Heroic years.
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Biomedical subjects
Publications and source records attributed to Joseph W Goldzieher.
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Venous thromboembolism (VTE) includes deep vein thrombosis (DVT) and pulmonary embolism (PE). A number of factors can increase VTE risk, including aging, smoking, immobility, pregnancy and a hereditary thrombophilia. Presenting symptoms are not definitive for DVT or PE, and objective testing is necessary for an accurate diagnosis. A number of antithrombolic agents are used in the prophylaxis and treatment of VTE. The current trend is toward using low-molecular-weight heparins instead of unfractionated heparin. There is increasing interest in new agents that can target a single factor in the coagulation cascade.
In the last decade, the contribution of the progestin component of oral contraceptives (OCs) to the risk of venous thromboembolism (VTE) has come under scrutiny. The publication of 4 papers in late 1995 and early 1996 led to many women discontinuing OCs containing desogestrel and gastodene, the so-called third-generation OCs. This "pill scare" was the result of study findings that the third-generation OCs were associated with a higher risk of VTE than were OCs containing older progestins, primarily levonorgestrel. Subsequent studies and reanalysis of the original studies have not provided a definitive answer to this continuing debate. More recently, a question was raised about a possible increase in the risk of VTE associated with the use of an OC containing the novel progestin drospirenone. However, the information to date does not support any increase in the risk of VTE with use of the drospirenone-containing OC as compared with any other combination OC.
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