-fibrinogen test during life or assessed by detailed post-mortem studies. Pulmonary embolism was eliminated in treated patients, but the difference in mortality between the treatment and control groups was not significant, indicating that causes of death other than pulmonary embolism are of major importance in these elderly patients. A case is made out for prophylactic anticoagulation on a selective basis.
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PMID:Warfarin sodium in prevention of deep venous thrombosis and pulmonary embolism in patients with fractured neck of femur. 6 11

The measurement of plasma beta-thromboglobulin as a potential diagnostic test for venous thrombosis has been investigated in 16 normal volunteers, 24 patients presenting with deep vein thrombosis (DVT) or pulmonary embolism and 46 patients screened by 125I fibrinogen test (IFT) for post-operative DVT. The normal mean was 33 ng/ml (range 15-117 ng/ml). Of the 24 patients with clinical thrombotic disease 22 presented with DVT confirmed by phlebogram or IFT and 2 presented with embolism confirmed by lung scan. At the time of first presentation 12 out of 24 had betaTG values greater than 70 ng/ml. All except 3 of this group of 24 patients had values of greater than 70 ng/ml at some stage during a subsequent week of daily sampling. DVT was detected in 13 out of 46 screened post-operative patients. There was a rise om betaTG observed within 24 hr of the IFT becoming positive but the mean rise did not reach significance at the 5% level. An association between DVT and high betaTG values has been confirmed. However, its clinical value cannot yet be fully elucidated until factors, probably related to blood sampling and clearance, are further investigated.
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PMID:beta-thromboglobulin and deep vein thrombosis. 7 29

From September 1962 to May 1972 145 patients with acute or subacute deep vein thrombosis confirmed by phlebography were treated with streptokinase. During the same period 42 patients considered unfit for thrombolytic therapy were treated with herapin and oral anticoagulants. The results, assessed by repeat phlebography, in 93 of the patients treated with streptokinase were compared with those in 42 patients treated with heparin. The age, sex, and severity of occlusion were roughly similar in both groups. Streptokinase treatment was successful in 42 per cent, partially successful in 25 per cent, and unsuccessful in 32 per cent of the 93 patients compared with none, 10 per cent, and 88 percent respectively in the 42 patients treated with heparin. Streptokinase was more effective when the thrombus was in proximal rather than calf veins. Thrombi of more than six days old were readily lysed. Plasma fibrinogen levels were below 0-8 g/1 (80 mg/100 ml) in nearly all patients successfully treated. The incidence of pulmonary embolism was no greater with streptokinase than with heparin treatment. Only prolonged follow-up would show whether thrombolytic treatment would be effective in preventing late complications of deep vein thrombosis such as chronic venous insufficiency.
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PMID:Treatment of deep vein thrombosis with streptokinase. 12 6

Spinal injuries in Burma as a result of a fall from height, especially from trees, in young male adults in low socio-economic classes; road traffic accidents are the second commonest cause; deep vein thrombosis and pulmonary embolism is very rare during the period of immobilisation. There are still some social problems of getting back to work and living conditions. We are trying our best to help the patients with spinal injuries.
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PMID:Spinal injuries in Rangoon, Burma. 15 9

This review deals with aspects of fibrinolysis in which significant developments have taken place in the last few years. The structural changes of plasminogen during its activation are now identified precisely; the recent description of a thrombotic tendency in a kindred characterized by a defect of this protein emphasizes its important role in the homeostatic balance. Several activators of plasminogen are now identified; some of them, such as tissue and vascular activators, appear to have an important role in physiology and pathology. The recent characterizations of the alpha 2-antiplasmin and of antiactivators have widened our understanding of the inhibitors of fibrinolysis: a defect of the plasmin inhibitor seems to be associated with an haemorrhagic tendency, whereas high antiactivator levels were encountered in thrombotic conditions. The clinical use of fibrinolytic agents appears to be promising in conditions such as recurrent deep vein thrombosis and in the post-phlebitic syndrome. Thrombolytic therapy with urokinase or streptokinase appears to have elective indications in patients with acute deep vein thrombosis and massive life-threatening pulmonary embolism.
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PMID:Progress in fibrinolysis. 16 15

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

Venous impedance plethysmography and respiratory-compression Doppler augmentation responses have proved to be diagnostically valuable in suspected thrombophlebitis of the lower extremities. These noninvasive methods can provide quantitative and reproducible data on the basis of which the presence of increased deep venous resistance can be confirmed, suspected, or doubted. A new scoring system for the composite evaluation of data from 100 consecutive patients with possible thrombophlebitis, pulmonary embolism, or both, is presented. These procedures assume added importance in view of the diagnostic limitations, and even potential hazards, of other methods. These methods indluce lung scanning, radioactive fibrinogen scanning, venography, and pulmonary angiography. Serial studies can be performed with impunity for following highrisk patients and evaluating various therapeutic or prophylactic measures. The importance of monitoring the femoral-popliteal segment is emphasized, because of the greater propensity for massive pulmonary thromboembolism from thrombi in these veins than in the calf vessels. Clinical observations coupled with these studies underscore the fallacy of several widely-held diagnostic biases pertaining to deep venous thrombosis and pulmonary thromboembolism. The long-term followup of 12 patients in whom inferior vena cava unbrellas has been inserted for life-threatening pulmonary embolism is presented. The possible propensity to deep vein thrombosis from vitamin E therapy is raised.
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PMID:The noninvasive diagnosis of thrombophlebitis in the lower extremities: clinical value of plethysmography combined with augmentation methods and a new scoring system. 30 91

Heparin remains the most effective antithrombotic drug. It acts by combining with plasma antithrombin, thereby accelerating the neurtalisation of thrombin and other acitvated coagulation factors. Full-dose intravenous heparin is indicated in all cases of pulmonary embolism and established deep venous thrombosis, unless there exist compelling contraindications. Continuous intravenous infusion of heparin appears to be safer than intermittent injection. Low-dose subcutaneous heparin is effective in preventing the initial occurrence of thigh vein thrombi and in reducing the incidence of fatal pulmonary embolism in general surgical patients over the age of 40. The efficacy of low-dose heparin in preventing pulmonary emboli following hip surgery has not been established. The incidence of severe heparin-induced thrombocytopenia appears to be rising. Platelet counts should be performed in all patients receiving heparin by any mode of administration.
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PMID:Heparin Therapy: regimens and management. 31 90


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