Prevention of Postoperative Deep Venous Thrombosis and Pulmonary Embolism

Abstract

was limited to one interview or occasionally two. Their prognosis tended to be worse than that of more intensively treated patients (Tables I and IV), and our results indicate that many of the patients who had only brief psychiatric contact subsequently benefited from further psychiatric treatment (Table II). The specific characteristics of patients who benefit mostand least-from psychiatric treatment will be described in a subsequent paper (Bagley and Greer, 1971).It was surprising to discover that more than one-fifth of the present series had no psychiatric contact whatsoever following their suicidal attempt. In most cases these patients were sent home because the casualty officer considered that there was no medical danger and the suicidal attempt was therefore a trivial matter. Our findings indicate that this assumption is both mistaken, since the degree of medical danger was not related to prognosis, and dangerous, since 39% of untreated patients made further suicidal attempts and 4.5% killed themselves within 18 months. These results lend force to the Central Health Services Council's (1968) recommendations: "All cases of deliberate self-poisoning should be referred to a designated poisoning centre, regardless of the seriousness or otherwise of their medical condition . . . they should never be sent home without undergoing psychiatric assessment."The present study shows that psychiatric treatment was associated with a significant fall in incidence of subsequent suicidal attempts. Since untreated patients are particularly liable to repeat suicidal attempts, and since multiple suicidal attempts increase the probability of eventual suicide (Ettlinger, 1964), it seems likely that adequate facilities for psychiatric treatment could save lives as well as reduce the repeat rate for parasuicide.We thank the patients whose co-operation made this study possible; Professor J. Anderson and Dr. D. Liddell for their encouragement; and Mr. I. Corkindale, who searched the General Register Office records for death entries.

Antimalarials in cutaneous lupus erythematosus: mechanisms of therapeutic benefit

“…128 HCQ treatment was shown to be protective against thromboembolism by Carter et al in 1971, 149 and con rmed by the same group in a randomized clinical trial of 204 post-operative orthopedic patients. 150 Although the mechanisms by which HCQ exerts an anti-thrombotic effect is not completely understood, it seems that it is caused by inhibition of platelet adhesion/aggregation, a reduction in blood viscosity and reduction in thrombus size.…”

Systemic lupus erythematosus in three ethnic groups: XVI. Association of hydroxychloroquine use with reduced risk of damage accrual

“…HCQ has also been shown in some studies to affect platelet aggregation and adhesion (66). It has been used to reduce the risk of pulmonary embolism in patients who undergo hip replacement (67, 68). In patients with SLE and antiphospholipid antibody syndrome, treatment with HCQ decreases the risk of thrombotic events (69, 70).…”

Hydroxychloroquine: past, present, future

“…35 A second role for HCQ in preventing long-term morbidity is in the prevention of thrombotic events. A potential anti-thrombotic role for HCQ in postoperative orthopedic patients was reported by Carter et al in 1971, 36 and con®rmed in a randomized clinical trial in 1974. 37 However, these studies used much higher doses of HCQ than those usually prescribed in the treatment of SLE.…”