Feasibility of low-dose infusion of alteplase for unsuccessful thrombolysis with urokinase in deep venous thrombosis.

Feasibility of low-dose infusion of alteplase for unsuccessful thrombolysis with urokinase in deep venous thrombosis. Exp Ther Med. 2019 Nov;18(5):3667-3674 Authors: Gong M, Zhao B, He X, Gu J, Chen G Abstract The aim of the present study was to investigate whether the rescue of thrombolysis with the recombinant tissue plasminogen activator (rt-PA) alteplase was an effective and safe therapeutic option in patients who did not respond to urokinase. Between February 2016 and February 2017, 26 patients with deep venous thrombosis (DVT) underwent rescue thrombolysis with alteplase. Unsuccessful thrombolysis with urokinase was defined as a lack of improvement in the degree of thrombotic removal with a lysis rate 3 million units of total urokinase, or>7 days infusion duration. The thrombus score, lysis rate and post-thrombolysis safety of alteplase, following unsuccessful urokinase thrombolysis were all evaluated. At the end of the unsuccessful urokinase thrombolytic therapy, the mean duration of the perfusion was 6.09±1.60 days, and the mean total dose was (362.5±90.0) ×104 units. No significant difference was detected in the total thrombus score before (7.85±2.40) and at the completion (6.19±2.33) of urokinase thrombolysis (P>0.05). The mean duration of perfusion was 3.36±1.69 days, and the mean total infusion dose was 44.8±22.6 mg for the rescue thrombolysis with alteplase. The mean thrombus score decreas...
Source: Experimental and Therapeutic Medicine - Category: General Medicine Tags: Exp Ther Med Source Type: research

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We present a case of a 68-year-old Hispanic female with a history of factor VII deficiency who presented with shortness of breath, chest pain, and palpitations and was found to have pulmonary embolism. Our patient did not have any of the above-mentioned thrombotic risk factors. Our case and review of the literature show that factor VII deficiency does not provide protection against thrombosis. PMID: 31590173 [PubMed - as supplied by publisher]
Source: Acta Haematologica - Category: Hematology Authors: Tags: Acta Haematol Source Type: research
r M Abstract OBJECTIVE: Fast track concepts are used to reduce the risk of perioperative and postoperative complications after total knee arthroplasty. INDICATIONS: The described concepts are used for patients with indications for the implantation of a total knee prosthesis. CONTRAINDICATIONS: Contraindications for fast track concepts are aged patients, dementia, American Society of Anesthesiologists (ASA) grade IV and implantation of large revision or tumor prostheses. Contraindications for tranexamic acid are bleeding in the urinary tract, caution in cases of known epilepsy, individual risk assessment ...
Source: Operative Orthopadie und Traumatologie - Category: Orthopaedics Authors: Tags: Oper Orthop Traumatol Source Type: research
Abstract Diagnosis of deep vein thrombosis (DVT) requires a multifaceted approach that includes clinical assessment, evaluation of pre-test probability, and objective diagnostic testing. Common symptoms and signs of DVT are pain, swelling, erythema and dilated veins in the affected limb. The pre-test probability of DVT can be assessed using a clinical decision rule that stratifies DVT into "unlikely" or "likely". If DVT is "unlikely", refer for D-dimer test. If the D-dimer level is normal, DVT can be excluded; if the D-dimer level is increased, refer for compression ultrasound. If DVT...
Source: Med J Aust - Category: General Medicine Authors: Tags: Med J Aust Source Type: research
Conclusion: Our findings describe the most reported risk factors for preventability of oral anticoagulant-induced bleedings. These factors may be useful for targeting interventions to improve pharmacovigilance activities in our regional territory and to reduce the burden of medication errors and inappropriate prescription. Introduction Oral anticoagulant therapy is widely used for the prevention of stroke and systemic embolism in patients with atrial fibrillation, or for the prevention and treatment of deep vein thrombosis and pulmonary embolism (Raj et al., 1994; Monaco et al., 2017). Oral anticoagulants can be di...
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
Individuals share about 99.97 percent of their DNA and only the remaining 0.03 percent is responsible for the differences in skin, hair or eye color, height, shoe size or sunspots. Scientists discovered somewhat recently that our bodies also metabolize drugs differently so it would make sense to prescribe medications based on the knowledge hidden in our DNA. In some cases, physicians already do that. Here’s what you need to know about pharmacogenomics and the future of prescription drugs. It’s all in your genes Why do some people eat creamy French cakes all the time, only do sports when they have to run after t...
Source: The Medical Futurist - Category: Information Technology Authors: Tags: Future of Pharma Genomics Medical Professionals Patients Researchers DNA dna testing drugs genetics Health Healthcare Innovation medication pharmacogenetics pharmacogenomics precision health precision medicine technology Source Type: blogs
(CNN) — In what researchers are calling “the largest genetic study ever performed” on varicose vein disease, a Stanford University School of Medicine study found a person’s height to be a significant risk factor for developing varicose veins. “We not only found an association between height and varicose veins, but the genetic studies we did showed a causal link,” said cardiologist and study author Dr. Nicholas Leeper, an associate professor of surgery and cardiovascular medicine at Stanford. “That suggests that the genes and pathways that drive human height are also likely to be ca...
Source: WBZ-TV - Breaking News, Weather and Sports for Boston, Worcester and New Hampshire - Category: Consumer Health News Authors: Tags: Health News Local TV Varicose Veins Source Type: news
Authors: Shimomura M, Kochi M, Hinoi T, Egi H, Adachi T, Kobayashi T, Tashiro H, Ohdan H Abstract Pharmacological prophylaxis was not routinely administrated following gastroenterological surgery because of concerns about bleeding complications. We tried to establish the original risk classification to determine the indication for pharmacological prophylaxis for selected patients at high risk of venous thromboembolism (VTE). One hundred and fifty-six consecutive patients who underwent lower abdominal elective surgery were divided into three groups (highest, high, and low risk groups) based on the original risk clas...
Source: Hiroshima Journal of Medical Sciences - Category: General Medicine Tags: Hiroshima J Med Sci Source Type: research
We report the case of a 70-year-old man who was admitted due to warmness, pain, and swelling in his left leg and a feeling of gait disturbance. Diagnoses: Contrast-enhanced computed tomography and venous ultrasonography revealed a pulmonary embolism and extensive DVT spreading to the IVC. Interventions: First, the patient was treated with fondaparinux. Since this was inadequate, he underwent CDT using a Fountain infusion catheter. Then, CDT was switched to direct oral anticoagulant (DOAC) treatment. Outcomes: Both CDT and subsequent DOAC treatments dramatically improved the DVT. His subjective symptoms have disapp...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
​BY BRUNA ALMEIDA, &AHMED RAZIUDDIN, MDA 30-year-old man presented to the ED with dyspnea and pleuritic chest pain radiating to his left shoulder that had started three days before. He was at a “sex party” four days earlier, and had used amphetamines and gamma-hydroxybutyric acid (GHB, also called Liquid G).The patient said deep breaths and movement worsened his pain. He also had exertional shortness of breath and occasional palpitations. He denied fever, cough, loss of consciousness, recent surgery, and prolonged immobilization. The patient had no personal or family history of DVT, PE, or cardiac conditi...
Source: The Case Files - Category: Emergency Medicine Tags: Blog Posts Source Type: research
Conclusions EHIT after endovenous ablation occurred in ∼1.5% of patients, which is similar to that reported in the literature. Our review shows that systemic anticoagulation is effective in the prevention of progression with a low risk of bleeding complications. Patients with EHIT grades 1 or 2 can be treated with aspirin alone with a low risk of progression (3%).
Source: Journal of Vascular Surgery: Venous and Lymphatic Disorders - Category: Surgery Source Type: research
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