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- Järemo, Petter, et al.
(författare)
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Individual variations of platelet inhibition after loading doses of clopidogrel
- 2002
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Ingår i: Journal of Internal Medicine. - : Wiley. - 0954-6820 .- 1365-2796. ; 252:3, s. 233-238
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Tidskriftsartikel (refereegranskat)abstract
- Objective. To investigate individual variations of platelet inhibition after clopidogrel-loading doses.Setting. Department of Cardiology, Linköping University Hospital, Linköping, Sweden.Subjects. Individuals with stable angina pectoris (n = 18) subject to percutaneous coronary interventions (PCI) and subsequent stenting were investigated.Methods and experimental protocol. A 300-mg clopidogrel loading dose was administrated immediately after stenting (day 1) followed by an additional 75 mg clopidogrel after 24 h (day 2). The ADP-evoked platelet fibrinogen binding was analysed to estimate platelet reactivity immediately before angiography and on day 2. A flow cytometry technique was used with two ADP solutions (final concentrations 0.6 and 1.7 μmol L−1) employed as platelet activating agents. Soluble P-selectin was used as a marker of platelet activity.Results. When using 1.7 μmol L−1 ADP to activate platelets four individuals had a strong inhibition (i.e. platelet reactivity <10% of the day 1-value day 2). In contrast, five patients demonstrated a weak inhibition (i.e. platelet reactivity >60% of the day 1-value day 2). Similar results were obtained when using 0.6 μmol L−1 ADP as a platelet-activating agent. Clopidogrel, however, fails to suppress platelet activity as estimated from soluble P-selectin.Conclusions. Clopidogrel evoked platelet inhibition exhibits a considerable individual heterogeneity. Some individuals only had weak responses whereas others displayed strong platelet inhibition. The present flow cytometry technique appears suitable for identifying patients with abnormal reactions after clopidogrel exposure.
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- Rajan, S., et al.
(författare)
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The Niebauer-Cutter prosthesis in excision arthroplasty of the trapezium
- 1982
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Ingår i: Journal of Hand Surgery, European Volume. - : Sage Publications. - 1753-1934 .- 2043-6289. ; 14:3, s. 295-303
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Tidskriftsartikel (refereegranskat)abstract
- Sixteen patients had excision arthroplasty of the trapezium, using the Niebauer-Cutter prosthesis. The average period of postoperative follow-up was thirteen months. All patients had severe preoperative disabilities and the majority were relieved from resting pain and pain during active use of their hands. The postoperative range of motion with regard to the palmar and radial abduction was found to be satisfactory, while varying degrees of limitation of circumduction was the rule. There was no correlation between the patients' own judgment of the postoperative benefits and the objectively measured range of motion. One patient had a luxation of the prosthesis, while another had a subluxation when opposing the thumb. This frequency of luxation/subluxation seems to be less than that experienced with the other common type of prosthesis, the Swanson prosthesis. Although it is obvious that the ideal prosthesis for treatment of disabilities in the carpometacarpal joint of the thumb is still not available, it was concluded that the Niebauer-Cutter prosthesis is the best choice at the present.
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- Rubboli, Andrea, et al.
(författare)
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Esperienza iniziale sulluso di abciximab nel trattamento di salvataggio della trombosi coronarica acuta nel Laboratorio di Emodinamica [Initial experience with the use of abciximab in the salvage treatment of acute coronary thrombosis in the Hemodynamics Laboratory]
- 1998
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Ingår i: Cardiologia (Rome, Italy). - 0393-1978. ; 43:11, s. 1221-1229
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- The optimal treatment of acute thrombotic complications in the Catheterization Laboratory has not been defined yet, due to the limited efficacy shown by various pharmacological regimens, even when associated to coronary angioplasty (PTCA). The aim of our study was therefore to evaluate the effects of abciximab (ReoPro), a new potent inhibitor of the platelet glycoprotein IIb/IIIa, when administered as a rescue treatment for acute thrombotic coronary occlusion during diagnostic or interventional procedures. Sixteen patients (12 males, 4 females, mean age 59.3 +/- 9.2 years, range 43-77 years), with unstable angina and consecutively treated with abciximab due to clinical instability attributable to coronary thrombosis angiographically proven during PTCA (9 cases) or diagnostic angiography (7 cases), were identified. The individual angiographic films and medical records were then reviewed in order to evaluate the effects of treatment on coronary flow, thrombus size and occurrence of in-hospital adverse events: death, non-fatal acute myocardial infarction (AMI), need for urgent myocardial revascularization and hemorrhage. The administration of abciximab, in association with PTCA (associated in turn with stent implantation in 8 cases), induced a significant increase of coronary TIMI flow grade (0.3 +/- 0.6 vs 2.4 +/- 0.9; p less than 0.05) and a significant decrease of thrombus score (size) 2.4 +/- 0.9 vs 1.3 +/- 0.6; p less than 0.01). No deaths nor need for urgent myocardial revascularization were observed; in 31% of cases (5 patients) evolution towards AMI occurred, while however 94% of cases (15 patients) had a coronary occlusion before treatment. No major hemorrhagic complications were observed, while in 12% of cases (2 patients) a groin hematoma associated with moderate hemoglobin drop, developed. In conclusion, the administration of abciximab, associated with the common rescue interventional procedures, in patients with acute thrombotic coronary occlusion in the Catheterization Laboratory, appears to be effective in restoring adequate coronary flow and reducing the thrombus size (limiting therefore the evolution towards AMI), and safe, not having been associated with significant hemorrhagic complications.
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- Öhlund, Carl, et al.
(författare)
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Calf compression for prevention of thromboembolism following hip surgery
- 1983
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Ingår i: Acta Orthopaedica. - : Informa Healthcare. - 1745-3674 .- 1745-3682 .- 0001-6470. ; 54:6, s. 896-899
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Tidskriftsartikel (refereegranskat)abstract
- A prospective, randomized trial of the effect of graded compression of the calf was done in 62 patients operated on electively for hip disease. After total hip arthroplasty, compression reduced the number of positive fibrinogen uptake tests by two-thirds, significant only in males, who seem to run a higher risk of thrombosis than females.
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