BACKGROUND To investigate the incidence of pulmonary embolism and risk factors for this condition after obstetric and gynecologic surgery, as well as the efficacy of intermittent pneumatic compression. METHODS A total of 6,218 patients operated at Keio University Hospital excluding obstetric or infertility-related surgery and uterine cervical conization were evaluated retrospectively to deter...

Major pulmonary embolism occurring insidiously over several weeks (subacute massive pulmonary embolism) has a high mortality and may not respond well to standard anticoagulant or thrombolytic treatment. A priming dose of plasminogen was used to enhance thrombolysis produced by a streptokinase infusion in five consecutive patients with subacute massive pulmonary embolism. In each patient a drama...

The diagnosis of pulmonary embolism may be confounded by a clinical presentation that is often subtle or atypical. Therefore pulmonary angiography, although invasive, has been widely used to prove pulmonary embolism. The aim of this review is to discuss the value of non-invasive techniques, such as lung scan and chest computed tomography scan, in the diagnosis of pulmonary embolism. Ventilation...

Systemic amyloidosis is a rare clinical disorder and can lead to single organ or fatal multiple organ failure, heart and kidneys are the most affected organs. Currently, there are no relevant guidelines and recommendations about the treatment of systemic amyloidosis. Ischemic stroke is an uncommon complication of systemic amyloidosis and patients with systemic amyloidosis may carry a worse prog...

BACKGROUND The prevalence of pulmonary embolism among patients hospitalized for syncope is not well documented, and current guidelines pay little attention to a diagnostic workup for pulmonary embolism in these patients. METHODS We performed a systematic workup for pulmonary embolism in patients admitted to 11 hospitals in Italy for a first episode of syncope, regardless of whether there were...

OBJECTIVE: To assess the value of parameters derived from arterial blood gas tests in the diagnosis of pulmonary embolism. METHOD: We measured alveolar-arterial partial pressure of oxygen [P(A-a)O2] gradient, PaO2 and arterial partial pressure of carbon diaxide (PaCO2) in 773 consecutive patients with suspected pulmonary embolism who were enrolled in the Prospective Investigative Study of Acute...

The natural course of acute pulmonary embolism depends primarily on whether the embolism has been detected and treated [1-4]. The haemodynamic severity of acute pulmonary embolism largely depends on the previous state of the cardiopuLmonary system in patients without any previous cardiopulmonary di ease [1, 5], the degree of haemodynamic severity (e.g. that of pulmonary hypertension) depends ex...

New oral anticoagulants have been shown to be not inferior to vitamin K antagonists in reducing thrombo-embolic events in patients with non-valvular atrial fibrillation and venous thrombo-embolism. However, those among them whichdirectly inhibit thrombin have been associated with greater risk of myocardial infarction. In this article we review the pleiotropic physiological effects of thrombin a...

We report two cases of septic pulmonary embolism associated with periodontitis. Chest CT revealed multiple nodular shadows with features characteristic of septic pulmonary embolism in both patients. Both patients had toothache, fever, and chest pain, and showed findings of periodontitis at initial presentation. Antimicrobial agents combined with dental surgery were successful in treatment. Whil...

Recent clinical studies have shed new light on the diagnosis of venous thromboembolism. Pulmonary embolism continues to be difficult to diagnose because the definitive test, pulmonary angiography, is complex and not widely available. However, new knowledge about ventilation perfusion lung scanning and non-invasive leg studies can help to reduce the need for pulmonary angiography. Furthermore, t...