scholarly journals Urokinase Attenuates Pulmonary Thromboembolism in an Animal Model by Inhibition of Inflammatory Response

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Ying Shi ◽  
Zhirong Zhang ◽  
Danli Cai ◽  
Jing Kuang ◽  
Shuifang Jin ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Animal Model ◽  
Inflammatory Response ◽  
Inflammatory Cell ◽  
Pulmonary Thromboembolism ◽  
Thrombus Formation ◽  
Inflammatory Cells ◽  
Hemodynamic Instability ◽  
Synergistic Action ◽  
Determining Factor

Inflammatory response is an important determining factor for the mortality of patients with pulmonary thromboembolism. Inflammatory mediators can promote thrombus formation and increase hemodynamic instability. Urokinase is a commonly used drug for the treatment of PTE. The effect of urokinase on inflammatory reaction in PTE is still unclear. Our study was aimed at evaluating the effects of the intervention of urokinase and urokinase combined with aspirin in PTE rats. Results revealed that a large amount of infiltrated inflammatory cells surrounding the bronchus, vessels, and pulmonary mesenchyme, and even pulmonary abscess were observed in the PTE rats. CX3CL1/CX3CR1 coexpression, CX3CL1/NF-κB coexpression, and TXA2 were significantly higher. After treatment with urokinase, pulmonary embolism was partially dissolved and inflammatory cell infiltration was significantly reduced. The expression of TNNI3, BNP, D2D, PASP, PADP, PAMP, and TXA2, as well as CX3CL1/CX3CR1 coexpression and CX3CL1/NF-κB coexpression were significantly lowered. Aspirin showed no synergistic action. Therefore, these findings suggested the occurrence of inflammation during the process of PTE in rats. Urokinase treatment reduced the inflammatory response.

Advanced Management Options for Massive and Submassive Pulmonary Embolism

2016 ◽  
Vol 10 (1) ◽  
pp. 30 ◽  
Author(s):  
Sonika Malik ◽  
◽  
Anju Bhardwaj ◽  
Matthew Eisen ◽  
Sanjay Gandhi ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Vena Cava ◽  
Right Ventricular Dysfunction ◽  
Hemodynamic Instability ◽  
Adverse Outcomes ◽  
Intermediate Risk ◽  
Management Options ◽  
Vena Cava Filters ◽  
Submassive Pulmonary Embolism ◽  
Risk Patients

Pulmonary embolism (PE) is an important cause of morbidity and mortality and presents with significant diagnostic and therapeutic challenges. Clinical presentation ranges from mild, nonspecific symptoms to syncope, shock, and sudden death. Patients with hemodynamic instability and/ or signs of right ventricular dysfunction are at high risk for adverse outcomes and may benefit from aggressive therapy and support. Therapeutic anticoagulation is indicated in all patients in the absence of contraindications. Thrombolysis should be strongly considered in selected high- and intermediate-risk patients, either by systemic infusion or percutaneous catheter-directed therapy. Other therapeutic modalities, such as vena cava filters and surgical embolectomy, are options for patients who fail or cannot tolerate anticoagulation and/or thrombolysis. This article reviews the assessment and advanced management options for acute PE with focus on high- and intermediate-risk patients.

scholarly journals Postmortem Demonstration of the Source of Pulmonary Thromboembolism: The Importance of the Autopsy

2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
Gina Elhammady ◽  
Andrew T. Schubeck ◽  
Vicky El-Najjar ◽  
Morton J. Robinson
Keyword(s):  
Pulmonary Embolism ◽  
Pulmonary Thromboembolism ◽  
Postmortem Examination ◽  
Pelvic Vein ◽  
Vein Thrombosis ◽  
Potential Source ◽  
Venous Thromboses

Periprostatic or paravaginal venous thromboses are rarely considered clinically as sites of clot origin in patients with pulmonary thromboembolism. The majority of emboli have been demonstrated to originate in the veins of the legs. This report raises awareness of pelvic vein thrombosis as a potential source of pulmonary embolism that is rarely considered or detected clinically, and which usually requires postmortem examination for recognition. It also reviews the possible routes emboli may take to reach the lungs.

Risk Stratification in Acute Pulmonary Embolism: The Latest Algorithms

2021 ◽  
Vol 42 (02) ◽  
pp. 183-198
Author(s):  
Georgios A. Triantafyllou ◽  
Oisin O'Corragain ◽  
Belinda Rivera-Lebron ◽  
Parth Rali
Keyword(s):  
Pulmonary Embolism ◽  
Risk Stratification ◽  
Prediction Models ◽  
Bleeding Risk ◽  
Hemodynamic Instability ◽  
Reperfusion Therapy ◽  
Mortality Prediction ◽  
Risk Scores ◽  
Short Term Mortality ◽  
Urgent Patient

AbstractPulmonary embolism (PE) is a common clinical entity, which most clinicians will encounter. Appropriate risk stratification of patients is key to identify those who may benefit from reperfusion therapy. The first step in risk assessment should be the identification of hemodynamic instability and, if present, urgent patient consideration for systemic thrombolytics. In the absence of shock, there is a plethora of imaging studies, biochemical markers, and clinical scores that can be used to further assess the patients' short-term mortality risk. Integrated prediction models incorporate more information toward an individualized and precise mortality prediction. Additionally, bleeding risk scores should be utilized prior to initiation of anticoagulation and/or reperfusion therapy administration. Here, we review the latest algorithms for a comprehensive risk stratification of the patient with acute PE.

Evaluation of Inflammatory Response of EDTA, EDTA-T, and Citric Acid in Animal Model

2010 ◽  
Vol 36 (3) ◽  
pp. 515-519 ◽  
Author(s):  
Míriam F. Zaccaro Scelza ◽  
Viviane Santos da Silva Pierro ◽  
Mauricio Alves Chagas ◽  
Licinio Esmeraldo da Silva ◽  
Pantaleo Scelza
Keyword(s):  
Animal Model ◽  
Citric Acid ◽  
Inflammatory Response

Use of Vicryl (Polyglactin 910) Mesh to Limit Epidural Scar Formation after Laminectomy

Neurosurgery ◽  
1990 ◽  
Vol 26 (4) ◽  
pp. 649-654 ◽  
Author(s):  
Charles E. Nussbaum ◽  
Joseph V. McDonald ◽  
Raymond B. Baggs
Keyword(s):  
Inflammatory Response ◽  
Subcutaneous Fat ◽  
Inflammatory Cells ◽  
Scar Formation ◽  
Good Survival ◽  
Polyglactin 910 ◽  
Chronic Inflammatory Response ◽  
Fat Grafts ◽  
Free Grafts ◽  
Vicryl Mesh

Abstract A variety of substances have been used at laminectomy sites to prevent postoperative epidural scarring. Free grafts of autologous subcutaneous fat are commonly used both clinically and experimentally. The free fat grafts usually survive, but decrease in size by about 50%. Postoperatively, subcutaneous seroma has been observed with the use of fat grafts, as well as recurrent symptoms of neural compression by the graft that required additional operations. When compared to the use of free fat grafts after laminectomy in dogs, Vicryl mesh produced slightly more scarring, but consistently less than that observed in control animals. The Vicryl mesh was resorbed by a minimal chronic inflammatory response over about 45 days. Seven of 11 fat-grafted zones showed signs of necrosis, at times with a greater collection of inflammatory cells than that associated with the Vicryl mesh. Of the 4 fat-grafted zones that showed good survival. 2 had gross evidence of neural compression. No surgical zone treated with Vicryl mesh exhibited evidence of neural compression. In view of these results, the use of Vicryl mesh at laminectomy sites may be a safer method of limiting postoperative epidural scar formation.

On postpartum pulmonary embolism

1934 ◽  
Vol 30 (10) ◽  
pp. 1027-1029
Author(s):  
A. I. Petchenko
Keyword(s):  
Pulmonary Embolism ◽  
Blood Flow ◽  
Blood Loss ◽  
Postpartum Period ◽  
Vascular Tone ◽  
Thrombus Formation ◽  
Obstetrics And Gynecology ◽  
Vascular Thrombosis ◽  
Vein Thrombosis

Vascular thrombosis in obstetrics and gynecology is quite common, although not always easy to recognize. In the postpartum period, after many vaginal operations we have massive thrombus formation. Placental vein thrombosis is almost physiological; slowed blood flow, decreased vascular tone after the fetus emerges, blood loss are predisposing moments to thrombosis formation in the postpartum period.

scholarly journals The Flavonoid Isoliquiritigenin Reduces Lung Inflammation and Mouse Morbidity during Influenza Virus Infection

2015 ◽  
Vol 59 (10) ◽  
pp. 6317-6327 ◽  
Author(s):  
Hussein Traboulsi ◽  
Alexandre Cloutier ◽  
Kumaraswamy Boyapelly ◽  
Marc-André Bonin ◽  
Éric Marsault ◽  
...  
Keyword(s):  
Influenza Virus ◽  
Virus Infection ◽  
Inflammatory Response ◽  
Lung Inflammation ◽  
Inflammatory Cell ◽  
Influenza Virus Infection ◽  
Cytokine Gene Expression ◽  
Cell Recruitment ◽  
Inflammatory Cell Recruitment ◽  
Anti Inflammatory

ABSTRACTThe host response to influenza virus infection is characterized by an acute lung inflammatory response in which intense inflammatory cell recruitment, hypercytokinemia, and a high level of oxidative stress are present. The sum of these events contributes to the virus-induced lung damage that leads to high a level of morbidity and mortality in susceptible infected patients. In this context, we identified compounds that can simultaneously reduce the excessive inflammatory response and the viral replication as a strategy to treat influenza virus infection. We investigated the anti-inflammatory and antiviral potential activities of isoliquiritigenin (ILG). Interestingly, we demonstrated that ILG is a potent inhibitor of influenza virus replication in human bronchial epithelial cells (50% effective concentration [EC50] = 24.7 μM). In addition, our results showed that this molecule inhibits the expression of inflammatory cytokines induced after the infection of cells with influenza virus. We demonstrated that the anti-inflammatory activity of ILG in the context of influenza virus infection is dependent on the activation of the peroxisome proliferator-activated receptor gamma pathway. Interestingly, ILG phosphate (ILG-p)-treated mice displayed decreased lung inflammation as depicted by reduced cytokine gene expression and inflammatory cell recruitment. We also demonstrated that influenza virus-specific CD8+effector T cell recruitment was reduced up to 60% in the lungs of mice treated with ILG-p (10 mg/kg) compared to that in saline-treated mice. Finally, we showed that administration of ILG-p reduced lung viral titers and morbidity of mice infected with the PR8/H1N1 virus.

Proteases from Inflammatory Cells: Regulation of Inflammatory Response

2011 ◽  
pp. 73-100 ◽  
Author(s):  
Magali Pederzoli-Ribeil ◽  
Julie Gabillet ◽  
Véronique Witko-Sarsat
Keyword(s):  
Inflammatory Response ◽  
Inflammatory Cells

Portable Ventilation/Perfusion Scanning is Useful for Evaluating Clinically Significant Pulmonary Embolism in the ICU Despite Abnormal Chest Radiography

2018 ◽  
Vol 35 (10) ◽  
pp. 1032-1038 ◽  
Author(s):  
Aaron S. Weinberg ◽  
William Chang ◽  
Grace Ih ◽  
Alan Waxman ◽  
Victor F. Tapson
Keyword(s):  
Pulmonary Embolism ◽  
Chest Radiograph ◽  
High Probability ◽  
Hemodynamic Instability ◽  
X Rays ◽  
X Ray ◽  
Abnormal Chest ◽  
Chest X Ray ◽  
Low Probability ◽  
Clinically Significant

Objective: Computed tomography angiography is limited in the intensive care unit (ICU) due to renal insufficiency, hemodynamic instability, and difficulty transporting unstable patients. A portable ventilation/perfusion (V/Q) scan can be used. However, it is commonly believed that an abnormal chest radiograph can result in a nondiagnostic scan. In this retrospective study, we demonstrate that portable V/Q scans can be helpful in ruling in or out clinically significant pulmonary embolism (PE) despite an abnormal chest x-ray in the ICU. Design: Two physicians conducted chart reviews and original V/Q reports. A staff radiologist, with 40 years of experience, rated chest x-ray abnormalities using predetermined criteria. Setting: The study was conducted in the ICU. Patients: The first 100 consecutive patients with suspected PE who underwent a portable V/Q scan. Interventions: Those with a portable V/Q scan. Results: A normal baseline chest radiograph was found in only 6% of patients. Fifty-three percent had moderate, 24% had severe, and 10% had very-severe radiographic abnormalities. Despite the abnormal x-rays, 88% of the V/Q scans were low probability for a PE despite an average abnormal radiograph rating of moderate. A high-probability V/Q for PE was diagnosed in 3% of the population despite chest x-ray ratings of moderate to severe. Six patients had their empiric anticoagulation discontinued after obtaining the results of the V/Q scan, and no anticoagulation was started for PE after a low-probability V/Q scan. Conclusion: Despite the large percentage of moderate-to-severe x-ray abnormalities, PE can still be diagnosed (high-probability scan) in the ICU with a portable V/Q scan. Although low-probability scans do not rule out acute PE, it appeared less likely that any patient with a low-probability V/Q scan had severe hypoxemia or hemodynamic instability due to a significant PE, which was useful to clinicians and allowed them to either stop or not start anticoagulation.

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