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)

2710 patients were admitted during 1988 in 14 ICU of a crowded urban area. We determined OMEGA score at the end of the ICU stay. OMEGA scores the intensity of the treatment and depicts the utilisation of resources giving rise to the variable costs. 2085 patients intensively treated resulted in a higher mean OMEGA score than 625 patients only monitored, the length of ICU stay over 8th day increases the allocation of resources. This was conditioned also by the diagnosis in both groups of patients being liver transplant (OLTX) and chronic obstructive lung diseases (COLD), the most resources-consuming intensive patients and cardiovascular (CARD), and drug intoxication (TS), the least ones. The efficiency of the use of resources (i.e. use in survivors) in ICU treatment was 100% in monitored patients and ranges from 47.3% to 90.9% in intensively treated ones: medical unspecified (Mm), COLD, strokes, surgical unscheduled, cardiac arrest, OLTX, pneumonia and ARDS, pulmonary embolism, surgical scheduled, trauma, neurological diseases, TS. Intensive patients could be divided in a group with a good utilization (26.5%) of employed resources: TS, PE, CARD, SS, TR, PNM, NRL, OLTX) in a group with a mean utilisation (50-65%: CCA, strokes, SU) and finally in a group with a weak utilisation of resources (Mm and COLD). We computed also the mean loss of resources for each diagnosis that ranges from COLD (76.1 OMEGA points) to OLTX, strokes, Mm, SU, PNM, CCA, NRL, TR, CARD, SS, PE, and TS (10.2 points). The implications of these results and the possibilities of improving the utilisation of resources in ICU are discussed.
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PMID:[Efficiency of use of resources in intensive care units in an urban area]. 192 56

A 66-year-old man was admitted to our department with left abducens palsy and pain in the territory of the left trigeminal nerve. He had a history of left mandibular osteomyelitis that had been treated for five years in the dental department. However, the osteomyelitis was resistant to therapy. Two months before this admission, he had an infectious aneurysm of the left extracranial carotid artery with occlusion. On admission, the ESR was 140 mm/hour. P-ANCA and antinuclear antibody were negative. Lumbar puncture revealed elevated cell counts (43% neutrophils) and protein. Microbiological studies were negative. Cranial MR images showed an enhanced lesion in the left cavernous sinus. His condition gradually improved with high dose of penicillin and low dose of corticosteroid. However, he died of pulmonary embolism after 81 days. At autopsy, the left extracranial carotid aneurysm was highly fibrose. The left CCA, ICA, and ECA were occluded from the origin of the left common carotid artery to the ICA in the cavernous sinus. There were also fibrosis, hemosiderin, and macrophages around these arteries, and parts of these arteries were destroyed. The left cavernous sinus lesion was also highly fibrose. These pathological findings indicated that there was old inflammation around the left extracranial carotid aneurysm, left carotid artery, and left cavernous sinus. We believe that the left cavernous sinus syndrome in our patient was caused by left carotid artery vasculitis induced by the left infectious extracranial carotid aneurysm. We also believe that this infectious aneurysm was caused by the left mandibular osteomyelitis.
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PMID:[A case of cavernous sinus syndrome following a mycotic aneurysm of extracranial carotid artery]. 1196 46