scholarly journals Impact of body mass index on the early experience of robotic pancreaticoduodenectomy

2021 ◽  
Author(s):  
Ying-Jui Chao ◽  
Ting-Kai Liao ◽  
Ping-Jui Su ◽  
Chih-Jung Wang ◽  
Yan-Shen Shan
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Complication Rate ◽  
Major Complication ◽  
Early Experience ◽  
Normal Weight ◽  
Learning Curves ◽  
Obese Group ◽  
Major Complication Rate ◽  
Robotic Pancreaticoduodenectomy

AbstractObesity increases surgical morbidity and mortality in open pancreaticoduodenectomy (OPD). Its influence on robotic pancreaticoduodenectomy (RPD) remains uncertain. This study aimed to investigate the impact of body mass index (BMI) on the early experience of RPD. Between June 2015 and April 2020, 68 consecutive RPDs were performed at the National Cheng Kung University Hospital. The patients were categorized as normal-weight (BMI < 23 kg/m2), overweight (BMI = 23–27.5 kg/m2), and obese (BMI > 27.5 kg/m2) according to the definition of obesity in Asian people from the World Health Organization expert consultation. Preoperative characteristics, operative details, and postoperative outcomes were prospectively collected. The cumulative sum was used to assess the learning curves. The average age of the patients was 64.8 ± 11.7 years with an average BMI of 24.6 ± 3.7 kg/m2 (23 normal-weight, 29 overweight, and 16 obese patients). Eighteen patients were required to overcome the learning curve. The overall complication rate was 51.5%, and the major complication rate (Clavien grade ≥ III) was 19.1%. The normal-weight group showed the most favorable outcomes. The blood loss, major complication rate, peripancreatic fluid collection rate, and conversion rate were higher in the obese group than in the non-obese group. There were no differences in the operative time, clinically relevant postoperative pancreatic fistula, postoperative hemorrhage, delayed gastric emptying, bile leak, wound infection, reoperation, hospital stay, and readmission rate between the obese and non-obese groups. Multivariate analysis showed obesity as the only independent factor for major complications (OR: 5.983, CI: 1.394–25.682, p = 0.001), indicating that obesity should be considered as a surgical risk factor during the implementation of RPD.

scholarly journals Influence of preoperative weight on the early and middle outcome of fixed platform medial unicompartmental knee arthroplasty

2020 ◽  
Vol 8 (9_suppl7) ◽  
pp. 2325967120S0054
Author(s):  
Chen Wenzhong ◽  
Zou Shiping ◽  
Siwen Teng
Keyword(s):  
Body Mass Index ◽  
Knee Osteoarthritis ◽  
Body Mass ◽  
Normal Weight ◽  
Obese Group ◽  
Weight Group ◽  
P Values ◽  
Overweight Group ◽  
Hss Score ◽  
Incision Healing

Introduction: Obesity is an important independent risk factor for the development of knee osteoarthritis .According to the data of the world Health Organization, there were more than 1.9 billion overweight adults in the world in 2014, among which at least 600 million were clinically obese .Therefore, among the patients undergoing knee replacement, the number of obese patients is increasing .The use of single condyle replacement for medial compartment arthritis of the knee began in the 1970s.With the continuous development of new implants, the continuous improvement of surgical techniques and the strict control of indications by surgeons, the 15-year survival rate of single condyle replacement is over 90%, and the 20-year survival rate is 84%, achieving good results.In the indications of knee monocepicondylar replacement, the maximum weight standard has been increased from 82kg in 1989 [8] to 90kg in 2002 [9].However, there is still controversy over the body weight cut-off point in the indications, especially the observation on the postoperative effect of single condyle replacement in obese patients, which has been rarely reported in China. Hypotheses: To evaluate the near and middle term efficacy of unicompartmental knee arthroplasty(UKA) in patients with medial knee osteoarthritis with different body mass index, and to determine the effect of body weight on the efficacy and complications of UKA. Methods: A total of 128 patients who underwent UKA in department I of arthropathy, zhengzhou orthopaedic hospital from December 2016 to December 2018 due to medial knee osteoarthritis were included as study subjects, and the clinical data of the study subjects were retrospectively analyzed. There were 29 males and 99 females, with an average age of 65.13± 7.37 years (range: 51˜87 years).According to the preoperative body mass index (BMI), the subjects were divided into three groups, namely the underweight or normal weight group (BMI < 24kg /㎡), the overweight group (24kg /㎡≤BMI < 28kg /㎡) and the obese group (BMI≥ 28kg /㎡).Visual analogue scale (VAS), knee range of motion(ROM), American hospital for special surgery (HSS) score of knee joint, complications and other relevant indicators were recorded before and at the last follow-up for each group. According to the data types of preoperative and postoperative efficacy evaluation indexes of the same group, paired sample T test, c² test or Wilcoxon sign rank sum test were used for difference analysis. One-way anova, c² test or K-W rank sum test were used to evaluate the difference between groups. Results: All subjects were followed up for 13-37 months (22.34± 7.22).Compared with before surgery, VAS scores of patients in the last follow-up were significantly lower in the underweight or normal weight group, the overweight group and the obese group (6.91±6.34 vs. 0.44±0.67, 6.90 ±0.77 vs. 0.63±0.68, 6.78±0.71 vs. 0.59±0.61) (t= 46.488-42.654,P values <0.01), knee ROM significantly increased (97.67±10.87 vs. 114.77±8.01, 98.96±10.67 vs. 116.03±6.96, 95.31±11.50 vs. 110.93±11.46) (t= -20.83 - -11.039,All P values were <0.01), and knee HSS score was significantly improved (51.63±0.61 vs 88.00±4.06, 50.68±6.46 vs 87.87±5.73, 48.25±6.70 vs 87.03±5.17) (t= -48.920- -34.010, all P values <0.01).There were no statistically significant differences in VAS score, knee ROM and knee HSS score between the overweight group and the obese group compared with the underweight or normal group. None of the patients had serious complications such as periprosthesis infection, simple prosthesis loosening and periprosthesis fracture. The incidence of venous thrombosis in lower extremities was 14.06% (18/128), with no significant difference between groups. There were 7 cases of poor incision healing (overweight group is 3 and obese group is 4), and the risk of poor incision healing was higher in the obese group than in the underweight or normal weight group, with statistical significance (P=0.03). Conclusion: UKA can achieve satisfactory clinical effect in patients with different body mass index, but patients in obesity group are prone to complications such as poor incision healing.

Persistence of altered metabolic responses to beta-endorphin after normalization of body weight in human obesity

1991 ◽  
Vol 124 (2) ◽  
pp. 159-165 ◽  
Author(s):  
Dario Giugliano ◽  
Domenico Cozzolino ◽  
Roberto Torella ◽  
Pierre J Lefebvre ◽  
Paul Franchimont ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Weight ◽  
Body Mass ◽  
Plasma Glucose ◽  
Normal Weight ◽  
Obese Group ◽  
Control Group ◽  
Human Obesity ◽  
C Peptide ◽  
Obese Subjects

Abstract. The responses of plasma glucose, insulin, C-peptide and glucagon to an infusion of human β-endorphin (0.5 mg/h) were studied in 10 formerly obese subjects who had lost 35 kg by dieting (body mass index <25) and compared with those of 10 normal-weight control (body mass index <25) and 10 obese (body mass index >30) subjects. The fasting plasma concentrations of β-endorphin were significantly higher in both the obese and the post-obese group than in the control group. In both obese and post-obese subjects, the infusion of β-endorphin caused significant increases in peripheral plasma glucose, insulin, C-peptide and glucagon concentrations. In the control group, matched for age, sex and weight with the formerly obese group, there was no appreciable change in plasma insulin and C-peptide concentrations during the infusion of β-endorphin, but the rise in plasma glucose was more sustained. Thus, 1. the increased plasma β-endorphin concentrations found in human obesity are not corrected by normalization of body weight; and 2. formerly obese, normal-weight subjects behave as obese subjects in their metabolic and hormonal responses to β-endorphin infusion. The alteration of the opioid system in human obesity may play some role in the predisposition to weight gain.

Influence of Obesity and Impact of a Physical Activity Program on Postural Control and Functional and Physical Capacities in Institutionalized Older Adults: A Pilot Study

2020 ◽  
Vol 17 (2) ◽  
pp. 169-176 ◽  
Author(s):  
Wael Maktouf ◽  
Sylvain Durand ◽  
Bruno Beaune ◽  
Sébastien Boyas
Keyword(s):  
Older Adults ◽  
Body Mass Index ◽  
Postural Control ◽  
Body Mass ◽  
Normal Weight ◽  
Obese Group ◽  
Quiet Standing ◽  
6 Minute Walk Test ◽  
Physical Capacities ◽  
Minute Walk

Objective: To evaluate the role of obesity in the effects of physical activity (PA) on postural control and functional and physical capacities in the older adults and to assess the effectiveness of a PA program on these capacities. Methods: Six obese (age = 78.8 [3.7] y; body mass index > 30 kg/m2), 7 overweight (age = 80.9 [2.8] y; 25 < body mass index < 30 kg/m2), and 6 normal weight (age = 80.8 [5.7] y; body mass index < 25 kg/m2) older adults performed the time up and go test, the 6-minute walk test, and the Tinetti test. Static and dynamic (forward leaning) postural control tests were also assessed. All these tests were similarly assessed 4 months later, during which only the obese group and overweight group participated in a PA program. Results: Before PA, results of the time up and go test, 6-minute walk test, Tinetti test, quiet standing, and forward lean tests revealed that physical capacities and static and dynamic postural control were impaired in the obese group when compared to the normal weight group. After PA, results of quiet standing, physical and functional tests were improved for obese group. Conclusions: Obesity is an additional constraint to age-related postural control and functional and physical capacities deteriorations. Nevertheless, a PA program is effective in improving balance and functional capacities in obese older adults.

scholarly journals Effect of Body Mass Index on Posttonsillectomy Hemorrhage

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Tetsuro Hoshino ◽  
Tohru Tanigawa ◽  
Gen Yanohara ◽  
Kenta Murotani ◽  
Yuichiro Horibe ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Multivariate Analysis ◽  
Body Mass ◽  
Demographic Data ◽  
Major Complication ◽  
Normal Weight ◽  
Adverse Outcomes ◽  
Confounding Factors ◽  
Indication For Surgery ◽  
Bleeding Episodes

Objective. Obesity affects adverse outcomes in patients undergoing various surgeries. Tonsillectomy is one of the most common surgical procedures and posttonsillectomy hemorrhage (PTH) is the major complication in patients with tonsillectomy. However, the effect of body mass index (BMI) on posttonsillectomy bleeding episodes is not well known. This study aimed to assess the clinical association between obesity and PTH. Methods. A total of 98 tonsillectomies were retrospectively reviewed. Patient charts were analyzed regarding demographic data and the indication for surgery. Patients with PTH were compared with uneventful cases. Patients were divided into three groups based on BMI: normal weight (BMI < 25 kg/m2), overweight (BMI ≥ 25 and <30 kg/m2), and obese (≥30 kg/m2). Results. PTH occurred in 13% of patients with normal weight, in 23.5% of patients with overweight, and in 50% patients with obesity. The occurrence of PTH was significantly higher in patients with obesity than in those with normal weight and overweight (p=0.008). Multivariate analysis showed that obesity was a significant factor affecting the incidence of PTH after adjusting for confounding factors. Conclusions. Our findings suggest that the obese condition is independently associated with the incidence of PTH.

EFFECT OF BODY MASS INDEX ON PEAK EXPIRATORY FLOW RATE

2019 ◽  
Vol 3 (9) ◽  
Author(s):  
K. Subramanyam ◽  
Dr. P. Subhash Babu
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Peak Expiratory Flow ◽  
Flow Rate ◽  
Peak Expiratory Flow Rate ◽  
Normal Weight ◽  
The Body ◽  
Health Care Centre ◽  
Expiratory Flow ◽  
Group B

Obesity has become one of the major health issues in India. WHO defines obesity as “A condition with excessive fat accumulation in the body to the extent that the health and wellbeing are adversely affected”. Obesity results from a complex interaction of genetic, behavioral, environmental and socioeconomic factors causing an imbalance in energy production and expenditure. Peak expiratory flow rate is the maximum rate of airflow that can be generated during forced expiratory manoeuvre starting from total lung capacity. The simplicity of the method is its main advantage. It is measured by using a standard Wright Peak Flow Meter or mini Wright Meter. The aim of the study is to see the effect of body mass index on Peak Expiratory Flow Rate values in young adults. The place of a study was done tertiary health care centre, in India for the period of 6 months. Study was performed on 80 subjects age group 20 -30 years, categorised as normal weight BMI =18.5 -24.99 kg/m2 and overweight BMI =25-29.99 kg/m2. There were 40 normal weight BMI (Group A) and 40 over weight BMI (Group B). BMI affects PEFR. Increase in BMI decreases PEFR. Early identification of risk individuals prior to the onset of disease is imperative in our developing country. Keywords: BMI, PEFR.

Body Mass Index Impact on Disease Activity, Clinical and Sonographic Remission Rates in Patients with Rheumatoid Arthritis

2019 ◽  
Vol 15 (3) ◽  
pp. 215-223
Author(s):  
Tanya Sapundzhieva ◽  
Rositsa Karalilova ◽  
Anastas Batalov
Keyword(s):  
Rheumatoid Arthritis ◽  
Body Mass Index ◽  
Disease Activity ◽  
Body Mass ◽  
Normal Weight ◽  
Clinical Disease ◽  
Clinical Disease Activity ◽  
Das 28 ◽  
Remission Rates ◽  
Activity Indices

Aim: To investigate the impact of body mass index (BMI) on clinical disease activity indices and clinical and sonographic remission rates in patients with rheumatoid arthritis (RA). Patients and Methods: Sixty-three patients with RA were categorized according to BMI score into three groups: normal (BMI<25), overweight (BMI 25-30) and obese (BMI≥30). Thirty-three of them were treated with conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs), and 30 with biologic DMARDs (bDMARDs). Patients underwent clinical and laboratory assessment and musculoskeletal ultrasound examination (MSUS) at baseline and at 6 months after initiation of therapy. We evaluated the rate of clinical and sonographic remission (defined as Power Doppler score (PD) = 0) and its correlation with BMI score. Results: In the csDMARDs group, 60% of the normal weight patients reached DAS28 remission; 33.3% of the overweight; and 0% of the obese patients. In the bDMARDs group, the percentage of remission was as follows: 60% in the normal weight subgroup, 33.3% in the overweight; and 15.8% in the obese. Within the csDMARDs treatment group, two significant correlations were found: BMI score–DAS 28 at 6th month, rs = .372, p = .033; BMI score–DAS 28 categories, rs = .447, p = .014. Within the bDMARDs group, three significant correlations were identified: BMI score–PDUS at sixth month, rs = .506, p =.004; BMI score–DAS 28, rs = .511, p = .004; BMI score–DAS 28 categories, rs = .592, p = .001. Sonographic remission rates at 6 months were significantly higher in the normal BMI category in both treatment groups. Conclusion: BMI influences the treatment response, clinical disease activity indices and the rates of clinical and sonographic remission in patients with RA. Obesity and overweight are associated with lower remission rates regardless of the type of treatment.

scholarly journals Accuracy of Age-Based Formula to Predict the Size and Depth of Cuffed Oral Preformed Endotracheal Tubes in Children Undergoing Tonsillectomy

2021 ◽  
pp. 014556132098051
Author(s):  
Matula Tareerath ◽  
Peerachatra Mangmeesri
Keyword(s):  
Body Mass Index ◽  
Endotracheal Tube ◽  
Body Mass ◽  
Normal Weight ◽  
Overweight And Obesity ◽  
The Body ◽  
Insertion Depth ◽  
Endotracheal Tubes ◽  
Endotracheal Tube Size ◽  
Actual Size

Objectives: To retrospectively investigate the reliability of the age-based formula, year/4 + 3.5 mm in predicting size and year/2 + 12 cm in predicting insertion depth of preformed endotracheal tubes in children and correlate these data with the body mass index. Patients and Methods: Patients were classified into 4 groups according to their nutritional status: thinness, normal weight, overweight, and obesity; we then retrospectively compared the actual size of endotracheal tube and insertion depth to the predicting age-based formula and to the respective bend-to-tip distance of the used preformed tubes. Results: Altogether, 300 patients were included. The actual endotracheal tube size corresponded with the Motoyama formula (64.7%, 90% CI: 60.0-69.1), except for thin patients, where the calculated size was too large (0.5 mm). The insertion depth could be predicted within the range of the bend-to-tip distance and age-based formula in 85.0% (90% CI: 81.3-88.0) of patients. Conclusion: Prediction of the size of cuffed preformed endotracheal tubes using the formula of Motoyama was accurate in most patients, except in thin patients (body mass index < −2 SD). The insertion depth of the tubes was mostly in the range of the age-based-formula to the bend-to-tip distance.

scholarly journals Association of body mass index and maternal age with first stage duration of labour

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Louise Lundborg ◽  
Xingrong Liu ◽  
Katarina Åberg ◽  
Anna Sandström ◽  
Ellen L. Tilden ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Maternal Age ◽  
Normal Weight ◽  
The Body ◽  
Younger Women ◽  
Individualized Approach ◽  
Quantile Regression Analysis ◽  
Labour Time ◽  
Group 1

AbstractTo evaluate associations between early-pregnancy body mass index (BMI) and active first stage labour duration, accounting for possible interaction with maternal age, we conducted a cohort study of women with spontaneous onset of labour allocated to Robson group 1. Quantile regression analysis was performed to estimate first stage labour duration between BMI categories in two maternal age subgroups (more and less than 30 years). Results show that obesity (BMI > 30) among younger women (< 30 years) increased the median labour duration of first stage by 30 min compared with normal weight women (BMI < 25), and time difference estimated at the 90th quantile was more than 1 h. Active first stage labour time differences between obese and normal weight women was modified by maternal age. In conclusion: (a) obesity is associated with longer duration of first stage of labour, and (b) maternal age is an effect modifier for this association. This novel finding of an effect modification between BMI and maternal age contributes to the body of evidence that supports a more individualized approach when describing labour duration.

scholarly journals Association between Maternal Origin, Pre-Pregnancy Body Mass Index and Caesarean Section: A Nation-Wide Registry Study

2021 ◽  
Vol 18 (11) ◽  
pp. 5938
Author(s):  
Fatou Jatta ◽  
Johanne Sundby ◽  
Siri Vangen ◽  
Benedikte Victoria Lindskog ◽  
Ingvil Krarup Sørbye ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Caesarean Section ◽  
Body Mass ◽  
Normal Weight ◽  
Sub Saharan Africa ◽  
Asia Pacific ◽  
Adjusted Relative Risk ◽  
Maternal Origin ◽  
Length Of Residence ◽  
Sub Saharan

Aims: To explore the association between maternal origin and birthplace, and caesarean section (CS) by pre-pregnancy body mass index (BMI) and length of residence. Methods: We linked records from 118,459 primiparous women in the Medical Birth Registry of Norway between 2013 and 2017 with data from the National Population Register. We categorized pre-pregnancy BMI (kg/m2) into underweight (<18.5), normal weight (18.5–24.9) and overweight/obese (≥25). Multinomial regression analysis estimated crude and adjusted relative risk ratios (RRR) with 95% confidence intervals (CI) for emergency and elective CS. Results: Compared to normal weight women from Norway, women from Sub-Saharan Africa and Southeast Asia/Pacific had a decreased risk of elective CS (aRRR = 0.57, 95% CI 0.37–0.87 and aRRR = 0.56, 0.41–0.77, respectively). Overweight/obese women from Europe/Central Asia had the highest risk of elective CS (aRRR = 1.42, 1.09–1.86). Both normal weight and overweight/obese Sub-Saharan African women had the highest risks of emergency CS (aRRR = 2.61, 2.28-2.99; 2.18, 1.81-2.63, respectively). Compared to women from high-income countries, the risk of elective CS was increasing with a longer length of residence among European/Central Asian women. Newly arrived migrants from Sub-Saharan Africa had the highest risk of emergency CS. Conclusion: Women from Sub-Saharan Africa had more than two times the risk of emergency CS compared to women originating from Norway, regardless of pre-pregnancy BMI.

scholarly journals Higher body mass index is associated with larger postoperative improvement in patient-reported outcomes following total knee arthroplasty

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
K Giesinger ◽  
JM Giesinger ◽  
DF Hamilton ◽  
J Rechsteiner ◽  
A Ladurner
Keyword(s):  
Body Mass Index ◽  
Total Knee Arthroplasty ◽  
Pain Relief ◽  
Body Mass ◽  
Knee Arthroplasty ◽  
Normal Weight ◽  
World Health ◽  
Obese Patients ◽  
Total Knee ◽  
The Impact

Abstract Background Total knee arthroplasty is known to successfully alleviate pain and improve function in endstage knee osteoarthritis. However, there is some controversy with regard to the influence of obesity on clinical benefits after TKA. The aim of this study was to investigate the impact of body mass index (BMI) on improvement in pain, function and general health status following total knee arthroplasty (TKA). Methods A single-centre retrospective analysis of primary TKAs performed between 2006 and 2016 was performed. Data were collected preoperatively and 12-month postoperatively using WOMAC score and EQ-5D. Longitudinal score change was compared across the BMI categories identified by the World Health Organization. Results Data from 1565 patients [mean age 69.1, 62.2% women] were accessed. Weight distribution was: 21.2% BMI < 25.0 kg/m2, 36.9% BMI 25.0–29.9 kg/m2, 27.0% BMI 30.0–34.9 kg/m2, 10.2% BMI 35.0–39.9 kg/m2, and 4.6% BMI ≥ 40.0 kg/m2. All outcome measures improved between preoperative and 12-month follow-up (p < 0.001). In pairwise comparisons against normal weight patients, patients with class I-II obesity showed larger improvement on the WOMAC function and total score. For WOMAC pain improvements were larger for all three obesity classes. Conclusions Post-operative improvement in joint-specific outcomes was larger in obese patients compared to normal weight patients. These findings suggest that obese patients may have the greatest benefits from TKA with regard to function and pain relief one year post-op. Well balanced treatment decisions should fully account for both: Higher benefits in terms of pain relief and function as well as increased potential risks and complications. Trial registration This trial has been registered with the ethics committee of Eastern Switzerland (EKOS; Project-ID: EKOS 2020–00,879)

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