[What is safe in antithrombotic therapy after acute myocardial infarct?].
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Coronary Circulation↗
Biomedical subjects
B Kirchhof
Publications and source records attributed to B Kirchhof.
Effect of enzyme induction on plasma lipids using antipyrine, phenobarbital, and rifampicin.
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17-Hydroxycorticosteroids↗
J blood group active lipoproteins extracted from bovine erythrocytes.
Ghosts of J-positive bovine erythrocytes were frozen overnight, thawed the next day, washed with ion-free water, and then extracted with a water-n-pentanol mixture. After centrifugation, the aqueous phase contained a great deal of the membrane proteins and lipids in a soluble form along with the J blood-group activity. After preparative ultracentrifugation, about 2/3 of the J activity were recovered in the high-density lipoprotein fraction, while the low-density lipoprotein fraction contained 1/3 J activity. This result is consistent with out finding that on treatment of the stroma lipoproteins with dextran sulphate, about 2/3 of J activity were recovered in the supernatant, 1/3 in the precipitate. These fractions obtained by dextran sulphate treatment were characterized by protein and lipid assay.
Animals↗
Low molecular weight heparin and unfractionated heparin for prevention of thrombo-embolism in general surgery: a meta-analysis of randomised clinical trials.
Low molecular weight heparin (LMWH), unfractionated heparin (UFH) and warfarin were compared with respect to efficacy and safety in the prevention of thrombo-embolism in general surgery. Meta-analysis (MA) with a priori definition of the MA protocol was used to combine the results from randomised trials with patients who underwent general surgery and deep-vein thrombosis (DVT) prophylaxis with LMWH, UFH or warfarin. Forty-four studies were identified for assessment and 33 were included, however, none for warfarin. For efficacy (DVT and pulmonary embolism) and major bleeding, no significant difference between the LMWH- and UFH-treated groups was demonstrated. The relative risk of minor bleedings for LMWH versus UFH was 0.75 (0.64-0.88; 95% confidence interval) and is significant (p < 0.05). Within the limitations of the MA, LMWH and UFH did not differ significantly in terms of prevention of thrombo-embolism, but LMWH had a significantly better safety profile. On this basis, LMWH may be preferable to UFH in the prevention of thrombo-embolism in general surgery.
Anticoagulants↗
Efficacy and safety of low molecular weight heparin, unfractionated heparin and warfarin for thrombo-embolism prophylaxis in orthopaedic surgery: a meta-analysis of randomised clinical trials.
UNLABELLED: The efficacy and safety of low molecular weight heparin (LMWH), unfractionated heparin (UFH) and warfarin for prophylaxis of thrombo-embolism in orthopaedic surgery were compared using meta-analysis techniques. Twenty-two studies were included, 2 of which compared LMWH to warfarin. The mean probabilities to develop deep-vein thrombosis (DVT), pulmonary embolism and major and minor bleeding using UFH were: 0.21 (95% confidence interval, CI: 0.18-0.24); 0.01 (95% CI: 0.01-0.02); 0.05 (95% CI: 0.03-0.07), and 0.19 (95% CI: 0.17-0.22), respectively. The relative risk (RR) of DVT for LMWH vs. UFH was 0.76 (95% CI: 0.60-0.91), p < 0.05 and for LMWH vs. warfarin 0.78 (95% CI: 0.69-0.87), p < 0.05. The RR of minor bleeding for LMWH vs. UFH was 0.76 (95% CI: 0.64-0.92), p < 0.05. The RR of minor bleeding for LMWH vs. warfarin was 3.28 (95% CI: 2.21-4.70), p < 0.05. CONCLUSION: in orthopaedic surgery, LMWH is significantly superior to both UFH and warfarin in the prevention of DVT and results in significantly less minor bleeding complications when compared to UFH, but significantly more minor bleeding when compared to warfarin.
Anticoagulants↗
Conjunctival fibrosis after application of mitomycin C: an animal experimental study.
Mitomycin C (MMC) is widely used as an antimetabolite to minimize scarring of filtering blebs. Its effectiveness has been demonstrated in several clinical studies. The drug's mechanism of action is attributed to its antiproliferative effect on the subconjunctival cells, reducing the wound healing response. We placed sponges soaked with various concentrations of MMC, from 0.05 to 1.0 mg/ml, under the conjunctiva of 18 rabbits. Four weeks later, there was marked concentration-dependent scarring of the substantia proppria of the conjunctiva. Macrophages were more numerous in treated eyes, as determined by immunohistochemistry. The reason for MMC-related fibrosis in this animal model is not clear but may be related to the substances toxic effects. Whether it is only present in rabbits remains to be clarified.
Animals↗
Major lower extremity amputation in patients with peripheral arterial insufficiency with special reference to the transgenicular amputation.
The selection of the proper level for lower extremity amputation in patients with advanced arterial ischemia poses a multiplicity of problems with regard to operative mortality, stump healing, re-amputation rate and rehabilitation status. In a retrospective study all these parameters have been evaluated in 413 patients submitted to below-knee (bk, n = 196), transgenicular (tg, n = 93) and above-knee (ak, n = 124) amputation between 1971 and 1980. As compared to the ak resection, the bk amputation has the following advantages: lower operative mortality (9% vs. 30.5%), higher prosthetic fitting rate (85% vs. 66%) and significantly improved rehabilitation (walking with artificial limb: bk 84%, ak 22%). Regarding surgical mortality (8.5%) and prosthetic gait (66%), the tg amputation was nearly equivalent to the bk resection and turned out to be clearly superior to the ak amputation. As compared to the latter procedure, knee disarticulation and bk amputation had a greater risk of delayed wound healing and re-amputation at a higher level (ak: 13.5 resp. 1%, tg: 22.5 resp. 25%, bk: 35% resp. 16%). The patient with a bk amputation has the best prospect concerning a successful rehabilitation. Whenever the very important knee joint cannot be saved an ak amputation should be avoided in favour of a knee disarticulation.
Adult↗