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

Pulmonary embolism (PE) after lung resection has a high mortality rate, and it is one of the most severe complications after lung resection. Early diagnosis and treatment are essential. We present a case of severe PE after left pneumonectomy for lung cancer. Computed tomography angiography was useful for confirming the diagnosis of PE. Low-molecular-weight heparin (LMWH) was used to treat the embolism, and the patient was discharged on the seventh day. LMWH is an effective and safe agent for the treatment of PE after pneumonectomy and may reduce the need for surgery. It may be used as an initial procedure. Secondary severe complications, including hemorrhage and subsequent empyema, may be avoided with the use of LMWH.
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PMID:Low-molecular-weight heparin for treatment of submassive pulmonary embolism after pneumonectomy. 1767 57

The purpose of this study is to assess the impact on clinical decision making of chest computed tomography (CT) in immunocompetent emergency department (ED) patients with chest radiographic (CXR) findings of pneumonia. We retrospectively identified 1,373 patients from our ED who underwent chest CT between 7/05 and 6/06. Report of CXR within 24 h before CT were reviewed to identify patients with findings of pneumonia. The following were the exclusion criteria: recommendation of CT on CXR report and immunocompromised status on chart review. Fifty-one patients met the inclusion criteria: 26 women and 25 men, with a mean age of 60 (range 29-103) years. Age- and sex-matched controls from the ED with CXR findings of pneumonia who did not undergo CT were identified. Charts were reviewed for clinical presentation, management, and follow-up. Patient and control groups were compared using Fisher exact and paired Student's t tests. The patients were sicker than the controls with more signs and symptoms including auscultation abnormalities, 64 (33 of 51) vs 47% (24 of 51), abnormal sputum 32 (16 of 51) vs 0%, hypoxemia 22 (11 of 51) vs 2% (1 of 51), weight loss, 20 (10 of 51) vs 4% (2 of 51), and night sweats, 16 (8 of 51) vs 2% (1 of 51; p < 0.05 each). Clinical management, (based on CT findings in 31% [16 of 51]), was more extensive for patients than controls: antibiotics initiated 82 (41 of 51) vs 47% (24 of 51), antibiotics changed 29 (15 of 31) vs 0%, procedures performed 24 (12 of 51) vs 0%, and mean length of stay was 8 days vs less than 1 (p < 0.05, each). Sixteen percent (8 of 51) of the patients had alternative/additional diagnosis based on CT: pulmonary embolism, lung cancer, hypersensitivity pneumonitis, multiple myeloma, renal cell carcinoma, small bowel obstruction, lung nodule, and endobronchial mass (n = 1, each). Eight percent (4 of 51) of the patients and no controls were diagnosed with tuberculosis (p = 0.06). Immunocompetent ED patients with CXR findings of pneumonia who underwent chest CT were sicker than those who were not imaged with CT. Chest CT was often useful in guiding therapy or providing an alternative diagnosis.
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PMID:Impact of chest CT on the clinical management of immunocompetent emergency department patients with chest radiographic findings of pneumonia. 1770 Dec 35

We reported 2 cases of acute pulmonary embolism after resection for lung cancer. A 47-year-old male was admitted to our hospital with ground-glass opacity (GGO) on a chest computed tomography (CT). We performed a right upper lobectomy and node dissection (ND) 2a dissection. Two days after the operation, he developed hypotension and hypoxemia. He was diagnosed as acute pulmonary embolism by chest CT and lung scintigram. A 68-year-old women was performed right S6 segmentectomy for lung cancer. The next day, she complained of sudden chest discomfort and dyspnea. She was diagnosed as acute pulmonary embolism by chest CT. Immediately, we started anticoagration therapy with heparin and their condition were improved. It was very important to early diagnose and start anticoagration therapy immediately for acute pulumonary embolism.
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PMID:[Acute pulmonary embolism following lung resection: report of two cases]. 1787 19

The evaluation of pleuritic pain in the emergency setting is a diagnostic challenge. Most patients are discharged from the Emergency Department (ED) with a diagnosis of chest wall pain not otherwise specified. It is important to rule out possible sources of acute pleuritic pain, like pulmonary embolism, pneumonia, lung cancer, and pneumothorax. Clinical examination, plain film radiography of the chest, and other routine investigations may be inadequate to make the correct diagnosis. In this setting, another bedside test to aid diagnosis would be useful. ED bedside lung ultrasound is a novel technique for the diagnosis of lung diseases. We report on 5 patients who presented to our ED complaining of pleuritic pain, few other symptoms, and negative routine investigations, in whom bedside lung ultrasound aided in making the diagnosis.
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PMID:Lung ultrasound in the evaluation of patients with pleuritic pain in the emergency department. 1802 61

Computer-aided detection (CADe) and computer-aided diagnosis (CADx) have been important areas of research in the last two decades. Significant progress has been made in the area of breast cancer detection, and CAD techniques are being developed in many other areas. Recent advances in multidetector row computed tomography have made it an increasingly common modality for imaging of lung diseases. A thoracic examination using thin-section computed tomography contains hundreds of images. Detection of lung cancer and pulmonary embolism on computed tomographic (CT) examinations are demanding tasks for radiologists because they have to search for abnormalities in a large number of images, and the lesions can be subtle. If successfully developed, CAD can be a useful second opinion to radiologists in thoracic CT interpretation. In this review, we summarize the studies that have been reported in these areas, discuss some challenges in the development of CAD, and identify areas that deserve particular attention in future research.
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PMID:Computer-aided diagnosis of lung cancer and pulmonary embolism in computed tomography-a review. 1842 10

Metastasis of lung cancer to the penis is very rare; it causes various clinical symptoms seriously affecting the quality of life. Early recognition and appropriate management will likely enhance survival in these patients. Here, we report a case of penile metastasis secondary to pulmonary carcinoma along with a review of the literature. One case of penile metastasis secondary to pulmonary carcinoma was detected in a 51-year-old patient who was admitted to the First Affiliated Hospital of Sun Yat-Sen University with persistent cough along with swelling of the perineum and penis. The clinical features, diagnosis, and treatment of this disease along with a relevant literature are reviewed and discussed. A MEDLINE search was performed to identify similar reports in the literature. CT scan revealed lung mass, and a glans penis ulcer and enlargement of inguinal lymph nodes was discovered upon physical examination. CT-guided percutaneous puncture of the lung mass revealed adenocarcinoma of lung, and biopsies of the glans penis ulcer and inguinal lymph nodes confirmed metastatic adenocarcinoma. The patients received chemotherapy and died of acute pulmonary embolism in less than 2 months. Metastasis of lung cancer to the penis is extremely rare. It presents an advanced form of lung cancer, and thus survival is extremely short. Although treatment of penile metastasis is almost always palliative, early recognition may enhance survival for these patients.
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PMID:Metastasis to the penis in a patient with adenocarcinoma of lung, case report and literature review. 1897 50

Pulmonary hypertension and interstitial lung disease are the two main causes of death in systemic sclerosis. The hallmark of these complications is dyspnea on exertion. Assessment of dyspnea in systemic sclerosis is based on a questionnaire; 6-minute walk test and Borg index. After excluding anemia, a deceptive cause mainly due to digestive haemorrhage, echocardiography, pulmonary function tests and high resolution computed tomography of the chest are the first step to diagnosis. Peak velocity of tricuspid regurgitation as measured by echocardiography is the main parameter to evaluate the risk of pulmonary hypertension before performing a right heart catheterization. Diastolic left ventricle dysfunction is another frequently encountered cause of dyspnea in systemic sclerosis. Other less common causes are pericarditis, respiratory muscle involvement, lung cancer, pulmonary embolism.
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PMID:[Dyspnea upon exertion in systemic scleroderma: from symptom to etiological diagnosis]. 1919 23

Lung perfusion scintigraphy (LPS) with technetium-99m-labeled macro-aggregates of albumin (Tc-99m-MAA) is well established in the diagnostic of pulmonary embolism (PE). In the last decade, it was shown that single-photon emission computer tomography (SPECT) acquisition of LPS overcame static scintigraphy. Furthermore, there are rare indications for LPS, such as preoperative quantification of regional lung function prior to lung resection or transplantation, optimization of lung cancer radiation therapy, quantification of right-left shunt, planning of intra-arterial chemotherapy, and several rare indications in pediatrics. Moreover, LPS with Tc-99m-MAA is a safe method with low radiation exposure. PE can also be diagnosed by spiral computer tomography (CT), ultrasound, magnetic resonance angiography, or pulmonary angiography (PA, former gold standard). The present review considers all these methods, especially spiral CT, and compares them with LPS with respect to sensitivity and specificity and gives an overview of established and newer publications. It shows that LPS with Tc-99m-MAA represents a diagnostic method of continuing value for PE. In comparison with spiral CT and/or PA, LPS is not to be defeated as mentioned also by the most actual Prospective Investigation of Pulmonary Embolism Diagnosis (PIOPED) II reports. This applies in particular to chronic or recurring embolisms, whereas currently spiral CT may be of greater value for major or life-threatening embolisms. At present, LPS cannot be replaced by other methods in some applications, such as pediatrics or in the quantification of regional pulmonary function in a preoperative context or prior to radiation therapy. LPS still has a place in the diagnostics of PE and is irreplaceable in several rare indications as described earlier.
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PMID:Ventilation/perfusion lung scintigraphy: what is still needed? A review considering technetium-99m-labeled macro-aggregates of albumin. 1920 33

Bevacizumab, a humanized monoclonal antibody against vascular endothelial factor (VEGF), is approved for the treatment of metastatic colon cancer, but it has also shown efficacy in first line therapy of non-squamous-cell non-smallcell lung cancer, breast cancer and clear-cell renal cancer. Antiangiogenic therapy severe toxic effects such as stroke, myocardial infraction, angina, arterial thromboembolism, pulmonary embolism or haemorrhage, gastrointestinal perforation, heart failure should be taken into account during treatment with bevacizumab. We describe and discuss two cases of cancer patients who developed fatal arterial thromboembolic episodes after administration of bevacizumab. Due to the recent launch of antiangiogenic agents and the limited experience with their use in clinical practice, their adverse effects and pharmacological toxicities, sometimes fatal, are not well-established and a detailed registration of them is needed.
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PMID:Implication of bevacizumab in fatal arterial thromboembolic incidents. 1936 80

Comorbidities of chronic obstructive pulmonary disease (COPD) include pneumonia, pulmonary embolism, lung cancer, musculoskeletal dysfunction, osteoporosis, gastroesophageal reflux disease, cardiac disease, diabetes, hyperlipidemia, anemia, and sleep dysfunction, amongst others. These medical conditions are commonly reported in COPD patients; however, the true prevalence of these conditions based on epidemiological studies is variable. Tobacco exposure is a common risk factor between COPD and many of its comorbidities but there is recent evidence that suggests that the harmful effects of these conditions on COPD is independent of their association with smoking. There has recently been an increasing focus on the impact that these health problems may have on the morbidity and mortality associated with COPD as these are now being recognized as part of the overall burden of the disease. It remains to be seen whether or not effective treatment of COPD reduces the risk of developing one of the comorbidities associated with it as well as if interventions that address specific comorbidities, such as improving anemia or preventing, will alter the natural course of COPD. Further investigation is required to gain a better understanding of the interrelationship between COPD and its comorbidities.
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PMID:Chronic obstructive pulmonary disease and its comorbidities. 1977 12


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