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Biomedical subjects

L Biland

Publications and source records attributed to L Biland.

At least 19 recordsLinked to original sources
PubMed1984

Fibrinogen, factor VIII related antigen, antithrombin III and alpha 2-antiplasmin in peripheral arterial disease.

In 306 subjects, 217 without and 89 with peripheral arterial disease (PAD), VIIIR:Ag and alpha 2-antiplasmin are significantly higher in PAD (p less than 0.01). In the PAD negative group the ratio alpha 2-antiplasmin/antithrombin III activity is significantly higher 1.11 +/- 0.3 in the patients with an abnormal exercise ECG typical of coronary disease than in normal subjects 1.02 +/- 0.2 (p less than 0.05). In the PAD positive group antithrombin III concentration is higher in patients with a normal exercise ECG than in patients with abnormal exercise ECG (p less than 0.05). The same is true for alpha 2-antiplasmin but not for the antithrombin III activity. Fibrinogen and VIIIR:Ag are higher in patients with a previous myocardial infarction, however, the age is also significantly different as compared to the group without previous myocardial infarction. Disturbance of the cerebral arterial circulation is characterized by an elevation of VIIR:Ag and of alpha 2-antiplasmin as compared to the values obtained in patients without this complication. There is a general tendency towards higher alpha 2-antiplasmin values with the extension of the arterial disease.

Antigens↗
PubMed1983

[The importance of peripheral-arterial occlusive diseases in medical practice. Conclusions from the Basel study].

Based on prospective epidemiological studies, tentative conclusions concerning the place of occlusive peripheral artery disease ( OPAD ) in general practice are presented. For men aged 35-64 the 5-year incidence of OPAD was found to be 76%, i.e. 3 times higher than that of intermittent claudication. In a high percentage of cases new occurrences of OPAD were predictable by the risk profile at entry. Men with 3 risk factors had an incidence of 114% compared to 20% in those free of risk at entry. A comparative 11-year follow-up of 273 men with OPAD and 273 age-matched, randomly selected controls without OPAD , revealed a moderate incidence of local complications (3% amputations) but an impressive excess mortality of 33% vs 11%, mainly due to coronary heart disease. The high correlation between the risk profile on the one hand and morbidity/mortality on the other emphasizes the need for action against risk factors. The efficacy of measures for the improvement of the risk profile and the reduction of cardiovascular mortality is discussed on the basis of the so-called " Mister Fit Study".

Adult↗
PubMed1983

[Systemic thrombolysis of arterial occlusions of the lower extremities. Comparison of various treatment schedules].

From 1971-1982 121 patients with arterial occlusions of the lower limbs underwent systemic thrombolysis treatment at the Kantonsspital Basel. During 4 time-periods, 3 different treatment schedules were evaluated consecutively: a) individually titrated high dose streptokinase (SK), b) individually titrated low dose SK and c) p-plasmin, followed by low dose SK-infusion. Thrombolytic success rates did not differ significantly with the 3 treatment schedules. Nevertheless, the p-plasmin-SK scheme tended to the thrombolytically more effective (68%) than high-dose (58%) or low-dose (50%) SK. The most frequent side effects were bleeding complications. In 6 out of the 121 patients, intracranial bleeding occurred and was lethal in 1 of the patients. The incidence of this most serious complication of 4/47 during the sequential p-plasmin-SK schedule led the authors to abandon this scheme for the treatment of arterial occlusions. The intracranial bleeding complications are much less frequent in patients with deep venous thrombosis undergoing systemic thrombolysis, and hence seem to be due in part to the generalized arteriopathy often present in patients with arterial occlusions. The p-plasmin-SK schedule induced the strongest systemic proteolysis in the light of thromboplastin time and factor V values. Comparison of these data with those of other authors is very difficult because of differences in patient selection, treatment schedules and observance of contraindications. The serious prognosis for patients with acute arterial occlusions, with an overall hospital mortality of 26% (experience at the Kantonsspital Basel, 1978-1982) relativizes the importance of the side effects due to systemic thrombolysis.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1982

Sequential treatment of arterial occlusions with porcine plasmin and low dose streptokinase.

Sequential treatment of arterial occlusions of the leg with porcine plasmin and low dose streptokinase results in a strong systemic proteolysis as already seen in deep leg vein thrombosis. In 31 of 45 patients the blood flow through major arterial segments could be restored. Thrombolytic success is possible within the first two treatment days but for the majority of the cases fibrinolytic therapy for 3-6 days is needed. On the average treatment was 1 day shorter than in DVT cases. No statistical relationship between local thrombolysis and systemic proteolysis was detected. The thrombolytic efficacy of this regimen compares favourably with earlier experience on fibrinolytic therapy in arterial occlusions.

Adult↗
PubMed1982

Sequential treatment of deep leg vein thrombosis with porcine plasmin and low dose streptokinase.

Sequential treatment of deep leg vein thrombosis with porcine plasmin and low dose streptokinase (10,000-20,000 U/h) produces strong systemic fibrinolysis as demonstrated by the sustained decrease of euglobulin lysis time, of thromboplastin time values in percent, fibrinogen and factor V levels. There is a statistically significant negative correlation between thrombolytic results and euglobulin lysis time. Treatment period below 3 days are unlikely to give satisfactory results. Occluded vein segments with an apparent median age of 4 days including thrombi older than 10 days (20% of cases) are cleared with an average chance of 50%. Complete dissolution of all thrombi proximal to the crural veins has been demonstrated in 47/114 = 41.2%, some thrombolytic effects in 31/114 = 27.2% and treatment failure in 36/114 = 31.6%. The data favour laboratory monitoring of thrombolytic therapy.

Adult↗
PubMed1982

Side effects of thrombolytic treatment with porcine plasmin and low dose streptokinase.

In the sequential thrombolytic therapy with porcine plasmin and low dose streptokinase side effects are mainly due to bleeding, intolerance reactions are less important. Treatment had to be prematurely stopped in 42 (37%) of 114 DVT cases because of severe bleeding and in 12 (10%) due to intolerance reactions. The corresponding figures for the 45 cases with arterial occlusions are 15 (33%) and 2 (4%) respectively. The intensity of systemic proteolysis as represented by the thromboplastin time is significantly correlated with haemorrhagic manifestations. Macrohematuria and bleeding from puncture sites are the most frequent haemorrhagic complications followed by spontaneous bleeding into skin and muscles. Non-fatal intracranial bleeding occurred in 1 DVT case (0.9%) and in 2 patients with arterial occlusions (4.4%). The benefit of this potent thrombolytic regimen would greatly improve if a strong reduction of premature treatment stop could be achieved.

Animals↗