Accurate risk stratification of normotensive patients with acute pulmonary embolism (PE) require further investigation. We aimed to develop a simple model using clinical (shock index) and laboratory findings (cardiac Troponin, echocardiography) to assess the risk of 30-day mortality in normotensive patients with acute PE. In this retrospective study, 489 normotensive patients with acute PE diagnosed objectively. The primary end-point was defined as a all cause 30-day mortality. Shock index was calculated on admission. The primary end-point occurred in 67 (13.7%, 95% CI 10.7-16.8) patients with acute PE. Predictors of complications included elevated cardiac troponin (OR 1.7, 95% CI 1.3-2.2) and shock index (OR 1.3, 95% CI 1.1-1.5) by multivariable analysis. Risk index point was created based on OR. The model identified stages (stage I: 0-1 point, stage II: 2 points and stage III: 3 point) with 30-day mortality rates of 4.3, 19 and 38.6 %, respectively. The shock index and cardiac troponin can be safely used in combination to determine intermediate risk in patients with PE in emergency departmant. The study provided observations that will require prospective validation before the proposed risk score is adopted in clinical practice.

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Summary. It appears that women classed as having pre-eclamptic toxaemia are less frequently consanguineous with their husbands than all other mothers and in particular those mothers classed as having pregnancies complicated by chronic hypertensive disease. Search revealed no evidence for possible biases which could have simulated such findings.Further evidence is advanced suggesting that, though pre-eclamptic toxaemia is more common in all types of twin pregnancies than in single births, it is more common where the twins are dizygous than where they are monozygous.It is pointed out that both these findings would be expected if there was a contribution to the aetiology of pre-eclamptic toxaemia by maternal/fetal immunological incompatibility. However, if such a mechanism exists it is not always determined at the same gene locus. (1971) concluded that the proportion of women who had pre-eclamptic toxaemia who were related to their husbands was significantly less than in the other patients.By early 1973, 23 416 mothers with single pregnancies and 271 with twin pregnancies had been studied. Basic information concerning these patients is set out in Table I. Records in respect of 58 of the patients with single pregnancies were incomplete in respect of one or more of the variables presented in subsequent tables, so these forms were ignored and the total in subsequent tables is 23 358.Ten women (none classified as having pre-eclamptic toxaemia) were identified as having been admitted for two pregnancies during the period of the study.

Objectives: Pulmonary artery stump thrombosis (PAST) following pneumonectomies/lobectomies is rare and the clinical importance is unknown. The objectives of this study were to analyse the prevalence and risk factors of PAST and the clinical significance (follow-up, treatment, resolution, etc.) in patients with pneumonectomy/lobectomy. Methods: All adult cases who underwent pneumonectomy/lobectomy in our hospital for any reason, and who underwent control contrast-enhanced thoracic CT during the follow-up period were included in the study. Demographic and clinical features of the patients, data about surgery and the features of thrombi were recorded. Results: During the 4-years study period, a total of 454 patients underwent pneumonectomy/lobectomy (93 pneumonectomy, 361 lobectomy). Among the patients, 202 patients (50 pneumonectomy, 152 lobectomy) with at least one follow-up thorax CT were included into the analyses. PAST was detected in 9 (4.5%) of 202 patients and mostly seen in patients with pneumonectomy (lobectomy: 2.6% vs. pneumonectomy: 10%, p=0.043) and in patients whose pulmonary artery were ligated by stapler (suture ligation 1% vs. stapler: 7.4%, p=0.034). Pulmonary artery stump was also longer in patients with PAST (8.48±11.22 mm vs. 23.55±11.22 mm, p<0.001). Univariate logistic regression analysis showed that pneumonectomy and longer pulmonary artery stump length were found to be significantly associated with PAST (p= 0.041 and p= 0.001, respectively). Conclusions: In conclusion, PAST were detected in 4.5% of our subjects undergoing lobectomy/pneumonectomy. PAST was found to be significantly higher in subjects who underwent pneumonectomy, those with longer pulmonary artery stump, and those with pulmonary artery stump ligated by stapler.

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OBJECTIVES:In the last 20 years, with the use of computed tomography (CT) angiography, the number of patients diagnosed with pulmonary thromboembolism (PTE) has increased. At the same time, data show that pulmonary embolism mortality has also reduced in this duration. MATERIAL AND METHODS:In this study, we analyzed records of patients with PTE (using ICD's) in the hospital automation system from 2001 to 2013. Data regarding age, sex, date of diagnosis, diagnosis of cancer, hemodynamic status, initial and maintenance treatment, hospital length of stay, and hospital mortality were recorded. Primary endpoints of the study were hospital length of stay and all-cause hospital mortality. RESULTS:The total number of patients included in the study was 1185. The median age was 61 years in 2001 and 71 years in 2013. The number of patients who were diagnosed using CT increased from 10% to 92.8%. Between 2001 and 2013, the number of patients diagnosed with PTE increased, and of all patients with PTE, 13.7% was diagnosed in 2009. The hospital length of stay of 13 days declined to 9 days. The use of a vena cava filter in 2007 was 1.1% and that in 2013 was 4.6%. Mortality rate was 15%, however hospital mortality did not significantly differ over the years but varied between 9.4% and 18.8%. Increased use of thrombolytics in patients with massive PTE has been observed over the years. Massive PTE ratio in 2006 was 8.5% and thrombolytic use was 5.8%, however in 2013, these ratios were 2.6%, 6% respectively (p=0.017). CONCLUSION:Finally, despite the increased number of patients diagnosed with PTE over the years, the mortality rate was not observed to have changed from 2001 to 2013. KEYWORDS:Pulmonary thromboembolism, heparin, thrombolytic, mortality, incidence INTRODUCTIONPulmonary thromboembolism (PTE) is an important public health concern that causes mortality and morbidity. Its non-specific symptoms and findings lead to difficulties in confirming its diagnosis. However, with the use of computed tomography (CT) angiography in recent years, an important step has been taken in the diagnosis of PTE. Moreover, improvements, such as the development of new anticoagulants and mechanical interventions, have occurred in the treatment of PTE. In parallel with all these improvements, data on the incidence and outcomes of the disease seems to be restricted.In a study conducted in USA the incidence of PTE was reported to increase from 23/100,000 to 65/100,000 [1]. On the other hand, in a study conducted in Canada, no significant change was observed in the incidence of PTE in the last decade [2]. A study was conducted on 60853 patients in Italy, and an increase was found in the incidence of PTE in the last 10 years [3]. In our study, the data of patients diagnosed with PTE between 2001 and 2013 were obtained from hospital recordings and were analyzed. MATERIAL AND METHODSIn our study, the records of patients diagnosed with PTE between 2001 and 2013 were obtained from the hospital's automations system (with the International Classification of Di...

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