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Biomedical subjects

J F Vitoux

Publications and source records attributed to J F Vitoux.

At least 19 recordsLinked to original sources
PubMed1994

Adjusted versus fixed doses of the low-molecular-weight heparin fragmin in the treatment of deep vein thrombosis. Fragmin-Study Group.

Treatment monitoring based on a laboratory parameter increases the efficacy and safety of standard heparin therapy, but it is not known if this also applies to low-molecular-weight heparin (LMWH) therapy of acute deep vein thrombosis (DVT). In a prospective randomized trial involving 122 consecutive patients, group A (58 patients) received a weight adjusted dose of Fragmin (100 IU/kg) subcutaneously twice a day throughout the treatment period (10 days +/- 1), while in group B (64 patients) the dosage was based on the results of an anti factor Xa (anti Xa) amidolytic assay to obtain a target concentration from 0.5 to 1 IU/ml. AntiXa and antithrombin activities were also measured retrospectively on frozen plasma from all patients. The two regimens were comparable in terms of hemorrhagic complications (4 in group A and 3 in group B). Bilateral ascending phlebography was performed before inclusion and at the end of LMWH treatment. Treatment efficacy, based on Marder's score, did not differ between the two groups (p = 0.3). Dosage adjustment to between 0.5 to 1 IU anti-Xa/ml does not therefore appear to improve the efficacy or safety of LMWH treatment. However, correlations between the change in Marder's score and both anti-Xa (p < 0.001) and antithrombin activity (p < 0.001) were observed, suggesting a relationship between the degree of FXa or thrombin inhibition and antithrombotic activity.

Acute Disease↗
PubMed1991

Heparin cofactor II: an acute phase reactant in patients with deep vein thrombosis.

In human plasma, heparin cofactor II (HCII) is a thrombin inhibitor which displays similarities with antithrombin III (ATIII). As previously reported for hereditary ATIII deficiency, cases of recurrent thrombosis were reported in patients with hereditary HCII deficiency. Here, plasma HCII activity was studied in 372 patients with a history of thrombosis, classified according to their anticoagulant therapy. The mean plasma HCII level was significantly higher in patients with acute deep vein thrombosis (DVT) under heparin therapy than in patients with a history of thrombosis, who were studied more than 3 months after the acute event, and were either on, or had been on, oral anticoagulant therapy. HCII and fibrinogen were significantly correlated in all three groups of patients. These results were strengthened by those of a follow-up study in 23 patients with acute DVT. Changes in plasma HCII activity paralleled those of fibrinogen. This suggests that HCII might behave like an acute phase reactant in patients with thrombosis and that the measurement of its plasma level as a risk factor for thrombosis should be performed some time after the acute episode. In conclusion, the prevalence of HCII deficiency in patients with a history of thrombosis might have been underestimated in series which included patients with acute thrombosis.

Acute-Phase Proteins↗
PubMed1990

[Thrombosis of the gastrocnemic veins. A clinical entity].

Among deep venous thromboses of the calf, isolated gastrocnemic vein thrombosis is a rare condition. Its main characteristics could be extracted from 5 cases. Following a positional or mechanical triggering factor, the diagnosis is suggested by pain localized to the calf. Ultrasonography shows the intraluminal thrombus better than phlebography, since the gastrocnemic veins, which bypass the larger deep veins, can be opacified only after a garrot is placed above the knee. The thrombus may extend to the popliteal vein, with a risk of pulmonary embolism and post-phlebitis disease. Treatment consists of anticoagulants and elastic bandage.

4-Hydroxycoumarins↗
PubMed1989

Variations of prothrombin time, factor VII and protein C with a single daily dose of acenocoumarol. Preliminary results.

In 11 patients on steady anticoagulation with a daily dose of acenocoumarol, prothrombin time, factor VII and protein C were measured 2 and 16 h after the daily intake of acenoumarol. Prothrombin time (expressed as International Normalised Ratio) increases significantly, factor VII and protein C decrease between the two samples. These results suggest that a daily dose of acenoumarol is associated with fluctuation of the anticoagulant effect.

Acenocoumarol↗
PubMed1989

[Role of myocardium scintigraphy with thallium dipyridamole in the evaluation of arterial disease of the legs].

Thirty-eight consecutive patients with severe arterial disease of the lower extremities benefited from an exploration of the coronary reserve by myocardial scintigraphy with thallium dipyridamole. With this examination, it has been possible to screen 20 p. cent of asymptomatic patients and at least modify the perioperative treatment or even the very indication for surgery.

Adult↗
PubMed1987

Circulating activities during constant infusion of heparin or a low molecular weight derivative (enoxaparine): failure to demonstrate any circadian variations.

We compared in six patients successively treated with an unfractionated heparin (UFH) and a low molecular weight heparin (LMWH) the variations in plasma anti-Xa activity, measured in a chromogenic assay, during a 36 h constant infusion. The values varied in a wider range during UHF infusion, but remained in the therapeutic range except once in one patient. No circadian rhythm could be demonstrated in our six patients. LMWH infusion yielded very constant anti-Xa circulating activities. In both cases, there were no significant modifications of three proteins with high heparin affinity (antithrombin III, heparin cofactor II, histidine-rich glycoprotein). Our results suggest that the circadian rhythm of the biological activities previously observed in patients treated with constant heparin infusion using clotting method is due to other factors than heparin itself.

Adult↗
PubMed1987

[Role of computerized pulmonary angiography by peripheral venous approach in the study of deep venous thromboses of the legs].

A pulmonary angiography through peripheral venous approach was systematically performed in 40 consecutive patients presenting a recent deep venous thrombosis. None of these patients had been sent for a suspected pulmonary embolus. The analysis of the images that were obtained, enabled to confirm the diagnosis of pulmonary migration in 9 of these patients (22.5%). The retrospective study of the files confirms the fact that these pulmonary emboli present few symptoms or are asymptomatic in 17.5 p. cent of the cases. The quality of the images, the good acceptability and the moderate cost of pulmonary angiography through peripheral venous approach allow the performance of this examination during the initial work-up of a deep venous thrombosis. The demonstration of a latent pulmonary embolus must enable to separate high risk patients and thus guide subsequent therapy.

Adult↗
PubMed1987

Local thrombolysis in peripheral arteries and bypass grafts.

Sixty-two patients hospitalized for recent angiographically documented arterial occlusion in the legs (46 femoropopliteal arteries and 16 grafts) benefited from local fibrinolytic therapy delivered at the site of the occlusion with a No. 4F or No. 5F catheter. This therapy combined a continuous urokinase (UK) infusion of 1000 U/kg/hr and a lysyl plasminogen (LYS-PLG) infusion of 15 mukat every 30 minutes. Angiographically confirmed lysis was obtained in 77% of the cases. Five percent of the patients had major and 8% had minor groin hematomas. Only two patients had concentrations of fibrinogen as low as 100 mg/dl. Intravascular infusion of UK and LYS-PLG is as effective as streptokinase but produces lower systemic fibrinolysis. However, local fibrinolysis remains a potentially hazardous procedure (10% suffered major complications) and must only be applied to patients with severe ischemia and little or no possibility of surgical intervention.

Adult↗