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)

Pulmonary embolism is described as an infrequent complication of axillary and subclavian vein thrombosis. We have reported our recent clinical experience with 14 patients admitted to the Harbor-UCLA Medical Center who had a clinical diagnosis of axillary and subclavian vein thrombosis documented by phlebography of the thrombosed arm. The causes of thrombosis were effort (three patients), trauma (three patients), drug abuse (four patients), underlying neoplastic disease (three patients), and congenital venous malformation (one patient). Pulmonary emboli were diagnosed by arteriogram, ventilation perfusion scans, and arterial blood gas abnormalities in five patients with respiratory symptoms for an incidence of 35.7 percent. Immediate anticoagulation with heparin, then switching to warfarin sulfate after 5 days, was the standard therapy in all patients. Follow-up examinations between 3 and 24 months demonstrated mild postphlebitic syndrome consisting of pain and minimal swelling in two patients. We conclude that pulmonary emboli may be a more frequent complication of axillary and subclavian vein thrombosis than has generally been recognized.
 ...
PMID:Pulmonary embolism secondary to venous thrombosis of the arm. 669 95

A number of medical disciplines are involved in the diagnosis and therapy of thoracic pain. The origin may be somatic or visceral. Individual diseases are discussed in particular such as myalgia epidemica, intercostal neuralgia, herpes zoster, pleuritis and pneumonia, pulmonary embolism, pneumothorax, mediastinal emphysema, mediastinitis, pulmonary hypertension and the hyperventilation syndrome. Differential diagnosis is also referred to.
 ...
PMID:[Pulmological aspects of diagnosis of thoracic pain (author's transl)]. 677 86

One hundred and thirty knees (112 patients) in which the intramedullary adjustable total knee prosthesis was inserted were followed for four to nine years. This prosthesis is designed to permit unconstrained rotation and includes a metal tray supporting the high-density-polyethylene tibial component as well as an intramedullary stem and two condylar intramedullary projections on both the femoral component and the tibial component. Using a rating system in which pain, function, stability, and motion each was graded independently on a scale of 1 to 6, the preoperative scores were 73 per cent poor and 27 per cent fair, while the postoperative scores were 77 per cent good, 15 per cent fair, and 8 per cent poor. If only the patients with unilateral or bilateral involvement of the knee without other functional disabilities were considered, four to nine years after the arthroplasty 92 per cent could be classified as good; 5 per cent, as fair; and 3 per cent, as poor. There were two deaths (one due to pulmonary embolism and the other, to overwhelming sepsis after attempted arthrodesis for a deep would infection) and five deep infections, four of which necessitated reoperation for arthrodesis. In addition, reoperations were necessary in five other knees: in two for secondary closure of the wound, in one for evacuation of a hematoma, in one for synovectomy and skin-grafting because of infection, and in one for recentralization of the patella. At final evaluation, 117 knees had radiographs of sufficiently good quality for assessment, and thirty-seven (32 per cent) of these showed evidence of a nonprogressive radiolucent line about the tibial component. In addition, two were considered clinically loose (one due to a traumatic injury and the other, to malpositioning of the tibial component).
 ...
PMID:Total knee-replacement arthroplasty. Results with the intramedullary adjustable total knee prosthesis. 682 92

The effects of continuous epidural anesthesia and of general anesthesia on the incidence of thromboembolism following total hip replacement were studied. Sixty patients were randomly allotted to one of two groups receiving either epidural or general anesthesia. Epidural anesthesia (N = 30) consisted of 0.5% bupivacaine with epinephrine intraoperatively; for pain relief in the postoperative period (24 h), 0.25% bupivacaine with epinephrine was given every 3 h. General anesthesia (N = 30) consisted of controlled ventilation with N2O-O2 and intravenous fentanyl and pancuronium bromide; postoperatively, narcotic analgesics were given intramuscularly on demand for pain relief. Significantly lower frequencies were found following epidural anesthesia than after general anesthesia in deep venous thrombosis involving the popliteal and femoral veins (13% and 67%, respectively), deep venous thrombosis involving both calf and thigh veins (40% and 77%), and pulmonary embolism (10% and 33%). Possible explanations for these differences include increased circulation in the lower extremities, less tendency for intravascular clotting to occur, and more efficient fibrinolysis in association with continuous epidural anesthesia. The decrease in blood loss associated with epidural anesthesia with lower transfusion requirements also might play a role. Epidural analgesia prolonged into the postoperative period, in addition to other appropriate thromboprophylactic measures, should be of value in patients undergoing operations associated with a high risk of thromboembolic complications.
 ...
PMID:Thromboembolism after total hip replacement: role of epidural and general anesthesia. 682 20

Twenty-eight patients with the diagnosis of deep vein thrombosis (DVT) were subjected to a prospective, randomized study comparing continuous and intermittent heparin treatment, utilizing the same doses and duration of therapy. The effect on pain (estimated with a scoring system) and the antithrombotic effect (assessed by the inhibition of 125I-fibrinogen accretion), followed for one week, were unrelated. Pulmonary embolism was scored and studied from lung perfusion scans and chest X-rays. A high frequency was found in both groups. The therapeutic efficacy and side-effects did not differ between the two treatment groups. Bleeding, preferentially from vein puncture (post-phlebography), was more common in women, while a heparin-induced elevation of serum aminotransferases (S-ALAT adn S-ASAT) (in 2/3 of the patients) was not related to age, sex or bleeding complications.
 ...
PMID:Heparin treatment of deep vein thrombosis. Effects and complications after continuous or intermittent heparin administration. 703 44

This paper deals with some selected complications of operation. The majority arise from technical faults and errors in judgement or documentation. My choice of topics here has been for their immediate treatment and the avoidance and aftercare of the others. Wrong technique. Combined operations resulting in damage to important adjacent structures: a) arteries: divisions, ligations, stripping; veins: ligation, tearing, avulsion of saphena femoral junction; b) nerves: division, femoral, lateral popliteal, cutaneous; c) lymphatics: particularly in recurrent operations, lymphoma and subsequent oedema; d) skin: particularly incisions through thickened skin, inflammatory skin, oedematous skin; e) connective tissues. Major complications. Haemorrhage, shock, problems with skin closure, methods of dressings, post-operative immediate, anaesthetic problems. Haemorrhage, haematoma, swelling, oedema, lymphatic deep vein thrombosis, pulmonary embolism (1 in 3000--fatal 1 in 30,000). Wound healing, skin necrosis, wound infection. Leg complications: persistent varicose veins, recurrent varicose veins, pain, nerve palsies, chronic oedema.
 ...
PMID:Some complications from surgery in varicose veins. 707 Nov 82

A case study report is presented of a 20 year old black woman with a past history of oral contraceptive (OC) use who developed Budd-Chiari syndrome (hepatic vein thrombosis) associated with decreased levels of antithrombin 3. This combination has not been previously reported. The woman presented on December 28, 1979 with midepigastric pain. She had no previous illnesses, but OCs had been used up to 2 years prior to admission. Shortly after admission the patient became hypotensive, developed oliguric renal failure, and began to rapidly accumulate ascites. During this admission, the patient's transaminase levels abruptly declined. A percutaneous liver biopsy obtained on January 9, 1980 showed centrilobular hemorrhagic necrosis of a severe degree. An inferior vena cavagram was repeated on January 14, 1980 demonstrating hepatic vein thrombosis. Streptokinase, followed by heparinization, was given in an effort to lyse the thrombi, but repeat inferior cavagram on January 24th proved this to be unsuccessful. Thrombosis of the left iliac and left femoral vein then appeared. Because of her apparent "hypercoagulable state," the antithrombin 3 level was measured on January 31st and found to be 27%. A simultaneous serum fibrinogen was 255 mg/dl. Family members (father, mother, and 4 children) were studied. All had normal antithrombin 3 levels, thus excluding a familial defect. The patient gradually improved and was discharged on February 25, 1980 on Coumadin, diuretics, and a 3 g sodium diet. Because of ascites and peripheral edema, a LeVeen shunt was placed on March 25, 1980. At surgery, she was noted to have obstruction of the right internal jugular and right cephalic veins. Because of possible thrombosis in the superior inferior vena cava branches, venography was performed on March 31st and demonstrated thrombosis of the right subclavian, inferior vena cava, and internal iliac veins. Despite the therapy, patient again began to reaccumulate ascites and was readmitted on May 17th. The then nonfunctioning shunt was repositioned in the patient's right atrium. Postoperatively, the patient's course was complicated by DIC. Because heparin induced thromboycytopenia was suspected, heparin was discontinued and Coumadin begun. On June 6th the patient became suddenly short of breath. A lung scan was consistent with pulmonary embolism. She could not be adequately ventilated and died on June 8th. Although the patient discontinued OC use 2 years prior to initial presentation of the disease, the morphologic features of the venous thrombosis and hepatic damage were indicative of a chronic, ongoing process of longer than 6 months' duration, thus raising the possibility of a cause-effect relationship between the OC and thrombotic process. Prospective studies are needed to substantiate the view of a relationship between OC use, antithrombin 3 deficiency, and the Budd-Chiari syndrome.
 ...
PMID:Budd-Chiari Syndrome and antithrombin III deficiency. 710 23

Pain relief is the most striking feature following this procedure. In Group I, in which the metal acetabular socket and the metal femoral cup were used, 60 per cent of the patients gained satisfactory pain relief at five to nine years of follow-up. In Group II, in which the metal-polyethylene socket and the metal cup were used, 84 per cent of the patients gained satisfactory pain relief, with 1 to 5 years of follow-up. There have been 12 revision cases in the 130 hips operated on, with the average time to revision being 3 years and 10 months. Revision procedures consisted of the conventional total hip replacement (seven cases), replacement of the socket and/or the cup (four cases), and arthrodesis (one case). The secondary operations could be performed without difficulties, probably because no bone cement was used in our surface replacement. No cases of pulmonary embolism, thrombophlebitis, deep infection, heterotopic ossification, or femoral neck fracture were encountered after the procedure.
 ...
PMID:Symposium on Surface Replacement Arthroplasty of the Hip. Socket and cup surface replacement. 714 50

We treated a 37 year old woman with venous aneurysm along left side of the neck. In the beginning, she was asymptomatic and with increase in size of the venous aneurysm she experienced severe pain. Pathohistological examinations revealed a destructive change of the venous wall and thrombosis. Therefore, in cases of venous aneurysm along the neck, such aneurysm should probably be treated surgically to prevent the occurrence of pulmonary embolism.
 ...
PMID:A case report of venous aneurysm of the neck vein. 731 Nov 87

In an investigation on deep venous thrombosis and pulmonary embolism, where neither dextran nor antithrombotic drug prophylaxis were employed, 30 patients undergoing total hip replacement were randomly allotted to one of two groups receiving either epidural or general anaesthesia. The epidural group (n = 15) was given 0.5% bupivacaine with epinephrine (5 micrograms/ml) and this was prolonged into the postoperative period for pain relief. The general anaesthesia group (n = 15) was operated on under artificial ventilation with nitrous oxide/oxygen via an endotracheal tube and intravenously administered fentanyl and pancuronium bromide. In this group of patients narcotic analgesics (ketobemidone) were given intramuscularly on demand for pain relief postoperatively. The frequency of deep venous thrombosis involving the femoral veins, as observed at phlebography, was significantly lower in patients receiving continuous epidural block (3 of 15; 20%), than in those receiving general anaesthesia and parenteral analgesics postoperatively (11 of 15; 73%). Further, the frequency of pulmonary embolism, as determined by pulmonary perfusion lung scanning, was lower in patients receiving continuous epidural block (2 of 15) than in the general anaesthesia group (7 of 15). Possible explanations for these findings are discussed, including a hyperkinetic lower limb blood flow and lower fibrinolysis inhibition activity in patients given epidural block. Lower blood transfusion requirements in patients given epidural block might also play a role, as well as a "stabilizing" effect of local anaesthetics on platelets, leukocytes and endothelial cells.
 ...
PMID:Comparative influences of epidural and general anaesthesia on deep venous thrombosis and pulmonary embolism after total hip replacement. 732 41


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>