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)

A double-blind study was carried out to investigate the effectiveness of several preventive regimens in postoperative deep vein thrombosis (DVT). The regimens consisted of postoperative (p.o.) acenocoumarin, dextran 40 + p.o. acenocoumarin, subcutaneous (s.c.) heparin alone and s.c. heparin + p.o. acenocoumarin. The 313 patients studied were stratified according to age (40-60 vs. less than 60 years) and type of operation (laparotomy, thoracotomy, hip replacement). Dextran 40 + p.o. acenocoumarin was more effective than p.o. acenocoumarin alone, which acted as control. Subcutaneous heparin alone or together with p.o. acenocoumarin was not more effective than p.o. acenocoumarin alone during the first part of the study, when about 4000 IU twice daily were administered accidentally. When the dose had been changed to 5000 IU twice daily, better results were obtained (DVT) incidence 5.9%). The results were strongly influenced by age and type of operation. Almost no DVT occurred in patients below 60 years of age with elective abdominal surgery. The incidence of perfusion disturbances in lung scans in patients with DVT was lowest in those treated with s.c. heparin in combination with acenocoumarin.
 ...
PMID:Comparison of postoperative coumarin, dextran 40 and subcutaneous heparin in the prevention of postoperative deep vein thrombosis. 33 93

Platelet aggregation, spreading capacity, adhesiveness (methods according to BREDDIN) have been investigated in 3 groups of 20 patients each after gynecological surgery. Group A (control group) got only 4-hydroxycumarin (Sintrom), group B--in addition to that--intraoperative 500 ml Dextran 60 (Macrodex 6%), group C 500 ml Dextran 60 as well intraoperative as on the 1., 2., 4., 7. and 10. day after surgery. The present data show that depending on the duration of Dextran application, platelet spreading capacity and adhesiveness are inhibited differently as to duration and extent. There was, above all, a reduction and with that a normalisation of the postoperatively increased spontaneous platelet aggregation. It is possible to influence the phase of early postoperative embolism in a favorable way by applicating Dextran already intraoperatively. After that one can use further infusions of Dextran, a prophylaxis by Cumarins or other anticoagulants. Giving dextran only once during surgery one can prove this normalisation of the increased platelet aggregation up to 24 hours postoperatively. By further infusions of Dextran 60 on the 1., 2., 4., 7. and 10. postoperative day it is possible to keep the extent of aggregation on a significantly reduced level till the complete mobilisation of the patient and consequently attain a protective effect on a possible development of deep venous thrombosis of the legs.
 ...
PMID:[Coagulation-physiological studies on the prevention of thromboembolism with dextran 60. I. The effect on platelet function]. 56 21

28 prospective, controlled, randomised studies on the incidence of deep vein thrombosis (DVT) and pulmonary embolism (PE) in surgical patients on dextran 70 prophylaxis are analysed. In all patients the diagnosis had been established by objective methods (fibrinogen test, phlebography, autopsy). In patients undergoing hip surgery (11 studies, mainly fractures of the upper end of the femur) the reduction in the number of DVT under dextran prophylaxis is the more evident the longer after operation phlebography is carried out. Coumarin and dextran prevention are equally effective. In 3 studies where diagnosis by the fibrinogen test was established during the first postoperative week only, no significant effect of dextran can be shown; there is no difference between the effect of dextran, coumarin or small doses of subcutaneous heparin. The effectiveness of dextran prophylaxis in reducing the DVT rate in general surgery (4 papers) is not clear, though 7 studies show that the number of fatal PE is reduced more than fivefold (p less than 0.0005). In patients on dextran prophylaxis, the incidence of DVT is equal to that in patients on coumarin prophylaxis before major gynecological surgery (4 papers). On postoperative initiation coumarin is significantly less effective than dextran. 2 further studies show that dextran is significantly effective as compared to controls and that there is no difference between dextran and heparin prophylaxis. Out of 1932 control patients 36 died of fatal PE verified at autopsy. Only 8 PE were seen in the group of 2011 patients receiving dextran prophylaxis (p less than 0.005). The effectiveness of dextran 70 corresponds to that of small doses of subcutaneous heparin. Dextran prevention is more effective in women than in men. Dextran prophylaxis is simple to carry out, has few contraindications, only rarely causes complications and is already effective during operation.
 ...
PMID:[The value of dextran 70 in the prevention of thromboembolism in general surgery, orthopedics, urology and gynecology. A review of the literature]. 76 76

1. The effect of 2 X 500 ml Dextran 70 i.v. for prevention of postoperative deep vein thrombosis in patients with transurethral resection of the prostate was investigated in a controlled, prospective and randomized study. The diagnosis of deep vein thrombosis was made by means of the 125I-fibrinogen test. 2. A total of 86 patients were studied. Two out of 47 in the control group developed deep vein thrombosis and 3 out of 39 in the dextran group. The total number of all thromboembolic complications in the control group is 19.2% as compared to 7.7% in the dextran group. This difference is statistically seen not significant. 3. Dextran prophylaxis showed no side effects. 4. A search of the literature on thromboembolic complications in urology shows the following. The incidence of deep vein thrombosis is general urology is about the same as in general surgery, i.e. every third patient develops deep vein thrombosis. There are no studies which would show that the number of fatal pulmonary emboli can be significantly reduced by any sort of preventive method in urologic patients. 5. The incidence of deep vein thrombosis in open prostatectomies is around 50%. In transurethral resection, however, this figure is between 5 and 10%. But nevertheless there are fatal pulmonary emboli. There exist no studies showing a significant reduction in the incidence of deep vein thrombosis after prostatectomy by any form of prevention. In order to avoid the postthrombotic syndrom and fatal complications, a prevention of thromboembolism seems reasonable, if this form of prevention has minimal side effects.
 ...
PMID:[Prevention of thromboembolic complications in transurethral resection of the prostate (author's transl)]. 85 69

The incidence of postoperative deep venous thrombosis in the lower limbs and of pulmonary embolism has been studied in 49 patients operated upon for gallbladder and gastric diseases. 125I fibrinogen test was performed preoperatively and usually five times postoperatively. Pulmonary scintigraphy was also performed preoperatively and usually twice after the operation. An attempt was made to evaluate the prophylactic effect of Dextran 40. Only one patient developed a deep vein thrombosis without clinical signs. Postoperative pulmonary embolism was found in 13 patients, all but one clinically silent. The second postoperative pulmonary scintigraphy showed that the emboli had disappeared or diminished in 6 patients. Because of the low number of patients with deep venous thrombosis the prophylactic effect of Dextran 40 could not be assessed. The present investigation showed that the incidence of deep venous thrombosis in the legs was low after operations in the upper part of the abdomen while the incidence of pulmonary embolism was high. No connection between leg vein thrombosis and pulmonary embolism could be demonstrated.
 ...
PMID:Postoperative leg vein thrombosis and pulmonary embolisn after upper abdominal operations. A prospective study with 125I fibrinogentest and pulmonary scintigraphy. 118 58

A randomized open trial was undertaken to compare the antithrombotic efficacy of a low molecular weight heparin (LMWH; Sandoparin) with that of dextran 70 in patients undergoing surgery for hip fracture. One hundred thirteen patients received LMWH once daily subcutaneously at a fixed dosage while 103 patients received intravenous dextran 70. Postoperative deep vein thrombosis (DVT) was assessed by a diagnostic algorithm using the 125Iodine fibrinogen uptake test as screening and Duplex ultrasonography and/or ascending venography as confirming techniques for suspected DVT. The frequency of DVT was significantly lower in the LMWH group than in the dextran group (15.5 versus 32.6%, p less than 0.005). Proximal DVT was rare in both groups (LMWH: 2%, Dextran: 1%). Only one case of fatal fat pulmonary embolism was observed during the 10 day prophylaxis period in a patient receiving Dextran. Three cases of pulmonary embolism occurred later; one fatal event in the dextran group on day 14, and two cases in the LMWH group (one fatal and one non-fatal event) on day 14 and 17, respectively. There was no major bleeding complication in either group. We conclude that the LMWH we used is safe, was well tolerated, and has a significantly better thromboprophylactic effect than dextran 70.
 ...
PMID:Prevention of deep vein thrombosis in patients with hip fractures: low molecular weight heparin versus dextran. 128 62

A prospective randomized study was conducted to evaluate the effect of moderate normovolemic haemodilution in arthroplastic surgery of the hip, to prevent postoperative deep vein thrombosis and the need for postoperative transfusion. The patients (n = 151) were divided into three groups: 48 patients received Dextran + Acetylsalicylic Acid as a prevention of the thromboembolic complications (Group I). 57 patients received a low dose of Heparin according to the Kakkar protocol (Group II). 52 patients were operated under Haemodilution (Group III). In Group I and II homologous blood transfusions were necessary in 83% of the cases, and in two cases posttransfusional hepatitis were observed. In Group III haemodilution avoided the use of homologous blood. Therefore of the three methods this study showed that haemodilution is the best way to prevent postoperative thrombo-embolism, significantly more effective than Heparin and Dextran, in arthroplastic hip surgery.
 ...
PMID:[Prevention of thromboembolic disease and post-transfusional complications using normovolemic hemodilution in arthroplasty surgery of the hip]. 170 52

In a prospective randomized study heptest, thrombin-antithrombin complexes (TAT), D-dimer, and t-PA:ag were analysed pre- and postoperatively in 206 consecutive patients undergoing hip arthroplasty during thromboprophylaxis with either a LMW heparin (Enoxaparin) or Dextran 70. Deep vein thrombosis (DVT) developed in 6 of 102 (6%) Enoxaparin and in 21 of 104 (20%) Dextran patients diagnosed by bilateral phelobography. In the Enoxaparin group heptest showed a significant increase from the pre- to the postoperative level opposed to a significant decrease in the Dextran group. Postoperative levels of TAT, D-dimer, and t-PA:ag were significantly increased in both groups, however, TAT was significantly higher in patients in the Dextran group than in the Enoxaparin patients. D-dimer was significantly higher in Dextran patients with DVT postoperatively compared with patients without DVT. No differences concerning TAT or t-PA:ag were observed between patients with and without DVT in any of the groups.
 ...
PMID:Components of coagulation and fibrinolysis during thrombosis prophylaxis with a low molecular weight heparin (Enoxaparin) versus Dextran 70 in hip arthroplasty. 171 55

The ability to produce a large increase in plasma volume is one of the hallmarks of a successful pregnancy. Data from Garn et al. (5), Knottnerus et al. (14) and Murphy et al. (15) have shown, that hemoglobin levels above 13 g/dl or hematocrit 38% before admittance to hospital are associated with a high incidence of IUGR (intrauterine growth retardation), gestational hypertension and with a greater perinatal mortality. Patients with an elevated viscosity and hematocrit have increased perinatal risks. In these cases the hemodilution with hydroxy- ethylstarch (HES) improves the blood flow and decreases the incidence of dysmature babies and pregnancy complications. The effect of HES on certain coagulation assays seems qualitatively similar to those of Dextran. In a prospective trial we evaluated the effect of HES in the incidence of thrombosis after cesarean section and we found a 5.9% incidence of thrombosis in patients treated with 6% HES 0.62 compared with a 7.8% incidence in heparin treated patients. Treatment with 1500 ml 6% HES 0.62 before and after cesarean section is similarly effective in preventing deep vein thrombosis as heparin prophylaxis.
 ...
PMID:[Value of hemodilution therapy in pregnancy]. 171 33

Among the various methods to diagnose deep venous thrombosis in the lower limbs, the radiofibrinogen uptake test has been mainly used in clinical studies. Physical means to accelerate venous return are of limited use and only in patients at a low thrombotic risk. Antivitamins K are efficient, but surgeons hesitate to use them because of the postoperative hemorrhagic risk. Dextran infusions are quite effective and without real risk of bleeding. The same holds for low dose heparin administered subcutaneously, particularly when combined with dihydroergotamine. Among the various anti-aggregating agents only aspirin may be effective in the prevention of venous thrombosis.
 ...
PMID:[Prevention of deep venous thrombosis and pulmonary embolism in general surgery]. 243 80


1 2 3 Next >>