Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0034065 (pulmonary embolism)
 14,979 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Radionuclide diagnostic imaging is an important adjunct to the diagnosis and treatment of several conditions that present to the emergency department. The emergency physician should be able to properly apply these tests. A normal radionuclide perfusion lung scan can reliably rule out pulmonary embolism. The use of the radionuclide ventilation lung scan may help interpretation of a perfusion lung scan that is of intermediate probability for pulmonary embolism. A radionuclide venogram of the lower extremities is both sensitive and accurate for detecting the presence of deep venous thrombosis. A radionuclide testicular scan is invaluable in the workup of the acute scrotum, as long as the test is available in a timely manner and the diagnosis has not been established by another means. A multiple-gated acquisition cardiac scan can help make the diagnosis of cardiac contusion after other causes of cardiac instability have been corrected. The renal radionuclide scan is useful in the workup of obstructive uropathy, especially if intravenous pyelography is contraindicated. The hepatobiliary nuclear scan is able to help differentiate acute cholecystitis from other causes of right upper quadrant pain. Proper and timely use of these tests can prevent serious sequelae from a missed diagnosis, and in some cases eliminate the need for invasive tests, dangerous treatment, or even exploratory surgery when it is unwarranted.
 ...
PMID:Emergency radionuclide scans. 351 91

There have been few reports of neonatal ischemic necrosis of the testis without torsion of the spermatic cord, which may be caused either by compression in utero or by transient torsion of the spermatic cord resolving spontaneously before surgery. The patient reported herein developed an inflammatory swelling of the right scrotum and an ecchymotic plaque over the left thigh at four days of age. Ischemic necrosis of the right testis without torsion was found upon surgery. When the patient was ten days of age, he developed an inflammatory swelling in the left scrotum; ischemic necrosis of the left testis without torsion was again found upon surgery. Thrombosis of the spermatic vessels was suspected. Postoperatively, ecchymotic and necrotic skin lesions developed, followed by pulmonary embolism and cerebral thrombosis. Outcome was fatal. Hematologic tests in the neonate and his parents established the diagnosis of inherited antithrombin III deficiency. Ischemic necrosis of the testes was thus probably due to hypercoagulability. No similar cases have been reported to date.
 ...
PMID:[Neonatal testicular ischemic necrosis without torsion, associated with antithrombin III deficit]. 812 35

One encounters a variety of radiopaque foreign objects when reviewing plain film radiographs of the abdomen. Recognizing such devices can offer important clues about a patient's medical history. Accordingly, intrauterine contraceptive devices (IUCD), tubal sterilization, varicoceles, inferior vena cava (IVC) filtration, and vaginal pessaries are discussed with reference made to an IUD, tubal sterilization clips, embolization coils for bilateral varicoceles, an IVC filter, and a vaginal pessary in five attached anteroposterior radiographs of the lower abdomen and pelvis for five different patients. IUCDs confer long-term, passive, reversible, and inexpensive protection against unwanted pregnancy. They may, however, induce menstrual complications as well as an increased risk of pelvic inflammatory disease and ectopic pregnancy. They can also be spontaneously expelled from the uterus without being noticed by the client. An IUCD increases the risk of spontaneous abortion unless removed in cases where intrauterine pregnancy occurs. Complications at the time of insertion include pain, syncope, and uterine perforation. Tubal sterilization is an effective, though largely irreversible method of contraception. Complications include an increased risk of ectopic gestation in the event of pregnancy and the usual risks of hemorrhage, infection, injury to adjacent structures, and anesthesia-related complications. A varicocele is a dilation of the pampiniform venous plexus of the scrotum. They are more often unilateral than bilateral, occurring in up to 20% of men most often on the left side. Although most cases are probably insignificant, varicoceles can decrease sperm count and motility and cause abnormal morphology. Correction of varicoceles has been shown to improve sperm quality and can increase the chances of fertility. Percutaneous venous embolization techniques have recently been developed to that end. Procedural risks include perforation of the vein, intimal dissection, inadvertent embolization of vessels via collateral channels, and reactions to contrast media. IVC filters are a feasible alternative treatment for deep venous thrombosis and pulmonary embolism among patients in whom anticoagulants are contraindicated or for those in whom anticoagulation therapy has failed. Introduced via the femoral or jugular veins, they are permanent metallic devices placed within the lumen of the IVC to filter thrombi which migrate from the deep veins of the lower extremities. Contraindications to IVC filter insertion include severe coagulopathy and thrombosis involving all venous access routes, while complications include hematoma at the insertion site, migration or tilting of the device due to poor anchoring in the IVC wall, and vena cava obstruction. A pessary is a prosthetic device used to support pelvic structures when their natural support is lacking. They are usually made of plastic or rubber and inserted into the vagina to aid in the non-operative treatment of uterine prolapse, proctoceles, and cystoceles. They must be properly fitted and removed every few months for cleaning.
 ...
PMID:Radiology rounds. Intrauterine contraceptive device. 821 57

A 47-year-old man with diabetes visited our hospital complaining of high fever, nausea, and scrotal swelling with pain on 11 April, 2009. He was diagnosed with right epididymitis and given antibiotics. The scrotum ruptured by itself, and the inflammation rapidly spread to the right inguinal area on 19 April. We diagnosed him with Fournier's gangrene. The patient underwent right orchidectomy and debridement of the scrotal contents. Seven days after the operation, he developed a cough. A lung computed tomographic scan (CT) revealed bilateral pleural effusion and multiple nodular lesions. A septic pulmonary embolism (SPE) was diagnosed. We increased the dose of antibiotics and added a new one. After 10 days, a CT showed that the lesions had completely disappeared.
 ...
PMID:[Septic pulmonary embolism associated with Fournier's gangrene: a case report]. 2061 Sep 27

The results of treatment of scrotum gangrene (Fournier's disease) in 25 patients aged from 34 to 82 years are presented in the article. The diseases of colorectal zone were nosological reasons of Fournier's disease in 13 patients, the diseases of urogenital tract - in 10 cases. Development of Fournier's disease was associated with closed trauma in 1 patient, and 1 case was associated with gunshot wound of perineum and scrotum. Slowly progressing forms of the disease were detected in 14 patients, fulminant and rapidly progressing variants - in 11 patients. Diabetes mellitus of different severity were identified in 6 patients. Clinical picture and laboratory data evidenced about systemic infection in all patients. Non-clostridial anaerobic microbes were the main exciters of pio-necrotic process (92%). 6 patients died. Mortality was about 24%. Toxic shock was the reason of death in 1 patient, progressing endotoxemia - in 3 cases, pulmonary embolism - in 2 cases. The authors consider that early diagnosis and active tactics of radical treatment of pio-necrotic hearth in combination with programmed (phased) remedial necrectomy are effective methods for improvement of treatment results. Also such ways as complex system of local wound treatment, focused and multicomponent therapy of systemic and metabolic disorders of homeostasis are very important in complex treatment of patients.
...
PMID:[Fournie's disease in the light of modern ideas]. 2481 85