RESUMO
We present a rare case of pulmonary embolism in a patient with disseminated hypernephroma. Necropsy showed a large tumor thrombus in the right ventricle. Modern chemotherapy treatments, whilst improving patient's life expectancy to a certain degree don't hinder the spread of metastases which appear then in areas not previously known of. Providing there are no obvious signs of peripheral thrombi and to exclude intracardiac metastases, we recommend echocardiography for all cancer patients with pulmonary emboli.
Assuntos
Carcinoma de Células Renais/secundário , Neoplasias Cardíacas/secundário , Neoplasias Renais/patologia , Células Neoplásicas Circulantes/patologia , Embolia Pulmonar/patologia , Carcinoma de Células Renais/patologia , Neoplasias Cardíacas/patologia , Ventrículos do Coração/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Artéria Pulmonar/patologiaRESUMO
A 69-year-old woman was admitted to the hospital for fever of unknown origin with nightsweats and weight loss. Diagnosis of endocarditis lenta with streptococcus viridans and a preexisting mitral-valve prolapse with small regurgitation jet was established. Signs and symptoms of endocarditis lenta are stressed in the discussion. Special attention is given to transesophageal echocardiography and to the connection of endocarditis with mitral-valve prolapse.
Assuntos
Endocardite Bacteriana/diagnóstico , Febre de Causa Desconhecida/etiologia , Transtornos do Sono-Vigília/etiologia , Infecções Estreptocócicas/diagnóstico , Sudorese , Redução de Peso , Idoso , Diagnóstico Diferencial , Endocardite Bacteriana/complicações , Feminino , Humanos , Insuficiência da Valva Mitral/complicações , Insuficiência da Valva Mitral/diagnóstico , Prolapso da Valva Mitral/complicações , Prolapso da Valva Mitral/diagnóstico , Infecções Estreptocócicas/complicaçõesRESUMO
In a Swiss multicentre study for evaluation of heparindihydroergotamine in the prevention of postoperative thromboembolic complications, 3887 patients received dextran 70 for comparison. During this trial monovalent hapten-dextran was introduced in two of the participating centres for clinical evaluation. 701 patients in the trial therefore received either 10 or 20 ml hapten before the first dextran infusion was started. Thus, direct evaluation of the incidence of dextran-induced anaphylactoid reactions in two groups of patients, on receiving hapten prevention and the other not, was possible for the first time. 32 dextran-induced anaphylactoid reactions occurred in the 3186 patients not receiving hapten. The incidence of these reactions is therefore 1%. Four of the reactions were severe and 1 was fatal. In the group of patients receiving hapten there was no reaction either to the dextran infusion or to the hapten injection. According to the zero hypothesis, 7 dextran-induced anaphylactoid reactions were expected.
