Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0149871 (deep vein thrombosis)
 12,364 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In a prospective, double-blind investigation of the prophylaxis of deep vein thrombosis (DVT) in patients undergoing elective major abdominal surgery, 269 patients were randomized into two groups. One hundred and thirty-two patients received a fixed combination of heparin sodium 5000 units plus dihydroergotamine mesylate 0.5 mg (H/DHE) twice a day and 137 patients received a fixed combination of low molecular weight heparin 1500 units plus dihydroergotamine mesylate 0.5 mg (LMWH/DHE) once a day as well as one injection of placebo per day. Treatment was initiated 2 h pre-operatively in both groups and continued for 7-10 days. The frequency of DVT determined by the 125I-labelled fibrinogen uptake test and phlebography was 10.3 per cent in patients receiving H/DHE and 10.4 per cent in those receiving LMWH/DHE. DVT of the femoral vein was detected in four patients of the H/DHE group and in none of the LMWH/DHE group. Intra- and postoperative blood loss did not differ significantly between both groups. Also no difference in the development of wound haematoma and injection site haematoma was found. While intra-operative volume substitution was comparable in both groups, significantly more patients under H/DHE prophylaxis received volume substitution during the postoperative phase. These results show that once-daily prophylaxis with the combination of low molecular weight heparin and dihydroergotamine is equally as effective and as safe as the twice-daily regimen using a combination of unfractionated heparin and dihydroergotamine in patients undergoing elective, major abdominal surgery. The advantages of the once-daily regimen of LMWH/DHE include greater patient acceptance, less nursing time and greater cost effectiveness, provided the new combination can be sold at a cost which maintains this advantage.
 ...
PMID:Low molecular weight heparin plus dihydroergotamine for prophylaxis of postoperative deep vein thrombosis. 353 Mar 67

A prospective study involving 120 consecutive patients undergoing total hip replacement was performed to compare the effectiveness of aspirin (high and low dose) or a combination of heparin plus dihydroergotamine (heparin-DHE) in preventing isotopic and phlebographic deep vein thrombosis (DVT), and to evaluate their effect on postoperative platelet changes. Phlebographic DVT was demonstrated in 9 cases (30%) in control group, in 1 (3.3%) in aspirin (high-dose) group (p less than 0.01), in 1 (3.3%) in aspirin (low-dose) group (p less than 0.01) and in 5 (16.6%) in heparin-DHE group (p = NS). Aspirin was able to reduce the postoperative increase in circulating platelet aggregates, platelet factor 4 and beta-thromboglobulin observed in control group. This study shows that aspirin is effective in the prevention of DVT for patients undergoing total hip replacement. Small aspirin dose (250 mg/day) represents an effective form of prophylaxis in these patients.
 ...
PMID:Prophylaxis of thromboembolic disease and platelet-related changes following total hip replacement: a comparative study of aspirin and heparin-dihydroergotamine. 353 58

The sensitivity of impedance plethysmography (IPG) for diagnosing deep vein thrombosis was evaluated in the presence of dihydroergotamine, an agent with significant venoconstrictor activity. In a prospective, randomized, controlled clinical trial, 105 patients undergoing total hip replacement surgery were investigated to evaluate the thromboprophylactic efficacy of DHE-Heparin using IPG and 125I-Fibrinogen Leg Scanning to monitor the incidence of DVT. Retrospective analysis of the IPG data indicated that DHE-Heparin impaired the sensitivity of impedance plethysmography by decreasing venous capacitance and venous outflow. Although the patient sample size was relatively small, the results showed trends which suggested that the utility of impedance plethysmography for diagnosing DVT was limited in the presence of a vasoactive agent. Alternate noninvasive diagnostic methods may need to be considered in select patients receiving concomitant medications possessing venoconstrictor activity.
 ...
PMID:Limitation of impedance plethysmography in assessing efficacy of dihydroergotamine-heparin prophylaxis of deep vein thrombosis. 388 36

In a randomized clinical trial the effect of subcutaneous heparin alone or in combination with dihydroergotamine or sulphinpyrazone in preventing postoperative deep vein thrombosis (DVT) was studied. Sodium heparin (5000 IU) was administered subcutaneously twice daily; dihydroergotamine (1/2 mg) was also administered subcutaneously twice daily, and sulphinpyrazone (400 mg) was administered orally or intravenously twice daily. Administration occurred for at least 7 days. The diagnosis DVT was made with the radiofibrinogen uptake test. 358 patients undergoing major elective abdominal surgery were allocated to three treatment groups: heparin alone (Hep), heparin + dihydroergotamine (DHE-Hep) and heparin + sulphinpyrazone (Sulph-Hep). The frequency of DVT was 14/114 in Hep, 10/115 in DHE-Hep and 20/114 in Sulph-Hep. These differences were not significant. After application of the "logistic regression" procedure of Cox (1) it turned out that the major risk factors for developing DVT were age, sex, weight, type of operation and presence of diabetes mellitus. Also a significant treatment influence was observed (p = 0.001). This treatment effect was most probably due to improvement in the DHE-Hep group. The results in the Sulph-Hep group were not significantly different from those in the Hep group. A risk index was formulated on the basis of the above mentioned risk factors by which the chance of occurrence of DVT during heparin prophylaxis in an individual patient could be predicted. Patients that should receive additional prophylactic treatment can be defined by using this risk index.
 ...
PMID:Prevention of postoperative deep vein thrombosis by a combination of subcutaneous heparin with subcutaneous dihydroergotamine or oral sulphinpyrazone. 408 92

57 papers dealing with the prevention of postoperative thromboembolic complications have been analyzed. They comprise 28 prospective, randomized, comparative studies using objective diagnostic techniques. 2 X 5000 IU daily of heparin-DHE lowers the incidence of deep vein thrombosis in general surgery, thoracic surgery and gynecology significantly better than 2 X 5000 IU heparin alone. In hip surgery 3 X 5000 IU heparin-DHE is more effective than the same amount of heparin alone. In the entire field of orthopedic surgery, heparin-DHE, in a dosage of 2 X 5000 IU, lowers the incidence of fatal pulmonary emboli just as well as dextran 70. With regard to prevention of deep vein thrombosis in general surgery, there is no statistically significant difference between prevention with 2 X 2500 IU heparin-DHE and 2 X 5000 IU heparin. 2 X 2500 IU heparin-DHE significantly lowers the incidence of bleeding complications in general surgery, as evaluated in double-blind studies and compared to 2 X 5000 IU heparin alone.
 ...
PMID:[The value of heparin-dihydergot in the prevention of thromboembolic complications]. 636 29

Postoperative pulmonary embolism continues to be a problem in patient care, especially in high-risk patients. This study was designed to evaluate a combined pharmacologic approach to the prophylaxis of postoperative deep venous thrombosis (DVT) by mediating at least two and probably three of Virchow's predisposing factors. Patients 40 years of age and older undergoing operations greater than 45 minutes under general anesthesia were placed in one of five treatment groups and studied by a prospective randomized, double-blind protocol. Study drugs were the following: (1) 0.5 mg of dihydroergotamine plus 5000 IU of sodium heparin (DHE 5000), (2) 0.5 mg DHE plus 2500 IU heparin (DHE 2500), (3) 5000 IU of HEP (HEP 5000), (4) 0.5 mg of DHE (DHE 0.5), and (5) a placebo. Study medications were administered 2 hours preoperatively and continuously thereafter every 12 hours postoperatively subcutaneously in the anterior abdominal wall for 5 to 7 days or until a positive radiofibrinogen uptake test (RFUT). The RFUT was performed according to standardized technique and was used to establish the presence or absence of DVT. This report is an analysis of the major subgroup of patients undergoing intra-abdominal operations. Results showed a highly statistically significant prophylactic benefit from DHE 5000 compared with the placebo (p less than 0.003) and all other treatment groups (p less than 0.05). There was no significant benefit from DHE 2500, HEP 5000 (p greater than 0.13), and DHE 0.5 (p greater than 0.3). All patients who entered the study had two or more risk factors for postoperative DVT, and high-risk patients were distributed equally throughout all treatment groups.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Prophylactic efficacy of low-dose dihydroergotamine and heparin in postoperative deep venous thrombosis following intra-abdominal operations. 638 9

The efficacy of combined dihydroergotamine and heparin (DHE-heparin) medication (2500 IU sodium heparin and 0.5 mg DHE, both given subcutaneously twice daily) or low doses of heparin (5,000 IU of sodium heparin given subcutaneously thrice daily) in preventing postoperative thromboembolic complications was investigated in a prospective, randomized trial in 125 patients over the age of 40 years undergoing elective major gynecological surgery. The I125-fibrinogen uptake test was used for the diagnosis of deep vein thrombosis. There was no statistically significant difference in the incidence of thromboembolism between the groups. Major bleeding occurred less often (p < 0.05) in the DHE-heparin group.
 ...
PMID:Dihydroergotamine and heparin or heparin alone for the prevention of postoperative thromboembolism in gynecology. 743 51

We compared the protective value of the above treatments in 227 randomised patients. Investigations in each patient included pulmonary scanning before and after operation, repeated postoperative Doppler and radioactive limb scanning completed by phlebography to confirm positive results. The heparin DHE group and the "physiotherapic" group each totalized 76 patients and the heparin group 75. These comparable groups show that HDHE and heparin prophylaxis are identical; but physiotherapy is perhaps better. Compared with phlebography leg scanning sensitivity is 95%, whilst it's specificity is 99%. Doppler sensitivity is only of 21%, whilst it's specificity is 95%. In conclusion, "physiotherapic" prophylaxis, including Flowtron, is as effective as heparin alone. Doses of heparin may be reduced, without loss of effect, if supplemented by a veinoconstrictive agent as DHE. The low Doppler sensitivity contraindicates its use in asymptomatic DVT detection.
 ...
PMID:[Prevention of deep venous thrombosis (TVP) and pulmonary embolism. Comparison of heparin (3 x 5000 IU/day), heparin (2 x 5000 IU/day) + 0.5 mg dihydroergot, and physiotherapy (intermittent compression stockings + physical exercise). Value of Doppler diagnosis in systematic detection of TVP compared with phlebography and scanning of the legs using labelled fibrinogen]. 744 Jan 92

Prophylaxis of thrombosis during and after surgery reduces the incidence of deep vein thrombosis and lung embolism in patients at risk. The kind of therapy applied is related to the individual risk of each patient. Antithrombotic stockings together with low-dose heparin or dextran, is recommended in low-risk patients. Alternatively intermittent pneumatic compression can be applied in these patients. In patients at high risk (hip or knee surgery) a prophylaxis regimen that has been proven efficient in this patient group must be used. Unfractionated and low-molecular-weight heparin (both also in combination with DHE), dextran and oral anticoagulants have been shown to be effective, but LMW heparin seems to be the best. Prophylaxis of thrombosis is also recommended in outpatients whose lower extremities are immobilized. The initiation of therapy, choice of medicament duration of therapy is ultimately the decision of the responsible physician, who must consider it for each individual patient.
 ...
PMID:[Prevention of thromboembolism with drugs]. 768 21


<< Previous 1 2