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May 3, 1965

Dextran vs Heparin in Thrombophlebitis

Author Affiliations

Commander and Director US Army Surgical Research Unit Brooke Army Medical Center Fort Sam Houston, Tex

JAMA. 1965;192(5):426. doi:10.1001/jama.1965.03080180084043

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To the Editor:—  I appreciate very much the interest manifested by Drs. Gurewich and Thomas. In general, the points made by their letter are valid ones as far as they go. While I realize there are limitations to what one can include in such a letter, it appears there are obvious omissions.The term "nonembolic thrombophlebitis" is certainly a legitimate one and used simply to indicate that significant clinical evidence of embolization had not occurred in the treatment group, except in those patients who were considered too poor a risk for surgery and were failures on heparin anticoagulant therapy. We do not feel anything short of effective surgical intervention is to be recommended in the embolic cases. Should Drs. Gurewich and Thomas feel heparin alone is the therapy of choice here, they certainly are in the small minority.While the effect of heparin on certain aspects of altered pulmonary physiology

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