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C Heinrichs

Publications and source records attributed to C Heinrichs.

At least 73 records · Page 4Linked to original sources
PubMed1988

[Local intra-arterial fibrinolytic therapy in acute vascular occlusions in the area of the internal carotid artery].

Report on the first experiences with the local intraarterial streptokinase therapy in 5 patients with acute obliteration processes of the vascular system of the internal carotid artery. Two peripheral obliterations (occlusions of the main branch of the media) could be completely recanalised, with complete regression of the neurological symptomatology. In one of the three complete occlusions of the internal carotid artery (region of the siphon) a considerable partial recanalisation could be achieved. A fourth patient could be dismissed with an essential clinical improvement 11 days later despite angiographic persistence of the occlusion. Two patients died. As directive value for the dosage from 50,000 to 100,000 units streptokinase are proposed as short-term infusion in 30 to 60 minutes.

Acute Disease↗
PubMed1988

Investigations of antithrombin III-activity in patients after myocardial infarction and a long-term coumarin therapy.

In 40 M.I. patients with long-term anticoagulant treatment, (Falithrom), the AT III-activity was determined at an interval of three years by means of Chromozym TH. We have found a mean AT III-value in the first testing period of 79.67 (+/- 14.16) per cent and in the second assessment of 82.5 (+/- 10.42) per cent. The difference is not significant. However, we were unable to confirm the comparatively marked increase AT III for dicoumarol treatment found by Roka and Bleyl. In acute M.I.-patients was demonstrated a decreased AT III-activity in the first 3-4 days and a normalisation tendency in the next 10-14 days. Our values of the mean AT III-activity were in the lower normal range for patients with long-term coumarin therapy. In dead patients (average age 70 years) there is a trend of a risk to an untimely death in the presence of pathologic AT III-activity (despite a good anticoagulation of an individual mean quick test from greater than or equal to 0.20 to less than or equal to 0.30) or a bad anticoagulation (mean individual quick tests greater than or equal to 0.30 to 0.35), but a normal AT III-activity. The three dimensional analysis was not significant.

Aged↗
PubMed1987

Evaluation and significance of the degree of pituitary-gonadal inhibition during intranasal administration of buserelin.

In 12 patients (11 girls, 1 boy) with central precocious puberty and 4 patients (3 girls, 1 boy) with idiopathic short stature treated for 1 year with a GnRH superagonist, buserelin (0.3 mg intranasally, 4 times a day), a variable degree of inhibition of sex steroid secretion and pubertal development was observed. Regression of breast or genital development required a daily dosage of buserelin greater than or equal to 34 microgram/kg. After 3, 6, 9 and 12 months of treatment, the serum oestradiol level in the girls was positively related (r = 0.69) to basal serum LH measured at the same time and to change in breast development during the previous 3 months. In contrast, LH response to GnRH was very low in all the patients and not related to the degree of oestradiol inhibition. Height velocity and bone age velocity during the year of treatment showed no significant correlation with mean oestradiol level. Bone age velocity during treatment was inversely related to bone age at onset of buserelin. These data show that 1) the pituitary gonadal suppression during intranasal administration of buserelin is variable and dose-dependent; 2) gonadotropin response to GnRH is not a sensitive indicator of incomplete pituitary suppression during buserelin treatment; and 3) bone age velocity during treatment is more reduced the more advanced bone age is at onset of treatment.

Administration, Intranasal↗
PubMed1987

[Significance of drug prevention of thromboembolism in urologic risk patients].

The phlebothrombosis and pulmonary embolism are severe postoperative complications. Urological patients are particularly at risk with thrombosis. Therefore it becomes necessary for urology to perform a consequent prophylaxis of thromboembolism which, when an increased risk is present, must contain medicamentous measures. As it is confirmed by evident studies, the low-dose heparin prophylaxis proved as optimum method. A still more effective thrombosis protection can be achieved by the combination of small heparin doses with dihydroergotamine. Retrospectively, 2 comparable groups of urological risk patients with and without heparin prophylaxis were examined. In the adenomectomies under heparin prophylaxis a trend to the reduction of the events of postoperative thromboembolism is revealed. The heparin prophylaxis does not lead to an increase of complications of haemorrhages which need therapy. The prophylaxis of thromboembolism with heparin and a heparin-DHE-combination, respectively, is recommended for the application in urological risk patients.

Dose-Response Relationship, Drug↗
PubMed1984

[Results of local intracoronary fibrinolysis in acute myocardial infarct and the effects of reperfusion on the function of the left ventricle].

Out of 46 patients who had undergone acute coronary angiography in 41 a definitive acute myocardial infarction was present. In 31 complete and in 10 cases subtotal obliterations of the infarct-related coronary artery were found. 14 patients had a one-vessel-disease, 8 a two-vessel-disease, but 19 a three-vessel-disease. In these 41 patients with acute myocardial infarction a subsequent intracoronary fibrinolysis therapy with streptokinase or urokinase immediately followed, which was successful in 33 patients (80.5%). Coronarographically neither a recanalization or a marked improvement of luminal patency of the infarct-related coronary artery could be proved. In 4 patients an additional guidewire thrombus perforation was necessary. The intracoronary fibrinolysis lasted maximally 2 hours (average total dosage 121.000 +/- 45.000 U streptokinase) and was essentially well tolerated. Only 3 patients of the treatment group died. 20 patients underwent a repeated angiography on average 8 1/2 months after fibrinolysis therapy, out of this group in 10 successfully treated patients comparable quantitative angiographic investigations are present. Heart index, stroke volume and systolic ejection fraction improved significantly. The percental size of the non-contracting area of the myocardium decreased statistically significantly. The recanalized coronary arteries were still patent at control.

Cardiac Output↗
PubMed1984

[Situational therapy of acute thrombophlebitis].

The insufficiently treated acute phlebothrombosis leads frequently to severe, in social-medical respect remarkable healings of defects (PTS and RDS), in the extreme case to a fatal pulmonary embolism. In order to avoid these complications a differentiated therapy concept is proposed which takes into consideration first therapy measures in the prehospital phase and represents multidisciplinary hospital measures (surgical thrombectomy, medicamentous fibrinolysis, anticoagulant therapy, physicotherapy), including their variants of dosage for risk patients.

Acute Disease↗
PubMed1984

[Clinical course study in thrombophilia].

The course of the disease in a 46 yr old female patient was characterised by an unusual frequency of thromboembolic complications. Thrombogenic factors were diathesis to cystine stones since adolescence, intake of oral contraceptives for 5 years, immune complex disease, liver cell adenoma, open foramen ovale. Differential therapeutic measures for treatment of thromboembolism were applied. Changes in clotting variables and pathogenetic aspects are discussed.

Antithrombin III Deficiency↗
PubMed1983

[Treatment results following acute thrombophlebitis. A comparison between thrombectomy and fibrinolysis therapy].

In a retrospective study 55 patients suffering from acute phlebothrombosis were subjected to an examination in order to evaluate the long term results of treatment. Good results of treatment could be achieved for the compensated stages 0-II of the postthrombotic syndrome in 22 patients after thromboectomy and in 33 patients after fibrinolysis (82 or 85% respectively). The portion of bad results of both methods, in the decompensated stages III-IV of the postthrombotic syndrome, was high (18 or 15% respectively). In both methods there was only 1 patient in stage IV of the postthrombotic syndrome, i.e. the total study comprised only 2 patients suffering from a postthrombotic crural ulcer.

Acute Disease↗
PubMed1983

[Disorders of blood coagulation during and after arterial vascular reconstruction].

In spite of a systemically increased clotting tendency in progredient arteriosclerosis there are locally restricted haemorrhagic sequelae following arterial vasoreconstruction. Because of the fact that each bleeding simultaneously includes the risk of wound infection with subsequent sepsis the formation of a haematoma is to be avoided in the surgical procedure. The development of disseminated intravascular coagulation caused by sepsis and that caused by massive haemorrhage are represented as to their clinical importance. Finally, an internationally accepted substitution concept for severe bleeding sequelae, e.g. in case of the rupture of an aortic aneurysm, is submitted.

Arteriosclerosis↗
PubMed1981

[Treatment of postoperative pulmonary embolism (author's transl)].

Peculiarities of the postoperative phase of gynaecological and puerperal patients with increased risk of bleeding and thrombo-embolism are reported in this paper. Fulminant outbreak, under such circumstances, of pulmonary embolism calls for immediate decision and no-delay action on the basis of a thoroughly defined therapeutic concept. Acute fibrinolysis and thrombectomy together with complementary therapy are described as high-risk but effective possible therapy.

Acute Disease↗
PubMed1980

[Clotting analysis in a surgical clinic].

In all selective surgical procedures a minimal programme concerning coagulation analysis should be performed preoperatively. In case of a disorder in haemostasis the laboratory parameters should be differentiated dependent on the clinical problem concerned. In a state of emergency the course should be closely surveyed by exact laboratory findings.

Blood Coagulation Disorders↗
PubMed1978

[The origin of complex coagulopathies in sleeping pill poisonings].

About 80 per cent of haemostasis disorders were found by systematic examinations of the clotting potential in 130 unselected moderately severe up to severe intoxications by tablets (degree of severity II--IV according to Reed). These disorders are essentially corresponding to a disseminated intravascular coagulation, but provided an extreme case they also may lead to a combination with production-, defect-, and casualty-coagulopathy. Occurring disorders in coagulation are to be treated dependent on stages by heparinisation, in case of need directed haemosubstitution and provided that a hyperfibrinolysis is proved also by antifibrinolytics. In special cases a--not too late beginning--therapy with streptokinase should be taken into consideration. These measures are to be classified into an optimal therapy regimen of detoxication and the exertion of influence of vital functions.

Adult↗
PubMed1978

[What emergencies arise from anticoagulant therapy?].

The antithrombotics (fibrinolytics, anticoagulants and aggregation inhibitors) belong to the most effective therapeutic methods and are used in all clinical specialties. The therapeutic mechanism of the fibrinolytics and anticoagulants is recognizable and can be regulated by hepatic parameters. Nevertheless, under this treatment patients undergo a potential risk of haemorrhage which not in every case can be estimated with the usual laboratory parameters. In addition to the factors increasing the potential risk false behaviour of the physician in charge and false behaviour on the side of the patient must be mentioned. In these two cases a treatment with antithrombotics should be omitted. If personal and technical insufficiencies are present the patient should be transferred to a centre for further treatment. In acute indications for discontinuing the treatment with antithrombotics depending on the clinical urgency a gradually different discontinuation by stages should be striven for, in order to avoid thromboembolic relapses.

Anticoagulants↗
PubMed1978

[Disorders of hemostasis in shock].

Shock and disturbance of haemostasis are described as the cause of a common severe basic disease evoking them. Haemodynamically rheological changes with disturbances of the perfusion of high degree which in the extreme case via formations of microcoagulations may lead to organ necroses with irreversible deleterius loss of organs are common to both. Bodily dysregulations may also lead to an increase of the potential of fibrinolysis with dramatic haemorrhagic complications. A coarsely orienting stage division of the consumption coagulopathy allows aimed therapeutic measures after differentiated indication, such as the application of antifibrinolytics and aimed haemosubstitution under heparin protection.

Disseminated Intravascular Coagulation↗