PubMed Health⌕ Search

Biomedical subjects

E A Loeliger

Publications and source records attributed to E A Loeliger.

At least 55 records · Page 3Linked to original sources
PubMed1984

[Protein C deficiency--a risk factor for venous thrombosis].

Protein C is a vitamin K-dependent protein which is produced in the liver. Activated protein C has an anticoagulant effect by inactivating the clotting factors V and VIII. We report on a young female patient who suffered from recurrent thrombosis of the deep calf and pelvic veins with pulmonary embolism. Superficial thrombophlebitis also occurred repeatedly. In the plasma of this patient we found reduced levels of protein C antigen (0.62 U/ml) and activity (0.42 U/ml). Investigation of other family members revealed a protein C deficiency in her father, sister, and son. During the anticoagulant treatment with Marcumar the patient developed a coumarin-induced skin necrosis, to which complication a protein C deficiency is evidently predisposed. This complication could only be prevented if heparin was given simultaneously during the adjustment period.

Adult↗
PubMed1984

The risk of intracerebral hemorrhage during oral anticoagulant treatment: a population study.

In a retrospective study of 166 patients, all admitted to the University Hospital, Leiden, The Netherlands, between January 1, 1970 and December 31, 1979, we estimated the relative risk of intracerebral hemorrhage from oral anticoagulant therapy. The risk was more than ten times higher for patients over 50 years of age than for similarly aged untreated individuals in the general population. Within this age group the risk was influenced by neither age nor sex. Hypertension, present in 80% of the patients, was the most important predisposing condition; the risk of bleeding rose with increasing intensity of anticoagulation. There was no substantial difference in clinical condition at onset, rate of progression, mortality, or degree of recovery between patients with anticoagulant-associated hemorrhage and those with spontaneous intracranial hemorrhage.

Administration, Oral↗
PubMed1983

The use of evacuated tubes for blood collection in oral anticoagulant control.

The prothrombin time (PT) test is used to monitor oral anticoagulant therapy. Contact activation of patient blood samples in vitro may shorten the PT and thus lead to underestimation of the degree of anticoagulation. Commercial evacuated tubes for blood collection have been reported to induce shortening of the PT. The Thrombotest modification of the PT determination was used to investigate the properties of different brands of evacuated siliconized tubes. Two recently manufactured batches of such tubes did not induce appreciable shortening of the PT and can therefore be recommended for use in monitoring oral anticoagulant treatment.

Administration, Oral↗
PubMed1983

A collaborative calibration study of reference materials for thromboplastins.

In a collaborative study of ten laboratories performed mainly within the framework of the BCR (the European Community Bureau of Reference), five thromboplastins were calibrated against the WHO (World Health Organisation) primary international reference preparation 67/40. Of these five thromboplastins, three were BCR reference materials (BCT/099, OBT/79 and RBT/79) and two were WHO secondary international reference preparations (68/434 and 70/178). Human brain tissue type is represented by 67/40 and BCT/099; bovine type by 68/434 and OBT/79, and rabbit type by 70/178 and RBT/79. The calibration relations are expressed in terms of a linear relationship between the logarithms of the prothrombin times, measured in seconds.

Calibration↗
PubMed1981

Prospective double-blind clinical trial of bovine, human, and rabbit thromboplastins in monitoring long-term oral anticoagulation.

A prospective double-blind trial was performed to investigate the safety of long-term oral anticoagulant control when dosaged adjustment depends on the prothrombin times assessed with one type of thromboplastin being calculated as if assayed by another type. The three main types of thromboplastin, i.e., bovine (Thrombotest), human (British Comparative Thromboplastin), and rabbit (Simplastin Automated) were tested. Before entering the actual trial, patients had been checked with the bovine type of thromboplastin. During the actual comparison study, prothrombin times obtained with the human and the rabbit types of thromboplastin were translated, using the appropriate calibration data, into terms of the bovine type of thromboplastin, which were used for dosage prescription. After six months, all patients returned to bovine-type thromboplastin control. No substantial difference among the three groups was observed in the prothrombin times, the dosage of the anticoagulant, the bleeding complications, and the dropouts. It was concluded that the safety of monitoring patients receiving long-term oral anticoagulation was independent of the type of thromboplastin used.

Administration, Oral↗
PubMed1981

Oral anticoagulation in the secondary prevention of myocardial infarction.

Evidence in favour of oral anticoagulant therapy (OAT) in patients suffering from an acute myocardial infarction has been published in 1977 by Chalmers and co-workers (New Engl. J. Med. 297, 1091). For OAT after discharge an International Review Group (IRG) concluded in 1970 that "anticoagulant therapy probably prolongs survival at least over two years, but that benefit is as a rule restricted to patients with a history of angina or previous infarction" (The Lancet, 1, 203). Since the IRG finished their analysis, favourable results of four additional comparative studies have been published, three of which were double-blind and performed in the Netherlands. These four studies demonstrated a beneficial effect of adequate oral anticoagulation. The latest study was performed to assess benefits and untoward reactions of long-term OAT in the elderly. Results were published in November 1980 (The Lancet, 2,989). Mortality in the 738 patients who entered the trial, all of whom older than sixty years, having survived a transmural infarction, and having been on OAT for at least six months (mean: six years), was lower in patients on active treatment (p = 0.016), due to the important difference in recurrent myocardial infarction (RMI). Fifty-eight RMI's occurred in the placebo group as compared to only twenty in the AC group (p less than 0.01). Fatal cerebrovascular accidents were evenly distributed over the two groups, with a preponderance of haemorrhage in patients on active treatment. No fatal extracranial haemorrhage occurred. Incidence and severity of bleeding complications were in agreement with good patient compliance. No significant relationship was found between the recurrence of infarction and either the age of the patient or the length of treatment before entering trial. The steadiness of the widening gap between the mortality and RMI's observed in the two groups indicates that the efficacy of OAT persisted throughout the entire observation period of two years.

Administration, Oral↗