RESUMO
To determine whether long-term oral anticoagulant treatment was effective in improving graft performance and preventing major amputation following vein bypass surgery for femoropopliteal atherosclerosis, a clinical trial was conducted in one single center and continued during 10 years. After 130 patients had electively received a femoropopliteal vein graft, they were randomly assigned to a therapy group (treatment with phenprocoumon [n = 66]) or to a control group (n = 64) that remained without any anticoagulant treatment. Primary end points of the study were graft reocclusion and limb loss. The median durations of primary patency and limb salvage were significantly longer for treated patients than that for controls. In addition, survival in the therapy group was longer. Following autologous vein bypass surgery in the treated group, the results were superior in terms of graft patency, limb salvage, and survival.
Assuntos
Arteriosclerose/cirurgia , Artéria Femoral/cirurgia , Femprocumona/uso terapêutico , Artéria Poplítea/cirurgia , Veia Safena/transplante , Administração Oral , Idoso , Testes de Coagulação Sanguínea , Feminino , Seguimentos , Gangrena/cirurgia , Oclusão de Enxerto Vascular/etiologia , Humanos , Claudicação Intermitente/cirurgia , Masculino , Pessoa de Meia-Idade , Femprocumona/administração & dosagem , Pulso Arterial , Taxa de Sobrevida , Comprimidos , Grau de Desobstrução VascularRESUMO
In a great number of patients with squamous cell cancer of the head and neck, tumour markers in the serum were determined before any therapy, in order to evaluate their possible usefulness as parameters for monitoring therapy as well as for early detection of cancer. Patients with primary tumours (n = 101) were distributed to groups TI-II and TIII-IV according to the UICC classification 1978, and investigated together with a group of recurrences (n = 105). 50 age-matched healthy individuals served as controls. Substances investigated were beta 2-Microglobulin (beta 2-M), Immunoglobulin E (IgE), Ferritin, N-Acetyl-Neuraminic Acid (sialic acid; NANA), Phosphohexose-Isomerase (PHI). Not only were the mean values of the groups compared with each other, but also the percentages of the respective groups displaying increases above the upper norm limit (95. percentile) were calculated. Critical evaluation of the results led to the conclusion that in particular IgE, NANA and--with some reservations--ferritin should be further investigated as biological serum markers in serial determination with special regard to their possible relevance for cancer treatment.
Assuntos
Biomarcadores Tumorais/análise , Carcinoma de Células Escamosas/sangue , Neoplasias de Cabeça e Pescoço/sangue , Carcinoma de Células Escamosas/diagnóstico , Ferritinas/sangue , Glucose-6-Fosfato Isomerase/sangue , Neoplasias de Cabeça e Pescoço/diagnóstico , Humanos , Imunoglobulina E/análise , Ácidos Siálicos/sangue , Microglobulina beta-2/análiseRESUMO
Urinary MDH, LDH, gamma-GT, LAP and muramidase levels were studied in 11 healthy persons with a wide age range and in 51 male Winstar rats weighing 300 to 400 g. Normal ranges of these urinary enzymes were determined and compared with the results of other authors.
Assuntos
L-Lactato Desidrogenase/urina , Leucil Aminopeptidase/urina , Malato Desidrogenase/urina , Muramidase/urina , gama-Glutamiltransferase/urina , Animais , Ritmo Circadiano , Humanos , Masculino , Ratos , Especificidade da EspécieRESUMO
Factor XIII concentration was investigated pre- and postoperatively in the plasma of 139 patients undergoing major abdominal surgery. Postoperative complications (impairment of wound healing and haemorrhage) were significantly more frequently seen in patients with a low concentration of factor XIII. A low preoperative concentration of factor XIII can be interpreted as a high risk factor.
Assuntos
Fator XIII/análise , Hemorragia/sangue , Complicações Pós-Operatórias/sangue , Cicatrização , Feminino , Humanos , Masculino , RiscoRESUMO
The iodine fibrinogen test was evaluated using 13 different methods in 5 patients. The great variation in obtained results to assess the data makes standardization of evaluation methods imperative.
Assuntos
Fibrinogênio , Radioisótopos do Iodo , Tromboflebite/diagnóstico , Estudos de Avaliação como Assunto , Humanos , MétodosRESUMO
Isosorbide dinitrate (ISD) was administered before, during and after 178 operations performed on 127 patients with arterial occlusive disease. Its influence on postoperative myocardial infarction, heart failure and mortality was tested by comparison with 188 operations performed on 140 patients with hypertension and/or old myocardial infarction receiving no ISD prophylaxis. Risk of cardiac complications was similar in both groups. Mortality in the ISD-treated group was significantly lowered as compared with the control group and was about half of the overall mortality in patients with arterial occlusive disease operated on at our hospital over the past 10 years. This difference depended partly on the influence of ISD on cardiac complications. Post-operative myocardial infarction during ISD prophylaxis occurred in 0.6% of cases as compared with 3.7% in the control group (p less than 0.05), whilst the respective values for postoperative heart failure were 5.7% and 18.2% (p less than 0.001). Both complications are related to absolute or relative hypoxia during the post-operative stress period. ISD is effective by lowering cardiac preload and afterload and thereby diminishing myocardial oxygen demand. ISD is the drug of choice for surgical patients since it provides a steady and long-lasting effect after sublingual absorption. ISD prophylaxis during the perioperative period is indicated in cases with coronary artery disease and with increased cardiac preload or afterload.
Assuntos
Cardiopatias/prevenção & controle , Dinitrato de Isossorbida/uso terapêutico , Arteriopatias Oclusivas/cirurgia , Parada Cardíaca/prevenção & controle , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/prevenção & controle , Complicações Pós-OperatóriasRESUMO
The excretion patterns of several urinary enzymes were investigated in the following four experimental groups of Wistar rats and compared with the normal range of each urinary enzyme studied. One group received vitamin A in high dosage; a second group was given vitamin A before and after bilateral clamping of the renal artery for 30 minutes; in the third group the renal arteries were clamped for 30 or 60 minutes; the last group of experimental animals received first low (2mg/kg, 4mg/kg) and subsequently high doses (100 mg/kg) of gentamicin. Vitamin A administration produced no increase in urinary enzyme activity, even in the group of rats with ischaemically-damaged kidneys, where ischaemia (clampin of the arteries) was responsible per se for an increase in enzyme excretion. With low doses of gentamicin the urinary enzymes remained within normal limits, but increased immediately to significantly pathological values after the first dose 100 mg/kg gentamicin.
Assuntos
Gentamicinas/farmacologia , L-Lactato Desidrogenase/urina , Malato Desidrogenase/urina , Artéria Renal , Vitamina A/farmacologia , Animais , Gentamicinas/administração & dosagem , Leucil Aminopeptidase/urina , Masculino , Muramidase/urina , Ratos , Vitamina A/administração & dosagem , gama-Glutamiltransferase/urinaRESUMO
Urinary enzymes were studied in 15 patients subjected to kidney transplantation. The investigation was initiated immediately after operation and was continued for a period of between 2 and 8 weeks. There was a significant increase in urinary MDH activity in 94.2% of cases, of LDH activity in 95,65% and of gamma-GT activity in 95,17% of the cases. This detected increase in urinary enzyme activities preceded the clinical diagnosis of rejection by activities preceded the clinical diagnosis of rejection by at least 24 hours. Determination of these enzymes provides a reliable tool for the early detection of rejection crises.
Assuntos
Enzimas/urina , Transplante de Rim , Eritrócitos/enzimologia , Humanos , L-Lactato Desidrogenase/urina , Leucócitos/enzimologia , Malato Desidrogenase/urina , Transplante Homólogo , gama-Glutamiltransferase/urinaAssuntos
Esofagite/diagnóstico por imagem , Herpes Simples/diagnóstico por imagem , Infecções Oportunistas/diagnóstico por imagem , Adulto , Biópsia , Esofagite/patologia , Esôfago/diagnóstico por imagem , Esôfago/patologia , Herpes Simples/patologia , Humanos , Masculino , Infecções Oportunistas/patologia , Radiografia , Úlcera/diagnóstico por imagem , Úlcera/patologiaAssuntos
Procedimentos Cirúrgicos Operatórios/mortalidade , Idoso , Arteriosclerose/complicações , Doenças Cardiovasculares/complicações , Doenças do Sistema Nervoso Central/complicações , Transtornos Cerebrovasculares/complicações , Complicações do Diabetes , Feminino , Fraturas Ósseas/cirurgia , Cardiopatias/complicações , Quadril/cirurgia , Humanos , Hipertensão/complicações , Nefropatias/complicações , Hepatopatias/complicações , Masculino , Neoplasias/complicações , Neoplasias/cirurgia , Doenças Respiratórias/complicações , Fatores de Tempo , Ferimentos e Lesões/complicações , Ferimentos e Lesões/cirurgiaAssuntos
Cálculos Urinários/metabolismo , Cálcio/sangue , Cálcio/metabolismo , Creatinina/sangue , Creatinina/metabolismo , Creatinina/urina , Feminino , Humanos , Concentração de Íons de Hidrogênio , Magnésio/sangue , Magnésio/metabolismo , Masculino , Oxalatos/sangue , Oxalatos/metabolismo , Oxalatos/urina , Fosfatos/sangue , Fosfatos/metabolismo , Fosfatos/urina , Ureia/sangue , Ureia/metabolismo , Ureia/urina , Ácido Úrico/sangue , Ácido Úrico/metabolismo , Ácido Úrico/urina , Cálculos Urinários/sangue , Cálculos Urinários/urina , Equilíbrio HidroeletrolíticoAssuntos
Sistema Cardiovascular/efeitos dos fármacos , Derivados de Hidroxietil Amido/administração & dosagem , Substitutos do Plasma/administração & dosagem , Amido/análogos & derivados , Procedimentos Cirúrgicos Vasculares , Sangue , Coagulação Sanguínea/efeitos dos fármacos , Gasometria , Viscosidade Sanguínea , Volume Sanguíneo , Feminino , Humanos , Concentração de Íons de Hidrogênio , Rim/efeitos dos fármacos , Masculino , Pessoa de Meia-Idade , Pressão Osmótica , Cuidados Pré-Operatórios , Equilíbrio HidroeletrolíticoAssuntos
Temperatura Alta/uso terapêutico , Papiloma/terapia , Neoplasias da Bexiga Urinária/terapia , Bacitracina/uso terapêutico , Soluções Tampão , Combinação de Medicamentos , Seguimentos , Hematúria/etiologia , Hematúria/terapia , Temperatura Alta/efeitos adversos , Humanos , Leucopenia/etiologia , Métodos , Neomicina/uso terapêutico , Recidiva Local de Neoplasia/terapia , Papiloma/tratamento farmacológico , Fosfatos/uso terapêutico , Escopolamina/uso terapêutico , Cloreto de Sódio/uso terapêutico , Irrigação Terapêutica/instrumentação , Tiotepa/administração & dosagem , Tiotepa/uso terapêutico , Fatores de Tempo , Tripsina/uso terapêutico , Neoplasias da Bexiga Urinária/tratamento farmacológico , Transtornos Urinários/etiologiaAssuntos
Rim/fisiopatologia , Procedimentos Cirúrgicos Operatórios , Nitrogênio da Ureia Sanguínea , Neoplasias do Ceco/cirurgia , Criança , Creatinina/sangue , Creatinina/urina , Diurese , Humanos , Infusões Parenterais , Rim/cirurgia , Falência Renal Crônica/cirurgia , Testes de Função Renal , Nitrogênio/sangue , Nitrogênio/urina , Reto/cirurgia , Sódio/urina , Ureia/urina , Urina , Doenças Urológicas/cirurgiaRESUMO
Experimental investigations have shown that antiaggregants affect the size rather than the rate of venous thrombosis, while clinical trials with prophylactic acetylsalicylic acid have indicated primarily a reduced incidence of pulmonary embolism. Current experiences with acetylsalicylic acid in combination with dipyridamole or low-dose heparin suggest that the incidence of pathology diagnosed by 125I-fibrinogen and of deep vein thrombosis is equally reduced.