Search results for "OSiS"
showing 10 items of 15931 documents
Cancer-Associated Deep Vein Thrombosis: The Role of Residual Vein Thrombosis for Assessing the Duration of Low Molecular Weight Heparin (the EXTENDED…
2014
Abstract Introduction. The optimal duration of Low Molecular Weight Heparin (LMWH) after cancer associated deep vein thrombosis (DVT) is unknown; current guidelines suggest to prolong anticoagulation until cancer is active. We have recently demonstrated, in a randomized trial, that detection of Residual Vein Thrombosis (RVT) after 6 months of LMWH identify patients who require or not extension of therapy with anticoagulants (JCO in press). Now we present data of a prospective study evaluating a RVT-based management of patients with cancer-associated DVT, in whom LMWH has been extended up to 2 years in patients considered at high-risk for recurrent DVT because of persistence of RVT. Material…
Platelet Cut-Off For Anticoagulant Therapy In Cancer Patients With Venous Thromboembolism and Thrombocytopenia: An Expert Opinion Based On RAND/UCLA …
2013
Abstract Introduction Cancer-related Venous Thromboembolism (VTE) requires treatment with Low Molecular Weight Heparin (LMWH), which is more effective and safer than warfarin; however, the risk of major hemorrhage still remains clinically relevant (up to 5%). This rate is even higher in case of impaired hemostasis, such as during thrombocytopenia (due to myelosuppression or chemo-therapy) where the bleeding risk is directly related to the platelet count level. At the present, the best management of adult patients with acute or non-acute cancer-related VTE during thrombocytopenia is uncertain. Objective To develop a consensus about the platelet cut-off for a safe LMWH administration in cance…
Management of Pulmonary Embolism
2016
Pulmonary embolism (PE) remains a major contributor to global disease burden. Risk-adapted treatment and follow-up contributes to a favorable outcome. Age-adjusted cutoff levels increase D-dimer specificity and may decrease overuse of imaging procedures and overdiagnosis of PE. Primary systemic fibrinolysis has an unfavorable risk-benefit ratio in intermediate-risk PE; catheter-directed techniques are an option for patients with hemodynamic decompensation and high bleeding risk. New oral anticoagulant agents are effective and safe alternatives to standard anticoagulation regimens. Recent trial data do not support insertion of cava filters in patients who can receive anticoagulant treatments…
Management of Antiaggregated and Anticoagulated Patients Scheduled for Thoracic Surgery: Recommendations for Venous Thromboprophylaxis
2017
The management of patients under the effect of antiplatelet or anticoagulant agents is a common challenge in thoracic surgery. Their temporary interruption or continuation needs a balanced assessment between the risk of thrombosis (interruption) and bleeding (continuation). Moreover, most patients must receive an anticoagulant for thromboprophylaxis (mainly a low-molecular-weight heparin). So, it is important to have in mind all surgical and anaesthetic implications of these drugs to take the optimal decision in each case.
Increase in Endogenous Fibrinolysis and Platelet Activity during Exercise in Young Volunteers
1992
Physicians at the Medical Clinic at the Johannes Gutenberg University in Mainz Germany compared data on 6 18-35 year old healthy women who took low-dose estrogen oral contraceptives (OCs) with data on 10 healthy women of same age who did not take OCs and with data on 12 18-35 year old males to examine gender differences of the coagulation system endogenous fibrinolytic activity and platelet aggregation under normal conditions and immediately after spiroergometric exercise beyond the anaerobic threshold. This type of exercise considerably boosted tissue plasminogen activator (t-PA) in both men and women (1.6-5.5 IU/ml and 1.8-5.3 IU/ml respectively; p < .005). The increase was not as high in…
Reinfarction Related to PTCA-Induced Coronary Embolism after Successful Thrombolytic Therapy
1989
Coronary embolism originating from residual thrombotic material is one of the complications arising during acute percutaneous transluminal coronary angioplasty (PTCA) in acute myocardial infarction. This case report describes a symptomatic embolization of the right posterolateral and right posterior descending branch during success-ful PTCA of a subtotal stenosis of the midright coronary artery after acute inferior myocardial infarction. Typical ECG signs of reinfarction were recorded. We succeeded in recanalizing these branches by superselective thrombolysis and angioplasty.
Maschineller und manueller Bronchusverschlu� ?ergebnisse einer konsekutiven untersuchungsserie
1989
After lobectomy and pneumonectomy in experimental evaluations stapled bronchial closures showed the lowest incidence of inflammatory reaction and the highest strength determined by leakage pressure compared with other suture material. A total of 233 lung resections-performed at Surgical University Clinic Koln-Lindenthal and the Clinic for General and Abdominal Surgery of the Johannes-Gutenberg-Universitat Mainz--were reviewed. Mechanical stapling reduced the rate of bronchopleural fistulas to 2.0% compared with 7.1% after manual suturing. In parallel, mortality related to bronchial stump leakage decreased to 0.7%. Main advantages of bronchial closure with staplers are the simplicity of thei…
Assoziation einer arteriellen Verschlußkrankheit mit Ciclosporin-Therapie nach Nierentransplantation
2008
Renal transplantation followed by immunosuppression with cyclosporine (whole-blood levels 200-300 micrograms/l) and methylprednisolone (4 mg daily) was performed in a 54-year-old man with chronic glomerulonephritis. Three years later rapidly progressive arterial obstructive disease (peripheral type) developed. Parenteral treatment with prostaglandins, calcium antagonists and nitrates, as well as a lumbar sympathectomy, was unsuccessful so that, in rapid succession, several amputations on upper and lower limbs became necessary. The disease progression was arrested only when azathioprine replaced cyclosporine. Raynaud's phenomenon, present at the time, also disappeared and analgesics were no …
Indications for early PTCA after thrombolysis
1986
There are several ways to reopen an acutely occluded coronary artery. Thrombolysis can be achieved with various methods (1, 5, 7, 10). After thrombolysis we find that the residual thrombus can sometimes be seen, but in most cases, a more or less high grade coronary stenosis remains (2). It is also a question of whether it is always optimal to reopen the vessel, because if the vessel remains occluded, another occlusion cannot occur. With this situation one faces the possibility that the patient will suffer another infarction, and that the vessel will occlude again (4).
Passagere Kolostomieanlagen nach Eingriffen am Colon Sigmoideum und Rektum—Sind Sie Noch Gerechtfertigt?
1997
Abstract Primary anastomosis is increasingly favored even in emergency colorectal surgery. Two-stage procedures are frequently considered obsolete. The aim of this study is to define conditions when a two-staged operative strategy with a temporary colostomy is still appropriate. We analyzed a series of 126 patients who were treated by a colostomy following resection and subsequent closure of the colostomy. In 44 cases the primary operation was a Hartmann resection, in 39 cases a resection with colostomy and mucous fistula and in 43 cases a resection with primary anastomosis and proximal loop colostomy. Complications of diverticular or neoplastic disease were generally managed by resection w…