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)

To determine whether sickle-cell trait and glucose-6-phosphate dehydrogenase deficiency influence the course and fatality rates of certain diseases requiring hospitalization, especially those associated with thrombotic phenomena, we conducted a co-operative study of 65,154 consecutively admitted, black male patients in 13 Veterans Administration hospitals. The overall frequency of sickle-cell trait was 7.8 per cent and of glucose-6-phosphate dehydrogenase dificiency 11.2 per cent. Both conditions were present in 0.9 per cent of those examined. There were regional, but no age-dependent, differences in the frequency of sickle-cell trait. Sickle-cell trait had no effect on average age at hospitalization or death, overall mortality, length of hospitalization on medical and surgical wards and frequency of any diagnosis, except essential hematuria and pulmonary embolism. Although statistically significant (P less than 0.001), the differences for the latter were small (1.5 per cent of all patients with normal hemoglobin and 2.2 per cent of patients with sickle-cell trait). Glucose-6-phosphate dehydrogenase deficiency had no adverse effect.
 ...
PMID:Clinical implications of sickle-cell trait and glucose-6-phosphate dehydrogenase deficiency in hospitalized black male patients. 43 93

Regional lung ischemia was imaged with a rapidly diffusible radioaerosol of pertechnetate. The method is compared with similar techniques using 11C and 15O. The principles involved include (A) the rapid alveolar-capillary diffusion of inhaled radioactive gases (11CO, C15O, and C15O2) and the radioaerosol of 99mTcO4-; (B) the patency of the airways to the ischemic regions; and, most importantly; (C) the much slower tracer removal from lung tissue with a stagnant circulation as opposed to the surrounding normal lung. The 11CO and C15O label the hemoglobin in red blood cells, and the C15O2 labels water in the circulation and in the stagnant ischemic region. The TcO4- probably labels the albumin of the plasma in the embolized regions and in the circulating blood. Experiments involving pulmonary embolism in dogs, proved by pre- and post-mortem angiography and gross post-mortem examination, show that positive ischemic lesions (hot spots) are observed, after TcO4- aerosol and C15O2 gas inhalation, in the embolized region on the same day. Clinical trials with aerosol-inhalation method in suspected pulmonary embolism and now under way.
 ...
PMID:Imaging experimental pulmonary ischemic lesions after inhalation of a diffusible radioaerosol: concise communication. 83 71

Fibrinolytic therapy was carried out in 59 patients suffering from a total of 60 deep venous thromboses of the iliac segment (n = 24), the femoropopliteal segment (n = 18), the deep calf veins (n = 2), or the subclavian vein (n = 16). 46 patients received streptokinase (SK), 4 were given urokinase (UK), and 10 were treated with streptokinase followed by urokinase (SK + UK). The duration of fibrinolytic therapy was between 19 and 596 hours (x = 166 +/- 111 hrs). Phlebographic examination was used to determine the location of the thrombotic occlusion as well as to evaluate therapeutic results. To assure sufficient anticoagulatory protection during therapy with streptokinase the dose of streptokinase was either reduced by steps of 20,000 U/hr to a minimum of 40,000 U/hr or heparin was added as a continuous infusion. Urokinase was administered with a mean loading dose of 75,000 IU followed by an average maintenance dose of 40,000 IU/hr; it was always given in combination with heparin. When therapeutic success was graded as complete/partial/no recanalisation, the following results were obtained: thrombotic occlusion up to 1 week old 35%/48%/17%; up to 2 weeks old 57%/14%/29%; 3 or 4 weeks old 12%/38%/50%; older than 4 weeks 13%/37%/50%. The two most common side effects were a fall of the hemoglobin and a rise of body temperature. Treatment with SK had to be interrupted for bleeding in two cases. One patient diet after rupture of the liver and of the spleen following development of subcapsular hematoma in these organs, 3 patients survived pulmonary embolism without major long-term impairment. Considering medical and social aspects (preservation of capability for working in young adults) it appears justified to administer fibrinolytic agents up to a thrombus age of 14 days, in some cases even up to a thrombus age of 28 days. Good results in cases of deep vein thrombosis of the lower limbs are often obtained only when fibrinolytic therapy is extended beyond 96 hours. It should be performed in intensive care units only. Follow-up examinations of the venous drainage capacity up to 2 years after fibrinolytic therapy document the good therapeutic effect that is warrented by streptokinase or urokinase induced complete recanalisation.
 ...
PMID:[Fibrinolytic therapy in deep venous thrombosis of the upper and lower extremity]. 84 72

A prospective, randomized trial has been undertaken to evaluate the prophylactic effects of low molecular weight heparin (LMWH) and dextran-70 in 216 patients with hip fracture during a postoperative period of ten days. Deep vein thrombosis (DVT) was diagnosed using the 125Iodine fibrinogen uptake test, confirmed by ascending venography. 113 patients received LMWH and 103 dextran-70. The frequency of DTV of 14.2% in the LMWH group was significantly lower compared with the 30.1% in the dextran group (p less than 0.003). During the first 10 days postoperative there were no fatal pulmonary embolism (PE). After this period PE occurred in 2 patients (1.8%) in the LMWH group and 1 patient (1.0%) in the dextran group. In each group one patient died from PE. There was no major bleeding in either group. The frequency of local complications was slightly higher in the dextran group (10.7%) compared with the LMWH group (3.5%). The postoperative hemoglobin level was significantly lower in dextran treated patients than in patients receiving LMWH (p less than 0.0001).
 ...
PMID:[Prevention of thromboembolism in hip traumatology: low molecular weight heparin versus dextran]. 137 76

Ninety consecutive outpatients with acute proximal and/or distal deep-vein thrombosis (DVT), as shown by phlebography, were entered into a prospective randomized trial comparing intravenous adjusted unfractionated heparin (UFH) with subcutaneous fixed doses of a low-molecular-weight heparin (CY216; 225 IC anti-Xa U/kg 12 hourly) for 10 days. The incidence of pulmonary embolism did not differ in the two groups (one episode per group). The comparison between pre- and posttreatment venograms and perfusion lung scans showed a statistically significant improvement (p less than 0.01 and p less than 0.05, respectively) only in the CY216-treated group. The incidence of major adverse reactions (major hemorrhages, relevant hemoglobin fall, and serious thrombocytopenia) was significantly higher (22 vs. 4.5%; p = 0.01) in the UFH-treated group. After a mean follow-up period of 2 years, the incidence of thromboembolic recurrences and that of post-thrombotic manifestations did not differ in the two groups. It is concluded that subcutaneous fixed doses of CY216 are more effective and safer than intravenous adjusted UFH in the treatment of acute DVT.
 ...
PMID:Treatment of deep venous thrombosis by fixed doses of a low-molecular-weight heparin (CY216). 196 64

Once daily dosing of Enoxaparin to prevent deep vein thrombosis (DVT) after total hip replacement has been defined through two double-blind prospective, randomized multicentric trials. A previous prospective study including 228 consecutive patients had determined optimal dose to be 40 mg daily (4000 anti Xa U) begun 12 hours pre-operatively. The first trial (118 patients) compared two modes of administration of the dose of 40 mg--either 40 mg once daily or 20 mg twice daily, every twelve hours. Results were a figure of 6% for total DVT detected by ascending bilateral phlebography, 5% of wound hematoma and did not shown a statistically significant difference between the two modes of administration as regard tolerance. The second trial (237 patients) compared unfractionated calcic Heparin (5000 U.I. every eight hourly begun two hours before surgery) with Enoxaparin, 40 mg/day begun twelve hours before surgery. In the unfractionated Heparin group, we observed 27 total DVT (25%) 20 proximal DVT (12.5%) and one case of non fatal pulmonary embolism. In the Enoxaparin group, we observed 15 total DVT (12.5%), 9 proximal DVT (7.5%) no case pulmonary embolism. Red-cell transfusion requirements and hemoglobin levels on the third post-operative day shown a significant better tolerance in the Enoxaparin group. Theses results are coherent with those observed in the placebo controlled trial of Turpie, Levine, et al (1986). They used a dose of 30 mg twice daily (6000 anti Xa IU) begun 12/24 hours post-operatively, and observed a figure of 12% for total DVT and 4% for proximal DVT. Tolerance was the same than in the placebo group.
 ...
PMID:[Prevention of deep vein thrombosis by enoxaparin after total hip prosthesis]. 217 35

A 43 year-old black man with sickle cell trait documented by hemoglobin electrophoresis presented with severe pleuritic chest pain and hypoxemia three weeks after discharge following abdominal surgery. A pulmonary embolus was diagnosed by angiography and he was treated with heparin; the minimum arterial pO2 was 55 torr while O2 was being administered at a rate of 3 L/min. During this therapy, he developed abdominal pain. Computerized tomography suggested splenic infarction, which was documented by radionuclide liver-spleen scan and magnetic resonance imaging (MRI); the patient's spleen had been normal at exploratory laparotomy three weeks previously. No source for emboli was identified in the deep venous system by MRI. Although splenic infarction has been reported in patients with sickle cell trait at high altitude, this is the first reported case of splenic infarction secondary to the hypoxemia of pulmonary embolism in a patient with sickle cell trait. The spleen is subject to infarction in sickle cell trait because blood flow is slow through a hypoxemic and acidemic environment. The additional hypoxemia due to pulmonary embolism is presumed, in our patient, to have created a local splenic environment which permitted infarction to occur.
 ...
PMID:Pulmonary embolism and splenic infarction in a patient with sickle cell trait. 231 14

A series of 80 patients operated for total hip prosthesis under epidural anesthesia was randomly allocated to treatment with Kabi 2165 (n = 40): 2,500 U anti-Xa preoperatively and evening of operation and 2,500 U anti-Xa morning and evening daily up to the 9th or 10th day postoperatively, or standard heparin (n = 40): 3,750 U preoperatively and then 8 hourly, at a dose adjusted with thrombin time and cephalin + activator time, daily up to the 9th or 10th day. Phlebography was performed routinely on the 9th or 10th day. Venous thrombosis occurred in 7 patients (17.5%) in the Kabi 2165 group, including two high, potentially emboligenic, localizations (5%), and in 4 patients (10%) in the standard heparin group, including 2 potentially emboligenic clots (5%). The difference is not statistically significant (total number: p = 0.5; potentially emboligenic: p = 0.33). Pulmonary embolism did not occur. Overall tolerance, evaluated from hemoglobin and hematocrit values, intra- and post-operative bleeding and operation wound hematoma and at injection site was comparable in the two groups.
 ...
PMID:[Comparison of the efficacy and tolerance of Kabi 2165 and standard heparin in the prevention of deep venous thrombosis in total hip prosthesis]. 283

A 71-year-old woman (Ped) received 3 units of red cells (RBCs), compatible by the indirect antiglobulin test but strongly (4+) incompatible by direct agglutination at 37 degrees C. The next day, her plasma hemoglobin was 1252 mg percent and the direct antiglobulin test (DAT) was weakly positive (IgG and C3). Less than 5 percent of the transfused cells could be detected 48 hours posttransfusion. Her clinical condition deteriorated and renal failure developed. The patient died of pulmonary embolism. Her serum contained a strong (4+) IgM agglutinin and a weakly reactive (microscopically positive) IgG antibody, with anti-EnaTS specificity. EnaFS and EnaTS antigens were severely depressed or absent from the patient's RBCs; the ficin-resistant Ena antigen (EnaFR) appeared to be present. Pretransfusion RBC sialic acid level was 53 +/- 2 percent of normal. The patient's RBC membranes were shown to contain sialoglycoproteins beta and delta by sodium dodecyl sulphate polyacrylamide gel electrophoresis with periodic acid Schiff's base staining, with weak staining of components in the regions corresponding to alpha, alpha 2 and alpha delta. The nature of these components was not identified, but their presence suggested that the patient's RBCs expressed a previously undescribed sialoglycoprotein alpha variant.
 ...
PMID:A severe transfusion reaction associated with anti-EnaTS in a patient with an abnormal alpha-like red cell sialoglycoprotein. 334 Oct 73

Four hundred and eighty consecutive renal transplant operations performed upon adults over a ten year period were reviewed to obtain the incidence of deep venous thrombosis (DVT) or pulmonary embolism (PE), or both. Using strict objective diagnostic criteria, 40 (8.3 per cent) thrombotic events were diagnosed, comprising 25 lower limb DVT alone, 11 DVT with PE and four PE alone. Four deaths were directly attributable to PE which was the fourth major cause of death in the review period. DVT was more common on the side of the transplant but the difference was not significant. The low incidence of thrombotic events (1.7 per cent) in the first month of transplantation does not suggest that chemical prophylaxis should be used during this period. However, the peak incidence occurred in the fourth month after transplantation which may be associated with a significant rise in mean hemoglobin concentration in both the thrombotic population and a control group of transplant recipients. Patient age at the time of transplantation and predisposing events, such as prolonged bedrest, further surgical treatment and pelvic pathology, were significant risk factors. All of the patients in the thrombotic population were receiving steroids at the time of diagnosis and no thrombotic events were demonstrated in patients receiving cyclosporin alone. The results of this review suggest that chemical prophylaxis is indicated for patients more than 40 years of age, with stable renal function and receiving steroids, who undergo periods of prolonged bedrest or further surgical treatment at some time after renal transplantation.
 ...
PMID:Deep venous thrombosis after renal transplantation. 354 75


1 2 3 4 5 6 7 8 9 Next >>