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H M Barber

Publications and source records attributed to H M Barber.

3 recordsLinked to original sources

A comparative study of dextran-70, warfarin and low-dose heparin for the prophylaxis of thrombo-embolism following total hip replacement.

In a randomized, controlled clinical study, dextran-70, warfarin, or low-dose heparin were administered to patients undergoing total hip replacement on one surgical unit in an attempt to prevent deep venous thrombosis and pulmonary embolism. Calf vein thrombosis was detected by the 125I-fibrinogen uptake test. None of the methods prevented calf vein thrombosis (dextran-70, 51%; warfarin, 58-6%; heparin, 52-6%). Pulmonary embolism was completely prevented in patients treated with warfarin but occurred in 4% of patients treated with dextran-70 and 15-5% of those treated with low-dose heparin. The incidence of complications of therapy was small and comparable in each group. It is suggested that calf vein thrombosis is a frequent and in itself a non-serious complication of total hip replacement surgery and that emphasis might be placed more usefully on prevention of pulmonary embolism.

Aged

The value of low dosage heparin for the prophylaxis of thromboembolism in patients with transcervical and intertrochanteric femoral fractures.

One hundred and ten female patients, over the age of 60, with intertrochanteric or transcervical fractures were included in a controlled, randomized, clinical trial investigating the value of low dosage heparin in the prophylaxis of deep vein thrombosis. There were 50 completed pairs. Eight (16 per cent) deep vein thromboses occurred in the heparinized group compared with 23 (46 per cent) deep vein thromboses in the control group. The incidence of pulmonary embolism was also reduced. The diagnosis of deep vein thrombosis was made on clinical grounds, supplemented by phlebography and autopsy. There was no difference in the wound hematoma or infection rate. The heparin was commenced on admission to hospital and it is suggested that in this group of patients low dosage heparin prophylaxis should start on admission and not wait until surgery.

Aged