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Tuesday, 29 July 2014

Obesity Complication of Deep Vein Thrombosis

By Kyle J. Norton

 Obesity is defined as a medical condition of excess body fat has accumulated overtime, while overweight is a condition of excess body weight relatively to the height. According to the Body Mass Index(BMI), a BMI between 25 to 29.9 is considered over weight, while a BMI of over 30 is an indication of obesity. According to the statistic, 68% of American population are either overweight or obese. 

How to calculate your BMI index
BMI= weight (kg)/ height (m2)

 Deep Vein Thrombosis
is defined as a condition of blood clot in one of the deep veins of the body, especially in veins of the leg or pelvis that can lead to pain and swelling. it is not life threatening but obstruction of the blood flow in major organ may have a D. How dangerous consequence.

The Association of  Obesity and Deep Vein Thrombosis
According "Recent korean perspective of deep vein thrombosis after total knee arthroplasty" by Kim KI, Cho KY, Jin W, Khurana SS, Bae DK., in a study of 311 consecutive knees in 227 patients for total knee arthroplasty, posted in PubMed, researchers found that there were 9 cases (3.03%) of proximal DVT, 70 cases (23.57%) of distal DVT, and no symptomatic pulmonary embolism. Although this cohort had limited number of patients by a single surgeon, there is still low incidence of proximal DVT in Koreans with rare pulmonary embolism occurrence compared with those of the Western. High postoperative d-dimer levels were correlative, but no appropriate cutoff value was found. Obesity was a significant associated risk factor.

2. According to the study of "Influence of lipids and obesity on haemorheological parameters in patients with deep vein thrombosis" by Vayá A, Falcó C, Simó M, Ferrando F, Mira Y, Todolí J, España F, Corella D., posted in PubMed, researchers concluded that obesity were also independently associated with a greater risk of DVT. The  results suggest that increased EA (erythrocyte aggregation) constitute an independent risk factor for DVT. However, when associated to hyperlipidaemia and obesity it further increases thrombotic risk.

3. In the study of in 665 patients (701 ankles) who underwent primary total ankle replacementof the abstract of "Risk factors for symptomatic deep-vein thrombosis in patients after total ankle replacement who received routine chemical thromboprophylaxis" by Barg A, Henninger HB, Hintermann B., posted in PubMed, researchers indicated that osing a logistic multiple regression model we identified obesity, a previous venous thromboembolic event and the absence of full post-operative weight-bearing as independent risk factors for developing a symptomatic DVT. The incidence of symptomatic DVT after total ankle replacement and use of low-molecular-weight heparin is comparable with that in patients undergoing total knee or hip replacement.

4. According to the study of "Deep-vein thrombosis is associated with large uterine fibroids" by Shiota M, Kotani Y, Umemoto M, Tobiume T, Tsuritani M, Shimaoka M, Hoshiai H., posted in PubMed, researchers wrote in abstract that Pulmonary thromboembolism (PE) may occur upon a patient's first postoperative attempt of ambulation. PE is a serious complication, often leading to shock or sudden death. Reported rates of PE following gynecologic surgery are between 0.3% and 0.8%, while the incidence of postoperative deep-vein thrombosis (DVT), the major cause of PE, is between 17% and 20%. Therefore, effective preventive measures, such as preoperative assessment for asymptomatic DVT, should be considered. It is well known that DVT and/or PE are associated with large uterine fibroids, the common, benign tumor of myometrium. Here, to establish the statistical relationship between DVT risk and uterine fibroid size/weight, we assessed the preoperative DVT rate with respect to three possible risk factors: age, obesity level, and uterine size/weight.

5. In the study of 843 Japanese patients with a preoperative diagnosis of benign ovarian tumor who underwent tumorectomy or adnexectomy at our institution between July 2003 and December 201 of "Risk factors for deep-vein thrombosis and pulmonary thromboembolism in benign ovarian tumor" by Shiota M, Kotani Y, Umemoto M, Tobiume T, Tsuritani M, Shimaoka M, Hoshiai H., posted in PubMed, researchers concluded that patience with age ≥ 50 years and BMI > 25 are independent risk factors for preoperative DVT in Japan.

6. Etc.

 Treatments of Obesity and Deep Vein Thrombosis
1. According to the abstract of "Management of deep vein thrombosis to reduce the incidence of post-thrombotic syndrome" by Lowe GD., posted in PubMed, researchers found that DVT should be individually assessed for the benefits and risks of continued oral anticoagulation, including patient preferences. Risk factors for recurrent DVT include active cancer, pregnancy, continued use of oral oestrogens, male sex, obesity, recurrent thrombosis, established PTS, permanent inferior vena caval filters, residual DVT, high fibrin d-dimer and other thrombophilias. Early walking, continued high levels of physical activity and wearing compression stockings for up to two years may also reduce the risk of PTS.

2. On the study of "Predictors of chronic disease at midlife and beyond--the health risks of obesity" by Nejat EJ, Polotsky AJ, Pal L., posted in PubMed, researchers indicated that A burgeoning pandemic of obesity is well characterized. 41% of U.S. adults are projected to be obese by 2015 and obesity, a potentially modifiable risk, is emerging as a leading predictor of lifetime health. The wide spectrum of morbidities related to excess body mass includes risks for diabetes, hypertension, coronary artery disease, dyslipidemia, malignancy, venous thrombosis, degenerative joint disease, pulmonary compromise, sleep apnea, cholelithiasis, depression and overall reduced quality of life....... Aggressive efforts must be targeted towards population-based strategies to educate and sensitize all generations on contributors to and sequelae of excess body mass as obesity represents one of the few modifiable factors that impact on the quantity and quality of lifespan.

3. Etc.

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