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1

Laparoendoscopic single-site nephrectomy in obese living renal donors.  

UK PubMed Central (United Kingdom)

BACKGROUND AND PURPOSE: Laparoendoscopic single-site (LESS) surgery has been shown to be feasible in living donor nephrectomies (DNs). Obesity is an established risk factor for perioperative morbidity. We sought to determine whether LESS-DN is safe and effective in the obese (body mass index [BMI] ?30 kg/m(2)) population. PATIENTS AND METHODS: Between August 2009 and September 2010, 125 consecutive LESS-DN were performed; 32 patients were obese. This group was matched to 32 nonobese LESS-DN (BMI <30 kg/m(2)) patients, 32 obese conventional laparoscopic DN (obese LAP-DN) patients, and 32 nonobese LAP-DN patients. Comparison parameters included organ recovery time, operative time, estimated blood loss (EBL), warm ischemia time (WIT), incision length, complications, and recipient allograft function. RESULTS: Demographic data were similar between the groups, except BMI (P>0.0001). Organ recovery time, EBL, WIT, complications, and recipient allograft function were similar between the obese LESS-DN group and the other three groups (P>0.05). Total operative time was longer in the obese LESS-DN compared with the nonobese LAP-DN (P<0.0001); however, incision length was shorter in the obese LESS-DN group compared with either LAP group (P<0.0001). Complete LESS-DN was successful in 62 (97%) cases (two obese donor cases were converted to hand-assisted laparoscopy). CONCLUSIONS: Our results indicate that LESS-DN can be performed safely in obese donors without increased donor morbidity and similar recipient allograft outcomes compared with ideal-sized donors as well as with conventional LAP-DN patients.

Afaneh C; Sheth S; Aull MJ; Leeser DB; Kapur S; Del Pizzo JJ

2012-02-01

2

Labeling of Previous Donation to Encourage Subsequent Donation Among Experienced Blood Donors.  

UK PubMed Central (United Kingdom)

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) 2013 APA, all rights reserved).

Sénémeaud C; Georget P; Guéguen N; Callé N; Plainfossé C; Touati C; Mange J

2013-07-01

3

Exploring the pattern of blood donor beliefs in first-time, novice, and experienced donors: differentiating reluctant altruism, pure altruism, impure altruism, and warm glow.  

UK PubMed Central (United Kingdom)

BACKGROUND: Using constructs from the Theory of Planned Behavior and theories of altruism, this article explores how multiple motivations and beliefs for blood donation are clustered and change across the donor career. In so doing important distinctions, for blood donation, between impure altruism, pure altruism, and warm glow are explored. STUDY DESIGN AND METHODS: Measures of intentions, cognitive and affective attitudes, role merger, pure altruism, trust, self-efficacy, subjective and moral norms, and habit formation were assessed in a sample of 12,580 whole blood donors. Analyses showed that a distinction between first-time, novice (one to four donations), and experienced donors (five or more donations) is justified. Principal components analysis and confirmatory factor analytic Multiple-Indicator Multiple-Causal models were used to compare models across these groups. RESULTS: A cognition-behavior (CB) factor, including intentions, was common to all groups. First-time and novice donors were marked by a newly identified motivational factor: "reluctant altruism" (i.e., the motivation to donate because of a lack of trust in others). First-time donors exhibited an impure altruism factor whereas for experienced donors warm glow and pure altruism factors were observed. For first-time donors impure altruism and reluctant altruism were both associated with the CB factor in females and impure altruism only in males. For both sexes reluctant altruism was associated of the CB factor in novice donors and warm glow and pure altruism for experienced donors. CONCLUSIONS: New avenues for intervention are suggested by the emergence of reluctant altruism for novice donors and warm glow for experienced donors. The importance of distinguishing aspects of altruism is highlighted.

Ferguson E; Atsma F; de Kort W; Veldhuizen I

2012-02-01

4

Laparoscopic adjustable gastric band in an obese unrelated living donor prior to kidney transplantation: a case report  

Directory of Open Access Journals (Sweden)

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.

Koshy Anoop N; Wilkinson Stephen; Coombes Jeff S; Fassett Robert G

2010-01-01

5

Transcriptomic and epigenetic changes in early liver steatosis associated to obesity: Effect of dietary methyl donor supplementation.  

UK PubMed Central (United Kingdom)

Non-alcoholic fatty liver disease is a primary hepatic manifestation of obesity and an important adverse metabolic syndrome trait. Animal models of diet-induced obesity promote liver fat accumulation putatively associated with alterations in epigenetic profile. Dietary methyl donor-supplementation may protect against this disturbance during early developmental stages affecting the molecular basis of gene regulation. The aim of this study was to investigate the transcriptomic and epigenetic mechanisms implicated in liver fat accumulation as a result of an obesogenic diet and the putative preventive role of dietary methyl donors. Forty-eight male Wistar rats were assigned into four dietary groups for 8weeks; control, control methyl-donor-supplemented with a dietary cocktail containing betaine, choline, vitamin B12 and folic acid, high-fat-sucrose and high-fat-sucrose methyl-donor-supplemented. Liver fat accumulation induced by a HFS diet was prevented by methyl donor supplementation in HFS-fed animals. A liver mRNA microarray, subsequently validated by real time-qPCR, showed modifications in some biologically relevant genes involved in obesity development and lipid metabolism (Lepr, Srebf2, Agpat3 and Esr1). Liver global DNA methylation was decreased by methyl donor supplementation in control-fed animals. Methylation levels of specific CpG sites from Srebf2, Agpat3 and Esr1 promoter regions showed changes due to the obesogenic diet and the supplementation with methyl donors. Interestingly, Srebf2 CpG23_24 methylation levels (-167bp and -156bp with respect to the transcriptional start site) correlated with HDLc plasma levels, whereas Esr1 CpG14 (-2623bp) methylation levels were associated with body and liver weights and fat content. Furthermore HFS diet-induced liver fat accumulation was prevented by methyl donor supplementation. In conclusion, both obesogenic diet and methyl donor supplementation modified the mRNA hepatic profile as well as the methylation of specific gene promoters and total DNA.

Cordero P; Campion J; Milagro FI; Martinez JA

2013-09-01

6

Obese Women Just as Likely to Have Success Using IVF with Donor Eggs  

Science.gov (United States)

... sharing features on this page, please enable JavaScript. Obese Women Just As Likely to Have Success Using ... August 5, 2013 Related MedlinePlus Pages Female Infertility Obesity MONDAY, Aug. 5 (HealthDay News) -- Obese women are ...

7

Four out of eight genes in a mouse chromosome 7 congenic donor region are candidate obesity genes.  

UK PubMed Central (United Kingdom)

We previously identified a region of mouse chromosome 7 that influences body fat mass in F2 littermates of congenic × background intercrosses. Current analyses revealed that alleles in the donor region of the subcongenic B6.C-D7Mit318 (318) promoted a twofold increase in adiposity in homozygous lines of 318 compared with background C57BL/6ByJ (B6By) mice. Parent-of-origin effects were discounted through cross-fostering studies and an F1 reciprocal cross. Mapping of the donor region revealed that it has a maximal size of 2.8 Mb (minimum 1.8 Mb) and contains a maximum of eight protein coding genes. Quantitative PCR in whole brain, liver, and gonadal white adipose tissue (GWAT) revealed differential expression between genotypes for three genes in females and two genes in males. Alpha-2,8-sialyltransferase 8B (St8sia2) showed reduced 318 mRNA levels in brain for females and males and in GWAT for females only. Both sexes of 318 mice had reduced Repulsive guidance molecule-a (Rgma) expression in GWAT. In brain, Family with sequence similarity 174 member b (Fam174b) had increased expression in 318 females, whereas Chromodomain helicase DNA binding protein 2 (Chd2-2) had reduced expression in 318 males. No donor region genes were differentially expressed in liver. Sequence analysis of coding exons for all genes in the 318 donor region revealed only one single nucleotide polymorphism that produced a nonsynonymous missense mutation, Gln7Pro, in Fam174b. Our findings highlight the difficulty of using expression and sequence to identify quantitative trait genes underlying obesity even in small genomic regions.

Sarahan KA; Fisler JS; Warden CH

2011-09-01

8

Four out of eight genes in a mouse chromosome 7 congenic donor region are candidate obesity genes.  

Science.gov (United States)

We previously identified a region of mouse chromosome 7 that influences body fat mass in F2 littermates of congenic × background intercrosses. Current analyses revealed that alleles in the donor region of the subcongenic B6.C-D7Mit318 (318) promoted a twofold increase in adiposity in homozygous lines of 318 compared with background C57BL/6ByJ (B6By) mice. Parent-of-origin effects were discounted through cross-fostering studies and an F1 reciprocal cross. Mapping of the donor region revealed that it has a maximal size of 2.8 Mb (minimum 1.8 Mb) and contains a maximum of eight protein coding genes. Quantitative PCR in whole brain, liver, and gonadal white adipose tissue (GWAT) revealed differential expression between genotypes for three genes in females and two genes in males. Alpha-2,8-sialyltransferase 8B (St8sia2) showed reduced 318 mRNA levels in brain for females and males and in GWAT for females only. Both sexes of 318 mice had reduced Repulsive guidance molecule-a (Rgma) expression in GWAT. In brain, Family with sequence similarity 174 member b (Fam174b) had increased expression in 318 females, whereas Chromodomain helicase DNA binding protein 2 (Chd2-2) had reduced expression in 318 males. No donor region genes were differentially expressed in liver. Sequence analysis of coding exons for all genes in the 318 donor region revealed only one single nucleotide polymorphism that produced a nonsynonymous missense mutation, Gln7Pro, in Fam174b. Our findings highlight the difficulty of using expression and sequence to identify quantitative trait genes underlying obesity even in small genomic regions. PMID:21730028

Sarahan, Kari A; Fisler, Janis S; Warden, Craig H

2011-07-05

9

Extracellular fluid volume and glomerular filtration rate in 1878 healthy potential renal transplant donors: effects of age, gender, obesity and scaling.  

UK PubMed Central (United Kingdom)

UNLABELLED: Aim. The aim of this study was to investigate the influence of age, gender, obesity and scaling on glomerular filtration rate (GFR) and extracellular fluid volume (ECV) in healthy subjects. METHODS: This is a retrospective multi-centre study of 1878 healthy prospective kidney transplant donors (819 men) from 15 centres. Age and body mass index (BMI) were not significantly different between men and women. Slope-intercept GFR was measured (using Cr-51-EDTA in 14 centres; Tc-99m-DTPA in one) and scaled to body surface area (BSA) and lean body mass (LBM), both estimated from height and weight. GFR was also expressed as the slope rate constant, with one-compartment correction (GFR/ECV). ECV was measured as the ratio, GFR to GFR/ECV. RESULTS: ECV was age independent but GFR declined with age, at a significantly faster rate in women than men. GFR/BSA was higher in men but GFR/ECV and GFR/LBM were higher in women. Young women (<30 years) had higher GFR than young men but the reverse was recorded in the elderly (>65 years). There was no difference in GFR between obese (BMI>30 kg/m2) and non-obese men. Obese women, however, had lower GFR than non-obese women and negative correlations were observed between GFR and both BMI and %fat. The decline in GFR with age was no faster in obese versus non-obese subjects. ECV/BSA was higher in men but ECV/LBM was higher in women. ECV/weight was almost gender independent, suggesting that fat-free mass in women contains more extracellular water. BSA is therefore a misleading scaling variable. CONCLUSION: There are several significant differences in GFR and ECV between healthy men and women.

Peters AM; Perry L; Hooker CA; Howard B; Neilly MD; Seshadri N; Sobnack R; Irwin A; Snelling H; Gruning T; Patel NH; Lawson RS; Shabo G; Williams N; Dave S; Barnfield MC

2012-04-01

10

Obesity.  

UK PubMed Central (United Kingdom)

Obesity has become common in critically ill patients as it is in the population at large. Despite large fuel stores, obese patients can become rapidly malnourished and are subject to the same inflammatory and catabolic responses as their nonobese counterparts. The concepts of early enteral nutrition are therefore equally applicable to the obese patient as to the nonobese patient. Monitoring of nutrition support likewise is the same. The main differences in obese versus nonobese patients is that nutrition assessment is somewhat more uncertain, and that hypocaloric high-protein feeding is more often recommended in the obese. The rationale for hypocaloric feeding in obese patients is multipart: (1) energy balance is not necessary to achieve nitrogen balance, (2) energy expenditure is difficult to predict in obese patients and is likely to lead to overfeeding, (3) overfeeding is especially detrimental to the obese patient, and (4) positive outcomes have been observed with hypocaloric high-protein feeding. That nitrogen balance can be achieved without energy balance has been demonstrated in several studies. However, the likelihood of overestimating resting metabolic rate in the obese may be overstated, and the evidence that hypocaloric feeding improves outcome is limited. It is therefore still an open question as to whether hypocaloric high-protein feeding should be standard practice in obese critically ill patients.

Frankenfield DC

2013-01-01

11

OBESITY  

Directory of Open Access Journals (Sweden)

Full Text Available Objectives: To assess frequency of obesity among college adolescent male and female students on BMI-Prime bases through anthropometric. Design: Cross sectional study. Setting: At higher secondary colleges located in urban areas of Bahawalpur City. Period: From February 2009 to March 2009 Materials & Methods: Assessment of obesity among 400 college male & female students equally divided, ages from 16 to 23 years was carried out on BMI-Prime bases. Weight categories so achieved were stratified and labeled. Results: There were 3(0.75%) severely under weight, 44(11%) under weight, 273(68.25%) normal, 68(17%) over weight, 9(2.25%) obese and 3(0.75%) were clinically obese. There was no morbidly obese. No statistical gender difference for severely under weight and clinically obese was noted. However females were more under weight (p<0.05) while males were more over weight (P<0.05) and obese (P<0.05) when compared with each other. Conclusion: The adolescent female college students were under weight when compared to their male colleagues. The frequency of obesity was higher among male students

ABDUL SALAM MALIK

2009-01-01

12

Living Donor Kidney Transplant Surgery  

Medline Plus

Full Text Available ... diabetes or cancer or mental illness or severe obesity are some of these conditions. And once we’ ... person. We generally try and avoid the very obese donor, particularly because they’re at long-term ...

13

Four out of eight genes in a mouse chromosome 7 congenic donor region are candidate obesity genes  

Digital Repository Infrastructure Vision for European Research (DRIVER)

We previously identified a region of mouse chromosome 7 that influences body fat mass in F2 littermates of congenic × background intercrosses. Current analyses revealed that alleles in the donor region of the subcongenic B6.C-D7Mit318 (318) promoted a twofold increase in adiposity in homozygous line...

Sarahan, Kari A.; Fisler, Janis S.; Warden, Craig H.

14

Torso Experienced Aerodynamic Forces Experienced during Ejection.  

Science.gov (United States)

The aerodynamic forces which are experienced by an ejecting aircrewmember are momentarily unique in direction and can be of severe magnitude. One difficulty of analyzing extremity injury during emergency escape is the diversity and intensity of the aerody...

A. J. Nestle

1981-01-01

15

The self-antigen, thyroglobulin, induces antigen-experienced CD4+ T cells from healthy donors to proliferate and promote production of the regulatory cytokine, interleukin-10, by monocytes  

DEFF Research Database (Denmark)

Thyroglobulin (TG), as autoantigen, induces in vitro proliferation of T and B cells from normal individuals, but the cytokine production differs from that in patients with autoimmune thyroid disease. Here, we investigate whether normal T cells responding to TG are naive, or have previously encountered TG in vivo, using their responses to classic primary and secondary antigens, keyhole limpet haemocyanin (KLH) and tetanus toxoid (TT), respectively, for comparison. While TG elicited T-cell proliferation kinetics typical of a secondary response, the cytokine profile was distinct from that for TT. Whereas TT induced pro-inflammatory cytokines [interleukin-2 (IL-2)/interferon-gamma (IFN-gamma)/IL-4/IL-5], TG evoked persistent release of the regulatory IL-10. Some donors, however, also responded with late IFN-gamma production, suggesting that the regulation by IL-10 could be overridden. Although monocytes were prime producers of IL-10 in the early TG response, a few IL-10-secreting CD4(+) T cells, primarily with CD45RO(+) memory phenotype, were also detected. Furthermore, T-cell depletion from the mononuclear cell preparation abrogated monocyte IL-10 production. Our findings indicate active peripheral tolerance towards TG in the normal population, with aberrant balance between pro- and anti-inflammatory cytokine responses for some donors. This observation has implications for autoantigen recognition in general, and provides a basis for investigating the dichotomy between physiological and pathological modes of auto-recognition.

Nielsen, Claus Kim Hostein; Galdiers, Marcel P

2010-01-01

16

Experiencing Wüstenberg's Habilitationsgeschrift (2003)  

Directory of Open Access Journals (Sweden)

Full Text Available How to cite this book review: Veldsman, D.P., 2011, ‘Experiencing Wüstenberg’s Habilitationsgeschrift (2003)’, HTS Teologiese Studies/Theological Studies 67(3), Art. #1128, 1 page. doi:10.4102/hts.v67i3.1128

Danie P. Veldsman

2011-01-01

17

Experiencing architecture, Ljubljana Island  

Directory of Open Access Journals (Sweden)

Full Text Available This workshop took place at the Florjan?i? studio in order to support 4th year students in designing their urban development projects in the city of Ljubljana. To serve this purpose, the workshop provided students with an opportunity to raise their awareness of a particular aspect of architecture and the city: the way it is experienced. The task was to design the undeveloped banks of the Ljubljanica River and Gruber Canal - but with an alternative perception in mind: not just as a sequence of river banks, but as parts that form a continuous promenade encircling the city which provides a whole range of spatial experiences.

Or Ettlinger; Lovrenc Košenina

2012-01-01

18

Donor Tag Game  

Science.gov (United States)

... Games > Donor Tag Game Printable Version Donor Tag Game This feature requires version 6 or later of ... Needles Blood Donor Community Donor Stories Recipient Stories Games Facebook Fanbox Avatars and Badges Banners eCards Twitter ...

19

Living kidney donors: current state of affairs.  

UK PubMed Central (United Kingdom)

Living kidney donation continues as the cornerstone of transplantation. In order to determine with ever-renewing assurance that living donation is safe for the donor, we need to periodically review the literature, review the United Network for Organ Sharing database for donor characteristics that may put them in danger, and scour databases for donors starting dialysis and/or listed for transplant. Additionally, we must encourage financing studies that follow large diverse cohorts of donors over their entire lifetimes in order to detect key characteristics that influence outcomes. Currently, it can be stated that living donation is, on the whole, safe, with few perioperative deaths, complications, or long-term medical issues. Additionally, the living donor reflects the demographics of the general population including increased rates of obesity with some donors having hypertension and low-grade proteinuria. In the long run, death rates (for the white donor) are no different than for the general population, whereas end-stage renal disease rates are slightly increased over the general population, ranging from 0.1% to 1.1%. The higher risk is especially notable in the black donor. Preeclampsia in female donors may also be marginally greater than in those with 2 kidneys. Thus, the new health age brings a rejuvenated responsibility of the medical community and those in governance to design systems that allow more complete and continued follow-up of the living kidney donor, especially those of color.

Davis CL

2009-07-01

20

PCBs and Obesity  

DEFF Research Database (Denmark)

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 ? 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.

Bräuner, Elvira; Raaschou-Nielsen, Ole

2013-01-01

 
 
 
 
21

Current mapping of obesity.  

UK PubMed Central (United Kingdom)

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.

Pérez Rodrigo C

2013-09-01

22

Obesity hypertension.  

Science.gov (United States)

The association between obesity and hypertension is well recognized. However, the exact mechanisms whereby obesity causes hypertension are complex and multifactorial. The current article summarizes some of the known mechanisms responsible for obesity hypertension. PMID:11866230

Rocchini, Albert P

2002-02-01

23

Perceived weight discrimination and obesity.  

UK PubMed Central (United Kingdom)

Weight discrimination is prevalent in American society. Although associated consistently with psychological and economic outcomes, less is known about whether weight discrimination is associated with longitudinal changes in obesity. The objectives of this research are (1) to test whether weight discrimination is associated with risk of becoming obese (Body Mass Index?30; BMI) by follow-up among those not obese at baseline, and (2) to test whether weight discrimination is associated with risk of remaining obese at follow-up among those already obese at baseline. Participants were drawn from the Health and Retirement Study, a nationally representative longitudinal survey of community-dwelling US residents. A total of 6,157 participants (58.6% female) completed the discrimination measure and had weight and height available from the 2006 and 2010 assessments. Participants who experienced weight discrimination were approximately 2.5 times more likely to become obese by follow-up (OR?=?2.54, 95% CI?=?1.58-4.08) and participants who were obese at baseline were three times more likely to remain obese at follow up (OR?=?3.20, 95% CI?=?2.06-4.97) than those who had not experienced such discrimination. These effects held when controlling for demographic factors (age, sex, ethnicity, education) and when baseline BMI was included as a covariate. These effects were also specific to weight discrimination; other forms of discrimination (e.g., sex, race) were unrelated to risk of obesity at follow-up. The present research demonstrates that, in addition to poorer mental health outcomes, weight discrimination has implications for obesity. Rather than motivating individuals to lose weight, weight discrimination increases risk for obesity.

Sutin AR; Terracciano A

2013-01-01

24

Obesity and its impact on transplantation and alloimmunity.  

UK PubMed Central (United Kingdom)

Obesity has become an increasing problem in healthcare worldwide with far-reaching consequences. More obese patients with irreversible end-stage organ failure undergo organ transplantation, and organs from obese donors are more frequently used. A growing body of evidence suggests more frequent postoperative complications and inferior patient and graft survival linked to obesity. More recently, adipose tissue has been linked to chronic inflammatory processes potentially impacting alloimmune responses and graft quality.

Heinbokel T; Floerchinger B; Schmiderer A; Edtinger K; Liu G; Elkhal A; Tullius SG

2013-07-01

25

Single port donor nephrectomy.  

UK PubMed Central (United Kingdom)

In 2007, Rane presented the first single port nephrectomy for a small non-functioning kidney at the World Congress of Endourology. Since that time, the use of single port surgery for nephrectomy has expanded to include donor nephrectomy. Over the next two years the technique was adopted for many others types of nephrectomies to include donor nephrectomy. We present our technique for single port donor nephrectomy using the Gelpoint device. We have successfully performed this surgery in over 100 patients and add this experience to our experience of over 1000 laparoscopic nephrectomies. With the proper equipment and technique, single port donor nephrectomy can be performed safely and effectively in the majority of live donors. We have found that our operative times and most importantly our transplant outcomes have not changed significantly with the adoption of the single port donor nephrectomy. We believe that single port donor nephrectomy represents a step forward in the care of living donors.

Leeser DB; Wysock J; Gimenez SE; Kapur S; Del Pizzo J

2011-01-01

26

Experiencing Security in Interaction Design  

DEFF Research Database (Denmark)

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; BØdker, Susanne

2011-01-01

27

Donor corneal tissue evaluation  

Directory of Open Access Journals (Sweden)

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.

Saini Jagjit; Reddy Madhukar; Sharma Savitri; Wagh Sangeeta

1996-01-01

28

Obesity Epidemic  

Science.gov (United States)

A one page activity that takes students to several websites related to the obesity epidemic. First they can calculate BMI, then learn about national trends in the rate of obesity and finally use a tutorial on insulin and diabetes.

Cooper, Scott

29

Deconstructing Obesity  

Science.gov (United States)

This lecture covers the basics of understanding obesity from the definition of the condition and quantifying it through BMI, as well as information about the chemical that is responsible for obesity, Leptin.

Jeffrey M. Friedman, M.D., Ph.D. (Howard Hughes Medical Institute;)

2008-04-16

30

Childhood Obesity  

Science.gov (United States)

This book aims to provide readers with a general as well as an advanced overview of the key trends in childhood obesity. Obesity is an illness that occurs due to a combination of genetic, environmental, psychosocial, metabolic and hormonal factors. The prevalence of obesity has shown a great rise both in adults and children in the last 30 years.…

Yuca, Sevil Ari, Ed.

2012-01-01

31

Experiencing sexuality after intestinal stoma  

Directory of Open Access Journals (Sweden)

Full Text Available 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 2005. 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.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.

Maria Angela Boccara de Paula; Renata Ferreira Takahashi; Pedro Roberto de Paula

2012-01-01

32

Experiencing sexuality after intestinal stoma  

Scientific Electronic Library Online (English)

Full Text Available 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 un (more) idade 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 2005. Data obtained from transcribed interviews were submitted to content analysis, resulting in the thematic unit "Giving new meaning to sexuality" and subthemes. RESULTS: The st (more) udy 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

2012-06-01

33

Childhood obesity.  

UK PubMed Central (United Kingdom)

Childhood obesity is an issue of serious medical and social concern. In developing countries including India, it is a phenomenon seen in higher socioeconomic strata due to the adoption of a western lifestyle. Consumption of high calorie food, lack of physical activity and increased screen time are major risk factors for childhood obesity apart from other genetic, prenatal factors and socio-cultural practices. Obese children and adolescents are at increased risk of medical and psychological complications. Insulin resistance is commonly present especially in those with central obesity and manifests as dyslipidemia, type 2 diabetes mellitus, impaired glucose tolerance, hypertension, polycystic ovarian syndrome and metabolic syndrome. Obese children and adolescents often present to general physicians for management. The latter play a key role in prevention and treatment of obesity as it involves lifestyle modification of the entire family. This article aims at discussing the approach to diagnosis and work-up, treatment and preventive strategies for childhood obesity from a general physician's perspective.

Seth A; Sharma R

2013-04-01

34

Working with previously anonymous gamete donors and donor-conceived adults: recent practice experiences of running the DNA-based voluntary information exchange and contact register, UK DonorLink.  

UK PubMed Central (United Kingdom)

This article describes recent practice experiences with donor conceived adults, donors, non-donor-conceived adult children of donors using the voluntary DNA-based register, UK DonorLink. It highlights additional complexities faced when using DNA rather than paper records for searching, in particular from the risk of false positives, low chances of success and potential inclusion of biological parents' DNA. Professionals' experiences in supporting those being "linked" suggest challenges as well as rewards. Registration carries the potential to be therapeutic for donor-conceived adults and donors and to enhance their political awareness regardless of links being made. Registrants value both peer and professional support, providing the latter can respond flexibly and be delivered by staff experienced in intermediary work. Given that the majority of those affected by donor conception internationally come from anonymous donation systems, these findings are highly pertinent and argue the need for political and moral debate about such service provision.

Crawshaw M; Gunter C; Tidy C; Atherton F

2013-03-01

35

Free tissue transfer in the obese patient: an outcome and cost analysis in 1258 consecutive abdominally based reconstructions.  

UK PubMed Central (United Kingdom)

BACKGROUND: The authors' institution has seen an increase in obese and morbidly obese patients seeking autologous breast reconstruction. The authors provide a comprehensive outcome analysis of patients undergoing abdominally based autologous breast reconstruction. METHODS: The authors identified obese patients receiving free tissue transfer for breast reconstruction. World Health Organization body mass index criteria were used: nonobese (body mass index, 20 to 29.9 kg/m), class I (30 to 34.9 kg/m), class II (35 to 39.9 kg/m), and class III (>40 kg/m). Patient comorbidities, body mass index, complications (medical and surgical), and hospital resource use were examined. RESULTS: Eight-hundred twelve patients undergoing 1258 free tissue transfers for breast reconstruction were included. Overall, 66.5 percent (n = 540) were considered nonobese, 22.9 percent (n = 186) had class I obesity, 5.0 percent (n = 41) had class II, and 5.7 percent (n = 45) had class III. Obesity was associated with a significant increase in minor (p = 0.001) and major (p = 0.013) complications. Morbidly obese patients had significantly higher rates of total flap loss (p = 0.006) and longer operative times (p = 0.0002). Complications translated into greater cost and resource consumption (p < 0.001). Muscle-sparing transverse rectus abdominis myocutaneous flap experienced a significantly higher rate of hernia compared with other flaps (p = 0.02), without a difference in flap loss rate (p = 0.61). CONCLUSIONS: Increasing obesity is associated with increased perioperative risk in free abdominally based autologous breast reconstruction, which translated into greater perioperative morbidity, higher hospital cost, and increased health care resource consumption. Higher body mass index is directly related to intraoperative technical difficulty, flap loss, donor-site morbidity, and cost use. CLINICAL QUESTION/LEVEL OF EVIDENCE: Risk, II.

Fischer JP; Nelson JA; Sieber B; Cleveland E; Kovach SJ; Wu LC; Serletti JM; Kanchwala S

2013-05-01

36

Childhood obesity.  

UK PubMed Central (United Kingdom)

PURPOSE OF REVIEW: As childhood obesity is associated with premature death in adults, a research is critical. This review focuses on the recent proceedings concerning genesis, prevention, and treatment. RECENT FINDINGS: Identifying genetic variants in well phenotyped small cohorts of extremely obese children (e.g., the search for copy number variants in obesity-associated large chromosomal deletions) confirmed afterwards in large population-based studies is a new promising genetic approach to understand the disposition to obesity. A further important finding is that obesity of mothers predisposes their offsprings to obesity by epigenetic, prenatal effects. Therefore, prevention programs targeting parents even before pregnancy should be developed. Prevention programs in kindergarten and schools without involving the parents failed to fight against the obesity epidemic. A new promising prevention approach is to change the environment (e.g., ban on sugar drinks in schools). Therapy of choice in already obese children is lifestyle intervention. Again, including their parents is crucial for success. However, this kind of intervention is only suitable for families motivated to change their lifestyle habits. Especially in extremely obese adolescents, additional therapeutic approaches such as drugs and bariatric surgery have to be considered. SUMMARY: Even if of knowledge of childhood obesity improves every year, many questions concerning prevention and treatment remain still open. Future longitudinal research has to focus on which children will benefit from which kind of intervention to develop specific therapies.

Reinehr T; Wabitsch M

2011-02-01

37

Donor selection and management.  

UK PubMed Central (United Kingdom)

This article reviews recent developments in the selection, assessment, and management of the potential lung donor, which aim to increase donor organ use. The scarcity of suitable donor organs continues to limit lung transplantation, but the situation is changing. An expanded donor pool, including the now widespread use of donation after cardiac death (DCD) lungs; the use of extended donor lungs; and the ability of ex vivo lung perfusion (EVLP) to evaluate and improve donor lungs are key initiatives. These strategies have substantially lifted donor lung utilization rates from historically low levels of less than 15% to rates greater than 50%. Indeed, since 2004 there has been an accelerated year-on-year increase in the number of lungs transplanted globally. Intermediate-term studies are now confirming that long-term outcomes are not being significantly compromised and that more individuals with terminal, symptomatic lung disease are being transplanted. It is now quite clear that many of the historical factors used to define a lung as "extended" do not actually produce significantly inferior outcomes. There has been a dramatic increase in research and clinical interest in donor lung assessment, management, and novel therapeutic strategies. The lessons learned are now being applied widely beyond the lung as researchers aim to increase availability and optimize other solid organs for transplantation.

Snell GI; Paraskeva M; Westall GP

2013-06-01

38

Childhood obesity.  

UK PubMed Central (United Kingdom)

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 overweight. Childhood overweight increases the risk for certain medical and psychological conditions. Encourage overweight children to expand high energy activity, minimize low energy activity (screen watching), and develop healthful eating habits. Breast feeding is protective against obesity. Diet restriction is not recommended in very young children. Children are to be watched for gain in height rather than reduction in weight. Weight reduction of less than 10% is a normal variation, not significant in obesity.

Ahmad QI; Ahmad CB; Ahmad SM

2010-01-01

39

Living donor kidney exchange.  

UK PubMed Central (United Kingdom)

Living donor kidney exchange, also referred to as kidney paired donation (KPD), is a relatively new transplant modality that is growing by leaps and bounds in the U.S. From its first realization as an exchange of kidneys between two incompatible donor/recipient pairs, KPD has expanded to include compatible pairs, nondirected donors, three-way and larger exchanges, and living/deceased donor exchanges. Innovations both clinical (transporting organs instead of donors, and improved HLA screening) and mathematical (simulation to test policies, optimization to find better and more matches) have made this modality even more useful and accessible. There are several independent multi-center paired donation registries and many more single-center registries operating in the U.S., but incompatible pairs are most likely to match when they participate in the largest possible paired exchange pool; a single, unified KPD program in the United States would likely best serve patients in search of matches.

Gentry S; Segev DL

2011-01-01

40

Scientists Identify Four Candidate Obesity Genes in Mice  

Science.gov (United States)

Press release on a recent study where researchers developed a strain of mice more likely to be obese and then, using this strain, identified four genes in mouse chromosome 7 that may relate to obesity. This study, ÃÂFour Out of Eight Genes in a Mouse Chromosome 7 Congenic Donor Region are Candidate Obesity Genes,ÃÂ was conducted by Craig H. Warden, Kari A. Sarahan, and Janis S. Fisler of the University of California, Davis. The study is published in Physiologic Genomics.

APS Communications Office (American Physiological Society Communications Office)

2011-09-06

 
 
 
 
41

Donor cycle and donor segmentation: new tools for improving blood donor management.  

UK PubMed Central (United Kingdom)

BACKGROUND AND OBJECTIVES: An adequate donor population is of key importance for the entire blood transfusion chain. For good donor management, a detailed overview of the donor database is therefore imperative. This study offers a new description of the donor cycle related to the donor management process. It also presents the outcomes of a European Project, Donor Management IN Europe (DOMAINE), regarding the segmentation of the donor population into donor types. MATERIALS AND METHODS: Blood establishments (BEs) from 18 European countries, the Thalassaemia International Federation and a representative from the South-Eastern Europe Health Network joined forces in DOMAINE. A questionnaire assessed blood donor management practices and the composition of the donor population using the newly proposed DOMAINE donor segmentation. 48 BEs in 34 European countries were invited to participate. RESULTS: The response rate was high (88%). However, only 14 BEs could deliver data on the composition of their donor population. The data showed large variations and major imbalances in the donor population. In 79% of the countries, inactive donors formed the dominant donor type. Only in 21%, regular donors were the largest subgroup, and in 29%, the proportion of first-time donors was higher than the proportion of regular donors. CONCLUSION: Good donor management depends on a thorough insight into the flow of donors through their donor career. Segmentation of the donor database is an essential tool to understand the influx and efflux of donors. The DOMAINE donor segmentation helps BEs in understanding their donor database and to adapt their donor recruitment and retention practices accordingly. Ways to use this new tool are proposed.

Veldhuizen I; Folléa G; de Kort W

2013-07-01

42

Back to Bentham? Explorations of Experienced Utility  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Two core meanings of “utility” are distinguished. “Decision utility” is the weight of an outcome in a decision. “Experienced utility” is hedonic quality, as in Bentham’s usage. Experienced utility can be reported in real time (instant utility), or in retrospective evaluations of past episodes (remem...

Kahneman, D.; Wakker, P.P.; Sarin, R.K.

43

Donor Selection & Transplant Process  

Science.gov (United States)

... Patient Stories Patient E-News The Donor Selection & Transplant Process If your doctor recommends a bone marrow ... Guidelines to Safeguard Patients The steps of a transplant The transplant process begins with your pre-transplant ...

44

Childhood obesity.  

Science.gov (United States)

Childhood obesity is an issue of serious medical and social concern. In developing countries including India, it is a phenomenon seen in higher socioeconomic strata due to the adoption of a western lifestyle. Consumption of high calorie food, lack of physical activity and increased screen time are major risk factors for childhood obesity apart from other genetic, prenatal factors and socio-cultural practices. Obese children and adolescents are at increased risk of medical and psychological complications. Insulin resistance is commonly present especially in those with central obesity and manifests as dyslipidemia, type 2 diabetes mellitus, impaired glucose tolerance, hypertension, polycystic ovarian syndrome and metabolic syndrome. Obese children and adolescents often present to general physicians for management. The latter play a key role in prevention and treatment of obesity as it involves lifestyle modification of the entire family. This article aims at discussing the approach to diagnosis and work-up, treatment and preventive strategies for childhood obesity from a general physician's perspective. PMID:23255079

Seth, Anju; Sharma, Rajni

2012-12-21

45

Family/friend donors are not true voluntary donors.  

UK PubMed Central (United Kingdom)

BACKGROUND: Family/replacement donors still provide more than 45% of the blood collected in India. National AIDS Control Organization passed the guideline that family/friend donors should be considered as voluntary donors by the blood banks in India. MATERIALS AND METHODS: We did a prospective analysis of Transfusion Transmitted Infections (TTI's) on our family donors for the years 2009 and 2010 to compare the results and evaluate if family donors are as safe as voluntary donors. RESULT: The prevalence of Human Immunodeficiency Virus, Hepatitis B surface antigen, Hepatitis C Virus, and Anti-Treponema Palladium antibody was much higher in family donors in comparison to voluntary donors. CONCLUSION: Family donors cannot be included amongst voluntary-non-remunerated blood donors as they have a higher rate of TTIs.

Jain R; Gupta G

2012-01-01

46

Obesity and Anesthesia  

Science.gov (United States)

... Expect Patient Stories FAQs Anesthesia Topics Obesity and Anesthesia Share PRINT Print Home > Anesthesia Topics > Detail Page Obesity and Anesthesia Surgery for obese patients presents special challenges for ...

47

Combatting Childhood Obesity  

Science.gov (United States)

... Añadir en... Favorites Delicious Digg Google Bookmarks Combatting Childhood Obesity Recent scientific studies are beginning to show progress ... increase in childhood obesity in the United States. Childhood Obesity Touches Approximately 1 of 6 Young People Obesity ...

48

Biological influences on obesity.  

UK PubMed Central (United Kingdom)

Severely obese children are even more likely to have mutations in obesity genes than are severely obese adults. Thus, investigators searching for obesity genes commonly focus on children, with the result that many human obesity genes were first identified in studies of children. Although the development of obesity depends on living in an obesity-promoting environment, it also is influenced strongly by individual genetic composition. Thus, the discovery of new obesity genes provides new opportunities to identify causes of severe obesity. Finally, identification of individual causes of obesity may, in the future, provide for a safe, effective, and individualized treatment recommendation for each obese person.

Warden NA; Warden CH

2001-08-01

49

Biological influences on obesity.  

Science.gov (United States)

Severely obese children are even more likely to have mutations in obesity genes than are severely obese adults. Thus, investigators searching for obesity genes commonly focus on children, with the result that many human obesity genes were first identified in studies of children. Although the development of obesity depends on living in an obesity-promoting environment, it also is influenced strongly by individual genetic composition. Thus, the discovery of new obesity genes provides new opportunities to identify causes of severe obesity. Finally, identification of individual causes of obesity may, in the future, provide for a safe, effective, and individualized treatment recommendation for each obese person. PMID:11494641

Warden, N A; Warden, C H

2001-08-01

50

Beliefs underlying the intention to donate again among first-time blood donors who experience a mild adverse event.  

UK PubMed Central (United Kingdom)

Using the belief basis of the theory of planned behavior (TPB), the current study explored the rate of mild reactions reported by donors in relation to their first donation and the intention and beliefs of those donors with regard to returning to donate again. A high proportion of first-time donors indicated that they had experienced a reaction to blood donation. Further, donors who reacted were less likely to intend to return to donate. Regression analyses suggested that targeting different beliefs for those donors who had and had not reacted would yield most benefit in bolstering donors' intentions to remain donating. The findings provide insight into those messages that could be communicated via the mass media or in targeted communications to retain first-time donors who have experienced a mild vasovagal reaction.

Masser BM; White KM; Terry DJ

2013-06-01

51

BLOOD DONORS CAMPAIGN  

CERN Document Server

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.

2001-01-01

52

BLOOD DONORS CAMPAIGN  

CERN Multimedia

Tuesday 19 March 2002 in restaurant nr 2, from 9.00 to 16.30 hrs A blood donors campaign, organized by the Centre de Transfusion sanguine of Geneva If you already have a card giving your blood group, please bring this with you.

2002-01-01

53

BLOOD DONORS CAMPAIGN  

CERN Document Server

A blood donors campaign, organized by the Centre de Transfusion d'Annemasse will be held at CERN on Tuesday 14 November 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.

2001-01-01

54

BLOOD DONORS CAMPAIGN  

CERN Multimedia

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.

2000-01-01

55

Childhood obesity.  

UK PubMed Central (United Kingdom)

Worldwide prevalence of childhood obesity has increased greatly during the past three decades. The increasing occurrence in children of disorders such as type 2 diabetes is believed to be a consequence of this obesity epidemic. Much progress has been made in understanding of the genetics and physiology of appetite control and from these advances, elucidation of the causes of some rare obesity syndromes. However, these rare disorders have so far taught us few lessons about prevention or reversal of obesity in most children. Calorie intake and activity recommendations need reassessment and improved quantification at a population level because of sedentary lifestyles of children nowadays. For individual treatment, currently recommended calorie prescriptions might be too conservative in view of evolving insight into the so-called energy gap. Although quality of research into both prevention and treatment has improved, high-quality multicentre trials with long-term follow-up are needed. Meanwhile, prevention and treatment approaches to increase energy expenditure and decrease intake should continue. Recent data suggest that the spiralling increase in childhood obesity prevalence might be abating; increased efforts should be made on all fronts to continue this potentially exciting trend.

Han JC; Lawlor DA; Kimm SY

2010-05-01

56

[Obesity paradox].  

UK PubMed Central (United Kingdom)

Obesity has reached global epidemic proportions and is associated with major cardiovascular diseases and reduced overall survival. This paper reviews the metabolic and vascular consequences of dysfunctional adipocytokines in obesity as well as the pathological effects on blood pressure, cardiovascular structure and function. Despite this adverse association, numerous studies have documented an obesity paradox in which overweight and obese population with established cardiovascular disease have a better prognosis. There are potential explanations offered by literature for these puzzling data. For obese hypertensive patients the paradox is possibly linked to the lower systemic vascular resistance and plasma renin activity. In heart failure the excess body weight may confer some protective effects on mortality, due to a more metabolic reserve, higher levels of arterial pressure compatible with higher doses of cardioprotective medications, and a specific neuroendocrine profile with lower levels of circulating natriuretic atrial peptides, attenuated sympathetic nervous system and renin-angiotensin responses. For coronary heart disease and peripheral arterial disease the mechanisms are still uncertain. There are discussed a lesser severity of coronary lesions and left ventricular dysfunction, or a reduced prevalence of moderate-severe chronic obstructive pulmonary disease in patients selected for surgery. On the other hand, the constellation of data which supports purposeful weight reduction in the prevention and treatment of cardiovascular diseases, induces a controversial position regarding this new concept.

Aursulesei V; Cozma A; Datcu MD

2009-10-01

57

Hydrogen donor cracking with donor soaking of pitch  

Energy Technology Data Exchange (ETDEWEB)

A hydrogen donor diluent cracking process is claimed in which the pitch fraction from the cracking step is heat soaked in the presence of hydrogen donor solvent and then returned to the cracking coil.

Poynor, P.C.; Romine, H.E.

1984-02-07

58

Soccer kick kinematic differences between experienced and non-experienced soccer players  

Directory of Open Access Journals (Sweden)

Full Text Available Purpose: to examine kinematic differences of instep soccer kick between experienced and non-experienced soccer players. Subjects: 17 men between 17 and 21 years old. Methodology: a 3D film system with 4 cameras was used. Maximum power instep kicks were executed. It was analyzed feet velocity in the impact, maximum hip extension, maximum knee flexion and kick phases duration. Results: were found significant differences in feet velocity with non-dominant leg in the impact moment (m/s) (Experienced: 14.5±.52, Non-experienced: 12.5±.5; p<.001) and maximum hip extension (degrees) (Experienced: 39.2 ± 1.3, Non-experienced: 34.28±3.2; p<.001). Also were significant differences in the second phase duration in both legs (p<.05). Conclusions: Maximum instep soccer kick show significant differences between groups of different level only in non-dominant leg.

Muñoz López, Alejandro; González Jurado, José Antonio

2012-01-01

59

Obesity genes.  

UK PubMed Central (United Kingdom)

This review highlights the considerable advances in the understanding of the inheritance of fatness and the possible genetic mechanisms. The investigation of animal models confirms the fundamental importance of genes in determining fatness and demonstrates a genetic link between adipocyte function, derangements of steroid metabolism, insulin secretion and hypothalamic regulation. The heterogeneous nature of human obesity makes it unwise to extrapolate directly from the findings in animals but these findings do provide important clues to the situation in man. It is crucial that advances in the knowledge of genes involved in human obesity are paralleled by an understanding of gene-gene interactions and the influence of environmental factors. The rapidly increasing prevalence of obesity in society underlines the paramount influence of the environment.

Beales PL; Kopelman PG

1996-10-01

60

Living Donor Kidney Transplant Surgery  

Medline Plus

Full Text Available ... well matched from, for example, a close family member, the recipient has to take anti-rejection medications ... third of our donors are not immediate family members or blood relatives of donors. We saw earlier ...

 
 
 
 
61

Living Donor Kidney Transplant Surgery  

Medline Plus

Full Text Available ... than with an open incision. There is a screening process for potential donors. It’s important to emphasize ... and surgically an acceptable candidate. This shows our screening process, first the potential donor meets with a ...

62

Living Donor Kidney Transplant Surgery  

Medline Plus

Full Text Available ... with an open incision. There is a screening process for potential donors. It’s important to emphasize that ... surgically an acceptable candidate. This shows our screening process, first the potential donor meets with a social ...

63

Hand-assisted laparoscopic versus open nephrectomies in living donors  

Science.gov (United States)

Shortages of cadaveric kidneys for transplant into rising numbers of patients with end-stage renal failure have increased the demand for kidneys from live donors. The morbidity associated with traditional open donor nephrectomies (ODN) may discourage many candidates. The newer laparoscopic technique has been promoted as having less morbidity. Objectives To evaluate outcomes of hand-assisted laparoscopic nephrectomies (HALN) and prospectively compare HALN and ODN. Methods After retrospectively reviewing donor and recipient outcomes in 33 HALN (December through August, 2000), we prospectively compared another 47 with 30 ODN performed from September 2000 through April 2001. Results All 80 HALN were successful, with no requirement to convert to an open procedure. Four donors experienced surgery-related complications: wound infection, retroperitoneal hematoma, prolonged ileus and early small-bowel obstruction, respectively. Two recipients had ureteral complications (1 stricture, 1 leak); 5 experienced delayed graft function, 2 requiring dialysis; and 2 kidneys were lost from infarction. The prospective comparison showed the operative time for HALN (mean 184 min, standard deviation [SD] 39 min) was significantly longer (143 [SD 27] min, p < 0.01), but resulted in less blood loss (p < 0.05). Lengths of time to warm ischemia/early graft function, resumption of oral intake/first bowel movement, and hospital discharge were similar. The abdominal-wall laxity and loss of cutaneous sensation from the flank incision experienced by many ODN patients after was uncommon in the HALN group. Three months after nephrectomy, donor complaints of incisional pain were less common after HALN (p < 0.01). Conclusions HALN had good outcomes for donors and recipients, with quicker, more complete recoveries 3 months afterward.

Rajab, Amer; Mahoney, John E.; Henry, Mitchell L.; Elkhammas, Elmahdi A.; Bumgardner, Ginny L.; Ferguson, Ronald M.; Pelletier, Ronald P.

2005-01-01

64

Experienced teachers' informal learning in the workplace  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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 ...

Hoekstra, A.

65

Forensic investigation methodology for structures experiencing settlement  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The progressive settlement of a plantation in North Carolina is explored through a post-damage inspection. If a building is experiencing settlement or other deleterious movement, the underlying causes must be established to prevent further damage and ensure effective repair. This article outlines a...

Laefer, Debra F.; Evans, Ashley; Frazier, Jon

66

Experiencing the New Geography in East Germany.  

Science.gov (United States)

|Considers the difficulties experienced by the East German School system adjusting to a more progressive educational philosophy. Specifically, contrasts the traditional East German geography instruction (focused solely on physical geography) with the West German emphasis on social issues and problem solving. Many East German instructors distrust…

Mai, Uli; Burpee, Peter

1996-01-01

67

[Metabolic syndrome prevalence and clinical features in blood donors].  

UK PubMed Central (United Kingdom)

BACKGROUND: Metabolic syndrome (MS) including obesity, diabetes mellitus, hypertension, dyslipidemia, etc.. is a major cause of morbidity and mortality worldwide. It was reported that 15.9% of blood donors showed changes in fasting plasma glucose. OBJECTIVE: To determine the prevalence of MS in a population of healthy donors in a secondary hospital. MATERIAL AND METHODS: A cross-sectional study, included 726 healthy donors who attended the blood bank HGZ36. The SM was identified with at least 3 of 5 criteria of the NCEP ATPIII, we applied a structured questionnaire. We determined HDL cholesterol, triglycerides, glucose Abnormal Fasting (GAA), hypertension (SAH), body mass index (BMI), waist circumference (WC), hip circumference (NCC). Plan Analysis: prevalence, t student, Chi2. RESULTS: Of the 726 donors, 85.1% were male, according to the ATPIII criteria, 54.8% (398) had a GAA, 63.2% (458) had hypertriglyceridemia, almost 17% (121) presented HDL hypocholesterolemia, 44.1% (320) were overweight by BMI, the prevalence of metabolic syndrome was 54.4%, in comparison by gender, men had a statistically significant difference compared to women, showing an OR = 2.27 (p = 0.0001, 95% CI 1.44-3.60). CONCLUSIONS: MS is highly prevalent in this population, which involves implementing preventive measures, changes in lifestyles and identify risk factors to be free from diseases like diabetes, hypertension, obesity and MS itself.

Cruz del Castillo AH; García Fierro R; Hess Moreno MI; Vigil Pérez CA; Córdova Fernández JA; Chuck Santiago MP; Domínguez Moreno R

2012-01-01

68

Molecular forms of butyrylcholinesterase and obesity  

Directory of Open Access Journals (Sweden)

Full Text Available This study compared obese (N = 134) and unobese (N = 92) male blood donors, regarding the relative intensity (RI) and activity of different molecular forms (G1, G2, G4 and G1-ALB) of butyrylcholinesterase (BChE, EC 3.1.1.8) found in plasma, thereby searching for an association between these variables with obesity and SNPs of exons 1 and 4 of the BCHE gene. It was shown that obese and unobese individuals do not differ in the RI of each BChE band, even when classifying the sample into three genotypes of exons 1 and 4 of the BCHE gene (-116GG/539AA, -116GG/539AT, -116GA/539AT). Although the mean BChE activity of each band was significantly higher in obese than in unobese blood donors, the proportions of BChE bands were maintained, even under the metabolic stress associated to obesity, thereby leading to infer that this proportion is somehow regulated, and may therefore be important for BChE functions.

Dellyana R. Boberg; Lupe Furtado-Alle; Ricardo L.R. Souza; Eleidi A. Chautard-Freire-Maia

2010-01-01

69

Molecular forms of butyrylcholinesterase and obesity  

Scientific Electronic Library Online (English)

Full Text Available Abstract in english This study compared obese (N = 134) and unobese (N = 92) male blood donors, regarding the relative intensity (RI) and activity of different molecular forms (G1, G2, G4 and G1-ALB) of butyrylcholinesterase (BChE, EC 3.1.1.8) found in plasma, thereby searching for an association between these variables with obesity and SNPs of exons 1 and 4 of the BCHE gene. It was shown that obese and unobese individuals do not differ in the RI of each BChE band, even when classifying the (more) sample into three genotypes of exons 1 and 4 of the BCHE gene (-116GG/539AA, -116GG/539AT, -116GA/539AT). Although the mean BChE activity of each band was significantly higher in obese than in unobese blood donors, the proportions of BChE bands were maintained, even under the metabolic stress associated to obesity, thereby leading to infer that this proportion is somehow regulated, and may therefore be important for BChE functions.

Boberg, Dellyana R.; Furtado-Alle, Lupe; Souza, Ricardo L.R.; Chautard-Freire-Maia, Eleidi A.

2010-01-01

70

The Impact of Full-Length, Trimeric and Globular Adiponectin on Lipolysis in Subcutaneous and Visceral Adipocytes of Obese and Non-Obese Women.  

UK PubMed Central (United Kingdom)

Contribution of individual adiponectin isoforms to lipolysis regulation remains unknown. We investigated the impact of full-length, trimeric and globular adiponectin isoforms on spontaneous lipolysis in subcutaneous abdominal (SCAAT) and visceral adipose tissues (VAT) of obese and non-obese subjects. Furthermore, we explored the role of AMPK (5'-AMP-activated protein kinase) in adiponectin-dependent lipolysis regulation and expression of adiponectin receptors type 1 and 2 (AdipoR1 and AdipoR2) in SCAAT and VAT. Primary adipocytes isolated from SCAAT and VAT of obese and non-obese women were incubated with 20 µg/ml of: A) full-length adiponectin (physiological mixture of all adiponectin isoforms), B) trimeric adiponectin isoform or C) globular adiponectin isoform. Glycerol released into media was used as a marker of lipolysis. While full-length adiponectin inhibited lipolysis by 22% in non-obese SCAAT, globular isoform inhibited lipolysis by 27% in obese SCAAT. No effect of either isoform was detected in non-obese VAT, however trimeric isoform inhibited lipolysis by 21% in obese VAT (all p<0.05). Trimeric isoform induced Thr172 p-AMPK in differentiated preadipocytes from a non-obese donor, while globular isoform induced Ser79 p-ACC by 32% (p<0.05) and Ser565 p-HSL by 52% (p?=?0.08) in differentiated preadipocytes from an obese donor. AdipoR2 expression was 17% and 37% higher than AdipoR1 in SCAAT of obese and non-obese groups and by 23% higher in VAT of obese subjects (all p<0.05). In conclusion, the anti-lipolytic effect of adiponectin isoforms is modified with obesity: while full-length adiponectin exerts anti-lipolytic action in non-obese SCAAT, globular and trimeric isoforms show anti-lipolytic activity in obese SCAAT and VAT, respectively.

Wedellova Z; Kovacova Z; Tencerova M; Vedral T; Rossmeislova L; Siklova-Vitkova M; Stich V; Polak J

2013-01-01

71

Grade of deceased donor liver macrovesicular steatosis impacts graft and recipient outcomes more than the Donor Risk Index.  

UK PubMed Central (United Kingdom)

BACKGROUND AND AIM: Donor liver steatosis can impact on liver allograft outcomes. The aim of the present study was to comprehensively report on the impact of type and grade of donor steatosis, as well as donor and recipient factors, including the reported Donor Risk Index (DRI), on liver allograft outcomes. METHODS: A review of unit data for all adult liver transplant procedures from 2001 to 2007, as well as donor offers. Donor liver biopsies were regraded for steatosis by an experienced histopathologist. RESULTS: Steatosis was detected in 184/255 (72%) of biopsies, of which 114 (62%) had microvesicular steatosis (MiS; 68 mild, 22 moderate, 24 severe) and 70 (38%) macrovesicular steatosis (MaS; 59 mild, 7 moderate, 4 severe). The majority (66/70, 94%) of biopsies with MaS also contained MiS. Allograft steatosis was associated with increasing donor body mass index (P = 0.000), plus donor male sex (P < 0.05). Primary non function (P = 0.002), early renal failure (P = 0.040), and requirement for retransplantation (P = 0.012) were associated only with severe MaS. Early biliary complications were associated with moderate MaS (P = 0.039). Only severe MaS was significantly associated with inferior allograft survival at 3 months (relative risk = 12.09 [8.75-19.05], P = 0.000) and 1 year (P = 0.000). CONCLUSIONS: MiS is a common finding and frequently coexists with MaS on liver allograft biopsy, while isolated MaS is uncommon. Only the presence of moderate to severe MaS is associated with inferior early allograft outcomes. The impact of severe MaS on allograft survival appears greater than other donor factors, including the calculated DRI.

de Graaf EL; Kench J; Dilworth P; Shackel NA; Strasser SI; Joseph D; Pleass H; Crawford M; McCaughan GW; Verran DJ

2012-03-01

72

Donor hepatectomy for living-donor liver transplantation.  

UK PubMed Central (United Kingdom)

Between September 1993 and November 1996, donor hepatectomy was performed in 22 living donor liver transplantation at Queen Mary Hospital, Hong Kong. In these donor operations, 7 extended right lobe grafts, 6 extended left lobe grafts and 9 left lateral segment grafts were obtained. The technique of donor operations consisted of initial hilar dissection, mobilization of the liver lobe, transection of the liver using ultrasonic dissector (without inflow or outflow vascular occlusion) at a plane on the left side of the middle hepatic vein for an extended right lobe graft, on the right side of the middle hepatic vein for an extended left lobe graft or on the right side of falciform ligament for a left lateral segment graft. The median blood loss was 775 ml. Complications occurred in 2 donors: one had incisional hernia and the other had biliary stricture. Both were treated successfully by re-operation. Currently all donors are well with completely normal liver biochemistry.

Fan ST; Lo CM; Liu CL

1998-01-01

73

[Childhood obesity].  

UK PubMed Central (United Kingdom)

UNLABELLED: Childhood obesity, due to the exponential increase of this chronic disease, is now considered a XXI century epidemic disease. Portugal, the sixth European country where this disease is more prevalent, expends 3,5% of the annual health budget with this pathology. AIM: Characterization of the obese children followed in the pediatric outpatient clinic. METHODOLOGY: A twelve year cohort study who comprehended 482 kids, analysing demographic variables; family and social backgrounds; personal backgrounds; habits; body mass index (BMI); comorbidities; blood tests; clinical intervention and follow-up. RESULTS: A positive family history with, at least, two obese elements was found in 64%, of the 246 boys (51%) and 236 girls (49%) analysed. We observed a 93% rate of eutocic delivery for an average birth weight of 3585 gr. These children were exclusively breastfeed for, at least, four months, in 38% of the cases. In our sample, we found an average of three meals per day, with an 81% rate of take-way. The absence of a regular physical activity plan was observed in 89% of the sample. Anthropometric evaluation and counselling about healthy habits were focused through all appointments. For a follow-up of 16 months (+/- 7 months), a 10% success rate was obtained, with an 1,22 BMI reduction. We verified a 20% dismissed rate, averagely occurring in the first 12 months (+/- 3 months). CONCLUSIONS: On the whole, the characterization of our sample seems to be according to the children obesity literature. Trough out follow-up, commitment to the interventional schedule was critical for life-style modification and desirable BMI achievement. Regular appointments and periodic evaluation of the results seems to be reliable strategies in the fight of this epidemic disease.

da Costa CD; Ferreira MG; Amaral R

2010-05-01

74

[Blood donor hemovigilance: impact for donor and recipient safety].  

UK PubMed Central (United Kingdom)

Since its creation in 1993, hemovigilance has an important place for blood safety. The part concerning donors, as the name suggests, targeted on improvement of donor's safety covers in fact the two points of the transfusion chain with serious adverse events in donor, epidemiologic survey for recipients and post-donation information on the two sides. Organized management and close collaboration between the actors of the transfusion chain are necessary to ensure the effectiveness of the system.

Hauser L; Beyloune A; Simonet M; Bierling P

2013-05-01

75

The growing burden of obesity in Thailand: a review of current trends and policies.  

UK PubMed Central (United Kingdom)

In recent years, there has been a rise in obesity-related diseases in transitional countries. These countries, once plagued with problems related to infectious disease and poverty, now face a dual burden of both chronic and infectious diseases. Thailand has recently experienced significant economic growth, and as a result, the numbers related to obesity and obesity-related diseases have risen significantly. Thailand is an important region to examine the timely issue of obesity-related policy because Thailand has been a model for successful public health interventions and policies throughout Asia. Further, such policies have significant implications for other regions of the world experiencing similar health transitions.

Pawloski LR; Ruchiwit M; Markham SM

2011-09-01

76

Childhood Obesity & Dental Disease: Common Causes, Common Solutions. Oral Health & Obesity Policy Brief  

Science.gov (United States)

Too many California children suffer from high rates of preventable chronic conditions associated with childhood obesity and dental disease. The state is experiencing a crisis in both areas. Fortunately, common factors that contribute to both conditions--including the rates of breastfeeding, access to healthy food and the consumption of…

Children Now, 2011

2011-01-01

77

[Deceased donor liver transplantation].  

Science.gov (United States)

Deceased donor liver transplantation is nowadays a routine procedure for the treatment of terminal liver failure and often represents the only chance of a cure. Under given optimal conditions excellent long-term results can be obtained with 15-year survival rates of well above 60 %.In Germany the outcome after liver transplantation has deteriorated since the introduction of an allocation policy, which is based on the medical urgency. At present 25 % of liver graft recipients die within the first year after transplantation. In contrast 1-year survival in most other countries, e.g. in the USA or the United Kingdom is around 90 % and therefore significantly better. Reasons for the inferior results in Germany are on the one hand an increasing number of critically ill recipients and on the other hand an unfavorable situation for organ donation. In comparison with other countries the organ donation rate is low and moreover the risk profile of these donors is above average. This combination of organ shortage and organ allocation represents a big challenge for the future orientation of liver transplantation and creates the potential for conflict. These cannot be solved on a medical basis but require a social consensus.Because of the present inferior results and because of the high expenses of the present system we suggest a discussion on future allocation policies as well as on future centre structures in Germany. In addition to the medical urgency the maximum benefit should also be considered for organ allocation. PMID:23576123

Seehofer, D; Schöning, W; Neuhaus, P

2013-05-01

78

Cognitive dissonance experienced by nurse practitioner faculty.  

UK PubMed Central (United Kingdom)

PURPOSE: The purpose of this study was to explicate the concept of cognitive dissonance as experienced and reported by nurse practitioner (NP) faculty members. DATA SOURCES: Responses from NP faculty members to an online survey about their experiences with cognitive dissonance. CONCLUSIONS: The respondents detailed their experiences with cognitive dissonance, citing differences between expectations for which they are rewarded and those for which they are paid. IMPLICATIONS FOR PRACTICE: Expecting all faculty members to excel in practice, research, teaching, and service may create unrealistic workloads for NP faculty members. Examining expectations and considering creation of a clinical track for faculty who practice may be options administrators of NP programs might explore.

Fontenot HB; Hawkins JW; Weiss JA

2012-08-01

79

Physical activity and body mass index among women who have experienced infertility.  

UK PubMed Central (United Kingdom)

INTRODUCTION: The experience of infertility is a common medical condition in the developing countries. The aim of this retrospective epidemiologic study was to determine fertility status and parity in Babol, Iran and then identify physical activity and body mass index (BMI) among women who have experienced infertility. MATERIAL AND METHODS: A total of 1,081 women aged 20-45 years were selected using cluster sampling. The current physical activity was measured using the original International Physical Activity Questionnaire short form. Lifestyle factors were compared between those who had experienced infertility (n = 168) and the rest of the women. A face-to-face household interview was conducted using a specially designed interview questionnaire. RESULTS: After adjusting for suspected confounding factors, women with infertility experience had a 4.8-fold increased risk of obesity (OR = 2.02, CI = 0.70, 5.84) and almost a 3.8-fold increased risk of being overweight (OR = 2.11, CI = 0.72, 6.17) compared to women without infertility. No significant differences were found in Met-minutes of sedentary activity, intensity of walking, moderate, vigorous, and total physical activity, self-reported dietary intake, exercise, and level of physical activity between women with and without experience of infertility. CONCLUSIONS: Since both obesity and infertility are increasing public health issues in Iranian women, more attention should be paid to lifestyle behaviors, especially gaining weight in women who have experienced infertility.

Esmaeilzadeh S; Delavar MA; Basirat Z; Shafi H

2013-06-01

80

Physics Climate as Experienced by LGBT+ Physicists  

Science.gov (United States)

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.

Long, Elena

2012-02-01

 
 
 
 
81

Vasovagal reactions in apheresis donors.  

UK PubMed Central (United Kingdom)

BACKGROUND: The incidence rate of vasovagal reactions (VVRs) in apheresis is known to be higher in women than in men donors. VVRs in women apheresis donors were therefore analyzed to find out possible factors for their high incidence. STUDY DESIGN AND METHODS: VVR incidence was compared between whole blood (WB) and apheresis donation in relation mainly to age and circulatory blood volume (CBV). In addition, blood pressure and pulse rate were measured during apheresis. RESULTS: In WB donors, the VVR incidence was 0.83 and 1.25 percent, while in apheresis donors it was 0.99 and 4.17 percent in men and women, respectively. The VVR incidence decreased with age in WB donors, but age dependence was very weak in apheresis donors. In elderly women, the incidence increased with repeating cycle of apheresis. There were three different patterns of pulse fluctuation during apheresis, that is, stable (type A), increased rate during blood withdrawal (type B), and irregular pattern (type C). Elderly women donors and donors who suffered from VVRs mostly showed type B fluctuation. There was no particular fluctuation in blood pressure in relation to apheresis cycles. CONCLUSION: The VVR incidence rate was particularly high in women apheresis donors over 45 years old and increased with repeating cycles of apheresis. Smaller CBV, high sensitivity of low-pressure baroreceptors, and citrate effects on cardiovascular reflex might be major factors involved in the high incidence of VVRs.

Tomita T; Takayanagi M; Kiwada K; Mieda A; Takahashi C; Hata T

2002-12-01

82

Organ Donor FAQ's: Who Can Be a Donor  

Science.gov (United States)

... citizens have been organ donors. Can non-resident aliens donate and receive organs? Non-resident aliens can both donate and receive organs in the ... the 12,375 organ donors were non-resident aliens. In this same year, 259 (1%) of the ...

83

Diets of obese and non-obese children  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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 (MNB...

Atsuko Satoh; Seiko Fujita; Kazuko Menzawa; Sangun Lee; Masao Miyamoto; Hidatada Sasaki

84

Personality types among experienced military pilots.  

UK PubMed Central (United Kingdom)

Three distinct personality subtypes were empirically identified in a sample of 170 experienced U.S. Army pilots, using a new measure of personality developed for use in occupational settings. The subtypes are similar to those previously derived in a sample of military aviation trainees. No significant differences across the clusters were found for the types of missions flown, years of aviation or military service, or number of flight hours. A significantly greater number of instructor pilots was found among a cluster which comprised the smallest percentage of pilots in the sample. Overall, the results support the notion that no one type of personality is a prerequisite for success in military aeronautics, and highlight the need for additional studies of personality type in military and commercial aviation, using more sophisticated measures of aeronautical adaptability.

Picano JJ

1991-06-01

85

Respecting donors to biobank research.  

UK PubMed Central (United Kingdom)

The most common way for people to consent to research with their banked biological material is through signing a blanket consent, which allows any future use, giving the donor no information or control. This does not respect the donor or the philosophy if donation.

Tomlinson T

2013-01-01

86

Managing childhood obesity  

Science.gov (United States)

The prevalence of childhood obesity has steadily increased over the last decades, with approximately 35% of children aged 6-19 classified as overweight or obese. Recently, a plateau in the increasing rates of obesity has been observed. Despite this leveling off, overweight and obese children are hea...

87

Assessment of dysplastic hematopoiesis: lessons from healthy bone marrow donors.  

UK PubMed Central (United Kingdom)

BACKGROUND: According to WHO 2008 guidelines, the required percentage of cells manifesting dysplasia in the bone marrow to qualify as significant is 10% or over in one or more hematopoietic cell lineages, but this threshold is controversial. No 'normal' values have been established. Therefore, we investigated dyshematopoiesis in bone marrow aspirate squash preparations of 120 healthy bone marrow donors. DESIGN AND METHODS: Bone marrow squash slides of 120 healthy unrelated bone marrow donors were examined independently by 4 experienced morphologists. Samples were taken from the first aspiration during the harvest. Bone marrow preparation and assessment were performed according to WHO recommendations and ICSH guidelines. RESULTS: More than 10% dysmyelopoiesis could be detected in 46% of bone marrow aspirate squash preparations with 26% in 2 or more cell lineages and 7% in 3 cell lineages in healthy bone marrow donors. Donors under the age of 30 years exhibited more dysgranulopoietic changes and dysmegakaryopoietic changes (P<0.001) compared to the older donors. Female donors showed more dysgranulopoietic changes than male donors (P = 0.025). The concordance rate between the 4 investigators was modest in dysgranulopoiesis but poor in dyserythropoiesis and dysmegakaryopoiesis. CONCLUSIONS: The poor reliability of the 10% cut off was partly related to the proximity of the current criteria to the observed cut-off mean values of the normal population. These findings question the current WHO threshold of the 10% or over necessary for the percentage of cells manifesting dysplasia to be considered significant, and suggest that either a higher threshold would be more appropriate or different thresholds should be set for each lineage.

Parmentier S; Schetelig J; Lorenz K; Kramer M; Ireland R; Schuler U; Ordemann R; Rall G; Schaich M; Bornhäuser M; Ehninger G; Kroschinsky F

2012-05-01

88

Support of unrelated stem cell donor searches by donor center-initiated HLA typing of potentially matching donors.  

Science.gov (United States)

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-DRB1 typing of donors who were only typed for the HLA loci A and B so far and were potential matches for patients in need of a stem cell transplant. In total, 8,861 donors were contacted for donor center-initiated HLA-DRB1 typing within 1,089 donor searches. 12 of these donors have donated stem cells so far, 8 thereof for their respective target patients. We conclude that chances of patients with ongoing donor searches to find an HLA-matched unrelated donor can indeed be improved by donor-center initiated typing that is carried out in addition to the standard donor search process. Our results also raise questions regarding the appropriate use of incompletely typed donors within unrelated donor searches. PMID:21625451

Schmidt, Alexander H; Solloch, Ute V; Baier, Daniel; Grathwohl, Alois; Hofmann, Jan; Pingel, Julia; Stahr, Andrea; Ehninger, Gerhard

2011-05-20

89

Support of unrelated stem cell donor searches by donor center-initiated HLA typing of potentially matching donors.  

UK PubMed Central (United Kingdom)

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-DRB1 typing of donors who were only typed for the HLA loci A and B so far and were potential matches for patients in need of a stem cell transplant. In total, 8,861 donors were contacted for donor center-initiated HLA-DRB1 typing within 1,089 donor searches. 12 of these donors have donated stem cells so far, 8 thereof for their respective target patients. We conclude that chances of patients with ongoing donor searches to find an HLA-matched unrelated donor can indeed be improved by donor-center initiated typing that is carried out in addition to the standard donor search process. Our results also raise questions regarding the appropriate use of incompletely typed donors within unrelated donor searches.

Schmidt AH; Solloch UV; Baier D; Grathwohl A; Hofmann J; Pingel J; Stahr A; Ehninger G

2011-01-01

90

Thermal cracking with hydrogen donor diluent  

Energy Technology Data Exchange (ETDEWEB)

An improved hydrogen donor for hydrogen donor diluent cracking is provided by extraction with naphtha from the cracked product and hydrogenation by hydrogen transfer from a lower boiling hydrogen donor such as tetralin.

Derbyshire, F.; Varghese, P.; Whitehurst, D.D.

1983-07-26

91

Experienced golfers' perspectives on choking under pressure.  

UK PubMed Central (United Kingdom)

Although researchers have experimentally examined the mechanisms underlying pressure-induced forms of suboptimal performance, or "choking under pressure," there is a lack of research exploring the personal experience of this phenomenon. In an attempt to fill this void in the literature, this study explored experienced golfers' perceptions of the choking experience within a personal construct psychology (Kelly, 1955/1991) framework. Both male and female golfers participated in either a focus group (n = 12; all males) or one-on-one interview (n = 10; female = 7, male = 3) using experience cycle methodology (Oades & Viney, 2000) to describe their perceptions of the choking experience. Discussions were transcribed verbatim and subsequently analyzed using grounded theory analytical techniques (Strauss & Corbin, 1998). Analyses revealed five central categories representing the personal experience of choking under pressure: antecedents, personal investment, choking event, consequences, and learning experiences. The findings reported here suggest that the choking phenomenon, which can involve acute or chronic bouts of suboptimal performance (relative to the performance expectations of the athlete), is a complex process involving the interplay of several cognitive, attentional, emotional, and situational factors. Implications of the findings for a construct definition of choking are discussed, and several applied considerations are offered.

Gucciardi DF; Longbottom JL; Jackson B; Dimmock JA

2010-02-01

92

Experienced golfers' perspectives on choking under pressure.  

Science.gov (United States)

Although researchers have experimentally examined the mechanisms underlying pressure-induced forms of suboptimal performance, or "choking under pressure," there is a lack of research exploring the personal experience of this phenomenon. In an attempt to fill this void in the literature, this study explored experienced golfers' perceptions of the choking experience within a personal construct psychology (Kelly, 1955/1991) framework. Both male and female golfers participated in either a focus group (n = 12; all males) or one-on-one interview (n = 10; female = 7, male = 3) using experience cycle methodology (Oades & Viney, 2000) to describe their perceptions of the choking experience. Discussions were transcribed verbatim and subsequently analyzed using grounded theory analytical techniques (Strauss & Corbin, 1998). Analyses revealed five central categories representing the personal experience of choking under pressure: antecedents, personal investment, choking event, consequences, and learning experiences. The findings reported here suggest that the choking phenomenon, which can involve acute or chronic bouts of suboptimal performance (relative to the performance expectations of the athlete), is a complex process involving the interplay of several cognitive, attentional, emotional, and situational factors. Implications of the findings for a construct definition of choking are discussed, and several applied considerations are offered. PMID:20167952

Gucciardi, Daniel F; Longbottom, Jay-Lee; Jackson, Ben; Dimmock, James A

2010-02-01

93

Concealment and fabrication by experienced research subjects.  

UK PubMed Central (United Kingdom)

BACKGROUND: Subjects who enroll in multiple studies have been found to use deception at times to overcome restrictive screening criteria. Deception undermines subject safety as well as study integrity. Little is known about the extent to which experienced research subjects use deception and what type of information is concealed, withheld, or distorted. PURPOSE: This study examined the prevalence of deception and types of deception used by subjects enrolling in multiple studies. METHODS: Self-report of deceptive behavior used to gain entry into clinical trials was measured among a sample of 100 subjects who had participated in at least two studies in the past year. RESULTS: Three quarters of subjects reported concealing some health information from researchers in their lifetime to avoid exclusion from enrollment in a study. Health problems were concealed by 32% of the sample, use of prescribed medications by 28%, and recreational drug use by 20% of the sample. One quarter of subjects reported exaggerating symptoms in order to qualify for a study and 14% reported pretending to have a health condition in order to qualify. LIMITATIONS: Although this study finds high rates of lifetime deceptive behavior, the frequency and context of this behavior is unknown. Understanding the context and frequency of deception will inform the extent to which it jeopardizes study integrity and safety. CONCLUSION: The use of deception threatens both participant safety and the integrity of research findings. Deception may be fueled in part by undue inducements, overly restrictive criteria for entry, and increased demand for healthy controls. Screening measures designed to detect deception among study subjects would aid in both protecting subjects and ensuring the quality of research findings.

Devine EG; Waters ME; Putnam M; Surprise C; O'Malley K; Richambault C; Fishman RL; Knapp CM; Patterson EH; Sarid-Segal O; Streeter C; Colanari L; Ciraulo DA

2013-07-01

94

Living Donor Kidney Transplant Surgery  

Medline Plus

Full Text Available ... We make group some together if they’re similar. I’d like to tell you a little ... at Sentara?” Paired donations, this would be another similar question about incompatible donors. An example of a ...

95

Living Donor Kidney Transplant Surgery  

Medline Plus

Full Text Available Living Donor Kidney Transplant Surgery Sentara Norfolk General Hospital, Norfolk, Virginia March 25, 2009 Welcome to this “ ... than 100 caregiving sites, including seven acute care hospitals, four advanced imaging centers, seven nursing homes, and ...

96

Living Donor Kidney Transplant Surgery  

Medline Plus

Full Text Available ... allow us to retrieve the kidney at the end of the procedure and actually allows us to ... a donor?” No. The recipient, by definition, had end-stage kidney disease and certainly can’t ever ...

97

Living Donor Kidney Transplant Surgery  

Medline Plus

Full Text Available ... spread much at all, so it has little risk of damaging other tissues. But it does a ... donor, particularly because they’re at long-term risks for health problems such as diabetes, which in ...

98

Living Donor Kidney Transplant Surgery  

Medline Plus

Full Text Available ... of work for a little while and my child is grown and I don’t have to ... donor, Anna, a question that pertains to having children. “What was your understanding about being able to ...

99

Living Donor Kidney Transplant Surgery  

Medline Plus

Full Text Available ... So after discharge, kidney donors generally take about ten days to get to the point where they ... has happened on two occasions over the last ten years. So it’s really unusual, 6 but it ...

100

Living Donor Kidney Transplant Surgery  

Medline Plus

Full Text Available ... from Nancy. The question is, “Is there a weight restriction on potential donors?” The answer to that is, “Yes.” We look closely not at the weight but the body mass index, which is a ...

 
 
 
 
101

Living Donor Kidney Transplant Surgery  

Medline Plus

Full Text Available ... medical condition, such as HIV positive status or diabetes or cancer or mental illness or severe obesity ... long-term risks for health problems such as diabetes, which in turn can cause kidney disease, but ...

102

The American Rare Donor Program.  

UK PubMed Central (United Kingdom)

The American Rare Donor Program (ARDP), headquartered in Philadelphia, Pennsylvania, maintains a comprehensive database of donors with "rare blood types." The ARDP secures blood and blood products for difficult-to-transfuse patients. Remarkably, a significant number of physicians, both in the United States and abroad, remain unaware of the unique and critical services that the ARDP provides to critical care specialists and their patients.

Meny GM; Flickinger C; Marcucci C

2013-02-01

103

Updated selection of unrelated donor  

Directory of Open Access Journals (Sweden)

Full Text Available For some time now, the transplant of haematopoietic stem cells (HSC) from unrelated adult donors or from umbilical cord blood is an effective treatment that is widely used to treat malignant and non-malignant haematological disorders. From the first HSC unrelated transplants in the 1990’s to the present day, the strategy of identification and the selection of an unrelated HSC donor have undergone a profound evolution...

N. Sacchi; C. Costa; F. Madia; R. Marciano; F. Vagnozzi; S. Pollichieni

2013-01-01

104

Obesity in Older Adults  

Directory of Open Access Journals (Sweden)

Full Text Available The prevalence of obesity in the United States is increasing in all age groups. During the past 30 years, the proportion of older adults who are obese has doubled. In this article the author describes the prevalence and causes of obesity among older adults as well as the consequences of obesity in older adults. Recommendations for interventions to address obesity are also provided. Differences between the two groups of older adults, those 50 to 65 years of age, and those over 65 years of age, will be addressed. The goal of the article is to raise nurses’ awareness of the challenges of obesity in older adults.

Ann Mabe Newman

2009-01-01

105

Donor heart preservation and perfusion  

Directory of Open Access Journals (Sweden)

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

2011-01-01

106

Support of Unrelated Stem Cell Donor Searches by Donor Center-Initiated HLA Typing of Potentially Matching Donors  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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 o...

Schmidt, Alexander H.; Solloch, Ute V.; Baier, Daniel; Grathwohl, Alois; Hofmann, Jan; Pingel, Julia; Stahr, Andrea

107

Obesity and the gut microbiota: does up-regulating colonic fermentation protect against obesity and metabolic disease?  

UK PubMed Central (United Kingdom)

Obesity is now considered a major public health concern globally as it predisposes to a number of chronic human diseases. Most developed countries have experienced a dramatic and significant rise in obesity since the 1980s, with obesity apparently accompanying, hand in hand, the adoption of "Western"-style diets and low-energy expenditure lifestyles around the world. Recent studies report an aberrant gut microbiota in obese subjects and that gut microbial metabolic activities, especially carbohydrate fermentation and bile acid metabolism, can impact on a number of mammalian physiological functions linked to obesity. The aim of this review is to present the evidence for a characteristic "obese-type" gut microbiota and to discuss studies linking microbial metabolic activities with mammalian regulation of lipid and glucose metabolism, thermogenesis, satiety, and chronic systemic inflammation. We focus in particular on short-chain fatty acids (SCFA) produced upon fiber fermentation in the colon. Although SCFA are reported to be elevated in the feces of obese individuals, they are also, in contradiction, identified as key metabolic regulators of the physiological checks and controls mammals rely upon to regulate energy metabolism. Most studies suggest that the gut microbiota differs in composition between lean and obese individuals and that diet, especially the high-fat low-fiber Western-style diet, dramatically impacts on the gut microbiota. There is currently no consensus as to whether the gut microbiota plays a causative role in obesity or is modulated in response to the obese state itself or the diet in obesity. Further studies, especially on the regulatory role of SCFA in human energy homeostasis, are needed to clarify the physiological consequences of an "obese-style" microbiota and any putative dietary modulation of associated disease risk.

Conterno L; Fava F; Viola R; Tuohy KM

2011-08-01

108

Obesity and the gut microbiota: does up-regulating colonic fermentation protect against obesity and metabolic disease?  

Science.gov (United States)

Obesity is now considered a major public health concern globally as it predisposes to a number of chronic human diseases. Most developed countries have experienced a dramatic and significant rise in obesity since the 1980s, with obesity apparently accompanying, hand in hand, the adoption of "Western"-style diets and low-energy expenditure lifestyles around the world. Recent studies report an aberrant gut microbiota in obese subjects and that gut microbial metabolic activities, especially carbohydrate fermentation and bile acid metabolism, can impact on a number of mammalian physiological functions linked to obesity. The aim of this review is to present the evidence for a characteristic "obese-type" gut microbiota and to discuss studies linking microbial metabolic activities with mammalian regulation of lipid and glucose metabolism, thermogenesis, satiety, and chronic systemic inflammation. We focus in particular on short-chain fatty acids (SCFA) produced upon fiber fermentation in the colon. Although SCFA are reported to be elevated in the feces of obese individuals, they are also, in contradiction, identified as key metabolic regulators of the physiological checks and controls mammals rely upon to regulate energy metabolism. Most studies suggest that the gut microbiota differs in composition between lean and obese individuals and that diet, especially the high-fat low-fiber Western-style diet, dramatically impacts on the gut microbiota. There is currently no consensus as to whether the gut microbiota plays a causative role in obesity or is modulated in response to the obese state itself or the diet in obesity. Further studies, especially on the regulatory role of SCFA in human energy homeostasis, are needed to clarify the physiological consequences of an "obese-style" microbiota and any putative dietary modulation of associated disease risk. PMID:21559992

Conterno, Lorenza; Fava, Francesca; Viola, Roberto; Tuohy, Kieran M

2011-05-11

109

Liver transplant with a marginal donor graft containing a hydatid cyst--a case report.  

UK PubMed Central (United Kingdom)

Liver transplantation has become the standard treatment for acute failure and end-stage liver disease, but there are fewer donor organs available than patients on the waiting list. The donor pool may be increased by using marginal donor candidates. Some infectious and metabolic diseases have been transmitted to the recipient via marginal donor grafts. Hydatid cyst disease is rarely transmitted to a recipient from the donor graft. A literature search showed only 2 previous cases of liver transplantation using a donor graft that contains a hydatid cyst. We treated a 19-year-old woman who experienced acute on chronic end-stage liver failure secondary to cryptogenic cirrhosis. The liver graft from a 97-year-old marginal cadaveric donor contained a calcified hydatid cyst. No complication was associated with the hydatid cyst at 3 years after transplantation. The present case shows that donor livers with an inactive, calcified hydatid cyst may be used for emergency liver transplantation after considering the location, size, and relation of the cyst to vascular and biliary structures. The cyst may be resected on the back table with a successful treatment outcome.

Eris C; Akbulut S; Sakcak I; Kayaalp C; Ara C; Yilmaz S

2013-03-01

110

Personality Characteristics And Obesity  

Directory of Open Access Journals (Sweden)

Full Text Available 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 ‘t� test. Results: On 16 PF scale obese women were found more reserved, critical, depressed, worried and troubled than the non-obese women. Obese also manifested subsequently less felling of contentment, happiness satisfaction with life experiences, low sense of achievement on PGI Well-Being. Obese women showed more distress and apprehension over their negative evaluation and distressed with day to day Conclusion: Obese women evidenced significantly more neurotic than non- obese women.

Asthana Sunita; Gupta V.M

1999-01-01

111

Donor heart preservation and perfusion  

Directory of Open Access Journals (Sweden)

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

2011-01-01

112

Increased macrophage migration into adipose tissue in obese mice.  

UK PubMed Central (United Kingdom)

Macrophage-mediated inflammation is a key component of insulin resistance; however, the initial events of monocyte migration to become tissue macrophages remain poorly understood. We report a new method to quantitate in vivo macrophage tracking (i.e., blood monocytes from donor mice) labeled ex vivo with fluorescent PKH26 dye and injected into recipient mice. Labeled monocytes appear as adipose, liver, and splenic macrophages, peaking in 1-2 days. When CCR2 KO monocytes are injected into wild-type (WT) recipients, or WT monocytes given to MCP-1 KO recipients, adipose tissue macrophage (ATM) accumulation is reduced by ~40%, whereas hepatic macrophage content is decreased by ~80%. Using WT donor cells, ATM accumulation is several-fold greater in obese recipient mice compared with lean mice, regardless of the source of donor monocytes. After their appearance in adipose tissue, ATMs progressively polarize from the M2- to the M1-like state in obesity. In summary, the CCR2/MCP-1 system is a contributory factor to monocyte migration into adipose tissue and is the dominant signal controlling the appearance of recruited macrophages in the liver. Monocytes from obese mice are not programmed to become inflammatory ATMs but rather the increased proinflammatory ATM accumulation in obesity is in response to tissue signals.

Oh DY; Morinaga H; Talukdar S; Bae EJ; Olefsky JM

2012-02-01

113

Adipokines in obesity.  

UK PubMed Central (United Kingdom)

White adipose tissue is recognized as a dynamic endocrine organ able to produce and release several bioactive polypeptides known as adipokines. Obesity is defined as an excessive growth of adipose tissue. As such, it is likely that adipokines could play an important role in the development of diseases associated with obesity including insulin resistance, inflammation, hypertension, cardiovascular risk and metabolic disorders. This review focuses on obesity specific-adipokine profiles and the role of some adipokines in obesity-related metabolic disorders.

Leal Vde O; Mafra D

2013-04-01

114

Obesity and respiratory diseases  

Directory of Open Access Journals (Sweden)

Full Text Available 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 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.Keywords: obesity, lung function, obstructive sleep apnea, obesity hypoventilation syndrome, anesthesia

Christopher Zammit; Helen Liddicoat; Ian Moonsie; et al

2010-01-01

115

[Pharmacological treatment for obesity].  

UK PubMed Central (United Kingdom)

The pharmacological treatment of obesity is just one of the therapeutic weapons that the multidisciplinary team involved in the treatment of the obese patients must use, it is helpful in order to achieve better adherence to nutritional and lifestyle modifications. The indications and agents used in the treatment of the obese patients are reviewed.

Mancillas-Adame L; Morales-González G

2004-07-01

116

Childhood Obesity: An Overview  

Science.gov (United States)

This article reviews recent research evidence, largely from systematic reviews, on a number of aspects of childhood obesity: its definition and prevalence; consequences; causes and prevention. The basis of the body mass index (BMI) as a means of defining obesity in children and adolescents is discussed: a high BMI for age constitutes obesity. In…

Reilly, John J.

2007-01-01

117

Diets of obese and non-obese children  

Directory of Open Access Journals (Sweden)

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.

Atsuko Satoh; Seiko Fujita; Kazuko Menzawa; Sangun Lee; Masao Miyamoto; Hidatada Sasaki

2011-01-01

118

Diets of obese and non-obese older subjects  

Directory of Open Access Journals (Sweden)

Full Text Available Aim: To compare diets between obese and non-obese in healthy older subjects. Methods: Forty-five obese and eighty-seven non-obese older subjects were recruited and their habitual factors that may contribute to obesity were assessed. Intakes of food by food-group in the obesity and non-obesity groups were checked using a visual type presentation of model nutriational balance chart (MNBC). Results: Average intake ratio of food relative to ideal food intake was significantly higher in the obesity group than the non-obesity group. The relationship of obesity and exercise or habitual activities was not significant. Conclusion: Food intake is a primary factor of obesity but regular exercise or habitual activities is not a key factor for obesity in older subjects. Since exercise habit is difficult to achieve in older subjects, particularly those who are obese, food control using the present visualtype MNBC would be one strategy forthe management of obesity.

Yukoh Yaegashi; Atsuko Satoh; Hideaki Kudoh; Sangun Lee; Chiaki Kitamiy; James P. Butler; Hidetada Sasaki

2013-01-01

119

Theory of Polar Corrections to Donor Binding  

CERN Multimedia

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

2011-01-01

120

Dengue antibodies in blood donors.  

UK PubMed Central (United Kingdom)

BACKGROUND: Dengue is an urban arbovirus whose etiologic agent is a virus of the genus Flavorius with four distinct antigen serotypes (DENV-1, DENV-2, DENV-3 and DENV-4) that is transmitted to humans through the bite of the mosquito Aedes aegypti. The Campo Mourão region in Brazil is endemic for dengue fever. OBTECTIVE: The aim of this study was to evaluate the presence of IgG and IgM antibodies specific to the four serotypes of dengue in donors of the blood donor service in the city of Campo Mourão. METHODS: Epidemiological records were evaluated and 4 mL of peripheral blood from 213 blood donors were collected in tubes without anticoagulant. Serum was then obtained and immunochromatographic tests were undertaken (Imuno-Rápido Dengue IgM/IgG(TM)). Individuals involved in the study answered a social and epidemiological questionnaire on data which included age, gender and diagnosis of dengue. RESULTS: Only three (1.4%) of the 213 blood tests were positive for IgG anti-dengue antibodies. No donors with IgM antibody, which identifies acute infection, were identified. CONCLUSIONS: The results of the current analysis show that the introduction of quantitative or molecular serological methods to determine the presence of anti-dengue antibodies or the detection of the dengue virus in blood donors in endemic regions should be established so that the quality of blood transfusions is guaranteed.

Ribas-Silva RC; Eid AA

2012-01-01

 
 
 
 
121

Sexual abuse, sexual orientation, and obesity in women.  

UK PubMed Central (United Kingdom)

BACKGROUND: Among adult women an association between childhood sexual abuse (CSA) and obesity has been observed. Research with lesbian women has consistently identified high rates of obesity as well as frequent reports of CSA, but associations between sexual abuse and obesity have not been fully explored. Our aim was to investigate the relationship between sexual abuse (SA) history and obesity among heterosexual (n = 392) and lesbian (n = 475) women (age 35-64) who participated in the Epidemiologic STudy of HEalth Risk in Women (ESTHER) Project in Pittsburgh, Pennsylvania. METHODS: Obesity was defined as body mass index (BMI) > or =30. Covariates included self-reported SA, sexual orientation, demographic factors, and history of a depression or anxiety diagnosis. SA history was assessed by three factors: (1) SA experienced under the age of 18 by a family member or (2) by a nonfamily member and (3) forced, unwanted sexual experience(s) at age > or =18. Data were analyzed using chi-square tests and logistic regression models. RESULTS: Multiple logistic regression analyses revealed that obesity was associated with African American race, lesbian sexual orientation, intrafamilial CSA, and history of mental health diagnosis. Protective factors were having a household income of at least $75,000 and having a bachelor's degree or higher. CONCLUSIONS: Results suggest that lesbian women may be at greater risk of obesity than heterosexual women and that intrafamilial CSA--regardless of sexual orientation--may play a role in the development of obesity.

Smith HA; Markovic N; Danielson ME; Matthews A; Youk A; Talbott EO; Larkby C; Hughes T

2010-08-01

122

Management of cadaveric organ donors  

Directory of Open Access Journals (Sweden)

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.

Jovanovi? B.; Bumbaširevi? V.; Pavlovi? A.; Palibrk I.; Pandurovi? M.

2008-01-01

123

Hypothalamic astrocytes in obesity.  

UK PubMed Central (United Kingdom)

Obesity is characterized by a chronic and low-grade inflammation in tissues including the hypothalamus. Hypothalamic inflammation is considered an early and determining factor for the onset of obesity, a factor that occurs even before body weight gain. Within the hypothalamus, microglia and astrocytes produce cytokines that drive inflammatory responses. Astrocytes are directly affected by nutrient excess and might play a unique role in promoting hypothalamic inflammatory responses in obesity. This article reviews evidence supporting the role of hypothalamic astrocytes in obesity, and suggests a new approach for neuroendocrine research designed to reveal pathogenesis and develop novel treatment strategies against obesity.

García-Cáceres C; Yi CX; Tschöp MH

2013-03-01

124

Obesity and contraception: controversy?  

Directory of Open Access Journals (Sweden)

Full Text Available Rebecca D Goldberg, Stefanie C Cardamone, Amitasrigowri S MurthyDepartment of Obstetrics and Gynecology, New York University School of Medicine, New York, NY, USAAbstract: Obesity is increasing worldwide and is affecting the reproductive health of women. Contraceptive considerations are difficult in obese women given concerns about efficacy and comorbid conditions. Once surgical treatment of obesity has occurred and weight loss initiated, fertility risks increase and unintended pregnancy can result; often at the time of greatest weight loss. Family planning counseling in the obese patient must account for both preoperative conditions as well as postoperative return to fertility.Keywords: obesity, contraception, bariatric surgery

Goldberg RD; Cardamone SC; Murthy AS

2012-01-01

125

Obesity and metabolic inflammation.  

UK PubMed Central (United Kingdom)

Obesity epidemics affect 35.7% of adults and approximately 17% of children in the United States. Obesity has been associated with several health disorders, such as type 2 diabetes, cardiovascular diseases, fatty liver disease, and certain forms of cancer. Medical costs associated with obesity were estimated at $147 billion in 2008. Chronic tissue inflammation, particularly in adipose tissue, has been considered as a key underlying mechanism for the development of obesity-related metabolic syndrome. In this review, we discuss the recent progress in the field of metabolic inflammation and the potential implication of anti-inflammation approaches as therapeutic interventions for treating obesity-related metabolic disorders.

Xu H

2013-06-01

126

The integration of high-throughput testing of blood donors for cardiovascular disease risk assessment and prevention.  

UK PubMed Central (United Kingdom)

BACKGROUND AND OBJECTIVES: Some blood centers provide health screening as a public health measure and to encourage donation. The goal of the current study was to provide cardiovascular disease (CVD) screening to donors using high-throughput testing and web-based communications. MATERIALS AND METHODS: CVD risk screening was offered to donors at selected mobile drives in a large metropolitan area. Risk factors were determined by donor questionnaire, laboratory testing (total cholesterol, HDL levels and hemoglobin A1c), and blood pressure measurement. Results were reported to participants via mail and website. A 60-day follow up web-based survey was sent to participants via email to assess the impact of the program on donor's behavior. RESULTS: 9435 donors, 17-75years old participated with the following risk factors: 61.3% BMIs>25, 28.8% high total cholesterol, and 31.4% lower than recommended HDL levels. 25.3% of donors that responded to the follow up survey went to see their health care provider based on screening results and 9% of these received new or modified treatment. CONCLUSION: In our sample, blood donors are healthier than the general population, but many still have CVD risk factors, particularly obesity. CVD screening can be successfully used to make donors aware of this important health information and some donors act on this information.

Kessler DA; Grima KM; Valinsky JE; Ortiz C; Hillyer CD; Nandi V; Jones RL; Shaz BH

2013-07-01

127

Challenges in obesity research.  

UK PubMed Central (United Kingdom)

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.

Palou A; Bonet ML

2013-09-01

128

Pharmacokinetic alterations in obesity.  

Science.gov (United States)

Although some medications have established dosing adjustments for obesity (Table 2), it remains unknown for the majority of medications if dosing adjustment is warranted. It is important to remember dosage adjustments may not be as simple as doubling an antibiotic dose because a patient is morbidly obese. Individualizing drug dosing is imperative in the obese, postoperative patient to ensure they simultaneously have therapeutic serum concentrations without drug toxicity. Much of what has been learned from studies in obese patients is that the pharmacokinetic alterations of medications are variable. Broad application of dosing guidelines even among medications within the same therapeutic class is likely not appropriate. An increased emphasis in researching the effects of obesity on the fate of medications is of paramount importance as the obese population grows. Practitioners should use caution and be vigilant in monitoring pharmacotherapy in obese individuals. PMID:17134048

Lee, Jane B; Winstead, P Shane; Cook, Aaron M

2006-11-01

129

Obesity and bone.  

UK PubMed Central (United Kingdom)

Recent studies indicate that fractures in obese postmenopausal women and older men contribute significantly to the overall fracture burden. The effect of obesity is to some extent site-dependent, the risk being increased for some fractures and decreased for others, possibly related to different patterns of falling and the presence or absence of soft tissue padding. Risk factors for fracture in obese individuals appear to be similar to those in the nonobese population, although falls may be particularly important in the obese. There is some evidence that the morbidity associated with fractures in obese individuals is greater than in the nonobese; however, a recent study indicates that the mortality associated with fracture is lower in obese and overweight people than in those of normal weight. The evidence base for strategies to prevent fractures in obese individuals is weak and is an important area for future research.

Compston J

2013-03-01

130

Obesity and Gastrointestinal Diseases  

Science.gov (United States)

The prevalence of obesity in the Japanese population has been increasing dramatically in step with the Westernization of lifestyles and food ways. Our study demonstrated significant associations between obesity and a number of gastrointestinal disorders in a large sample population in Japan. We demonstrated that reflux esophagitis and hiatal hernia were strongly related to obesity (BMI > 25) in the Japanese. In particular, obesity with young male was a high risk for these diseases. On the other hand, it has been reported that obesity is also associated with Barrett's esophagus and colorectal adenoma; however, obesity was not a risk factor for these diseases in our study. The difference of ethnicity of our subjects may partly explain why we found no data to implicate obesity as a risk factor for Barrett's esophagus. Arterial sclerosis associated with advanced age and hyperglycemia was accompanied by an increased risk of colorectal adenoma.

Fujimoto, Ai; Hoteya, Shu; Iizuka, Toshiro; Ogawa, Osamu; Mitani, Toshifumi; Kuroki, Yuichiro; Matsui, Akira; Nakamura, Masanori; Kikuchi, Daisuke; Yamashita, Satoshi; Furuhata, Tsukasa; Yamada, Akihiro; Nishida, Noriko; Arase, Koji; Hashimoto, Mitsuyo; Igarashi, Yoshinori; Kaise, Mitsuru

2013-01-01

131

Which incision is better for living-donor right hepatectomy? Midline, J-shaped, or Mercedes.  

UK PubMed Central (United Kingdom)

Incision-related morbidity for donors is a major concern in living-donor right hepatectomy (LDRH). Open approaches use midline, J-shaped, and Mercedes incisions for LDRH. We retrospectively studied 95 consecutive donors who underwent LDRH between January 2009 and November 2010. They underwent midline (n = 32), J-shaped (n = 28), or Mercedes (n = 35) incisions. We studied resection times, perioperative bleeding, postoperative hospital stay, and postoperative pain assessed by the visual analog scale (VAS) and by analgesic requirements as well as laboratory data and complications. Postoperative analgesic requirements and postoperative VAS scores were significantly lower in the midline group (P < .05) upon univariate but not multivariate analyses. The postoperative complications as well as other parameters were similar between the groups. In conclusion, compared with a J-type shaped or not for Mercedes incision, a donor hepatectomy can be satisfactorily performed via a midline incision by experienced surgeons without increased risk.

Demirbas T; Bulutcu F; Dayangac M; Yaprak O; Guler N; Oklu L; Akyildiz M; Altaca G; Tokat Y; Yuzer Y

2013-01-01

132

Clinical comparative study of aquacel and paraffin gauze dressing for split-skin donor site treatment.  

UK PubMed Central (United Kingdom)

The management of split-thickness skin graft donor sites is targeted towards promoting the healing process, while minimizing adverse effects and complications. The aim of this study was to compare donor site treatment outcome between Aquacel, a carboxymethylcellulose-based hydrofiber dressing, and the standard mesh paraffin gauze dressing. The study included 23 adult patients. Half of the skin graft donor site in the proximal thigh was dressed with paraffin gauze and the rest with Aquacel. The results indicated that patients treated with Aquacel experienced significantly less pain and a more rapid rate of epithelialization compared with patients treated with mesh paraffin gauze dressing. Final scarring (ie, after the 1-year follow-up) was significantly better with the Aquacel dressing. We conclude that Aquacel dressing is superior to the standard mesh paraffin gauze dressing for split-thickness donor site area in pain relief, ease of treatment, promotion of epithelialization, and the quality of scarring.

Barnea Y; Amir A; Leshem D; Zaretski A; Weiss J; Shafir R; Gur E

2004-08-01

133

Clinical comparative study of aquacel and paraffin gauze dressing for split-skin donor site treatment.  

Science.gov (United States)

The management of split-thickness skin graft donor sites is targeted towards promoting the healing process, while minimizing adverse effects and complications. The aim of this study was to compare donor site treatment outcome between Aquacel, a carboxymethylcellulose-based hydrofiber dressing, and the standard mesh paraffin gauze dressing. The study included 23 adult patients. Half of the skin graft donor site in the proximal thigh was dressed with paraffin gauze and the rest with Aquacel. The results indicated that patients treated with Aquacel experienced significantly less pain and a more rapid rate of epithelialization compared with patients treated with mesh paraffin gauze dressing. Final scarring (ie, after the 1-year follow-up) was significantly better with the Aquacel dressing. We conclude that Aquacel dressing is superior to the standard mesh paraffin gauze dressing for split-thickness donor site area in pain relief, ease of treatment, promotion of epithelialization, and the quality of scarring. PMID:15269581

Barnea, Yoav; Amir, Aharon; Leshem, David; Zaretski, Arik; Weiss, Jerry; Shafir, Raphael; Gur, Eyal

2004-08-01

134

Diets of obese and non-obese older subjects  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Aim: To compare diets between obese and non-obese in healthy older subjects. Methods: Forty-five obese and eighty-seven non-obese older subjects were recruited and their habitual factors that may contribute to obesity were asses...

Yukoh Yaegashi; Atsuko Satoh; Hideaki Kudoh; Sangun Lee; Chiaki Kitamiy; James P. Butler; Hidetada Sasaki

135

Organs transplanted from intoxicated donors.  

UK PubMed Central (United Kingdom)

PURPOSE: The purpose of our study was to evaluate short- and long-term results of transplants from cadaver donors who have died of poisoning by various substances. MATERIALS AND METHODS: The actuarial survival rate of organs from intoxicated donors was calculated using the Kaplan-Meier method. RESULTS: Among the 507 donors between January 1998 and December 2002, 5 (0.98%) had a cause of brain death of poisoning, namely, organo-phosphates (n = 2), methanol (n = 1), cyanide (n = 1) and acetylsalicilic acid(n = 1), from whom were procured 10 kidneys, 1 liver, 2 corneas, and 1 set of bones. The follow up for patients receiving solid organs was 15.2 months (range, 0-48 months). At 3 months, 90% of kidneys had normal function. No delayed graft function rejection episodes or major complications were reported in any recipient. None showed evidence of acute or chronic poisoning. Two died, 1 early mortality was due to anesthetic complications and the other at 17 months to an unknown cause. Actuarial kidney survival rates were 90% and 80% at 12 and 24 months, respectively. The liver recipient was well at the end of follow up. CONCLUSION: Using organs of poisoned donors is feasible with comparable graft survival rates to other recipient.

Duque E; Duque J; Henao J; Mejia G; Arango J; Arroyave I; Pena L; Tobón R; Carvajal J; Zuluaga G; Garcia A; Sanín E; Gutiérrez J; Velásquez A; Arbeláez M

2004-07-01

136

Live Donor Partial Hepatectomy for Liver Transplantation: Is There a Learning Curve?  

Directory of Open Access Journals (Sweden)

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; N. Elias; D. S. Ko; T. Kawai; J. Markmann; S. Feng; A. B. Cosimi; M. Hertl

2010-01-01

137

Hand-assisted retroperitoneoscopic versus standard laparoscopic donor nephrectomy: HARP-trial  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Transplantation is the only treatment offering long-term benefit to patients with chronic kidney failure. Live donor nephrectomy is performed on healthy individuals who do not receive direct therapeutic benefit of the procedure themselves. In order to guarantee the donor's safety, it is important to optimise the surgical approach. Recently we demonstrated the benefit of laparoscopic nephrectomy experienced by the donor. However, this method is characterised by higher in hospital costs, longer operating times and it requires a well-trained surgeon. The hand-assisted retroperitoneoscopic technique may be an alternative to a complete laparoscopic, transperitoneal approach. The peritoneum remains intact and the risk of visceral injuries is reduced. Hand-assistance results in a faster procedure and a significantly reduced operating time. The feasibility of this method has been demonstrated recently, but as to date there are no data available advocating the use of one technique above the other. Methods/design The HARP-trial is a multi-centre randomised controlled, single-blind trial. The study compares the hand-assisted retroperitoneoscopic approach with standard laparoscopic donor nephrectomy. The objective is to determine the best approach for live donor nephrectomy to optimise donor's safety and comfort while reducing donation related costs. Discussion This study will contribute to the evidence on any benefits of hand-assisted retroperitoneoscopic versus standard laparoscopic donor nephrectomy. Trial Registration Dutch Trial Register NTR1433

Dols Leonienke FC; Kok Niels FM; Terkivatan Turkan; Tran TC Khe; d'Ancona Frank CH; Langenhuijsen Johan F; zur borg Ingrid RAM; Alwayn Ian PJ; Hendriks Mark P; Dooper Ine M; Weimar Willem; IJzermans Jan NM

2010-01-01

138

Asthma and obesity.  

UK PubMed Central (United Kingdom)

The prevalence and incidence of asthma have increased among obese children and adults, particularly among women. Obesity seems to be a predisposing factor for the development of asthma, but the underlying mechanisms of its influence are still uncertain. Various hypotheses have been proposed to explain the link between obesity and asthma such as a common genetic predisposition, developmental changes, altered lung mechanics, the presence of a systemic inflammatory process, and an increased prevalence of associated comorbid conditions. Over-diagnosis of asthma does not seem to be more frequent in obese compared to non-obese subjects, but the added effects of obesity on respiratory symptoms can affect asthma control assessment. Obesity can make asthma more difficult to control and is associated with a reduced beneficial effect of asthma medications. This could be due to a change in asthma phenotype, particularly evidenced as a less eosinophilic type of airway inflammation combined to the added effects of changes in lung mechanics. Weight loss is associated with a universal improvement of asthma and should be part of asthma management in the obese patient. Additional research should be conducted to better determine how obesity influences the development and clinical expression of asthma, establish the optimal management of asthma in this population and determine how obesity affects long-term asthma outcomes in these patients.

Boulet LP

2013-01-01

139

Obesity: A chronic disease  

Directory of Open Access Journals (Sweden)

Full Text Available The last decades, obesity represents one of the most serious health issues with approximately 310 million people presently affected globaly and is frequently cited as a chronic disease. The term obesity refers to the excessive accumulation of fat, mainly under the skin but also on various organs of the body. Obesity’s most common cause is the intake of more calories than those required for one’s daily needs.The aim of the study was to review etiology of obesity, as well as the accountable risk factors.The method ?f this study included bibliography research from both the review and the research literature which referred to the etiology, the risk factors of obesity and the beneficial role of physical exercise on weight management.Results: The majority of research studies showed that a growing number of adults, children and adolescents around the world, is facing the danger of becoming obese. In literature is cited that both genetic and environmental factors are accountable for the development of obesity. It is well established that the main therapeutic approaches to loose weight are life-style modifications and the combination of a well-balanced hypocaloric diet with regular physical exercise.Conclusions: The problem of obesity and overweight has become an epidemic in most developed countries. The rapid increase in the numbers of obese people reflects environmental changes, the reduced activity and also the increased food intake.

Styliani Zerva; Magdalini Zerdila

2009-01-01

140

Five Years on: Leadership Challenges of an Experienced CEO  

Science.gov (United States)

Experienced leaders face challenges that demand different leadership approaches to those of inexperienced leaders. The purposes of this article are to: (1) explore the leadership initiatives prominent for experienced leaders compared with inexperienced leaders; (2) examine the relationship between transformational leadership and these initiatives;…

Sarros, James C.; Sarros, Anne M.

2011-01-01

 
 
 
 
141

Provider Adherence to Recommended Prenatal Care Content: Does It Differ for Obese Women?  

UK PubMed Central (United Kingdom)

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 <50 %, medium 50-79 %, and high ?80 %) was compared between obese (n = 69) and non-obese (n = 128) women in a linked database of deliveries to low-income, minority women from 2003 to 2004. Sample content items included procedures delivered at every visit (blood pressure, urinalysis, maternal weight, fetal heart rate check), timed screenings for birth defects and gestational 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.

Kominiarek MA; Rankin K; Handler A

2013-08-01

142

The obesity paradox in the US population.  

UK PubMed Central (United Kingdom)

BACKGROUND: Recently a number of studies have found a lower risk of dying for obese individuals than for normal-weight individuals. The explanation for these paradoxical findings has not yet been identified. OBJECTIVE: The objective was to assess whether this paradoxical pattern exists in the US population and whether it can be explained by reverse causation. DESIGN: Survival analyses were used to calculate the RR of all-cause mortality for obesity by using data from 35,673 participants in NHANES I (1971-1975), NHANES II (1976-1980), and NHANES III (1988-1994), which reported 7087 deaths during 3 different 15-y follow-up periods. RESULTS: With normal weight as a referent, a lower relative mortality risk of obesity was found only in NHANES III and only among men with a wide variety of preexisting serious illnesses. For this subgroup, the relative mortality risks in NHANES I, II, and III were 2.22 (95% CI: 1.45, 3.40), 0.89 (95% CI: 0.70, 1.15), and 0.65 (95% CI: 0.47, 0.91), respectively. Whereas the mortality rate among seriously ill normal-weight men did not change significantly between NHANES I and III, it did decrease significantly among seriously ill obese men, suggesting that reverse causation was not responsible for the lower relative mortality risk among seriously ill obese men in NHANES III. CONCLUSIONS: Only obese NHANES male participants with a wide variety of serious illnesses experienced lower mortality risk than their normal-weight counterparts and only in NHANES III. Reverse causation seems unlikely to have played a role. These conclusions require confirmation.

Greenberg JA

2013-06-01

143

Changes in obesity-related attitudes in women seeking weight reduction.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To examine changes in obesity-related attitudes in a sample of obese women who participated in either dieting or non-dieting interventions. RESEARCH METHODS AND PROCEDURES: A total of 123 obese women were randomly assigned to one of three weight control programs: meal replacement diet, balanced deficit diet, or a non-dieting program. (The first two groups were combined as a single dieting condition.) Participants completed questionnaires (at baseline, Week 20, and Week 40) to assess beliefs and attitudes about obesity, along with measures of self-esteem, depression, and body image. RESULTS: At Weeks 20 and 40, participants in the non-dieting condition reported significantly less negativity about obesity than those in the dieting group. Women in the dieting condition did not report an increase in negative attitudes toward obesity, despite losing significantly more weight than non-dieting participants. Both groups experienced improvements in self-esteem, body image, and depressive symptoms. Improvement in self-esteem was associated with a reduction in negativity about obesity and with improvements in body image. DISCUSSION: The non-dieting program produced greater reductions in negative attitudes toward obesity than the dieting intervention. Dieting (with successful weight loss), however, did not result in greater negativity toward obesity. Non-dieting programs seem to be useful in obese women for improving self-esteem, body image, and internalized negative attitudes about obesity.

Crerand CE; Wadden TA; Foster GD; Sarwer DB; Paster LM; Berkowitz RI

2007-03-01

144

Influence of donor-donor transport on excitation energy transfer  

International Nuclear Information System (INIS)

Energy migration and transfer from acriflavine to rhodamine B and malachite green in poly (methylmethacrylate) have been investigated using the decay function analysis. It is found that the influence of energy migration in energy transfer can be described quite convincingly by making use of the theories of Loring, Andersen and Fayer (LAF) and Huber. At high acceptor concentration direct donor-acceptor transfer occurs through Forster mechanism. (author). 17 refs., 5 figs.

1989-01-01

145

Quality Donor System v2.1  

Science.gov (United States)

... Quality Donor System v2.1. Applicant: Talisman Ltd. 510(k) number: BK070020. Product: Quality Donor System v2.1. Date: 07/16/2007. -. ... More results from www.fda.gov/biologicsbloodvaccines/bloodbloodproducts/approvedproducts

146

Donor Information System (DIS) 3.2  

Science.gov (United States)

... Donor Information System (DIS) 3.2. Applicant: BioLife Plasma Services, LP. 510(k) number: BK060017. Product: Donor Information System (DIS) 3.2 ... More results from www.fda.gov/biologicsbloodvaccines/bloodbloodproducts/approvedproducts

147

Biological Dressings for Skin Graft Donor Sites.  

Science.gov (United States)

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

1972-01-01

148

Who Can Be an Organ Donor?  

Science.gov (United States)

... be an Organ Donor? Questions and Answers about Organ Donation Nasimul Ahsan Steven Alexander Roy Bloom Carl Cardella ... be an Organ Donor? Questions and Answers about Organ Donation 1. Why ask healthy people to be organ ...

149

Group-VI Donor Impurities in Silicon.  

Science.gov (United States)

It is suggested that the recently obtained impurity potentials of the group-V donors may account for the deep-level group-VI donors. Good agreement with experiment is obtained for sulfur in silicon. (Author)

C. T. Sah T. H. Ning

1971-01-01

150

Becoming a Blood Stem Cell Donor  

Science.gov (United States)

... in Upload Search Guide Loading... Becoming a Blood Stem Cell Donor NCIcancertopics · 30 videos Subscribe Subscribed Unsubscribe 299 ... Ever considered becoming a bone marrow or blood stem cell donor? Follow this true story of a former ...

151

Obesity and pregnancy.  

DEFF Research Database (Denmark)

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

2004-01-01

152

Obesity and obstetric anaesthesia.  

UK PubMed Central (United Kingdom)

Obesity is increasing in the population as a whole, and especially in the obstetric population, among whom pregnancy-induced physiological changes impact on those already present due to obesity. In particular, changes in the cardiovascular and respiratory systems during pregnancy further alter the physiological effects and comorbidities of obesity. Obese pregnant women are at increased risk of diabetes, hypertensive disorders of pregnancy, ischaemic heart disease, congenital malformations, operative delivery postpartum infection and thromboembolism. Regional analgesia and anaesthesia is usually preferred but may be challenging. Obese pregnant women appear to have increased morbidity and mortality associated with caesarean delivery and general anaesthesia for caesarean delivery in particular, and more anaesthesia-related complications. This article summarises the physiological and pharmacological implications of obesity and pregnancy and describes the issues surrounding the management of these women for labour and delivery.

Mace HS; Paech MJ; McDonnell NJ

2011-07-01

153

Lipoprotein lipase and obesity  

Directory of Open Access Journals (Sweden)

Full Text Available Obesity is one of the fast-growing major diseases in developed and developing countries. As has been persuasively argued, long-term imbalance between intake and expenditure of fat is a central factor in the etiology of obesity. Obesity aggravates insulin resistance and promotes cardiovascular diseases and atherosclerosis. We hypothesized that elevating lipoprOtein lipase (LPL) activity in skeletal muscle would cause an improvement of obesity. To test this hypothesis, we studied the effects of the LPL activator NO-1886 inobese animals. NO-1886 elevated LPL activity in skeletal muscle, and improved obesity as well as insulin resistance in obese rats. Furthermore, NO-1886 mitigated body weight gain induced by pioglitazone without suppressive effect on the adiponectin-increasing action of pioglitazone. LPL activators hold a lot of promise of curing several diseases shown above in clinical scene.

2012-01-01

154

Consequences of childhood obesity.  

UK PubMed Central (United Kingdom)

INTRODUCTION: The incidence of childhood obesity is rising across the globe, and obesity related co-morbidities are increasing concomitantly in the paediatric population. MATERIALS AND METHODS: PubMed search for research and review papers on complications of childhood obesity was performed. RESULTS: The consequences of childhood obesity can be broadly classified into medical and psychosocial consequences. Medical consequences include metabolic complications such as diabetes mellitus, hypertension, dyslipidaemia and non-alcoholic fatty liver disease, and mechanical problems such as obstructive sleep apnoea syndrome and orthopaedic disorders. Psychological and social consequences are prevalent but often overlooked. Local data on these complications were also discussed. CONCLUSION: Childhood obesity is associated with significant morbidities, which not only have immediate impact on the health of the obese children, but also significantly increase the risk of morbidities in adulthood.

Lee YS

2009-01-01

155

Genetics of childhood obesity.  

UK PubMed Central (United Kingdom)

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 disorders; indeed there is general consensus on these findings from generally positive replication outcomes by independent groups. To date, there have been only a few GWAS-related reports for childhood obesity specifically, with studies primarily uncovering loci in the adult setting instead. It is clear that a number of loci previously reported from GWAS analyses of adult BMI and/or obesity also play a role in childhood obesity.

Zhao J; Grant SF

2011-01-01

156

Healthy donor effect: its magnitude in health research among blood donors.  

UK PubMed Central (United Kingdom)

BACKGROUND: The healthy donor effect has been mentioned as a methodologic problem in blood donor health research. The aim of this study was to investigate different elements of the healthy donor effect. STUDY DESIGN AND METHODS: First, recent donors (<4 years registered as a donor) were compared with the general population. Second, active and lapsed donors were compared. Third, short-career donors (<14 donations) were compared with long-career donors (>37 donations). Various health and lifestyle indicators were used as outcome measures. RESULTS: Compared to the general population, recent donors had a better self-rated health (odds ratio [OR], 1.43; 95% confidence interval [CI], 1.27-1.61), visited the general practitioner (GP) less often (OR, 0.66; 95% CI, 0.60-0.72), and were less often treated by a specialist (OR, 0.83; 95% CI, 0.75-0.93). Recent donors also exhibited a healthier lifestyle compared to the general population. When examining active versus lapsed donors, similar results were found in favor of active donors. With respect to donation career, long-career donors were healthier than short-career donors, but effects were less strong; the ORs were 1.33 (95% CI, 1.15-1.54) for self-rated health, 0.85 (95% CI, 0.76-0.94) for GP visit, and 0.83 (95% CI, 0.68-1.00) for specialist treatment. When comparing long- and short-career donors on lifestyle indicators, there were barely any significant differences. CONCLUSIONS: The findings strongly point to the presence of a healthy donor effect when comparing donors with the general population and active versus lapsed donors. The healthy donor effect was less pronounced within active donors, when comparing long- and short-career donors. Therefore, health research should primarily be carried out within active donors.

Atsma F; Veldhuizen I; Verbeek A; de Kort W; de Vegt F

2011-08-01

157

Obesity: A multifactorial disease  

Directory of Open Access Journals (Sweden)

Full Text Available Obesity represents one of the most serious global health issues with approximately 310 million people presently affected. Main cause of it’s development is the increase of energy intake in regard to energy expenditure.Aim: The aim of the present study was to review the literature about the causes and treatment of obesity, as well as the anthropometrical measurements used for the assessment of obesity. The method ?f this study included bibliography research from both the review and the research literature, mainly in the “pub med data base” which referred to the causes and treatment of obesity, as well as the anthropometrical measurements used for the assessment of obesity. Results: The prevalence of obesity has increased markedly, throughout the world. Although the etiology of obesity has not been fully understood yet, however it seems to be a multifactorial disease for which are responsible a great deal of psychological, environmental, genetic and behavioral factors. The most common anthropometrical measurement that is used for assessment of obesity is Body Mass Index (BMI) and is calculated by the following equation: ???=Weight/Height2. A value of ??? ? 30 kg/m2 equals obesity. Another simple test used to measure obesity is Waist to Hip Ratio, which measures abdominal adiposity. Values greater than 0,95 should be treated seriously as they normally indicate body fatness. The majority of studies show that life-style modification in conjunction with a well-balanced nutrition and regular physical exercise consist the cornerstone for the treatment and prevention of obesity.Conclusions: Obesity is a disease that can be preventable through modification of way of living. The development of proper strategy prevention capable to change attitudes, to promote nutrition and physical activity should be the primary goal of every community and government.

Maria Saridi; Marianna Ntokou

2010-01-01

158

Programming towards childhood obesity.  

UK PubMed Central (United Kingdom)

There is now considerable evidence that a constitutional susceptibility to fat gain is necessary for children to become obese under the pressure of an obesogenic environment; this is the programming towards obesity. The role of genetics in this programming is dominant. Besides the rare monogenic recessive forms of obesity secondary to mutations in genes involved in the hypothalamic appetite control pathways, obesity linked to mutations in melanocortin 3 and 4 receptors are more frequent due to their dominant mode of transmission. Predisposition to common obesity is polygenic and involves a network of genes; nevertheless, more research is required to elucidate their exact role. Fetal and perhaps early postnatal programming is also possible. Under- and overnutrition, diabetes, and maternal smoking during pregnancy were shown to promote later obesity and may affect the central body weight regulatory system during fetal development. The role of early postnatal factors such as formula-feeding rather than breastfeeding, excess in n-6 polyunsaturated fatty acids or protein intakes, and excessive weight gain early in life is more questionable and needs further investigation. Taking into consideration that childhood obesity is a programmed disease should modify its clinical management. Childhood obesity should no longer be considered as the result of inappropriate eating habits and/or excessive inactivity in order to relieve the obese children's discrimination and their parents' guilt. Since treatment of obese children requires a substantial motivation to continuously fight against the programmed excessive drive to eat, it seems wiser to wait for children to be old enough, thus more motivated, to initiate energy restriction. Moreover, with the great majority of children being not predisposed to obesity, prevention strategies should not be addressed to the whole pediatric population but targeted to those children at risk. Improvement of knowledge on programming towards obesity is essential to develop more promising therapeutic and preventive approaches.

Tounian P

2011-01-01

159

Social consequences of obesity.  

UK PubMed Central (United Kingdom)

Although social behavior has been studied by sociologists, the absence of references to such work is strikingly apparent in many discussions of the behavioral aspects of obesity. This paper presents some sociologic notions and research that can contribute to the health care professional's understanding of the problems of obesity and its treatment possibilities. One such approach could well be the use of weight control programs predicated on rearranging the social environment in which obese people live and eat.

Tobias AL; Gordon JB

1980-04-01

160

Estimating the number of lifetime follicular units: a survey and comments of experienced hair transplant surgeons.  

UK PubMed Central (United Kingdom)

BACKGROUND: Quantitative estimates of the yield of follicular units (FUs) containing likely "permanent" hair for hair transplanting have been only theoretically estimated. OBJECTIVE: To clarify the number of likely permanent hair follicles in potential donor areas. METHODS AND MATERIALS: Thirty-four highly experienced surgeons were surveyed and estimated the number of FUs containing "permanent" hair in hypothetical 30-year-old male patients with varying hair densities and destined to develop Type V or VI male pattern baldness (MPB). RESULTS: Patients with average hair density and destined to develop Type V MPB were estimated to yield an average of 6,404 FUs, 4,963 FUs with below average density, and 7,904 FUs with above-average density. When Type VI MPB is anticipated, estimated mean harvest yields are 5,393 FUs with average density, 4,204 FUs with below-average density, and 6,661 FUs with above-average density. CONCLUSION: There are a finite number of FUs containing permanent hairs in any patient. The results of this survey provide a guideline that should be helpful in avoiding inappropriately aggressive goals such as creating overly dense or overly anterior frontal and temporal hairlines without regard for a cautious evaluation of the limitations of likely long-term donor/recipient area ratios. We present useful guideline numbers that can help physicians choose appropriate surgical goals.

Unger WP; Unger RH; Wesley CK

2013-05-01

 
 
 
 
161

Liver transplantation from hepatitis B surface antigen-positive donors.  

UK PubMed Central (United Kingdom)

One possibility to increase the organ pool is to use grafts from hepatitis B virus (HBV) surface antigen (HBsAg)-positive donors, but few data are currently available in this setting. Herein, we reviewed the outcome of 92 liver transplantations using allografts from HBsAg-positive donors in the United States (1990-2009). They had experienced HBV-related (n = 68) or HBV-unrelated disease (n = 24). There was no difference between patients who received HBsAg-positive versus HBsAg-negative allografts based on age, Model for End-stage Liver Disease (MELD) score, length of stay, wait time, and donor risk index. HBsAg-positive allografts were more likely to be imported and used in MELD exceptional cases. Allograft and patient survival were comparable between the two groups. HBsAg-positive allografts deserve consideration when no other organ is available in a suitable waiting time in the present era of highly effective antiviral therapy.

Saidi RF; Jabbour N; Shah SA; Li YF; Bozorgzadeh A

2013-01-01

162

Mind/Body Health: Obesity  

Science.gov (United States)

Mind/body health: Obesity Obesity is one of the nation's fastest-growing and most troubling health problems. Unless you ... can lead to long-term problems. A mind-body interaction Obesity is also frequently accompanied by depression ...

163

Obesity and eating style.  

UK PubMed Central (United Kingdom)

Eating styles of 30 obese women and 37 matched women of normal weight were observed unobtrusively in a fast-food restaurant in the search for an "obese eating style" or other differences between the two groups. The size and character of the food was carefully matched by giving each woman a coupon entitling her to a free meal of either 985 or 1,800 calories. There were only small and inconsistent differences between obese and normal-weight women. No evidence of an "obese eating style" was found.

Stunkard A; Coll M; Lundquist S; Meyers A

1980-10-01

164

Childhood obesity in America.  

UK PubMed Central (United Kingdom)

PURPOSE OF REVIEW: To provide an overview of the current advances in childhood obesity physiology, intervention, and prevention. RECENT FINDINGS: Structural and functional brain impairments are present in obese adolescents with metabolic syndrome (MetS). Aerobic training for 20 or 40?min per day produced similar affects on metabolic risk factors. Vitamin D supplementation has been shown to improve the metabolic risk factors in obese children; however, obese children require greater doses to treat vitamin D deficiency. A 10-week community-based exergaming weight management program significantly decreased the BMI in obese children. SUMMARY: There is surmounting research on MetS and its associated risk factors in obese children. Gaining a comprehensive overview of the factors associated with obesity in children is crucial in developing the most effective intervention strategies. Community-based and family-centered interventions have generated positive results in reducing children's BMI and improving MetS risk factors. In addition to obesity intervention efforts, ongoing prevention initiatives are imperative to reduce the prevalence of childhood obesity.

Van Grouw JM; Volpe SL

2013-10-01

165

Behavioral treatment of obesity  

Directory of Open Access Journals (Sweden)

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; Ruth Fabbri Ramos Ascencio

2006-01-01

166

[Hemodynamics of massive obesity  

UK PubMed Central (United Kingdom)

Congestive heart failure is a frequent complication of massive obesity and a major cause of death. Prior to the cardiac decompensation stage, infraclinical haemodynamic disturbances can be observed in obese subjects with normal blood pressure: the cardiac output and cardiac index increase, due to a rise in systolic ejection volume, the total peripheral resistance falls and the intravascular volume augments. Cardiac adjustment takes place in the form of excentric left ventricular hypertrophy. Ventricular extrasystoles, often associated with this hypertrophy, might be the cause of sudden death in some obese patients. Arterial hypertension is about 3 times more frequent in obese subjects than in subjects of normal weight, and even more frequent in those with massive obesity. To the high preload due to obesity hypertension adds an increased after-load. This results in augmentation of the mass and work of the left ventricle with progressive alteration of its function. The incidence of coronary disease is increased in obese subjects, notably those with abnormal adiposity. Finally, the return circulation is very often perturbed, notably in gynecoid obesity: there is venous insufficiency with a higher risk for thromboembolism, and lymphatic insufficiency or capillary permeability disorders. A low-calorie diet and a physical rehabilitation of sedentary obese subjects facilitate weight reduction and at the same time tend to correct the associated metabolic disturbances; they reduce blood pressure and also seem to reduce the left ventricular hypertrophy.

Valensi P

1993-10-01

167

New Biologically Active Hydrogen Sulfide Donors.  

UK PubMed Central (United Kingdom)

Generous donors: The dithioperoxyanhydrides (CH3 COS)2 , (PhCOS)2 , CH3 COSSCO2 Me and PhCOSSCO2 Me act as thiol-activated hydrogen sulfide donors in aqueous buffer solution. The most efficient donor (CH3 COS)2 can induce a biological response in cells, and advantageously replace hydrogen sulfide in ex vivo vascular studies.

Roger T; Raynaud F; Bouillaud F; Ransy C; Simonet S; Crespo C; Bourguignon MP; Villeneuve N; Vilaine JP; Artaud I; Galardon E

2013-10-01

168

Donor notification and counseling - Experience and challenges.  

UK PubMed Central (United Kingdom)

BACKGROUND AND OBJECTIVES: In India, screening of blood for human immunodeficiency virus, hepatitis B surface antigen, and hepatitis C virus is mandatory before issue for transfusion, but donors are not informed of their reactive status. Advising donors who have reactive test results of viral markers is an essential adjunct to blood donor testing and is part of donor care. We realized that donor disclosure is an important public health issue. Therefore, we took the initiative of posttest counseling of blood donors. MATERIALS AND METHODS: The donors reactive for any transfusion transmitted diseases by enzyme linked immunosorbent assay in duplicate as well as by rapid tests, were notified of their reactive test results and called for counseling. We tried to maintain confidentiality at each step. Counseling and information about confirmation, evaluation, early treatment and prevention of transmission were given to responding donors. RESULTS: The results were analyzed for the period from 1st April 2011 to 30th June 2012. Among 15,844 donors, 172 were found to be reactive for various infectious markers. Letters were sent to all reactive donors. Only 60 donors responded and were counseled. The counseling rate was 49%, 45.5%, 50% and 17% for HBsAg, HCV, HIV and syphilis respectively. CONCLUSION: This study describes our experience and challenges faced in implementing the program of donor counseling in a resource poor setting.

Kaur G; Kaur P; Basu S; Kaur R; Sharma S

2013-06-01

169

Donor generation in plasma treated silicon  

Energy Technology Data Exchange (ETDEWEB)

As inversion of the conduction type of the p-silicon surface layer by gas discharge plasma treatment was observed. It was found that this conduction inversion was conditioned by donor center formation. Donor behavior are discussed. Some plasma treatment regimes to induce the donor centers in silicon are reported.

Kusmartseva, O.E.; Senchukov, F.D.

1989-04-20

170

The survival benefit of kidney transplantation in obese patients.  

UK PubMed Central (United Kingdom)

Obese patients have a decreased risk of death on dialysis but an increased risk of death after transplantation, and may derive a lower survival benefit from transplantation. Using data from the United States between 1995 and 2007 and multivariate non-proportional hazards analyses we determined the relative risk of death in transplant recipients grouped by body mass index (BMI) compared to wait-listed candidates with the same BMI (n = 208 498). One year after transplantation the survival benefit of transplantation varied by BMI: Standard criteria donor transplantation was associated with a 48% reduction in the risk of death in patients with BMI ? 40 kg/m(2) but a ? 66% reduction in patients with BMI < 40 kg/m2. Living donor transplantation was associated with ? 66% reduction in the risk of death in all BMI groups. In sub-group analyses, transplantation from any donor source was associated with a survival benefit in obese patients ? 50 years, and diabetic patients, but a survival benefit was not demonstrated in Black patients with BMI ? 40 kg/m(2). Although most obese patients selected for transplantation derive a survival benefit, the benefit is lower when BMI is ? 40 kg/m(2), and uncertain in Black patients with BMI ? 40 kg/m(2).

Gill JS; Lan J; Dong J; Rose C; Hendren E; Johnston O; Gill J

2013-08-01

171

Blood donor: nursing care plan  

Directory of Open Access Journals (Sweden)

Full Text Available The standardized nursing care plan can be used as a means through which the nurse will assess and identify the particular needs of the blood donor.To draw up the care plan, we have conducted the evaluation on the basis of the Marjory Gordon’s functional health patterns.The more prevailing diagnosis according to the NANDA taxonomy have been identified, results have been established according to the NOC (Nursing Outcomes Classification) taxonomy, and nursing interventions have been suggested according to the NIC (Nursing Interventions Classification) taxonomy. Also, certain potential complications, which are infrequent, must be observed and controlled in the blood donation process. Our main aim with this article has been to offer to professionals resources that grant to the caring activity scientific rigor, professional recognition and an unique and valid tool to evaluate the assistance with the best levels of quality for the blood donor.

Marco Antonio Zapata Sampedro; Laura Castro Varela

2008-01-01

172

Obesity and weight gain in relation to depression: findings from the Stirling County Study.  

UK PubMed Central (United Kingdom)

OBJECTIVE: This study concerns the question of whether obese subjects in a community sample experience depression in a different way from the nonobese, especially whether they overeat to the point of gaining weight during periods of depression. DESIGN: A representative sample of adults was interviewed regarding depression and obesity. SUBJECTS: The sample consisted of 1396 subjects whose interviews were studied regarding relationships between obesity and depression and among whom 114 had experienced a major depressive episode at some point in their lives and provided information about the symptoms experienced during the worst or only episode of major depression. MEASUREMENTS: The Diagnostic Interview Schedule (DIS) was used to identify major depressive episodes. Information was also derived from the section on Depression and Anxiety (DPAX) of the Stirling Study Schedule. Obesity was calculated as a body mass index >30. Logistic regressions were employed to assess relationships, controlling for age and gender, by means of odds ratios and 95% confidence intervals. RESULTS: In the sample as a whole, obesity was not related to depression although it was associated with the symptom of hopelessness. Among those who had ever experienced a major depressive episode, obese persons were 5 times more likely than the nonobese to overeat leading to weight gain during a period of depression (P<0.002). These obese subjects, compared to the nonobese, also experienced longer episodes of depression, a larger number of episodes, and were more preoccupied with death during such episodes. CONCLUSIONS: Depression among obese subjects in a community sample tends to be more severe than among the nonobese. Gaining weight while depressed is an important marker of that severity. Further research is needed to understand and possibly prevent the associations, sequences and outcomes among depression, obesity, weight gain and other adversities.

Murphy JM; Horton NJ; Burke JD Jr; Monson RR; Laird NM; Lesage A; Sobol AM

2009-03-01

173

Mini-Incision Living Donors Nephrectomy Using Anterior Muscle-Splitting Approach with Hybrid Technique  

Directory of Open Access Journals (Sweden)

Full Text Available Background: Significant morbidity is associated with standard open flank living donor nephrectomy. Laparoscopicdonor nephrectomy is criticized for a steep learning curve and a tendency to avoid the right kidney. The anterior muscle-splitting technique uses principles or advantages of an open extraperitoneal approach with minimal morbidity and the advantageous muscle-splitting (instead of cutting) procedure.Objective: To compare mini-incision laparoscopic instrument-assisted (MILIA) live donor nephrectomy using a muscle-splitting technique to the standard open-flank donor nephrectomy (ODN) approach for efficacy and safety.Methods: MILIA living donor nephrectomies were performed in 119 donors and compared to a cohort of open-flank nephrectomy donors (n=38) from the same center. Both donor groups were matched for body mass index as well as other personal characteristics.Results: The mean donor age was 35 (range: 18–60) years. The right kidney was procured in 28% of cases. The majority of donors were female (58%) and Caucasian (60%). No differences were observed between MILIA and ODN donors for the age, gender and ethnicity. However, MILIA donors experienced a longer mean±SD operative time (234±47 vs. 197±33 min, p<0.0001) but a shorter hospital stay (4±1 vs. 6±3 days for the ODN group, p<0.0001) and less intraoperative blood loss (215±180 vs. 331±397 mL, p<0.02). No difference was found in the number of units of blood transfused (0.13±0.6 vs. 0.34±1.0 units, p=0.13). Right-sided kidneys were almost equally harvested in both groups (29% of MILIA donors vs. 26% of ODN donors). Post-operatively, MILIA donors had a significantly lower mean pain scores at one week and one month after surgery (p<0.001). They showed significant better post-operative recovery—earlier stopping of pain medications and restoration of other preoperative activities. Moreover, they were better satisfied with their scar appearance. Scores on the short form-36 quality of life questionnaire were comparable for both groups.Conclusion: MILIA is a viable option as an alternative for pure laparoscopic donor nephrectomy. MILIA appearsto be as safe as open donor nephrectomy and may provide advantages over ODN, such as smaller incision, shorter hospital stay, and less incisional pain. Patient recovery and satisfaction after MILIA are excellent.This technique avoids the possibility of adhesive intestinal obstruction and also improves handling of major complications (e.g., bleeding) of laparoscopic donor nephrectomy. Utilization of this hybrid techniqueis particularly feasible on smaller (BMI<24 kg/m2) and medium-sized (BMI<28 kg/m2) donors. We believe that this technique should be adopted by centers that have limited advanced laparoscopic surgical experience and also it could be used selectively for the right donor nephrectomies, even in centers performinghand assisted donor nephrectomies by including a small patch of inferior vena cava for a better quality of right donor kidney during transplantation.

N Nazakatgoo; M M Hashad; A Saharia; LW Moore; A Osama Gaber

2010-01-01

174

Donor selection for adult-to-adult living donor liver transplantation: well begun is half done.  

UK PubMed Central (United Kingdom)

BACKGROUND: Donor selection criteria for adult-to-adult living donor liver transplantation vary with the medical center of evaluation. Living donor evaluation uses considerable resources, and the nonmaturation of potential into actual donors may sometimes prove fatal for patients with end-stage liver disease. On the contrary, a thorough donor evaluation process is mandatory to ensure safe outcomes in otherwise healthy donors. We aimed to study the reasons for nonmaturation of potential right lobe liver donors at our transplant center. METHODS: A retrospective data analysis of all potential living liver donors evaluated at our center from 1998 to 2010 was done. RESULTS: Overall, 324 donors were evaluated for 219 potential recipients, and 171 (52.7%) donors were disqualified. Common reasons for donor nonmaturation included the following: (1) donor reluctance, 21%; (2) greater than 10% macro-vesicular steatosis, 16%; (3) assisted donor withdrawal, 14%; (4) inadequate remnant liver volume, 13%; and (5) psychosocial issues, 7%, and thrombophilia, 7%. Ten donors (6%) were turned down because of anatomic variations (8 biliary and 2 arterial anomalies). Donors older than 50 years and those with body mass index of more than 25 were less likely to be accepted for donation. CONCLUSIONS: We conclude that donor reluctance, hepatic steatosis, and assisted donor withdrawal are major reasons for nonmaturation of potential into actual donors. Anatomic variations and underlying medical conditions were not a major cause of donor rejection. A system in practice to recognize these factors early in the course of donor evaluation to improve the efficiency of the selection process and ensure donor safety is proposed.

Sharma A; Ashworth A; Behnke M; Cotterell A; Posner M; Fisher RA

2013-02-01

175

[Is the traditional open donor nephrectomy in living donor renal transplantation still up to date?].  

UK PubMed Central (United Kingdom)

BACKGROUND: Living donor kidney transplantation is a well-established method to reduce time on the waiting list. Although the laparoscopic donor nephrectomy has already been established worldwide, more than 80% of the living donor nephrectomies are performed as a traditional open donor nephrectomy in Germany. The aim of our study was to analyze perioperative data and long-term outcome of donors and recipients following open donor nephrectomy. METHODS: From February 2004 to July 2008, a total of 51 open donor nephrectomies were performed in Tuebingen University Hospital. Forty-five data of corresponding transplant donors and recipients were analyzed. The Kocak classification which provides a format to compare postoperative complications after living donor nephrectomy was used. RESULTS: Five-year graft survival was 100%. No intraoperative complications occurred. Postoperatively Grad I complications were observed in 10 donors (22.2%). In the long term no major complications occurred. Two donors (4.4%) had newly diagnosed hypertension and required antihypertensive medication. None of the donors developed proteinuria. Right-sided transabdominal donor nephrectomy was associated with a shorter mean hospital stay compared to left-sided lumbar nephrectomy. (7.8 ± 2.4 vs. 9.2 ± 1.8 days, p < 0.05). CONCLUSION: Open donor nephrectomy is a safe procedure with an excellent graft survival. Complication rates in our center are comparable to recent results in laparoscopic living donor nephrectomy. Therefore, the open donor nephrectomy remains important.

Thiel K; Thiel C; Schenk M; Ladurner R; Nadalin S; Heyne N; Königsrainer A; Steurer W

2012-01-01

176

The dermatological consequences of obesity.  

UK PubMed Central (United Kingdom)

Obesity is emerging as a global epidemic with at least 300 million people thought to be obese worldwide. This has implications for health professionals including dermatologists. Recent interest has focused on the role of obesity in psoriasis, but obesity is implicated in many dermatoses. Perhaps most worrying is emerging data which suggest that obesity may constitute a risk factor for the development of skin cancer. Its rising incidence ensures that obesity-related skin disease will represent an increasing proportion of dermatologists' work load. In this article, we review dermatoses associated with obesity and review the epidemiology and treatment for obesity.

Tobin AM; Ahern T; Rogers S; Collins P; O'Shea D; Kirby B

2013-08-01

177

Bloodless donor hepatectomy in living donor liver transplantation: counterclockwise liver rotation and early hanging maneuver.  

UK PubMed Central (United Kingdom)

INTRODUCTION: Living donor hepatectomy is important because it determines donor safety and recipient outcome. METHODS: We applied the counter-clockwise liver rotation method and the hanging maneuver from an early stage in two major types of living donor operations. RESULT: Twenty-eight living donors underwent these procedures with significant reduction in blood loss. Right hepatectomy was performed in 14 of the donors and extended left hepatectomy was performed in the other 14 donors. CONCLUSION: These techniques facilitate safe and bloodless living donor hepatectomy.

Sadamori H; Yagi T; Shinoura S; Umeda Y; Yoshida R; Satoh D; Nobuoka D; Utsumi M; Yoshida K; Fujiwara T

2013-01-01

178

An experience of laparoscopic sleeve gastrectomy in obese, morbidly obese, and super morbid obese patients  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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.

Haitham M. Al Falah; Saleh M. AlSalamah; Muhammad Abdullah; Hamad H. AlQahtani; Ghanem S. Abbas; Yasir A. AlSalamah

179

Donor-site morbidity of the radial forearm free flap versus the ulnar forearm free flap.  

UK PubMed Central (United Kingdom)

BACKGROUND: Donor-site morbidity following harvest of the radial forearm free flap was compared with that following harvest of the ulnar forearm free flap. METHODS: Twenty-eight radial forearm and 27 ulnar forearm flaps were harvested in 55 patients with head and neck defects. Pressure perception was measured with Semmes-Weinstein monofilaments. Cold perception was tested with chloroethyl. Donor-site healing was evaluated. Patients were interviewed about grip and pinch strength and donor-site appearance. RESULTS: In the radial forearm free flap group, pressure perception and cold perception were reduced in the donor hand, whereas in the ulnar group, no differences were observed between the donor and unoperated hands. In the radial forearm group, 15 percent of patients experienced reduced strength in the donor hand, whereas in the ulnar forearm group, none of the patients reported reduced strength in the donor hand. In the radial forearm group, 14 percent had partial or complete loss of the skin graft, whereas in the ulnar forearm group, 4 percent had partial loss of the skin graft. In the radial forearm group, 18 percent of patients were dissatisfied with the appearance of the donor site, and no complaints were reported in the ulnar forearm group. CONCLUSIONS: The authors' study shows less donor site-morbidity following harvest of the ulnar forearm free flap than following harvest of the radial forearm free flap. These results emphasize that the ulnar forearm free flap should be considered as an alternative for the radial forearm free flap for reconstruction of soft-tissue defects. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.

Hekner DD; Abbink JH; van Es RJ; Rosenberg A; Koole R; Van Cann EM

2013-08-01

180

Childhood obesity in Taiwan.  

UK PubMed Central (United Kingdom)

As other developed countries of the world, obesity has become a major health problem of children and adolescents in Taiwan. According to an island-wide survey, the prevalence of obesity varied from 4.3% to 17.4% in children aged three to nineteen years. Obesity is defined as an excess of body fat. Since the standard references of weight-for-height and body mass index for Taiwanese are not available, a weight-for-length index has been introduced. We have found that its easy computation and interpretation with high reliability make it a desirable measure of relative weight either in clinical practice or in research. The family background of the obese children has been investigated by many workers. In our own series, the obese children were about five times as likely to have an obese parent as control. There was also a significant difference in the chance of having an obese sibling between the obese and control groups. Several health sequelae of childhood obesity have been studied in Taiwan. Obese children appear to have high prevalence of hypertension, hyperlipidemia, and abnormal glucose metabolism. Of several cutaneous manifestations of obesity, colored striae were sometimes overlooked. In our experience, 40% of the moderate to severe obese cases have such striking marks prominently located on the thighs, arms and abdomen. A few pediatric weight-losing programs have been carried out in Taiwan. In our Pediatric Anti-Obesity Club, four fundamental components: diet, exercise, behavior modification and parent involvement were included in the treatment program. In family-based parent-directed program, 11% of the participants showed decreases in degree of obesity after one year follow-up, compared to 3% of a control group. In another individualized outpatient counseling clinic, the success rate was 59% after one year. Although the long-term effectiveness cannot determined, it seems rational that a realistic and culturally sensitive weight reduction program should be developed for countries, such as Taiwan, with increasing prevalence of childhood obesity.

Chen W

1997-11-01

 
 
 
 
181

Obesity and colorectal cancer.  

UK PubMed Central (United Kingdom)

Excess body weight, as defined by the body mass index (BMI), has been associated with several diseases and includes subjects who are overweight (BMI ? 25-29.9 kg/m(2)) or obese (BMI ? 30 kg/m(2)). Overweight and obesity constitute the fifth leading risk for overall mortality, accounting for at least 2.8 million adult deaths each year. In addition around 11% of colorectal cancer (CRC) cases have been attributed to overweight and obesity in Europe. Epidemiological data suggest that obesity is associated with a 30-70% increased risk of colon cancer in men, whereas the association is less consistent in women. Similar trends exist for colorectal adenoma, although the risk appears lower. Visceral fat, or abdominal obesity, seems to be of greater concern than subcutaneous fat obesity, and any 1 kg/m(2) increase in BMI confers additional risk (HR 1.03). Obesity might be associated with worse cancer outcomes, such as recurrence of the primary cancer or mortality. Several factors, including reduced sensitivity to antiangiogenic-therapeutic regimens, might explain these differences. Except for wound infection, obesity has no significant impact on surgical procedures. The underlying mechanisms linking obesity to CRC are still a matter of debate, but metabolic syndrome, insulin resistance and modifications in levels of adipocytokines seem to be of great importance. Other biological factors such as the gut microbiota or bile acids are emerging. Many questions still remain unanswered: should preventive strategies specifically target obese patients? Is the risk of cancer great enough to propose prophylactic bariatric surgery in certain patients with obesity?

Bardou M; Barkun AN; Martel M

2013-06-01

182

[Living Donor Liver Transplantation - Past and Present.  

UK PubMed Central (United Kingdom)

Since the first living donor liver transplantations at the end of the 1980s, this transplantation technique has developed as an established tool within the modern transplantation medicine. Especially in Asia, the majority of liver transplantation is performed through living donation, mainly for religious reasons. Liver grafts for adult recipients are mainly the right liver lobe of the donor, for paediatric recipients mainly the left lateral lobe. In some cases, the living donor liver transplantation is realised from two different donors for one recipient, the so-called "dual graft" transplantation. This article summarises the history of living donor liver transplantation up to the current status of this transplantation procedure worldwide.

Rauchfuss F; Bauschke A; Bärthel E; Scheuerlein H; Schüle S; Malessa C; Settmacher U

2013-07-01

183

Experienced and anticipated discrimination against people with schizophrenia  

Directory of Open Access Journals (Sweden)

Full Text Available Aim of this research was to describe the nature, direction and severity of anticipated and experienced discrimination reported by people with schizophrenia. We applied interview to 50 patients with diagnosis of schizophrenia in two psychiatric hospitals in Belgrade. Discrimination was measured with discrimination and stigma scale (DISC) which produce 3 subscores, positive experienced discrimination, negative experienced discrimination and anticipated discrimination. The same scale was used in cross-cultural research in 27 european countries. Results have shown that participants from Serbia do not recognize discrimination in all areas of life equally. The discrimination recognized is more frequentlly negative then positive and is associated with existentially important realms of life. Due to anticipated discrimination participants in our study prevent themselves from looking for a close relationship. Anticipated discrimination could not be predicted on the grounds of experienced, positive or negative discrimination.

Mila?i?-Vidojevi? Ivona; ?uri?-Jo?i? Dragana; Toškovi? Oliver

2011-01-01

184

Experienced and potential medical tourists' service quality expectations.  

UK PubMed Central (United Kingdom)

PURPOSE: The paper's aim is to compare experienced and potential US medical tourists' foreign health service-quality expectations. DESIGN/METHODOLOGY/APPROACH: Data were collected via an online survey involving 1,588 US consumers engaging or expressing an interest in medical tourism. The sample included 219 experienced and 1,369 potential medical tourists. Respondents completed a SERVQUAL questionnaire. Mann-Whitney U-tests were used to determine significant differences between experienced and potential US medical tourists' service-quality expectations. FINDINGS: For all five service-quality dimensions (tangibles, reliability, responsiveness, assurance and empathy) experienced medical tourists had significantly lower expectations than potential medical tourists. Experienced medical tourists also had significantly lower service-quality expectations than potential medical tourists for 11 individual SERVQUAL items. PRACTICAL IMPLICATIONS: Results suggest using experience level to segment medical tourists. The study also has implications for managing medical tourist service-quality expectations at service delivery point and via external marketing communications. ORIGINALITY/VALUE: Managing medical tourists' service quality expectations is important since expectations can significantly influence choice processes, their experience and post-consumption behavior. This study is the first to compare experienced and potential US medical tourist service-quality expectations. The study establishes a foundation for future service-quality expectations research in the rapidly growing medical tourism industry.

Guiry M; Scott JJ; Vequist DG 4th

2013-01-01

185

Satiety signals and obesity.  

UK PubMed Central (United Kingdom)

PURPOSE OF REVIEW: The obesity epidemic over the world has called to attention different ways to manage this development. As bariatric surgery today is the only manner by which rapid and sustained weight control can be achieved, new ways of treating obesity are under investigation. This review focuses on today's knowledge on satiety signaling as a means to combat obesity. RECENT FINDINGS: The combined knowledge achieved from obesity surgery with gastric bypass and duodenal switch together with the pharmacological treatment of type 2 diabetes have given us some clues of how to manage obesity. The basis for our understanding is the present research focusing on the gut peptide hormones that are released in response to food intake, and the paucity of satiety signaling seems to prevail in obesity. This means that obese patients experience less activation of higher brain centers in association with a meal and therefore compensate with increased meal size or frequent food intake. SUMMARY: Altered satiety signaling primarily emanating from the gastrointestinal tract seems to lead to the development of obesity and type 2 diabetes. Pharmacological tools that enhance the gut hormone signaling are in focus for the upcoming venues of treatment.

Hellström PM

2013-03-01

186

PPARs, Obesity, and Inflammation  

Directory of Open Access Journals (Sweden)

Full Text Available The worldwide prevalence of obesity and related metabolic disorders is rising rapidly, increasing the burden on our healthcare system. Obesity is often accompanied by excess fat storage in tissues other than adipose tissue, including liver and skeletal muscle, which may lead to local insulin resistance and may stimulate inflammation, as in steatohepatitis. In addition, obesity changes the morphology and composition of adipose tissue, leading to changes in protein production and secretion. Some of these secreted proteins, including several proinflammatory mediators, may be produced by macrophages resident in the adipose tissue. The changes in inflammatory status of adipose tissue and liver with obesity feed a growing recognition that obesity represents a state of chronic low-level inflammation. Various molecular mechanisms have been implicated in obesity-induced inflammation, some of which are modulated by the peroxisome proliferator-activated receptors (PPARs). PPARs are ligand-activated transcription factors involved in the regulation of numerous biological processes, including lipid and glucose metabolism, and overall energy homeostasis. Importantly, PPARs also modulate the inflammatory response, which makes them an interesting therapeutic target to mitigate obesity-induced inflammation and its consequences. This review will address the role of PPARs in obesity-induced inflammation specifically in adipose tissue, liver, and the vascular wall.

Rinke Stienstra; Caroline Duval; Michael Müller; Sander Kersten

2006-01-01

187

[Obesity and pregnancy].  

UK PubMed Central (United Kingdom)

Obesity during pregnancy increases the risk of complications for both the mother (gestational hypertension, diabetes mellitus) and the newborn (malformations and macrosomia). Deliveries are also more difficult with more c-section and failure in peridural analgesia. A specific organization supported by the perinatal network should improve the management of these women, especially for morbid obesity.

Deruelle P

2011-02-01

188

The new obesity genes.  

UK PubMed Central (United Kingdom)

Individual susceptibility to obesity is recognized to be influenced significantly by genetic inheritance. Recently, candidate obesity genes have been identified that may contribute to the inheritance of body fat mass and the partitioning of fat between central and peripheral fat depots. In studies of animal models of obesity, the genetic basis for obesity in the obese (Ob/Ob) mouse, the Fat mouse, and the Yellow (Vvy) mouse has been identified. Further research is needed to determine whether abnormalities in these genes contribute to human obesity as well. In studies of humans, sequence variation in at least six genes has been linked to increased body fatness and/or susceptibility to obesity. In addition, five other encoding genes have been linked to a disproportionate storage of fat in the abdominal region. These genes identified in studies of humans are currently thought to be modifying or background genes, each separately conferring a modest increase in susceptibility to fatness. Further research is needed to identify additional candidate genes that confer susceptibility to obesity and to determine the relative importance of each one in a range of human populations with distinct environments.

Roberts SB; Greenberg AS

1996-02-01

189

Morbid Obesity - Anaesthetic Management  

Directory of Open Access Journals (Sweden)

Full Text Available Obesity means excessive body fat. The term obese, derived from Latin word means fattened by eating. The amount of fat tissue may increased to such an extent that mental and physical health is affected and life expectancy is reduced.

Dr. S. Manimala Rao

2003-01-01

190

Obesity: A Bibliographic Review  

Science.gov (United States)

The study of obesity is a relatively new interdisciplinary academic field. The community college library shelves should contain two types of resources. First, several kinds of reference materials, and second, a host of broader materials that place the discussion of obesity within a cultural framework. This overview is divided into two major…

McGowan, Beth

2012-01-01

191

Obesity drug therapy.  

UK PubMed Central (United Kingdom)

Obesity is a chronic disease, and it requires chronic therapy. Hypertension, dyslipidemia, diabetes and cardiovascular diseases are leading causes of mortality in the modern world. All of them are strongly linked to obesity. While treating obesity, those conditions are also managed. Obese patients should always be treated through lifestyle interventions, though the results of such interventions are modest. Pharmacotherapy is a second step in the treatment of obesity, approved only when weight loss targets were not reached through lifestyle intervention. During the history of antiobesity drugs, many of them were withdrawn because of their side effects. Various guidelines recommend prescribing drug therapy for obesity through consideration of the potential benefits and limitations. Orlistat deactivates intestinal lipase and inhibits intestinal fat lipolysis. It is actually the only drug on the European market approved for the treatment of obesity. Orlistat therapy reduces weight to a modest extent, but it reduces the incidence of diabetes beyond the result achieved with lifestyle changes. Recently, some effective antiobesity drugs like sibutramine and rimonabant have been removed from the market due to their side effects. The new combination of topimarate and fentermine is approved in the US but not in Europe. The cost effectiveness of long-term pharmacotherapy of obesity is still an unresolved question.

Bareti? M

2013-09-01

192

GENETICS OF CHILDHOOD OBESITY  

Science.gov (United States)

Obesity is a complex disease influenced by multiple genetic and environmental factors. Because of its complexity, obesity does not conform to simple Mendelian patterns of inheritance, but displays variable expression. Classical genetic studies on twins, siblings and nuclear families clearly have est...

193

Childhood Obesity PSA (:60)  

Centers for Disease Control (CDC) Podcasts

This 60 second public service announcement is based on the August 2013 CDC Vital Signs report. The rate of obesity among low-income preschoolers has declined, but one in eight is still obese. This program briefly discusses what can be done.  Created: 8/6/2013 by Centers for Disease Control and Prevention (CDC).   Date Released: 8/6/2013.

2013-08-06

194

Obesity and Women  

Centers for Disease Control (CDC) Podcasts

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.

2009-05-11

195

Prolonged financial stress predicts subsequent obesity: Results from a prospective study of an Australian national sample.  

UK PubMed Central (United Kingdom)

Objective: The aim of this research was to assess the association of prolonged financial stress (FS) with subsequent obesity. Design and Methods: Data were from Waves 8 (2008), 9 (2009), and 10 (2010) of Household Income and Labour Dynamics in Australia (HILDA) survey. The outcome was obesity measured in 2010. Prolonged FS was defined as having experienced FS in both 2008 and 2009. FS was measured in each year using seven questionnaire items. Analyses adjusted for health, physical activity, income, education, baseline obesity, and other covariates. Results: Prolonged FS was a strong predictor of subsequent obesity. The adjusted risk of being obese in 2010 were 20% higher (RR: 1.20; 95% CI: 1.10-1.30) among individuals who experienced FS in both 2008 and 2009 than those who did not experience FS in either year. The association of FS with obesity was independent of income and constant across income categories. Conclusions: Obesity prevention research should pay more attention to FS as an important dimension of economic deprivation, a concept that is distinct from common indicators of socioeconomic status such as income. Future research can examine the effect of financial education and counseling programs that help individuals with such skills as money management, budgeting, and saving on a reduction in FS and obesity.

Siahpush M; Huang TT; Sikora A; Tibbits M; Shaikh RA; Singh GK

2013-07-01

196

Iron deficiency in Canadian blood donors.  

UK PubMed Central (United Kingdom)

BACKGROUND: The adequacy of communication and knowledge of donors and physicians regarding iron needs and the relationship between hemoglobin (Hb) and iron stores require evaluation to address donor iron deficiency. STUDY DESIGN AND METHODS: A prospective cohort study was performed on 550 successful donors and 50 donors deferred for low Hb (<125?g/L on repeat fingerstick). Donors participated in an on-clinic interview and had serum ferritin measured. They were mailed their results and recontacted regarding follow-up. RESULTS: Most donors are unaware of possible health impacts of donation and do not discuss donation with their physician. In successful donors, mean ferritin levels were 37 and 131??g/L in first-time and reactivated (no donation for 2 years) females and males and 19 and 29??g/L in frequent repeat females and males, respectively (p?donors having intermediate results. Mean ferritin was 12??g/L in donors deferred for low Hb. Twenty of 22 donors failing initial Hb testing and passing on repeat testing had ferritin below 25??g/L. On follow-up, 63 of 164 donors (38%) with low ferritin were taking iron supplements 2 months postdonation. CONCLUSION: Iron deficiency is frequent, particularly in female donors and frequent donors. A fail on initial Hb testing followed by a pass on repeat testing is likely to be due to iron deficiency and borderline anemia. Donors and physicians need to be more aware of iron needs associated with blood donation and appropriate treatment for low iron stores.

Goldman M; Uzicanin S; Scalia V; O'Brien SF

2013-08-01

197

Obesity and metabolic syndrome  

Directory of Open Access Journals (Sweden)

Full Text Available Prevalence of Metabolic syndrome in the general population in India is about 40%, much higher than of 25% quoted for western population. Obesity leading to Metabolic Syndrome is the soil for Diabetes and Cardio vascular diseases like PVD, strokes, MI. If we control the incidence of Obesity, we can prevent the future cardiovascular problems. In my study it is found that persons with increased abdominal obesity, levels of FBS, PPBS, MA, BP, Triglycerides, and decreased levels of HDL. These values were normal in persons without abdominal obesity. So person can escape from the future complications if he controls obesity by adopting simple change in life style to loose weight like regular physical exercise and healthy diet habits.

A. Krishnaveni; Lakshmi ANR.; Paramjyothi P.

2013-01-01

198

Obesity and craniopharyngioma  

Directory of Open Access Journals (Sweden)

Full Text Available 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 understand the metabolic disturbances and the mechanisms of weight gain among cancer survivors. The hypothalamic-pituitary axis damage secondary to cancer therapies or to primary tumor location affect long-term outcomes. Nevertheless, the aetiology of obesity in craniopharyngioma is not yet fully understood. The present review has the aim of summarizing the published data and examining the most accepted mechanisms and main predisposing factors related to weight gain in this particular population.

Iughetti Lorenzo; Bruzzi Patrizia

2011-01-01

199

Use of a semi-permeable membrane dressing in donor sites in Nigerians.  

UK PubMed Central (United Kingdom)

Most published studies on the use of a semi-permeable membrane dressing (opsite) on split-skin donor sites have been on Caucasians. To assess this new method on the black population of a developing country where donor sites are notoriously slow to heal, a study was conducted on fifty Nigerians of varying age groups in whom split-skin grafts of identical thickness were taken from both thighs by the same surgeon: 100 donor sites were studied. In all the patients one thigh was dressed with the conventional sofratulle and the other with opsite. The allocation was made randomly. Twenty-five donor sites (53.4%) treated with sofratulle healed by the 13th postoperative day. By contrast, thirty donor sites (62.5%) treated with opsite healed by the 7th postoperative day. All opsite treated wounds were completely healed by the 11th day but it took nearly four weeks for the sofratulle treated thighs to heal. Minimal discomfort was experienced by 10% of the patients treated with opsite but about 80% of those treated with sofratulle required mild analgesics on ambulation during the first 48 hours on account of pain. Opsite effectively reduces healing time in donor sites, is easy to apply, less bulky to use, painfree and well tolerated by patients.

Iregbulem LM

1983-04-01

200

Vital signs: obesity among low-income, preschool-aged children - United States, 2008-2011.  

UK PubMed Central (United Kingdom)

Background: The prevalence of obesity among U.S. preschoolers has doubled in recent decades. Childhood obesity increases the risk for adult obesity and is associated with negative health consequences. Trends in the state-specific prevalence of obesity among low-income U.S. preschool children have not been examined since 2008. State-specific obesity prevalence surveillance helps determine the need for and impact of state and local obesity prevention strategies. Methods: Measured weight and height data from approximately 11.6 million low-income children aged 2-4 years from 40 states, the District of Columbia, and two U.S. territories who participated in the Pediatric Nutrition Surveillance System during 2008-2011 were used to estimate state obesity prevalence. Obesity was defined as having an age- and sex-specific body mass index ?95th percentile, according to the 2000 CDC growth charts. Logistic regression models adjusted for age, sex, and race/ethnicity were used to examine trends in the state-specific obesity prevalence. Results: During 2008-2011, statistically significant downward trends in obesity prevalence were observed in 18 states and the U.S. Virgin Islands. Florida, Georgia, Missouri, New Jersey, South Dakota, and the U.S. Virgin Islands had the largest absolute decreases in obesity prevalence, each with a decrease of ?1 percentage point. Twenty states and Puerto Rico experienced no significant change, and obesity prevalence increased significantly in three states. Conclusions and Implications for Public Health Practice: Small but significant declines in obesity among low-income preschoolers were observed in 19 of 43 states/territories examined. Continued prevention efforts are needed to sustain and expand the implementation and evaluation of population-level interventions to prevent childhood obesity.

2013-08-01

 
 
 
 
201

Visual information search in simulated junction negotiation: gaze transitions of young novice, young experienced and older experienced drivers.  

UK PubMed Central (United Kingdom)

INTRODUCTION: Older drivers and young novice drivers have problems negotiating road junctions. Explanations for problems largely focus on limitations in visual information processing and observation errors associated with age and experience. METHOD: Gaze transitions provide information on the positional relationship of fixations, providing a useful tool for highlighting gaps in driver's visual information acquisition strategies. The gaze transitions of three driver groups (young novice, young experienced, and older experienced) were compared during gap selection in right turn junction negotiation manoeuvres. RESULTS: When scanning the junction, young experienced drivers distributed their gaze more evenly across all areas, whereas older and novice drivers made more sweeping transitions, bypassing adjacent areas. The use of a preview strategy in the decision phase was less evident in the older experienced group compared to the younger groups. IMPACT: The application of results to driver training interventions and future research are discussed.

Scott H; Hall L; Litchfield D; Westwood D

2013-06-01

202

Genetics of obesity.  

Science.gov (United States)

Obesity is a typical common multifactorial disease in which environmental and genetic factors interact. In rare cases of severe obesity with childhood onset, a single gene has a major effect in determining the occurrence of obesity, with the environment having only a permissive role in the severity of the phenotype. Exceptional mutations of the leptin gene and its receptor, pro-opiomelanocortine (POMC), prohormone convertase 1 (PC1) and more frequently, mutations in the melanocortin receptor 4 (1 to 4% of very obese cases) have been described. All these obesity genes encode proteins that are strongly connected as part of the same loop of the regulation of food intake. They all involve the leptin axis and one of its hypothalamic targets; the melanocortin pathway. Pathways of bodyweight regulation involved in monogenic forms of obesity might represent targets for future drug development. Successful leptin protein replacement in a leptin-deficient child has contributed to the validation of the usefulness of gene screening in humans. However, the individual variability in response to leptin treatment might be related to genetic variability. The efficiency of leptin itself or of small-molecule agonists of the leptin receptor should be studied in relation with genetic variations in the leptin gene promoter. The most common forms of obesity are polygenic. Two general approaches have been used to date in the search for genes underlying common polygenic obesity in humans. The first approach focuses on selected genes having some plausible role in obesity on the basis of their known or presumed biological role. This approach yielded putative susceptibility genes with only small or uncertain effects. The second approach attempts to map genes purely by position and requires no presumptions on the function of genes. Genome-wide scans identify chromosomal regions showing linkage with obesity in large collections of nuclear families. Genome-wide scans in different ethnic populations have localized major obesity loci on chromosomes 2, 5, 10, 11 and 20. Susceptibility gene(s) for obesity may be positionally cloned in the intervals of linkage. The candidate gene and positional cloning of major obesity-linked regions approaches are discussed in this paper. PMID:12383024

Clement, Karine; Boutin, Philippe; Froguel, Philippe

2002-01-01

203

Paediatric living donor liver transplantation  

Scientific Electronic Library Online (English)

Full Text Available 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 refinement 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

2012-01-01

204

Living-donor liver transplantation from second generation children for atomic bomb survivors.  

Science.gov (United States)

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

2009-11-01

205

Living-donor liver transplantation from second generation children for atomic bomb survivors.  

UK PubMed Central (United Kingdom)

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.

Eguchi S; Takatsuki M; Nakashima M; Kanematsu T

2009-11-01

206

Burden experienced by community health volunteers in Taiwan: a survey.  

UK PubMed Central (United Kingdom)

BACKGROUND: Volunteers in Taiwan complement the delivery of health services by paid health professionals. However, in doing so, community health volunteers experience burdens associated with their activities. The reasons for these burdens and degree to which they are experienced are explored in this paper. Our study adds to international research regarding the burden experienced by volunteers. This project is the first to assess how community health volunteers in Taiwan experience burden. METHODS: The 20 item Burden on Community Health Volunteer (BCHV) instrument, specifically designed for this project, was administered to 435 volunteers attached to Community Health Promotion Development Centres in northern Taiwan. RESULTS: The overall burden experienced by volunteers is relatively low. However, a multivariate adjusted regression analysis revealed significant differences in volunteer burden depending on the number of people each volunteer served on average per week, as well as the volunteer's marital status and their perceptions about personal health. Volunteers who served many people and who perceived their own health as poor experienced a higher level of burden. Those who were a widow or a widower felt less burdened than others. CONCLUSIONS: The results of the study identify areas where burden is high and where strategies can be developed to reduce the level of burden experienced by community health volunteers in Taiwan. Community health volunteers in Taiwan complement the role of nurses and other health care providers so their retention is important to ongoing service delivery.

Gau YM; Buettner P; Usher K; Stewart L

2013-01-01

207

[Asthma, obesity and diet].  

UK PubMed Central (United Kingdom)

Asthma and obesity have a considerable impact on public health and their prevalence has increased in recent years. Numerous studies have linked both disorders. Most prospective studies show that obesity is a risk factor for asthma and have found a positive correlation between baseline body mass index (BMI) and the subsequent development of asthma, although these results are not conclusive when studying the association between airway hyperresponsiveness with BMI. Furthermore, several studies suggest that whereas weight gain increases the risk of asthma, weight loss improves the course of the illness. Different factors could explain this association. Obesity is capable of reducing pulmonary compliance, lung volumes and the diameter of peripheral respiratory airways as well as affecting the volume of blood in the lungs and the ventilation-perfusion relationship. Furthermore, the increase in the normal functioning of adipose tissue in obese subjects leads to a systemic proinflammatory state, which produces a rise in the serum concentrations of several cytokines, the soluble fractions of their receptors and chemokines. Many of these mediators are synthesized and secreted by cells from adipose tissue and receive the generic name of adipokines, including IL-6, IL-10, eotaxin, TNF-?, TGF- 1, PCR, leptin y adiponectin. Finally, specific regions of the human genome which are related to both asthma and obesity have been identified. Most studies point out that obesity is capable of increasing the prevalence and incidence of asthma, although this effect appears to be modest. The treatment of obese asthmatics must include a weight control program.

Barranco P; Delgado J; Gallego LT; Bobolea I; Pedrosa M; García de Lorenzo A; Quirce S

2012-01-01

208

Obesity in children & adolescents.  

UK PubMed Central (United Kingdom)

Worldwide, obesity trends are causing serious public health concern and in many countries threatening the viability of basic health care delivery. It is an independent risk factor for cardiovascular diseases and significantly increases the risk of morbidity and mortality. The last two decades have witnessed an increase in health care costs due to obesity and related issues among children and adolescents. Childhood obesity is a global phenomenon affecting all socio-economic groups, irrespective of age, sex or ethnicity. Aetiopathogenesis of childhood obesity is multi-factorial and includes genetic, neuroendocrine, metabolic, psychological, environmental and socio-cultural factors. Many co-morbid conditions like metabolic, cardiovascular, psychological, orthopaedic, neurological, hepatic, pulmonary and renal disorders are seen in association with childhood obesity. The treatment of overweight and obesity in children and adolescents requires a multidisciplinary, multi-phase approach, which includes dietary management, physical activity enhancement, restriction of sedentary behaviour, pharmacotherapy and bariatric surgery. A holistic approach to tackle the childhood obesity epidemic needs a collection of activities including influencing policy makers and legislation, mobilizing communities, restructuring organizational practices, establishing coalitions and networks, empowering providers, imparting community education as well as enriching and reinforcing individual awareness and skills. The implications of this global phenomenon on future generations will be serious unless appropriate action is taken.

Raj M; Kumar RK

2010-11-01

209

Obesity and heart failure.  

UK PubMed Central (United Kingdom)

Epidemiological studies have recently shown that obesity, and abdominal obesity in particular, is an independent risk factor for the development of heart failure (HF). Higher cardiac oxidative stress is the early stage of heart dysfunction due to obesity, and it is the result of insulin resistance, altered fatty acid and glucose metabolism, and impaired mitochondrial biogenesis. Extense myocyte hypertrophy and myocardial fibrosis are early microscopic changes in patients with HF, whereas circumferential strain during the left ventricular (LV) systole, LV increase in both chamber size and wall thickness (LV hypertrophy), and LV dilatation are the early macroscopic and functional alterations in obese developing heart failure. LV hypertrophy leads to diastolic dysfunction and subendocardial ischemia in obesity, and pericardial fat has been shown to be significantly associated with LV diastolic dysfunction. Evolving abnormalities of diastolic dysfunction may include progressive hypertrophy and systolic dysfunction, and various degrees of eccentric and/or concentric LV hypertrophy may be present with time. Once HF is established, overweight and obese have a better prognosis than do their lean counterparts with the same level of cardiovascular disease, and this phenomenon is called "obesity paradox". It is mainly due to lower muscle protein degradation, brain natriuretic peptide circulating levels and cardio-respiratory fitness than normal weight patients with HF.

De Pergola G; Nardecchia A; Giagulli VA; Triggiani V; Guastamacchia E; Minischetti MC; Silvestris F

2013-03-01

210

Prevalence of immediate vasovagal reaction in blood donors visiting two blood banks of Karachi.  

UK PubMed Central (United Kingdom)

Vasovagal reaction (VVR) is a very common adverse event related to blood donation. No study has been conducted in Pakistan to estimate the prevalence of VVR in blood donors. This study was conducted to estimate the prevalence of immediate VVR in blood donors of Karachi, Pakistan. The study was conducted in two blood banks of Karachi. Data regarding the development of immediate VVR were documented. The effect of blood donation on vital parameters like pulse rate, blood pressure (BP), temperature and respiratory rate was also observed. Six hundred and seventy-four blood donors were recruited. All the donors who consented were males. Weakness and dizziness were two most common symptoms which were reported by 91 (13.5%) and 73 (10.8%) of the participants, respectively. Out of 91 donors in whom signs and symptoms of immediate VVR were observed, a significant drop in systolic BP (13.5 +/- 2.5 mmHg) and decrease in pulse rate (13.3 +/- 3.6) were concurrently noted in 55 donors (8.2% of all the participants). There was lack of association of age, body mass index (BMI), estimated blood volume, ethnicity, educational status, profession and first time donation status with the frequency of VVR. Only marital status was found to be significantly associated with higher frequency of immediate VVR, where married donors were having higher odds as compared to singles. The prevalence of VVR in the blood donors at two blood banks of Karachi is at least 8.2%. Furthermore, married men are at more risk of experiencing VVR in our population.

Rohra DK; Juriasinghani V; Rai K; Azam SI

2010-06-01

211

Prevalence of immediate vasovagal reaction in blood donors visiting two blood banks of Karachi.  

Science.gov (United States)

Vasovagal reaction (VVR) is a very common adverse event related to blood donation. No study has been conducted in Pakistan to estimate the prevalence of VVR in blood donors. This study was conducted to estimate the prevalence of immediate VVR in blood donors of Karachi, Pakistan. The study was conducted in two blood banks of Karachi. Data regarding the development of immediate VVR were documented. The effect of blood donation on vital parameters like pulse rate, blood pressure (BP), temperature and respiratory rate was also observed. Six hundred and seventy-four blood donors were recruited. All the donors who consented were males. Weakness and dizziness were two most common symptoms which were reported by 91 (13.5%) and 73 (10.8%) of the participants, respectively. Out of 91 donors in whom signs and symptoms of immediate VVR were observed, a significant drop in systolic BP (13.5 +/- 2.5 mmHg) and decrease in pulse rate (13.3 +/- 3.6) were concurrently noted in 55 donors (8.2% of all the participants). There was lack of association of age, body mass index (BMI), estimated blood volume, ethnicity, educational status, profession and first time donation status with the frequency of VVR. Only marital status was found to be significantly associated with higher frequency of immediate VVR, where married donors were having higher odds as compared to singles. The prevalence of VVR in the blood donors at two blood banks of Karachi is at least 8.2%. Furthermore, married men are at more risk of experiencing VVR in our population. PMID:19958470

Rohra, D K; Juriasinghani, V; Rai, K; Azam, S I

2009-12-02

212

Thyroid function and obesity.  

UK PubMed Central (United Kingdom)

Nowadays, childhood obesity is one of the biggest health emergencies in the developed countries. Obesity leads to multiple metabolic alterations which increase the risk of developing diabetes and cardiovascular diseases. Thyroid function has been often described as altered in obese children, however, it is not clear whether the altered thyroid function is the cause or the consequence of fat excess. On the other hand, thyroid structure seems also to be affected. Nevertheless, both functional and structural alterations seem to improve after weight loss and therefore no treatment is needed.

Longhi S; Radetti G

2013-01-01

213

Syncope secondary to obesity?  

UK PubMed Central (United Kingdom)

The frequency of obesity is increasing worldwide. The relationship between obesity and mortality is known. Bariatric surgery is well established in the treatment of morbid obesity to reduce weight permanently. Bariatric procedures are effective and influencing associated comorbidities. Adjustable gastric banding is a popular and effective bariatric operation in Europe for more than 10 years. Classic complications of gastric banding are known, but here we describe one more example. In this study, we report the case of a patient with gastric banding who presented with syncope after a meal.

Muschart X; Blommaert D

2013-11-01

214

[Management of childhood obesity].  

UK PubMed Central (United Kingdom)

Endocrine diseases (hypothyroidism, growth hormone deficiency, hypercortisolism) are exceptional in obese children and are searched only in case of short stature. It is not necessary to test systematically glucose tolerance (fasting glucose; oral glucose tolerance test) and lipids in order to look for obesity related comorbidities. Decreased caloric intake is the main goal for the treatment. Ways to succeed need to be adapted to each child with pragmatism and without dogmatism. Goals for treatment are reasonable (stabilization of weight excess). Weight loss surgery in obese children may be discussed in some cases with multidisciplinary expert team (doctors, surgeons, psychologist...) and close collaboration between adults teams and paediatricians.

Dubern B

2010-09-01

215

Obesity and gestational diabetes.  

UK PubMed Central (United Kingdom)

The prevalence of both obesity and gestational diabetes mellitus (GDM) is increasing worldwide. GDM affects about 7% of all pregnancies and is defined as any degree of impaired glucose tolerance during gestation. The presence of obesity has a significant impact on both maternal and fetal complications associated with GDM. These complications can be addressed, at least in part, by good glycaemic control during pregnancy. The significance and impact of obesity in women with GDM are discussed in this article, together with treatment options, the need for long-term risk modification and postpartum follow-up.

Sathyapalan T; Mellor D; Atkin SL

2010-04-01

216

Team cognition in experienced command-and-control teams.  

UK PubMed Central (United Kingdom)

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 control a UAV to take reconnaissance photos. Experienced teams exceeded performance of inexperienced teams, suggesting transfer of previous command-and-control experience. Compared to inexperienced teams, experienced teams had fewer errors on process-related training knowledge, superior team process ratings, and communications containing fewer coordination-related utterances. These findings support the view that team cognition emerges through the interactions of team members, that interactions distinguish high-performing teams from average teams, and that these interactions transfer across different tasks.

Cooke NJ; Gorman JC; Duran JL; Taylor AR

2007-09-01

217

Quality of life assessment in a living donor kidney transplantation program: evaluation of recipients and donors.  

UK PubMed Central (United Kingdom)

BACKGROUND: Quality of life (QOL) in donors before and after living kidney donor transplantation (LKDT) has been an important concern. Investigation of these issues in related recipients is not as common. Since 2002, a protocol of psychosocial evaluation for donors and recipients was included in the living kidney donation program. We sought to evaluate QOL in donors and recipients, before and after transplantation, and to compare the 2 groups. METHODS: Before and after transplantation, 35 recipients and 45 donors completed a Sociodemographic Questionnaire and Short-Form 36 Health Survey Questionnaire (SF-36). The Wilcoxon test, Mann-Whitney test, and logistic regression were applied. RESULTS: Before transplantation, recipients had lower QOL values than donors for all dimensions (P < .05), with the exception of Mental Health. After transplantation, they had higher values (P < .05) for every dimension on the SF-36. Among donors, there were no significant changes. Physical function and social function were considered poorer by donors versus recipients (P < .05). CONCLUSIONS: In this LKDT program, more females were donors and fewer were recipients. Most of donors were siblings. All donors were related (the Portuguese law pertaining to unrelated donation was enacted in 2007). QOL was significantly poorer among recipients before surgery. After surgery, QOL significantly improved in recipients and was not poorer in donors. LKDT improved recipients' lives and did not affect donors' negatively.

Lopes A; Frade IC; Teixeira L; Almeida M; Dias L; Henriques AC

2013-04-01

218

Harmful Effect of Anti-Class II Antibodies in Kidney Transplant Patients who Experienced an Acute Rejection Episode  

Directory of Open Access Journals (Sweden)

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.

M. Phayphet; E. Alamartine; C. Mariat; L. Absi; F. Berthou

2006-01-01

219

Shallow donors in GaN.  

Energy Technology Data Exchange (ETDEWEB)

High-resolution, variable temperature PL experiments were performed in the spectral region associated with recombination processes involving the ground and excited states of the neutral donor bound excitons. High-resolution infrared measurements in combination with high-sensitive SIMS unambiguously identified Si and O shallow donors and yield their ground state binding energies. These binding energies are in excellent agreement with values obtained by the analysis of the two-electron-satellite PL spectra considering the participation of ground and excited state donor bound excitons. This work clarifies conflicting aspects existing in donor identification and the binding energies of the impurities and excitons.

Lee, S. K. (Samsung Advanced Institute of Technology, Suwon, Korea); Koleske, Daniel David; Moore, W. J. (SFA, Inc., Largo, MD); Freitas, J. A., Jr. (Naval Research Laboratory, Washington, DC); Shanabrook, B. V. (Naval Research Laboratory, Washington, DC); Braga, G. C. B. (Naval Research Laboratory, Washington, DC); Han, J. Y. (Samsung Advanced Institute of Technology, Suwon, Korea); Park, S. S. (Samsung Advanced Institute of Technology, Suwon, Korea)

2004-06-01

220

Historical perspective of living donor liver transplantation  

Directory of Open Access Journals (Sweden)

Full Text Available Living donor liver transplantation (LDLT) has gone through its formative years and established as a legitimate treatment when a deceased donor liver graft is not timely or simply not available at all. Nevertheless, LDLT is characterized by its technical complexity and ethical controversy. These are the consequences of a single organ having to serve two subjects, the donor and the recipient, instantaneously. The transplant community has a common ground on assuring donor safety while achieving predictable recipient success. With this background, a reflection of the development of LDLT may be appropriate to direct future research and patient-care efforts on this life-saving treatment alternative.

See Ching Chan, Sheung Tat Fan

2008-01-01

 
 
 
 
221

Acute dialysis risk in living kidney donors.  

UK PubMed Central (United Kingdom)

BACKGROUND: Reduced kidney function confers a higher risk of acute kidney injury at the time of an inciting event, such as sepsis. Whether the same is true in those with reduced renal mass from living kidney donation is unknown. METHODS: We conducted a population-based matched cohort study of all living kidney donors in the province of Ontario, Canada who underwent donor nephrectomy from 1992 to 2009. We manually reviewed the medical records of these living kidney donors and linked this information to provincial health care databases. Non-donors were selected from the healthiest segment of the general population. RESULTS: There were 2027 donors and 20 270 matched non-donors. The median age was 43 years (interquartile range 34-50) and individuals were followed for a median of 6.6 years (maximum 17.7 years). The primary outcome was acute dialysis during any hospital stay. Reasons for hospitalization included infectious diseases, cardiovascular diseases and hematological malignancies. Only one donor received acute dialysis in follow-up (6.5 events per 100 000 person-years), a rate which was statistically no different than 14 non-donors (9.4 events per 100 000 person-years). CONCLUSIONS: These results are reassuring for the practice of living kidney donation. Longer follow-up of this and other donor cohorts will provide more precise estimates about this risk.

Lam N; Huang A; Feldman LS; Gill JS; Karpinski M; Kim J; Klarenbach SW; Knoll GA; Lentine KL; Nguan CY; Parikh CR; Prasad GV; Treleaven DJ; Young A; Garg AX

2012-08-01

222

Response of severely obese children and adolescents to behavioral treatment.  

UK PubMed Central (United Kingdom)

OBJECTIVES: To investigate whether the degree of obesity predicts the efficacy of long-term behavioral treatment and to explore any interaction with age. DESIGN: A 3-year longitudinal observational study. Obese children were divided into 3 age groups (6-9, 10-13, and 14-16 years) and also into 2 groups (moderately obese, with a body mass index [BMI]-standard deviation [SD] score [or z score] of 1.6 to <3.5, and severely obese, with a BMI-SD score of ?3.5). SETTING: National Childhood Obesity Center, Stockholm, Sweden. PARTICIPANTS: Children 6 to 16 years of age who started treatment between 1998 and 2006. INTERVENTION: Behavioral treatment of obesity. MAIN OUTCOME MEASURE: Change in BMI-SD score during 3 years of treatment; a reduction in BMI-SD score of 0.5 units or more was defined as clinically significant. RESULTS: A total of 643 children (49% female children) met the inclusion criteria. Among the youngest moderately obese children, 44% had a clinically significant reduction in BMI-SD score (mean reduction, -0.4 [95% CI, -0.55 to -0.32]). Treatment was less effective for the older moderately obese children. Twenty percent of children who were 10 to 13 years of age and 8% of children who were 14 to 16 years of age had a reduction in BMI-SD score of 0.5 units or more; 58% of the severely obese young children showed a clinically significant reduction in BMI-SD score (mean reduction, -0.7 [95% CI, -0.80 to -0.54]). The severely obese adolescents showed no change in mean BMI-SD score after 3 years, and 2% experienced clinically significant weight loss. Age was found to be a predictor of a reduction in BMI-SD score (odds ratio, 0.68 units per year [95% CI, 0.60-0.77 units per year]). CONCLUSIONS: Behavioral treatment was successful for severely obese children but had almost no effect on severely obese adolescents.

Danielsson P; Kowalski J; Ekblom Ö; Marcus C

2012-12-01

223

The Gordian Knot of dysbiosis, obesity and NAFLD.  

UK PubMed Central (United Kingdom)

The development of obesity and NAFLD is known to be determined by host genetics, diet and lack of exercise. In addition, the gut microbiota has been identified to influence the development of both obesity and NAFLD. Evidence for the role of the gut microbiota has been shown by preclinical studies of transfer of gut microbiota from lean and obese individuals, with the recipient developing the metabolic features of the donor. Many bidirectional interactions of the gut microbiota, including with food, bile and the intestinal epithelium, have been identified. These interactions might contribute to the distinct steps in the progression from lean to obese states, and to steatosis, steatohepatitis and eventually fibrosis. The predominant steps are efficient caloric extraction from the diet, intestinal epithelial damage and greater entry of bacterial components into the portal circulation. These steps result in activation of the innate immune system, liver inflammation and fibrosis. Fortunately, therapeutic interventions might not require a full understanding of these complex interactions. Although antibiotics are too unselective in their action, probiotics have shown efficacy in reversing obesity and NASH in experimental systems, and are under investigation in humans.

Mehal WZ

2013-08-01

224

Obesity Hypoventilation Syndrome  

Science.gov (United States)

... Links Related Topics Overweight and Obesity Sleep Apnea CPAP Sleep Studies Ventilator/Ventilator Support Related Media Videos ... keep your airways open. Your doctor might recommend CPAP (continuous positive airway pressure) or BiPAP (bilevel positive ...

225

Vitamin D and Obesity  

Directory of Open Access Journals (Sweden)

Full Text Available 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. There is a clear need for adequately-powered, prospective interventions which include baseline measurement of 25D concentrations and involve adequate doses of supplemental vitamin D. Until such studies have been reported, the role of vitamin D supplementation in obesity prevention remains uncertain.

Simon Vanlint

2013-01-01

226

Vitamin D and obesity.  

UK PubMed Central (United Kingdom)

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. There is a clear need for adequately-powered, prospective interventions which include baseline measurement of 25D concentrations and involve adequate doses of supplemental vitamin D. Until such studies have been reported, the role of vitamin D supplementation in obesity prevention remains uncertain.

Vanlint S

2013-03-01

227

Pharmacological treatment of obesity.  

Science.gov (United States)

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

2006-05-23

228

Obesity, Adipocytokines and Cancer  

Directory of Open Access Journals (Sweden)

Full Text Available A great amount of literature has demonstrated a connection between obesity, visceral fat and the metabolic disorders such as hyperglycemia, hypertension, and hyperlipidemia. Lately, there has been an increased interest in understanding if cancer is related to obesity and visceral fat accumulation. The prevalence of both obesity and cancer are increasing and there has been keen interest in the relationship between visceral adiposity and the biology of cancers. White adipose tissue (WAT) provides a limitless capacity for triglyceride storage vital for survival. The concurrent rise in insulin, glucose, and lipids during meals stimulates triglyceride formation and storage in WAT. WAT is also recognized as an endocrine organ that secretes multiple cytokines such as leptin and adiponectin. In addition, leptin and adiponectin have been adipocytokines that attracted attention for cancer research. Thus, in this review, we will describe recent progress made in obesity, visceral adiposity, leptin and adiponectin in the involvement of various cancers.

Takayuki Masaki; Hironobu Yoshimatsu

2008-01-01

229

Chronobiological Effects on Obesity.  

Science.gov (United States)

The development of obesity is the consequence of a multitude of complex interactions between both genetic and environmental factors. It has been suggested that the dramatic increase in the prevalence of obesity over the past 30 years has been the result of environmental changes that have enabled the full realization of genetic susceptibility present in the population. Among the many environmental alterations that have occurred in our recent history is the ever-increasing dyssynchrony between natural cycles of light/dark and altered patterns of sleep/wake and eating behavior associated with our "24-hour" lifestyle. An extensive research literature has established clear links between increased risk for obesity and both sleep deprivation and shift work, and our understanding of the consequences of such dyssynchrony at the molecular level is beginning to emerge. Studies linking alterations in cellular circadian clocks to metabolic dysfunction point to the increasing importance of chronobiology in obesity etiology. PMID:23682347

Bray, Molly S; Young, Martin E

2012-03-01

230

Chronobiological Effects on Obesity.  

UK PubMed Central (United Kingdom)

The development of obesity is the consequence of a multitude of complex interactions between both genetic and environmental factors. It has been suggested that the dramatic increase in the prevalence of obesity over the past 30 years has been the result of environmental changes that have enabled the full realization of genetic susceptibility present in the population. Among the many environmental alterations that have occurred in our recent history is the ever-increasing dyssynchrony between natural cycles of light/dark and altered patterns of sleep/wake and eating behavior associated with our "24-hour" lifestyle. An extensive research literature has established clear links between increased risk for obesity and both sleep deprivation and shift work, and our understanding of the consequences of such dyssynchrony at the molecular level is beginning to emerge. Studies linking alterations in cellular circadian clocks to metabolic dysfunction point to the increasing importance of chronobiology in obesity etiology.

Bray MS; Young ME

2012-03-01

231

Adipokines in childhood obesity.  

UK PubMed Central (United Kingdom)

The worldwide increase in the prevalence of obesity in children and adolescents during the past decades, in addition to mounting evidence indicating that obesity is associated with an increased incidence of comorbidities and the risk of premature death, resulting in a high economical impact, has stimulated obesity-focused research. These studies have highlightened the prominent endocrine activity of adipose tissue, which is exerted through the synthesis and secretion of a wide variety of peptides and cytokines, called adipokines. In the present review, we have summarized the current knowledge and most relevant studies of adipokine dynamics and actions in children, focusing on the control of energy homeostasis, metabolic regulation (particularly, carbohydrate metabolism), and inflammation. The particularities of adipose secretion and actions in healthy children, from birth to adolescence, and the modifications induced by early-onset obesity are highlighted.

Martos-Moreno GÁ; Barrios V; Chowen JA; Argente J

2013-01-01

232

Musculo-skeletal pain in overweight and obese children.  

UK PubMed Central (United Kingdom)

This review seeks to provide a current overview of musculo-skeletal 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 January 1, 2000 and December 30, 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, musculo-skeletal 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 due to the heterogeneity of reported outcome measures. Ninety-seven records were initially identified using a variety of terms associated with children, obesity, and musculo-skeletal 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 musculo-skeletal pain.International Journal of Obesity accepted article preview online, 30 September 2013. doi:10.1038/ijo.2013.187.

Smith SM; Sumar B; Dixon KA

2013-09-01

233

Convergence of obesity and high glycemic diet on compounding diabetes and cardiovascular risks in modernizing China: An emerging public health dilemma  

Digital Repository Infrastructure Vision for European Research (DRIVER)

As China is undergoing dramatic development, it is also experiencing major societal changes, including an emerging obesity epidemic, with the prevalence of overweight and obesity doubling in the past decade. However, the implications of a high glycemic index (GI) and glycemic load (GL) traditional C...

Ding, Eric L.; Malik, Vasanti

234

Convergence of Obesity and High Glycemic Diet on Compounding Diabetes and Cardiovascular Risks in Modernizing China: An Emerging Public Health Dilemma  

Digital Repository Infrastructure Vision for European Research (DRIVER)

As China is undergoing dramatic development, it is also experiencing major societal changes, including an emerging obesity epidemic, with the prevalence of overweight and obesity doubling in the past decade. However, the implications of a high glycemic index (GI) and glycemic load (GL) traditional C...

Ding, Eric L.; Malik, Vasanti

235

Assortative mating for obesity.  

UK PubMed Central (United Kingdom)

BACKGROUND: Assortative mating is the nonrandom mating of individuals with respect to phenotype and cultural factors. Previous studies of assortative mating for obesity have indicated that it may have contributed to the obesity epidemic. However, those studies all used body mass index or skinfold thicknesses to measure obesity and did not always account for potential confounding factors. OBJECTIVE: We aimed to assess the level of assortative mating for obesity by using dual-energy X-ray absorptiometry to characterize body composition. DESIGN: This was a cross-sectional study of 42 couples. RESULTS: Raw spousal correlations showed assortative mating for age, weight, body mass index, lean mass, and fat mass. Removing the effect of age on fat mass strengthened the spousal correlation (r = 0.405). Social homogamy did not appear to be important, because in this sample there was no significant effect of area of origin on age-corrected fat and lean tissue masses for either sex. Regional body-composition analysis showed that subjects with disproportionately large arms (both fat and lean) assortatively mated with partners with the same trait. However, both men and women with high lean tissue in their arms assortatively mated with partners that had a disproportionately low fat content in their legs. CONCLUSIONS: These data confirm that assortative mating for obesity exists when dual-energy X-ray absorptiometry is used to evaluate adiposity. We hypothesize that assortative mating may have contributed to the obesity epidemic because the time course of obesity development has shifted progressively earlier, allowing singles in their late teens and early twenties to more easily distinguish partners with obese and lean phenotypes.

Speakman JR; Djafarian K; Stewart J; Jackson DM

2007-08-01

236

Treatment of obesity  

UK PubMed Central (United Kingdom)

A method for the treatment of obesity in an animal such as a human, comprises administering to the animal an effective amount of a peptide which comprises the carboxyl-terminal sequence of a growth hormone, particularly the carboxyl-terminal sequence of human growth hormone containing amine acid residues 177-191. A pharmaceutical composition for use in the treatment of obesity is also disclosed.

NG FRANK MAN-WOON; NATERA SIRIA HELEN ANNA; JIANG WOEI-JIA

237

[Micronutrient deficiency in obesity].  

UK PubMed Central (United Kingdom)

Obesity is frequently associated with micronutrient deficiency due to unhealthy diet, lack of antioxidants and polyunsaturated fat on one side and abundance of saturated fat on the other side. The micronutrients play an important role in inflammation, metabolic syndrome and insulin resistance and could influence the weight loss. The screening of micronutrient deficiency should therefore be systematic in order to improve the management of obesity. This is of particular importance for bariatric surgery patients.

Carpentier A; Pataky Z; Bobbioni-Harsch E; Golay A

2013-03-01

238

[Obesity and male fertility].  

UK PubMed Central (United Kingdom)

Obesity and male infertility have increased in the last decades; therefore, a possible association between these pathologies has been explored. Studies inform that obesity may affect fertility througth different mechanisms, which alltogether could exert erectile dysfunction and/or sperm quality impairment. These include: 1) hypothalamic-pituitary-testicular (HPG) axis malfunction: obese hormonal profile is characterized by reduction of testosterone, gonadotrophins, SHBG and/or inhibin B concentrations (marker of Sertoli cells function) and hyperestrogenemy (consequence of aromatase overactivity ascribed to adipose tissue increase); 2) increased release of adipose-derived hormones: leptin increase could be responsible for some of the alterations on the HPG axis and could also exert direct deleterious effects on Leydig cells physiology, spermatogenesis and sperm function; 3) proinflammatory adipokines augmentation, higher scrotal temperature (due to fat accumulation in areas surrounding testes) and endocrine disruptors accumulation in adiposites, all of these responsible for the increase in testes oxidative stress and 4) sleep apnea, frequent in obese patients, suppresses the nocturnal testosterone rise needed for normal spermatogenesis. Finally, although controversial, all the above mentioned factors could comprise gametes quality; i.e. decrease sperm density and motility and increase DNA fragmentation, probably disturbing spermatogenesis and/or epididymal function. In summary, although obesity may impair male fertility by some/all of the described mechanisms, the fact is that only a small proportion of obese men are infertile, probably those genetically predisposed or morbidly obese. Nevertheless, it is likely that because the incidence of obesity is growing, the number of men with reduced fertility will increase as well.

Martini AC; Molina RI; Ruiz RD; Fiol de Cuneo M

2012-01-01

239

Growth of a nation part II: impact of recipient obesity on whole-organ pancreas transplantation.  

UK PubMed Central (United Kingdom)

Obesity has reached epidemic proportions in the USA. Consequently, there is an increasing number of obese diabetic patients who would otherwise be appropriate candidates for pancreas transplantation (PTx). This is a retrospective study of all PTx performed at Indiana University between 2003 and 2009 (n = 308) comparing recipients with body mass index (BMI) < 25, 25-29.9, and ?30 kg/m(2) Data included recipient and donor demographics, seven and 90-d graft loss, one-yr pancreas, kidney (for SPK only) and patient survival, causes of graft loss and death, peak amylase and lipase, length of stay, readmissions, complications, HbA1C, and c-peptide. Of the 308 PTx, 100 (32%) were overweight and 42 (14%) were obese. Obese recipients were older and more likely to be men. Donor demographics were similar. There was no difference in seven-d or 90-d graft loss, one-yr pancreas, kidney or patient survival, cause of graft loss or death, 30-d peak amylase or lipase, HbA1C, or C-peptide. The incidence of post-transplant technical, immunological and infectious complications was similar except for an increased incidence of cytomegalovirus infection in the obese group. Two recipients returned to insulin therapy despite normal C-peptide levels. Although technically challenging, PTx can be successful in select obese recipients with similar results compared to normal BMI recipients.

Fridell JA; Mangus RS; Taber TE; Goble ML; Milgrom ML; Good J; Vetor R; Powelson JA

2011-07-01

240

The effect of cytokine profiles on the viral response to re-treatment in antiviral-experienced patients with chronic hepatitis C virus infection.  

UK PubMed Central (United Kingdom)

BACKGROUND: There have been few studies on the potential immunological factors associated with viral controls in antiviral-experienced patients on a second round of combination therapy. In this study, we evaluated the level of systemic cytokines and potential impact on combination therapy in both antiviral-naïve and -experienced patients chronically infected with hepatitis C virus. METHODS: Longitudinal analysis of 27 cytokines and chemokines was performed using the multiplex Biorad 27 plex assay in 37 antiviral-naïve and 24 experienced chronically HCV-1b-infected patients during combination therapy with peginterferon-alfa and ribavirin. A group of healthy donors was included as the control (n=11). RESULTS: Fifty percent of antiviral-experienced chronically HCV-patients could achieve a delayed and slow virologic response after 48 weeks combination therapy, comparing with an early and fast virologic response in antiviral-naïve patients. A distinction of immune mediators profiling before and during antiviral therapy between antiviral-naïve and -experienced patients was identified, IL-4, IFN-? and CCL-3 (MIP-1a) were significantly higher in naïve patients than those in experienced patients (P=0.005, 0.047 and 0.017, respectively) while G-CSF in naïve was lower than in experienced patients (P<0.05). Notably, higher Th1 type cytokine IFN-? and lower Th2 type cytokine IL-4 at baseline and week 4 were associated with HCV clearance in naïve patients, and a similar trend appeared at week 12 in experienced patients. CONCLUSIONS: We found a successful second round therapy in antiviral-experienced patients appears to be associated with the host immune response. Dominant Th1-polar cytokines, especially IFN-?, is a potential predictor of viral responsiveness.

Zhang Y; Guo D; Zhao Y; Chen X; Ma L; Jin Y; Yan H; Wu H; Wei L; Dong T; Chen X

2011-11-01

 
 
 
 
241

[Dying with living donor transplantation].  

UK PubMed Central (United Kingdom)

A female patient with primary sclerosing cholangitis developed a cholangiocarcinoma (Klatskin tumor) at the age of 42 years. It was successfully resected by hemihepatectomy and hepaticojejunostomy. In the next 15 years she had recurrent episodes of bacterial cholangitis and had to be hospitalized several times a year for intravenous antibiotics. At the same time the sclerosing cholangitis progressed and she developed liver cirrhosis. The patient, who was never willing to give up, underwent liver transplantation by receiving the left liver lobe of her daughter (living donor). Postoperatively she suffered from severe complications including a biliary leak, sepsis, intraabdominal abscesses and cachexia. Soon after she was dismissed by the transplantation center, she was admitted to our hospital in a very poor condition. She refused any further intensive care and died, with the well functioning donated left liver lobe of the daughter dying with her.

Reinhart W

2012-12-01

242

[Dying with living donor transplantation].  

Science.gov (United States)

A female patient with primary sclerosing cholangitis developed a cholangiocarcinoma (Klatskin tumor) at the age of 42 years. It was successfully resected by hemihepatectomy and hepaticojejunostomy. In the next 15 years she had recurrent episodes of bacterial cholangitis and had to be hospitalized several times a year for intravenous antibiotics. At the same time the sclerosing cholangitis progressed and she developed liver cirrhosis. The patient, who was never willing to give up, underwent liver transplantation by receiving the left liver lobe of her daughter (living donor). Postoperatively she suffered from severe complications including a biliary leak, sepsis, intraabdominal abscesses and cachexia. Soon after she was dismissed by the transplantation center, she was admitted to our hospital in a very poor condition. She refused any further intensive care and died, with the well functioning donated left liver lobe of the daughter dying with her. PMID:23188779

Reinhart, W

2012-12-01

243

A STUDY OF EXPERIENCED REALITY OF AUDITORY HALLUCINATIONS IN SCHIZOPHERENICS  

Digital Repository Infrastructure Vision for European Research (DRIVER)

30 Schizophrenics having verbal auditory hallucinations and satisfying the criteria of Feighner et al. (1972) were examined for the experienced reality of auditory hallucinations and the influence of certain variables on such reality. Number of hallucinating days per month, fast movement of time dur...

Ramanathan, A.

244

Student Teachers' Research Skills as Experienced in Their Educational Training.  

Science.gov (United States)

|Investigated Dutch student teachers' practice, experience, and problems with their required educational research project. Researchers followed four student teachers and created a description of the four cases in terms of the operational, experienced, and attained curriculum. From these descriptions, they formulated improvements for the training…

Brinkman, F. G.; Van Rens, E. M. M.

1999-01-01

245

Working with Families Experiencing Homelessness: Understanding Trauma and Its Impact  

Science.gov (United States)

The prevalence of traumatic stress in the lives of families who are homeless is extraordinarily high. Often these families are headed by single mothers who have experienced ongoing trauma in the form of childhood abuse and neglect, domestic violence, and community violence, as well as the trauma associated with poverty and the loss of home,…

Guarino, Kathleen; Bassuk, Ellen

2010-01-01

246

Team Cognition in Experienced Command-and-Control Teams  

Science.gov (United States)

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.

2007-01-01

247

Music and the Expressive Arts with Children Experiencing Trauma  

Science.gov (United States)

|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.

2010-01-01

248

HIV integrase inhibitors in ART-experienced patients.  

UK PubMed Central (United Kingdom)

PURPOSE OF REVIEW: We review the most recent clinical trials of integrase inhibitors (INIs) in antiretroviral therapy (ART)-experienced patients, including trails of new strategies such as intensification and simplification therapy with this new class of compounds. RECENT FINDINGS: After the excellent results of the first-generation INIs [raltegravir (RAL) and elvitegravir] in the treatment of ART-experienced patients, dolutegravir--a new second-generation compound in this drug class--adds the possibility of rescuing ART-experienced patients after virologic failure to first-generation INIs like RAL. RAL may have a role in an intensification strategy--adding RAL to a suppressive ART therapy--that could have an effect in avoiding new cycles of infection and cellular activation. On the contrary, RAL has clearly shown efficacy in switching away from boosted protease inhibitors (PI/r). This simplification strategy may be an interesting option in patients suffering from side effects of boosted protease inhibitors. In simplification, the length of time of HIV suppression before the switch may be used as a marker of probable success. SUMMARY: In ART-experienced patients INIs are a new and exciting part of the armamentarium for the control of HIV replication. INIs could play an interesting role in strategies such as intensification or simplification.

Blanco JL; Martinez-Picado J

2012-09-01

249

[Inequality, poverty and obesity].  

UK PubMed Central (United Kingdom)

National studies have been demonstrating the positive relationship among inequality, poverty and obesity revealing the singularities and complexity of the nutritional transition in Brazil. In this direction, the women constitute a vulnerable group to the dynamics of the obesity in the poverty context. Such fact imposes the theoretical deepening and the accomplishment of researches that make possible a larger approach with the phenomenon in subject. In this perspective, the study analyzed the daily life of poor and obese women, users of basic units of health of the city of Diamantina, Vale do Jequitinhonha, Minas Gerais State. The results revealed the complex relationship between feminine obesity and poverty. The cultural and material aspects of life, as well as the different feeding and body conceptions that demonstrated to be fundamental elements for the analysis of the multiple faces of the obesity among the investigated group. Facing these results it is appropriate to encourage public policies that promote equity widening the access of those groups to the main resources for the prevention and combat of obesity.

Ferreira VA; Silva AE; Rodrigues CA; Nunes NL; Vigato TC; Magalhães R

2010-06-01

250

Pharmacotherapy for obesity.  

Science.gov (United States)

Obesity is associated with increased risk of conditions such as hypertension, dyslipidaemia, diabetes mellitus, and obstructive sleep apnoea. Pharmacotherapy for obesity should be considered in combination with lifestyle changes in obese patients, or overweight patients with other conditions that put them at risk of developing heart disease. Sibutramine and orlistat are the only two anti-obesity medications approved for long-term use. Sibutramine is a serotonergic and adrenergic drug that reduces food intake. Orlistat is a gastrointestinal lipase inhibitor that interferes with fat absorption. However, it commonly causes flatulence and diarrhoea. Rimonabant is the first of a series of endocannabinoid receptor antagonists. It was approved by the Committee for Medicinal Products for Human Use of the European Medicines Agency (EMEA) as an adjunct to diet and exercise in treating obesity in 2006. However, despite the extensive clinical trial data, EMEA announced in 2008 that it has recommended suspension of rimonabant because of its psychiatric side effects. Studies evaluating the long-term safety and efficacy of anti-obesity agents are needed. PMID:20002075

Li, Mingfang; Cheung, Bernard M Y

2009-12-01

251

Pharmacotherapy for obesity.  

UK PubMed Central (United Kingdom)

Obesity is associated with increased risk of conditions such as hypertension, dyslipidaemia, diabetes mellitus, and obstructive sleep apnoea. Pharmacotherapy for obesity should be considered in combination with lifestyle changes in obese patients, or overweight patients with other conditions that put them at risk of developing heart disease. Sibutramine and orlistat are the only two anti-obesity medications approved for long-term use. Sibutramine is a serotonergic and adrenergic drug that reduces food intake. Orlistat is a gastrointestinal lipase inhibitor that interferes with fat absorption. However, it commonly causes flatulence and diarrhoea. Rimonabant is the first of a series of endocannabinoid receptor antagonists. It was approved by the Committee for Medicinal Products for Human Use of the European Medicines Agency (EMEA) as an adjunct to diet and exercise in treating obesity in 2006. However, despite the extensive clinical trial data, EMEA announced in 2008 that it has recommended suspension of rimonabant because of its psychiatric side effects. Studies evaluating the long-term safety and efficacy of anti-obesity agents are needed.

Li M; Cheung BM

2009-12-01

252

Underestimation of adolescent obesity.  

UK PubMed Central (United Kingdom)

BACKGROUND: Previous studies assessing the validity of adolescent self-reported height and weight for estimating obesity prevalence have not accounted for, potential bias due to nonresponse in self-reports. OBJECTIVES: The aim of this study was to assess the implications of selective nonresponse in self-reports of height and weight for estimates of adolescent obesity. METHODS: The authors analyzed 613 adolescents ages 12-17 years from the 2006-2008 Los Angeles Family and Neighborhood Survey, a longitudinal study of Los Angeles County households with an oversample of poor neighborhoods. Obesity prevalence estimates were compared based on (a) self-report, (b) measured height and weight for those who did report, and (c) measured height and weight for those who did report. RESULTS: Among younger teens, measured obesity prevalence was higher for those who did not report height and weight compared with those who did (40% vs. 30%). Consequently, obesity prevalence based on self-reported height and weight underestimated measured prevalence by 12 percentage points (when accounting for nonresponse) versus 9 percentage points (when nonresponse was not accounted for). Results were robust to the choice of difference child growth references. DISCUSSION: Adolescent obesity surveillance and prevention efforts must take into account selective nonresponse for self-reported height and weight, particularly for younger teens. Results should be replicated in a nationally representative sample.

Buttenheim AM; Goldman N; Pebley AR

2013-05-01

253

Childhood obesity case statement.  

UK PubMed Central (United Kingdom)

OBJECTIVE: The goal of this publication is to raise awareness of the impact of childhood obesity on the musculoskeletal health of children and its potential long-term implications. METHODS: Relevant articles dealing with musculoskeletal disorders either caused by or worsened by childhood obesity were reviewed through a Pub Med search. Efforts to recognize and combat the childhood obesity epidemic were also identified through Internet search engines. This case statement was then reviewed by the members of the pediatric specialty group of the US Bone and Joint Initiative, which represents an extensive number of organizations dealing with musculoskeletal health. RESULTS: Multiple musculoskeletal disorders are clearly caused by or worsened by childhood obesity. The review of the literature clearly demonstrates the increased frequency and severity of many childhood musculoskeletal disorders. Concerns about the long-term implications of these childhood onset disorders such as pain and degenerative changes into adulthood are clearly recognized by all the member organizations of the US Bone and Joint Initiative. CONCLUSIONS: It is imperative to recognize the long-term implications of musculoskeletal disorders caused by or worsened by childhood obesity. It is also important to recognize that the ability to exercise comfortably is a key factor to developing a healthy lifestyle and maintaining a healthy body weight. Efforts to develop reasonable and acceptable programs to increase physical activity by all facets of society should be supported. Further research into the long-term implications of childhood musculoskeletal disorders related to childhood obesity is necessary.

Esposito PW; Caskey P; Heaton LE; Otsuka N

2013-04-01

254

Dietary Polyphenols and Obesity  

Directory of Open Access Journals (Sweden)

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.

Mohsen Meydani; Syeda T. Hasan

2010-01-01

255

Obesity prevention in children.  

UK PubMed Central (United Kingdom)

The prevalence of childhood overweight and obesity continues to be unacceptably high and of public health concern in Europe. During childhood and adolescence, environmental factors are the main drivers of obesity development. Obesity is caused by a chronic energy imbalance involving both dietary intake and physical activity patterns. Several risk factors are influencing obesity development, even starting in the prenatal period. From birth, along life, mainly diet and physical activity/inactivity are the most important drivers on top of genetic susceptibility. The first years of life can therefore be crucial to start preventive interventions that can have an impact on lifestyle and on later overweight and obesity. Schools are an attractive and popular setting for implementing interventions for children. Interventions including a community component are considered to be the most effective. Obesity control will require policy interventions to improve the environments that promote poor dietary intake and physical inactivity rather than individually focused interventions. More solid institutional and health policies are needed together with more effective interventions to obtain evident changes for the prevention of excess adiposity among children.

Moreno LA; Bel-Serrat S; Santaliestra-Pasías AM; Rodríguez G

2013-01-01

256

Psoriasis and Obesity  

Directory of Open Access Journals (Sweden)

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; Hilal Gökalp

2012-01-01

257

More than meets the eye. Feminist poststructuralism as a lens towards understanding obesity.  

UK PubMed Central (United Kingdom)

AIM: ? This paper presents a discussion of the application of a feminist poststructuralist-based theoretical framework as an innovative approach towards understanding and managing the complex health issue of obesity. BACKGROUND: ? Obesity is often viewed as a lifestyle choice for which the individual is blamed. This individualistic, dichotomous and behavioural perspective only allows for a narrow understanding of obesity and may even lead to misperceptions, stereotypes and marginalization of clients experiencing obesity. Feminist poststructuralism can provide a critical lens to understand the social construction of obesity and the broader environmental and cultural contexts of this health issue. DATA SOURCES: ? The theoretical framework draws from the writings of Foucault, Scott, Butler, Cheek, and Powers, published between 1983 and 2005. DISCUSSION: ? The concepts of discourse analysis and power relations are explored and discussed in a clear manner so that nurses can easily apply this framework to their practice as they observe, question, analyse, critique and assess the care experienced by clients who are obese. The concepts of personal and social beliefs, values and stereotypes are also discussed and examples of how to apply them in practice are provided. IMPLICATIONS: ? It is imperative that we continue to question our everyday nursing practices as we work to support clients, especially those who feel marginalized. This focus on power relations and reflective practice can give direction to new possibilities for change in obesity management.

Aston M; Price S; Kirk SF; Penney T

2012-05-01

258

Increasing the donor and recipient pool-expanded criteria in living kidney donors.  

UK PubMed Central (United Kingdom)

To increase the donor and recipient pool in living related renal transplantation, kidneys from expanded criteria living donors are used more frequently to reduce the general problem of organ shortage. This article presents an overview of the current literature concerning this topic to further improve donor selection and transplant decision making.

Kocot A; Giessing M

2013-04-01

259

CDC Vital Signs: Progress on Childhood Obesity  

Science.gov (United States)

... the MMWR Science Clips August 2013 Progress on Childhood Obesity Many States Show Declines On this Page Introduction ... increase in obesity. To learn more about how childhood obesity is measured, see http://www.cdc.gov/obesity/ ...

260

Payment for donor kidneys: pros and cons.  

Science.gov (United States)

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

2006-03-01

 
 
 
 
261

The value of living donor liver transplantation.  

UK PubMed Central (United Kingdom)

Living donor liver transplantation (LDLT) is a very successful procedure that develops liver resources in case of worldwide shortages. As the technology has developed so much in the past 2 decades, LDLT has the same good prognosis as DDLT. However, LDLT still has lots of ethical & technical problems. It causes great psychiatric, physical and psychosocial harm to donors. Also, it has some negative effects on society by providing a platform for organ trade. Therefore, there is much controversy about the social value of LDLT. After review of recent papers, we find much progress can be made in inspiring the public to become organ donors and creating donation model new to improve the consent rate for solid organ donation from deceased donors. That is the key strategy for increasing the liver supply. With this serious shortage of organs, liver donor transplantation still has its advantages, but we should not place all our hopes on LDLT to increase the liver supply. We all need to try our best to increase donor awareness and promote organ donor registration--when cadaver organs could meet the needs for liver transplantation, living donor liver transplants would not be necessary.

Yang X; Gong J; Gong J

2012-12-01

262

The value of living donor liver transplantation.  

Science.gov (United States)

Living donor liver transplantation (LDLT) is a very successful procedure that develops liver resources in case of worldwide shortages. As the technology has developed so much in the past 2 decades, LDLT has the same good prognosis as DDLT. However, LDLT still has lots of ethical & technical problems. It causes great psychiatric, physical and psychosocial harm to donors. Also, it has some negative effects on society by providing a platform for organ trade. Therefore, there is much controversy about the social value of LDLT. After review of recent papers, we find much progress can be made in inspiring the public to become organ donors and creating donation model new to improve the consent rate for solid organ donation from deceased donors. That is the key strategy for increasing the liver supply. With this serious shortage of organs, liver donor transplantation still has its advantages, but we should not place all our hopes on LDLT to increase the liver supply. We all need to try our best to increase donor awareness and promote organ donor registration--when cadaver organs could meet the needs for liver transplantation, living donor liver transplants would not be necessary. PMID:23274332

Yang, Xiaoli; Gong, Junhua; Gong, JianPing

2012-12-31

263

Electron transport through single donors in silicon  

Energy Technology Data Exchange (ETDEWEB)

This thesis will focus on the basic element of two (beyond-transistor-logic) computation schemes, namely a single dopant atom in a three terminal geometry. Although the schemes to implement single donors are already well-developed, until recently, not much experimental work existed. Here, we will describe one of the first experimental studies on such structures where, by means of carefully analyzing electronic transport in scaled FinFET devices, we are able to obtain single donor structures effectively and study the physics that governs them. Chapter 2 will provide a general theoretical background on how transport through single donors takes place. In Chapter 3, we will describe the devices we use to electrically access single dopants and focus on the sub-threshold transport, the regime where single donor transport characteristics are typically observed. Chapter 4 explains what the characteristic fingerprint of a single donor is and how it relates to the energy scales of the donor atom. In Chapter 5 we discuss the orbitals of the singly-charged donor atom and show how they are effected by the high electric field induced by the gate electrode. Chapter 6 discusses the orbitals of the doubly charged donor and the charging energy between the singly- and -doubly charged states. Finally, Chapter 7 describes the influence of Kondo effects on the electronic transport, an effect generated by entanglement between the localized electron spin on the atom and the delocalized electrons in the source/drain leads.

Lansbergen, G.P.

2010-03-09

264

Fecal microbiota transplantation and donor standardization.  

UK PubMed Central (United Kingdom)

Clostridium difficile diarrhea is a common and severe infectious disease. Antibiotics, which are standard initial treatment, are less effective for treating refractory or recurrent infection. Fecal microbiota transplantation, where healthy donor stool is transplanted into a patient, is an alternative to antibiotic therapy that requires standardization for donors and patients.

Owens C; Broussard E; Surawicz C

2013-09-01

265

[Transplantation with living organ donors: ethical issues].  

UK PubMed Central (United Kingdom)

Living organ donation has raised ethical issues, which have not been fully addressed. The scarcity of organs as well as medical advances promote this procedure. However, the psychological outcome of donors may not be as good as expected. The usual assessment is not able to identify donors who are at risk. Patients' autonomy is privileged but may lead to the underestimation of underlying psychopathological processes. Without minimizing the importance of donors' self-determination, benevolence and sense of justice, we suggest that it could be useful to investigate the roots of donors' motivations. We could consider the existence of a shared responsibility between patients and clinicians. The ethics of responsibility may complete the ethics of autonomy, leading to a better identification of donors at risk.

Stagno D; Benaroyo L

2007-02-01

266

Soy Consumption and Obesity  

Directory of Open Access Journals (Sweden)

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.

Dante Roccisano; Maciej Henneberg

2012-01-01

267

Percutaneous renal cryoablation in obese and morbidly obese patients.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To compare percutaneous renal cryoablation complications and outcomes in obese and morbidly obese vs nonobese patients. METHODS: Three hundred eighty-nine percutaneous cryoablation procedures were performed in 367 patients for treatment of 421 renal masses at our institution between 2003 and 2012. Patients were categorized into 3 groups on the basis of body mass index (BMI): nonobese (BMI <30.0 kg/m(2)), obese (BMI 30.0-39.9 kg/m(2)), and morbidly obese (BMI ?40.0 kg/m(2)). Each group was retrospectively analyzed for major complications (Clavien ?grade 3) and oncologic outcomes. RESULTS: One hundred eighty-nine renal cryoablation procedures (48.6%) were performed on nonobese patients, 161 (41.4%) on obese patients, and 39 (10.0%) on morbidly obese patients. Eleven (5.8%) major complications occurred in nonobese patients, 15 (9.3%) in obese patients, and 3 (7.7%) in morbidly obese patients. As such, there was no significant difference in the rate of major complications in obese (P = .23) or morbidly obese (P = .67) compared with nonobese patients. There was 1 ablation-related death from complications of urosepsis. Thirteen local treatment failures were identified, including 5 technical failures and 8 local tumor recurrences during median imaging follow-up of 18 months (interquartile range: 8-36). Six local treatment failures (3.2%) occurred in nonobese patients, 5 (2.9%) in obese patients, and 2 (4.8%) in morbidly obese patients. Again, no significant difference was noted in local treatment failure rate between obese (P = .96) or morbidly obese (P = .57) compared with nonobese patients. CONCLUSION: Percutaneous renal cryoablation complication rates and short-term outcomes in obese and morbidly obese patients are similar to those in nonobese patients.

Schmit GD; Thompson RH; Boorjian SA; McDonald RJ; Kurup AN; Weisbrod AJ; Kor DJ; Callstrom MR; Atwell TD

2013-09-01

268

Life spans experienced by steam-electric generating units  

International Nuclear Information System (INIS)

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

1993-01-01

269

Anticipated and experienced emotions in environmental risk perception  

Directory of Open Access Journals (Sweden)

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.

Gisela Bohm; Hans-Rudiger Pfister

2008-01-01

270

[Hospitalization by court order: ethical dilemmas experienced by nurses].  

UK PubMed Central (United Kingdom)

A qualitative study aimed at describing the situations experienced and the ethical dilemmas of nurses in the process of referring and receiving hospitalized patients by court order who require admission to the Intensive Care Unit (ICU). A partially structured interview was conducted with 10 nurses who worked in the ICU and 10 who worked in the Emergency Room (ER) in public and private hospitals in the metropolitan area of Porto Alegre, Brazil. The data was analyzed following the Semantic Analysis. The results indicated that nurses experienced ethical dilemmas associated with problems of overcrowding in emergency rooms and ICUs, poor specialized technology and orientation as to the benefits provided by law. We concluded that it is essential for nurses to participate in discussions that allow the planning of the different instances that have been promoting this often chaotic situation.

Vargas MA; Ramos FR; Schneider DG; Schneider N; dos Santos AC; Leal SM

2013-03-01

271

Maternal obesity and preeclampsia  

Directory of Open Access Journals (Sweden)

Full Text Available Background: Obesity is a modern day epidemic. The incidence appears to be rapidly increasing in bothdeveloped and developing countries and has become much more obvious in the last decade.Aim& Objective: The present research was done with the aim of studying the effects of obesity definedas a first trimester maternal body mass index >30 on the preeclampsia.Methods: This study was a descriptive-comparative study two hundred fifty singleton pregnancies ofwomen with first trimester BMI >30 who delivered at Emam Hospital, Sari Iran during 2008–2009 werestudied A control group with two hundred fifty nine women of normal body mass index matched for ageand parity were selected and incidence of preeclampsia were compared between groups. ?2 and Oddsratioand 95% confidence were used to analyze the data. Statistical significance was defined as P < 0.05.Results: There was a significant relation between obesity and preeclampsia (20.8 vs. 5.8%, P<0.0001)compared to non-obese women.Conclusion: Obesity in pregnant women appears to be a risk factor for adverse perinatal outcomes.

Azar Aghamohammadi

2011-01-01

272

Obesity and periodontal disease  

Directory of Open Access Journals (Sweden)

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.

Jagannathachary Sunitha; Kamaraj Dinesh

2010-01-01

273

The challenge of obesity.  

UK PubMed Central (United Kingdom)

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. (PsycINFO Database Record (c) 2013 APA, all rights reserved).

Cook JA; Mueser KT

2013-09-01

274

[Obesity-related hypertension].  

UK PubMed Central (United Kingdom)

Hypertension occurs in more than 40% of obese adults and leads to increased risk for cardiovascular disease and death. In practice, obesity-related hypertension is often difficult to control with pharmacological treatment. The association of obesity and hypertension can partly be explained by mutual risk factors, but there is also an etiological relation. Increasing obesity may lead to dysfunctional adipose tissue, characterised e.g. by deranged production of hormones and cytokines (adipokines). This results in sympathoactivation, upregulation of the renin-angiotensin-aldosterone system (RAAS) and systemic low grade inflammation and oxidative stress. The common result of these deregulations is increased resistance of the peripheral vasculature due to endothelial dysfunction, vasoconstriction and vascular wall hypertrophy, and increased circulating volume due to impaired pressure natriuresis. This leads to the development of hypertension that is relatively resistant to drug therapy. Lifestyle modifications by means of weight reduction and salt restricted diet are the cornerstones of obesity-related hypertension treatment. Pharmacological treatment with beta-blockers or diuretics is not self-evident, since this increases the risk of developing de novo diabetes mellitus.

Dorresteijn JA; Visseren FL; van den Meiracker AH; Spiering W

2011-01-01

275

Health-Related Quality of Life in Kidney Donors From the Last Five Decades: Results From the RELIVE Study.  

Science.gov (United States)

Live donation benefits recipients, but the long-term consequences for donors remain uncertain. Renal and Lung Living Donors Evaluation Study surveyed kidney donors (N?=?2455; 61% women; mean age 58, aged 24-94; mean time from donation 17 years, range 5-48 years) using the Short Form-36 Health Survey (SF-36). The 95% confidence intervals for White and African-American donors included or exceeded SF-36 norms. Over 80% of donors reported average or above average health for their age and sex (p?1 SD below norm). Obesity, history of psychiatric difficulties and non-White race were risk factors for impaired physical health; history of psychiatric difficulties was a risk factor for impaired mental health. Education, older donation age and a first-degree relation to the recipient were protective factors. One percent reported that donation affected their health very negatively. Enhanced predonation evaluation and counseling may be warranted, along with ongoing monitoring for overweight donors. PMID:24011252

Gross, C R; Messersmith, E E; Hong, B A; Jowsey, S G; Jacobs, C; Gillespie, B W; Taler, S J; Matas, A J; Leichtman, A; Merion, R M; Ibrahim, H N

2013-09-06

276

Overweight and obesity among African immigrants in Oslo.  

UK PubMed Central (United Kingdom)

BACKGROUND: Norway is experiencing an increase in overweight/obese adults, with immigrants from developing countries carrying a heavy burden. The aim of this study is to assess the prevalence of overweight and obesity among Somali immigrants in Oslo. FINDINGS: A cross-sectional study involving 208 respondents aged 25 and over was conducted among Somali immigrants in Oslo, using a structured questionnaire. Prevalence of overweight/obesity varied by gender, with women having a significantly higher prevalence (66%) than men (28%). The mean BMI for females and males were 27.4 and 23.6, respectively. Similarly, 53% of women and 28% of men were abdominally obese. In a logistic regression analysis, both generalized and abdominal obesity were significantly associated with increasing duration of residence in Norway, and with being less physically active. CONCLUSION: Public health policymakers should facilitate an environment that enables Somali immigrants, particularly women, to lead healthy lifestyles. In this time of epidemiological transition, health education in the areas of physical exercise and healthy eating should be a major focus for working with new immigrants.

Gele AA; Mbalilaki AJ

2013-01-01

277

Experienced Qualities of Vegetated Space in a Scandinavian Context  

DEFF Research Database (Denmark)

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 – 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 & Videgård. There is a close contact between interior space and façade plants as a large part of the façade 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

2013-01-01

278

If I Had - Morbid Obesity  

Medline Plus

Full Text Available ... of Testing for Concussion If I Had - Morbid Obesity - Dr. Michael Tarnoff, MD, FACS, Tufts University School ... Back to Home Page If I Had - Morbid Obesity - Dr. Michael Tarnoff, MD, FACS, Tufts University School ...

279

Childhood obesity for pediatric gastroenterologists.  

UK PubMed Central (United Kingdom)

Obesity in childhood is one of the major health issues in pediatric health care today. As expected, the prevalence of obesity-related comorbidities has risen in parallel with that of obesity. Consultation regarding these concomitant diseases and subsequent management by subspecialists, including pediatric gastroenterologists, is now common and has resulted in obesity being recognized as a chronic disease requiring coordination of care. Although medications and even surgery may provide effective, though often temporary, treatments for obesity and its comorbidities, behavioral interventions addressing healthy dietary and physical activity habits remain a mainstay in the obesity treatment paradigm. Therefore, the issue of weight management must be addressed by both general practitioner and subspecialist alike. In this report, we review select aspects of pediatric obesity and obesity-related management issues because it relates in particular to the field of pediatric gastroenterology and hepatology.

Huang JS; Barlow SE; Quiros-Tejeira RE; Scheimann A; Skelton J; Suskind D; Tsai P; Uko V; Warolin JP; Xanthakos SA

2013-01-01

280

[Transplantation of the right hepatic lobe from an alive relative donor  

UK PubMed Central (United Kingdom)

The use of relative donors in the transplantation of the liver has shown a good performance as an alternative line in its orthotopical grafting. Shortage of donor organs actively stimulates the development of relative transplantation. The main problem of relative hepatic transplantation is the limited capacity of obtaining a required mass of a hepatic graft for obese recipients. To settle this problem, the Russian Surgery Research Center, Russian Academy of Medical Sciences, has developed an original safe procedure for obtaining the right lobe of the liver from an alive relative donor and for implanting it in a recipient. In November 1997 to October 2001, transplantation of the right hepatic lobe from an alive relative donor was made in 23 recipients (10 males and 13 females aged 9 to 55 (mean 22.3 +/- 3.1) years. Their body weight was 24 to 80 (mean 51.4 +/- 3.0) kg. Indications for surgery were as follows: hepatic cirrhosis (HC) at the end stage of the Wilson-Konovalov disease (n = 10), primary sclerotic cholangitis (n = 4), HC of viral etiology (n = 3), Bailer's disease (n = 2), primary biliary HC (n = 2), HC in the presence of alpha 1-antitrypsin deficiency (n = 1), and secondary biliary HC (n = 1). The donors of the right lobe of the liver were recipients' mothers in 9 cases, their fathers in 6 cases, sisters in 2 cases, sons in 1 cases, their daughter, brother, aunt, cousin in 1 case each. The donors' age ranged from 19 to 49 (mean 37.9 +/- 1.4) years. The donors underwent right hemihepatectomy, complications were absent in them. There were early mortality among the recipients. Two patients died in the late postoperative period. The remaining 21 recipients were survivors and followed up for 1 to 48 (mean 14.9 +/- 2.9) months. Their life quality was good. The use of the right lobe of the liver from an alive relative donor is the optimum alternative to transplantation of the cadaverous liver and partially compensates the shortage of donor organs for children, adolescents, and adults.

Got'e SV; Tsirul'nikova OM; Filin AV; Vabishchevich AV; Kamalov IuR; Lokshin LS; Lapti? AV; Konstantinov BA

2002-01-01

 
 
 
 
281

The association between maltreatment and obesity among preschool children.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To determine whether child maltreatment is associated with obesity in preschool children. METHODS: Data were obtained from the Fragile Families and Child Wellbeing Study, a birth cohort study of 4898 children born between 1998 and 2000 in 20 large US cities. At 3 years of age, 2412 of these children had their height and weight measured, and mothers answered items on the Parent-Child Conflict Tactics Scales about three types of child maltreatment--neglect, corporal punishment, and psychological aggression. The frequency of each type of maltreatment behavior in the prior year was analyzed using categories--ever/never for neglect and quintiles for the other two types of maltreatment. Child obesity was defined as measured body mass index (kg/m(2)) > or =95th percentile. RESULTS: Eighteen percent of the children were obese, and the prevalence of any episode of neglect, corporal punishment, and psychological aggression was 11%, 84%, and 93%, respectively. The odds of obesity were increased in children who had experienced neglect (odds ratio 1.56, 95% confidence interval, 1.14-2.14), after controlling for the income and number of children in the household, the mothers' race/ethnicity, education, marital status, body mass index, prenatal smoking, and age, and the children's sex and birth weight. Neither the frequency of corporal punishment nor psychological aggression was associated with an increased risk of obesity. CONCLUSIONS: In a sample of preschool children from 20 large US cities, maternal self-report of neglectful behavior was associated with an increased risk of childhood obesity, after controlling for birth weight, maternal obesity, and multiple socioeconomic factors.

Whitaker RC; Phillips SM; Orzol SM; Burdette HL

2007-11-01

282

Our experience with deceased organ donor maintenance  

Directory of Open Access Journals (Sweden)

Full Text Available Deceased organ donors in an intensive care unit (ICU) are the richest source of organs for transplantation. Careful donor maintenance plays a vital role in the successful functioning of the organ in the recipient. Aims : Early identification of brain stem death (BSD) in the ICU, problems and management in donor maintenance till retrieval are the main objectives. Materials and Methods : BSD was identified in a level I trauma center over a period of eight years (1996-2004) using UK code. After screening for fitness, they were maintained to achieve normothermia, systolic BP > 90 mm Hg, CVP 8-10 cm water, urine output > 80 ml/hour and normal acid base balance. Results: 168 cases of BSD were maintained, 30 with identity unknown. Common transient complications noted were hypotension (68%), hypokalemia (62%), hypothermia (12%), diabetes insipidus (70%). Brain stem death was identified early and resuscitated to maintain normal tissue perfusion. 17 (12.3%) consent for organ donation was obtained. Organs (24 kidneys and one liver) were retrieved from 12 donors. Four donors sustained cardiac arrest before retrieval. Conclusion: Early recognition of brain stem death and prompty correction of hemodyanamic instability is the key to deceased donor maintenance. Optimal care of potential donor translates to care of multiple recipients.

Kumar Meena; Shendge Prakash; Kumar Vineet; Trivedi Vatsala; Waghela Jagruti; Rajpal Dilip

2007-01-01

283

Depression, quality of life, work productivity, resource use, and costs among women experiencing menopause and hot flashes: a cross-sectional study.  

UK PubMed Central (United Kingdom)

Objective: To examine the effect of depression on health-related quality of life, work productivity, resource use, and costs among women experiencing menopausal symptoms, including hot flashes. Method: The study included data from the 2005 US National Health and Wellness Survey (N = 41,184), a cross-sectional, Internet-based survey representative of the adult US population. Among women who reported experiencing menopausal symptoms, including hot flashes, women who reported experiencing depression in the last year (n = 1,165) were compared with women who did not report experiencing depression in the last year (n = 2,467), controlling for demographic and health characteristics. Outcome measures included health-related quality of life (Medical Outcomes Study 8-item Short-Form Health Survey [SF-8]), work productivity within the past 7 days, self-reported health care resource use within the past 6 months, and indirect and direct costs. Results: Women experiencing depression were significantly more likely to be white, to be unemployed, to be uninsured, to currently smoke, to not exercise, and to be obese (all P < .05). After controlling for these differences, women experiencing depression reported significantly lower mental (39.66 vs 50.85, P < .05) and physical (44.05 vs 46.38, P < .05) SF-8 component summary scores. Similarly, the prevalences of time missed from work (5.31% vs 2.80%, P < .05), impairment while at work (25.00% vs 14.32%, P < .05), and impairment of daily activities (37.32% vs 23.16%, P < .05) due to health were greater among women experiencing depression. The numbers of physician visits (2.47 vs 1.77, P < .05), emergency room visits (0.27 vs 0.16, P < .05), and days hospitalized (0.36 vs 0.18, P < .05) in the past 6 months were also higher among women experiencing depression. Per woman per year indirect and direct costs were $3,066 and $1,075 higher, respectively, for women experiencing depression compared with those not experiencing depression. Conclusion: Approximately one-third of women experiencing menopausal symptoms, including hot flashes, also reported experiencing depression. These women reported significantly worse quality of life and significantly greater work productivity loss, health care resource use, and costs. Given the prevalence and burden, these findings suggest that proper assessment and management of depressive symptoms among women with menopause may have an important humanistic and economic benefit.

Dibonaventura MD; Wagner JS; Alvir J; Whiteley J

2012-01-01

284

Osteoarthritis, inflammation and obesity.  

UK PubMed Central (United Kingdom)

PURPOSE OF REVIEW: Obesity is one of the main risk factors of the incidence and prevalence of knee osteoarthritis. Recent epidemiological data showing an increased risk of hand osteoarthritis in obese patients opened the door to a role of systemic inflammatory mediators, adipokines, released by adipose tissue. RECENT FINDINGS: Recent experimental studies confirm the critical roles of adipokines in the pathophysiologic features of osteoarthritis, with an emphasis on a new member, chemerin. Animal models of diet-induced obesity show that overload cannot completely explain the aggravation of spontaneous or posttraumatic knee osteoarthritis. We now have data suggesting that some adipokines may be surrogate biomarkers for severity of osteoarthritis. SUMMARY: Preclinical studies targeting adipokines are now expected to provide new hope for patients with osteoarthritis, especially those with metabolic syndrome.

Berenbaum F; Eymard F; Houard X

2013-01-01

285

Obesity hypoventilation syndrome  

Directory of Open Access Journals (Sweden)

Full Text Available Obesity is becoming a major medical concern in several parts of the world, with huge economic impacts on health- care systems, resulting mainly from increased cardiovascular risks. At the same time, obesity leads to a number of sleep-disordered breathing patterns like obstructive sleep apnea and obesity hypoventilation syndrome (OHS), leading to increased morbidity and mortality with reduced quality of life. OHS is distinct from other sleep- related breathing disorders although overlap may exist. OHS patients may have obstructive sleep apnea/hypopnea with hypercapnia and sleep hypoventilation, or an isolated sleep hypoventilation. Despite its major impact on health, this disorder is under-recognized and under-diagnosed. Available management options include aggressive weight reduction, oxygen therapy and using positive airway pressure techniques. In this review, we will go over the epidemiology, pathophysiology, presentation and diagnosis and management of OHS.

Al Dabal Laila; BaHammam Ahmed

2009-01-01

286

[Dietary therapy for obesity].  

UK PubMed Central (United Kingdom)

In the majority of obese patients adjustment of the diet will be required to reduce calorie intake. In general, diets containing 1,000 to 1,800 kcal/day should be selected for obese patients. VLCD (very low calorie diet) is below 600 kcal/day. VLCD should not be used routinely for weight loss therapy because they require special monitoring and supplementation. A diet should be integral part of any program aimed an achieving a weight loss of 5%. Protein is approximately 15-20%, carbohydrate 60%, fat is 20-25% of total calories. Low carbohydrate-high protein diets, used on a regular basis and without consideration of the nature of carbohydrates the source of proteins, are associated with the increased risk of cardiovascular disease. Consumption of high-fructose corn syrup in beverages may play a role the epidemic of obesity.

Tokunaga K; Furubayashi T

2013-02-01

287

Mysore childhood obesity study.  

UK PubMed Central (United Kingdom)

We conducted this study to document the prevalence of obesity, overweight and underweight in the school children aged 5 to 16 years from Mysore. 5 Principal Investigators and 13 Co-Investigators trained the teachers of 139 schools (Private--111, Govt--28) to record the vital statistics of the children studying in their schools. A total of 43,152 school children (23,527 boys and 19,625 girls) were surveyed. 36,354 children were from private schools and 6798 children were from Government (Govt) schools. Indian Academy of Pediatrics growth charts were used as reference. The prevalence of obesity, overweight and underweight were 3.4%, 8.5% and 17.2%, respectively. The prevalence of obesity was maximum in the age group of 5-7 years and in those from private schools.

Premanath M; Basavanagowdappa H; Shekar MA; Vikram SB; Narayanappa D

2010-02-01

288

Impaired platelet function among platelet donors.  

UK PubMed Central (United Kingdom)

BACKGROUND: Platelet transfusions are effective for the prevention and treatment of bleeding in patients with disorders of platelet number and/or function. In recent years plateletpheresis concentrates have outnumbered pooled platelet concentrates, albeit with significant differences between nations. Thus, the platelet quality of individual donors has become increasingly important. The aim of this study was to gain an estimate for the prevalence of impaired platelet function among platelet donors. STUDY DESIGN AND METHODS: We determined the inter-donor variability in platelet plug formation with a PFA-100 analyzer, the prevalence of impaired thromboxane formation, and effects of the density in alpha2 integrin polymorphism and density. RESULTS: (i) Collagen-epinephrine induced closure time (CEPI-CT) showed a great inter-subject variability in platelet donors and was higher than in healthy controls (p = 0.008). One-fifth of donors had abnormal CEPI-CT values and 11% exceeded >300 s (max measurable value). (ii) Decreased serum thromboxane B2 levels were found in 9% of all donors, compatible with surreptitious intake of cyclooxygenase inhibitors or with an aspirin-like defect. CEPI-CT correlated inversely with TxB2-levels in donors and controls. (iii) The density of the alpha2-integrin correlated negatively with CEPI-CT and CADP-CT values in controls, but was not responsible for the observed impaired platelet function in donors. (iv) Finally, the ABO blood group system modulates closure times. CONCLUSION: In sum, a large number of platelet donors present with prolonged closure times. Decreased thromboxane formation and frequent platelet donation partly account for this observation.

Jilma-Stohlawetz P; Hergovich N; Homoncik M; Dzirlo L; Horvath M; Janisiw M; Panzer S; Jilma B

2001-09-01

289

Iron status of regular voluntary blood donors  

Directory of Open Access Journals (Sweden)

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 P Conclusion: Regular voluntary blood donors should receive iron supplementation to prevent iron deficiency and depletion in iron stores.

Mahida Vilsu; Bhatti Apksha; Gupte Snehalata

2008-01-01

290

Relationship of obesity to diabetes.  

UK PubMed Central (United Kingdom)

In a representative sample of 201 diabetic patients of Tripoli, Libya, 138 were obese. The highest percent of diabetics and obese belong to the age group 41-50 years. In all age groups, there was a parallel increase/decrease in obesity with diabetes. Regulation of body weight should be considered very important in control of diabetes.

Rao GM; Morghom LO

1984-04-01

291

Burns in morbidly obese patients.  

UK PubMed Central (United Kingdom)

It has been estimated that 26% of Americans are obese. A very small subset of this group can be categorized as morbidly obese, fulfilling the criteria of being 100 pounds, or 100%, over ideal body weight. The clinical records of seven morbidly obese burn patients treated over a 20-year period are reviewed. Particularly notable was a 43% incidence of fatal pulmonary embolism.

Sheridan RL; Rue LW 3rd; McManus WF; Pruitt BA Jr

1992-12-01

292

Donor policy rules and aid effectiveness  

DEFF Research Database (Denmark)

The present paper examines the macroeconomic impact of aid, by introducing endogenous aid allocations into a neoclassical growth framework. On this basis it is shown that donor policies can have important implications for the trajectory of recipients' GDP per capita. Depending on specific donor policy choices, aid disbursements may lead to faster transitional growth, stagnation or cyclical growth. Moreover, the analysis also suggests that donor policies may be part of the reason why foreign aid is not found to be uniformly effective in raising long-run productivity across recipients

Dalgaard, Carl-Johan Lars

2008-01-01

293

Obesity and kidney transplantation.  

UK PubMed Central (United Kingdom)

Obesity confers increased risk for graft loss and death among renal transplant recipients. However the relationship of changes in body weight and composition to outcome on the transplant waitlist and post-transplantation is not straightforward. Strategies to manage weight in the waitlisted patient and after kidney transplantation must be performed in the context of a multidisciplinary approach and individualized based on risk factors in particular patients. Although retrospective studies offer considerable insights into the relationship between obesity and kidney transplant outcome, causal inferences must be made with great caution.

Srinivas TR; Meier-Kriesche HU

2013-01-01

294

Bibliography: obesity treatment.  

UK PubMed Central (United Kingdom)

Abstract: References pertaining to treatment methods for obesity are briefly summarized in this annotated bibliography. Listings include review articles, research studies, chapters in selected texts, and some nontechnical readings. References are categorized into the following areas: 1) general, 2) treatment methods- behavioral, dietary, fad diets, surgery, and other, 3) treatment programs- comprehensive and worksite, and 4) attrition/maintenance. A special bibliography section identifies references on the causes, characteristics, and treatment of obesity in children and adolescents. Bibliographical entries include the item title, author(s), source, and a brief content description.(aje)

Sumner SK; Bolton DL

1986-01-01

295

Access to living donor transplantation for Aboriginal recipients: a study of living donor presentation and exclusion.  

Science.gov (United States)

Aboriginals experience high rates of end-stage renal disease (ESRD) and are less likely to receive a kidney transplant from a living donor. We hypothesized that higher rates of hypertension and diabetes in Aboriginal communities would result in fewer potential living donors coming forward and more exclusions for medical reasons. We performed a retrospective study to examine the frequency of potential donor presentation and the reasons for donor exclusion among Aboriginal and Caucasian wait-listed ESRD patients at our center. Three hundred and eighty-five wait-listed patients were studied, including 174 Aboriginals and 211 Caucasians. Time on the waiting list was similar between groups. A similar proportion of Aboriginals and Caucasians had at least one potential donor (40% vs. 46%), and the rate of donor exclusion for medical reasons was also similar (23% vs. 21%). Potential donors to Aboriginals were more likely to be excluded for non-medical reasons (50% vs. 30%; p < 0.0001), of which 96% were because of loss of contact. Waitlisted Aboriginal ESRD patients appear just as likely as Caucasians to have potential living donors initiate evaluation and have a similar rate of donor exclusion because of medical reasons. Further work is required to identify why donors to Aboriginals are more likely to withdraw from the evaluation process. PMID:21919960

Dunsmore, S; Karpinski, M; Young, A; Storsley, L

2011-09-15

296

Responses to recipient and donor B cells by genetically donor T cells from human haploidentical chimeras  

International Nuclear Information System (INIS)

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

1986-03-01

297

Dietary energy density: a mediator of depressive symptoms and abdominal obesity or independent predictor of abdominal obesity?  

UK PubMed Central (United Kingdom)

BACKGROUND: In the U.S., Europe, and throughout the world, abdominal obesity prevalence is increasing. Depressive symptoms may contribute to abdominal obesity through the consumption of diets high in energy density. PURPOSE: To test dietary energy density ([DED]; kilocalories/gram of food and beverages consumed) for an independent relationship with abdominal obesity or as a mediator between depressive symptoms and abdominal obesity. METHODS: This cross-sectional study included 87 mid-life, overweight adults; 73.6% women; 50.6% African-American. Variables and measures: Beck depression inventory-II (BDI-II) to measure depressive symptoms; 3-day weighed food records to calculate DED; and waist circumference, an indicator of abdominal obesity. Hierarchical regression tested if DED explained waist circumference variance while controlling for depressive symptoms and consumed food and beverage weight. Three approaches tested DED as a mediator. RESULTS: Nearly three-quarters of participants had abdominal obesity, and the mean waist circumference was 103.2 (SD 14.3) cm. Mean values: BDI-II was 8.67 (SD 8.34) which indicates that most participants experienced minimal depressive symptoms, and 21.8% reported mild to severe depressive symptoms (BDI-II ? 14); DED was 0.75 (SD 0.22) kilocalories/gram. Hierarchical regression showed an independent association between DED and waist circumference with DED explaining 7.0% of variance above that accounted for by BDI-II and food and beverage weight. DED did not mediate between depressive symptoms and abdominal obesity. CONCLUSIONS: Depressive symptoms and DED were associated with elevated waist circumference, thus a comprehensive intervention aimed at improving depressive symptoms and decreasing DED to reduce waist circumference is warranted.

Grossniklaus DA; Dunbar SB; Gary R; Tohill BC; Frediani JK; Higgins MK

2012-12-01

298

Minimally invasive transforaminal lumbar interbody fusion for spondylolisthesis in patients with significant obesity.  

UK PubMed Central (United Kingdom)

Comparative studies evaluating efficacy and safety of minimally invasive spinal fusion between patients with significant obesity (body mass index [BMI]?35 kg/m(2)) and those of normal weight are scarce. We examined complication rates and outcomes for minimally invasive transforaminal lumbar interbody fusion (MITLIF) in patients with significant obesity and those of normal weight undergoing treatment for symptomatic spondylolisthesis. Patients with a BMI?35 kg/m(2) or <25 kg/m(2) undergoing elective MITLIF for symptomatic spondylolisthesis for the period 2006-09 were identified. Of the 16 patients identified, nine patients with a mean BMI of 37.4 kg/m(2) were included in the obese group, while seven patients with a mean BMI of 23.4 kg/m(2) comprised the normal weight group. Estimated blood loss (EBL), operative time, complication rate, length of hospital stay, and clinical outcomes were assessed. Outcome measures included patient-reported visual analog scale (VAS) score for pain and the Oswestry Disability Index (ODI) questionnaire completed by the patient. No significant differences were found in blood loss (p=0.436), hospital stay (p=0.606), or number of surgical complications (p=0.920) between the two groups. Mean follow-up intervals were 15.0 months for patients with obesity, and 18.6 months for those of normal weight. Both groups had significant improvements in VAS (obese, p=0.003; normal, p=0.016) and ODI (obese, p=0.020; normal, p=0.034) scores. There were no statistically significant differences between normal weight and obese groups in postoperative VAS (p=0.728) and ODI (p=0.886) scores. Patients with significant obesity experienced clinical improvement similar to that of patients with normal weight, suggesting that obesity does not impact MITLIF outcomes. In addition, both groups experienced similar complication rates, operative times, EBL, and length of hospital stay.

Lau D; Ziewacz J; Park P

2013-01-01

299

Dynamic model predicting overweight, obesity, and extreme obesity prevalence trends.  

UK PubMed Central (United Kingdom)

Objective: Obesity prevalence in the United States (US) appears to be leveling, but the reasons behind the plateau remain unknown. Mechanistic insights can be provided from a mathematical model. The objective of this study is to model known multiple population parameters associated with changes in body mass index (BMI) classes and to establish conditions under which obesity prevalence will plateau. Design and Methods: A differential equation system was developed that predicts population-wide obesity prevalence trends. The model considers both social and non-social influences on weight gain, incorporates other known parameters affecting obesity trends, and allows for country specific population growth. Results: The dynamic model predicts that: obesity prevalence is a function of birth rate and the probability of being born in an obesogenic environment; obesity prevalence will plateau independent of current prevention strategies; and the US prevalence of obesity, overweight, and extreme obesity will plateau by about 2030 at 28%, 32%, and 9%, respectively. Conclusions: The US prevalence of obesity is stabilizing and will plateau, independent of current preventative strategies. This trend has important implications in accurately evaluating the impact of various anti-obesity strategies aimed at reducing obesity prevalence.

Thomas DM; Weedermann M; Fuemmeler BF; Martin CK; Dhurandhar NV; Bredlau C; Heymsfield SB; Ravussin E; Bouchard C

2013-06-01

300

Obese schizophrenia spectrum patients have significantly higher 10-year general cardiovascular risk and vascular ages than obese individuals without severe mental illness.  

UK PubMed Central (United Kingdom)

BACKGROUND: Individuals with schizophrenia have a life expectancy that is 20 years less than the general population, along with high rates of obesity and cardiovascular disease (CVD) mortality. OBJECTIVE: This study assessed the 10-year general CVD risk and vascular ages of 106 obese schizophrenia spectrum patients and 197 demographically matched obese controls without severe mental illness (SMI) from the National Health and Nutrition Examination Survey (NHANES). METHODS: Vascular age and general CVD risk were calculated using the Framingham global CVD calculator, which incorporates age, sex, total and HDL cholesterol levels, systolic blood pressure, smoking status, and diabetes or hypertension treatment. RESULTS: Obese schizophrenia spectrum patients had a mean vascular age that was 14.1 years older than their mean actual age, whereas obese NHANES participants had only a 6.7-year difference. The probability of experiencing a CVD event within the next 10 years was 10.7% for obese patients and 8.5% for obese NHANES participants. CONCLUSION: These findings suggest that schizophrenia spectrum patients experience increased metabolic risk independent of weight. Primary care clinicians can utilize general CVD risk and vascular age scores to communicate metabolic risk more easily and to help make treatment decisions.

Ratliff JC; Palmese LB; Reutenauer EL; Srihari VH; Tek C

2013-01-01

 
 
 
 
301

[Gastroesophageal reflux disease in obesity].  

UK PubMed Central (United Kingdom)

Obesity is currently one of the top health problems worldwide. Its prevalence is markedly increasing in developed countries, but it is becoming a problem even in developing countries. In fact, the epidemic magnitude of obesity leads the WHO to coin the term globesity. Obesity is commonly associated with other diseases, like diabetes (diabesity) and other metabolic disorders. However, many organs and systems are affected, including the gastrointestinal tract. Gastroesophageal reflux disease is associated with obesity, as many studies showed. Several factors are involved in this association; among them, the onset of GERD has been related to weight gain, placing obesity in a critical point at the beginning of the natural history of GERD.

García MD

2011-01-01

302

The dead donor rule: a defense.  

UK PubMed Central (United Kingdom)

Miller, Truog, and Brock have recently argued that the "dead donor rule," the requirement that donors be determined to be dead before vital organs are procured for transplantation, cannot withstand ethical scrutiny. In their view, the dead donor rule is inconsistent with existing life-saving practices of organ transplantation, lacks a cogent ethical rationale, and is not necessary for maintenance of public trust in organ transplantation. In this paper, the second of these claims will be evaluated. (The first and third are not addressed.) The claim that the dead donor rule lacks a cogent ethical rationale will be shown to be an expression of the contemporary rejection of the moral significance of the traditional distinction between killing and allowing to die. The moral significance of this traditional distinction, and the associated norm that doctors should not kill their patients, will be defended, and this critique of it shown to be unsuccessful.

Birch SC

2013-08-01

303

[Potential benefits of living donor kidney transplantation].  

UK PubMed Central (United Kingdom)

Living donor kidney transplantation is the best therapeutic option for endstage renal failure. In spite of being an underused option in our country, it acquires an important role reducing the waiting lists for transplantation because cadaver donation is not enough. Living donor kidney transplantation offers multiple advantages when compared with cadaver donor transplantation: longer graft and patient survival on the short, mid and long-term; the fact that a scheduled procedure allows us to optimize donor and receptor's conditions; and ischemia time between nephrectomy and transplantation can be shortened to a minimum. A good initial function without need of dialysis (up to 90%) and lower incidence of rejection, which diminishes the need of antirejection drugs, should also be emphasized.

Corral Molina JM; Luque Gálvez P; Alcover García JB

2005-07-01

304

Alginate dressing as a donor site haemostat.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

An alginate fibre dressing has been used to reduce blood loss from skin graft donor sites. Significant haemostasis has been achieved in the immediate post surgery phase and no adverse reactions observed.

Groves, A. R.; Lawrence, J. C.

305

Improving Donor Intervention in Rural Financial Markets.  

Science.gov (United States)

Credit project design largely determines credit project performance. Criticisms of the performance of donor-supported credit projects often cite problems which can be traced to project design flaws. The principal modifications required for a reorientation...

J. D. Von Pischke

1981-01-01

306

Signing an organ donor card: psychological factors.  

UK PubMed Central (United Kingdom)

Personality factors related to organ donor card signing were explored in a sample of 94 students. Nondonors scored higher on Templer's Death Anxiety Scale, Collett-Lester Fear of Death of Self, Death of Others, and Dying of Self subscales, and a scale of physical anxiety. Donors scored higher on a Likert scale reflecting acceptance of dying and, not surprisingly, on self-efficacy to sign an organ donor card. When regrouped on the basis of whether they believed in donation, those nondonors who believed they should donate were intermediate in self-efficacy between donors and those who had no interest in donating. This nondonor/believer group may be most likely to donate but may be restrained by the anxiety factors noted above. Further efforts should focus on clarifying these issues, so as to increase donation of greatly needed organs.

Robbins RA

1990-01-01

307

Signing an organ donor card: psychological factors.  

Science.gov (United States)

Personality factors related to organ donor card signing were explored in a sample of 94 students. Nondonors scored higher on Templer's Death Anxiety Scale, Collett-Lester Fear of Death of Self, Death of Others, and Dying of Self subscales, and a scale of physical anxiety. Donors scored higher on a Likert scale reflecting acceptance of dying and, not surprisingly, on self-efficacy to sign an organ donor card. When regrouped on the basis of whether they believed in donation, those nondonors who believed they should donate were intermediate in self-efficacy between donors and those who had no interest in donating. This nondonor/believer group may be most likely to donate but may be restrained by the anxiety factors noted above. Further efforts should focus on clarifying these issues, so as to increase donation of greatly needed organs. PMID:10104695

Robbins, R A

1990-01-01

308

Patient education by electroconvulsive therapy-experienced volunteer.  

UK PubMed Central (United Kingdom)

By diminishing the patient's attention, concentration, motivation, and decisiveness, melancholic depression makes the process of informed consent for electroconvulsive therapy more difficult. With such interference, obtaining informed consent can be a slow and lengthy process, despite the use of patient brochures, videotape programs, and heartfelt educational discussions. A case is presented of an impasse in the informed consent process despite protracted and lengthy efforts, with lengthened hospital stay. The impasse continued until a volunteer discussed his own electroconvulsive therapy experiences with the patient. The use of an experienced volunteer with good interpersonal and communication skills can help avoid lengthening hospital stay to obtain informed consent, especially for patients with melancholic depression.

Parvin MM; Swartz C; LaMontagne B

2004-06-01

309

Well-being in refugee women experiencing cultural transition.  

UK PubMed Central (United Kingdom)

This article presents a situation-specific theory of well-being in refugee women experiencing cultural transition. The theory resulted from 2 studies, an ethnography and a community-based collaborative action research project, with refugee women from South Sudan, who were resettled to the United States. The theory extends the middle-range theory of transition to include cultural transition as a distinct type of transition with a unique set of properties and conditions including 3 phases-separation, liminality, and integration. Community action research is discussed as a culturally relevant intervention for nurses working with immigrants and refugee populations to foster well-being in resettlement.

Baird MB

2012-07-01

310

Students' ways of experiencing human-centered design  

Science.gov (United States)

This study investigated the qualitatively different ways which students experienced human-centered design. The findings of this research are important in developing effective design learning experiences and have potential impact across design education. This study provides the basis for being able to assess learning of human-centered design which will allow educational programs to determine their impact, and what aspects are most effective. Because the object of study was the variation of students' experiences human-centered design, a phenomenographic framework was used to guide the methodology of the study. The literature and research on service-learning and human-centered design informed the construction of the phenomenographic study and also provided ways to interpret the data and situate the results. Thirty-three student designers from a variety of academic contexts were interviewed using a semi-structured, open-ended approach in which they discussed concrete experiences "designing for others", and reflections and meanings associated with those experiences. Analysis of the data yielded seven qualitatively different ways in which the students experienced human-centered design, or categories of description. Logically related, the seven categories of description formed an outcome space that was two-dimensional with distinct, but not independent, axes. The critical differences among the categories provided the basis for developing their hierarchical relationship. Five of the categories were nested hierarchically. From less comprehensive to more comprehensive, those categories included: Human-centered design as "User as Information Source Input to Linear Process", "Keep Users' Needs in Mind", "Design in Context", "Commitment" and "Empathic Design". Two categories represented ways of experiencing human-centered design that were distinct: design was not human-centered, but "Technology-Centered" and human-centered design was not design, but "Service". In addition, this study found that students' understanding of the user and their ability to integrate that into their design are related in the development of more comprehensive ways of experiencing human-centered design, and a conception of both aspects is needed. Furthermore, critical or immersive experiences involving real clients and users were important in allowing the students to experience human-centered design in more comprehensive ways.

Zoltowski, Carla B.

311

Experiencing Project Management Best Practices, Challenges and Lessons Learned  

CERN Document Server

A project manager must not only be permanently aware of all relevant tools, techniques and processes he may need for his work, but, moreover, he has to be able to master unexpected, new and critical situations. On top of that, he should have fun in managing a project and own the creativity he needs to steer projects and bring them to a good end. In this book, experienced project managers tell about exciting tasks in different countries, the personal approach to handle a task, about daily life as a project manager and about what they learned during their work in projects. That way, readers expe

Bittner, Elisabeth

2010-01-01

312

The verbal helping behavior of experienced and novice telephone counselors.  

UK PubMed Central (United Kingdom)

The verbal helping behavior of experienced and novice volunteer telephone counselors was evaluated. Taped telephone interactions with typical helpees were analyzed for the usage of specific response types and for helper talk time, self-references, and feelings. Novices were found to give significantly less advice and their helpees talked significantly longer. The use of continuing responses was significantly associated with helpee talk time for all helpers. Even though telephone counseling may elicit a leading response style from helpers, a continuing or reflective style might be more effective in the relationship-building aspect of telephone counseling.

D'Augelli AR; Handis MH; Brumbaugh L; Illig V; Searer R; Turner DW; D'Augelli JF

1978-07-01

313

Day-of-surgery rejection of donors in living donor liver transplantation  

Directory of Open Access Journals (Sweden)

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.

Bassem Hegab; Mohamed Rabei Abdelfattah; Ayman Azzam; Hazem Mohamed; Waleed Al Hamoudi; Faisal Aba Alkhail; Hamad Al Bahili; Hatem Khalaf; Mohammed Al Sofayan; Mohammed Al Sebayel

2012-01-01

314

International Principles of Deceased Donor Organ Allocation  

Directory of Open Access Journals (Sweden)

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

2013-01-01

315

The development of organic super electron donors.  

UK PubMed Central (United Kingdom)

In the past decade, a host of exceptionally strong organic electron donors has been designed and prepared; their redox potentials are more negative than any previous neutral organic donors and extend beyond E(1/2) = -1 V vs. the saturated calomel electrode (SCE). Their ability to reduce a wide range of organic functional groups has been demonstrated and this article provides an overview of the main advances in the area and the guiding principles for the design of these reagents.

Zhou S; Farwaha H; Murphy JA

2012-01-01

316

[Obesity prevalence in Iasi county].  

UK PubMed Central (United Kingdom)

UNLABELLED: Our study is a part of a national study initiated by ARSO (Romanian Association for Study of Obesity). We selected a statistically representative sample (1500 cases). Study was built upon a questionnaire, made by primary care physicians. Anthropometrical data evaluated the obesity (weight, waist circumference and body mass index, BMI) and we considered associated risk factors (cholesterol levels, diabetes, and hypertension). BMI, more than 25 and 30, defines overweight and obesity. Waist more than 80 cm, for women and 94 cm for men, was considered abdominal obesity. Prevalence of obesity was globally 28.69%, by BMI and abdominal obesity, 57.87%. Non-obese cases are mostly on 20-29 years (2:1), both sex and 30-39 years, mostly on women. After these decades, percents for overweight and obesity are, constantly, more on women (48%) than men (31.03%). Abdominal obesity rises constantly with age, between 42.8% and 73.04%. A lot of patient didn't know theirs cholesterol values, over 25%. The highest percent of high cholesterol is located on 50-59 years (42%) and 35.63% on previous decade. High number of menopausal women can explain this. CONCLUSIONS: 1. We consider a high prevalence of obesity, 28.69%, predominant on women and aged persons. 2. Abdominal obesity has higher prevalence, 57.87%. 3. There are multiple risk factors, especially on 50-59 years decades but are not searched sufficiently.

Coman AE; Petrovanu R; Palel G; Petrovanu C; Bogdan A; Codrescu C; Nisioiu A; Romanescu R

2003-01-01

317

Curcumin and obesity.  

UK PubMed Central (United Kingdom)

Turmeric has been long recognized for its anti-inflammatory and health-promoting properties. Curcumin is one of the principal anti-inflammatory and healthful components of turmeric comprising 2-8% of most turmeric preparations. Experimental evidence supports the activity of curcumin in promoting weight loss and reducing the incidence of obesity-related diseases. With the discovery that obesity is characterized by chronic low-grade metabolic inflammation, phytochemicals like curcumin which have anti-inflammatory activity are being intensely investigated. Recent scientific research reveals that curcumin directly interacts with white adipose tissue to suppress chronic inflammation. In adipose tissue, curcumin inhibits macrophage infiltration and nuclear factor ?B (NF-?B) activation induced by inflammatory agents. Curcumin reduces the expression of the potent proinflammatory adipokines tumor necrosis factor-? (TNF?), monocyte chemoattractant protein-1 (MCP-1), and plasminogen activator inhibitor type-1 (PAI-1), and it induces the expression of adiponectin, the principal anti-inflammatory agent secreted by adipocytes. Curcumin also has effects to inhibit adipocyte differentiation and to promote antioxidant activities. Through these diverse mechanisms curcumin reduces obesity and curtails the adverse health effects of obesity.

Bradford PG

2013-01-01

318

Behavioural treatment of obesity.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Behaviour modification is a promising method of therapy for obesity. Helping the patient to gain control over environmental stimuli and positive reinforcement for the acquisition of appropriate eating and exercise habits are the basis of most treatment programs. While behavioural approaches have, on...

Davis, B. A.; Roncari, D. A.

319

Psychological Stress and Obesity  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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-projec...

Koch, Felix-Sebastian; Sepa, Anneli; Ludvigsson, Johnny

320

Obesity in adults.  

UK PubMed Central (United Kingdom)

INTRODUCTION: About one third of the US population and one quarter of the UK population are obese, with increased risks of hypertension, dyslipidaemia, diabetes, cardiovascular disease, osteoarthritis, and some cancers. Fewer than 10% of overweight or obese adults aged 40 to 49 years revert to a normal body weight after 4 years. Nearly 5 million US adults used prescription weight-loss medication between 1996 and 1998, but one quarter of all users were not overweight. METHODS AND OUTCOMES: We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of drug treatments in adults with obesity? What are the effects of bariatric surgery in adults with morbid obesity? We searched: Medline, Embase, The Cochrane Library, and other important databases up to September 2010 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). RESULTS: We found 39 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. CONCLUSIONS: In this systematic review, we present information relating to the effectiveness and safety of the following interventions: bariatric surgery versus medical interventions, biliopancreatic diversion, diethylpropion, gastric bypass, gastric banding, mazindol, orlistat (alone and in combination with sibutramine), phentermine, sibutramine (alone and in combination with orlistat), sleeve gastrectomy, and vertical banded gastroplasty.

Delaet D; Schauer D

2011-01-01

 
 
 
 
321

Commensality and Obesity Epidemics  

DEFF Research Database (Denmark)

Three examples of the appropriateness of including the investigation of commensality to curb obesity epidemics, and a methodological note on the application of the concept of Foodscape as a fruitful holistic analytical perspective on the interplay between food, people, meals, and the physical conditions under which we eat.

Andersen, Boris

2013-01-01

322

Curcumin and obesity.  

Science.gov (United States)

Turmeric has been long recognized for its anti-inflammatory and health-promoting properties. Curcumin is one of the principal anti-inflammatory and healthful components of turmeric comprising 2-8% of most turmeric preparations. Experimental evidence supports the activity of curcumin in promoting weight loss and reducing the incidence of obesity-related diseases. With the discovery that obesity is characterized by chronic low-grade metabolic inflammation, phytochemicals like curcumin which have anti-inflammatory activity are being intensely investigated. Recent scientific research reveals that curcumin directly interacts with white adipose tissue to suppress chronic inflammation. In adipose tissue, curcumin inhibits macrophage infiltration and nuclear factor ?B (NF-?B) activation induced by inflammatory agents. Curcumin reduces the expression of the potent proinflammatory adipokines tumor necrosis factor-? (TNF?), monocyte chemoattractant protein-1 (MCP-1), and plasminogen activator inhibitor type-1 (PAI-1), and it induces the expression of adiponectin, the principal anti-inflammatory agent secreted by adipocytes. Curcumin also has effects to inhibit adipocyte differentiation and to promote antioxidant activities. Through these diverse mechanisms curcumin reduces obesity and curtails the adverse health effects of obesity. PMID:23339049

Bradford, Peter G

2013-01-22

323

Pharmacotherapy of obesity.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The growing recognition of the health risks of obesity coupled with the difficulties in treating it successfully by lifestyle modification predicates a need for effective drug treatment. The history of drug treatment in the second half of the 20th century is, however, one of disappointment and conce...

Finer, N

324

Current obesity drug treatment  

Directory of Open Access Journals (Sweden)

Full Text Available Pharmacological treatment of obesity is an area of sudden changes,development of new drugs and treatment propositions. This articlepresents information on physiological agents that are currentlybeing used as well as drugs that were widely used but are nomore available.

Marcio C. Mancini; Alfredo Halpern

2006-01-01

325

Obesity in celiac sprue.  

UK PubMed Central (United Kingdom)

Celiac sprue usually results in biochemical and clinical signs of malabsorption, nutrient loss, and resulting growth failure. We report a child with celiac sprue diagnosed at 1 year of age who was initially cachectic but who eventually developed obesity while taking a gluten-containing diet.

Semeraro LA; Barwick KW; Gryboski JD

1986-04-01

326

Buffets and obesity.  

UK PubMed Central (United Kingdom)

Buffets are the "perfect" environment for facilitating excessive energy intake. Customers at buffets often eat considerably more food than is the usual case at regular restaurants. However, extremely little research has been conducted on the relationship between buffets, energy intake, and weight gain. Research studies are therefore needed that investigate whether buffets do indeed contribute to excessive food intake and thence obesity.

Temple NJ; Nowrouzi B

2013-08-01

327

Obesity and Intellectual Disability  

Science.gov (United States)

While much of the industrialized world struggles for clues to the growing rise in obesity in their respective countries, researchers and service providers involved in understanding the health characteristics and health behaviors of persons with intellectual disability (ID) struggle with their own issues regarding the increased prevalence of…

Rimmer, James H.; Yamaki, Kiyoshi

2006-01-01

328

Dietary treatment of obesity  

Directory of Open Access Journals (Sweden)

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

2006-01-01

329

Obesity and colorectal cancer.  

UK PubMed Central (United Kingdom)

This review outlines the association of obesity with risk of colorectal cancer and the potential underlying mechanisms from an epidemiological perspective. Current research indicates that there is a moderate but consistently reported association between general obesity (as determined by BMI) and colorectal cancer incidence and mortality. The relative risk associated with obesity is higher for cancer of the colon than for cancer of the rectum and it is higher in men than in women. By contrast, abdominal adiposity (as determined by waist circumference or waist-to-hip ratio) is similarly strongly associated with colon cancer in men and women, suggesting that abdominal adiposity is a more important risk factor for colon cancer than general adiposity, at least in women. Putative mechanisms that may account for the link between adiposity and colorectal cancer risk include hyperinsulinemia, insulin resistance, inflammation, altered immune response, oxidative stress, as well as disturbances in insulin-like growth factors, adipokines, and sex steroids. Understanding the link between obesity and colorectal cancer may pave the way for targeted prevention of colorectal cancer morbidity and mortality.

Aleksandrova K; Nimptsch K; Pischon T

2013-01-01

330

Utilization of Expanded Criteria Donors in Liver Transplantation  

Directory of Open Access Journals (Sweden)

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

2013-01-01

331

Psychiatric comorbidity of childhood obesity.  

UK PubMed Central (United Kingdom)

The onset of psychiatric symptoms and disorders is relatively common in childhood, occurring among youths across the weight spectrum. However, available research suggests that certain psychiatric comorbidities are more prevalent in obese children and adolescents than in healthy weight youths. First, we review research on disordered eating, including evidence to suggest that loss of control eating is associated with weight gain and obesity in youths, as well as poor outcome in family-based treatment of paediatric obesity. Second, we highlight evidence on the relationship between depression and obesity, especially in girls. Third, we present data on attention deficit hyperactivity disorder (ADHD), particularly the symptoms of impulsivity and inattention, and childhood obesity. We also consider that some medical conditions and psychotropic medications contribute to weight gain and obesity in children and adolescents. Throughout the review, we emphasize that psychiatric comorbidity may be a cause or consequence of childhood obesity, or they may share common aetiological factors.

Kalarchian MA; Marcus MD

2012-06-01

332

Childhood Obesity and Cardiovascular Dysfunction.  

UK PubMed Central (United Kingdom)

Obesity-related cardiovascular disease in children is becoming more prevalent in conjunction with the rise in childhood obesity. Children with obesity are predisposed to an increased risk of cardiovascular morbidity and mortality in adulthood. Importantly, research in children with obesity over the last decade has demonstrated that children may exhibit early signs of cardiovascular dysfunction as a result of their excess adiposity, often independent of other obesity-related comorbidities such as dyslipidemia and insulin resistance. The clinical evidence is accumulating to suggest that the cardiovascular damage, once only observed in adults, is also occurring in obese children. The objective of this review is to provide a synopsis of the current research on cardiovascular abnormalities in children with obesity and highlight the importance and need for early detection and prevention programs to mitigate this potentially serious health problem.

Cote AT; Harris KC; Panagiotopoulos C; Sandor GG; Devlin AM

2013-08-01

333

Living Donor Kidney Transplantation: Chance for the Recipient – Financial Risk for the Donor?  

Directory of Open Access Journals (Sweden)

Full Text Available Background: The persisting lack of cadaveric organs for transplantation has led to a rising number of transplantations after living donation. In addition to the medical risk the financial risk for the donor is essential especially in case of complications which potentially can lead to disability and loss of work. We report the experiences of those who have donated a kidney in our transplant centre. Methods: Using a questionnaire we asked 80 donors who donated a kidney at least 6 months prior to our evaluation. 58 (72%) answered the 33 questions (21 (36%) male, 37 (64%) female donors; mean age: 54 ± 10 (33 - 75) years). The mean time since donation was 28 ± 18 months. 40 (69%) donated for a relative, 18 (31%) donated for husband or wife. Results: 91 % (53) of the donors reported to have no financial expenses due to donation. 5 (9 %) of the donors had expenses, but only few of them clarified the exact amount and circumstances. 1 donor had to lend money to cover the lack of money when he was not able to do his job. Another claimed the disparity between normal salary and payment from the insurance company while he was ill as a financial expense. The days for evaluation prior to donation were organised very variously: Some of the donors were on holiday while evaluated, some officially were ill, others had to take some days off without payment. None of the donors lost his job due to donation. Conclusion: The financial risk of living donation is – theoretically – well covered by different insurances. However some of the donors had to cover some expenses by themselves. Fortunately so far in our centre a major complication did not occur and any of the donors went home in good health after donation. If any costs are covered if a healthy donor looses his ability to work due to donation remains unclear until the first donor will experience it.

N. Senninger; H. H. Wolters

2003-01-01

334

[Pharmacological therapy of obesity].  

Science.gov (United States)

Obesity is reaching epidemic proportions worldwide and it is correlated with various comorbidities, among which the most relevant are diabetes mellitus, arterial hypertension, and cardiovascular diseases. Obesity management is a modern challenge because of the rapid evolution of unfavorable lifestyles and unfortunately there are no effective treatments applicable to the large majority of obese/overweight people. The current medical attitude is to treat the complications of obesity (e.g. dyslipidemia, hypertension, diabetes, and cardiovascular diseases). However, the potential of treating obesity is enormous, bearing in mind that a volitional weight loss of 10 kg is associated with important risk factor improvement: blood pressure -10 mmHg, total cholesterol -10%, LDL cholesterol -15%, triglycerides -30%, fasting glucose -50%, HDL cholesterol +8%. Drug treatment for obesity is an evolving branch of pharmacology, burdened by severe side effects and consequences of the early drugs, withdrawn from the market, and challenged by the lack of long-term data on the effect of medications on obesity-related morbidity and mortality, first of all cardiovascular diseases. In Europe three antiobesity drugs are currently licensed: sibutramine, orlistat, and rimonabant; important trials with clinical endpoints are ongoing for sibutramine and rimonabant. While waiting for their results, it is convenient to evaluate these drugs for their effects on body weight and cardiometabolic risk factors. Sibutramine is a centrally acting serotonin/noradrenaline reuptake inhibitor that mainly increases satiety. At the level of brown adipose tissue, sibutramine can also facilitate energy expenditure by increasing thermogenesis. The long-term studies (five) documented a mean differential weight reduction of 4.45 kg for sibutramine vs placebo. Considering the principal studies, attrition rate was 43%. This drug not only reduces body weight and waist circumference, but it decreases triglycerides and uric acid as well and it increases HDL cholesterol; in diabetics it improves glycated hemoglobin. Sibutramine has conflicting effects on blood pressure: in some studies there was a minimal decrease, in some others a modest increase. In all the studies this drug increased pulse rate. Sibutramine is not recommended in patients with uncontrolled hypertension, or in case of history of cardio- and cerebrovascular disease. Orlistat is a pancreatic lipase inhibitor that reduces fat absorption by partially blocking the hydrolysis of dietary triglycerides. A recent meta-analysis evaluated 22 studies lasting for at least 12 months, in obese patients with a mean body mass index of 36.7 kg/m2, where orlistat was associated with hypocaloric diet or behavioral interventions: the net average weight loss was 2.89 kg (confidence interval 2.27-3.51 kg). Considering the principal studies, attrition rate ranged from 33 to 57%. Orlistat significantly decreases waist circumference, blood pressure, total and LDL cholesterol, but has no effect on HDL and triglycerides. This drug significantly reduced the incidence of diabetes only in subjects with impaired glucose tolerance. The major adverse effects with orlistat are mainly gastrointestinal (fatty and oily stool, fecal urgency, oily spotting, fecal incontinence) and attenuate over time. Orlistat should be avoided in patients with chronic malabsorption and cholestasis. Rimonabant is a selective antagonist of cannabinoid type 1 receptor. This drug, by inhibiting the overactivation of the endocannabinoid system, produces anorectic stimuli at the central nervous level, but also has effects on the peripheral systems involved in metabolism control, such as liver, adipose tissue, skeletal muscles, endocrine pancreas, and gastrointestinal apparatus, influencing many processes partially unknown. An ample experimental program named RIO (Rimonabant In Obesity) involved about 6600 obese or overweight patients to identify the effects of rimonabant in weight loss and associated cardiometabolic abnormalities, over and beyond a caloric restriction

Pagotto, Uberto; Vanuzzo, Diego; Vicennati, Valentina; Pasquali, Renato

2008-04-01

335

Living kidney donor advocacy program: a quality improvement project.  

UK PubMed Central (United Kingdom)

OBJECTIVE: : In 2007, the Centers for Medicare & Medicaid Services mandated that kidney transplant programs establish a living donor advocate program to ensure safe care and support for living organ donors. This quality improvement project assessed the impact of establishing a living donor advocate program and identified the ethical commitments and threats living kidney donors perceive throughout the donation process. METHOD: : This quality improvement project reflects a mixed-methods methodology. Qualitative as well as quantitative data were generated through the donor-advocate consultation sessions and the written Living Donor Satisfaction Survey. Thirteen living donors participated. RESULTS: : No threats to donor rights were identified by either the donor or the advocate. Nonrelated donors were motivated by altruism, whereas related donors were motivated by a sense of family. A majority of donors reported being changed emotionally and spiritually by the act of serving as a living donor. The living kidney donors were overwhelmingly extremely satisfied with their decision to donate and perceived the living donor advocacy program as being very good. DISCUSSION: : Questions have been raised about what role the donor's spouse should have during the informed consent process. Further research is needed to better understand the role and power of an advocate when threats to the donor's rights are noted.

Bosek MS; Sargeant IL

2012-01-01

336

Obesity in adults with epilepsy.  

UK PubMed Central (United Kingdom)

Sixty-eight percent of the US adult population is overweight, and 35% is obese. The rate of obesity in patients with epilepsy is unknown. Its determination was the goal of the present study. Weight and height were measured, and body mass index (BMI) was calculated in all newly evaluated patients with epilepsy at a single epilepsy center between 2003 and 2009. Five hundred fifty-four patients aged ?16-87years were included (62.7% were women, 12.6% with primary generalized epilepsy, and 86.4% with localization-related epilepsy). Three hundred six (55.2%) patients were overweight or obese (BMI>25kg/m(2)) (95% confidence interval [CI]: 51.1%-59.3%), 173 (31.2%) were obese (BMI>30kg/m(2)) (95% CI: 27.5%-35.2%), and 24 (4.3%) were morbidly obese (BMI>40kg/m(2)). Overweight/obesity combined was more common in men (65.4% [95% CI: 58.8%-71.5%]) than in women (49% women [95% CI: 43.3%-54.3%]) (p?0.001). The rate of overweight/obesity combined trended to be greater in blacks (67.9%) than in whites (51.9%). Obesity alone was more common in blacks (46.4%) than in whites (29.4%), with too few Hispanics and Asians to allow a comparison. Overweight/obesity and obesity rates were higher in patients with refractory than nonrefractory epilepsy (60.4% vs. 49.2% overweight, 36.9% vs.24.6% obesity). Obesity was more common in patients treated with polytherapy than those treated with monotherapy (37.7% vs. 25%). There were no associations between obesity and other disease characteristics such as epilepsy type, duration, or etiology. Obesity is common in patients with epilepsy, similar to the general population.

Janousek J; Barber A; Goldman L; Klein P

2013-09-01

337

Donor-dependent risk factors for early surgical complications after simultaneous pancreas-kidney transplantation.  

UK PubMed Central (United Kingdom)

INTRODUCTION: The success of simultaneous pancreas-kidney transplantation (SPK) depends in a large degree on avoidance of surgical complications in the early postoperative period. The aim of the study was to analyze the Pre-procurement Pancreas Allocation Suitability Score (P-PASS) and the deceased donor parameters included within it as risk factors for early surgical complications after SPK. MATERIAL AND METHODS: Forty-six consecutive donors whose kidney and pancreas were simultaneously transplanted were included in the study. RESULTS: Donor age was older among recipients who lost their pancreatic grafts: 30.4±6.9 versus 24.1±6.9 years. Donor age was also older among recipients who lost their pancreatic grafts or died compared with those discharged with a functioning graft: 29.3±5.7 versus 24.0±6.9 years. Donor body mass index (BMI) was higher among patients who died compared with those who were discharged: 25.3±1.1 versus 23.2±2.5 kg/m2. P-PASS was higher in patients who lost their pancreatic grafts (17.6±2.1 vs 15.2±1.8) or died (15.3±1.9 vs 17.2±1.9), or lost pancreatic graft or died (15.2±1.8 vs 17.0±2.2) or with intra-abdominal infections (IAI; 17.1±1.7 vs 15.0±1.8). The incidence of donors?30 years old was higher among recipients with IAI (45.4% vs 14.3%; P=.04). An higher rate of donors with P-PASS>16 was revealed among patients who lost their pancreatic grafts (26.7% vs 3.2%), died (26.7% vs 3.2%), lost the pancreatic graft or died (33.3% vs 6.4%), or experienced IAI (46.7% vs 9.7%). Multivariate logistic regression analysis revealed P-PASS (odds ratio 2.57; P=.014) and serum sodium (odds ration, 0.91; P=.048) to be important predictors of IAI development. CONCLUSION: Older age and higher BMI among deceased donors increased the risk of IAI, pancreatic graft loss, or recipient death after SPK. Transplantation of a pancreas from a donor with a low P-PASS score was associated with a lower risk of surgical complications after SPK.

Ziaja J; Król R; Pawlicki J; Heitzman M; Wilk J; Kowalik A; Bo?ek-Paj?k D; Sekta S; Cierpka L

2011-10-01

338

Single-dose thymoglobulin induction in living-donor renal transplantation.  

UK PubMed Central (United Kingdom)

BACKGROUND: The use of Thymoglobulin induction therapy in living-donor renal transplantation remains controversial. We aimed to evaluate outcomes in living-related donor (LRD) and living unrelated donor (LURD) renal transplants with Thymoglobulin induction. MATERIAL/METHODS: We retrospectively analysed the outcome of all Thymoglobulin induced living-donor renal transplants performed at our centre from 2002 to 2010. RESULTS: We reviewed 100 living-donor renal transplants (LRD=60; LURD=40) who received thymoglobulin induction (single dose, 1.5 mg/kg bodyweight) with a mean follow-up of 52.6 ± 31.9 months. Although baseline characteristics of the LRD and LURD groups were similar, differences were noted for recipient age, gender, and HLA-matching. Overall, the estimated 5-year patient survival was 92% and graft survival, 83%. The 1- and 5-year patient survival rates were 97.4% and 90.7% for LRD and 98.3% and 92.2% for LURD (P=0.79), respectively. Cumulative graft survival (LRD vs. LURD) rates were 93% vs. 95% after 1 year and 80% vs. 88% after 5 years (P=0.53). Kidney graft function was comparable for both the groups. Acute rejection was observed in 17% LRD and 35% LURD patients (P=0.035). Further, 10% of the patients experienced delayed graft function (LRD 11% vs. LURD 8%; P=NS). Rates of cytomegalovirus (CMV) infection (10%), polyomavirus infection (5%), malignancy (4%), and lymphoproliferative disorder (0%) were low, with no differences between the 2 groups. CONCLUSIONS: Single-dose thymoglobulin induction in living-donor renal transplantation was associated with high patient and graft survival without increasing the risk of infections or malignancy and without significant differences between LRD and LURD patients.

Schenker P; Ozturk A; Vonend O; Krüger B; Jazra M; Wunsch A; Krämer B; Viebahn R

2011-04-01

339

Prospective randomized controlled trial: fibrin sealant reduces split skin graft donor-site pain.  

UK PubMed Central (United Kingdom)

BACKGROUND: Pain at split skin graft donor sites is common. Fibrin sealant has been demonstrated to reduce time to hemostasis at wound sites, and patients receiving this treatment were incidentally noted to report less pain. This study aimed to evaluate pain and incapacity in split skin graft donor sites treated with and without fibrin sealant. METHODS: Fifty patients requiring thigh donor-site split skin grafts were prospectively randomized to receive either a self-adhesive fabric dressing alone or fibrin sealant plus the self-adhesive fabric dressing as primary donor-site dressings. External secondary dressings were the same. Patients were blinded with regard to treatment group. Using visual analogue scales (scored 0 to 5), patients rated their donor-site pain and incapacity for 14 days postoperatively. Secondary endpoints were length of hospital stay and duration of requirement for dressings. RESULTS: Forty patients were included in the study analysis and completed self-reported pain and incapacity scores. Twenty received the fibrin sealant plus self-adhesive fabric dressing and 20 received the fabric dressing only (controls). Patients using the fibrin sealant plus the dressing reported significantly less pain (mean score, 0.42 versus 1.60, p < 0.001) and significantly less incapacity (mean score, 0.48 versus 1.71, p < 0.001). Patients allocated to the fibrin sealant group recorded shorter lengths of stay and faster time to discontinuation of dressing, though statistical significance was not achieved. CONCLUSION: Patients whose split skin graft donor sites were dressed with fibrin sealant plus self-adhesive fabric dressing experienced significantly less pain and incapacity than patients with self-adhesive fabric dressings alone, allowing a more rapid return to normal activity. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, II.

Healy C; Greig AV; Murphy AD; Powell C; Pinder RJ; Saour S; Abela C; Knight W; Geh JL

2013-07-01

340

Antecedents of Spiritual Distress Experienced by Iranian Muslim Patients  

Directory of Open Access Journals (Sweden)

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 relatives’ involvement based on the family’s wishes and limiting the stress and difficulties experienced by the family.

M. Karimollahi; H.A. Abedi; A.R. Yousefi

2008-01-01

 
 
 
 
341

Experiencing a Natural Disaster Alters Children's Altruistic Giving.  

UK PubMed Central (United Kingdom)

Altruism is thought to be a major contributor to the development of large-scale human societies. However, much of the evidence supporting this belief comes from individuals living in pacific and often affluent environments. It is entirely unknown whether humans act altruistically when facing adversity. Adversity is arguably a common human experience (as manifested in, e.g., personal tragedies, political upheavals, and natural disasters). In the research reported here, we found that experiencing a natural disaster affected children's altruistic giving. Immediately after witnessing devastations caused by a major earthquake, 9-year-olds became more altruistic. In addition, the more empathic they were, the more they gave. In contrast, experiencing a major earthquake caused 6-year-olds to be more selfish. Three years after the earthquake, children's altruistic tendencies returned to pre-earthquake levels, which suggests that changes in children's altruistic giving are an acute response to the immediate aftermath of a major natural disaster. These findings suggest that environmental insults and empathy play crucial roles in human altruism.

Li Y; Li H; Decety J; Lee K

2013-07-01

342

Symptoms experienced in connection with mobile phone use.  

UK PubMed Central (United Kingdom)

Many people in Norway and Sweden reported headaches, fatigue, and other symptoms experienced in connection with the use of a mobile phone (MP). Therefore, we initiated a cross-sectional epidemiological study among 17,000 people, all using an MP in their job. Thirty-one percent of the respondents in Norway and 13% of those in Sweden had experienced at least one symptom in connection with MP use. Next to the sensations of warmth on the ear and behind/around the ear, burning sensations in the facial skin and headaches were most commonly reported. Most symptoms usually began during or within half an hour after the call and lasted for up to 2 h. Relatively few had consulted a physician or been on sick leave because of the symptoms, but about 45% among those with an MP attributed symptom had taken steps to reduce the symptom. These results suggest an awareness of the symptoms, but not necessarily a serious health problem.

Oftedal G; Wilén J; Sandström M; Mild KH

2000-05-01

343

Misinformation can influence memory for recently experienced, highly stressful events.  

UK PubMed Central (United Kingdom)

A large body of research has demonstrated that exposure to misinformation can lead to distortions in human memory for genuinely experienced objects or people. The current study examined whether misinformation could affect memory for a recently experienced, personally relevant, highly stressful event. In the present study we assessed the impact of misinformation on memory in over 800 military personnel confined in the stressful, mock POW camp phase of Survival School training. Misinformation introduced after the negatively affected memory for the details of the event (such as the presence of glasses or weapons), and also affected the accuracy of identification of an aggressive interrogator. In some conditions more than half of the subjects exposed to a misleading photograph falsely identified a different individual as their interrogator after the interrogation was over. These findings demonstrate that memories for stressful events are highly vulnerable to modification by exposure to misinformation, even in individuals whose level of training and experience might be thought to render them relatively immune to such influences.

Morgan CA 3rd; Southwick S; Steffian G; Hazlett GA; Loftus EF

2013-01-01

344

Quantification of experienced hearing problems with Item Response Theory.  

UK PubMed Central (United Kingdom)

PURPOSE: To improve the effectiveness of adult hearing screens and interventions assessment methods are needed which address the individual's experienced hearing. Item Response Theory, which provides a methodology for assessing Patient Reported Outcomes, will be examined here to demonstrate its usefulness in hearing screens and interventions. METHOD: The Graded Response Model is applied to a scale of 11 items assessing perceived hearing functioning and 10 items assessing experienced social limitations completed by a sample of 212 persons aged 55+. Fixed and variable slope models are compared. Discrimination and threshold parameters are estimated and information functions evaluated. RESULTS: Variable slope models for both scales provided the best fit. The estimated discrimination parameters for all items except for one in each scale were good if not excellent (1.5-3.4). Threshold values varied demonstrating the complementary and supplementary value of items within a scale. The information provided by each item varies relative to trait values so that each scale of items provides information over a wider range of trait values. CONCLUSION: IRT methodology facilitates the comparison of items relative to their discriminative ability and information provided and thus provides a basis for the selection of items for application in a screening setting.

Chenault M; Berger M; Kremer B; Anteunis L

2013-07-01

345

Experiencing a Natural Disaster Alters Children's Altruistic Giving.  

UK PubMed Central (United Kingdom)

Altruism is thought to be a major contributor to the development of large-scale human societies. However, much of the evidence supporting this belief comes from individuals living in pacific and often affluent environments. It is entirely unknown whether humans act altruistically when facing adversity. Adversity is arguably a common human experience (as manifested in, e.g., personal tragedies, political upheavals, and natural disasters). In the research reported here, we found that experiencing a natural disaster affected children's altruistic giving. Immediately after witnessing devastations caused by a major earthquake, 9-year-olds became more altruistic. In addition, the more empathic they were, the more they gave. In contrast, experiencing a major earthquake caused 6-year-olds to be more selfish. Three years after the earthquake, children's altruistic tendencies returned to pre-earthquake levels, which suggests that changes in children's altruistic giving are an acute response to the immediate aftermath of a major natural disaster. These findings suggest that environmental insults and empathy play crucial roles in human altruism.

Li Y; Li H; Decety J; Lee K

2013-09-01

346

On avoiding framing effects in experienced decision makers.  

UK PubMed Central (United Kingdom)

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 whether they would recommend the technique to policy makers. Officers also rated their confidence in this recommendation. When information about the effectiveness of the counterterrorism technique was presented in a numerical format, officers' perceptions of accuracy and recommendation decisions were susceptible to the framing effect: The technique was perceived to be more accurate and was more likely to be recommended when its effectiveness was presented in a positive than in a negative frame. However, when the information was represented visually using icon arrays, there were no such framing effects. Finally, perceptions of accuracy mediated the debiasing effect of visual aids on recommendation decisions. We offer potential explanations for the debiasing effect of visual aids and implications for communicating risk to experienced, professional decision makers.

Garcia-Retamero R; Dhami MK

2013-01-01

347

The Prognostic Relevance of the Donor IL-6 Serum Level with Respect to the Postoperative Course of Cadaveric Kidney Grafts  

Directory of Open Access Journals (Sweden)

Full Text Available In a retrospective study the postoperative courses of 100 consecutive kidney graft recipients (women 36, men 64) aged between 17 and 69 years were analyzed according to the beginning of graft function, frequency of rejections, occurrence of serious infections, duration of postoperative stay on the ward as well as serum creatinine level at discharge and were related to the serum IL-6 level of organ donors. Neither the creating of two large groups (donor IL-6: 31.6 ±19.6 versus 797 ±1709 pg/ml) nor of five smaller groups (donor IL-6: 0-50, 50.1-100, 100.1-200, 200.1-500, >500 pg/ml) reveals statistic significant differences of the postoperative courses. An additional analysis of data of so-called kidney pairs, that means the transplantation of both kidneys of one donor into two recipients in the same centre, showed without any doubt that the majority of kidney pairs (17 out of 23) experienced different postoperative courses with respect to the above mentioned parameters and did not depend on the height of donor IL-6 serum level differing between 8 pg/ml and 1071.2 pg/ml. Thus, the donor IL-6 level did not have any prognostic relevance with respect to the postoperative kidney graft fate.

J. Kaden; G. May; V. Strobelt; C. Wesslau

2006-01-01

348

Impact of body mass index on luteinizing hormone secretion in gonadotropin-releasing hormone stimulation tests of boys experiencing precocious puberty.  

UK PubMed Central (United Kingdom)

OBJECTIVE: Excess adiposity may influence various aspects of pubertal development, including the timing of pubertal initiation and hormonal parameters during puberty. The aim of the study was to evaluate the impact of body mass index (BMI) on luteinizing hormone (LH) secretion to gonadotropin-releasing hormone (GnRH) stimulation test in boys with precocious puberty. METHODS: Boys with precocious puberty, who were normal weight, overweight, and obese underwent GnRH stimulation tests between 2003 and 2010. Subjects were classified as normal weight (BMI ?5th percentile and BMI <85th percentile), overweight (BMI ?85th percentile and BMI <95th percentile), and obese (BMI ?95th percentile). RESULTS: Of 56 children whose data were included in the final analysis, mean age at diagnosis was 8.7 ± 1.0 years. The majority of boys were of normal weight (n = 28, 50%), while 15 children (26%) were overweight, and 13 (23%) obese. Peak LH levels after GnRH stimulation were 19.8 ± 8.8, 9.0 ± 3.5, and 8.1 ± 4.0 mIU/ml among normal weight, overweight, and obese subjects, respectively (p < 0.001 for all comparisons). By multivariate analysis, there was a significant negative association of BMI with peak-stimulated LH level. CONCLUSIONS: The higher BMI is associated with lower LH response to the GnRH stimulation test in boys experiencing precocious puberty. In boys with precocious puberty, BMI should be considered when interpreting GnRH stimulation test.

Lee HS; Park HK; Ko JH; Kim YJ; Hwang JS

2013-01-01

349

Assessment of obesity and abdominal obesity among Portuguese children.  

UK PubMed Central (United Kingdom)

BACKGROUND: Childhood obesity is a major public health issue in developed countries, and frequently proceeds into adulthood. The aim of this study was to estimate the prevalence of obesity and abdominal fat distribution in 6-12 years old children from the central region of Portugal, providing new data about trends on prevalence, epidemiology and evolution in obesity. METHODS: Weight, height and waist circumference were measured in a random representative sample of 1,433 children (747 girls and 686 boys) from public schools in 2011. International Obesity Task Force (IOTF) cut-offs were used to define overweight and obesity. Abdominal obesity was estimated using the sex and age-specific = 90th waist circumference percentile and waist-to-height ratio cut-off. RESULTS: The prevalence of overweight and obesity among children was 33.0%; 10.7% were obese. Overweight was significantly higher in boys than in girls (p = 0.044), whereas no gender differences was found in obesity (10.6 % in boys and 10.7% in girls, p = 0.571). The prevalence of abdominal obesity based on waist circumference was similar in girls and boys (3.8% vs. 3.9% respectively; p = 0.924), but significantly higher in boys than in girls based on waist-to-height ratio (28.1% vs. 19.4%, respectively; p = 0.009). Comparison with previous studies showed a slightly increase in overweight/obesity in children of central Portugal in the last 10 years, reaching values of 40.0% prevalence in the 7-9 years old. CONCLUSION: In conclusion, this study shows a very high prevalence of overweight/obesity and abdominal obesity among Portuguese children, following the trend of other southern European countries. Thus, it is of the utmost importance the development of preventive and treatment strategies.

Albuquerque D; Nóbrega C; Samouda H; Manco L

2012-05-01

350

Malaria seroprevalence in blood bank donors from endemic and non-endemic areas of Venezuela  

Scientific Electronic Library Online (English)

Full Text Available Abstract in english In Venezuela, a total of 363,466 malaria cases were reported between 1999-2009. Several states are experiencing malaria epidemics, increasing the risk of vector and possibly transfusion transmission. We investigated the risk of transfusion transmission in blood banks from endemic and non-endemic areas of Venezuela by examining blood donations for evidence of malaria infection. For this, commercial kits were used to detect both malaria-specific antibodies (all species) and (more) malaria antigen (Plasmodium falciparum only) in samples from Venezuelan blood donors (n = 762). All samples were further studied by microscopy and polymerase chain reaction (PCR). The antibody results showed that P. falciparum-infected patients had a lower sample/cut-off ratio than Plasmodium vivax-infected patients. Conversely, a higher ratio for antigen was observed among all P. falciparum-infected individuals. Sensitivity and specificity were higher for malarial antigens (100 and 99.8%) than for antibodies (82.2 and 97.4%). Antibody-positive donors were observed in Caracas, Ciudad Bolívar, Puerto Ayacucho and Cumaná, with prevalences of 1.02, 1.60, 3.23 and 3.63%, respectively. No PCR-positive samples were observed among the donors. However, our results show significant levels of seropositivity in blood donors, suggesting that more effective measures are required to ensure that transfusion transmission does not occur.

Contreras, Carmen Elena; Donato, Marcos de; Rivas, María Ana; Rodulfo, Hectorina; Mora, Robert; Batista, María Eulalia; Marcano, Norka

2011-03-01

351

Malaria seroprevalence in blood bank donors from endemic and non-endemic areas of Venezuela.  

UK PubMed Central (United Kingdom)

In Venezuela, a total of 363,466 malaria cases were reported between 1999-2009. Several states are experiencing malaria epidemics, increasing the risk of vector and possibly transfusion transmission. We investigated the risk of transfusion transmission in blood banks from endemic and non-endemic areas of Venezuela by examining blood donations for evidence of malaria infection. For this, commercial kits were used to detect both malaria-specific antibodies (all species) and malaria antigen (Plasmodium falciparum only) in samples from Venezuelan blood donors (n = 762). All samples were further studied by microscopy and polymerase chain reaction (PCR). The antibody results showed that P. falciparum-infected patients had a lower sample/cut-off ratio than Plasmodium vivax-infected patients. Conversely, a higher ratio for antigen was observed among all P. falciparum-infected individuals. Sensitivity and specificity were higher for malarial antigens (100 and 99.8%) than for antibodies (82.2 and 97.4%). Antibody-positive donors were observed in Caracas, Ciudad Bolívar, Puerto Ayacucho and Cumaná, with prevalences of 1.02, 1.60, 3.23 and 3.63%, respectively. No PCR-positive samples were observed among the donors. However, our results show significant levels of seropositivity in blood donors, suggesting that more effective measures are required to ensure that transfusion transmission does not occur.

Contreras CE; Donato Md; Rivas MA; Rodulfo H; Mora R; Batista ME; Marcano N

2011-03-01

352

'It seemed churlish not to': How living non-directed kidney donors construct their altruism.  

UK PubMed Central (United Kingdom)

Our objective was to explore how prospective altruistic kidney donors construct their decision to donate. Using a qualitative design and biographical-narrative semi-structured interviews, we aimed to produce text for analysis on two levels: the social implications for subjectivity and practice and a tentative psychodynamic explanation of the participants' psychological investment in the discourses they used. A total of six prospective altruistic kidney donors were interviewed. A psychosocial approach to the analysis was taken. In-depth discourse analysis integrated Foucauldian with psycho-discursive approaches and psychodynamic theory was applied to sections of text in which participants seemed to have particular emotional investment. Analysis generated three major discursive themes: other-oriented, rational and self-oriented discourses. The desire to donate was experienced as compelling by participants. Participants used discourses to position themselves as concerned with the needs of the recipient, to resist questioning and criticism, and to manage difficult feelings around mortality. Participants tended to reject personal motivations for altruistic donation, positioning relatives' disapproval as selfish and illogical. These results suggest that the term 'altruistic' for living non-directed organ donation constrains available discourses, severely limiting what can be said, felt, thought and done by donors, clinicians and the public. A more useful approach would acknowledge potential psychological motives and gains for the donor.

Challenor J; Watts J

2013-09-01

353

Parental coping with sudden infant death after donor insemination: case report.  

Science.gov (United States)

We report the case of an artificial donor insemination couple experiencing sudden infant death of their 8-month-old child. Six months after the incident, the couple were investigated by means of an extensive interview, a repertory grid investigation and the Family Assessment Measure, as well as at 6 years after the incident by an extensive interview. The results show the importance of the diagnosis of male infertility and the preceding fertility treatment for coping with the death of their child. Six months after the incident, acute feelings associated with bereavement are mixed with feelings of anger and shame, apparently due to the experience of infertility. However, secrecy and shame associated with male infertility and donor insemination make it impossible for the couple to communicate their feelings to each other or to friends and relatives; furthermore, they decline psychological counselling. Repertory grid investigation and the Family Assessment Measure point to significant problems within the partnership. Six years after the incident, the couple's relationship is destabilized and both partners plan to divorce. We suggest a possible link between donor insemination secrecy and difficulties with coping. We discuss implications for couple counselling and emphasize the necessity for an improved legal framework for donor insemination in Germany. PMID:15665018

Conrad, Rupert; Schilling, Guntram; Liedtke, Reinhard

2005-01-21

354

Obesity is associated with increased prevalence and severity of pelvic floor disorders in women considering bariatric surgery.  

UK PubMed Central (United Kingdom)

BACKGROUND: Although an association between obesity and urinary incontinence (UI) has been reported, the association between obesity and other PFDs is less clear. The aim of this study was to determine the prevalence of pelvic floor disorders (PFDs), including stress urinary incontinence (SUI), urge urinary incontinence (UUI), pelvic organ prolapse (POP), and anal incontinence (AI), in obese women contemplating bariatric surgery compared with nonobese subjects at a tertiary care referral hospital. METHODS: From September 2006 to December 2007, obese women contemplating bariatric surgery and nonobese women from general gynecology clinic completed a validated screening questionnaire for PFDs, the Sandvik urinary incontinence severity index, and the Rockwood fecal incontinence severity index. RESULTS: A total of 217 obese (mean body mass index of 50 +/- 10 kg/m(2)) and 210 nonobese controls (mean body mass index 23 +/- 3 kg/m(2)) were screened. The presence of any PFD occurred in 159 patients (75%) in the obese group compared with 89 nonobese patients (44%; P <.0001). More obese patients experienced SUI, UUI, and AI, but not POP. Obese patients also had more severe UI and AI. Obesity remained a significant risk factor for UI and AI, even after adjusting for baseline differences in demographics and medical conditions, with an adjusted odds ratio of 4.1 (95% confidence interval 2.3-7.8) and 2.1 (95% confidence interval 1.1-4.1), respectively. CONCLUSION: The prevalence of PFDs, including SUI, UUI, and all forms of AI, was greater in the obese and morbidly obese women contemplating bariatric surgery. Obesity was also associated with an increased severity of UI and AI. Obesity appears to confer a fourfold and twofold increased risk of UI and AI, respectively.

Chen CC; Gatmaitan P; Koepp S; Barber MD; Chand B; Schauer PR; Brethauer SA

2009-07-01

355

Observations on residual donors in GaP LPE  

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Electron and donor concentrations and mobilities of non doped liquid phase epitaxial GaP layers were studied when varying the annealing process prior to growth. Main donors or the presence of more than one donor were identified by donor ionization energies. After short anneallings the incorporation ...

Pfeifer, J.; Pödör, B.; Csontos, L.; Nádor, N.

356

Pediatric Obesity: Looking into Treatment  

Directory of Open Access Journals (Sweden)

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.

Angelo Pietrobelli; Simone Rugolotto; Paolo De Cristofaro; Marcella Malavolti

2009-01-01

357

Increased coagulation in childhood obesity.  

UK PubMed Central (United Kingdom)

OBJECTIVE: This study aims to explore the relation between childhood obesity and procoagulant and anticoagulant systems. METHOD: Fifty-one obese children and 32 normal-weighted children with similar age and gender distribution and between ages of 5 and 16 years were recruited to the study. Antropometric measures of all subjects, existence of any accompanying disease, and medication histories had been recorded. Full blood count, procoagulant, and anticoagulant coagulation tests were run for all subjects. RESULTS: When hematologic variables of obese children were compared with those of healthy controls, it was found that average erythrocyte hemoglobin concentration, erythrocyte distribution width, and platelet count of obese children are significantly higher than healthy control group. It was also found that fibrinogen, thrombin time, factor (F) VIII, FIX, FX, and von Willebrand factor levels of obese children are higher than healthy control group. By contrast, antithrombin levels of obese children are found to be lower. CONCLUSION: In our study, we found that there is a procoagulant increase in the coagulation system activity of obese children compared to non-obese healthy children, whereas there is a significant decrease in anticoagulant system. These changes occurred in obese patients, especially higher levels of plasma procoagulant factors such as fibrinogen, FVIII, FIX, and von Willebrand factor, lead us to think that there is an activity in these patients at endothelial level. Further studies are needed on endothelial activity of obese children.

Bilge YD; Alioglu B; Sim?ek E; Tapci AE; Ozen C

2012-11-01

358

Orexin: Pathways to obesity resistance?  

Science.gov (United States)

Obesity has increased in prevalence worldwide, attributed in part to the influences of an obesity-promoting environment and genetic factors. While obesity and overweight increasingly seem to be the norm, there remain individuals who resist obesity. We present here an overview of data supporting the idea that hypothalamic neuropeptide orexin A (OXA; hypocretin 1) may be a key component of brain mechanisms underlying obesity resistance. Prior work with models of obesity and obesity resistance in rodents has shown that increased orexin and/or orexin sensitivity is correlated with elevated spontaneous physical activity (SPA), and that orexin-induced SPA contributes to obesity resistance via increased non-exercise activity thermogenesis (NEAT). However, central hypothalamic orexin signaling mechanisms that regulate SPA remain undefined. Our ongoing studies and work of others support the hypothesis that one such mechanism may be upregulation of a hypoxia-inducible factor 1 alpha (HIF-1?)-dependent pathway, suggesting that orexin may promote obesity resistance both by increasing SPA and by influencing the metabolic state of orexin-responsive hypothalamic neurons. We discuss potential mechanisms based on both animal and in vitro pharmacological studies, in the context of elucidating potential molecular targets for obesity prevention and therapy. PMID:24005942

Butterick, Tammy A; Billington, Charles J; Kotz, Catherine M; Nixon, Joshua P

2013-12-01

359

Orexin: Pathways to obesity resistance?  

UK PubMed Central (United Kingdom)

Obesity has increased in prevalence worldwide, attributed in part to the influences of an obesity-promoting environment and genetic factors. While obesity and overweight increasingly seem to be the norm, there remain individuals who resist obesity. We present here an overview of data supporting the idea that hypothalamic neuropeptide orexin A (OXA; hypocretin 1) may be a key component of brain mechanisms underlying obesity resistance. Prior work with models of obesity and obesity resistance in rodents has shown that increased orexin and/or orexin sensitivity is correlated with elevated spontaneous physical activity (SPA), and that orexin-induced SPA contributes to obesity resistance via increased non-exercise activity thermogenesis (NEAT). However, central hypothalamic orexin signaling mechanisms that regulate SPA remain undefined. Our ongoing studies and work of others support the hypothesis that one such mechanism may be upregulation of a hypoxia-inducible factor 1 alpha (HIF-1?)-dependent pathway, suggesting that orexin may promote obesity resistance both by increasing SPA and by influencing the metabolic state of orexin-responsive hypothalamic neurons. We discuss potential mechanisms based on both animal and in vitro pharmacological studies, in the context of elucidating potential molecular targets for obesity prevention and therapy.

Butterick TA; Billington CJ; Kotz CM; Nixon JP

2013-09-01

360

Are live kidney donors at risk?  

UK PubMed Central (United Kingdom)

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. DESIGN: A department-based prospective study. PLACE AND DURATION OF STUDY: Department of Urology and Kidney Transplantation, Lahore General Hospital, Lahore, (September 1998 to March 2002). SUBJECTS AND METHODS During the study period, 58 patients had undergone live donor nephrectomy through 11th rib bed flank incision. Evaluation of donors comprised of counseling, history taking, physical examination and laboratory testing and radiological studies to document bilaterally functioning kidneys. Medical ailments, immunological incompatibility and inability to make a valid consent were contraindications for kidney donation. 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 nephrectomy 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.

Kamran T; Zaheer K; Hussain SW; Zahid KH; Akhtar MS

2003-03-01

 
 
 
 
361

Surgical Procedures of Morbid Obesity  

Directory of Open Access Journals (Sweden)

Full Text Available Background: Surgical intervention has been recently advocated in the treatment of morbid obesity. The objective of this study was to review surgery as an alternative in the treatment of morbidly obese adolescents. Materials and Methods: This research was conducted by searching English websites such as PubMed, Up to Date, and Google Scholar, as well as some Persian websites including SID, Iranmedex, and Magiran. Articles published from 2000 to 2010 on interventional and clinical trials were reviewed for treatment of morbid obesity in adolescents. Keywords used in internet searches include obesity; adolescence; and surgery.Results: The results obtained from the studies indicated that 4% of American adolescents suffer from morbid obesity. So far, pharmacological treatment and other approaches toward this type of obesity have been inefficient. Hence, surgery was employed as one of the new approaches to the treatment of this disorder. According to the National Health Institute criteria, in the treatment of adolescent candidates for surgery, anthropometric measurements are performed together with the measurement of other co-morbidities of obesity. Adolescents whose percentiles are ?99 are considered as morbidly obese patients. Conclusion: The results of the studies suggested that for the extremely obese adolescents, who do not respond to other types of medical interventions within 6 months, surgery can be performed. Adolescents with BMI of ?40 kg/m2 and skeletal maturity, or those with co morbidities of obesity, or 13-year-old girls and boys ?15 years of age can be candidates for surgery. However, the side effects of obesity should not be neglected. Therefore, before the adolescent obesity become morbid obesity, preventive measures should be taken through changes in lifestyle.

Zinat Salem; Mahmood Sheikh-Fathollahi

2013-01-01

362

Obesity prevalence in Mexico: impact on health and economic burden.  

UK PubMed Central (United Kingdom)

OBJECTIVE: Along with other countries having high and low-to-middle income, Mexico has experienced a substantial change in obesity rates. This rapid growth in obesity prevalence has led to high rates of obesity-related diseases and associated health-care costs. DESIGN: Micro-simulation is used to project future BMI trends. Additionally thirteen BMI-related diseases and health-care costs are estimated. The results are simulated for three hypothetical scenarios: no BMI reduction and BMI reductions of 1 % and 5 % across the population. SETTING: Mexican Health and Nutrition Surveys 1999 and 2000, and Mexican National Health and Nutrition Survey 2006. SUBJECTS: Mexican adults. RESULTS: In 2010, 32 % of men and 26 % of women were normal weight. By 2050, the proportion of normal weight will decrease to 12 % and 9 % for males and females respectively, and more people will be obese than overweight. It is projected that by 2050 there will be 12 million cumulative incidence cases of diabetes and 8 million cumulative incidence cases of heart disease alone. For the thirteen diseases considered, costs of $US 806 million are estimated for 2010, projected to increase to $US 1·2 billion and $US 1·7 billion in 2030 and 2050 respectively. A 1 % reduction in BMI prevalence could save $US 43 million in health-care costs in 2030 and $US 85 million in 2050. CONCLUSIONS: Obesity rates are leading to a large health and economic burden. The projected numbers are high and Mexico should implement strong action to tackle obesity. Results presented here will be very helpful in planning and implementing policy interventions.

Rtveladze K; Marsh T; Barquera S; Sanchez Romero LM; Levy D; Melendez G; Webber L; Kilpi F; McPherson K; Brown M

2013-02-01

363

Is renal living-donor transplantation indicated in adult patients with orthotopic ileal neobladder? Lessons learned from a clinical case.  

UK PubMed Central (United Kingdom)

Renal transplantation is the treatment of choice for patients with end-stage renal disease and it has already been described in the literature in patients with orthotopic neobladders, mostly in the paediatric population. We report the first case of a living-donor renal graft in an adult patient with a orthotopic neobladder that was performed after radical cystectomy for urinary tuberculosis and reflux nephropathy. This patient experienced urologic and metabolic complications since the early posttransplant period.

Airoldi A; Volpe A; Billia M; Marchioro G; Fenoglio R; Lazzarich E; Sacchetti G; Baiocco C; Inglese E; Menegotto A; Terrone C; Stratta P

2010-11-01

364

Is renal living-donor transplantation indicated in adult patients with orthotopic ileal neobladder? Lessons learned from a clinical case.  

Science.gov (United States)

Renal transplantation is the treatment of choice for patients with end-stage renal disease and it has already been described in the literature in patients with orthotopic neobladders, mostly in the paediatric population. We report the first case of a living-donor renal graft in an adult patient with a orthotopic neobladder that was performed after radical cystectomy for urinary tuberculosis and reflux nephropathy. This patient experienced urologic and metabolic complications since the early posttransplant period. PMID:19493610

Airoldi, Andrea; Volpe, Alessandro; Billia, Michele; Marchioro, GianSilvio; Fenoglio, Roberta; Lazzarich, Elisa; Sacchetti, GianMario; Baiocco, Cinzia; Inglese, Eugenio; Menegotto, Alberto; Terrone, Carlo; Stratta, Piero

2009-05-19

365

Subjective well-being in Finnish adolescents experiencing family violence.  

UK PubMed Central (United Kingdom)

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.

Lepistö S; Joronen K; Åstedt-Kurki P; Luukkaala T; Paavilainen E

2012-05-01

366

Subjective well-being in Finnish adolescents experiencing family violence.  

Science.gov (United States)

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

2012-01-24

367

[Experiencing the postpartum period: a comprehensive approach of social phenomenology].  

UK PubMed Central (United Kingdom)

The aim of this study was to achieve an understanding of what new mothers served by private health care realize about the postpartum period, as well as identifying what their help and care needs are, during this life cycle. The research development proposition has been grounded on a qualitative research model with the phenomenological approach. Some categories came out from the statements: Taking charge of her child; feeling overloaded, overwhelmed and insecure; sensing herself vulnerable; experiencing a magic and unique emotion; reporting postpartum care satisfaction. After reviewing the categorical analysis, the postpartum living experiences as described by the subjects have been found quite similar to that of women without private health care. Nevertheless, the access to good quality in private health services became an important aspect because it enabled a close subjective relationship of mother and health care professional, allowing a safe postpartum experience.

Merighi MA; Gonçalves R; Rodrigues IG

2006-11-01

368

Counting is easier while experiencing a congruent motion.  

UK PubMed Central (United Kingdom)

Several studies suggest that numerical and spatial representations are intrinsically linked. Recent findings demonstrate that also motor actions interact with number magnitude processing, showing a motor-to-semantic effect. The current study assesses whether calculation processes can be modulated by motions performed with the whole body. Participants were required to make additions or subtractions while performing (on-line condition) or after having experienced (off-line condition) an ascending or descending motion through a passive (i.e., taking the elevator) or an active (i.e., taking the stairs) mode. Results show a congruency effect between the type of calculation and the direction of the motion depending on: a) the off-line or on-line condition, b) the passive or active mode and c) the real or imagined task. Implications of the results for an embodied and grounded perspective view will be discussed.

Lugli L; Baroni G; Anelli F; Borghi AM; Nicoletti R

2013-01-01

369

Cytogenetic variability in pinus sylvestris L. populations experiencing anthropogenic influence  

Energy Technology Data Exchange (ETDEWEB)

Techno-genic pollution has become one of the most significant ecological factors determining biosphere existence and development. An analysis of genetic consequences of the radiation accidents in the South Urals and Chernobyl has shown that mutation and recombination processes are considerably accelerated in plant and animal's populations experiencing techno-genic influence. This implies that there are complicated adaptation processes leading to changes in genetic structure of populations and increasing genetic load. Pinus sylvestris L. populations growing at the territory of the 'radon' Leningrad regional radioactive waste reprocessing enterprise and Sosnovy Bor town were monitored 6 years (1997-2002) by a set of cyto-genetical and morphological tests. Cytogenetic damage levels within intercalary meristem of needle as well as in root meristem of seedlings were found to significantly exceed corresponding controls. A higher radioresistance of the Scots pine seeds analyzed was demonstrated with an acute {gamma}-radiation that also revealed a selection process directed at an enhancement of repair efficiency and resulting in a shift of mean values of radioresistance in populations towards higher values. An enlargement of variance of studied cytogenetic parameters was found in the populations experiencing techno-genic influence. This indicates, with an account of phenomenon of the enhanced radioresistance, that there are processes of cyto-genetical adaptation in the investigated regions. An analysis of the structure of ecological-genetical variability was carried out with the purpose of separating two components in the inter-population variability - the first is engaged to the genetically determined variability of biological characteristics intrinsic for this species, and the second is responsible for the variability originating from anthropogenic contamination of the natural habitat. Changes of these two types of variability were studied in dependence on time and techno-genic impact. (author)

Oudalova, A.; Geras' kin, S.; Vasiliev, D.; Dikarev, V. [Russian Institute of Agricultural Radiology and Agroecology, Obninsk (Russian Federation)

2004-07-01

370

Molecular assembly of amino acid interlinked, topologically symmetric, ?-complementary donor-acceptor-donor triads  

Science.gov (United States)

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

2013-01-01

371

Molecular assembly of amino acid interlinked, topologically symmetric, ?-complementary donor-acceptor-donor triads.  

UK PubMed Central (United Kingdom)

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 MB; Sandeepa KV; Govindaraju T

2013-01-01

372

Access to information about donors by donor-conceived individuals: a human rights analysis.  

UK PubMed Central (United Kingdom)

While assisted reproductive treatment using donated gametes is widespread, and in many places, widely accepted, it has historically been shrouded in secrecy. Over time, however, there has been an increasing call from donor-conceived people, recipient parents and some donors to end the secrecy, and to release identifying information about donors to donor-conceived people. "Rights-based" arguments have at times been used to justify this call. This article examines whether a human rights framework supports the release of information and how such a framework might be applied when there are competing rights. It argues that the current balancing approach used to resolve such issues weighs in favour of release. Legal action has the potential to be legitimate and justifiable. A measure such as a contact veto system, which would serve to prevent unwanted contact with the person lodging the veto (either the donor or the donor-conceived person), would ensure proportionality. In this way, both donor-conceived people's rights to private life, identity and family, and donors' rights to privacy may be recognised and balanced.

Allan S

2013-03-01

373

Malaria and obesity: obese mice are resistant to cerebral malaria  

Directory of Open Access Journals (Sweden)

Full Text Available Summary Background The relationship between malaria and obesity are largely unknown. This is partly due to the fact that malaria occurs mainly in tropical areas where, until recently, obesity was not prevalent. It now appears, however, that obesity is emerging as a problem in developing countries. To investigate the possible role of obesity on the host-parasite response to malarial infection, this study applied a murine model, which uses the existence of genetically well characterized obese mice. Methods The receptivity of obese homozygous ob/ob mice was compared to the receptivity of control heterozygous ob/+ lean mice after a single injection of Plasmodium berghei ANKA sporozoites. Both parasitaemia and mortality in response to infection were recorded. Results The control mice developed the expected rapid neurological syndromes associated with the ANKA strain, leading to death after six days, in absence of high parasitaemia. The obese mice, on the other hand, did not develop cerebral malaria and responded with increasing parasitaemia, which produced severe anemia leading to death 18–25 days after injection. Conclusion The observed major differences in outward symptoms for malarial infection in obese versus control mice indicate a link between obesity and resistance to the infection which could be addressed by malariologists studying human malaria.

Robert Vincent; Bourgouin Catherine; Depoix Delphine; Thouvenot Catherine; Lombard Marie-Noëlle; Grellier Philippe

2008-01-01

374

Health consequences of obesity.  

UK PubMed Central (United Kingdom)

Epidemiologic studies have established that cardiovascular (CV) risk factors including obesity are identifiable in childhood. Childhood risk factors are predictive of adult cardiac risk and even premature death [Franks et al. (2010) N Engl J Med 362:485-493]. In the United States, CV diseases remains the leading causes of death. In fact, heart disease has become the major cause of death worldwide, surpassing undernutrition and infectious diseases, largely related to obesity in childhood [Wang and Lobstein (2006) Int J Pediatr Obes 1:11-25]. The concept that adult heart diseases begin in childhood is an outgrowth of extensive long-term epidemiologic studies in youth, that is, the Bogalusa Heart Study [Berenson et al. (1986) Causation of cardiovascular risk factors in children: Perspectives on cardiovascular risk in early life, Raven Press Books Ltd].

Berenson GS

2012-01-01

375

Endocannabinoids and obesity.  

UK PubMed Central (United Kingdom)

A safe and effective antiobesity drug is needed to combat the global obesity epidemic. The discovery of cannabinoids from medicinal herbs has revealed the endocannabinoid system (ECS) in animals and humans, which regulates various physiological activities such as feeding, thermogenesis, and body weight (BW). Although cannabinoid receptors 1 (CB1) antagonists have shown antiobesity efficacies in animal models and in the clinic, they failed to establish as a treatment due to their psychological side effects. Recent studies indicate that CB1 in various peripheral tissues may mediate some of the therapeutic effects of CB1 antagonists, such as improved lipid and glucose homeostasis. It rationalizes the development of compounds with limited brain penetration, for minimizing the side effects while retaining the therapeutic efficacies. A survey of the literature has revealed some controversies about how the ECS affects obesity. This review summarizes the research progresses and discusses some future perspectives.

Chen G; Pang Z

2013-01-01

376

[Obesity and menopause].  

UK PubMed Central (United Kingdom)

Menopause is one of the critical periods of a woman's life during which weight gain and onset or worsening of obesity are favoured. It is at this period when obesity prevalence is the highest. There are several causes for this disorder, ones clearly related with hypo-oestrogenism and others depend on age favouring increased food intake and decreased energy waste. This weight gain is related to adverse health effects that get worse due to changes in fat distribution observed during menopause. The increase in visceral fat favours the development of insulin resistance and its clinical consequences such as carbohydrate metabolism impairments and type 2 diabetes, arterial hypertension, and dyslipidaemia, leading to increased cardiovascular risk, among other complications.

Pavón de Paz I; Alameda Hernando C; Olivar Roldán J

2006-11-01

377

[Psychological consequences of obesity].  

UK PubMed Central (United Kingdom)

Overweight and obesity is associated with a broad variety of stigmatization and discrimination in every day live. Obese people have more difficulties in finding a job, have a lower income, and are less often seen in leadership positions. In society, responsibility for the weight situation in seen as lying by the individuals affected altogether, leading to chronic stress, problems with self esteem and perception of loss of control. As a consequence, there is an increased risk for developing serious psychological problems such as affective and anxiety disorders. As a reaction, coping strategies to deal with the psychological pressure such as dysfunctional eating behavior, binge eating and physical inactivity are used. Females, people belonging to another ethnic or social minority, adolescents and people with eating disorders are considered at increased risk of psychological distress. Psychological vulnerabilities and the consequences of stigmatization need to be considered. Moreover, perceived behavioral control and self esteem are key aspects of to be addressed on the treatment.

Müller R

2013-02-01

378

Metabolic complications of obesity.  

UK PubMed Central (United Kingdom)

Obesity is a risk factor for several metabolic complications, with insulin resistance being the common denominator in these conditions. Impaired blood glucose regulation is one of the most important of these complications, and includes type 2 diabetes mellitus (T2DM), prediabetes, and gestational diabetes. Metabolic syndrome describes a constellation of features including insulin resistance, hypertension, dyslipidemia, and abdominal obesity. Polycystic ovary syndrome is a condition characterized by ovulatory dysfunction and clinical evidence of hyperandrogenism. As many of these complications can go unnoticed for years without overt clinical complications, awareness of both patients and health care professionals is essential such that appropriate screening and diagnostic strategies can be undertaken. Aggressive management strategies of diabetic and prediabetic states are essential for prevention of complications over time. Strategies for identification of vascular risk factors must be implemented such that appropriate risk reduction strategies can be undertaken to minimize the risk of development of cardiovascular complications.

Pedersen SD

2013-04-01

379

Association between sleeping hours and siesta and the risk of obesity: the SUN Mediterranean Cohort.  

UK PubMed Central (United Kingdom)

OBJECTIVES: Our aim was to investigate the association between sleeping hours at night and during the siesta and the incidence of obesity in a Mediterranean cohort. METHODS: After a median of 6.5 years of follow-up, we included 10,532 or 9,470 participants without chronic disease or obesity at baseline for analyzing the association between the incidence of obesity and nocturnal sleep duration or having siesta. Sleeping hours and siesta were assessed at baseline. Weight was recorded at baseline and every 2 years during the follow-up. The outcome was the incidence of obesity during follow-up among participants with initial BMI <30 kg/m(2). RESULTS: During follow-up we observed 446 new cases of obesity in the analysis of nocturnal sleep duration. Sleeping less than 5 h at night was associated with a higher risk of becoming obese compared to sleeping between 7 and <8 h (HR 1.94; 95% CI 1.19-3.18; p for quadratic trend = 0.06) after adjusting for potential confounders. During follow-up, we observed 396 incident cases of obesity in the analysis of siesta. Those who took a siesta for 30 min/day had a 33% lower risk of becoming obese (HR 0.67; 95% CI 0.46-0.96; p for quadratic trend = 0.13) compared to those who did not take siesta. CONCLUSION: Our results suggest that short nocturnal sleep duration could be a modifiable risk factor for obesity. It is possible that this association may be stronger among men and subjects who experienced previous weight gain. Additionally, siesta might be a novel and independent protective factor for obesity; however, confirmatory studies are needed.

Sayón-Orea C; Bes-Rastrollo M; Carlos S; Beunza JJ; Basterra-Gortari FJ; Martínez-González MA

2013-01-01

380

Positive effect of curcumin on inflammation and mitochondrial dysfunction in obese mice with liver steatosis.  

UK PubMed Central (United Kingdom)

Obesity contributes to the increased risk of liver- related morbidity and mortality. The accumulation of macrophages in adipose tissue in an inflammatory state is a hallmark of obesity-induced hepatic steatosis. In this study, we reveal the role of curcumin in the molecular mechanisms underlying inflammatory events in a model consisting of obese mice with hepatic steatosis. Obese mice fed with curcumin experienced significant weight loss and significantly reduced serum triglyceride (TG) levels. The adipose tumor necrocis factor-?, interleukin-6 (IL-6) and monocyte chemotactic protein-1 levels were significantly higher in obese mice compared to mice fed with curcumin. Compared to the obese mice, curcumin decreased the number of F4/80-positive macrophages in epididymal adipose and liver tissue. The induction of signal transducer and activator of transcription 3 phosphorylation by curcumin resulted in the downregulation of the suppressor of cytokine signaling 3 in the liver of obese mice. Curcumin decreased hepatic TG in obese mice by downregulating the gene expression of sterol regulatory element-binding protein-1c in the liver. The hepatic expression of several mitochondrial biogenesis genes decreased in the obese mice, including mitochondrial DNA (mtDNA), nuclear respiratory factor 1 (NRF1) and mitochondrial transcription factor A (Tfam), which are responsible for the lower mitochondrial respiratory chain (MRC) complex I activity and adenosine triphosphate production. By contrast, obese mice treated with curcumin showed normalized mtDNA, NRF1 and Tfam gene expression, reduced hepatic nuclear factor-?B activities and levels of thiobarbituric acid reactive substances (TBARS) and restored mitochondrial oxidative metabolism and biogenesis. The results from the present sudy show that curcumin prevents fatty liver disease through multiple mechanisms, and suggest that curcumin may be used to prevent the development and progression of non-alcoholic fatty liver disease (NAFLD).

Kuo JJ; Chang HH; Tsai TH; Lee TY

2012-09-01

 
 
 
 
381

Obesity among Danish seafarers.  

UK PubMed Central (United Kingdom)

BACKGROUND: Danish seafarers have an excess of life style related diseases where obesity may be a factor. Obesity may in itself be a safety issue at sea. OBJECTIVES: The purpose was to study overweight among male seafarers and determine the consequences if a maximum Body Mass Index (BMI) for seafarers is decided. METHODS: As part of the mandatory pre-employment health examination, height and weight of the seafarers are recorded and BMI calculated. From a register comprising all seafarers, basic information on each individual seafarer was obtained from the last employment period before the health examination. In this study, normal weight is defined as a BMI from 20 and up to 25, moderate overweight from 25 up to 30 and obesity from 30 and above. RESULTS: The study comprised 1257 male seafarers. There were statistically significant more overweight seafarers in all age groups compared to a reference group ashore. Among those between 45 and 66 years of age 0.7% had a weight below normal, 22.7% had normal weight and 76.6% had a weight above normal, while 30.9% of this age group was obese. CONCLUSION: The method is applicable as a tool for an objective description of seafarers' health profile in a national and an international perspective. Overweight is found to be common and may influence the health of the seafarers and shipboard safety. Fixed BMI limits for seafarers on Danish ships would result in loss of license and that would have major implications even if the limit is set high.

Hoeyer JL; Hansen HL

2005-01-01

382

Molecular mapping of obesity genes.  

UK PubMed Central (United Kingdom)

Advances in molecular genetics have made it possible to clone mutant genes from mammals. This capability should facilitate efforts to determine the genetic factors that control food intake and body composition. In order to identify these genetic factors, we have been making use of mouse mutations that cause obesity. The basic premise of this approach is to take advantage of the mouse as a genetic system for the analysis of genetically complex disorders and to then apply that information to the study of human disease. This paper reviews: (1) current concepts concerning the control of body weight in man and other mammals; (2) the biologic characteristics of the mouse obesity mutations; (3) our progress in the use of positional cloning techniques to clone the mouse obese (ob) and diabetes (db) genes; (4) an approach to polygenic obesity in mice; and (5) the possible relevance of the mouse obesity mutations to human obesity.

Friedman JM; Leibel RL; Bahary N

1991-01-01

383

[Pathogenesis of overweight and obesity.  

UK PubMed Central (United Kingdom)

Obesity results from a predominance of caloric intake over energy expenditure. Twin, adoption and family studies have demonstrated that, together with environmental conditions, various genetic factors play an important role in the pathogenesis of obesity. In recent years, it was possible to identify several defects in single genes responsible for obesity in rodents, some of which may also be involved in human obesity. Besides leptin as the most notable example, numerous other proteins and neuropeptides have been identified in recent years that participate in a complex network to regulate food intake and energy expenditure. The ongoing search for the important obesity genes should not only result in a better understanding of energy metabolism, but may also help in the development of new strategies for the treatment of obese patients.

Hamann; Tafel; Münzberg

2000-08-01

384

[Etiology of overweight and obesity].  

Science.gov (United States)

Obesity results from a predominance of caloric intake over energy expenditure. Twin, adoption and family studies have demonstrated that, together with environmental conditions, various genetic factors play an important role in the pathogenesis of obesity. In recent years, it was possible to identify several defects in single genes responsible for obesity in rodents, some of which may also be involved in human obesity. Besides leptin as the most notable example, numerous other proteins and neuropeptides have been identified in recent years that participate in a complex network to regulate food intake and energy expenditure. The ongoing search for the important obesity genes should not only result in a better understanding of energy metabolism, but may also help in the development of new strategies for the treatment of obese patients. PMID:11026083

Hamann, A; Tafel, J; Münzberg, H

2000-08-01

385

[Etiology of overweight and obesity  

UK PubMed Central (United Kingdom)

Obesity results from a predominance of caloric intake over energy expenditure. Twin, adoption and family studies have demonstrated that, together with environmental conditions, various genetic factors play an important role in the pathogenesis of obesity. In recent years, it was possible to identify several defects in single genes responsible for obesity in rodents, some of which may also be involved in human obesity. Besides leptin as the most notable example, numerous other proteins and neuropeptides have been identified in recent years that participate in a complex network to regulate food intake and energy expenditure. The ongoing search for the important obesity genes should not only result in a better understanding of energy metabolism, but may also help in the development of new strategies for the treatment of obese patients.

Hamann A; Tafel J; Münzberg H

2000-08-01

386

Pharmacokinetic considerations in the obese.  

UK PubMed Central (United Kingdom)

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.

Leykin Y; Miotto L; Pellis T

2011-03-01

387

An experience of laparoscopic sleeve gastrectomy in obese, morbidly obese, and super morbid obese patients.  

UK PubMed Central (United Kingdom)

OBJECTIVE: 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.

Al Falah HM; AlSalamah SM; Abdullah M; AlQahtani HH; Abbas GS; AlSalamah YA

2013-05-01

388

An experience of laparoscopic sleeve gastrectomy in obese, morbidly obese, and super morbid obese patients  

Directory of Open Access Journals (Sweden)

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. 

Haitham M. Al Falah; Saleh M. AlSalamah; Muhammad Abdullah; Hamad H. AlQahtani; Ghanem S. Abbas; Yasir A. AlSalamah

2013-01-01

389

Social jetlag and obesity.  

Science.gov (United States)

Obesity has reached crisis proportions in industrialized societies. Many factors converge to yield increased body mass index (BMI). Among these is sleep duration. The circadian clock controls sleep timing through the process of entrainment. Chronotype describes individual differences in sleep timing, and it is determined by genetic background, age, sex, and environment (e.g., light exposure). Social jetlag quantifies the discrepancy that often arises between circadian and social clocks, which results in chronic sleep loss. The circadian clock also regulates energy homeostasis, and its disruption-as with social jetlag-may contribute to weight-related pathologies. Here, we report the results from a large-scale epidemiological study, showing that, beyond sleep duration, social jetlag is associated with increased BMI. Our results demonstrate that living "against the clock" may be a factor contributing to the epidemic of obesity. This is of key importance in pending discussions on the implementation of Daylight Saving Time and on work or school times, which all contribute to the amount of social jetlag accrued by an individual. Our data suggest that improving the correspondence between biological and social clocks will contribute to the management of obesity. PMID:22578422

Roenneberg, Till; Allebrandt, Karla V; Merrow, Martha; Vetter, Céline

2012-05-10

390

Social jetlag and obesity.  

UK PubMed Central (United Kingdom)

Obesity has reached crisis proportions in industrialized societies. Many factors converge to yield increased body mass index (BMI). Among these is sleep duration. The circadian clock controls sleep timing through the process of entrainment. Chronotype describes individual differences in sleep timing, and it is determined by genetic background, age, sex, and environment (e.g., light exposure). Social jetlag quantifies the discrepancy that often arises between circadian and social clocks, which results in chronic sleep loss. The circadian clock also regulates energy homeostasis, and its disruption-as with social jetlag-may contribute to weight-related pathologies. Here, we report the results from a large-scale epidemiological study, showing that, beyond sleep duration, social jetlag is associated with increased BMI. Our results demonstrate that living "against the clock" may be a factor contributing to the epidemic of obesity. This is of key importance in pending discussions on the implementation of Daylight Saving Time and on work or school times, which all contribute to the amount of social jetlag accrued by an individual. Our data suggest that improving the correspondence between biological and social clocks will contribute to the management of obesity.

Roenneberg T; Allebrandt KV; Merrow M; Vetter C

2012-05-01

391

Endoscopic approaches to obesity.  

UK PubMed Central (United Kingdom)

Given the emerging role of endoscopic procedures in the treatment of obesity and rapid changes in endoscopic technologies and techniques, this review considers the current state of endoscopic management of obesity. Endoluminal interventions performed entirely through the GI tract by using flexible endoscopy offer the potential for an ambulatory weight loss procedure that may be safer and more cost- effective compared with current surgical approaches. Endoscopic techniques attempt to mimic the anatomic features of bariatric surgery. Accordingly, there are two main endoscopic weight loss modalities - restrictive and malabsorptive. Restrictive procedures act to decrease gastric volume by space-occupying prosthesis and/or by suturing or stapling devices, while malabsorptive procedures tend to create malabsorption by preventing food contact with the duodenum and proximal jejunum. The former include intragastric balloon treatment, endoluminal vertical gastroplasty, transoral gastroplasty and transoral endoscopic restrictive implant system, while the latter include duodenojejunal bypass sleeve. Gastroduodenojejunal bypass sleeve is a combination of both procedures. Except for intragastric balloon, all mentioned procedures are rather new, tested on a small number of human subjects, with a high rate of success, but with limited knowledge on safety and long-term efficacy. The role of gastric electrical stimulation and intragastric injections of botulinum toxin in obesity treatment is also considered as is the role of minimally invasive bariatric endoscopic interventions.

Stimac D; Majanovi? SK

2012-01-01

392

Obesity and atrial fibrillation.  

Science.gov (United States)

Atrial fibrillation (AF) is an increasing public health problem, often described as the epidemic of the new millennium. The rising health economic impact of AF, its association with poor quality of life and independent probability of increased mortality, has recently been highlighted. Although population ageing is regarded as an important contributor to this epidemic, obesity and its associated cardiometabolic comorbidities may represent the principal driving factor behind the current and projected AF epidemic. Obesity-related risk factors, such as hypertension, vascular disease, obstructive sleep apnea and pericardial fat, are thought to result in atrial electro-structural dysfunction. In addition, insulin resistance, its associated abnormalities in nutrient utilization and intermediary metabolic by-products are associated with structural and functional abnormalities, ultimately promoting AF. Recent elucidation of molecular pathways, including those responsible for atrial fibrosis, have provided mechanistic insights and the potential for targeted pharmacotherapy. In this article, we review the evidence for an obesity-related atrial electromechanical dysfunction, the mechanisms behind this and its impact on AF therapeutic outcomes. In light of the recently described mechanisms, we illustrate proposed management approaches and avenues for further investigations. PMID:23879190

Abed, H S; Wittert, G A

2013-07-24

393

Prevention of obesity and diabetes in childbearing women.  

UK PubMed Central (United Kingdom)

Obesity and diabetes have become pandemic in the United States, with more than one-third of the US population obese and 8.3% of the population affected by diabetes. Efforts to prevent type 2 diabetes focus primarily on healthy eating and physical activity. In particular, women from at-risk racial and ethnic groups and those who have experienced gestational diabetes are at high risk for developing type 2 diabetes. Achieving a healthy weight prior to conception, staying within weight gain guidelines during pregnancy, and losing accumulated pregnancy weight postpartum are key prevention factors. Maintaining a healthy weight in the long-term is a challenge. Behavioral psychology and coaching techniques are presented in this article that can be useful in sustaining behaviors that promote a healthy weight.

Trout KK; Ellis KK; Bratschie A

2013-05-01

394

Donor motivation in Xi'an, China: comparison with Canadian donors.  

UK PubMed Central (United Kingdom)

Background and Objectives? In China, paid donation is prohibited by law. There is little literature assessing donor motivation in China, and comparison with western countries such as Canada is important in understanding the application of Western literature. We compared motivational factors in donors from the city of Xi'an, China, with Canadian donors matched for age, sex and donation status. Materials and Methods? A total of 218 donors in Xi'an completed an interview about motivation as did 218 Canadian donors matched for age, sex and donation status. Frequencies and percentages of responses to questions were tabulated and compared using the Chi-squared test. Results? Donors in Xi'an and Canada felt a personal responsibility to donate blood (81·2% vs. 78·0%, P?=?0·2057), but Xi'an donors were more likely to consider blood donation a social responsibility (81·7% vs. 45·2%, P?donors more often believed that society views donation as a normal activity (98·6% vs. 48·4%, P?donors believed in balance between their life force (Qi) and blood (86·7% vs. 49·8%, P?donors. There is a need for more research specific to China to tailor recruitment strategies.

O'Brien SF; Shao ZJ; Osmond L; Yi QL; Li CY; An QX

2013-04-01

395

Evaluation of potential liver donors: limits imposed by donor variables in liver transplantation.  

UK PubMed Central (United Kingdom)

The aim of this study was to evaluate the predictive value of different donor and recipient parameters that have been recognised previously as proven and to suggest prognostic factors for immediate liver function and final outcome after liver transplantation. We evaluated a total of 228 liver grafts transplanted in the last 3 years in our institution. Parameters were recorded for the donor (age, polytransfusion, atherosclerosis, presence of infection, episodes of hypoxia or hypotension, use of vasoactive drugs, intensive care unit stay, steatosis, and ischemia time) and recipient (red blood cell requirements, immediate liver function [score], incidence of hepatic artery thrombosis, survival, and cause of death or retransplantation). Liver biopsy after reperfusion of the donor liver was performed before closure of the abdomen. Donor age over 65 years and presence of steatosis were associated significantly with initial poor function. The mortality rate at 6 months was related to donor age over 65 years. When donor age over 65 years was combined with transfusion requirement of > 10 U of red blood cells (RBC), the incidence of graft loss increased to 53%. The probability of graft survival at two years decreased when donor age was over 65 years. Moreover, when donor age over 65 years was combined with requirement of > 10 units RBC the probability of 2-year survival was significantly reduced. This study shows, for the first time, that the use of donor livers from older donors in liver transplant procedures, requiring more than 10 U of RBC, results in a significantly worse prognosis in terms of immediate liver function and long-term survival.

Rull R; Vidal O; Momblan D; González FX; López-Boado MA; Fuster J; Grande L; Bruguera M; Cabrer K; García-Valdecasas JC

2003-04-01

396

Energy status of pig donor organs after ischemia is independent of donor type.  

UK PubMed Central (United Kingdom)

BACKGROUND: Literature is controversial whether organs from living donors have a better graft function than brain dead (BD) and non-heart-beating donor organs. Success of transplantation has been correlated with high-energy phosphate (HEP) contents of the graft. METHODS: HEP contents in heart, liver, kidney, and pancreas from living, BD, and donation after cardiac death in a pig model (n=6 per donor type) were evaluated systematically. BD was induced under general anesthesia by inflating a balloon in the epidural space. Ten hours after confirmation, organs were retrieved. Cardiac arrest was induced by 9V direct current. After 10min of ventricular fibrillation without cardiac output, mechanical and medical reanimation was performed for 30min before organ retrieval. In living donors, organs were explanted immediately. Freeze-clamped biopsies were taken before perfusion with Celsior solution (heart) or University of Wisconsin solution (abdominal organs) in BD and living donors or with Histidine-Tryptophan-Ketoglutaric solution (all organs) in non-heart-beating donors, after perfusion, and after cold ischemia (4h for heart, 6h for liver and pancreas, and 12h for kidney). HEPs (adenosine triphosphate, adenosine diphosphate, adenosine monophosphate, and phosphocreatine), xanthine, and hypoxanthine were measured by high-performance liquid chromatography. Energy charge and adenosine triphosphate-to-adenosine diphosphate ratio were calculated. RESULTS: After ischemia, organs from different donor types showed no difference in energy status. In all organs, a decrease of HEP and an increase in hypoxanthine contents were observed during perfusion and ischemia, irrespective of the donor type. CONCLUSION: Organs from BD or non-heart-beating donors do not differ from living donor organs in their energy status after average tolerable ischemia.

Stadlbauer V; Stiegler P; Taeubl P; Sereinigg M; Puntschart A; Bradatsch A; Curcic P; Seifert-Held T; Zmugg G; Stojakovic T; Leopold B; Blattl D; Horki V; Mayrhauser U; Wiederstein-Grasser I; Leber B; Jürgens G; Tscheliessnigg K; Hallström S

2013-04-01

397

Marginal donors: can older donor hearts tolerate prolonged cold ischemic storage?  

UK PubMed Central (United Kingdom)

BACKGROUND AND AIMS: Both advanced donor age and prolonged ischemic time are significant risk factors for the 1-year mortality. However, its functional consequences have not been fully evaluated in the early-phase after transplantation; even early graft dysfunction is the main determinant of long-term outcome following transplantation. We evaluated in vivo left-ventricular (LV) cardiac and coronary vascular function of old-donor grafts after short and prolonged cold ischemic times in rats 1 h after heart transplantation. METHODS: The hearts were excised from young donor (3-month-old) or old donor (18-month-old) rats, stored in cold preservation solution for either 1 or 8 h, and heterotopically transplanted. RESULTS: After 1 h of ischemic period, in the old-donor group, LV pressure, maximum pressure development (dP/dt max), time constant of LV pressure decay (?), LV end-diastolic pressure and coronary blood flow did not differ compared with young donors. However, endothelium-dependent vasodilatation to acetylcholine resulted in a significantly lower response of coronary blood flow in the old-donor group (33 ± 4 vs. 51 ± 15 %, p < 0.05). After 8 h preservation, two of the old-donor hearts showed no mechanical activity upon reperfusion. LV pressure (55 ± 6 vs. 72 ± 5 mmHg, p < 0.05), dP/dt max (899 ± 221 vs. 1530 ± 217 mmHg/s, p < 0.05), coronary blood flow and response to acetylcholine were significantly reduced and ? was increased in the old-donor group in comparison to young controls. CONCLUSIONS: During the early-phase after transplantation, the ischemic tolerance of older-donor hearts is reduced after prolonged preservation time and the endothelium is more vulnerable to ischemia/reperfusion.

Korkmaz S; Bährle-Szabó S; Loganathan S; Li S; Karck M; Szabó G

2013-08-01

398

Impact of the cornea donor study on acceptance of corneas from older donors.  

UK PubMed Central (United Kingdom)

PURPOSE: To evaluate retrospectively whether the findings from the Cornea Donor Study (CDS) led to changes in the transplantation of corneas from older donors. METHODS: Eye banks in United States provided complete data on donor age and placement (domestic or international) for 86,273 corneas from 1998 to 2009. The data were analyzed by 3 periods, preceding CDS (1998-1999), during CDS (2000-2007), and after publication of CDS 5-year results (2008-2009), and separately for corneas placed within versus outside the United States. RESULTS: For corneal tissues transplanted in the United States, the percentage of donors who were 66 years or older increased from 19% before CDS to 21% during CDS and 25% after CDS (P<0.001). Corresponding median (25th-75th percentile) donor ages were 53 (39-63), 54 (41-64), and 57 (46-66), respectively (P<0.001). The opposite trend was observed for corneas distributed outside the United States, with the percentage of donors 66 years and older decreasing from 56% to 42% to 34%, respectively. Donor age trends over time varied by eye bank. CONCLUSIONS: There was a modest overall increase in the donor age of corneas transplanted in the United States from 1998 to 2009, but the retrospective nature of the study limits our ability to attribute this change to the CDS. The modest increases in the donor age of corneas transplanted is a positive finding, but wider acceptance of older corneal donor tissue should be encouraged based on the 5-year evidence generated by the CDS.

Sugar A; Montoya MM; Beck R; Cowden JW; Dontchev M; Gal RL; Kollman C; Malling J; Mannis MJ; Tennant B

2012-12-01

399

Pharmacological management of obese child.  

UK PubMed Central (United Kingdom)

Childhood overweight and obesity are increasingly common management problems for clinicians. This review focuses on the pharmacological management of obesity in children. It considers historical treatments, the options currently available (principally orlistat and metformin) and some potential future therapeutic interventions. The short term psychological effect of obesity and longer term health impact are discussed. The clinical settings in which drug treatment may be appropriate, the importance of lifestyle interventions, and the evidence and clinical guidance that underpin their use are discussed.

Petkar R; Wright N

2013-06-01

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Smoking among morbidly obese patients  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Smokers usually have a lower Body Mass Index (BMI) when compared to non-smokers. Such a relationship, however, has not been fully studied in obese and morbidly obese patients. The objective of this study was to evaluate the relationship between smoking and BMI among obese and morbidly obese subjects. Methods In a case-control study design, 1022 individuals of both genders, 18-65 years of age, were recruited and grouped according to their smoking status (smokers, ex-smokers, and non-smokers) and nutritional state according to BMI (normal weight, overweight, obese, and morbidly obese). Results No significant differences were detected in the four BMI groups with respect to smoking status. However, there was a trend towards a higher frequency of smokers among the overweight, obese, and morbidly obese subjects compared to normal weight individuals (p = 0.078). In a logistic regression, after adjusting for potential confounders, morbidly obese subjects had an adjusted OR of 2.25 (95% CI, 1.52-3.34; p Discussion In this sample, while the frequency of smokers diminished in normal weight subjects as the BMI increased, such a trend was reversed in overweight, obese, and morbidly obese patients. In the latter group, the prevalence of smokers was significantly higher compared to the other groups. A patient with morbid obesity had a 2-fold increased risk of becoming a smoker. We speculate that these finding could be a consequence of various overlapping risk behaviors because these patients also are generally less physically active and prefer a less healthy diet, in addition to having a greater alcohol intake in relation to their counterparts. The external validity of these findings must be confirmed.

Chatkin Raquel; Mottin Claudio C; Chatkin José M

2010-01-01