Abdominal wall skin lesions in adult morbid obese women

Objective: To present only skin lesions in the abdominal wall that we detected in morbidly obese patients and to examine them in the light of the literature. Material and Method: Patients who applied to the general surgery outpatient clinic for bariatric surgery and who also had dermatological complaints and were referred to the dermatology outpatient clinic with the detection of skin-related complaints were retrospectively evaluated in terms of age and breast skin findings. Normal skin findings were separated into intertrigo, chronic recurrent folliculitis, eczemas, acanthosis nigricans and striae. Results: A total of 60 obese female patients were included in the study. The mean age of the patients was 32.4 ± 8.8 years (19-53), and the mean body mass index was 42.6 ± 2.4 (40-49). Normal skin findings were present in 28.3% of the patients (17 patients). The most common finding was striae, and 60% (36 patients) had it. Then respectively, intertrigo was detected in 14 patients (23%), chronic recurrent folliculitis in 12 patients (20%), eczema in 5 patients (8.3%), and acanthosis nigricans in 2 patients (3.3%). Conclusion: The most common findings on the abdominal wall skin of obese individuals are striae and intertrigo, and similar findings have been found in many studies in the literature.

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Induction of Labor versus Scheduled Cesarean in Morbidly Obese Women: A Cost-Effectiveness Analysis

American Journal of Perinatology ◽

10.1055/s-0038-1668591 ◽

2018 ◽

Vol 36 (04) ◽

pp. 399-405

Author(s):

Chad Grotegut ◽

Geeta Swamy ◽

Evan Myers ◽

Laura Havrilesky ◽

Maeve Hopkins

Keyword(s):

Cost Saving ◽

Induction Of Labor ◽

Morbidly Obese ◽

Complication Rates ◽

Obese Women ◽

Class Iii ◽

Group 13 ◽

Class Iii Obesity ◽

The Mean ◽

Mean Cost

Objective To assess the costs, complication rates, and harm-benefit tradeoffs of induction of labor (IOL) compared to scheduled cesarean delivery (CD) in women with class III obesity. Study Design We conducted a cost analysis of IOL versus scheduled CD in nulliparous morbidly obese women. Primary outcomes were surgical site infection (SSI), chorioamnionitis, venous thromboembolism, blood transfusion, and readmission. Model outcomes were mean cost of each strategy, cost per complication avoided, and complication tradeoffs. We assessed the costs, complication rates, and harm-benefit tradeoffs of IOL compared with scheduled CD in women with class III obesity. Results A total of 110 patients underwent scheduled CD and 114 underwent IOL, of whom 61 (54%) delivered via cesarean. The group delivering vaginally experienced fewer complications. SSI occurred in 0% in the vaginal delivery group, 13% following scheduled cesarean, and 16% following induction then cesarean. In the decision model, the mean cost of induction was $13,349 compared with $14,575 for scheduled CD. Scheduled CD costs $9,699 per case of chorioamnionitis avoided, resulted in 18 cases of chorioamnionitis avoided per additional SSI and 3 cases of chorioamnionitis avoided per additional hospital readmission. In sensitivity analysis, IOL is cost saving compared with scheduled CD unless the cesarean rate following induction exceeds 70%. Conclusion In morbidly obese women, induction of labor remains cost-saving until the rate of cesarean following induction exceeds 70%.

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Personality of a Group of Grossly Obese Women

Australian & New Zealand Journal of Psychiatry ◽

10.3109/00048677809159096 ◽

1978 ◽

Vol 12 (4) ◽

pp. 297-299 ◽

Cited By ~ 5

Author(s):

Harry Perelberg ◽

Sandra E. Neil ◽

Daniel Kahans ◽

Mathew G. Soccio ◽

Robert A. Costa

Keyword(s):

General Practice ◽

Personality Factors ◽

Current View ◽

Morbidly Obese ◽

Obese Women ◽

Female Patients ◽

Obese Female ◽

Personality Pattern ◽

Neuroticism Scale

The current view that the morbidly obese do not show a unique personality pattern is challenged. A sample of 91 obese female patients at a general practice are identified as having a significant personality pattern using the Sixteen Personality Factors Questionnaire (16 PF) and the Neuroticism Scale Questionnaire (N.S.Q.). Further the personality factors are consistent with a model that explains aspects of morbid exogenous obesity.

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Faculty Opinions recommendation of Minimally Invasive Surgery in Morbidly Obese Women.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.737043468.793570312 ◽

2020 ◽

Author(s):

Eva Chalas

Keyword(s):

Minimally Invasive Surgery ◽

Minimally Invasive ◽

Invasive Surgery ◽

Morbidly Obese ◽

Obese Women

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A new customised placental weight standard redefines the relationship between maternal obesity and extremes of placental size and is more closely associated with pregnancy complications than an existing population standard

Journal of Developmental Origins of Health and Disease ◽

10.1017/s2040174419000576 ◽

2019 ◽

Vol 11 (4) ◽

pp. 350-359

Author(s):

Jacqueline M. Wallace ◽

Joeleita P. Agard ◽

Graham W. Horgan

Keyword(s):

Pregnancy Complications ◽

Maternal Obesity ◽

Population Based ◽

Multiple Regression Model ◽

Placental Weight ◽

Morbidly Obese ◽

Obese Women ◽

Entire Cohort ◽

Multiparous Women ◽

The Difference

AbstractPlacental weight is a valuable indicator of its function, predicting both pregnancy outcome and lifelong health. Population-based centile charts of weight-for-gestational-age and parity are useful for identifying extremes of placental weight but fail to consider maternal size. To address this deficit, a multiple regression model was fitted to derive coefficients for predicting normal placental weight using records from healthy pregnancies of nulliparous/multiparous women of differing height and weight (n = 107,170 deliveries, 37–43 weeks gestation). The difference between actual and predicted placental weight generated a z-score/individual centile for the entire cohort including women with pregnancy complications (n = 121,591). The association between maternal BMI and placental weight extremes defined by the new customised versus population-based standard was investigated by logistic regression, as was the association between low placental weight and pregnancy complications. Underweight women had a greater risk of low placental weight [<10thcentile, OR 1.84 (95% CI 1.66, 2.05)] and obese women had a greater risk of high placental weight [>90th centile, OR 1.98 (95% CI 1.88, 2.10)] using a population standard. After customisation, the risk of high placental weight in obese/morbidly obese women was attenuated [OR 1.17 (95% CI 1.09, 1.25)]/no longer significant, while their risk of low placental weight was 59%–129% higher (P < 0.001). The customised placental weight standard was more closely associated with stillbirth, hypertensive disease, placental abruption and neonatal death than the population standard. Our customised placental weight standard reveals higher risk of relative placental growth restriction leading to lower than expected birthweights in obese women, and a stronger association between low placental weight and pregnancy complications generally. Further, it provides an alternative tool for defining placental weight extremes with implications for the placental programming of chronic disease.

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Inhibition of Hippo Signaling Improves Skin Lesions in a Rosacea-Like Mouse Model

International Journal of Molecular Sciences ◽

10.3390/ijms22020931 ◽

2021 ◽

Vol 22 (2) ◽

pp. 931

Author(s):

Jihyun Lee ◽

Yujin Jung ◽

Seo won Jeong ◽

Ga Hee Jeong ◽

Gue Tae Moon ◽

...

Keyword(s):

Mouse Model ◽

Signaling Pathway ◽

Normal Skin ◽

Skin Lesions ◽

Hippo Signaling ◽

Vascular Endothelial ◽

Expression Levels ◽

Hippo Signaling Pathway ◽

Endothelial Growth Factor

The Hippo signaling pathway plays a key role in regulating organ size and tissue homeostasis. Hippo and two of its main effectors, yes-associated protein (YAP) and WWTR1 (WW domain-containing transcription regulator 1, commonly listed as TAZ), play critical roles in angiogenesis. This study investigated the role of the Hippo signaling pathway in the pathogenesis of rosacea. We performed immunohistochemical analyses to compare the expression levels of YAP and TAZ between rosacea skin and normal skin in humans. Furthermore, we used a rosacea-like BALB/c mouse model induced by LL-37 injections to determine the roles of YAP and TAZ in rosacea in vivo. We found that the expression levels of YAP and TAZ were upregulated in patients with rosacea. In the rosacea-like mouse model, we observed that the clinical features of rosacea, including telangiectasia and erythema, improved after the injection of a YAP/TAZ inhibitor. Additionally, treatment with a YAP/TAZ inhibitor reduced the expression levels of YAP and TAZ and diminished vascular endothelial growth factor (VEGF) immunoreactivity in the rosacea-like mouse model. Our findings suggest that YAP/TAZ inhibitors can attenuate angiogenesis associated with the pathogenesis of rosacea and that both YAP and TAZ are potential therapeutic targets for patients with rosacea.

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Breast Reconstruction Completion in the Obese: Does Reconstruction Technique Make a Difference in Its Achievement?

Journal of Reconstructive Microsurgery ◽

10.1055/s-0041-1726031 ◽

2021 ◽

Author(s):

Christine Velazquez ◽

Robert C. Siska ◽

Ivo A. Pestana

Keyword(s):

Breast Reconstruction ◽

Perioperative Complications ◽

Major Complication ◽

Normal Body Mass Index ◽

Reconstruction Technique ◽

Autologous Reconstruction ◽

Obese Women ◽

Areolar Complex ◽

Obese Female ◽

Increased Risk

Abstract Background Breast mound and nipple creation are the goals of the reconstructive process. Unlike in normal body mass index (BMI) women, breast reconstruction in the obese is associated with increased risk of perioperative complications. Our aim was to determine if reconstruction technique and the incidence of perioperative complications affect the achievement of reconstruction completion in the obese female. Methods Consecutive obese women (BMI ≥30) who underwent mastectomy and implant or autologous reconstruction were evaluated for the completion of breast reconstruction. Results Two hundred twenty-five women with 352 reconstructions were included. Seventy-four women underwent 111 autologous reconstructions and 151 women underwent 241 implant-based reconstructions. Chemotherapy, radiation, and delayed reconstruction timing was more common in the autologous patients. Major perioperative complications (requiring hospital readmission or unplanned surgery) occurred more frequently in the implant group (p ≤ 0.0001). Breast mounds were completed in >98% of autologous cases compared with 76% of implant cases (p ≤ 0.001). Nipple areolar complex (NAC) creation was completed in 57% of autologous patients and 33% of implant patients (p = 0.0009). The rate of successfully completing the breast mound and the NAC was higher in the autologous patient group (Mound odds ratio or OR 3.32, 95% confidence interval or CI 1.36–5.28 and NAC OR 2.7, 95% CI 1.50–4.69). Conclusion Occurrence of a major complication in the implant group decreased the rate of reconstruction completion. Obese women who undergo autologous breast reconstruction are more likely to achieve breast reconstruction completion when compared with obese women who undergo implant-based breast reconstruction.

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Handling Associated with Drenching Does Not Impact Survival and General Health of Low Birth Weight Piglets

Animals ◽

10.3390/ani11020404 ◽

2021 ◽

Vol 11 (2) ◽

pp. 404

Author(s):

Kevin Van Tichelen ◽

Sara Prims ◽

Miriam Ayuso ◽

Céline Van Kerschaver ◽

Mario Vandaele ◽

...

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Significant Risk ◽

Skin Lesions ◽

Additional Stress ◽

Bioactive Substances ◽

Blood Samples ◽

Panel Test ◽

Esterified Fatty Acids ◽

The Mean

The increase in litter sizes in recent years has resulted in more low birth weight (LBW) piglets, accompanied by a higher mortality. A potential intervention to overcome this is drenching bioactive substances. However, if the act of drenching provokes additional stress in LBW piglets, it might counteract the supplement’s effect and be detrimental for the piglet’s survival. To study the effect of the drenching act, piglets from 67 sows were weighed within 4 h after birth. The mean litter birth weight (MLBW) and standard deviation (SD) were calculated. LBW piglets (n = 76) were defined as weighing between (MLBW-1*SD) and (MLBW-2.5*SD). They were randomly allocated to two treatments: “sham” (conducting the act of drenching by inserting an empty 2.5 mL syringe in the mouth during 20 s, once a day, d1 till d7; n = 37) or “no treatment” (no handling; n = 39). On day 1, 3, 9, 24 and 38, piglets were weighed and scored for skin lesions. Blood samples were collected on day 9 and 38 and analyzed to determine glucose, non-esterified fatty acids (NEFA), urea, immunoglobulin G (IgG), insulin-like growth factor 1 (IGF-1) and a standard blood panel test. There was no difference between sham drenched and untreated piglets regarding any of the parameters. In conclusion, this study showed that drenching does not impose a significant risk to LBW piglets and can be applied safely during the first 7 days after birth.

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