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

One hundred sixty patients were retrospectively evaluated to determine the effect of prophylactic inferior vena caval interruption in association with aortic surgery. Sixty-three patients underwent aortic procedures without inferior vena caval interruption and ninety-seven patients underwent placement of an Adams-DeWeese clip as prophylaxis against pulmonary embolism. Pulmonary embolism occurred in 10 per cent of the group without the clip and in no patients in the group with the clip. The incidence of deep vein thrombosis was identical in both groups (10 per cent). The 6 per cent rate of early (within 6 months) postoperative leg edema in the group with the inferior vena caval clip was a significant problem in only one patient after twenty-four months. Prophylactic interruption of the inferior vena cava has been shown to be a safe method of decreasing the incidence of pulmonary embolism without increasing the incidence of venous-related complications.
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PMID:Prophylactic interruption of the inferior vena cava. A retrospective evaluation. 43 37

I have encountered 50 patients with clinical thrombophlebitis involving the lower extremites, with or without associated edema and pulmonary embolism, in whom longstanding self-medication with large amounts of vitamin E appeared to be a significant factor. The majority improved following cessation of vitamin E. In view of the epidemic nature of thrombophlebitis and deep vein thrombosis in the United States, the presumed innocuousness of vitamin E therapy requires reevaluation. Other clinical side effects also have been noted in patients receiving large doses of vitamin E. They include breast tenderness, elevation of blood pressure, a fatigue syndrome, myopathy, intestinal cramps, urticaria, and the possible aggravation of diabetes mellitus. The influence of concomitant metabolic, endocrine, and cardiovascular disorders on the thrombogenic potential of vitamin E is raised, and several possible mechanisms conducive to thrombophlebitis are reviewed.
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PMID:Thrombophlebitis associated with vitamin E therapy. With a commentary on other medical side effects. 43 74

The physician frequently encounters the problems of deep vein thrombosis and pulmonary embolism. Recently, a number of studies have been published which are of considerable help in the management of these disorders. It has been shown that in many cases, low-dose heparin is effective in the prevention of both venous thrombosis and pulmonary embolism. However, once venous thrombosis has already occurred, it is necessary to use full-dose heparin, preferably by the continuous intravenous route, with maintenance of the partial thromboplastin time (PTT) at 1 1/2 times the control at all times. Although monitoring the PTT may not prevent hemorrhage, it will help prevent further thrombosis. Heparin is generally continued for seven to ten days. During this time warfarin is generally begun, and it is important to continue the patient on warfarin for five to seven days while the patient is receiving intravenous heparin therapy. After stopping heparin, oral anticoagulation with warfarin should be continued for six weeks. Then, in the absence of a previous history of venous thromboembolism or a known predisposing condition, it is safe to abruptly discontinue anticoagulation in most patients.
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PMID:Heparin and warfarin: use of anticoagulants in the prevention and treatment of venous thrombosis and pulmonary embolism. 43 53

A perspective study by the Royal College of General Practitioners reported that the risk of developing deep venous thrombosis of the legs in women taking oral contraceptives was 5.66 times higher than women not on medication. Estrogen-progestogen compounds are highly potent hormones that produce alterations in metabolic and endocrine functions. Clinical examination of the leg is the most reliable method of determining the earliest indication of thrombophlebitis even with the latest diagnostic tools of venography. The key to diagnosis and treatment of pulmonary embolism, which often occurs with patients with thrombophlebitis, is a patient's complaint of leg pains. Those who have undergone surgery, especially abdominal and pelvic, are bedridden, and those who are taking oral contraceptives are at risk of thrombophlebitis. Deep thrombophlebitis of the leg is not recognized clinically in 50-80% of those with venographically documented thrombophlebitis because the signs and symptoms are so protean. Treatment with heparin and leg bandages is most common. Heparin is often followed with coumarin therapy. Some methods of diagnosis are calf tenderness, edema, skin temperature, Homan's Sign, Lowenberg's Sign, Pratt's Sign, cyanosis, systemic signs, and contrast venogram.
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PMID:A review of the birth control pill and its relationship to thrombophlebitis. 44 35

Complications are the major causes of illness and death after burning and most of them stem from the burn wound. Their origin and importance are reviewed with emphasis on problems and growing points in knowledge. Fluid leakage from the circulation into the burn is the cause of hypovolemic shock, but the underlying permeability changes in the burn are only partly understood. Other nonbacterial complications include acute cardiac failure, acute anemia, hemolytic jaundice, renal failure, encephalopathy, complex hypermetabolic effects including pseudodiabetes, gastric and duodenal ulceration, deep vein thrombosis and pulmonary embolism, pulmonary and glomerular microthrombosis, hepatic jaundice, and arterial thrombosis. Involvement of the airway in conflagrations carries special hazards like glottic edema and inhalation of irritant fumes. Nowadays, bacterial causes are dominant and these remain the main challenge. Bacterial infection and invasion of the burn are usually responsible for septicemia, bronchopneumonia, and pyelonephritis although other sources also contribute. Indirect manifestations of septicemia include paralytic ileus, acute gastric dilatation, toxic myocarditis, and some cases of renal failure. Therapeutic complications like agranulocytosis, thrombocytopenia, and colitis occur at times. High concentrations of oxygen given therapeutically can produce fatal aseptic hypoxic pneumonitis.
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PMID:A review of the complications of burns, their origin and importance for illness and death. 44 73

From 1973 to 1977 a total of 63 patients with thrombosis of the deep veins in leg and pelvis and in the V. cava inferior was treated by operative thrombectomy. Prior to the operation all patients were submitted to phlebography. The mean age of all was 52 years. One patient died from pulmonary embolism during thrombectomy, there was no further hospital mortality. Because of low mortality incidence and rarely postthrombotic complications we prefer the operative treatment of deep vein thrombosis. The preoperative cavography helps to avoid pulmonary embolism during thrombectomy.
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PMID:[Operative treatment of deep vein thrombosis (author's transl)]. 46 96

The prime therapeutic objective of prophylactic anticoagulation for patients undergoing total hip replacement is to reduce to a minimum fatalities from pulmonary embolism. Our low-dose heparin-warfarin prophylactic anticoagulation protocol affords significant protection in this regard (one fatal pulmonary embolism in 796 cases) without the use of venography or other objective tests to check for deep venous thrombosis and for all patients including those with venous disease or a history of prior thromboembolic disease. The 13.1% hematoma rate (5.0% late major) is a small, nonlethal, and acceptable price to pay for this protection.
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PMID:The efficacy of low-dose heparin--warfarin anticoagulation prophylaxis after total hip replacement arthroplasty. 47 94

Two hundred patients were evaluated retrospectively to determine the clinical effects of prophylactic inferior vena cava (IVC) interruption in association with aortic reconstruction. No pulmonary embolism occurred in the group with IVC interruption, but embolisms did occur in seven of 68 patients who had aortic reconstruction performed without IVC interruption. In two patients, the pulmonary embolism was fatal. Postoperative incidence of deep vein thrombosis was fatal. Postoperative incidence of deep vein thrombosis was 9% in both groups. Clinical and hemodynamic effects of prophylactic IVC interruption were studied in 20 additional patients. Venous hemodynamics (maximum venous outflow, inferior vena cava pressure, and ambulatory venous pressure) showed no change following interruption in 19/20. Sixteen patients from the original group of patients with prophylactic interruption were studied hemodyamically. No pulmonary embolism was clinically evident. One new case of deep vein thrombosis was seen. Again, venous hemodynamics showed no change as a result of IVC interruption. Prophylactic IVC interruption is a safe means of decreasing the incidence of pulmonary embolism without increasing venous-related morbidity.
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PMID:Prophylactic interruption of the inferior vena cava: immediate and long-term hemodynamic effects. 48 34

Fifty-three Hong Kong Chinese patients with fractures of the proximal femur have been studied after hip surgery using functional ascending phlebograms for evaluating deep vein thrombosis. There was an incidence of deep vein thrombosis of 53.1 per cent in the fractured limbs and 14.3 per cent in the uninjured limbs. The majority of thrombi (84.6 per cent) were located in the calf. No clinical or fatal pulmonary embolism was observed.
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PMID:The incidence of deep vein thrombosis in Hong Kong Chinese after hip surgery for fracture of the proximal femur. 49 53

In a prospective study of 51 patients with fractures of the femoral neck, aspirin was used as a prophylactic measure against thromboembolic disease. Thrombi were detected by cuff impedence plethysmography, Doppler ultrasonography and ascending venography. Thrombi were identified in 20 (39.2%) of the patients. There was no significant difference between the frequency with which thrombi occurred in men and in women. Blood salicylate values were the same for patients who had and who did not have thrombi. There were no instances of pulmonary embolism. The frequency of deep vein thrombosis was comparable to that in a previous series of untreated patients from the same centre. It appears from this study that in these cases prophylaxis against venous thromboembolism using aspirin in a dosage of 600 mg bid is ineffective.
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PMID:Aspirin prophylaxis of venous thromboembolic disease following fracture of the upper femur. 49 17


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