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)

Eight cases with lupus anticoagulants (LA) were diagnosed over the last five years (1984-88). Of these, three were established cases of systemic lupus erythematosus (SLE), where bad obstetric history (2 cases) and recurrent deep venous thrombosis (DVT--1 case) prompted execution of laboratory tests for LA. In the remaining 5 cases, there was no clinical evidence of SLE. However, one case developed laboratory findings suggestive of SLE at a later date. One of these 5 patients was referred for unexplained abnormality in partial thromboplastin time (K). Three had recurrent abortions (one with additional history of DVT) while one had DVT with raised PTT (K). The clinical findings and laboratory tests by which lupus anticoagulants can be diagnosed have been discussed.
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PMID:Lupus anticoagulant. A report of 8 cases. 190 56

Early diagnosis, treatment, and appropriate prophylaxis may prevent serious maternal sequelae of thromboembolism. Objective techniques for diagnosis should be used aggressively, using noninvasive methods such as Doppler or IPG when possible for DVT. 125I-fibrinogen should be avoided. The possible consequences of failure to treat or unnecessary use of anticoagulant therapy outweigh risks to the fetus of the appropriate radiologic procedures. Because of its low fetal risk, heparin is the anticoagulant of choice. Measurement of heparin levels by antifactor Xa activity appears to be more sensitive than the current standard, the aPTT, and it is hoped that this will become widely available. Although the risks and benefits of prophylaxis during pregnancy are currently debated, it appears most prudent to use subcutaneous heparin prophylaxis in doses larger than for nonpregnant patients in women at high risk for recurrence.
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PMID:Deep venous thrombosis and pulmonary embolism in pregnancy. 194 60

In the treatment of DVT fibrinolytic therapy offers the possibility of rapid clot dissolution resulting in symptomatic relief of the acute episode as well as preservation of venous valve function and prevention of long-term disability from chronic venous insufficiency. A review of published studies comparing fibrinolytic therapy with SK to anticoagulation alone indicates that substantial venographic improvement occurs in 45% of SK treated patients compared with only 5% receiving only anticoagulation. Substantial data indicate a high incidence of venous valvular dysfunction and eventual development of chronic venous insufficiency in patients with extensive leg DVT treated with anticoagulants alone. The available data on the long-term benefits of thrombolytic therapy in preventing chronic venous insufficiency suggest that fibrinolytic therapy reduces long-term morbidity. Because best results are obtained by treatment soon after the onset of symptoms, it follows that the postphlebitic syndrome can be best avoided by prompt thrombolytic therapy of patients with acute DVT. Bleeding complications are more frequent after thrombolytic therapy than anticoagulant therapy, but most are related to invasive vascular procedures and can be minimized by proper patient selection and management. Available studies of rt-PA in treatment of DVT indicate that infusion durations of 24 hours or more may be required; further studies will be needed to evaluate the response to rt-PA compared with those of SK or UK. Thrombosis of the axillary/subclavian veins of the upper extremity, occurring spontaneously or in association with indwelling venous catheters, also respond well to regional or systemic fibrinolytic therapy, which may reduce the likelihood of developing chronic arm symptoms related to venous insufficiency.
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PMID:Fibrinolytic therapy for venous thrombosis. 194 24

Real-time venous ultrasound has replaced phlebography for making the diagnosis of clinically relevant lower extremity DVT. Phlebography is still useful in suspected calf vein thrombosis when an immediate diagnosis is required and in the postoperative patient. A combination of sonography and contrast phlebography is used to sort out the extent of chronic and acute venous changes in patients with chronic deep vein thrombosis.
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PMID:Suspected acute deep vein thrombosis in patients with rheumatoid arthritis. 194 8

The plethysmographic strain gauge venous outflow curves were studied by means of an exponential function. The parameters analyzed made possible the establishment of differences between patients with and without DVT.
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PMID:[A mathematical analysis of strain-gauge curves in the diagnosis of deep venous thrombosis]. 195 54

A prospective randomized double-blind trial was performed comparing conventional low-dose heparin with a LMWH fragment (Kabi 2165, Fragmin) for thromboprophylaxis in elective general abdominal surgical patients. The first dose of the fragment was given in the evening before surgery, and thereafter every evening. There were 1002 analyzable patients, 826 having received correct prophylaxis. Sixty three percent of the patients were operated on for malignant diseases. The frequency of DVT was significantly reduced among patients with correct prophylaxis with the heparin fragment (9.2 to 5.0%, p = 0.02). In patients with malignancies the reduction was from 11.2 to 6.4% (p = 0.06). The frequency of bleeding was 6.7% among the heparin fragment patients and 2.7% among the patients given conventional heparin (p = 0.01). The corresponding frequencies for patients with malignancies were 3.2 and 2.8%, respectively (p = 0.28). All bleedings were minor and of no clinical significance. Local pain at the injection site was reported significantly less often among patients with the fragment. Twenty patients died, 13 with malignant disease, mortality being the same in the two groups. It is concluded that heparin fragment administered in the evening before surgery and then every evening is a practically acceptable alternative to prevent postoperative DVT in patients undergoing elective abdominal surgery, also when the histology shows malignancy. Thus, the advantages of using LMWH compared with conventional low-dose heparin are simplified administration routines, better thromboprophylactic effect, and less local pain at injection sites. A disadvantage is the slight increase in hemorrhagic side effects, all of minor clinical importance and not seen in patients undergoing surgery for malignancy.
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PMID:Thromboprophylactic effect of low molecular weight heparin started in the evening before elective general abdominal surgery: a comparison with low-dose heparin. 196

The effect of LMW heparin (Kabi 2165, Fragmin) was compared with placebo for the prevention of DVT in 103 patients with acute ischemic stroke using a prospective, double-blind, randomized trial design. Treatment was started within 72 hours, and LMW heparin was administered subcutaneously once daily according to body weight classes, which corresponded to about 55 to 65 Factor-Xa inhibitory U/kg, for 14 days, or until discharge from the hospital, if earlier. All patients underwent thrombosis surveillance with unilateral venography of the paretic limb. Evaluation of venography could be performed in 42 of 52 patients randomized to LMW heparin and in 50 of 51 patients randomized to placebo. The frequency of DVT was 15 of 42 patients or 36% (95% confidence interval 22 to 52%) in the LMW heparin group and 17 of 50 patients or 34% (21 to 49%) in the placebo group. The frequency of proximal thrombi was 5 of 42 (12%) and 8 of 50 (16%), respectively. There was one fatal pulmonary embolism in the placebo group. The mortality rate (28 days follow-up) was 5 of 52 in the LMW heparin group and 1 of 51 in the placebo group (p = 0.24). None of the deaths was related to treatment. No major hemorrhagic complications were observed. The mean Factor Xa inhibitory activity levels at peak concentration were 0.34 U/ml on day 2 and 0.42 U/ml on day 12 (p = 0.02). We conclude that LMW heparin in the dose range studied did not provide efficient prophylaxis against DVT in patients with acute ischemic stroke.
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PMID:A double-blind and randomized placebo-controlled trial of low molecular weight heparin once daily to prevent deep-vein thrombosis in acute ischemic stroke. 196 1

In 1988 and 1989 4581 patients had been hospitalized in the surgical department of the Stadtkrankenhaus Neuwied. These patients were treated prophylactically with a combination of low molecular weight heparin and dihydroergotamine in order to prevent deep vein thrombosis. The observed incidence of DVT and pulmonary embolism was extremely low. In patients who died during hospitalization, death was mainly caused by cancer or multimorbidity. Although some risk factors for developing DVT are recognized, we are at present not able to calculate the individual risk of a patient. Therefore, we need an effective and safe prophylaxis regimen for all patients undergoing surgical operations.
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PMID:[Can the individual risk of the patient for thromboembolic complications be estimated? What references can be used for differential therapeutic procedure?]. 198 3

Coagulation and fibrinolytic studies have been performed in patients who were undergoing major gynaecological surgery and randomised to either fixed minidose warfarin (1 mg daily) or matched placebo. With warfarin, a prolongation of the prothrombin time was observed on day 2 which persisted for at least 5 days and was greater than with placebo. The maximal postoperative mean INR was, however, only 1.2 which is considerably less than the target value for prophylaxis of deep vein thrombosis with full dose warfarin. The warfarin group showed two unexpected findings: significantly elevated fibrin specific degradation products throughout the postoperative period compared with placebo and absence of the expected rise of PAI, the major fibrinolytic inhibitor, on the first day after surgery. Levels of fibrinogen degradation products and F1 + 2 prothrombin fragments rose significantly and progressively in both groups in the postoperative period. With placebo, F1 + 2 showed an apparent higher percentage increase on each post-operative day but the differences between the groups were not significant. Increased fibrinolysis may be one of the mechanisms for the protective action of minidose warfarin in prophylaxis of DVT after major surgery.
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PMID:Effects of fixed minidose warfarin on coagulation and fibrinolysis following major gynaecological surgery. 208 36

255 hip fracture patients were studied by 125I-fibrinogen uptake test and bilateral phlebography. We found the sensitivity of fibrinogen scanning to be 44% for the non-operated limb and 50% for the calves. The predictive value of a negative result was found to be 92% and 93% respectively. We conclude that the use of fibrinogen uptake test as single diagnosticum is not valid and can only be recommended in combination with phlebography when studying patient where the frequency of DVT is expected to be low.
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PMID:The use of fibrinogen uptake test in screening for deep vein thrombosis in patients with hip fracture. 208 47


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