Double-Blind, Randomized Comparison of Systemic Continuous Infusion of 0.25 Versus 0.50 mg/kg/24 h of Alteplase over 3 to 7 Days for Treatment of Deep Venous Thrombosis in Heparinized Patients: Results of the European Thrombolysis with rt-PA in Venous Thrombosis (ETTT) Trial

1992 ◽  
Vol 67 (03) ◽  
pp. 306-309 ◽  
Author(s):  
H Bounameaux ◽  
J D Banga ◽  
E Bluhmki ◽  
S Coccheri ◽  
J N Fiessinger ◽  
...  
Keyword(s):  
Treatment Group ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Continuous Infusion ◽  
Dosage Regimen ◽  
Lower Limbs ◽  
Double Blind ◽  
Vein Thrombosis ◽  
Group I ◽  
Group Ii

SummaryThirty-two patients with acute, proximal-vein thrombosis were treated with heparin and alteplase (0.25 versus 0.5 mg/kg/24 h during 3-7 days) in a randomized, double-blind, multicenter, European (ETTT) trial. The treatment resulted in a decrease of the venographic Marder’s score from 18 (6-25) to 13 (2-24) units (median, range) in Group I (0.25 mg/kg/24 h, n = 15, median decrease 3.0, p = 0.32) and from 17.5 (3-33) to 15.5 (0-27) in Group II (0.5 mg/kg/24 h, n = 16, median decrease 4.0, p = 0.23). Comparison of the sequential venograms could be performed in 14 cases of Group I and in 15 cases in Group II. A minority of patients showed substantial partial recanalization of the initially obstructed veins on the control venogram (one in each treatment group) and most of the control venograms showedThus, the results of the ETTT trial show that the used low dosages of alteplase administered intravenously over 3-7 days in heparinized patients cannot be recommended as a treatment for patients with deep venous thrombosis of lower limbs and/or pelvis. Further studies are needed to define a more suitable dosage regimen of alteplase in this indication.

Rivaroxaban versus Warfarin in the Management of Deep Venous Thrombosis

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mahmoud Shawky El-metieni ◽  
Tamer Mohamed Fekry ◽  
Mohammed Ahmed Hassan Rady ◽  
Ahmed Magdy Farrag ◽  
Ahmed Mohamed Ismail
Keyword(s):  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Randomized Study ◽  
Duplex Ultrasound ◽  
Lower Limbs ◽  
P Value ◽  
Vein Thrombosis ◽  
Warfarin Group ◽  
Blood Clots ◽  
Study Population

Abstract Background Deep venous thrombosis (DVT) refers to the formation of one or more blood clots in one of the body’s large veins, most commonly in the lower limbs. The clot can cause partial or complete blocking of circulation in the vein, which in some patients leads to pain, swelling, tenderness, discolouration of the skin that is warm to touch. Aim of the Work Compare the effect of direct Oral Anticoagulant (Rivaroxaban) versus Antivitamin K (warfarin) in treatment of lower limb Deep Venous Thrombosis. Patients and Methods Type of study: prospective single blinded randomized study, study setting: was conducted at Kobri Elkobba hospitals, study period: 6 months, study population: Eligible all patients above 18 years had femoropopliteal vein thrombosis, confirmed with duplex ultrasound scanning and D-dimer test and qualified under the inclusion and exclusion criteria of the study. Results Our study shows that Rivaroxaban alone is as effective as standard therapy, with similar safety, for the treatment of acute DVT and in preventing recurrence and has low risk of bleeding. There was statistically significant increase in INR monitoring during 6 months in warfarin group than Rivaroxaban group with p-value < 0.001. This because warfarin has many drug and food interaction. There's no response in treatment out come after 3 months duplex as the study was on patient of femoro popliteal DVT, however there were clinical improvement in both groups. Complete recanalization with normal augmentation by muscle compression occurred in all Rivaroxaban patients compared to 5% were partially compressible with incomplete recanalization in warfarin group after 6 months of treatment. Conclusion We concluded in patients with unprovoked VTE, rivaroxaban has the potential to reduce both the risk of major bleeding and recurrent VTE compared to warfarin. And there’s no need for adjusting the dose and INR monitoring, and Rivaroxaban has no food nor drug interactions.

DEEP VEIN THROMBOSIS PROPHYLAXIS IN SURGICALLY TREATED FRACTURED HIP PATIENTS

1987 ◽  
Author(s):  
P J Powers ◽  
M Gent ◽  
R Jay ◽  
J Hirsh ◽  
M Levine ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Placebo Group ◽  
Venous Thrombosis ◽  
Major Complication ◽  
Lower Limbs ◽  
Thrombosis Prophylaxis ◽  
Double Blind ◽  
Vein Thrombosis ◽  
Warfarin Group ◽  
Deep Vein

Deep vein thrombosis is a major complication in'patients treated surgically for fractured hip. Methods employed toreduce the risk of thrombosis include dextran, ASA, warfarin, low or adjusted dose heparin and calf compression, but none has widespread acceptance.A randomized trial wascarried out to assess the effectiveness of sodium warfarinand acetyl salicylic acid(aspirin) compared to placebo inthe prevention of venous thrombosis in fractured hip patients. One hundred and ninty four patients were randomizedto receive warfarin (65 patients), ASA (66 patients) or placebo (63 patients).Prophylaxis commenced post operatively and continued for 21 days or until discharge, if earlier.Warfarin patients received 10 mg sodium warfarin orally as soon as possible after surgery. Warfarin was then given daily according to the prothrombin time (PT), to obtain a PT of 16 seconds on the 5th post operative day. The PT was maintain at 16 to 18 seconds until the end of treatment.ASA and placebo patients received enteric coated tablets, 650 mg twice daily, in a double blind fashion beginning as soon as possible post operatively and continuingto the end of treatment. Surveillance testing and I-fibrinogen leg scanning and impedance plethysmography was performed and venography was done if either test suggested thrombus at the popliteal vein or above. Otherwise venography was performed at day 21 or prior to discharge, if earlier. Venous thrombosis occurred in 13 patients (20%) in the warfarin group, 27 patients (^0.9%) in the ASA group, and 29 patients (46%) in the placebo group (P=0.005). Proximal vein thrombosis or pulmonary embolism occurred in 6patients (9.2%) in the warfarin group,7 patients (10.6%) in the ASA and 19 patients (30.2%) in the placebo group (P=0.002). Two major hemorrhages occurred in the warfarin group, none in the ASA group, and 2 in the placebo group.The results of this study show sodium warfarin to be safeand effective in reducing thromboembolic complications infractured hip patients and ASA to be effective in reducing thrombosis involving the proximal deep veins of the lower limbs in these patients.

scholarly journals Clinical and etiological profile of unprovoked thrombosis in young patients admitted at a tertiary care hospital

2017 ◽  
Vol 5 (10) ◽  
pp. 4595
Author(s):  
Nadeem Ahmad ◽  
Nihida Akhter ◽  
Tufail Ahmad Sheikh
Keyword(s):  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Factor V Leiden ◽  
Janus Kinase ◽  
Lower Limbs ◽  
Cerebellar Infarction ◽  
Factor V ◽  
Care Hospital ◽  
Factor V Leiden Mutation ◽  
Vein Thrombosis

Background: It is now possible to identify acquired and hereditary risk factors in a substantial percentage of patients presenting with a venous thrombotic event. The objective of the study was to study the clinical and etiological profile of patients with unprovoked thrombosis in young patients.Methods: Twenty-one patients 09 males (42.8%) and 12 females (57.14%) with a mean age of 29.67±5.21 were studied, who presented with unprovoked thrombosis.Results: Among 21 patients studied most common presentation was deep venous thrombosis of lower limbs (38.09%) followed by recurrent abortions with deep venous thrombosis (14.28%) and cerebellar infarction (14.28%). In etiological profile, the most common thrombophilla was factor V Leiden mutation (28.57%) followed by antiphospholipid antibody syndrome (23.8%), protein C deficiency (19.04%), methylene tetrahydrofolate reductase (9.52%) and antithrombin, prothrombin gene mutation, hyperhomocystenemia and janus kinase 2 mutations (4.76%). Among 6 patients of factor V Leiden mutation 3 presented with deep venous thrombosis of lower limbs, 1 patient each with middle cerebral artery infarct, juglar vein thrombosis and subclavian vein thrombosis respectively.Conclusions: Factor V Leiden mutation is the most common inherited thrombophillias which has been "substantiated from various studies.

Proximal deep venous thrombosis following PTA of the superficial femoral artery – an obligation to disclose a complication that is rarely taken into account

VASA ◽  
2006 ◽  
Vol 35 (1) ◽  
pp. 41-44 ◽  
Author(s):  
Klein-Weigel ◽  
Pillokat ◽  
Klemens ◽  
Köning ◽  
Wolbergs ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Femoral Artery ◽  
Superficial Femoral Artery ◽  
Rare Complication ◽  
Femoral Vein ◽  
Vein Thrombosis ◽  
Explicit Information ◽  
Life Threatening ◽  
Legal Consequences

We report two cases of femoral vein thrombosis after arterial PTA and subsequent pressure stasis. We discuss the legal consequences of these complications for information policies. Because venous thrombembolism following an arterial PTA might cause serious sequel or life threatening complications, there is a clear obligation for explicit information of the patients about this rare complication.

Outcome of Anticoagulation in Isolated Distal Deep Vein Thrombosis Compared to Proximal Deep Venous Thrombosis

2021 ◽  
Author(s):  
Danielle T Vlazny ◽  
Ahmed K Pasha ◽  
Wiktoria Kuczmik ◽  
Waldemar E Wysokinski ◽  
Matthew Bartlett ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Vein Thrombosis ◽  
Distal Deep Vein Thrombosis ◽  
Deep Vein

A DOUBLE BLIND COMPARATIVE STUDY BETWEEN INTRATHECAL BUPIVACAINE AND INTRATHECAL FENTANYLAS THE INITIAL DOSE OF COMBINED SPINAL EPIDURAL TECHNIQUE FOR LABOUR ANALGESIA

2021 ◽  
pp. 48-50
Author(s):  
Niraj Kumar Mishra ◽  
Sushil Kumar
Keyword(s):  
Side Effects ◽  
Fetal Distress ◽  
Labour Pain ◽  
Sampling Procedure ◽  
Chi Square ◽  
Double Blind ◽  
Motor Weakness ◽  
Group I ◽  
Group Ii ◽  
Fetal Oxygenation

Introduction: Labour pain is among the most severe pain a woman can experience in her lifetime. Painful labour has decrimental effects on both mother and fetus leads to severe physical and psychological stress. Maternal hyperventilation in response to pain reduces fetal oxygenation and hypoventilation between contractions combined with decreased blood ow worsens fetal hypoxemia. It has been suggested that conning women to bed during labour may cause the labour to be longer and more painful with increase in abnormal presentation, instrumental deliveries and fetal distress. Aims And Objectives:The onset, quality and duration of their analgesic action. Incidence of unwanted effects like muscle weakness, hypotension, pruritus, nausea/vomiting, fetal bradycardia by the individual drugs. Materials And Methods: The study was conducted in the department of anesthesia, Darbhanga Medical College & Hospital, Laheriasarai, Bihar. Methods of collection of data (including sampling procedure if any) : After institutional committee approval and written informed consent from parturients and their relatives for the procedure the study was conducted and data were collected. Results: Duration of analgesia was found varying widely. It was 55±12.34 minutes in Group I whereas 75 ±14.36 minutes in Group II. The incidence of pruritus almost mild or negligible in both groups. The incidence of motor weakness in group II was 24 (80%) whereas in group I it was 10(33%). There was signicant statistics difference in motor weakness between two groups (p< 0.001) by Chi square test 9 with yate's correction. Other side effects differences between two groups were not statistically signicant. Summary And Conclusion:Both the drugs provided excellent quality of analgesia to the parturient in pain. The difference in duration of analgesia was signicant between the two groups statistically. Mean duration of analgesia lasted for 55 minutes in group I whereas in group II, it lasted for 75 minutes. Main side effects encountered in this study were motor weakness of longer duration in group II than in group I. Other side effects like nausea-vomiting were comparable to each other and were minimal in nature.

scholarly journals Efektivitas Ekstrak Artemisia vulgaris L. sebagai Hepatoprotektor pada sel-sel Hati Tikus yang Diinduksi Niasin

2018 ◽  
Vol 6 (2) ◽  
pp. 251
Author(s):  
Laily Rahmawati ◽  
Erma Sulistyaningsih ◽  
Rosita Dewi
Keyword(s):  
Treatment Group ◽  
Liver Damage ◽  
Negative Control Group ◽  
Positive Control ◽  
Negative Control ◽  
Positive Control Group ◽  
Control Group ◽  
Artemisia Vulgaris ◽  
Group I ◽  
Group Ii

  The niacin in energy drinks has metabolic product that cause oxidative stress and liver damage, while the liver damage can be prevented by hepatoprotective agents. Scoparone in Artemisia vulgaris L. can act as a hepatoprotector by its antioxidant effect. This study aimed to investigate the effectivity of Artemisia vulgaris L. extract as a hepatoprotector in wistar hepatocytes induced by niacin. This study used 25 male rats which were divided into 5 groups: normal, the negative control, the positive control, the treatment group I, and II. Treatment was conducted for 28 days. The samples were terminated and the hepatocyte were prepared for histological examination. Histological appearance was catagorized as mild, moderate, and severe damage with or without inflamatory cells activity. The data analysis by Kruskal Wallis showed significant difference (p<0,001). Further analysis by Mann Whitney revealed significantly difference (p<0,05) between normal group and all groups, negative control group and positive control group, and positive control group and treatment group I, but not significantly difference between negative control group and treatment group I, negative control group and treatment group II, positive control group and treatment group II, and between treatment groups. The study concluded that the effectivity of Artemisia vulgaris L. extract has not been proven as a hepatoprotector but further study is needed to draw a definite conclusion.   Keywords: energy drink, niacin, Artemisia vulgaris L., hepatoprotector  

scholarly journals Value of Entheseal Ultrasonography and Serum Cartilage Oligomeric Matrix Protein in the Preclinical Diagnosis of Psoriatic Arthritis

2010 ◽  
Vol 3 ◽  
pp. CMAMD.S4461 ◽  
Author(s):  
Hanan Mohamed Farouk ◽  
Afaf Abdel Alim Mostafa ◽  
Sahar S. Youssef ◽  
Moataz Mohammed Samy Elbeblawy ◽  
Naglaa Youssef Assaf ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Cartilage Oligomeric Matrix Protein ◽  
Matrix Protein ◽  
Serum Levels ◽  
Lower Limbs ◽  
Control Group ◽  
Group I ◽  
Significant Difference ◽  
Preclinical Diagnosis ◽  
Group Ii

Objective To evaluate the utility of entheseal ultrasonography and serum COMP in the preclinical diagnosis of psoriatic arthritis. Methods 60 psoriatic patients were divided into: 30 patients with psoriasis (group I) and 30 patients with psoriatic arthritis as control (group II). They underwent independent clinical and ultrasonographic examination of both lower limbs at the calcaneal insertions of Achilles tendons. Psoriatic arthritis disease activity and severity was assessed by modified DAS28 and Steinbrockers scores. Serum levels of COMP were measured for all patients by ELISA. Results On clinical examination, no entheseal abnormalities were detected in group I while they were present in 23.3% of group II with statistically significant difference between them ( P < 0.001). Ultrasonographic entheseal abnormalities were detected in 33.3% of group I and in 46.7% of group II with no significant difference between them ( P > 0.05). Serum COMP were significantly elevated in group I and II with no statistically significant difference between them (mean ± SD 5.9 ± 3 and 6.8 ± 12 respectively, P > 0.05). Entheseal ultrasound was more specific (67%) while serum COMP was more sensitive (87%) in the preclinical diagnosis of psoriatic arthritis. Serum COMP levels were significantly correlated with CRP in both groups and with DAS28 and Steinbrockers scores in group II ( P < 0.01). Conclusion Entheseal ultrasonography and serum COMP levels may be used complementary to each other for preclinical diagnosis of psoriatic arthritis. Serum COMP seems to be promising prognostic marker for psoriatic arthritis patients.

The risk of lower-limb superficial vein thrombosis relative to lower-limb venous thrombotic events is not increased in winter months

2020 ◽  
Vol 35 (7) ◽  
pp. 533-537
Author(s):  
Samir Henni ◽  
Pierre Ramondou ◽  
Guillaume Duval ◽  
Jean Picquet ◽  
Georges Leftheriotis ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Lower Limb ◽  
Homogeneous Distribution ◽  
Superficial Vein ◽  
Chi Square ◽  
Venous Flow ◽  
Vein Thrombosis ◽  
Superficial Vein Thrombosis ◽  
Chi Square Test

Objectives Ambient temperature (that impacts differently venous flow in superficial and deep veins) could have a different effect on the risk of superficial and deep venous thrombosis. We searched for a trimestral variation of the risk of superficial venous thrombosis among all lower-limb thrombotic events (lower-limb thrombotic events = superficial venous thrombosis + deep venous thrombosis). Methods We retrospectively analyzed the results of venous ultrasound investigations performed among 11,739 patients (aged 67 ± 19 years old, 56.1% males) referred for suspected lower-limb thrombotic events over a 12-year period. Chi-square test was used to compare the superficial venous thrombosis/lower-limb thrombotic events ratio observed by trimesters to a homogeneous distribution. Results The proportion of lower-limb thrombotic events were 30.7%, 28.8%, 31.1%, and 31.4% (Chi2: 0.133; p = 0.987) of total investigations, while that of superficial venous thrombosis among all lower-limb venous thrombotic events were 27.2%, 30.0%, 31.4%, and 31.0%, for the first, second, third, and fourth trimesters respectively (Chi2: 0.357; p: 0.949). Conclusion No trimestral variation of the superficial venous thrombosis/lower-limb venous thrombotic events ratio was observed.

The Clinical Diagnosis Of Deep Venous Thrombosis

1981 ◽  
Author(s):  
E Briët ◽  
M J Boekhout-Mussert ◽  
L H van Hulsteijn ◽  
C W Koch ◽  
H W C Loose ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Doppler Ultrasound ◽  
Clinical Examination ◽  
False Positive ◽  
False Negative ◽  
Diagnostic Strategies ◽  
Vein Thrombosis ◽  
Deep Vein

Fifty-three patients were examined because of suspected deep venous thrombosis, by means of clinical examination, Doppler ultrasound and venography. Eighty-two legs were examined with all three methods. Venography was positive in 40 and normal in 42. The clinical examination was false positive in 4 legs and false negative in 6. The Doppler ultrasound studies gave false positive results in 3 legs and false negative results in 6. These results are better than those reported in the literature probably because the thrombosis extended to the popliteal vein or the more proximal veins in 38 of the 40 legs with deep vein thrombosis. This high percentage of upper leg vein thrombosis can be explained by the fact that 47 of the 53 patients were ambulant when they developed the signs and symptoms of thrombosis. It is concluded, that the clinical examination and Doppler ultrasonography can be used to diagnose deep vein thrombosis in ambulant patients in our clinic. We presume that the findings reported in the literature cannot be used indiscriminately as a basis for diagnostic strategies in other hospitals because of widely varying categories of patients, referral patterns and diagnostic criteria that are virtually impossible to standardize.

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