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1

LATIF, ANSAR, ANILA BASHIR, AURANGZEB ,, and Umar Ghani. "FAT EMBOLISM AND FAT EMBOLISM SYNDROME;." Professional Medical Journal 15, no. 04 (March 10, 2008): 407–13. http://dx.doi.org/10.29309/tpmj/2008.15.04.2940.

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Fat Embolism and the associated Fat Embolism Syndrome is a serious and potentially life threatening condition. It tends tooccur usually after fractures or intramedullary instrumentation of long bones. Non-traumatic conditions such as Diabetes Mellitus severe Burns,SLE, sickle cell disease and Pancreatitis can also lead to Fat Embolic syndrome. Young adults are commonly affected. Presentation consistsof an asymptomatic interval followed by pulmonary and neurological manifestations combined with petechial haemorrhages. The diagnosislargely depends on high index of suspicion and exclusion of other conditions. Treatment of this condition remains supportive. Mortalityassociated with this condition is significant, ranging from 10-20% .
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2

Rothberg, David L., and Christopher A. Makarewich. "Fat Embolism and Fat Embolism Syndrome." Journal of the American Academy of Orthopaedic Surgeons 27, no. 8 (April 2019): e346-e355. http://dx.doi.org/10.5435/jaaos-d-17-00571.

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3

Capan, Levon M., Sanford M. Miller, and Katie P. Patel. "FAT EMBOLISM." Anesthesiology Clinics of North America 11, no. 1 (March 1993): 25–54. http://dx.doi.org/10.1016/s0889-8537(21)00766-5.

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4

Yakovlev, V. N., Yu V. Marchenkov, N. S. Panova, V. G. Alekseyev, and V. V. Moroz. "Fat Embolism." General Reanimatology 9, no. 4 (August 20, 2013): 50. http://dx.doi.org/10.15360/1813-9779-2013-4-50.

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5

Peltier, Leonard F. "Fat Embolism." Clinical Orthopaedics and Related Research 422 (May 2004): 148–53. http://dx.doi.org/10.1097/01.blo.0000131647.64240.89.

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6

HARRIS, HELENE. "Fat embolism." Nursing 34, no. 6 (June 2004): 96. http://dx.doi.org/10.1097/00152193-200406000-00064.

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7

Mellor, A., and N. Soni. "Fat embolism." Anaesthesia 56, no. 2 (February 2001): 145–54. http://dx.doi.org/10.1046/j.1365-2044.2001.01724.x.

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8

Prys-Roberts, C. "Fat embolism." Anaesthesia 56, no. 7 (July 2001): 692–93. http://dx.doi.org/10.1046/j.1365-2044.2001.02137-5.x.

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9

Horowitz, P. E., and N. Soni. "Fat embolism." Anaesthesia 57, no. 8 (July 18, 2002): 818–38. http://dx.doi.org/10.1046/j.1365-2044.2002.02752_17.x.

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10

Gupta, Amandeep, and Charles S. Reilly. "Fat embolism." Continuing Education in Anaesthesia Critical Care & Pain 7, no. 5 (October 2007): 148–51. http://dx.doi.org/10.1093/bjaceaccp/mkm027.

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11

Akhtar, Shamsuddin. "Fat Embolism." Anesthesiology Clinics 27, no. 3 (September 2009): 533–50. http://dx.doi.org/10.1016/j.anclin.2009.07.018.

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12

Grazer, Frederick M., and William A. Mathews. "FAT EMBOLISM." Plastic and Reconstructive Surgery 79, no. 4 (April 1987): 671. http://dx.doi.org/10.1097/00006534-198704000-00050.

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13

PELTIER, LEONARD F. "Fat Embolism." Clinical Orthopaedics and Related Research &NA;, no. 232 (July 1988): 263???270. http://dx.doi.org/10.1097/00003086-198807000-00033.

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14

Gresham, G. A. "Fat embolism." Forensic Science International 31, no. 3 (July 1986): 175–80. http://dx.doi.org/10.1016/0379-0738(86)90185-4.

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15

Milroy, Christopher M., and Jacqueline L. Parai. "Fat Embolism, Fat Embolism Syndrome and the Autopsy." Academic Forensic Pathology 9, no. 3-4 (September 2019): 136–54. http://dx.doi.org/10.1177/1925362119896351.

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Fat embolism is common following trauma and is a common autopsy finding in these cases. It may also be seen in non-traumatic cases and is seen in children as well as adults. In comparison fat embolism syndrome (FES) only occurs in a small number of trauma and non-trauma cases. Clinical diagnosis is based on characteristic clinical and laboratory findings. Fat embolism exerts its effect by mechanical blockage of vessels and/or by biochemical means including breakdown of fat to free fatty acids causing an inflammatory response. Fat embolism can be identified at autopsy on microscopy of the lungs using fat stains conducted on frozen tissue, including on formalin fixed but not processed tissue. With FES fat emboli can be seen in other organs including the brain, kidney and myocardium. Fat can also be identified with post-fixation staining, typically with osmium tetroxide. Scoring systems have been developed to try and determine the severity of fat embolism in lung tissue. Fat embolism is also common following resuscitation. When no resuscitation has taken place, the presence of fat on lung histology has been used as proof of vitality. Diagnosis of fat embolism syndrome at autopsy requires analysis of the history, clinical and laboratory findings along with autopsy investigations to determine its relevance, but is an important diagnosis to make which is not always identified clinically. This paper reviews the history, clinical and laboratory findings and diagnosis of fat embolism and fat embolism syndrome at autopsy.
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16

Dhand, Nitish, Kishalay Datta, Vaibhav Gulati, Indranil Das, E. V. Balasubramanyam, and Vikram Shah. "An Unusual Presentation of Fat Embolism Syndrome as Cerebral Fat Embolism in Trauma: A Rare Clinical Entity." Indian Journal of Emergency Medicine 3, no. 2 (2017): 316–18. http://dx.doi.org/10.21088/ijem.2395.311x.3217.32.

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17

Stump, Benjamin, and Gerald Weinhouse. "Fat Embolism Syndrome: Fact or Myth?" Current Trauma Reports 2, no. 2 (April 13, 2016): 66–72. http://dx.doi.org/10.1007/s40719-016-0042-2.

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18

Michel, A. S., J. Coolen, J. Verschakelen, and W. De Wever. "Pulmonary fat embolism." Journal of the Belgian Society of Radiology 96, no. 5 (September 1, 2013): 319. http://dx.doi.org/10.5334/jbr-btr.445.

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19

Kwiatt, MichaelE, and MarkJ Seamon. "Fat embolism syndrome." International Journal of Critical Illness and Injury Science 3, no. 1 (2013): 64. http://dx.doi.org/10.4103/2229-5151.109426.

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20

Allibert, Rémi, Charles Mellerio, Julie Zyss, Mathieu Zuber, and Emmanuel Touzé. "Cerebral fat embolism." Sang thrombose vaisseaux 25, no. 1 (January 2013): 34–39. http://dx.doi.org/10.1684/stv.2013.0755.

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21

Johnson, Michael J., and George L. Lucas. "FAT EMBOLISM SYNDROME." Orthopedics 19, no. 1 (January 1996): 41–49. http://dx.doi.org/10.3928/0147-7447-19960101-09.

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22

Luff, D., and D. W. Hewson. "Fat embolism syndrome." BJA Education 21, no. 9 (September 2021): 322–28. http://dx.doi.org/10.1016/j.bjae.2021.04.003.

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23

Carr, James B., and Sigvard T. Hansen. "Fulminant Fat Embolism." Orthopedics 13, no. 2 (February 1990): 258–61. http://dx.doi.org/10.3928/0147-7447-19900201-20.

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24

FABIAN, TIMOTHY C., ANTHONY V. HOOTS, DEBORAH S. STANFORD, C. RICHARD PATTERSON, and EUGENE C. MANGIANTE. "Fat embolism syndrome." Critical Care Medicine 18, no. 1 (January 1990): 37–46. http://dx.doi.org/10.1097/00003246-199001000-00011.

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25

Nayduch, Donna A., Becki Stuhlemmer, Marisa S. DʼHeere, Dough Houghton, and Enrique Ginzburg. "Fat Embolism Syndrome." Journal of Trauma Nursing 6, no. 3 (July 1999): 73–76. http://dx.doi.org/10.1097/00043860-199907000-00011.

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26

George, Jacob, Reeba George, R. Dixit, RC Gupta, and N. Gupta. "Fat embolism syndrome." Lung India 30, no. 1 (2013): 47. http://dx.doi.org/10.4103/0970-2113.106133.

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27

Piolanti, Marco, Giorgia Dalpiaz, Mariano Scaglione, Carlo Coniglio, Marco Miceli, Sara Violini, Rocco Trisolini, and Libero Barozzi. "Fat Embolism Syndrome." Journal of Computer Assisted Tomography 40, no. 3 (2016): 335–42. http://dx.doi.org/10.1097/rct.0000000000000376.

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28

Nucifora, Gaetano, Fjoralba Hysko, Alessandro Vit, and Annarosa Vasciaveo. "Pulmonary Fat Embolism." Journal of Computer Assisted Tomography 31, no. 5 (September 2007): 806–7. http://dx.doi.org/10.1097/rct.0b013e318032566e.

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29

WILLIAMS, ARVIS G., FRED A. METTLER, JAMES H. CHRISTIE, and ROBERT E. GORDON. "Fat Embolism Syndrome." Clinical Nuclear Medicine 11, no. 7 (July 1986): 495–97. http://dx.doi.org/10.1097/00003072-198607000-00008.

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30

Stein, Paul D., Abdo Y. Yaekoub, Fadi Matta, and Michael Kleerekoper. "Fat Embolism Syndrome." American Journal of the Medical Sciences 336, no. 6 (December 2008): 472–77. http://dx.doi.org/10.1097/maj.0b013e318172f5d2.

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31

Georgopoulos, Dimitris, and Demosthenes Bouros. "Fat Embolism Syndrome." Chest 123, no. 4 (April 2003): 982–83. http://dx.doi.org/10.1378/chest.123.4.982.

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32

Kosova, Ethan, Brian Bergmark, and Gregory Piazza. "Fat Embolism Syndrome." Circulation 131, no. 3 (January 20, 2015): 317–20. http://dx.doi.org/10.1161/circulationaha.114.010835.

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33

Fenire, Mahmoud. "Fat Embolism Syndrome." Southwest Respiratory and Critical Care Chronicles 2, no. 5 (December 10, 2013): 21. http://dx.doi.org/10.12746/swrccc.v2i5.103.

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34

Liu, Hsiao-Kan, and Wen-Chau Chen. "Fat Embolism Syndrome." New England Journal of Medicine 364, no. 18 (May 5, 2011): 1761. http://dx.doi.org/10.1056/nejmicm1006177.

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35

Goenka, Naila, and Allan H. Ropper. "Cerebral Fat Embolism." New England Journal of Medicine 367, no. 11 (September 13, 2012): 1045. http://dx.doi.org/10.1056/nejmicm1100944.

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36

Fablan, Timothy C., Anthony V. Hoots, Deborah S. Stanford, Richard Patterson, and Eugene C. Mangiante. "FAT EMBOLISM SYNDROME." Journal of Trauma: Injury, Infection, and Critical Care 27, no. 7 (July 1987): 820. http://dx.doi.org/10.1097/00005373-198707000-00044.

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37

Moore, P. G., and Owen James. "Pulmonary Fat Embolism." Seminars in Respiratory Medicine 3, no. 04 (March 20, 2008): 275–78. http://dx.doi.org/10.1055/s-2007-1012206.

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38

Carlson, Dorothy S., and Ellen Pfadt. "Fat embolism syndrome." Nursing 41, no. 4 (April 2011): 72. http://dx.doi.org/10.1097/01.nurse.0000395312.91409.7f.

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39

Bartelink, Anton KM, Emiel S. Boon, and Leo M. Budel. "Asymmetrical fat embolism." Lancet 358, no. 9284 (September 2001): 795. http://dx.doi.org/10.1016/s0140-6736(01)05968-2.

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40

Caricato, Anselmo, Giovanni Russo, Daniele Guerino Biasucci, and Maria Giuseppina Annetta. "Fat embolism syndrome." Intensive Care Medicine 43, no. 9 (June 27, 2017): 1411–12. http://dx.doi.org/10.1007/s00134-017-4868-z.

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41

Mims, Barbara Clark. "Fat Embolism Syndrome." Orthopaedic Nursing 8, no. 3 (May 1989): 22???30. http://dx.doi.org/10.1097/00006416-198905000-00009.

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42

Liauw, L., M. A. van Buchem, J. D. M. Feuth, A. B. van Vugt, and P. J. Bode. "Cerebral fat embolism." European Radiology 8, no. 6 (July 28, 1998): 1059. http://dx.doi.org/10.1007/s003300050515.

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43

Decaminada, N., M. Thaler, R. Holler, A. Salsa, C. Ladiges, and G. Rammlmair. "Brain Fat Embolism." Neuroradiology Journal 25, no. 2 (April 2012): 193–99. http://dx.doi.org/10.1177/197140091202500207.

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Fat embolism syndrome [FES] is an uncommon but serious complication of traumatic injures, which can follow a wide range of other surgical and medical conditions and can manifest with a collection of respiratory, hematological, neurological and cutaneous symptoms. FES should be suspected in all cases of traumatic injures with altered mental status following a period of normal neurological function, especially after orthopedic fixation of long bone fractures. Neurological symptoms must not be related to the initial trauma. The objective of this study was to describe the characteristics of FES and to correlate the neuroradiological findings with the clinical symptoms and the outcome of two cases of cerebral FES which occurred in two young men after bone fractures of the extremities without cranial traumatism. Both patients were studied by brain computed tomography (CT) and by brain magnetic resonance (MR). While Cerebral CT was inadequate to the diagnosis, Cerebral MR, performed 48 hours after injury, showed several focal areas of pathological signal in the white matter of the subcortical, periventricular and centrum semiovale regions, as well as in the basal ganglia and cerebellum. The neuroradiological findings of the two patients were compared with their clinical symptoms and outcome. The patient with the worst prognosis showed more lesions on MR and a restricted diffusion on DWI-MR, due to cytotoxic edema, whereas the patient with the better outcome showed lesions due to vasogenetic edema without any restricted diffusion. Cerebral MR and DW-MR are sensitive indicators for the early diagnosis of FES and can give a vast amount of information on the prognosis and future outcome.
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44

Fukumoto, Lauren E., and Kathryn D. Fukumoto. "Fat Embolism Syndrome." Nursing Clinics of North America 53, no. 3 (September 2018): 335–47. http://dx.doi.org/10.1016/j.cnur.2018.04.003.

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45

Taviloglu, Korhan, and Hakan Yanar. "Fat Embolism Syndrome." Surgery Today 37, no. 1 (December 25, 2006): 5–8. http://dx.doi.org/10.1007/s00595-006-3307-5.

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46

Bulger, Eileen M. "Fat Embolism Syndrome." Archives of Surgery 132, no. 4 (April 1, 1997): 435. http://dx.doi.org/10.1001/archsurg.1997.01430280109019.

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47

Sogunuru, Guruprasad, and Nagabhishek Moka. "Fat embolism syndrome." International Journal of Emergency Medicine 3, no. 4 (April 1, 2010): 471. http://dx.doi.org/10.1007/s12245-010-0160-5.

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48

Arai, Fumio, Takashi Kita, Takeshi Nakai, Tatsuyuki Hori, Naritoshi Maki, Masaaki Kakiuchi, and Shigeta Sasaki. "Histopathologic Features of Fat Embolism in Fulminant Fat Embolism Syndrome." Anesthesiology 107, no. 3 (September 1, 2007): 509–11. http://dx.doi.org/10.1097/01.anes.0000278898.62036.5f.

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49

Olivera Arencibia, Yanetsy, Mai Vo, Jennifer Kinaga, Jorge Uribe, Gloria Velasquez, Mario Madruga, and S. J. Carlan. "Fat Embolism and Nonconvulsive Status Epilepticus." Case Reports in Neurological Medicine 2018 (December 20, 2018): 1–4. http://dx.doi.org/10.1155/2018/5057624.

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Fat embolism syndrome (FES) typically occurs following orthopedic trauma and may present with altered mental status and even coma. Nonconvulsive status epilepticus is an electroclinical state associated with an altered level of consciousness but lacking convulsive motor activity and has been reported in fat embolism. The diagnosis is clinical and is treated with supportive care, antiepileptic therapy, and sedation. A 56-year-old male presented with altered mental status following internal fixation for an acute right femur fracture due to a motor vehicle accident 24 hours earlier. Continued neuromonitoring revealed nonconvulsive status epilepticus. Magnetic resonance imaging of the brain showed multiple bilateral acute cerebral infarcts with a specific pattern favoring the diagnosis of fat embolism syndrome. He was found to have a significant right to left intracardiac shunt on a transesophageal echocardiogram. He improved substantially over time with supportive therapy, was successfully extubated on day 6, and discharged to inpatient rehabilitation on postoperative day 15. Fat embolisms can result in a wide range of neurologic manifestations. Nonrefractory nonconvulsive status epilepticus that responds to antiepileptic drugs, sedation, and supportive therapy can have a favorable outcome. A high index of suspicion and early recognition reduces the chances of unnecessary interventions and may improve survival.
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50

Shiffman, Melvin A. "Fat Tissue Embolism following Fat Transfer." American Journal of Cosmetic Surgery 29, no. 2 (June 2012): 145–49. http://dx.doi.org/10.5992/ajcs-d-11-00055.1.

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