scholarly journals Postoperative Venous Thromboembolism Prophylaxis Utilizing Enoxaparin Does Not Increase Bleeding Complications After Abdominal Body Contouring Surgery

2019 ◽  
Vol 40 (9) ◽  
pp. 989-995 ◽  
Author(s):  
Vasileios Vasilakis ◽  
Gabriel M Klein ◽  
Michael Trostler ◽  
Muntazim Mukit ◽  
Jocellie E Marquez ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Postoperative Bleeding ◽  
Body Contouring ◽  
Assessment Model ◽  
Bleeding Complications ◽  
Preoperative Period ◽  
Once Daily ◽  
Body Contouring Surgery ◽  
Group I ◽  
Group Ii

Abstract Background Venous thromboembolism (VTE) chemoprophylaxis warrants an individualized, risk-stratified approach, and constitutes a relatively controversial topic in plastic surgery. Objectives The aim of this study was to determine the safety of a 7-day postoperative enoxaparin regimen for VTE prophylaxis compared with a single preoperative dose of heparin in abdominal body contouring surgery. Methods This single-institution pre-post study investigated the safety of a 7-day enoxaparin postoperative regimen in abdominal body contouring procedures performed by a single surgeon from 2007 to 2018. Four procedures were included: traditional panniculectomy, abdominoplasty, fleur-de-lis panniculectomy, and body contouring liposuction. Group I patients received a single dose of 5000 U subcutaneous heparin in the preoperative period, and no postoperative chemical prophylaxis was administered. Group II patients received 40 mg subcutaneous enoxaparin in the immediate preoperative period, then once daily for 7 days postoperatively. Results A total of 195 patients were included in the study, 66 in Group I and 129 in Group II. The groups demonstrated statistically similar VTE risk profiles, based on the 2005 Caprini risk-assessment model. There were no statistically significant differences in the 2 primary outcomes: postoperative bleeding and VTE events. Group I patients had higher reoperation rates (22.7% vs 10.1%, P = 0.029), which was secondary to higher rates of revision procedures. Conclusions A 7-day postoperative course of once-daily enoxaparin for VTE risk reduction in abdominal body contouring surgery does not significantly increase the risk of bleeding. Implementation of this regimen for postdischarge chemoprophylaxis, when indicated following individualized risk stratification, is appropriate. Level of Evidence: 4

scholarly journals Safety of Rivaroxaban for Postoperative Venous Thromboembolism Prophylaxis Following Abdominal Body Contouring Surgery: 600 Patients

2020 ◽  
Author(s):  
Vasileios Vasilakis ◽  
Bill G Kortesis ◽  
Gaurav Bharti ◽  
Matthew H Isakson ◽  
Joseph P Hunstad
Keyword(s):  
Venous Thromboembolism ◽  
Oral Anticoagulants ◽  
Body Contouring ◽  
Bleeding Complications ◽  
Bleeding Events ◽  
Level Of Evidence ◽  
Once Daily ◽  
Postoperative Course ◽  
Body Contouring Surgery ◽  
Vte Prophylaxis

Abstract Background Reducing the incidence of venous thromboembolism (VTE) following abdominal body contouring surgery remains a top priority for patient safety. There is a lack of consensus regarding the optimal chemoprophylactic agent for postoperative VTE prophylaxis, and the role of oral anticoagulants warrants further investigation. Objectives The aim of this multisurgeon, single-institution study was to determine the safety and efficacy of a 7-day postoperative rivaroxaban regimen for VTE prophylaxis in abdominal body contouring surgery. Methods A retrospective chart review was performed of all patients who underwent abdominoplasty, circumferential body lift, fleur-de-lis panniculectomy, or circumferential fleur-de-lis panniculectomy at our surgical center from August 2014 to November 2019. A 7-day postoperative course of once-daily 10 mg rivaroxaban, starting on postoperative day 1, was administered to every patient unless there was a contraindication. The 2 primary endpoints were the incidence of VTE and bleeding events. Results A total of 600 patients were included in the study. There were no deaths. There were 4 (0.7%) incidents of VTE events: 2 (0.3%) patients suffered pulmonary embolus and 2 (0.3%) patients suffered a lower-extremity deep venous thrombosis. A total of 13 (2.2%) patients suffered complications related to bleeding. Of these, operative intervention for control and evacuation was required in 7 (1.2%) patients. Conclusions A 7-day postoperative course of once-daily rivaroxaban for VTE risk reduction in abdominal body contouring surgery is associated with a low incidence of VTE events and a low risk of bleeding complications. Level of Evidence: 4

Fondaparinux Significantly Reduces Postoperative Venous Thromboembolism After Body Contouring Procedures Without an Increase in Bleeding Complications

2019 ◽  
Vol 39 (11) ◽  
pp. 1214-1221 ◽  
Author(s):  
Deniz Sarhaddi ◽  
Kyle Xu ◽  
Alex Wisbeck ◽  
Olivier Deigni ◽  
Sumesh Kaswan ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
High Risk ◽  
Postoperative Bleeding ◽  
Body Contouring ◽  
Retrospective Chart Review ◽  
Bleeding Complications ◽  
Level Of Evidence ◽  
Vte Prophylaxis ◽  
Patient Demographics ◽  
Significant Difference

Abstract Background It is well established that abdominoplasty confers a uniquely high risk of venous thromboembolism (VTE) complications. However, chemoprophylaxis is not routinely utilized due to the risk of bleeding complications. Fondaparinux, a factor Xa inhibitor FDA approved in 2001 for postoperative VTE prophylaxis, has emerged as a safe option for preventing VTE complications after high-risk surgeries. Objectives The goal of this study was to examine the effectiveness and safety of fondaparinux for VTE chemoprophylaxis in patients undergoing abdominoplasty. Methods This is a single-center retrospective chart review from January 2008 to December 2014 of 492 patients who underwent abdominoplasty with or without an additional body procedure. Prior to 2011, no VTE chemoprophylaxis was utilized (n = 233). In 2011, the routine employment of postoperative chemoprophylaxis with fondaparinux was implemented (n = 259). Patient demographics and 2005 Caprini scores were evaluated. Primary outcomes included postoperative VTE and bleeding complications. Results There were no statistical differences in patient demographics or median Caprini score. The treatment group demonstrated a statistically significant reduction in the rate of VTE compared with the nontreatment group (0% vs 2.1%, respectively, P = 0.02). There was no statistically significant difference in the rate of hematoma requiring reoperation between the nontreatment and treatment groups (1.7% vs 2.3%, P = 0.76) or blood loss requiring transfusion (0% vs 0.8%, P = 0.5). Conclusions Fondaparinux for VTE chemoprophylaxis after abdominoplasty is efficacious in decreasing the risk of VTE in this susceptible patient population without increasing the risk of postoperative bleeding complications. Level of Evidence: 3

scholarly journals Effect of Aging on the Cornea of Male Albino Rat and Possible Therapeutic Role of Royal Jelly

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
H R Elareny ◽  
A I Ahmed ◽  
A F Alneklawy ◽  
M K Tawfik
Keyword(s):  
Royal Jelly ◽  
Male Rats ◽  
Distilled Water ◽  
Oral Gavage ◽  
Albino Rat ◽  
Therapeutic Role ◽  
Once Daily ◽  
Group I ◽  
Group Ii

Abstract Introduction Nowadays interest in aging has greatly increased, Aging is a complex natural process involving every molecule, cell, and organ in the body that is associated with tissue dysfunction in many organs. Aging of the cornea causes major eye effects and leads to substantial cost in medical and social terms. These effects include the highly prevalent dry eye disease (DED) that affects both visual function and quality of life in elderly. Symptoms of (DED) include, ocular pain, visual disturbances, and increase lacrimation. Functional foods such as Royal jelly (RJ) have a growing attention because of consumers increasing concerns about their health. Its importance not only for its nutritional properties but also for its functional and biological properties such as antioxidant, anti-inflammatory, antibacterial, antiviral, and anti-ulcerous activities. It is used as a cheap natural source in daily life and medicine. (RJ) is a complex substance composed of proteins, sugars, lipids, amino acids, vitamins, and minerals. Aim The present study aimed to investigate the histological effect of aging on the cornea of male albino rat and possible therapeutic role of (RJ) on senile group. Materials and Methods Twenty-four male albino rats were used in this study divided into Group I: consisted of 6 adult male rats aged 3- 6 months. Group II: consisted of 18 senile male rats aged 18-24 months, were further subdivided into three subgroups as follows: Group II A: (n = 6) negative control senile rats, not subjected to any procedure for 4 weeks. Group II B: (n = 6) control senile rats and were given distilled water by oral gavage once daily for 4 weeks. Group II C: (n = 6) senile rats were given (RJ) by oral gavage dissolved in distilled water once daily for 4 weeks. At the end of the experiment, rats were sacrificed after being deeply anesthetized with ether according to the protocol of the Committee of Animal Research Ethics (CARE). The cornea of each animal was carefully dissected out after death and immediately fixed in 10% formalin for preparation of paraffin blocks 5 micrometer thickness. Sections were stained with hematoxylin and eosin (I-I&E), Masson's trichrome and periodic acid-Schiff (PAS). Statistical analysis and quantitative morphometric study were done. Results Light microscopic examination of corneas of senile rats revealed different pathological changes included irregularity in the surface epithelium as well as surface erosions and cytoplasmic vacuolations. The stroma showed widely separated collagen fibers with decreased keratocyte density. It was concluded that (RJ) supplementation to senile rats obviously unproved all layers of the cornea histologically.

Effect of Ethanolic Extract of Carica Papaya seeds in Drug-Induced Acute Nephrotoxicity

2021 ◽  
Vol 15 (11) ◽  
pp. 2951-2953
Author(s):  
Sameer Ahmed ◽  
Muhammad Tahir ◽  
Attiya Munir ◽  
Amtul Hafeez ◽  
Sher Afghan Khan ◽  
...  
Keyword(s):  
Carica Papaya ◽  
Ethanolic Extract ◽  
Control Group ◽  
Standard Diet ◽  
Serum Urea ◽  
Once Daily ◽  
Group Iii ◽  
Group I ◽  
Papaya Seeds ◽  
Group Ii

Background: Nephrotoxicity is characterized by raised serum urea and creatinine levels and kidneys being one of the primary organs of drug concentration and excretion are vulnerable to many widely used marketed drugs, including anti-cancer drugs, antibiotics, immunosuppressants, and radio contrast agents, are nephrotoxic. Aim: To determine the nephroprotective effect of ethanolic extract of Carica papaya seeds in Aminoglycoside induced acute nephrotoxicity. Study design: Quasi Experimental study. Methodology: Thirty Sprague Dawley rats were sub divided into 3 groups i.e., I, II and III with 10 rats in each group. Group II and III were administered Aminoglycoside drug; Gentamycin in 80 mg/kg) via intraperitoneal route once daily for 5 consecutive days to induce acute nephrotoxicity. At day 6, nephrotoxicity was confirmed by measuring serum urea and creatinine. Ethanolic extract of Carica papaya seeds (1000 mg/kg) was started once daily through oral route in group III for 5 consecutive days to see the nephroprotective effects of seed extract after causing acute kidney injury. All animals were given standard diet pellets manufactured at NIH. Results: Mean serum urea and creatinine for Group I (Control Group) at day 0 were 24.90 mg/dL ± 1.633 and .750 mg/dL ± .0619 respectively. Mean serum urea and creatinine for Group II (Disease Control Group) was 81.00 mg/dL ± 1.247 and 1.980mg/dL ± .0467 at day 6th. This suggested induction of nephrotoxicity by Gentamycin. Mean serum urea and creatinine for Group III (Ethanolic Extract Treated Group) at 11 day was 72.40mg/dL± .991 and 1.680 mg/dL± .0467 after 5 days treatment with ethanolic extract of Carica papaya seeds. Conclusion: We concluded that ethanolic extract of Carica papaya seeds has significant nephroprotective effects on Aminoglycoside induced acute nephrotoxicity in rats. Keywords: COVID-19, Vaccination, Awareness and Adverse Effects

Safety and Efficacy of Low-Molecular-Weight Heparin in Pregnant Women at Increased Risk of Venous Thromboembolism: A Prospective Stratified Multicentre Trial.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 715-715
Author(s):  
Rupert M. Bauersachs ◽  
Joachim Dudenhausen ◽  
Andree Faridi ◽  
Thorsten Fischer ◽  
Samson Fung ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Pregnant Women ◽  
Risk Group ◽  
High Risk Group ◽  
Group Iii ◽  
Group I ◽  
Increased Risk ◽  
At Deficiency ◽  
Group Ii ◽  
Heparin Prophylaxis

Abstract Women with a history of VTE, thrombophilia or both are at increased risk for VTE during pregnancy, but the optimal management strategy, and the need for thromboprophylaxis is not well defined in clinical guidelines because of limited trial data. The EThIG (Efficacy of Thromboprophylaxis as an Intervention during Gravidity) is a multicenter trial that prospectively enrolled 810 pregnant women at risk of VTE. Women were assigned to one of 3 management strategies: Low risk group I (including women with prior secondary VTE, or asymptomatic thrombophilia) with “watchful waiting” management, and dalteparin prophylaxis postpartum (50–100 IU/kg), or earlier if additional risk factors occurred; high risk group II (e.g. idiopathic VTE or symptomatic thrombophilia) receiving 50–100 IU/kg dalteparin; and very high-risk group III (e.g. acute VTE, prior long-term OAC, symptomatic AT-deficiency or antiphospholipid syndrome), receiving 100–200 IU/kg dalteparin. Primary efficacy outcome measure was symptomatic VTE, main safety outcome measures were haemorrhages, osteoporosis, thromboctopenia and pregnancy outcome. Results (mean ± SD / 95% CI): 810 women (age 30.8±5.4 years, weight 73.6±16.1kg) were enrolled, 28 % in group I, 58 % in II and 14% in III, including 66 women with acute VTE. 60.1% had prior VTE, 75.4% had thrombophilia (42.1 % FV-Leiden, 2.1 % homozygous, 9.5 % FII G20210A, 4.1% PC-, 1 % AT-deficiency; 17.4 % APS). 35.8 % had previous miscarriage, still birth or physical malformation. Comorbid conditions included lupus erythematosus, liver transplantation, ventricular septum defect, paraplegia, hepatitis C, nephrotic syndrome, asthma, chronic haemolytic anaemia, thalassaemia, osteoporosis and thrombocytopaenia. Median treatment initiation was at 17.0 weeks, at 24.0 weeks in group I, 14.5 weeks in group II and 16.0 weeks for group III. Mean daily dose was 66.2 ± 22.5 IU per kg (group I), 76.8 ± 24.1 IU per kg (group II) and 120.0 ± 49.1 IU per kg (group III). Objectively confirmed, symptomatic VTE occurred in 5 of 810 women (0.6%;0.2–1.5%). The rate of serious bleeding was 3.0% (1.9–4.4%), 0.9% (0.3–1.8%) occurred in the antepartum period, 2.1% (1.3–3.4%) peri-partum;1.1% (0.5–2.2%) was possibly heparin-related. There was no evidence of heparin-induced thrombocytopenia, and one case of osteoporosis (fracture of the saccygous bone during delivery). There were 94.4% successful pregnancies, 40 foetuses (4.9%; 3.6–6.7%) were lost due to miscarriage, 7 due to elective termination. Risk-stratified heparin prophylaxis was associated with a low incidence of symptomatic venous thromboembolism and few clinically important adverse events. Antepartum heparin prophylaxis is warranted in pregnant women with prior idiopathic thrombosis or symptomatic thrombophilia.

scholarly journals HMG-COA Reductase Inhibition by Simvastatin Reduces Neointimal Inflammation in a Rat Model of Atherosclerosis

2014 ◽  
Vol 28 (1-2) ◽  
pp. 5-9
Author(s):  
Rezina Sultana ◽  
Md Sayedur Rahman ◽  
Nargis Akhter
Keyword(s):  
Soybean Oil ◽  
Atherosclerotic Lesion ◽  
Male Rats ◽  
Control Group ◽  
Hmg Coa Reductase ◽  
Once Daily ◽  
Group I ◽  
Group Ii ◽  
Coa Reductase ◽  
Ischemic Events

Background: Inhibitors of HMG-CoA-reductase reduce cardiovascular mortality through the mechanisms yet elucidated. Most ischemic events are secondary to disruption of atherosclerotic plaques highly infiltrated by macrophages.Objectives: To study the effect of the 3-hydroxy-3-methyl-glutaryl coenzyme A (HMG-CoA)-reductase inhibitor simvastatin on the potential mechanisms involved in the recruitment of monocytic cells into the vessel wall.Methodology: This experimental study was carried out in the Laboratory of the Department of Pharmacology & Therapeutics, BSMMU, Shahbag, Dhaka, during the period from 1st July 2008 to 30th June 2009. Fifty healthy Long-Evans Norwegian male rats aged between 3-4 months and weighing between 180-200gm were randomly selected and divided into 3 groups (A, B & C). Control group A (n=10) were fed on standard rat diet for 8 weeks, Vehicle fed group B (n=10) were fed soybean oil at a dose of 1ml once daily for 8 weeks and 2% cholesterol fed group C (n=30) were fed a 2% cholesterol enriched diet (suspension of cholesterol powder in soybean oil) at a dose of 100mg/ml of 2ml once daily for 8 weeks. After 8 weeks 10 rats of each group were sacrificed and remaining 20 rats of group C were continued to the part II of the experiment and divided into two groups. Group-I (cholesterol fed control group, n=10) and Group-II (simvastatin treated group). Group-I fed 0.5ml of o.1% cholesterol enriched diet once daily to maintain atherosclerotic state & Group-II treated with 1ml of 60mg/ml simvastatin at a dose of 300mg/Kg/day along with 0.5ml of 0.1% cholesterol enriched diet. After 8 weeks all the rats of two group were sacrified. Blood collected from each rats for estimation of serum lipid profile by enzymatic methods and aorta was preserved for histopathological examination and Intima-media ratio was measured using Image-proplus software (Silva et al, 2000).Results: Simvastatin induced a significant reduction in serum lipids (p<0.001) and in atherosclerotic lesion size (p<0.001). Aortic macrophage infiltration was abolished by the treatment.Conclusions: In a rat atherosclerosis model, simvastatin diminished the neointimal inflammation and this could contribute to the stabilization of the atherosclerotic plaque. This may be an additional explanation for the reduction of acute ischemic events in patients treated with statins. DOI: http://dx.doi.org/10.3329/bjpp.v28i1-2.20073 Bangladesh J Physiol Pharmacol 2012; 28(1&2):5-9

Ticlopidin In The Prevention Of Platelet Hyperaggregation In Surgery

1981 ◽  
Author(s):  
M L Scrobohaci ◽  
T Petrilắ ◽  
D Mihắitắ ◽  
M Alexapdrescu ◽  
I Pop ◽  
...  
Keyword(s):  
Platelet Aggregation ◽  
Platelet Function ◽  
Postoperative Period ◽  
Congenital Heart ◽  
Coronary Bypass ◽  
Preoperative Period ◽  
Heart Patients ◽  
Group I ◽  
Group Ii ◽  
Platelet Hyperaggregation

The effects of ticlopidin on platelet function was estimated in two groups of patients: group I: 9 patients with thrombocytosis (6 chronic granulocytic leukaemia patients, 3 idiopathic thrombocytopenic purpura patients); group II: 18 patients undergoing extracorporeal circulation (ECC)-(4 aorto-coronary bypass patients, 9 valvular patients and 5 congenital heart patients). Platelet function was assessed by the following tests: platelet aggregation (Born ’ s technique) with ADP and collagen; index of aggregated platelets (Wu and Hoak’s technique). The treatment with ticlopidin was administrated: in group I (24-48h), in the postoperative period, when platelets were ≃500,000/mm3; in group II (24-48h), for the preoperative period (750 mg. daily).The index of aggregated platelets normalized in group I - from 0.2 to 0.8 and in group II - from 0.4 to 0.8. The extent of platelet aggregation decreased in group I - from 80% to 20% and in Group II - from 50% to 20% at the beginning of anaesthesia before ECC.We did not observe any haemorrhagic accident in the postoperative period in either group.

Venous thromboembolism incidence in radiation oncology: Retrospective trial.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e18289-e18289
Author(s):  
Mikhail A Cherkashin ◽  
Natalia A Berezina
Keyword(s):  
Radiation Therapy ◽  
Venous Thromboembolism ◽  
Outpatient Setting ◽  
External Beam Radiation Therapy ◽  
External Beam Radiation ◽  
External Beam ◽  
Beam Radiation ◽  
Group Iii ◽  
Group I ◽  
Group Ii

e18289 Background: Venous thromboembolism (VTE) prevention in oncology patients during external beam radiation therapy (RT) in outpatient setting is the challenging question. We performed analysis of our own data. The aim of study is the clear assessment of VTE incidence in these patients Methods: In retrospective analysis 5134 patients' medical records were included (2612 with RT and 2522 with chemotherapy). Inclusion criteria were: RT in outpatient setting and chemotherapy in outpatient setting. Exclusion criteria: combined radiochemotherapy, hospitalzation, central venous catheter, palliative treatment. 487 patients were selected for the final analysis and stratified in 3 groups: group I (n = 165) 3D-conformal RT for brain tumors or brain metastasis; group II (n = 158) RT for body tumors (abdominal, retroabdominal, pelvic, chest, breast); group III (n = 164) was control –brain and body tumors on chemotherapy. Mean fraction numbers were 25 (11 - 32), mean total dose – 52 Gy (22 - 66). VTE assessment based on clinical data, ultrasound examination (US) and chest CT. Statistical analysis was performed by OpenEpi, Version 3 software pack. Results: Deep vein thrombosis (DVT) was detected in 10 cases (6.06%) in group I, 4 cases in group II and 4 case in control group. VTE patients has a different tumors (astrocytomas, brain trunk tumors, skull basis cancer, rectal cancer, breast cancer). 3 patients were available for long-term outcomes assessment (12 months after radiation therapy). During 1-year period we haven’t detected thrombosis recurrence. One patient on 11th follow-up month was exposed with repeated course of RT without any complications. The difference between VTE incidence for group I and group III characterized by statistical significance (p = 0.018). Risk difference for these groups was 5% (p < 0.05). Conclusions: Based on study results we suggest that external beam radiation therapy is potentially an independent risk factor for VTE development even in outpatient settings. High degree of clinical suspicion and aggressive diagnostic work-up in case of suspicion is necessary. In our opinion low molecular weight heparins prevention should be considered at least during active radiation therapy.

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