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

Estrogen replacement in menopause should be used for specific symptoms such as ovarian failure, hot flushes, vaginal atrophy, atrophy of the vulva, and atrophic urethritis. The dose should be as low as possible to be effective and perscribed for as short as time as possible, since there are possible risks of uterine cancer, breast cancer, increased blood pressure, gallstones, deep vein thrombosis, and thromboembolism. Estrogens should be administered to provide the maximum benefit with the minimum risk involved. Estrogens should not be given to patients with known contraindications such as: suspected breast or uterine cancer; undiagnosed genital bleeding; Dubin-Johnson syndrome; acute hepatic disease; previous or present thromboembolism; or severe thrombophlebitis. Careful evaluation should be made before administering estrogen to women with uterine myomata, hyperlipidemia, hypercholesterolemia, sevare varicose veins, chronic hepatic dysfunction, diabetes mellitus, porphyria, or severe hypertension.
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PMID:Estrogen replacement in the menopause. 39 Apr 56

The [125I]fibrinogen uptake test was modified to give a quick result, and improve sensitivity and specificity in the diagnosis of deep venous thrombosis (DVT). At least 800 counts were recorded at each measuring point. The leg veins were emptied more effectively. Thus the proximal thigh could be evaluated and the influence of varicose veins reduced. The feet and the leg points were measured in a zig-zag order (from side to side) to avoid systematic errors in early diagnosis. The modified test detected 62% of the thrombi 1 h after injection, 82% after 1 day and 95% after 2 days. The method still lacks in specificity; this is unavoidable since fibrin accumulates in various other conditions than DVT. The combination of high sensitivity and low specificity makes the modified test reliable as a screening procedure, but not as an independent method.
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PMID:A modified [125I]fibrinogen technique for thrombus detection in the whole leg. 39 97

The posterior stocking seam approach to radical subfascial ligation of perforating veins has been advocated for the patient with postphlebitic syndrome presenting with severe stasis dermatitis, leg edema, and recurrent ulceration. Our indications for this procedure have been extended to include signs and symptoms of advanced venous insufficiency which persist after multiple operative procedures for recurrent varicose veins in the absence of deep venous thrombosis. In this series of twenty-five operations there was one instance of recurrent stasis ulceration after the procedure, and reversal of the pigmentation of stasis dermatitis was dramatic in the majority of cases. All limbs have completely healed, and there has been no significant swelling. The long-term results of this surgical procedure have been excellent, and short-term complications have been minimal.
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PMID:The posterior stocking seam approach to radical subfascial clipping of perforating veins. 68 63

The fibrinogen uptake test has been used to detect deep vein thrombosis after total hip replacement in 90 patients. The upper third of the thigh in each leg was ignored and peripheral leg counting carried out distal to this. The results were directly compared with the findings of venography in the 170 legs of the 90 patients. There was a high false positive rate (30 per cent) with the fibrinogen uptake test which was associated with the presence of the knee joint effusion or varicose veins, but not with the site of operation. There was a low false negative rate (less than 5 per cent), and the fibrinogen uptake test, used in this way, may fail to detect a percentage of small thrombi in the wound area that are probably produced by the local trauma of operation. It is considered that the fibrinogen uptake test has a clinical use as a screening test for deep vein thrombosis after hip replacement, but venography is required in the interests of accuracy.
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PMID:The fibrinogen uptake test after hip surgery. 69 32

To refine 1974 results on venous thrombosis and oral contraceptives (OCs) from a prospective study begun in 1968 comparing 23,000 women using OCs with 23,000 controls, women with known preexisting conditions relevant to thrombosis were excluded. Rates in each contraceptive category (users, ex-users, and controls) were indirectly standardized for age, parity, cigarette consumption, and social class. The relative risk (users to nonusers) of deep vein thrombosis was 4.17; for superficial vein thrombosis, it was 2.41. For other thrombosis and pulmonary embolism, trends were similar but the differences were not significant. Rates of ex-users did not differ significantly from the controls, implying no persistent risk after OC use ends. Superficial thrombosis correlated significantly with age, parity, and estrogen dose and progesterone content of OCs, but deep vein thrombosis did not. The risk of superficial thrombosis was significantly increased in users and nonusers with severe varicose veins, and increased with the severity; no significant relationship was found with deep vein thrombosis.
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PMID:Oral contraceptives, venous thrombosis, and varicose veins. Royal College of General Practitioners' Oral Contraception Study. 70 53

Five hundred and sixty-four patients undergoing abdominal surgery, who were carefully assessed at the time of operation for evidence of venous thrombosis, have been followed up to determine the incidence of leg symptoms, varicose veins and post-thrombotic syndrome. Patients are frequently troubled by pain, swelling and phlebitis, which can persist for up to a year after operation. New varicose veins developed by 1 year in 20 per cent of patients. These occurred with increased frequency in patients who also developed a deep vein thrombosis, but they were also seen in patients who showed no clinical or isotopic evidence of thrombosis. The post-thrombotic syndrome was present in 26 patients by 3 years after the operation; half of these patients had suffered the syndrome before the definitive operation. Assessment of the long term effects of venous thrombosis must be carried out against the background of similar effects seen in patients without thrombi, and the development of the post-thrombotic syndrome may best be considered as the summation of a number of incidents, overt or occult, occurring throughout a lifetime.
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PMID:The long term sequelae of deep vein thrombosis. 70 77

Scientific knowledge is reliable because it has been built on accurate measurements. Clinical knowledge is not. The science of biometry was started in 1835 by the Belgian astronomer Adolphe Quetelet. In the last fifty years a precise set of rules have been invented for this science. The method is suitable for a wide range of problems in clinical medicine and as the result of its application in recent years a firm foundation has been laid upon which scientific clinical knowledge can be built. Surge-ns, particularly, have been slow to apply biometrical methods to their clinical problems; but a start has now been made. The outcome of a particular type of treatment is determined by a complex set of inter-acting factors. The basis of the appropriate biometrical method is the elimination of all bias in favour of one of the rival techniques being compared. If this precaution is taken the observed results of the trial can be fitted onto Quetelet's distribution graph, and the probability of the observed difference in the results being due to chance, and nothing else, can be measured mathematically. The accuracy of this measurement deteriorates the greater are the number of the patients who can not be found and examined at the end of the trial. To make this point two trials conducted by the author are used. In the trial designed to discover if postoperative deep vein thrombosis and pulmonary embolism could be prevented by electrically stimulating the patients legs during the operation there was no difficulty. All the patients were examined at the end of the trial, because it ended before any of the patients left the hospital. The trial to discover if the primary treatment of varicose veins ought to be by Fegan's sclerotherapy or by operation was the exact opposite. At the end of the first year of the two year trial 15% of the patients could not be traced. The results in these patients, therefore, was unknown. Because of this, elaborate mathematical calculations had to be made to try and reach a reliable conclusion to the trial. The loss of patients before the end of the trial is a very serious practical difficulty which besets all long-term clinical trials.
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PMID:Clinical trials in surgery. 79 Aug 78

A range of clinical data was obtained from 124 patients about to undergo operation and several coagulation tests were performed. No patient received prophylaxis for deep vein thrombosis, and isotopic scanning after operation showed that 20 patients had developed thrombosis. a simiple prognostic index for predicting which patients would develop postoperative deep vein thrombosis was constructed using the clinical and coagulation data obtained before operation. The five variables with the best predictive power-euglobulin lysis time, age, presence of varicose veins, fibrin related antigen, and percentage overweight-produced an equation that identfied 95% of those who developed deep vein thrombosis and misallocated only 28% of those who did not develop thrombosis. In view of the complications that low-dose heparin and dextran can cause, giving prophylaxis to under a third of the patients who will not develop deep vein thrombosis is clearly better than giving it to all.
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PMID:Preoperative prediction of postoperative deep vein thrombosis. 97 58

Postpartum superficial and deep venous thrombosis were found in 22.3% and 5.3% of women with varicose veins who delivered vaginally, or by cesarean section. The preventive use of low doses of heparin (5,000 U every 12 h injected subcutaneously) in 116 parturients with varicose veins reduced significantly the incidence of postpartum venous thrombosis. None of the 26 women with previous thrombosis who received preventive treatment, developed such an event.
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PMID:Prevention of postpartum venous thrombosis with low doses of heparin. 105 20

We present the results of a control group of 95 patients who were thoroughly investigated in a prospective, randomized study, where the efficacy of small doses of s.c. heparin and dextran 40 is checked. The 125I-fibrogen test was used in all patients. 1. 35.8% of the patients develop deep vein thrombosis (DVT) during the first post-operative week. More than half of them show bilateral thrombosis. 2. There is no statistically significant difference in the thrombosis incidence between males and females. 3. 47% of the patients over 60 years develop postoperative DVT. Among those younger than 60 years, only 23% have DVT (P less than 0.025). 4. The DVT incidence in surgery of the colon is 58.3%. 5. Surgery for a malignant disease means probably increased risk for DVT (P less than 0.025). 6. More than half of the patients having a previous history of varicose veins develop postoperative DVT (P less than 0.025). 7. Obese patients are statistically seen not more prone to develop DVT than those of normal body build. 8. Immediately after operation 32.4% of DVT are diagnosed, 24 hrs. later 61.8%. 94% of all DVT are diagnosed up to the third postoperative day. 9. With the exeption of one patient, all DVT develop in the calf veins, 3/4 of all abnormal values were measured in the midcalf region.
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PMID:[Incidence of postoperative deep vein thrombosis in general surgical and urological patients an investigation by means of the 125I-Fibrinogen test in 95 patients withoug prophylaxis (author's transl)]. 122 Dec 27


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