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Query: UMLS:C0034065 (pulmonary embolism)
 14,979 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The purpose of this study was to evaluate the efficacy of thoracoscopic techniques applied for anterior spinal cord decompression and fusion in osteoporotic thoracolumbar vertebral pseudoarthrosis with paralysis that otherwise require open thoracotomy and diaphragm section. Thirteen patients (average age, 65.7 years old) underwent this operation. Unilateral lung ventilation, otherwise bilateral high frequency jet ventilation was applied for general anesthesia. Three ports were routinely prepared through the intercostal spaces. Minimal subperiosteal dissection of the diaphragm was made from its insertion to L1 vertebra by 2 cm. Following corpectomy procedure of collapsed vertebra, spinal cord was decompressed and spinal fusion was performed in either of one or two stages. Spinal cord decompression could be achieved under bright illumination and a magnified view by assistance of endoscope system. Anterior spinal reconstruction could be performed by a titanium mesh cage packed with local bone in 9, or by autogenic iliac strut bone graft in 4 cases. There was no mortality and no major endoscope-related morbidity such as dural tear, spinal cord, lung, or major vascular injury except one case of pulmonary embolism. By avoiding open thoracotomy, thoracoscopic approach resulted in less postoperative wound pain and better respiratory function for such aged high-risk patients.
Chir Narzadow Ruchu Ortop Pol
PMID:Spinal cord anterior decompression for delayed spinal cord paralysis after osteoporotic vertebral compression fracture: application of thoracoscopic approach. 1868 34

There are some doubts whether in a severe renal failure the dose of alteplase should not be modified, especially when its plasma clearance may be decreased by liver ischemia. The authors present a case of a 67-year old woman with massive pulmonary embolism (PE) and acute renal failure (creatinine 580 micromol/l) of a mixed etiology (renal calculosis with hydronephrosis and shock as PE presentation). Alteplase administration (10 mg bolus followed by reduced to 50 mg two hours infusion) resulted in hemodynamic stabilization but was complicated by gross subcutaneous hematomas, intensive epistaxis and hematuria, and hemoglobin decrease which required blood transfusions.
Kardiol Pol 2008 Aug
PMID:[Massive pulmonary embolism treated with a reduced dose of alteplase in a patient with acute renal failure]. 1880 42

The increasing life expectancies among octogerians ang nanogerians cause increased need for total hip replacement in this age group. The aim of our study was to analyze final results after total hip arthroplasty in patients 75 years of age and older. Clinical and radiological retrospective study was performed on a group of 59 patients (72 hips) in the mean age of 78 years. Minimal follow-up was 3 years. According to Harris Hip Score hip function improved on an average of 47 points and at final follow-up was 86 points. Patients with medical diseases had poorer hip function improvement. Early dislocation was found in 3 patients with was treated conservatively with good result. Almost 1/4 of patients suffered medical postoperative complications: pneumonia (n = 1), urinary tract infection (n = 4), pulmonary embolism (n = 1), acute myocardial infarction (n = 1), postoperative confusion (n = 5) and mild intestinal occlusion (n = 1). Additionally, one patient died for pulmonary embolism. There were no radiological signs of aseptic loosening or need for revision operation. Three fourth of our patients had satisfactory results after total hip replacement, despite relatively high medical (24%) and local complication rate. Aseptic loosening is rear in this age group.
Chir Narzadow Ruchu Ortop Pol
PMID:[Elective total hip arthroplasty for patients 75 years of age and older]. 1884 21

A case of a 25-year-old woman with life-threatening pulmonary embolism, which occurred on fourth day after appendectomy and was safely treated with alteplase infusion. Before surgery, oral contraceptive use history, as a sole venous thromboembolic risk factor has been missed and the patient did not receive perioperative, pharmacologic antithrombotic prophylaxis. Further screening for thrombophilia was negative. This case proves that contraceptives use may create, irrespectively of the woman age, a possibility of perioperative thromboembolic complications, even for such minor procedure as appendectomy.
Kardiol Pol 2008 Oct
PMID:[Oral contraceptives use increases venous thromboembolic risk even for minor surgical procedure - a case report]. 1900 32

Heparin-induced thrombocythopenia (HIT) is a potentially serious complication of heparin treatment, rarely observed in cardiological wards. We present a case of a 38-year-old woman with dilated cardiomyopathy and massive pulmonary embolism treated with alteplase and unfractionated heparin. On 12th day an unexpected fall in platelet count was observed, without new signs of thrombosis. The HIT type II was diagnosed. Patient was treated effectively and safely by 7.5 mg of fondaparinux given subcutaneously once daily for 10 days.
Kardiol Pol 2008 Dec
PMID:[Heparin-induced thrombocythopenia in a patient with massive pulmonary embolism and dilated cardiomyopathy, successfuly treated with fondaparinux - a case report]. 1916 78

In spite of widely applied prophylaxis against thrombo-embolic venous disease its future complications still present important clinical issue. According to rough statistics this disease occurs in 71/100 000 persons per year and reveals in 1/3 as pulmonary embolism and in 2/3 as a pure thrombotic venous disease. Massive pulmonary embolism is at present a major cause of death in hospitalized subjects. In the USA mortality due to diagnosed pulmonary embolism is reported as approximately 25 000 cases per year. The aim of this paper is to draw attention to the asymptomatic cases of the thrombotic venous disease in the patients before hip arthroplasty. A retrospective clinical analysis of 210 total hip replacements (years 2005-2008) was performed. Standard perioperative routine antithrombotic prophylaxis with low-molecule heparins was introduced in each case. Special attention was paid to the occurrence of the risk factors or the presence of venous thrombosis in the lower extremities perioperatively. In the analyzed group preoperative ultrasound revealed in 5 (2.38%) cases asymptomatic venous thrombi reaching above the knee region and this was the cause of postponing of the procedure. In the early postoperative period pulmonary embolism was evidenced in 4 cases (1.9%). The authors suggested that preoperative ultrasound investigation of lower extremities venous system is important issue together with the assessment of d-dimers in the blood in all patients admitted to total hip arthroplasty. In any suspicion of the pulmonary embolism in these patients an angio-CT should be performed as an emergency.
Chir Narzadow Ruchu Ortop Pol
PMID:[Asymptomatic thrombo-embolic venous disease before total hip replacement--when the risk is important?]. 1924 87

We present a case of a 45-year-old-female who developed myocardial infarction and 6 weeks following first hospitalisation--pulmonary embolism. The disease was probably triggered by hormone replacement therapy. Coronary angioplasty and anticoagulant therapy with unfractioned heparin and acenokumarol were used with success. The woman and her 17-year-old daughter were shown to be heterozygous for prothrombin mutation G20210A. This case shows that trombophilia should be considered in young women with deep venous thrombosis, pulmonary embolism, venous thromboembolism or with myocardial infarction especially in women with high-risk factors.
Kardiol Pol 2009 Feb
PMID:[Myocardial infarction and pulmonary embolism in a 45 year-old woman with the prothrombin 20210A mutation--a case report]. 1928 79

Recent epidemiologic studies indicate that use of combined oral contraception is associated with a increase in the incidence of cardiovascular disease (venous thromboembolism, pulmonary embolism, myocardial infarction and stroke). The risk of cardiovascular disease is strongly related to estrogen dose, progestogen type and other factors for example thrombogenic mutations and cigarette smoking among female over age 35. The progestogen only contraception is safe alternative to combined hormonal contraception. Progestogen only pill (POP) has different levels of action (local and/or central) which may vary from one drug to another. As for the cardiovascular disease risk, progestogens are not considered to be risk factors. Desogestrel containing POP is advised in the following cases: bad tolerance of exogenous oestrogens; in order to counteract an endogenous hyperoestrogenosis; medical, metabolic or cardiovascular contraindications to estroprogestogen contraception. Lastly, POP should be used as a prime contraception in some particular situations (breast feeding, endometriosis, adenomyosis, cigarette smoking, contraception for older women). These recommendations present the actual system of care in that population of women in Poland.
Ginekol Pol 2009 Jan
PMID:[The statement of Polish Gynecological Society experts on oral use of contraceptive 75 microg desogestrel minipill in different clinical cases--state of art in 2008]. 1932 63

Antiphospholipid syndrome is a disorder characterized by recurrent venous or arterial thrombosis and/or recurrent abortions associated with persistently elevated levels of antiphospholipid antibodies. In some patients antiphospholipid syndrome occurs in association with systemic lupus erythematosus, or other autoimmune disorders or malignancies. Antiphospholipid syndrome can be induced by certain drugs. A correct diagnosis of this disease is necessary as it is potentially associated with serious and sometimes life-threatening complications. Clinical presentations of antiphospholipid syndrome may vary widely even in the same patient. The time between individual manifestations of the disease also varies considerably. Therefore its early detection requires a strong index of suspicion especially when thrombosis occurs at unusual sites or non-specific symptoms predominate in the clinical presentation. We report a case of a 20-year-old woman with a recent history of pulmonary embolism who was admitted to the hospital because of severe symptomatic anemia. Once the diagnosis of antiphospholipid syndrome coexisting with systemic lupus erythematosus as a primary disorder has been established, implemention of specific treatment resulted in markedly improved condition.
Pol Arch Med Wewn
PMID:Atypical clinical manifestation of antiphospholipid syndrome. 1934 Nov 87

We present a case of 80-year-old woman with a history of paroxysmal atrial fibrillation admitted to the cardiology department due to syncope and chest pain with suspicion of pulmonary embolism. In course of further diagnostics the initial diagnosis was excluded and anticoagulant treatment was stopped. The real cause of the above signs and symptoms was aortic dissection. It was diagnosed by echocardiography and confirmed by CT scan. Patient was immediately transferred to the cardiosurgery department and successfully operated. The patient was discharged after 33 days in good condition.
Kardiol Pol 2009 Mar
PMID:[Aortic aneurysym dissection in 80-year-old woman]. 1937 37


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