Cusp tear in bicuspid aortic valve possibly caused by phentermine
ABSTRACT A 28 year old woman underwent echocardiography following an incidental finding of a diastolic murmur. She has been taking phentermine for weight reduction for 8 months. Trans-esophageal echocardiography revealed a tear of the posterior cusp of the aortic valve causing severe regurgitation. Phentermine is known to cause valvular disease with prolonged use, but aortic valve rupture was not previously reported as a complication of phentermine valvulopathy. (c) 2005 Elsevier Ireland Ltd. All rights reserved.
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ABSTRACT: Weight loss can reduce the increased cardiovascular risk associated with obesity. Pharmacotherapy is a recognized weight loss treatment option; however, cardiovascular safety issues with some previous weight loss drugs raise concerns for newly approved pharmacotherapies. Phentermine is approved for short-term obesity treatment in conjunction with lifestyle modifications, but is commonly used chronically. Topiramate, approved for treating epilepsy and preventing migraines, also induces weight loss. A single-dose combination of low-dose phentermine and topiramate extended-release was recently approved by the United States Food and Drug Administration as an adjunct to lifestyle intervention for the chronic treatment of overweight/obese adults. This review summarizes and evaluates the cardiovascular risk/benefit profile associated with phentermine and topiramate, individually and in combination. Cardiovascular data associated with long-term use of phentermine and topiramate extended-release indicate that this combination may be a safe and effective option for reducing weight in overweight/obese patients at low-to-intermediate cardiovascular risk.This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivitives 3.0 License, where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially. http://creativecommons.org/licenses/by-nc-nd/3.0.Journal of Hypertension 03/2014; 32(6). DOI:10.1097/HJH.0000000000000145 · 4.22 Impact Factor
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ABSTRACT: Obesity has become particularly prevalent in both the United States and worldwide. Mississippi continues to lead the nation in prevalence of obesity estimates. The proportion of morbidly obese subjects is increasing at a disproportionately greater rate and the burden of obesity and its complications are more prevalent among ethnic minorities. We present the unique case of a Choctaw lady with morbid obesity who has shown a profound response to pharmacotherapy with phentermine. The clinical case history of the patient; a 34-year-old Choctaw lady with morbid obesity, hypertension, hyperlipidemia, and type 2 diabetes is presented, followed by discussion of issues relevant to impacting the obesity epidemic in Mississippi. A 34-year-old Choctaw lady with 1.5 year follow up was noted to have a peak initial body mass index (BMI) of 62.6 kg/m2 and weight of 176 kg. Since commencement of phentermine, initially at 15 mg daily and slowly up-titrated to 37.5 mg daily, she has lost over 23 kg (13% of baseline peak weight) with a current weight of 153 kg and BMI of 54.4 kg/m2. Accompanying the weight reduction has been sustained normal blood pressure and improvement in glycemic control. Phentermine is a viable and important adjunct in the medical approach to weight management in obese subjects. Its potential utility should be considered even among subjects with morbid obesity. Given its cost it could be a cost effective adjunct in comprehensive weight loss programs for Mississippi that may positively impact the ongoing obesity epidemic. There remains a need for more studies of phentermine to better define its place in obesity management.Journal of the Mississippi State Medical Association 12/2009; 50(12):407-15.
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ABSTRACT: The softening mechanisms after hot deformation of an austenitic stainless steel under different thermomechanical conditions were modelled using a 2D cellular automaton (CA) model. The input data to the CA model included stored energy during deformation, different levels of dynamically recrystallized (DRX) microstructures, temperature, strain and strain rate. The effects of the parameters were studied on the static and meta-dynamic recrystallization (SRX and MDRX, respectively) kinetics using the CA model. As in reality, it is not possible to abandon DRX episode from the experimental procedure and obtain SRX or MDRX, it would not be practical to study the effect of DRX on the consequent SRX and MDRX. To study the explicit effect of DRX on the post-deformation softening kinetics, deformation was simulated with and without the occurrence of DRX. Comparison of the results for the two different deformation conditions revealed that DRX and the partial recrystallized austenitic microstructure affected the post-deformation softening mechanisms by a deceleration of the post-deformation recrystallization kinetics and that the time for 50% recrystallization (t50) decreased with increasing strain, strain rate and temperature for a given initial grain size.Computational Materials Science 03/2012; 54. DOI:10.1016/j.commatsci.2011.10.023 · 1.88 Impact Factor