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PULMONARY EMBOLISM and Thyroid

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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 Unknown  Thyroid Hormone Dose Adjustment in Pregnancy
Conditions: Pregnancy;   Hypothyroidism
Interventions: Drug: Anticipatory dose increase of levothyroxine;   Drug: levothyroxine
Outcome Measures: proportion of patients in each treatment arm euthyroid through gestation;   the proportion of patients in each arm who required, and the gestation week at which, levothyroxine dose adjustments (either increased or decreased) occurred to maintain a euthyroid state;   Determination of the necessary frequency of serum evaluation of TSH during the first half of gestation.
2 Recruiting Study of Optimal Replacement of Thyroxine in the Elderly
Condition: Hypothyroidism
Intervention: Drug: Levothyroxine
Outcome Measures: Participant's acceptability of study design and willingness to enter study;   Participant recruitment rate;   Time to achieve desired TSH levels;   Medication compliance;   The acceptability of three patient completed questionnaires;   Assessment of mobility;   Change in specific cardiovascular risk factors;   Measure of risk of falls
3 Recruiting Study of Dose Adjustment From Levothyroxine to a New Levothyroxine Sodium Test Formulation.
Condition: Hypothyroidism
Intervention: Drug: Levothyroxine sodium new formulation
Outcome Measures: The proportion of patients that do not need a change of dose.;   The magnitude of the change in daily dose needed.;   Proportion of patients that obtained a thyroid stimulating hormone between 0.4-2.5 mU/L;   Change from baseline serum thyroid stimulating hormone (in mIU/L and percentage).
4 Unknown  Thyroxin Treatment in Sub Clinical Hypothyroidism, on the Apnea Hypopnea Index Score, Lipids and Highly Sensitive CRP
Condition: Dyslipidemia
Interventions: Drug: levothyroxine;   Drug: sugar pill
Outcome Measures: Effect of the treatment of subclinical hypothyroidism on the apnea hypopnea index (AHI) score.;   Effect of the treatment of subclinical hypothyroidism on the lipid profile in patient with dyslipidemia and on hs-CRP
5 Recruiting Effects of L-thyroxine Replacement on Serum Lipid and Atherosclerosis in Hypothyroidism
Conditions: Hypothyroidism;   Thyroid Diseases;   Endocrine System Diseases
Intervention: Drug: L-thyroxine
Outcome Measures: Rate of First CVD Events, CVD Mortality and All-cause Mortality;   Change in Serum Lipid Levels;   Change in Thickness of Blood Vessel Wall;   Change in Oxidative Stress and Chronic Inflammatory Factors Associated with Atherosclerosis
6 Recruiting Desiccated Thyroid Extract and Levothyroxine for Hypothyroidism Treatment
Condition: Primary Hypothyroidism.
Interventions: Drug: Levothyroxine;   Drug: Desiccated thyroid extract
Outcome Measures: thyroid-symptom questionnaire;   Wechsler Memory Scale-Version IV (WMS-IV);   Biochemical measures
7 Recruiting Thyroid Hormone Replacement for Subclinical Hypothyroidism
Condition: Subclinical Hypothyroidism
Interventions: Drug: Levothyroxine;   Drug: Placebo
Outcome Measures: Fatal and non-fatal cardiovascular events;   Thyroid-specific quality of life;   Health-related quality of life;   Handgrip strength;   Executive cognitive function;   Total mortality;   Basic Activities of Daily Living;   Extended activities of daily living;   Haemoglobin
8 Recruiting Treatment Trial of Subclinical Hypothyroidism in Down Syndrome
Conditions: Down Syndrome;   Subclinical Hypothyroidism
Intervention: Drug: Levothyroxine
Outcome Measures: Change in non-HDL cholesterol from baseline at 6, 12 and 18 months.;   Change in quality of life from baseline at 6, 12 and 18 months.
9 Recruiting L-Thyroxine Supplementation for Preterm Newborns Less Than 32 Weeks of Gestation With Hypothyroxinemia
Condition: Hypothyroxinemia
Interventions: Drug: L-Thyroxine;   Drug: water
Outcome Measures: Neurodevelopmental outcome;   Morbidity associated with management of newborns < 32 WG with hypothyroxinemia
10 Recruiting Effect of L-Thyroxine on Lipid Profiles and Atherosclerosis in Subclinical Hypothyroidism
Conditions: Hypothyroidism;   Thyroid Diseases;   Endocrine System Diseases
Intervention: Drug: L-thyroxine
Outcome Measures: change in lipid profile;   change in thickness of blood vessel wall;   change in endothelial function;   change of adipocytokines;   Change of Oxidative Stress and Chronic Inflammatory Factors Related with Atherosclerosis
11 Recruiting Thyroid Study Type 2 Diabetes Mellitus (T2DM)
Conditions: Diabetes;   Hypothyroidism
Intervention: Drug: Euthyrox (levothyroxine)
Outcome Measures: Thyroid hormone-induced change in whole body insulin sensitivity (change in insulin-stimulated glucose disposal) and muscle mitochondrial function;   Thyroid hormone-induced change of lipid content in skeletal muscle and liver and brown adipose tissue activity
12 Recruiting Early Levothyroxine Post Radioactive Iodine
Condition: Graves' Disease
Intervention: Drug: Levothyroxine
Outcome Measures: Prevention of overt hypothyroidism;   Quality of Life
13 Recruiting Antithyroid Drug Treatment of Thyrotoxicosis in Young People
Condition: Paediatric Thyrotoxicosis
Interventions: Procedure: Block and Replace;   Procedure: Dose Titration;   Drug: carbimazole;   Drug: propylthiouracil;   Drug: thyroxine
Outcome Measures: Remission rate as defined by patients who are biochemically euthyroid at the end of the 6 year study period.;   Biochemical control as reflected by blood TSH and thyroxine levels;   The frequency of adverse events on the 2 treatment regimens.
14 Recruiting The Effect of Coffee on the Absorption of Thyroid Hormone in Patients With Thyroid Carcinoma
Conditions: Thyroid Carcinoma;   Hypothyroidism
Interventions: Other: Black Coffee;   Other: Coffee with Milk;   Other: Black Tea;   Other: Water
Outcome Measures: Change in TSH (thyrotropin-stimulating-hormone) with each beverage type;   Change in TSH with various beverages;   Change in total T4 with each beverage type;   Change in free T4 with each beverage type;   Change in total T3 with each beverage type
15 Not yet recruiting Thyroid Hormones Treatment in Asthma Exacerbation
Condition: Asthma
Interventions: Drug: IV thyroxin;   Drug: Placebo
Outcome Measures: time to normalization of PEF (peak expiratory flow);   Length of stay;   Time to oxygenation;   heart rate;   respiratory rate
16 Recruiting Selenium Supplementation in Pregnancy
Conditions: Pregnancy;   Infertility;   Auto-immune Thyroiditis
Interventions: Dietary Supplement: Selenium;   Other: Sugar Pill Placebo;   Other: Selenium + L-Thyroxine (LT4);   Other: Sugar Pill Placebo + L-Thyroxine (LT4)
Outcome Measures: Changes in TPOab and/or Tgab;   Changes in thyroid volume and echogenicity;   Changes in thyroid hormones (TSH, FT4, FT3);   Evaluation of Maternal risks;   Evaluation of Infant risks;   Changes in of quality of life;   Evaluation of Health Services:;   Changes in the selenium-dependent antioxidant enzyme glutathione peroxidase;   Changes in implantation and pregnancy rates
17 Recruiting The TRUST Study - Depression Substudy
Conditions: Subclinical Hypothyroidism;   Depression
Interventions: Drug: Levothyroxine;   Drug: Placebo
Outcome Measure: Change from baseline in 15-items Geriatric Depression Scale
18 Recruiting Preconceptional Thyroid Screening and Childhood Nerocognitive Function
Condition: Hypothyroidism
Intervention: Procedure: levothyroxine
Outcome Measures: Offspring neurocognitive assessment at 0-3 yrs;   Offspring IQ assessment at 0-3 yrs;   Incidence of neonatal hypothyroid and complications
19 Unknown  The Effect of Thyroid Hormone Levels in Pregnant Women on the Intelligence Quotient (IQ) of Their Children
Conditions: Child Development Disorders;   Pregnancy;   Subclinical Hypothyroidism
Intervention:
Outcome Measure:
20 Recruiting Efficacy Assessment of Systematic Treatment With Folinic Acid and Thyroid Hormone on Psychomotor Development of Down Syndrome Young Children
Condition: Down Syndrome
Intervention: Drug: thyroid hormone and folinic acid
Outcome Measures: GMDS ( Griffiths Mental Development Scale);   BL (Brunet Lezine revised scale)