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Letteratura scientifica selezionata sul tema "Low molecular weight heparin"

Autore: Grafiati

Pubblicato: 4 giugno 2021

Ultima modifica: 10 marzo 2023

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Articoli di riviste sul tema "Low molecular weight heparin"

1

&NA;. "Heparin/low molecular weight heparins". Reactions Weekly &NA;, n. 1414 (agosto 2012): 28–29. http://dx.doi.org/10.2165/00128415-201214140-00091.

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2

&NA;. "Heparin/low-molecular-weight heparins". Reactions Weekly &NA;, n. 1198 (aprile 2008): 22. http://dx.doi.org/10.2165/00128415-200811980-00068.

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3

&NA;. "Heparin/low molecular weight heparins". Reactions Weekly &NA;, n. 1210 (luglio 2008): 18. http://dx.doi.org/10.2165/00128415-200812100-00051.

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4

&NA;. "Heparin/low molecular weight heparins". Reactions Weekly &NA;, n. 1211 (luglio 2008): 17–18. http://dx.doi.org/10.2165/00128415-200812110-00053.

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5

&NA;. "Heparin/low molecular weight heparins". Reactions Weekly &NA;, n. 1211 (luglio 2008): 18. http://dx.doi.org/10.2165/00128415-200812110-00056.

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6

&NA;. "Heparin/low molecular weight heparins". Reactions Weekly &NA;, n. 1277 (novembre 2009): 23. http://dx.doi.org/10.2165/00128415-200912770-00068.

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7

&NA;. "Heparin/low molecular weight heparins". Reactions Weekly &NA;, n. 1231 (dicembre 2008): 16–17. http://dx.doi.org/10.2165/00128415-200812310-00049.

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8

&NA;. "Heparin/low molecular weight heparins". Reactions Weekly &NA;, n. 989 (febbraio 2004): 10. http://dx.doi.org/10.2165/00128415-200409890-00030.

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9

Mulloy, Barbara, Trevor Barrowcliffe e Elaine Gray. "Heparin and low-molecular-weight heparin". Thrombosis and Haemostasis 99, n. 11 (2008): 807–18. http://dx.doi.org/10.1160/th08-01-0032.

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Abstract (sommario):

SummaryHeparin is one of the oldest biological medicines, and has an established place in the prevention and treatment of venous thrombosis. Low-molecular-weight heparins (LMWH) have been developed by several manufacturers and have advantages in terms of pharmacokinetics and convenience of administration. They have been shown to be at least as effective and safe as unfractionated heparin and have replaced the latter in many indications. In this article the chemistry, mechanisms of action, measurement of anticoagulant activities, and clinical status of heparin and LMWH are reviewed.

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10

Hoppensteadt, Debra, Jeanine M. Walenga, Jawed Fareed e Rodger L. Bick. "Heparin, low–molecular-weight heparins, and heparin pentasaccharide". Hematology/Oncology Clinics of North America 17, n. 1 (febbraio 2003): 313–41. http://dx.doi.org/10.1016/s0889-8588(02)00091-6.

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Tesi sul tema "Low molecular weight heparin"

1

Hettiarachchi, Rohan Jagath Kumara. "Venous thromboembolism, cancer and low molecular weight heparin". [S.l. : Amsterdam : s.n.] ; Universiteit van Amsterdam [Host], 2000. http://dare.uva.nl/document/84386.

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2

Matthíasson, Stefán E. "Low molecular weight heparin and dextran in thromboprophylaxis human and experimental studies /". Malmö : Dept. of Surgery, Lund University, Malmö General Hospital, 1994. http://books.google.com/books?id=9OxsAAAAMAAJ.

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3

Vecchietti, D. G. "Low Molecular Weight Heparins : in depth structural characterization to understand their different biological properties". Doctoral thesis, Università degli Studi di Milano, 2008. http://hdl.handle.net/2434/59669.

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Heparin is a linear, heterogeneous, highly sulfated polysaccharide belonging to the family of glycosaminoglycans, endowed with anticoagulant and antithrombotic properties. Its linear chains are made up of 15-200 disaccharide units of N-sulfated or N-acetylated D-glucosamine linked to hexuronic (glucuronic or iduronic) acid. Low molecular weight heparins (LMWHs), developed to circumvent some unwanted side effect of unfractionated heparins (UFH), are obtained from UFH by diverse chemical and enzymatic depolymerisation processes. Fragments generated by cleavage of heparin may therefore structurally differ from each other more than the original chains because of the modification induced by the depolymerisation methods and the heterogeneity of the UFH. Only about one-third of heparin chains contains a unique pentasaccharide sequence (AGA*IA), which specifically binds antithrombin (AT) thus promoting the inhibition of certain proteases of the coagulation cascade. Such a sequence, characterized by a central trisulfated glucosamine (A*), is believed to survive the depolymerising procedures used for the preparation of LMWHs. Functional assays performed in vitro, evaluating plasma protein binding and antiprotease activity AT mediated, showed wide variations among the commercially available LMWHs, indicating that their compositional differences have an important impact on function. With the aim of contributing to the elucidation of structure-activity relationship of LMWHs, the present work is focusing on the in depth study of the oligosaccharide composition of different LMWH preparations. Three of the most popular commercial preparations Enoxaparin, Dalteparin and Tinzaparin were analysed. Their compositional differences were determined by analyzing their oligosaccharidic populations by gel permeation chromatography, a very characteristic fingerprint for each sample was revealed. Affinity chromatography on AT-Sepharose was performed to separate and quantify the high affinity fraction,. Structural characterization of all samples was obtained by 1D and 2D NMR spectroscopy and all molecular weight parameters were evaluated through HP-SEC/TDA. All the HA fractions exhibited a considerably higher molecular weight and a reduced polydispersity with respect to NA fractions. To deepen the characterization of HA components, HA heparin chains of each LMWH were further fractionated into three subfractions with graded affinity toward AT HA1>HA2>HA3. All the above fractions were analysed via NMR evaluating the average content of all the monosaccharide components and, in particular, the percentage of A* (N-glucosamine tri-sulfated) and G-A* (disaccharide composed by glucuronic acid and A*) both regarded as markers of heparin active site for AT (AGA*IA). Selected oligomeric fractions and the HA1, HA2, HA3 fractions were analysed via ESI-TOF (as detector after a SEC chromatography). The molecular weight of all HA subfractions were estimated by two different methods: HP-SEC/ESI-MS and NMR. The results suggest that neither the molecular weight nor the sulfation degree calculated via NMR exhibited any correlation with the degree of affinity for AT. By combining information obtained by NMR (G-A* content) and the chain length (calculated by Mw evaluation)the AGA*IA content per chain was approximately calculated pointing out the presence of some chains containing more than an active pentasaccharide (HA1 of enoxaparin and dalteparin). Preliminary data on biological activity in vitro indicated that the different anti-Xa activities were directly related to the degree of AT affinity and the overall structural considerations. The present work represents the first insight into the detailed and comparative structural characterization of three commercial LMWHs differing in manufacturing process. Important and characteristic structural parameters were defined, including the precise oligomeric composition, the relative content of AT interacting species, and their molecular weight, together with the relative content of variously substituted monosaccharide components. Further studies are required to unravel the correlation of structural features with LMWH functional properties.

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4

Mauron, Thomas. "Influence of low molecular weight heparin and low molecular weight dextran sulfate on the inhibition of coagulation factor XIa by serpins /". Bern : Hämatologisches Zentrallabor der Universität Inselspital, 1998. http://www.ub.unibe.ch/content/bibliotheken_sammlungen/sondersammlungen/dissen_bestellformular/index_ger.html.

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5

Gandara, Esteban. "Is an Intermediate Dose of LMWH Effective for Secondary Prevention of Recurrent Venous Thromboembolism in Pregnant Patients Diagnosed with Deep Vein Thrombosis or Pulmonary Embolism? Design of a Pilot Study". Thèse, Université d'Ottawa / University of Ottawa, 2012. http://hdl.handle.net/10393/23388.

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Statement of the problem The primary objective of this thesis was to determine the best study design to evaluate the safety and effectiveness of an intermediate dose of low molecular weight heparin for secondary prevention of pregnancy associated VTE (PAVTE). An RCT was deemed unfeasible,so the use of a single arm study with prior evaluation of feasibility with a pilot study is proposed. // Methods - A systematic review was conducted to evaluate the efficacy of current strategies used for secondary prevention of PAVTE.A survey was used to elicit the non-inferiority margin. // Results - The pooled proportion of recurrent VTE in patients treated with full dose LMWH was 0.012(95% CI 0.006 to 0.02) and the rate of major bleeding was 0.025(95% CI=0.01 to 0.041). The non-inferiority margin was elicited at 2.5%. // Conclusions - Although a randomized controlled trial should be conducted whenever possible, in certain scenarios they are unfeasible. Therefore, an alternative study design should perhaps be used to evaluate the safety and efficacy of therapeutic strategies.

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6

Holmström, Margareta. "Clinical aspects on treatment of deep venous thrombosis with a low molecular weight heparin /". Stockholm, 1998. http://diss.kib.ki.se/1998/91-628-2989-0/.

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7

Näsström, Birgit. "Lipoprotein lipase in hemodialysis patients and healthy controls : effects of heparin /". Umeå : Univ, 2004. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-340.

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8

Steward, David W., John B. Bossaer, Brian Odle, Emily Flores e Somi Rikhye. "Prescribing of Low-Molecular-Weight Heparin and Warfarin in Patients with Acute Venous Thromboembolism and Active Cancer". Digital Commons @ East Tennessee State University, 2014. https://dc.etsu.edu/etsu-works/2322.

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Background: Malignancy is a significant risk factor for venous thromboembolism (VTE), conferring a 4- to 7-fold increased risk in patients with cancer. Because of its effect on certain tumors, low-molecular-weight heparin (LMWH) has been evaluated as a treatment option for cancer and as an alternative to traditional warfarin therapy in patients with active cancer. LMWH is associated with a reduced recurrence of VTE, fewer adverse bleeding events, and, in some instances, decreased mortality. The American College of Chest Physicians/American Society of Clinical Oncology has recommended LMWH for at least the initial 3 to 6 months when treating VTE in patients with cancer, based on the positive outcomes associated with LMWH. Objective: The purpose of this study was to evaluate physician prescribing patterns for LMWH or warfarin in patients with acute VTE and active cancer. Methods: We conducted a retrospective chart review of hospitalized patients at a community teaching hospital with an affiliated regional cancer center located in a rural area of the United States. Patients included in the analysis had an International Classification of Diseases, Ninth Revision code indicative of any cancer type and a concomitant code for any VTE. The primary outcome was the drug prescribed at discharge for the treatment of VTE. Secondary outcomes included specialty of the prescribing physician, adverse bleeding events, and the need for transfusion. VTE treatment regimen was evaluated using the binomial test, and logistic regression analysis was used to determine correlation of the prescriber’s specialty with the patient’s prescribed regimen. Results: Of 129 patients included in the analysis, 107 (82.9%) were prescribed warfarin compared with 9 (7%) who were prescribed LMWH. Hematologists and oncologists were more likely to prescribe LMWH than general practitioners (odds ratio, 7.8; 95% hazard ratio, 1.5-42). Seven patients had a documented adverse bleeding event and 2 patients required a transfusion. Four of the 7 adverse bleeding events and 1 of the 2 transfusions occurred in the group receiving vitamin K antagonist therapy. Conclusion: Physicians in our system were significantly more likely to prescribe warfarin for acute treatment of VTE in patients with active cancer—despite consistent evidence and multiple evidence-based guidelines recommending treatment with LMWH in this patient population. This was lower than other observations in Canadian populations but may more accurately represent nonteaching centers in the United States, particularly those in rural areas. Specialists in oncology were significantly more likely to prescribe LMWH than generalists.

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9

Pranckevičienė, Gabrielė. "Pharmacoepidemiologic assessment of low-molecular-weight heparins utilization in Lithuania and development of pharmacoeconomic model". Doctoral thesis, Lithuanian Academic Libraries Network (LABT), 2014. http://vddb.library.lt/obj/LT-eLABa-0001:E.02~2014~D_20140305_141832-70667.

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In recent years, many countries have struggled with the fact that expenditures on health care are growing much faster than the overall level of wealth. Research objectives: 1) to conduct a meta-analysis of heparins by the means of their efficacy, safety parameters and treatment outcomes; 2) to conduct pharmacoepidemiological assessment of long-term heparins utilization in Lithuania; 3) to develop a pharmacoeconomic cost-minimization model for low-molecular-weight heparins based on reference pricing methodology; 4) to investigate heparins prescribing trends and to evaluate heparins prescription adherence to international clinical guidelines at a secondary level clinical hospital. Meta-analysis results showed that low-molecular-weight heparins could be considered interchangeable due to similar therapeutic profiles in some indications. In Lithuania consumption of heparins and corresponding costs were constantly increasing during the period of investigation; therefore it would be relevant to implement modern pharmacoeconomic methodologies to regulate costs. Cost-minimization model suggested that expenditures on this group of medicines could be decreased by nearly 70 percent. Analysis of pharmacoepidemiological study data confirmed that heparins prescription practices at the clinical hospital were insufficiently regulated. In addition this study conducted at the clinical hospital revealed non-compliance of heparins safety monitoring practices with clinical guidelines.
Pastaraisiais metais daugelyje šalių sveikatos priežiūros išlaidos augo daug greičiau nei bendras gerovės lygis, todėl yra nuolat diskutuojama, kaip šį išlaidų augimą reikėtų kontroliuoti. Darbo uždaviniai: 1) atlikti heparinų preparatų meta-analizę, palyginant jų efektyvumo ir saugumo parametrus bei gydymo baigtis; 2) atlikti heparinų preparatų ilgalaikio suvartojimo Lietuvoje farmakoepidemiologinį tyrimą; 3) suformuluoti farmakoekonominį kaštų mažinimo sprendimų modelį mažos molekulinės masės heparinų preparatų grupei, remiantis referentinės kainos metodika; 4) ištirti heparinų preparatų skyrimo tendencijas antrinio lygio klinikinėje ligoninėje ir palyginti heparinų preparatų skyrimo atitikimą tarptautinėms gairėms. Meta-analizės rezultatai parodė, jog mažos molekulinės masės heparinai gali būti tarpusavyje pa¬keičiami dėl analogiškų terapinių savybių tam tikrose indikacijose. Heparinų preparatų suvartojimas ir atitinkamos išlaidos tiriamuoju laikotarpiu Lietuvoje nuolat didėjo, todėl būtų aktualu taikyti šiuolaikines farmakoekonomines išlaidų reguliavimo metodikas. Pritaikius kaštų mažinimo modelį heparinų preparatų grupei, būtų galima sumažinti išlaidas šios grupės preparatams beveik 70 procentų. Farmakoepidemiologinio tyrimo rezultatai atskleidė, jog heparinų preparatų skyrimo praktika klinikinėje ligoninėje buvo nepakankamai reglamentuota. Taip pat heparinų preparatų saugumo parametrų stebėjimo praktika ligoninėje neatitiko tarptautinių rekomendacijų.

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Lima, Juliana Pego. "Development of Nanoparticles as Low Molecular Weight Heparins Carriers for Oral Administration". Master's thesis, Faculdade de Farmácia da Universidade do Porto, 2007. http://hdl.handle.net/10216/7486.

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Libri sul tema "Low molecular weight heparin"

1

Barrowcliffe, Trevor W. Low molecular weight heparin. Chichester, West Sussex, England: Wiley, 1992.

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2

Hyers, Thomas M. Treatment handbook of low-molecular-weight heparin. London: Science Press, 2000.

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3

Thromoprophylaxis with low-molecular-weight heparins. London: Current Medicine Group, 2006.

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4

Christian, Doutremepuich, a cura di. Low molecular weight heparins in clinical practice. New York: Dekker, 1992.

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5

1940-, Kher André, Sarret Monique 1938- e Toulemonde Francis 1926-, a cura di. Low molecular weight heparin therapy: An evaluation of clinical trials evidence. New York: Marcel Dekker, 1999.

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6

Holmer, Erik. Heparin and its low molecular weight derivatives: Basic and applied studies in the development of a new antithrombotic drug. Uppsala: Sveriges Lantbruksuniversitet, 1987.

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7

Maguire, Jacinta Marie. Low molecular weight heparin regime or unfractionated heparin and as pirin in the treatment of unstable angina. [S.l: The Author], 1994.

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8

Shukla, Vijay K. Low molecular weight heparins for major orthopedic surgery: A case for clinical outcomes. Ottawa, Ont: Canadian Coordinating Office for Health Technology Assessment, 1998.

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9

Kampen, Thorsten U. Low Molecular Weight Organic Semiconductors. Weinheim, Germany: Wiley-VCH Verlag GmbH & Co. KGaA, 2010. http://dx.doi.org/10.1002/9783527629978.

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10

Bäckvall, Helena, e Janne Lehtiö, a cura di. The Low Molecular Weight Proteome. New York, NY: Springer New York, 2013. http://dx.doi.org/10.1007/978-1-4614-7209-4.

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Capitoli di libri sul tema "Low molecular weight heparin"

1

Davis, James W., Dana Forman, La Scienya M. Jackson, James W. Davis, Javier Garau, David N. O’Dwyer, Elisa Vedes et al. "Low Molecular Weight Heparin". In Encyclopedia of Intensive Care Medicine, 1341–43. Berlin, Heidelberg: Springer Berlin Heidelberg, 2012. http://dx.doi.org/10.1007/978-3-642-00418-6_716.

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2

Pineo, G. F., e R. D. Hull. "Low Molecular Weight Heparin". In Antithrombotics, 305–29. Berlin, Heidelberg: Springer Berlin Heidelberg, 1999. http://dx.doi.org/10.1007/978-3-642-59942-2_10.

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3

Malloy, Rhynn J., Jessica Rimsans, Megan Rhoten, Katelyn Sylvester e John Fanikos. "Unfractionated Heparin and Low-Molecular-Weight Heparin". In Anticoagulation Therapy, 31–57. Cham: Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-73709-6_3.

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4

Stromich, Ashley. "Unfractionated Heparin and Low Molecular Weight Heparin". In Anticoagulation Management, 53–75. Cham: Springer International Publishing, 2015. http://dx.doi.org/10.1007/978-3-319-22602-6_3.

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5

Combs, David J., e Lisa Leffert. "Low Molecular Weight Heparin, Unfractionated Heparin and Neuraxial Anaesthesia". In Quick Hits in Obstetric Anesthesia, 329–35. Cham: Springer International Publishing, 2022. http://dx.doi.org/10.1007/978-3-030-72487-0_49.

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6

Gray, Elaine. "Standardisation of Unfractionated and Low-Molecular-Weight Heparin". In Heparin - A Century of Progress, 65–76. Berlin, Heidelberg: Springer Berlin Heidelberg, 2011. http://dx.doi.org/10.1007/978-3-642-23056-1_4.

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7

Guerrini, Marco, e Antonella Bisio. "Low-Molecular-Weight Heparins: Differential Characterization/Physical Characterization". In Heparin - A Century of Progress, 127–57. Berlin, Heidelberg: Springer Berlin Heidelberg, 2011. http://dx.doi.org/10.1007/978-3-642-23056-1_7.

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8

Elliott, C. Gregory. "Low Molecular Weight Heparins". In Pulmonary Embolism, 161–71. Tokyo: Springer Japan, 1999. http://dx.doi.org/10.1007/978-4-431-66893-0_12.

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9

Mousa, Shaker A. "Heparin and Low-Molecular Weight Heparins in Thrombosis and Beyond". In Anticoagulants, Antiplatelets, and Thrombolytics, 109–32. Totowa, NJ: Humana Press, 2010. http://dx.doi.org/10.1007/978-1-60761-803-4_3.

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10

Iqbal, Zafar, Omar Hasan e Marc Cohen. "Unfractionated Heparin and Low Molecular Weight Heparin in Ischemic Heart Disease". In Therapeutic Advances in Thrombosis, 111–27. Oxford, UK: Blackwell Publishing Ltd., 2012. http://dx.doi.org/10.1002/9781118410875.ch8.

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Atti di convegni sul tema "Low molecular weight heparin"

1

Ordu, Y., J. Augustin, E. V. Hodenberg, V. Bode e J. Harenberg. "COMPARATIVE CLINICAL PHARMACOLOGY OF LOW MOLECULAR WEIGHT HEPARINS IN MAN". In XIth International Congress on Thrombosis and Haemostasis. Schattauer GmbH, 1987. http://dx.doi.org/10.1055/s-0038-1643228.

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Low molecular weight (LMW) heparins are obtained by diffent chemical procedures from conventional pig intestinal mucosa heparin. The LMW heparins differ in their molecular weight distribution and physicochemical properties. Therefore, we report of comparative studies on the anticoagulant and lipolytic effects of low molecular weight heparins in man.The following LMW heparins were used: BM 21-23 (Braun, Melsungen, FRG), CY 216 (Choay Laboratories, Paris, France), Heparin NM (Sandoz, Niimberg, FRG), Kabi 2165 (Kabi Vitrum AB, Stockholm, Sweden), RD Heparin (Hepar Industries, Franklin, US A), normal heparin (Braun). All heparins were administered intravenously and subcutaneously to six volunteers each.The data show considerable differences in the anticoagulant and lipolytic effects between the different low molecular weight heparins. From the area under the activity time curves (AUC) of the clotting assays for factor Xa (heptest), aPTT and thrombin clotting time the aXa/aPTT ratio ex vivo and aXa/alla ratio ex vivo were determined (table, average values)It can be seen that there are clear differences in the ex vivo ratios of the LMW heparins. There is a good correlation between the average molecular weight of the LMW heparins and the aXa/aPTT ratio after s.c. administration and of the aXa/alla ratio ex vivo after s.c. administration. Therefore, LMW heparins differ significantly in their clinical pharmacological properties.

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2

Fareed, J., J. M. Walenga, D. Hoppensteadt, R. N. Emanuele e A. Racanell. "PHARMACOLOGIC INEQUIVALENCE OF LOW MOLECULAR WEIGHT HEPARINS". In XIth International Congress on Thrombosis and Haemostasis. Schattauer GmbH, 1987. http://dx.doi.org/10.1055/s-0038-1644163.

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Abstract (sommario):

Compared to unfractionated heparin, low molecular weight heparins (LMWHs) have been found to exhibit marked variations in in vitro effects due to variations in molecular weight and structure. Moreover, when the in vitro potency of these agents is equally adjusted bypharmacopeial assay (current and proposed) wide variations in the in vivo responses have been noted. These variations were strongly dependent on the route of administration. Utilizing defined animal models, a systematic comparative study of the in vivo responses of seven commercial LMWHs was undertaken. Choay Fraxiparine (CY 216} Choay CY 222, NovoLHN, Kabi Fragmin, Opocrin 2123 (OP), Hepar RD 11885 (RD), Pharmuka Enoxaparin (PK) and Choay porcine mucosal heparin (PMH) were tested in identical settings at equigravimetric dosages. The graded results are given in the following.Wide variations in the in vivo pharmacologic and toxicity responseswere noted suggesting that different LMWHs are not bioequivalent at equigravimetric levels. When these responses were expressed in anti-factor Xa or pharmacopeial potency, these differences were further magnified. The clinically reported dosimetric and safety problems may be minimized by profiling LMWHs in defined in vivo test systems to optimize their safety/efficacy ratio.

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3

Lasker, S. E., B. Y. Lee e R. E. Madden. "LOW MOLECULAR WEIGHT HEPARINS s ORAL ABSORPTION IN MONKEYS". In XIth International Congress on Thrombosis and Haemostasis. Schattauer GmbH, 1987. http://dx.doi.org/10.1055/s-0038-1644855.

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An orally administered low molecular weight heparin-like derivative of the commercial polydisperse polysaccharide is desirable clinically. The dissociation of antithrombotic properties and the induction of bleeding as well as minimal effect on platelet function are characteristics of some low-molecular weight heparins; however the circulating level of the anti Xa activity associated with demonstrable theraputic efficacy is not yet defined.The availability of a variety of low molecular weight heparins provided us with the opportunity to evaluate the gastrointestinal absorption characteristics of the preparations in the primate.Average molecular weight is only one of a spectrum of variables associated with absorbability, while Xa/APTT ratio differences and non-equivalent structural alterations may be responsible for functional differences in a living test system. Nevertheless, because of the clinical potential it is instructive to evaluate the GI absorbability of several preparations for which we have precise molecular weight data.Preparations: Low molecular weight heparins were prepared by a variety of methods including isolationby alcohol fractionation from broadly polydisperse commercial or crude heparins, depolymerization of commercial or crude heparin and franctionation of depolymerization products.Methods:Molecular weights were established by equilibrium ultracentrifugation and anti Xa activity was assayed by the Yin-Wessler coagulation method. Faste rhesus monkeys weighing 8-13 kg. were anesthestized and intubated with a radio opaque catheter. One cubic centimeter of a heparin preparation in saline was instilled directly into the duodenum. Blood samples assayed for anti Xa activity and thromboelasticity were drawn at periodic intervals from an indwelling femoral catheter.Results:Standard unfractionated heparin was detectable in blood only after one-half hour. The maximum activity for low molecular weight preparations was achieved after one-half to one hour.One fraction demonstrated activity in the plasma after four hours. Thedose response curve for one fraction at half-hour wascuyvilineal between 7 and 16 Mg/Kg.

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4

Zimmerman, R. A., C. T. Rieger, K. Hübner, C. W. Harenber e W. Kübler. "EXPERIMENTAL THROMBUS FORMATION AND HAEMOSTASIS OF DIFFERENT LOW MOLECULAR WEIGHT HEPARINS AND DOSAGES". In XIth International Congress on Thrombosis and Haemostasis. Schattauer GmbH, 1987. http://dx.doi.org/10.1055/s-0038-1644162.

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Low molecular weight heparin induces a higher anti factor Xa (a-Xa) and a lower antithrombin activity in plasma in comparison to conventional heparin. From this constellation a more pronounced antithrombotic effect and a minor incidence of bleeding Complications has been suggested.Therefore the antithrombotic activity of heparins was studied in a standardized experimental thrombosis model in rabbits. Three low molecular weight heparins with a mean molecular weight of 4.200 (heparin I),4.000 (heparin II),4.600 Dalton (heparin III) and standard heparin were tested at different dosages in 120 experiments. In the first series the dose of 60 anti Xa units (a-Xa U) given initially and 60 a-Xa U/kg/h induced a reduction of the thrombus size by 40 % (heparin I),37 % (heparin II) and 53 % (heparin III) and a prolongation of the aPTT to 45 (heparin I),66 (heparin II) and 79 sec (heparin III). The a-Xa activity was minor than 0.1 U/ml. In the second series heparins were given to aim at an a-Xa activity of 0.2-0.3 U/ml. Thereby the thrombus formation could be reduced by 84 % (heparin I), 62 % (heparin II) and 39 % (heparin III). aPTT and a-Xa activity were measured at 65.5 sec and 0.22 a-Xa U/ml (heparin I),67.3 sec and 0.3 a-Xa U/ml (heparin II) and 67.5 and 0.31 a-Xa U/ml (heparin III),respectively. In the third series the increase of the a-Xa activity to more than 0.3 U/ml showed no further reduction of the thrombus formation by heparin I, while heparins II and III already at this level reachedthe antithrombotic activity of heparin I.Our data on three different low molecular weight heparins demonstrate that already a heparin level ranging at a minimal a-Xa activity induces a clear and statistically significant antithrombotic effect. A higher heparin dosage with higher a-Xa activity increases the antithrombitic effect. At a level of 0.2-0.3 a-Xa U/ml an obvious and maximum effect could be reached, but the further elevation of the a-Xa activity produced no further antithrombotic action.

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5

Mätzsch, T., D. Berggvist, U. Hedner, B. Nilsson e P. Østergaard. "INDUCTION OF OSTEOPOROSIS IN RATS BY STANDARD HEPARIN AND LOW MOLECULAR WEIGHT HEPARIN". In XIth International Congress on Thrombosis and Haemostasis. Schattauer GmbH, 1987. http://dx.doi.org/10.1055/s-0038-1642930.

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Long-term treatment with heparin can induce osteoporosis. This complication is suspected to be related to the dosage of heparin rather than to duration of therapy, but the mechanism by which heparin induces osteoporosis is unknown. In a previous study we reported the same degree of reduction in mineral bone mass in rats after treatment with 2 IU heparm/g bw for 33 and 65 days (Thromb Haemostas 1986,56:293-4). Using the same animal model we compared the effect of a high-dose standard heparin (SH) and a low molecular weight heparin (LMWH) in a high and a low dose on the mineral bone mass in the femur of rats. Method: 60 female Wistar rats (207±1.8 g) were randomly allocated to treatment with either 2 Xal U/g bw of standard heparin (SH), 2 Xal U/g bw of LMWH ("high-dose"), 0.4 Xal U/g bw LMWH ("low-do-se") or placebo (saline). A standard sodium salt heparin of porcine origin was used, and the LMWH was an enzymatically depolymerized pork mucosal heparin (LHN-1, mean MW 4900 D). Treatment with s.c. injections was continued for 34 days. 24 hours after the last injection the rats were sacrificed and the carefully cleaned femora weighed in air and in water under standardized conditions. Volumes and densities were calculated from the weights. The bones were then incinerated for 48 hours at 600°C and weighed again to determine the ash content (expressed as ash weight per ml of unashed femur volume). Results: There was a significant decrease in ash content (p<0.01) and density (p<0.01) of the femora in all heparin treated groups as compared with controls. High-dose LMWH caused the same reduction in bone mineral mass as standard heparin. Treatment with low-dose LMWH resulted in a significantly less pronounced reduction in ash content (p<0.001) and density (p<0.05) of the femora when compared with high-dose standard heparin and high-dose LMWH. CONCLUSION: Daily injections of 2 Xal U/g body weight of standard heparin or low molecular weight heparin for 34 days causes the same degree of reduction of mineral bone mass in rats. The reduction of mineral bone mass in rats by treatment with low molecular weight heparin is dose dependent.

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6

Giese, Ch, A. Knodler, R. Zimmermann e J. Harenberg. "A NEW ONE STAGE CLOTTING ASSAY FOR HEPARIN AND LOW MOLECULAR WEIGHT HEPARINS". In XIth International Congress on Thrombosis and Haemostasis. Schattauer GmbH, 1987. http://dx.doi.org/10.1055/s-0038-1644851.

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Heparin and its low molecular weight (LMW) derivatives are usually measured by chromogenic or fluorogenic synthetic substrate assays and by coagulation tests. Since the activated partial thromboplastin time (aPTT) and thrombin clotting time (TCT) are insensitive to LMW heparins, we report here of data obtained with heptest, a new one stage modification of the original heparin in plasma assay of Yin. The assay was compared with the antifactor Xa chromogenic substrate S2222 method, the TCT and aPTT tests in 100 patients receiving unfractionated pig intestinal mucosa heparin and 100 patients treated with low molecular weight heparin Kabi 2165. The results indicate a high correlation between the heptest and the anti Xa chromogenic substrate method, whereas the correlations were lower for the aPTT and TCT. correlations with LMW heparinThe lowest detection limit of the heptest is 0,005 heparin units per ml plasma. The test is very sensitive, simple, highly reproducable and reliable clotting assay for unfractionated and low molecular weight heparins in human plasma. The test detects with high preference the inhibition on factor Xa but also the other anticoagulant effects on die coagulation tractors.

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7

Sakuragawa, N., T. Shimotori e K. Takahashi. "COMPARATIVE STUDIES ON ANTITHROMBIN III AFFINITY OF LOW MOLECULAR WEIGHT HEPARIN AND UNFRACTIONATED HEPARIN". In XIth International Congress on Thrombosis and Haemostasis. Schattauer GmbH, 1987. http://dx.doi.org/10.1055/s-0038-1644365.

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Purpose: Low molecular weight(LMW)heparin shows stronger antifactor Xa(F-Xa) and weaker anti-thrombin(TH) activities compared with unfractionated(UF) heparin, and shows less bleeding tendency in the cases of clinical use. These characteristics were surmised to be depend on antithrombin III(AT-III) affinity of the heparin. Materials and methods: LMW heparin(Kabi and Pharmuka), UF heparin (Novo) and heparin cofactor II(HC-II) purified by our method were used. AT-III affinity column chromatography with 0.1 M Tris-buffer (pH 7.4)-NaCl 0.02 to 2.5 M linear gradient was performed. From the point of AT-III affinity strength, non-affinity(Na), low affinity (La) and high affinity(Ha) were separated, and aPTT, anti-F-Xa and anti-TH activities were assayed on each fractions. HC-II was assayed by biological activity.Results: (1) Kabi-LMW heparin; Na 34.5%, La 39.3%, Ha 26.2%, Pharmuka-LMW heparin; Na 58.0%, La 24.1%, Ha 17.3%. Novo; Na 0%, La 50%, Ha 50%. (2) APTT; Na showed no effect, but Ha showed the strongest prolonging effects on aPTTs even having less amount of uronic acid, and more prominent effects were observed in UF(Novo)-heparin than LMW heparins. (3) La showed higher activity of anti-F-Xa and anti-TH activities than Ha. (4) Anti-TH activity of AT-III was observed in both fractions of La and Ha, but that of HC-II was observed in each fractions including Na.Conclusion: It was surmised that the differences of the characteristics between LMW heparin and UF heparin were depend on to the strength of AT-III. The different characteristics of HC-II from AT-III to anti-TH were observed and surmised to be depend on the binding ability to the fractions.

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8

Briel, R. C., P. C. Hermann e P. Doller. "LOW MOLECULAR WEIGHT HEPARIN (FRAGMIN) PROPHYLAXIS IN GYNECOLOGIC SURGERY". In XIth International Congress on Thrombosis and Haemostasis. Schattauer GmbH, 1987. http://dx.doi.org/10.1055/s-0038-1643223.

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In a prospective, randomized study patients undergoing hysterectomy were treated either by the low molecular weight heparin Fragmin or by the combination of unfractionated sodium heparin + dihydroergotamin (HDHE). The dosage in the Fragmin group was 2× 2500 anti Xa-U on day 1 = day of surgery, from day 2-8: 1× 5000 anti Xa-U, in the HDHE-group from day 1-8: 2× 5000 IU heparin + 0.5 mg DHE. 99 patients were randomly allocated to prophylaxis with Fragmin, 101 to HDHE prophylaxis. 95 and 96 respectively were evaluated, the others excluded for different reasons. The 2 groups were comparable for general data and risk factors. Duration of surgery, intraoperative blood loss, transfusion rates and postoperative hemoglobin levels were identical. Blood volumes in subcutaneous and subfascial drainages were slightly but not significantly higher in the Fragmin group. In patients with an additional Marshall-Marchetti-operation, blood volumes in the drainages of the spatium retzii were significantly higher in patients on Fragmin. No differences were observed in the incidence of minor and major wound hematoma. Painful injections and sugillations at the injection sites were more frequently observed in the HDHE-group. The thermographic DeVeTherm test, which was carried out daily for diagnosis of DVT, gave positiv results (= temperature difference 1°C) on one day only in 14 patients of each group. The test was positive on 2 or more consecutive days in 4 patients on Fragmin and 2 patients on HDHE. Phlebography, which was carried out in the latter patients, gave a positive result in 1 patient of each group. Localization of DVT was mainly the lower limb. Plasma anti-Xa activity (S-2222) 4 hrs. after injection of 5000 anti-Xa IU Fragmin was 0.45 IU/ml being 10 fold higher than after HDHE. aPTT was slightly prolonged in both groups, thrombin time and thrombelastogramm gave even more pronounced changes in the Fragmin group. The present data indicate that Fragmin dosage should be further decreased to avoid bleeding complications.

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9

Chong, B. H., F. Ismail, J. Cade, A. S. Gallus, S. Gordon e C. N. Chesterman. "HEPARIN-INDUCED THROMBOCYTOPENIA: IN VITRO STUDIES WITH LOW MOLECULAR WEIGHT HEPARINOID, ORG 10172". In XIth International Congress on Thrombosis and Haemostasis. Schattauer GmbH, 1987. http://dx.doi.org/10.1055/s-0038-1643926.

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Heparin-induced thrombocytopenia (HIT), an adverse effect of heparin therapy, may be associated with serious thrombosis resulting in severe disability or death. An IgG heparin-dependent antibody may be demonstrated in HIT by platelet aggregation studies with patient serum/plasma and standard (s) heparin. A recent study showed high cross-reactivity of the antibody with low molecular weight (LMW) heparins as most of the 22 patient sera tested gave a positive reaction with various LMW heparins including CY222, CY216, PK10169 and Kabi 2165 (Messmore HL et al, Blood 64(5), 1984 suppl). However, cross-reactivity rate with Org 10172, a LMW heparinoid which has strong anti-Xa but negligible antithrombin activity, is unknown. We tested the plasma of 17 patients with HIT for cross-reactivity with Org 10172. Although all 17 patient plasmas reacted positively with s.heparin (0.2 1.0 IU/ml), only 3 patient plasmas gave a positive but weaker reaction with Org 10172 (0.2-1.0 IU/ml).Further studies were performed to investigate the effect of adding Org 10172 (0.2 to 2.0 anti-Xa U/ml) to a reaction mixture of normal platelet-rich plasma, patient plasma and s.heparin (0.2 IU/ml). With 7 patient plasmas which showed no cross-reactivity with Org 10172, the antibody-induced platelet aggregation was inhibited when the concentration of Org 10172 exceeded 0.5 to 1.0 anti-Xa U/ml. When the study was repeated with other s.heparin concentrations (0.05, 0.1, 0.4 IU/ml), this inhibitory effect was again present provided the ratio of Org 10172 concentration (anti-Xa U/ml) to heparin concentration (IU/ml) exceeds 2.5 to 5. However, this inhibitory effect was not observed with the 3 patient plasmas which showed cross-reactivity with the heparinoid whqp. the same concentrations of Org 10172 were added. This inhibitory effect appeared to be specific for platelet aggregation induced by the heparin-dependent antibody as Org 10172 (<10 anti-Xa U/ml) did not affect platelet aggregation induced by collagen (2 ug/ml) and ADP (2.5 uM). These findings together with our experience of 3 cases of HIT successfully treated with Org 10172 suggest that this LMW heparinoid may be a useful drug for the treatment of HIT.

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10

Emanuele, R. M., e J. Fareed. "THE EFFECT OF MOLECULAR WEIGHT ON THE RELATIVE BIOAVAILABILITY OF HEPARIN". In XIth International Congress on Thrombosis and Haemostasis. Schattauer GmbH, 1987. http://dx.doi.org/10.1055/s-0038-1644179.

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Three fractions of different molecular weight (M. W.) were obtained from gel-filtration of porcine mucosal heparin. These fractions along with unfractionated and a low M. W. heparin (CY 216) were compared for relative bioavailability in primates (Macaca mulatta: n = 5). The M. W.'s of all fractions were determined using high performance liquid chromatography - gel permeation and characterizied in terms of mean M. W., peak M. W. and M. W. distribution. Area under the plasma concentration time curve (AUC) was calculated by the trapezoidal method after intravenous and subcutaneous administration and used as an index of bioavailability. For the AUC calculations, plasma heparin concentrations were determined using a Xa/IIa clotting assay (Heptest) and individual callibration curves. Using the AUC data, relative bioavailability was calculated using the following formula:Bioavailability = subcutaneous AUC / dose intravenous AUC / dose Significant differences in the bioavailability of the various molecular weight fractions were observed and inversely related to M. W. The highest M. W. fraction (23,000) showed the least bioavailability at 3 %. The bioavailability of the 13,300 M. W. fraction was 9 % while the 5,100 M. W. fraction was 93 % bioavailable. CY 216 (M. W. 5,400) displayed a relative bioavailability of 88 % while unfractionated heparin (M. W. 12,600) was 40 %. The apparent discrepancy in the bioavailability of the unfractionated heparin is likely due to differences in molecular weight distribution.These studies suggest that the M. W. of heparin preparations influences the relative bioavailability. Heparins of lower M. W. exhibit greater relative bioavailability compared to high M. W. preparations. Furthermore, characterization of both mean M. W. and M. W. distribution are necessary for predicting the bioavailability characteristics of heparin. The relationship between relative bioavailability and the M. W. of heparin may help identify low M. W. heparins as a more efficient agent for subcutaneous regimens in the prophylaxis of venous thrombosis.

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Rapporti di organizzazioni sul tema "Low molecular weight heparin"

1

Chen, Chen, Peng Chen, Xia Liu e Hua Li. Combined 5-Fluorouracil and Low Molecular Weight Heparin for the Prevention of Postoperative Proliferative Vitreoretinopathy in Patients with Retinal Detachment. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, agosto 2021. http://dx.doi.org/10.37766/inplasy2021.8.0117.

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Review question / Objective: The aim of this meta-analysis is to evaluate the efficacy and safety of intraoperative infusion of combined 5-fluorouracil and low molecular weight heparin (LMWH) for the prevention of postoperative proliferative vitreoretinopathy in patients with retinal detachment. Condition being studied: Postoperative proliferative vitreoretinopathy (PVR) is the primary cause of failure of retinal reattachment surgery. 5-fluorouracil (5-FU) inhibits the proliferation of fibroblasts, and suppresses collagen contraction. On the other hand, heparin reduces fibrin exudation, and inhibits the adhesion and migration of retinal pigment epithelial cells. We conduct this comprehensive literature search and meta-analysis to address whether intraoperative infusion of combined 5-FU and LWMH improves the primary success rate of pars plana vitrectomy, as well as reduces postoperative PVR. Our study aims to provide clinical evidence for retinal surgeons concerning their choice of intraoperative medication.

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2

Wei, Qingqing, Weiying Wang, Guobin Miao, Li Li, Ge Wang, Chang Meng e Peng Liu. Aspirin Versus Low-Molecular-Weight Heparin for Venous Thromboembolism Prophylaxis in Patients after Postoperative Joint Surgery: A Meta-Analysis. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, febbraio 2023. http://dx.doi.org/10.37766/inplasy2023.2.0117.

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3

Rungjirajittranon, Tarinee, Weerapat Owattanapanich, Yingyong Chinthammitr, Theera Ruchutrakool e Bundarika Suwanawiboon. Direct oral anticoagulants versus low-molecular-weight heparin for acute treatment of venous thromboembolism in patients with gastrointestinal cancer: A systematic review and meta-analysis. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, agosto 2021. http://dx.doi.org/10.37766/inplasy2021.8.0113.

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4

Roberts, Christine Cardinal, Alan Graham, Martin Nemer, Leslie M. Phinney, Robert M. Garcia, Melissa Marie Soehnel e Emily Kate Stirrup. Physical Properties of Low-Molecular Weight Polydimethylsiloxane Fluids. Office of Scientific and Technical Information (OSTI), febbraio 2017. http://dx.doi.org/10.2172/1343365.

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5

Gao, H. Crosslinked, flexible, low-molecular-weight polyacrylamide gels for mobility control. Office of Scientific and Technical Information (OSTI), dicembre 1989. http://dx.doi.org/10.2172/5405561.

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6

Scharf, Michael E., Sam N. Nguyen, Cheol Song e Phillip G. Koehler. Bioassay for Volatile Low Molecular Weight Insecticides and Methods of Use. Fort Belvoir, VA: Defense Technical Information Center, luglio 2007. http://dx.doi.org/10.21236/ada605489.

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7

Woods, W. T., e Jr. Mechanisms of Action of Low Molecular Weight Toxins in the Cardiovascular System. Fort Belvoir, VA: Defense Technical Information Center, ottobre 1987. http://dx.doi.org/10.21236/ada225113.

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8

Ren, Tong. Hydrolytic and Peroxyhydrolytic Degradation of Nerve Agent Analogs with Low Molecular Weight Bimetallic Catalysts. Fort Belvoir, VA: Defense Technical Information Center, gennaio 2005. http://dx.doi.org/10.21236/ada429791.

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9

Arenson, D. R., e C. J. King. Separation of low molecular weight alcohols from dilute aqueous solutions by reversible chemical complexation. Office of Scientific and Technical Information (OSTI), aprile 1989. http://dx.doi.org/10.2172/6094599.

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10

Wingate, Hannah F., e Khandan Keyomarsi. The Role of the Low Molecular Weight (LMW) Isoforms of Cyclin E in Breast Cancer Tumorigenesis. Fort Belvoir, VA: Defense Technical Information Center, giugno 2005. http://dx.doi.org/10.21236/ada443238.

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