vitamin-k-1 and Postoperative-Complications

The assessment of the vitamin K status and its effects on clinical outcomes in kidney transplantation (KT) patients has sparked interest, but it is still largely unfulfilled. In part, this is due to difficulties in laboratory measurements of vitamin K, especially K2 vitamers. Vitamin K status is currently best assessed by measuring undercarboxylated vitamin-K-dependent proteins. The relative contribution of vitamin K1 and K2 to the health status of the general population and CKD (chronic kidney disease) patients, including KT patients, is also poorly studied. Through a complete and first review of the existing literature, we summarize the current knowledge of vitamin K pathophysiology and its potential role in preventing KT complications and improving organ survival. A specific focus is placed on cardiovascular complications, bone fractures, and the relationship between vitamin K and cancer. Vitamin K deficiency could determine adverse outcomes, and KT patients should be better studied for vitamin K assessment and modalities of effective therapeutic approaches.

Topics: Cardiovascular Diseases; Fractures, Bone; Humans; Kidney Transplantation; Neoplasms; Nutritional Status; Postoperative Complications; Preoperative Period; Renal Insufficiency, Chronic; Treatment Outcome; Vitamin K 1; Vitamin K 2; Vitamin K Deficiency

Topics: Acenocoumarol; Anti-Bacterial Agents; Blood Coagulation Tests; Clinical Trials as Topic; Coronary Disease; Coumarins; Dental Service, Hospital; Humans; Phenindione; Postoperative Complications; Thrombosis; Tooth Extraction; Vitamin K 1

Recently, a single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) has become increasingly popular for patients with BMI > 50 as a primary or staged surgery. Staging allows surgeons to do the sleeve gastrectomy (SG) first with the conversion only happening when a failure or technical challenge is identified.. We present the mid-term outcomes of SADI bypass surgery after SG.. A retrospective analysis was performed on a prospective database from four institutions. Ninety-six patients were identified from 2013 to 2018. Patients were divided into two groups: one had two-stage SADI because of insufficient weight loss, the second had planned two-stage SADI because of super obesity (BMI > 50 kg/m. Of 96 patients, 3 patients were completely lost to follow-up. The mean age was 44.8 ± 11.3 years. There were no deaths or conversion to open surgery. The postoperative early complication and late complication rate was 5.3% and 6.4% respectively. At 24 months, group 2 had higher %weight loss (WL) and change in BMI units compared to group 1 with statistically significant difference. The average WL and change in BMI for entire patient's population at 24 months after 2nd stage SADI was 20.5% and 9.4 units respectively. The remission rate for DM was 93.7% with or without the use of medication.. The two-stage approach to SADI-S appears technically simpler than a single compromised operation. However, this approach needs more patients to understand its limitations.

Topics: Adult; Anastomosis, Surgical; Duodenum; Female; Gastrectomy; Humans; Hyperparathyroidism; Hypertension; Ileum; Length of Stay; Lipids; Male; Middle Aged; Obesity, Morbid; Patient Readmission; Postoperative Complications; Reoperation; Retrospective Studies; United States; Vitamin K 1; Weight Loss; Zinc

Developing an optimal anticoagulant strategy poses a challenging task in patients with mechanical heart valves (MHVs) throughout their lifetime. We report an optimal anticoagulant therapy in a cancer patient with hepatic metastases after MHV replacement.. A 68-year-old female with MHVs suffered from gallbladder cancer with hepatic metastases. Her international normalized ratio (INR) fluctuated owing to the declined hepatic function.. Gallbladder cancer and hepatic metastases, with a history of mechanic aortic valve replacement and mitral valve replacement.. Warfarin was discontinued and Vitamin K1 was immediately administrated via intravenous infusion. low-molecular-weight heparin (LMWH) was regarded as a preferable option, and nadroparin at the dosage of 4100IU daily was administered.. No adverse event occurred during the patient's hospitalization and two-week follow up after discharge.. LMWH may represent a reasonable alternative regarding the inhibition of thrombus and bleeding in MHVs carriers with cancer and hepatic metastases.

Topics: Aged; Anticoagulants; Aortic Valve; Female; Gallbladder Neoplasms; Heart Valve Diseases; Heart Valve Prosthesis; Heart Valve Prosthesis Implantation; Heparin, Low-Molecular-Weight; Humans; International Normalized Ratio; Liver Neoplasms; Mitral Valve; Postoperative Complications; Thrombosis; Vitamin K 1

Topics: Acenocoumarol; Anticoagulants; Dicumarol; Drug Therapy; Heparin; Phenindione; Postoperative Complications; Preventive Medicine; Pulmonary Embolism; Thrombophlebitis; Toxicology; Venous Thrombosis; Vitamin K 1; Warfarin