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)

The British comparative thromboplastin (BCT) was used to monitor the effectiveness of oral anticoagulants in preventing deep vein thrombosis (DVT) in patients undergoing major gynaecological surgery. All patients were screened for DVT with the use of the (125)I-fibrinogen scan.One hundred and forty-five patients aged 40 years or more were randomised into three groups. Group 1 received oral anticoagulant (nicoumalone) treatment, stabilised over five days before surgery and continuing into the second postoperative week. The other patients served as two contrast groups and were managed on a double-blind basis. Group 2 received a subcutaneous low-dose regimen of heparin calcium. Group 3 received subcutaneous saline. Eleven of 48 patients in the saline group, three of 49 patients in the heparin group, and three of 48 patients in the oral anticoagulant group developed DVT as judged by (125)I-fibrinogen scanning. The incidences in groups 1 and 2 were significantly lower than in the saline group. The falls in haemoglobin concentration and incidence of haemorrhage were similar in all three groups.The study showed that oral anticoagulant prophylaxis stabilised preoperatively and low-dose heparin were equally effective in preventing deep vein thrombosis in a moderate-risk group. Immediate preoperative prothrombin ratios of 2.0-2.5 and postoperative ratios of 2.0-4.0 with the BCT gave adequate protection without increased haemorrhagic risk.
 ...
PMID:Oral anticoagulants controlled by the British comparative thromboplastin versus low-dose heparin in prophylaxis of deep vein thrombosis. 34 5

Presently available data indicate that low-dose heparin will significantly diminish postoperative deep venous thrombosis and pulmonary embolism in patients over the age of 40 subjected to major elective abdomino-thoracic surgery. The schedule is 5,000 USP units of heparin subcutaneously beginning two hours before operation and continued every twelve hours (10,000 units per day) until the patient is discharged. Whether anticoagulent therapy should be continued after discharge should be decided on an individual basis. Preoperative tests for patients on this regimen should include an hematocrit, prothrombin time, partial thromboplastic time, and a platelet count. They should also not be receiving aspirin or other platelet anti-aggregating agents for five days before operation. The efficacy of this regimen is complemented by the fact that it is well tolerated by the patient and requires no laboratory monitoring. However, it does produce a definite but acceptably low frequency of minor intraoperative and postoperative bleeding. This low-dose regimen has not proved effective in open prostatectomy or major orthopedic operations. Data are not available concerning the drug's safety in patients receiving spinal or epidural anesthesia. Nor is it recommended for operations on the eye, brain or in patients who are experiencing an active thrombotic process. More than five million individuals over the age of 40 undergo major general surgical operations annually in this country. One or two out of each thousand of these patients will die postoperatively from pulmonary embolism. If low dose heparin prophylaxis in 80% effective, then the possibility exists of saving 4,000 to 8,000 lives annually. Such an impact might be realized if physicians are prepared to recommend the low-dose heparin regimen as primary prophylaxis for all hemostatically competent patients over the age of 40 who undergo abdomino-thoracic surgery.
 ...
PMID:Prevention of venous thromboembolism in surgical patients by low-dose heparin: prepared by the Council on Thrombosis of the American Heart Association. 83 57

Presently available data indicate that low-dose heparin prophylaxis will significantly diminish massive postoperative pulmonary emboli in patients more than 40 years of age subjected to major elective abdominothoracic surgery. The schedule is 5,000 USP units of heparin sodium subcutaneously, beginning two hours before surgery and continued every 12 hours (10,000 units/day) until the patient is discharged. Patients receiving this therapy should have a preoperative screening that includes a hematocrit reading, prothrombin time, partial thromboplastin time, and a platelet count. They should also not be receiving aspirin or other platelet antiaggregating agents for five days prior to surgery. The efficacy of this regimen is complemented by the fact that it is well tolerated by the patient, free of side effects, requires no laboratory monitoring, and produces minimal intraoperative or postoperative bleeding. This low-dose regimen has not proved effective in open prostatectomy or major orthopedic surgery. Data are not available concerning the drug's safety in spinal or epidural anesthesia, nor is it recommended for eye or brain surgery or in patients with an active thrombotic process. Other data are suggestive but still inconclusive that the regimen may reduce the incidence of postoperative acute myocardial infarction. In non-surgical patients hospitalized with acute myocardial infarction and receiving a low-dose heparin regimen, the findings reflect a significant decrease in deep venous thrombosis, though no observations are yet available concerning reductions in pulmonary emboli, mural thrombi, or systemic emboli.
 ...
PMID:Heparin as an antithrombotic agent. Low-dose prophylaxis. 94 59

The activated partial thromboplastin time is compared with the corresponding prothrombin ratio in 6378 samples of platelet-poor plasma from 446 patients treated for a total of more than 4500 patient/months with oral anticoagulatnts. A relative decrease in the activated partial thromboplastin time following deep vein thrombosis is described, which tends to become less obvious during the first year of treatment and is greater in older patients. Although this relative decrease is also found in patients treated after cerebrovascular accidents, it is not found in patients treated after myocardial infarction or in patients with mitral valve disease treated prophylactically with long-term oral anticoagulants. It is though possible that these changes following deep vein thrombosis might be useful in helping to determine the duration of oral anticoagulant treatment.
 ...
PMID:The efficacy of long-term oral anticoagulant therapy and its laboratory assessment. 112 47

On the basis of the hemocoagulation and hemostasis parameters study the actual hemostasis state was evaluated in 30 patients treated for active deep venous thrombosis (DVT) in dependence on its extent. In comparison with 30 healthy persons there were found statistically significant changes in a majority of laboratory parameters that can indicate thrombophilic state. Platelet activation, increased coagulation system activity, decreased fibrinolytic activity as well as increased fibrinogen and fibrin degradation products were demonstrated. The positive correlation between the extent of DVT and the relevance of hemostasis changes was revealed which results to these conclusions: the more extensive DVT--the more intensive tendency to thrombophilia up to intravascular blood coagulation activation was observed. Although the adequate prolongation of the prothrombin time (during the coumarin therapy) or APTT (during the heparin therapy) was achieved, the laboratory parameters showed a therapy insufficiency. In the cases of laboratory signs of the activated intravascular blood coagulation we can recommended a fortification of the oral anticoagulant therapy by its combination with antiplatelet drugs or by its temporary replacement by the heparin therapy.
 ...
PMID:Evaluation of blood coagulation tests in deep venous thrombosis. 130 56

Patients over 40 years of age who undergo elective orthopaedic surgery have a relatively high risk for developing post-surgical deep vein thrombosis (DVT). Prophylactic use of heparin or low molecular weight heparins can reduce the incidence of post-operative DVT by up to 80%. It is not known whether prophylaxis is achieved by inhibition of prothrombin activation or catalysis of thrombin inhibition in vivo. We determined the changes in concentrations of factor VII zymogen and thrombin-antithrombin III (the latter as an index of prothrombin activation) in the plasmas of 129 patients randomized to receive two daily subcutaneous injections of placebo or 30 mg of Enoxaparin after elective knee surgery. Enoxaparin reduced the frequency of post-surgical DVT by 70%. The concentration of factor VII zymogen had decreased by approximately 50% within 24 h after the knee surgery, followed by a gradual increase to near presurgical values. Additionally, post-Enoxaparin plasmas had statistically significant higher concentrations of factor VII zymogen than post-placebo plasmas. Post-Enoxaparin plasmas had significantly lower concentrations of endogenous thrombin-antithrombin III than comparable post-placebo plasmas. Finally, post-Enoxaparin plasmas inactivated exogenous factor Xa and thrombin more effectively than comparable post-placebo plasmas. As Enoxaparin moderated the generation of endogenous thrombin-antithrombin III after elective knee surgery, inhibition of prothrombin activation in vivo by Enoxaparin may be important for its prophylactic antithrombotic effect.
 ...
PMID:The low molecular weight heparin Enoxaparin inhibits the consumption of factor VII and prothrombin activation in vivo associated with elective knee replacement surgery. 132 19

In an open, randomised controlled study, 101 patients with phlebographically diagnosed deep vein thrombosis of the leg, not extending into more than two thirds of the femoral vein, were randomised to receive Fragmin (a low molecular weight heparin) administered subcutaneously either once or twice daily in doses of 200 U(anti-FXa)/kg/24h or 100 U(anti-FXa)/kg/12h respectively. Prior to Fragmin unfractionated heparin had been administered by continuous iv infusion for not longer than 24h. Warfarin was administered from the first treatment day. Fragmin was administered for at least 5 days or until the prothrombin complex had been within the therapeutic range for at least 2 days. Patients were kept in bed for the first day but thereafter were ambulant. Phlebography was repeated at 5-7 days. Comparison of the phlebograms revealed a similar improvement (reduction in Marder score) in both groups. There were 5 cases of bleeding: 1 major and 3 minor in the twice daily group and 1 minor bleed in the once daily group. There were no cases of clinical pulmonary embolism. It is concluded that Fragmin, administered as a single daily subcutaneous injection, is effective in the treatment of deep vein thromboses, and offers the advantages of reduced costs, despite higher price of the drug, including reduced nursing time.
 ...
PMID:Fragmin once or twice daily subcutaneously in the treatment of deep venous thrombosis of the leg. 133 13

Three groups of patients receiving oral anticoagulation treatment were evaluated. The groups consisted of patients with mechanical heart valve prosthesis (n = 60), patients after coronary bypass graft surgery (n = 60) and patients using oral anticoagulation after deep venous thrombosis or pulmonary embolism (n = 60). The patient groups were subdivided into three groups of 20 patients, each group receiving different levels of oral anticoagulation as indicated by the international normalized ratio (INR). Prothrombin fragment 1 + 2, thrombin-antithrombin III complexes and fibrin monomers were determined as coagulation activation makers. The prothrombin fragments 1 + 2 were INR dependent in all groups whereas the thrombin-antithrombin III values were only INR dependent in the group of patients with mechanical heart valve prosthesis. For fibrin monomers no correlation with the INR levels could be found. These results indicate that prothrombin fragment 1 + 2 is the only laboratory quantity of the three, which provides a suitable index of low thrombin activity during anticoagulation therapy.
 ...
PMID:Comparison of markers of coagulation activation in patients under oral anticoagulation at different levels. 144 59

Patients with intracoronary stent implantation are treated with aggressive anticoagulant and antiplatelet therapy consisting of high-dose heparin, phenprocoumon, acetylsalicylic acid, dipyridamole, and the infusion of dextran to prevent a subacute thrombotic occlusion of the stented segment. In an effort to optimize this treatment by reducing both imminent bleeding complications and subacute thrombotic occlusion, the concentrations of prothrombin fragment 1 + 2 (F 1 + 2) were determined after intracoronary Palmaz-Schatz stent implantation in 19 consecutive patients. The F 1 + 2 concentrations after stent implantation and before the initiation of oral anticoagulant therapy (OAT) were 0.35 nm/l and 0.25-0.53 nm/l (median and 25th-75th percentile), versus 0.74 nm/l and 0.52-0.78 nm/l, in healthy subjects and 0.61 nm/l and 0.30-1.02 nm/l in 15 patients with ongoing proximal DVT. Nine days after initiation of OAT, F 1 + 2 concentrations in both patient groups had not yet reached levels observed in patients with OAT in the stable state (0.16 nm/l, 0.12-0.26 nm/l; n = 76; P less than 0.0001 compared with healthy subjects; INR 2.0-4.5). Despite an INR greater than 2.0, accompanying heparinization was terminated on day 9. In two stented patients a minor bleeding complication arose after the removal of the arterial catheter. Subacute thrombotic occlusions were not observed. Since F 1 + 2 concentrations did not exceed the upper limit of normal range (1.11 nm/l) in any of the 19 patients, the therapeutic regimen was not changed. Monitoring F 1 + 2 may thus be helpful in introducing a more individual treatment if aggressive anticoagulation has to be performed.
 ...
PMID:Monitoring prothrombin fragment 1 + 2 during initiation of oral anticoagulant therapy after intracoronary stenting. 151 Oct 62

Fine-needle aspiration (FNA) of the liver is a procedure considered virtually risk-free. We report here a patient with carcinoma of the pancreas, who suffered a fatal hemoperitoneum (HP) subsequent to FNA of the liver under the guidance of ultrasound. The patient had presented with migratory deep vein thrombosis (DVT), and recurrent cerebral embolism. The prothrombin time (PT) and partial thromboplastin time (PTT) had been normal, and FNA demonstrated adenocarcinoma cells. Autopsy findings demonstrated carcinoma in the tail of the pancreas with liver and adrenal metastases, massive HP, and findings of chronic disseminated intravascular clotting (DIC). Since chronic DIC with enhanced fibrinolysis might have participated in the fatal bleeding, we recommend that FNA should be contraindicated in patients suspected of having malignancy with migratory DVT and recurrent arterial embolism, despite normal PT and PTT tests, unless the appropriate laboratory tests succeed in excluding DIC.
 ...
PMID:Fatal hemoperitoneum after fine-needle aspiration of a liver metastasis. 153 72


1 2 3 4 5 6 7 8 9 10 Next >>