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https://www.readbyqxmd.com/read/28520085/assessment-of-the-relationship-between-body-mass-index-and-incidence-of-venous-thromboembolism-in-hospitalized-overweight-and-obese-patients
#1
Sophie Samuel, Leigh Gomez, Jude P Savarraj, Suhas Bajgur, Huimahn A Choi
STUDY OBJECTIVE: To assess whether a positive linear association exists between body mass index (BMI) and incidence of venous thromboembolism (VTE) in overweight and obese hospitalized patients. DESIGN: Single-center retrospective observational cohort study. SETTING: Large academic tertiary care medical center. PATIENTS: A total of 1452 adults hospitalized between January 1, 2013, and December 31, 2014, who weighed more than 100 kg and had a BMI of 25 kg/m(2) or greater on admission, and received heparin subcutaneously for VTE prophylaxis...
May 18, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28511582/evaluation-of-an-unfractionated-heparin-pharmacy-dosing-protocol-for-the-treatment-of-venous-thromboembolism-in-nonobese-obese-and-severely-obese-patients
#2
Lindsey M Hosch, Emily Y Breedlove, Lauren E Scono, Chad A Knoderer
BACKGROUND: Despite large interpatient variability in dose response, heparin is utilized for treatment of venous thromboembolism (VTE). Current data on the optimal heparin dosing in obese patients are conflicting. OBJECTIVE: The objective was to evaluate the time and dose required to achieve a therapeutic activated partial thromboplastin time (aPTT) in nonobese, obese, and severely obese patients using a pharmacist-directed heparin dosing protocol. METHODS: This was a retrospective cohort study in a single-center community hospital inpatient setting...
May 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28460259/adjusted-value-of-thromboprophylaxis-in-hospitalized-obese-patients-a-comparative-study-of-two-regimens-of-enoxaparin-the-itohenox-study
#3
Sébastien Miranda, Véronique Le Cam-Duchez, Jacques Benichou, Nathalie Donnadieu, Virginie Barbay, Maelle Le Besnerais, François-Xavier Delmas, Antoine Cuvelier, Hervé Lévesque, Ygal Benhamou, Guillaume Armengol
Thromboprophylaxis is a mainstay of hospital care in patients at high risk of thrombosis. Fixed doses of low-molecular-weight heparin (LMWH) are recommended for thromboprophylaxis in patients admitted to hospital for an acute medical condition. However, the distribution of LMWH is weight-based, and the efficacy of standard doses in obese patients may be decreased. Data for obese patients are mainly available in bariatric surgery with extremely obese patients who are at greater risk of venous thromboembolism than those hospitalized for a medical condition...
April 12, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28455803/experience-with-an-enhanced-recovery-after-surgery-eras-program-for-bariatric-surgery-comparison-of-mgb-and-lsg-in-374-patients
#4
Marie-Cécile Blanchet, Benoît Gignoux, Yann Matussière, Alexandre Vulliez, Thomas Lanz, Fabienne Monier, Vincent Frering
BACKGROUND: Strategic multidisciplinary protocols for "enhanced recovery after surgery" (ERAS) have demonstrated reductions in length of hospital stay (LOS), morbidity, and costs in conjunction with bariatric procedures. METHODS: We prospectively investigated the effectiveness and safety of an ERAS protocol with laparoscopic omega loop gastric bypass ("mini" gastric bypass, MGB) and LSG in morbidly obese patients. RESULTS: Average LOS was 1...
April 28, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28440519/-prevention-diagnosis-and-treatment-of-perioperative-complications-of-bariatric-and-metabolic-surgery
#5
Haifu Wu, Ming Zhong, Di Zhou, Chenye Shi, Heng Jiao, Wei Wu, Xinxia Chang, Jing Cang, Hua Bian
Surgical operation in treating obesity and type 2 diabetes is popularizing rapidly in China. Correct prevention and recognition of perioperation-related operative complications is the premise of ensuring surgical safety. Familiar complications of the operation include deep venous thrombosis, pulmonary artery embolism, anastomotic bleeding, anastomotic fistula and marginal ulcer. The prevention of deep venous thrombosis is better than treatment. The concrete measures contain physical prophylaxis (graduated compression stocking and intermittent pneumatic compression leg sleeves) and drug prophylaxis (unfractionated heparin and low molecular heparin), and the treatment is mainly thrombolysis or operative thrombectomy...
April 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28395380/streptozotocin-treated-high-fat-fed-mice-a-new-type-2-diabetes-model-used-to-study-canagliflozin-induced-alterations-in-lipids-and-lipoproteins
#6
Tian Yu, Mitchell J Sungelo, Ira J Goldberg, Hong Wang, Robert H Eckel
The pharmacological effects of type 2 diabetes (T2DM) medications on lipoprotein metabolism are difficult to assess in preclinical models because those created failure to replicate the human condition in which insulin deficiency is superimposed on obesity-related insulin resistance. To create a better model, we fed mice with high fat (HF) diet and treated the animals with low dose streptozotocin (STZ) to mimic T2DM. We used this model to evaluate the effects of canagliflozin (CANA), a drug that reduces plasma glucose by inhibiting the sodium-glucose transporter 2 (SGLT2), which mediates ~90% of renal glucose reabsorption] on lipid and lipoprotein metabolism...
May 2017: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
https://www.readbyqxmd.com/read/28331932/pulmonary-embolism-and-in-situ-pulmonary-artery-thrombosis-in-paediatrics-a-systematic-review
#7
Madhvi Rajpurkar, Tina Biss, Ernest Amankwah, Denise Martinez, Suzan Williams, C Heleen Van Ommen, Neil A Goldenberg
Data on paediatric pulmonary embolism (PE) are scarce. We sought to systematically review the current literature on childhood PE and conducted a search on paediatric PE via PubMed (1946-2013) and Embase (1980-2013). There was significant heterogeneity in reported data. Two patterns were noted: classic thromboembolic PE (TE-PE) and in situ pulmonary artery thrombosis (ISPAT). Mean age of presentation for TE-PE was 14.86 years, and 51 % of cases were males. The commonest method for diagnosis of TE-PE was contrast CT with angiography (74 % of patients)...
March 23, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28326488/is-lmwh-sufficient-for-anticoagulant-prophylaxis-in-bariatric-surgery-prospective-study
#8
Farraj Moaad, Bramnik Zakhar, Kvasha Anton, Merie Moner, Sbeit Wisam, Farraj Safy, Waksman Igor
BACKGROUND: The objective of this study was to evaluate the coagulation profile by thromboelastography in morbidly obese patients who undergo bariatric surgery. Morbid obesity entails increased risk for thromboembolic events. There is no clear protocol for thromboembolic prophylaxis, regarding timing and length of treatment, in bariatric surgery. Thromboelastography provides data on a coagulation process from creation of the clot until the fibrinolysis. METHODS: Ninety-three morbidly obese patients were prospectively recruited within a 2-year period...
March 22, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28294347/nadroparin-carries-a-potentially-high-risk-of-inducing-cutaneous-delayed-type-hypersensitivity-responses
#9
Marc Schindewolf, Andreas Recke, Detlef Zillikens, Edelgard Lindhoff-Last, Ralf J Ludwig
BACKGROUND: Heparins are widely used for the prophylaxis/treatment of thromboembolic events. As adverse effects, heparin-induced skin lesions occur frequently (in 7.5-39% of patients). Skin lesions may be the only clinical manifestation of life-threatening immune-mediated heparin-induced thrombocytopenia, but are commonly caused by a delayed-type hypersensitivity response [heparin-induced delayed-type hypersensitivity (HIHS)]. Risk factors have not been prospectively identified. OBJECTIVES: To identify possible risk factors for heparin-induced skin lesions from three independent clinical trials in a combined analysis...
March 14, 2017: Contact Dermatitis
https://www.readbyqxmd.com/read/28290648/deep-venous-thrombosis-and-pulmonary-embolism-current-therapy
#10
Jason Wilbur, Brian Shian
Pulmonary embolism and deep venous thrombosis are the two most important manifestations of venous thromboembolism (VTE), which is the third most common life-threatening cardiovascular disease in the United States. Anticoagulation is the mainstay of VTE treatment. Most patients with deep venous thrombosis or low-risk pulmonary embolism can be treated in the outpatient setting with low-molecular-weight heparin and a vitamin K antagonist (warfarin) or direct-acting oral anticoagulants. Inpatient treatment of VTE begins with parenteral agents, preferably low-molecular-weight heparin...
March 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/28203409/practice-patterns-in-venous-thromboembolism-vte-prophylaxis-in-thoracic-surgery-a-comprehensive-canadian-delphi-survey
#11
John Agzarian, Lori-Ann Linkins, Laura Schneider, Waël C Hanna, Christian J Finley, Colin Schieman, Marc De Perrot, Mark Crowther, James Douketis, Yaron Shargall
BACKGROUND: The incidence of venous thromboembolic events (VTE) after resection of thoracic malignancies can reach 15%, but prophylaxis guidelines are yet to be established. We aimed to survey Canadian practitioners regarding perioperative risk factors for VTE, impact of those factors on extended prophylaxis selection, type of preferred prophylaxis, and timing of initiation and duration of thromboprophylaxis. METHODS: A modified Delphi survey was undertaken over three rounds with thoracic surgeons, thoracic anesthesiologists and thrombosis experts across Canada...
January 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28158916/acute-recapitulation-of-the-hyperinsulinemia-and-hyperlipidemia-characteristic-of-metabolic-syndrome-suppresses-gonadotropins
#12
Justin Chosich, Andrew P Bradford, Amanda A Allshouse, Jane E B Reusch, Nanette Santoro, Irene E Schauer
OBJECTIVE: To determine the effect of lipid/heparin versus saline infusion, with or without concurrent euglycemic hyperinsulinemia, on serum follicle-stimulating hormone (FSH) and luteinizing hormone (LH). Obesity is associated with hyperlipidemia, insulin resistance, and relative hypogonadotropic hypogonadism. It was hypothesized that acutely elevated fatty acids and insulin would impair gonadotropin secretion. METHODS: Regularly cycling women and men without obesity underwent a crossover 6-hour infusion study over four visits...
March 2017: Obesity
https://www.readbyqxmd.com/read/28107569/higher-maximum-doses-and-infusion-rates-compared-with-standard-unfractionated-heparin-therapy-are-associated-with-adequate-anticoagulation-without-increased-bleeding-in-both-obese-and-nonobese-patients-with-cardiovascular-indications
#13
Catherine K Floroff, Nicole M Palm, Daniel H Steinberg, Eric R Powers, Barbara S Wiggins
STUDY OBJECTIVE: To evaluate the time to achieve therapeutic activated partial thromboplastin time (aPTT) values and occurrence of bleeding based on standard unfractionated heparin (UFH) weight-based dosing recommendations compared with an aggressive weight-based UFH dosing strategy using higher maximum doses and infusion rates in both obese and nonobese patients who presented with non-ST-segment elevation myocardial infarction or unstable angina (NSTEMI/UA) or atrial fibrillation. DESIGN: Retrospective cohort study...
April 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28097621/practice-patterns-of-venous-thromboembolism-prophylaxis-in-underweight-critically-ill-patients-with-neurologic-injury
#14
Kevin Betthauser, Hannah Pope, Mollie Gowan, Theresa Human
PURPOSE: Venous thromboembolism (VTE) prophylaxis in underweight patients with neurologic injury remains unaddressed by guidelines and primary literature. This study aimed to describe VTE prophylaxis strategies employed in this population and compare the impact of underweight and non-obese patients on thrombotic and bleeding events. METHODS: A retrospective review of adults admitted with a diagnosis of neurologic injury to a neurology/neurosurgery intensive care unit (ICU) over 6 years...
January 17, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28070821/evaluation-of-safety-and-effectiveness-of-standardized-antifactor-xa-based-unfractionated-heparin-protocols-in-obese-versus-non-obese-patients
#15
Manuel Isherwood, Michelle L Murphy, Angela L Bingham, Laura A Siemianowski, Krystal Hunter, James M Hollands
Recent data have suggested that standard unfractionated heparin (UFH) protocols may over-anticoagulate obese patients. The goal of this retrospective study was to observe differences in anticoagulation parameters and safety outcomes for standardized antifactor Xa UFH protocols in obese and non-obese populations. Obese patients (N = 148) were identified over a 20-month period and matched to 148 non-obese patients based on age, gender, and admission date. Patients were included if they were on one of three approved UFH protocols [high (target antifactor Xa 0...
May 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28065766/changes-in-one-year-mortality-in-elderly-patients-admitted-with-acute-myocardial-infarction-in-relation-with-early-management
#16
Etienne Puymirat, Nadia Aissaoui, Guillaume Cayla, Alexandre Lafont, Elisabeth Riant, Marco Mennuni, Olivier Saint-Jean, Didier Blanchard, Patrick Jourdain, Meyer Elbaz, Patrick Henry, Vincent Bataille, Elodie Drouet, Geneviève Mulak, François Schiele, Jean Ferrières, Tabassome Simon, Nicolas Danchin
BACKGROUND: Elderly patients are underrepresented in acute myocardial infarction trials. Our aim was to determine whether, in elderly patients, changes in management in the past 15 years are associated with improved 1-year mortality after hospital admission for myocardial infarction. METHODS: We used data from 4 1-month French registries, conducted 5 years apart from 1995 to 2010, including 3389 elderly patients (≥75 years of age). RESULTS: From 1995 to 2010, mean age remained stable (82...
January 5, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28044236/vascular-adhesion-protein-1-in-hemodialysis-and-hemodiafiltration-patients-effect-of-single-hemodialysis-session-on-its-level-in-regard-to-type-of-anticoagulant
#17
Jolanta Malyszko, Ewa Koc-Zorawska, Piotr Kozminski, Jacek S Malyszko
PURPOSE: Traditional anticoagulants used in intermittent hemodialysis (HD) are unfractionated heparin (UFH) and increasingly low molecular weight heparins (LMWHs). Repeated and prolonged exposure to UFH and/or LMWHs may further disturb hemostasis in uremic patients. Vascular adhesion protein-1 (VAP-1) is secreted by vascular smooth muscle cells, adipocytes and endothelial cells with functional monoamine oxidase activity and is elevated in atherosclerosis, diabetes mellitus and obesity...
May 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28031644/ineffective-treatment-of-low-molecular-weight-heparin-in-obese-subject-with-traumatic-fractures-of-the-leg
#18
Egidio Imbalzano, Michele Creazzo, Giovanni Trapani, Giuseppina Lizio, Antonino Saitta
American College of Chest Physicians Evidence-Based Clinical Practice Guidelines, 9th edition, 2012, suggest no prophylaxis rather than pharmacological thromboprophylaxis in management of venous thromboembolism (VTE) risk of isolated lower leg injuries distal to knee requiring leg immobilization. Low-molecular-weight heparin (LMWH) is a class of drugs commonly used as antithrombotics in surgery and in case of prolonged bed rest and hypomobility. A 35-year-old obese man with no history of health disease (height, 170 cm; weight, 95 kg; and body mass index, 32...
December 2016: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/27994886/does-obesity-predispose-medical-intensive-care-unit-patients-to-venous-thromboembolism-despite-prophylaxis-a-retrospective-chart-review
#19
Bradley J Peters, Ross A Dierkhising, Kristin C Mara
Background. Obesity is a significant issue in the critically ill population. There is little evidence directing the dosing of venous thromboembolism (VTE) prophylaxis within this population. We aimed to determine whether obesity predisposes medical intensive care unit patients to venous thromboembolism despite standard chemoprophylaxis with 5000 international units of subcutaneous heparin three times daily. Results. We found a 60% increased risk of venous thromboembolism in the body mass index (BMI) ≥ 30 kg/m(2) group compared to the BMI < 30 kg/m(2) group; however, this difference did not reach statistical significance...
2016: Critical Care Research and Practice
https://www.readbyqxmd.com/read/27861210/symptomatic-venous-thromboembolism-after-adolescent-knee-arthroscopy
#20
Robert F Murphy, Benton Heyworth, Dennis Kramer, Manahil Naqvi, Patricia E Miller, Yi-Meng Yen, Mininder S Kocher, Benjamin J Shore
BACKGROUND: The frequency of knee arthroscopy procedures is increasing in pediatric and adolescent patients. In general, complications after these procedures in adolescents are uncommon. The purposes of this study are to report the incidence of venous thromboembolism (VTE) in adolescent patients after knee arthroscopy procedures, as well identify risk factors in this patient population. METHODS: Medical records were reviewed in all pediatric and adolescent patients (≤19 y) who underwent an arthroscopic knee procedure from 2010 to 2014 and were diagnosed with a symptomatic VTE in the postoperative period...
November 17, 2016: Journal of Pediatric Orthopedics
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