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Recommendations for obesity prevention and treatment confront biological adaptations Share This Page
  February 12, 2015Experts suggest obesity is a chronic disease with largely biological causes. "For most individuals, these biological adaptations need to be addressed for weight loss to be sustained long-term," they note.

Experts suggest obesity is a chronic disease with largely biological causes. "For most individuals, these biological adaptations need to be addressed for weight loss to be sustained long-term," they note. "We believe these mechanisms largely explain the poor long-term success rates of lifestyle modification, and obligate clinicians to go beyond mere recommendations to eat less and move more." They suggest that many clinicians may not be familiar enough with the reasons that people with obesity face in achieving and maintaining weight loss. The authors' clinical recommendations for obesity prevention and treatment include proactively addressing prevention with overweight patients, focusing on lifestyle choices, and continuing to monitor progress and adjust strategy as necessary. In terms of treatment, they recommend encouraging patients with obesity to consider treatment, even if it is not the primary complaint; considering biologically based interventions; implementing a multifaceted treatment strategy; recommending surgery when appropriate; and informing patients of the challenges to weight-loss maintenance.

The Lancet Diabetes & Endocrinology (02/11/2015) Ochner, Christopher N.; Tsai, Adam G.; Kushner, Robert F.; et al.

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RhOD immune globulin products for prevention of alloimmunization during pregnancy Skip to main page content

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RhOD immune globulin products for prevention of alloimmunization during pregnancy Samuel L. Aitken and Eric M. Tichy?

Samuel L. Aitken, Pharm.D., BCPS, is Clinical Pharmacy Specialist in Infectious Diseases, The University of Texas MD Anderson Cancer Center, Houston. Eric M. Tichy, Pharm.D., FCCP, BCPS, is Senior Clinical Pharmacy Specialist, Solid Organ Transplantation, and Director, Postgraduate Year 2 Residency, Department of Pharmacy Services, Yale–New Haven Hospital, New Haven, CT. Address correspondence to Dr. Tichy (eric.tichy{at}ynhh.org). Abstract Purpose The pharmacologic properties of Rhesus (Rh) immune globulin (RhIG) and clinical data on its effectiveness in preventing Rh-antigen alloimmunization in pregnant women are reviewed.

Summary RhIG is a human plasma derivative that targets red blood cells (RBCs) positive for RhO antigen (also called D antigen). In the United States and other countries, the widespread use of RhIG has markedly reduced the occurrence of hemolytic disease of the fetus and newborn (HDFN), a devastating condition caused by D-antigen sensitization of a pregnant woman via exposure to fetal RBCs (usually during detachment of the placenta in labor) that results in a maternal immune response leading to severe hemolysis in the fetus. Routine administration of RhIG at 26–30 weeks’ gestation and again within 72 hours of delivery has been shown to be highly effective in preventing maternal Rh alloimmunization, with very low rates of D-antigen sensitization (in the range of 0–2.2%) reported in multiple studies of at-risk women. The four RhIG products currently available in the United States have common clinical indications but differ in certain attributes. Pharmacists can play an important role in guiding other clinicians on the rationale for the use of RhIG, important differences between products, and appropriate timing of RhIG therapy.

Conclusion Routine administration of RhIG to women at risk for Rh alloimmunization is clinically effective and has made HDFN a rare clinical event. The available RhIG products are not the same and should be carefully reviewed to ensure that they are administered safely.

Copyright ? 2015 by the American Society of Health-System Pharmacists, Inc. All rights reserved. CiteULike Delicious Digg Facebook Google+ Reddit Twitter What's this?

? Previous | Next Article ? Table of Contents This Article doi: 10.2146/ajhp140288 American Journal of Health-System Pharmacy February 15, 2015 vol. 72 no. 4 267-276 ? Abstract Full Text Full Text (PDF) Classifications Print Content Clinical Review Services Email this article to a colleague Alert me when this article is cited Alert me if a correction is posted Alert me when eLetters are published Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Download to citation manager eLetters Submit an eLetter No eLetters published Citing Articles Load citing article information Google Scholar Articles by Aitken, S. L. Articles by Tichy, E. M. PubMed PubMed citation Articles by Aitken, S. L. Articles by Tichy, E. M. Related Content Load related web page information Social Bookmarking CiteULike Delicious Digg Facebook Google+ Reddit Twitter What's this?

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