ABSTRACT
Efficacy and safety of a low molecular weight heparin (Alfa LMWH) was compared with unfractionated heparin (UFH) in the prevention of post-operative venous thromboembolism after hip fractures. Forty-nine patients were randomized to treatment with Alfa LMWH 7500 anti-Xa coagulometric units twice daily or with UFH 5000 IU t.i.d. Screening for thrombosis was performed with 125-I-fibrinogen leg scanning and strain-gauge plethysmography. Positive results were confirmed by venography. Five patients in the Alfa LMWH group (20 per cent) developed venographycally proven deep vein thrombosis (DVT) versus seven (29 per cent) in the UFH group. One pulmonary embolism and two deaths occurred in the UFH group and none in the LMWH group. No differences in haemorrhagic complications and blood loss indices were observed. Alfa LMWH appears to be a promising drug for prevention of venous thromboembolism after orthopaedic surgery. A "flexible" schedule of administration is proposed on the basis of the results of plasma anti-Xa assays.
Subject(s)
Heparin, Low-Molecular-Weight/administration & dosage , Heparin/administration & dosage , Hip Fractures/surgery , Postoperative Complications/prevention & control , Thrombophlebitis/prevention & control , Aged , Aged, 80 and over , Blood Coagulation Tests , Female , Heparin/adverse effects , Heparin, Low-Molecular-Weight/adverse effects , Humans , Male , Randomized Controlled Trials as TopicABSTRACT
The authors report follow-up observations for a case of isolated leukemic uveopathy that was first diagnosed in an 11-year-old girl shortly after cessation of treatment for acute lymphoblastic leukemia (ALL). Prior therapy for the complication included systemic antiblastic chemotherapy and low doses of radiation (3.9 Gy) to the affected eye. In July 1979, 2 months after chemotherapy was stopped for the second time, she presented with recurrent leukemic hypopyon in the left eye and was treated again with antiblastic chemotherapy followed in 1 year by high-dose (20 Gy) local irradiation. After a third recurrence, which was diagnosed as pre-B/B-cell ALL with a variable position of maturation arrest, enucleation was performed. The patient remains in complete remission for 26+ months after an additional course of systemic chemotherapy. This case illustrates the difficulty of eradicating leukemic cells from the eye with conventional treatment but suggests that a relapse in this site is not necessarily an ominous prognostic sign.
Subject(s)
Eye Neoplasms/pathology , Leukemia, Lymphoid/pathology , Neoplasm Recurrence, Local/pathology , Adult , Anterior Chamber , Eye Neoplasms/radiotherapy , Female , Humans , Leukemia, Lymphoid/radiotherapy , Neoplasm Recurrence, Local/radiotherapy , SuppurationABSTRACT
A 7-year-old girl was successfully treated for acute lymphoblastic leukaemia, and remained in remission after treatment had been completed in 3 years. Four months after cessation of treatment, iridocyclitis with hypopyon developed in one eye. Exudate from the anterior chamber contained numerous lymphoblasts. Local radiotherapy led to complete resolution of the ocular lesions, and the patient remains well 22 months later.
