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)

Between April 1988 and February 1989, 877 patients undergoing total hip (394 patients) and total knee (483 patients) replacement surgeries were given warfarin prophylaxis perioperatively and were tested with impedance plethysmography (IPG) approximately 17 days postoperatively (10 days post-discharge) in the outpatient office. There were 69 positive IPG tests (7.8%). Further assessment of patients with positive IPG results using duplex scanning or venography confirmed DVT in 25 of the 69 patients (3.6%) in the popliteal or thigh areas, and ruled out venous disease in 44 patients. All 25 patients were readmitted for anticoagulation therapy with intravenous (IV) heparin and warfarin. There were no cases of pulmonary embolus. This study indicates that IPG testing is a safe and effective method of screening patients for DVT and its potentially fatal sequela of pulmonary embolus. Furthermore, IPG testing has proven to be cost effective, as it is a relatively simple procedure which can be administered by non-professional personnel in the outpatient office setting.
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PMID:Impedance plethysmography for surveillance of deep venous thrombosis following early discharge of total joint replacement patients. 227 77

Intravascular activation of the coagulation system produces disseminated intravascular coagulation or deep vein thrombosis and is characterized by the occurrence of circulating soluble fibrin monomer complexes (FM) in plasma. In order to evaluate the prognostic and diagnostic value of this parameter in 156 patients with fractures of the femur, neck of the femur, tibia, and fibula, and with knee-joint or elective hip surgery, soluble fibrin monomer complexes (FM) were determined using the FM Test from Boehringer Mannheim/Diagnostica STAGO (erythrocyte agglutination test according to Largo). Plasma samples were taken prior to and on the 1st, 2nd, 3rd, 5th, 7th, and 9th postoperative day. Diagnosis of DVT was carried out by 125-I-labelled fibrinogen test in parallel. Positive results were checked by phlebography on the 7th or 9th postoperative day. Positive FM results were obtained in only 26% of patients without DVT. In 34 of 36 patients (94%) with postoperative DVT confirmed by phlebography, on the other hand, elevated FM levels were detected 2-4 days before the 125-I-labelled fibrinogen test gave positive results. The predictive value calculated on the basis of elevated FM levels is 63-73%. These results show that the FM Test allows early detection of a prethrombotic state in the development of postoperative DVT.
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PMID:Predictive value of fibrin monomers in postoperative deep vein thrombosis. 228 91

In this review, an attempt has been made to present new data on the mechanisms that can be involved in DVT and to emphasize the role of the cell in these processes. It has been demonstrated that cells can mediate the relevant expression of tissue factor without cell disruption and that the fibrinolytic responses can also be modulated by the cells. It has also been demonstrated that the fibrinolytic system seems to be designed to work on the cell surface based upon (1) the existence of specific receptors, (2) the modulation of the expression of these receptors and (3) the comprehensive increase in plasmin generation by up-regulating, for example, the plasminogen receptors. It could also be worthwhile to attempt to explain some beneficial effects of drugs such as heparins by studying their action on these compartments. It is important to note that recently Rosenfeld et al. have described an increase in t-PA and u-PA binding to endothelium by pre-incubation of endothelial cells with unfractionated heparin. This work would be a first step in a very exciting and interesting new era in the prevention of venous thromboembolism.
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PMID:Biochemical aspects of the pathogenesis of venous thrombosis. 228 80

The effect of four DVT-prophylaxis-stockings was examined by computer-aided-video-plethysmography. An increase of venous outflow was observed under the influence of all elastic stockings; knee-stockings have a better effect than thigh-stockings.
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PMID:[The effect of antithrombotic stockings on venous return in the human leg]. 234 53

As patient advocates, perioperative nurses are vital to the safety and protection of the surgical patient. They are responsible for providing a safe environment and efficient and economical nursing care. Using the treatment options available, they can optimize the patient's surgical experience and postoperative recovery. OR nurses and managers can potentially prevent extended hospital stays and expense for patients by requiring pneumatic compression stockings and anticoagulants as the standard of care in their operating rooms. Prophylaxis is the key to reducing the incidence of DVT and PE. The perioperative nurse, cognizant of the effects of general anesthesia, Virchow's triad, and inherent patient risk factors, can greatly contribute to reducing the incidence of DVT and PE morbidity and mortality by using these treatment modalities as ordered by the attending physician.
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PMID:Pneumatic compression stockings. Preventing deep vein thrombus and pulmonary embolus. 237 19

Plasma levels of betathromboglobulin (BTG), fibrinopeptide A (FPA) and B beta 15-42 fragment, indices of platelet release, thrombin generation and plasmin activity respectively, were measured in 32 high risk patients during a double blind study of a single dose of the anabolic steroid stanozolol (50 mg IM) in the prevention of DVT after major gastro-intestinal surgery. The prevalence of malignancy and the incidence of DVT (125I fibrinogen scan) were similar in the two treatment groups. On the first postoperative day, BTG, FPA and B beta 15-42 levels were increased in most patients. Plasma BTG levels were significantly increased on the first post-operative day in patients who developed a DVT (n = 14) compared to those patients who did not (n = 18). A significant increase in FPA levels was found in the DVT group, 7 days after surgery. On the morning before surgery, plasma B beta 15-42 levels were significantly increased in patients who developed a DVT. In patients undergoing surgery for early malignancy (n = 17), we observed a pre-operative increase in FPA levels when compared to patients without malignancy. At post-operative day 7, B beta 15-42 levels were significantly increased in patients who received stanozolol (n = 15), when compared to the placebo group, suggesting that intramuscular stanozolol increases fibrinolysis in vivo.
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PMID:Plasma beta-thromboglobulin, fibrinopeptide A and B beta 15-42 antigen in relation to postoperative DVT, malignancy and stanozolol treatment. 241 Sep 95

Nine patients with, and 11 without, venous thromboses (DVT) from two families were studied. In family 1, four members with, and one without, DVT had t-PA activity below the lower limit of the controls (21.3 IU/ml, n = 19) after 20 min venous occlusion (VO). After VO t-PA antigen (t-PA:Ag) was below the lowest value of the controls (22.8 ng/ml) in all five cases with low t-PA activity. All the family members, both with and without thrombosis, had normal t-PA inhibitor activities (PAI). In family 2 t-PA activity after VO was low in three symptomatic and four asymptomatic family members. t-PA:Ag was also low in four of these. PAI level was normal in all but one family member. Mild type I von Willebrand's disease was discovered in four members of family 2. Deficient t-PA:Ag response was found in two of these. Antithrombin III, protein C and protein S were normal in both families. It is concluded that low fibrinolytic capacity, independent of PAI, is associated with familial DVT. Our data suggests autosomal dominant inheritance.
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PMID:Familial hypofibrinolysis and venous thrombosis. 249 18

A new method involves 2 stages: 1st, injection of three 10 ml boluses of 99mTc-pertechnetate through a dorsal vein of the foot with recording of 3 separate dynamic studies of venous flow in the calf, thigh and pelvis; and 2nd, static equilibrium venography (EV), which can be completed 15 min later after 99mTc-RBC labelling in vivo. The method was performed in 100 patients with suspected DVT. Due to the large pertechnetate bolus followed with 20-40 ml flush of normal saline, the flow study provides a significant improvement in filling of major calf veins, which makes this technique more similar to contrast phlebography. The flow study was found much more sensitive than EV, especially for calf DVT. However, EV, providing information about the unaffected leg, plays an important complementary role when the study is negative for DVT. In conclusion, both stages are recommended for routine examination of patients referred with suspected DVT.
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PMID:Radionuclide venography: two stage--flow and equilibrium technique using 99mTc pertechnetate, and 99mTc RBC labelled "in vivo". 254 Sep 83

A prospective study compared real-time B-mode ultrasound examination with bilateral ascending phlebography in the diagnosis of postoperative deep vein thrombosis in 60 patients undergoing elective total hip replacement. The overall sensitivity and specificity of the ultrasound method were 54 and 91%, respectively, and the positive and negative predictive values were 83 and 69%, respectively. The rather low overall sensitivity of the ultrasound method in this study was due to difficulty in detecting thrombi smaller than 1 cm wherever they were located in the deep veins, and in diagnosing thrombi in the calf, regardless of their size. We conclude that real-time B-mode ultrasonography is a technique that can easily be used routinely for detection of postoperative DVT in hip surgery, but its sensitivity for proximal thrombosis (63%) is too low for it to be used alone.
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PMID:Comparison of real-time B-mode ultrasonography and bilateral ascending phlebography for detection of postoperative deep vein thrombosis following elective hip surgery. The Venous Thrombosis Group. 267 82

The analysis of the descriptive data from the present trial leads to the following conclusions. A statistically detectable influence of the risk factors for advanced age (for Fraxiparin) are body weight above 80 kg (for calcium heparin), and malignant disease on the development of postoperative DVT was observed. In general, some influence of these risk factors persisted even though prophylactic medication was administered. The statistical considerations on risk factors do not permit any predictions for the individual patient concerning the possible risk of developing DVT. The levels of transaminases and gamma-GT increased by 20 to 30% in both groups during the treatment period. The occurrence of wound hematoma in patients operated on for hernia compared with patients with other surgical interventions revealed a clear dependence of this parameter on the type of operation performed. In keeping with other tolerance data no differences between either treatment was observed concerning the rate of wound hematoma in patients undergoing herniotomy. As to the frequency of DVT, a considerable difference between men and women was recorded in the Fraxiparin group. However, this observation needs to be confirmed in further trials. No difference was detected concerning the onset of DVT in either treatment group: 70% of the thromboses occurred within 3 days after surgery. Significantly, fewer thromboses with clinical signs and fewer proximal vein thromboses occurred in the Fraxiparin group. This seems to be most important for the clinician, since it indicates a twofold effect of the LMW heparin Fraxiparin: Both the frequency of postoperative DVT and the severity of these complications were significantly reduced.
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PMID:Descriptive analysis of the European Fraxiparin Study. 268 91


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