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Biomedical subjects

F Duckert

Publications and source records attributed to F Duckert.

At least 109 records · Page 6Linked to original sources
PubMed1976

[Dextran 40 in the prophylaxis of deep vein thrombosis in surgery (author's transl)].

The effectiveness of 4 X 500 ml dextran-40 infusions (Rheomacrodex) for the prevention of postoperative deep vein thrombosis was evaluated in a prospective, controlled, randomized study in urological and general surgical patients. The 125I-fibrinogen test was performed daily in all patients. 36 of 100 control patients developed deep vein thrombosis, but only 20 out of 92 (21.7%) did so in the dextran group (P less than 0.05). The number of patients showing bilateral deep vein thrombosis was significantly reduced under dextran prophylaxis (P less than 0.01). No side effects of dextran prophylaxis were seen.

Adult↗
PubMed1976

[The course of postoperative deep vein thrombi as judged by repeated phlebographies].

Phlebography was carried out in a prospective randomised, controlled study during which dextran and small doses of s.c. heparin have been compared in general surgical and urological patients, in 31 persons with proven deep vein thrombois diagnosed with the 125I-fibrinogen test. In 16 out of the 31 patients a second phlebogram coule be performed two weeks later. In this study all thrombi occurred intraoperatively. In 24 of the 31 patients, the appearance of thrombi was multilocular. Independent of the prevention instituted and irrespective of the therapy, the following phenomena could be seen 14 days after the first phlebogram: 9 thrombi retracted, 6 disappeared completely and 1 occluded the vein completely. 2 thrombi disappeared without any therapy whatsoever, the 4 others disappeared in patients receiving heparin and/or coumarin for treatment.

Clinical Trials as Topic↗
PubMed1976

[Severe coagulopathy due to inhibitors of several clotting factors in IgM paraproteinaemia (author's transl)].

A 62-year-old man presented with an IgM paraproteinaemia and then suddenly developed an haemophilia-like haemorrhagic diathesis. Clotting tests revealed markedly prolonged Quick prothrombin times (more than 2 min) and much diminished factor II, V, VII, and X activities. Cross-mixing experiments indicated the presence of a circulating inhibitor, which specifically blocked the activity of these factors. But the exact mechanism remains uncertain, no inhibitor of this type having been previously reported. In addition to the clotting defect there was a probably monoclonal immunoglobulin IgM. Complete remission occurred and has now persisted for 18 months, after immuno-suppressive treatment with azathioprine and prednisone. It is suggested that the inhibitory capacity is confined to the abnormal IgM, due to a primary immunological disorder. A review of similar reported cases emphasizes the importance of immunosuppressive treatment in this disorder.

Azathioprine↗
PubMed1976

[Trends in the nuclear-medical diagnosis of thrombosis].

Use of the 125I-fibrinogen-uptake test for detection of freshly developing thrombi is well known. The administration of radiofibrinogen to detect preformed thrombus - the retrospective variant of the 125I-fibrinogen-uptake test - allows the diagnosis of established thrombosis. The correlation with ascending phlebography is 90%. 125I-Fibrinogen cannot be used for scanning, due to its low energy, while 131I-fibrinogen if used involves a high radiation dose to the patient. First experiments with new radiopharmaceuticals for detection of deep vein thrombosis are proposed. Indication lists for the retrospective variant of the 125I-fibrinogen-uptake test are given.

Fibrinogen↗
PubMed1975

[The value of dextran 70 in the prevention of thromboembolism in general surgery, orthopedics, urology and gynecology. A review of the literature].

28 prospective, controlled, randomised studies on the incidence of deep vein thrombosis (DVT) and pulmonary embolism (PE) in surgical patients on dextran 70 prophylaxis are analysed. In all patients the diagnosis had been established by objective methods (fibrinogen test, phlebography, autopsy). In patients undergoing hip surgery (11 studies, mainly fractures of the upper end of the femur) the reduction in the number of DVT under dextran prophylaxis is the more evident the longer after operation phlebography is carried out. Coumarin and dextran prevention are equally effective. In 3 studies where diagnosis by the fibrinogen test was established during the first postoperative week only, no significant effect of dextran can be shown; there is no difference between the effect of dextran, coumarin or small doses of subcutaneous heparin. The effectiveness of dextran prophylaxis in reducing the DVT rate in general surgery (4 papers) is not clear, though 7 studies show that the number of fatal PE is reduced more than fivefold (p less than 0.0005). In patients on dextran prophylaxis, the incidence of DVT is equal to that in patients on coumarin prophylaxis before major gynecological surgery (4 papers). On postoperative initiation coumarin is significantly less effective than dextran. 2 further studies show that dextran is significantly effective as compared to controls and that there is no difference between dextran and heparin prophylaxis. Out of 1932 control patients 36 died of fatal PE verified at autopsy. Only 8 PE were seen in the group of 2011 patients receiving dextran prophylaxis (p less than 0.005). The effectiveness of dextran 70 corresponds to that of small doses of subcutaneous heparin. Dextran prevention is more effective in women than in men. Dextran prophylaxis is simple to carry out, has few contraindications, only rarely causes complications and is already effective during operation.

Amputation, Surgical↗
PubMed1975

Local treatment of recent arterial thromboembolic occlusions with brinase.

Brinase was administered intra-arterially in 16 patients with thrombotic or embolic arterial occlusions. Angiography could be performed before and after treatment in 13 patients. Thrombolysis was obtained in 3 of 9 patients with thrombotic and in 3 of 4 patients with embolic occlusions. In 3 patients severe local side effects occurred.

Blood Pressure↗
PubMed1975

[Incidence of postoperative deep vein thrombosis in general surgical and urological patients an investigation by means of the 125I-Fibrinogen test in 95 patients withoug prophylaxis (author's transl)].

We present the results of a control group of 95 patients who were thoroughly investigated in a prospective, randomized study, where the efficacy of small doses of s.c. heparin and dextran 40 is checked. The 125I-fibrogen test was used in all patients. 1. 35.8% of the patients develop deep vein thrombosis (DVT) during the first post-operative week. More than half of them show bilateral thrombosis. 2. There is no statistically significant difference in the thrombosis incidence between males and females. 3. 47% of the patients over 60 years develop postoperative DVT. Among those younger than 60 years, only 23% have DVT (P less than 0.025). 4. The DVT incidence in surgery of the colon is 58.3%. 5. Surgery for a malignant disease means probably increased risk for DVT (P less than 0.025). 6. More than half of the patients having a previous history of varicose veins develop postoperative DVT (P less than 0.025). 7. Obese patients are statistically seen not more prone to develop DVT than those of normal body build. 8. Immediately after operation 32.4% of DVT are diagnosed, 24 hrs. later 61.8%. 94% of all DVT are diagnosed up to the third postoperative day. 9. With the exeption of one patient, all DVT develop in the calf veins, 3/4 of all abnormal values were measured in the midcalf region.

Adult↗
PubMed1975

[Subcutaneous small heparin doses for the prevention of thrombosis in general surgery and urology].

1. The effectiveness of 3 X 5000 IU s. c. heparin daily (starting preoperatively) for the prevention of postoperative deep vein thrombosis was evaluated in a prospective, controlled, randomized study including general surgical and urological patients. 125I-fibrinogen test was performed daily in all patients. 2. 178 patients fulfilled the conditions of the protocol. 35.8% of the 95 patients in the control group developed deep vein thrombosis, but only 13.3% of 83 subjects in the heparin group did so. The difference is statistically highly significant (p less than 0.001). 3. The vast majority of all thrombi in both groups appeared before the 3rd postoperative day. 4. With 1 exception, all deep vein thrombi in the heparin group started in the mid-calf region. In the control group 5 deep thrombi originated in the popliteal vein. 5. Heparin displays a better effect in males (n = 34; p less than 0.01) than in females (n = 49; p less than 0.025). 6. In patients undergoing surgery for malignant disease heparin does not reduce the incidence of deep vein thrombosis. 7. Heparin is far more effective in patients under 60 years of age than in those over 60 (p less than 0.005). 8. Heparin is more effective in obese patients than in those of normal body build. 9. Heparin prophylaxis also reduces the incidence of deep vein thrombosis in patients who exhibit predisposing factors. In patients of the control group with preexisting disease of the venous system, there were significantly more deep vein thrombi (p less than 0.01) than in those without predisposing factors. 10. In the heparin group 29% of all thrombin time determinations show a definite prolongation of more than 26 sec (normal value 15 sec). 11. In 14 patients (=16.9%) of the heparin group, 21 side effects or complications were seen. Bleeding complications were the main problem, comprising 5 wound hematomas and hematomas at the injection site, 4 postoperative bleeding episodes and 2 reoperations. There were no complications in the control group. 12. According to the results of 10 well controlled studies, there is no doubt that in general surgery small doses of subcutaneous heparin, commencing preoperatively, do reduce the incidence of postoperative deep vein thrombosis to a significant degree. However, whether this form of prophylaxis is also effective in patients with fractures of the hip and in elective hip surgery cannot, on the evidence available, be decided. In the fields of gynecological surgery and urology as well, more data are needed before this form of heparin prophylaxis can be recommended.

Adult↗
PubMed1975

[Substitution treatment of hemophilia a and b].

The availability of factor VIII and factor IX concentrates has considerably improved substitution therapy in hemophilia A and B respectively. The desired activity levels and the corresponding factor VIII or factor IX dosage are indicated. Antifibrinolyics have a favorable action when given simultaneously, though hematuria is an absolute contraindication for antifibrinolytic treatment. The administration of factor IX concentrate in case of hemorrhage due to oral anticoagulation or to liver disease, or in newborns, should be used in emergency situations only, since this material may provoke either thrombosis or disseminated intravascular coagulation. Transmission of hepatitis is also possible.

Antifibrinolytic Agents↗
PubMed1975

[Hemophilia A: early detection of women carriers by Laurell's quantitative immunoelectrophoresis].

Using one-stage quantitative factor VIII assay and the quantitative immunoelectrophoretic method of LAURELL a good correlation has been found between factor VII activity and protein concentration. In 80% of the known hemophilia A carriers the protein concentration was about twice as high as in normals as compared to the factor VIII activity, whereas about 20% of the known carriers have the same ratio between factor VIII protein and factor VIII activity as normals. The reliability of the test and its usefulness for the detection of hemophilia A carriers are discussed.

Antibodies, Heterophile↗