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Biomedical subjects

F Bachmann

Publications and source records attributed to F Bachmann.

At least 127 records · Page 7Linked to original sources
PubMed1978

The hemostatic mechanism after open-heart surgery. III. Correlation between the appearance of an abnormal protein demonstrated by gel electrophoresis and of an inhibitor of the extrinsic coagulation system (PEC).

A prospective study in 13 patients undergoing open-heart surgery with extracorporeal circulation revealed a marked decrease of the mean one-stage prothrombin time activity from 88% to 54% (p less than 0.005) but lesser decreases of factors I, II, V, VII and X. This apparent discrepancy was due to the appearance of an inhibitor of the extrinsic coagulation system, termed PEC (Protein after Extracorporeal Circulation). The mean plasma PEC level rose from 0.05 U/ml pre-surgery to 0.65 U/ml post-surgery (p less than 0.0005), and was accompanied by the appearance of additional proteins as evidenced by disc polyacrylamide gel electrophoresis of plasma fractions (p less than 0.0005). The observed increases of PEC, appearance of abnormal protein bands and concomitant increases of LDH and SGOT suggest that the release of an inhibitor of the coagulation system (similar or identical to PIVKA) may be due to hypoxic liver damage during extracorporeal circulation.

Aspartate Aminotransferases↗
PubMed1976

[Intermittent pneumatic compression of leg and thigh: a new successful method for the prevention of postoperative thrombosis].

In a prospective study, 54 patients undergoing joint-replacement operations were randomized into a control and a treatment group. In the treatment group low pressure intermittent compression (Phlebo-Dynastat) to calves and thighs was started on the day of operation and continued until patients were fully mobilized. In 34 evaluable patients undergoing total hip arthroplasty the incidence of deep vein thrombosis (DVT) as determined by venography was 43% in the control group and 22% in the treatment group (p = 0.18). In 17 patients undergoing total knee replacement, DVT occurred postoperatively in 70% of the control group but in none of the treatment group (p = 0.002). The difference between the control and Phlebo-Dynastat group when comparing all patients was highly significant (p less than 0.005). Low pressure intermittent venous compression offers a welcome alternative method of thrombosis prophylaxis in patients with increased risk of bleeding.

Air Pressure↗
PubMed1976

Spectrophotometric assays for warfarin sodium and dicumarol. Use in rapid detection of patients suspected of drug intoxication or surreptitious noningestion.

The usefulness of assays for the rapid identification and determination of quantitative plasma levels of warfarin sodium and dicumarol is documented by the case histories of five patients: a man who accidentally took dicumarol for several weeks and developed an acute condition within the abdomen, a man who ingested 500 mg of warfarin sodium in a suicide attempt, a malingering nurse who surreptitiously took dicumarol, a nurse with warfarin intoxication who did not follow dosage prescription because of fear of developing thrombosis, and a woman with calf vein thrombosis who did not ingest the administered warfin sodium becausing of fear of developing bleeding. In every patient, the diagnosis of surreptitious ingestion or noningestion was suspected on the basis of the coagulation profile pattern. Confirmation of the disorder by the spectrophotometric assay enable the clinician to choose the appropriate course of action with speed and purpose.

Accidents, Home↗
PubMed1976

Thromboembolic disease in patients undergoing total knee replacement.

In a prospective study fo the incidence of deep-vein thrombosis in thirty patients undergoing total knee replacement, all patients had clinical examinations and 125I fibrinogen scanning, while those suspected of having deep venous thrombosis also had confirmatory venography. Sixteen (53 per cent) of the thirty patients had thromboembolic disease; nine had thrombi only in the limb operated on; four had bilateral deep venous thrombi; and three had pulmonary embolism. In nine patients who took aspirin regularly the incidence of thromboembolism was 11 per cent, while in the eight who did not take aspirin or any other antiplatelet drug the incidence was 88 per cent, a difference which was highly significant (p = 0.003).

Aged↗
PubMed1975

[Proceedings: Hypercoagulability and compensated intravascular coagulation in chronic kidney insufficiency and after kidney transplantation].

Seven blood coagulation tests which may indicate a state of hypercoagulability or of chronic intravascular coagulation were assayed in 106 blood samples from 50 patients with chronic renal insufficiency or after renal transplantation. The following abnormal results were obtained: increased titer of fibrin(ogen) degradation products in 60%, abnormal fibrinogen immunoelectrophoresis in 49%, shortened partial thromboplastin time and whole blood clotting time in 45 and 37% respectively, prolonged thrombin time in 34%, increased cryofibrinogen level in 21% and positive protamine sulfate gelation test in 11%. The greatest number of abnormalities was found during the first week after transplantation and during transplant rejection, and the smallest in patients with stable transplant who were anticoagulated with warfarin. Partial thromboplastin times of less than 19 sec were associated in 3/4 patients with thrombosis of the renal artery or vein or with rejection. Rejections could be identified with high probability (p less than 0.001).

Anticoagulants↗
PubMed1975

The hemostatic mechanism after open-heart surgery. I. Studies on plasma coagulation factors and fibrinolysis in 512 patients after extracorporeal circulation.

Blood coagulation screening profiles were performed in 512 patients who underwent open-heart surgery with extracorporeal circulation. Severe coagulation disorders were found in 29 (5.6 per cent) patients. The most common abnormalities were low one-stage prothrombin time (PT) activities and impaired whole blood clot retractions. In the majority of patients the discrepancy between low PT's and normal or only slightly depressed factor II, V, VII, and X activities was explained by the presence of an inhibitor of the extrinsic system. Eight patients demonstrated the heparin rebound phenomenon but only 1 bled excessively. The pattern of severe hepatic dysfunction was found in 4 and severe depression of vitamin K-dependent factors due to oral anticoagulants in 2. Two had disseminated intravascular coagulation. Seventeen patients with normal coagulation screening profiles bled excessively postoperatively. Of these, 2 had moderate thrombocytopenia associated with a marked platelet functional abnormality. Revision of the wound in 13 revealed a surgical hemostatic defect and in 2 the cause of bleeding could not be determined.

Blood Coagulation Disorders↗
PubMed1975

The hemostatic mechanism after open-heart surgery. II. Frequency of abnormal platelet functions during and after extracorporeal circulation.

In a prospective study of 13 patients undergoing open-heart surgery with extracorporeal circulation, marked qualitative platelet function defects were observed in addition to the usually occurring drop of the thrombocyte count. At the end of bypass, the following test results were significantly abnormal: concentration of fibrinogen and of circulating fibrin degradation products, platelet count, platelet adhesiveness to glass beads, and platelet aggregation induced by low and high doses of ADP. One to 2 hours after neutralization of heparin with protamine sulfate all abnormal test results improved, but the template bleeding time was markedly prolonged in 10 patients. There was no correlation between length of bypass and platelet fall and between concentration of circulating fibrin degradation products and extent of platelet dysfunction. An apparent correlation was found between the length of the postoperative bleeding time and the number of units of blood transfued during surgery. The results of this study suggest that dilution of the patient's own platelets by nonviable platelets contained in 3-day-old transfused ACD blood and the production of a refractory state of the patient's circulating platelets to ADP induced aggregation played a significant role in the development of platelet function abnormalities during extracorporeal circulation.

Adenosine Diphosphate↗
PubMed1972

Surgical bleeding.

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Blood Coagulation Disorders↗