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Query: UMLS:C0028754 (obesity)
124,988 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We studied 30 control women and 131 pill users to evaluate effects of birth control pills and clinical factors on hemostasis. When control patients were matched with an equal number of pill users, none of the direct markers of activated hemostasis (fibrinopeptide A, platelet factor 4, and beta thromboglobulin) were increased. Plasminogen, prekallikrein, and protein C (protective against clotting) were significantly higher in pill users. Fibrinogen, antithrombin, alpha-2 antiplasmin, and fibronectin were comparable. Among the 131 pill users, antithrombin levels decreased with a family history of thromboembolism. Fibrinogen and fibronectin were increased with obesity, but there was no evidence of activated hemostasis. Overall, pill use did not appear to result in hypercoagulability. Considering family history of thromboembolism might further improve the safety of oral contraceptive use.
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PMID:Oral contraceptives and the hemostatic system. 335 50

Risk factors for atherosclerosis are often associated with haemorheological changes. On this point, obesity (recently advocated as an independent risk factor) was not much studied and with not univocal results. We have studied 70 obese patients (BMI greater than 30) and 50 healthy subjects (BMI less than 25). Among obese 26 had no more pathologies, 29 had hypertension, 3 suffered from ischemic heart disease, 3 suffered from occlusive arteriopathy, 9 were hyperlipidemic, 10 were smokers. We determined plasma viscosity and whole blood viscosity (at haematocrit corrected to 45% too). Washed erythrocytes, poor in leucocytes and platelets and resuspended in phosphate-buffered saline, were used for study of erythrocyte viscosity and deformability. Obese patients showed raised mean blood viscosity values when compared to healthy controls (p less than 0.01); an even more significant increase (p less than 0.001) was found concerning plasma viscosity and fibrinogen. Erythrocyte viscosity and red blood cell filterability index did not show any significant difference. We found no significant correlation between viscosity values and presence of hypertension, hyperlipidemia and smoking habit among obese. In conclusion, the higher vasculopathy incidence might be caused by an increase in blood viscosity, mostly due to plasmatic component. This fact appears to be independent from the presence of atherosclerosis complications or other risk factors.
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PMID:[Hemorrheologic disorders in obese patients. Study of the viscosity of the blood, erythrocytes, plasma, fibrinogen and the erythrocyte filtration index]. 360 Nov 35

In over 30 years of surveillance of 2873 women, 574 developed initial clinical manifestations of CHD. A number of antecedent metabolic risk factors proved atherogenic, including blood lipids, glucose tolerance, uric acid, and menopause. Serum total cholesterol predicts as strongly in women as in men. The predictive power of cholesterol is strengthened when the total cholesterol is partitioned into its atherogenic LDL and protective HDL fractions. Contrary to the case in men, triglyceride may be a contributor to risk in older women. A total-to-HDL cholesterol ratio exceeding 7.5 equalizes the risk in men and women. Impaired glucose tolerance also eliminates the female CHD risk advantage over men, conferring a three-fold increased risk. Serum uric acid, although lower in women than in men, is equally predictive in the sexes. Central obesity confers an increased CHD risk in women and predisposes to diabetes, hyperuricemia, hypertension, and an unfavorable LDL/HDL cholesterol ratio. A combination of obesity, low HDL cholesterol, and impaired glucose tolerance predisposes especially. Age-adjusted risk of CHD is increased two- to threefold compared to pre menopausal women, even when induced surgically without removing the ovaries. It is not clear whether post menopausal estrogen replacement eliminates this excess risk. Fibrinogen is higher in women than in men, and is increased with hypertension, diabetes, hypercholesterolemia, high hematocrit, and cigarette smoking. At any level of multivariate risk, fibrinogen added to the CHD risk in women.
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PMID:Metabolic risk factors for coronary heart disease in women: perspective from the Framingham Study. 360

Whether systolic or diastolic, labile or fixed, at any age in either sex, hypertension is dangerous. Adiposity, heart rate, alcohol intake, hematocrit, blood sugar, serum cholesterol, and triglycerides are all related to the occurrence of hypertension in one or both sexes. These factors also contribute to the occurrence of the cardiovascular sequelae of hypertension. The influence of blood pressure on the incidence of cardiovascular disease is independent of other predisposing cofactors but is greatly affected by them. Elevated pressures are often accompanied by hyperlipidemia, hyperglycemia, elevated fibrinogen, and ECG abnormalities, all of which augment the risk. Coronary disease is now the most common sequela of hypertension, and the excess risk is concentrated in those with an increased low-density lipoprotein/high density lipoprotein ratio, impaired glucose tolerance, and ECG abnormalities, and in cigarette smokers. Hypertension is only a component of a multifactorial coronary risk profile which must be considered when implementing optimal therapy. Both the urgency for treatment and judgment of efficacy should be guided by the multivariate risk profile.
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PMID:Hypertension and other risk factors in coronary heart disease. 366 84

Defibrotide, a new antithrombotic compound without anticoagulant activity, has been tested for prevention of deep venous thrombosis (DVT) in patients undergoing gynecological surgery (mainly hysterectomy). Eighty-nine women (mean age 48.5) were randomly allocated to defibrotide (44 patients) or placebo (45 patients). 800 mg defibrotide was given daily (200 mg intravenously 4 times a day), starting on the day before operation and then for the next 7 days. DVT were detected by the conventional 125I-fibrinogen test. The two groups were homogeneous for known risk factors (age, varicosities, obesity, neoplasia and previous thromboembolic episodes). The results showed a statistically significant reduction of DVT incidence in patients on defibrotide, as compared with those on placebo: 4/44 = 9% vs. 13/45 = 28.8% (p less than 0.05). There were no side effects, including hemorrhagic complications. The numbers of units transfused were comparable for the 2 groups. In conclusion, the trial shows that defibrotide is an effective and safe drug for the prevention of DVT in gynecological surgery.
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PMID:Effectiveness of defibrotide for prophylaxis of deep venous thrombosis in gynecological surgery: a double-blind, placebo-controlled clinical trial. 375 34

The epidemiological characteristics of platelet aggregability were established in 958 participants in the Northwick Park Heart Study. The main analyses were based on the dose of adenosine diphosphate at which primary aggregation occurred at half its maximum velocity. Aggregability increased with age in both sexes, was greater in whites than blacks (particularly among men), and tended to decrease with the level of habitual alcohol consumption. Aggregability was, however, greater in women than men and in nonsmokers than smokers. There was no relation between aggregability on the one hand and obesity, current or past oral contraceptive use, menopausal state, or blood cholesterol and triglyceride concentrations on the other. Aggregability was somewhat, though not significantly, higher in men with a history of ischaemic heart disease and in those with electrocardiographic evidence of ischaemia than in those without. There was a strong association between the plasma fibrinogen concentration and aggregability. The widely held concept of platelet aggregability and its implications is probably an oversimplification. In the prevention of thrombosis it may be as useful to consider modifying external influences on platelet behaviour, such as plasma fibrinogen concentration or thrombin production, as it is to rely solely on platelet active agents.
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PMID:Epidemiological characteristics of platelet aggregability. 391 15

A prethrombotic or hypercoagulable state is one in which the hemostatic balance is disturbed, with increasing procoagulant activity or decreasing activity of intrinsic anticoagulant properties. A basic problem in the study of hypercoagulable states is that it cannot be determined with certainty whether changes in hemostatic variables are causative or consequences of thromboses that have already occurred. This chapter discusses the ways in which various physiologic and pathologic states may be associated with alterations in hemostatic systems and, by weighting the balance in favor of readier coagulability, may predispose to thrombosis. Physiologic conditions discussed include stress, cold, pregnancy, oral contraceptives (OCs), aging, and smoking. It is noted that major alterations in blood coagulability, rheology, and flow during pregnancy combine to increase the risk of thrombosis, especially venous. The risk that venous thromboembolism will occur is increased 10-fold in OC users. The increased risk may be related to alterations in hemostatic variables that occur gradually over the 1st year of use, with no further subsequent increase. At present, no individual laboratory test is capable of identifying patients at risk of thrombosis, but a number of variables in combination (e.g., obesity, age, presence of varocose veins, euglobulin lysis time, level of fibrinogen degradation products) may provide a useful indication. In the absence of reliable predictive indicators, assessment and management efforts should be directed in 3 ways. 1st, simple tests should be undertaken in all individuals in whom thromboembolism has occurred to diagnose treatable predisposing factors. 2nd, efforts should be directed toward refining a safe, effective prophylactic regimen. 3rd, a few selected patients (e.g., those who have their 1st thrombotic episode before age 30 years) should be investigated in greater detail.
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PMID:Hypercoagulable states. 400 61

In a study of 41 fasting subjects it was confirmed that fibrinolytic activity was reduced in obese persons: an increase in fibrinogen was also associated with obesity. There was no correlation between obesity and the platelet count, platelet adhesiveness to glass, the level of serum fibrin degradation products, or the whole blood clotting time in plastic tubes.
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PMID:Platelet adhesiveness, coagulation, and fibrinolytic activity in obesity. 504 73

Five methods for preventing deep venous thrombosis in postoperative patients were evaluated and compared with a control group. Five hundred patients from five surgical specialties were studied. The incidence of deep venous thrombosis was 37.3 percent in the control group but significantly less within all treatment groups. The minidose heparin group had the highest incidence (26.9 percent) because there were a large number of bilateral thromboses. The antistasis modalities did slightly better than the drugs; the intermittent pneumatic compression group had the fewest thromboses (11.9 percent). The significant risk factors for postoperative deep venous thrombosis are (1) obesity, (2) malignancy, (3) a history of venous disease, major surgery or major fracture, (4) length of surgery greater than 1 hour, and (5) increasing age. Four nonfatal pulmonary emboli occurred in 500 patients. Two were in women with hysterectomies in whom thrombosis had never been detected in an extremity; it is presumed that these clots arose from pelvic veins. It is thus recommended that patients in these high risk groups be treated prophylactically with one of the aforementioned modalities to decrease the risk of postoperative deep venous thrombosis. Of the different methods used to detect deep venous thrombosis, iodine-125 fibrinogen scanning was superior to both impedance plethysmography and venous Doppler ultrasound. One hundred percent of the thrombi were identified with scanning, whereas far fewer were detected with the latter methods. It is recommended that fibrinogen scanning be used clinically in patients in high risk categories who are undergoing major operative procedures.
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PMID:Postoperative venous thrombosis. Evaluation of five methods of treatment. 616 50

This review examines the incidence, natural history, diagnosis, prophylaxis, and management of deep vein thrombosis (DVT) and pulmonary embolism (PE) in neurosurgical patients. Recent studies estimate the incidence of postoperative DVT detected by fibrinogen scanning in neurosurgical patients to be 29% to 43%. Specific factors that enhance the risk of venous thromboembolism include previous DVT, surgery, immobilization, advanced age, obesity, limb weakness, heart failure, and lower extremity trauma. Clinical diagnosis of venous thromboembolism is unreliable but can be augmented by noninvasive screening tests such as iodine-125-fibrinogen scanning, Doppler ultrasonography, and impedance plethysmography. As prophylactic measures, mini-dose heparin and external pneumatic compression of the legs have decreased the incidence of DVT in clinical studies of neurosurgical patients. However, no prophylactic measure has been convincingly shown to prevent PE in neurosurgical patients. Thrombi involving the popliteal, deep femoral, and iliac veins appear most likely to cause significant PE. Anticoagulation therapy constitutes standard management of DVT and PE; however, in neurosurgical patients the potential for precipitating intracranial or intraspinal hemorrhage may necessitate vena caval interruption. This appears to be an effective alternative to anticoagulation.
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PMID:Deep vein thrombosis and pulmonary emboli in neurosurgical patients: a review. 638 85


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