Comparative Effects Of Tissular Urokinase And Urinary Urokinase In The Treatment Of 30 Patients With Pulmonary Embolism And Deep Venous Thrombosis

1981 ◽  
Author(s):  
M F Lorient-Roudaut ◽  
C Vergnes ◽  
J Bonnet ◽  
M R Boisseau ◽  
H Bricaud

Two types of Urokinase are actually available for the clinical use : tissular urokinase (tUK), isolated from cell culture and urinary urokinase (uUK), partially purified from human urine. Their clinical and biological effects have to be compared.In this study 30 patients with acute pulmonary embolism and/or deep venous thrombosis were treated, using tUK or uUK, 4500 units/kg, during 12 hours.In the clinical field pulmonary angiographies, scintigrams, and phlebographies were obtained before and after the treatment. The biological study was first established on serial determination of fibrinogen, platelets, Quick Time, FDP using two methods and euglo- biiin lysis time. At the end of the treatment plasmatic samples of each patients were studied by immunoprecipitations followed by polyacrylamid gel electrophoresis, in the view of evaluation of the D dimer E complex. Two methods were used (LANE D.A. and al., 1977and WHITAKER A.N. and al, 1980).The results showed a quick similar improvement of the clinical situation. In return tUK appeared to be more effective on the biological point of view. Significant differences were found in : decrease of fibrinogen, increase of FDP and the presence of D dimer fragments. The better action of tUK, especially on the fibrin depositions, is so far unexplained.

2013 ◽  
Vol 79 (10) ◽  
pp. 1050-1053
Author(s):  
Mayin Lin ◽  
Joseph Vivian Davis ◽  
David T. Wong

There is currently no accepted standard for deep venous thrombosis (DVT) and pulmonary embolism (PE) prophylaxis in patients with traumatic brain injury (TBI). The objective of our study was to evaluate the effects of implementing a subcutaneous heparin prophylaxis protocol for patients with TBI that began in our hospital as of June 2009. In our retrospective cohort study, we examined 3812 TBI records between January 2007 and December 2011. A significant reduction in the risk of DVT/PE development was not demonstrated by comparing DVT and PE incidences before and after protocol implementation. A clear trend between heparin use and DVT occurrence could not be determined from a review of TBI records after June 2009. The use of heparin after initiation of our protocol among operative TBI cases without intracranial hemorrhage (ICH) based on admission head computed tomography was 58 per cent. ICH complication from heparin prophylaxis was 10.6 per cent for patients with TBI with ICH on admission (five of 47 cases) compared with 0.7 per cent for those without ICH on admission (four of 535 cases).


1987 ◽  
Author(s):  
O Hauch ◽  
H Nerstrøm ◽  
T R Kølle ◽  
L N Jørgensen ◽  
P Wille-Jørgensen ◽  
...  

An increased plasma level of D-dimer has been suggested as an indicator of postoperative thromboembolism (TE). We studied the D-dimer level in patients undergoing major elective abdominal surgery and in healthy volunteers to evaluate a possible value of D-dimer as a screening test for TE. 18 patients and 5 healthy volunteers were studied. The patients received low molecular weight heparin (Logiparin TM) subcutaneously once . daily for 7 days. The 125 I-fibrinogen uptake test (FUT) was done in all patients. Blood samples were taken preoperatively, postoperatively and on the postoperative day 1, 3, 4, 5 and 6. The volunteers had blood samples taken before and 4 hours after subcutaneous Logiparin injection. D-dimer was assayed by enzyme-immunoassay (Boehringer Mannheim, Elisa D-dimer, Cat.no. 998117). Results are given as median with 95% confidence limits in brackets.One patient developed deep venous thrombosis verified by phlebography. Two patients had abnormal FUT but normal phlebography. The plasma level for D-dimer in the 15 patients with normal FUT was 500 ng/ml (300-800) preoperatively. The D-dimer level increased postoperatively to 1700 ng/ml (900-3300) (p < 0.001). The following days the D-dimer level increased steadily to 4800 ng/ml (2600-6800) 6 days postoperatively. The plasma level of D-dimer in the volunteers were less than 110 ng/ml both before and after injection of Logiparin. The plasma level of D-dimer in the patient with deep venous thrombosis and the 2 patients with abnormal FUT were within the range of the patients with normal FUT.The postoperative D-dimer level was as high as that reported in patients with diagnosed thromboembolism.In conclusion, the D-dimer test does not seem to be a potential screening test for postoperative thromboembolism.


2011 ◽  
Vol 24 (4) ◽  
pp. E35-E39 ◽  
Author(s):  
Toyomi Yoshiiwa ◽  
Masashi Miyazaki ◽  
Chikahiro Takita ◽  
Ichiro Itonaga ◽  
Hiroshi Tsumura

1998 ◽  
Vol 79 (01) ◽  
pp. 32-37 ◽  
Author(s):  
H. Trillaud ◽  
S. Labrouche ◽  
P. Gauthier ◽  
S. Javorschi ◽  
P. Bernard ◽  
...  

SummaryDD are now recognized as a valuable tool to screen patients suspected of deep venous thrombosis or pulmonary embolism before carrying out a gold standard radiologic examination. The newest methods available claim to be able to ascertain the absence of thrombosis, but they have yet to prove their efficiency. We compared the performances of 3 reference ELISA methods (D-DI Asserachrom™ Stago, D-dimer Enzygnost™ Behring and Dimertest GOLD EIA™ Agen), 5 recent rapid methods (VIDAS D-Dimer™ bioMérieux, Instant IA™ Stago, Simplired™ Agen, Nycocard D-dimer™ Nycomed and Accuclot D-Dimer™ Sigma Diagnostics) and two routine latex methods (Dimertest™ American Diagnostica and FDP-Slidex™ bioMérieux) in 100 patients. One of the rapid quantitative methods was demonstrated to have a level of efficiency comparable to that of ELISA methods. Finally, the cost and efficiency of different strategies were evaluated, the association of a routine latex method with the VIDAS D-Dimer™ bioMérieux being proven to be the most efficient.


2008 ◽  
Vol 3 ◽  
pp. 117727190800300 ◽  
Author(s):  
Dawn M Barnes ◽  
Thomas W Wakefield ◽  
John E Rectenwald

Primary and recurrent venous thromboembolic disease (VTE, deep venous thrombosis and pulmonary embolism) remain a significant source of morbidity and mortality in the hospitalized patient. Non-specific subjective complaints and lack of specific objective findings related to acute deep venous thrombosis (DVT) and pulmonary embolism (PE) complicate the diagnosis. There remains no single serum marker available to exclusively confirm the diagnosis of VTE. While D-dimer is highly sensitive and useful for diagnostic exclusion, it lacks the specificity necessary for diagnostic confirmation resulting in the need for a variety of additional studies (i.e.: duplex ultrasound, venography, V/Q scanning, helical thoracic and pelvic CT scans and pulmoary angiography). There is evolving research supporting the utility of various plasma markers as novel “biomarkers” for VTE including selectins, microparticles, interleukin-10 and other cytokines. This review attempts to examine recent literature assessing the utility of P-selectin, microparticles, D-dimer, E-selectin, thrombin, interleukins and fibrin monomers in the diagnosis and guidance of therapy for VTE.


2021 ◽  
pp. 026835552199096
Author(s):  
Xiaoying Chen ◽  
Xian Liu ◽  
Jinglun Liu ◽  
Dan Zhang

Objective To investigate the risk factors, predilection sites in pulmonary embolism (PE) patients caused by deep venous thrombosis (DVT) and explore the value of scoring systems in assessing the risk of PE in DVT patients. Methods A total of 692 DVT patients were enrolled, and divided into no pulmonary embolism (NPE, 226, 32.66%), silent pulmonary embolism (SPE, 330, 47.67%) and featuring pulmonary embolism (FPE, 136, 19.65%) groups. For each group, the differences of clinical data and PE locations were compared, and the risk factors of PE secondary to DVT were analyzed. The predictive value of the scoring system for the diagnosis of PE and FPE was evaluated. Results PE presented more in the bilateral pulmonary arteries (PAs) (249, 53.43%) and has no significant difference in PESI scores in different locations. Gender, DVT locations, and previous surgery were the independent risk factors of PE. DVT locations, previous history of COPD, and previous surgical interventions were the independent risk factors of FPE. The results for areas under the ROC curves were: AUC(Wells) = 0.675, AUC (Revised Geneva) = 0.601, AUC(D-dimer) = 0.595 in the PE group; AUC(Wells) = 0.722, AUC (Revised Geneva) = 0.643, AUC(D-dimer) = 0.557 in the FPE group. Conclusions PE secondary to DVT mostly occurs in the bilateral PAs. Male gender, DVT locations, and previous surgery increased the risk of PE. The Wells scoring system was more advantageous for evaluating the diagnosis of PE in patients with DVT.


1987 ◽  
Author(s):  
D Wachel ◽  
M Segers ◽  
P Leautaud ◽  
J J Rodzynek

In order to determine the sensitivity and the specificity of laboratory tests in the diagnosis of thrombotic disease, D-Dimer (D-D) latex, Fibrin(ogen) Degradation Products (FDP), Ethanol Gel Test (EGT) and Transfer Test (TT) were performed in two groups of patients : group 1 = 199 consecutive patients without thrombotic disease, group 2 = 56 patients with thrombosis (Deep Venous Thrombosis confirmed by radiological phlebography, n=19, and Pulmonary Embolism confirmed by ventilation-perfusion lung scintigraphy, n=37). The sensitivity, the specificity, the positive and negative predictive values (PV+ and PV-) for the different tests appeared as follows :Conclusion :1) Among the different parameters which have been studied, D-Dimer latex appears to be the most useful in the clinical practice (sensitivity 98% and specificity 90%).2) Easy to perform, cheap, the results can be obtained within 20 minutes (for instance during the night in emergency situations).


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