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)

Five hundred indium-111 labeled platelet imaging studies (387 donor and 113 autologous) were performed postoperatively in 473 patients who had undergone total hip replacement, total knee replacement, or internal fixation of a hip fracture to detect occult deep venous thrombosis. All patients had been anticoagulated prophylactically with aspirin, warfarin sodium (Coumadin), or dextran. Thirty-four possible cases of proximal deep venous thrombosis were identified in 28 asymptomatic patients. To verify the scan results, 31 venograms were performed in 25 patients (three refused). In 21 of 31 cases, totally occlusive thrombi were detected; in 5 cases, partially occlusive thrombi were detected; in 5 cases, no thrombus was seen. No patient who had a negative scan nor any patient who had a verified positive scan (and received appropriate heparin therapy) subsequently developed symptoms or signs of pulmonary embolism. One hundred forty-one indium study patients also underwent Doppler ultrasonography/impedance plethysmography (Doppler/IPG) as a comparative non-invasive technique. In 137 cases, the results of the indium study and Doppler/IPG studies were congruent. The indium study had no false negative results that were detected by Doppler/IPG. No patient had any clinically evident toxicity. These results suggest that indium-111 labeled platelet scanning is a safe, noninvasive means for identifying DVT in high risk patients.
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PMID:The use of indium-111 labeled platelet scanning for the detection of asymptomatic deep venous thrombosis in a high risk population. 268 88

Pulmonary thromboembolism affects 750,000 Americans annually. DVT is the primary origin of PE, which results in approximately 150,000 patient deaths annually. Normal variants affect the incidence of DVT. Patients with duplicated or fenestrated superficial femoral veins and patients with five or more valves are at increased risk for development of DVT. Positive contrast venography performed in the radiology department under fluoroscopic control remains the "gold standard" for the diagnosis of DVT, despite the development of other modalities. Low-osmolar contrast agents, either nonionic or dilute ionic, and postprocedure infusion of 2,500 U of heparin mixed in 150 mL of physiologic saline should be used to reduce the incidence of postphlebography DVT. Positive venographic signs of DVT include filling defect, cutoff, nonvisualization, and collateralization.
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PMID:Deep vein thrombosis: a perspective on anatomy and venographic analysis. 269 99

18 elderly patients submitted to major surgery for malignancies or other disease were studied to assess the relationship between changes of blood coagulation factors and inhibitors in the early post-operative period and the appearance of lower limb deep vein thrombosis. A decrease in serum antithrombin III (AT III) Protein C antigen (PC: Ag) and Plasminogen activity (PLG) levels from the second to the fourth postoperative day, together with a simultaneous increase in serum fibrinogen (FG) and von Willebrand Factor (vWF:Ag) antigen levels was observed. In 8 patients, PC:Ag levels dropped below the limit considered at risk to develop DVT (less than 60 U/dl). A patient with the lowest PC:Ag levels had deep vein thrombosis From the analysis of data it was concluded that in the postoperative period, blood coagulation changes occur in elderly patients, predisposing to the risk of deep vein thrombosis.
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PMID:Evaluation of postoperative blood coagulation changes in elderly patients undergoing major surgery. 278 5

The safety and efficacy of a low molecular weight heparin fragment Kabi 2165, given in the dose 2,500 anti-Xa units once daily, in preventing postoperative venous thromboembolism, was assessed against calcium heparin in the dose 5,000 IU twice daily, in a multicenter double blind randomized study. On an intention to treat basis 385 patients scheduled for major surgery were included in this study. Six patients (3.1%) out of 195 developed isotopic DVT in the Kabi 2165 group. Corresponding figures for calcium heparin was 7 patients (3.7%). There was no statistically significant difference between the two groups with respect to the bleeding variables; blood loss during operation, postoperative drainage, blood transfusion, haemoglobin and haematocrit levels; wound haematoma and haematoma at the injection sites. No patient had to undergo evacuation of wound haematoma or reoperation due to bleeding. It is concluded that one single daily injection of Kabi 2165 provides a convenient safe and effective prophylaxis against thromboembolism in general surgery.
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PMID:A randomized double-blind study between a low molecular weight heparin Kabi 2165 and standard heparin in the prevention of deep vein thrombosis in general surgery. A French multicenter trial. 283 23

In a double-blind, randomized trial, the antithrombotic effect and haemorrhagic complications of low molecular weight heparin (LMWH) (Heparin fragment 2165, KabiVitrum) and unfractionated heparin (UH) were compared. LMWH (5000 anti-XaU) was injected every 24 h, UH (5000 IU) every 12 h; both drugs by subcutaneous injection. During 1984-85, 215 patients were examined clinically and by plethysmography. Venography was performed whenever DVT was suspected. None of the patients proved to have DVT. Bleeding complications were found in 54% of the cases. The LMWH group had a statistically significant predominance of bleeding complications as reflected by wound haematomas (p = 0.02) and the number of blood transfusions (p = 0.02). The heparin concentration was higher in the LMWH group (mean 0.13 IU/ml) than in the UH group (mean 0.13 IU/ml) measured 2 h after the injection. In the doses administered, LMWH and UH seem effective in the prevention of thrombosis. The increased bleeding tendency in the LMWH group probably was a consequence of the to high dosage.
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PMID:Comparison of low molecular weight heparin vs. unfractionated heparin in gynecological surgery. 284 7

A low molecular weight heparin (Fragmin, Kabi-Vitrum) with a mean molecular weight of 4,000-5,000 D has been investigated in healthy volunteers and in patients with DVT. We found a T 1/2 of 4 hours and a high bioavailability after subcutaneous injection in volunteers. In a randomised study, patients with phlebographically verified DVT, 120 U(anti-FXa)/kg Fragmin injected twice daily was found to be as effective as 240 U/kg, 12 h standard heparin as continuous infusion in preventing DVT progress. No major bleedings were seen in the Fragmin group. We conclude that Fragmin administered subcutaneously twice daily results in adequate anticoagulation and is safe and practical in the treatment of DVT.
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PMID:Clinical experiences in the administration of a low molecular weight heparin (Fragmin, Kabi-Vitrum) to healthy volunteers and in the treatment of established deep venous thrombosis. 284 65

Eighty patients undergoing pelvic or abdominal surgery for cancer were randomized in two groups for prevention of postoperative thromboembolism: 40 patients received a 15,000 IU day-1 Calciparine prophylaxis and 40 patients a 5000 anti-Xa U/d Fragmin prophylaxis for 10 days. In the Calciparine group, two patients (5%) developed postoperative pulmonary embolism but none developed it in the Fragmin group. Two patients in the Fragmin group (5%) developed isotopic DVT, which was not confirmed by phlebography. There was no deep vein thrombosis of the lower limbs in the two groups. Important postoperative bleeding (one patient in the Calciparine group and two patients in the Fragmin group) was similar in both groups. Moderate and minor bleeding were significantly lower in the Fragmin group. Haemoglobin and haematocrit changes, total blood loss and transfusion requirements were not different in both groups. It is concluded that, over a 10-day period, one daily 5000 U Fragmin prophylaxis was as effective and safe as three daily 5000 IU Calciparine injections.
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PMID:Low dose heparin versus low molecular weight heparin (Kabi 2165, Fragmin) in the prophylaxis of thromboembolic complications of abdominal oncological surgery. 285 11

Since clinical diagnosis of DVT is often inaccurate, it has become accepted that an objective means of diagnosing clot in the deep venous system becomes critically important in the management of these patients. Important to understanding the diagnostic capabilities of any test are the anatomic and physiologic characteristics of the deep venous system. The venous Doppler examination monitors the velocity of blood flowing through a particular vein. Doppler probes in the 5 to 10 mHz range are routinely used. Respiratory variation is a normal finding due to a diminished flow signal during inspiration, followed by a progressive increase in flow signal during expiration. Characteristics of the spontaneous flow signals are the most important part of interpreting the venous Doppler examination. In addition, the response to distal or proximal compression (augmentation) adds important information to the interpretation; however, the response during any augmentation maneuver depends on the rapidity of compression, the force of compression, the quantity of blood in the veins at the time of compression, and the distance between the Doppler probe and the compression point. The literature reports a wide range of sensitivity and specificity for the Doppler examination, but there is uniform agreement and an observable trend that physicians with a large experience and a dedicated interest will obtain much better results than physicians with less experience and less interest. Phleborheography is a six-channel volumetric plethysmographic technique that monitors volume changes in the lower extremities associated with respiration and foot and calf compression. The volumetric tracings obtained are similar to the velocity profiles obtained on the venous Doppler examination. The criteria used in interpreting phleborheographic tracings are respiratory waves and baseline elevation (major criteria), and prominent arterial pulse waves and foot emptying (minor criteria). Previously reported overall sensitivities for detecting DVT are 83 to 93 percent, with sensitivities of detecting proximal vein thrombosis of 92 to 96 percent. Specificities have been reported to be 87 to 97 percent. In a prospective analysis of 126 extremities with phleborheography and phlebography carried out within the same 24 hour period at Temple University Hospital, we found an overall sensitivity of 79 percent (51 of 65 patients); however, the sensitivity for proximal vein thrombosis was 91 percent (49 of 54 patients).(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Diagnostic methods for deep vein thrombosis: venous Doppler examination, phleborheography, iodine-125 fibrinogen uptake, and phlebography. 293 2

A pneumatic compression device was applied to 155 patients with a normal Doppler venous examination who underwent a general surgical procedure of at least 1 hr in duration. One hundred fifty-three patients had neither PE nor DVT clinically or by Doppler studies, one patient had a venographically proven DVT, and one patient had a clinical pulmonary embolism verified by lung scanning. Using clinical and Doppler criteria, the device was effective in the prophylaxis of thromboembolic complications.
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PMID:Pneumatic compression devices for prophylaxis of deep venous thrombosis (DVT). 294 68

Based on a prospective study of 92 patients with DVT initiated in 1979, including a follow-up every year, the following investigations were performed: phlebography, Doppler-ultrasound, plethysmography (strain gauge and PPG) and foot-volumetry. In ulcer-patients skin blood flow was measured by Laser-Doppler and local oxygen supply by measurement of transcutaneous oxygen. Transcapillary protein-leakage was assessed by isotopic methods, local lymph-drainage by isotopic lymphography and indirect x-ray lymphography. From the results of these investigations the following course of events, which may be of importance for the development of venous ulceration, can be outlined: 1. Venous refluxes penetrating into the venules of the skin. 2. Chronic venous ambulatory hypertension (lack of pressure-fall during walking), waves of high pressure in the capillaries. 3. Protein-rich oedema. 4. Failure of fibrin clearance from the pericapillary space due to inadequate (exhausted?) fibrinolysis and deficient local lymph drainage. 5. Resulting changes in the ground substance, proliferation of fibres. 6. Local hypoxia due to a diffusion block by the impermeable pericapillary cuffs, partially due to a reduction of capillaries in the superficial layers.
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PMID:Investigations on the pathogenesis of venous leg ulcers. 305 24


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