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)

Neoplastic cervical spine lesions are seen infrequently by the spinal surgeon. The surgical management of these tumors, particularly with associated neurovascular compromise, is challenging in terms of achieving proper resection and spinal stabilization and ensuring no subsequent recurrence or failure of fixation. In this report we highlight some of the problems encountered in the surgical management of tumors involving the cervical spine with techniques applied for gross total resection of the tumor without compromising the vertebral arteries. Ten patients with neoplastic cervical spine lesions were managed in our study. The common cardinal presentation was neck and arm pain with progressive cervical radiculo-myelopathy. All patients had plain X-rays, computer tomography scans, and magnetic resonance imaging of the cervical spine. Digital subtraction or magnetic resonance angiograms were performed on both vertebral arteries when the pathology was found to be in proximity to the vertebral artery. When a tumor blush with feeders was evident, endovascular embolization to minimize intraoperative bleeding was also considered. A single approach or a combined anterior cervical approach for corpectomy and cage-with-plate fixation and posterior decompression for resection of the rest of the tumor with spinal fixation was then accomplished as indicated. All cases made a good neurological recovery and had no neural or vascular complications. On the long-term follow-up of the survivors there was no local recurrence or surgical failure. Only three patients died: two from the primary malignancy and one from pulmonary embolism. This report documents a safe and reliable way to deal with neoplastic cervical spine lesions in proximity to vertebral arteries with preservation of both arteries.
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PMID:Surgical resection of neoplastic cervical spine lesions in relation to the vertebral artery V2 segment. 2157 35

The prevalence of upper extremity deep vein thrombosis (UEDVT) has shown a dramatic increase with the use of central venous catheters (CVCs) for patient care. The objective of this study was to identify risk factors and clinical outcomes in patients diagnosed with UEDVT at an academic medical center over a 1-year period. Medical records of 373 consecutive patients who underwent upper extremity venous duplex ultrasound (VDU) examination were retrospectively reviewed. A quarter of the patients screened by VDU (94 of 373) had acute UEDVT; 63% presented with arm swelling or arm pain; 48% had cancer; and 93% had indwelling CVCs. Cancer patients with CVCs were more likely to develop UEDVT (48%). Of the 94 UEDVTs, 16% had concurrent lower extremity DVT. The incidence of objectively confirmed pulmonary embolism (PE) was 9% (8 of 94 patients), and the 1-month mortality rate was 6.4%. The majority of patients (80%) with UEDVT received anticoagulation therapy and 20% were not treated. The most common risk factors for UEDVT were indwelling CVCs and a diagnosis of cancer. The incidence rate of PE and mortality rate from UEDVT were not insignificant at 9% and 6%, respectively. There were no institutional screening protocols for patients at risk of UEDVT associated with CVCs. Future research should focus on risk assessment and management protocols for patients at risk of UEDVT. In addition, a comparison of clinical outcomes associated with the type, size, and duration of catheter placement should be conducted in patients at risk of or diagnosed with UEDVT.
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PMID:The risk factors and clinical outcomes of upper extremity deep vein thrombosis. 2232 50