Abstract:
BACKGROUND:Low-molecular-weight heparins (LMWH) have been shown to be safer, more effective and more convenient than unfractionated heparin (UFH) in many clinical situations. However, their use is limited in patients with renal insufficiency (RI) due to bioaccumulation. METHOD:The literature is critically reviewed and known pharmacokinetic properties are summarised. An approach to using LMWH in patients with RI is proposed on the basis of currently available evidence. RESULTS AND DISCUSSION:Pharmacokinetic data of commonly used LMWH and of UFH are summarised in respect of RI. Most data are known on enoxaparin. A dose reduction is recommended in patients with severe RI. Limited data on dalteparin and tinzaparin suggest that there is less bioaccumulation. However, further studies are needed, in respect of long-term use and clinical end-points in particular.There are no data on certoparin and only very limited data on nadroparin. A detailed approach is suggested for the use of LMWH in patients with severe RI. Briefly: (1) before using LMWH, evaluate the patient's renal function, ist expected course, imminent interventions, and general bleeding risk; (2) prefer LMWH to UFH in view of better efficacy and lower bleeding risk in general; (3) however, prefer i.v. UFH to s.c. LMWH if a patient is unstable, is awaiting emergency interventions, or has a high bleeding risk, since UFH can be stopped more quickly due to i.v. administration, has a shorter half-life time, and can be effectively antagonised; (4) prefer a well documented LMWH; use established dosing schemes; (5) monitor LMWH with peak anti-Xa levels in patients with severe RI regularly, and adjust dose to be in target range; (6) do not use LMWH in patients with severe RI if there is no possibility of measuring anti-Xa levels. CONCLUSIONS:LMWH may be considered for patients with severe RI. However, experience, judicious choice and careful monitoring of patients with severe RI treated with LMWH are necessary.
journal_name
Swiss Med Wklyjournal_title
Swiss medical weeklyauthors
Schmid P,Fischer AG,Wuillemin WAdoi
smw-11284subject
Has Abstractpub_date
2009-08-08 00:00:00pages
438-52issue
31-32eissn
1424-7860issn
1424-3997pii
smw-11284journal_volume
139pub_type
杂志文章,评审abstract:AIMS:In comparison with other central European countries, Switzerland has a high prevalence of gun ownership and a high rate of suicide by shooting. After the Army XXI reform in 2003, which reduced personnel from about 400,000 to approximately 200,000, a decline in suicides by firearms and a decline in the total number...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:10.4414/smw.2018.14646
更新日期:2018-09-23 00:00:00
abstract:QUESTIONS UNDER STUDY:In view of the alarming trend in childhood obesity (O) and overweight (OW) observed in certain countries, the aim of the study is to measure the prevalence of O and OW in successive cohorts of elementary school children in Geneva. METHODS:All 5-6-year-old children attending public schools in the ...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:10.4414/smw.2010.13040
更新日期:2010-07-22 00:00:00
abstract:QUESTION UNDER STUDY:What are the trends in avoidable cancer mortality in Switzerland and neighbouring countries? METHODS:Mortality data and population estimates 1996-2010 were obtained from the Swiss Federal Statistical Office for Switzerland and the World Health Organization Mortality Database (http://www.who.int/he...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:10.4414/smw.2015.14184
更新日期:2015-10-02 00:00:00
abstract::Understanding how best to manage the complex healthcare needs of hospitalised, mostly multimorbid medical patients is an international priority. Healthcare should be effective, safe and provide high quality at a reasonable cost. However, basic logistic and organisational issues of medical ward-based care have received...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:10.4414/smw.2017.14515
更新日期:2017-10-22 00:00:00
abstract:AIMS:This study evaluated the evolution of the prenatal diagnosis of congenital heart disease (CHD) between 2003 and 2008 and its repercussion for the CHD prevalence rate at birth in a well-defined population (Canton of Vaud, Switzerland). METHODS AND RESULTS:All 572 cases of CHD reported in the Eurocat Registry of Va...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:10.4414/smw.2014.14068
更新日期:2014-12-04 00:00:00
abstract:PRINCIPLES:A decrease in plasma lipids occurs during severe sepsis and has prognostic implications in critical illness. Whether lipids have prognostic implications or could help to differentiate community-acquired pneumonia from other lower respiratory tract infections remains unknown. METHODS:We analysed data from pa...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:smw-12494
更新日期:2009-03-21 00:00:00
abstract:PRINCIPLES:Apolipoprotein E (ApoE), an important glycoprotein in the transport, uptake and redistribution of cholesterol, is necessary in nerve tissue repair. The APOE gene (APOE) is involved in neurodegenerative diseases, the best-known association being that between the APOE ε4 allele and Alzheimer's disease. Multipl...
journal_title:Swiss medical weekly
pub_type: 杂志文章,多中心研究
doi:10.4414/smw.2010.13119
更新日期:2010-11-26 00:00:00
abstract::The WHO recommends screening of Latin American migrants for Chagas disease to reduce morbidity and mortality and increase the likelihood of eradicating the disease. The objective was to assess the feasibility and acceptability of a screening strategy in one Swiss canton. From February 2011 to September 2012, people at...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:10.4414/smw.2019.20050
更新日期:2019-04-04 00:00:00
abstract:BACKGROUND:With its high incidence and subsequent adverse consequences in the intensive care setting, several instruments have been developed to screen for and detect delirium. One of the more commonly used is the Intensive Care Delirium Screening Checklist (ICDSC); however, the optimal cut-off score indicating deliriu...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:10.4414/smw.2018.14597
更新日期:2018-03-14 00:00:00
abstract:QUESTION UNDER STUDY:Domestic accidents are an important problem in paediatric medicine. This study was designed to gain a better understanding of burn mechanisms and target prevention. METHODS:Children treated for burn lesions in the Department of Paediatric Surgery between August 2004 and August 2005 were included i...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:smw-12605
更新日期:2009-09-19 00:00:00
abstract:QUESTIONS UNDER STUDY:Paraoxonase-1 (PON1) is an HDL-bound enzyme system which plays a key role in the protection of LDL and HDL from oxidation by hydrolysing activated phospholipids and lipid peroxide products. Oxidative stress has been involved in the pathogenesis of many complications of human pregnancy, including e...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:smw-12495
更新日期:2009-02-07 00:00:00
abstract:BACKGROUND:The principality of Liechtenstein had its first COVID-19 case at the beginning of March 2020. After exponential growth, the pandemic’s first wave was contained, with the last case being diagnosed 52 days after the initial occurrence. AIM:To characterise the COVID-19 pandemic in Liechtenstein. METHODS...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:10.4414/smw.2020.20361
更新日期:2020-10-16 00:00:00
abstract:AIMS:We aimed to identify familial hypercholesterolaemia mutation carriers among participants to the Lausanne Institutional Biobank (BIL). Our experimental workflow was designed as a proof-of-concept demonstration of the resources and services provided by our integrated institutional clinical research support platform....
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:10.4414/smw.2016.14326
更新日期:2016-08-06 00:00:00
abstract::Patients with chronic heart failure who are not eligible for heart transplant and whose life expectancy depends mainly on the heart disease may benefit from mechanical circulatory support. Mechanical circulatory support restores adequate cardiac output and organ perfusion and eventually improves patients' clinical con...
journal_title:Swiss medical weekly
pub_type: 杂志文章,评审
doi:10.4414/smw.2016.14267
更新日期:2016-03-05 00:00:00
abstract:INTRODUCTION:Data suggest that a substantial proportion of psychotherapists engage in therapist-client sex (TCS), violating national and international ethical guidelines. The objective of our study was to find a new and effective starting point for preventive interventions. METHOD:Using an online questionnaire, this s...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:10.4414/smw.2015.14099
更新日期:2015-02-04 00:00:00
abstract::The authors report on bilateral simultaneous knee arthroplasty in a 40-year-old male patient with haemophilia A, high inhibitor titre and an aneurysma spurium of the right popliteal artery. Both knees showed a fixed flexion deformity of 20 degrees. To build up haemostasis, treatment with activated prothrombin complex ...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:10.4414/smw.2010.13094
更新日期:2010-08-24 00:00:00
abstract:AIM:The levels of teamwork and clinician burnout in healthcare differ depending on demographic and unit characteristics. However, the impact of these characteristics varies between clinical settings. In addition, the impact of objectively measured workload in such settings is largely unknown. The aim of this study was ...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:10.4414/smw.2019.20033
更新日期:2019-03-24 00:00:00
abstract:QUESTION UNDER STUDY:The present study aimed to compare the prevalence of work-life conflicts and the health status of physicians, with a representative sample of university graduates as well as with a representative sample of the general Swiss working population. Furthermore, it aimed to analyse whether work-life conf...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:10.4414/smw.2010.13063
更新日期:2010-07-11 00:00:00
abstract:BACKGROUND:Several publications reported on the safety and efficacy of bortezomib, a novel first-in-class anti-cancer agent, in the treatment of relapsed/refractory multiple myeloma in controlled clinical trials. Complementary data on the experience with bortezomib in daily oncology practice are needed. We report on th...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:2007/21/smw-11716
更新日期:2007-06-02 00:00:00
abstract:OBJECTIVES:Women are still underrepresented in the senior ranks of medical school faculties. Thus far information has been lacking on gendersensitive career paths for professorial and nonprofessorial staff of Swiss medical schools. The aim of this study was to survey faculty members of all Swiss medical schools on soci...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:2003/21/smw-10230
更新日期:2003-05-31 00:00:00
abstract::Patients with a solid organ transplant have increased in numbers and in individual survival in Switzerland over the last decades. As a consequence of long-term immunosuppression, skin cancer in solid organ recipients (SOTRs) has been recognized as an important problem. Screening and education of potential SOTRs about ...
journal_title:Swiss medical weekly
pub_type: 杂志文章,实务指引
doi:smw-12725
更新日期:2009-07-25 00:00:00
abstract::Atrial arrhythmias complicate the clinical course of adult patients with an atrial septal defect. Atrial flutter is more prevalent in younger patients, and frequently regresses after surgical defect closure. Atrial fibrillation however, which results from a chronic underlying disease, rarely reverts to sinus rhythm af...
journal_title:Swiss medical weekly
pub_type: 杂志文章,评审
doi:2005/11/smw-10926
更新日期:2005-03-19 00:00:00
abstract:QUESTIONS UNDER STUDY / PRINCIPLES:Colonoscopies are complex procedures that depend greatly on the patient's cooperation and on the correct judgment of a tolerable amount of discomfort by the endoscopy team, even in sedated patients. Little is known regarding the accuracy of the patient comfort level assessments made b...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:10.4414/smw.2012.13726
更新日期:2012-11-05 00:00:00
abstract:INTRODUCTION:It has been proposed that reactive oxygen species play a role in renal fibrosis. 8-OHdG, a metabolite of oxidative damage to leukocyte DNA, has been identified as a marker of oxidative stress in patients with chronic renal failure. MATERIALS AND METHODS:Seventy-four patients following nephrectomy were ret...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:10.4414/smw.2011.13268
更新日期:2011-10-12 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Sleep disturbances are prevalent but often overlooked or underestimated. We suspected that sleep disorders might be particularly common among pharmacy customers, and that they could benefit from counselling. Therefore, we described the prevalence and severity of symptoms associated with sleep a...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:2006/09/smw-11265
更新日期:2006-03-04 00:00:00
abstract:AIMS OF THE STUDY:To describe patterns of systemic lupus erythematosus (SLE) care and the clinical effectiveness of belimumab plus standard of care therapy in a real-world clinical setting in Switzerland. METHODS:This multicentre, observational, retrospective cohort study included adults with SLE who initiated belimum...
journal_title:Swiss medical weekly
pub_type: 杂志文章,多中心研究
doi:10.4414/smw.2019.20022
更新日期:2019-03-10 00:00:00
abstract:BACKGROUND:Evaluation of the current clinical treatment of psoriasis in Switzerland remains to be measured with the parameters cost-of-illness and quality of life. OBJECTIVE:To obtain data on out-of-pocket expenses, costs of outpatient/office-based care and inpatient care for psoriasis, and to extrapolate total costs ...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:smw-12756
更新日期:2010-02-06 00:00:00
abstract:OBJECTIVE:To evaluate the impact of a voluntary termination of pregnancy (TOP) on contraceptive practice and sexual well-being in women. STUDY DESIGN AND METHODS:Comparative evaluation of a retrospective study conducted in Lugano in 1995 with 85 women interviewed 3-6 months post-TOP, and a prospective study carried ou...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:2001/35/smw-09768
更新日期:2001-09-08 00:00:00
abstract:OBJECTIVES:The sero-prevalence of co-infection with the hepatitis B virus (HBV) and the hepatitis D virus (HDV) is well known in many European countries, starting from 6.8% in Germany to more than 27% in some Turkish areas. To gain a better description of this infection in Switzerland, and to characterise those affecte...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:10.4414/smw.2011.13176
更新日期:2011-03-18 00:00:00
abstract:OBJECTIVE:To assess outcomes 24 months after treatment start for multidrug-resistant tuberculosis (MDR-TB). METHODS:Cohort study of all culture-positive MDR-TB cases notified in Switzerland from 01/2003 to 07/2010. RESULTS:Fifty-one cases were observed, with a median age of 26 years (range 2-56). Twenty-seven were ma...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:10.4414/smw.2014.14053
更新日期:2014-12-04 00:00:00