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)

Portable percutaneous cardiopulmonary support (PCPS) with heparin-coated circuits and a biopump was employed in a patient who had a massive pulmonary embolism with circulatory collapse after stripping of varicosities of the leg. Emergency pulmonary embolectomy was successfully performed. The main pulmonary incision was facilitated by cross-clamping of the main pulmonary arterial root. The bypass circuit was kept closed, and used with the normothermic beating heart without converting to conventional total cardiopulmonary bypass. Blood flow from the lung was removed by pump suction, stored in the reservoir, and intermittently returned to the venous circulation. Heparin was added to the circuits to keep the activated clotting time greater than 300 sec. In massive pulmonary embolism, PCPS is useful for preoperative, intraoperative, and postoperative support.
 ...
PMID:Pulmonary embolectomy for acute massive pulmonary embolism under percutaneous cardiopulmonary support. 1022 7

Pulmonary embolus in children is rare. A case of massive pulmonary embolus, after surgery, in a child of 14 years is described. Accident and emergency doctors should be aware that pulmonary embolus can occur in children and exercise a high index of suspicion for the diagnosis in those patients with risk factors for the condition who present acutely with typical symptoms such as dyspnoea, chest pain, haemoptysis, or collapse.
 ...
PMID:Massive pulmonary embolus in a 14 year old boy. 1041 42

Acute massive pulmonary embolism carries a high mortality with the majority of deaths occurring during the early phase. We describe a case of massive pulmonary embolism resulting in severe cardiovascular collapse and cardiac arrest which was treated successfully with inhaled nitric oxide.
 ...
PMID:Use of inhaled nitric oxide in pulmonary embolism. 1047 Apr

The aim of this retrospective study was to determine the late result after operative treatment of acute thoracolumbar fractures and fracture dislocations. 29 patients, treated between 1988 and 1995 at the Department of Trauma Surgery, Hannover Medical School with posterior stabilization and interbody fusion with transpedicular cancellous bone grafting, were reexamined 3 1/2 years after surgery. The incorporation and effect on the fusion was analyzed with spiral CT scan after implant removal and the patients were seen for clinical and conventional radiologic examination. We treated 24 type A, 4 type B and 1 type C lesion according to the Magerl classification. 27 patients were stabilized with an internal fixator, 2 with a plate system. The mean operative time totalled 2:50 hours, the intraoperative fluoroscopy time averaged 4:07 minutes and a mean blood loss counted 376 ml. 4 patients out of 6 with an incomplete neurologic lesion (Frankel/ASIA D) improved to Frankel/ASIA grade E. 2 complications were observed: 1 delayed wound healing and 1 venous thrombosis with secondary pulmonary embolism. Compared to the preoperative status our follow-up examinations demonstrated permanent social sequelae: The percentage of individuals able to do physical labor was reduced (15 to 5 patients; p < 0.01) whereas the share of unemployed or retired patients increased (2 to 12 patients; p < 0.01). The assessment of complaints and functional outcome with the "Hannover Spinal Trauma Score" reflected a significant difference (p < 0.001) between the status before injury (96.6/100 points) and at the time of follow-up (64.4/100 points). The correlation between the "Hannover Spinal Trauma Score" and the finger-ground-distance was found to be significant (Coefficient Spearman = -0.71; p < 0.01). The radiographic assessment of the segmental kyphosis (Cobb technique) demonstrated a significant (p < 0.001) mean restoration from an initial angle of -15.2 degrees (kyphosis) to -3.4 degrees (kyphosis). Serial postoperative radiographic follow-up showed progressive loss of correction; at follow-up examination we found a mean of 7.8 degrees (p < 0.005). In 16 patients with an additional posterior fusion with autogenous bone grafting an analogous loss of correction was noted. CT scans after implant removal demonstrated an interbody fusion and incorporation of the transpedicular bone graft in 10 (34%) patients. In another 10 (34%) patients the CT scans proved the interbody fusion at the anterior and posterior wall of the vertebral body via direct contact due to collapse of the disc space. In these patients the bone graft was not incorporated and no central interbody fusion could be found. In 9 (31%) patients neither interbody fusion nor incorporation of the transpedicular graft was achieved. A frequent interbody fusion could not be achieved with the technique of transpedicular bone grafting. In case of incomplete or complete thoracolumbar burst fractures the authors recommend a combined operation with restoration of the anterior column with a strut graft or body replacement.
 ...
PMID:[Transpedicular fusion of the thoraco-lumbar junction. Clinical, radiographic and CT results]. 1050 73

A 75-year-old man with a recent history of pulmonary embolism, presented with collapse followed by a gran mal seizure and right-sided non-pulsatile proptosis. On recovery, he had diplopia on lateral and upward gaze and signs of congestive cardiac failure. Further pulmonary embolism was proven by lung scintigraphy. Computed tomography of his orbits confirmed a contrast-enhancing space-occupying lesion of the medial wall of the right orbit, with no intracranial abnormality. The patient was investigated for metastatic tumour as a possible cause of the space-occupying lesion and the unprovoked thromboembolic event, but no evidence of malignancy was found. The orbital lesion was not biopsied because of the risk of bleeding from anticoagulation. Three weeks later, the patient represented with recurrent cardiac failure, proptosis, and diplopia. A transorbital ultrasound confirmed an encapsulated, well-defined vascular lesion, with typical appearances and Doppler flow characteristics of a cavernous haemangioma. Diuretic therapy abolished the proptosis and diplopia in tandem with relief of the cardiac failure. This is the first description of recurrent proptosis with diplopia due to recurrent congestive expansion of an orbital cavernous haemangioma.
 ...
PMID:Recurrent proptotic diplopia due to congestive expansion of cavernous haemangioma with relapsing right-sided cardiac failure. 1062 2

A 41-year old primigravida underwent caesarean section because of foetal distress following prostin induction of labour. Intraoperative coagulopathy, haemorrhage and hypotension necessitated a hysterectomy. Subsequently, she developed respiratory and renal failure, requiring mechanical ventilation and haemodialysis. She made a full recovery. The likely diagnosis was amniotic fluid embolism (AFE), a rare complication of pregnancy with a variable presentation, ranging from cardiac arrest and death through to mild degrees of organ system dysfunction with or without coagulopathy. The differential diagnosis includes pre-eclamptic toxaemia/pregnancy-induced hypertension, anaphylaxis and pulmonary embolism. There is no diagnostic test for AFE; the finding of foetal elements in the maternal circulation is non-specific. Historically, AFE was thought to induce cardiovascular collapse by mechanical obstruction of the pulmonary circulation. It is now thought that a combination of left ventricular dysfunction and acute lung injury occur, with activation of several of the clotting factors. An immunological basis for these effects is postulated. There is no specific therapy and treatment is supportive. The mortality of the condition remains high.
 ...
PMID:Amniotic fluid embolism: a case report and review. 1069 74

The use and scope of thrombolytic therapy in the management of pulmonary embolism (PE) continues to evolve. The results of small studies suggest that thrombolytic therapy might have an impact on survival in massive PE with cardiogenic shock; however, no large studies to further this notion exist. Furthermore, the expanded application of thrombolytic therapy to patients with PE and right ventricular dysfunction (RVD) but without overt hemodynamic collapse remains controversial. We report successful use of the thrombolytic agent tissue plasminogen activator (tPA) in the management of life-threatening PE with RVD without overt cardiovascular collapse. We present evidence for the meritorious use of thrombolytic therapy in this category of PE patients. We believe that a broadened application of thrombolytic therapy to patients with PE and RVD but without cardiogenic shock, especially in younger patients, is beneficial and worth the risk.
 ...
PMID:Successful thrombolytic therapy for massive pulmonary embolism. 1072 26

Fulminant pulmonary embolism (PE) with circulatory collapse is associated with a high mortality rate due to acute right ventricular failure and hypoxia. Immediate and appropriate resuscitation and circulatory support in the perioperative period is mandatory to prevent sudden death. Extracorporeal membrane oxygenation (ECMO) was recently introduced for extracorporeal life support in patients with circulatory collapse and has provided an excellent outcome. We report on the effectiveness of ECMO support for fulminant PE. Seven patients were placed on veno-arterial ECMO for circulatory collapse caused by fulminant PE refractory to conventional treatment. After resuscitation, all patients underwent pulmonary angiography, and thrombolytic therapy was administered in all 7 patients under ECMO support. Three patients who did not improve by thrombolysis underwent embolectomy with standard cardiopulmonary bypass. Two thrombolysis and 2 surgery patients were weaned from bypass and survived. The duration of support ranged from 18-168 h (mean = 67.8 +/- 67.1 h), with maximum bypass flow rates of 2.0-4.5 (mean = 3.5 +/- 0.9). There were no device-related complications during support. In total, 4 patients (57%) were successfully weaned from support and discharged from the hospital in good condition. All patients who survived required prolonged support (27, 82, 151, and 168 h). We conclude that resuscitation and circulatory support using ECMO can be effective, life-saving measures in cases of circulatory collapse caused by fulminant PE.
 ...
PMID:Resuscitation and circulatory support using extracorporeal membrane oxygenation for fulminant pulmonary embolism. 1088 59

Pulmonary embolism is a common event in hospitalized patients. In some cases it presents with hemodynamic collapse, indicating massive obliteration of the pulmonary vasculature and has a very grim prognosis; 2/3 of such patients die within 2 hours of onset of symptoms. We describe our experience in 13 patients with massive pulmonary embolism. An aggressive diagnostic and therapeutic approach, utilizing sophisticated imaging techniques, thrombolytic therapy and surgery, led to the survival of 8 of the patients. Our experience supports an aggressive approach in these seriously ill patients.
 ...
PMID:[Massive pulmonary embolism--summary of experiences with 13 patients]. 1090 55

A 30-year-old HBsAg-positive woman was admitted to the hospital because of 6 days of progressive shortness of breath. She was in severe respiratory distress with circulatory collapse. She had an enlarged liver but no stigmata of chronic liver disease or signs of cirrhosis. She had rapidly developed respiratory arrest and was transferred to intensive care unit. Heart ultrasonography and Doppler scan showed right heart straining and high pulmonary artery pressure. Despite cardiovascular and respiratory support she died a few hours after admission. Autopsy revealed combined hepatocellular-cholangiocarcinoma infiltrating the entire liver, metastatic invasion of lung blood vessels and absence of right ventricular hypertrophy. The incidence of hepatocellular-cholangiocarcinoma, a variant of hepatocellular carcinoma, is roughly 2-3% and the presenting symptoms are abdominal pain, weight loss, jaundice, fever or decompensation of liver disease. Associated HBsAg positivity and cirrhosis are reported in 20-30% and 60% of patients, respectively. Metastases to lungs are relatively frequent but this is the first report of hepatocellular-cholangiocarcinoma presented with acute respiratory distress due to massive pulmonary embolism.
 ...
PMID:Combined hepatocellular-cholangiocarcinoma presented with massive pulmonary embolism. 1102 Aug 95


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