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)

The effect of a single dose of 500 mg acetaminophen (paracetamol) on the in vivo synthesis of prostacyclin was studied in healthy volunteers by measurements of the urinary excretion of 2,3-dinor-6-keto-PGF1 alpha. Acetaminophen caused a marked reduction of prostacyclin synthesis for 6-8 hours without any obvious effect on the thromboxane synthesis. Thus, acetaminophen may at least theoretically be disadvantageous for patients suffering from diseases where prostacyclin mediated vascular defence mechanisms are activated, like myocardial infarction, deep vein thrombosis and following surgery.
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PMID:Pronounced reduction of in vivo prostacyclin synthesis in humans by acetaminophen (paracetamol). 266 1

Blood echogenicity was measured in four patient groups with circulatory disturbances (myocardial infarction, stroke, claudication, and deep venous thrombosis) at hospital admission and one week later. The recording was done by an A-mode ultrasonic method at three shear rates down to 4.1 s-1. The rheological effects of adding an anti-aggregatory drug, naftidrofuryl, was tested in vitro at concentrations ranging from 10(-8)-10(-6) M. Echogenicity was lowest in blood from healthy volunteers and significantly greater in blood from patients with claudication. The in vitro addition of naftidrofuryl significantly lowered the echogenicity of blood samples taken from patients with venous thrombosis in the lower extremities. The authors suggest that increased blood echogenicity, which can be pharmacologically manipulated, may be a nonspecific indicator of disease.
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PMID:The in vitro echogenicity of flowing blood in patients with vascular disease and the effect of naftidrofuryl. 267 60

Our studies on the urinary excretion of 2,3-dinor-TxB2 and 2,3-dinor-6-keto-PGF1 alpha in humans strongly indicate that these metabolites are good indicators of the in vivo synthesis of TxA2 and PGI2. Our finding that physical exercise increases PGI2 synthesis was of particular importance for the design of adequate studies on the effects of various drugs on the in vivo formation of PGI2. The rapid recovery (within 3-4 h) of PGI2 formation found following administration of 1.0 g of aspirin together with the long-lasting inhibition of TxA2, suggests that in the prophylaxis of thromboembolic events an intermittent dosage of 0.5 g of aspirin every third day should be a better alternative than daily low or high doses of aspirin. The increased TxA2 formation found in patients with acute myocardial infarction, deep vein thrombosis and in patients following insertion of synthetic surfaces into the circulation, is very likely a reflection of an increased activation of platelets. The increased TxA2 synthesis may cause further platelet activation, vasoconstriction and activation of the coagulation system. Thus, theoretically, inhibition of TxA2 could diminish platelet activation and reduce the risk of thrombotic complications. It is well known that the interaction between platelets and the vessel wall plays an important role in haemostasis and in the development of thrombosis. On the basis of its biological properties, PGI2 may play a local haemostatic role in the regulation of this interaction. Our studies of myocardial infarction and deep vein thrombosis clearly demonstrate the involvement of PGI2 in those diseases.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Measurements of the in vivo synthesis of thromboxane and prostacyclin in humans. 306 Sep 85

The clinical and echocardiographic features of right atrial thrombi were examined in 9 patients, 5 men and 4 women aged 16 to 86 years. The 2D echocardiographic diagnosis was confirmed at autopsy (4 cases) or by the association of severe recurrent pulmonary embolism (5 cases). Three patients had associated ischaemic heart disease and on patient had dilated cardiomyopathy. The clinical presentation was: acute cor pulmonale (5 cases including 2 patients which biventricular myocardial infarction), chronic post-embolic cor pulmonale (1 case), tricuspid valve obstruction (1 case), general ill health with pyrexia (1 case) and heparin-induced thrombocytopenia (1 case). Predisposing factors included: absence of anticoagulent therapy (7 cases), previous supraventricular arrhythmias (2 cases) and right ventricular failure (6 cases, including 2 of right ventricular infarction). In 2 patients the thrombi were relatively immobile and had a wide base of implantation on the interatrial septum; in 1 patient, multiple thrombi were observed lining the right heart cavities from the inferior vena cava to the pulmonary infundibulum. In the other 6 patients, the thrombi were very mobile with a visible pedicule of implantation (2 cases) or totally free (4 cases). The variable polylobulated appearances, completely irregular whirling motion and intermittent prolapse into the tricuspid valve were characteristic features of the latter 4 cases. They disappeared spontaneously (2 cases) or after fibrinolytic therapy (2 cases) in under 36 hours. Three patients were operated with one postoperative death. The global hospital mortality was 22%. The present occasional detection of right atrial thrombosis will certainly become more common if patients with pulmonary embolism, right ventricular infarction or deep venous thrombosis are systematically examined by 2D echocardiography in the acute phase of their illness.
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PMID:[Clinical, echocardiographic and evolutive aspects of right atrial thrombosis]. 308 12

Since the introduction of thrombolytic treatment based on the activation of plasminogen (PLG) by streptokinase (SK) and urokinase (UK) the search for new and improved methods has been continuing. The pivotal issue is how to achieve clot-specific fibrinolysis without producing systemic fibrinogenolysis. One out of various approaches to enhance lysis rates has been the use of PLG either alone or in combination with UK or SK in the light of the fact that fibrinolytic treatment, particularly using SK, is associated with a consumption of PLG, and that thrombi contain relatively small amounts of native PLG, however, are capable of incorporating added PLG in vitro. PLG-concentrates from various manufactures have been administered intravenously for treatment of deep venous thrombosis, mainly in combination with SK, and of pulmonary embolism in combination with UK. Local intracoronary and intraarterial administration in combination with UK has been reported in patients with myocardial infarction, and peripheral arterial occlusions, respectively. Lysis rates obtained in these studies were in most cases superior to results obtained with SK or UK alone, without increasing the incidence of bleeding complications. In addition, excellent results in larger group of patients with cerebral thrombosis were obtained with PLG alone. The encouraging results of these studies may be explained by the fact that all of the preparations used contained partially activated forms of PLG (commonly designated lys-PLG) to a greater or lesser extent. Lys-PLG has a higher affinity for fibrin than the native glu-PLG and is activated by UK or SK by a manyfold faster. These properties allow for a rapid formation of plasmin which--bound to fibrin--is also protected from the attack of neutralizing antiplasmin. The design and results of previous studies with lys-PLG concentrates will be reviewed and approaches to further improve fibrinolytic regimens with lys-PLG-concentrates discussed.
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PMID:Review of studies with plasminogen concentrates and proposals for further therapeutic strategies with plasminogen concentrates. 328 Apr 22

In 1933 Streptokinase (SK) was isolated from bacterial strains of haemolytic Streptococci. Since then it has become the widest spread drug for fibrinolysis. SK, a protein, consists of 415 aminoacids and has a molecular weight of 47,000u. Together with the plasminogen (PLG) of the blood it forms activator complexes, which then convert other PLG molecules of the blood to plasmin. Plasmin attacks and dissolves fibrin deposits. As a substance produced by bacteria SK stimulates antibody formation in the body, the titer will increase during therapy, and SK lysis should be terminated after 6 days of treatment. Usually SK is administered intravascularly to treat a wide range of diseases, associated with pathological activation of hemostasis, like deep vein thrombosis, pulmonary embolism, myocardial infarction etc.. Contraindications can be traced back to the effects of SK on coagulation and the immune system. Bleeding is the most common side effect, but also a few anaphylactic reactions, caused by massive antigen-antibody precipitation have been observed. The rate of lethality of the treatment was established at 0.7% of the cases. To reduce the incidence of side effects modifications of the drug have been proposed, such as activator complex, light B chain SK, and acylated activator therapy. Compared with Urokinase, SK shows a higher rate of side effects, especially in the field of the immune system. Therapy with Urokinase can be controlled more easily. Nevertheless because of considerable price differences and logistics, SK is preferred in Europe and the USA. If strict guidelines in therapeutic use are followed, the rate of side effects of the drug can be curtailed and will be comparable to those of Urokinase.
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PMID:Review and current status of thrombolytic therapy with streptokinase. 354 44

This artical examines the risks and benefits associated with use of the oral contraceptive pill (OCP) by adolescents and the various alternatives and methods of prescribing OCPs. Any adolescent who is either sexually active or contemplating sexual activity should be offered a contraceptive method that is appropriate to her individual needs. The contraceptive needs to be highly effective, safe and within the means and desires of the adolescent. For the majority of teenagers, the contraceptive of choice will be the OCP. The IUD should almost never be prescribed to the adolescent. Most OCPs marketed today are combination pills containing both an estrogen and a progestin in each pill. A variety of contraceptive actions combines to create a contraceptive method that is 99.3-99.9% effective. OCPs provide some protection against the development of pelvic inflammatory disease (PID). Oral contraceptives also decrease the incidence of anemia by decreasing the amount and duration of menstrual flow. Ovarian cysts do not form in the ovaries of the OCP user. On the other hand, a serious risk of the use of OCPs is the increased danger of thromboembolic events including deep venous thrombosis, pulmonary embolus, and myocardial infarction. The increased risk of myocardial infarction in OCP users is additive with other risk factors including hypertension, hypercholesterolemia, cigarette smoking, obesity, diabetes mellitus, and age. OCP use seems to provide some protection against development of endometrial or ovarian cancer. Oral contraceptives are associated with the development of benign hepatocellular adenomas. A variety of metabolic and hormonal alterations also occur in pill users. Most appropriate for the adolescent is a formulation containing a low dose of estrogen because of the decreased risk of thromboembolic complications. Dysmenorrhea effects more than 1/2 of female adolescents, and can best be treated with ibuprofen.
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PMID:Oral contraceptives and dysmenorrhea. 354 24

We reviewed the records for 100 consecutive cases of elective hip replacement in 91 patients in their 80s (average age 82.8 years), all of whom lived in their own homes before surgery. In 92 cases the patients returned home, 59 within 3 weeks. The average duration of hospital stay was 20.1 days. In eight cases there were major complications, including three cases of myocardial infarction (one of them fatal) and two cases of pulmonary embolism (one of them fatal). In 15 cases there were moderate complications, including deep venous thrombosis (in 5) and urinary tract complications necessitating transurethral prostatectomy (in 2). In 44 cases there were minor complications, including the need for urinary catheterization (in 27) and brief periods of postoperative confusion (in 14). In 33 cases there were no complications; in 31 of these cases the patients returned directly home within 3 weeks. The preoperative risk rating of the American Society of Anesthesiologists (ASA) correlated well with the complication rates: the rates of major complications in cases with a rating of ASA class I, II or III were 0%, 6% and 15% respectively. In 49 of 52 cases in which the procedure had been performed more than 2 years previously, the patients were happy they had had the operation.
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PMID:Risks and benefits of elective hip replacement in the octogenarian. 365 11

Epidemiologic studies, chiefly in English and US populations, have generated concern regarding cardiovascular hazards associated with the use of oral contraceptives (OCs). A detailed analysis of these data suggests, however, that such studies have serious methodological flaws. For example, the clinical diagnosis of deep vein thrombosis may be incorrect up to 1/2 of the time, rendering statistical analysis meaningless. The known cardiovascular risks of cigarette smoking may be amplified by OC use, but nonsmokers probably do not have an increased risk. Further, a number of studies in developing-world countries do not yield evidence of increased cardiovascular risks of OC use. Abnormal levels of serum lipids appear to affect cardiovascular (that is, myocardial infarction) risks in Western populations. Whether normalization of these levels improves the outlook is not entirely certain. The hormonal components of OCs are known to affect serum lipids, raising concern about possible long-term consequences. Newer low-dose OC formulations (such as triphasics) do not cause changes in serum lipids and therefore eliminate the putative risk.
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PMID:Hormonal contraception: benefits versus risks. 367 79

The procedure of interruption of the inferior caval vein is designed to prevent pulmonary embolism, but its effectiveness has yet to be compared with thrombolytic therapy. Sixty patients hospitalized for pulmonary embolism and proximal deep vein thrombosis were divided into two groups of 31 and 29 patients, respectively. The patients were selected because of persistent venous thrombosis in the inferior caval, iliac or femoral veins. The patients in the first group (mean age 53.2 years) were treated by interruption of the inferior caval vein. The second group of patients (mean age 57) received only fibrinolytic treatment. From those patients having caval venous interruption due to peri-operative myocardial infarction 1 died and 3 others presented pulmonary embolism (massive in two cases). No patients treated by fibrinolysis suffered from pulmonary embolism. Five patients died of cancer, 2 having had caval interruption, as opposed to only 2 having fibrinolysis. Eight patients undergoing surgery had a severe functional handicap. This study demonstrated a high recurrence of pulmonary embolism in patients with persistent venous thrombosis who were treated by interruption of the inferior caval vein. These patients also had a high morbidity. Fibrinolytic treatment (even in the presence of persistent venous thrombosis) appeared to be more effective in avoiding recurrence of pulmonary embolism.
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PMID:Comparison of fibrinolytic treatment with interruption of the inferior caval vein in the prevention of pulmonary embolism. 374 1


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