Review: of the various D-dimer assays, negative ELISA results are most useful for excluding a diagnosis of deep venous thrombosis or pulmonary embolism.
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Early diagnosis, treatment, and appropriate prophylaxis may prevent serious maternal sequelae of thromboembolism. Objective techniques for diagnosis should be used aggressively, using noninvasive methods such as Doppler or IPG when possible for DVT. 125I-fibrinogen should be avoided. The possible consequences of failure to treat or unnecessary use of anticoagulant therapy outweigh risks to the fetus of the appropriate radiologic procedures. Because of its low fetal risk, heparin is the anticoagulant of choice. Measurement of heparin levels by antifactor Xa activity appears to be more sensitive than the current standard, the aPTT, and it is hoped that this will become widely available. Although the risks and benefits of prophylaxis during pregnancy are currently debated, it appears most prudent to use subcutaneous heparin prophylaxis in doses larger than for nonpregnant patients in women at high risk for recurrence.
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The use of adaptive linear neuron is referred to in recognizing veinous thromboses and lung embolism in a total of 88 acute palsies. As the input signs, the accessible clinical and laboratory data were used. Both training and adaptation of neuron have been performed in a part of total [35 patients], and 53 patients were submitted to the classification of patients with unknown distribution. In classified group with present complications, the screened diseases have been recognized in 16/20 patients. In 29 from 33 patients without thromboembolic states, the distribution by classificator appeared as correct one. The level of correct resolution was as high as 88% in all.
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Transvenous Greenfield filter insertion is a safe and efficient mechanical means of protection against recurrent pulmonary thromboembolism both in the infrarenal and suprarenal positions. Long-term follow-up to 12 years has demonstrated a consistently high patency rate of 96%, which is independent of concomitant anticoagulant therapy. The incidence of recurrent embolism in patients with filters has not changed over time, and there has been no significant filter migration over prolonged periods of observation.
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