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Biomedical subjects

W Habscheid

Publications and source records attributed to W Habscheid.

At least 37 records · Page 2Linked to original sources
PubMed1993

Incidence and prophylaxis of deep venous thrombosis in outpatients with injury of the lower limb.

253 outpatients were included in a prospective randomized study. All patients had incidence of injuries of the lower limb immobilized by a plaster cast. 126 patients (group I) received a subcutaneous injection of Fraxiparin daily, and 127 patients (group II) received no thromboprophylaxis. Without prophylaxis 21 (16.5%) cases developed a thrombosis, and with prophylaxis a thrombosis could be proven in 6 (4.8%) patients only (p < 0.01). Thus, for all patients with an injury of the lower limb being immobilized by a plaster cast, a thromboprophylaxis with a low-molecular-weight heparin is recommended.

Adolescent↗
PubMed1992

Heparin Study in Internal Medicine (HESIM): design and preliminary results.

The Heparin Study in Internal Medicine (HESIM) compares the efficacy and safety of an unfractionated (UF) heparin with a low molecular weight (LMW) heparin (CY 216 D) for prevention of proximal deep vein thrombosis (DVT) and pulmonary embolism (PE) in medical inpatients with a high risk for development of thromboembolism. Patients are randomized and receive three times daily 5000 IU UF heparin or once daily 3100 IU LMW heparin and two placebo injections subcutaneously for 10 days. All patients are screened for the presence of proximal DVT at day 1 and 10 by real-time B-mode compression sonography and for PE by repeated clinical examinations. Perfusion scintigraphy is used for confirmation of the clinical diagnosis of PE. The study protocol includes a stratified randomization of patients on admission to the hospital according to one of the following main diagnoses: malignant disease, cardiovascular disease, bronchopulmonary disease, neurologic disease, and other diseases. The present study may serve as a model for further clinical trials in medical inpatients using the biometric approach of statistical analysis for proving equivalence of drug efficacy, and to adopt less sensitive but noninvasive methods for the detection of primary endpoints.

Aged↗
PubMed1992

[Thrombosis prevention in outpatients with lower limb injuries].

The antithrombotic effect of a low molecular weight heparin was examined in a prospective randomized trial of 204 outpatients (121 men, 83 women, mean age 34.7 [16-76] years) who required immobilization with a plaster cast because of injury to the lower limb. Subjects in group I (n = 99) received a daily subcutaneous injection (36 mg) of heparin fragment calcium throughout their period in plaster (mean of 15.6 [7-66] days), while group II subjects (n = 105, mean period in plaster 15.7 [7-41] days) acted as untreated controls. Thrombosis was diagnosed by compression sonography, and positive findings were confirmed by phlebography. Thrombosis occurred in 24 patients altogether, 6 in group I (6.1%) and 18 in group II (17.1%) (P less than 0.05). While patients with thromboses had a mean of 1.96 risk factors overall, those in group I had a mean of 2.6 risk factors. Patients without thrombosis had a mean of 1.24 risk factors. The rate of thrombosis was higher in patients with fractures (4 out of 27 in group I; 10 out of 35 in group II) than in those with ligament and soft-tissue injuries (2 out of 72 in group I; 8 out of 70 in group II). The severity of trauma is apparently an important thrombogenic factor.--General thrombo-prophylaxis seems advisable for surgical outpatients requiring immobilisation treatment with a plaster cast.

Adolescent↗
PubMed1991

[Atraumatic Clostridium septicum infection in granulocytopenia].

A fatal Clostridium septicum infection occurred in three patients. Case 1. A 55-year-old man died of septicaemia resulting from granulocytopenia of uncertain aetiology; it was associated with perforation of ileal mucosal ulcers. Autopsy revealed neutropenic enterocolitis and diffuse gas formation, especially in the brain, caused by Clostridium septicum. Case 2. A 18-year-old boy developed a caecal invagination during imipenem-induced granulocytopenia. A fulminant postoperative Clostridium septicum infection ended fatally. At autopsy many ulcers were found at the site of invagination with gas formation involving all organs. Case 3. Myonecrosis of the left arm, caused by Clostridium septicum, developed without external cause in a 12-year-old girl with congenital neutropenia. Despite aggressive surgical intervention she died of toxic shock. Autopsy revealed caecal mucosal ulcers as the portal of entry of Clostridium septicum.

Adolescent↗
PubMed1991

[The frequency of false aneurysms of the femoral artery following heart catheterization and PTA (percutaneous transluminal angioplasty)].

In a prospective study, the arterial puncture site was studied sonographically in 1120 patients who had undergone cardiac catheterisation or angioplasty (renal or extremities). Contrary to the figures in the literature, there was an incidence of 3.84% of false aneurysms (catheters 5.26%, angioplasty 2.36%). Conventional sonography and colour-coded duplex sonography were of equal value for demonstrating false aneurysms, but colour-coded duplex sonography was superior for demonstrating their relationships and haemodynamic effects.

Adult↗
PubMed1991

[Prevention of thrombosis with low molecular weight heparin in ambulatory patients with injury of the lower extremity: an ultrasound study].

The aim of the study was to evaluate the risk of thrombo-embolism in outpatients with traumatic injuries of the lower limb, which are immobilised by plaster cast. 204 patients were randomly divided into 2 groups. Group I (99 pat.) got a daily injection of a low molecular weight heparin. In group II (105 pat.) no prophylaxis was done. The diagnosis of deep venous thrombosis (DVT) was carried out by compression sonography. A total of 24 patients developed DTV: In group 16 patients (6.1%), in group II 18 (17.1%) (p less than 0.05). In patients with fractures in group I (22 pat.) 4 DVT (14.8%) occurred and in group II (35 pat.) 10 (28.6%), respectively. The median age of all the patients was 34.7 years and relatively low. A general prophylaxis in all outpatients having traumatic injuries of the lown limb with immobilisation by cast is recommended.

Adult↗
PubMed1990

[Compression sonography as a screening method in thrombosis diagnosis].

The incidence of thromboses in the leg was studied in 542 patients (220 women and 322 men, mean age 61 [15-88] years) in a medical intensive care unit who had routinely undergone ultrasound examinations of the venous system of the legs. Not previously known thromboses were demonstrated in 62 (11.4%) of patients, bilaterally in 27.4% of them. Thromboses were most frequent (28.8%) in patients with malignant disease, rarest (3.7%) in those with myocardial infarction. 45% of thromboses were located solely in the lower leg. Autopsy, performed in 87 of the patients, revealed recent pulmonary emboli in 14. In eight of them venous thrombosis had been diagnosed by ultrasound before death, while the total number of leg vein thromboses identified in the 87 patients was 11.

Adolescent↗
PubMed1990

[Puncture track metastasis after ultrasound-guided fine-needle puncture biopsy. A rare complication?].

Bilaterally enlarged adrenals were diagnosed by ultrasonography in a 57-year-old man with a potentially resectable adenocarcinoma of the lung. Ultrasound-guided fine-needle biopsy of the left adrenal revealed a metastasis, proven cytologically. Chemotherapy was tried but failed to influence tumour growth. Three months later a painful subcutaneous nodule was noted in the area of the previous needle puncture, which on removal proved to be a skin metastasis. The patient died later from the underlying tumour.

Adenocarcinoma↗
PubMed1990

[Compression sonography as a procedure in the diagnosis of acute deep venous thrombosis of the leg].

It is well known that clinical symptoms of deep venous thrombosis of the leg are not reliable. We studied the diagnostic value of compression sonography in the diagnosis of venous thrombosis of the lower extremity. Ultrasound examination was performed in patients in the supine position. The venous segments were evaluated almost exclusively with transversal scanning. In the thigh lacking compressibility of the venous lumen was the only criterion for thrombosis. In the calf, unobstructed veins can usually not be seen in the patient supine. In thrombosis however the vessel is dilated by the clot and appears as sonolucent incompressible channel. 178 patients were examined comparatively by venography and ultrasound (226 one extremity phlebogramms). Phlebography demonstrated 113 thromboses which could be demonstrated by ultrasound with a sensitivity of 95% and a specificity of 100%. In 92% the extension of thrombosis was estimated accurately. Thigh vein thrombosis was detected with a sensitivity of 97% and a specificity of 99%. Occlusion or patency of the common femoral vein was seen correctly in each case. Ultrasonic diagnosis of the superficial femoral vein thrombosis had a sensitivity of 97%, that of the popliteal vein of 98% and a specificity of 100% in both. Venous occlusion confined to the calf was detected with a sensitivity of 89% and a specificity of 99%. We conclude that compression sonography is a highly accurate diagnostic procedure for the diagnosis of deep venous thrombosis of the thigh as well as the calf. It should be the first choice of imaging method in the diagnosis of venous thrombosis of the leg.

Acute Disease↗
PubMed1990

[Diagnosis of acute deep leg vein thrombosis with compression ultrasonography].

We studied the accuracy of compression sonography in 238 patients suspected of deep venous thrombosis comparable to phlebography. The veins in the thigh were considered to be occluded when their lumen did not collapse under slight pressure with the scanner. In the lower leg, incompressible echosparse strings were regarded to be equivalent to thrombosed veins. Since in some patients both legs were submitted to phlebography, 301 x-ray-examinations of one leg were compared to ultrasound. 153 thromboses were detected by venography. Ultrasound diagnosis of venous occlusion was made with a sensitivity of 96% and a specificity of 99%. In 91% it was possible to predict the extent of the clot. Thigh vein thromboses were correctly seen with a sensitivity of 97% and a specificity of 99%. Isolated calf vein thromboses were detected with a sensitivity of 90% and a specificity of 99%. In 10% of the examinations ultrasound brought new essential information compared to phlebography. We conclude that compression sonography is an accurate method in the diagnosis of deep venous thrombosis and that it should be applied liberally in patients with suspected venous occlusions.

Diagnosis, Differential↗
PubMed1990

[Gadolinium-DTPA as an oral contrast medium for MR tomography of the abdomen].

150 MR examinations of the upper abdomen were carried out after the oral administration of 5 ml/kg body weight of a gadolinium DTPA formulation (1.0 mmol/l, 15 g/l mannitol), with reference to the delineation of the pancrease, the liver and intra-abdominal fat. For comparison, 100 MR examinations without oral opacification of the G.I. tract were evaluated. Contrast administration resulted in a signal-intensive demonstration of the G.I. tract for all measurement sequences. The intraluminal contrast improved the distinction between normal and abnormal structures. T1 and T2 sequences and the demonstration of fat on T2-weighted series. T1-weighted series showed the best diagnostic results. In 25% there was meteorism and diarrhoea within 24 hours of the administration of the oral contrast.

Abdomen↗
PubMed1990

Real-time ultrasound in the diagnosis of acute deep venous thrombosis of the lower extremity.

One hundred twenty-six patients with clinically suspected acute deep venous thrombosis of the lower extremity (DVT) were examined comparatively with ultrasound and venography. In total, 174 lower extremity venograms were obtained. Ultrasonic examinations were performed on patients in the supine position. The venous segments were evaluated almost exclusively with transversal scanning. In the thigh, the only criterion for DVT was the reduced or absent compressibility of the venous lumen when gently compressed with the transducer. In the calf, normal unobstructed veins can usually not be viewed in the supine patient, whereas thrombotic veins appear as sonolucent, incompressible channels. Eight-three of the 174 lower extremity venograms were positive for DVT. In the majority of cases (53 of 83) the thrombotic process had involved two or more segments in combination. The sites of involvement of the different venous segments were distributed as follows: 24 occlusions of the common femoral vein, 52 of the superficial femoral vein, 56 of the popliteal vein, and 71 of the calf veins. Ultrasound had a sensitivity of 100% for thrombosis of the common femoral vein, 96% for the superficial femoral veins, 98% for the popliteal vein, and 93% for the calf veins. For the entire lower extremity, in regard to the diagnosis of thrombosis, the overall sensitivity was 95%. In 90% the extension of the occlusion was foreseen correctly. In no cases were false-positive results reported. Thus the overall specificity was 100%. The authors conclude that real-time ultrasound is a highly accurate method for the diagnosis of DVT of the lower extremity. It is the only indirect method capable of evaluating the venous system of the thigh, as well as that of the calf, with high accuracy. It should be the first choice of diagnostic imaging method in the diagnosis of deep venous thrombosis of the lower extremity.

Adolescent↗