scholarly journals Basal and longitudinal changes in serum levels of TSH in morbid obese patients experiencing failure or success of dietary treatment

2020 ◽  
Author(s):  
Laura Croce ◽  
Cristina Pallavicini ◽  
Silvia Crotti ◽  
Francesca Coperchini ◽  
Linda Minnelli ◽  
...  
Keyword(s):  
Thyroid Function ◽  
Intervention Program ◽  
Dietary Intervention ◽  
Case Control ◽  
Obese Patients ◽  
Baseline Serum ◽  
Failure Group ◽  
Success Group ◽  
The Impact

Abstract Purpose The relationship between thyroid function and obesity is a widely investigated one. The impact of thyroid hormones in determining the outcome of dietary/lifestyle interventions remains to be fully elucidated. The aim of this study was to compare basal and post dietary-intervention circulating thyroid-function parameters, lipid profile and fasting-glucose in euthyroid obese patients according to a success or failure of a dietary intervention program. Methods In a retrospective longitudinal case–control study we enrolled 50 euthyroid obese patients who experienced a success in dietary intervention, as defined by a BMI reduction of at least 5% from baseline (Success Group) and 50 sex and age-matched euthyroid obese patients who experienced failure in dietary intervention as defined by either stable or increased body weight throughout the follow-up (Failure Group). Serum thyroid function parameters and metabolic profile at baseline and at the end of follow-up were collected. Results At baseline, the two groups showed similar BMI, total-cholesterol, HDL-cholesterol and fasting-blood-glucose, but patients in Success Group had a significantly higher TSH as compared with Failure Group (2.20 ± 0.97 vs 1.66 ± 0.73, respectively, p < 0.001). Throughout a mean follow-up of 21.4 months TSH significantly decreased in Success Group (2.20 ± 0.97 vs 2.06 ± 0.98; p = 0.029) and increased in Failure Group (1.63 ± 0.72 vs 2.01 ± 0.99; p < 0.001). Multiple regression analysis showed that the outcome of the dietary intervention was significantly and independently related to baseline BMI (0.925; 0.861–0.993), age (0.957; 0.922–0.993), TSH (0.531; 0.290–0.973) and TSH-changes (1.011; 1.000–1.022) during follow-up. Conclusions Baseline serum TSH level is related to the final outcome of a dietary intervention program in obese patients. Level of evidence III Evidence obtained from a retrospective cohort or case–control analytic studies.

Mediating Factors in Dietary Change: Understanding the Impact of a Worksite Nutrition Intervention

2000 ◽  
Vol 27 (1) ◽  
pp. 112-125 ◽  
Author(s):  
Alan R. Kristal ◽  
Karen Glanz ◽  
Barbara C. Tilley ◽  
Shuhui Li
Keyword(s):  
Stages Of Change ◽  
Intervention Program ◽  
Dietary Intervention ◽  
Dietary Change ◽  
Nutrition Intervention ◽  
Enabling Factors ◽  
Knowledge And Beliefs ◽  
Mediating Factors ◽  
The Impact

This report, based on 1,795 participants in the Next Step Trial, examines how a dietary intervention program affected mediating factors for dietary change. The model tested whether intervention increased predisposing (skills, knowledge, and beliefs) and enabling (social support and norms) factors for change and advanced participants into action and maintenance stages of change. The intervention significantly increased both predisposing factors for dietary change and the likelihood of moving into or remaining in action and maintenance stages of change. Changes in predisposing and enabling factors and stage of change at follow-up (regardless of stage at baseline) were associated with significant dietary change. Changes in mediating variables explained between 34% and 55% of the effects of the dietary intervention. These results support the value of measuring mediating factors as part of dietary intervention evaluations and suggest that interventions that target norms and eating environments in addition to skills and knowledge may further increase intervention effectiveness.

scholarly journals Impact of obesity on male urethral sling outcomes

2020 ◽  
Vol 12 ◽  
pp. 175628722092799
Author(s):  
M. Francesca Monn ◽  
Hannah V. Jarvis ◽  
Thomas A. Gardner ◽  
Matthew J. Mellon
Keyword(s):  
Operative Time ◽  
Cohort Analysis ◽  
Obese Patients ◽  
Retrospective Cohort Analysis ◽  
Surgical Complexity ◽  
History Of ◽  
Sling Placement ◽  
The Impact ◽  
Male Urethral Sling

Background: The impact of obesity on AdVance male urethral sling outcomes has been poorly evaluated. Anecdotally, male urethral sling placement can be more challenging due to body habitus in obese patients. The objective of this study was to evaluate the impact of obesity on surgical complexity using operative time as a surrogate and secondarily to evaluate the impact on postoperative pad use. Methods: A retrospective cohort analysis was performed using all men who underwent AdVance male urethral sling placement at a single institution between 2013 and 2019. Descriptive statistics comparing obese and non-obese patients were performed. Results: A total of 62 patients were identified with median (IQR) follow up of 14 (4–33) months. Of these, 40 were non-obese and 22 (35.5%) were obese. When excluding patients who underwent concurrent surgery, the mean operative times for the non-obese versus obese cohorts were 61.8 min versus 73.7 min ( p = 0.020). No Clavien 3–5 grade complications were noted. At follow up, 47.5% of the non-obese cohort and 63.6% of the obese cohort reported using one or more pads daily ( p = 0.290). Four of the five patients with a history of radiation were among the patients wearing pads following male urethral sling placement. Conclusion: Obese men undergoing AdVance male urethral sling placement required increased operative time, potentially related to operative complexity, and a higher proportion of obese compared with non-obese patients required postoperative pads for continued urinary incontinence. Further research is required to better delineate the full impact of obesity on male urethral sling outcomes.

The Impact of Cannabis in the Early Stages of Schizophrenia: A 3-Year Longitudinal Study on Cannabis Influence on Relapse Rates

2017 ◽  
Vol 41 (S1) ◽  
pp. S196-S197
Author(s):  
M. Gomez Revuelta ◽  
M. Juncal Ruiz ◽  
O. Porta Olivares ◽  
V. Gajardo Galan ◽  
G. Pardo de Santayana Jenaro ◽  
...  
Keyword(s):  
Intervention Program ◽  
Response To Treatment ◽  
Rank Test ◽  
First Episode ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Early Stages ◽  
Increased Risk ◽  
The Impact

IntroductionThe first five years after the onset of a first episode of psychosis (FEP) are crucial for long term outcome. In this period, the risk of relapse is particularly high. Consequences of relapse include an increased risk of neurotoxicity, chronicity, hospitalization, decreased response to treatment, increased economic burden and functional impairment.ObjectivesTo discern the influence of cannabis on relapse as it may contribute to adopt specific measures in patients during early stages of the illness.Material and methodsPAFIP is an early intervention program for patients with a FEP. Between January 2005 and January 2011, 163 patients were recruited for this study. They were followed-up during 3 years at intervals of three months. The sample was divided into three groups: (1) those non-cannabis users neither before the FEP nor during follow-up (nn), (2) consumers before the FEP and during follow-up (ss) and (3) consumers before the FEP that gave up consumption during follow-up (sn).ResultsNo statistically significant differences between the three groups were observed but a trend (P = 0.057) towards a more enduring survival in Group 3 (sn). (Kaplan–Meier curve and detailed Log Rank Test results will be included in the final poster).ConclusionsCannabis has a detrimental effect on schizophrenia. The interruption of its use could contribute to improve the outcome of the disease, as the results of our study suggest.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals 711 Effect of Roux-En-Y Gastric Bypass on HbA1c As Well As Number of Medications in Diabetic Patients

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
M Bhandari ◽  
M Rao ◽  
G Bussa ◽  
C Rao
Keyword(s):  
Diabetes Mellitus ◽  
Gastric Bypass ◽  
Glycosylated Haemoglobin ◽  
Morbidly Obese ◽  
Diabetic Patients ◽  
Obese Patients ◽  
The Mean ◽  
The Impact

Abstract Aim Roux en Y gastric bypass (RYGB) is known to ameliorate Type 2 Diabetes Mellitus (T2DM) in morbidly obese patients. We aimed to determine both the reduction in the glycosylated haemoglobin (HbA1c) and the number of anti-diabetic medications (including insulin) in diabetic patients undergoing RYGB over a five-year period. Method We reviewed data of diabetic patients (n = 530) who underwent RYGB from January 2012 – December 2017, including those with a minimum of a 2-year post-operative follow up (n = 47). Preoperatively, BMI, HbA1c and the number of anti-diabetic medications and the duration of T2DM since diagnosis were recorded. These measurements were repeated at the end of the two year follow up. Results At the time of enrolment in the bariatric programme, the median BMI was 42.5 (range, 31.7-61.5) kg/m2, mean duration of T2DM was 58 months and median HbA1c was 59 (37-118) mmol/mol. The mean number of anti-diabetic medications taken, including insulin, was 2. At the end of 2-year follow-up, the median BMI was 32 (range, 24-41) kg/m2 and HbA1c was 41(range, 33-91) mmol/mol. 15 patients (31.9%) still required anti-diabetic medication, 12 of whom had a diagnosis of T2DM for 3 years or more at time of enrolment. Conclusions RYGB is strongly associated with a resolution of T2DM in morbidly obese patients. In those who were not resolved, the number of anti-diabetic medications taken and HbA1c were reduced. The impact of the surgery is dependent on the duration of T2DM since diagnosis preoperatively.

The impact of obesity on perioperative and postoperative outcomes after elective endovascular abdominal aortic aneurysm repair

Vascular ◽  
2021 ◽  
pp. 170853812110633
Author(s):  
Selami Gurkan ◽  
Ozcan Gur ◽  
Ayhan Sahin ◽  
Mehmet Donbaloglu
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Endovascular Aneurysm Repair ◽  
Group Versus ◽  
Obese Group ◽  
Obese Patients ◽  
Dose Area Product ◽  
Aneurysm Repair ◽  
The Impact

Background Obesity is a common and growing health problem in vascular surgery patients, as it is in all patient groups. Evidence regarding body mass index (BMI) on endovascular aneurysm repair (EVAR) outcomes is not clear in the literature. We aimed to determine the impact of obesity on perioperative and midterm outcomes of elective EVAR between obese and non-obese patients. Methods Under a retrospective study design, a total of 120 patients (109 males, 11 females, mean age: 74.45 ± 8.59 (53–92 years)) undergoing elective EVAR between June 2012 and May 2020 were reviewed. Patients were stratified into two groups: obese (defined as a body mass index (BMI) ≥ 30 kg/m2) and non-obese (mean BMI < 30 kg/m2 (32.25 ± 1.07 kg/m2 vs 25.85 ± 2.69 kg/m2)). Results Of the 120 patients included in the study, 81 (67.5%) were defined as “nonobese,” while 39 (32.5%) were obese. The mean BMI of the study group was 27.93 ± 3.78 kg/m2. In obese patients, the procedure time, fluoroscopy time, and dose area product (DAP) values were longer than those of non-obese patients: 89.74 ± 20.54 vs 79.69 ± 28.77 min ( p = 0.035), 33.23 ± 10.14 vs 38.17 ± 8.61 min ( p = 0.01) and 133.69 ± 58.17 vs 232.56 ± 51.87 Gy.cm2 ( p < 0.001). Although there was no difference in sac shrinkage at 12-month follow-up, there was a significant decrease at 6-month follow-up in both groups ( p = 0.017). Endoleak occurred in 17.9% ( n = 7) of the obese group versus 11.1% ( n = 9) of the non-obese group ( p = 0.302). Iliac branch occlusion developed in four patients, 3 (3.7%) in the non-obese group and 1 (2.6%) in the obese group ( p = 0.608). The all-cause mortality rate was slightly higher in the obese group; however, it did not differ between the groups ( p = 0.463). Conclusion In addition to the longer procedure times, fluoroscopy times, and DAP values in obese patients, regardless of obesity, significant sac shrinkage in the first 6 months of follow-up was observed in both groups. No difference was documented with regards to mortality or morbidity following EVAR.

The impact of Cannabis in Schizophrenia: Pafip Three-year Longitudinal Study on Outcome and Functionality After a First Episode of Psychosis

2017 ◽  
Vol 41 (S1) ◽  
pp. S136-S137
Author(s):  
M. Gomez Revuelta ◽  
M. Juncal Ruiz ◽  
O. Porta Olivares ◽  
M. Fernández Rodríguez ◽  
D. Abejas Díez ◽  
...  
Keyword(s):  
Intervention Program ◽  
Age Of Onset ◽  
Cannabis Use ◽  
First Episode ◽  
Long Term Outcome ◽  
Clinical Prognosis ◽  
Increased Risk ◽  
The Impact

IntroductionThe association between cannabis and psychosis makes crucial the intervention on cannabis use disorder at first episodes of psychosis (FEP), especially among young population. In this group of patients, the harmful potential of cannabis is more evident by its influence on neurodevelopment. However, the nature of the association cannabis-psychosis is not clearly described. It seems to represent a mediating factor for an increased risk of psychosis in healthy and high-risk populations, determining an earlier age of onset and worsening long term outcome.ObjectivesTo assess the impact of cannabis in terms of functional and clinical prognosis in patients recruited after a FEP.Material and methodsPAFIP is an early intervention program for early stages of psychosis. One hundred and sixty-three were included, followed-up at regular intervals of six months for three years with administration of clinical and functional scales (BPRS, SAPS, SANS, CDRS, GAF and Drake). Patients were divided into three groups: (1) those non-users neither before the onset nor during follow-up (nn) PEP, (2) consumers before the FEP and during follow-up (ss) and (3) consumers before the FEP that gave up consumption during follow-up (sn).ResultsNo statistically significant differences were observed in terms of functionality at three-year follow-up endpoint but a trend to a better-preserved functionality in the sn group. The sn group presented lower scores in scales for positive symptoms with respect to the comparison groups.ConclusionsThe interruption in cannabis use may have a beneficial effect on short-term clinical prognosis and functionality on long term.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Low Serum Vitamin D Levels Are Associated With Inferior Survival in Follicular Lymphoma: A Prospective Evaluation in SWOG and LYSA Studies

2015 ◽  
Vol 33 (13) ◽  
pp. 1482-1490 ◽  
Author(s):  
Jennifer L. Kelly ◽  
Gilles Salles ◽  
Bryan Goldman ◽  
Richard I. Fisher ◽  
Pauline Brice ◽  
...  
Keyword(s):  
Vitamin D ◽  
Overall Survival ◽  
Follicular Lymphoma ◽  
Serum Vitamin ◽  
Baseline Serum ◽  
Serum Vitamin D ◽  
Hazard Ratios ◽  
Vitamin D Levels ◽  
The Impact

Purpose Recent literature reports a potential association between high vitamin D and improved lymphoma prognosis. We evaluated the impact of pretreatment vitamin D on follicular lymphoma (FL) outcome. Patients and Methods SWOG participants were previously untreated patients with FL enrolled onto SWOG clinical trials (S9800, S9911, or S0016) involving CHOP chemotherapy plus an anti-CD20 antibody (rituximab or iodine-131 tositumomab) between 1998 and 2008. Participants included in our second independent cohort were also previously untreated patients with FL enrolled onto the Lymphoma Study Association (LYSA) PRIMA trial of rituximab plus chemotherapy (randomly assigned to rituximab maintenance v observation) between 2004 and 2007. Using the gold-standard liquid chromatography–tandem mass spectrometry method, 25-hydroxyvitamin D was measured in stored baseline serum samples. The primary end point was progression-free survival (PFS). Results After a median follow-up of 5.4 years, the adjusted PFS and overall survival hazard ratios for the SWOG cohort were 1.97 (95% CI, 1.10 to 3.53) and 4.16 (95% CI, 1.66 to 10.44), respectively, for those who were vitamin D deficient (< 20 ng/mL; 15% of cohort). After a median follow-up of 6.6 years, the adjusted PFS and overall survival hazard ratios for the LYSA cohort were 1.50 (95% CI, 0.93 to 2.42) and 1.92 (95% CI, 0.72 to 5.13), respectively, for those who were vitamin D deficient (< 10 ng/mL; 25% of cohort). Conclusion Although statistical significance was not reached in the LYSA cohort, the consistent estimates of association between low vitamin D levels and FL outcomes in two independent cohorts suggests that serum vitamin D might be the first potentially modifiable factor to be associated with FL survival. Further investigation is needed to determine the effects of vitamin D supplementation in this clinical setting.

scholarly journals Association between pre-ablation bariatric surgery and atrial fibrillation recurrence in morbidly obese patients undergoing atrial fibrillation ablation

EP Europace ◽  
2019 ◽  
Vol 21 (10) ◽  
pp. 1476-1483 ◽  
Author(s):  
Eoin Donnellan ◽  
Oussama M Wazni ◽  
Mohamed Kanj ◽  
Bryan Baranowski ◽  
Paul Cremer ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Bariatric Surgery ◽  
Propensity Score ◽  
Multivariable Analysis ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Af Ablation ◽  
The Impact ◽  
Af Recurrence

Abstract Aims Obesity decreases arrhythmia-free survival after atrial fibrillation (AF) ablation by mechanisms that are not fully understood. We investigated the impact of pre-ablation bariatric surgery (BS) on AF recurrence after ablation. Methods and results In this retrospective observational cohort study, 239 consecutive morbidly obese patients (body mass index ≥40 kg/m2 or ≥35 kg/m2 with obesity-related complications) were followed for a mean of 22 months prior to ablation. Of these patients, 51 had BS prior to ablation, and our primary outcome was whether BS was associated with a lower rate of AF recurrence during follow-up. Adjustment for confounding was performed with multivariable Cox proportional hazard models and propensity-score based analyses. During a mean follow-up of 36 months after ablation, 10/51 patients (20%) in the BS group had recurrent AF compared with 114/188 (61%) in the non-BS group (P < 0.0001). In the BS group, 6 patients (12%) underwent repeat ablation compared with 77 patients (41%) in the non-BS group, (P < 0.0001). On multivariable analysis, the association between BS and lower AF recurrence remained significant. Similarly, after weighting and adjusting for the inverse probability of the propensity score, BS was still associated with a lower hazard of AF recurrence (hazard ratio 0.14, 95% confidence interval 0.05–0.39; P = 0.002). Conclusion Bariatric surgery is associated with a lower AF recurrence after ablation. Morbidly obese patients should be considered for BS prior to AF ablation, though prospective multicentre studies should be performed to confirm our novel finding.

scholarly journals A Brief Intervention Designed to Increase Breast Cancer Self-Screening

2009 ◽  
Vol 23 (5) ◽  
pp. 320-323 ◽  
Author(s):  
Nangel M. Lindberg ◽  
Victor J. Stevens ◽  
K. Sabina Smith ◽  
Russell E. Glasgow ◽  
Deborah J. Toobert
Keyword(s):  
Brief Intervention ◽  
Intervention Program ◽  
Dietary Intervention ◽  
Health Maintenance Organization ◽  
Cancer Control ◽  
Control Group ◽  
Individual Counseling ◽  
Health Maintenance ◽  
Self Examination

Purpose. To assess the efficacy of an intervention designed to increase appropriate use of breast self-examination (BSE). Methods. Two-armed randomized clinical trial of cancer-control interventions in women that compared a BSE intervention program to a dietary intervention, which served as the control group. The study was conducted at a large health maintenance organization in Portland, Oregon. Participants were 616 female members of the health maintenance organization who were aged 40 to 70 years. The intervention consisted of a 30- to 45-minute individual counseling session that featured BSE instruction, training and practice with silicone models, identification of barriers to BSE, and problem-solving. This intervention was followed by two brief follow-up telephone calls. The study outcome measure was self-reported BSE practice, which included duration, frequency, and specific elements of exam. Results. The study had a 90% response rate. At the 1-year follow-up, χ2 analyses showed that significantly more individuals in the BSE intervention (59%) reported adequate BSE performance compared with those in the control group (12.2%; p < .001). Conclusions. This brief intervention was successful in encouraging women to perform adequate BSEs. Although the role of the BSE in patient care remains controversial, these results show that even brief intervention programs can be effective at encouraging self-screening for cancer. This intervention could easily be modified to target other screening practices (e.g., skin or testicular cancer screening) that are associated with reduced cancer morbidity and mortality.

scholarly journals School-based intervention: evaluating the role of water, latrines and hygiene education on trachoma and intestinal parasitic infections in Ethiopia

2013 ◽  
Vol 4 (1) ◽  
pp. 120-130 ◽  
Author(s):  
Bizu Gelaye ◽  
Abera Kumie ◽  
Nigusu Aboset ◽  
Yemane Berhane ◽  
Michelle A. Williams
Keyword(s):  
Intervention Program ◽  
Parasitic Infection ◽  
Epidemiologic Study ◽  
Parasitic Infections ◽  
Post Intervention ◽  
Intestinal Parasitic Infections ◽  
Active Trachoma ◽  
Hygiene Education ◽  
The Impact

We sought to evaluate the impact of a hygiene and sanitation intervention program among school-children to control active trachoma and intestinal parasitic infections. This longitudinal epidemiologic study was conducted among 630 students in rural Ethiopia. Baseline and follow-up surveys were conducted to evaluate the impact of a three-pronged intervention program: (i) construction of ventilated improved pit latrines; (ii) provision of clean drinking water; and (iii) hygiene education. Socio-demographic information was collected using a structured questionnaire. Presence of trachoma and intestinal parasitic infections were evaluated using standard procedures. At baseline, 15% of students had active trachoma, while 6.7% of them were found to have active trachoma post-intervention (p &lt; 0.001). Similar improvements were noted for parasitic infections. At baseline, 7% of students were reported to have helminthic infections and 30.2% protozoa infections. However, only 4% of students had any helminthic infection and 13.4% (p &lt; 0.001) of them were found to have any protozoa infection during follow-up surveys. Improvements were also noted in students' knowledge and attitudes towards hygiene and sanitation. In summary, the results of our study demonstrated that provision of a comprehensive and targeted sanitation intervention program was successful in reducing the burden of trachoma and intestinal parasitic infection among schoolchildren.

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