***TASK*** the task is to summarize an input biomedical literature in six sentences 
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    Input: To evaluate the role of low-molecular weight heparin ( LMWH ) as an alternative to oral anticoagulants in the prevention of recurrent venous thromboembolism , we compared in a r and omized trial conventional warfarin treatment with a three-month course of enoxaparin 4000 anti-Xa units once a day subcutaneously . 187 patients with symptomatic deep-vein thrombosis ( DVT ) , diagnosed by strain-gauge plethysmography plus D-dimer latex assay and confirmed by venography in most cases , were treated with full-dose subcutaneous heparin for ten days and then r and omized to secondary prophylaxis . During the 3-month treatment period , 6 of the 93 patients who received  LMWH ( 6 % ) and 4 of the 94 patients on  warfarin ( 4 % ) had symptomatic recurrence of venous thromboembolism confirmed by objective testing ( p = 0.5 ; 95 % confidence interval [ CI ] for the difference , -3 % to 7 % ) . Four patients in the LMWH group had bleeding complications as compared with 12 in the warfarin group ( p = 0.04 ; 95 % CI for the difference , 4 % to 14 % ) . In the 9-month follow-up period , during which 34 patients on warfarin prolonged treatment for other 3 months and 14 up to one year , 10 patients in the enoxaparin group and 4 patients in the warfarin group suffered a documented recurrence of venous thromboembolism . Of these 14 late recurrences , just one occurred in patients with postoperative DVT . After one year there were 16 recurrences ( 17 % ) in the LMWH group and 8 ( 9 % ) in the warfarin group ( p = 0.07 ; 95 % CI for the difference , 1 % to 16 % ) . ( ABSTRACT TRUNCATED AT 250 WORDS The aim of this study was to assess the effectiveness of low-molecular-weight heparin ( LMWH ) treatment of  deep vein thrombosis ( DVT ) in terms of the evolution of thrombosis , the incidence of adverse events , and compliance with heparin treatment using 2 types of LMWH available on the market administered in therapeutic doses throughout the period of treatment ( Nadroparin ) or at therapeutic doses only during the first month of treatment followed by a prophylactic phase at half dose ( Parnaparin ) . A r and omized prospect i ve study was carried out on patients under observation with a recent diagnosis of DVT . The objectives of the study were to confirm the effectiveness of therapy with LMWH in terms of prevention of the risk of thromboembolism , of relapse of DVT , and of hemorrhagic complications , and to complete an evaluation of venous recanalization and residual valve competence in the 2 groups of patients . From December 2002 to June 2005 , we r and omized a total of 91 patients ( 51 in the Parnaparin group and 40 in the Nadroparin group ) . Overall , there was 1 case of nonfatal pulmonary embolism ( 1.1 % ) at 7 days into therapy with LMWH . There were 3 cases ( 3.3 % ) of progression of thrombosis despite therapy with LMWH , 2 cases ( 5 % ) in the Nadroparin group , and 1 case ( 2 % ) in the Parnaparin group ( P = NS ) , and after suspension of the therapy , there was 1 case of relapse of thrombosis . Three of the 4 thrombotic events occurred in patients with active neoplasia . Moreover , only 1 major hemorrhagic event ( 1.1 % ) required blood transfusion . The Doppler ultrasound in the follow-up showed a complete resolution of 56 % of the vein thromboses at an average of 6.1 ± 4.6 ( mean ± SD ) months . Valve competence recovered in 65.9 % of cases with no significant difference between the 2 heparin groups . Home treatment of sural and femoral-popliteal DVT using LMWH represents a safe and effective method in the prevention of pulmonary embolism and encourages the process of recanalization of the thrombosed vessel , especially in cases of sural and /or popliteal DVT . Administration can be carried out with the same degree of safety at the therapeutic dose throughout the period of treatment or can be halved after the first month of treatment . In patients with active neoplasia , treatment with oral anticoagulant therapy must be considered PURPOSE The purpose of this study was to compare the efficacy and safety of treating mobile iliofemoral patients with deep venous thrombosis ( DVT ) with subcutaneous low-molecular-weight heparin ( dalteparin sodium ) either 200 IU/kg once-daily ( group 1 ) or 100 IU/kg twice-daily ( group 2 ) . METHODS Consecutive patients with suspected iliofemoral DVT diagnosed by duplex ultrasonography and verified by radionuclide venography were r and omized to one of the two low-molecular-weight heparin ( LMWH ) regimens . Perfusion and when necessary ventilation scans were performed for diagnosis of pulmonary emboli ( PE ) in all patients immediately after admission and were repeated after approximately 10 days , whereupon oral anticoagulation was started unless contraindicated . Minimal and maximal anti-factor Xa activity was measured after 2 to 3 days of therapy . All patients were kept mobile with compression b and ages . The primary end point was reduction in frequency of PE as assessed on the second lung scan . RESULTS A total of 140 patients with confirmed DVT were r and omized , 76 to group 1 and 64 to group 2 . The two groups were comparable in their baseline clinical characteristics . In the initial lung scans 36 ( 47.4 % ) patients in group 1 and 29 ( 45.3 % ) patients in group 2 had objective ly verified PE , but only 11 ( 14.5 % ) and 8 ( 12.5 % ) patients , respectively , had symptoms . After dalteparin treatment PE disappeared in two patients in group 1 , but in two other cases new PEs occurred , ( NS ) . In group 2 a resolution of PEs was observed in eight patients , whereas only one new PE could be detected . This change reflects the efficacy of therapy as defined by resolution of existing PEs and by the occurrence of new PEs and is statistically significant according to McNemar 's chi-square test with the exact binomial method pair procedure ( p < 0.05 ) . Symptomatic PE was reduced from 14.5 % to 5.3 % in group 1 ( 96 % to CI for the difference , -1.5 % to + 17.3 % ) and from 12.5 % to 1.6 % in group 2 ( 95 % CI for the difference 0.7 % to 18 % , p < 0.05 ) . There was one single fatal PE , one serious and three minor bleeding episodes in group 1 , and one minor bleeding episode in group 2 ( 95 % CI for the difference : -3.6 % to + 8.1 % ) . CONCLUSIONS Treatment of ambulant iliofemoral patients with DVT with 100 IU/kg dalteparin twice-daily appears to be moe safe and effective than 200 IU/kg given once-daily . Bed rest is not necessary for treating mobile patients Treatment of deep venous thrombosis with low molecular weight heparin ( LMWH-Novo , Logiparin ) was carried out with two different doses of Logiparin , 75 XaI U/kg b.w . twice daily and 150 XaI U/kg b.w . once daily subcutaneously for 5 days . Simultaneously warfarin was given from the first day of heparin treatment . Mean age of the twenty patients was 65 years and one third was females .  No serious side effects , hematomas , pulmonary emboli or signs of recurrent thrombosis occurred during treatment with either dose regime . Venografic assessment with Marder scoring one week after initiation of Logiparin treatment showed a slight not significant improvement apparent in 40 % of the patients . The activities of F-IIaI and F-XaI in the blood plasma were found to increase after injection of Logiparin . These two parameters seem to be the most suitable for monitoring the effect during treatment . For future studies on the therapeutic effect of Logiparin in deep venous thrombosis a single dose of 150 to 200 F-XaI activity per 24 hours seems to be most suitable INTRODUCTION Trials comparing the use of full dose unfractionated heparin ( UFH ) or low molecular weight heparins ( LMWHs ) in very elderly patients with impaired renal function are lacking . IRIS aim ed to assess whether LMWH is at least as safe as UFH in this population . MATERIAL S AND METHODS The study included renally impaired patients ≥70 years with acute symptomatic lower limb deep vein thrombosis ( DVT ) . Patients were r and omized to initial treatment with either tinzaparin 175 IU/kg once daily ( n=269 ) or activated partial thromboplastin time-adjusted UFH twice daily ( n=270 ) . After acute management both groups received vitamin K antagonist to day 90 . RESULTS The trial was stopped prematurely due to a difference in mortality favoring the UFH group ( 11.5 vs. 6.3 % ; p=0.035 ) . Rates of clinical ly relevant bleedings by day 90 were similar in the tinzaparin ( 11.9 % ) and UFH ( 11.9 % ) groups , as were rates of confirmed recurrent venous thromboembolism ( VTE ) ( 2.6 vs. 1.1 % ; p=0.34 ) . As the mortality difference could not be explained by bleedings or recurrent VTE , a post-hoc analysis was performed . This identified six baseline characteristics significantly correlated with mortality , of which five were over-represented in the tinzaparin group . CONCLUSION The IRIS study was a challenging study involving patients ( mean age 83 years ) usually excluded from clinical studies , but its early termination has left questions unanswered . The mortality difference observed with tinzaparin vs. UFH in elderly , renally-impaired patients with DVT can not be explained on the basis of bleedings or recurrent VTE , and may reflect an imbalance of mortality risk factors at baseline BACKGROUND Optimal doses and duration of low-molecular-weight heparin ( LMWH ) for the treatment of superficial vein thrombosis ( SVT ) are still uncertain . OBJECTIVES To compare the efficacy and safety of different doses and duration s of LMWH parnaparin for symptomatic lower limb SVT . PATIENTS AND METHODS Out patients with at least a 4-cm-long SVT of long or short saphenous veins or their collaterals were r and omized to receive parnaparin either 8500 UI once daily ( o.d . ) for 10 days followed by placebo for 20 days ( group A ) or 8500 UI o.d . for 10 days followed by 6400 UI once daily ( o.d . ) for 20 days ( group B ) or 4250 UI o.d . for 30 days ( group C ) in a double-blind fashion in 16 clinics . Primary outcome was the composite of symptomatic and asymptomatic deep vein thrombosis ( DVT ) , symptomatic pulmonary embolism ( PE ) and relapse and /or symptomatic or asymptomatic SVT recurrence in the first 33 days with 60 days follow-up . RESULTS Among 664 patients , primary outcome occurred in 33/212 ( 15.6 % ) , 4/219 ( 1.8 % ) and 16/217 ( 7.3 % ) subjects in groups A , B and C , respectively ( B vs. A : absolute risk reduction [ ARR ] : 13.7 % , 95 % confidence intervals [ CI ] : 8 - 18.9 P<0.001 ; B vs. C : ARR : 5.5 % ; 95 % CI : 1.6 - 9.4 P= 0.011 ; C vs. A : ARR : 8.2 % , 95 % CI : 2 - 14 P=0.012 ) . During days 0 - 93 , the event rate was higher in group A ( 22.6 % ) than either in group B ( 8.7 % ; P=0.001 ) or C ( 14.3 % , P=0.034 ) . No major hemorrhages occurred . CONCLUSIONS An intermediate dose of parnaparin for 30 days is superior to either a 30-day prophylactic dose or a 10-day intermediate dose for lower limb SVT treatment Treatment monitoring based on a laboratory parameter increases the efficacy and safety of st and ard heparin therapy , but it is not known if this also applies to low-molecular-weight heparin ( LMWH ) therapy of acute deep vein thrombosis ( DVT ) . In a prospect i ve r and omized trial involving 122 consecutive patients , group A ( 58 patients ) received a weight adjusted dose of Fragmin ( 100 IU/kg ) subcutaneously twice a day throughout the treatment period ( 10 days + /- 1 ) , while in group B ( 64 patients ) the dosage was based on the results of an anti factor Xa ( anti Xa ) amidol 
    Output:
    
AUTHORS ' CONCLUSIONS Once daily treatment with LMWH is as effective and safe as twice daily treatment with LMWH