PubMed Health⌕ Search

Biomedical subjects

L Steidl

Publications and source records attributed to L Steidl.

At least 19 recordsLinked to original sources
PubMed2002

Predictors of residual venous obstruction after deep vein thrombosis of the lower limbs: a prospective cohort study.

INTRODUCTION: Delayed thrombus regression after deep vein thrombosis (DVT) of the lower limbs is associated with increased risk of DVT recurrence. Predictors of residual venous occlusion are unknown. We hypothesized that obesity, which causes reduced fibrinolytic activity, can predict delayed thrombus regression. MATERIALS AND METHODS: In a prospective cohort study, 98 patients with objective diagnosis of DVT underwent compression ultrasonography (CUS) after 6 and 12 months. Persistent occlusion was arbitrarily defined as a thrombus occupying, at maximal point of compressibility, more than 20% of the vein area in the absence of compression. The body mass index (BMI) and waist circumference were measured at baseline and at follow up to assess individual patterns of body fat distribution. Information on antithrombotic treatment, family history of varicose veins, cigarette smoking, concomitant disorders, the presence of known risk factors for DVT, the duration of anticoagulant treatment and the use of elastic stockings was collected. RESULTS: Post-thrombotic recanalization was documented in 34 patients (34.7%) at 6 months and in 44 patients (44.9%) at 12 months. There was no difference in the mean BMI (p=0.469 at 12 months), in the prevalence of obesity (p=0.479) and visceral pattern of body fat distribution (p=0.239) between patients who did and did not show thrombus regression. The presence of a permanent risk factor for DVT was the only predictor of delayed thrombus regression (OR 11.0, 95% CI 1.359-61.978). CONCLUSIONS: Despite consistent evidence of impaired fibrinolysis, obesity is not associated with persistent venous obstruction.

Body Mass Index↗
PubMed2002

Low dose oral vitamin K to reverse acenocoumarol-induced coagulopathy: a randomized controlled trial.

Low dose oral vitamin K rapidly reverses warfarin-associated coagulopathy. Its effect in patients receiving acenocoumarol is uncertain. We compared the effect of withholding acenocoumarol and administering 1 mg oral vitamin K with simply withholding acenocoumarol in asymptomatic patients presenting with INR values between 4.5 and 10.0. The primary end-point of the study was the INR value on the day following randomisation. We found that patients receiving oral vitamin K had more sub-therapeutic INR levels than controls (36.6% and 13.3%, respectively; RR 1.83, 95% confidence interval 1.16, 2.89) and a lower, but non-significant, proportion of INR values in range (50% and 66.6%, respectively) on the day following randomisation. After 5 +/- 1 days, there were more patients with an INR value in range in the vitamin K group than in controls (74.1% and 44.8%, respectively). There were no clinical events during 1 month follow-up. We conclude that the omission of a single dose of acenocoumarol is associated with an effective reduction of the INR in asymptomatic patients presenting with an INR value of 4.5 to 10.0. Furthermore, the use of a 1 mg dose of oral vitamin K results in an excessive risk of over-reversal of the INR.

Acenocoumarol↗
PubMed2001

Comparison of a daily fixed 2.5-mg warfarin dose with a 5-mg, international normalized ratio adjusted, warfarin dose initially following heart valve replacement.

Patients starting oral anticoagulant therapy after heart valve replacement initially require a lower target international normalized ratio (INR) (2.0, range 1.5 to 2.6) because of a higher risk of bleeding until pericardial wires are removed. In a previous retrospective analysis, we observed a higher sensitivity to warfarin in these patients compared with nonsurgical patients. In a randomized clinical trial, we compared a fixed, lower dose of warfarin (2.5 mg) with the standard treatment consisting of a 5-mg loading dose, then adjusted to the target INR during the first 5 days of anticoagulation. INRs were measured daily, but the fixed dose was only modified on day 3 if the INR was <1.5 or >3.0. One hundred ninety-seven patients were considered eligible for the study. The 2 groups were well matched according to age, gender, body mass index, concomitant treatments, and type of valves implanted. The proportion of INRs >2.6 during the study period was 42.5% in the 5-mg group and 26.2% in the 2.5-mg group (p <0.05), and the proportion of INRs >3.0 on day 3 was 23.9% and 9.5% (p <0.05), respectively. In the 2.5-mg group, 35.7% of patients had an INR <1.5 on day 3 and had the dose increased (vs 3.5%, p <0.001); however, in the 5-mg group, 95.6% had the initial dose reduced, 49.6% had the dose withheld for at least 1 day, and the mean dose during the 5 days of study was 3.08 mg. Average time to achieve therapeutic range was higher in the 2.5-mg group (2.72 vs 1.98 days, p <0.0001), but the approach to the targeted INR was more regular, and the gap between target and mean INR on day 5 was smaller. There were no bleeding or thromboembolic complications in either group. Thus, a lower loading dose of warfarin in patients after heart valve replacement reduces excessive anticoagulation and offers a more regular achievement of the therapeutic target by reducing the number of dose adjustments. Daily monitoring of the INR is still recommended.

Aged↗
PubMed2001

Atrial fibrillation and antithrombotic treatment in Italian hospitalized patients: a prospective, observational study.

BACKGROUND: We studied the prevalence of atrial fibrillation within a large Italian inpatient population, and evaluated the use of antithrombotic therapy among these individuals. METHODS: A prospective cross sectional study (Phase 1) with a 1-year follow-up period (Phase 2) was conducted at a single Italian centre. During Phase 1, we conducted a chart review of all inpatients on 5 separate days, each 1 month apart, between January and May 1999. During Phase 2, at 1-year of follow-up, patients or their families were contacted to document the occurrence of new clinical events, as well as current antithrombotic therapy use. RESULTS: A total of 3121 patient charts were reviewed. The prevalence of atrial fibrillation was 7.2%. Of these 224 patients, 21.3% were on oral anticoagulants, 29.7% on antiplatelets, while 49% received neither. Patients on oral anticoagulants were significantly younger (mean age 72.3 years) than those on antiplatelets (mean age 80.6 years; p<0.001) or neither therapy (mean age 80.7 years; p<0.001). At 1 year follow up, an acute ischaemic stroke occurred among 7.4% of the 121 contacted patients. Among patients with chronic atrial fibrillation [98], 25.5% were receiving an oral anticoagulant. CONCLUSIONS: Despite clear evidence from clinical trials, oral anticoagulants are significantly underused among patients with chronic atrial fibrillation. Methods should be developed to improve both physician and patient knowledge about the overall benefits of anti-thrombotic therapy among these individuals.

Adult↗
PubMed2001

Serum magnesium and calcium in patients with dorsalgias.

Serum magnesium and calcium was examined in 70 patients with chronic dorsalgias. Values of calcium were stabilized, but values of magnesium were unstable and exceeded the 2SD lines, being more often over than under these lines. Lability of serum magnesium levels is considered a secondary consequence, caused by the stress of pain. These symptoms may be alleviated by Mg administration, by local application of Mg through transdermic iontophoresis or sonophoresis, or by hydropathy of the paravertebral muscles.

Adult↗
PubMed1994

[Prolymphocytic B-cell leukemia with fatal acute liver failure. A case report].

Prolymphocytic leukemia (LPL) is a well defined entity with a relatively low incidence in our country. This disease usually is seen in patients over 50 years of age, and there is a very definite male preponderance. This lymphoproliferative disorder is characterized by very high white cells counts, massive splenomegaly, poor response to therapy and short term survival. The neoplastic cell in prolymphocytic leukemia usually is of B-cell origin (80% of cases). In our patient, affected by B-lineage prolymphocytic leukemia, a acute hepatic failure occurred, leading him to death in a short time. Autoptic findings evidenced a massive leukemic infiltration of the liver with parenchymal necrosis that caused fatal hepatic failure. Autoptic findings did not show histological patterns of acute viral infections or of any other infectious or systemic disease which could have induced a so massive liver injury. In literature there are no evidences of such a massive and lethal involvement of the liver during prolymphocytic leukemia or chronic lymphocytic leukemia and patients affected by LPL generally come to death because of other causes.

Diagnosis, Differential↗
PubMed1993

[The oral magnesium loading test for detecting possible magnesium deficiency].

In 26 top sportsmen (volleyball players, rower) aged 15-18 years the serum magnesium level and urinary Mg excretion before and after oral administration of 5 g Mg lactate was assessed (oral magnesium load test). In 11 sportsmen (42.3%) a low percentage of excretion of administered Mg was found, suggesting magnesium deficiency, irrespective of the basal serum Mg levels. After subsequent 10-day Mg supplementation 6 volleyball players responded by a markedly lower retention after an identical Mg load, again without marked changes of the serum Mg level. The authors consider the magnesium load test a more sensitive indicator of latent Mg deficiency than the serum Mg level which is maintained at a relatively stable level and declines only in severe deficiency. The test assumes normal renal function and intestinal absorption.

Administration, Oral↗
PubMed1992

Single fiber EMG in cerebrovascular stroke (CVS).

This paper gives previously unpublished data about fiber density (FD) and jitter in patients with CVS. The cluster of these values is very similar to that found in sclerosis multiplex (SM). There is a problem whether both clusters represents the same disorder of CNS compared with amyotrophic lateral sclerosis (ALS) or spinal muscular atrophy which have different values. Another problem is the participation of presumed central lesion on the increased jitter, the mechanism of which is still unknown.

Aged↗
PubMed1992

Tetanic syndrome and its examination.

The article presents a new electromyographic method; it describes the non-invasive examination of tetany with surface electrodes. This method is more sensitive than the classical needle technique and, moreover, the necessity to use expensive disposable needle electrodes is avoided.

Electromyography↗
PubMed1991

Blood magnesium, calcium and zinc in osteoporosis.

We examined blood Mg, Ca and Zn in 33 patients with senile, 18 patients with postmenopausal and 9 patients with medicamentous osteoporosis. The biochemical signs of chronic Mg deficiency were present in the first two groups due to lowering erythrocyte Mg. Correlation among these three ions in serum and erythrocytes brought different patterns which were richer in the first two groups compared with the third one. It seems probable that treatment with Mg lactate potentiates the storage of intracellular Zn. The correlation between biochemical and clinical findings was carried out, too. Pain, kyphosis, spine movement, x-ray picture were evaluated.

Calcium↗
PubMed1991

Osteoporosis treated with magnesium lactate.

33 patients with senile, 18 patients with postmenopausal and 9 patients with medicamentous (corticosteroids) osteoporosis were treated with single therapy of Mg lactate (37 patients) and with the combined one of Mg lactate and Na fluoride (23 patients). They were evaluated in three periods of half a year, one year, two years. The better results were achieved with the single therapy than with the combined one and in the senile and postmenopausal osteoporosis than in the medicamentous one. Pain and restricted spine movement were influenced favourably. Kyphosis and x-ray findings were stabilized.

Aged↗
PubMed1991

Tetanic syndrome questionnaire in stutterers.

Clinical symptoms of 32 stutterers--schoolchildren of 14-year average age were evaluated according to the questionnaire containing 45 complaints of tetanic syndrome. We found headache, fatigue, anxiety, paresthesias and hypothermia of limbs in 30 per cent of this group. More than 80 per cent of the patients had positive Chvostek sign and 60 per cent had positive ischemic and hyperventilation tests.

Adolescent↗
PubMed1991

Treatment of soft tissue calcifications with magnesium.

80 patients with soft tissue calcifications were treated. 24 patients suffered from myositis ossificans traumatica, 23 from calcific bursitis (Duplay's disease), 6 from osteoarthropathy of elbow joint after severe craniocerebral trauma, 9 from calcifications round elbow joint after local trauma, 13 from calcifications round hip joint, 5 from calcifications in ligaments and tendons. About 75 per cent patients were cured. Calcifications disappeared or substantially diminished. Very good functional improvement followed in affected joints. Patients were treated with new method: local application of MgSO4 into calcification area was used for 2-20 weeks, peroral administration of Mg lactate was given for 4-6 months. There were neither complications nor side effects of this treatment.

Adolescent↗
PubMed1990

[Biochemical findings in osteoporosis. II. The importance of zinc].

The authors examined 33 cases of senile, 18 cases of postmenopausal and 9 cases of medicamentous osteoporosis and assessed serum and red cell zinc content. The mean blood levels of zinc were highest in the group of medicamentous osteoporosis. In all three groups the zinc level was reduced more frequently in serum than in red cells.

Erythrocytes↗
PubMed1990

[Biochemical findings in osteoporosis. I. The significance of magnesium].

The authors examined in 60 patients with osteoporosis the serum and red cell magnesium and calcium content. Thirty-three patients suffered from senile osteoporosis, 18 patients from postmenopausal osteoporosis and nine had osteoporosis caused by corticoids. In the former two groups were signs of chronic magnesium deficiency, in the third groups there was a trend of low serum calcium levels. The results indicate the important role of magnesium in these disorders of bone metabolism.

Aged↗
PubMed1990

Soft tissue calcification treated with local and oral magnesium therapy.

Eighty patients with soft tissue calcification were treated: 24 suffered from myositis ossificans traumatica, 23 from calcific bursitis (Duplay's disease), six from osteoarthropathy of elbow joint after severe craniocerebral trauma, nine from calcification around the elbow joint after local trauma, 13 from calcification around the hip joint, and five from calcification in ligaments and tendons. Using a new method of treatment about 75% of patients were cured. Calcifications disappeared or diminished substantially. Very good functional improvement followed in affected joints. The treatment involved local application of MgSO4 under local anaesthesia into calcified areas for 2-20 weeks, together with peroral administration of Mg lactate for 4-6 months. There were no complications or side effects of this treatment.

Administration, Oral↗