dicumarol and Pulmonary-Embolism

Topics: Acenocoumarol; Administration, Oral; Anticoagulants; Dicumarol; Drug Evaluation; Heparin; Humans; Pulmonary Embolism; Warfarin

Topics: Anti-Bacterial Agents; Blood Coagulation; Blood Flow Velocity; Cesarean Section; Dextrans; Dicumarol; Female; Femoral Vein; Heparin; Humans; Iliac Vein; Pelvis; Pregnancy; Pregnancy Complications, Cardiovascular; Puerperal Disorders; Pulmonary Embolism; Thrombophlebitis; Varicose Veins

Topics: Coumarins; Dicumarol; Embolism; Fibrinolysis; Fibrinolytic Agents; Heparin; Heparinoids; Humans; Myocardial Infarction; Pulmonary Embolism; Streptodornase and Streptokinase; Streptokinase; Thrombophlebitis; Thrombosis

Topics: Angiography; Anticoagulants; Blood Gas Analysis; Cardiac Catheterization; Diagnosis, Differential; Dicumarol; Humans; Pathology; Prognosis; Pulmonary Embolism; Radiography, Thoracic; Spirometry

Topics: Dicumarol; Heart Failure; Heparin; Humans; Hydrocortisone; Muscle Relaxants, Central; Norepinephrine; Pulmonary Embolism; Thromboembolism

A consensus has not been reached about the optimal duration of oral anticoagulant therapy after a second episode of venous thromboembolism.. In a multicenter trial, we compared six months of oral anticoagulant therapy with anticoagulant therapy continued indefinitely in patients who had had a second episode of venous thromboembolism. Of 227 patients enrolled, 111 were randomly assigned to six months of anticoagulation and 116 were assigned to receive anticoagulant therapy indefinitely; for both groups, the target international normalized ratio was 2.0 to 2.85. The initial episodes of deep-vein thrombosis (n = 193) and pulmonary embolism (n = 34), as well as recurrent episodes, were all objectively confirmed.. After four years of follow-up, there were 26 recurrences of venous thromboembolism that fulfilled the diagnostic criteria, 23 in the group assigned to six months of therapy (20.7 percent) and 3 in the group assigned to continuing therapy (2.6 percent). The relative risk of recurrence in the group assigned to six months of therapy, as compared with the group assigned to therapy of indefinite duration, was 8.0 (95 percent confidence interval, 2.5 to 25.9). There were 13 major hemorrhages, 3 in the six-month group, (2.7 percent) and 10 in the infinite-treatment group (8.6 percent). The relative risk of major hemorrhage in the six-month group, as compared with the infinite-treatment group was 0.3 (95 percent confidence interval, 0.1 to 1.1). There was no difference in mortality between the two groups.. Prophylactic oral anticoagulation that was continued for an indefinite period after a second episode of venous thromboembolism was associated with a much lower rate of recurrence during four years of follow-up than treatment for six months. However, there was a trend toward a higher risk of major hemorrhage when anticoagulation was continued indefinitely.

Topics: Administration, Oral; Aged; Anticoagulants; Dicumarol; Female; Follow-Up Studies; Hemorrhage; Heparin; Heparin, Low-Molecular-Weight; Humans; Male; Middle Aged; Probability; Pulmonary Embolism; Recurrence; Thrombophlebitis; Time Factors; Warfarin

Topics: Age Factors; Aged; Anticoagulants; Cerebrovascular Disorders; Clinical Trials as Topic; Diabetes Complications; Dicumarol; Electrocardiography; Female; Heart Failure; Hemorrhage; Heparin; Humans; Hypertension; Male; Middle Aged; Myocardial Infarction; Phenindione; Placebos; Pulmonary Embolism; Recurrence; Sex Factors; Thrombophlebitis; Time Factors; Warfarin

Topics: Adult; Aged; Clinical Trials as Topic; Dicumarol; Electric Stimulation; Female; Hemodynamics; Heparin; Humans; Leg; Male; Methods; Middle Aged; Postoperative Complications; Posture; Pulmonary Embolism; Statistics as Topic; Thrombophlebitis; Vena Cava, Inferior

Topics: Adult; Clinical Trials as Topic; Dicumarol; Heparin; Humans; Injections, Intravenous; Male; Middle Aged; Pulmonary Embolism; Streptokinase; Thrombophlebitis

The morbidity and mortality of pulmonary embolism (PE) have been found to be related to early diagnosis and appropriate treatment. The examinations used to diagnose PE are expensive and not always easily accessible. These options include noninvasive examinations, such as clinical pretests, ELISA D-dimer (DD) tests, and volumetric capnography (VCap). We report the case of a patient whose diagnosis of PE was made via pulmonary arteriography. The clinical pretest revealed a moderate probability of the patient having PE, and the DD result was negative; however, the VCap associated with arterial blood gases result was positive. The patient underwent all noninvasive exams following admission to hospital and again eight months after discharge. Results gained from invasive tests were similar to those produced by image exams, highlighting the importance of VCap as an important noninvasive tool.

Topics: Adult; Anticoagulants; Biomarkers; Capnography; Chronic Disease; Dicumarol; Enzyme-Linked Immunosorbent Assay; Fibrin Fibrinogen Degradation Products; Humans; Lung; Male; Perfusion Imaging; Predictive Value of Tests; Prognosis; Pulmonary Embolism; Respiratory Dead Space; Thromboembolism; Ventilation-Perfusion Ratio

To assess the efficacy and safety of mechanical fragmentation combined with intrapulmonary thrombolysis in massive pulmonary thromboembolism (PTE) with hemodynamic impairment.. Fifty-nine patients diagnosed with massive PTE with hemodynamic impact were treated. The initial clinical symptoms were shock in 23 patients (38.9%), syncope in eight (13.5%), and dyspnea at rest in 28 (47.4%). Mean O2 saturation was 67.8%. Mean pulmonary artery pressure (PAP) was 42.1 mm Hg. During fragmentation, thrombolysis was administered in the form of a urokinase bolus of 200,000-500,000 U in 57 patients and 20 mg of recombinant tissue plasminogen activator (rt-PA) in two patients. The mean urokinase dose used was 2,500,000 IU, whereas the total dose of rt-PA was 100 mg. Heparin sodium infusion was performed to reach activated partial thromboplastin time ratios of 2. The follow-up consisted of clinical assessment, pulmonary scintigraphy, and echocardiography. The patients received treatment with dicoumarin for 6 months after the procedure.. Clinical improvement was seen in 56 patients (94%). Three patients died. The mean PAP after the treatment was 21.8 mm Hg. The mean posttreatment Miller index was 0.35. Technical success was achieved in all cases and clinical symptoms improved in all cases except those in which the patients died. Pulmonary scintigraphy showed improved perfusion in all cases. Echocardiography was performed after 3-6 months, showing a mean pressure of 22.8 mm Hg (corrected values). There were no signs of recurrent PTE or arterial hypertension in the follow-up.. The data provided confirm the efficacy and safety of mechanical fragmentation and pharmacologic thrombolysis in the treatment of massive PTE with hemodynamic impairment, showing improvement of symptoms and a decrease in PAP.

Topics: Adult; Aged; Aged, 80 and over; Angiography; Anticoagulants; Catheterization; Combined Modality Therapy; Dicumarol; Echocardiography; Female; Fibrinolytic Agents; Hemodynamics; Heparin; Humans; Male; Middle Aged; Pulmonary Embolism; Radionuclide Imaging; Thrombolytic Therapy; Tissue Plasminogen Activator; Tomography, X-Ray Computed; Treatment Outcome; Urokinase-Type Plasminogen Activator

Topics: Administration, Oral; Anticoagulants; Dicumarol; Embolism; Follow-Up Studies; Humans; Incidence; Neoplasms; Pulmonary Embolism; Risk Factors; Thrombosis; Time Factors; Warfarin

Ferrokinetic studies in two patients with haemolytic anaemia due to haemoglobin Wien revealed increased haemoglobin synthesis and an increase in effective erythropoiesis. Haemolysis is due to an instability of the haemoglobin itself. The spleen does not appear to play any appreciable role in the aetiology of this condition. There was no extramedullary erythropoiesis in our patients.

Topics: Adolescent; Adult; Anemia, Hemolytic; Dicumarol; Erythropoiesis; Female; Hemoglobins, Abnormal; Humans; Iron; Lung; Male; Pulmonary Embolism; Radionuclide Imaging; Spleen

A series of 108 arterial embolectomies in 91 patients performed during 1960-64 and 1970-74 is presented. The Fogarty catheter was introduced in our clinic between these periods. Early mortality was 56 and 29%, respectively. Limb salvage rate according to our definition was 38 and 53%, respectively. We found a significantly higher mortality when embolies were located proximal to the profunda femoral artery compared to more distally located embolies. Amputation frequency was 4% after embolectomies performed within 12 hours, but 27% with longer duration of symptoms. Limb salvage rate was significantly higher in patients treated with anticoagulation. In conclusion it is stressed that local surgical therapy should be combined with adequate measures against cardiac failure and other systemic complications. This therapeutic principle is particularly important in cases with proximal embolies.

Topics: Aged; Amputation, Surgical; Arm; Dicumarol; Embolism; Female; Heart Failure; Heparin; Humans; Leg; Male; Middle Aged; Myocardial Infarction; Postoperative Complications; Pulmonary Embolism; Time Factors

The authors report a series of 22 cases of subdural hematomas in patients submitted to anticoagulant therapy. A review of the literature finds 150 cases. Subdural hematomas occurs in about one third of the patients presenting hemorrhage of central nervous system related to anticoagulant therapy. Among subdural hematomas of any cause, the possible role of a previous anticoagulant therapy is stressed in 4,8 to 14% of cases. In most cases, long term anticoagulants were indicated for arterial or heart (ischemic) lesions (16/22 cases). In 6 cases, anticoagulants were indicated for prevention or treatment of pulmonary embolies. In 18 cases, anticoagulant drug is from the group of dicoumarol or phenylindanedione. In 3 cases, the only anticoagulant given to patient was heparin. Pathogenic study suggests that hypocoagulability might not always be the only factor of bleeding: high blood pressure, other drugs and head trauma (10 cases) are often associated. Clinical features, in our series, are similar to those encountered in cases of subdural hematoma of any cause. According to the existence of a cranial injury and to the chronology of anticoagulant therapy, the authors divide their 22 patients into 3 groups. The use of protamin sulfate or human plasma fraction PPSB provides in few minutes a normal coagulability. Neurosurgical treatment in all our cases evacuated in 11 patients a chronic subdural hematoma, in 2 cases an acute, and in 9 cases a subacute hematoma. Results were fair in 19 patients with no sequelae. 3 patients died during the immediate post-operative period. The authors conclude by stressing several preventive measures.

Topics: Anticoagulants; Cerebral Angiography; Coronary Disease; Craniocerebral Trauma; Dicumarol; Hematoma, Subdural; Heparin; Humans; Phenindione; Pulmonary Embolism

Topics: Aged; Anticoagulants; Dicumarol; Heparin; Humans; Ligation; Postoperative Complications; Pulmonary Embolism; Recurrence; Vena Cava, Inferior; Warfarin

Topics: Acute Disease; Aged; Diagnosis, Differential; Dicumarol; Fibrin Fibrinogen Degradation Products; Hemodynamics; Heparin; Humans; Male; Pulmonary Circulation; Pulmonary Embolism; Spirometry; Streptokinase; Ventilation-Perfusion Ratio

Topics: Angina Pectoris; Anticoagulants; Aspirin; Dicumarol; Disseminated Intravascular Coagulation; Electric Countershock; Heart Valve Diseases; Humans; Myocardial Infarction; Pulmonary Embolism; Thrombophlebitis; Thrombosis; Warfarin

Topics: Aged; Angiography; Anticoagulants; Blindness; Dicumarol; Eye Diseases; Fluoresceins; Hemorrhage; Humans; Intraocular Pressure; Male; Pulmonary Embolism; Retina; Retinal Degeneration; Ultrasonography

Topics: Acute Disease; Arteries; Dicumarol; Femoral Artery; Femoral Vein; Heparin; Humans; Iliac Vein; Leg; Myocardial Infarction; Pulmonary Embolism; Retinal Artery; Streptokinase; Thrombophlebitis; Thrombosis

Topics: Adolescent; Adult; Aged; Child; Dicumarol; Diuretics; Female; Heparin; Hospitalization; Humans; Leg; Male; Middle Aged; Movement; Phlebography; Physical Therapy Modalities; Prothrombin; Pulmonary Embolism; Thrombophlebitis; Time Factors

Topics: Arteriovenous Fistula; Blood Coagulation Disorders; Dicumarol; Female; Hemodynamics; Humans; Hypoxia; Middle Aged; Pulmonary Circulation; Pulmonary Embolism

Topics: Adult; Age Factors; Aged; Aprotinin; Dicumarol; Female; Hemorrhage; Humans; Male; Middle Aged; Peritonitis; Postoperative Complications; Pulmonary Embolism; Sex Factors; Wound Healing

Topics: Adult; Age Factors; Aged; Aminocaproates; Anticoagulants; Dicumarol; Female; Heparin; Humans; Male; Middle Aged; Obesity; Postoperative Care; Postoperative Complications; Preoperative Care; Pulmonary Embolism; Surgical Procedures, Operative

Topics: Adult; Anesthesia, Spinal; Antibodies; Autoimmune Diseases; Blood Coagulation Tests; Blood Protein Electrophoresis; Dicumarol; Eosinophilia; Fibrinogen; Heparin; Humans; Jaundice; Male; Pneumonia; Priapism; Pulmonary Embolism; Steroids; Thrombophlebitis; Vitamin K

Topics: Aged; Breast Diseases; Breast Neoplasms; Dicumarol; Female; Gangrene; Hemorrhage; Humans; Middle Aged; Necrosis; Pulmonary Embolism; Thrombophlebitis

Topics: Dicumarol; Humans; Postoperative Care; Postoperative Complications; Pulmonary Embolism; Thrombophlebitis; Warfarin

Topics: Acenocoumarol; Anticoagulants; Dicumarol; Drug Therapy; Heparin; Phenindione; Postoperative Complications; Preventive Medicine; Pulmonary Embolism; Thrombophlebitis; Toxicology; Venous Thrombosis; Vitamin K 1; Warfarin

Topics: Acenocoumarol; Anticoagulants; Coumarins; Dicumarol; Drug Therapy; Ecchymosis; Ethyl Biscoumacetate; Gangrene; Necrosis; Phenindione; Pulmonary Embolism; Purpura; Skin Diseases; Thrombophlebitis; Toxicology; Warfarin

Topics: Anaphylaxis; Dicumarol; Fibrinolysin; Hemorrhage; Heparin; Hepatitis; Hepatitis B virus; Humans; Myocardial Infarction; Pulmonary Embolism; Thromboembolism; Thrombophlebitis; Toxicology

Topics: Anticoagulants; Arrhythmias, Cardiac; Blood Cell Count; Cerebrovascular Disorders; Coronary Disease; Diabetes Mellitus; Dicumarol; Heart Failure; Heparin; Humans; Hypertension; Kidney Diseases; Liver Diseases; Myocardial Infarction; Peptic Ulcer; Pulmonary Embolism; Shock; Thromboembolism; Thrombophlebitis; Thrombosis; Varicose Veins; Warfarin

Topics: Anti-Bacterial Agents; Cecum; Dicumarol; Diverticulitis; Heparin; Humans; Postoperative Complications; Pulmonary Embolism; Shock; Surgical Procedures, Operative

Topics: 4-Aminobenzoic Acid; Aminobenzoates; Bronchopneumonia; Cerebral Hemorrhage; Cerebrovascular Disorders; Dicumarol; Dihydroergotoxine; Ergot Alkaloids; Femoral Neck Fractures; Fracture Fixation; Heparin; Mortality; Myocardial Infarction; Neoplasms; Phenindione; Preventive Medicine; Pulmonary Embolism; Surgical Procedures, Operative; Sweden; Thromboembolism

Topics: Blood Coagulation; Dicumarol; Female; Heparin; Humans; Infant, Newborn; Injections, Intravenous; Labor, Induced; Labor, Obstetric; Oxytocin; Pregnancy; Pregnancy Complications; Pregnancy Complications, Hematologic; Prothrombin Time; Pulmonary Embolism; Sparteine; Thrombophlebitis; Toxicology; Warfarin

Topics: Cardiac Tamponade; Colonic Neoplasms; Dicumarol; Eye; Female; Gastrointestinal Hemorrhage; Geriatrics; Hematoma; Hemoperitoneum; Hemorrhage; Humans; Ileum; Intestinal Obstruction; Ovarian Follicle; Pulmonary Embolism; Surgical Procedures, Operative; Toxicology

Topics: Dicumarol; Heparin; Humans; Phlebitis; Postoperative Complications; Preoperative Care; Pulmonary Embolism; Vascular Surgical Procedures; Vena Cava, Inferior

Topics: Anticoagulants; Dicumarol; Fibrinolysis; Heparin; Humans; Pulmonary Embolism; Thrombophlebitis

Topics: Dicumarol; Heart Massage; Heparin; Humans; Pulmonary Artery; Pulmonary Embolism

Topics: Anticoagulants; Dicumarol; Humans; Postoperative Complications; Pulmonary Embolism; Surgical Procedures, Operative; Thromboembolism

Topics: Anticoagulants; Dicumarol; Embolism; Heparin; Pulmonary Embolism

Topics: Anticoagulants; Dicumarol; Embolism; Heparin; Pulmonary Embolism; Thrombophlebitis

Topics: Anticoagulants; Dicumarol; Heparin; Pulmonary Embolism; Thrombophlebitis

Topics: Anticoagulants; Dicumarol; Embolism; Heparin; Humans; Phlebitis; Postoperative Period; Pulmonary Embolism

Topics: Dicumarol; Embolism; Humans; Pulmonary Embolism; Thrombosis; Venous Thrombosis

Topics: Dicumarol; Pulmonary Embolism

Topics: Coronary Thrombosis; Dicumarol; Heparin; Humans; Pulmonary Embolism; Thrombophlebitis