Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0149871 (deep vein thrombosis)
 12,364 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

BACKGROUND. Mortality in pulmonary thromboembolism (PTE) decreases considerable when it is diagnosed early. The suspicion based on clinical and complementary data is essential for an early diagnosis. METHODS. Retrospective review of the clinical features in patients diagnosed of PTE in an Internal Medicine department from January 1993 to December 1999. RESULTS. A total of 117 patients with PTE were identified. The median age was 68.8 years. Sixty-six patients (56.4%) had one or more risk factors for PTE. The most common risk factor was immobilization (37.6%). Dyspnea was the most common symptom (74.4%) and tachypnea the most common sign (66.7%). Fever/low grade fever and leukocytosis were present in 16.2% and 31.6% of patients, respectively. Respiratory failure, alkalosis and hypocapnia were present in 44.4%, 38.5% and 47% of patients, respectively. An alveolar-arterial oxygen gradient > 20 mmHg was demonstrated in 96.6% of patients. Chest radiographs and electrocardiograms were normal in 52.1% and 23.9% of patients, respectively. A vein echo-duplex of the lower limbs demonstrated deep vein thrombosis (DVT) in 52.1% of patients. The hospital mortality rate was 6.8%. CONCLUSIONS. PTE still affects older patients mainly and frequently known risk factors are not detected. The presence of fever/low grade fever and/or leukocytosis does not rule out PTE. Both chest radiographs and electrocardiograms may be normal. Not demonstrating DVT in the lower limbs by the vein echo-duplex does not rule out PTE. The hospital mortality rate has not decreased considerably in the last few years.
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PMID:[The current clinical spectrum of pulmonary thromboembolism]. 1199 39

Protein C (PC) is the pivotal anticoagulant and antithrombotic in the human coagulation cascade. PC deficiency can result in major medical problems such as deep vein thrombosis (DVT), leading to tissue oxygen deprivation. PC treatment has no bleeding or skin necrosis problems because it circulates in the blood as a zymogen and is only activated when and where it is needed. One source of PC is transgenic animal milk. The major components in the milk, such as alpha-casein, beta-casein, kappa-casein, alpha-lactalbumin and beta-lactoglobulin, are proteins that must be separated from PC. Immobilized metal affinity chromatography (IMAC) is an inexpensive separation technology with relatively high specificity, and it has great potential for difficult protein separations. After systematic studies of different chelator, metal ion and buffers, the combination of iminodiacetic acid (IDA) and Fe was found to be effective to separate PC from major milk components. alpha-Lactalbumin and beta-lactoglobulin fell through the column in the starting buffer. PC was eluted. alpha-Casein, beta-casein, kappa-casein remained bound in the column after PC elution. This technology might be applied for PC separation from transgenic animal milk. It is very important for PC production in large quantities and at low cost to treat PC-deficient patients.
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PMID:Chelator, metal ion and buffer studies for protein C separation. 1206 12

All stroke patients ideally should be admitted to a stroke unit in which personnel are familiar with strategies for taking care of stroke patients. Prevention of worsening cerebral ischemia by appropriate blood pressure and serum glucose management, fever control, and supplemental oxygen for hypoxemic patients is recommended. Recognition of common complications, such as aspiration pneumonia and deep venous thrombosis, highlights the need for swallowing evaluation and the use of pneumatic compression devices or subcutaneous heparin. Patients should be monitored closely for deterioration in their neurologic status and should have complications appropriately addressed. After evaluation of stroke etiology, appropriate secondary stroke prophylaxis should be selected and initiated before hospital discharge.
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PMID:Post-emergency department management of stroke. 1237 68

The number of persons traveling by airplane, railway or bus is on the increase. Recently, there has been a growing number of reports on travel-related disorders after long journeys, especially long-haul flights (i.e. deep venous thrombosis (DVT) and pulmonary thromboembolism (VTE), also known as "economy class syndrome" or "traveler's thrombosis"). The exact incidence of travel related thrombosis is not known. Contributing factors for DVT and VTE are sitting in a cramped position for hours, low humidity and lowered oxygen pressure in the aircraft cabin, reduced fluid intake and dehydration, as well as individual risk factors. In this review article definitions for risk groups (low, moderate and high risk for DVT and VTE) and recommendations for prevention (leg exercise, fluid intake, compression stockings and application of low molecular weight heparins) of travel related thrombosis, based on the outcome of a recent expert meeting, are presented.
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PMID:[Traveler's thrombosis: incidence, etiology, prevention]. 1240 30

Every day in the United States the airline industry boards over 1.7 million passengers for a total of 600 million passengers per year. As these passengers enter the cabin of their aircraft few are aware of the artificial environment that will protect them from the hazards of flight. Passengers are exposed to reduced atmospheric pressure, reduced available oxygen, noise, vibration, and are subject to below zero temperatures that are only a quarter inch away-the thickness of the aircraft's skin. Over the past decade there have been both technical and lay articles written on the perception of poor cabin air quality. Studies have, in part, supported some of those concerns, but, in general, the air quality exceeds that found in most enclosed spaces on terra firma. Since the events of September 11th, passengers have not only been exposed to the physical stress of flight, but also to social and emotional stress preceding departure. There has been a significant increase in air rage on board aircraft, which poses a threat to flight safety and a fear of harm to passengers and crew. The phrase "economy class syndrome" has received popular press attention and refers to the possibility of deep vein thrombosis (DVT) in the tight confines of an aircraft cabin. Studies have been conducted that demonstrate DVT can occur in flight just as it occurs in other modes of transportation or with prolonged sitting. In part, because of the stress related to commercial flight it is not a mode of transportation for everyone. Certain cardiovascular, pulmonary, and neuropsychiatric conditions are best left on the ground. Although medical problems and death are rare in flight, they do occur, and one major airline reported 1.52 medical diversions per billion revenue passenger miles flown. To provide medical support at 36,000 ft (11,000 m) most airlines now carry on-board medical kits as well as automatic external defibrillators. A recent survey conducted by a major airline revealed that there was at least one physician on 85% of all its flights. Both passenger and cargo aircraft have proven to be vectors of disease in that they transport humans, mosquitoes, and other insects and animals who, in turn, transmit disease. Transmission to other passengers has occurred with tuberculosis and influenza. Vectors for yellow fever, malaria, and dengue have been identified on aircraft. Although there are numerous health issues associated with air travel they pale in comparison to the enormous benefits to the traveler, to commerce, to international affairs, and to the public's health.
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PMID:Health issues of air travel. 1242 33

A 50-year-old woman underwent open reduction and internal fixation for bilateral lower extremity fracture under general anesthesia. During the surgery, arterial oxygen saturation and expired CO2 concentration dropped suddenly when the left limb was fixed. Immediately, we performed aspiration of the pulmonary thrombus and inserted a temporary infra-vena cava filter followed by heparinization. Ten days later, we carried out the surgery on the right limb uneventfully. The major cause of APTE is deep vein thrombosis (DVT), which is extremely common during perioperative period. Therefore, we must perform antithrombotic therapy for the patient at high risk for DVT.
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PMID:[Acute pulmonary thromboembolism during the surgery for bilateral lower extremity fracture]. 1550 Jan 11

A case is described of a previously healthy obese woman in her fourth pregnancy who presented for caesarean section due to cephalopelvic disproportion (CPD). Forty minutes after a spinal anaesthetic a healthy child was delivered. Shortly after the injection of ergometrine and Syntocinon into the uterus, the patient described a general feeling of discomfort which was followed by convulsions and cardiac arrest. Resuscitation was successful and the circulation was restored. However, it was difficult to maintain oxygenation and the patient was mechanically ventilated for 24 hours and subsequently supplementary oxygen therapy was given for three days. A pulmonary scintigram on the fourth day after delivery showed large uptake defects indicative of pulmonary embolism. The patient recovered completely and was discharged home after two weeks. Differential diagnosis and measures to reduce the risk of deep vein thrombosis (DVT) are discussed.
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PMID:Cardiac arrest during caesarean section. 1563 80

The aetiology of chronic thromboembolic pulmonary hypertension (CTEPH) is largely unknown and may be heterogeneous, because there are several ethnic differences in the clinical characteristics of CTEPH. Female predominance and a higher ratio of chronic to acute pulmonary thromboembolism have been reported in Japan as compared with the USA. Because such ethnic differences may be controlled by genetic factors, the current study investigated HLA polymorphisms in Japanese patients with CTEPH. HLA typing by serological and/or DNA typing methods was performed (for HLA-A, B, DPB1, DRB1) in 80 patients and 678 controls, and the association of clinical characteristics with HLA alleles was studied. The frequencies of HLA-B*5201 (40 versus 24%) and DPB1*0202 (19 versus 6%) were significantly higher in the patients. HLA-B*5201 positive patients showed a significant female predominance. Total pulmonary vascular resistance and mixed venous oxygen tension were better in the HLA-B*5201 positive patients. In contrast, cardiac index and gas exchange parameters were worse in the HLA-DPB1*0202 positive patients. In the patients carrying HLA-B*5201 and/or -DPB1*0202, the frequency of deep vein thrombosis was significantly lower than the other patients. These observations suggested that both the susceptibility and clinical characteristics of chronic thromboembolic pulmonary hypertension were controlled in part by the HLA-B and -DPB1 loci.
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PMID:Association of clinical features with HLA in chronic pulmonary thromboembolism. 1564 Mar 34

The therapy of acute pulmonary thromboembolism (APTE) is based on the clinical grade and ranges from ambulant therapy with anticoagulation, to thrombolysis, inferior vena cava (IVC) filtration, and catheter thrombectomy. In the absence of contraindications, initial treatment of APTE should consist of parenteral anticoagulation with unfractionated heparin. Long-term anticoagulation therapy, usually with warfarin, should be administered according to the individual risk profile of the patient. Thrombolytic therapy may be appropriate for patients with massive APTE with cardiac shock, syncope, etc. Similarly, thrombolysis has been reported to be effective in submassive APTE with right ventricular overload on echocardiography. IVC filters should be reserved for APTE with deep vein thrombosis (DVT) in which there are absolute contraindications to anticoagulation, recurrent thromboemboli despite therapeutic anticoagulation, and status after surgical thrombectomy. Relative indications for IVC filters that require individualized decision making include proximal DVT, especially with free-floating thrombi or in patients with limited cardiopulmonary reserve. For patients with massive APTE with contraindications to anticoagulation or in whom anticoagulation is uneffective, transcatheter aspiration with catheterization or fragmentation using a guidewire and rotating pig-tail catheter can be used. In addition, cardiopulmonary management such as supplemental oxygen, catecholamine administration, percutaneous cardiopulmonary support, etc. may be necessary for individual patients.
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PMID:[Therapy of acute pulmonary thromboembolism from the physician's standpoint]. 1579 33

For an extended period of time various research projects have been conducted on the relationship of hypoxia and haemostasis. The enclosed article contains the conclusion to which extent lack of oxygen can activate the coagulation system and induce a prothrombotic state. The majority of studies proved a shortening of coagulation times during acute exposure to hypoxia, whereas activated parameters of coagulation and fibrinolysis like prothrombin fragment F1+2 as well as thrombin-antithrombin III complexes and D-dimer remained mostly unmodified. It is suggested that a prolonged sojourn at high altitudes could lead to activation of the coagulation system through an increase of haematocrit and blood viscosity. Recently it was proven that people living at high altitudes show an enhanced risk of stroke incidents. The significance of the change in haemostasis on that outcome has not yet been part of the research. However, it has been proven that the activity of the coagulation system does not play a pathophysiological part in the development of acute mountain sickness and high altitude pulmonary edema. Recent studies also demonstrated that moderate hypoxia during long haul flights may not be the main trigger in inducing deep vein thrombosis in passengers.
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PMID:[Interaction of hypoxia and haemostasis--hypoxia as a prothrombotic factor at high altitude?]. 1596 61


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