Thromboembolic disease.
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Fibrinolytic Agents↗
Biomedical subjects
T D Painter
Publications and source records attributed to T D Painter.
Deep venous thrombosis of the upper extremity five years experience at a university hospital.
All patients with deep vein thrombosis of the arm seen at one University Hospital over a 5 year period were reviewed. The 17 cases could be divided into distinct patient groups. The first group (primary thrombosis) consisted of 7 patients primarily healthy young males (mean age 23) who had vocations or avocations which involved vigorous physical activity of the arms. The 10 patients with secondary thrombosis tended to be older (mean age 47.3) and to be ill or hospitalized at the time of onset of their illness. Followup information could be obtained in 9 of the cases and 7 of these patients had persistence in their symptoms consisting of residual discomfort and edema of the involved arm especially after exercise. None of the patients treated with anticoagulation were asymptomatic. The only patients who were symptomatic were one patient who received streptokinase and another who underwent thrombectomy. Three illustrative case studies are included.
Adolescent↗
Anticoagulation. Current approach to heparin and warfarin therapy.
Anticoagulant therapy is required for a variety of indications. Heparin, usually administered intravenously, is the drug of choice for acute anticoagulation, with the infusion monitored by partial thromboplastin time. For long-term therapy the standard regimen includes heparin given via intravenous infusion for 7 to 14 days followed by oral warfarin therapy, monitored by prothrombin time. The duration of anticoagulant therapy depends on the indication for its use. The most serious complication with the anticoagulants is bleeding. Physicians should be aware of the risk factors for bleeding and of the measures capable of reversing the effects of the drugs.
Blood Coagulation↗
Thrombophlebitis: diagnostic techniques.
A review of the extensive literature on the diagnosis of deep vein thrombophlebitis (DVT) is presented. DVT affects approximately 10% of all patients with superficial thrombophlebitis. Many authors have shown that the clinical finding of DVT are unreliable. Although pulmonary emboli are relatively frequent in all patients with calf DVT, these emboli are generally not associated with clincial events. Venography is the "gold standard" of diagnostic tests, but it is too cumbersome to be practical as a screening procedure. Radioisotope-labeled fibrinogen is reasonable accurate in diagnosing calf DVT, but much less so in proximal lesions. The results of Doppler ultrasound and impedance plethysmography (IPG) agree with those of venography in 90% of the cases of proximal DVT.
Fibrinogen↗
Phytobezoar occurring as a complication of gastric carcinoma.
Phytobezoar occurring as a complication of gastric carcinoma is reported for the first time. A review of the pathogenesis of phytobezoar suggests that hypomotility and hyposecretion are the two most important factors in bezoar formation. In the case discussed, hypomotility as a consequence of neoplastic involvement of the gastric antrum was the most important precipitating factor. However, documentation of prior hyposecretion was also noted and suggests that a combination of these two factors may be more significant than each taken alone. The therapeutic management of bezoars in patients who are not candidates for surgery is frequently difficult. This is the third case in which the enzyme cellulase has been used successfully for bezoar dissolution.
Adenocarcinoma, Scirrhous↗
Effect of ligands on alkaline denaturation of fetal hemoglobin and isolated gamma subunits.
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Carboxyhemoglobin↗
Superior vena cava syndrome: diagnostic procedures.
The hospital records of patients discharged from Presbyterian-University Hospital of Pittsburgh with the diagnosis of superior vena cava syndrome (SVCS) were reviewed in order to determine if diagnostic procedures were associated with an unacceptable risk of complications. Fifty-six cases were reviewed. Symptoms had been present for an average of five weeks. Forty-five patients underwent diagnostic tests including sputum cytology, lymph node biopsy, bone marrow biopsy, bronchoscopy, mediastinoscopy and thoracotomy. The diagnostic yield of these procedures ranged from 28% (cytology) to 100% (thoracotomy). Complications occurred only with mediastinoscopy and none of these were fatal or caused long-term morbidity. We conclude that most patients with SVCS (excepting those with neurologic or respiratory compromise) can tolerate a vigorous pursuit of a histologic diagnosis before therapy is instituted.
Bronchoscopy↗