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Query: UMLS:C0149871 (deep vein thrombosis)
 12,364 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The following clinical groups of volunteers were studied: patients long after recovery from myocardial infarction (MI), others after recovery from deep vein thrombosis (DVT), patients with intermittent claudication, with diabetes, and male and female controls who were well matched. All were subjected to many platelet and clotting tests together with clinical, biochemical and haematological measurements in an attempt to find long term abnormalities in these various diseases. The male MIs differed very significantly from the controls in having much more heparin neutralizing activity (P less than 0.001)and less anti-thrombin (P less than 0.01). Less significantly, some bleeding time tests indicated less bleeding and the patients' platelets were larger. The females with MI had in general the same abnormalities but to a lesser degree. The patients with intermittent claudication, none of whom had a history of MI, had almost the same abnormalities and to the same degree. In deep vein thrombosis the heparin neutralizing activity was also clearly increased; the other tests were generally in the same direction but many were not significant. The diabetics had shorter bleeding times but little else abnormal relative to the controls, suggesting a different pathological process. When all male patients and controls were "scored" according to the degree of atherosclerosis there was a close overall correlation between the degree of atherosclerosis and the increase in the HNA level (r = --0.50, n = 66, P less than 0.001) and the decreased anti-thrombin (r = 0.25, n = 66, P less than 0.05).
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PMID:Blood changes in atherosclerosis and long after myocardial infarction and venous thrombosis. 5 92

Two thrombolytic agents are mainly used in patients: streptokinase (SK) and urokinase (UK). UK from human origin is an endopeptidase which is able to convert plasminogen into plasmin. UK is only secreted by the kidney and is only found in urine which is presently the only source of extraction. Studies in man have shown that UK produces a highly reproducible state of enhanced plasma thrombolytic activity with a high fibrinolysis/fibrnogenolysis ratio and a lack of toxicity and antigenicity. The half life in Animal is short as well as the duration of fibrinolytic activity in Man. In clinical experience, positive results have been reported in pulminary embolism while the issues in myocardial infarction are controversial. Suggestive results have been registered in deep vein thrombosis, in ophthalmologic field and in desobstruction of arterio-venious shunts. No evident benefit has been noted in cerebral vascular disease. Up to now, UK has been very well tolerated.
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PMID:[Urokinase. Biochemical therapeutical and therapeutical data (author's transl)]. 6 58

The mechanisms of action of three most commonly used antiplatelet agents (aspirin, sulfinpyrazone, dipyridamole) are briefly discussed. Aspirin inhibits the prostaglandin synthetase of platelets irreversibly and thereby blocks the production of prostaglandin endoperoxides and thromboxane A2, which stimulate platelet aggregation. A daily aspirin dose of 200--300 mg is sufficient to achieve this effect. Sulfinpyrazone appears to interfere with the adhesion of platelets to subendothelial structures and atherosclerotic plaques. Dipyridamole increases cyclic AMP in platelets and thus reduces platelet response to aggregating agents. A few of the satisfactorily performed studies on the clinical effectiveness of antiplatelet agents are mentioned. Sulfinpyrazone treatment of patients with myocardial infarction (Killip--classification I and II), starting 25--35 days after the acute myocardial infarction, reduces cardiac mortality and incidence of sudden death for a period of two years. The efficacy of aspirin treatment in coronary artery disease is not yet definitely established. In patients with transient ischemic attacks, particularly males with appropriate carotid lesions, aspirin therapy reduces the frequency of transient ischemic attacks and possibly the incidence of stroke and death. Sulfinpyrazone is ineffective in these patients. Sulfinpyrazone and aspirin are of value in the prevention of thrombosis in straight arterio-venous shunts. Aspirin reduces the frequency of deep venous thrombosis after total hip replacement in males but not in females. In patients with recurrent venous thrombosis, sulfinpyrazone treatment is effective in preventing thrombosis.
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PMID:[Action mechanism and clinical indications for thrombocyte aggregation inhibitors]. 42 7

Platelet adhesiveness was measured in a total of 589 healthy volunteers and patients. Patients suffered from heart failure, diabetes mellitus, myocardial infarction and deep vein thrombosis have a significant higher platelet adhesiveness as healthy volunteers. The effect of the socalled stressors on platelet adhesiveness was shown in vivo; the same values of platelet adhesiveness were seen as in patients. Therefore it can be concluded that stressors constitute a risk factor in patients with altered vessel walls.
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PMID:[Effects on platelet functions]. 43 58

The most important side effects of oral contraceptives (OCs) and their incidence, together with advice and monitoring of the patient at risk, are pointed out. There is a mild increase in blood pressure in longterm contraceptive use caused by increased angiotensinogen production by the liver. It is significant only for women with a history of familial hypertension, diabetes mellitus, or pre-eclampsia. Smoking increases this risk. Urinary tract infections are 25-50% more frequent in pill users. Glucose tolerance is slightly decreased. Contraceptives' diabetogenic effect is higher in women with hereditary tendency for diabetes, latent diabetes, and/or obesity. They are contraindicated in latent diabetes. Findings are contradictory in their effects on cholesterol and triglyceride serum level, but the pill is contraindicated in lipid metabolism disorders. There is an increased incidence in cholecystitis and cholelithiasis in pill-users (70-80 additional cases/100,000 user years). Liver diseases, intrahepatic cholestasis, occur rarely and benign liver tumors have not conclusively been proved to be caused by the pill. A variety of laboratory findings have been related to contraceptive use and drug interactions occur with barbiturates, rifampicin, hydantoin, and phenylbutazone. Blood coagulation is increased, partially by increased production of various blood coagulation factors; but more importantly, by a decreased synthesis of antithrombin III, a natural protective mechanism against intravascular coagulation. This increases thrombosis risk. Risk doubles with simultaneous cigarette smoking. Various epidemiological studies indicate a 5-10 fold increase in thromboembolism and thrombophlebitis, deep vein thrombosis, and pulmonary embolism. There is a correlation between contraceptive use and cerebrovascular disorders and myocardial infarction. This risk increases with age and years of pill use. The pill is contraindicated with symptoms of thrombophlebitis and thromboembolism, sickle cell anemia, proposed surgery, and longterm immobilization. Overall risk factors are not too high. Recommendations for rational pill use related to age are given and further contraindications are mentioned.
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PMID:[Adverse effects of oral contraceptives]. 55 52

Study of the literature on the prevention of deep vein thrombosis shows the inefficacy of calf bandaging in the ambulation phase. Since thrombosis starts soon after or during operation, prophylactic measures are successful only if performed from the beginning of hospitalization. Orthostatic disturbances are not a general problem in the mobilization phase, as is shown in a study on 20 patients after myocardial infarction or heart surgery in whom leg compression did not influence circulatory regulation. In chronic venous or lymphatic insufficiency, however, compression therapy is of proven value. Such patients should be identified and treated. On the other hand, leg bandaging as a general preventive measure in the mobilization phase is no longer justified, but is indicated in individual patients with venous or orthostatic problems.
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PMID:[Indications for bandaging of the legs]. 62 42

The incidence of deep vein thrombosis (DVT) as diagnosed by the 125I fibrinogen test (125IFT) was determined in a series of 300 newly admitted medical and 201 surgical patients. 6 medical patients died before 125IFT screening could be completed. The incidence of DVT was 14% in medical patients and 18% in surgical patients. Increasing age, a malignant condition and a past history of thromboembolism all increased the risk of DVT. Increasing levels of cigarette smoking were found to be associated with a reduced incidence of DVT. Although statistical significance was achieved at only the 10% level for this finding it is in agreement with the results from studies on patients with myocardial infarction. The protective effect of cigarrette smoking was observed at all ages, and in both medical and surgical patients.
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PMID:Smoking and risk factors in deep vein thrombosis. 72 43

Detailed analysis of the clinical data and autopsy material of 100 consecutive renal transplant recipients revealed significant thromboembolic disease in 25 patients and a total of 41 complications. In six of them, thromboembolism was associated with sepsis. Nine patients died (20% of total number of deaths) due to a primary thromboembolic event. The incidence of pulmonary embolism was 14%; myocardial infarction, 3%; cerebrovascular disease, 4%; renal artery thrombosis, 2%; renal vein thrombosis, 3%; thrombophlebitis/deep vein thrombosis, 13%; and miscellaneous, 2%. The incidence of thromboembolism was higher in patients older than 40 years of age (P = .02) and during the earlier months after transplantation. We summarize the general incidence and mortality related to thromboembolism and discuss the factors predisposing the graft recipient to thromboembolic disease. Prevention and therapy of this complication should decrease the morbidity and mortality in graft recipients and enhance the success of renal transplantation.
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PMID:Thromboembolic disease in renal allograft recipients. What is its clinical significance? 78 76

Notwithstanding the large number of clinical trials, most of them designed and performed according to the requirements of modern clinical pharmacology, only a few firm clinical recommendations on drugs affecting platelet function in the prevention of arterial or venous thrombosis can be made at present. There is no good evidence for the clinical effectiveness of aspirin or any other drug affecting platelet function in patients with peripheral arterial occlusion or after vascular grafting. In cerebrovascular disease there is reasonable evidence that the administration of sulfinpyrazone can significantly reduce cerebral ischemia or mortality, but similar trials performed with aspirin, dipyridamole or clofibrate failed to reveal a significant difference in favor of the experimental treatment. Patients with angina only were shown to benefit from treatment with clofibrate, but prospective trials with dipyridamole or aspirin in the primary or secondary prevention of myocardial infarction did not reveal a significant reduction in morbidity or mortality in the experimental group. Use of a combination of the latter two drugs did, however, reveal a reduction in morbidity and mortality. In patients with prosthetic heart valves, there is firm evidence that dipyridamole and sulfinpyrazone therapy can normalize decreased platelet survival, an effect which has been shown to correlate well with the incidence of thromboembolism. Provided further trials lead to confirmatory conclusions, drugs inhibiting platelet function associated or not with oral anticoagulants may constitute an ideal prophylaxis in patients with a substitute valve. There is still much uncertainty as to whether dipyridamole, given in addition to conventional treatment, benefits patients with membranous or mesangiocapillary glomerulonephritis. The same holds for drugs inhibiting platelet function after kidney or heart transplantation in man. Only scanty reports are available on the usefulness of drugs affecting platelet function in thrombotic thrombocytopenic purpura and the hemolytic uremic syndrome. Three different types of antiplatelet drugs are available for the prevention of postoperative deep vein thrombosis: dextran, oral drugs also affecting platelet function and heparin administered subcutaneously in small doses. In orthopedic surgery dextran 70 administered before and every second day after surgery was the drug showing the most convincing reduction in the incidence of phlebographically proved deep vein thrombosis. Major orthopedic surgery is precisely the type of surgery in which the effectiveness of small dose heparin is much in doubt and in which the effectiveness of aspirin and dipyridamole is still to be confirmed. In general surgery, use of a combination of 1 g aspirin and 0.225 g dipyridamole daily was shown to offer approximately the same level of protection as small doses of heparin, land these two forms of prevention seem to offer a greater degree of protection than dextran...
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PMID:Are agents affecting platelet functions clinically useful? 79 99

The activated partial thromboplastin time is compared with the corresponding prothrombin ratio in 6378 samples of platelet-poor plasma from 446 patients treated for a total of more than 4500 patient/months with oral anticoagulatnts. A relative decrease in the activated partial thromboplastin time following deep vein thrombosis is described, which tends to become less obvious during the first year of treatment and is greater in older patients. Although this relative decrease is also found in patients treated after cerebrovascular accidents, it is not found in patients treated after myocardial infarction or in patients with mitral valve disease treated prophylactically with long-term oral anticoagulants. It is though possible that these changes following deep vein thrombosis might be useful in helping to determine the duration of oral anticoagulant treatment.
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PMID:The efficacy of long-term oral anticoagulant therapy and its laboratory assessment. 112 47


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