ABSTRACT
In order to evaluate the usefulness of determining D-dimer and thrombin-antithrombin III complex (TAT) in the diagnosis of deep venous thrombosis (DVT), three D-dimer assays were tried: one ELISA and one latex test from Diagnostica Stago and one new latex method from Biopool. TAT was assessed using an ELISA (Behringwerke). We studied 96 consecutive outpatients with suspected DVT, of whom 36 had phlebographically confirmed DVT. Statistical calculations showed high sensitivity and a negative predictive value for the D-dimer ELISA (97% for both), confirming the results obtained by others. The new latex method (Biopool) showed similar figures (96% for both). The latex method from Diagnostica Stago and TAT showed lower sensitivity and negative predictive values. No differences in the D-dimer results were found with or without antifibrinolytics in the tubes for blood sampling. Our data suggest that negative results when using the new simple and cheap latex method (Biopool) may reduce the number of phlebographic examinations.
Subject(s)
Antithrombin III/analysis , Fibrin Fibrinogen Degradation Products/analysis , Peptide Hydrolases/analysis , Thrombophlebitis/diagnosis , Adult , Aged , Aged, 80 and over , Enzyme-Linked Immunosorbent Assay , Female , Humans , Latex Fixation Tests , Male , Middle Aged , Phlebography , Predictive Value of Tests , Sensitivity and Specificity , Thrombophlebitis/diagnostic imagingABSTRACT
Restorative proctocolectomy with an ileal pouch-anal anastomosis preserves anal sphincters, the normal route of defaecation and the normal body image and it has been suggested that the procedure might be associated with less gynaecological and sexual problems than conventional proctocolectomy. To shed further light on this subject 60 female patients were invited to participate in a study comprising a detailed interview, examination by a gynaecologist and investigation with hysterosalpingography and vaginography. Twenty-one women with a mean follow-up of 38 months after surgery agreed to participate. Their gynaecological state was considered normal although one woman complained of vaginal discharge. Five women experienced occasional dyspareunia and 2 patients had to take special precautions to avoid bowel leaks at intercourse. While the position of the vagina and uterus in the pelvis appeared normal, hysterosalpingography disclosed bilateral occlusion of the fallopian tubes in 2 and unilateral occlusion in another 9 patients with tubes adhering to the bottom of the lesser pelvis in 10 of the patients. Only one out of 14 patients succeeded in trying to conceive during the follow-up period. Among the remaining 39 women not specially studied 5 out of 14 had conceived after the operation.
Subject(s)
Infertility, Female/etiology , Menstruation Disturbances/etiology , Postoperative Complications/epidemiology , Proctocolectomy, Restorative , Sexual Dysfunction, Physiological/etiology , Adult , Female , Humans , Hysterosalpingography , Postoperative Complications/etiology , Surveys and Questionnaires , Vagina/diagnostic imagingABSTRACT
The vagina, uterus and adnexa of 21 women who had a proctocolectomy for ulcerative colitis or Crohn's colitis were examined with vaginography and hysterosalpinography. Six healthy women were used as controls. A characteristic post-operative deformation of the adnexa and the vagina was demonstrated. In 17 of 21 women the fallopian tube anatomy was pathological, in four cases with total obstruction. These abnormalities explain why vaginal discharge, dyspareunia and involuntary sterility are common complaints in women after this type of surgery.
