<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0873-3015</journal-id>
<journal-title><![CDATA[Millenium - Journal of Education, Technologies, and Health]]></journal-title>
<abbrev-journal-title><![CDATA[Mill]]></abbrev-journal-title>
<issn>0873-3015</issn>
<publisher>
<publisher-name><![CDATA[Instituto Politécnico de Viseu (IPV)]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0873-30152024000300203</article-id>
<article-id pub-id-type="doi">10.29352/mill0224.34653</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[An unusual cause of pulmonary embolism following blunt chest trauma: a case study]]></article-title>
<article-title xml:lang="pt"><![CDATA[Uma causa incomum de embolia pulmonar após trauma torácico contuso: um estudo de caso]]></article-title>
<article-title xml:lang="es"><![CDATA[Una causa inusual de embolia pulmonar después de un traumatismo torácico cerrado: un estudio de caso]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Garg]]></surname>
<given-names><![CDATA[Shweta]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Gupta]]></surname>
<given-names><![CDATA[Hima]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Felix Hospital  ]]></institution>
<addr-line><![CDATA[Greater Noida ]]></addr-line>
<country>India</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,IILM University Gurugram  ]]></institution>
<addr-line><![CDATA[Haryana ]]></addr-line>
<country>India</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>08</month>
<year>2024</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>08</month>
<year>2024</year>
</pub-date>
<numero>24</numero>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.pt/scielo.php?script=sci_arttext&amp;pid=S0873-30152024000300203&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.pt/scielo.php?script=sci_abstract&amp;pid=S0873-30152024000300203&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.pt/scielo.php?script=sci_pdf&amp;pid=S0873-30152024000300203&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Introduction: Chest injury resulting from thoracic trauma experienced by an individual is presented in this study. The results obtained from this analysis conducted retrospectively are anticipated to contribute to raising awareness of early diagnosis of embolism in the context of trauma.  Objective:  Pulmonary embolism remains a disease that needs clinical suspicion to prevent mortality and morbidity. More so in young individuals, suspicion is very low as compared to old age individuals with multiple co-morbid conditions. There is a high risk of mortality associated with Pulmonary embolism in case of not detected and treated in the early stage.  Methods:  This document outlines a case study involving a young male patient who exhibited sudden breathlessness after experiencing blunt chest trauma. The patient was diagnosed with pulmonary thromboembolism later on.  Results:  The patient was discharged on the novel oral anticoagulant Rivaroxaban. It is one of the first available direct factor Xa inhibitors, recommended for use in venous thromboembolism. It allows predictable anticoagulation, and routine coagulation monitoring is not required, unlike warfarin.  Conclusion:  The authors concluded that the development of a hypercoagulable state leads to the occurrence of pulmonary embolism triggered by epithelial injury following a traumatic event. In the case of submissive pulmonary embolism, catheter-directed thrombolysis is considered useful when systemic thrombolysis poses a potential risk of hemorrhage.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo  Introdução:  A lesão torácica resultante de trauma torácico vivenciado por um indivíduo é apresentada neste estudo. Espera-se que os resultados obtidos a partir desta análise realizada retrospetivamente contribuam para a sensibilização para o diagnóstico precoce da embolia no contexto do trauma.  Objetivo:  A embolia pulmonar continua sendo uma doença que necessita de suspeita clínica para prevenir mortalidade e morbidade. Mais ainda em indivíduos jovens, a suspeita é muito baixa em comparação com indivíduos de idade avançada com múltiplas comorbidades. Existe um elevado risco de mortalidade associado à embolia pulmonar em caso de não deteção e tratamento na fase inicial.  Métodos:  Trata-se do relato de um caso de um jovem do sexo masculino que apresentou um início agudo de dispneia na sequência de um traumatismo torácico fechado, sendo posteriormente diagnosticado como um caso de tromboembolismo pulmonar.  Resultados:  O paciente teve alta medicado com o novo anticoagulante oral Rivaroxaban. Trata-se de um dos primeiros inibidores directos do fator Xa disponíveis, recomendado para utilização no tromboembolismo venoso. Permite uma anticoagulação previsível e não requer monitorização de rotina da coagulação, ao contrário da varfarina.  Conclusão:  Conclui-se que a lesão epitelial causada por trauma pode produzir um estado de hipercoagulabilidade resultando em embolia pulmonar. No embolismo pulmonar submisso, a trombólise dirigida por cateter é útil nos casos em que a trombólise sistémica acarreta o risco de hemorragia.]]></p></abstract>
<abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Introducción: En este estudio se presenta el traumatismo torácico por traumatismo torácico experimentado por un individuo. Se espera que los resultados obtenidos de este análisis realizado retrospectivamente contribuyan a la concienciación sobre el diagnóstico precoz de la embolia en el contexto del trauma.  Objetivo:  La embolia pulmonar sigue siendo una enfermedad que necesita sospecha clínica para prevenir la mortalidad y la morbilidad. Más aún en los individuos jóvenes, la sospecha es muy baja en comparación con los individuos de edad avanzada con múltiples condiciones comórbidas. Existe un alto riesgo de mortalidad asociado a la embolia pulmonar en caso de no detectarse y tratarse en una etapa temprana.  Métodos:  Este documento describe un estudio de caso que involucra a un paciente joven de sexo masculino que presentó disnea repentina después de experimentar un traumatismo torácico cerrado. El paciente fue diagnosticado de tromboembolismo pulmonar posteriormente.  Resultados:  El paciente fue dado de alta con el nuevo anticoagulante oral Rivaroxabán. Es uno de los primeros inhibidores directos del factor Xa disponibles, recomendado para su uso en tromboembolismo venoso. Permite una anticoagulación predecible y no se requiere un monitoreo rutinario de la coagulación, a diferencia de la warfarina.  Conclusión:  Los autores concluyeron que el desarrollo de un estado de hipercoagulabilidad conduce a la aparición de embolia pulmonar, desencadenada por lesión epitelial después de un evento traumático. En caso de embolia pulmonar sumisa, la trombólisis dirigida por catéter se considera útil en la situación en la que la trombólisis sistémica presenta un riesgo potencial de hemorragia.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[pulmonary embolism]]></kwd>
<kwd lng="en"><![CDATA[trauma]]></kwd>
<kwd lng="en"><![CDATA[hypercoagulable state]]></kwd>
<kwd lng="en"><![CDATA[tissue injury]]></kwd>
<kwd lng="en"><![CDATA[catheter-directed thrombolysis]]></kwd>
<kwd lng="pt"><![CDATA[embolia pulmonar]]></kwd>
<kwd lng="pt"><![CDATA[traumatismo]]></kwd>
<kwd lng="pt"><![CDATA[estado hipercoagulável]]></kwd>
<kwd lng="pt"><![CDATA[lesão tecidular]]></kwd>
<kwd lng="pt"><![CDATA[trombólise dirigida por cateter]]></kwd>
<kwd lng="es"><![CDATA[embolia pulmonar]]></kwd>
<kwd lng="es"><![CDATA[traumatismo]]></kwd>
<kwd lng="es"><![CDATA[estado de hipercoagulabilidad]]></kwd>
<kwd lng="es"><![CDATA[lesión tisular]]></kwd>
<kwd lng="es"><![CDATA[trombólisis dirigida por catéter]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<nlm-citation citation-type="book">
<collab>Electronic Medicines Compendium</collab>
<source><![CDATA[Xarelto 20mg film-coated tablets]]></source>
<year>2023</year>
<publisher-name><![CDATA[EMC]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B2">
<nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Gibson]]></surname>
<given-names><![CDATA[C. M.]]></given-names>
</name>
</person-group>
<source><![CDATA[Pulmonary embolism natural history, complications and prognosis]]></source>
<year>2020</year>
</nlm-citation>
</ref>
<ref id="B3">
<nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Jancin]]></surname>
<given-names><![CDATA[B.]]></given-names>
</name>
</person-group>
<source><![CDATA[Pulmonary Embolism Risk Higher With Traumatic Chest Injury]]></source>
<year>2011</year>
<publisher-name><![CDATA[MDedge]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B4">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kuo]]></surname>
<given-names><![CDATA[W. T.]]></given-names>
</name>
<name>
<surname><![CDATA[Gould]]></surname>
<given-names><![CDATA[M. K.]]></given-names>
</name>
<name>
<surname><![CDATA[Louie]]></surname>
<given-names><![CDATA[J. D.]]></given-names>
</name>
<name>
<surname><![CDATA[Rosenberg]]></surname>
<given-names><![CDATA[J. K.]]></given-names>
</name>
<name>
<surname><![CDATA[Sze]]></surname>
<given-names><![CDATA[D. Y.]]></given-names>
</name>
<name>
<surname><![CDATA[Hofmann]]></surname>
<given-names><![CDATA[L. V.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Catheter-directed therapy for the treatment of massive pulmonary embolism: Systematic review and meta-analysis of modern techniques]]></article-title>
<source><![CDATA[Journal of Vascular and Interventional Radiology: JVIR]]></source>
<year>2009</year>
<volume>20</volume>
<numero>11</numero>
<issue>11</issue>
<page-range>1431-40</page-range></nlm-citation>
</ref>
<ref id="B5">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lewis]]></surname>
<given-names><![CDATA[C.]]></given-names>
</name>
<name>
<surname><![CDATA[Mustafa]]></surname>
<given-names><![CDATA[D.]]></given-names>
</name>
<name>
<surname><![CDATA[Wilson]]></surname>
<given-names><![CDATA[K.]]></given-names>
</name>
<name>
<surname><![CDATA[Danner]]></surname>
<given-names><![CDATA[O.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Pulmonary embolism diagnosed immediately following blunt trauma]]></article-title>
<source><![CDATA[International Journal of Case Reports and Images]]></source>
<year>2013</year>
<volume>4</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>248-51</page-range></nlm-citation>
</ref>
<ref id="B6">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Marx]]></surname>
<given-names><![CDATA[J. A.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Pulmonary Embolism Can Occur Early After Trauma]]></article-title>
<source><![CDATA[J Trauma]]></source>
<year>2007</year>
<volume>63</volume>
<numero>620</numero>
<issue>620</issue>
</nlm-citation>
</ref>
<ref id="B7">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Menaker]]></surname>
<given-names><![CDATA[J.]]></given-names>
</name>
<name>
<surname><![CDATA[Stein]]></surname>
<given-names><![CDATA[D. M.]]></given-names>
</name>
<name>
<surname><![CDATA[Scalea]]></surname>
<given-names><![CDATA[T. M.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Incidence of early pulmonary embolism after injury]]></article-title>
<source><![CDATA[The Journal of Trauma]]></source>
<year>2007</year>
<volume>63</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>620-4</page-range></nlm-citation>
</ref>
<ref id="B8">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[O&#8217;Malley]]></surname>
<given-names><![CDATA[K. F.]]></given-names>
</name>
<name>
<surname><![CDATA[Ross]]></surname>
<given-names><![CDATA[S. E.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Pulmonary embolism in major trauma patients]]></article-title>
<source><![CDATA[The Journal of Trauma]]></source>
<year>1990</year>
<volume>30</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>748-50</page-range></nlm-citation>
</ref>
<ref id="B9">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ouellette]]></surname>
<given-names><![CDATA[D. R.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Pulmonary Embolism (PE)]]></article-title>
<source><![CDATA[Medscape]]></source>
<year>2020</year>
<page-range>1-59</page-range></nlm-citation>
</ref>
<ref id="B10">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Selby]]></surname>
<given-names><![CDATA[R.]]></given-names>
</name>
<name>
<surname><![CDATA[Geerts]]></surname>
<given-names><![CDATA[W.]]></given-names>
</name>
<name>
<surname><![CDATA[Ofosu]]></surname>
<given-names><![CDATA[F. A.]]></given-names>
</name>
<name>
<surname><![CDATA[Craven]]></surname>
<given-names><![CDATA[S.]]></given-names>
</name>
<name>
<surname><![CDATA[Dewar]]></surname>
<given-names><![CDATA[L.]]></given-names>
</name>
<name>
<surname><![CDATA[Phillips]]></surname>
<given-names><![CDATA[A.]]></given-names>
</name>
<name>
<surname><![CDATA[Szalai]]></surname>
<given-names><![CDATA[J. P.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Hypercoagulability after trauma: Hemostatic changes and relationship to venous thromboembolism]]></article-title>
<source><![CDATA[Thrombosis Research]]></source>
<year>2009</year>
<volume>124</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>281-7</page-range></nlm-citation>
</ref>
<ref id="B11">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Sharma]]></surname>
<given-names><![CDATA[G.]]></given-names>
</name>
<name>
<surname><![CDATA[Kothari]]></surname>
<given-names><![CDATA[S. S.]]></given-names>
</name>
<name>
<surname><![CDATA[Bahl]]></surname>
<given-names><![CDATA[V. K.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Thrombolytic therapy for acute pulmonary embolism]]></article-title>
<source><![CDATA[Indian Heart Journal]]></source>
<year>2002</year>
<volume>54</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>667-71</page-range></nlm-citation>
</ref>
<ref id="B12">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Siddiqui]]></surname>
<given-names><![CDATA[T.]]></given-names>
</name>
<name>
<surname><![CDATA[Asim]]></surname>
<given-names><![CDATA[M.]]></given-names>
</name>
<name>
<surname><![CDATA[Ahmed]]></surname>
<given-names><![CDATA[K.]]></given-names>
</name>
<name>
<surname><![CDATA[Mathradikkal]]></surname>
<given-names><![CDATA[S.]]></given-names>
</name>
<name>
<surname><![CDATA[Bakhsh]]></surname>
<given-names><![CDATA[Z.]]></given-names>
</name>
<name>
<surname><![CDATA[Masood]]></surname>
<given-names><![CDATA[M.]]></given-names>
</name>
<name>
<surname><![CDATA[Al-Hassani]]></surname>
<given-names><![CDATA[A.]]></given-names>
</name>
<name>
<surname><![CDATA[Nabir]]></surname>
<given-names><![CDATA[S.]]></given-names>
</name>
<name>
<surname><![CDATA[Ahmed]]></surname>
<given-names><![CDATA[N.]]></given-names>
</name>
<name>
<surname><![CDATA[Strandvik]]></surname>
<given-names><![CDATA[G.]]></given-names>
</name>
<name>
<surname><![CDATA[El-Menyar]]></surname>
<given-names><![CDATA[A.]]></given-names>
</name>
<name>
<surname><![CDATA[Al-Thani]]></surname>
<given-names><![CDATA[H.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Clinical Characteristics and Risk Factors for Early versus Late Pulmonary Embolism in Trauma Patients: A Retrospective, Observational Study]]></article-title>
<source><![CDATA[International Journal of General Medicine]]></source>
<year>2022</year>
<volume>15</volume>
<page-range>7867-78</page-range></nlm-citation>
</ref>
<ref id="B13">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Simpson]]></surname>
<given-names><![CDATA[D.]]></given-names>
</name>
<name>
<surname><![CDATA[Siddiqui]]></surname>
<given-names><![CDATA[M. A. A.]]></given-names>
</name>
<name>
<surname><![CDATA[Scott]]></surname>
<given-names><![CDATA[L. J.]]></given-names>
</name>
<name>
<surname><![CDATA[Hilleman]]></surname>
<given-names><![CDATA[D. E.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Reteplase: A review of its use in the management of thrombotic occlusive disorders]]></article-title>
<source><![CDATA[American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions]]></source>
<year>2006</year>
<volume>6</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>265-85</page-range></nlm-citation>
</ref>
<ref id="B14">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[ten Wolde]]></surname>
<given-names><![CDATA[M.]]></given-names>
</name>
<name>
<surname><![CDATA[Söhne]]></surname>
<given-names><![CDATA[M.]]></given-names>
</name>
<name>
<surname><![CDATA[Quak]]></surname>
<given-names><![CDATA[E.]]></given-names>
</name>
<name>
<surname><![CDATA[Mac Gillavry]]></surname>
<given-names><![CDATA[M. R.]]></given-names>
</name>
<name>
<surname><![CDATA[Büller]]></surname>
<given-names><![CDATA[H. R.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Prognostic value of echocardiographically assessed right ventricular dysfunction in patients with pulmonary embolism]]></article-title>
<source><![CDATA[Archives of Internal Medicine]]></source>
<year>2004</year>
<volume>164</volume>
<numero>15</numero>
<issue>15</issue>
<page-range>1685-9</page-range></nlm-citation>
</ref>
<ref id="B15">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[U Nazir]]></surname>
<given-names><![CDATA[P. B.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Role of thrombolytics in the management of submassive pulmonary embolism]]></article-title>
<source><![CDATA[OA Critical Care]]></source>
<year>2022</year>
<volume>2</volume>
<numero>1</numero>
<issue>1</issue>
</nlm-citation>
</ref>
<ref id="B16">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Van Gent]]></surname>
<given-names><![CDATA[J.-M.]]></given-names>
</name>
<name>
<surname><![CDATA[Zander]]></surname>
<given-names><![CDATA[A. L.]]></given-names>
</name>
<name>
<surname><![CDATA[Olson]]></surname>
<given-names><![CDATA[E. J.]]></given-names>
</name>
<name>
<surname><![CDATA[Shackford]]></surname>
<given-names><![CDATA[S. R.]]></given-names>
</name>
<name>
<surname><![CDATA[Dunne]]></surname>
<given-names><![CDATA[C. E.]]></given-names>
</name>
<name>
<surname><![CDATA[Sise]]></surname>
<given-names><![CDATA[C. B.]]></given-names>
</name>
<name>
<surname><![CDATA[Badiee]]></surname>
<given-names><![CDATA[J.]]></given-names>
</name>
<name>
<surname><![CDATA[Schechter]]></surname>
<given-names><![CDATA[M. S.]]></given-names>
</name>
<name>
<surname><![CDATA[Sise]]></surname>
<given-names><![CDATA[M. J.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Pulmonary embolism without deep venous thrombosis: De novo or missed deep venous thrombosis?]]></article-title>
<source><![CDATA[The Journal of Trauma and Acute Care Surgery]]></source>
<year>2014</year>
<volume>76</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>1270-4</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
