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Biomedical subjects

W Theiss

Publications and source records attributed to W Theiss.

At least 19 recordsLinked to original sources
PubMed1990

[Fibrinolytic therapy of acute venous thrombosis].

Fibrinolytic therapy carries a greater risk in the treatment of deep-vein thrombosis than mere anticoagulation. It must therefore be considered an elective measure in the case of a young patient with extensive thrombotic disease who wishes removal of the thrombus in order to reduce his risk of postthrombotic sequelae. Regardless the type of fibrinolytic agent used and of the dosage employed, one must reckon with a mortality of 1%. One can expect good results in 80-90% of the patients with fresh thrombi.

Dose-Response Relationship, Drug↗
PubMed1989

[Long-term results following fibrinolytic treatment of deep venous thromboses in the area of the pelvis and leg].

68 patients who underwent fibrinolytic treatment due to deep vein thrombosis of the lower extremity were followed-up after a median time interval of 6.3 years. Phlebography was carried out in all patients prior to and following fibrinolytic treatment. 28% of all patients showed complete patency and 38% partial patency. 34% showed no improvement. For the long term follow-up, physical examination, doppler-sonography, phlebodynamometry and vein occlusion plethysmography were assessed. The acute intervention, regarding treatment, turned out to be the crucial prognostic parameter. While late symptoms and clinical findings on the one hand and site, extent and age of thrombosis prior to fibrinolytic treatment on the other hand did not correlate with one another, symptoms and clinical findings did indeed correlate quite well with the outcome of fibrinolytic treatment. Postthrombotic syndrom was rare in cases with complete patency. In cases where patency was only partially or not at all achieved, postthrombotic syndrom was present to a higher degree the more central and the more extensive the remaining thrombosis was.

Adolescent↗
PubMed1988

[Which laboratory parameters are useful and necessary in fibrinolytic therapy?].

Even sophisticated assays of blood coagulation and of fibrinolysis cannot predict the clinical success of thrombolytic therapy, nor can they prevent bleeding complications. Nevertheless, some laboratory monitoring is indicated before thrombolytic therapy to rule out contraindications, and it should also be performed during thrombolytic therapy as a guideline for substitution therapy in case of bleeding and for control of concommitant or subsequent anticoagulant therapy. An initial assessment should comprise the assay of fibrinogen, prothrombin time, partial thromboplastin time, and a platelet count. One to two hours after initiation of thrombolytic therapy and at its end (as well as at 12-hourly intervals in between in prolonged courses of thrombolytic therapy), a fibrinogen assay and a test that is sensitive to fibrin(ogen) degradation products (e.g. thrombin time, reptilase time, prothrombin time) should be performed.

Blood Coagulation Tests↗
PubMed1987

[Fibrinolytic treatment of deep venous thromboses with streptokinase at an ultrahigh dosage].

Twenty-one patients with deep vein thrombosis were treated for six hours per day in accordance with an "ultrahigh" dose scheme with 1,500,000 units/hour streptokinase. A maximum of two such cycles were administered in the first ten patients, and the subsequent patients received up to five cycles as required. In terms of clinical chemical parameters, a pronounced lowering of fibrinogen with corresponding elevation of fibrin(ogen) cleavage products regularly occurred during the first cycle. There were great differences in the individual times for which these alterations persisted (12-72 hours). The alterations during the subsequent cycles were very much less, probably because of the pronounced lowering of the plasminogen concentration. The clinical tolerance (including hemorrhagic complications) was roughly comparable with that of a streptokinase treatment with conventional doses. Phlebographic checking of the result of treatment showed that the ultrahigh dosed intermittent dosage scheme is a highly effective treatment procedure with which the duration of treatment can be appreciably shortened compared to conventional dosage schemata: in four cases, a full recanalization could already be attained after a single cycle.

Adolescent↗
PubMed1987

[Syncopes of unclear etiology. Diagnosis, follow-up observation and pacemaker therapy].

Clinical findings after syncopal attacks were evaluated in 295 inpatients for examining their clinical significance and the course and prognosis in syncopes of unclear aetiology. This was done after having defined the criteria for "very probable" and "possible" causes of the syncopes. A "typically rhythmogenic" anamnesis had a sensitivity rating of 79%. Long-term ECG proved the most frequent contribution to clarification. Doppler examination of the carotid artery was hardly relevant. Patients with tachycardia usually suffered from cardiac disease (coronary heart disease or cardiomyopathy). Bradycardia predominated in patients with a clinically "healthy" heart, especially in elderly patients. An overall percentage of 37% of the cases could not be clarified despite thorough clinical examination using all available diagnostic tools. Follow-ups over two years and outpatient examinations revealed a favourable prognosis in patients whose syncopes had remained unexplained: No further syncopes had occurred in 75% of these patients over a period of two years. In 12% of the subjects the cause was identified by the follow-up examinations. In 95.5% of the patients subjected to pacemaker treatment no syncopes recurred. A relatively small proportion (19.5%) of the patients with unclarified syncopes continued to suffer from syncopes, the aetiology of which could not be determined during the 2-year follow-up period. This group of patients would require better diagnostic techniques, e.g. long-term ECGs over several days or long-term EEGs.

Adolescent↗
PubMed1987

[Effect of respiration on variations of central venous blood temperature].

We examined the course of right ventricular blood temperature before, during and after treadmill exercise in three patients with implanted cardiac pacemakers, and in two healthy volunteers. Temperature measurements were performed with a specially developed 5F electrode with an incorporated thermistor (measurement accuracy: 1/100 degrees C). After electronic amplification, the temperature signals were recorded on a three-channel strip chart recorder, together with ECG and respiration (measured by impedance plethysmography). In one of the volunteers, blood flow in the jugular and femoral veins was recorded by Doppler sonography, before and after exercise. We observed a decrease in central venous blood temperature with inspiration and an increase with expiration before, during and after exercise. The amplitudes of the variations became smaller during exercise, reached a maximum immediately after exercise and returned to their resting values within a few minutes after the end of exercise. We suppose different distributions of venous blood flow in different phases of the respiratory cycle to be the reason for the respiration-induced variations in central venous blood temperature. Under exercise conditions, the influence of respiration on the blood flow in the larger veins is small compared to the influence of an increased cardiac output; at rest, respiration has a more pronounced effect on venous blood flow. The analysis of our blood flow measurements in the femoral and jugular veins supported this assumption.

Adult↗
PubMed1986

[Principles of physical prevention of thrombosis].

Physical methods of prophylaxis against deep vein thrombosis aim to counteract the stasis of venous blood flow that occurs during immobilisation. Prospective randomized studies have documented that perioperative electrical calf stimulation, intermittent pneumatic compression, and graduated compression stockings effectively reduce the frequency of post-operative deep-vein thromboses. However, up to date it has not been proved that they also reduce the incidence of fatal pulmonary embolism, and so these physical methods represent no valid alternative to the pharmacological methods of prophylaxis against thromboembolic events. Their use is justified, however, when the pharmacological agents are contraindicated, and as an adjunct to the pharmacological methods.

Clothing↗
PubMed1983

Systemic fibrinolytic activity and inhibitor levels during treatment of deep vein thrombosis with urokinase and streptokinase.

In a prospective, randomized trial 33 patients with deep vein thrombosis were treated either with 2,200 or 1,100 IU/kg/h urokinase or with 100,000 IU/h streptokinase for at least 6 days. While streptokinase was given continuously, urokinase was administered intermittently (12 hr urokinase alternating with 12 hr heparin). Urokinase treatment resulted in a dose-dependent fibrinolytic state with shortening of the euglobulin clot lysis time, easily demonstrable amidolytic activity and moderate decrease of plasminogen. At the end of each urokinase-free interval the fibrinolytic activity had mostly faded, but was reproducibly elicited again by each new urokinase administration. Streptokinase immediately evoked the customary, intense fibrinolytic state, which progressively tapered off as plasminogen fell to 1% of its pretreatment concentration. In all treatment groups alpha-2-antiplasmin dropped to approximately 40% of its initial value during the first 12 hr with a further decrease to about 20% after 6 days. alpha-2-macroglobulin fell only moderately with either urokinase regimen, whereas it decreased progressively to 45% under streptokinase. While the fibrinolytic activity decreased under streptokinase over the 6-day infusion period, it appeared to increase with each successive urokinase infusion particularly with 1100 IU/kg/h. Thus the final euglobulin clot lysis times and the final fibrinogen concentrations were similar in all three treatment groups on the sixth day.

Blood Coagulation Tests↗
PubMed1983

The success rate of fibrinolytic therapy in fresh and old thrombosis of the iliac and femoral veins.

Since it is still a wide-held belief that fibrinolytic therapy can clear thrombi from deep veins only while they are fresh, we retrospectively analyzed the phlebographic results obtained in 85 patients with thrombosis of the iliac and/or femoral veins with symptoms present for 1 day to 8 weeks prior to treatment. Streptokinase, urokinase, or both drugs successively were administered in these patients for a mean of 9 days (range: 2 to 26 days). Complete or partial resolution of the thrombotic occlusion was obtained in 94%, 82%, and 69%, respectively, in those patients who presented within 3 days, 1 to 2 weeks, and 3 to 4 weeks after the first appearance of symptoms. With a delay of 5 to 8 weeks the results were uniformly poor with only 1 partial recanalization in 7 patients.

Adolescent↗
PubMed1980

[Coagulation studies and rheological measurements during streptokinase therapy of myocardial infarction (author's transl)].

In a multicenter, randomized trial of streptokinase in acute myocardial infarction one group of patients was given streptokinase for 24 h; the remainder served as controls and received a placebo infusion instead. Coagulation assays and rheological measurements were serially performed on patients entered into the trial at one of the participating centers. Streptokinase was found to improve considerably the flow properties of blood for a period of time exceeding the duration of its administration. These results may well explain the positive clinical effect of streptokinase therapy observed in this trial.

Acute Disease↗