PubMed Health⌕ Search

Biomedical subjects

M T Widmer

Publications and source records attributed to M T Widmer.

13 recordsLinked to original sources
PubMed1994

[The incidence of post-thrombotic syndrome].

To evaluate the clinical and socio-economic importance of the postthrombotic syndrome (PTS), the following epidemiologic parameters are to be known: The incidence of deep vein thrombosis (DVT) in the population, the incidence of PTS after DVT, the prevalence of the PTS, the socio-medical consequences and the mortality. The DVT-incidence in the literature is about 3/1000 per year in the adult population. In our own follow-up study we found a global PTS-incidence of 40% (10% with, 30% without ulcer) 13 years after DVT. The PTS-incidence was correlated with the initial DTV-extent. The risk of PTS after 3- and 4-level DVT is significantly reduced by a successful fibrinolysis in the acute stage (p = 0.01). The mortality of patients with PTS is 3 times higher than in the population. 4% of the patients with PTS get disabled. To our knowledge an adequate study with direct assessment of the PTS-prevalence does not exist, but the PTS-prevalence can be deduced from large epidemiologic studies, such as the Basel-Study, in which the global chronic venous insufficiency is assessed. It amounts in the adult population between 0.5 to 1% for the PTS with and 3 to 5% for the PTS without ulcer.

Adult↗
PubMed1994

[Late sequelae of deep venous thrombosis: a 13-year follow-up of 223 patients].

To investigate late sequelae of deep vein thrombosis, 223 consecutive patients, 148 men, 75 women, aged 61.5 +/- 14.7 years, with phlebographically documented unilateral deep vein thrombosis were reexamined 13 years after the acute event. 29 had an isolated calf vein thrombosis, 45 a 2-level- (calf an popliteal), 72 a 3-level- (calf, popliteal and femoral), 62 a 4-level- (calf, popliteal, femoral and pelvic) thrombosis and 15 had a special location, for example an isolated popliteal or pelvic involvement. In the acute stage all patients were given full dose heparin followed by a six month period of oral anticoagulation. 144 were initially treated by thrombolytic treatment with streptokinase. Control phlebography 5-14 days after the onset of the treatment revealed no clearance in a so called negative group of 123 patients, aged 63.5 +/- 14.9 years, namely the 79 "only" anticoagulated and 44 unsuccessfully thrombolysed. In this negative group natural course of deep vein thrombosis can be studied. The positive group, comprising 100 patients, aged 59.4 +/- 13.9 years (25 with complete and 75 with partial lysis, after streptokinase), is compared with the negative group. The global incidence of postthrombotic syndrome in the natural course, 13 years after deep vein thrombosis, was 39%, 9.8% with and 29.2% without ulcer. Slight changes were noted in 25% and no change in 36%. The incidence of postthrombotic syndrome was correlated with the extent of the original thrombosis: 3.7% after isolated calf vein thrombosis vs. 55.2% after 4-level thrombosis. Moreover, the mortality after deep vein thrombosis and the frequency of recurrence in the interval and of venous symptoms were also correlated to the extent of the thrombosis. The incidence of post phlebitic syndrome in the positive group is significantly lower in patients with 3- and 4-level thrombosis (p = 0.01). Patients with complete and partial lysis also have less venous symptoms (for 3- and 4-level thrombosis p < 0.0001). Thus, the successful thrombolysis seems to be beneficial in long terms for patients with extended thrombosis. Therefore, in our hospital thrombolytic treatment is offered as an additional treatment to anticoagulation to patients with recent, less than 7 days old, 3- and 4-level-thrombosis without contraindications.

Adult↗
PubMed1991

[Sequelae of venous thrombosis. Incidence in of the post-thrombosis syndrome after 5 years].

The authors report on an epidemiological study carried out in Basle, Switzerland, which prospectively included 341 consecutive patients (226 men, 115 women, mean age 52 +/- 16 years) who had developed deep venous thrombosis evidenced by phlebography. The treatment of the acute phase most often consisted in thrombolysis, conventional heparin being reserved for the contra-indications of thrombolysis. A second phlebographic examination allowed dividing up the series into two groups, ie. positive and negative, according to the presence or absence of a complete or partial return of patency. Each group was subdivided according to the location and extension of the thrombosis. Both groups (positive vs. negative) are different as regards the location and extent of the thrombosis. The selective comparison of both groups according to the objective subdivision demonstrated: the absence of post-phlebitis disease in sural phlebitis; the same risk of post-phlebitis disease in thrombosis extending to 4 levels, whether patency was restored or not; lower incidence of post-phlebitis disease in the positive group for single -, two - or three-level phlebitis. Leg ulcers occur within an average of 5.5 +/- 2.1 years after the acute episode in 6.7% of all patients. Complete return of patency is obtained in 23% of cases only.

Adult↗
PubMed1985

[The fate of the patient with deep vein thrombosis].

Late results in 278 consecutive patients with unilateral deep vein thrombosis treated with streptokinase or heparin/dicoumarol were analysed as to mortality rate, recurrent thrombo-embolism and incidence of postthrombotic syndrome (PTS). The five-year mortality rate was three times as high as that of the age-matched population. The overall mortality rate was 16%, more than half the patients dying of tumour, males largely of gastric or bronchial carcinoma, females of urogenital carcinoma. Thrombo-embolism had recurred in 14% of 204 patients who had been re-examined, in 9% thrombosis, in 3% pulmonary embolism, and in 2% both. A PTS without ulcer had developed in 16%, an ulcer in 8%. The PTS incidence correlated with the original extent of the thrombosis: no PTS if the thrombosis had been confined to the lower-leg axis, but 34% after four-level thrombosis. The data confirm the importance of thrombo-embolism prophylaxis, early diagnosis and subsequent treatment with anticoagulants and compression.

Adult↗
PubMed1978

[Mortality rates and causes of death in the "Basle study"].

The Basle Study of cardiovascular diseases (CVD) from 1960 to 1973 showed, in the original cohort, a mortality rate of 6% in 4858 men aged 15-65 at entry and of 2.2% in 1471 women aged 15-55. In the male cohort, the age-specific 10-year mortality is lower than in the general Swiss population, due to a smaller number of fatal accidents and a low incidence of various diseases with fatal outcome. This is not true of cardiovascular mortality, which accounted for 40%, or of tumors, which accounted for 35% of the observed mortality. In females, 59% of the fatal events were caused by tumors and 16% by CVD. The autopsy rate was 61% and allowed confirmation of the death certificate. Myocardial infarction was the cause of death in 51% of all males dying from CVD. A comparison of findings at the entry examination between subjects who died from CVD and those who died from other causes showed a significantly higher incidence of CVD in both the family history and the personal history in the cardiovascular mortality group. Cigarette smoking was more prevalent. Blood cholesterol, betalipoproteins, and blood pressure were significantly higher than in the non-cardiovascular mortality group. Our findings demonstrate that no measurable preventive action against CVD was taken even in a group of presumably healthy subjects interested in health maintenance. The necessity of increased efforts toward prevention of CVD is evident.

Accidents↗
PubMedDate not supplied

[Sequelae of deep venous thrombosis, 5-year follow-up of 341 patients].

In order to see whether thrombolytic therapy led to a reduction of CPT, a cause of long periods of inability to work, a study on the development of phlebothrombosis was carried out at the Department of Angiology at the Hospital Cantonal of Basle. Subjects presenting deep phlebothrombosis, either acute or sub-acute, were observed after 5 years... Or the 341 patients, 208 received streptokinase and 133 heparin. After the 5 years, 1 in 5 patients had developed CPT. The incidence of CPT was above all related to the extent of the thrombosis. If one considers not only the immediate therapeutic effect but also the extent of the thrombosis, then the incidence of CPT, especially in leg ulcers, is roughly twice as high in patients with extensive thromboses, and therapy is negative, as in the patients with thromboses limited to two stages only, in which group the therapy is positive. It has even been eliminated where the thrombosis had been limited to the leg. Prophylactic measures are therefore necessary in the groups at high risk. The diagnosis must be swift in order to commence correct therapy whilst the thrombosis is not as yet extensive. Heparin therapy seems to be enough for those thromboses limited to the leg. Whilst awaiting thrombolytic methods without serious side-effects, thrombolytic treatment should be reserved for extensive thromboses in young patients with no contraindications. It is a condition sine qua non that the patient and the parameters of coagulation should be monitored.

Female↗