Objective: This study aims to examine the effects of persuasive messages focused on the labeling of previous blood donation behavior on subsequent donation among experienced blood donors. Method: Participants (N = 410) received blood drive invitations by mail that were categorized with the labeling of the previous donation. They were randomly assigned to one of three conditions: functional labeling (which underlines the utility of their donation), social labeling (which underlines their own social value), and no label of previous donation (control condition). Dependent Variable: Number of participants who made a new blood donation. Results: Donors are more likely to make a new blood donation when they have received a message labeling their previous donation (26.7%), whether it be social or functional, compared with a nonlabeled message (17.5%). Moreover, labeling condition interacted with age parameter indicating that the older the donor, the more sensitive the donor to the labeling technique. Labeling condition also interacted with gender, revealing that women were almost three times more likely to come back to give their blood in labeling conditions compared with the no-label condition. Conclusion: Our findings highlight the interest in using strategies based on the recall of previous donation, that is a labeling technique, to help blood centers to stimulate repeat donation. Labeling the previous donation increases the likelihood of a new donation among experienced donors, especially among older people and women, the latter being a part of the most reluctant profiles to repeat blood donation. (PsycINFO Database Record (c) 2014 APA, all rights reserved). PMID:23895199
Sénémeaud, Cécile; Georget, Patrice; Guéguen, Nicolas; Callé, Nathalie; Plainfossé, Candice; Touati, Christelle; Mange, Jessica
Abstract Introduction Obese living donors who undergo donor nephrectomy have higher rates of intra-operative and post-operative complications. Many centres exclude obese donors from living donor transplant programs. Diet, exercise and medication are often ineffective weight loss interventions for donors, hence bariatric surgery should be considered. Case presentation We report the case of a 53-year-old Caucasian woman who underwent laparoscopically adjustable ga...
Full Text Available Abstract Introduction Obese living donors who undergo donor nephrectomy have higher rates of intra-operative and post-operative complications. Many centres exclude obese donors from living donor transplant programs. Diet, exercise and medication are often ineffective weight loss interventions for donors, hence bariatric surgery should be considered. Case presentation We report the case of a 53-year-old Caucasian woman who underwent laparoscopically adjustable gastric banding. The procedure enabled her to lose sufficient weight to gain eligibility for kidney donation. After losing weight, she had an uncomplicated laparoscopic donor nephrectomy surgery, and the recipient underwent successful kidney transplantation. Conclusion Laparoscopically adjustable gastric banding should be considered for obese potential living kidney donors whenever transplantation units restrict access to donor nephrectomy based on the increased surgical risk for donors.
Coombes Jeff S
Full Text Available SciELO Brazil | Language: English Abstract in english In the past, morbid obesity was considered a relative contraindication to renal donation; however, more recent publications have shown that laparoscopic renal surgery is safe and effective for obese donor nephrectomy. We report the performance of a bariatric surgery before the kidney donation in 2 p [...] atients in order to improve their medical condition and to reduce their surgical risk to the transplantation procedure. After bariatric surgery, both donors lost more than 30% of their initial corporal weight and their donation procedure was successfully performed, with uneventful postoperative courses.
Anibal W., Branco; Alcides J., Branco Filho; William, Kondo.
We examined the impact of donor obesity on surgical complications and graft function after pancreas transplants. From January 1994 through December 2001, we performed 711 cadaver pancreas transplants. We analyzed outcomes for three groups based on donor body mass index (BMI): 30 (n=81). Donor characteristics were similar between the three groups except for donor cause of death. Cerebrovascular deaths were more common in the BMI >30 group (p=0.002), while trauma deaths were more common in the BMI 30 group, surgical complications, most notably surgical infections and thrombosis, were significantly more common; in addition, technical failure rates were higher and short-term graft survival was inferior. The incidence of technical failure was 9.7% in the BMI 30 group (p=0.04). However, when we looked at only technically successful transplants, we found minimal differences in the three groups with regard to graft survival at 1 and 3 years posttransplant. Donor obesity increased the incidence of surgical complications in our pancreas recipients, but did not affect initial graft function posttransplant. Technically successful transplants using obese donors results in good graft function at 1 and 3 years posttransplant. PMID:15023153
Humar, Abhinav; Ramcharan, Thigarajan; Kandaswamy, Raja; Gruessner, Rainer W G; Gruessner, Angelika G; Sutherland, David E R
Delayed graft function (DGF) is a risk factor for poor long-term graft and patient survival after kidney transplantation. The aim of our study was to explore the beneficial effect of steroid maintenance on outcomes in deceased donor kidney (DDK) transplant recipients with DGF. Using organ procurement and transplant network/United network of organ sharing (OPTN/UNOS) database, we identified adult patients who developed DGF following DDK transplantation performed between January 2000 and December 2008. They received induction with rabbit antithymocyte globulin (r-ATG), alemtuzumab or an interluekin-2 receptor blocker (IL-2B) and were discharged on a calcineurin inhibitor (CNI)/mycophenolate (MMF) based immunosuppression with or without steroids. Adjusted graft and patient survivals were compared between steroid versus no steroid groups for each induction modality. Median follow-up was 29.6 months for the 10,058 patients who developed DGF. There were 5624 patients in r-ATG (steroid, n = 4569, no steroid, n = 1055), 819 in alemtuzumab (steroid, n = 301, no steroid, n = 518) and 3615 in IL-2B (steroid, n = 3380, no steroid, n = 235) groups. Adjusted graft survivals were similar for steroid versus no-steroid groups in patients who received r-ATG (HR: 0.98, 95% CI 0.85-1.13, P = 0.75), alemtuzumab (HR 0.88, 95% CI 0.65-1.19, P = 0.41), and IL-2B (HR 1.01, 95%CI 0.78-1.30, P = 0.96) inductions. The adjusted patient survivals were also similar in r-ATG (HR: 1.19, 95% CI 0.96-1.46, P = 0.19), alemtuzumab (HR: 0.89, 95% CI: 0.57-1.39, P = 0.96), and IL-2R (HR: 1.07, 95% CI: 0.77-1.49, P = 0.96) groups. Our study failed to show any significant graft or patient survival benefits associated with steroid addition to CNI/MMF regimen in DDK recipients with DGF. This may be related to the early immunogenic and non-immunogenic allograft damage from DGF with long-term consequences that are unaltered by steroids. PMID:24339515
Tangirala, B; Marcus, R J; Hussain, S M; Sureshkumar, K K
Full Text Available Abstract Background This study explored co-receptor usage and prediction of V3 genotyping algorithms in HIV-1 subtype B' from paid blood donors experienced anti-retroviral therapy in Chinese central province in order to design effectively therapeutic regimen. Methods HIV-1 strains were isolated in treatment HIV-1 infections and treatment-naïve HIV-1 infections, then co-receptor usage of HIV-1 strains was identified based on Ghost cell lines using flow cytometry. HIV-1 V3 region was amplified and submitted into web-server (WebPSSM and geno2pheno to predict HIV-1 co-receptor usage. The feasibility of prediction HIV-1 usage with Web-server assay was analyzed by comparing prediction of V3 genotyping algorithms with HIV phenotype assay based on Ghost cell line. Results 45 HIV-1 strains and 114 HIV-1 strains were isolated from HIV-1 infections exposed anti-retroviral therapy and treatment-naïve, respectively. 41% clinical viruses from ART patients and 18% from treatment-naïve patients used CXCR4 as co-receptor. The net charge in the V3 loop was significantly difference in both groups. The sensitivity and specificity for predicting co-receptor capacity is 54.6% and 90.0% on 11/25 rule, 50.0% and 90% on Web-PSSMx4r5, 68.2% and 40.0% on Geno2pheno[co-receptor]. Conclusion Dual/mixed/X4 co-receptor utilization was higher in ART patients than treatment-naïve patients. It is should paid attention to predicting HIV-1 co-receptor usage based on V3 genotyping algorithms in HIV-1 subtype B' from paid blood donors experienced anti-retroviral therapy in Chinese central province.
Objective: Adipose tissue is a robust source of adipose-derived stem cells (ADSCs) that may be able to provide secreted factors that promote the ability of wounded tissue to heal. However, adipocytes also have the potential to dedifferentiate in culture to cells with stem cell-like properties that may improve their behavior and functionality for certain applications. Approach: ADSCs are adult mesenchymal stem cells that are cultured from the stromal vascular fraction of adipose tissue. However, adipocytes are capable of dedifferentiating into cells with stem cell properties. In this case study, we compare ADSC and dedifferentiated fat (DFAT) cells from the same patient and fat depot for mesenchymal cell markers, embryonic stem cell markers, ability to differentiate to adipocytes and osteoblasts, senescence and telomerase levels, and ability of conditioned media (CM) to stimulate migration of human dermal fibroblasts (HDFs). Innovation and Conclusions: ADSCs and DFAT cells displayed identical levels of CD90, CD44, CD105, and were CD34- and CD45-negative. They also expressed similar levels of Oct4, BMI1, KLF4, and SALL4. DFAT cells, however, showed higher efficiency in adipogenic and osteogenic capacity. Telomerase levels of DFAT cells were double those of ADSCs, and senescence declined in DFAT cells. CM from both cell types altered the migration of fibroblasts. Despite reports of ADSCs from a number of human depots, there have been no comparisons of the ability of dedifferentiated DFAT cells from the same donor and depot to differentiate or modulate migration of HDFs. Since ADSCs were from an obese diabetic donor, reprogramming of DFAT cells may help improve a patient's cells for regenerative medicine applications.
Watson, James E.; Patel, Niketa A.; Carter, Gay; Moor, Andrea; Patel, Rekha; Ghansah, Tomar; Mathur, Abhishek; Murr, Michel M.; Bickford, Paula; Gould, Lisa J.; Cooper, Denise R.
... compound the stress the family feels. Families experiencing homelessness: Are typically comprised of a mother in her ... than other low-income families. 4 Mothers Experiencing Homelessness: The impact of homelessness on mothers is profound. ...
Although many researchers have focused their efforts on studying first-year teachers, little research has been conducted about experienced new teachers, educators who have teaching experience but are new to a school or school system. This qualitative study of the experiences of three experienced new teachers reveals that many experienced new…
Gant, Angela B.
The paper argues that two types of lexical dative experiencers need to be distinguished. Regular dative experiencer arguments are merged in unaccusative structures, but a natural class of unergative predicates optionally license low dative experiencer adjuncts and assign them a theta role. The differences between the two dative types are discussed and explained in a lexicalist framework
Dative experiencer predicates in Hungarian investigates the argument structure and the syntax of appeal to- and important-type predicates in Hungarian. Couched in terms of Reinhart's (2000, 2002) Theta System, the thesis presents arguments for the need to resort to the lexicon in setting up systematic generalizations concerning the licensing and the basic syntactic behavior of dative experiencers. Dative experiencer predicates are distinct both conceptually and thematically from subject- and...
Obesity is a major risk factor for non-communicable diseases (NCDs), such as diabetes, cardiovascular diseases, and cancers. The worldwide prevalence of obesity has almost doubled between 1980 and 2008. In some regions, such as Europe, the Eastern Mediterranean and the Americas, more than 50% of women are overweight. Tonga, Nauru and the Cook Islands show the highest prevalence of obesity worldwide, above 60% in men and in women. China and the United States are the countries that experienced the largest absolute increase in the number of overweight and obese people between 1980 and 2008, followed by Brazil and Mexico. The regions with the largest increase in the prevalence of female obesity were Central Latin America, Oceania and Southern Latin America. Updated data provide evidence that the progression of the epidemic has effectively slowed for the past ten years in several countries. In low-income countries obesity is generally more prevalent among the better-off, while disadvantaged groups are increasingly affected as countries grow. Many studies have shown an overall socio-economic gradient in obesity in modern industrialized societies. Rates tend to decrease progressively with increasing socio-economic status. Children obesity rates in Spain are amongst the highest in the OECD. One in 3 children aged 13 to 14 are overweight. Overweight in infants and young children is observed in the upper middle-income countries. However, the fastest growth occurs in the group of lower middle-income countries. There is a growing body of evidence for an inverse association between SES and child obesity in developed countries. The prevalence of overweight and obesity is high in all age groups in many countries, but especially worrying in children and adolescents in developed countries and economies in transition. PMID:24010741
Pérez Rodrigo, Carmen
Attention to internal body sensations is practiced inmost meditation traditions. Many traditions state that this practice results in increased awareness of internal body sensations, but scientific studies evaluating this claim are lacking. We predicted that experienced meditators would display performance superior to that of nonmeditators on heartbeat detection, a standard noninvasive measure of resting interoceptive awareness. We compared two groups of meditators (Tibetan Buddhist and Kundal...
Khalsa, Sahib S.; Rudrauf, David; Damasio, Antonio R.; Davidson, Richard J.; Lutz, Antoine; Tranel, Daniel
Concern exists about accepting live kidney donation from “medically complex donors” -those with risk factors for future kidney disease. This study’s aim was to examine variation in complex kidney donor use across United States (US) transplant centers. We conducted a retrospective cohort study of live kidney donors using Organ Procurement and Transplantation Network data. Donors with hypertension, obesity, or estimated glomerular filtration rate (eGFR) <60 ml/minute/1.73m2 were considere...
Security is experienced differently in different contexts. This paper argues that in everyday situations, users base their security decisions on a mix of prior experiences. When approaching security and interaction design from an experience approach, tools that help bring out such relevant experiences for design are needed. This paper reports on how Prompted exploration workshops and Acting out security were developed to target such experiences when iteratively designing a mobile digital signature solution in a participatory design process. We discuss how these tools helped the design process and illustrate how the tangibility of such tools matters. We further demonstrate how the approach grants access to non-trivial insights into people's security experience. We point out how the specific context is essential for exploring the space between experience and expectations, and we illustrate how people activate their collections of security experiences rather than deploying one security strategy in all situations.
Mathiasen, Niels Raabjerg; BÃ¸dker, Susanne
Kidney transplantation is the preferred option for patients with end-stage renal disease facing the need for dialysis because it provides maximum survival benefit. The number of people seeking kidney transplantation greatly exceeds available deceased donor organs. Organs from live donors provide a survival advantage over organs from deceased donors while also broadening the pool of available organs. The purpose of this review is to discuss the clinical guidelines that pertain to live kidney organ donation and to describe the nutrition evaluation and care of live kidney donors. The process for living kidney donation is dictated by policies centered on protecting the donor. In a perfect world, the living donor would present with a flawless medical examination and a benign family health history. The obesity epidemic has emerged as a major health concern. Live donor programs are faced with evaluating increasing numbers of obese candidates. These "medically complex donors" may present with obesity and its associated comorbid conditions, including hypertension, impaired glycemic control, and kidney stone disease. The dietitian's role in the live donor program is not well defined. Participation in the living donor selection meeting, where details of the evaluation are summarized, provides a platform for risk stratification and identification of donors who are at increased lifetime risk for poor personal health outcomes. Guiding the donor toward maintenance of a healthy weight through diet and lifestyle choices is a legitimate goal to minimize future health risks. PMID:24523133
Bergen, Carol R; Reese, Peter P; Collins, Donna
Limited data are available describing donor adverse events (AEs) associated with filgrastim mobilized peripheral blood stem cell (PBSC) collections in unrelated volunteers. We report results in 2408 unrelated PBSC donors prospectively evaluated by the National Marrow Donor Program (NMDP) between 1999 and 2004. Female donors had higher rates of AEs, requiring central line placement more often (17% vs 4%, P < .001), experiencing more apheresis-related AEs (20% vs 7%, P < .001), more bone pain (...
Pulsipher, Michael A.; Chitphakdithai, Pintip; Miller, John P.; Logan, Brent R.; King, Roberta J.; Rizzo, J. Douglas; Leitman, Susan F.; Anderlini, Paolo; Haagenson, Michael D.; Kurian, Seira; Klein, John P.; Horowitz, Mary M.; Confer, Dennis L.
Obesity is increasing at an alarming rate throughout the world. Today it is estimated that there are more than 300 million obese people world-wide. Obesity is a condition of excess body fat often associated with a large number of debilitating and life-threatening disorders. It is still a matter of debate as to how to define obesity in young people. Overweight children have an increased risk of being overweight as adults. Genetics, behavior, and family environment play a role in childhood over...
Obesity Data/Statistics Obesity is a growing epidemic in the United States. From 1980 to 2008, the prevalence of obesity among ... likely to be obese than Non-Hispanic whites. Statistics on African Americans and Obesity . Statistics on American ...
Full Text Available SciELO Brazil | Language: English Abstract in portuguese OBJETIVO: Identificar as Representações Sociais (RS) da pessoa estomizada intestinal sobre vivência da sexualidade após confecção do estoma. MÉTODOS: Estudo exploratório, descritivo, qualitativo do ponto de vista do referencial da Representação Social. Participaram 15 estomizados, sendo 8 mulheres, [...] com idade média de 57,9 anos, entre agosto e setembro de 2005. Dados obtidos por entrevistas, transcritas, foram submetidos à análise de conteúdo, originando a unidade temática "Ressignificando a sexualidade" e subtemas. RESULTADOS: Demonstrou-se que o estoma intestinal interfere na dinâmica da vivência da sexualidade, desvelando que os significados a ela atribuídos estão ancorados nas histórias individuais de vida, na qualidade das relações pessoais/conjugais estabelecidas na prática e na percepção da sexualidade, apesar do estoma. CONCLUSÕES: Representações Sociais sobre vivência da sexualidade após estoma estão ancoradas nos significados atribuídos ao corpo, veiculadas no cotidiano e presentes no imaginário social. É influenciada por outros fatores, como alterações fisiológicas decorrentes do ato cirúrgico e da existência de parceiro. Cuidados adotados nas práticas sexuais propiciam maior segurança e conforto nos momentos de intimidade, tornando-as mais próximas daquilo que vivenciavam antes do estoma. A autoirrigação, associada ou não ao oclusor, constituiu estratégia facilitadora para melhor aceitação do estoma, sendo essencial para vida sexual mais prazerosa. A assistência à pessoa estomizada deve ser integral, não se limitando apenas à doença e ao cuidado técnico, que são importantes, mas não únicos. O trabalho interdisciplinar da equipe de saúde deve vislumbrar a pessoa em sua totalidade, buscando real encontro entre sujeitos. Abstract in english OBJECTIVE: Identify the Social Representations (SR) of ostomized people in terms of sexuality after the stoma. METHODS: An exploratory, descriptive, qualitative study using the Social Representation Theory with 15 ostomized people (8 females), mean age of 57.9 years, between August and September 200 [...] 5. Data obtained from transcribed interviews were submitted to content analysis, resulting in the thematic unit "Giving new meaning to sexuality" and subthemes. RESULTS: The study demonstrated that the intestinal stoma interferes in the sexuality experience, showing that the meanings attributed to this experience are based on individual life stories, quality of personal relationships established in practice and perception of sexuality, despite the stoma. CONCLUSIONS: The Social Representations, in terms of experiencing sexuality after the stoma, are based on meanings attributed to the body, associated with daily life and present in the social imaginary. It is influenced by other factors, such as physiological changes resulting from the surgery and the fact of having or not a partner. Care taken during sexual practices provide greater security and comfort in moments of intimacy, resembling the closest to what ostomized people experienced before the stoma. The self-irrigation technique associated or not with the use of artificial occluder, has been attested by its users as a positive element that makes a difference in sexual practice after the stoma. The support to ostomized people should be comprehensive, not limited to technical care and disease, which are important, but not sufficient. The interdisciplinary health team should consider all aspects of the person, seeking a real meeting between subjects.
Paula, Maria Angela Boccara de; Takahashi, Renata Ferreira; Paula, Pedro Roberto de.
Proper evaluation of donor cornea is critical to the success of corneal transplantation. Attention must be paid to the cause of death and ocular condition as several general and ocular diseases constitute contraindications for donor corneal usage. Death to enucleation time should be noted. Gross examination and slit lamp biomicroscopy are mandatory for the evaluation of the donor eye while specular microscopy adds another useful dimension to information regarding donor cornea. This article pr...
The advantages of living donor pancreas transplants for the recipient include good HLA matching, lower immunologic risk, less immunosuppression, lower risk of infection and of posttransplant malignancies, and shorter pancreas graft preservation time. In 2008, a total of 155 segmental pancreas transplants using living donors were reported to the International Pancreas Transplant Registry from six countries. Pancreas living donors need to undergo a thorough pretransplant endocrinologic workup in order to minimize the risk of metabolic complications. The pretransplant workup has evolved over time, after initial reports showed that up to 25% of living donors had elevated hemoglobin A(1c) levels after donation. Avoiding obesity after donation diminishes the risk of long-term metabolic complications. The risk of surgical complications for the donor (such as pancreatitis, pancreatic leak or fistula, pancreatic abscess, and pancreatic pseudocyst) is less than 5%. If both the donor and recipient operations are technically successful, the long-term graft survival rate is significantly higher for living (versus deceased) donor pancreas transplant recipients. Future long-term studies of metabolic function in living donors are warranted to determine whether living donor pancreas transplants can safely be applied more widely and whether living donors can be used for islet transplants. PMID:19652901
Reynoso, Jason F; Gruessner, Christine E; Sutherland, David E R; Gruessner, Rainer W G
Full Text Available Proper evaluation of donor cornea is critical to the success of corneal transplantation. Attention must be paid to the cause of death and ocular condition as several general and ocular diseases constitute contraindications for donor corneal usage. Death to enucleation time should be noted. Gross examination and slit lamp biomicroscopy are mandatory for the evaluation of the donor eye while specular microscopy adds another useful dimension to information regarding donor cornea. This article provides a comprehensive review of all the aspects of donor corneal evaluation as practised today worldwide.
O-Glycosyl donors, despite being one of the last successful donors to appear, have developed themselves into a burgeoning class of glycosyl donors. They can be classified in two main types: O-alkyl and O-aryl (or hetaryl) glycosyl donors. They share, however, many characteristics, they can be (1) synthesized from aldoses, either by modified Fisher glycosidation (O-alkyl) or by nucleophilic aromatic substitution (O-aryl or O-hetaryl), (2) stable to diverse chemical manipulations, (3) directly used for saccharide coupling, and (4) chemoselectively activated. Among these, n-pentenyl glycosides stand apart. They were the first O-alkyl glycosyl donors to be described and have paved the way to many conceptual developments in oligosaccharide synthesis. The development of the chemoselectivity-based "armed-disarmed" approach for saccharide coupling, including its stereoelectronic or torsional variants, now extended to other kinds of glycosyl donors, was first recognized in n-pentenyl glycosides. The chemical manipulation of the anomeric substituent in the glycosyl donor to induce reactivity differences between related species (sidetracking) was also introduced in n-pentenyl glycosides. An evolution of this concept, the "latent-active" strategy for glycosyl couplings, first described in thioglycosyl donors (vide infra), has been elegantly applied to O-glycosyl donors. Thus, allyl and vinyl glycosides, 2-(benzyloxycarbonyl)benzyl (BCB) glycosides and 2'-carboxybenzyl (CB) glycosides are useful "latent-active" glycosyl pairs. Finally, unprotected 3-methoxy-2-pyridyl (MOP) glycosides have been used in glycosylation processes with moderate success.
López, J. Cristóbal
The shifting ideological winds of foreign aid donors have driven their policy towards governments in poor countries. Donors supported state-led development policies in poor countries from the 1940s to the 1970s; market and private-sector driven reforms during the 1980s and 1990s; and returned their attention to the state with an emphasis on…
Thomas, M. A.
This study analyses the experienced age discrimination of old European citizens and the factors related to this discrimination. Differences in experienced discrimination between old citizens of different European countries are explored. Data from the 2008 ESS survey are used. Old age is defined as being 62 years or older. The survey data come from 28 European countries and 14,364 old-age citizens. Their average age is 72 years. Factor analysis is used to construct the core variable ‘exper...
Den Heuvel, Wim J. A.; Santvoort, Marc M.
Full Text Available Presently life style modification at the transitionof menopause will go long way in preventing weight gainduring this metabolically vulnerable period which will helpin primary and secondary prevention of several chronicdiseases (e.g., cardiovascular disease, diabetes, cancer,hypertension, obesity, depression and osteoporosis andpremature death beside keeping women physically andmentally fit in her menopause.
Obesity is the result of long-term energy imbalances, where daily energy intake exceeds daily energy expenditure. Obesity in children is associated with physical as well as psychosocial problems. Long-term adverse health consequences of childhood obesity may include increased risk for cardiovascular and metabolic disease in adulthood. Most obese adolescents stay obese as adults.
Canoy, Dexter; Bundred, Peter
... however you can Daughter's dying wish became mother's motivation Donors and recipients meet Marrow donation leads to ... Roberts Wristband Careers Working with us Career opportunities Employee benefits Contact Us Questions or feedback Request trademark ...
Full Text Available Abstract Background Limited data exist on the impact of living kidney donation on the donor-recipient relationship. Purpose of this study was to explore motivations to donate or accept a (living donor kidney, whether expected relationship changes influence decision making and whether relationship changes are actually experienced. Methods We conducted 6 focus groups in 47 of 114 invited individuals (41%, asking retrospectively about motivations and decision making around transplantation. We used qualitative and quantitative methods to analyze the focus group transcripts. Results Most deceased donor kidney recipients had a potential living donor available which they refused or did not want. They mostly waited for a deceased donor because of concern for the donor’s health (75%. They more often expected negative relationship changes than living donor kidney recipients (75% vs. 27%, p?=?0.01 who also expected positive changes. Living donor kidney recipients mostly accepted the kidney to improve their own quality of life (47%. Donors mostly donated a kidney because transplantation would make the recipient less dependent (25%. After transplantation both positive and negative relationship changes are experienced. Conclusion Expected relationship changes and concerns about the donor’s health lead some kidney patients to wait for a deceased donor, despite having a potential living donor available. Further research is needed to assess whether this concerns a selected group.
de Groot Ingrid B
Previously, recurrence of insulin-dependent diabetes mellitus after pancreas transplants was only sporadically reported. Newer data, however, indicate recurrence rates as high as 5%. After identical-twin pancreas transplants, diabetes recurs in the absence of immunosuppressive therapy - strong evidence that it is an autoimmune disease. After deceased donor pancreas transplants, immunologic markers (autoantibodies, autoreactive T cells) herald recurrence. Selective destruction of ? cells, still relatively uncommon, is not restricted to MHC compatibility. The development of diabetes in living pancreas donors is rare; it can be largely avoided by meticulous metabolic evaluation before donation and prevention of obesity after donation. PMID:21790295
Gruessner, Rainer W G; Pugliese, Alberto; Reijonen, Helena K; Gruessner, Stephan; Jie, Tun; Desai, Chirag; Sutherland, David E R; Burke, George W
This review seeks to provide a current overview of musculoskeletal pain in overweight and obese children. Databases searched were Academic Search Complete, CINAHL, Medline, Proquest Health and Medical Complete, Scopus, Google Scholar, SPORTDiscuss and Trove for studies published between 1 January 2000 and 30 December 2012. We used a broad definition of children within a 3- to 18-year age range. The search strategy included the following terms: obesity, morbid obesity, overweight, pain, musculoskeletal pain, child, adolescent, chronic pain, back pain, lower back pain, knee pain, hip pain, foot pain and pelvic pain. Two authors independently assessed each record, and any disagreement was resolved by the third author. Data were analysed using a narrative thematic approach owing to the heterogeneity of reported outcome measures. Ninety-seven records were initially identified using a variety of terms associated with children, obesity and musculoskeletal pain. Ten studies were included for thematic analysis when predetermined inclusion criteria were applied. Bone deformity and dysfunction, pain reporting and the impact of children being overweight or obese on physical activity, exercise and quality of life were the three themes identified from the literature. Chronic pain, obesity and a reduction in physical functioning and activity may contribute to a cycle of weight gain that affects a child's quality of life. Future studies are required to examine the sequela of overweight and obese children experiencing chronic musculoskeletal pain.
Smith, S M; Sumar, B; Dixon, K A
This review seeks to provide a current overview of musculoskeletal pain in overweight and obese children. Databases searched were Academic Search Complete, CINAHL, Medline, Proquest Health and Medical Complete, Scopus, Google Scholar, SPORTDiscuss and Trove for studies published between 1 January 2000 and 30 December 2012. We used a broad definition of children within a 3- to 18-year age range. The search strategy included the following terms: obesity, morbid obesity, overweight, pain, musculoskeletal pain, child, adolescent, chronic pain, back pain, lower back pain, knee pain, hip pain, foot pain and pelvic pain. Two authors independently assessed each record, and any disagreement was resolved by the third author. Data were analysed using a narrative thematic approach owing to the heterogeneity of reported outcome measures. Ninety-seven records were initially identified using a variety of terms associated with children, obesity and musculoskeletal pain. Ten studies were included for thematic analysis when predetermined inclusion criteria were applied. Bone deformity and dysfunction, pain reporting and the impact of children being overweight or obese on physical activity, exercise and quality of life were the three themes identified from the literature. Chronic pain, obesity and a reduction in physical functioning and activity may contribute to a cycle of weight gain that affects a child's quality of life. Future studies are required to examine the sequela of overweight and obese children experiencing chronic musculoskeletal pain. PMID:24077005
Smith, S M; Sumar, B; Dixon, K A
This study was conducted to examine the types of stresses experienced by professionals. Subjects were 56 persons enrolled in graduate classes who completed the Tennessee Stress Scale-L, Work Related Stress Inventory for Professionals. Besides the Total stress score, the instrument produced three subscale scores: Stress Producers, Coping…
Gadzella, Bernadette M.; And Others
Adult living donor liver transplantation (ALDLT) is an accepted procedure to overcome the organ shortage. The advantages of ALDLT must be balanced against the first concern of donor safety. We analyzed the results of our early experience among a series of eight ALDLT performed between April 2001 and October 2003. All patients were listed as United Network for Organ Sharing UNOS status 2b and 3. Transplant recipients consisted of four men and four women. The living donors included four sons, three daughters, and one son-in-law (ages 20 to 45 years). One donor was anti-HBc-positive and negative for hepatitis B virus-DNA by polymerase chain reaction analysis in serum and in liver tissue. GR/WR >0.8 and fatty liver <10% were considered suitable for the hepatectomy. Residual left lobe volume was at least 33%. No exogenous blood and blood products were transfused into the donors and a cell-saver device was used in all donors (blood loss 490 +/- 160 mL). All procedures were right lobe hepatectomy; in one case the middle hepatic vein was withdrawn with the right graft. The mean ischemia time was 1.5 +/- 0.5 hours. All donors survived the procedure. Median hospital stay was 8.5 +/- 2.1 days in all donors but one who had a long stay because of drug-related hepatitis. One graft was lost and one donor aborted because of preoperative overestimated volumetry. Complications were experienced by two donors (25%). Five recipients (62.5%) experienced major complications; one patient underwent retransplantation because of donor graft loss. Two biliary and two vascular complications (33.3%) occurred in three patients. No perioperative death occurred. Two patients died at 9 and 10 months after transplant because of heart and respiratory failure in the first case and tumor recurrence in the second. One-year actuarial survival is 75%. ALDLT using right lobe has gained acceptance to overcome the organ shortage. Donor selection criteria must be stringent with respect to residual donor hepatic volume, steatosis, and liver function. PMID:16757277
Cuomo, O; Ragozzino, A; Iovine, L; Santaniello, W; Di Palma, M; Ceriello, A; Arenga, G; Canfora, T; Picciotto, F; Marsilia, G Marino
Living organ donation has become more common across the world. To ensure an informed consent process, given the complex issues involved with organ donation, independent donor advocacy is required. The choice of how donor advocacy is administered is left up to each transplant center. This article presents the experience and process of donor advocacy at University of Texas Southwestern Medical Center administered by a multidisciplinary team consisting of physicians, surgeons, psychologists, medical ethicists and anthropologists, lawyers, a chaplain, a living kidney donor, and a kidney transplant recipient. To ensure that advocacy remains fair and consistent for all donors being considered, the donor advocacy team at University of Texas Southwestern Medical Center developed the Independent Donor Ethical Assessment, a tool that may be useful to others in rendering donor advocacy. In addition, the tool may be modified as circumstances arise to improve donor advocacy and maintain uniformity in decision making. PMID:24919733
Choudhury, Devasmita; Jotterand, Fabrice; Casenave, Gerald; Smith-Morris, Carolyn; For The University Of Texas Southwestern Medical Center Donor Advocacy Team
Background In Mexico, diabetes mellitus is the main cause of end???stage kidney disease, and some patients may be transplant candidates. Organ supply is limited because of cultural issues. And, there is a lack of standardized clinical guidelines regarding organ donation. These issues highlight the tension surrounding the fact that living donors are being selected despite being prediabetic. This article presents, examines and discusses using the principles of non-maleficience, autonomy, justice and the constitutionally guaranteed right to health, the ethical considerations that arise from considering a prediabetic person as a potential kidney donor. Discussion Diabetes is an absolute contraindication for donating a kidney. However, the transplant protocols most frequently used in Mexico do not consider prediabetes as exclusion criteria. In prediabetic persons there are well known metabolic alterations that may compromise the long???term outcomes of the transplant if such donors are accepted. Even so, many of them are finally included because there are not enough donor candidates. Both, families and hospitals face the need to rapidly accept prediabetic donors before the clinical conditions of the recipient and the evolution of the disease exclude him/her as a transplant candidate; however, when using a kidney potentially damaged by prediabetes, neither the donor’s nor the recipient’s long term health is usually considered. Considering the ethical implication as well as the clinical and epidemiological evidence, we conclude that prediabetic persons are not suitable candidates for kidney donation. This recommendation should be taken into consideration by Mexican health institutions who should rewrite their transplant protocols. Summary We argue that the decision to use a kidney from a living donor known to be pre-diabetic or from those persons with family history of T2DM, obesity, hypertension, or renal failure, should be considered unethical in Mexico if the donor bases the decision to donate on socially acceptable norms rather than informed consent as understood in modern medicine.
The aim of the research reported in this dissertation is to describe how experienced secondary school teachers learn at work in an informal environment. Until recently, teacher learning has mainly been studied in the context of professional development programs. Teachers themselves, however, report that they continuously learn from the daily activities they undertake as part of their job, not only in professional development. Not much is known yet about how teachers learn in such an informal ...
The emphasis of this diploma thesis is on experiencing and coping with posttraumatic stress disorder. Psychological trauma can do a lot of harm to a person and can have physiological, emotional, cognitive and behavioral effects. If traumatic event is too intense, it can lead to a posttraumatic stress disorder which can have negative impact on every aspect of person's life. Therefore it is crucial that they search for help and start a new life.
Aims and objectives. The aim of this study was to show what the experience of local anaesthesia and a surgical situation meant to patients. Background. Many patients who receive local anaesthesia will remain awake during surgery. The very fact of staying awake causes psychological and psychosocial needs. These needs must be met and it is therefore important to identify them. Design/method. Seven patients (aged 61–79) experiencing local anaesthesia and hip sur...
Larsson-mauleon, Annika; Palo-bengtsson, Liisa; Ekman, Sirkka-liisa
Full Text Available Background and Objectives : Living donor liver transplantation (LDLT has been expanding to adult recipients by using right lobe grafts. However, the incidence of complications is more frequent than that involving left lobe grafts. Hence, we aimed to analyze postoperative complications in right lobe liver donors as a step to improve the results in the donors. Methods : Three hundred and eleven right lobe liver donors were retrospectively reviewed between February 1998 and December 2003. Results : The ages of the donors ranged from 19 to 64 years (median: 46 years. Their body mass index ranged from 16.6 to 34.3 (median: 22.1. The mean duration of the operation was 6.58 (1.25 hours and blood loss was 289 (254 mL. The estimated median donor residual liver volume was 42.2% (range: 20.6-60.3% and the median hospital stay was 14.5 days (range: 6-267 days. One donor died of liver failure due to small residual liver volume (26% and steatohepatitis. One hundred and twenty three complications occurred in 104 donors (33.4%. Donors experienced one or more complications. According to the Clavien classification, grade I complications occurred in 71 of the episodes (57.7%, grade II complications in 9 (7.3%, grade IIIa complications in 39 (31.7%, grade IIIb complications in 3 (2.5%, and grade V complications in 1 (0.8%. Biliary complications were the most common and occurred in 37 donors (12%. Conclusion : Right lobe liver donation is a widely accepted procedure that results in the expansion of the indication for LDLT to adults and large children. However, remnant liver size and anatomical variations in the biliary tree represent important risk factors for postoperative complications.
Obesity is the result of long term energy imbalances, where daily energy intake exceeds daily energy expenditure. Along with long term health problems, obesity in children is associated with short term psychosocial problems, including social marginalisation, low self esteem, and impaired quality of life.Most obese adolescents stay obese as adults.
Arteburn, David E.
A blood donors campaign, organized by the Centre de Transfusion Sanguine of Geneva will be held at CERN on Tuesday 13 March 2001 in restaurant nr 2, from 9.00 to 16.30 hrs If you already have a card giving your blood group, please bring this with you.
A blood donors campaign, organized by the Établissement de Transfusion de Rhône-Alpes will be held at CERN on Tuesday 14 November 2000 in restaurant nr 2, from 8.30 to 16.30 hrs If you already have a card giving your blood group, please bring this with you.
The transplantation of organs and tissues from one human to another human has become an essential and well established form of therapy for many types of organ and tissue failure. In Malaysia, kidney, cornea and bone marrow transplantation are well established. Recently, liver, bone and heart transplanation have been performed. Unfortunately, because of the lack of cadaveric organ donation, only a limited number of solid organ transplantation have been performed. The cadaveric organ donor rate in Malaysia is low at less than one per million population. The first tissue transplanted in Malaysia was the cornea which was performed in the early 1970s. At that time and even now the majority of corneas came from Sri Lanka. The first kidney transplant was performed in 1975 from a live related donor. The majority of the 629 kidney transplants done at Hospital Kuala Lumpur to date have been from live related donors. Only 35 were from cadaver donors. Similarly, the liver transplantation programme which started in 1995 are from live related donors. A more concerted effort has been made recently to increase the awareness of the public and the health professionals on organ and tissue donation. This national effort to promote organ and tissue donation seems to have gathered momentum in 1997 with the first heart transplant successfully performed at the National Heart Institute. The rate of cadaveric donors has also increased from a previous average of I to 2 per year to 6 per year in the last one year. These developments are most encouraging and may signal the coming of age of our transplantati on programme. The Ministry of Health in conjunction with various institutions, organizations and professional groups, have taken a number of proactive measures to facilitate the development of the cadaveric organ donation programme. Efforts to increase public awareness and to overcome the negative cultural attitude towards organ donation have been intensified. Equally important are efforts to promote the concept and understanding of organ donation among health professionals. A review of the Human Tissues Act 1974 which governs organ and tissue donation in this country is being undertaken. A number of seminars have been held to garner the support of religious groups in the promotion of organ donation. A major weakness had been the lack of a national organizational framework to facilitate and coordinate the development of organ donation and transplantation in this country. Therefore a National Transplantation Coordinating Committee and a Transplant Programme Working Committee have been formed to oversee the development and implementation of national policy guidelines and programmes. With these measures it is hoped that the donor transplant programme in Malaysia will be one of the success stories of the future
Obese women (body mass index ?30 kg/m(2)) are at greater risk than normal weight women of pregnancy complications associated with maternal and infant morbidity, particularly the development of cardiovascular disease and metabolic disorders in later life; why this occurs is unknown. Nonpregnant, obese individuals exhibit systemic vascular endothelial dysfunction. We tested the hypothesis that obese pregnant women have altered myometrial arterial function compared to pregnant women of normal (18-24 kg/m(2)) and overweight (25-29 kg/m(2)) body mass index. Responses to vasoconstrictors, U46619 (thromboxane mimetic) and arginine vasopressin, and vasodilators, bradykinin and the nitric oxide donor sodium nitroprusside, were assessed by wire myography in myometrial arteries from normal weight (n = 18), overweight (n = 18), and obese (n = 20) women with uncomplicated pregnancies. Thromboxane-prostanoid receptor expression was assessed using immunostaining in myometrial arteries of normal weight and obese women. Vasoconstriction and vasodilatation were impaired in myometrial arteries from obese women with otherwise uncomplicated pregnancies. Disparate agonist responses suggest that vascular function in obese women is not globally dysregulated but may be specific to thromboxane and nitric oxide pathways. Because obesity rates are escalating, it is important to identify the mechanisms underlying impaired vascular function and establish why some obese women compensate for vascular dysfunction and some do not. Future studies are needed to determine whether central adiposity results in an altered endocrine milieu that may promote vascular dysfunction by altering the function of perivascular adipose tissue. PMID:24478391
Hayward, Christina E; Cowley, Elizabeth J; Mills, Tracey A; Sibley, Colin P; Wareing, Mark
The obesity epidemic is a global problem, which is set to increase over time. However, the effects of obesity on the respiratory system are often underappreciated. In this review, we will discuss the mechanical effects of obesity on lung physiology and the function of adipose tissue as an endocrine organ producing systemic inflammation and effecting central respiratory control. Obesity plays a key role in the development of obstructive sleep apnea and obesity hypoventilation syndrome. Asthma ...
Zammit, Christopher; Liddicoat, Helen; Moonsie, Ian; Makker, Himender
Obesity is an important disease with a growing incidence. Because obesity is related to several other diseases, and decreases life span, it is important to identify the population at risk. Several risk factors for obesity have been described in the literature. A higher incidence of obesity in certain breeds is often suggested. The aim of this study was to determine whether obesity occurs more often in certain breeds. The second aim was to relate the increased prevalence of o...
Corbee, R. J.
It is estimated that about half of the population in developed countries are either overweight or obese. In some developing nations obesity rates have increased to surpass those seen in Western countries. This rate increase in obesity has many implications as obesity has been associated with numerous negative health effects including increased risks of hypertension, diabetes, cardiovascular disease, stroke, liver disease, apnea, and some cancer types. Obesity is now considered to be one of th...
Parsi, Mansour A.
Obesity is a risk factor for colorectal cancer based on its molecular and metabolic effects on insulin and IGF-1, leptin, adipocytokines, and sex hormones. Obese men have a higher risk of colorectal cancer compared with normal weight men, but the association between obesity and rectal cancer is weaker than with colon cancer. There is a weaker association between obesity and colon cancer in women than in men, and no appreciable association between obesity and rectal cancer in women. Although o...
Gribovskaja-rupp, Irena; Kosinski, Lauren; Ludwig, Kirk A.
Individuals with migraine headaches who are obese or overweight may be at elevated risk for experiencing more frequent migraines and for developing chronic migraine. This makes it imperative that clinicians consider including weight management as part of a migraine treatment plan in situations where the patient is overweight or obese. Weight loss and weight maintenance therapy should employ a combination of behavioral strategies, in particular nutritional education, dietary intervention, and ...
Abstract Background In the past year Lebanon has been experiencing a nutritional transition in food choices from the typical Mediterranean diet to the fast food pattern. As a consequence, the dietary habits of young adults have been affected; thus, overweight and obesity are increasingly being observed among the young. The purpose of this study is to assess the prevalence of overweight and obesity on a sample of students from the Lebanese American University (in Beirut) and t...
Yahia Najat; Achkar Alice; Abdallah Abbass; Rizk Sandra
Full Text Available SciELO Spain | Language: Spanish Abstract in spanish En este artículo la autora propone para la obesidad una intervención estratégica basada en el comportamiento. Explica los asuntos teóricos de base y expone con detalle las fases de actuación. El método, por su estructuración, puede interesar no solo a psicólogos y psicoterapeutas sino también a médi [...] cos de familia puesto que la parte propiamente psicoterapéutica no es larga y puede ser realizada por un profesional que colabora sólo durante las cuatro primeras entrevistas. Abstract in english The author proposes a strategic intervention on behavioural base for obesity. The article exposes the theoretical points wich is based on and the phases of intervention are described in detail. The method, because of its structure will not only be of interest to psychologist and psychotherapist, but [...] also to family doctors as the psychotherapeutic part is limited and may be put into act by a supporting therapist during the first four sessions.
Living donor liver transplantation (LDLT) has been controversial since its inception. Begun in response to deceased donor organ shortage and waiting list mortality, LDLT was initiated in 1989 in children, grew rapidly after its first general application in adults in the US in 1998, and has declined since 2001. There are significant risks to the living donor, including the risk of death and substantial morbidity, and two highly publicized donor deaths are thought to have contributed to decreas...
In 2009, Elena Long created the LGBT+ Physicists website (http://lgbtphysicists.x10hosting.com) as a warehouse for resources useful for sexual and gender minorities working in physics. This resource has grown to include networking resources, lists of LGBT-friendly universities and localities, recommendations for enacting positive change in physics communities, and out-reach to other STEM-oriented LGBT organizations. This has been possible in large part by the dynamic community of LGBT+ physicists and allies looking to make physics more welcoming towards our community. In 2011, Elena used hir position as Member at Large on the executive committee of the Forum of Graduate Student Affairs (FGSA) to conduct a climate survey that included, among other things, the first serious look at LGBT+ demographics in physics. The survey focused particularly on issues of language heard and harassment experienced by physicists and was broken down into categories based on race, physical and mental ability, gender, and sexuality. Furthermore, it examined the outcomes of experienced harassment and the reasons for when harassment was not reported. Due to the nature of the study, overlapping demographics, especially ``multiple minorities,'' were also explored. This talk will give a brief history of the LGBT+ Physicists resource as well as an overview of the FGSA study.
OBJECTIVE: In this first report of a clinical series of simultaneous pancreas-kidney transplants (SPKs) from live donors, the authors assess donor and recipient outcome as well as the spectrum of surgical and metabolic complications. SUMMARY BACKGROUND DATA: The rationale for live (vs. cadaveric) donation includes an immunologic advantage (better matching, decreased drugs, and fewer rejection episodes) and elimination of waiting time. Only sequential kidney and pancreas or pancreas transplants alone from live donors had been done until the authors' current series. METHODS: Between March 15, 1994, and March 15, 1997, the authors performed 20 SPKs from live donors (6 human leukocyte antigen-identical siblings, 14 mismatched relatives [5 parents, 7 siblings, 1 daughter, 1 aunt]). Of the 20 donors, 13 were women, and 7 were men; median age was 43 years (range, 30-58 years). All donors underwent standardized metabolic workup, including oral glucose tolerance tests, determination of hemoglobin A1 c levels, and tests to study insulin secretion and functional insulin secretory reserve. Of the 20 recipients, 12 were women, and 8 were men; median age was 34 years (range, 14-50 years). Management of exocrine pancreatic secretions was with bladder drainage in 17 and duct injection in 3 recipients. Median follow-up was 9 months (range, 1-36 months). RESULTS: Currently, all 20 kidney grafts are functioning. Of the 20 pancreas grafts, 15 are functioning, 3 thrombosed, but 2 of those patients underwent immediate retransplantation from a cadaveric donor, and their grafts currently are functioning. Recipient complications included three anastomotic leaks and three intra-abdominal abscesses. Donor complications included four splenectomies, two peripancreatic fluid collections, one pseudocyst, and one intra-abdominal abscess; two donors underwent reoperation. Three donors had impaired glucose metabolism postdonation. Using tacrolimus and mycophenolate mofetil for mainstay immunosuppression, only 8 of 20 recipients experienced > or =1 rejection episode; only 1 pancreas graft was lost to rejection. Donor and recipient mortality was 0%. CONCLUSION: Simultaneous pancreas-kidney transplants from live donors can be done with no mortality and good graft outcome. With stringent donor criteria, this approach could become another surgical alternative for endocrine replacement therapy in selected patients with uremic type I diabetes. Images Figure 1. Figure 2.
Gruessner, R W; Kendall, D M; Drangstveit, M B; Gruessner, A C; Sutherland, D E
The objective of this study was to examine provider adherence to prenatal care (PNC) content in obese and non-obese women and perinatal outcomes in obese women experiencing low and medium versus high adherence to PNC content. Provider adherence to PNC content (low diabetes, prenatal vitamin prescriptions, and depression screening. Weight gain, preterm deliveries, cesareans, and birthweight were compared between obese women with low and medium versus high adherence to PNC content using multivariable logistic regression. High provider adherence to an eight-item PNC content score (56.3 vs. 66.5 %, p = 0.02) and depression screening (2.0 vs. 11.4 %, p = 0.001) were both lower for obese versus non-obese women. Among obese women, there were no differences by level of provider adherence to PNC content in preterm delivery, cesareans, and low birth weight, but obese women experiencing low and medium versus high adherence were more likely to gain ?20 lbs (aOR 5.5, 95 % CI 1.3-23.3). Providers may be administering PNC differently to obese and non-obese women. PNC for obese women who are at high risk of adverse perinatal outcomes needs to be addressed especially as it relates to depression screening and gestational weight gain. PMID:23912316
Kominiarek, Michelle A; Rankin, Kristin; Handler, Arden
... added to your dashboard . Overweight and obesity during pregnancy Being overweight or obese during pregnancy can cause ... women (25 percent) is obese. What kinds of pregnancy complications can overweight and obesity cause? If you’ ...
Full Text Available SciELO South Africa | Language: English Abstract in english Employees attach value to their job features/total job and when they perceive threats to these and experience feelings of powerlessness, their level of job insecurity increases. Since job insecurity is a subjective phenomenon, the study aims to assess who is more susceptible to experiencing job inse [...] curity by assessing biographical correlates. The research adopts a formal, hypothesis-testing approach where quantitative data were collected using a cross-sectional, survey method from a sample of 1620 employees. The results, generated using the ANOVA model, indicate that biographical influences do exist in terms of job insecurity. The implication is that change managers need to take cognisance of these influences and develop suitable strategies for each group to reduce the prevalence of job insecurity. Recommendations are made in this regard.
Leigh-Anne Paul, Dachapalli; Sanjana Brijball, Parumasur.
Full Text Available The aim of this study is to describe forgivenessand the factors contribute to it in wives experiencing domestic violence who choose to save their marriages in UPT-P2TP2A Kota Bandung. Descriptive method was employed in this study with 15 participants as the subjects. The data were gathered through forgiveness measurement adopted and based in the forgiveness theory proposed by McCullough. Its reliability score was 0,721. The results of the study revealed that 73, 3% of domestic violence victims who insist to save their marriages did forgive or gave for forgiveness. Among the factors determine the forgiveness, the low Rumination factor as well as high personal and moral commitment, encouraged a wife to forgive. Forgiveness showed by a wife, in some way impacted on the domestic violence doer. It lessened the intensity of the violence.
... Nose & Throat Emotional Problems Fever Genitals & Urinary Tract Head, Neck & Nervous System Obesity Skin Treatments View all Injuries & ... From Insects or Animals Genitals and Urinary Tract Head Neck & Nervous System Heart Infections Learning Disabilities Obesity Orthopedic ...
Full Text Available Context: Blood donation results in a substantial loss of iron (200 to 250 mg at each bleeding procedure (425 to 475 ml and subsequent mobilization of iron from body stores. Recent reports have shown that body iron reserves generally are small and iron depletion is more frequent in blood donors than in non-donors. Objective: The aim of this study was to evaluate the frequency of iron deficiency in blood donors and to establish the frequency of iron deficiency in blood donors according to sex, whether they were first-time or multi-time donors. Design: From march 20 to April 5, 2004, three hundred potential blood donors from Hemocentro del Café y Tolima Grande were studied. Diagnostic tests: Using a combination of biochemical measurements of iron status: serum ferritin (RIA, ANNAR and the hemoglobin pre and post-donation (HEMOCUE Vital technology medical . Results: The frequency of iron deficiency in potential blood donors was 5%, and blood donors accepted was 5.1%; in blood donors rejected for low hemoglobin the frequency of iron deficiency was 3.7% and accepted blood donors was 1.7% in male and 12.6% in female. The frequency of iron deficiency was higher in multi-time blood donors than in first-time blood donors, but not stadistic significative. Increase nivel accepted hemoglobina in 1 g/dl no incidence in male; in female increase of 0.5 g/dl low in 25% blood donors accepted with iron deficiency, but increased rejected innecesary in 16.6% and increased is 1 g/dl low blood donors female accepted in 58% (7/12, but increased the rejected innecesary in 35.6%. Conclusions: We conclude that blood donation not is a important factor for iron deficiency in blood donors. The high frequency of blood donors with iron deficiency found in this study suggests a need for a more accurate laboratory trial, as hemoglobin or hematocrit measurement alone is not sufficient for detecting and excluding blood donors with iron deficiency without anemia, and ajustes hacia nivel more high in standars of accepted of hemoglobin no help the situation and no assure the blood suplly; increased exclusion blood donors of 9% at 44.6%.
Obesity is an increasingly serious socioeconomic and clinical problem. Between 1/4 - 1/3 of population in the developed countries can be classified as obese. Four major etiological factors for development of obesity are genetic determinants, environmental factors, food intake and exercise. Obesity increases the risk of the development of various pathologic conditions including: insulin-resistant diabetes mellitus, cardiovascular disease, non-alcoholic fatty liver disease, endocrine problems, ...
Gurevich-panigrahi, Tatiana; Wiechec, Emilia; Panigrahi, Soumya; Los, Marek Jan
The prevalence of childhood obesity has increased dramatically during the past decades all over the world. The majority of obesity in adulthood has its origins in childhood which makes obesity a pediatric concern and the period when interventions should be done. Obesity is associated with increased morbidity and mortality in adult life and several adverse consequences in childhood like insulin resistance, type 2 diabetes, dyslipidemia, polycystic ovarian syndrome, pulmonary and orthopedic dis...
Abstract An epidemic of pediatric obesity has occurred across the world in recent years. There are subgroups within the population at high-risk of becoming obese and especially of having experience of precocious cardiovascular and metabolic co-morbidities of obesity. One of these subgroups comprises patients treated for childhood cancers and namely survivors of craniopharyngioma. The high incidence of obesity in this group makes these patients an important disease model to better un...
Iughetti Lorenzo; Bruzzi Patrizia
... the NHLBI on Twitter. What Are Overweight and Obesity? The terms "overweight" and "obesity" refer to body weight that’s greater than what ... height. The most useful measure of overweight and obesity is body mass index (BMI). BMI is calculated ...
Obesity currently affects about one third of the U.S. population, while another one third is overweight. The importance of obesity for certain conditions such as heart disease and type 2 diabetes is well appreciated. The effects of obesity on the respiratory system have received less attention and are the subject of this chapter. Obesity alters the static mechanic properties of the respiratory system leading to a reduction in the functional residual capacity (FRC) and the expiratory reserve volume (ERV). There is substantial variability in the effects of obesity on FRC and ERV, at least some of which is related to the location, rather than the total mass of adipose tissue. Obesity also results in airflow obstruction, which is only partially attributable to breathing at low lung volume, and can also promote airway hyperresponsiveness and asthma. Hypoxemia is common is obesity, and correlates well with FRC, as well as with measures of abdominal obesity. However, obese subjects are usually eucapnic, indicating that hypoventilation is not a common cause of their hypoxemia. Instead, hypoxemia results from ventilation perfusion mismatch caused by closure of dependent airways at FRC. Many obese subjects complain of dyspnea either at rest or during exertion, and the dyspnea score also correlates with reductions in FRC and ERV. Weight reduction should be encouraged in any symptomatic obese individual, since virtually all of the respiratory complications of obesity improve with even moderate weight loss.
Shore, Stephanie A.
Full Text Available Aim: To compare diets between obese and non-obese in children. Methods: Thirty-four obese and ten non-obese school children were recruited and their habitual factors of obesity were asked. Intakes of food in the obesity and non-obesity groups were checked using a model nutritional balance chart (MNBC. Results: Average intake ratio of food relative to ideal food intake was significantly higher in the non-obesity group than the obesity group. The relationship between obesity and exercise was significant but not significant for intake ratio of food, times watching TV and playing games. Conclusion: Food intake is not a primary factor of obesity but exercise is a key factor for obesity in school children. Since the effect of diet intervention in obese children was slight, exercise habit would be a more important strategy to reduce obesity than diet in school children.
The purpose of this qualitative, phenomenological study is to describe intimate partner violence as experienced by men and to formulate the common structure of meanings of experiences of men exposed to intimate partner violence. The data were gathered by open-ended interviews with 10 (n = 10) men. The participants had experiences in intimate partner violence. All the 10 men were interviewed twice and they were allowed to tell their experiences as they liked. The data were analysed by applying the method developed by Colaizzi. The experiences of men formulated three main themes describing the factors leading to intimate partner violence, being a victim of intimate partner violence and own violent behavior. The main themes are named as follows: (1) a burden on the pair relationship; (2) face to face with violence; and (3) from denying violence to striving towards the truth. The research results enhance the understanding of the experiences of men. The information may be useful in promoting women's, men's and families' health, developing work on violence and in the education of professionals in social and health care. The results may also help women to understand men's experiences in a pair relationship. PMID:18387151
Flinck, A; Astedt-Kurki, P; Paavilainen, E
Large registries of potential unrelated stem cell donors have been established in order to enable stem cell transplantation for patients without HLA-identical related donors. Donor search is complicated by the fact that the stored HLA information of many registered donors is incomplete. We carried out a project that was aimed to improve chances of patients with ongoing donor searches to find an HLA-matched unrelated donor. For that purpose, we carried out additional donor center-initiated HLA...
Adult obesity is a growing problem. From 1962 to 2006, obesity prevalence nearly tripled to 35.1 percent of adults. The rising prevalence of obesity is not limited to a particular socioeconomic group and is not unique to the United States. Should this widespread obesity epidemic be a cause for alarm? From a personal health perspective, the answer is an emphatic "yes." But when it comes to justifications of public policy for reducing obesity, the analysis becomes more complex. A common starting point is the assertion that those who are obese impose higher health costs on the rest of the population—a statement which is then taken to justify public policy interventions. But the question of who pays for obesity is an empirical one, and it involves analysis of how obese people fare in labor markets and health insurance markets. We will argue that the existing literature on these topics suggests that obese people on average do bear the costs and benefits of their eating and exercise habits. We begin by estimating the lifetime costs of obesity. We then discuss the extent to which private health insurance pools together obese and thin, whether health insurance causes obesity, and whether being fat might actually cause positive externalities for those who are not obese. If public policy to reduce obesity is not justified on the grounds of external costs imposed on others, then the remaining potential justification would need to be on the basis of helping people to address problems of ignorance or self-control that lead to obesity. In the conclusion, we offer a few thoughts about some complexities of such a justification. PMID:21598459
Bhattacharya, Jay; Sood, Neeraj
CONTEXT: Blood donation results in a substantial loss of iron (200 to 250 mg) at each bleeding procedure (425 to 475 ml) and subsequent mobilization of iron from body stores. Recent reports have shown that body iron reserves generally are small and iron depletion is more frequent in blood donors than in non-donors. OBJECTIVE: The aim of this study was to evaluate the frequency of iron deficiency in blood donors and to establish the frequency of iron deficiency in blood donors according to sex...
Rodolfo Delfini Cançado; Carlos Sérgio Chiattone; Fausto Forin Alonso; Dante Mário Langhi Júnior; Rita de Cássia Silva Alves
Obesity is the main nutritional problem and one of the most important health problems in developed societies. Central to the challenge of obesity prevention and management is a thoroughly understanding of its determinants. Multiple socio-cultural, socio-economic, behavioural and biological factors--often interrelated and many of them still unknown or poorly understood--can contribute to the establishment and perpetuation of obese phenotypes. Here, we address current research challenges regarding basic aspects of obesity and emerging science for its control, including brown adipose tissue thermogenesis and browning of white fat as possible therapeutic targets for obesity, the influence of the microbioma, and genetics, epigenetics, nutrigenomics and nutrigenetics of obesity. We also highlight hot topics in relation to food and lifestyle as determinants of obesity, including the brain mechanisms underlying environmental motivation to eat, the biological control of spontaneous physical activity, the possible role of concrete foods and food components, and the importance of early life nutrition and environment. Challenges regarding the connections of obesity with other alterations and pathologies are also briefly addressed, as well as social and economical challenges in relation to healthy food production and lifestyle for the prevention of obesity, and technological challenges in obesity research and management. The objective is to give a panoramic of advances accomplished and still ahead relevant to the different stakeholders engaged in understanding and combating obesity. PMID:24010755
Palou, Andreu; Bonet, M Luisa
Prevalence of pediatric obesity continues to rise worldwide. Increasing the number of health care practitioners as well as pediatricians with expertise in obesity treatment is necessary. Because many obese patients suffer obesity-associated cardiovascular, metabolic and other health complications that could increase the severity of obesity, it is fundamental not only to identify the child prone to obesity as early as possible, but to recognize, treat and monitor obesity-related diseases durin...
Angelo Pietrobelli; Simone Rugolotto; Paolo De Cristofaro; Marcella Malavolti
A discussion of donor records in college and university fund-raising programs looks at a variety of issues, including who sees them (administrators, donors, volunteers, and members of the legal profession), how access to them is controlled, and what is kept in them. Suggestions are offered for managing such records, and the experiences of a number…
Walker, Mary Margaret
A totally voluntary plasmapheresis program recruits 900 individual donors per year at a cancer institute, where 500 to 900 units of platelets are transfused each month. Staff and donors use a film and brochures to recruit donors from the local community. Television and radio spots, with donor recognition pins, certificates, receptions, and picnics are utilized. Donor motivation was studied by use of: 1) California Psychological Inventory--measures a variety of "normal" personality traits; 2) Study of values--measures theoretical, economic, aesthetic, social, political, religious values; 3) Internal-External Control Scale--measures degree to which a person blames self vs. external events for what happens to him; 4) Faith in People Scale--measures individual's confidence in his fellow man; 5) Anomia Scale--measure of feelings of self-to-others alienation; 6) Mach IV Scale--measure of persons tendency to manipulate others; and 7) Biographical Data Form. Results are presented for 25 male donor subjects studied, as they compare with normative data for the scales used. Donors appeared to have the same traits as do the general population, but appeared lower in Machiavellianism than non-plasmapheresis donors. Prospective study plans include additional subjects to provide appropriate control groups. PMID:951736
Cataldo, J F; Cohen, E; Morganti, J B
Summary Obesity and osteoporosis are two common diseases with an increasing prevalence and a high impact on morbidity and mortality. Obese women have always been considered protected against osteoporosis and osteoporotic fractures. However, several recent studies have challenged the widespread belief that obesity is protective against fracture and have suggested that obesity is a risk factor for certain fractures. Fat and bone are linked by many pathways, which ultimately serve the function of providing a skeleton appropriate to the mass of adipose tissue it is carrying. Leptin, adiponectin, adipocytic estrogens and insulin/amylin are involved in this connection. However, excessive body fat, and particularly abdominal fat, produces inflammatory cytokines which may stimulate bone resorption and reduce bone strength. This review aimed to examine the literature data on the relationships of BMI and fat mass with factures in adult and elderly subjects. Even though the more recent studies have shown conflicting results, there is growing evidence that obesity, and particularly severe obesity, may be related to an increased risk of fracture at different skeletal sites which is partially independent from BMD. Moreover, the relationship between obesity and fracture appears to be markedly influenced by ethnicity, gender and fat distribution. Even though the incidence and the pathogenesis of fracture in obese individuals has not yet been clearly defined, the growing evidence that obesity may be related to an increased risk of fracture has important public health implications and emphasizes the need to develop effective strategies to reduce fracture risk in obese subjects.
Gonnelli, Stefano; Caffarelli, Carla; Nuti, Ranuccio
The obesity epidemic is a global problem, which is set to increase over time. However, the effects of obesity on the respiratory system are often underappreciated. In this review, we will discuss the mechanical effects of obesity on lung physiology and the function of adipose tissue as an endocrine organ producing systemic inflammation and effecting central respiratory control. Obesity plays a key role in the development of obstructive sleep apnea and obesity hypoventilation syndrome. Asthma is more common and often harder to treat in the obese population, and in this study, we review the effects of obesity on airway inflammation and respiratory mechanics. We also discuss the compounding effects of obesity on chronic obstructive pulmonary disease (COPD) and the paradoxical interaction of body mass index and COPD severity. Many practical challenges exist in caring for obese patients, and we highlight the complications faced by patients undergoing surgical procedures, especially given the increased use of bariatric surgery. Ultimately, a greater understanding of the effects of obesity on the respiratory disease and the provision of adequate health care resources is vital in order to care for this increasingly important patient population.
Zammit, Christopher; Liddicoat, Helen; Moonsie, Ian; Makker, Himender
BACKGROUND: As obesity is an increasing problem among fertile women, it is crucial that specialists involved in the treatment of these women be aware of the risks of complications and know how to deal with them. Complications associated with obesity in pregnancy are gestational diabetes mellitus, hypertensive disorders, and thromboembolic complications. Complications associated with obesity in labor are augmentation, early amniotomy, cephalopelvic disproportion, cesarean section, and perioperative morbidity. Complications associated with obesity in children are macrosomia, shoulder dystocia, small for gestational age, late fetal death, and congenital malformations, especially neural tube defects. OBJECTIVE: The aim was to review the potential complications associated with obesity and pregnancy. RESULTS: Obesity is associated with a higher risk of all reviewed complications except small for gestational age.
Andreasen, Kirsten Riis; Andersen, Malene Lundgren
Abstract Background China has experienced an increase in the prevalence of childhood overweight/obesity over the last decades. The purpose of this study was to examine the prevalence of obesity and metabolic syndrome among Chinese school children and determine if there is a significant association between childhood obesity and metabolic syndrome. Methods A cross-sectional study was conducted among 1844 children (938 males and 906 females) in six elementary schoo...
This paper describes the interplay among energy intake, energy expenditure and body energy stores and illustrates how an understanding of energy balance can help develop strategies to reduce obesity. First, reducing obesity will require modifying both energy intake and energy expenditure and not simply focusing on either alone. Food restriction alone will not be effective in reducing obesity if human physiology is biased toward achieving energy balance at a high energy flux (i.e. at a high le...
Christopher Zammit, Helen Liddicoat, Ian Moonsie, Himender MakkerSleep and Ventilation Unit, Department of Respiratory Medicine, North Middlesex University Hospital, London, UKAbstract: The obesity epidemic is a global problem, which is set to increase over time. However, the effects of obesity on the respiratory system are often underappreciated. In this review, we will discuss the mechanical effects of obesity on lung physiology and the function of adipose tissue as an endocrine organ produ...
Christopher Zammit; Helen Liddicoat; Ian Moonsie; et al
Asthma and obesity are prevalent disorders, each with a significant public health impact, and a large and growing body of literature suggests an association between the two. The systemic inflammatory milieu in obesity leads to metabolic and cardiovascular complications, but whether this environment alters asthma risk or phenotype is not yet known. Animal experiments have evaluated the effects of leptin and obesity on airway inflammation in response to both allergic and nonallergic exposures a...
Beuther, David A.; Weiss, Scott T.; Sutherland, E. Rand
Research question: Whether certain personality characteristics of obese women make them prone towards psychological problem? Objective: To assess certain personality characteristics of obese women. Study design: Cross-sectional community based study. Setting: Affluent localities of Varanasi city. Participants: Women above 15 years of age. Statistical Analysis: Mean, S.D and â€˜tâ€? test. Results: On 16 PF scale obese women were found more reserved, crit...
Asthana Sunita; Gupta V.M
Obesity is a significant health problem world-wide, particularly in developed nations. Vitamin D deficiency is pandemic, and has been implicated in a wide variety of disease states. This paper seeks to examine the consistently reported relationship between obesity and low vitamin D concentrations, with reference to the possible underlying mechanisms. The possibility that vitamin D may assist in preventing or treating obesity is also examined, and recommendations for future research are made. ...
Obesity is a major health problem and an immense economic burden on the health care systems both in the United States and the rest of the world. The prevalence of obesity in children and adults in the United States has increased dramatically over the past decade. Besides environmental factors, genetic factors are known to play an important role in the pathogenesis of obesity. Genome-wide association studies (GWAS) have revealed strongly associated genomic variants associated with most common ...
The current obesity epidemic clearly has many causes, including the impact of our modern world on both our diet and our lifestyle/physical activity. Although many interventions have been recommended, the prevalence of obesity continues to rise and has forced a re-evaluation of the potential interventions that could have an impact. In recent years it has been definitively shown that microbiota in the gastrointestinal tract are altered in obese individuals. Recent data provide a potential mecha...
Wolf, Kyle J.; Lorenz, Robin G.
Obesity is the main nutritional problem and one of the most important health problems in developed societies. Central to the challenge of obesity prevention and management is a thoroughly understanding of its determinants. Multiple socio-cultural, socio-economic, behavioural and biological factors often interrelated and many of them still unknown or poorly understood can contribute to the establishment and perpetuation of obese phenotypes. Here, we address current research challenges regardin...
Full Text Available Great population studies do not confirm the hypothesis that atypical personality of obese would exist. Obeses in the generalpopulation do not present more psychological disturbs thanthe ones that are not obeses. Obeses adolescents and adultsare discriminated in their academic and professional lifes. Thissocial, cultural, economic and affective impoverishment seemsto be directly related to the gravity of their obesity, what means,higher the ICM (Index of Corporal Mass, bigger are thepsychological problems. This abandonment contributes to thebig risk of unchain psychiatric pictures as depression, anxyetdisturbs, drugs and alcoholic excessive consumption andalimentary disturbs. Obeses of the general population do notpresent more psychological or psychiatric symptoms than theclinical population of obeses (obeses under treatment, presentmore clinical and psychiatric problems, mainly compulsoryalimentary standards. Some studies indicate that there is alinear relation between the ICM and the highest frequency ofalimentary compulsory behavior or bulimic episode. Thepsychiatric patients negative body perception added to theirother negative perceptions about their performance in searchingsocial interaction increase the trend to the isolation. Thepsychiatric picture presence in the bariatric surgery preoperatoryin a III degree overweight pacient has not to be facedas absolute surgery counter indication since such procedurecan be the difference between giving a better life quality orwaiting for a potentially lethal complication. We cannot forgetthat the obesity itself, due to the common associatedcomorbidyties, loads a great lethality potential. The surgerycounter-indication could be relative, it depending on how muchthe psychiatric disturbs interfere on the treatment andconditioned to the rigorous psychiatric control in the anteriorand post surgical period.
Táki Athanássios Cordas
Obesity; a state of being 20% over one?s normal weight due to excessive fat; that is, it is defined as the accumulation of too much fat in the body. The rate of obesity in the world has elevated. In the last two decades, it is considered that there have been increases in the rates of the obesity with changes in the socio-economic state and nutritional habits in Turkey as well as in modern western countries. The increase of the obesity is a matter of concern but the aspect which is much m...
Serap Ejder Apay; Turkan Pasinlioglu
Full Text Available It is estimated that about half of the population in developed countries are either overweight or obese. In some developing nations obesity rates have increased to surpass those seen in Western countries. This rate increase in obesity has many implications as obesity has been associated with numerous negative health effects including increased risks of hypertension, diabetes, cardiovascular disease, stroke, liver disease, apnea, and some cancer types. Obesity is now considered to be one of the major public health concerns facing the society. Cholangiocarcinomas (bile duct cancers are malignant tumors arising from cholangiocytes inside or outside of the liver. Although cholangiocarcinomas are relatively rare, they are highly lethal. The low survival rate associated with cholangiocarcinoma is due to the advanced stage of the disease at the time of diagnosis. Prevention is therefore especially important in this cancer type. Some data suggest that the incidence of cholangiocarcinoma in the western world is on the rise. Increasing rate of obesity may be one of the factors responsible for this increase. Determining whether obesity is a risk factor for cholangiocarcinoma has significant clinical and societal implications as obesity is both prevalent and modifiable. This paper seeks to provide a summary of the current knowledge linking obesity and cholangiocarcinoma, and encourage further research on this topic.
Mansour A Parsi
From open surgery to laparoscopic surgery, there has been an evolution in the surgical technique for live donor nephrectomy which goes beyond patient comfort. As a unique operation where the margin for error is nearly nil, and where the patient is essentially harmed for an altruistic goal, ensuring the best possible result is vital. Additionally, as the morbidity of the operation decreases, there is a theoretical increase in the donor pool. In this review, the latest techniques for minimally invasive live donor nephrectomy are covered, including new approaches such as laparoendoscopic single-site surgery, natural orifice surgery, and new tools such as robotics. PMID:24338815
Caso, Jorge R
Abstract Background We previously established a congenic mouse strain with TALLYHO/Jng (TH) donor segment on chromosome 6 in a C57BL/6 (B6) background that harbors an obesity quantitative trait locus, tabw2. The B6.TH-tabw2 congenic mice developed increased adiposity that became exacerbated upon feeding a high fat-high sucrose (HFS) diet. To fine map the tabw2, in this study we generated and characterized subcongenic lines with smaller TH donor segm...
Stewart Taryn P; Mao Xia; Aqqad Maha N; Uffort Deon; Dillon Kristy D; Saxton Arnold M; Kim Jung
This article summarizes the current hypotheses that link visceral obesity and kidney malfunction and provides information on the epidemiology and renal pathology resulting from visceral obesity. PMID:19751896
Ritz, Eberhard; Koleganova, Nadezda
... Why Donate RELATED INFORMATION Minority Focused Grantee Publications Organ Donation Process Enrolling as a Donor Trying to Save ... match one another, all individuals waiting for an organ transplant will have a better chance of receiving one ...
Skin grafting is an integral part of burn wound management. The pain experienced at skin graft donor sites is significant. Banana leaf dressing (BLD) developed by our unit in 1996 is an excellent, non-adhesive, pain-free, cheap and easily available dressing material. We conducted a trial to compare efficacy of BLD with vaseline gauze (VG) dressing used by majority of burns centers for dressing skin graft donor areas. Thirty patients undergoing skin grafting were included in the study. BLD was applied on one half and VG on the other half of the donor area. Dressing change was done on the eighth day. Using the visual analogue scale we assessed the pain score, the dressing removal pain score and ease of dressing removal score. The advantage of early epithelisation of donor areas cannot be over stressed in burnt patients. The epithelisation status of the donor area on eight post-operative day was noted. The day of complete epithelisation was also noted. The average pain score with BLD was 1.1+0.71 while that with VG was 6.9+0.84. The average dressing removal pain score was 0.97 with BLD while that with VG it was 9.47. Ease of dressing removal score average was 1.1 with BLD while it was 9.53 with VG. In all the above scores the difference observed was statistically significant with P<0.001. The mean complete epithelisation day was 8.67 in the BLD covered areas as compared to 11.73 in the VG covered areas. This observation was highly significant with P<0.001. Our study clearly indicates that BLD is a completely non-adherent and painless dressing. We strongly recommend the use of BLD for all skin graft donor areas. PMID:12880730
Gore, Madhuri A; Akolekar, Deepika
AIM: The British Andrology Society recommends screening semen donors for sexually transmitted infections to minimise the risk of pathogen transmission to the mother and fetus. The aim was to review recent findings of semen donor screening and, if appropriate, recommend changes to the screening protocol. SUBJECTS: 175 consecutive men attending for STD screening between January 1992 and December 1995 who had been preselected by the Department of Obstetrics and Gynaecology as suitable semen dono...
Craig, J. M.; Barratt, C. L.; Kinghorn, G. R.
All right hepatic lobe (RHL) donors in our program are asked to participate in a longitudinal quality-of-life study that begins at their evaluation and continues throughout the first postdonation year. Here we report the characteristics of donor candidates who completed the donation process despite ambivalence. In all, 183 RHL candidates consented, and 133 became donors. Ambivalent donors (ADs; n = 45) identified themselves through verbal statements or written comments, or they were identified by staff during the evaluation. ADs were predominantly male (73.3%), were older than unambivalent donors (UADs; >35 years: 76% of ADs versus 53% of UADs, P = 0.008), and were well educated (college graduate: 60% of ADs versus 17% of UADs, P = 0.01). Brother-to-brother and son-to-father combinations were most common among ADs. Alcohol (22% versus 11%, P = 0.04) and hepatitis C virus (51% versus 27%, P = 0.008) were more common as disease etiologies for recipients with ADs versus recipients with UADs. More ADs than UADs considered themselves to be religious (68.9% versus 43.2%, P = 0.007). Ambivalence about RHL donation was present in 33.8% of the candidates who completed the donation process. These results suggest that ambivalence should not be the sole reason for disqualifying a potential donor who otherwise satisfies program requirements. PMID:21604356
Simpson, Mary Ann; Kendrick, Julia; Verbesey, Jennifer E; Morin, Denise S; Dew, Mary Amanda; Trabucco, Agnes; Pomposelli, James J; Pomfret, Elizabeth A
Full Text Available Due to its technically simple and easily reproducible nature cold static preservation is still the current gold standard for myocardial protection in between donor explantation and recipient implantation. It allows “safe” overall ischemic periods of up to 4 hours with a primary graft failure rate less than 2%. Additional measures such as second rinsing or leucocyte depleted in-situ reperfusion allow to extend the ischemic tolerance in ideal donor hearts to 6 hours. Recent technological progress and research improved results of continuous warm, blood based in-vitro perfusion reducing the necessity of myocardial ischemia to the surgical procedures of ex- and implantation. First clinical experiences with this challenging but also very expensive technology indicate its safety and efficacy with at least similar results as cold static preservation even with extended transport times. Due to possible donor evaluation or even resuscitation strategies during ex-vivo perfusion, it offers furthermore promising potential to compensate the ever increasing donor risk profile and could also help to increase availability of transplantable donor hearts. As of December 2011 a German multicenter prospective registry study will start with the goal to evaluate efficacy and outcome of this method in 250 heart transplants using donor organs with extended criteria or expected transport times of >3 hours. Expected duration of this project is 2 years and final analyses of collected data will help to clarify if application of this complex and expensive technology is ultimately beneficial and justified.
F. M. Wagner
Learn about obesity and the community initiatives taking place to prevent and reduce this epidemic. Created: 7/18/2011 by National Center for Chronic Disease Prevention and Health Promotion, Division of Nutrition, Physical Activity and Obesity. Date Released: 7/18/2011.
Obesity is a major health problem around the globe. The statistics of overweight and obesity at early ages have reached alarming levels and placed our country in the first place in regard to childhood obesity. In the development of obesity two major factors take part, one genetic and the other one environmental. From the perspective of environmental changes both overweight and obesity result from the imbalance in the energy balance: people ingest more energy than they expend. Despite people live in the same obesogenic environment not all of them develop obesity; it requires genetic factors for this to happen. This review focuses on the description of the main methodologies to find genetic markers, as well as the main loci in candidate genes, whose single nucleotide polymorphisms (SNPs) are associated with obesity and its comorbidities in children, highlighting the association of these genes in the Mexican population. Knowledge of the genetic markers associated with obesity will help to understand the molecular and physiological mechanisms, the genetic background and changes in body mass index in the Mexican population. This information is useful for the planning of new hypotheses in the search for new biomarkers that can be used in a predictive and preventive way, as well as for the development of new therapeutic strategies. PMID:24866313
Peralta-Romero, José Jesús; Gómez-Zamudio, Jaime Héctor; Estrada-Velasco, Bárbara; Cruz-López, Miguel
This women's health podcast focuses on obesity in women and girls. It discusses obesity-related health risks and includes tips to help achieve and maintain a healthy weight. Created: 5/11/2009 by Office of Womenâ??s Health (OWH) and National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP). Date Released: 5/11/2009.
This study examined the perceptions of a cross section of new and experienced assistant principals regarding the realities of their jobs. Findings indicated that their challenges pertain to workload and task management, conflicts with adults and students, and curriculum and instruction issues. Novice and experienced assistant principals' responses…
Barnett, Bruce G.; Shoho, Alan R.; Oleszewski, Ashley M.
This article presents the perceptions of approximately 300 experienced New Zealand principals who participated in a pilot leadership development initiative funded by the Ministry of Education. The Experienced Principals Development Programme (EPDP) underwent a rigorous evaluation that included formative (mid-point) and summative (end-point)…
Cardno, Carol; Youngs, Howard
After a review of the literature elucidating the status quo for students experiencing homelessness, this article shares the results of a mixed methods study. With a phenomenological qualitative emphasis, the mixed methods study explored the perceptions of parents and children experiencing homelessness regarding their academic needs and the…
Grothaus, Tim; Lorelle, Sonya; Anderson, Kie; Knight, Jasmine
Full Text Available Donor heart preservation and perfusionFlorian M. WagnerDept. of Cardiovascular Surgery, University Heart Center Hamburg, Germany[Applied Cardiopulmonary Pathophysiology 15: 198-206, 2011] AbstractDue to its technically simple and easily reproducible nature cold static preservation is still the current gold standard for myocardial protection in between donor explantation and recipient implantation. It allows “safe” overall ischemic periods of up to 4 hours with a primary graft failure rate less than 2%. Additional measures such as second rinsing or leucocyte depleted in-situ reperfusion allow to extend the ischemic tolerance in ideal donor hearts to 6 hours. Recent technological progress and research improved results of continuous warm, blood based in-vitro perfusion reducing the necessity of myocardial ischemia to the surgical procedures of ex- and implantation. First clinical experiences with this challenging but also very expensive technology indicate its safety and efficacy with at least similar results as cold static preservation even with extended transport times. Due to possible donor evaluation or even resuscitation strategies during ex-vivo perfusion, it offers furthermore promising potential to compensate the ever increasing donor risk profile and could also help to increase availability of transplantable donor hearts. As of December 2011 a German multicenter prospective registry study will start with the goal to evaluate efficacy and outcome of this method in 250 heart transplants using donor organs with extended criteria or expected transport times of >3 hours. Expected duration of this project is 2 years and final analyses of collected data will help to clarify if application of this complex and expensive technology is ultimately beneficial and justified.
F. M. Wagner
We calculate the optical phonon correction to the binding energy of electrons to donors in cubic materials. Previous theories calculated the Rydberg energy reduced by the effective mass and the static dielectric function. They omitted an important energy term from the long-range polarization of the ionized donor, which vanishes for the neutral donor. They also omitted the donor-phonon interaction. Including these terms yields a new formula for the donor binding energy.
Mahan, G D
Full Text Available Obesity; a state of being 20% over one?s normal weight due to excessive fat; that is, it is defined as the accumulation of too much fat in the body. The rate of obesity in the world has elevated. In the last two decades, it is considered that there have been increases in the rates of the obesity with changes in the socio-economic state and nutritional habits in Turkey as well as in modern western countries. The increase of the obesity is a matter of concern but the aspect which is much more matter of concern is in the increase of obesity in women at the reproductive age or gradually increasing rate of being overweight. If the pregnant woman is obese, most of the physiological changes occurring during pregnancy may be various. During their childbearing years, obese women are at an increased risk for pregnancy-induced hypertension, gestational diabetes, labour induction, caesareans births, and failed vaginal birth following to caesarean. Nurses should have the knowledge to adapt the care they provide according to this knowledge and encourage the pregnant women to acquire behaviours which will improve their health. [TAF Prev Med Bull 2009; 8(4.000: 345-350
Serap Ejder Apay
Obesity is a common disorder affecting approximately 1 in 3 women. Assessment should consist of measuring BMI and waist circumference, a thorough history regarding nutrition, physical activity, and prior attempts at weight loss, and identification of obesity-related comorbidities. As a chronic disease, obesity requires management using a chronic care model employing multimodal therapy. Behavioral therapy to bring about changes in nutrition and physical activity can be supplemented with long-term use of medications (lorcaserin, orlistat, phentermine/topiramate) to help patients both achieve and maintain meaningful weight loss. PMID:24527479
Ryan, Donna H; Braverman-Panza, Jill
This article represents another approach to the topic of obesity in African-American women. It will not give the usual statistical data on obesity in African American women, because as African-American women, it is known that a greater majority is at risk. Instead the article represents a historical, cultural and psychosocial journey in attempting to understand obesity in African-American women from this perspective. The following thoughts are reflective of interactions with African-American women who have struggled with their weight and who have strived to understand the dynamics of their dilemma of being overweight and/or obese in America. This article explains that obesity in African-American women is more than an alteration in ones physiological processes. For some African-American women obesity is the essence of ones being and it has had a deleterious impact on them. Obesity in the African-American woman is not as simplistic as perceived. It is more than the management of the intake of food. Obesity is also more than the type of food that African-American women prepare and consume. Obesity in this sense maybe linked to the very essence of the women's cultural, historical and psychosocial well being. Being large can be a familial characteristic bearing no connection to the consumption and preparation of food. Important to the latter concept, and essential to the understanding of obesity in African-American women, it needs to be remembered that food may have many symbolic meanings. The symbols may be of a cultural and psychological nature and could be consciously unknown to the individual. Whatever the situation, it needs to be clear that for many African-Americans, obesity is not merely a medical problem. Being obese in America, and particularly for African-American women, has a far-reaching effect. It has reek havoc on the cultural psyche of the African-American women. The popular cultural concept conveyed by all types of media, is one of being thin and/or slim. PMID:12856445
Johnson, Ruth W; Broadnax, Pier A
The incidence of childhood obesity has increased dramatically, including severe childhood obesity and obesity-related comorbid conditions. Cases of severe childhood obesity have prompted the following question: does childhood obesity ever constitute medical neglect? In our opinion, removal of a child from the home is justified when all 3 of the following conditions are present: (1) a high likelihood that serious imminent harm will occur; (2) a reasonable likelihood that coercive state interve...
Varness, Todd; Allen, David B.; Carrel, Aaron L.; Fost, Norman
This paper examines the child obesity epidemic that is gripping our nation, and explores various causes and treatments that may help to defeat child obesity. First there is a description of the obesity epidemic, its causal factors, and its consequences. Additionally there is a summary and critique of the FDAâ€™s obesity report and recommendations. There is a description of drug treatments that are available for obese children and why more research is necessary to ensure the s...
Obesity is a global epidemic resulting in major morbidity and premature death. About 64% of Libyan adults are either overweight or obese, obesity progressively increasing with age, and two times more common among Libyan women than men. Cases of obesity and overweight are increasing in Libya as well as all over the world, with genetic and environmental factors playing a contributory role. With its known significant morbidity and mortality, obesity should draw the attention of the healthcare co...
Elmehdawi, Rafik R.; Albarsha, Abdulwahab M.
The South Pacific archipelago of Vanuatu, like many developing countries, is currently experiencing a shift in disease burdens from infectious to chronic diseases with economic development. A rapid increase in obesity prevalence represents one component of this “health transition.” We sought to identify behaviors associated with measures of obesity in Vanuatu. We surveyed 534 adults from three islands varying in level of economic development. We measured height; weight; waist and hip circ...
Dancause, Kelsey Needham; Vilar, Miguel; Wilson, Michelle; Soloway, Laura E.; Dehuff, Christa; Chan, Chim; Tarivonda, Len; Regenvanu, Ralph; Kaneko, Akira; Lum, J. Koji; Garruto, Ralph M.
Full Text Available Because the supply of cadaveric organ donors is limited and their ICU management is complex, a multidisciplinary, well-coordinated, and institutionally supported approach to management is essential to ensure the maintenance of the current supply and to increase the future supply of organs and tissues that are suitable for transplantation. The potential organ donor is at high risk for instability as a direct consequence of the loss of physiologic homeostatic mechanisms that are dependent on functioning of the central nervous system. The keys to successful ICU management of the potential organ donor include a team approach that is focused on the anticipation of complications, appropriate physiologic monitoring, aggressive life support, with frequent reassessment and titration of therapy.
The obesity pandemic has grown to concerning proportions in recent years, not only in the Western World, but in developing countries as well. The corresponding decrease in male fertility and fecundity may be explained in parallel to obesity, and obesity should be considered as an etiology of male fertility. Studies show that obesity contributes to infertility by reducing semen quality, changing sperm proteomes, contributing to erectile dysfunction, and inducing other physical problems related to obesity. Mechanisms for explaining the effect of obesity on male infertility include abnormal reproductive hormone levels, an increased release of adipose-derived hormones and adipokines associated with obesity, and other physical problems including sleep apnea and increased scrotal temperatures. Recently, genetic factors and markers for an obesity-related infertility have been discovered and may explain the difference between fertile obese and infertile obese men. Treatments are available for not only infertility related to obesity, but also as a treatment for the other comorbidities arising from obesity. Natural weight loss, as well as bariatric surgery are options for obese patients and have shown promising results in restoring fertility and normal hormonal profiles. Therapeutic interventions including aromatase inhibitors, exogenous testosterone replacement therapy and maintenance and regulation of adipose-derived hormones, particularly leptin, may also be able to restore fertility in obese males. Because of the relative unawareness and lack of research in this area, controlled studies should be undertaken and more focus should be given to obesity as an etiolgy of male infertility. PMID:20531281
Cabler, Stephanie; Agarwal, Ashok; Flint, Margot; du Plessis, Stefan S
Patients with a history of diabetes mellitus (DM) have worse survival than those without DM after liver transplantation. However, the effect of liver grafts from DM donors on the post-transplantation survival of recipients is unclear. Using the Scientific Registry of Transplant Recipients database (2004–2008), 25,413 patients were assessed. Among them, 2,469 recipients received grafts from donors with DM. The demographics and outcome of patients were assessed. Patient survival was assessed using Kaplan–Meier methodology and Cox regression analyses. Recipients from DM donors experienced worse graft survival than recipients from non-DM donors (one-year survival: 81% versus 85%, and five-year survival: 67% versus 74%, P5 years (P<0.001) compared with those with DM duration <5 years. Cox regression analyses showed that DM donors were independently associated with worse graft survival (hazard ratio, 1.11; 95% confidence interval, 1.02–1.19). The effect of DM donors was more pronounced on certain underlying liver diseases of recipients. Increases in the risk of graft loss were noted among recipients from DM donors with hepatitis-C virus (HCV) infection, whereas those without HCV experienced similar outcomes compared with recipients from non-DM donors. These data suggest that recipients from DM donors experience significantly worse patient survival after liver transplantation. However, in patients without HCV infection, using DM donors was not independently associated with worse post-transplantation graft survival. Matching these DM donors to recipients without HCV may be safe.
Zheng, Jun; Xiang, Jie; Zhou, Jie; Li, Zhiwei; Hu, Zhenhua; Lo, Chung Mau; Wang, Weilin
The present study was carried out in B.A.R.C. Hospital Blood Bank over a span of five years, and includes 2734 donors. All the bags were screened for HIV, HBsAg, HCV and VDRL and the plasma in the pilot tubes of the blood bags was observed to detect any abnormality in color. In 27 cases plasma was found to be icteric and liver function tests were carried out on these samples. Two donors showed higher SGPT level, and were excluded. No significant increases in liver enzymes were recorded in the...
... nhqrdr12/index.html At a Glance – Risk Factors: Obesity is a risk factor for several diseases. For statistics on these related diseases see: Diabetes – See Diabetes and African Americans Heart Disease – See Heart Disease and African Americans ...
This review offers an overview of physiological agents, current therapeutics, as well as medications, which have been extensively used and those agents not currently available or non-classically considered anti-obesity drugs. As obesity - particularly that of central distribution - represents an important triggering factor for insulin resistance, its pharmacological treatment is relevant in the context of metabolic syndrome control. The authors present an extensive review on the criteria for anti-obesity management efficacy, on physiological mechanisms that regulate central and/or peripheral energy homeostasis (nutrients, monoamines, and peptides), on beta-phenethylamine pharmacological derivative agents (fenfluramine, dexfenfluramine, phentermine and sibutramine), tricyclic derivatives (mazindol), phenylpropanolamine derivatives (ephedrin, phenylpropanolamine), phenylpropanolamine oxytrifluorphenyl derivative (fluoxetine), a naftilamine derivative (sertraline) and a lipstatine derivative (orlistat). An analysis of all clinical trials - over ten-week long - is also presented for medications used in the management of obesity, as well as data about future medications, such as a the inverse cannabinoid agonist, rimonabant. PMID:16767304
Mancini, Marcio C; Halpern, Alfredo
Affective forecasting with respect to two environmental risks (ozone depletion, air pollution) was investigated by studying tourists who travelled to either Australia or Bangkok and were thus confronted with one of these risks. We measured anticipated outcome and anticipated emotions before the journey, actually experienced outcome and actually experienced emotions during the journey, and anticipated outcome and emotions concerning a future encounter with the same risk after the journey. Resu...
Full Text Available SciELO Brazil | Language: English Abstract in portuguese INTRODUÇÃO: A doação de sangue causa redução substancial na quantidade de ferro do organismo (cada unidade de sangue retirada [425 a 475 ml] contém 200 a 250 mg de ferro) com conseqüente mobilização do ferro de depósito. Recentes estudos têm demonstrado que as reservas de ferro do organismo são pequ [...] enas, e sua deficiência é mais freqüente nos doadores de sangue que nos indivíduos não-doadores de sangue. OBJETIVO: Avaliar a freqüência da deficiência de ferro em doadores de sangue do Hemocentro da Santa Casa de São Paulo segundo o sexo, o tipo de doador e a freqüência de doações realizadas nos últimos 12 meses. LOCAL: Hemocentro da Santa Casa de São Paulo. PARTICIPANTES: No período de 20 de setembro a 5 de outubro de 1999 foram estudados 300 doadores de sangue. TESTES DIAGNÓSTICOS: Utilizamos a determinação das dosagens do ferro sérico, da capacidade total de ligação do ferro, do índice de saturação da transferrina, da ferritina sérica e dos índices eritrocitários. RESULTADOS: A freqüência de doadores de sangue que apresentavam deficiência de ferro observada foi de 11, 0 % (33/300), sendo 5, 5% (13/237)nos doadores do sexo masculino e de 31, 7% (20/63) nos doadores do sexo feminino. Para as mulheres, 18, 5% delas já apresentavam deficiência de ferro à primeira doação de sangue, e para as doadoras freqüentes foi 41, 5%. Entre os homens, nenhum doador apresentava deficiência de ferro à primeira doação de sangue e, para os doadores freqüentes, a deficiência de ferro foi de 7, 6%. A freqüência observada foi maior para os doadores com três ou mais doações nos últimos 12 meses (P Abstract in english CONTEXT: Blood donation results in a substantial loss of iron (200 to 250 mg) at each bleeding procedure (425 to 475 ml) and subsequent mobilization of iron from body stores. Recent reports have shown that body iron reserves generally are small and iron depletion is more frequent in blood donors tha [...] n in non-donors. OBJECTIVE: The aim of this study was to evaluate the frequency of iron deficiency in blood donors and to establish the frequency of iron deficiency in blood donors according to sex, whether they were first-time or multi-time donors, and the frequency of donations per year. DESIGN: From September 20 to October 5, 1999, three hundred blood donors from Santa Casa Hemocenter of São Paulo were studied. DIAGNOSTIC TESTS: Using a combination of biochemical measurements of iron status: serum iron, total iron-binding capacity, transferrin saturation index, serum ferritin and the erythrocyte indices. RESULTS: The frequency of iron deficiency in blood donors was 11.0%, of whom 5.5% (13/237) were male and 31.7% (20/63) female donors. The frequency of iron deficiency was higher in multi-time blood donors than in first-time blood donors, for male blood donors (7.6% versus 0.0%, P
Rodolfo Delfini, Cançado; Carlos Sérgio, Chiattone; Fausto Forin, Alonso; Dante Mário, Langhi Júnior; Rita de Cássia Silva, Alves.
In recent years, it has been thought that a strong association exists between metabolic syndrome, specifically obesity, and psoriasis. Obesity is a multifactorial disease affected by both genetic and environmental factors. Adipokines (e.g. leptin) secreted by the adipose tissue are believed to play a role in the pathogenesis of psoriasis. The main role of leptin is to adjust metabolism by controlling appetite. Serum leptin levels in patients with severe and moderate psoriasis were found to be...
Non-alcoholic steatohepatitis (NASH) is a disease of emerging identity and importance. It is frequently associated with obesity, especially visceral fat, and is intimately related to fatty liver and markers of the insulin resistance syndrome. Both the prevalence and the severity of liver steatosis are related to body mass index, waist circumference, hyperinsulinaemia, hypertriglyceridaemia and impaired glucose tolerance or type 2 diabetes. The identification of obese patients who may progress...
Scheen, Andre?; Luyckx, Franc?oise
Obesity is associated with increased risk for cardiovascular health problems including diabetes, hypertension, and stroke. These cardiovascular afflictions increase risk for cognitive decline and dementia, but it is unknown whether these factors, specifically obesity and type II diabetes, are associated with specific patterns of brain atrophy. We used tensor-based morphometry (TBM) to examine gray matter (GM) and white matter (WM) volume differences in 94 elderly subjects who remained cogniti...
Childhood obesity is a complex disease with different genetic, metabolic, environmental and behavioural components that are interrelated and potentially confounding, thus making causal pathways difficult to define. Given the tracking of obesity and the associated risk factors, childhood is an important period for prevention. To date, evidence would support preventative interventions that encourage physical activity and a healthy diet, restrict sedentary activities and offer behavioural suppor...
In recent years the levels of obesity in the United States has risen greatly especially amongst children. Doctors, psychologists, and other scientists have been studying the growing problem for years. Implications for childhood obesity not only have enormous physical consequences but emotional repercussions which can affect the child’s academic and social development. A number of factors have been identified as having an effect on these children; family life reveals the grocery store habits...
Obesity is a worldwide problem affecting both children and adults. Genetic, physiological, environmental, psychological, social and economic factors interact in varying degrees, influencing body weight and fat distribution and the progress of obesity. Moreover, some anthropogenic chemicals have proven to be endocrine disrupting chemicals (EDCs) with the potential to interfere with different actions of hormones in the body. EDCs may thereby disrupt homeostasis, modifying developmental, behavio...
Full Text Available Background: Donor safety is the first priority in living donor liver transplantation (LDLT.Objective: To determine the characteristics and outcome of live liver donors who underwent donor hepatectomyfrom January, 1997 to May, 2007 at Massachusetts General Hospital.Methods: 30 patients underwent LDLT between January, 1997 and May, 2007 at our institution.Results: The type of graft was the right lobe (segments 5-8 in 14, left lobe (segments 2-4 in 4, and left lateralsector (segments 2 and 3 in 12 patients. The mean donor age was 36 (range: 26-57 years. The mean follow-up was 48 (range: 18-120 months. No deaths occurred. Overall, 8 (26.6% patients experienced a total of 14 post-operative complications. Donor complications based on graft type were as follows: left lateralsector (16.7%, left lobe (25%, and right lobe (35.7%. The experience was divided into two periods 1997-2001 (n=15 and 2002-2007 (n=15. Overall complications during 2 periods were 40% and 13.3%, respectively (p<0.001. The incidence of grade III complication also significantly decreased; 66.7% vs 33.3% (p<0.01.Conclusion: Partial hepatectomy in living donors has a learning curve which appears to be approximately 15 cases. This learning curve is not restricted to the surgeons performing the procedure but involves all aspects of patient care.
R. F. Saidi
Full Text Available In recent years, it has been thought that a strong association exists between metabolic syndrome, specifically obesity, and psoriasis. Obesity is a multifactorial disease affected by both genetic and environmental factors. Adipokines (e.g. leptin secreted by the adipose tissue are believed to play a role in the pathogenesis of psoriasis. The main role of leptin is to adjust metabolism by controlling appetite. Serum leptin levels in patients with severe and moderate psoriasis were found to be higher than in normal control groups. In many similar studies, leptin secretion has been found to stimulate keratinocyte proliferation, which is one of the characteristics of psoriasis. Although many studies showed increased prevalence of obesity in psoriasis patients, few others reported development of obesity in psoriasis patients. Additionally, obesity was found to affect treatment responses not only in classical systemic/topical treatment approaches in psoriasis, but also in newer biological treatments. Overall, increasing epidemiological evidence suggests strong association between obesity and psoriasis, increase in serum leptin levels is thought to have a major role, and weight loss may have significant impact on response to treatment.
Mehmet Ali Gürer
Obesity was probably rare in ancient times, with the current increase starting in the Industrial Revolution of the eighteenth century, and becoming much more widespread from about 1950, so concurrent with the increased consumption of carbohydrates from cereals in the Green Revolution. However, dietary components such as oligosaccharides from plants including cereals may improve health following fermentation to short-chain carboxylic acids in the intestine by bacteria which constitute of the microbiome. Such non-digestible and fermentable components of diet, called prebiotics, have been part of the human diet since at least Palaeolithic times, and include components of the cereals domesticated in the Neolithic Revolution. If consumption of these cereals has now increased, why is obesity increasing? One reason could be lowered prebiotic intake combined with increased intake of simple sugars, thus changing the bacteria in the microbiome. Processing of food has played an important role in this change of diet composition. Since obesity is a low-grade inflammation, changing the microbiome by increased consumption of simple carbohydrates and saturated fats may lead to obesity via increased systemic inflammation. Conversely, there is now reasonable evidence that increased dietary prebiotic intake decreases inflammation, improves glucose metabolism and decreases obesity. Would widespread increases in prebiotics in the modern diet, so mimicking Palaeolithic or Neolithic nutrition, decrease the incidence and morbidity of obesity in our communities? PMID:24844456
Carnahan, S; Balzer, A; Panchal, S K; Brown, L
Full Text Available The prevalence of overweight and obesity and their associated metabolic disorders are considered a major threat to the public’s health. While several diet and exercise programs are available for weight loss and prevention of weight regain, progress is often slow and disappointing. Recently, natural bioactive phytochemicals present in foods have been discovered for their potential health benefit effects on the prevention of chronic disorders such as cancer, cardiovascular disease, inflammatory and metabolic diseases including obesity.Polyphenols are a class of naturally-occurring phytochemicals, of which some such as catechins, anthocynines, resveratrol and curcumin have been shown to modulate physiological and molecular pathways that are involved in energy metabolism, adiposity, and obesity. The potential in vivo, beneficial effects of these polyphenols on adiposity and obesity as complementary agents in the up-regulation of energy expenditure have emerged by investigating these compounds in cell cultures, animal models of obesity and in some human clinical and epidemiological studies. In this brief review, the efficacy of the above-named polyphenols and their potential efficacy to modulate obesity and some associated disorders are discussed.
Longitudinal correlations were obtained between amniotic fluid insulin concentration at 32 to 38 weeks' gestation and anthropometric characteristics at the age of 6 years in 56 children of diabetic mothers. The prospective studies indicated that at the age of 6 years, as at birth, the greatest increase in weight in relation to height (relative obesity) was seen in children who experienced the greatest exposures to insulin in the uterus (as judged by amniotic fluid insulin concentration). Sign...
Metzger, B. E.; Silverman, B. L.; Freinkel, N.; Dooley, S. L.; Ogata, E. S.; Green, O. C.
Kidney transplantation in morbidly obese patients can be technically demanding. Furthermore, morbidly obese patients experience a high rate of wound infections and related complications, which mostly result from the longer length and extent of the incision. These complications can be avoided through minimally invasive surgery; however, conventional laparoscopic instruments are unsuitable for the safe performance of a kidney transplant in morbidly obese patients. Herein, we report the first minimally invasive, total robotic kidney transplant in a morbidly obese patient. A left, deceased donor kidney was transplanted into a 29-year-old woman with a body mass index (BMI) of 41 kg/m(2) who had been on hemodialysis for 5 years. The operation was performed intraabdominally using the DaVinci Robotic Surgical System with 4 trocars and a 7 cm midline incision. The operative time was 223 min, and the blood loss was less than 50 cc. The kidney had immediate graft function. No perioperative complications were observed, and the patient was discharged on postoperative day 5 with normal kidney function. Minimally invasive access and robotic technology facilitated the safe performance of a successful kidney transplant in a morbidly obese patient. PMID:20486912
Giulianotti, P; Gorodner, V; Sbrana, F; Tzvetanov, I; Jeon, H; Bianco, F; Kinzer, K; Oberholzer, J; Benedetti, E
Full Text Available ... Good evening, I’m Dr. John Colonna, the surgical director of the kidney transplant program here at Sentara Norfolk General Hospital. I would like to thank the audience for joining us tonight for our live webcast on living donor kidney transplant surgery. Please feel free to e-mail questions as ...
... Content Index > Data/Statistics > Data by Health Topic > Obesity Obesity and Native Hawaiians/Pacific Islanders Native Hawaiians/Pacific ... be obese than non-Hispanic Whites in 2011 Obesity continues to be a health risk in the ...
Full Text Available Obesity is now present worldwide, including China, India and developing countries. It now seems no longer acceptable to argue that obesity can simply be explained in terms of caloric consumption only using simple concept of energy in and energy out. There may be specific causes of altered metabolism that produce nutritional imbalances. Individual variation in response to food intake may also be considered. Specific substances in the food chain can influence meta-bolism towards an increase in fat deposits. Xenoestrogens have been suggested to have such an influence. Soy contains phytoestrogens plus phytates, protease inhibitors and other anti-nutrients which block or compromise the body’s uptake of essential vitamins and minerals. This may contribute to nutritional anomalies. We analyzed data from WHO and FAO for 167 countries. These contained percentage of obese individuals (BMI > 30 kg/m2, GDP, caloric consump-tion per capita, and sugar and soy consumption per capita. Regressions and partial correlations were used. Soy con-sumption correlates significantly with levels of obesity, irrespective of GDP and caloric intake. For instance, poor Latin America with soy consumption of 28.9 kg/person/year has more obesity (18.4% than better off European Union (14.1% consuming 16.1 kg/person/year of soy. Soy consumption seems to contribute approximately 10% - 21% to the worldwide variation in obesity, depending on the method of statistical analysis. The ubiquitous presence of unfermented soy products in mass produced foods seems to be an important contributor to the obesity epidemic.
There are two groups of approved drugs that can be used to manage weight in patients with obesity: medications approved for obesity per se and medications that affect body weight for obese patients who have complications from their obesity and are receiving these medications for chronic disease management. For obesity per se, treatment is with one of the three drugs currently approved for long-term treatment of obesity or one of a few others that can be used for short-term treatment. Among these, orlistat partially blocks intestinal digestion of fat and produces weight loss of 5-8 kg but major limitations are associated gastrointestinal symptoms; lorcaserin, a serotonin-2C agonist with few side effects, produces a mean weight loss of 4-7 kg; and the combination of phentermine and topiramate (extended release) produces a mean weight loss of 8-10 kg, but should only be used after verifying a woman is not pregnant. Failure to lose more than 3% of body weight within 3 months with any of these agents should lead to reevaluation of therapy. The short-term drugs for treating obesity per se are sympathomimetics, with phentermine being most widely used. The second group of drugs is for weight-centric prescribing for patients with a chronic disease such as diabetes, depression, or psychiatric disorders. For each disorder, some drugs produce weight gain, others are weight neutral, but the best choice for these patients is the combination of drugs that treat the underlying condition and also produce weight loss. PMID:24641701
Bray, George A; Ryan, Donna H
Three methods of donor site management were tested in 17 patients to determine if any resulted in faster wound healing. Gross inspection and biopsies revealed no differences between donor sites left uncovered or those treated with fine mesh gauze. However...
B. A. Pruitt D. W. Wilmore P. Silverstein R. E. Salisbury
Renal transplantation is the treatment of choice for a suitable patient with end stage renal disease. Unfortunately, the supply of donor organs is greatly exceeded by demand. In many countries the use of kidneys from living donors has been widely adopted as a partial solution. Traditionally donor nephrectomy has been performed via a open flank incision however with some morbidity like pain and a loin scar. Currently, the donor nephrectomy is increasingly being performed laparoscopically with ...
Srivastava, A.; Gupta, N.; Kumar, Anant; Kapoor, Rakesh; Dubey, Deepak
Full Text Available Introduction Studies carried out in various parts of the world indicate that family obesity significantly affects the incidence of obesity in children. This is especially a characteristic of children whose both parents are obese. Material and methods The study was conducted using a polling method. Questionnaires were filled out by parents and brothers and sisters, including their body height and weight. The collected data served as the basis for assessing the family nutritional status. Results Statistical analysis of the results showed that obese children frequently have obese parents, brothers and sisters in regard to normal-weight children. Differences are statistically significant in relation to fathers (r=0.043, i.e. statistically obese schoolchildren have more frequently obese fathers than those of normal nutritional status. Other differences could not be considered significant (p > 0.05. Discussion Obese children have more often obese parents, brothers and sisters than normal-weight children. It was found that the nutritional status of moderately and extremely obese children was quite different from that of normal-weight children and that there was a statistically significant dependence between the nutritional status of children and their fathers. Conclusion This research showed that family obesity is a potential contributing factor to obesity of schoolchildren.
Screening and treatment of plasma lipid abnormalities secondary to obesity are among the interventions that should be implemented in children who are overweight or obese, in order to prevent a cardiovascular event. Dyslipidemias are a group of asymptomatic diseases that are commonly caused by abnormal levels of lipoproteins in blood; they are a comorbidity that is commonly related to obesity, without considering the age of the patient. Among dyslipidemias, hypertriglyceridemia has the highest prevalence. The etiology of the dyslipidemia should be identified; it allows the proper selection of therapy for the patients and their family. The goal is the prevention of cardiovascular complications. Reduced caloric intake and a structured physical activity plan should be considered for initial treatment for all the overweight and obese patients. For adherence to treatment to be successful, the participation of the primary care physician and a multidisciplinary team is required. With treatment, the risks and complications can be reduced. The participation of a specialist in handling the pediatric obese patient with dyslipidemia should be limited to severe cases or those at risk for having pancreatitis. PMID:24866316
Gómez-Díaz, Rita Angélica; Wacher-Rodarte, Niels H
Full Text Available Obesity is characterized by the abnormal or excessive deposition of fat in the adipose tissue. Its consequences go far beyond adverse metabolic effects on health, causing an increase in oxidative stress, which leads not only to endothelial dysfunction but also to negative effects in relation to periodontitis, because of the increase in proinflammatory cytokines. Thus obesity appears to participate in the multifactorial phenomenon of causality of periodontitis through the increased production of reactive oxygen species. The possible causal relationship between obesity and periodontitis and potential underlying biological mechanisms remain to be established; however, the adipose tissue actively secretes a variety of cytokines and hormones that are involved in inflammatory processes, pointing toward similar pathways involved in the pathophysiology of obesity, periodontitis and related inflammatory diseases. So the aim of this article is to get an overview of the association between obesity and periodontitis and to review adipose-tissue - derived hormones and cytokines that are involved in inflammatory processes and their relationship to periodontitis.
This editorial discusses the problem of obesity in people with serious mental illnesses, as well as the role of those in the field of psychiatric/psychosocial rehabilitation (PSR) in addressing this issue. The term "obesogenic environment" has been coined to refer to environments that both promote weight gain and act as a barrier to weight loss. In an ecological model of obesity, people in obesogenic environments struggle against a culture that promotes consumption of high-fat, sugar-laden foods and encourages sedentary behaviors. Multiple influences affect an individual's response to obesogenic environments such as degree of exposure, access to resources, and biological predisposition to obesity. The ecological model of obesity has much to offer the field, given PSR's emphasis on community participation and social integration. By working together to propose, implement, and test changes at both organizational and professional levels, members can address overweight and obesity and alter the landscape of the obesogenic environments for those they serve and care about. PMID:24059628
Cook, Judith A; Mueser, Kim T
Screening blood donors for rare antigen constellations has been implemented using simple PCR methods: PCR with enzyme digestion has been used to type donor cohorts for Dombrock antigens, and PCR with sequence-specific priming to identify donors negative for antigens of high frequency. The advantages and disadvantages of the methods as well as their current state is discussed.
Full Text Available During the past decade, the number of transplantation from living kidney donors has substantially increased worldwide. The rate of increase varies from one country to another. The risk of unilateral nephrectomy to the donor includes perioperative mortality and morbidity plus the long-term risk of living with a single kidney. The rate of perioperative mortality and morbidity is about 0.03% and 10%, respectively. More attentionis required to prevent serious complications of laparoscopic donor nephrectomy. A grading system in recording perioperative complications is necessary for making it available to each potential donor. The number of studies on long-term outcome of living donors is very limited. The overall evidence suggests that the risk of end-stage kidney disease is not increased in donors, however, mild renal failure, hypertension and proteinuria are not uncommon in living donors. There is also concern that the incidence of cardiovasculardisease may be higher in kidney donors. Establishing living donor registry and follow-up is extremely important. Only through these registries the long-term risk of kidney donation will become more apparent. Because of severe shortage of transplantable kidneys, some transplant centers are now using donors with comorbidities and few centers are involved in transplant tourism with inadequate donor screening and follow-up. Prevention of these unacceptable practices in living kidney donors was emphasized in AmsterdamForum in 2004 and Istanbul Summit in 2008.
Ahad Jafari Ghods
The report summarizes a 1978 expert panel discussion on obesity in infants and children. The panel concluded that: Definitions of obesity in adults are not applicable to children; Accurate prevalence data are not available for children under five years of...
Full Text Available The prevalence of obesity, an established risk and progression factor for many cancers, has increased dramatically in many countries over the past three decades. Worldwide, an estimated 600 million adults are currently obese. Thus, a better understanding of the mechanistic links between obesity and cancer is urgently needed to identify intervention targets and strategies to offset the procancer effects of obesity. This review synthesizes the evidence on key biological mechanisms underlying the obesity-cancer association, with particular emphasis on obesity-associated enhancements in growth factor signaling, inflammation, and perturbations in the tumor microenvironment. These interrelated pathways and processes that are aberrantly regulated in obese individuals represent mechanism-based targets for disrupting the obesity-cancer link using phytochemicals.
... Nose & Throat Emotional Problems Fever Genitals & Urinary Tract Head, Neck & Nervous System Obesity Skin Treatments View all Injuries & ... From Insects or Animals Genitals and Urinary Tract Head Neck & Nervous System Heart Infections Learning Disabilities Obesity Orthopedic ...
This article unites the results from an integrative reconsideration of actual data about obesity from the viewpoint of recent developments in general pathology, epidemiology, immunology, genetics, and evolution. The focus is on the origin of genetic diversity in obesity manifestations on different levels of the disease. In contrast to the current paradigm of nutritive origin of obesity, the revealed set of evidences shows that the origin of obesity is based on either hereditary or post-infect...
Rumyantsev, Sergey N.
Obesity is at epidemic proportions in the United States and in other developed and developing countries. The prevalence of obesity is increasing not only in adults, but especially among children and adolescents. In the United States in 2003 to 2004, 17.1% of children and adolescents were overweight, and 32.2% of adults were obese. Obesity is a significant risk factor for and contributor to increased morbidity and mortality, most importantly from cardiovascular disease (CVD) and diabetes, but ...
Abstract Childhood obesity has reached epidemic levels in developed countries. Twenty five percent of children in the US are overweight and 11% are obese. Overweight and obesity in childhood are known to have significant impact on both physical and psychological health. The mechanism of obesity development is not fully understood and it is believed to be a disorder with multiple causes. Environmental factors, lifestyle preferences, and cultural environment play pivotal roles in the ...
Childhood obesity has reached epidemic levels in developed countries. Twenty five percent of children in the US are overweight and 11% are obese. Overweight and obesity in childhood are known to have significant impact on both physical and psychological health. The mechanism of obesity development is not fully understood and it is believed to be a disorder with multiple causes. Environmental factors, lifestyle preferences, and cultural environment play pivotal roles in the rising prevalence o...
There are numerous reports of multi-system genetic disorders with obesity. Many have a characteristic presentation and several, an overlapping phenotype indicating the likelihood of a shared common underlying mechanism or pathway. By understanding the genetic causes and functional perturbations of such syndromes we stand to gain tremendous insight into obesogenic pathways. In this review we focus particularly on Bardet-Biedl syndrome, whose molecular genetics and cell biology has been elucidated recently, and Prader-Willi syndrome, the commonest obesity syndrome due to loss of imprinted genes on 15q11-13. We also discuss highlights of other genetic obesity syndromes including Alstrom syndrome, Cohen syndrome, Albright's hereditary osteodystrophy (pseudohypoparathyroidism), Carpenter syndrome, MOMO syndrome, Rubinstein-Taybi syndrome, cases with deletions of 6q16, 1p36, 2q37 and 9q34, maternal uniparental disomy of chromosome 14, fragile X syndrome and Börjeson-Forssman-Lehman syndrome. PMID:18230893
Goldstone, Anthony P; Beales, Philip L
Full Text Available The present study was carried out in B.A.R.C. Hospital Blood Bank over a span of five years, and includes 2734 donors. All the bags were screened for HIV, HBsAg, HCV and VDRL and the plasma in the pilot tubes of the blood bags was observed to detect any abnormality in color. In 27 cases plasma was found to be icteric and liver function tests were carried out on these samples. Two donors showed higher SGPT level, and were excluded. No significant increases in liver enzymes were recorded in the others. Causes of icteric plasma in these apparently healthy donors are discussed. Differential diagnosis includes Gilbert?s disease, hemolytic anemia, drug-induced anemia and other hepatic causes of hyperbilirubinemia, of which Gilbert?s disease is most probable cause with a prevalence of 0.91% in our population. As there are no studies to document the safety of the recipients receiving such abnormal colored plasma as well as to document the hazards in its transfusion, the question arises whether to transfuse such units or not. This study highlights this dilemma. A reassessment of existing policies and regulations is merited.
Describes the role caregivers play in helping young children dealing with obesity. Examines: (1) causes of childhood obesity; (2) caregiver's position; (3) learning nutrition concepts; (4) preparing and serving healthy foods; (5) encouraging physical activity; (6) working with parents; and (7) assisting an obese child. (SD)
The internet is widely used by everyone as a source of health information,namely in obesity and weight lost. However, the easy production and edition of documents on the Internet enables any user to be an author and write the information according to their will, not ensuring the veracity of it. In this context the internet may be seen as a threat to one’s health. Thus, the aim of the study was to characterize and evaluate Portuguese websites obesity information and verify if the technical a...
Martins, Diana; Almendra, Joana; Jesus, Marta; Soares, Sandra; Dias, Ta?nia; Ferro-lebres, Vera; Fernandes, Anto?nio
Appetite has recently received the attention of researchers in developing countries due to the increasing prevalence of obesity. There are multiple complex mechanisms involved in food intake. The satiety level and the physiological state of a person are responsible for appetite expression. Specific manipulations of macronutrients have the potential to affect appetite control. Certain pharmaceutical formulations and sensitizer compounds/chemicals can also be used as appetite suppressants either orally or intravenously. Several aspects related to appetite control and obesity have been briefly reviewed in view of the current scientific and commercial trends. PMID:22747082
Wadikar, D D; Premavalli, K S
The prevalence of obesity, and the human and economic costs of the disease, creates a need for better therapeutics and better understanding of the physiological processes that balance energy intake and energy expenditure. Leptin is the primary signal from energy stores and exerts negative feedback effects on energy intake. In common obesity, leptin loses the ability to inhibit energy intake and increase energy expenditure; this is termed leptin resistance. This review discusses the evidence in support of leptin resistance in mouse models and humans and the possible mechanisms of leptin resistance. PMID:17021377
Enriori, Pablo J; Evans, Anne E; Sinnayah, Puspha; Cowley, Michael A
Hypertension after pediatric renal transplant is a common and important risk factor for graft loss and patient survival. The mechanism of post kidney transplant hypertension is complex and multifactorial. Control of blood pressure in renal transplant patients is important but often times blood pressures remain uncontrolled. The management of hypertension and obesity in pediatric kidney transplant patients is based on the pathophysiology. Compared to the general pediatric hypertensive population, special attention needs to be focused on the additional impact of immunosuppressive medications side effects and interactions, recurrent disease, and donor and recipient comorbidities such as obesity on blood pressure control with thoughtful consideration of the risk of graft failure. In general, there is a need for prospective studies in pediatric kidney transplant patients to understand the pathophysiology of hypertension and obesity and the appropriate approach to achieve a balance between the primary need to avoid rejection and the need to lower blood pressure and prevent obesity.
John, Eunice G.; Domingo, Liezl T.
Full Text Available The presence of anti-lymphocytes antibodies is associated with the occurrence of acute rejection after kidney transplantation but few is known on their role after the rejection episode. We conducted a retrospective study in kidney transplant recipients who experienced a biopsy proven acute rejection episode to analyse the influence of anti-lymphocytes antibodies on clinical outcome. Anti-lymphocytes antibodies were detected before and after transplantation and characterized for isotype, class I and class II targets and donor specificity. 76 kidney recipients were included and analysed for steroid resistance of acute rejection, serum creatinine and 1-year actual graft survival. The presence of anti-lymphocytes antibodies was noticed in 80% of patients. Anti-lymphocytes antibodies were associated with more frequent steroid resistant rejection episodes, higher creatinine at discharge and throughout the first year post transplantation and with a worse graft survival, at the condition they were of the IgG isotype, donor-specific, and they recognized class II targets. We conclude that donor-specific anti-class II IgG antibodies are deleterious in the subgroup of kidney transplant recipients who develope an acute rejection.
The creative and expressive use of music can be a powerful therapeutic intervention with children and adolescents who have experienced trauma. In this article, a model for increasing self-awareness and self-understanding including materials, facilitation, and processing of musical activities in group format is presented. Creative activities such…
Davis, Keith M.
The aim of this phenomenographic study was to identify student teachers' ways of experiencing the teaching of health education, and to determine the aspects that are educationally critical in gaining a deeper understanding of the teaching. Qualitative data (written essays, semi-structured interviews) were gathered twice during health education…
Paakkari, Leena; Tynjala, Paivi; Kannas, Lasse
Team cognition in experienced command-and-control teams is examined in an UAV (Uninhabited Aerial Vehicle) simulation. Five 3-person teams with experience working together in a command-and-control setting were compared to 10 inexperienced teams. Each team participated in five 40-min missions of a simulation in which interdependent team members…
Cooke, Nancy J.; Gorman, Jamie C.; Duran, Jasmine L.; Taylor, Amanda R.
This article provides a thorough, literature-based review of the impact of near-death experiences on children and adolescents in the areas of social and academic functioning in school. Gleaned from the published literature about how various non-school health professionals can most effectively assist near-death experiencers, practical suggestions…
Bell, Kathleen E.; Holden, Janice Miner; Bedwell, James
Research supervisors' different ways of experiencing their supervision of doctoral students are analysed in terms of the students' questions and problems as they relate to the supervisor's research, and what consequences this connection, or non-connection, to the supervisor's research has for supervision and the role of supervisor. Thirty…
Franke, Anita; Arvidsson, Barbro
In the past half-century, solid-organ transplantation has become standard treatment for a variety of diseases in children and adults. The major limitation for all transplantation is the availability of donors, and the gap between demand and supply continues to grow despite the increase in living donors. Although rare, children do serve as living donors, and these donations raise serious ethical issues. This clinical report includes a discussion of the ethical considerations regarding minors serving as living donors, using the traditional benefit/burden calculus from the perspectives of both the donor and the recipient. The report also includes an examination of the circumstances under which a minor may morally participate as a living donor, how to minimize risks, and what the informed-consent process should entail. The American Academy of Pediatrics holds that minors can morally serve as living organ donors but only in exceptional circumstances when specific criteria are fulfilled. PMID:18676567
Ross, Lainie Friedman; Thistlethwaite, J Richard
Explicit negative attitudes and blameful beliefs (e.g. poor diet, laziness) towards obese individuals are well documented and are pervasive even among health professionals. Here we sought to determine whether obesity stigma is reflected in a fundamental feature of intersubjectivity namely the automatic neural resonance with others' affective experiences. During fMRI, normal-weight female participants observed short clips depicting normal-weight (NW) and obese (Ob) models experiencing pain. Importantly, participants believed that half of the Ob were overweight due to a hormonal disorder (HormOb) and ignored the cause of obesity of the remaining models (Unknown obese models; UnkOb). Analyses of hemodynamic responses showed reduced activity to the pain of Ob compared to that of NW in areas associated with pain processing and early visual processing. The comparison between the two Ob conditions revealed a further decrease of activity to HormOb's pain compared to UnkOb's (and NW) pain in the right inferior frontal gyrus, an area associated with emotional resonance. Our study demonstrates that stigma for obese individuals can be observed at implicit levels, and that it is modulated by knowledge concerning the etiology of obesity, with the seemingly surprising result that obesity due to disease may result in greater stigmatization. Moreover, the perceived similarity with the models and the ambivalent emotion of pity may index biased brain responses to obese individuals' pain. The study highlights a possibly important neural link between resonance with the pain of others and obesity stigma. PMID:24287441
Azevedo, R T; Macaluso, E; Viola, V; Sani, G; Aglioti, S M
Objectives: To report experience with laparoscopic sleeve gastrectomy (LSG) in obese, morbidly obese, and super morbid obese patients, and to evaluate comparative efficacy of LSG among these patient groups. Methods: A total of 147 patients underwent LSG between March 2008 and December 2011 at the Department of Surgery, King Saud Medical City, Riyadh, Kingdom of Saudi ...
Al Falah, Haitham M.; Alsalamah, Saleh M.; Muhammad Abdullah; Alqahtani, Hamad H.; Abbas, Ghanem S.; Alsalamah, Yasir A.
Obesity prevalence has more than doubled globally within the last 30 years. Obesity affects quality of life as well as impacts the risks and prognosis for a number of serious diseases. Established causes include a high calorie diet combined with a sedentary lifestyle and possibly the widespread cessation of smoking, but these do not fully explain the epidemic. Polychlorinated biphenyl congeners (PCBs) are endocrine-disrupting chemicals and evidence from animal experiments suggests an association with obesity development. Our knowledge of the effects of these compounds on weight gain in humans is limited. Our objective was to investigate the association between exposure to PCBs experienced by a general Danish population and development of obesity. We randomly selected 204 persons (113 obese and 91 overweight), aged â?¥ 50 years, from a prospective Danish cohort of 57,053 persons and examined ten PCBs as potential determinants of abdominal obesity. Adipose tissue was collected upon enrolment and PCBs were quantified using gas chromatography-mass spectroscopy. Median levels of the included PCBs were lower in women, except for PCB118 and all PCBs were positively associated with increased abdominal circumference, although this association was not significant. These data indicate a positive link between PCBs and obesity. More work is needed to fully elucidate the complex role of compounds such as PCBs in the present obesity epidemic.
BrÃ¤uner, Elvira; Raaschou-Nielsen, Ole
Blood transfusion services are the integral part of health care system and these services have safe blood transfusion as the major goal. Voluntary blood donation is the key to safe blood and this safety is further enhanced when the voluntary blood donors become repeat/regular donors. Retention of donors is therefore a very crucial strategy to ensure enhanced blood safety. Tele-recruitment is an effective medium of recruiting and more importantly retaining donors via means of telephone/Short Message Service. This study was carried out at a standalone blood bank during the period from January to December 2011 with objectives of donor retention, relationship management with the support of personnel with good communication skills, Donor data base, Integrated software and communication facility. For Initial 4 months there was no tele-recruiter, then for 2 months two tele-recruiter and for next 6 months three tele-recruiter were dedicated. Only impact of tele-recruitment on in-house donation was taken into consideration. 2,091 donors were recruited through tele-recruitment in this eight-month period. This was 63 % of in-house donations and 13 % of total donations. In other words out of every five in-house donations, three donations were from people contacted through tele-recruitment. Repeat voluntary blood donation is the safest donation. Tele-recruitment does this by converting 'first-time' donors into repeat/regular donors. Simple intervention like reminder calls on telephone can be highly effective tool to retain donors. Tele-recruitment helped the blood center establish relationships with individual donors, and, maybe, even the society at large. Tele-recruitment is a very low-cost model which can be easily replicated in all kind of blood banks, be it standalone, or a hospital based. Even the blood centers which are largely dependent on replacement donors can possibly have good results and convert replacement donors into repeat/regular voluntary blood donors. PMID:24554816
Agrawal, Amit; Tiwari, A
Undue tension on the donor vessels during organ procurement is associated with intimal dissection, which can form the nidus for the thrombosis of the hepatic artery (HA) and graft loss. According to the US OPTN database, 143 grafts were discarded in the last 15 yr due to vascular damage during procurement. The most common technique to expose the supraceliac aorta is dissection between the left lateral segment of the liver and the esophagus-stomach. In obese donors, due to restricted space and in pediatric donors where the vessels are very delicate and this space is very small, the replaced or accessory left HA(R/A LHA) is prone to damage if approached conventionally. We describe a technique for the exposure of the supraceliac aorta in which the aorta is approached from the left side behind the gastroesophageal junction that does not require division of the gastrohepatic ligament. From May 2007 to May 2013, 104 liver procurements were performed. Eighty-nine (85.6%) were adults, and 15 (14.4%) were pediatric donors. Twenty-three (22.1%) had R/A LHA. No donor organ suffered any damage. One adult recipient with R/A LHA suffered HA thrombosis not related to it. In summary, this technical modification offers improved safety during cadaveric procurement and increases the ease. PMID:24654564
Desai, Chirag S; Girlanda, Raffaele; Hawksworth, Jason; Fishbein, Thomas M
Full Text Available The fast global increased prevalence of obesity has been classifiedas an epidemics by the World Health Organization. The etiology ofobesity is very complex and involves genetic and environmentalfactors. One of the main factors that trigger obesity is sedentarylife, as well as the great availability of fat-rich foods that present ahigh energy density. According to the NHANES II, although thepopulation has decreased the ingestion of fat, the total consumptionof food has increased. The main factors that influence in choice offood are flavor, followed by cost, convenience and, finally, itsnutritional value. The dietary treatment of obesity should haverealistic goals concerning weight loss rate and amount. It issuggested to prescribe a balanced low-calorie diet, emphasizingmostly the quality of foods by using the food pyramid. Therefore,patients may learn the appropriate criteria to select food and makehealthy choices. The dietary treatment of obesity also includesthe use of behavioral techniques directed at dietary education,thus resulting in choice of healthy foods with adequate energyvalue.
Ana Maria Pita Lottenberg
Type 2 diabetes and obesity are intimately linked; reduction of bodyweight improves glycemic control, mortality and morbidity. Treating obesity in the diabetic is hampered as some diabetic treatments lead to weight gain. Bariatric surgery is currently the most effective antiobesity treatment and causes long-term remission of diabetes in many patients. However, surgery has a high cost and is associated with a significant risk of complications, and in practical terms only limited numbers can undergo this therapy. The choice of pharmacological agents suitable for treatment of diabetes and obesity is currently limited. The glucagon-like peptide-1 receptor agonists improve glycemia and induce a modest weight loss, but there are doubts over their long-term safety. New drugs such as lorcaserin and phentermine/topiramate are being approved for obesity and have modest, salutary effects on glycemia, but again long-term safety is unclear. This article will also examine some future avenues for development, including gut hormone analogues that promise to combine powerful weight reduction with beneficial effects on glucose metabolism. PMID:23473594
Kenkre, Julia; Tan, Tricia; Bloom, Stephen
No report has been available regarding organ transplantation for atomic bomb survivors, even with renal graft. We experienced a living-donor liver transplantation for two atomic bomb survivors using grafts from second-generation children. Post transplant course was uneventful without any systemic disorders under regular immunosuppression schema during 3-year follow-up. The detailed results are herein reported for the first time in the literature. PMID:19878350
Eguchi, Susumu; Takatsuki, Mitsuhisa; Nakashima, Masahiro; Kanematsu, Takashi
Liver transplantation is the only curative treatment in patients with end-stage liver disease. Neurological complications (NC) are increasingly reported to occur in patients after cadaveric liver transplantation. This retrospective cohort study aims to evaluate the incidence and causes of NC in living donor liver transplant (LDLT) patients in our transplant center. Between August 1998 and December 2005, 121 adult LDLT patients were recruited into our study. 17% of patients experienced NC, and...
Saner, Fuat Hakan; Gensicke, Julia; Olde Damink, Steven W. M.; Pavlakovic?, Goran; Treckmann, Juergen; Dammann, Marc; Kaiser, Gernot M.; Sotiropoulos, Georgios C.; Radtke, Arnold; Koeppen, Susanne; Beckebaum, Susanne; Cicinnati, Vito; Nadalin, Silvio; Malago?, Massimo; Paul, Andreas
Full Text Available OBJECTIVE: To present the initial experience of videolaparoscopic nephrectomy in live renal donor. MATERIALS AND METHODS: In the period from April 2000 to August 2003, 50 left nephrectomies in live donor were performed by videolaparoscopy for transplantation. Twenty-eight patients were male (56% and 22 female (44%. Mean age was 37.2 years, and the mean body mass index (BMI was 27.1 kg/m². RESULTS: Mean surgical time was 179.5 minutes, and warm ischemia time of the graft was 3.79 minutes. The mean estimated bleeding was 141 mL. There was no need of blood transfusion or conversion to open surgery. In 42 cases (84%, the vascular portion of the graft was considered good by the recipient's surgical team and in all cases, the ureter was considered of proper size, though in one of them (2% its vascularization was considered improper. The transplanted kidneys produced urine still in the surgical room in 46 of the 50 transplantations considered. In only 2 cases opioid was required for analgesia. In average, 3.1 doses of dipyrone were used for each patient during hospital stay, and hospital discharge occurred, in average, after 3.2 days post-operatively. Two patients required re-operations and one of them evolved to death. CONCLUSIONS: The laparoscopic nephrectomy in live donor for renal transplantation is an alternative to conventional open surgery. In relation to the graft, no alteration, either anatomic or functional, was detected. Though there is already a large documentation in the international literature regarding this procedure, in our setting a prospective randomized study with the usual surgical study is still necessary in order to prove the advantages and disadvantages of the method.
Anuar I. Mitre
Full Text Available SciELO Brazil | Language: English Abstract in english OBJECTIVE: To present the initial experience of videolaparoscopic nephrectomy in live renal donor. MATERIALS AND METHODS: In the period from April 2000 to August 2003, 50 left nephrectomies in live donor were performed by videolaparoscopy for transplantation. Twenty-eight patients were male (56%) an [...] d 22 female (44%). Mean age was 37.2 years, and the mean body mass index (BMI) was 27.1 kg/m². RESULTS: Mean surgical time was 179.5 minutes, and warm ischemia time of the graft was 3.79 minutes. The mean estimated bleeding was 141 mL. There was no need of blood transfusion or conversion to open surgery. In 42 cases (84%), the vascular portion of the graft was considered good by the recipient's surgical team and in all cases, the ureter was considered of proper size, though in one of them (2%) its vascularization was considered improper. The transplanted kidneys produced urine still in the surgical room in 46 of the 50 transplantations considered. In only 2 cases opioid was required for analgesia. In average, 3.1 doses of dipyrone were used for each patient during hospital stay, and hospital discharge occurred, in average, after 3.2 days post-operatively. Two patients required re-operations and one of them evolved to death. CONCLUSIONS: The laparoscopic nephrectomy in live donor for renal transplantation is an alternative to conventional open surgery. In relation to the graft, no alteration, either anatomic or functional, was detected. Though there is already a large documentation in the international literature regarding this procedure, in our setting a prospective randomized study with the usual surgical study is still necessary in order to prove the advantages and disadvantages of the method.
Mitre, Anuar I.; Dénes, Francisco T.; Piovesan, Affonso C.; Simões, Fabiano A.; Castilho, Lísias N.; Arap, Sami.
An improved explosive composition is disclosed and comprises a major portion of an explosive having a detonation velocity between about 1500 and 10,000 meters per second and a minor amount of a donor additive comprising an organic compound or mixture of organic compounds capable of releasing low molecular weight free radicals or ions under mechanical or electrical shock conditions and which is not an explosive, or an inorganic compound or mixture of inorganic compounds capable of releasing low molecular weight free radicals or ions under mechanical or electrical shock conditions and selected from ammonium or alkali metal persulfates.
Walker, Franklin E. (15 Way Points Rd., Danville, CA 94526); Wasley, Richard J. (4290 Colgate Way, Livermore, CA 94550)
Full Text Available SciELO South Africa | Language: English Abstract in english Paediatric liver transplantation is a highly effective therapy for children with end-stage liver disease; 1-year survival rates currently exceed 90% and long-term survivors enjoy an almost-normal quality of life. Key to the success of paediatric liver transplantation has been the technical refinemen [...] t to provide children with suitably sized grafts. Adult-to-paediatric living donor liver transplantation highlights this success and has been instrumental in decreasing waiting list mortality to less than 5%.
Botha, J F.
Knowledge of the life spans actually experienced by steam-electric generating units is useful for a number of purposes. Industry data on experienced life spans have been limited, but recently became available from the Utility Data Institute (UDI) and the Edison Electric Institute (EEI). The purpose of this presentation is to discuss the author's analyses of these data and his interpretation of their significance. The UDI data are from the January 1990, Publication UDI-005-90, Inventory of Retired U.S. Steam-Electric Plants. Units for which fuel type, size, installation date and retirement date are listed were extracted from this UDI publication, which amounted to about 65 percent of the units listed. The EEI data are from the 1990 Power Directory, which was produced by UDI. Only units currently in operation were extracted from this EEI publication
Full Text Available Affective forecasting with respect to two environmental risks (ozone depletion, air pollution was investigated by studying tourists who travelled to either Australia or Bangkok and were thus confronted with one of these risks. We measured anticipated outcome and anticipated emotions before the journey, actually experienced outcome and actually experienced emotions during the journey, and anticipated outcome and emotions concerning a future encounter with the same risk after the journey. Results indicate that tourists underestimate (air pollution or correctly predict (ozone depletion both the seriousness of the outcome and their emotional reactions. The relationship between actual outcome and actual emotions is stronger than that between anticipated outcome and anticipated emotions. Furthermore, tourists learn from their travel experience and adjust their anticipations concerning future encounters with the environmental risk. Findings suggest that the domain of environmental risks differs from personal outcomes with respect to the process of affective forecasting.
Despite the importance and pervasiveness of marketing, almost nothing is known about the neural mechanisms through which it affects decisions made by individuals. We propose that marketing actions, such as changes in the price of a product, can affect neural representations of experienced pleasantness. We tested this hypothesis by scanning human subjects using functional MRI while they tasted wines that, contrary to reality, they believed to be different and sold at different prices. Our resu...
Plassmann, Hilke; O Doherty, John; Shiv, Baba; Rangel, Antonio
The World Health Organization (WHO) has proclaimed that the definition of health includes four domains of well-being: Physical, mental, social and spiritual. It is therefore suggested, that nurses should prepare themselves to assist individuals and families not only to cope with illness and suffering, but also to find meaning in these experiences. The purpose of this investigation is to explore antecedents of spiritual distress experienced by Muslim patients in the Islamic context of Iran. Qu...
Background and PurposeThe aim of this paper was to describe and analyse the impact of formal education and professional experience on physiotherapy students' ways of experiencing interaction within a patient encounter.MethodTwo groups of physiotherapy students were interviewed on two occasions; during the second and last term of their formal education programme, and during the last term and after 18 months' professional experience. Data were subjected to a qualitative analysis. Changes in con...
Abrandt Dahlgren, Madeleine
The present study aimed to (a) demonstrate the effect of positive-negative framing on experienced criminal justice decision makers, (b) examine the debiasing effect of visually structured risk messages, and (c) investigate whether risk perceptions mediate the debiasing effect of visual aids on decision making. In two phases, 60 senior police officers estimated the accuracy of a counterterrorism technique in identifying whether a known terror suspect poses an imminent danger and decided whethe...
Garcia-retamero, R.; Dhami, Mk
The sharp increase in the present need for healthcare services has been attributed to the expanding population of older adults (those above the age of 65 years) and the increasing number of aging healthcare professionals seeking retirement without enough qualified replacements. In this regard, retaining experienced healthcare professionals, especially hospital administrators, may be the key to managing this growing demand for healthcare services at present and for the future. Veteran hospital administrators have many years of experience and can offer a wide array of skills and competencies to their organization. As such, organizations should make every effort to retain these individuals and implement efforts for their continued contribution to the healthcare industry. Given the nature of their work and the various changes accompanying aging, experienced hospital administrators may have specific personal and professional challenges that may be compelling them to consider retirement options. The authors' primary focus was to identify the unique issues associated with retaining experienced hospital administrators and to propose certain accommodations and recommendations to promote their continued and valued contributions to the healthcare industry. PMID:24255937
Anjum, Javad; Bolon, Douglas
Studies have shown that vegetation near to or integrated in buildings can increase the quality of life by e.g. visual appeal, stress reduction, climatic comfort, and protection from pollution and noise. Vegetation can furthermore provide solutions to make our buildings and cities more environmentally sustainable for example as a passive technology of energy reduction, or as a way to avoid overheat of cities. This paper studies the experienced qualities of a vegetated space â?? a one-family Stockholmian house completely covered by trellis. The house is 180 sq., two-story, built in 2008, and drawn by Swedish architects Tham & VidegÃ¥rd. There is a close contact between interior space and faÃ§ade plants as a large part of the faÃ§ade behind the trellis is glass. The paper addresses potentially fruitful approaches to studying experienced qualities of vegetated space, such as visual ethnography, and interviews with residents about their experiences of comfort and discomfort of dwelling. The larger perspective of this study is to investigate the performance of vegetated space in a temperate Scandinavian climate within an agenda of environmental architecture and to identify the perspectives in new low energy buildings or renovations that combine insulation and vegetation, thus offering new experienced qualities in urban environments and within houses.
Olesen, Hans Bruun
Full Text Available Abstract Background Clinician adherence to obesity screening guidelines from United States health agencies remains suboptimal. This study explored how personal and career demographics influence pediatricians' weight assessment and management practices. Methods A web-based survey was distributed to U.S. pediatricians. Respondents were asked to identify the weight status of photographed children and about their weight assessment and management practices. Associations between career and personal demographic variables and pediatricians' weight perceptions, weight assessment and management practices were evaluated using univariate and multivariate modeling. Results 3,633 pediatric medical providers correctly identified the weight status of children at a median rate of 58%. The majority of pediatric clinicians were white, female, and of normal weight status with more than 10 years clinical experience. Experienced pediatric medical providers were less likely than younger colleagues to correctly identify the weight status of pictured children and were also less likely to know and use BMI criteria for assessing weight status. General pediatricians were more likely than subspecialty practitioners to provide diverse interventions for weight management. Non-white and Hispanic general practitioners were more likely than counterparts to consider cultural approaches to weight management. Conclusion Pediatricians' perceptions of children's weight and their weight assessment and management practices are influenced by career and personal characteristics. Objective criteria and clinical guidelines should be uniformly applied by pediatricians to screen for and manage pediatric obesity.
Full Text Available Prevalence of pediatric obesity continues to rise worldwide. Increasing the number of health care practitioners as well as pediatricians with expertise in obesity treatment is necessary. Because many obese patients suffer obesity-associated cardiovascular, metabolic and other health complications that could increase the severity of obesity, it is fundamental not only to identify the child prone to obesity as early as possible, but to recognize, treat and monitor obesity-related diseases during adolescence. This short review outlines the treatment of pediatric obesity that may have applications in the primary care setting. It examines current information on eating behavior, sedentary behavior, and details studies of multidisciplinary, behavior-based, obesity treatment programs. We also report the less common and more aggressive forms of treatment, such as medication and bariatric surgery. We emphasize that health care providers have the potential to improve outcomes by performing early identification, helping families create the best possible home environment, and by providing structured guidance to obese children and their families.
Obesity is a growing public health problem in the general population, and significantly increases the risk for the development of new-onset heart failure (HF). However, in the setting of chronic HF, overweight and mild to moderate obesity is associated with substantially improved survival compared to normal-weight patients. Evidence exists for an "obesity paradox" in HF, with the majority of data measuring obesity by body mass index, but also across various less-frequently used measures of body fat (BF) and body composition including waist circumference, waist-hip ratio, skinfold estimates of percent BF, and bioelectrical impedance analysis of body composition. Other emerging areas of investigation such as the relationship of the obesity paradox to cardiorespiratory fitness are also discussed. Finally, this review explores various explanations for the obesity paradox, and summarizes the current evidence for intentional weight loss treatments for HF in context. PMID:24438732
Clark, Adrienne L; Fonarow, Gregg C; Horwich, Tamara B
The paper builds on recent empirical evidence on the importance of strategic donor behaviour in aid allocation in order to develop a theoretical model where donor pressure on a recipient for influencing the aid disbursement of a multilateral institution is endogenously determined. Our game-theoretic, multi-agent model with one aid recipient, two bilateral donors and one multilateral institution illustrates the advantage of putting pressure on the recipient as an instrument for foreign policy,...
Mavrotas, George; Villanger, Espen
During the past decade, the number of transplantation from living kidney donors has substantially increased worldwide. The rate of increase varies from one country to another. The risk of unilateral nephrectomy to the donor includes perioperative mortality and morbidity plus the long-term risk of living with a single kidney. The rate of perioperative mortality and morbidity is about 0.03% and 10%, respectively. More attentionis required to prevent serious complications of laparoscopic donor n...
Introduction Studies carried out in various parts of the world indicate that family obesity significantly affects the incidence of obesity in children. This is especially a characteristic of children whose both parents are obese. Material and methods The study was conducted using a polling method. Questionnaires were filled out by parents and brothers and sisters, including their body height and weight. The collected data served as the basis for assessing the family nutritional status. Result...
Renal transplantation is the treatment of choice for a suitable patient with end stage renal disease. Unfortunately, the supply of donor organs is greatly exceeded by demand. In many countries the use of kidneys from living donors has been widely adopted as a partial solution. Traditionally donor nephrectomy has been performed via a open flank incision however with some morbidity like pain and a loin scar. Currently, the donor nephrectomy is increasingly being performed laparoscopically with the objective of reducing the morbidity. It is also hoped that this will lead to increasing acceptance of living donation. The first minimally invasive living donor nephrectomy was carried out in 1995 at the Johns Hopkins Medical Center and since then many centers have undertaken laparoscopic living donor nephrectomy. The laparoscopic approach substantially reduces the donor morbidity and wound related problems associated with open nephrectomy. The laparoscopic techniques thus have the potential to increase the number of living kidney donors. The present article attempts to review the safety and efficacy of transperitoneal laparoscopic donor nephrectomy. PMID:19718333
Srivastava, A; Gupta, N; Kumar, Anant; Kapoor, Rakesh; Dubey, Deepak
The disparity between the number of available deceased liver donors and the number of patients awaiting transplantation continues to be an ongoing issue predisposing to death on the liver transplant waiting list. Deceased donor shortage strategies including the use of extended donor-criteria deceased donor grafts, split liver transplants, and organs harvested after cardiac death have fallen short of organ demand. Efforts to raise donor awareness are ongoing, but the course has been arduous to date. Living donor transplantation is a means to access an unlimited donor organ supply and offers potential advantages to deceased donation. Donor safety remains paramount demanding improvements and innovations in both the donor and recipient operations to ensure superior outcomes. The specialty operation is best preformed at centers with specific expertise and shuttling of select patients to these centers supported by third party payers is critical. Training future surgeons at centers with this specific experience can help disseminate this technology to improve local availability. Ongoing research in immunosuppression minimization, withdrawal and tolerance induction may make living donation a desired first-line operation rather than a necessary albeit less-desirable option. This chapter summarizes the progress of living liver donation and its potential applications. PMID:23397534
Lobritto, Steven; Kato, Tomoaki; Emond, Jean
Full Text Available Kidney transplantation is considered the treatment of choice for patients with end-stage renal disease. Living donor transplantation has increased because of the shortage, the needs of cadaver donors.Based on existing literature the authors address ethical issues and major psychiatric aspects involved in the evaluation of living donor kidney transplant, and the interference of this procedure on quality of life for donors, and their contraindications. The authors further describe the evaluation procedures used in the Hospital S. Joa?o, as well as data related to the 32 patients evaluated in the Department of Psychiatry since 2004.
The high prevalence of obesity and diabetes will lead to higher rates of morbidity and mortality. The search for drugs to treat these metabolic disorders has, therefore, intensified. The stomach-derived peptide ghrelin regulates food intake and body weight. Recent work suggests that ghrelin also controls glucose metabolism. In addition, current evidence suggests that most of the actions of ghrelin could contribute to the metabolic syndrome. The ghrelin signaling system is, therefore, a promis...
Cardiovascular disease is the leading cause of death in the United States despite a steady reduction in mortality over the last 4 decades. Much of this success is attributed to public health efforts to reduce cardiovascular risk factors, such as national dietary changes and reductions of smoking, as well as more aggressive treatment of clinical disease, including recognition and treatment of hypertension and hypercholesterolemia. The rising rates of obesity and diabetes, especially among adol...
Cook, Stephen; Kavey, Rae Ellen W.
Objective: To examine whether there is a relationship between psychological stress in the family and obesity in 5- to 6-year-old children. Study design: A total of 7443 Swedish families reported on psychological stress across 4 domains as part of the prospective All Babies in Southeast Sweden-project (ABIS). Domains assessed included serious life events, parenting stress, lack of social support, and parental worries. These variables were summarized in cross-sectional and longitudinal composit...
Koch, Felix-sebastian; Sepa, Anneli; Ludvigsson, Johnny
The prevalence of overweight and obesity and their associated metabolic disorders are considered a major threat to the public’s health. While several diet and exercise programs are available for weight loss and prevention of weight regain, progress is often slow and disappointing. Recently, natural bioactive phytochemicals present in foods have been discovered for their potential health benefit effects on the prevention of chronic disorders such as cancer, cardiovascular disease, inflammato...
Mohsen Meydani; Hasan, Syeda T.
Obesity is, in part, a result of positive energy balance or energy intake exceeding physiological needs. Excess energy intake is determined by a series of food choices over time. These choices involve both motivational and executive function processes. Problems arise when there is excessive motivation to eat and low impulse control, a situation we have termed reinforcement pathology. Motivational and executive function processes have also been implicated in the development of drug dependence ...
Carr, Katelyn A.; Daniel, Tinuke Oluyomi; Lin, Henry; Epstein, Leonard H.
Liver transplants, originally obtained from deceased donors, can now be harvested from living donors as well. This technique, called living-donor liver transplantation (LDLT), provides an effective alternative means of liver transplantation and is a method of expanding the donor pool in light of the demand and supply imbalance for organ transplants. Imaging plays an important role in LDLT programmes by providing robust evaluation of potential donors to ensure that only anatomically suitable donors with no significant co-existing pathology are selected and that crucial information that allows detailed preoperative planning is available. Imaging evaluation helps to improve the outcome of LDLT for both donors and recipients, by improving the chances of graft survival and reducing the postoperative complication rate. In this review, we describe the history of LDLT and discuss in detail the application of imaging in donor assessment with emphasis on use of modern computed tomography (CT) and magnetic resonance imaging (MRI) techniques
The steady rise in obesity observed in the recent years, coupled with its associated co-morbidities, suggests that clinicians will encounter obese patients with increasing frequency in their daily practice. Unfortunately, obese subjects are often excluded from clinical trials during the drug development process. Hence, the appropriate dose for obese patients is most often inferred from normal-weight subjects. Pharmacokinetic and pharmacodynamic variations induced by obesity are numerous and with profound clinical implications, particularly in anaesthesia and intensive care. This review provides a pragmatic approach to the pharmacokinetic considerations that should guide drug administration. We hereby offer a systematic approach to dosing scalars, followed by an analysis of the factors affecting pharmacokinetics in obesity, and provide a detailed discussion on the single most commonly used pharmacological agents in anaesthesia. PMID:21516911
Leykin, Yigal; Miotto, Linda; Pellis, Tommaso
Full Text Available Objectives: To report experience with laparoscopic sleeve gastrectomy (LSG in obese, morbidly obese, and super morbid obese patients, and to evaluate comparative efficacy of LSG among these patient groups. Methods: A total of 147 patients underwent LSG between March 2008 and December 2011 at the Department of Surgery, King Saud Medical City, Riyadh, Kingdom of Saudi Arabia. Patients were grouped according to the preoperative body mass index (BMI into obese (35-39.9 kg/m2, morbidly obese (40-49.9 kg/m2, and super morbid obese (>50 kg/m2. Patients who did not have a regular follow-up (n=38 were excluded, and 108 patients were included in this prospective study. Results: The mean total weight loss (TWL among the super morbid obese group (41.31 ± 21.23 kg was statistically significantly greater compared to the obese group (24.31 ± 13.00 kg, p=0.009 and morbidly obese group (26.81 ± 15.56 kg, p=0.001. The mean percentage excess weight loss (EWL was clinically significant among obese (57.8%, morbidly obese (42.5%, and super morbid obese patients (45.7%, however, it was not statistically significant between the groups (F[2,105]=2.132, p=0.124. There was no mortality; however, 6 major complications occurred including intra-abdominal collection with suspected leak, staple line bleeding, bowel ischemia, and inferior vena cava injury. Conclusion: Laparoscopic sleeve gastrectomy resulted in satisfactory and effective EWL in all 3 groups of obesity patients at 30-months follow-up.
Hamad H. AlQahtani
Purpose: Clinicians typically cap an obese patient's chemotherapy regimen as a result of concern for excessive toxicity, without adequate clinical evidence. The purpose of this study was to evaluate the incidence of grade 3 or 4 myelosuppression in obese patients versus nonobese patients with capped dosing on the basis of body surface area (BSA). Methods: A retrospective chart review was conducted comparing obese patients (body mass index [BMI] ? 30 kg/m2) with capped dosing who received capped chemotherapy doses at a BSA of 2.2 m2 with nonobese (BMI < 25 kg/m2) patients with lung, colorectal, or hormone-refractory prostate cancer. Results: Forty-one obese patients with capped dosing and 244 nonobese patients were included. The obese patient group received on average significantly more cycles of chemotherapy (6 v 4 cycles) compared with the nonobese group. The overall incidence of any chemotherapy-related toxicity was 34% in the obese patient group, compared with 42% in the nonobese patient group (P = .356). The incidence of grade 3 or 4 myelosuppression was lower, but not statistically significant, in obese patients with capped dosing compared with the nonobese patient group (22% v 27%; P = .493). Conclusions: Overall, obese patients with capped dosing experienced a lower incidence of severe myelosuppression and tolerated more cycles of chemotherapy compared with nonobese patients. The better tolerability of chemotherapy in obese patients with capped dosing suggests that there is room to increase the dose in obese patients above the nationally recognized BSA cap of 2.0 m2, especially in early-stage lung or colon cancers in which the intention of treatment is curative.
Lopes-Serrao, Monique D.; Ussery, Sarah M. Gressett; Hall, Ronald G.; Shah, Sachin R.
Introduction: Acetabular component position can be an important determinant of joint stability and bearing surface wear after THA. Nonetheless, the incidence of malpositioning is high. Patient obesity, low surgeon volume, and minimally invasive approaches are known risk factors for malposition. As the incidence of obesity continues to increase, it is important to recognise its effect on intraoperative component positioning in THA.Objectives: Our goal was to assess the impact of obesity on component position for a high-volume surgeon using a standard postero-lateral approach.Methods: A consecutive series of 120 obese (BMI >30, mean BMI 34.4) and 120 non-obese patients (mean BMI 25.4), who had undergone primary THA by a single surgeon, were included in our retrospective study. AP pelvis and cross-table radiographs obtained at the first postoperative visit were analysed using EBRA software to determine inclination and anteversion angles. Optimal position was defined as 30-45º of inclination and 5-25º of anteversion.Results: Mean inclination and anteversion were 40.6 (+/-5.4º) and 16.6 (+/-5.5º) respectively, in the obese group and 39º (+/-5.0º) and 16.2º (+/-7.5º) in the non-obese group. In the obese group 89 (74%) patients were within the desired range for both measurements, 31 (26%) were out of range in at least one, compared to 91 (76%) and 29 (24%) in the non-obese group, respectively. The overall incidence of malpositioning was 25% for both groups. Among outliers, mean deviation from the optimal range was ?3.8º in both groups.Conclusions: The risk of component malpositioning in THA may be reduced when surgery is performed by an experienced, high volume surgeon utilising a standard posterolateral approach. In this setting the deleterious effect of obesity may be overcome. PMID:24817400
McArthur, Benjamin A; Vulcano, Ettore; Cross, Michael; Nguyen, Joseph; Della Valle, Alejandro G; Salvati, Eduardo
Pediatric obesity is a major health problem and has reached epidemiological proportions today. The present paper reviews major psychological issues in pediatric obesity from a developmental perspective. Research and literature has shown that a number of developmental, family, maternal and child factors are responsible in the genesis of pediatric obesity. Family food habits, early developmental lifestyle of the child, parenting, early family relationships and harmony all contribute towards the...
Kalra, Gurvinder; Sousa, Avinash; Sonavane, Sushma; Shah, Nilesh
Obesity has various deleterious effects on health largely associated with metabolic abnormalities including abnormal glucose and lipid homeostasis that are associated with vascular injury and known cardiac, renal, and cerebrovascular complications. Advanced age is also associated with increased adiposity, decreased lean mass, and increased risk for obesity-related diseases. Although many of these obesity- and age-related disease processes have long been subsumed to be secondary to metabolic o...
Lee, Edward B.
The prevalence of overweight among children worldwide is growing at an alarming rate. Social relationships may contribute to the development of obesity through the interaction of biological, behavioral, and environmental factors. Although there is evidence that early environment influences the expression of obesity, very little research elucidates the social context of obesity among children or adolescents. Social network approaches can contribute to research on the role of social environment...
Koehly, Laura M.; Loscalzo, Aunchalee
Background: Obesity is associated with reduced quality of life, development of serious chronic conditions such as heart disease and diabetes, increased medical care costs, and premature death. Environmental effects, especially feeding habits may cause hyperinsulinemia and obesity. A Healthy People 2010 objective is to reduce the proportion of adults who are obese to 15%. Materials and Methods: This cross-sectional study was conducted on 1647 persons in a sampl...
Ozcirpici Birgul; Coskun Ferhat; Sahinoz Saime; Ozgur Servet; Bozkurt Ali
Childhood obesity is increasing in prevalence in the United States. Comorbid diseases once thought of as adult issues such as hypertension, diabetes, and dyslipidemia, are now being encountered in the pediatric population as a result of obesity. Primary prevention is still the most cost-effective approach to this growing problem. In terms of management, the treatment of obesity in children is not identical to that in adults. Thus far, the only accepted weight loss therapy for children are die...
Salazar, Maria L.; Eiland, Lea S.
Background: Obesity is associated with reduced quality of life, development of serious chronic conditions such as heart disease and diabetes, increased medical care costs, and premature death. Environmental effects, especially feeding habits may cause hyperinsulinemia and obesity. A Healthy People 2010 objective is to reduce the proportion of adults who are obese to 15%. Materials and Methods: This cross-sectional study was conducted on 1647 persons in a sampl...
Ozcirpici Birgul; Coskun Ferhat; Sahinoz Saime; Ozgur Servet; Bozkurt Ali
The exposure of mycophenolic acid in live donor liver transplant patients (those receiving a partial hepatic volume) in comparison to deceased donor liver transplant patients (those receiving the whole hepatic volume) after administration of mycophenolate mofetil has not been reported earlier. The aim of the present study is to compare the pharmacokinetics parameters of mycophenolic acid and mycophenolic acid glucuronide in live donor liver transplant patients versus deceased donor liver transplant patients. Twelve live donor liver transplant and 12 deceased donor liver transplant recipients were studied over a dosing interval after intravenous administration of mycophenolate mofetil. The maximum concentration (Cmax) and the area under the plasma concentration versus time curve (AUC) for mycophenolic acid in live donor liver transplant patients were significantly higher than in deceased donor liver transplant patients (Cmax/AUC: live donor liver transplant patients: 16.1 +/- 6.6 microg/mL/43.9 +/- 12.6 microg/mL.h vs deceased donor liver transplant patients: 10.7 +/- 2.0 microg/mL/28.9 +/- 7.1 microg/mL.h; P = .046/.002). The volume of distribution was higher in the deceased donor liver transplant patients compared with live donor liver transplant patients. However, the mean plasma concentration at 12 hours (Clast), drug disposition rate constant, half-life (t 1/2), and mean residence time were similar in both groups. The mean plasma concentration of mycophenolic acid glucuronide was 1.4 to 2.0 times higher in deceased donor liver transplant patients compared with live donor liver transplant patients. These observations point to the need to use a lower dosage (approximately 30%) of mycophenolate mofetil in live donor liver transplant patients compared with deceased donor liver transplant patients. PMID:18440919
Jain, Ashok; Venkataramanan, Raman; Sharma, Rajeev; Kwong, Tai; Abt, Peter; Orloff, Mark; Kashyap, Randeep; Tsoulfas, Georgious; Bozorgzadeh, Adel
... Submit What's this? Submit Button CDC Features Obesity Trends in Adults with Arthritis Obesity rates are 54% ... Pan L, Helmick CG, Hannan C. State-specific trends in obesity prevalence among adults with arthritis, Behavioral ...
Human uncoupling protein 3 (UCP3) is a mitochondrial transmembrane carrier that uncouples oxidative ATP phosphorylation. With the capacity to participate in thermogenesis and energy balance, UCP3 is an important obesity candidate gene. A missense polymorphism in exon 3 (V102I) was identified in an obese and diabetic proband. A mutation introducing a stop codon in exon 4 (R143X) and a terminal polymorphism in the splice donor junction of exon 6 were also identified in a compound heterozygote t...
Argyropoulos, G.; Brown, A. M.; Willi, S. M.; Zhu, J.; He, Y.; Reitman, M.; Gevao, S. M.; Spruill, I.; Garvey, W. T.
Objective Roux-en-Y gastric bypass (RYGB) surgery is the most common surgical intervention for long-term weight loss in morbidly obese patients. By reducing obesity-associated hyperfiltration, diabetes, and hypertension, RYGB is touted to stabilize if not prevent progression of chronic renal disease. To test this, we compare renal histology of diet-induced obese rats that have undergone RYGB surgery to pair-fed and sham obese controls. Research Methods and Procedures Sprague-Dawley rats, fed a high fat, low-oxalate diet to induce gross obesity, were randomized to RYGB (n=6), GI-intact sham-operated obese controls (Sham, n=4), or GI-intact sham-operated obese pair-fed rats (Fed, n=8). Daily body weight and food intake were recorded. On post-operative day 42, renal histology and immunohistochemistry was examined. Renal pathology was assessed by a categorical glomerular lesion score and a quantitative glomerular/tubular scoring system by experienced veterinary pathologists. Osteopontin (OPN) and ED-1 (monocyte/macrophage cell) staining were estimated on percentage of stained area and number of counted cells/high power field respectively. Results Compared to sham and fed controls, RYGB rats had significant reductions in body weight (pobese rat model, RYGB is associated with chronic glomerulosclerosis and tubulointerstitial nephritis, confirmed by histology and immunohistochemistry. Prospective studies to better define the injurious mechanisms in this model are planned.
Canales, Benjamin K.; Reyes, Leticia; Reinhard, Mary K.; Khan, Saeed R.; Goncalves, Carolina G.; Meguid, Michael M.
Living unrelated donors (LUDs) constitute an incremental source of kidneys for transplantation at a global level. Excellent outcomes are reported, superior to those of deceased-donor transplantation and comparable to related donor transplantation. LUD include six categories: spouses, distant relatives, paired-exchange, living-deceased exchange, and non-directed and directed donors. Although a financial reward may be involved in any of these categories, it is in the declared selling of organs that ethical concerns have intensified. There are three patterns of paid LUDs in the developing world: organized, erratic and commercial. The only model of organized LUDs is in Iran, where a central agency assigns and compensates the donors. Erratic LUD transplantation has been experienced, and subsequently banned, in the development of transplant programmes in most developing countries. However, the tightness and enforcement of the official ban are geographically different, providing variable room for uncontrolled trafficking. Commercial transplantation has, thus, become phenomenal in a few countries, gradually evolving into an organized business that follows market dynamics, including advertisement, brokerage, commissions, auctions and tourism. While most international organizations and activist groups condemn commercial transplantation, it is often perceived, in certain cultures and under particular socioeconomic standards, as a human right that meets the demands of all stakeholders, and should be organized rather than declined just for the purpose of meeting the values of a third party. PMID:18536939
Barsoum, Rashad S
The utilization of en bloc renal allografts from small pediatric donors has been adopted as an effective strategy to expand the organ donor pool in adult recipients. Data in children are limited. The aim of our study is to describe the outcomes of en bloc renal transplants in children from our center. Medical records of children receiving pediatric en bloc renal transplants at our institution from January 2007 were abstracted. Data collected included recipient and donor demographics, operative technique and complications, and post-operative studies. Eight children received en bloc renal transplants at a median age of 17 yr; median follow-up was 0.9 yr. Donor body weight ranged from 4 to 22 kg. One kidney was lost to intra-operative thrombosis, while the other kidney from this en bloc graft remained viable. All grafts showed increased renal size at follow-up ultrasound. Surveillance biopsies showed glomerulomegaly in two patients. At last follow-up, the median eGFR was 130 mL/min/1.73 m(2). The urinary protein to creatinine ratio was normal in four of seven patients. Our data suggest that in experienced centers, en bloc renal transplantation from young donors into pediatric recipients is effective. Long-term follow-up to monitor for complications, including hyperfiltration injury, is warranted. PMID:23170991
Butani, Lavjay; Troppmann, Christoph; Perez, Richard V
The study was made to determine violence experienced by nurse students in clinical settings. It was applied to the School of Health Nursing Student of a university during a week in June, 2010. There were 360 students, 53 of whom were senior, 60 of whom were thirdyear, 114 of whom were sophomore, 79 of whom were first-year and 102 of whom were prep-school students, at the school. Students in preparatory classes were not included in the scope of the study since they didn't take applied courses....
Adult-to-adult living donor liver transplantation (A2ALDLT) is an accepted mode of treatment for end-stage liver disease. Right-lobe grafts have usually been preferred in view of the higher graft volume, which lowers the risk of a small-for-size syndrome. However, donor left hepatectomy is associated with less morbidity than when it is compared to right hepatectomy. Laparoscopic donor hepatectomy (LDH) has been considered almost exclusively in pediatric transplantation. The results of laparoscopic left-liver graft procurement for calculated small-for-size A2ALDLT in four donors are presented. The graft-to-recipient body weight ratio was <0.8 in all recipients. The mean portal vein flow and the pressure and hepatic artery flows were measured at 190 ± 56 mL/min/100 g, 13 ± 1.4 mm/Hg and 109 ± 19 mL/min, respectively. No early postoperative donor complications were recorded. One graft was lost due to intrahepatic abscesses. Asymptomatic stenosis of a right posterior duct was treated with a Roux-en-Y loop 4 months later in one donor. We show that LDH of the full-left lobe is feasible. LDH is a very demanding operation, potentially decreasing donor morbidity. Standardization of this procedure, making it accessible to the growing number of experienced laparoscopic liver surgeons, could help renewing the interest for A2ALDLT in the Western world. PMID:23914734
Troisi, R I; Wojcicki, M; Tomassini, F; Houtmeyers, P; Vanlander, A; Berrevoet, F; Smeets, P; Van Vlierberghe, H; Rogiers, X
The global epidemic of childhood and adolescent obesity and its immediate as well as long-term consequences for obese individuals and society as a whole cannot be overemphasized. Obesity in childhood and adolescence is associated with an increased risk of adult obesity and clinically significant consequences affecting the cardiovascular and metabolic systems. Importantly, obesity is additionally complicated by obstructive sleep apnea (OSA), occurring in up to 60% of obese children. OSA, which...
Full Text Available Abstract Small bowel contractility may be more prominent in obese subjects, such that there is enhanced nutrient absorption and hunger stimulation. However, there is little evidence to support this. This study examined in vitro small bowel contractility in obese patients versus non-obese patients. Samples of histologically normal small bowel were obtained at laparoscopic Roux-en-Y gastric bypass from obese patients. Control specimens were taken from non-obese patients undergoing small bowel resection for benign disease or formation of an ileal pouch-anal anastamosis. Samples were transported in a pre-oxygenated Krebs solution. Microdissected circular smooth muscle strips were suspended under 1 g of tension in organ baths containing Krebs solution oxygenated with 95% O2/5% CO2 at 37°C. Contractile activity was recorded using isometric transducers at baseline and in response to receptor-mediated contractility using prostaglandin F2a, a nitric oxide donor and substance P under both equivocal and non-adreneregic, non-cholinergic conditions (guanethidine and atropine. Following equilibration, the initial response to the cholinergic agonist carbachol (0.1 mmol/L was significantly increased in the obese group (n = 63 versus the lean group (n = 61 with a mean maximum response: weight ratio of 4.58 ± 0.89 vs 3.53 ± 0.74; (p = 0.032. Following washout and re-calibration, cumulative application of substance P and prostaglandin F2a produced concentration-dependent contractions of human small bowel smooth muscle strips. Contractile responses of obese small bowel under equivocal conditions were significantly increased compared with non-obese small bowel (p Stimulated human small bowel contractility is increased in obese patients suggesting faster enteric emptying and more rapid intestinal transit. This may translate into enhanced appetite and reduced satiety.
Baird Alan W
The ideal nephrectomy technique for living donors should preserve donor safety and maximize graft quality for the recipient. The laparoscopic technique performs as well as the traditional open technique and has become the procedure of choice in up to 70% of the transplant centers in the US. Since November 2001, 70 living donor kidney transplants have been performed at the Transplant Center of Padua: 42 of the donors underwent laparoscopic left nephrectomy, 28 standard open nephrectomy. Donor and recipient results were analyzed retrospectively. After a mean follow-up of 38+/-26 months (laparoscopic group) and 40+/-27 months (open nephrectomy group) no deaths had occurred among the donors. Only one minor surgical complication was registered (hernia at the port site in a laparoscopic donor). Renal function was optimal in both groups of recipients, without significant differences in the incidence of delayed graft function and acute rejection. Minimally invasive approaches to donor nephrectomy are as safe and effective as the traditional open technique, minimizing postoperative pain and disability, and providing a better cosmetic result. PMID:19644840
Furian, L; Rigotti, Paolo
Continuous growth of the end stage renal disease population treated by dialysis, outpaces deceased donor kidneys available, lengthens the waiting time for a deceased donor transplant. As estimated by the United States Department of Health & Human Services: '17 people die each day waiting for transplants that can't take place because of the shortage of donated organs.' Strategies to expand the donor pool--public relations campaigns and Drivers' license designation--have been mainly unsuccessful. Although illegal in most nations, and viewed as unethical by professional medical organizations, the voluntary sale of purchased donor kidneys now accounts for thousands of black market transplants. The case for legalizing kidney purchase hinges on the key premise that individuals are entitled to control of their body parts even to the point of inducing risk of life. One approach to expanding the pool of kidney donors is to legalize payment of a fair market price of about 40,000 dollars to donors. Establishing a federal agency to manage marketing and purchase of donor kidneys in collaboration with the United Network for Organ Sharing might be financially self-sustaining as reduction in costs of dialysis balances the expense of payment to donors. PMID:16482095
Friedman, E A; Friedman, A L
Low hemoglobin deferral occurs in about 10% of attempted whole blood donations and commonly is a consequence of iron deficiency anemia. Pre-menopausal women often have iron deficiency anemia caused by menstruation and pregnancy and have low hemoglobin deferral on their first donation attempt. Frequent donors also develop iron deficiency and iron deficiency anemia because blood donation removes a large amount of iron from the donor and the 56-day minimum inter-donation interval for donors in the United States is not sufficient for recovery of hemoglobin and iron stores. Other causes for low hemoglobin deferral range from a medically insignificant deferral of a woman with hemoglobin between 12.0 and 12.4 g/dL, which is within the normal reference range but below the 12.5 g/dL needed to donate blood, to anemia caused by an unrecognized malignancy in a "healthy" individual attempting to donate blood. The diverse causes of anemia in blood donors make it difficult to provide accurate information to donors about the cause of their low hemoglobin deferral and complicate implementation of programs to prevent them by blood collecting agencies. This article reviews how hemoglobin is measured and the demographics and causes of low hemoglobin deferral in blood donors. It provides recommendations for how blood collection agencies can provide donors with accurate information about the cause of their deferral and discusses programs that can be implemented to decrease these deferrals in regular donors. PMID:24332843
Mast, Alan E
Full Text Available The World Health Organization (WHO has proclaimed that the definition of health includes four domains of well-being: Physical, mental, social and spiritual. It is therefore suggested, that nurses should prepare themselves to assist individuals and families not only to cope with illness and suffering, but also to find meaning in these experiences. The purpose of this investigation is to explore antecedents of spiritual distress experienced by Muslim patients in the Islamic context of Iran. Qualitative descriptive research was conducted using unstructured Interviews. Three main categories were found: Failure in communication, non-holistic care and inability to worship. The results showed that the patient`s satisfaction could depend on good communication, good listening and good information. In ending, it can be said that staff members have a great deal of responsibility for assuring that the patient feels as good as possible, facilitating relativesâ€™ involvement based on the familyâ€™s wishes and limiting the stress and difficulties experienced by the family.
Background Obesity and knee osteoarthritis are among the most frequent chronic conditions affecting Americans aged 50 to 84 years. Objective To estimate quality-adjusted life-years lost due to obesity and knee osteoarthritis and health benefits of reducing obesity prevalence to levels observed a decade ago. Design The U.S. Census and obesity data from national data sources were combined with estimated prevalence of symptomatic knee osteoarthritis to assign persons aged 50 to 84 years to 4 subpopulations: nonobese without knee osteoarthritis (reference group), nonobese with knee osteoarthritis, obese without knee osteoarthritis, and obese with knee osteoarthritis. The Osteoarthritis Policy Model, a computer simulation model of knee osteoarthritis and obesity, was used to estimate quality-adjusted life-year losses due to knee osteoarthritis and obesity in comparison with the reference group. Setting United States. Participants U.S. population aged 50 to 84 years. Measurements Quality-adjusted life-years lost owing to knee osteoarthritis and obesity. Results Estimated total losses of per-person quality-adjusted life-years ranged from 1.857 in nonobese persons with knee osteoarthritis to 3.501 for persons affected by both conditions, resulting in a total of 86.0 million quality-adjusted life-years lost due to obesity, knee osteoarthritis, or both. Quality-adjusted life-years lost due to knee osteoarthritis and/or obesity represent 10% to 25% of the remaining quality-adjusted survival of persons aged 50 to 84 years. Hispanic and black women had disproportionately high losses. Model findings suggested that reversing obesity prevalence to levels seen 10 years ago would avert 178 071 cases of coronary heart disease, 889 872 cases of diabetes, and 111 206 total knee replacements. Such a reduction in obesity would increase the quantity of life by 6 318 030 years and improve life expectancy by 7 812 120 quality-adjusted years in U.S. adults aged 50 to 84 years. Limitations Comorbidity incidences were derived from prevalence estimates on the basis of life expectancy of the general population, potentially resulting in conservative underestimates. Calibration analyses were conducted to ensure comparability of model-based projections and data from external sources. Conclusion The number of quality-adjusted life-years lost owing to knee osteoarthritis and obesity seems to be substantial, with black and Hispanic women experiencing disproportionate losses. Reducing mean body mass index to the levels observed a decade ago in this population would yield substantial health benefits. Primary Funding Source The National Institutes of Health and the Arthritis Foundation.
Losina, Elena; Walensky, Rochelle P.; Reichmann, William M.; Holt, Holly L.; Gerlovin, Hanna; Solomon, Daniel H.; Jordan, Joanne M.; Hunter, David J.; Suter, Lisa G.; Weinstein, Alexander M.; Paltiel, A. David; Katz, Jeffrey N.
As increasing demand for organs is a challenge for transplant services worldwide it is essential to audit the process of organ donation. To address this, a national audit of potential organ donors was undertaken across hospitals with Intensive Care Units (N = 36). Questionnaires were returned on all patients (n = 2073) who died in these units from 1\\/9\\/07-31\\/8\\/08; 200 (10%) of these patients were considered for Brain Stem Testing (BST), 158 patients (79%) were diagnosed Brain Stem Dead (BSD) and 138 patients (87%) became potential donors. Consent for donation was given by 92 (69%) next of kin and 90 potential donors (65%) became organ donors. There was no evidence of a large number of potential organ donors being missed. Recommendations included completion of BSTs on all appropriate patients, development of support on BST, referral of all BSD patients to the Organ Procurement Service; enhanced co-ordination within hospitals and sustained information\\/education campaigns.
Blood donor recruitment models have changed from paid donors to employer-organized donors and to voluntary donors in China. Reports on the hepatitis C virus (HCV) infection among voluntary blood donors in China have been rarely found at present. The prevalence of anti-HCV and genotypes among the first-time voluntary blood donors was investigated in Chongqing area of China. A total of 13,620 serum samples were collected from the first-time voluntary blood donors in Chongqing, China. Anti-HCV antibody was tested by ELISA. The Core/E2 region of HCV RNA from HCV seropositive samples was amplified by RT-PCR for genotyping. The results indicated that the prevalence of anti-HCV averaged 0.49% (67/13,620), and the highest rate (0.86%) was obtained in the group aged 40 to 49. A higher prevalence was observed among the more educated donors, and metropolitan donors. The ratios of following genotypes 1b, 2a, 3a and 3b were 4 (18%), 5 (23%), 9 (41%) and 4 (18%) in all the 22 samples respectively. Genotype 3 (3a and 3b) was the predominant genotype. In conclusion, the prevalence of anti-HCV was low among the population of voluntary blood donors in Chonqing area. The genotyping results showed the possibility of presence of druggies among the voluntary blood donors. Therefore, more attention should be paid to exclude those high-risk persons from the volunteers. PMID:18549653
Zhao, Shu-Ming; Jiang, Tian-Lun; Li, Ru-Qing; Gao, Feng-Xiang; Lu, Ling; Zheng, Hao-Qiang; Hu, Jian; Fan, Ya-Han; Li, Bing; Xiao, Rui-Qing; Yury, Khudoyakov
Dendritic cells (DCs) are suspected to be involved in the development of atherogenesis, but their role is still unclear. The aim of this study was to characterize circulating DCs and monocyte-derived DCs (Mo-DCs) of obese and diabetic patients (T2D), and to study their interaction with human coronary smooth muscle cells (CASMCs). Obese post-menopausal women with or without insulin resistance were enrolled and were compared to age-matched healthy women. Myeloid circulating DCs significantly increased in obese T2D patients compared to healthy donors and a smaller increase was observed for plasmacytoid one. Mature Mo-DCs from obese T2D patients significantly decreased when compared to control, but they were significantly more capable of adhering to CASMCs compared to that from healthy controls and from not-T2D obese subjects. Altogether these data suggest that in conditions of insulin-resistance and obesity there is an up-regulation of myeloid DCs that might contribute to pathological vascular remodeling. PMID:21940050
Musilli, Claudia; Paccosi, Sara; Pala, Laura; Gerlini, Gianni; Ledda, Fabrizio; Mugelli, Alessandro; Rotella, Carlo Maria; Parenti, Astrid
Obesity is a very complex illness. It is one of the most prevalent diseases in the western world, its importance lies in the comorbidities that surround it, as well as the predisposition to cardiovascular events and other diseases that reduce life quality and expectancy. There are many factors that contribute to obesity pathogenesis; genetic, psychological, emotional, social factor...
Bolan?os-ji?menez, R.; Arizmendi-vargas, J.; Salazar-marioni, S.; Escamilla-ocan?as, C. E.; Lozano-andrade, K.; Marti?nez¬-menchacab, H. R.; Rivera-silva, G.
Cardiovascular disease is the leading cause of morbidity and mortality in obese individuals. Obesity dramatically increases the risk of development of metabolic and cardiovascular disease. This risk appears to originate from disruption in adipose tissue function leading to a chronic inflammatory state and to dysregulation of the endocrine and paracrine actions of adipocyte-derived factors. These, in turn, impair vascular homeostasis and lead to endothelial dysfunction. An altered endothelial cell phenotype and endothelial dysfunction are common among all obesity-related complications. A crucial aspect of endothelial dysfunction is reduced nitric oxide (NO) bioavailability. A systemic pro-inflammatory state in combination with hyperglycemia, insulin resistance, oxidative stress and activation of the renin angiotensin system are systemic disturbances in obese individuals that contribute independently and synergistically to decreasing NO bioavailability. On the other hand, pro-inflammatory cytokines are locally produced by perivascular fat and act through a paracrine mechanism to independently contribute to endothelial dysfunction and smooth muscle cell dysfunction and to the pathogenesis of vascular disease in obese individuals. The promising discovery that obesity-induced vascular dysfunction is, at least in part, reversible, with weight loss strategies and drugs that promote vascular health, has not been sufficiently proved to prevent the cardiovascular complication of obesity on a large scale. In this review we discuss the pathophysiological mechanisms underlying inflammation and vascular damage in obese patients. PMID:25001649
Iantorno, M; Campia, U; Di Daniele, N; Nistico, S; Forleo, G B; Cardillo, C; Tesauro, M
Full Text Available ... HealthDay January 24, 2014 Related MedlinePlus Pages Child Nutrition Obesity in Children Weight Control Transcript Fast food ... overall diet is more strongly linked to poor nutrition and obesity than fast food consumption though the ...
According to data from the National Center for Health Statistics, childhood obesity rates are highest among ethnic minorities. It is very helpful to consider the role of culture when attempting to analyze and explain obesity rates in ethnic minority populations. Culture influences the attitudes and beliefs toward exercise, food and nutrition, and…
Epidemiological studies show an increased prevalence of osteoarthritis of the knee and hand with increased body mass index [BMI]. Osteoarthritis of the hip joint is not related to BMI. The connection between obesity and osteoarthritis cannot exclusively be explained by genetic factors or by the accumulation of tear and wear. Overweight occurs prior to knee joint degeneration, not as a result of diminished activity due to joint degeneration. Weight control seems to be an influential tool in the prophylaxis of overweight-specific joint degeneration.
Sonne-Holm, Stig; Jacobsen, Steffen
Pharmacotherapy for the management of obesity is primarily aimed at weight loss, weight loss maintenance and risk reduction, and has included thyroid hormone, amphetamines, phentermine, amfepramone (diethylpropion), phenylpropanolamine, mazindol, fenfluramines and, more recently, sibutramine and orlistat. These agents decrease appetite, reduce absorption of fat or increase energy expenditure. Primary endpoints used to evaluate anti-obesity drugs most frequently include mean weight loss, percentage weight loss and proportion of patients losing >or=5% and >or=10% of initial bodyweight. Secondary endpoints may include reduction in body fat, risk factors for cardiovascular disease and the incidences of diseases such as diabetes mellitus. Most pharmacotherapies have demonstrated significantly greater weight loss in patients on active treatment than those receiving placebo in short-term (or=10% loss of initial bodyweight in 46% of patients. For patients taking orlistat, weight loss was 2.2 kg greater than those on placebo at 4 years (por=10% loss of initial bodyweight (26.2% and 15.6%, respectively; p<0.001). Other drugs that have been evaluated for weight loss include ephedrine, the antidepressants fluoxetine and bupropion, and the antiepileptics topiramate and zonisamide. Two clinical trials with fluoxetine both reported no significant difference in weight loss compared with placebo at 52 weeks. Clinical trials evaluating ephedrine, bupropion, topiramate and zonisamide have demonstrated significantly greater weight loss than placebo but have been limited to 16-26 weeks' treatment. A major obstacle to the evaluation of the clinical trials is the potential bias resulting from low study completion rates. Completion rates varied from 52.8% of phentermine recipients in a 9-month study, to 40% of fenfluramine recipients in a 24-week comparative study with phentermine and 18% of amfepramone recipients in a 24-week study. One-year completion rates range from 51% to 73% for sibutramine and from 66% to 85% for orlistat. Other potential sources of bias include run-in periods and subsequent patient selection based on compliance or initial weight loss. Several potential new therapies targeting weight loss and obesity through the CNS pathways or peripheral adiposity signals are in early phase clinical trials. Over the next decade the drug treatment of obesity is likely to change significantly because of the availability of new pharmacotherapies to regulate eating behaviours, nutrient partitioning and/or energy expenditure. PMID:15977970
Ioannides-Demos, Lisa L; Proietto, Joseph; McNeil, John J
Weight management interventions during adolescence are challenging. Migration adds complexity to this problem, making migrant families more vulnerable. Teenagers confront families to new values transmitted by the host society: opulence, junk food, video games. Obesity should not be seen as a single issue of calories-excess, but must be considered as being part of a larger problem, which takes into account the context of the familial and societal life of the migrants. The caregivers must have an overall view of the situation to provide appropriate approaches to weight management. PMID:22787729
Chamay-Weber, Catherine; Shehu-Brovina, Shqipe; Narring, Françoise
Full Text Available Abstract Childhood obesity has reached epidemic levels in developed countries. Twenty five percent of children in the US are overweight and 11% are obese. Overweight and obesity in childhood are known to have significant impact on both physical and psychological health. The mechanism of obesity development is not fully understood and it is believed to be a disorder with multiple causes. Environmental factors, lifestyle preferences, and cultural environment play pivotal roles in the rising prevalence of obesity worldwide. In general, overweight and obesity are assumed to be the results of an increase in caloric and fat intake. On the other hand, there are supporting evidence that excessive sugar intake by soft drink, increased portion size, and steady decline in physical activity have been playing major roles in the rising rates of obesity all around the world. Consequently, both over-consumption of calories and reduced physical activity are involved in childhood obesity. Almost all researchers agree that prevention could be the key strategy for controlling the current epidemic of obesity. Prevention may include primary prevention of overweight or obesity, secondary prevention or prevention of weight regains following weight loss, and avoidance of more weight increase in obese persons unable to lose weight. Until now, most approaches have focused on changing the behaviour of individuals in diet and exercise. It seems, however, that these strategies have had little impact on the growing increase of the obesity epidemic. While about 50% of the adults are overweight and obese in many countries, it is difficult to reduce excessive weight once it becomes established. Children should therefore be considered the priority population for intervention strategies. Prevention may be achieved through a variety of interventions targeting built environment, physical activity, and diet. Some of these potential strategies for intervention in children can be implemented by targeting preschool institutions, schools or after-school care services as natural setting for influencing the diet and physical activity. All in all, there is an urgent need to initiate prevention and treatment of obesity in children.
Merchant Anwar T
Empirical estimation of critical points at which complex systems abruptly flip from one state to another is among the remaining challenges in network science. However, due to the stochastic nature of critical transitions it is widely believed that critical points are difficult to estimate, and it is even more difficult, if not impossible, to predict the time such transitions occur [1-4]. We analyze a class of decaying dynamical networks experiencing persistent attacks in which the magnitude of the attack is quantified by the probability of an internal failure, and there is some chance that an internal failure will be permanent. When the fraction of active neighbors declines to a critical threshold, cascading failures trigger a network breakdown. For this class of network we find both numerically and analytically that the time to the network breakdown, equivalent to the network lifetime, is inversely dependent upon the magnitude of the attack and logarithmically dependent on the threshold. We analyze how perma...
Podobnik, B; Horvatic, D; Majdandzic, A; Bishop, S; Stanley, H E
This article describes the relationship between adolescent subjective well-being and experiences of family violence reported by a sample of 14- to 17-year-old adolescents living in one Finnish municipality (N = 1,393). Survey results found that experiences of family violence were common. The logistic regression model showed that experiences of violence were associated with adolescents' feeling of inner disequilibrium and markedly strong relationships with friends. In additional, adolescents who experienced family violence rated their health as poorer than adolescents from nonviolent homes. They also surprisingly reported being satisfied with their life and did not necessarily identify their need for help. Although adolescents are resilient and have some resources to cope with violence, nurses and other professionals should attend more carefully to adolescents' reports of health and behavioral problems and assess for the presence of family violence and school bullying. PMID:22274937
Lepistö, Sari; Joronen, Katja; Åstedt-Kurki, Päivi; Luukkaala, Tiina; Paavilainen, Eija
Background: The pregnancy was a risk factor for excessive weight gain for women. However, there is no information about the prevalence of obesity and its relationship with a history of pregnancy in girls. Therefore, the purpose of this study was to investigate differences in the prevalence of obesity in adolescent females with a history of pregnancy and factors associated with it, in Korea.Methods: In 2009, 69 of 34,247 female students revealed that they had experienced pregnancy in respons...
This study explored experiences of obesity, its perceived causes and motives for surgery, as described by seven Saudi women contemplating bariatric surgery. The women experienced cultural restrictions on their physical and social activities. Obesity embodied these restrictions, attracting stigma and moral failure. Traditional clothing, foods, hospitality norms and limited outdoor female activities were regarded as barriers to weight loss. Bariatric surgery was chosen to protect health and to access normative female roles. Some were encouraged by relatives who had undergone surgery. Opting for surgery reflected both participants' sense of powerlessness to self-manage weight and the social acceptability, within their family context, of this biomedical approach. PMID:23479306
Alqout, Ohud; Reynolds, Frances
We will present an experimental study of production and transport of polyatomic molecular ions to be used as proton donors in charge transfer reactions with organic molecules. The experimental set-up (D. Smith and N. G. Adams, Adv. At. Mol. Phys. 24), 1 (1987). consists of a discharge chamber as an ion source, and reaction and detection chambers. Ions are generated in the negative glow of a hollow cathode discharge. A model was developed to optimize the discharge and to maximize ion production on the axis. The model is being verified using emission and mass spectroscopy techniques. Preliminary tests are made with water-based ions. Preparations are under way to generate ions based on molecules with a higher proton affinity, suitable for study of reactions with organic molecules possessing an equivalent proton affinity. Design of primary ion extraction and transport section was completed using a combination of free molecular flow and SIMION codes ( D. A. Dhal and J. E. Delmore, Idaho National Engineering Laboratory, Internal Publication EEG-CS-7233 (1988).) and estimating space charge effects. Results of preliminary experiments with pre-selected molecules will be discussed at the conference.
Hing, M.; Brooke, G.; Popovi?, S.; Vuškovi?, L.
Full Text Available Abstract Background While obesity is known to have many physiological consequences, the psychopathology of this condition has not featured prominently in the literature. Cross-sectional studies have indicated that obese children have increased odds of experiencing poor quality of life and mental health. However, very limited trial evidence has examined the efficacy of exercise therapy for enhancing mental health outcomes in obese children, and the Sheffield Obesity Trial (SHOT will provide evidence of the efficacy of supervised exercise therapy in obese young people aged 11–16 years versus usual care and an attention-control intervention. Method/design SHOT is a randomised controlled trial where obese young people are randomised to receive; (1 exercise therapy, (2 attention-control intervention (involving body-conditioning exercises and games that do not involve aerobic activity, or (3 usual care. The exercise therapy and attention-control sessions will take place three times per week for eight weeks and a six-week home programme will follow this. Ninety adolescents aged between 11–16 years referred from a children's hospital for evaluation of obesity or via community advertisements will need to complete the study. Participants will be recruited according to the following criteria: (1 clinically obese and aged 11–16 years (Body Mass Index Centile > 98th UK standard (2 no medical condition that would restrict ability to be active three times per week for eight weeks and (3 not diagnosed with insulin dependent diabetes or receiving oral steroids. Assessments of outcomes will take place at baseline, as well as four (intervention midpoint and eight weeks (end of intervention from baseline. Participants will be reassessed on outcome measures five and seven months from baseline. The primary endpoint is physical self-perceptions. Secondary outcomes include physical activity, self-perceptions, depression, affect, aerobic fitness and BMI.
Wright Neil P
Obesity is associated with important decrements in lung volumes. Despite this, ventilation remains normally or near normally distributed at least for moderate decrements in functional residual capacity (FRC). We tested the hypothesis that this is because maximum flow increases presumably as a result of an increased lung elastic recoil. Forced expiratory flows corrected for thoracic gas compression volume, lung volumes, and forced oscillation technique at 5-11-19 Hz were measured in 133 healthy subjects with a body mass index (BMI) ranging from 18 to 50 kg/m(2). Short-term temporal variability of ventilation heterogeneity was estimated from the interquartile range of the frequency distribution of the difference in inspiratory resistance between 5 and 19 Hz (R5-19_IQR). FRC % predicted negatively correlated with BMI (r = -0.72, P recoil. Regression analysis of R5-19_IQR against FRC % predicted and expiratory reserve volume (ERV) yielded significantly higher correlation coefficients by nonlinear than linear fitting models (r(2) = 0.40 vs. 0.30 for FRC % predicted and r(2) = 0.28 vs. 0.19 for ERV). In conclusion, temporal variability of ventilation heterogeneities increases in obesity only when FRC falls approximately below 65% of predicted or ERV below 0.6 liters. Above these thresholds distribution is quite well preserved presumably as a result of an increase in lung recoil. PMID:24651986
Pellegrino, Riccardo; Gobbi, Alessandro; Antonelli, Andrea; Torchio, Roberto; Gulotta, Carlo; Pellegrino, Giulia Michela; Dellacà, Raffaele; Hyatt, Robert E; Brusasco, Vito
The shortage of deceased donor liver grafts led to the use of living donor liver transplant (LDLT). Patients who undergo LDLT have a higher risk of complications than those who undergo deceased donor liver transplantation (LT). Interventional radiology has acquired a key role in every LT program by treating the majority of vascular and non-vascular post-transplant complications, improving graft and patient survival and avoiding, in the majority of cases, surgical revision and/or re-transplant. The aim of this paper is to review indications, diagnostic modalities, technical considerations, achievements and potential complications of interventional radiology procedures after LDLT.
Cheng, Yu-Fan; Ou, Hsin-You; Yu, Chun-Yen; Tsang, Leo Leung-Chit; Huang, Tung-Liang; Chen, Tai-Yi; Hsu, Hsien-Wen; Concerjero, Allan M; Wang, Chih-Chi; Wang, Shih-Ho; Lin, Tsan-Shiun; Liu, Yueh-Wei; Yong, Chee-Chien; Lin, Yu-Hung; Lin, Chih-Che; Chiu, King-Wah; Jawan, Bruno; Eng, Hock-Liew; Chen, Chao-Long
A shortage of organs is available for transplantation, with 116,000 patients on the Organ Procurement and Transplantation Network/United Network for Organ Sharing wait list. Because the demand for organs outweighs the supply, considerable care must be taken to maximize the number of organs transplanted per donor and optimize the quality of recovered organs. Studies designed to determine optimal donor management therapies are limited, and this research has many challenges. Although evidenced-based guidelines for managing potential organ donors do not exist, research in this area is increasing. This article reviews the existing literature and highlights recent trials that can guide management. PMID:24287350
Sally, Mitchell; Malinoski, Darren
The shortage of deceased donor liver grafts led to the use of living donor liver transplant (LDLT). Patients who undergo LDLT have a higher risk of complications than those who undergo deceased donor liver transplantation (LT). Interventional radiology has acquired a key role in every LT program by treating the majority of vascular and non-vascular post-transplant complications, improving graft and patient survival and avoiding, in the majority of cases, surgical revision and/or re-transplant. The aim of this paper is to review indications, diagnostic modalities, technical considerations, achievements and potential complications of interventional radiology procedures after LDLT. PMID:24876742
Cheng, Yu-Fan; Ou, Hsin-You; Yu, Chun-Yen; Tsang, Leo Leung-Chit; Huang, Tung-Liang; Chen, Tai-Yi; Hsu, Hsien-Wen; Concerjero, Allan M; Wang, Chih-Chi; Wang, Shih-Ho; Lin, Tsan-Shiun; Liu, Yueh-Wei; Yong, Chee-Chien; Lin, Yu-Hung; Lin, Chih-Che; Chiu, King-Wah; Jawan, Bruno; Eng, Hock-Liew; Chen, Chao-Long
Background and aims: Blood banks in Norway struggle to close the gap between need and supply of blood. The overall objective of this study was to investigate the iron status in blood donors. The aims of this thesis were first to compare the iron status in new blood donors in 1993-97 and in 2005-06, to describe possible changes in iron status. To describe the effect of four consecutive blood donations without iron supplementation for newly recruited donors was the second aim. The third objecti...
Røsvik, Anne Synnøve
Following administration of haploidentical stem cells to infants with severe combined immunodeficiency (SCID), mature T cells of donor karyotype appear later in the recipient without causing graft-versus-host disease. To investigate the effect of the host environment on the responsiveness of these genetically donor T cells, blood B and T lymphocytes from 6 SCID recipients, their parental donors and unrelated controls were purified by double SRBC rosetting. T cells were stimulated by irradiated B cells at a 1:1 ratio in 6 day cultures. Engrafted T cells of donor karyotype gave much smaller responses to irradiated genetically recipient B cells than did fresh donor T cells. Moreover, engrafted T cells of donor karyotype from two of the three SCIDs who are longest post-transplantation responded more vigorously (14,685 and 31,623 cpm) than fresh donor T cells (5141 and 22,709 cpm) to donor B cells. These data indicate that T lymphocytes which have matured from donor stem cells in the recipient microenvironment behave differently from those that have matured in the donor.
Schiff, S.; Sampson, H.; Buckley, R.
Following administration of haploidentical stem cells to infants with severe combined immunodeficiency (SCID), mature T cells of donor karyotype appear later in the recipient without causing graft-versus-host disease. To investigate the effect of the host environment on the responsiveness of these genetically donor T cells, blood B and T lymphocytes from 6 SCID recipients, their parental donors and unrelated controls were purified by double SRBC rosetting. T cells were stimulated by irradiated B cells at a 1:1 ratio in 6 day cultures. Engrafted T cells of donor karyotype gave much smaller responses to irradiated genetically recipient B cells than did fresh donor T cells. Moreover, engrafted T cells of donor karyotype from two of the three SCIDs who are longest post-transplantation responded more vigorously (14,685 and 31,623 cpm) than fresh donor T cells (5141 and 22,709 cpm) to donor B cells. These data indicate that T lymphocytes which have matured from donor stem cells in the recipient microenvironment behave differently from those that have matured in the donor
Full Text Available Introduction. In most developed countries, endometrial cancer appears as most frequent invasive neoplasm of genital tract. Obesity is one of most important risk factors. Aim of study was to establish characteristics endometrial cancer in obese women. Material and methods. The study included 50 surgically treated women with endometrial cancer. According body mass index they were divided into two groups - group A (30 obese women, group B (20 non-obese women. Results and Discussion. Non-obese women with endometrial cancer are statistically significantly older than obese. Menopausal status, parity are not statistically significant. The obese group most frequently includes endometrioid type of tumor, while non-obese group most frequently includes non-endometrioid types of endometrial cancer. Over 50% thick myometrial invasion is statistically more frequent in non-obese group than in obese group. In obese group, less than 50% thick myometrial invasion, is statistically significant in comparison to non-obese group. High-differentiated endometrial cancer(G1 is statistically significantly more present in obese women than non-obese. Low-diferentiated endometrial cancer is statistically more frequent in non-obese women than in obese. Most frequent in both groups is NG2. According to FIGO stage I, disease is statistically significantly more frequent in obese group than in non-obese. In non-obese group, total number of deseased in higher stages (II and III is statistically significantly higher than in stage I. Conclusion. Endometrial cancer present in obese women is mostly endometroid type I, with slow myometrial invasion, with hystological grade I, nuclear grade II in FIGO stage I of disease. In non-obese women, non-endometrioid cancer - type II is more frequent, with faster myometrial invasion, hystological grade II and III, nuclear grade II, in FIGO stage II of disease.
With American children on course to grow into the most obese generation of adults in history, Sonia Caprio argues that it is critical to develop more effective strategies for preventing childhood obesity and treating serious obesity-related health complications. She notes that although pediatricians are concerned about the obesity problem, most…
Full Text Available Objective: Thyroid functions in obese children and adolescentswere evaluated in order to determine subclinicaland clinical hypothyroidism.Materials and methods: In this study, 85 obese (Bodymass index >97th percentile children, aged 2-14 years, aswell as 47 healthy controls were enrolled. Levels of serumfree triiodothyronine (fT3, free thyroxine (fT4 and thyroidstimulatinghormone (TSH of the two groups were compared.Obese children with TSH level above 5.4 IU/mlwere also analyzed for thyroid autoantibodies and thyroidultrasounds were performed.Results: Obese children showed higher serum concentrationsof TSH and fT3 than the controls but no significantdifference in serum fT4 levels was found between the twogroups (P=0.001. One child had high auto antibodiesand 32 had high TSH levels. Of 28 children with TSH >5,4IU/ml, 25 children had normal thyroid ultrasound findingsand three had nodules or thyroiditis but no enlargementof the thyroid gland.Conclusion: TSH and fT3 levels were found to be higherin obese children compared with non-obese children withno difference of fT4 levels between two groups.Key words: Body mass index, obesity, thyroid functions
The aim of this study was to investigate the prevalence of moderate and extreme obesity among an Irish obstetric population over a 10-year period, and to evaluate the obstetric features of such pregnancies. Of 31,869 women delivered during the years 2000-2009, there were 306 women in the study group, including 173 in the moderate or Class 2 obese category (BMI 35-39.9) and 133 in the extreme or Class 3 obese category (BMI > or = 40).The prevalence of obese women with BMI > or = 35 was 9.6 per 1000 (0.96%), with an upward trend observed from 2.1 per 1000 in the year 2000, to 11.8 per 1000 in the year 2009 (P = 0.001). There was an increase in emergency caesarean section (EMCS) risk for primigravida versus multigravid women, within both obese categories (P < 0.001). However, there was no significant difference in EMCS rates observed between Class 2 and Class 3 obese women, when matched for parity. The prevalence of moderate and extreme obesity reported in this population is high, and appears to be increasing. The increased rates of abdominal delivery, and the levels of associated morbidity observed, have serious implications for such women embarking on pregnancy.
Abdelmaboud, M O
Because obesity is a risk factor for many serious illnesses such as diabetes, better understandings of obesity and eating disorders have been attracting attention in neurobiology, psychiatry, and neuroeconomics. This paper presents future study directions by unifying (i) economic theory of addiction and obesity [4-6], and (ii) recent empirical findings in neuroeconomics and neurobiology of obesity and addiction. It is suggested that neurobiological substrates such as adiponectin, dopamine (D2 receptors), endocannabinoids, ghrelin, leptin, nesfatin-1, norepinephrine, orexin, oxytocin, serotonin, vasopressin, CCK, GLP-1, MCH, PYY, and stress hormones (e.g., CRF) in the brain (e.g., OFC, VTA, NAcc, and the hypothalamus) may determine parameters in the economic theory of obesity. Also, the importance of introducing time-inconsistent and gain/loss-asymmetrical temporal discounting (intertemporal choice) models based on Tsallis' statistics and incorporating time-perception parameters into the neuroeconomic theory is emphasized. Future directions in the application of the theory to studies in neuroeconomics and neuropsychiatry of obesity at the molecular level, which may help medical/psychopharmacological treatments of obesity (e.g., with sibutramine), are discussed. PMID:20462703
Malaysians indicating that they did not intend to become organ donors upon their death were surveyed regarding interest in non-fungible financial incentives to be granted to surviving family members. Among the 730 (56% of the total sample of 1311) indicating unwillingness to be donors, 29.6% (216/730) subsequently indicated that they would be willing donors if the government introduced policies that, upon their death, "rewarded your (their) family with incentives for your (their) deeds." Among the 69% (504/730) who insisted that they would not become organ donor even with incentive, nearly 80% (404/501) of them were able to identify relevant incentives they thought should be provided by the state to those who make organ donations upon death. The majority of both groups preferred the state provide medical benefits to a surviving family member, suggesting this may be an attractive policy option for the state to raise the deceased organ donation pool. PMID:23600843
Tumin, Makmor; Noh, Abdillah; Chong, Chin-Sieng; Lim, Soo-Kun; Abdullah, Nawi; Ng, Kok-Peng
In patients with metastatic breast cancer, immune cells from a genetically matched donor can attack and shrink tumors, researchers from the National Cancer Institute (NCI) announced today at the Annual Meeting of the American Society of Clinical Oncology in Chicago.
Living kidney donation from donors BMI at donation, eGFR at donation, and year of donation. After a mean follow-up of 31.8 ± 8.0 yr, 94.9% of adolescent donors were alive vs. 93.8% of controls. There was no significant difference in having eGFR (MDRD) <60 mL/min/1.73 m(2) (26.1% vs. 40.9%), hypertension (35.9% vs. 39.4%), diabetes (5.1% vs. 12.5%), or proteinuria (15.4% vs. 14.1%): adolescent donors vs. controls for all comparisons. These data suggest that adolescent donors are not at a higher risk of shortened survival, hypertension, diabetes, or proteinuria. Nevertheless, they probably should donate only when other options are exhausted as they have to live with a single kidney for decades and longer follow-up is needed. PMID:24646177
Macdonald, David; Kukla, Aleksandra K; Ake, Sarah; Berglund, Danielle; Jackson, Scott; Issa, Naim; Spong, Richard; Matas, Arthur J; Ibrahim, Hassan N
The shortage of available organs for transplantation is a worldwide issue. To maximize the number of transplantations, increasing the number of organs transplanted per donor (OTPD) is widely recognized as an important factor for improving the shortage. In Japan, we have had 211 donors, 1112 organs transplanted, and 924 recipients receiving the transplants, resulting in 4.4 ± 1.4 recipients receiving transplants per donor and 5.3 ± 1.6 OTPD as of February 2013. Because donor age is a well-recognized factor of donor suitability, we analyzed the correlation between donor age group and OTPD. Only the age group 60 to 69 years and the age group 70 to 79 years were significantly different (P organs. PMID:24815124
Ashikari, J; Omiya, K; Konaka, S; Nomoto, K
Full Text Available AIM: To study diagnostic laparoscopy as a tool for excluding donors on the day of surgery in living donor liver transplantation (LDLT. METHODS: This study analyzed prospectively collected data from all potential donors for LDLT. All of the donors were subjected to a three-step donor evaluation protocol at our institution. Step one consisted of a clinical and social evaluation, including a liver profile, hepatitis markers, a renal profile, a complete blood count, and an abdominal ultrasound with Doppler. Step two involved tests to exclude liver diseases and to evaluate the donor’s serological status. This step also included a radiological evaluation of the biliary anatomy and liver vascular anatomy using magnetic resonance cholangiopancreatography and a computed tomography (CT angiogram, respectively. A CT volumetric study was used to calculate the volume of the liver parenchyma. Step three included an ultrasound-guided liver biopsy. Between November 2002 and May 2009, sixty-nine potential living donors were assessed by open exploration prior to harvesting the planned part of the liver. Between the end of May 2009 and October 2010, 30 potential living donors were assessed laparoscopically to determine whether to proceed with the abdominal incision to harvest part of the liver for donation. RESULTS: Ninety-nine living donor liver transplants were attempted at our center between November 2002 and October 2010. Twelve of these procedures were aborted on the day of surgery (12.1% due to donor findings, and eighty-seven were completed (87.9%. These 87 liver transplants were divided into the following groups: Group A, which included 65 transplants that were performed between November 2002 and May 2009, and Group B, which included 22 transplants that were performed between the end of May 2009 and October 2010. The demographic data for the two groups of donors were found to match; moreover, no significant difference was observed between the two groups of donors with respect to hospital stay, narcotic and non-narcotic analgesia requirements or the incidence of complications. Regarding the recipients, our study clearly revealed that there was no significant difference in either the incidence of different complications or the incidence of retransplantation between the two groups. Day-of-surgery donor assessment for LDLT procedures at our center has passed through two eras, open and laparoscopic. In the first era, sixty-nine LDLT procedures were attempted between November 2002 and May 2009. Upon open exploration of the donors on the day of surgery, sixty-five donors were found to have livers with a grossly normal appearance. Four donors out of 69 (5.7% were rejected on the day of surgery because their livers were grossly fatty and pale. In the laparoscopic era, thirty LDLT procedures were attempted between the end of May 2009 and October 2010. After the laparoscopic assessment on the day of surgery, twenty-two transplantation procedures were completed (73.4%, and eight were aborted (26.6%. Our data showed that the levels of steatosis in the rejected donors were in the acceptable range. Moreover, the results of the liver biopsies of rejected donors were comparable between the group A and group B donors. The laparoscopic assessment of donors presents many advantages relative to the assessment of donors through open exploration; in particular, the laparoscopic assessment causes less pain, requires a shorter hospital stay and leads to far superior cosmetic results. CONCLUSION: The laparoscopic assessment of donors in LDLT is a safe and acceptable procedure that avoids unnecessary large abdominal incisions and increases the chance of achieving donor safety.
Hamad Al Bahili
Abstract Allogeneic stem cell transplant (allo-SCT) is considered a clinical option for patients with Hodgkin lymphoma (HL) who have experienced at least two chemosensitive relapses. The aim of this systematic review was to determine the benefits and harms of allo-SCT with an unrelated donor (UD) versus related donor (RD) allo-SCT for adult patients with HL. Alternative donor sources such as haploidentical donor cells (Haplo) and umbilical cord blood (UCB) were also included. The available evidence was limited. Ten studies were included in this assessment. Four studies provided sufficient data to compare UD with RD allo-SCT. None of these studies was a randomized controlled trial. Additionally, three non-comparative studies, such as registry analyses, which considered patients with UD transplants were included. The risk of bias in the studies was high. Results on overall and progression-free survival (PFS) showed no consistent tendency in favor of a donor type. Results on therapy-associated mortality and acute (grade II-IV) and chronic graft-versus-host disease were also inconsistent. The study comparing UCB with RD transplants and two non-comparative studies with UCB transplants showed similar results. One of the studies comparing additionally Haplo with RD transplants indicated a benefit in PFS for the Haplo transplant group. In summary, our findings do not indicate a substantial outcome disadvantage of UD and alternative donor sources versus RD allo-SCT for adult patients with advanced HL. PMID:23656201
Messer, Melanie; Steinzen, Andrea; Vervölgyi, Elke; Lerch, Christian; Richter, Bernd; Dreger, Peter; Herrmann-Frank, Annegret
Full Text Available Background: Our blood bank is a regional blood transfusion centre, which accepts blood only from voluntary donors. Aim: The aim is to study iron status of regular voluntary donors who donated their blood at least twice in a year. Materials and Methods: Prior to blood donation, blood samples of 220 male and 30 female voluntary donors were collected. Control included 100 each male and female healthy individuals in the 18- to 60-year age group, who never donated blood and did not have any chronic infection. In the study and control groups, about 10% subjects consumed non-vegetarian diet. After investigation, 85 males and 56 females having haemoglobin (Hb levels above 12.5 g/dl were selected as controls. Donors were divided into ?10, 11-20, 21-50 and> 50 blood donation categories. Majority of the donors in> 50 donation category donated blood four times in a year, whereas the remaining donors donated two to three times per year. Haematological parameters were measured on fully automatic haematology analyzer, serum iron and total iron-binding capacity (TIBC by biochemical methods, ferritin using ELISA kits and transferrin using immunoturbidometry kits. Iron/TIBC ratio x 100 gave percentage of transferrin saturation value. Statistical Analysis: Statistical evaluation was done by mean, standard deviation, pair t -test, ?2 and anova ( F -test. Results: Preliminary analysis revealed that there was no significant difference in the iron profile of vegetarian and non-vegetarian subjects or controls and the donors donating < 20 times. Significant increase or decrease was observed in mean values of various haematological and iron parameters in donors who donated blood for> 20 times ( P < 0.001, compared to controls. Anaemia, iron deficiency and depletion of iron stores were more prevalent in female donors ( P < 0.05 compared to males and especially in those male donors who donated their blood for more than 20 times. Conclusion: Regular voluntary blood donors should receive iron supplementation to prevent iron deficiency and depletion in iron stores.
Full Text Available Improvements in surgical techniques, immunosuppression, and post-transplantation patientcare have led to the optimization of liver transplantation outcomes. However, the waiting listfor liver transplantation is increasing at a greater pace. The large gap between the growing poolof patients waiting for liver transplantation and the scarcity of donor organs has fueled effortsto maximize existing donors and identify new sources.This article will be focused on the current state of liver transplantation using grafts from extendedcriteria donors (elderly donors, steatotic donors, donors with malignancies, donors withviral hepatitis and from donation after cardiac death (DCD, as well as the use of partial grafts(split grafts and living-donor liver transplantation and other suboptimal donors (donors withhypernatremia, infections, hypotension and inotropic support. Overall, broadened criteria foracceptable donor livers appear to lessen graft survival rates somewhat compared with rates forstandard criteria organs.
R. F. Saidi
Improvements in surgical techniques, immunosuppression, and post-transplantation patient care have led to the optimization of liver transplantation outcomes. However, the waiting list for liver transplantation is increasing at a greater pace. The large gap between the growing pool of patients waiting for liver transplantation and the scarcity of donor organs has fueled efforts to maximize existing donors and identify new sources. This article will be focused on the current state of liver transplantation using grafts from extended criteria donors (elderly donors, steatotic donors, donors with malignancies, donors with viral hepatitis) and from donation after cardiac death (DCD), as well as the use of partial grafts (split grafts and living-donor liver transplantation) and other suboptimal donors (donors with hypernatremia, infections, hypotension and inotropic support). Overall, broadened criteria for acceptable donor livers appear to lessen graft survival rates somewhat compared with rates for standard criteria organs. PMID:25013654
Saidi, Reza F
Full Text Available Abstract Background Weight-related stigmatization is a public health problem. It impairs the psychological well-being of obese individuals and hinders them from adopting weight-loss behaviors. We conducted an experimental study to investigate weight stigmatization in work settings using a sample of experienced human resource (HR professionals from a real-life employment setting. Methods In a cross-sectional, computer-based experimental study, a volunteer sample of 127 HR professionals (age: 41.1?±?10.9 yrs., 56% female, who regularly make career decisions about other people, evaluated individuals shown in standardized photographs regarding work-related prestige and achievements. The photographed individuals differed with respect to gender, ethnicity, and Body Mass Index (BMI. Results Participants underestimated the occupational prestige of obese individuals and overestimated it for normal-weight individuals. Obese people were more often disqualified from being hired and less often nominated for a supervisory position, while non-ethnic normal-weight individuals were favored. Stigmatization was most pronounced in obese females. Conclusions The data suggest that HR professionals are prone to pronounced weight stigmatization, especially in women. This highlights the need for interventions targeting this stigmatization as well as stigma-management strategies for obese individuals. Weight stigmatization and its consequences needs to be a topic that is more strongly addressed in clinical obesity care.
Giel Katrin E
Obesity has become pandemic, and the annual cost in related illnesses and loss of productivity is already over $100 billion and rising. Research has shown that obesity can and does cause changes in behavior and in the brain itself that are very similar to changes caused by drugs of abuse. While food addiction is not the causal agent of all obesity, it is clear that many people no longer eat to survive, but instead survive to eat. This review considers the importance of the brain’s reward sy...
Yarnell, S.; Oscar-berman, M.; Avena, Nm; Blum, K.; Gold, Ms
Obesity is a major health hazard in developed countries, and morbid obesity is associated with serious, debilitating and life-threatening sequelae. Medical treatments have been unsuccessful in the long run, if at all. Operations for massive obesity have developed over the last 40 years, based on malabsorption or gastric reduction, or a combination of both. These operations are being extended into the laparoscopic realm. Operation has been found to be the only method of achieving sustained significant weight loss, with reversal of the co-morbidities and rehabilitation, and with an acceptable complication rate, in the majority of these patients. PMID:10102211
The obesity epidemic has forced us to evaluate the role of inflammation in the health complications of obesity. This has led to a convergence of the fields of immunology and nutrient physiology and the understanding that they are inextricably linked. The reframing of obesity as an inflammatory condition has had a wide impact on our conceptualization of obesity-associated diseases. In this Review, we highlight the cellular and molecular mechanisms at play in the generation of obesity-induced i...
Lumeng, Carey N.; Saltiel, Alan R.
Obesity and dyslipidemia are emerging as major public health challenges in South Asian countries. The prevalence of obesity is more in urban areas than rural, and women are more affected than men. Further, obesity in childhood and adolescents is rising rapidly. Obesity in South Asians has characteristic features: high prevalence of abdominal obesity, with more intra-abdominal and truncal subcutaneous adiposity than white Caucasians. In addition, there is greater accumulation of fat at “ecto...
Anoop Misra; Usha Shrivastava
Obesity, especially upper body fat distribution, has become an increasingly important medical problem in children and adolescents. Outcomes related to childhood obesity include, as in adult population, hypertension, type 2 diabetes mellitus, dyslipidemia, left ventricular hypertrophy, obstructive sleep apnea, orthopedic and socio-psychological problems. Obese children are at approximately 3-fold higher risk for hypertension from non-obese ones. Obesity-hypertension appears to be characterized...
Fat accumulation has been classically considered as a means of energy storage. Obese people are theorized as metabolically ‘thrifty’, saving energy during times of food abundance. However, recent research has highlighted many neuro-behavioral and social aspects of obesity, with a suggestion that obesity, abdominal obesity in particular, may have evolved as a social signal. We tested here whether body proportions, and abdominal obesity in particular, are perceived as signals revealing pers...
Mankar, Manasee; Joshi, Radhika S.; Belsare, Prajakta V.; Jog, Maithili M.; Watve, Milind G.
Living donation is a common procedure in the United States. Substantial variation exists among transplant centers in their protocols and exclusion criteria for potential living donors. In the absence of clinical trial data to guide decisions about exclusion criteria, knowledge of current practices is an important first step in guiding the formulation of donor protocols as well as future studies. Certain trends in live donation practices have become apparent from surveys of transplant programs...
This manuscript is a survey of the halachic attitudes toward organ transplant procedures from a living donor which can be defined as life-saving procedures for the recipient or at least life-prolonging procedures. Three fundamental problems concerning the halachic aspects of such transplantation are discussed in detail: the danger to the donor, donation under coercion, and the sale of organs and tissues. The terms "halacha" and "Jewish law" are defined in the introduction. PMID:23908800
This manuscript is a survey of the halachic attitudes toward organ transplant procedures from a living donor which can be defined as life-saving procedures for the recipient or at least life-prolonging procedures. Three fundamental problems concerning the halachic aspects of such transplantation are discussed in detail: the danger to the donor, donation under coercion, and the sale of organs and tissues. The terms “halacha” and “Jewish law” are defined in the introduction.
Aid is given for various purposes. Its impact on donors? exports usually depends on whether it is given for altruistic reasons (to overcome human tragedies and disasters) or in an understanding to promote development (to finance infrastructure or social projects). As to humanitarian aid the impact of aid on donors? exports will be most probably lower than in the latter case where related and unrelated imports for realizing development projects have been explicitly or implicitly agre...
Nowak-lehmann D, Felicitas; Marti?nez-zarzoso, Inmaculada; Klasen, Stephan; Herzer, Dierk
Full Text Available Transplant professionals are entrustedwith a unique position in the practiceof medicine—the stewardship ofthe organs from either the deceased or livingdonor. This stewardship entails two majorresponsibilities for which society holds transplantprofessionals accountable: the equitableallocation of deceased donor organs to medicallysuitable recipients, and the evaluationand care for the living organ donor. Data,experience and ethical principles relevant toorgan transplantation become invaluable infulfilling these responsibilities and they arepresented in this Editorial.
F. L. Delmonico
AIM: To investigate the health related quality of life (HRQoL) and psychological outcome of donors after living donor liver transplantation. METHODS: Participants were 92 consecutive liver transplant donors who underwent hepatectomy without middle hepatic vein at West China Hospital of Sichuan University between January 2007 and September 2010. HRQoL was measured using the Chinese version of the Medical Outcomes Study Short Form-36 (SF-36), and psychological symptoms were measured using the S...
Shu-Guang Jin; Bo Xiang; Lu-Nan Yan; Zhe-Yu Chen; Jia-Ying Yang; Ming-Qing Xu; Wen-Tao Wang
Background: South Africa is experiencing a unique double burden of disease due to the nutrition transition, facing diseases related to both under and over nutrition. Childhood obesity is associated with a poor childhood diet, physical inactivity and sedentary lifestyle. Promoting healthy eating and physical activity is important. Promoting healthy eating patterns and regular activity are essential components of lifestyle modification of children. An obesity prevention programme with elements ...
The research deals with experiencing infertility and its consequences in the adoption of a child and focuses on infertile couples that have wished to adopt a child and joined a program preparing them to be foster parents. The results show that most of the infertile couples experience infertility very much as being different from couples with children as well as having to cope with the feelings of deep emotional loss resulting from the inability to reproduce biologically. There is therefore the question whether these facts should be taken into account by the profession (i.e. social workers) when dealing with child adoption as, according to most of the respondents of our survey, the process of coming to terms with infertility and its consequences is an important factor in establishing healthy family relationships and the child's identity within the adoptive family. We concluded from the results of the research that the infertile couples preparation program for adopting a child carried out by the Society of Adoptive Families "Deteljica", is a comprehensive autopoietic social workers' answer to the needs of participants for a successful adoption of a child, as it makes it possible to supply these future adoptive parents with the requisite information and experience and provides support to the entire family upon accepting a child in its midst, while its fundamental attribute is offering help to couples in overcoming the traumas resulting from their infertility. PMID:14746131
Bevc, Viktorija; Jerman, Janja; Ovsenik, Rok; Ovsenik, Marija
This study examined the amount of jaw opening used by two groups of singers, those with less than 4 years of training (novice) and those with more than 8 years of training (experienced) in the Western tradition of opera and art song. Movement of the jaw in the superior-inferior plane was measured with the use of a lightweight head-mounted cephalostat with a strain gauge. The subjects spoke and then sung a carrier phrase "I say b(v)p," where (v) was each of three vowels, [a], [i], and [u]. The phrase was first spoken with a natural inflection and then sung on a repeated pitch at three notes from the low, medium, and high singing voice range. There was no statistically significant difference in jaw opening between the two groups of singers. Vowel was significant for jaw opening in both groups, with [a] being produced with more jaw opening than [i] or [u]. The voicing condition was also significant for jaw opening with greater jaw opening being used as pitch increased. In general the amount of jaw opening was smallest for the low singing voice condition and greatest for the high singing voice condition. The jaw opening most typically was less in the low voice condition than in the speech condition and then increased for both the medium and high voice tasks. All but two singers used more jaw opening on the [a] vowel than the other two vowels at all voicing conditions. PMID:16413745
Austin, Stephen F
Transplant surgeons have historically traveled to donor hospitals, performing complex, time-sensitive procedures with unfamiliar personnel. This often involves air travel, significant delays, and frequently occurs overnight.In 2001, we established the nation's first organ recovery center. The goal was to increase efficiency,reduce costs and reduce surgeon travel. Liver donors and recipients, donor costs, surgeon hours and travel time, from April 1,2001 through December 31,2011 were analyzed. Nine hundred and fifteen liver transplants performed at our center were analyzed based on procurement location (living donors and donation after cardiac death donors were excluded). In year 1, 36% (9/25) of donor procurements occurred at the organ procurement organization (OPO) facility, rising to 93%(56/60) in the last year of analysis. Travel time was reduced from 8 to 2.7 h (p<0.0001), with a reduction of surgeon fly outs by 93% (14/15) in 2011. Liver organ donor charges generated by the donor were reduced by37% overall for donors recovered at the OPO facility versus acute care hospital. Organs recovered in this novel facility resulted in significantly reduced surgeon hours, air travel and cost. This practice has major implications for cost containment and OPO national policy and could become the standard of care. PMID:24612713
Doyle, M B M; Vachharajani, N; Wellen, J R; Lowell, J A; Shenoy, S; Ridolfi, G; Jendrisak, M D; Coleman, J; Maher, M; Brockmeier, D; Kappel, D; Chapman, W C
In renal transplant, there is a well-known deficiency in organ supply relative to demand. Live donation provides superior results when compared with deceased donation including a better rate of graft success and fewer immunologic complications. This deficiency in organs leads to significant morbidity and mortality rates. Alternative avenues have been extensively explored that may expand the live donor pool. They include altruistic donation as well as paired and pooled exchange programs. Altruistic donation is a truly selfless act from a donor unknown to the recipient. Kidney paired donation involves 2 incompatible donor-recipient pairs swapping donors to produce compatibility. Pooled donation involves at least 2 pairs, and can take the form of domino chains in which altruistic input sets up a chain of transplants, in which each recipient's incompatible donor makes a donation for the next recipient. Despite application of these various methods, there lie extensive ethical issues surrounding them. Misconceptions frequently occur; for instance, the perceived benefit that donating an organ to a loved one is greater for a related donor than for an altruistic one. Additionally, it is frequently believed that immunologic incompatibility offers coerced donors liberation from surgery, and that overcoming these barriers by introducing exchange programs provides vulnerable donors less protection. This article explores these and other complex ethical issues surrounding the various methods of expanding the donor pool. The authors offer opinions that challenge the ethical issues and attempt to overcome those views that hinder progress in the field. PMID:21649566
Patel, Shaneel Rajendra; Chadha, Priyanka; Papalois, Vassilios
Selection of the appropriate donor is essential to a successful allograft recipient outcome for solid organ transplantation. Multiple infectious diseases have been transmitted from the donor to the recipient via transplantation. Donor-transmitted infections cause increased morbidity and mortality to the recipient. In recent years, a series of high-profile transmissions of infections have occurred in organ recipients prompting increased attention on the process of improving the selection of an appropriate donor that balances the shortage of needed allografts with an approach that mitigates the risk of donor-transmitted infection to the recipient. Important advances focused on improving donor screening diagnostics, using previously excluded high-risk donors, and individualizing the selection of allografts to recipients based on their prior infection history are serving to increase the donor pool and improve outcomes after transplant. This article serves to review the relevant literature surrounding this topic and to provide a suggested approach to the selection of an appropriate solid organ transplant donor.
Jr, Christopher S Kovacs; Koval, Christine E; van Duin, David; de Morais, Amanda Guedes; Gonzalez, Blanca E; Avery, Robin K; Mawhorter, Steven D; Brizendine, Kyle D; Cober, Eric D; Miranda, Cyndee; Shrestha, Rabin K; Teixeira, Lucileia; Mossad, Sherif B
With the proliferation and expanding applications of laparoscopic techniques, we determined the applicability of the laparoscopic approach to living pancreas donation. We performed the first laparoscopic donor distal pancreatectomy in 1999. We herein present our initial experience with five hand-assisted laparoscopic donor pancreatectomies. Three donors underwent distal pancreatectomy alone; two underwent a simultaneous left nephrectomy. The mean donor age was 48.4+/-8.7 years with a body mass index of 23.7 kg/m2. The donor and recipient survival rate was 100% at up to 3 years of follow-up. There were no episodes of pancreatitis, leaks, or pseudocysts. All donors returned to their preoperative state of health and to work. None of the donors have required oral anti-diabetic medications or insulin. We conclude that laparoscopic donor distal pancreatectomy is a safe and efficient procedure; hand-assisted laparoscopic distal pancreatectomy appears to be preferable, because of the added margin of safety from increased tactile feedback and ease of pancreatic dissection. The procedure can be accomplished with a single 6-cm periumbilical incision and only two 12-mm ports, resulting in excellent cosmesis and high donor satisfaction. PMID:15996246
Tan, Miguel; Kandaswamy, Raja; Sutherland, David E R; Gruessner, Rainer W G
Purpose: to evaluate contrast-enhanced 3D magnetic resonance angiography (CE-MRA) and digital subtraction angiography (DSA) in comparison with the intraoperative findings in living kidney donors. Materials and methods: a total of 156 kidneys in 78 potential kidney donors were prospectively examined using CE-MRA (0.2 mmol Gd/kg, voxel size 1.3 x 0.8 x 2.0) and DSA. Two experienced radiologists assessed the images in consensus regarding the renal vascular anatomy and variants. The results for the 67 candidates accepted for donation were compared to the intraoperative findings. In the other kidneys not accepted for donor nephrectomy, MRA and DSA were compared with each other. Results: nineteen arterial variants were identified intraoperatively, of which 11 (58%) were also detected by preoperative CE-MRA and 10 (53%) by preoperative DSA. Of the 10 venous variants found intraoperatively, CE-MRA detected 8 (80%) and DSA 3 (30%). The agreement (kappa test) between MRI and DSA for all 156 evaluated kidneys was 0.7 for arterial variants (McNemar p = 0.12) and 0.3 for venous variants (McNemar p = 0.01). The preoperative choice of kidney (right or left) made on the basis of the renal vascular anatomy seen on CE-MRA and DSA differed in 22% of the 78 potential donors (McNemar P = 0.3). (orig.)
Frequent blood donors become iron deficient. HFE mutations are present in over 30% of donors. A 24-month study of 888 first time/reactivated donors and 1537 frequent donors measured haemoglobin and iron status to assess how HFE mutations impact the development of iron deficiency erythropoiesis. Donors with two HFE mutations had increased baseline haemoglobin and iron stores as did those with one mutation, albeit to a lesser extent. Over multiple donations haemoglobin and iron status of donors...
Mast, Alan E.; Lee, Tzong-hae; Schlumpf, Karen S.; Wright, David J.; Johnson, Bryce; Carrick, Danielle M.; Cable, Ritchard G.; Kiss, Joseph E.; Glynn, Simone A.; Steele, Whitney R.; Murphy, Edward L.; Sacher, Ronald; Busch, Michael P.
Throughout the 1990s, many villagers in rural China were infected with HIV through commercial plasma/blood donation. These former plasma/blood donors (FPDs) experienced many HIV-related stressors. This study tested a cognitive appraisal model of stress and coping in a sample of HIV-positive adult FPDs. Participants (N = 207) from multiple villages completed a battery of questionnaires assessing HIV-related stress, HIV symptoms, cognitive appraisal, coping behaviors, and psychological distress...
Meade, Christina S.; Wang, Jianping; Lin, Xiuyun; Wu, Hao; Poppen, Paul J.
Full Text Available ... with dieticians and nutritionists, it entails meeting with internal medicine physicians who specialize in obesity treatment, and ... would be concerned about longevity. There are now multiple studies that show that unless you are able ...
... and the Follow-Up Care of Patients Experiencing Homelessness Emergency departments (EDs) serve as a critical gateway for persons experiencing homelessness to access care for both acute and chronic ...
... on the Prevalence and Characteristics of People Experiencing Homelessness in the United States (Last Updated July 2011) ... use issues 2 Individuals Experiencing Chronic/Long-Term Homelessness On a given night in January 2010 v : • ...
A decade ago, the World Health Organization declared obesity to be a global epidemic. Accordingly, there is a growing body of research examining how “obesogenic environments” contribute to the increasing prevalence of obesity. Using the ANGELO Framework, this research explores the role of municipal policies and practices in constructing obesogenic environments in two Southern Ontario cities in order to examine how socio-cultural and political environments shape excess body weight. Data wa...
Given the unabated obesity problem, there is increasing appreciation of expressions like “my eyes are bigger than my stomach,” and recent studies in rodents and humans suggest that dysregulated brain reward pathways may be contributing not only to drug addiction but also to increased intake of palatable foods and ultimately obesity. After describing recent progress in revealing the neural pathways and mechanisms underlying food reward and the attribution of incentive salience by internal ...
Berthoud, Hans-rudolf; Lenard, Natalie R.; Shin, Andrew C.
Childhood obesity has reached epidemic proportions. Many of these children have risk factors for later disease, including cardiovascular disease. For optimal cardiovascular health, health care professionals must be able to identify children and youth at risk and provide appropriate support as needed. The present article reviews the current medical literature on obesity and cardiovascular disease risk factors in the paediatric population, the long-term cardiovascular consequences of childhood ...
Childhood and adolescent rates of obesity and overweight are continuing to increase in much of the world. Risk factors such as diet composition, excess caloric intake, decreased exercise, genetics, and the built environment are active areas of etiologic research. The obesogen hypothesis, which postulates that pre- and peri- natal chemical exposure can contribute to risk of childhood and adolescent obesity, remains relatively under-examined. This review surveys numerous classes of chemicals fo...
Childhood obesity is a serious health problem and prevalence increases dramatically around the world, including Sweden. The aim of the current thesis was to examine parents’ and children’s stress in relation to childhood obesity. Parenting stress, social support, parental worries, and serious life events, as well as children’s temperament, self-esteem, body dissatisfaction, saliva cortisol, weight and height were measured to estimate stress and the relation between stress and childhood ...
Central obesity is a relevant risk factor for major cardiovascular events due to the atherosclerotic involvement of coronary, cerebral and lower limb arterial vessels. A major role in the increased cardiovascular risk is played by platelets, which show an increased activation and a reduced sensitivity to the physiological and pharmacological antiaggregating agents. This review focuses on platelet dysfunction in central obesity. The mechanisms involved are related to: i) the reduced sensitivit...
Trovati, Mariella; Russo, Isabella; Anfossi, Giovanni
Frequent collisions are common for small bodies in the Solar System, and the cumulative damage to these bodies is thought to significantly affect their evolution. It is important to study the effects of multiple impacts such as the number of impacts on the impact strength and the ejection velocity of impact fragments. Here we conducted multiple-impact experiments using a polycrystalline water ice target, varying the number of impacts from 1 to 10 times. An ice cylindrical projectile was impacted at 84-502 m s-1 by using a single-stage gas gun in a cold room between -10 and -15 °C. The impact strength of the ice target that experienced a single impact and multiple impacts is expressed by the total energy density applied to the same target, ?Q, and this value was observed to be 77.6 J kg-1. The number of fine impact fragments at a fragment mass normalized by an initial target mass, m/Mt0 ? 10-6, nm, had a good correlation with the single energy density at each shot, Qj, and the relationship was shown to be n=10·Qj1.31±0.12. We also estimated the cumulative damage of icy bodies as a total energy density accumulated by past impacts, according to the crater scaling laws proposed by Housen et al. (Housen, K.R., Schmidt, R.M., Holsapple, K.A. . J. Geophys. Res. 88, 2485-2499) of ice and the crater size distributions observed on Phoebe, a saturnian icy satellite. We found that the cumulative damage of Phoebe depended significantly on the impact speed of the impactor that formed the craters on Phoebe; and the cumulative damage was about one-third of the impact strength ?Q* at 500 m s-1 whereas it was almost zero at 3.2 km s-1.
Yasui, Minami; Hayama, Ryo; Arakawa, Masahiko
Full Text Available AIM: To evaluate the relationship between donor safety and remnant liver volume in right lobe living donor liver transplantation (LDLT. METHODS: From July 2001 to January 2009, our liver transplant centers carried out 197 LDLTs. The clinical data from 151 cases of adult right lobe living donors (not including the middle hepatic vein were analyzed. The conditions of the three groups of donors were well matched in terms of the studied parameters. The donors’ preoperative data, intraoperative and postoperative data were calculated for the three groups: Group 1 remnant liver volume (RLV < 35%, group 2 RLV 36%-40%, and group 3 RLV > 40%. Comparisons included the different remnant liver volumes on postoperative liver function recovery and the impact of systemic conditions. Correlations between remnant liver volume and post-operative complications were also analyzed. RESULTS: The donors’ anthroposomatology data, operation time, and preoperative donor blood test indicators were calculated for the three groups. No significant differences were observed between the donors’ gender, age, height, weight, and operation time. According to the Chengdu standard liver volume formula, the total liver volume of group 1 was 1072.88 ± 131.06 mL, group 2 was 1043.84 ± 97.11 mL, and group 3 was 1065.33 ± 136.02 mL. The three groups showed no statistically significant differences. When the volume of the remnant liver was less than 35% of the total liver volume, the volume of the remnant had a significant effect on the recovery of liver function and intensive care unit time. In addition, the occurrence of complications was closely related to the remnant liver volume. When the volume of the remnant liver was more than 35% of the total liver volume, the remnant volume change had no significant effect on donor recovery. CONCLUSION: To ensure donor safety, the remnant liver volume should be greater than the standard liver volume (35% in right lobe living donor liver transplantation.
Full Text Available Abstract Background Brazil is currently experiencing a nutrition transition: the displacement of traditional diets with foods high in saturated fat, sodium, and cholesterol and an increase in sedentary lifestyles. Despite these trends, our understanding of child obesity in Brazil is limited. Thus, the aims of this study were (1 to investigate the current prevalence of overweight and obesity in a large sample of children and adolescents living in São Paulo, Brazil, and (2 to identify the lifestyle behaviors associated with an increased risk of obesity in young Brazilians. Methods A total of 3,397 children and adolescents (1,596 male aged 7-18 years were randomly selected from 22 schools in São Paulo, Brazil. Participants were classified as normal weight, overweight, or obese based on international age- and sex-specific body mass index thresholds. Selected sociodemographic, physical activity, and nutrition behaviors were assessed via questionnaire. Results Overall, 19.4% of boys and 16.1% of girls were overweight while 8.9% and 4.3% were obese. Two-way analysis of variance revealed that the prevalence of overweight and obesity was significantly higher in boys and in younger children when compared to girls and older children, respectively (P Conclusions Our results show that obesity in São Paulo children and adolescents has reached a level equivalent to that seen in many developed countries. We have also identified three key modifiable factors related to obesity that may be appropriate targets for future intervention in Brazilian youth: transport mode to school, computer usage, and breakfast consumption.
Codogno Jamile S
Full Text Available Background: The behavior and dietary treatments are not so successful for extremely obese adolescents. Therefore, using drugs to treat extremely obese children and adolescents are among the modern approaches. This research aims to study the pharmaceutical interventions performed for treatment of obese children. Materials and Methods: The strategy of research was using of key words ‘obesity’, ‘adolescence’, ‘treatment’ and ‘anti-obesity drugs’ were searched in websites of PubMed, Iranian Medical Digital Library, SID, Iran Medex, Magiran. This study reviewed all the available published papers in English and Farsi languages during 2000-2010. The Criteria for exclusion was The papers that had been published on interventions and treatment of eating disorders, type II diabetes or the obesity caused by the secondary syndromes. Results: Twelve papers were found as short-term clinical trials and/or long-term follow-ups. In these studies, the positive effects of ‘sibutramine’ in some studies are shown; although some other side effects are reported as well. A significant weight-loss had been reported on ‘orlistat’ medicine, but digestive complications had been observed as well. None of the studies had followed up patients for more than one year. Apparently, ‘Metformin’ requires further studies.Conclusion: The FDA has only approved ‘sibutramine’ and ‘orlistat’ drugs. But side effects of long-term these drugs have already been unknown. However, it seems that ‘orlistat’ is applied for ?12-year-old children and ‘sibutramine’ for ? 16-year-old children.
Abstract Background Weight-related stigmatization is a public health problem. It impairs the psychological well-being of obese individuals and hinders them from adopting weight-loss behaviors. We conducted an experimental study to investigate weight stigmatization in work settings using a sample of experienced human resource (HR) professionals from a real-life employment setting. Methods In a cross-sectional, computer-based experimental study, a volunteer sample...
Giel Katrin E; Zipfel Stephan; Alizadeh Manuela; Schäffeler Norbert; Zahn Carmen; Wessel Daniel; Hesse Friedrich W; Thiel Syra; Thiel Ansgar
We report the results of a prospective, longitudinal quality of life survey on our adult right lobe (RL) liver donors. A total of 47 donors were enrolled; a standard SF-36 form and 43 questions developed by our team were completed before donation, at 1 week, and 1, 3, 6 and 12 months after donation. There were no donor deaths. Twenty-nine complications occurred in 16 patients. Major complication rate was 12.8%. Employment status and personal finances were identified as major stressors. All donors who wished to return to work did so by 1 year (mean 3.4 months). Individuals reported between 0 dollars and 25,000 dollars in losses (wages, travel, lodging, etc.). Relationships with recipients and other family members were not altered significantly. Anticipated pain (predonation) was greater than actual pain reported. Donors indicated satisfaction with the donation process regardless of recipient outcome. Physical complaints were significant at 1 week and 1 month, but returned to baseline. Donor mental health remained stable. In conclusion, RL donors found the experience to be a positive one throughout the first postdonation year. The study identified areas (finances, employment and expected recipient outcomes) to be stressed as future donors are evaluated. PMID:16212639
Verbesey, Jennifer E; Simpson, Mary Ann; Pomposelli, James J; Richman, Eric; Bracken, Alyson M; Garrigan, Kathryn; Chang, Hong; Jenkins, Roger L; Pomfret, Elizabeth A
Amino acid interlinked pyrene and naphthalenediimide (NDI) based novel donor-acceptor-donor (D-A-D) triads are designed to exploit their topological symmetry and complementary ?-character for facile charge-transfer complexation. Consequently, free-floating high-aspect-ratio supercoiled nanofibres and hierarchical helical bundles of triads are realized by modulating the chemical functionality of interlinking amino acids. PMID:23946856
Avinash, M B; Sandeepa, K V; Govindaraju, T
Summary Amino acid interlinked pyrene and naphthalenediimide (NDI) based novel donor–acceptor–donor (D-A-D) triads are designed to exploit their topological symmetry and complementary ?-character for facile charge-transfer complexation. Consequently, free-floating high-aspect-ratio supercoiled nanofibres and hierarchical helical bundles of triads are realized by modulating the chemical functionality of interlinking amino acids.
Avinash, M B; Sandeepa, K V
Objective: To share experience of live donor nephrectomy (including intraoperative variables, morbidity and ethical aspects) and to give an overview of surgical technique being practiced. Results: Majority of the donors (58.5%) were 31-50 years old and 70.6% were first-degree relatives. Left sided kidney was taken in 96.5% cases. Mean operative time was 145 minutes. Mean renal warm ischemia time from cross clamping of renal vessels to cold perfusion on the bench was 1.5 minutes per operation. Operative complications encountered were injury to lumbar veins in 5.1 % cases, slipping of satinsky clamp on vena cava stump in 1.7 % and accidental pleural damage in 5.1 % cases. Postoperative morbid complications found were urinary retention in 6.4 % cases, epididymo-orchitis in 1.7 %, prolonged lymph drain in 3.4 %, stitch infection in 1.7 % and prolonged wound discomfort in 5.1 % patients. Conclusions: Open live donor nepherectomy appears to be safe procedure for harvesting kidney. Related or emotionally related donors must be the choice in all cases. Non-related donors may be entertained in selected cases despite the probability of organ vending in our society. (author)
Full Text Available Global increases in obesity have led public health experts to declare this disease a pandemic. Although prevalent in all ages, the dire consequences associated with maternal obesity have a pronounced impact on the long-term health of their children as a result of the intergenerational effects of developmental programming. Previously, fetal under-nutrition has been linked to the predisposition to pediatric obesity explained by the adiposity rebound and ‘catch-up’ growth that occurs when a child born to a nutrient deprived mother is exposed to the obesogenic environment of present day. Given the recent increase in maternal overweight/obesity (OW/OB our attention has shifted from nutrient restriction to overabundance and excess during pregnancy. Consideration must now be given to interventions that could mitigate pregravid body mass index (BMI, attenuate gestational weight gain (GWG and reduce postpartum weight retention (PPWR in an attempt to prevent the downstream signaling of pediatric obesity and halt the intergenerational cycle of weight related disease currently plaguing our world. Thus, this paper will briefly review current research that best highlights the proposed mechanisms responsible for the development of child OW/OB and related sequalae (e.g. type II diabetes (T2D and cardiovascular disease (CVD resulting from maternal obesity.
Obesity and asthma prevalence have been increasing over the past decade. Epidemiological evidence demonstrates that obesity results in an increased risk of developing incident asthma. Even modest levels of increased weight increase asthma risk. Recently published data suggest that obese asthma patients may represent a distinct phenotype of asthma. Obese asthma patients demonstrate increased asthma severity, as indicated by increased exacerbations and decreased asthma control; however, they do not appear to have increased airway cellular inflammation. It seems likely that obesity does not contribute to asthma through conventional Th type 2-mediated inflammatory pathways but, rather, through separate mechanisms that are specific to the obese state. This may explain the variable responses of obese asthma patients to conventional asthma therapies, specifically, relative corticosteroid resistance. Small studies suggest improvements in the disease with weight loss in obese asthma patients, and other interventions to target asthma in obese individuals need to be investigated. Several postulated mechanisms for the occurrence of this distinct phenotype have been postulated: 1) the presence of comorbidities, such as gastroesophageal reflux disease and sleep disordered breathing, 2) systemic inflammation associated with obesity (with elevated levels of circulating cytokines, such as IL-6 and TNF-alpha), 3) increased oxidative stress, and 4) hormones of obesity, such as adiponectin, leptin, and resistin. Although the mechanisms underlying obesity in asthma require further investigation, obesity plays a major role in the asthma epidemic and likely results in a distinct phenotype of the disease. PMID:19875708
Lugogo, Njira L; Kraft, Monica; Dixon, Anne E
Full Text Available Abstract Background In the past year Lebanon has been experiencing a nutritional transition in food choices from the typical Mediterranean diet to the fast food pattern. As a consequence, the dietary habits of young adults have been affected; thus, overweight and obesity are increasingly being observed among the young. The purpose of this study is to assess the prevalence of overweight and obesity on a sample of students from the Lebanese American University (in Beirut and to examine their eating habits. Methods A cross-sectional survey of 220 students (43.6% male and 56.4% female, aged 20 ± 1.9 years, were chosen randomly from the Lebanese American University (LAU campus during the fall 2006 semester. Students were asked to fill out a self-reported questionnaire that included questions on their eating, drinking and smoking habits. Also, their weight, height, percentage body fat and body mass index were measured. Body mass index (BMI was used to assess students' weight status. Statistical analyses were performed using the Statistical Package for Social Sciences software (version 13.0 to determine overweight and obesity among students and to categorize eating habits. Results This study showed that the majority of the students (64.7% were of normal weight (49% male students compared to 76.8% female students. The prevalence of overweight and obesity was more common among male students compared to females (37.5% and 12.5% vs. 13.6% and 3.2%, respectively. In contrast, 6.4% female students were underweight as compared to 1% males. Eating habits of the students showed that the majority (61.4% reported taking meals regularly. Female students showed healthier eating habits compared to male students in terms of daily breakfast intake and meal frequency. 53.3% of female students reported eating breakfast daily or three to four times per week compared to 52.1% of male students. There was a significant gender difference in the frequency of meal intake (P = 0.001. Intake of colored vegetables and fruits was common among students. A total of 30.5% reported daily intake of colored vegetables with no gender differences (31.5% females vs. 29.2% males. Alcohol intake and smoking were not common among students. Conclusion In spite of the overall low prevalence of overweight and obesity in the studied sample, results indicate that university students would possibly benefit from a nutrition and health promotion program to reduce the tendency of overweight and obesity, especially among male students, and to improve students' eating habits.
No research has compared expressions of weight bias across different subgroups of obese individuals. This study compared attitudes toward and beliefs about obesity in women with and without binge eating disorder (BED) and examined whether these attitudes are related to psychological factors. Fifty obese women with BED were compared with an age- and body mass index (BMI)-matched group of 50 obese women without BED on a battery of established measures of anti-fat attitudes and beliefs about wei...
Puhl, R. M.; Masheb, R. M.; White, M. A.; Grilo, C. M.
One reason donors provide foreign aid is to support their exports to aid-recipient countries. Time series data for Germany suggests an average return of between US$ 1.04 to US$ 1.50 for each US dollar of aid spent by Germany. Although this is well below previous estimates, the value is robust to different specifications and econometric approaches. Interestingly, we find strong evidence of crowding out between bilateral donors in the sense that bilateral aid from other EU members significantly...
Nowak-lehmann D, Felicitas Nowak-lehmann; Marti?nez Zarzoso, Inmaculada; Klasen, Stephan; Herzer, Dierk
Excessive weight gain arises from the interactions among environmental factors, genetic predisposition and the individual behavior. However, it is becoming evident that interindividual differences in obesity susceptibility depend also on epigenetic factors. Epigenetics studies the heritable changes in gene expression that do not involve changes to the underlying DNA sequence. These processes include DNA methylation, covalent histone modifications, chromatin folding and, more recently described, the regulatory action of miRNAs and polycomb group complexes. In this review, we focus on experimental evidences concerning dietary factors influencing obesity development by epigenetic mechanisms, reporting treatment doses and durations. Moreover, we present a bioinformatic analysis of promoter regions for the search of future epigenetic biomarkers of obesity, including methylation pattern analyses of several obesity-related genes (epiobesigenes), such as FGF2, PTEN, CDKN1A and ESR1, implicated in adipogenesis, SOCS1/SOCS3, in inflammation, and COX7A1 LPL, CAV1, and IGFBP3, in intermediate metabolism and insulin signalling. The identification of those individuals that at an early age could present changes in the methylation profiles of specific genes could help to predict their susceptibility to later develop obesity, which may allow to prevent and follow-up its progress, as well as to research and develop newer therapeutic approaches. PMID:19413700
Campión, J; Milagro, F I; Martínez, J A
Obesity is recognized as a major health problem worldwide. Genetic factors play a major role in obesity, and genomewide association studies have provided evidence that several common variants within the fat mass- and obesity-associated (FTO) gene are significantly associated with obesity. Very limited data is available on FTO in the Italian population.
Objective In this study, we investigated whether serum androgen levels and endometrial thickness differed in obese and non-obese women. Material and Methods Thirtytwo non-obese (BMI 5 mm had significant pathology. Conclusion These results suggest that obesity may be a risk factor for endometrial carcinoma and other pathologies in post-menopausal women through an action on androgen concentrations.
Ar?kan, Ilker Inan; Barut, Aykut; Ar?kan, Deniz; Harma, Muge; Harma, Mehmet Ibrahim; Bozkurt, Serpil
Context: Relatively little is known about the factors shaping public attitudes toward obesity as a policy concern. This study examines whether individuals' beliefs about the causes of obesity affect their support for policies aimed at stemming obesity rates. This article identifies a unique role of metaphor-based beliefs, as distinct from conventional political attitudes, in explaining support for obesity policies.
Barry, Colleen L.; Brescoll, Victoria L.; Brownell, Kelly D.; Schlesinger, Mark
The clinical presentations of gastrointestinal bleeding (GIB) occurring after living donor liver transplantation (LDLT) have not been fully described. We performed a retrospective analysis of 297 LDLT cases. Nineteen patients (6.4%) experienced GIB after LDLT. The etiology of GIB included bleeding at the jejunojejunostomy following hepaticojejunostomy (n = 13), peptic ulcer disease (n = 2), portal hypertensive gastropathy (n = 2), and other causes (n = 2). Hemostasis was achieved in 13 patients (68.4%) by endoscopic (n = 3), surgical (n = 1), or supportive treatments (n = 15), but not in the other six patients. Graft dysfunction (P 20 mmHg (P = 0.002), and operative blood loss >10 L (P = 0.004) were risk factors. One-year graft survival rate was significantly lower in patients with GIB than in patients without GIB (P < 0.001). The inhospital mortality rate was 52.6% for patients with GIB, 75.0% for patients with graft dysfunction, and 14.3% for patients without graft dysfunction (P = 0.028). Despite its infrequency after LDLT, GIB has strong correlation with graft dysfunction and inhospital mortality. PMID:24673842
Kimura, Koichi; Ikegami, Toru; Bekki, Yuki; Ninomiya, Mizuki; Yamashita, Yo-Ichi; Yoshizumi, Tomoharu; Yoshiya, Shohei; Soejima, Yuji; Harada, Noboru; Shirabe, Ken; Maehara, Yoshihiko
Obesity is prevalent worldwide and associated with co-morbidities that result in increased cardiovascular risk. Hypertension is the most prevalent obesity comorbidity associated with increased cardiovascular risk. Obesity hypertension is a distinct subtype of essential hypertension. While endogenous Cushing's syndrome is an uncommon cause of both obesity and hypertension, the recent recognition of other hypercortisolemic states has raised the profile of hypercortisolism as an important contributor in obesity hypertension. The high prevalence of exogenous, iatrogenic, pseudo, and subclinical Cushing's syndromes makes hypercortisolism an important diagnostic consideration in the evaluation and management of patients with obesity hypertension who are resistant to conventional management. Available data suggest that the renin-angiotensin-aldosterone system modulating antihypertensives have the best efficacy in hypercortisolism-mediated obesity hypertension. Strategies aimed at reducing cortisol production and action also have utility. This review provides a comprehensive overview of the epidemiology, etiopathogenesis and management options available for glucocorticoid-mediated obesity hypertension. PMID:24801134
Varughese, Amy G; Nimkevych, Oksana; Uwaifo, Gabriel I
Obesity has struck with all its might and the results are the increased world-wide prevalence along with increased mortality rate and other obesity-related diseases. Genetic, hormonal and environmental factors interact to cause obesity. Very low calorie diet and physically active lifestyle are the primary means to treat obesity. Additional intervention is by pharmacological treatment, using two new drugs, namely cyclobutane methanamine HCl and tetra hidrolipstatin that are potential for ...
Obesity and asthma prevalence have been increasing over the past decade. Epidemiological evidence demonstrates that obesity results in an increased risk of developing incident asthma. Even modest levels of increased weight increase asthma risk. Recently published data suggest that obese asthma patients may represent a distinct phenotype of asthma. Obese asthma patients demonstrate increased asthma severity, as indicated by increased exacerbations and decreased asthma control; however, they do...
Lugogo, Njira L.; Kraft, Monica; Dixon, Anne E.
The epidemic of obesity has become a major public health problem. Common-form obesity is underpinned by both environmental and genetic factors. Epidemiological studies have documented that increased intakes of energy and reduced consumption of high-fiber foods, as well as sedentary lifestyle, were among the major driving forces for the epidemic of obesity. Recent genome-wide association studies have identified several genes convincingly related to obesity risk, including the fat mass and obes...
Qi, Lu; Cho, Young Ae
Childhood obesity appears to be increasing throughout the world. China has joined the global epidemic. Childhood obesity is not only a chronic disease which is associated with lifestyle, but also a public health problem in children. Obesity intervention should become a public health priority in China. This thesis reports on intervention to treat and prevent childhood obesity. The field work was implemented in Beijing, China. This thesis is based on four papers: Paper I evaluated the feasibil...
Objectives: Epidemiologic data suggests an association between obesity and depression. However, a limited number of studies have investigated the prevalence of psychiatric symptoms among obese patients without a psychiatric diagnosis. The objective of this study was to determine psychiatric diagnosis in patients with obesity who applied to the endocrinology department and to determine the pattern of the depression and anxiety symptom levels in obese patients without a psychiatric diagnosis.Ma...
Although the effects of obesity on children's physical health are well documented, the social consequences of obesity are less well described and may not be addressed in intervention programs. Weight bias may take several forms. It may result in teasing and discrimination and may affect employment and educational opportunities. Health care providers may limit care of overweight or obese children. The media promote weight bias in multiple ways. Some parents are biased against their obese child...
Washington, Reginald L.
Diverticular disease is common in the Western world and is a considerable source of morbidity. Many have proposed an association between diverticular disease, its complications, and obesity. We examine this question through a review of the available literature. While it is likely that an association between diverticular disease and obesity exists, there is no evidence suggesting that obese patients should be managed any differently from the non-obese.
Johnson, Eric K.; Champagne, Bradley J.
Childhood obesity can cause social, psychological and health problems, and is linked to obesity later in life and poor health outcomes as an adult. Obesity development is related to physical activity and nutrition. To prevent obesity, 55 studies conducted internationally have looked at programmes aiming to improve either or both of these behaviours. Although many studies were able to improve children’s nutrition or physical activity to some extent, only some studies were able to see an ef...
Over the last decade, obesity rates have reached epidemic proportions in the United States of America. Comorbidities associated with overweight and obesity include, but are not limited to, hypertension, type 2 diabetes, cardiovascular disease, and elevated cholesterol levels. As a direct result of obesity, data indicates that these diseases are now being detected in an unprecedented number of American children, adolescents, and adults. Although the major cause of the obesity epidemic in Ameri...
Stolzer, Jeanne M.
Abstract Obesity is a growing international health problem that has already reached epidemic proportions, particularly within the United States where a majority of the population is overweight or obese. Effective methods of treatment are needed, and should be taught to physicians by efficient means. There exists a disconnect between the rising obesity prevalence with its high toll on medical resources, and the lack of obesity education provided to practitioners in the course of thei...
This brief review focuses on the genetic contribution to childhood obesity. Evidence for a genetic component to excess body weight during growth is presented from the perspective of genetic epidemiology studies. Parental obesity is a predictor of childhood excess weight. The familial risk ratio for childhood obesity when a parent is obese reaches >2.5. Birth weight is characterized by a genetic heritability component on the order of 30%, with significant maternal and paternal effects in addit...
Obesity in women is a concern in many countries. This causes numerous health issues; however, this review focuses on the impact of obesity on women’s reproduction, and in particular the oocyte. Data from infertility clinics and experimental animal models that address the effects of obesity are presented. Bidirectional communication and metabolic support from the surrounding cumulus cells are critical for oocyte development, and the impact of obesity on these cells is also addressed. Both oo...
Purcell, Scott H.; Moley, Kelle H.
Obesity rates have increased dramatically among children in many parts of the world, especially in North America and several other English-speaking countries. The impact of obesity on pediatric health has become a major prevention initiative by the Obama administration and several public health organizations. Children with obesity are at increased risk for developing asthma, which is already one of the most common chronic diseases among children. The cause underlying obesity's impact on asthm...
Lang, Jason E.
BACKGROUND: Almost one-third of adult Canadians are at increased risk of disability, disease and premature death because of being obese. In order to allocate limited health care resources rationally, it is necessary to elucidate the economic burden of obesity. OBJECTIVE: To estimate the direct costs related to the treatment of and research into obesity in Canada in 1997. METHODS: The prevalence of obesity (body mass index of 27 or greater) in Canada was determined using data from the National...
Birmingham, C. L.; Muller, J. L.; Palepu, A.; Spinelli, J. J.; Anis, A. H.
In many affluent Western societies the less educated are at higher risk of developing obesity. Within a conceptual framework of sociology of embodiment, this study analyzed the embodied experiences associated with obesity and the management of body weight among women and men with different social backgrounds. Qualitative in depth interviews were conducted with 20 Danish middle-aged men and women who were categorized as clinically obese in a national dietary survey. The study found a devastating impact of obesity in the lives of highly educated women related to motherhood, career and wifehood which interrelated with persistent efforts to lose weight and repeated involvement in a great variety of weight-loss activities. In contrast, body weight among the less educated interviewees was a concern only in specific situations of everyday life, and it was a health-related concern especially for those men who had experienced weight-related disease, which interrelated with less commitment to, and variation in, weight-loss activities. These findings may help to explain why obesity is least prevalent among highly educated women in Danish society as well as other western societies. A marked difference between men and women was that only few men followed dietary regimes which involved a focus on cooking or changing eating habits on their own initiative. In addition they did not participate in commercial weight-loss programs. We discuss how the social and gendered differences found relate to wider societal contexts and how the findings may both challenge and inform public health promotion.
Smith, Louise; Holm, Lotte
Full Text Available New societies, specially those that are transitioning towesternized lifestyles, are experiencing substantial increases inprevalence of obesity that is showing epidemic characteristicsin several communities. Besides it is well accepted that geneticfactors have an important role in weight control, the observedexplosion of obesity seen in the last century can not be explainedexclusively by alterations in genes that occurred in this shortperiod of time but it is much more suitable to be the result ofenvironmental changes related to the contemporaryindustrialization and technological advances. The primaryenvironmental determinants of obesity are those related to theincrease in caloric intake and low levels of activity thatgenetically susceptible subjects to the weight gain are exposedby the modern style of living. Stimulated by the cheaper andgreater availability of food, the increase in automation andmechanization facilitating the physical inactivity and thecontinuous psychological stress the modern man is actually moreexposed to behavior changes favoring the weight gain. Sinceobesity is widely recognized to be an important cardiovascularand diabetes risk factor, prevention of obesity must be recognizedby policy-makers as an important public health actions to protecthealth. To combat the epidemic of obesity we must cure the“toxic environmental” changing our behavior and promoting newfood technologies.
Simão Augusto Lottenberg
Various Pacific Island populations have experienced a marked increase in the prevalence of obesity in past decades. This study examined the association of a promoter polymorphism of the leptin gene (LEP), G-2548A (rs7799039), and two non-synonymous single nucleotide polymorphisms of the leptin receptor gene (LEPR), K109R (rs1137100) and Q223R (rs1137101), with body weight, body mass index (BMI) and obesity (BMI > or = 30) in Pacific Islanders. A total of 745 Austronesian (AN)-speaking participants were analyzed after adjusting for age, gender, and population differences. The results revealed that carriers of the 223Q alleles of LEPR had significantly higher body weight (P = 0.0009) and BMI (P = 0.0022) than non-carriers (i.e., 223R homozygotes); furthermore, the 223Q carriers also had a signiWcantly higher risk of obesity in comparison to non-carriers (P = 0.0222). The other two polymorphisms, G-2548A and K109R, were associated with neither body weight, BMI, nor obesity. The 223Q allele was widely found among the AN-speaking study subjects, thus suggesting that the LEPR Q223R polymorphism is one of the factors contributing to the high prevalence of obesity in the Pacific Island populations. PMID:20183928
Furusawa, Takuro; Naka, Izumi; Yamauchi, Taro; Natsuhara, Kazumi; Kimura, Ryosuke; Nakazawa, Minato; Ishida, Takafumi; Inaoka, Tsukasa; Matsumura, Yasuhiro; Ataka, Yuji; Nishida, Nao; Tsuchiya, Naoyuki; Ohtsuka, Ryutaro; Ohashi, Jun
Obesity concerns more than 200 million people in the world, with an increasing prevalence in western countries. It is closely related to multiple medical conditions, such as diabetes and hypertension. It was recently shown that testosterone deficiency syndrome and erectile dysfunction (ED) are also linked to male obesity. In this group of patients, ED may be due to defects in corpus cavernosum relaxation, endocrine modifications and nerve signal alterations. Weight loss and increased physical activities can improve erectile function in 30% of obese patients. Additional medical treatments of ED enhance erectile function in more than 80% of patients. Self image improvement associated with appropriate erectile dysfunction medical treatment allow better sexual life and potentially increased motivation for weight loss. PMID:23330231
Lucca, Ilaria; Paduch, Darius A; Pralong, François; Vaucher, Laurent
That the brain is involved in the pathogenesis and perpetuation of obesity is broadly self-intuitive, but traditional evaluation of this relationship has focused on psychological and environment-dependent issues, often referred to as the "it's all in the head" axiom. Here we review evidence that excessive nutrition or caloric flux, regardless of its primary trigger, elicits a biological trap which imprints aberrant energy control circuits that tend to worsen with the accumulation of body fat. Structural and functional changes in the brain can be recognized, such as hypothalamic inflammation and gliosis, reduction in brain volume, reduced regional blood flow or diminished hippocampal size. Such induced changes collectively translate into a vicious cycle of deranged metabolic control and cognitive deficits, some of which can be traced back even to childhood or adolescence. Much like other components of the obese state, brain disease is inseparable from obesity itself and requires better recognition to allow future therapeutic targeting. PMID:23911925
Shefer, Gabi; Marcus, Yonit; Stern, Naftali
The aim of the study was to find out the prevalence of transfusion transmitted infections (TTI) in voluntary and replacement donors. A total of 9599 donors were analysed for the prevalence of TTI over a period of 2 years.Of these 61.2% were voluntary donors and 38.8% were replacement donors. Prevalence of TTI in total donors was 0.6%. Prevalence of hepatitis B was highest (0.34%) followed by syphilis (0.11%), HIV&HCV (0.06%) and malaria (0.01%). Prevalence was more in male replacement donors...
Obesity has been a great interest of public health. Studies simultaneously examining various factors associated with obesity among adolescents have been limited. Therefore, this study aimed to examine how various factors (socio-economic status, sex, age, diet, and physical activity) were simultaneously associated with obesity among Korean adolescents. This study analyzed two na...
Gyu Jin Heo; So Young Nam; Soo-Kyung Lee
... Content Index > Data/Statistics > Data by Health Topic > Obesity Obesity and American Indians/Alaska Natives American Indian/Alaska ... findings/nhqrdr/nhqrdr12/index.html HEALTH IMPACT OF OBESITY More than 80 percent of people with type ...
Researchers are only gradually becoming aware of the gravity of the risk that overweight and obesity pose for children's health. In this article Stephen Daniels documents the heavy toll that the obesity epidemic is taking on the health of the nation's children. He discusses both the immediate risks associated with childhood obesity and the…
Daniels, Stephen R.
Improved liquid yields are obtained during the hydrogen-donor solvent liquefaction of coal and similar carbonaceous solids by maintaining a higher concentration of material having hydrogenation catalytic activity in the downstream section of the liquefaction reactor system than in the upstream section of the system.
Wilson, Jr., Edward L. (Baytown, TX); Mitchell, Willard N. (Baytown, TX)
Full Text Available Objective: To investigate the use of plasma homocysteine levelsin blood bank donors as a risk marker for the development ofcardiovascular diseases in healthy individuals. Methods: Thirtynineblood donors were evaluated and a correlation was establishedbetween the plasma homocysteine levels and the different ageand gender groups. Results: The values of homocysteine levelswere found to be within the normal range, as expected for a healthypopulation. Only three male donors, aged between 40 and 60years, presented hyperhomocysteinemia within the risk rangefor developing cardiovascular disease. Comparing females andmales with regard to homocysteine levels, the values presentedstatistically significant differences, however of little relevance.Variance analysis did not show significant differences betweenthe considered age groups, regardless of gender, but there was aclear increase in homocysteine concentration in males betweenthe 5th and 6th decades of life. Conclusions: It was not possible tosuggest the use of plasma homocysteine levels as an early markerfor the development of cardiovascular diseases in healthy bloodbank donors, but one can speculate about a critical homocysteinelevel to be defined as a cutoff point, above which there wouldbe an increased risk of developing cardiovascular disease.
Luiz Antonio Rosa
Idiopathic intracranial hypertension (IIH), also known as primary pseudotumor cerebri syndrome (PTCS), is a condition of unknown etiology which affects primarily overweight, reproductive-aged women and causes increased intracranial pressure (ICP). This review discusses the recently revised diagnostic criteria for PTCS for adults and children. Additionally, the role of obesity in the epidemiology, etiology, and management of IIH as well as the current knowledge of obesity profiles and markers in IIH are reviewed. We also highlight the emerging, unifying theory of the neuroendocrine effects on the mineralocorticoid receptor to explain a possible mechanism for the increased cerebrospinal fluid production and ICP in secondary PTCS. PMID:24642712
Andrews, Laura E; Liu, Grant T; Ko, Melissa W
The upward trend in obesity prevalence across regions and continents is a worldwide concern. Today a majority of the world’s population live in a country where being overweight or obese causes more deaths than being underweight. Only a portion of those qualifying for treatment will get the health care they need. Still, a minor weight loss of 5–10% seems to be sufficient to provide a clinically significant health benefit in terms of risk factors for cardiovascular disease and diabetes. Die...
Lagerros, Ylva Trolle; Ro?ssner, Stephan
Remedying childhood obesity cannot take place without first identifying relevant issues commonly influencing gatekeepers of food for children as well as the role modeling for encouraging or discouraging daily activities. Children cannot drive to the store, form grocery lists or complete menu management tasks without adult assistance. Excessive…
Keen, Valencia Browning; Potts, Claudia Sealey
The autonomic responsiveness of lean women to standing, passsive vertical tilting, noradrenaline infusion and the valsalva manoeuvre has been compared with that of obese women and a group of formerly obese women (post-obese). Upon standing, the lean and obese groups had comparable cardiovascular responses with similar rises in plasma noradrenaline. With passive 85 degrees head-up tilting at an ambient temperature of 26 degrees C the obese and post-obese subjects had a greater rise in plasma noradrenaline than the lean group who were less able to withstand the test. Noradrenaline infusions (at 26 degrees C) in the lean and post-obese subjects led to similar increases in plasma noradrenaline, systolic and diastolic pressures and plasma free fatty acids but the post-obese showed a greater bradycardia. The response to the valsalva manoeuvre was normal in lean and obese patients and was unaltered after a reduced energy intake in the obese. On energy restriction for two weeks 10 obese subjects showed a fall in pulse rate, in systolic and diastolic pressures and in plasma noradrenaline while the subjects remained supine. On standing there was less of a rise in plasma noradrenaline than when energy intake was high. The response in noradrenaline was restored to that seen on high energy intakes by giving L-dopa. Seasonal changes in venous noradrenaline concentrations were apparent in obese and post-obese patients but not in lean subjects. These differences may relate to altered responses to environmental temperature or to an altered food intake in the two obese groups. There appears to be no generalised in the autonomic system in obese women either before or after weight loss but the process of slimming does lead to a reduction in plasma noradrenaline levels. PMID:7095970
Jung, R T; Shetty, P S; James, W P; Barrand, M A; Callingham, B A
In the word obesity, a clinical concept of chronic systemic disease pairs up with pejorative individual or social representations. Being obese is also facing situations of disability, organ failure, uncertainty of the fate and stigmatization. A care concept inspired by rehabilitation and therapeutic patient education could offer a new way and other purposes to the treatment of obesity. Restoring functions, learning how to adapt and change their environment, obese people may live better today, out of their isolation and develop partners in their projects of life and health. Rehabilitation of an obese patient is much more than weight loss! PMID:24783735
Sittarame, F; Lagger, G; Chambouleyron, M; Lasserre-Moutet, A; Joly, C; Vergotte, S; Pataky, Z; Golay, A
Obesity is a medical condition in which excess body fat that it may have an adverse effect on health, leading to life expectancy and increased health problems. In keeping with the general international trend of rising prevalence of obesity, maternal obesity prevalence is rising. According to WHO, the prevalence of obesity in pregnancy ranges from 1.8 to 25.3%. Maternal obesity has been identified to be a risk factor for maternal and perinatal mortality. The aim of this article was reviewed in...
Emre Yanikkerem; Selviye Mutlu
The purpose of this phenomenological study was to examine the meaning of being a live liver donor. Six people between ages 27 and 53 years participated. A qualitative, in-depth, semistructured interview format was used to explore donors' thoughts and feelings about being an organ donor. Five themes were identified: (1) no turning back--how do I live without you? (2) roller coaster marathon, (3) donor network, (4) the scar, and (5) reflections--time to think. At the center of the experience was the donor's commitment to the recipient. Once donors began the process, they were determined to see it through. The process was complex, and donors received various levels of support from family, friends, health care professionals, and others. After donation, as donors recovered and were able to resume their usual daily responsibilities, they reflected on the impact of the experience and how it changed their view of life. PMID:18831484
Cabello, Charlotte C; Smolowitz, Janice
Full Text Available ... 27, 2008 Genetically Modified Tomato to Fight Cancer, Pneumonia May Lead to ACS, Physical Activity Improves Mental Function In the Elderly ... of morbid obesity generally includes two broad options. Clearly medical therapy is an option for just about every patient, ...
A consecutive series of 33 grossly obese individuals treated by gastric partitioning is described. There was no operative mortality. Weight loss at one year was 19% of original body weight and little loss occurred thereafter. Radiological assessment of the proximal compartment demonstrated progressive postoperative enlargement.
Radionuclide studies of the upper gastrointestinal tract have been useful in many gastrointestinal disorders. However, the literature relating to radionuclide techniques in morbid obesity is limited and, at times, controversial. It is hoped that this brief review will stimulate interest in the use of tracer techniques in this complex disorder. 23 references.
The youth of today are faced with a big problem; they are becoming more obese every day. The time of children playing outside all day and being extremely active has been overtaken by the television and video games. The days of sitting down as a family and eating a good healthy meal has been replaced by the rush to the nearest fast food…
Costley, Kevin C.; Leggett, Timothy
Open donor nephrectomy for live donor kidney transplantation is a safe procedure that has been used for more than 30 years with excellent results. Laparoscopic donor nephrectomy is a relatively new technique that has the potential of decreased postoperative pain, less incisional morbidity, and shorter recovery time. Furthermore, it has been reported that this potentially less traumatic approach increases the number of potential live donors. This review article focuses on the currently used la...
Skrekas, George; Papalois, Vassilios E.; Mitsis, Michail; Hakim, Nadey S.
In this paper I investigate, from an ethical perspective, the legal prospects of unrelated living donors from Romania. In the present-day shortage of organs necessary for transplantation, the organs from living donors represent an alternative to the organs from deceased ones. Worldwide, unrelated living donors begin to be considered as a promising category among overall living donors. However, their situation raises many ethical questions that need to be addressed by adequate regulations and ...
It has been suggested that an increase in serum alanine transaminase (ALT) activity in blood donors may identify infection with non-A, non-B hepatitis. To facilitate identification of such donors, the reference range for ALT was measured on a Technicon SMAC 1 Analyser, using serum from 364 blood donors and 567 plasmapheresis donors. The distribution of ALT activities displayed a positive skewness, and so both logarithmic transformation and subsequent calculation of mean and standard deviation...
Each year, a relevant proportion of the invited blood donors is eventually deferred from donation because of low hemoglobin (Hb) levels. Deferrals are meant to protect donors from developing iron deficiency anemia after a blood donation, however, they may increase the risk of donor lapse, even though the donor may actually meet the Hb criterion at the time of the next donation invitation. Early estimation of the risk of Hb deferral on the next visit to the blood collection center could be hel...
Baart, A. M.
Full Text Available Abstract Obesity is a growing international health problem that has already reached epidemic proportions, particularly within the United States where a majority of the population is overweight or obese. Effective methods of treatment are needed, and should be taught to physicians by efficient means. There exists a disconnect between the rising obesity prevalence with its high toll on medical resources, and the lack of obesity education provided to practitioners in the course of their training. One particular shortfall is the lack of representation of obesity on standardized medical examinations. Physician attitudes toward obesity are influenced by their lack of familiarity with the management of the disease. This may include dietary restriction, increasing physical activity, behavior modification, pharmacotherapy, and surgical interventions. Thus, curricular changes in the medical education of obesity could help reduce morbidity and mortality associated with this disease.
Obesity is a major risk factor for the development of asthma, and causes severe, uncontrolled disease that responds poorly to therapy. The obese state alters early onset allergic asthma, and leads to the development of a novel form of late onset asthma secondary to obesity. The presentation of early onset allergic asthma is altered through effects on immune function. Factors such as mechanical loading, effects of adipokines on airways, altered diet, insulin resistance and altered metabolism of nitric oxide likely all contribute to increased airway reactivity in obesity, causing late onset asthma in obesity. Obesity also alters responses to environmental factors such as ozone and particulate matter. Focused studies to understand the importance of these factors in the pathogenesis of airway disease in obesity will be essential to develop therapies to intervene in this new epidemic of airway disease. PMID:24115053
Sideleva, O; Dixon, A E
Full Text Available Obesity is performed by genetic, environmental, and complex interaction between genetic and environmental factors. Fatness levels in obese children are indicative of increased risk for elevated blood pressure, cholesterol, and lipoprotein ratios children and adolescents. Serum cholesterol and blood pressure are related to raise atherosclerotic lesion. Certain cardiovascular disease risk factors in obese children are related to the earliest stages of atherosclerosis disease. Obese children have the high risk factors of certain cardiovascular disease. Genetic factors affecting metabolic rate can be successfully managed by the introduction of environmental factors such as decrease caloric intake and increase physical activity. The treatment of obesity and of atherosclerotic patients should include dietary restriction (protein sparing modified fast and hypocaloric balanced diet, nutrition education, increased physical activity, behavior modification, and familial support. Success fully management of obesity can improve the quality of life and reduce the risk of morbidity and mortality associated with obesity.
Mellova Amir Masrizal
Blue collar workers are at risk for obesity. Little is known about obesity in Operating Engineers, a group of blue collar workers, who operate heavy earth-moving equipment in road building and construction. Therefore, 498 Operating Engineers in Michigan were recruited to participate in a cross-sectional survey to determine variables related to obesity in this group. Bivariate and multivariate analyses were conducted to determine personal, psychological, and behavioral factors predicting obesity. Approximately 45% of the Operating Engineers screened positive for obesity, and another 40% were overweight. Multivariate analysis revealed that younger age, male sex, higher numbers of self-reported co-morbidities, not smoking, and low physical activity levels were significantly associated with obesity among Operating Engineers. Operating Engineers are significantly at risk for obesity, and workplace interventions are needed to address this problem. PMID:22005801
Duffy, Sonia A; Cohen, Kathleen A; Choi, Seung Hee; McCullagh, Marjorie C; Noonan, Devon
Full Text Available Obesity markedly increases the odds of developing depression. Depressed mood not only impairs motivation, quality of life and overall functioning but also increases the risks of obesity complications. Abdominal obesity is a better predictor of depression and anxiety risk than overall adipose mass. A growing amount of research suggests that metabolic abnormalities stemming from central obesity that lead to metabolic disease may also responsible for the increased incidence of depression in obesity. As reviewed here, a higher mass of dysfunctional adipose tissue is associated with several metabolic disturbances that are either directly or indirectly implicated in the control of emotions and mood. To better comprehend the development of depression in obesity, this review pulls together select findings addressing the link between adiposity, diet and negative emotional states and discusses the evidence that alterations in glucocorticoids, adipose-derived hormones and inflammatory signalling that are characteristic of central obesity may be involved.
There is increasing evidence that obesity and overweight may be related, in part, to adverse work conditions. In particular, the risk of obesity may increase in high-demand, low-control work environments, and for those who work long hours. In addition, obesity may modify the risk for vibration-induced injury and certain occupational musculoskeletal disorders. We hypothesized that obesity may also be a co–risk factor for the development of occupational asthma and cardiovascular disease that and it may modify the worker’s response to occupational stress, immune response to chemical exposures, and risk of disease from occupational neurotoxins. We developed 5 conceptual models of the interrelationship of work, obesity, and occupational safety and health and highlighted the ethical, legal, and social issues related to fuller consideration of obesity’s role in occupational health and safety.
Schulte, Paul A.; Wagner, Gregory R.; Ostry, Aleck; Blanciforti, Laura A.; Cutlip, Robert G.; Krajnak, Kristine M.; Luster, Michael; Munson, Albert E.; O'Callaghan, James P.; Parks, Christine G.; Simeonova, Petia P.; Miller, Diane B.
Full Text Available Probably, obesity can be considered as the most common metabolic disorder. In other words, the control of metabolism is disrupted in this condition. The most important metabolic control is performed by hormones. Today, adipose tissue is considered as an active tissue in secretion of hormones. In obesity, in addition to adipose tissue hormones, effective neuropeptides on appetite are interfered. There are 4 main approaches in the management and treatment of obesity including nutrition and diet therapy, physical activity, medical and surgical approaches. The specialists and obese patients prefer the first and second approaches. Physical activity helps to control and treat this disorder by influencing on obesity-related hormones. The main obesity-related hormones are ghrelin, agouti, obestatin, leptin, adiponectin, nesfatin, visfatin, tumor necrosis factor, interleukin-6, and resistin. In this review, the effect of physical activity on 10 major obesity-related hormones has been discussed.
Full Text Available Cardiovascular disease is now a major public health problem in India and is emerging as a major killer. The non diabetic obese and non obese subjects with cardio vascular disease? were carried out with the objective of studying or investing the (effect cause of cardiovascular diseases in obese and Non-obese subjects. The level of lipoprotein a of non obese subject showed a significant (P < 0.001 increase than in the obese subject. The level of lipid ratio (total cholesterol / HDL cholesterol found to be significantly (P < 0.001 high in obese subjects than in non-obese subjects. The present study has been designed to evaluate or investigate the risk of cardiovascular disease due to obesity in both male and female middle age group. [Int J Res Med Sci 2013; 1(4.000: 515-522
M. Prasad Naidu
How single, partnered lesbian, and partnered heterosexual women undertaking donor insemination rate the importance of donor characteristics is explored in the context of Trivers's parental investment theory. Consistent with this theory, single women placed higher value on biographical traits reflective of the donor's level of potential resources (occupation, hobbies, age) and good character compared with either partnered lesbian or heterosexual women. PMID:21821248
Rodino, Iolanda S; Burton, Peter J; Sanders, Katherine A
Full Text Available Background: Obesity is associated with reduced quality of life, development of serious chronic conditions such as heart disease and diabetes, increased medical care costs, and premature death. Environmental effects, especially feeding habits may cause hyperinsulinemia and obesity. A Healthy People 2010 objective is to reduce the proportion of adults who are obese to 15%. Materials and Methods: This cross-sectional study was conducted on 1647 persons in a sample representing Gaziantep, Turkey. Over the selected 329 houses, 310 houses were reached (94.2% and data about 1315 related persons was collected. The body mass index (BMI shows the relationship between the weight and the height of people, calculated by the ratio of mass by kg over the square value of height measure. In statistical analyses chi-square, student?s t -test and logistic regression analysis were used. Results: The mean BMI increased with time for both sex, whereas decreased for 60+ age group. The fastest increase for both sex was seen while transition from 18 year to 19-29 age groups occurred. Another increase in women was in 30-39 age group; BMI=25.08±4.39 in 19-29 ages whilst BMI=29.02±5.79 in 30-39 ages. The increases in both sex in other age groups were not as much as in this group. Conclusion: Obesity is not only a problem in the Gaziantep but is also a major health concern in Europe and other regions of the world. As an accepted method against obesity, life-style changes should be put into use from childhood supported in school and family life.
Treatment of obesity and overweight is based primarily on dietary measures and physical exercise.There are still no drugs with a favourable harm-benefit balance in this setting. Lorcaserin, a "selective" 5HT2C serotonin receptor agonist, has been refused marketing authorisation in the European Union despite approval in the United States. Clinical evaluation of lorcaserin is based on three placebo-controlled trials, each lasting one year, in a total of about 6000 patients. Two trials involved obese patients, and one obese patients with type 2 diabetes. The results of these trials are undermined by the large proportion (40% to 50%) of patients who were lost to follow-up before the end of the trial. None of the trials examined the impact of lorcaserin on the clinical complications of obesity. From an average initial weight of about 100 kg, patients taking lorcaserin lost only about 3 kg more than those in the placebo groups.The patients put on weight again after lorcaserin was discontinued. Adverse effects observed in clinical trials were mainly gastrointestinal (dry mouth, nausea) and neuropsychiatric (dizziness, fatigue, headache, euphoria). The incidence of cardiac valve disorders was higher with lorcaserin than with placebo. These trials were too short in duration to exclude a risk of cancer (breast cancer and astrocytoma) that was reported in experimental animals. This serotonin agonist is metabolised by the liver, creating a risk of multiple drug interactions. In practice, lorcaserin has not been shown to prevent complications of obesity or even lead to substantial weight loss.There is therefore no justification for exposing patients to the risk of adverse effects. PMID:24926508
Oxygenation maintenance is the cornerstone of airway management in the obese patient related to anatomic and pathophysiologic issues. Difficult mask ventilation (DMV) risk is increased in obese patients according recognized predictors (Body Mass Index [BMI]>26 kg/m2, age >55 years, jaw protrusion severely limited, lack of teeth, snoring, beard, Mallampati class III or IV) and should systematically search. Difficult tracheal intubation (DTI) risk may be increased and risk should be assessed in a careful manner. Increased neck circumference and high BMI (>35 kg/m2) should be added to "standard" preoperative airway assessment including:Mallampati class, mouth opening and thyromental distance. In obese patients, preoxygenation is mandatory by 25° head-up position achieving better gas exchange than in supine position. In addition, to prevent early arterial oxygen desaturation related to a reduced functional residual capacity (FRC), atelectasis formation during anesthetic induction and after tracheal intubation, non invasive positive pressure ventilation and application of PEEP throughout this period are recommended. Airway management in obese patients has to consider: the anesthesia technique with maintenance or not of spontaneous ventilation, the available oxygenation technique in case of anticipated DMV, and the appropriate tracheal intubation technique (fiberoptic intubation technique or videolaryngoscope) according to the patient status and will. In unexpected difficult airway, the very first priority is oxygenation and a predefined strategy has to be implemented with oxygenation devices first (supraglottic devices or ILMA). Lastly, the final step of the obese airway management is tracheal extubation and recovery. A strategy with a fully awake patient, without residual paralysis, and a 25° head-up position is mandatory. PMID:24122033
Langeron, O; Birenbaum, A; Le Saché, F; Raux, M
Summary: Mazindol, a centrally acting monoamine re-uptake inhibitor, enhances satiety and supports body weight loss, but response to this drug among obese patients is very variable. The possible involvement of the Trp64Arg polymorphism of the ?3-adrenergic receptor (ADRB3) gene in the development of severe obesity and weight loss response to anorexigenic drugs has not been established. In the present study, the allelic frequency of the Trp64Arg ADRB3 gene polymorphism was determined in massively obese Japanese outpatients (BMI > 35 kg/m(2)), and we investigated whether allelic differences may determine the weight loss effect of mazindol. The allelic frequency of Trp64Arg heterozygotes and homozygotes did not differ in severely obese subjects compared to non-obese subjects. Trp64Arg heterozygotes experienced significantly increased weight loss and reduced blood pressure following mazindol administration for 12 weeks. Thus the ADRB3 gene polymorphism is predictive for difficulty in weight reduction with mazindol treatment, but is not related to the development of severe obesity in the Japanese population.: PMID:24351452
Shimizu, Hiroyuki; Tsuchiya, Takafumi; Oh-I, Shinsuke; Ohtani, Ken-Ichi; Okada, Shuichi; Mori, Masatomo
Full Text Available The growing trend of obesity worldwide and in sub-Saharan Africa can be linked to theurbanization drift experienced in recent years both in developed and developing countrieslike Nigeria, at four pivotal points namely: physical activity level, socio-economic status(SES, nutritional and psychosocial factors. Literature search was done usingMedline/PubMed and Google Scholar for published studies on the urbanization rate, andthe prevalence of overweight and obesity in Nigeria. The socio-demographic determinantsof obesity among adults in the Nigerian population were female gender, marriage, lowphysical activity level, positive family history, urban area of residence and age ? 40 years.Obesity was more prevalent among women of low SES living in the urban area than thoseof high SES. Also overweight and obesity was more prevalent among young children (girlsthan boys living in an urban than rural area and attending private than public schools. Inorder to prevent a higher trend of obesity in future, more of awareness/attitudinalreorientation programmes need to be created by health based action groups incollaboration with government agencies on perception, risky lifestyles and culturesassociated with excessive weight gain.
Full Text Available Acute abdominal pain following laparoscopic live donor nephrectomy (LLDN might be a diagnostic dilemma,and prompt diagnosis and management is of paramount importance. Herein, we describe a case of acute appendicitis in a 62-year-old kidney donor who presented with acute abdominal pain 16 days following LLDN with features inconsistent with a diagnosis of acute appendicitis. An ultrasound scan suggested strangulatedSpigelian hernia unrelated to the operative wound. Exploration of the wound and mini-laparotomy showed no evidence of wound dehiscence or a hernia, but revealed an inflamed appendix wrapped up with omentum. Appendectomy led to complete recovery of the patient. It is imperative to maintain a high index of suspicion for acute appendicitis in this situation to avoid septic complications that might adversely affect the residual renal function and cause negative impact on kidney donation. To the best of our knowledge, this is the first reported case of acute appendicitis following LLDN.
Identification of an HLA identical donor/recipient pair using high-resolution techniques at HLA A, B, C and DRB1 optimizes survival after adult unrelated hematopoetic stem cell transplant. It has been estimated that roughly 50% of African-Americans have suitable unrelated donors based on serologic typing, but there is little information on the likelihood of identifying an HLA-identical unrelated donor using molecular techniques. From 2/2002 to 5/2007, we performed 51 unrelated donor searches ...
Dew, Alexander; Collins-jones,