“
“High altitude exposure is often accompanied by weight loss. Postulated mechanisms are a reduction of
nutritional energy intake, a reduction of intestinal energy uptake from impaired intestinal function and increased energy expenditure. Beyond the field of altitude, there are good reasons for renewed interest in the relationship between hypoxia and energy balance. The increasing prevalence of obesity and associated comorbidities represent a major health concern. Obesity is frequently associated with sleep disorders leading to intermittent Mizoribine systemic hypoxia with deleterious cardiovascular and metabolic consequences. Hypoxic regions may be present within hypertrophic white adipose tissue leading to chronic systemic inflammation. Among the increasing number of people commuting to altitude for work or leisure, obesity is a risk factor for acute mountain sickness. Paradoxically, exposure to intermittent hypoxia might be considered as a means to lose body mass and to improve metabolic risk Ferroptosis inhibitor factors. Daytime exposure to intermittent hypoxia has been used to treat hypertension in former Soviet Union countries
and is now being experimented elsewhere. Such intermittent hypoxic exposure at rest or during exercise may lead to improvement in body composition and health status with improved exercise tolerance, metabolism and systemic arterial pressure. Future research should confirm whether hypoxic training could be a new treatment strategy for weight loss and comorbidities in obese subjects and elucidate the underlying mechanisms and signalling pathways.”
“One of the
most concerning and potentially fatal complications of gastric bypass surgery is pulmonary CA-4948 mouse embolism (PE) with published rates exceeding 1%. Although this procedure has been proven effective in reducing the morbidity and mortality of obesity and associated health care costs, it is elective and risk must be minimized. No dosing guidelines exist for pharmacologic prophylaxis in obese patients who are already at increased risk for these events. Although the current ASMBS and Chest guidelines recommend preoperative pharmacologic prophylaxis against thromboembolic events, no standard dosing protocols exist for the obese population. We propose a protocol including immediate pre followed by twice daily postoperative BMI-based dosing of low-molecular-weight heparin (LMWH), along pneumatic compression devices, and early ambulation.
We retrospectively reviewed the charts of 170 patients who underwent Roux-en-Y gastric bypass surgery between March 2004 and December 2007. The incidence of deep venous thrombosis (DVT) and PE and bleeding complications associated with a BMI-based preoperative dosing protocol of LMWH was determined.