Venous Thromboembolic Disease: DVT and PE

Abstract

Deep venous thrombosis (DVT) and pulmonary emboli (PE) are usually considered the same disease, namely, thromboembolic disease (TED), as a large proportion of patients with DVT have "asymptomatic" PE and about 40 % of patients with PE have "asymptomatic DVT". Furthermore, in most instances the treatment is the same. TED is a common disorder that carries a high mortality rate. In a population based study performed in Canada, Tagalakis and colleagues reported an incidence of venous thromboembolism of 0.90 per 1,000 person-years; the 30-day and 1-year case-fatality rates were 10.6 % and 23.0 % respectively [ 1 ]. The 1-year survival rate was 47 % in patients with cancer, 93 % in patients with unprovoked venous thromboembolism and 84 % in patients with venous thromboembolism secondary to a major risk factor. In this study 62 % of cases were associated with a major risk factor, with cancer, hospitalization, and surgery being the most common. In the International Cooperative Pulmonary Embolism Registry (ICOPER), all-cause mor ta lity rate at 3 month was 17 % [ 2 ]. PE was considered to be the cause of death in 45 % of patients. Important prognostic factors associated with death from pulmonary embolism were age older than 70 years, cancer, congestive heart failure, chronic obstructive pulmonary disease, systolic arterial hypotension, tachypnea, and right ventricular hypokinesis on echocardiography.

Shared and Distinct Aspects of the Sepsis Transcriptomic Response to Fecal Peritonitis and Pneumonia

“…In fecal peritonitis (FP), sepsis is triggered by a polymicrobial infection within the peritoneal cavity, complicated by the release of damage-associated molecular patterns (DAMPs) and the effects of anesthesia (14). Conversely, CAP is caused by specific bacterial or atypical pathogens, and it is commonly preceded or caused by viral infection (15). Antibiotic choice, such as macrolides for CAP, may also have immunomodulatory effects (16,17).…”

The importance of salivary cortisol in the diagnosis of adrenal insufficiency in cirrhosis

“…It has critical roles in the maintenance of normal functions in the immune system, vascular tone, cardiac output, metabolic states, and several other cellular processes (1,2). The prevalence of adrenal insufficiency (AI) has been reported to be 66% in decompensated cirrhosis, 33% in acute liver failure, 72% in patients in transplantation centers, 51% in cirrhotic patients with sepsis, 68-77% in cirrhotic patients with septic shock, and 38% in stable cirrhotic patients without any hemodynamic instability (1,(3)(4)(5)(6)(7).…”