Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis
-
Clin. Appl. Thromb. Hemost. · Dec 2009
Clinical TrialUse of heparin in women with early and late miscarriages with and without thrombophilia.
In women with a history of recurrent miscarriage, the risk of miscarriage in a subsequent pregnancy is about 30% to 40%. In patients with thrombophilia, the risk is even higher. Placental thrombosis has been found in women with unexplained recurrent miscarriage independent of thrombophilia. In addition, proinflammatory changes, for example, altered Th1 to Th2 cytokine ratio and complement activation, have been repeatedly demonstrated in these women. Because of the fact that heparin has both anticoagulative and anti-inflammatory effects, the current study evaluated the efficacy of low-molecular-weight heparin (LMWH) in unexplained abortions. ⋯ Our data support the notion that LMWH is efficacious in patients with recurrent abortions and thrombophilia. We demonstrated the same effect of LMWH in women with unexplained abortions without thrombophilia. The potential mechanism of action of LMWH in early and late abortions warrants further study.
-
Clin. Appl. Thromb. Hemost. · Dec 2009
Case ReportsAcute massive pulmonary embolism with hemodynamic compromise treated successfully with thrombolytic therapy.
A 78 year-old woman presented with a history of 15 days of dyspnea and tachypnea at rest. A distended right ventricle with free-wall hypokinesis and displacement of the interventricular septum toward the left ventricle were shown on echocardiography. ⋯ With the diagnosis of pulmonary embolism confirmed, recombinant tissue plasminogen activator was given immediately in the catheterization room. This case shows how pulmonary embolism can be diagnosed with pulmonary angiography during cardiopulmonary resuscitation and the life-saving result from rapid thrombolysis with recombinant tissue plasminogen activator.
-
Clin. Appl. Thromb. Hemost. · Dec 2009
Effect of recombinant activated factor VII in critical bleeding: clinical experience of a single center.
Recombinant activated factor VII (rFVIIa) has been successfully used ''off-label'' in patients with refractory life-threatening hemorrhage. Intravenous rFVIIa was given to 31 patients unresponsive to standard therapy with blood products and surgical reexploration, who were bleeding due to trauma, surgery, organ transplantation, liver cirrhosis, ruptured uterus. ⋯ Four patients had adverse events potentially related to rFVIIa. The survival rates after 1 and 30 days were 48.4% and 29.1%, respectively.