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A Gallus

Publications and source records attributed to A Gallus.

18 recordsLinked to original sources
PubMed2003

Subcutaneous fondaparinux versus intravenous unfractionated heparin in the initial treatment of pulmonary embolism.

BACKGROUND: The standard initial treatment of hemodynamically stable patients with pulmonary embolism is intravenous unfractionated heparin, requiring laboratory monitoring and hospitalization. METHODS: We conducted a randomized, open-label trial involving 2213 patients with acute symptomatic pulmonary embolism to compare the efficacy and safety of the synthetic antithrombotic agent fondaparinux with those of unfractionated heparin and to document noninferiority in terms of efficacy. Patients received either fondaparinux (5.0, 7.5, or 10.0 mg in patients weighing less than 50, 50 to 100, or more than 100 kg, respectively) subcutaneously once daily or a continuous intravenous infusion of unfractionated heparin (ratio of the activated partial-thromboplastin time to a control value, 1.5 to 2.5), both given for at least five days and until the use of vitamin K antagonists resulted in an international normalized ratio above 2.0. The primary efficacy outcome was the three-month incidence of the composite end point of symptomatic, recurrent pulmonary embolism (nonfatal or fatal) and new or recurrent deep-vein thrombosis. RESULTS: Forty-two of the 1103 patients randomly assigned to receive fondaparinux (3.8 percent) had recurrent thromboembolic events, as compared with 56 of the 1110 patients randomly assigned to receive unfractionated heparin (5.0 percent), for an absolute difference of -1.2 percent in favor of fondaparinux (95 percent confidence interval, -3.0 to 0.5). Major bleeding occurred in 1.3 percent of the patients treated with fondaparinux and 1.1 percent of those treated with unfractionated heparin. Mortality rates at three months were similar in the two groups. Of the patients in the fondaparinux group, 14.5 percent received the drug in part on an outpatient basis. CONCLUSIONS: Once-daily, subcutaneous administration of fondaparinux without monitoring is at least as effective and is as safe as adjusted-dose, intravenous administration of unfractionated heparin in the initial treatment of hemodynamically stable patients with pulmonary embolism.

Aged↗
PubMed1996

[Role of color flow mapping ultrasonography in kidney transplant monitoring].

Color flow mapping and duplex ultrasonography are a more accurate technique in renal allograft monitoring by combining real time us with pulsed doppler studies of renal vasculature. Doppler spectral analysis, pulsatility and resistive index evaluation are usefull in the diagnosis of renal allograft dysfunction (I.E. rejection, cyclosporine nefroto-city and acute tubular necrosis). Cfm and duplex ultrasonography allow a non invasive and easy evaluation of the whole renal artery and vein in the diagnosis of renal artery stenosis, vein trombosys and A-V fistula.

Humans↗
PubMed1996

[Role of color flow mapping ultrasonography in the study of renal tumors].

Tumors cm. 3 in diameter or less have revealed a high frequency of hyperecoic sonographic features mimicking angio-myolipoma. C.T. can confirm the presence of intralesion fat useful to exclude a potentially curable renal cell carcinoma. CFM and duplex ultra sonography can depict a peri and intra lesion neovascularization in small renal cell carcinoma. In the tumor langer than cm. 3 when hyper-vascular CFM and duplex sonography can detect the neovascularized blood vessels surrounding and penetrating the tumors. In the tumor staging the duplex and CFM ultrasonography is useful to demonstrate neoplastic trombosis of renal vein and inferior vena cava.

Humans↗
PubMed1993

Orgaran (Org 10172) or heparin for preventing venous thrombosis after elective surgery for malignant disease? A double-blind, randomised, multicentre comparison. ANZ-Organon Investigators' Group.

This double-blind, randomised, multicentre trial in 513 patients having elective surgery for intra-abdominal or intrathoracic malignancy compared the efficacy and safety of venous thrombosis (VT) prophylaxis using 750 anti-factor Xa units of Orgaran (a mixture of low molecular weight heparinoids) given subcutaneously (sc) twice-daily with that of twice-daily injections of 5,000 units standard heparin. The main study endpoints were the development of postoperative VT detected by 125I-fibrinogen leg scanning, and the onset of clinically significant venous thromboembolism or bleeding. "Intent to treat" analysis showed a statistically non-significant trend towards less VT during Orgaran prophylaxis (10.4%) than after heparin (14.9%) and there was no difference in bleeding complications between the two study groups. Results remained similar if only patients who completed the intended course of therapy ("compliant patients") were analysed. Other trials have shown that Orgaran prevents VT after hip surgery and stroke. We now show it is also safe and effective in patients having major surgery for cancer.

Aged↗
PubMed1989

The influence of Org 10172, an antithrombotic heparinoid, on urinary blood loss after transurethral prostatectomy.

We have measured the effects of Org 10172 (a mixture of naturally occurring glycosaminoglycans derived from hog intestinal mucosa) on blood loss after transurethral prostatectomy (TURP), using doses which are likely to prevent postoperative venous thrombosis (VT). 48 patients entered a double-blind randomised pilot study: 18 were given subcutaneous (sc) injections of a placebo and 30 received sc Org 10172 (750 anti-Xa units/day, 500 units twice daily (bid), or 750 units bid, starting just before TURP and continued until discharge; 10 patients per group). No Org 10172 regimen increased peroperative blood loss but all caused a similar trend towards increased urinary bleeding after surgery. Since there was no apparent dose effect gradient, it was decided to pool the data from all three dosing blocks: this analysis showed that Org 10172 increased geometric mean blood loss during the first 2 days after surgery from 10.4 gm hemoglobin (Hgb; range = 3.2-71) to 20.5 gm Hgb (range = 1.9-147) (p = .005), an effect which retained its significance after allowing for two other major determinants of postoperative bleeding, the weight of prostate resected and the length of surgery, and also when pooling was restricted to the twice daily Org 10172 injection groups and their corresponding controls. Bleeding was not severe, but our results indicate a need for caution when considering the use of Org 10172 in this setting.

Aged↗
PubMed1989

Focal glomerulosclerosis treated with heparin.

A boy with focal glomerulosclerosis as a result of nephrotic syndrome became unresponsive to corticosteroids and cyclophosphamide. He was given prolonged subcutaneous heparin with reduction in proteinuria, return of corticosteroid sensitivity, and no further deterioration (possibly improvement) in histological appearance. He remained completely well after five years.

Child↗
PubMed1986

Safety and efficacy of warfarin started early after submassive venous thrombosis or pulmonary embolism.

Two anticoagulant regimens, similar except for the timing of warfarin therapy, were compared in patients with clinically submassive venous thromboembolism (VTE). Warfarin was begun after 7 days of continuous intravenous heparin infusion in group L (127 patients) or within 3 days (average 1 day) of starting heparin in group S (139 patients), with similar outcomes. The frequency of symptomatic VTE recurrence during the hospital stay was 4.7% in group L and 3.6% in group S, and that of symptomless new perfusion defects 8.5% in group L and 3.9% in group S. On routine iodine-125-fibrinogen leg scanning of patients presenting with distal thrombosis (in the calf, popliteal, or distal femoral veins) 3.6% of group S but no group L patients had symptomless proximal extension. The incidence of bleeding was similar with both regimens. Outpatient follow-up showed no excess recurrent VTE in either treatment group. Early warfarin treatment significantly shortened hospital stay by an average of 3.9 days (30%) in patients admitted solely because of VTE.

Aged↗
PubMed1983

Venous thrombosis after elective hip replacement--the influence of preventive intermittent calf compression and of surgical technique.

The effect of preventive intermittent calf compression on the incidence, distribution and extent of venous thrombosis after elective hip replacement was examined by randomized trial in 90 patients who were screened for postoperative thrombosis with 125I-fibrinogen leg scanning and impedance plethysmography, followed by routine venography on the seventh postoperative day. Venography showed that leg compression reduced the incidence of calf vein thrombosis from 45 per cent (21/47) in untreated patients to 16 per cent (7/43) (P less than 0.005), but not that of proximal (i.e. popliteal or femoral) vein thrombosis, which occurred in 23 per cent of treated and 26 per cent of untreated patients. However, proximal vein thrombosis appeared to be less extensive in treated patients. Proximal vein thrombosis was found in 40 per cent of patients who had hip replacement by a modified Charnley technique (17/43 patients), and 9 per cent of patients in whom a posterior surgical approach was used (4/43 patients) (P less than 0.005), strongly suggesting that surgical technique may influence the proximal vein thrombosis rate after elective hip replacement.

Aged↗
PubMed1977

Prevention of venous thrombosis in patients with intracranial disease by intermittent pneumatic compression of the calf.

In a randomized study of 128 patients, we evaluated intermittent pneumatic compression of the calf in the prevention of leg scan-detected venous thrombosis in intracranial disease. Pneumatic compression of the calf for 5 days reduced the rate of venous thrombosis from 12 of 63 control patients (19.1 percent) to one of 65 patients (1.5 percent) given prophylaxis (p = 0.00082). In patients who had craniotomy for brain tumor, subarachnoid hemorrhage, or subdural hematomas, calf compression reduced the incidence of venous thrombosis from nine of 49 control patients (18.4 percent) to one of 53 patients (1.9 percent) given prophylaxis (p - 0.0051). In patients who remained at risk after 5 days, the rate of venous thrombosis was no different in the control group than in the group that had received prophylaxis.

Adult↗
PubMed1976

Thrombotic thrombocytopenic purpura: a syndrome of intravascular platelet consumption.

In four of five patients with thrombotic thrombocytopenic purpura (TTP) in whom serial tests of hemostatic function were performed, severe thrombocytopenia, normal plasma fibrinogen concentrations and mildly increased concentrations of fibrinogen/fibrin degradation products were observed. Widespread platelet thrombi were found in arterioles and capillaries. Fibrin could be seen around some of the platelet clumps and was the main component in a small number of the thrombi in two patients. The observations show that TTP is a disorder in which intravascular platelet consumption results in disseminated platelet thrombosis. The coagulation system is apparently activated secondarily to platelet aggregation and variable quantities of fibrin are incorporated into the thrombi. Clinical improvement resulted from combined therapy with corticosteroids, heparin and drugs that suppress platelet function.

Adult↗