Clinical Presentation and Outcomes of Surgery for Upper Extremity Lipomas

Background. Lipomas are benign neoplasms arising from fat tissue, with an incidence in the upper extremity of 1%-3,8%. There is scarce literature on the outcomes of the treatment of lipomas in this region. The objective of this study was to assess clinical manifestations and outcomes of surgery for upper extremity lipomas. Material and methods. The sample comprised 40 patients, including 26 women (65%) and 14 men (35%), at a mean age of 37 years, with lipomas located in the upper limbs. Treatment outcomes were assessed at a mean of 4.2 years after surgery in 27 patients from this group. Results. Most of the tumours (29 cases, 73%) were located in the forearm and arm, with 11 patients (27%) presenting with lipomas of the metacarpus and wrist. In 35 patients (87%), lesions were located superficially, within subcutaneous tissue, whereas in 5 (13%) they were located more deeply, in the metacarpus and in the forearm muscles. The follow-up assessment was conducted as telephone interviews in 27 patients. No recurrence was noted. Seven patients (26%) complained of mild tenderness of the postoperative scar. Conclusions. 1. Lipomas are moderately frequent benign lesions occurring in the upper limb. 2. Surgical treat­ment is effective and the recurrence rate is very low.

Nutrition of Pregnant and Lactating Women in the First 1000 Days of Infant

Nutrition for pregnant and breastfeeding women is fundamental to the development of the child in its first 1000 days and beyond. To evaluate the adequacy of this nutrition, we have relied on historical dietary surveys and on personal French studies (4 studies from 1997 to 2014) involving dietary surveys over 3 days (3D-Diet). Furthermore, our team specialized in lipids has measured the fatty acids of breast milk, which reflect the dietary intake of lipids, from breast milk (1997–2014) and from the lipids of cord blood and maternal fat tissue, in 1997. According to our results, pregnancy needs require an additional 300 Kcal, but surveys show a bad equilibrium of macronutrients: an excess of proteins of fetus [17% of total energy intake (TEI) vs. 15%], excess of fats (45% vs. 35%), excess of saturated fatty acids (SFA), not enough polyunsaturated fatty acids (PUFA), particularly omega 3, and a deficit in carbohydrates (45% vs. 55%). There is also a deficiency in calcium, iron, magnesium, zinc, and vitamins D, B6, B5, and folates. Breast milk adequately provides all the macronutrients necessary for the growth of the child. Proteins and carbohydrates vary little according to the mother’s diet; on the other hand, its composition in lipids, trace elements, and vitamins is highly variable with the mother’s diet of breast milk. In our study in 2014, in 80 participants, the diet was low in calories (1996 Kcal vs. 2200 Kcal RDA), normoprotidic, normolipidic, but low in carbohydrate, especially polysaccharides. We note a very insufficient intake of fish and dairy products, and therefore calcium, but also magnesium, zinc, iron, and vitamins D, E, B6, and folate. Consequently, if the mother does not achieve a diet adequate to her needs during pregnancy and breastfeeding, it will be necessary to resort to medicinal supplements in minerals, trace elements, vitamins, and omega 3.

Association of Prescription With Body Composition and Patient Outcomes in Incident Peritoneal Dialysis Patients

Objective: The nutritional status of patients on peritoneal dialysis (PD) is influenced by patient- and disease-related factors and lifestyle. This analysis evaluated the association of PD prescription with body composition and patient outcomes in the prospective incident Initiative for Patient Outcomes in Dialysis–Peritoneal Dialysis (IPOD-PD) patient cohort.Design and Methods: In this observational, international cohort study with longitudinal follow-up of 1,054 incident PD patients, the association of PD prescription with body composition was analyzed by using the linear mixed models, and the association of body composition with death and change to hemodialysis (HD) by means of a competing risk analysis combined with a spline analysis. Body composition was regularly assessed with the body composition monitor, a device applying bioimpedance spectroscopy.Results: Age, time on PD, and the use of hypertonic and polyglucose solutions were significantly associated with a decrease in lean tissue index (LTI) and an increase in fat tissue index (FTI) over time. Competing risk analysis revealed a U-shaped association of body mass index (BMI) with the subdistributional hazard ratio (HR) for risk of death. High LTI was associated with a lower subdistributional HR, whereas low LTI was associated with an increased subdistributional HR when compared with the median LTI as a reference. High FTI was associated with a higher subdistributional HR when compared with the median as a reference. Subdistributional HR for risk of change to HD was not associated with any of the body composition parameters. The use of polyglucose or hypertonic PD solutions was predictive of an increased probability of change to HD, and the use of biocompatible solutions was predictive of a decreased probability of change to HD.Conclusion: Body composition is associated with non-modifiable patient-specific and modifiable treatment-related factors. The association between lean tissue and fat tissue mass and death and change to HD in patients on PD suggests developing interventions and patient counseling to improve nutritional markers and, ultimately, patient outcomes.Study Registration: The study has been registered at Clinicaltrials.gov (NCT01285726).

LOW WEIGHT GAIN, BETTER GLYCAEMIA AND NO CENTRAL OBESITY ACHIEVED THROUGH A HIGH-PROTEIN DIET

A compendium of metabolic diseases associated with unhealthy habits plague the modern world today. Weight gain, hyperglycemia and excess adiposity are some of the metabolic diseases plaguing our modern society. Unhealthy dietary habits coupled with a sedentary lifestyle are recognized as important factors for the development of some metabolic illnesses. Cardiovascular diseases, diabetes mellitus, hypertension, and dyslipidemia were recognized as stemming from metabolic dysregulation due to the consumption of excess calories from certain macronutrients. Our objective in this study is to find out which diet most affects circulating blood glucose levels, body weight, and visceral fat tissue deposition. 35 male Sprague - Dawley rats were separated into five groups and were given five distinct diets for the duration of 8 weeks. The five diets are normal rat feed, high-fat, high-protein, high-sugar, and high-starch. The feeding provided was ad libitum with tap water given as drinking water. Every week, each rat was weighed, and blood were sampled for glucose. Post-sacrifice, mesenteric fat was harvested, fixed, and stained for histological analysis. The results revealed a high-protein diet significantly reduces body weight gain, improved blood sugar with no development of central obesity. At the same time, a high-fat diet was shown to be a promoter of mesenteric fat tissue hypertrophy. It was concluded that the consumption of a high-protein diet was found to achieve low weight gain, better glycaemia with no central obesity.

Regulation of Swine Growth by Backfat Tissue during Growing and Finishing Stages

Recently, interest in the function of pig backfat (BF) has increased in the field of livestock animals, and many transcriptome-based studies using commercial pig breeds have been conducted. However, there is a lack of comprehensive studies regarding the biological mechanisms of Korean native pigs (KNPs) and Yorkshire pig crossbreeds. In this study, therefore, BF samples of F1 crossbreeds of KNPs and Yorkshire pigs were investigated to identify differentially expressed genes (DEGs) and their related terms using RNA-sequencing analysis. DEG analysis identified 611 DEGs, of which 182 were up-regulated and 429 were down-regulated. Lipid metabolism was identified in the up-regulated genes, whereas growth and maturation-related terminologies were identified in the down-regulated genes. LEP and ACTC1 were identified as highly connected core genes during functional gene network analysis. Fat tissue was observed to affect lipid metabolism and organ development due to hormonal changes driven by transcriptional alteration. This study provides a comprehensive understanding of BF contribution to crossbreeds of KNPs and Yorkshire pigs during growth periods.

Subcutaneous Fat Thickness Remarkably Influences Contact Pressure and Load Distribution of Buttock in Seated Posture

Spinal cord injury patients are prone to develop deep tissue injury (DTI) as they may spend half their time per day in sitting postures, which produce excessive load in their buttocks. However, the impact of fat thickness on the biomechanical response of buttock in sitting posture remained unclear. This study aimed to investigate the influence of subcutaneous fat thickness on the interface pressure and load distribution of buttock of seated humans. To achieve this goal, a 3-dimensional finite element model of male buttock was constructed and the contact pressure on a rigid cushion was evaluated against experimental results. The modified models, which had various fat thicknesses under ischial tuberosity, were built and used to simulate the sitting conditions with different cushion stiffnesses. In the models simulating sitting on the rigid cushion, the peak contact pressure ranges from 0.052 MPa to 0.149 MPa. In the simulation of sitting on the soft cushion, the peak stress of muscle underneath ischial tuberosity in the model with the thickest fat tissue was slightly higher than that of the other models. The results demonstrate that the fat tissue in the buttock could reduce the contact pressure when sitting on the rigid seat. However, contact pressure solely could not be used to estimate the internal tissue stress of seated buttock, especially in subjects with thicker fat tissue.

Profibrillatory Structural and Functional Properties of the Atrial-Pulmonary Junction in the Absence of Remodeling

Background: Sole pulmonary vein (PV) isolation by ablation therapy prevents atrial fibrillation (AF) in patients with short episodes of AF and without comorbidities. Since incomplete PV isolation can be curative, we tested the hypothesis that the PV in the absence of remodeling and comorbidities contains structural and functional properties that are proarrhythmic for AF initiation by reentry.Methods: We performed percutaneous transvenous in vivo endocardial electrophysiological studies and quantitative histological analysis of PV from healthy sheep.Results: The proximal PV contained more myocytes than the distal PV and a higher percentage of collagen and fat tissue relative to myocytes than the left atrium. Local fractionated electrograms occurred in both the distal and proximal PVs, but a large local activation (>0.75 mV) was more often present in the proximal PV than in the distal PV (86 vs. 50% of electrograms, respectively, p = 0.017). Atrial arrhythmias (run of premature atrial complexes) occurred more often following the premature stimulation in the proximal PV than in the distal PV (p = 0.004). The diastolic stimulation threshold was higher in the proximal PV than in the distal PV (0.7 [0.3] vs. 0.4 [0.2] mA, (median [interquartile range]), p = 0.004). The refractory period was shorter in the proximal PV than in the distal PV (170 [50] vs. 248 [52] ms, p < 0.001). A linear relation existed between the gradient in refractoriness (distal-proximal) and atrial arrhythmia inducibility in the proximal PV.Conclusion: The structural and functional properties of the native atrial-PV junction differ from those of the distal PV. Atrial arrhythmias in the absence of arrhythmia-induced remodeling are caused by reentry in the atrial-PV junction. Ablative treatment of early paroxysmal AF, rather than complete isolation of focal arrhythmia, may be limited to inhibition of reentry.