scholarly journals Postcesarean Thromboprophylaxis with Two Different Regimens of Bemiparin

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Milagros Cruz ◽  
Ana M. Fernández-Alonso ◽  
Isabel Rodríguez ◽  
Loreto Garrigosa ◽  
Africa Caño ◽  
...  
Keyword(s):  
Risk Factors ◽  
Placental Abruption ◽  
Pulmonary Thromboembolism ◽  
Thromboembolic Disease ◽  
Additional Risk Factor ◽  
Thromboembolic Events ◽  
Additional Risk ◽  
Once Daily ◽  
Emergency Cesarean ◽  
Study Population

Objectives. To compare the effectiveness of postcesarean thromboprophylaxis with two different regimens of bemiparin.Material and Methods. The study included 646 women with cesarean delivery in our hospital within a 1-year period, randomly assigned to one of two groups for prophylaxis with 3500 IU bemiparin once daily for 5 days or 3500 IU bemiparin once daily for 10 days.Results. There was one case of pulmonary embolism (first day following cesarean). An additional risk factor was present in 98.52% of the women, most frequently emergency cesarean, anemia, or obesity. The only risk factors for thromboembolic disease significantly related to pulmonary thromboembolism were placental abruption and prematurity. There were no differences in thromboembolic events among the two thromboprophylaxis regimens.Conclusions. Cesarean-related thromboembolic events were reduced in our study population due to the thromboprophylactic measures taken. Thromboprophylaxis with 3500 IU bemiparin once daily for 5 days following cesarean was sufficient to avoid thromboembolic events.

Prevalence and prognostic impact of left ventricular systolic dysfunction after acute myocardial infarction

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
T.J Jernberg ◽  
E.O Omerovic ◽  
E.H Hamilton ◽  
K.L Lindmark ◽  
L.D Desta ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Myocardial Infarction ◽  
Atrial Fibrillation ◽  
Risk Factor ◽  
Reperfusion Therapy ◽  
Left Ventricular ◽  
Funding Source ◽  
Additional Risk Factor ◽  
Additional Risk

Abstract Background Left ventricular dysfunction after an acute myocardial infarction (MI) is associated with poor outcome. The PARADISE-MI trial is examining whether an angiotensin receptor-neprilysin inhibitor reduces the risk of cardiovascular death or worsening heart failure (HF) in this population. The aim of this study was to examine the prevalence and prognosis of different subsets of post-MI patients in a real-world setting. Additionally, the prognostic importance of some common risk factors used as risk enrichment criteria in the PARADISE-MI trial were specifically examined. Methods In a nationwide myocardial infarction registry (SWEDEHEART), including 87 177 patients with type 1 MI between 2011–2018, 3 subsets of patients were identified in the overall MI cohort (where patients with previous HF were excluded); population 1 (n=27 568 (32%)) with signs of acute HF or an ejection fraction (EF) <50%, population 2 (n=13 038 (15%)) with signs of acute HF or an EF <40%, and population 3 (PARADISE-MI like) (n=11 175 (13%)) with signs of acute HF or an EF <40% and at least one risk factor (Age ≥70, eGFR <60, diabetes mellitus, prior MI, atrial fibrillation, EF <30%, Killip III-IV and STEMI without reperfusion therapy). Results When all MIs, population 1 (HF or EF <50%), 2 (HF or EF <40%) and 3 (HF or EF <40% + additional risk factor (PARADISE-MI like)) were compared, the median (IQR) age increased from 70 (61–79) to 77 (70–84). Also, the proportion of diabetes (22% to 33%), STEMI (38% to 50%), atrial fibrillation (10% to 24%) and Killip-class >2 (1% to 7%) increased. After 3 years of follow-up, the cumulative probability of death or readmission because of heart failure in the overall MI population and in population 1 to 3 was 17.4%, 26.9%, 37.6% and 41.8%, respectively. In population 2, all risk factors were independently associated with death or readmission because of HF (Age ≥70 (HR (95% CI): 1.80 (1.66–1.95)), eGFR <60 (1.62 (1.52–1.74)), diabetes mellitus (1.35 (1.26–1.44)), prior MI (1.16 (1.07–1.25)), atrial fibrillation (1.35 (1.26–1.45)), EF <30% (1.69 (1.58–1.81)), Killip III-IV (1.34 (1.19–1.51)) and STEMI without reperfusion therapy (1.34 (1.21–1.48))) in a multivariable Cox regression analysis. The risk increased with increasing number of risk factors (Figure 1). Conclusion Depending on definition, post MI HF is present in 13–32% of all MI patients and is associated with a high risk of subsequent death or readmission because of HF. The risk increases significantly with every additional risk factor. There is a need to optimize management and improve outcomes for this high risk population. Figure 1 Funding Acknowledgement Type of funding source: Private company. Main funding source(s): Novartis

Thrombosis and the Antiphospholipid Syndrome

Hematology ◽  
2005 ◽  
Vol 2005 (1) ◽  
pp. 462-468 ◽  
Author(s):  
Thomas L. Ortel
Keyword(s):  
Risk Factors ◽  
Antiphospholipid Syndrome ◽  
Antiphospholipid Antibodies ◽  
Thromboembolic Event ◽  
Randomized Clinical Trials ◽  
Venous Thromboembolic Event ◽  
Thromboembolic Events ◽  
Additional Risk ◽  
Initial Event ◽  
Venous Thromboembolic

Abstract The antiphospholipid syndrome is an antibody-mediated hypercoagulable state characterized by recurrent venous and arterial thromboembolic events. Several studies have determined that the frequency of antiphospholipid syndrome in patients presenting with a venous thromboembolic event is between 4% and 14%. Because of the high risk for recurrent thromboembolism in these patients, current recommendations suggest a longer, potentially lifelong, course of antithrombotic therapy following an initial event. Although most authorities agree on an extended course of therapy, considerable controversy surrounds the optimal target therapeutic INR for patients with antiphospholipid syndrome. For an initial venous thromboembolic event, a target INR of 2.0 to 3.0 is supported by two prospective, randomized clinical trials. In contrast, relatively limited data exist for an initial arterial thromboembolic event in patients who have the antiphospholipid syndrome, and therapeutic recommendations range from aspirin to warfarin with a high target INR. Recurrent thromboembolic events can be extremely difficult to treat, and some patients may benefit from the addition of immunosuppressive therapies. Importantly, as many as 50% of the initial thromboembolic events sustained by patients with antiphospholipid antibodies occur in the setting of additional, coincident prothrombotic risk factors, indicating the importance of addressing any additional risk factors, such as hypercholesterolemia, in these patients. Prospective studies are needed to address the role of thromboprophylactic strategies in asymptomatic individuals with antiphospholipid antibodies in the absence of additional risk factors.

scholarly journals Pneumonia hospitalisation and case-fatality rates in older Australians with and without risk factors for pneumococcal disease: implications for vaccine policy

2019 ◽  
Vol 147 ◽  
Author(s):  
S. Dirmesropian ◽  
B. Liu ◽  
J. G. Wood ◽  
C. R. MacIntyre ◽  
P. McIntyre ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Risk Factor ◽  
Pneumococcal Disease ◽  
Large Population ◽  
Case Fatality ◽  
Population Based ◽  
Additional Risk Factor ◽  
Additional Risk ◽  
Non Invasive

AbstractCommunity-acquired pneumonia (CAP) results in substantial numbers of hospitalisations and deaths in older adults. There are known lifestyle and medical risk factors for pneumococcal disease but the magnitude of the additional risk is not well quantified in Australia. We used a large population-based prospective cohort study of older adults in the state of New South Wales (45 and Up Study) linked to cause-specific hospitalisations, disease notifications and death registrations from 2006 to 2015. We estimated the age-specific incidence of CAP hospitalisation (ICD-10 J12-18), invasive pneumococcal disease (IPD) notification and presumptive non-invasive pneumococcal CAP hospitalisation (J13 + J18.1, excluding IPD), comparing those with at least one risk factor to those with no risk factors. The hospitalised case-fatality rate (CFR) included deaths in a 30-day window after hospitalisation. Among 266 951 participants followed for 1 850 000 person-years there were 8747 first hospitalisations for CAP, 157 IPD notifications and 305 non-invasive pneumococcal CAP hospitalisations. In persons 65–84 years, 54.7% had at least one identified risk factor, increasing to 57.0% in those ⩾85 years. The incidence of CAP hospitalisation in those ⩾65 years with at least one risk factor was twofold higher than in those without risk factors, 1091/100 000 (95% confidence interval (CI) 1060–1122) compared with 522/100 000 (95% CI 501–545) and IPD in equivalent groups was almost threefold higher (18.40/100 000 (95% CI 14.61–22.87) vs. 6.82/100 000 (95% CI 4.56–9.79)). The CFR increased with age but there were limited difference by risk status, except in those aged 45 to 64 years. Adults ⩾65 years with at least one risk factor have much higher rates of CAP and IPD suggesting that additional risk factor-based vaccination strategies may be cost-effective.

scholarly journals Fatores de risco adicionais à Escala de Braden: um risco para úlceras de pressão

2011 ◽  
Vol 2 (4) ◽  
pp. 222-225
Author(s):  
Marisa Hans ◽  
Júlia Valéria De Oliveira Vargas Bitencourt ◽  
Flaviana Pinheiro
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Pressure Ulcers ◽  
Inflammatory Diseases ◽  
Additional Risk Factor ◽  
Additional Risk ◽  
Madre De Dios ◽  
Braden Scale ◽  
Factores De Riesgo ◽  
Immunosuppressive Diseases

Estudo quantitativo que tem por objetivo analisar a presença de fatores de risco de úlceras de pressão (UPs), adicionais à Braden, com 134 clientes internados no CTI do Hospital Mãe de Deus, em maio/ junho de 2010 com aprovação dos comitês institucionais: 39/2010; 353/10. Realizou-se coleta de informações do prontuário dos clientes, com instrumento estruturado. Dos 134 clientes, 43 desenvolveram UP, com fator de risco adicional à Braden: infecção, sepse, corticoides, noradrenalina, ventilação mecânica, edema, diabetes mellitus, insuficiência respiratória aguda, doenças inflamatórias, respectivamente com um p <0,001 e neoplasias e doenças imunossupressoras com p <0,05, assim, com significância estatística. Entretanto, sem possibilidade de comparação significativa, considerando o reduzido quantitativo de estudos, tratando da problemática. Portanto, na avaliação do risco das UPs devem ser agregados outros fatores, visando a otimização das medidas de prevenção e qualificação assistencial, além de haver mais estudos permitindo a comparação.Descritores: Úlcera de Pressão, Escala de Braden, Prevenção.Additional risk factors related to Braden Scale: a risk for pressure ulcersThis is a quantitative study that aims to analyze the presence of risk factors for pressure ulcers (UPs), in addition to Braden, with 134 clients admitted to the ICU of the Mother of God Hospital in May / June 2010 with the approval of institutional committees: 39 / 2010, 353/10. We carried out data collection from medical records of clients with structured instrument. Of the 134 clients, 43 developed UP, with the additional risk factor Braden: infection, sepsis, corticosteroids, noradrenaline, mechanical ventilation, edema, diabetes mellitus, acute respiratory failure, inflammatory diseases, respectively with p <0.001 and immunosuppressive diseases and cancers p <0.05, thus statistically significant. However, without the possibility of meaningful comparison, considering the small quantity of studies, dealing with the problem. Therefore, the risk assessment of UPs must be added other factors in optimizing the prevention and care skills, and be more studies allowing the comparison.Descriptors: Pressure Ulcers, Braden Scale, Prevention.Factores de riesgo adicionales a la escala Braden: un riesgo para las úlceras por presiónSe trata de um estudio cuantitativo que tiene por objectivo analizar la presencia de factores de riesgo de úlceras por presión (UP), además de Braden, con 134 pacientes admitidos a la UCI del Hospital de la Madre de Dios en mayo / junio de 2010 con la aprobación de los comités institucionales: 39 / 2010, 353/10. Se llevó a cabo la recopilación de datos de los registros médicos de los clientes con instrumentos estructurados. De los 134 clientes, 43 desarrollaron UP, con la Braden factores de riesgo adicionales: infección, sepsis, los corticosteroides, la noradrenalina, la ventilación mecánica, edema, diabetes mellitus, insuficiencia respiratoria aguda, enfermedades inflamatorias, respectivamente, con p enfermedades <0,001 e inmunosupresores y cánceres p <0,05, por lo tanto estadísticamente significativa. Sin embargo, sin la posibilidad de comparación significativa, considerando la pequeña cantidad de estudios, para tratar el problema. Por lo tanto, la evaluación del riesgo de UPS hay que añadir otros factores en la optimización de la prevención y técnicas de atención y ser más estudios que permitan la comparación.Descriptores: Las úlceras por Presión, Escala de Braden, La Prevención.

Fibrinogen Is not an Additional Risk Factor of Thromboembolic Disease in Factor V Leiden Patients

1999 ◽  
Vol 81 (04) ◽  
pp. 659-660 ◽  
Author(s):  
Sandrine Billon ◽  
Martine Escoffre-Barbe ◽  
Bernard Mercier ◽  
Jean François Abgrall ◽  
Claude Ferec
Keyword(s):  
Risk Factor ◽  
Factor V Leiden ◽  
Thromboembolic Disease ◽  
Additional Risk Factor ◽  
Factor V ◽  
Additional Risk

Cross-National Comparison of Breastfeeding, Malnutrition and Associated Risk Factors among Mexican-Origin Children Living in Mexico and the US

2021 ◽  
pp. 106939712110215
Author(s):  
Ana Paola Campos ◽  
Mireya Vilar-Compte ◽  
Summer Sherburne Hawkins
Keyword(s):  
Risk Factors ◽  
National Health ◽  
Low Birthweight ◽  
Mexican Origin ◽  
Additional Risk Factor ◽  
Nutrition Survey ◽  
Additional Risk ◽  
Logistic Regression Models ◽  
Health And Nutrition ◽  
The Us

To examine breastfeeding, individual and household risk factors for malnutrition (i.e., overweight and stunting) among Mexican-origin children aged 6 to 35 months living in Mexico and the US. We ran logistic regression models using subsamples of the 2012 Mexican National Health and Nutrition Survey, and four waves (2007-2014) of the US National Health and Nutrition Examination Survey. We found evidence for a protective effect of any breastfeeding on stunting in Mexico. Risk factors for overweight and stunting across countries were high- and low-birthweight, correspondingly. An additional risk factor for overweight was introducing complementary foods before 6 months; while being male, living in Mexico and moderate-severe household food insecurity were additional risk factors for stunting. To prevent malnutrition among Mexican-origin children, pre- and post-natal culturally-sensitive policies and interventions in both countries should be aimed toward preventing high- and low-birthweight, and promoting positive maternal health behaviors such as appropriate child feeding practices.

Drinking water contaminants as risk factors for the health of the Ulyanovsk region population

2021 ◽  
Author(s):  
S.V. Ermolaeva
Keyword(s):  
Risk Factors ◽  
Drinking Water ◽  
Maximum Permissible Concentration ◽  
Additional Risk Factor ◽  
Water Contaminants ◽  
Additional Risk ◽  
Chronic Effects ◽  
Ulyanovsk Region ◽  
Iron Manganese ◽  
Iron And Manganese

The main goal of health risk analysis is to obtain and generalize information about the possible influence of environmental factors on human health. As a result of hydrochemical analysis of drinking water supply sources in the Ulyanovsk region, a list of main contaminants has been established. It includes ammonium, iron, copper, phosphates, sulfates, chlorides, nitrates, zinc, manganese and chromium. Among them three pollutants - iron, manganese and sulfates – had surpassed maximum permissible concentration. The concentration of iron at the level of threshold chronic effects was found in drinking water of Baryshsky (0.13), Melekessky (0.16), Sengileevsky (0.13) districts. Severe chronic effects can be caused by the concentration of iron and manganese in the drinking water of the Staromainsky (0.4 and 0.3) and Cherdaklinsky (0.9 and 0.27) districts. Assessment of health risks led us to the conclusion that drinking water can serve as an additional risk factor and provoke disease development. Key words: risk factors, morbidity, maximum permissible concentration, pollutants, relative conditional risk, average daily dose.

Hospitalization Earlier than 1 Year Prior to Admission as an Additional Risk Factor for Methicillin-Resistant Staphylococcus aureus Colonization

2010 ◽  
Vol 31 (05) ◽  
pp. 538-540 ◽  
Author(s):  
Laura McAllister ◽  
Robert P. Gaynes ◽  
David Rimland ◽  
John E. McGowan
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Hospital Admission ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Additional Risk Factor ◽  
Additional Risk ◽  
Methicillin Resistant ◽  
Related Risk ◽  
Mrsa Colonization ◽  
Control Study

Our case-control study sought to identify risk factors for colonization with methicillin-resistant Staphylococcus aureus (MRSA) at hospital admission among patients with no known healthcare-related risk factors. We found that patients whose most recent hospitalization occurred greater than 1 year before their current hospital admission were more likely to have MRSA colonization. In addition, both the time that elapsed since the most recent hospitalization and the duration of that hospitalization affected risk.

Incidence Rate of Thromboembolic Events (TE) In a Prospectively Evaluated Population of Patients with Lymphoma Enrolled In First Line Treatment Clinical Trials: a Report From the Gruppo Italiano Per Lo Studio Dei Linfomi (GISL)

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 4208-4208
Author(s):  
Mauro Silingardi ◽  
Stefano Luminari ◽  
Elisa Barbolini ◽  
Fiorella Ilariucci ◽  
Dimitriy Arioli ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clinical Trials ◽  
Follicular Lymphoma ◽  
Hodgkin Lymphoma ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Venous Catheter ◽  
Thromboembolic Events ◽  
Additional Risk

Abstract Abstract 4208 Introduction: Patients with lymphoma are considered at high risk of thrombosis, due to the disease itself or to the use of chemotherapy. The global risk of thrombosis is around 5%, higher in Non Hodgkin Lymphoma compared to Hodgkin Lymphoma and in advanced stages compared to localized disease. So far few studies have addressed the risk of thrombosis in lymphomas with a prospective approach. In 2007 we started a prospective study on patients with malignant lymphoma (ML) to assess the risk of thromboembolism in such patients and to identify possible risk factors. Methods: from March 1st 2007 all patients enrolled in any of the active clinical trials conducted by the Gruppo Italiano Studio Linfomi for the initial treatment of ML were screened for the occurrence of thromboembolic events (TE) at 3 timepoints: at the time of diagnosis (D), during chemotherapy (C) and during follow-up (F). For each registered TE additional data were required with respect to presence of additional risk factors (drugs, bed stay, comorbidities), concomitant use of anticoagulants, venous catheter implant. A detailed description of TE with treatment and outcome details was also required. Results: as of July 20th 2010, 643 patients have been registered in an active GISL clinical trial. Lymphoma subtype was Follicular Lymphoma (FL) in 70%, Indolent Non Follicular Lymphoma (INFL) in 10%, Hodgkin Lymphoma (HL) in 6%, Mantle Cell Lymphoma (MCL) in 6%, Diffuse Large B Cell Lymphoma (DLBCL) in 7%. Patients had a median age of 57 years (range 16 to 86), the male to female ratio was 1.16: Stage was advanced (III-IV) in 84%. Median follow-up was 18 months. Overall 27 TE have been reported, which corresponds to a proportion of 4.4%. Most events occurred during treatment or follow-up (15 and 6 at C and F timepoints, respectively), while TE proportion at D was low (0.9%). TE rate (×100 person-year) was 3.9 in MCL, followed by other lymphoma subtypes: HL 3.8, FL 2.6, DLBCL 2.4, and INFL 1.8. Interestingly, in MCL all the TE occurred at the C and F timepoints, and these patients were treated with an intense chemotherapy regimen (alternating R-hyperCVAD and HD ARA-C and mtx), while other lymphomas received conventional dose chemotherapy. Overall, the only parameter associated with TE development was PS>2 (RR 6.2, P=0.013), while the RR is 3.8 (P=0.188) if the 21 TE at C+F timepoints are considered. So far, detailed informations concerning TE were received for 20 patients. Of these, only 3 had comorbidities (1 case of diabetes mellitus, 1 case of cardiovascular disease and 1 case of prostatic adenocarcinoma receiving hormonotherapy) and no prior DVT or PE have been described. Two of the 5 cases of bedridden patients stayed in bed for more than 7 days before experiencing TE. Seventeen patients took no thrombogenic drugs as ongoing estroprogestinic therapy or hormonotherapy. Five patients had a venous catheter implant, which was removed only in 1 case due to thromboembolic occurrence. Overall we registered 7 cases of PE and 13 cases of DVT. When looking at the TE event description, 14 patients have been recorded as symptomatic and 4 were already treated with anticoagulants when the TE was diagnosed. The most frequent sites of TE were femoral vein or jugular vein (3 and 3 events, respectively), while the principal diagnostic tool employed for the TE diagnosis was Color Doppler ultrasound. Conclusions: To the best of our knowledge this is the study with the highest number of newly diagnosed patients with ML prospectively considered for the risk of TE. It shows a lower than expected rate of TE, probably because there is a representation of the different histotypes which doesn't replicate the real incidence: Follicular Lymphoma, a subtype with low risk of TE, is certainly over-represented. Our data suggest that therapy is the most important cause for TE. Further analyses on reported events may help to identify additional risk factors. Disclosures: No relevant conflicts of interest to declare.

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