Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0149871 (deep vein thrombosis)
 12,364 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Sodium warfarin was administered to a 59-year-old woman with congestive cardiac failure and deep vein thrombosis. After 3 days of therapy the nipple and areola of the left breast became inflamed; the entire breast then became necrotic. Gangrene spread and a simple mastectomy was performed. The patient died from pulmonary embolism 1 day after operation. Histologic examination of the breast revealed thrombi in some of the arteries and veins. The etiology of this condition is obscure, and there is no known way of preventing or effectively treating the condition. Simple mastectomy or more conservative local excision recommended.
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PMID:Cutaneous gangrene: a rare complication of coumarin therapy. 124 9

Pulmonary embolism (PE) is thought to occur infrequently after cardiac operations, possibly because systemic heparinization during cardiopulmonary bypass prevents deep vein thrombosis. This retrospective study was undertaken to determine the actual incidence of PE after cardiac operations and to identify risk factors. Between January 1, 1985, and December 31, 1989, 5,694 adult patients (greater than 18 years old) had open heart operations at the Johns Hopkins Hospital. Thirty-two patients (20 men and 12 women) had PE within 60 days of operation, an overall PE incidence of 0.56%. The diagnosis of PE was established by ventilation/perfusion scan, pulmonary angiogram, or autopsy. Mortality among patients with PE was 34%. Using a case-control method, preoperative and postoperative risk factors for PE were identified by multivariate and multiple logistic regression analyses. Preoperative risk factors included bed rest (p less than 0.003), prolonged hospitalization before operation (p less than 0.004), and cardiac catheterization performed through the groin within 15 days before operation (p less than 0.01). Post-operative risk factors were congestive heart failure (p less than 0.008), prolonged bed rest (p less than 0.05), and deep vein thrombosis (p less than 0.03). This study demonstrates that PE is an unusual complication after cardiac operations, has a high mortality rate, and is often related to perioperative immobility and recent groin catheterization. These results also suggest that minimizing preoperative hospital stay may be important in PE prophylaxis.
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PMID:Pulmonary embolism in the cardiac surgical patient. 159 61

In a prospective study, peripheral pulses, claudication, peripheral oedema, and rest pain were evaluated in 314 sequentially presenting diabetic patients with foot ulcers. In the ulcerated limb pedal pulses were found to be present in 44% of the patients, peripheral oedema in 38%, and rest pain in 19%. Twelve per cent had claudication. Presence of pedal pulses was more common in patients whose ulcers underwent primary healing (56%) than in those who healed after amputation (23%) or died (25%, p less than 0.001). Eighty per cent of the patients with pedal pulses present underwent primary healing. However, 49% of patients with absence of pedal pulses also underwent primary healing and 12 patients developed gangrene despite presence of pedal pulses. Peripheral oedema was more common in patients who required amputation (58%) or died (55%) than in patients with primary healing (26%, p less than 0.001). A tentative predisposing factor was identified in 95% of the patients, the most common factors being neuropathy, congestive heart failure, and previous deep venous thrombosis. Rest pain was more common in patients who required amputation (48%) or died (23%) than in those with primary healing (7%; p less than 0.001). Only 50% of patients with gangrene had rest pain and of these patients, only one underwent primary healing. The presence of pedal pulses, oedema, and rest pain give valuable but imperfect information on the possible primary healing of foot ulcers in diabetic patients.
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PMID:The importance of peripheral pulses, peripheral oedema and local pain for the outcome of diabetic foot ulcers. 214 65

Upper extremity venous thrombosis is a clinical entity with numerous etiologic factors. Only 2% of all cases of deep venous thrombosis involve the upper extremity, and the incidence of pulmonary embolism related to thrombosis in this location is approximately 12%. Primary or "effort" thrombosis of the upper limb is related to the inherent anatomical structure of the thoracic outlet and axillary region. Secondary thrombosis may have such diverse origins as trauma, infection, congestive heart failure, central venous catheters, neoplasms, septic phlebitis, intravenous drug use, and hypercoagulable states. Patients present with peripheral edema and prominent superficial veins, and neurologic symptoms (pain and paresthesias) are usually present as well. Clinical diagnosis is confirmed by venography or sonography. Treatment regimens include conservative measures, thrombolysis with fibrinolytic agents, and surgical correction of indicated thoracic outlet and axillary structures. We present an unusual case in which upper extremity venous thrombosis in a young healthy female athlete was associated with the presence of cervical ribs. The patient was successfully treated with focal thrombolysis and surgical resection of her ipsilateral cervical rib.
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PMID:Upper extremity venous thrombosis. Case report and literature review. 218 88

In a prospective multicenter study, 244 men with highly or moderately differentiated prostatic cancer in stage I, II or III (VACURG) were consecutively randomized to three groups of treatment: Group A (77 patients) received polyestradiol phosphate (Estradurin, Leo) 80 mg i.m. every fourth week + ethinyl estradiol (Etivex, Leo) 150 micrograms daily, group B (72 patients) estramustine phosphate (Estracyt, Leo) 280 mg twice daily, and group C (76 patients) no therapy. Only men without current or previous other malignancy and without cardiovascular disease were admitted to the study. After 4 1/2 years 125 of the 244 patients had left the study, 9 because of cancer progression (stage IV, VACURG). The most serious complications were cardiovascular, including ischemic heart disease, cardiac decompensation, cerebral ischemia and venous thromboembolism, which occurred in 24 patients from group A and 9 from group B as compared to only one patient in group C. The subgroup superficial or deep venous thrombosis comprised 11 group A and 2 group B patients. Estrogens (E + e) offered as palliative treatment to patients with non-generalized prostatic carcinoma is burdened with a high incidence of serious cardiovascular complications.
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PMID:Cardiovascular complications of estrogen therapy for nondisseminated prostatic carcinoma. A preliminary report from a randomized multicenter study. 352 68

The diagnostic features and operative results of six patients with spontaneous aorto-caval fistula associated with abdominal aortic aneurysm were analyzed. Abdominal pain, pulsatile abdominal mass and haematuria were constant preoperative findings in all patients. Radiological signs of congestive heart failure of various degrees were present in five, abdominal bruit in four and preoperative renal failure in three patients. As preoperative diagnostic examinations i.v. pyelography was done in two patients and ultrasound scanning and angiography of the abdominal aorta in a further two patients. In one ultrasound scanning a dilated inferior vena cava and hepatic veins were seen as an indirect sign of ACF, while in both angiograms the ACF was seen. In these two cases the diagnosis of ACF was made preoperatively, while in four other cases the diagnosis was made during the operation. Three patients survived the operation and were still alive after eight months, four years and six years respectively. Postoperative complications developed in two patients: postoperative ileus in one and deep venous thrombosis and pneumonia in another. Because of its rarity aorto-caval fistula is difficult to diagnose. The presence of haematuria in a patient suffering from abdominal aortic aneurysm should strongly suggest the diagnosis of an aorto-caval fistula.
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PMID:Diagnosis and treatment of spontaneous aorto-caval fistula. 355 68

Vascular lesions following surgery of the lumbar disc are very infrequent, and exceptionally an arteriovenous fistula can developed. An important proportion of the reported cases were previously diagnosed as deep venous thrombosis, because this kind of pathology was not suspected. Postsurgical arteriovenous fistula produces severe haemodynamic disturbances, and congestive heart failure will develop if they are left to their natural course without intervention. Arteriovenous fistula should be suspected in the post-operative period of the lumbar disc surgery if congestive heart failure appears, accompanied by swelling of one or both lower limbs. Early surgery is the treatment of choice in order to prevent the congestive heart failure, and to preserve the normal function of the lower extremities. The technical choice seems to be the closure of the orifice of the fistula through the arterial lumen, together with appropriate arterial reconstruction.
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PMID:Iliac arteriovenous fistula as a complication of lumbar disc surgery. Report of two cases and review of literature. 394 61

We determined the response of the common femoral vein to respiratory maneuvers using high resolution real-time ultrasound in 10 normal subjects, and we evaluated this modality in the diagnosis of iliofemoral venous thrombosis in 36 patients. We developed diagnostic criteria for assessment of the venous system and have confirmed them with phlebography or pathologic findings. An increase in venous diameter of 50-200% on performance of the Valsalva maneuver, with a prompt return to the original configuration, was always associated with a normal iliofemoral venous system. Two patterns of occlusion of the femoral venous system were found: an enlarged circular femoral vein that did not increase in size on deep inspiration or performance of the Valsalva maneuver, and difficulty or inability to detect the common femoral vein. A dampened response, i.e., a 10-50% diameter increase on performance of the Valsalva maneuver, was associated with deep vein thrombosis in four of six patients. The false positive rate of 8% was due to gross congestive cardiac failure in one patient. This technique is simple to perform, relatively inexpensive, expeditious, and has proved useful in confirming or denying the presence of iliofemoral venous thrombosis.
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PMID:Iliofemoral venous thrombosis: real-time ultrasound diagnosis, normal criteria, and clinical application. 669 81

The clinical history, signs, symptoms, and laboratory and radiographic results of 154 consecutive patients who had contrast phlebography for evaluation of deep venous thrombosis were evaluated retrospectively to determine their relationship to deep venous thrombosis. Malignancy, history of recent blood transfusions, recent surgery, congestive heart failure, immobility, and infection exhibited the strongest correlation with acute thrombophlebitis. Receiver operating characteristic curves were constructed to demonstrate the additive value of certain signs and symptoms in predicting the development of or protection from deep venous thrombosis. With these curves, a cutoff point can be selected for this population that will aid in determining which patients should undergo further diagnosis and/or treatment in the evaluation of deep venous thrombosis.
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PMID:Deep venous thrombosis: predictive value of signs and symptoms. 677 65

In a randomized double blind clinical trial, we compared indobufen, an antiplatelet drug, with acenocoumarol for the prevention of deep venous thrombosis (D.V.T.) in patients with acute myocardial infarction. Therapy was started on admission and continued for 10 days. All patients were screened daily with impedance plethysmography (I.P.G.) and 125I-fibrinogen leg scanning. Diagnosis of D.V.T. was made when either one or both tests became positive. 74 patients were randomized to treatment with indobufen (200 mg b.i.d.) and 76 patients to acenocoumarol (controlled by thrombotest). The incidence of venous thrombosis in patients with indobufen was 11% and in those treated with acenocoumarol 9%. Major bleeding was observed in 2 patients treated with acenocoumarol. In the indobufen group, no bleeding complications or other serious side-effects were observed. The majority of patients developed thrombosis after the first week of admission. For patients with and without thrombosis, there was no significant difference between the two treatment groups concerning the age, the coronary prognostic index, the maximum C.P.K. value, mobility, incidence of congestive heart failure and the site or extent of the infarct. In this study no clinical or laboratory (fibrinogen, platelet count and anti-thrombin III) parameter, either alone or in combination, was of predictive value for the development of D.V.T. It can be concluded that indobufen appears to be as good as acenocoumarol for the prevention of D.V.T. in patients with acute myocardial infarction. Because it is safe and easy to administer, indobufen seems to be preferable. Prophylaxis is required for at least 10 days.
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PMID:The incidence of deep venous thrombosis in patients with an acute myocardial infarction treated with acenocoumarol or indobufen. 717 1


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