scholarly journals The BAriatic surgery SUbstitution and nutrition (BASUN) population: a data-driven exploration of predictors for obesity

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Gudrún Höskuldsdóttir ◽  
My Engström ◽  
Araz Rawshani ◽  
Ville Wallenius ◽  
Frida Lenér ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Surgical Treatment ◽  
Psychological Health ◽  
Predictive Value ◽  
Demographic Data ◽  
Gastrointestinal Symptoms ◽  
Obesity Treatment ◽  
Relative Importance ◽  
Lifestyle Habits ◽  
Clinical Criteria

Abstract Background The development of obesity is most likely due to a combination of biological and environmental factors some of which might still be unidentified. We used a machine learning technique to examine the relative importance of more than 100 clinical variables as predictors for BMI. Methods BASUN is a prospective non-randomized cohort study of 971 individuals that received medical or surgical treatment (treatment choice was based on patient’s preferences and clinical criteria, not randomization) for obesity in the Västra Götaland county in Sweden between 2015 and 2017 with planned follow-up for 10 years. This study includes demographic data, BMI, blood tests, and questionnaires before obesity treatment that cover three main areas: gastrointestinal symptoms and eating habits, physical activity and quality of life, and psychological health. We used random forest, with conditional variable importance, to study the relative importance of roughly 100 predictors of BMI, covering 15 domains. We quantified the predictive value of each individual predictor, as well as each domain. Results The participants received medical (n = 382) or surgical treatment for obesity (Roux-en-Y gastric bypass, n = 388; sleeve gastrectomy, n = 201). There were minor differences between these groups before treatment with regard to anthropometrics, laboratory measures and results from questionnaires. The 10 individual variables with the strongest predictive value, in order of decreasing strength, were country of birth, marital status, sex, calcium levels, age, levels of TSH and HbA1c, AUDIT score, BE tendencies according to QEWPR, and TG levels. The strongest domains predicting BMI were: Socioeconomic status, Demographics, Biomarkers (notably TSH), Lifestyle/habits, Biomarkers for cardiovascular disease and diabetes, and Potential anxiety and depression. Conclusions Lifestyle, habits, age, sex and socioeconomic status are some of the strongest predictors for BMI levels. Potential anxiety and / or depression and other characteristics captured using questionnaires have strong predictive value. These results confirm previously suggested associations and advocate prospective studies to examine the value of better characterization of patients eligible for obesity treatment, and consequently to evaluate the treatment effects in groups of patients. Trial registration March 03, 2015; NCT03152617.

scholarly journals Measuring appropriate need for unicompartmental knee arthroplasty: results of the MANUKA study

2021 ◽  
Author(s):  
Antonio Klasan ◽  
Matthias Luger ◽  
Rainer Hochgatterer ◽  
Simon W. Young
Keyword(s):  
Surgical Treatment ◽  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Demographic Data ◽  
Treatment Decision ◽  
Level Of Evidence ◽  
Radiological Criteria ◽  
Clinical Criteria ◽  
Knee Oa ◽  
Unicompartmental Knee

Abstract Purpose Indications for unicompartmental knee arthroplasty (UKA) are controversial. Studies based solely on radiographic criteria suggest up to 49% of patients with knee osteoarthritis (OA) are suitable for UKA. In contrast, the ‘Appropriate use criteria’ (AUC), developed by the AAOS, apply clinical and radiographic criteria to guide surgical treatment of knee OA. The aim of this study was to analyze patient suitability for TKA, UKA and osteotomy using both radiographic criteria and AUC in a cohort of 300 consecutive knee OA patients. Methods Included were consecutive patients with clinical and radiographic signs of knee OA referred to a specialist clinic. Collected were demographic data, radiographic wear patterns and clinical findings that were analyzed using the AUC. A comparison of the radiographic wear patterns with the treatment suggested by the AUC as well as the Surgeon Treatment Decision was performed. Results There were 397 knees in 300 patients available for analysis. Median age was 68 [IQR 15], BMI 30 [6] with 55% females. Excellent consistency for both the radiographic criteria and the AUC criteria was found. Based on radiological criteria, 41% of knees were suitable for UKA. However, when using the AUC criteria, UKA was the appropriate treatment in only 13.3% of knees. In 19.1% of knees, no surgical treatment was appropriate at the visit, based on the collected data. Conclusion Application of isolated radiologic criteria in patients with knee OA results in a UKA candidacy is misleadingly high. AUC that are based on both radiological and clinical criteria suggest UKA is appropriate in less than 15% of patients. Level of evidence III retrospective study.

scholarly journals Mediterranean Diet and Lifestyle Habits during Pregnancy: Is There an Association with Small for Gestational Age Infants? An Italian Single Centre Experience

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1941
Author(s):  
Rachele De Giuseppe ◽  
Manuela Bocchi ◽  
Silvia Maffoni ◽  
Elsa Del Bo ◽  
Federica Manzoni ◽  
...  
Keyword(s):  
Gestational Diabetes ◽  
Mediterranean Diet ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Small Sample Size ◽  
Demographic Data ◽  
Small Sample ◽  
Activity Level ◽  
Lifestyle Habits ◽  
Increased Risk

Background. The small-for-gestational-age (SGA) in infants is related to an increased risk of developing Non-Communicable Diseases later in life. The Mediterranean diet (MD) is related to lower odds of being SGA. The study explored retrospectively the association between SGA, maternal MD adherence, lifestyle habits and other SGA risk factors during pregnancy. Methods. One hundred women (16–44 years) with a pregnancy at term were enrolled. Demographic data, parity, pre-gestational BMI, gestational weight gain, pregnancy-related diseases, and type of delivery were collected. The MD adherence (MEDI-LITE score ≥ 9), physical activity level, and smoking/alcohol consumption were registered. SGA neonates were diagnosed according to the neonatal growth curves. Results. Women were divided into “SGA group” vs. “non-SGA group”. The MD was adopted by 71% of women and its adherence was higher in the “non-SGA group” (p = 0.02). The prevalence of pregnancy-related diseases (gestational diabetes/pregnancy-induced hypertension) was higher in the “SGA group” (p = 0.01). The logistic regression showed that pregnancy-related diseases were the only independent risk factor for SGA. Conclusions. MD may indirectly reduce the risk of SGA since it prevents and exerts a positive effect on pregnancy-related diseases (e.g., gestational diabetes and hypertension). The small sample size of women in the SGA group of the study imposes a major limitation to the results and conclusions of this research, suggesting however that it is worthy of further investigation.

scholarly journals The Positive Predictive Value of Diagnostic Ultrasound for Occult Herniae

2006 ◽  
Vol 88 (2) ◽  
pp. 165-167 ◽  
Author(s):  
M Bradley ◽  
J Morgan ◽  
B Pentlow ◽  
A Roe
Keyword(s):  
Positive Predictive Value ◽  
Predictive Value ◽  
Diagnostic Tests ◽  
Diagnostic Ultrasound ◽  
Pain Clinic ◽  
Diagnostic Problem ◽  
Clinical Criteria ◽  
Negative Results ◽  
Positive Results

INTRODUCTION The aim of this study is to ascertain the accuracy of diagnostic ultrasound in the assessment of the occult abdominal and groin herniae. The authors have previously demonstrated its efficacy in diagnosing the type of clinical groin herniae but occult herniae provide a further diagnostic problem. PATIENTS AND METHODS A total of 113 consecutive patients were referred prospectively for ultrasound examinations with clinically suspected occult herniae. All positive scans were offered surgery whilst the negative results were offered further imaging or other diagnostic tests depending on the clinical criteria. The end point for negative scans was based on 18-month follow-up or resolution of symptoms. RESULTS Overall, 59 scans showed positive results for herniae and 56 of these had surgery. In the other three patients, two refused an operation, and one had no hernia detected at operation. In the remaining 57 scans, ultrasound offered alternative soft tissue diagnoses in 23 patients and surgical/endoscopic diagnoses accounted for a further 8 patients. CONCLUSIONS Ultrasound offered a diagnosis for the symptomology in 82 patients (70.6%) of which 59 were herniae. The positive predictive value for hernia is 98.3%. Twenty-six patients with no diagnosis or confirmation of herniae on follow-up showed symptom resolution in 22 cases, and four patients were treated by the pain clinic.

scholarly journals Charlson Comorbidity Index Predicts 5-Year Survivorship of Surgically Treated Hip Fracture Patients

2018 ◽  
Vol 9 ◽  
pp. 215145931880644 ◽  
Author(s):  
Lei Jiang ◽  
Andrew Chia Chen Chou ◽  
Nivedita Nadkarni ◽  
Caris En Qi Ng ◽  
Yun San Chong ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Hip Fracture ◽  
Charlson Comorbidity Index ◽  
Demographic Data ◽  
Survival Rates ◽  
Predictive Ability ◽  
Fracture Pattern ◽  
Mortality Data ◽  
Comorbidity Index

Introduction: This study aims to assess the correlation of the age-adjusted Charlson comorbidity index (ACCI) with 5-year mortality in a surgically treated hip fracture population. Materials and Methods: A retrospective analysis was performed on 1057 patients aged 60 years and above who underwent surgery for hip fracture with a minimum of 5-year follow-up (92.2% 5-year follow-up rate) in a tertiary hospital. Manual review of patients’ electronic hospital records was performed to record demographic data, comorbidities, and length of stay. Mortality data were extracted from the hospital’s electronic medical records and corroborated with the National Electronic Health Record. Results: Of the 1057 patients, 283 (26.8%) were male. The majority of patients were 80 years of age and above (42.5%), with the oldest patient operated on age 102 with a mean age of 77.8 (8.6) years. Four hundred eighteen (39.5%) patients sustained extracapsular intertrochanteric fractures. The mean follow-up duration was 8 years and 3 days with an overall survivorship of 37.2%. A multiple regression model constructed with ACCI, age, gender, and fracture pattern demonstrated satisfactory predictive ability with a concordance statistic of 0.68. Patients with a higher ACCI category (≥6) had an increased 5-year mortality rate (41.8%) with an odds ratio of 13.6 (6.7-31.8, P < .001) compared to those with an ACCI category of 3 and below (89.3%). Discussion: The study demonstrates that ACCI correlated with 5-year mortality after surgical treatment of hip fracture. This information is pertinent in the counseling of patients with regard to their midterm survival following hip fracture surgery and may inform policy makers of the varied midterm survival rates in patients with differing ACCI scores and educate the allocation of health-care resources. Conclusion: The ACCI correlates with 5-year mortality after surgical treatment of hip fracture.

scholarly journals Effectiveness of mebeverine in patients with post-cholecystectomy gastrointestinal spasm: results of prospective observational program “odyssey”

2018 ◽  
Vol 90 (8) ◽  
pp. 40-47 ◽  
Author(s):  
I V Maev ◽  
Yu A Kucheravy ◽  
V V Tsukanov ◽  
E Yu Eremnia ◽  
D N Andreev ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Abdominal Pain ◽  
Surgical Treatment ◽  
Rating Scale ◽  
Clinical Symptoms ◽  
Gastrointestinal Symptoms ◽  
Marked Change ◽  
Numeric Rating Scale ◽  
Observational Assessment

Aim: to assess the effectiveness of mebeverine 200 mg BID in patients with post-cholecystectomy gastrointestinal spasm not requiring surgical treatment. Materials and methods. 218 patients were included in 16 clinical centers in 14 cities in Russia. All patients had post-cholecystectomy gastrointestinal spasms, not requiring surgical treatment and received mebeverine (Duspatalin®) 200 mg BID. The observational assessment period lasted from the moment of their inclusion into the study up to 6 weeks post inlusion. The therapy results were evaluated using visual analog scales (GPA and 11-point numeric rating scale) by patient self-assessment of the dynamics of spasm/discomfort and other post-cholecystectomic gastrointestinal symptoms after 2 and 6 weeks of treatment. Gastrointestinal Quality of Life Index (GIQLI) was used to assess patient quality of life. Results and discussion. All 218 patients completed the 2-week mebeverine treatment course, 101 of them finished the 6-week course (“prolonged population”). Significant positive changes in the relief of abdominal pain and dyspepsia were noted as well as normalization of stool frequency and consistency. A more marked change in values was observed during prolonged (up to 6 weeks) therapy. Both 2-week and 6-week mebeverine courses led to a normalization of patient quality of life. After 6 week therapy, an effect of mebeverine on the quality of life 91% of patients was observed comparable to cholecystectomy itself, speficially related to the quality of life subscore ‘symptoms’. Conclusion. The results of our study demonstrate that mebeverine (Duspatalin®) therapy leads to an effective elimination of clinical symptoms associated with post-cholecystectomy GI-spasm disorders, like abdominal pain, symptoms of dyspepsia and stooldisorders. A more marked change in values was observed during prolonged (up to 6 weeks) therapy.

scholarly journals Depression, Anxiety and Stress among Dental Undergraduate Students: Prevalence, Stressors and Relieving Factors

2018 ◽  
Vol 17 (2) ◽  
Author(s):  
Munirah Yaacob ◽  
Nor Asilah Harun ◽  
Farizah Ramli ◽  
Hannah Abdul Razak ◽  
Noor Aisyah Sajuni
Keyword(s):  
Undergraduate Students ◽  
Psychological Health ◽  
Demographic Data ◽  
Binary Logistic Regression ◽  
Cross Sectional Study ◽  
Dental Students ◽  
Dental Student ◽  
Cross Sectional ◽  
Stress Symptoms ◽  
Stress Relieving

Aim: To investigate the depression, anxiety and stress, stressors and relieving factors among dental students at Kulliyyah of Dentistry (KOD). Materials and methods:  A cross-sectional study was conducted among 222 dental students. Their socio-demographic data, self-reported depression, anxiety and stress (DASS-21) scores, causes and relieving factors were collected using validated semi-structured pre-tested questionnaires. The data was analysed using percentages, chi-square test and Binary logistic regression tests with SPSS version 24. Results: The prevalence of depression, anxiety and stress was 41%, 68.9% and 34.2% respectively. Cross analysis showed that academic-related and laboratory or clinical related reasons were significantly associated with the depressive symptoms [(X2= 15.86, p<0.0001) and (X2= 10.45, p=0.001) respectively] and stress symptoms [(X2= 19.95, p<0.0001) and (X2= 6.11, p<0.05) respectively] among dental student. Furthermore, the item ‘examination’ being the highest factor chosen in academic-related stressors. The response for stress-relieving factors was high for Islamic ritual prayer/spiritual activities (94.6%), sleeping (86.5%) and doing exercise/playing sports (76.1%), while ‘seeking professional help’ (19.8%) was the least. Conclusion: This study shows that depressive, anxiety and stress symptoms are prevalent among dental students. Islamic ritual prayer and involvement in spiritual related activities was found to be the most preferred way for students to relief stress. Hence, it is vital that the university continually evaluates the psychological health of the students, tailor preventive measures and spiritual related programs to help students to cope with stress.

scholarly journals Predictive Validity of the Bayley-III Cognitive Scores at 6 Months for Cognitive Outcomes at 24 Months in Very-Low-Birth-Weight Infants

2021 ◽  
Vol 9 ◽  
Author(s):  
Tzu-Yu Liu ◽  
Jui-Hsing Chang ◽  
Chun-Chih Peng ◽  
Chyong-Hsin Hsu ◽  
Wai-Tim Jim ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Birth Weight ◽  
Cognitive Function ◽  
Low Birth Weight ◽  
Predictive Validity ◽  
Predictive Value ◽  
Very Low Birth Weight ◽  
Muscle Tone ◽  
Cognitive Outcomes ◽  
Cognitive Score

Purpose: To assess the predictive validity of the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III) cognitive scores at 6 months of corrected age (CA) for cognitive outcomes at 24 months of CA in very-low-birth-weight (VLBW) infants and investigate the predictors of change in cognitive outcomes.Methods: We retrospectively evaluated VLBW children enrolled in the Taiwan Premature Infant Follow-up Network between 2010 and 2015 and completed the Bayley-III at CA of 6 and 24 months. The predictive validity of the cognitive performance at 6-month CA for the cognitive outcomes at 24-month CA was analyzed. The positive and negative predictive factors were also evaluated using logistic regression. Cut-off scores of &lt;70 and &lt;85 were used to identify lower functioning groups based on the Bayley-III definition.Results: A total of 2,972 VLBW children, born with a mean weight of 1116.4 ± 257.5 g and mean gestational age of 29.0 ± 2.8 weeks, were evaluated. A cognitive score of &lt;70 at 6-month CA had a positive predictive value (PPV) of 27.4% (95% confidence interval [CI]: 19.2–35.7%) for a cognitive score of &lt;70 at 24-month CA, while the negative predictive value (NPV) was 97.3% (95% CI: 96.7–97.9%). A cut-off score of 85 had a PPV of 33.6% (95% CI: 28.1–39.0%) and an NPV of 87.7% (95% CI: 86.4–88.9%). Abnormal muscle tone at 6 months was a risk factor for cognitive function decline at 24 months for both Bayley-III cognitive cut-off scores: scores of 70 (adjusted odds ratio [AOR]: 2.8; 95% CI: 1.5–5.5) and 85 (AOR: 2.6; 95% CI: 1.6–4.1). Lower maternal socioeconomic status was associated with a worsening of the cognitive function in infants at 24 months who scored ≥85 at 6 months (AOR: 1.6; 95% CI: 1.2–2.0).Conclusion: Subnormal Bayley-III cognitive scores at 6-month CA were not predictive of subnormal cognitive function at 24-month CA. In children with normal cognition during early infancy, abnormal muscle tone and lower maternal socioeconomic status may influence the cognitive developing process; this highlighted the importance of early identification of high risk infants and complete preterm infant-associated public health policies to promote an improved neurodevelopmental outcome.

scholarly journals IMPACT OF THE COVID-19 PANDEMIC ON PSYCHOLOGICAL HEALTH STATUS DURING LOCKDOWN PERIOD: A CROSS-SECTIONAL STUDY

2021 ◽  
Vol 20 (2) ◽  
pp. 217-223
Author(s):  
Sonu Punia ◽  
◽  
Mohini Mohini ◽  
Shailja Sharma ◽  
Varun Singh ◽  
...  
Keyword(s):  
Health Status ◽  
Rural Community ◽  
Psychological Health ◽  
Online Survey ◽  
Demographic Data ◽  
Psychosocial Health ◽  
Cross Sectional Study ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Prevention Measure

Objective. The aim of this research was access the effect of lockdown on the psychological health status of people. Methods. This was an online questionnaire survey developed and circulated among people using snow-ball sampling techniques from April to mid of June 2020. The online survey collected information on demographic data and psychosocial health elements. Results. This study included 604 peoples (59.1% were female and 40.8% were females) of Haryana. Of the total respondents, 57.6% were in age group of 18-30 years, 40.8% were in 31-45 years and 1.5% was in 45-60 years group. 90% of people have normal self- reported BMI, 6.5% were overweight, 3% were underweight and 0.5% people have obesity. 74% respondents were graduate, 11.5% postgraduate, 3.2% were PhD, and 9.2% were 12th pass. 31.8% were unemployed, 35.9% were student, 15.8% regular government employee, 4.7% were self- employed and 2.5% were adhoc/contract employee. 79.5% people reside in urban community and 16% in rural community and 4.5% in semi-urban area. Most of the respondents have agree with the statement that lockdown induced constant sense of insecurity (72.9%); anxiety (58.7%),psychological stress (66.4%); work & financial stress (52.4%), phobia of infection (50.9%); stigma towards symptomatic people, which might be because of simple flu (55.2%); stress from watching & listening COVID-19 news (38.6%); stress from practice of prevention measure (31.9%). Most of people also agree with that behavior-change modification (follow preventive regulations) can improve mental stress (53.2%). Conclusion. Majority of people has realized the lockdown have significant impact on psychological health status of people.

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