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PULMONARY EMBOLISM and Naproxen

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PULMONARY EMBOLISM Symptoms and Causes

What is a pulmonary embolism (PE)?

A pulmonary embolism (PE) is a sudden blockage in a lung artery. It usually happens when a when a blood clot breaks loose and travels through the bloodstream to the lungs. PE is a serious condition that can cause

  • Permanent damage to the lungs
  • Low oxygen levels in your blood
  • Damage to other organs in your body from not getting enough oxygen

PE can be life-threatening, especially if a clot is large, or if there are many clots.

What causes a pulmonary embolism (PE)?

The cause is usually a blood clot in the leg called a deep vein thrombosis that breaks loose and travels through the bloodstream to the lung.

Who is at risk for a pulmonary embolism (PE)?

Anyone can get a pulmonary embolism (PE), but certain things can raise your risk of PE:

  • Having surgery, especially joint replacement surgery
  • Certain medical conditions, including
    • Cancers
    • Heart diseases
    • Lung diseases
    • A broken hip or leg bone or other trauma
  • Hormone-based medicines, such as birth control pills or hormone replacement therapy
  • Pregnancy and childbirth. The risk is highest for about six weeks after childbirth.
  • Not moving for long periods, such as being on bed rest, having a cast, or taking a long plane flight
  • Age. Your risk increases as you get older, especially after age 40.
  • Family history and genetics. Certain genetic changes that can increase your risk of blood clots and PE.
  • Obesity
What are the symptoms of a pulmonary embolism (PE)?

Half the people who have pulmonary embolism have no symptoms. If you do have symptoms, they can include shortness of breath, chest pain or coughing up blood. Symptoms of a blood clot include warmth, swelling, pain, tenderness and redness of the leg.

How is a pulmonary embolism (PE) diagnosed?

It can be difficult to diagnose PE. To make a diagnosis, your health care provider will

  • Take your medical history, including asking about your symptoms and risk factors for PE
  • Do a physical exam
  • Run some tests, including various imaging tests and possibly some blood tests
What are the treatments for a pulmonary embolism (PE)?

If you have PE, you need medical treatment right away. The goal of treatment is to break up clots and help keep other clots from forming. Treatment options include medicines and procedures.

Medicines

  • Anticoagulants, or blood thinners, keep blood clots from getting larger and stop new clots from forming. You might get them as an injection, a pill, or through an I.V. (intravenous). They can cause bleeding, especially if you are taking other medicines that also thin your blood, such as aspirin.
  • Thrombolytics are medicines to dissolve blood clots. You may get them if you have large clots that cause severe symptoms or other serious complications. Thrombolytics can cause sudden bleeding, so they are used if your PE is serious and may be life-threatening.

Procedures

  • Catheter-assisted thrombus removal uses a flexible tube to reach a blood clot in your lung. Your health care provider can insert a tool in the tube to break up the clot or to deliver medicine through the tube. Usually you will get medicine to put you to sleep for this procedure.
  • A vena cava filter may be used in some people who cannot take blood thinners. Your health care provider inserts a filter inside a large vein called the vena cava. The filter catches blood clots before they travel to the lungs, which prevents pulmonary embolism. But the filter does not stop new blood clots from forming.
Can pulmonary embolism (PE) be prevented?

Preventing new blood clots can prevent PE. Prevention may include

  • Continuing to take blood thinners. It's also important to get regular checkups with your provider, to make sure that the dosage of your medicines is working to prevent blood clots but not causing bleeding.
  • Heart-healthy lifestyle changes, such as heart-healthy eating, exercise, and, if you smoke, quitting smoking
  • Using compression stockings to prevent deep vein thrombosis (DVT)
  • Moving your legs when sitting for long periods of time (such as on long trips)
  • Moving around as soon as possible after surgery or being confined to a bed

NIH: National Heart, Lung, and Blood Institute

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PULMONARY EMBOLISM Clinical Trials and Studies

Treatments might be new drugs or new combinations of drugs, new surgical procedures or devices, or new ways to use existing treatments. The goal of clinical trials is to determine if a new test or treatment works and is safe. Clinical trials can also look at other aspects of care, such as improving the quality of life for people with chronic illnesses. People participate in clinical trials for a variety of reasons. Healthy volunteers say they participate to help others and to contribute to moving science forward. Participants with an illness or disease also participate to help others, but also to possibly receive the newest treatment and to have the additional care and attention from the clinical trial staff.
Rank Status Study
1 Recruiting Naproxen in Preventing DNA Mismatch Repair Deficient Colorectal Cancer in Patients With Lynch Syndrome
Condition: Precancerous Condition
Interventions: Drug: Naproxen;   Other: placebo;   Other: laboratory biomarker analysis
Outcome Measures: Change in PGE2 concentration levels in normal colorectal mucosa;   Minimal biologically effective dose of Naproxen defined by modulation of PGE2 levels;   Response defined as >= 30% reduction in PGE2 levels;   Incidence of toxicity graded according to National Cancer Institute Common Criteria for Adverse Events (NCI CTCAE) version 4.0;   Naproxen concentrations in plasma samples;   Naproxen concentrations in normal colorectal mucosa;   PGE-M levels in urine samples;   Change in number of polyps observed in the rectosigmoid area;   Changes in the microRNA profile of the normal colorectal mucosa;   Changes in gene expression mRNA profiles of the normal colorectal mucosa;   Changes in the mutational rate of the normal colorectal mucosa
2 Unknown  Trial of Naproxen to Evaluate Various Methods of Measuring Analgesic Effect in Osteoarthritis Pain of the Knee
Condition: Osteoarthritis, Knee
Interventions: Drug: Naproxen;   Drug: Placebo
Outcome Measures: Efficacy of Naproxen vs. placebo;   Safety
3 Not yet recruiting Efficacy and Safety of a Fixed-dose Combination of Naratriptan and Naproxen in Acute Treatment of Migraine.
Conditions: Migraine;   Headache
Interventions: Drug: naratriptan + Naproxen;   Drug: naratriptan;   Drug: Naproxen
Outcome Measures: Headache relief 2 hours after dosing, without use of rescue medication;   Headache relief 4 hours after dosing, without use of rescue medication;   Maintenance of pain relief between 2 and 24 hours after dosing, without use of rescue medication;   Pain-free response 2 and 4 hours after dosing, without use of rescue medication;   Maintenance of pain-free response between 2 and 24 hours, without use of rescue medication;   Freedom from nausea, vomiting, photophobia and phonophobia 2 and 4 hours after dosing;   Maintenance of freedom from nausea, vomiting, photophobia and phonophobia between 2 and 24 hours after dosing, without use of rescue medication;   Recurrence of pain between 2 and 24 hours after dosing, without use of rescue medication;   Proportion of subjects who used rescue medication between 2 and 24 hours after dosing, at least once;   Safety descriptive about occurence of adverse events, evaluation of results of general physical examination.
4 Unknown  Efficacy and Safety of a Fixed-dose Combination of Naratriptan and Naproxen in Acute Treatment of Migraine
Conditions: Migraine;   Headache
Interventions: Drug: Fixed-dose combination of naratriptan + Naproxen;   Drug: Naratriptan;   Drug: Naproxen
Outcome Measures: Headache relief 2 hours after dosing, without use of rescue medication.;   Headache relief 4 hours after dosing, without use of rescue medication;   Sustained headache relief over 24 hours, without use of rescue medication;   Pain-free response 2 and 4 hours after dosing, without use of rescue medication;   Sustained pain-free response over 24 hours, without use of rescue medication;   Freedom from photophobia, phonophobia and nausea 2 and 4 hours after dosing, without use of rescue medication;   Sustained freedom from photophobia, phonophobia and nausea from 2 through 24 hours after dosing, without use of rescue medication;   Proportion of subjects who used rescue medication between 2 and 24 hours after dosing, at least once;   Safety descriptive about occurence of adverse events, evaluation of results of general physical examination.
5 Recruiting Celecoxib Versus Naproxen for Prevention of Recurrent Ulcer Bleeding in Arthritis Patients
Conditions: Arthritis;   Cardiovascular Diseases;   Cerebrovascular Disorders
Interventions: Drug: Celecoxib(drug);   Drug: Naproxen(drug)
Outcome Measures: Recurrent ulcer bleeding within 78 weeks according to pre-specified criteria;   Cardiovascular events
6 Recruiting NOLAN: Naproxen or Loratadine and Neulasta
Condition: Bone Pain in Stage I - III Breast Cancer
Interventions: Drug: Naproxen;   Drug: Loratadine
Outcome Measures: Bone pain (all grade) in cycle 1;   Bone pain (all grade) by cycle (2-4) and across cycles;   Severe (grade 3/4) bone pain by cycle and across cycles;   Subject reported bone pain;   Maximum Subject Reported bone pain;   Area under the Curve for subject-reported bone pain;   Adverse Event and Serious Adverse Events;   Severity of Adverse Events
7 Unknown  Naproxen for Acute Pain After Surgery: A Randomized, Placebo-Controlled Trial
Condition: Pain, Postoperative
Interventions: Drug: Naproxen;   Drug: placebo
Outcome Measures: cumulative opiate dose administered, as recorded on the computerized medication administration record (CMAR);   patient reported pain scores;   side effects of study medication and opiate analgesia
8 Recruiting The Effect of Non-Steroidal Anti-Inflammatory Drug Naproxen on Pleural Effusion Formation After Lung Resection
Conditions: Pleural Effusion;   Pleural Effusion Malignant
Interventions: Drug: Naproxen;   Drug: Placebo
Outcome Measures: Change in volume of pleural effusion collected;   Hospital length of stay; compared between intervention and control arms;   Gastrointestinal complications;   General re-admission rates;   Total number of days chest tubes remain in-situ
9 Recruiting Prospective Randomized Evaluation Of Celecoxib Integrated Safety Vs Ibuprofen Or Naproxen
Condition: Arthritis, Rheumatoid
Interventions: Drug: celecoxib;   Drug: Ibuprofen;   Drug: Naproxen
Outcome Measures: The first occurrence of cardiovascular death (including hemorrhagic death), non-fatal myocardial infarction, or non-fatal stroke (APTC composite endpoint).;   The occurrence of Clinical Significant Gastrointestinal Events (CSGIEs);   Patient's Assessment of Arthritis Pain (VAS);   The first occurrence of a MACE defined as the composite of cardiovascular death (including hemorrhagic death), non-fatal MI, non-fatal stroke, hospitalization for UA, revascularization or hospitalization for TIA
10 Not yet recruiting Effect of L-dopa In Subacute Back Pain Population
Condition: Sub-acute Back Pain
Interventions: Drug: Naproxen;   Drug: Carbidopa/Levodopa;   Drug: Placebo
Outcome Measure: VAS pain scale
11 Not yet recruiting Colchicine Or Naproxen Treatment for ACute gouT
Condition: Gout
Interventions: Drug: Low-dose colchicine;   Drug: Naproxen
Outcome Measure: Change in pain intensity
12 Not yet recruiting Efficacy of Co-administration of an NSAID With a Dopamine Agonist In Healthy Subjects
Condition: Acute Pain
Interventions: Drug: Naproxen;   Drug: Sinemet;   Drug: Placebo
Outcome Measure: VAS pain scale
13 Recruiting Efficacy of Sumatriptan With Naprosyn in Migraine With Aura
Condition: Migraine With Aura
Interventions: Drug: sumatriptan with naprosyn;   Drug: placebo
Outcome Measures: Primary outcome measure will be comparative percentage of patients pain free at 2 and 4 hours from initiating treatment with placebo vs treatment with Treximet (sumatriptan with naprosyn).;   Secondary outcomes will be percentage of patients with pain relief at 2 and 4 hours.
14 Recruiting A Safety Study of VIMOVO in Adolescents With Juvenile Idiopathic Arthritis (JIA)
Condition: Juvenile Idiopathic Arthritis (JIA)
Interventions: Drug: VIMOVO 250/20;   Drug: VIMOVO 375/20;   Drug: VIMOVO 500/20
Outcome Measures: Incidence of severity of AEs and SAEs.;   Change in serum iron/total iron binding capacity (serum iron/TIBC), Vitamin B12, and magnesium.;   Change from baseline in vital signs, physical examination results and clinical laboratory tests.;   Pharmacokinetic (PK) in terms of characteristics of VIMOVO (Naproxen / esomeprazole).
15 Not yet recruiting Placebo In Chronic Pain
Condition: Chronic Back Pain
Interventions: Drug: Naproxen;   Drug: Placebo;   Drug: Omeprazole
Outcome Measure: VAS pain scale
16 Recruiting Low Level Laser Therapy Versus Pharmacotherapy in in Improving Masticatory Muscle Pain
Condition: TMD
Interventions: Radiation: low level laser therapy;   Drug: Naproxen
Outcome Measure: reduction of paim measured by VAS
17 Recruiting Comparison Of Ketorolac Tromethamine Versus Naproxen For Moderate to Severe Back Pain Treatment
Condition: Back Pain
Interventions: Drug: Ketorolac Tromethamine;   Drug: Naproxen
Outcome Measures: Efficacy of treatment in back pain relief based on Visual Analog Scale (VAS).;   Safety will be evaluated by the adverse events occurrences
18 Not yet recruiting Comparison Of Ketorolac Tromethamine Oral Drops Versus Naproxen For Moderate to Severe Back Pain Treatment
Condition: Back Pain
Interventions: Drug: Ketorolac Tromethamine;   Drug: Naproxen
Outcome Measures: Efficacy of treatment in back pain relief based on Visual Analogic Score (VAS).;   Safety will be evaluated by the adverse events occurrences
19 Recruiting A Randomized Study of Three Medication Regimens for Acute Low Back Pain
Condition: Acute Low Back Pain
Interventions: Drug: Naproxen;   Drug: Cyclobenzaprine;   Drug: Oxycodone/ acetaminophen
Outcome Measure: Roland Morris low back pain functional disability scale
20 Unknown  Ictal and Interictal Inflammatory Markers in Migraine
Condition: Migraine
Interventions: Drug: sumatriptan/Naproxen sodium;   Drug: Placebo
Outcome Measure: Blood levels of proteins will be evaluated at baseline when subjects are pain-free and then repeated during an acute attack, both prior to drug administration and then at 30 minutes, 1 hour and 2 hours after acute treatment.