Background
Recent studies seem to confirm the relationship between residual pulmonary obstruction (RPO) in pulmonary embolism (PE) and risk of recurrent thrombosis and chronic thromboembolic pulmonary hypertension (CTEPH). However, the prognostic factors associated with PE resolution on follow‐up computed tomography angiography (CTA) are not clear.
Objectives
To determine the prognostic factors of resolution of PE diagnosed and monitored by CTA and the impact of RPO on late complications.
Methods
We retrospectively analyzed 241 patients with PE who had undergone a 12‐month follow‐up and CT scan evaluation at 6 months. Factors related to resolution and the impact of RPO on the outcome were analyzed.
Results
Resolution was achieved in 74.3% of all cases after 6 months of treatment. Absence of chronic obstructive pulmonary disease (COPD) (OR, 3.22 [1.35–7.71]; p = 0.009), provoked PE (OR, 2.02 [1.08–3.79]; p = 0.028), early initiation of treatment (<7 days) (OR, 2.42 [1.22–4.78]; p = 0.011), and degree of obstruction caused by the initial PE as indicated by a Qanadli score lower than 16 (OR, 2.12 [1.03–4.37]; p = 0.043) were associated with complete resolution. RPO was associated with recurrent PE as well as the combined endpoint consisting of recurrent VTE and/or CTEPH (4.67 [95% CI, 1.26–17.26]; p = 0.02) and (OR 6.4 [95% CI, 1.9–21.2]; p < 0.005), respectively.
Conclusions
Resolution of PE is associated with a lower risk of recurrent thrombosis. Earlier initiation of treatment improves prognosis as measured by resolution on follow‐up CTA.
Protein kinase activity of intact, motile sperm was assessed by measuring the transfer of the terminal phosphate from [32P]ATP to tricholoroacetic acid (TCA)-precipitable casein. The action of TEST (TES and Tris) yolk buffer (TYB) treatment on phosphorylation of sperm and TYB proteins was studied by detecting labelled phosphoproteins by autoradiography of polyacrylamide gel electrophoresis (PAGE). Results demonstrate that intact, forward-motile sperm have cell surface protein kinase activities. Although the difference between the kinase activity of freshly ejaculated sperm and sperm incubated in TYB was not significant, the protein phosphorylation during incubation in TYB showed that: (i) specific sperm surface proteins were phosphorylated to different degrees during the course of treatment; (ii) TYB proteins were phosphorylated by sperm during incubation; (iii) solubilised [32P]-labelled surface proteins were similar in molecular weight to TYB-labelled proteins. Taking into account that specific proteins on the human sperm surface undergo phosphorylation during incubation in TYB and that the sperm enzyme also acts specifically on some TYB proteins that become attached to the surface of the sperm, working hypotheses are proposed that suggest some correlation between the preservation of semen in TYB and the phosphorylation of proteins by intact human sperm.
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