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https://www.readbyqxmd.com/read/29764885/compliance-with-current-vte-prophylaxis-guidelines-and-risk-factors-linked-to-complications-of-vte-prophylaxis-in-medical-inpatients-a-prospective-cohort-study-in-a-spanish-internal-medicine-department
#1
Ignacio Novo-Veleiro, Lucía Alvela-Suárez, Alba Costa-Grille, Javier Suárez-Dono, Fernando Ferrón-Vidan, Antonio Pose-Reino
OBJECTIVES: To evaluate the degree of compliance with the current guidelines regarding venous thromboembolism (VTE) prophylaxis in medical patients during admission and to identify risk factors linked to complications of VTE prophylaxis. DESIGN: Prospective cohort study. SETTING: The Internal Medicine Department of the University Hospital of Santiago de Compostela (tertiary referral hospital). PARTICIPANTS: A total of 396 hospitalised, elderly patients who did not undergo surgery and had no active or previous oral anticoagulation or low molecular weight heparin (LMWH) treatment (during the previous year) and who received VTE prophylaxis during admission...
May 14, 2018: BMJ Open
https://www.readbyqxmd.com/read/29754385/four-year-evolution-of-a-thrombophylaxis-protocol-in-an-enhanced-recovery-after-surgery-eras-program-recent-results-in-485-patients
#2
Marie-Cécile Blanchet, Vincent Frering, Benoît Gignoux, Yann Matussière, Philippe Oudar, Romain Noël, Alban Mirabaud
"Enhanced recovery after surgery" (ERAS) protocols may reduce morbidity, length of hospital stay (LOS), and costs. During the 4-year evolution of a bariatric ERAS protocol, we found that administration of thrombophylaxis selectively to high-risk morbidly obese patients (assessed postoperatively by Caprini score ≥ 3) undergoing omega loop gastric bypass ("mini" gastric bypass) or sleeve gastrectomy resulted in safe outcomes. Both procedures proved equally effective with this protocol...
May 12, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29709455/the-approach-to-peripartum-management-of-anticoagulation-a-multidisciplinary-survey
#3
Sagar Rohailla, Ann Kinga Malinowski, Shital Gandhi, Anne McLeod, Rosane Nisenbaum, Nadine Shehata
OBJECTIVE: This study sought to determine whether there is practice variation in the treatment and prevention of acute venous thromboembolism (VTE) in pregnant patients, potentially to prioritize future studies. BACKGROUND: The risk of VTE during pregnancy is five-fold that of the non-pregnant state. Guidance is often lacking for the treatment and prophylaxis of VTE because there are few RCTs. METHODS: The study used a cross-sectional study design using a self-administered electronic questionnaire consisting of 11 case scenarios that were sent to hematologists, maternal-fetal medicine specialists, obstetricians and gynaecologists, and internal medicine specialists across Canada...
April 27, 2018: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/29697459/the-effect-of-obesity-on-the-rate-of-heparin-induced-thrombocytopenia
#4
Jacob L Marler, G Morgan Jones, Brian J Wheeler, Abdulrahman Alshaya, Jonathan L Hartmann, Carrie S Oliphant
: Heparin-induced thrombocytopenia (HIT) occurs in patients receiving heparin-containing products due to the formation of platelet-activating antibodies to heparin and platelet factor 4. Diagnosis includes utilization of a scoring system known as the 4-T score, and HIT laboratory assays. Recently, obesity was identified as a potential factor associated with the development of HIT. The objective of this study was to evaluate the association of HIT with obesity in ICU and general medicine patients. We performed a chart review of adult patients within the Methodist Healthcare System, and included patients who had an ELISA and serotonin release assay laboratory tests reported within same hospital admission in which they also had documented receipt of heparin...
April 24, 2018: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/29693598/inulin-improves-postprandial-hypertriglyceridemia-by-modulating-gene-expression-in-the-small-intestine
#5
Sophie Hiel, Audrey M Neyrinck, Julie Rodriguez, Barbara D Pachikian, Caroline Bouzin, Jean-Paul Thissen, Patrice D Cani, Laure B Bindels, Nathalie M Delzenne
Postprandial hyperlipidemia is an important risk factor for cardiovascular diseases in the context of obesity. Inulin is a non-digestible carbohydrate, known for its beneficial properties in metabolic disorders. We investigated the impact of inulin on postprandial hypertriglyceridemia and on lipid metabolism in a mouse model of diet-induced obesity. Mice received a control or a western diet for 4 weeks and were further supplemented or not with inulin for 2 weeks (0.2 g/day per mouse). We performed a lipid tolerance test, measured mRNA expression of genes involved in postprandial lipid metabolism, assessed post-heparin plasma and muscle lipoprotein lipase activity and measured lipid accumulation in the enterocytes and fecal lipid excretion...
April 25, 2018: Nutrients
https://www.readbyqxmd.com/read/29691098/improved-patency-after-axillofemoral-bypass-for-aortoiliac-occlusive-disease
#6
Russell H Samson, David P Showalter, Michael R Lepore, Deepak G Nair, Douglas A Dorsay, Ricardo E Morales
OBJECTIVE: Axillofemoral bypasses (AxFBs) have been used since 1962 to treat aortoiliac disease. In the past, reported patency rates (37%-76%) for these extra-anatomic grafts have been inferior to those for anatomic aortic grafting. Reported low survival rates after AxFB (40%-50%) have confirmed that these procedures have been used primarily in patients at high risk for complications from aortofemoral bypass. However, modern medical and anesthesia management, preoperative scanning, donor artery preparation, postoperative graft surveillance, and graft technology may improve outcomes after AxFB, possibly supporting expansion of its use...
April 21, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29666642/positive-association-of-metabolic-syndrome-with-a-single-nucleotide-polymorphism-of-syndecan-3-rs2282440-in-the-taiwanese-population
#7
Betty Chia-Chen Chang, Lee-Ching Hwang, Wei-Hsin Huang
Background/Purpose: Metabolic syndrome (MetS) poses a major public health burden on the general population worldwide. Syndecan-3 (SDC3), a heparin sulfate proteoglycan, had been found by previous studies to be linked with energy balance and obesity, but its association with MetS is not known. The objective of this study is to investigate whether SDC3 polymorphism (rs2282440) is associated with MetS in the Taiwanese population. Methods: Genotypes of SDC3 polymorphism (rs2282440) were analyzed in 545 Taiwanese adult subjects, of which 154 subjects had MetS...
2018: International Journal of Endocrinology
https://www.readbyqxmd.com/read/29521662/adjusted-calculation-model-of-heparin-management-during-cardiopulmonary-bypass-in-obese-patients-a-randomised-controlled-trial
#8
Matthias Vienne, Emmanuel Haas, Thibaut Wipf, Lelia Grunebaum, François Levy, Laurent Sattler, Tam Hoang Minh, François Severac, Charles Tacquard, Olivier Collange, Paul-Michel Mertes, Annick Steib
BACKGROUND: Anticoagulation during cardiopulmonary bypass (CPB) is usually adapted to total body weight (TBW). This may be inaccurate in obese patients and lead to heparin overdose with a risk of bleeding. OBJECTIVES: To validate the efficacy and safety of an adjusted calculation model of heparin dosing based on ideal body weight (IBW) rather than TBW in obese CPB patients, with an expected target mean plasma heparin concentration of 4.5 IU ml after onset of CPB in the experimental group...
March 7, 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29505511/cardiovascular-risk-factors-in-patients-with-combined-central-retinal-vein-occlusion-and-cilioretinal-artery-occlusion-case-report
#9
Andrzej Grzybowski, Waldemar Elikowski, Magdalena Gaca-Wysocka
RATIONALE: To analyze cardiovascular risk factors and comorbidity of acute unilateral visual loss due to combined central retinal vein occlusion (CRVO) and cilioretinal artery occlusion (CLRAO). PATIENT CONCERNS: Among patients with retinal vein or artery occlusion hospitalized at the Department of Ophthalmology between January 2011 and August 2017, subjects with combined CRVO/CLRAO were selected. All of them underwent ophthalmologic and cardiologic examination, including fluorescein angiography, optical coherence tomography, 12-lead electrocardiogram, transthoracic and transesophageal echocardiography, carotid Doppler sonography, cerebral magnetic resonance imaging, and a panel of laboratory tests...
January 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29452290/lean-body-weight-is-the-best-scale-for-venous-thromboprophylaxis-algorithm-in-severely-obese-patients-undergoing-bariatric-surgery
#10
Bénédicte Gaborit, Pierre-Antoine Moulin, Thierry Bege, Sandrine Boullu, Clara Vincentelli, Olivier Emungania, Pierre-Emmanuel Morange, Stéphane Berdah, Joe-Elie Salem, Anne Dutour, Corinne Frere
Severely obese patients undergoing bariatric surgery (BS) are at increased risk for venous thromboembolism (VTE). How standard low molecular weight heparin (LMWH) regimen should be adapted to provide both sufficient efficacy and safety in this setting is unclear. We aimed to compare the influence of four body size descriptors (BSD) on peak anti-Xa levels in BS obese patients receiving LMWH fixed doses to identify which one had the greatest impact. One hundred and thirteen BS obese patients [median body mass index (BMI), 43...
May 2018: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/29417372/adipose-tissue-but-not-skeletal-muscle-sirtuin-1-expression-is-decreased-in-obesity-and-related-to-insulin-sensitivity
#11
Magdalena Stefanowicz, Agnieszka Nikołajuk, Natalia Matulewicz, Monika Karczewska-Kupczewska
PURPOSE: Sirtuin 1 may regulate glucose and lipid metabolism. We aimed to assess adipose tissue and skeletal muscle sirtuin 1 expression in relation to insulin sensitivity, the expression of proinflammatory and metabolic genes, and to study the regulation of sirtuin 1 expression by hyperinsulinemia and circulating free fatty acids elevation. METHODS: We examined 60 normal-weight, 42 overweight and 15 obese young subjects. The hyperinsulinemic-euglycemic clamp technique was applied throughout to measure insulin sensitivity...
May 2018: Endocrine
https://www.readbyqxmd.com/read/29404935/the-effect-of-obesity-on-anti-xa-concentrations-in-bariatric-patients
#12
W Schijns, M J Deenen, E O Aarts, J Homan, I M C Janssen, F J Berends, K A H Kaasjager
BACKGROUND: Morbidly obese patients are at increased risk to develop venous thromboembolism (VTE), especially after bariatric surgery. Adequate postoperative thrombosis prophylaxis is of utmost importance. It is assumed that morbidly obese patients need higher doses of low molecular weight heparin (LMWH) compared to normal-weight patients; however, current guidelines based on relative efficacy in obese populations are lacking. OBJECTIVES: First, we will evaluate the relationship between body weight descriptors and anti-Xa activity prospectively...
February 5, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29310972/porto-mesenteric-venous-thrombosis-after-laparoscopic-sleeve-gastrectomy-a-case-report-and-systematic-review-of-the-104-cases
#13
Kerem Karaman, Mehmet Aziret, Ali Bal, Volkan Öter, Metin Ercan, Erdal Birol Bostancı
INTRODUCTION: Porto-mesenteric venous thrombosis (PMVT) is a rare but fatal complication after bariatric surgery. However, an increasing number of PMVT complications have been observed in the last years after laparoscopic sleeve gastrectomy (LSG) operations. CASE REPORT: A 35-year-old male was admitted to the emergency clinic in a septic status with a sudden once of abdominal pain and vomiting. The patient underwent laparoscopic sleeve gastrectomy (LSG) 15 days ago...
January 5, 2018: Obesity Research & Clinical Practice
https://www.readbyqxmd.com/read/29238515/role-of-therapeutic-plasma-exchange-in-the-treatment-of-severe-hypertriglyceridemia-an-experience
#14
Shaikh Ahmed Muntajib Wassay, Farhan Javed Dar, Asem K Saleh, Ibrahim Mansoor
Hypertriglyceridemia of obesity, the metabolic syndrome, and type II diabetes mellitus are highly prevalent in Saudi Arabia. Severe hypertriglyceridemia is a rare but well known cause of acute pancreatitis. In treatment pancreatic rest, lifestyle changes, and lipid-lowering medications are essential, but the response is slow. Recently the role of therapeutic plasma exchange (TPE) has been stressed for fast and effective management in addition to insulin and heparin infusion. TPE for hypertriglyceridemic pancreatitis resulted in drastic improvements in clinical and laboratory findings and patient outcomes as suggested in our cases...
December 2017: Therapeutic Advances in Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29226883/deep-vein-thrombosis-prophylaxis-are-we-overdoing-an-asian-survey-on-trends-in-bariatric-surgery-with-a-systematic-review-of-literature
#15
Siddhartha Bhattacharya, S Saravana Kumar, Parimala Devi Kumara Swamy, C Palanivelu, P Praveen Raj
BACKGROUND: Obesity is a risk factor for deep vein thrombosis (DVT) and venous thromboembolism (VTE). VTE is the most common cause of mortality in patients undergoing bariatric surgery. There is considerable variation in practice regarding methods, dosages and duration of prophylaxis in this patient population. Most of the literature is based on Western patients and specific guidelines for Asians do not exist. METHODS: We conducted a web-based survey amongst 11 surgeons from high-volume centres in Asia regarding their DVT prophylaxis measures in patients undergoing bariatric surgery...
December 11, 2017: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/29169973/-maternal-death-by-venous-thromboembolic-disease
#16
M Rossignol, E Morau, M Dreyfus
Pregnancy and postpartum are very high-risk periods for venous thromboembolism events (TEE), which seems to extend far beyond the classical 6-8 weeks after childbirth. Pulmonary embolism (PE) is one of the 3 main causes of direct maternal death in western countries. Between 2010 an 2012 in France, 24 deaths were related to PE giving a maternal mortality ratio of 1/100,000, which is not different from the former report (2007-2009). PE is responsible of 9% of maternal deaths, in equal position with postpartum hemorrhage and amniotic fluid embolism...
December 2017: Gynecologie, Obstetrique, Fertilite & Senologie
https://www.readbyqxmd.com/read/29131442/increased-rates-of-atrial-fibrillation-recurrence-following-pulmonary-vein-isolation-in-overweight-and-obese-patients
#17
Bhradeev Sivasambu, Muhammad A Balouch, Tarek Zghaib, Rizma J Bajwa, Jonathan Chrispin, Ronald D Berger, Hiroshi Ashikaga, Saman Nazarian, Joseph E Marine, Hugh Calkins, David D Spragg
INTRODUCTION: Catheter ablation is common for patients with symptomatic, drug-refractory atrial fibrillation (AF). Obesity is a known risk factor for incident AF. The impact of obesity on AF ablation outcomes is incompletely understood. We sought to determine the impact of elevated body mass index (BMI) on pulmonary vein isolation (PVI) procedural outcomes and associated complications. METHODS AND RESULTS: We evaluated patients undergoing PVI from 2001 to 2015, dividing them into four groups: normal weight (BMI ≥ 18...
November 13, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/29112546/european-guidelines-on-perioperative-venous-thromboembolism-prophylaxis-surgery-in-the-obese-patient
#18
Linas Venclauskas, Almantas Maleckas, Juan I Arcelus
: A systematic literature search was performed and patients were selected as obese patients undergoing bariatric surgery or obese patients undergoing nonbariatric surgical procedures. In addition, patients were stratified according to low risk of venous thromboembolism and high risk of venous thromboembolism (age >55 years, BMI >55 kg m, history of venous thromboembolism, venous disease, sleep apnoea, hypercoagulability or pulmonary hypertension). Prophylaxis of venous thromboembolism was analysed depending on the type of modality: compression devices of the lower extremities (including intermittent pneumatic compression and graduated compression stockings), pharmacological prophylaxis or inferior vena cava filters...
February 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29064195/-prevention-of-thrombosis-among-medical-inpatients-should-we-adapt-enoxaparin-doses-to-the-patient-s-weight
#19
Mikael Tognon, Pauline Darbellay Farhoumand, Marc Blondon, Thomas Agoritsas
Venous thromboembolism (VTE) is a common condition affecting hospitalized patients and it is associated with increased mortality, length of stay and health-care costs. Prophylaxis using low-molecular weight heparins (LMWH) is an efficient intervention preventing VTE in high-risk patients, yet some evidence suggests suboptimal prophylaxis in obese inpatients. This narrative review evaluates current evidence, both on clinical and surrogate outcomes, which can guide the adaptation of prophylactic doses of enoxaparin among obese medical inpatients...
October 18, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29032910/venous-thromboembolism-after-laparoscopic-or-robotic-biliopancreatic-diversion-with-duodenal-switch-ninety-days-outcome-of-a-10-years-experience
#20
Hamzeh M Halawani, Charis F Ripley-Hager, Mary C Naglak, Fernando Bonanni, Gintaras Antanavicius
BACKGROUND: Venous thromboembolism (VTE) is a feared complication after bariatric surgery. Biliopancreatic diversion with duodenal switch (BPD-DS) is a complex bariatric procedure that is offered typically to super morbidly obese patients. Scarce data exist in reporting VTE outcome and identifying the risk factors associated with it after BPD-DS. OBJECTIVE: To determine the risk factors for VTE after BPD-DS at 90-day follow-up. SETTING: A nonprofit regional referral center and teaching hospital in Pennsylvania...
December 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
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