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J Bohnet

Publications and source records attributed to J Bohnet.

5 recordsLinked to original sources

Thromboembolic prophylaxis in total hip replacement: a comparison between the low molecular weight heparinoid Lomoparan and heparin-dihydroergotamine.

In a prospective, randomized, assessor-blind multicentre study two antithrombotic subcutaneous regimens were compared in patients undergoing total hip replacement. Group 1 (154 patients) received 750 anti-Xa units of a new low molecular weight heparinoid (Lomoparan) subcutaneously twice a day and group 2 (155 patients) received 5000 units heparin and 0.5 mg dihydroergotamine (heparin-DHE 5000) twice a day. The incidence of deep vein thrombosis, assessed by routine bilateral venography on day 10 (+/- 1), was 17 and 32 per cent in groups 1 and 2 respectively (risk reduction 47 per cent; P = 0.007). One patient in each group developed a symptomatic pulmonary embolism confirmed by lung scanning. Major bleeding complications occurred in one patient in each group and no significant difference was observed between the two groups with respect to minor bleeding complications. Subcutaneous Lomoparan appears to be as safe as heparin-DHE 5000 at the above doses with regard to bleeding complications, and is more efficacious with respect to venous thrombosis.

Aged↗

Adjusted subcutaneous heparin versus heparin plus dihydroergotamine in prevention of deep vein thrombosis after total hip arthroplasty.

In a prospective randomized study, two different antithrombotic regimens were compared with regard to their effects on the incidence of deep vein thrombosis (DVT) in 102 patients undergoing elective total hip arthroplasty. Fifty patients (group 1) received heparin subcutaneously three times daily in doses adjusted as a function of activated partial thromboplastin time (APTT), and 52 patients (group 2) received a fixed dose of 5,000 IU heparin plus 0.5 mg dihydroergotamine twice daily. Both treatments were started 2 days before operation and continued for 7-9 days after operation, when venography of the operated leg was performed in all patients. The overall incidence of DVT was 22% in group 1 and 19.6% in group 2. Eight patients (16%) in group 1 and four (7.6%) in group 2 developed proximal DVT. These differences were not statistically significant. Hemorrhagic complications occurred more frequently in group 1. Heparin plus dihydroergotamine is a simple and effective method of preventing DVT in patients undergoing total hip arthroplasty. Daily APTT-adjusted subcutaneous heparin remains the best method of prevention of DVT in patients with contraindications to the use of dihydroergotamine and those with two or more DVT risk factors.

Dihydroergotamine↗

Endoscopic non-aggressive assessment of oesophageal variceal pressure compared with wedged hepatic venous pressure in alcoholic liver cirrhosis.

Ten alcoholic cirrhotic patients presenting with oesophageal varices underwent simultaneous measurement of wedged hepatic venous pressure and endoscopic variceal pressure. The latter was obtained by means of a pneumatic pressure gauge fixed to the tip of a gastrofibroscope. The correlation between these two parameters was highly significant.

Aged↗

CT of the thoracic duct.

The ability of computed tomography to demonstrate the normal anatomy of the thoracic duct was investigated after lymphangiography in 20 patients without evidence of chest diseases on the plain films. The entire opacified thoracic duct can be easily imaged from its origin at the thoraco-abdominal level, up to its arch, which enters the venous blood stream, usually at the left subclavian-jugular confluent. Variations of the arch of the duct have been observed in our series. The ability to detect the non-opacified duct with CT was also assessed in 80 patients. Imaging of part or totality of the lower, mid and upper segments of the thoracic duct is possible respectively in 81, 54 and 69 per cent of subjects. The arch of the duct was displayed in 57 per cent. Knowledge of the normal anatomy of the thoracic duct is important since it can be involved in many diseases of the posterior mediastinum and of the thoracic outlet.

Adult↗