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1.
Rev Lat Am Enfermagem ; 27: e3177, 2019.
Artículo en Portugués, Inglés, Español | MEDLINE | ID: mdl-31596412

RESUMEN

OBJECTIVE: analyze associations between demographic, academic, health, stress, overweight and obesity characteristics among nursing students. METHOD: this is a cross-sectional study with 95 students from a private university in Rio Grande do Sul, Brazil. A demographic, academic and health characterization questionnaire and the Assessment of Stress in Nursing Students (ASNS) scale were applied. Anthropometric measures were taken and descriptive and bivariate analyses were performed. RESULTS: female students predominated in this study, mean age: 25.6±5.87 years. Weight gain was observed in 52.6% of the students, with the 'Professional training' session reporting high (29.5%) and very high (36.8%) levels of stress. None of the stress scale sessions was associated with overweight and obesity. CONCLUSION: overweight and obesity were associated with male participants, high blood pressure, weight gain since the beginning of the course, altered waist circumference, no physical activity, eating more in stressful situations, and consumption of unhealthy foods.


Asunto(s)
Sobrepeso/psicología , Estrés Psicológico/epidemiología , Estudiantes de Enfermería/psicología , Adulto , Presión Sanguínea/fisiología , Índice de Masa Corporal , Brasil/epidemiología , Estudios Transversales , Femenino , Humanos , Estilo de Vida , Masculino , Persona de Mediana Edad , Obesidad/epidemiología , Obesidad/prevención & control , Obesidad/psicología , Sobrepeso/prevención & control , Circunferencia de la Cintura
2.
Zhonghua Wei Chang Wai Ke Za Zhi ; 22(10): 966-971, 2019 Oct 25.
Artículo en Chino | MEDLINE | ID: mdl-31630495

RESUMEN

Objective: To analyze the clinicopathological features of type 2 diabetes mellitus complicated with colorectal cancer (DCRC). Methods: A case-control study was conducted. Inclusion criteria: (1) hospitalized patients receiving fibrocolonoscopy; (2) adenocarcinoma and mucinous adenocarcinoma diagnosed by pathology; (3) with preoperative cTNM clinical staging; (4) colorectal cancer patients undergoing surgical treatment; (5) with postoperative pTNM staging; (6) no smoking or drinking habits. Exclusion criteria: (1) familial adenomatous polyposis (FAP); (2) Lynch syndrome; (3) carcinoma of anal canal and perianal carcinoma; (4) multiple primary cancer; (5) with serious cardiocerebrovascular diseases or multiple organ failure. Clinicopathlogical data of 32 DCRC patients who were diagnosed and treated in Peking University Shougang Hospital from December 2017 to December 2018 were retrospectively collected and analyzed. Forty nondiabetic colorectal cancer (CRC) patients during the same period were selected as control group according to the sex ratio and the age difference less than 5 years. Student's t test and χ(2) test were used to compare the difference between the two groups in baseline clinicopathological data, clinical test results, tumor markers and infiltration status of T cells in tumor immune microenvironment. Results: Among 32 DCRC patients, 24 were males and 8 were females with a mean age of (63.0±1.7) years; among 40 CRC patients, 30 were males and 10 were females with a mean age of (60.5±1.6) years. The duration of diabetes mellitus in DCRC patients (from the diagnosis of diabetes mellitus to the diagnosis of colorectal cancer) was (9.2±1.3) years. The body mass index (BMI) of DCRC group was significantly higher than that of CRC group [(24.8±0.6) kg/m(2) vs. (23.2±0.4) kg/m(2), t=2.372, P=0.020]. There were no significant differences in other baseline data (sex, age, primary site of tumor, R0 resection rate, pathological stage, pathological type, differentiation degree of tumor, preoperative intestinal obstruction) between the two groups (all P>0.05). Serum triglyceride level in DCRC group was higher than that in CRC group [(2.1±0.2) mmol/L vs. (1.5±0.1) mmol/L, t=3.085, P=0.003], while hemoglobin [(120.3±5.2) g/L vs. (132.7±2.8) g/L, t=-2.224, P=0.029], anti- thrombin III [(94.2±3.7)% vs. (103.5±2.4)%, t=-2.197, P=0.031], and red blood cell count [(4.2±0.1)×10(12)/L vs. (4.5±0.1)×10(12)L, t=-2.055, P=0.044] were all lower than those in CRC group. The preoperative carcinoembryonic antigen (CEA) level in DCRC group was higher than that in CRC group [(50.3±21.8) µg/L vs. (5.6±1.0) µg/L, t=2.339, P=0.022]. There were no significant differences in preoperative levels of other four tumor molecular markers (CA199, CA242, CA724 and CA125) between the two groups (all P>0.05). The expression of Foxp3 [specific markers of CD4+, CD25+ regulatory T cells (Treg)] in DCRC group was higher than that in CRC group [(82.7±6.2) cell/HPF vs. (62.6±4.9) cell/HPF, t=2.586, P=0.012]. There were no significant differences in the infiltration of CD4, CD8, PD-1 and PD-L1 positive cells between two groups (all P>0.05). Conclusions: The average diabetic history of DCRC patients is nearly 10 years. They have higher BMI and serum CEA level, and more Treg cell infiltration in the tumor. Close attention should be paid to these patients in clinical practice.


Asunto(s)
Neoplasias Colorrectales/cirugía , Diabetes Mellitus Tipo 2/diagnóstico , Adenocarcinoma/sangre , Adenocarcinoma/complicaciones , Adenocarcinoma/diagnóstico , Adenocarcinoma/cirugía , Anciano , Índice de Masa Corporal , Antígeno Carcinoembrionario/sangre , Estudios de Casos y Controles , Neoplasias Colorrectales/sangre , Neoplasias Colorrectales/complicaciones , Neoplasias Colorrectales/diagnóstico , Diabetes Mellitus Tipo 2/sangre , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/inmunología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Linfocitos T Reguladores/inmunología , Microambiente Tumoral/fisiología
3.
Am Surg ; 85(9): 1025-1027, 2019 Sep 01.
Artículo en Inglés | MEDLINE | ID: mdl-31638518

RESUMEN

From 1991 to 2013, Mississippi was without liver transplant services. In 2013, a new liver transplant program was established at the University of Mississippi Medical Center. Here, we describe our experience with the first 150 transplants over a 4.5-year period. This study is a review of 147 patients who underwent the first 150 liver transplants at the University of Mississippi Medical Center between March 5, 2013, and January 4, 2018. There were no exclusion criteria for this study. Donor, recipient, and outcome variables were analyzed. Recipients were 46% female and 74% white. Age at the time of transplant was 57 [IQR 49-63]. BMI at transplant was 30 [IQR 25-35]. Thirty per cent of transplants were for alcoholic cirrhosis, 25% non-alcoholic steatohepatitis, 24% hepatitis C, and 12% cholestatic. Mean model for end-stage liver disease (MELD) at the time of transplant was 20 [95% confidence interval 19-21] and MELD-Na was 22 [95% confidence interval 20-23]. One-year patient- and graft survival were 89% and 87%, respectively, which were as expected based on Scientific Registry of Transplant Recipient reports after risk adjustment. The data published here verifies it is possible to establish a new liver transplant center in an underserved area previously lacking comprehensive liver care and to achieve results similar to other high-volume centers across the country.


Asunto(s)
Centros Médicos Académicos , Trasplante de Hígado , Índice de Masa Corporal , Colestasis/cirugía , Hígado Graso/cirugía , Femenino , Supervivencia de Injerto , Hepatitis C/cirugía , Humanos , Tiempo de Internación , Cirrosis Hepática Alcohólica/cirugía , Trasplante de Hígado/efectos adversos , Trasplante de Hígado/normas , Masculino , Persona de Mediana Edad , Mississippi , Evaluación de Resultado (Atención de Salud) , Complicaciones Posoperatorias , Desarrollo de Programa , Reoperación
4.
Am Surg ; 85(9): 1061-1065, 2019 Sep 01.
Artículo en Inglés | MEDLINE | ID: mdl-31638525

RESUMEN

As minimally invasive operations evolve, it is imperative to evaluate the advantages and risks involved. The aim of our study was to evaluate our institution's experience in incorporating a robotic platform for transhiatal esophagectomy (THE). Patients undergoing robotic THE were prospectively followed. Data are presented as median (mean ± SD). Forty-five patients were of 67 (67 ± 6.9) years and BMI 26 (27 ± 5.5) kg/m². Nine per cent of operations were converted to "open," but none in the last 25 operations. Operative duration of robotic THE was 334 (364 ± 108.8) minutes and estimated blood loss was 200 (217 ± 144.0) mL, which decreased with time (P = 0.017). Length of stay was 8 (12 ± 11.1) days. Twenty per cent had respiratory failure requiring intubation that resolved, 4 per cent developed pneumonia, 11 per cent developed a surgical site infection, 2 per cent developed renal insufficiency, and 2 per cent developed a UTI. Two per cent (one patient) died within 30 days postoperatively, because of cardiac arrest. Our experience with robotic THE promotes robotic application because we endeavor to achieve high-level proficiency. With experience, we improved estimated blood loss and converted fewer transhiatal esophagectomies to "open." Our length of hospital stay seems long but reflects the ill-health of patients, as does the variety of complications. Our data support the evolving future of THE, which will integrally include a robotic approach.


Asunto(s)
Esofagectomía/efectos adversos , Esofagectomía/métodos , Procedimientos Quirúrgicos Robotizados/efectos adversos , Procedimientos Quirúrgicos Robotizados/métodos , Anciano , Pérdida de Sangre Quirúrgica , Índice de Masa Corporal , Conversión a Cirugía Abierta , Femenino , Estudios de Seguimiento , Mortalidad Hospitalaria , Humanos , Intubación Intratraqueal , Tiempo de Internación , Masculino , Persona de Mediana Edad , Tempo Operativo , Neumonía/diagnóstico , Complicaciones Posoperatorias , Estudios Prospectivos , Insuficiencia Respiratoria/terapia , Infección de la Herida Quirúrgica , Infecciones Urinarias
5.
J Clin Pediatr Dent ; 43(6): 432-436, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31657983

RESUMEN

Objective: The aim of this study was to determine relationships between dental maturity and body mass index (BMI) in Korean children. Study Design: 600 Korean children aged between 5 and 10 years for whom panoramic radiographs have been obtained between 2010 and 2017 were selected. Subjects were divided into four weight-status groups: underweight, normal weight, overweight, and obese. Five lower-left permanent teeth were observed and rated. The stage of each tooth was converted into a score using the table suggested by Demirjian, and the sum of these scores was designated as the 'maturity score'. Results: This study found statistically significant differences in dental maturity between the weight groups (analysis of variance, P=0.003), with the maturity score being higher in the obese group than in normal-weight subjects (Tukey's post-hoc test, P=0.004). The linear regression showed a positive association between BMI and the maturity score after adjusting for sex and age (ß=0.34, P<0.001). The linear regression coefficient was higher in girls (ß=0.61, P<0.001) than in boys (ß=0.31, P=0.02). Conclusions: These data suggest that dental maturation is positively associated with BMI in Korean children. Since many treatment decisions are made in relation to dental maturity, these findings may have implications for pediatric dental care.


Asunto(s)
Odontogénesis , Delgadez , Índice de Masa Corporal , Niño , Preescolar , Femenino , Humanos , Masculino , Sobrepeso , República de Corea
6.
Clin Exp Rheumatol ; 37 Suppl 120(5): 24-30, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31621563

RESUMEN

Rheumatic and musculoskeletal diseases (RMDs) are common, with osteoarthritis (OA) being the most prevalent. RMDs, including OA, are associated with significant pain and functional limitations, as well as mortality rates up to 1.6-fold higher than in the general population. Most studies of OA and mortality have focused on knee and hip OA. Some, but not all, of these studies suggest an increased risk of death, however risks may differ by region. Reasons for discordant findings may be due to methodological considerations including definition of OA, study design, length of follow-up, and whether variables that can change and develop over time, such as measures of OA, body mass index (BMI) and comorbidities, were re-assessed during the follow-up period. Research has shown that the prognosis of OA is similar to that seen in rheumatoid arthritis (RA) patients, in many respects. In RA, disability and comorbidities are the most important predictors of mortality, although pain may be more prominent in the prognosis of OA mortality. The data suggest that addressing functional limitations and pain seen with OA could potentially reduce the increased mortality that has been observed in these individuals. Further study is needed concerning the potential excess mortality attributable to lower body OA, as well as associated disability, pain and comorbidities.


Asunto(s)
Osteoartritis de la Cadera , Osteoartritis de la Rodilla , Índice de Masa Corporal , Comorbilidad , Humanos , Articulación de la Rodilla , Mortalidad Prematura , Osteoartritis de la Cadera/mortalidad , Osteoartritis de la Rodilla/mortalidad
7.
Medicine (Baltimore) ; 98(43): e17353, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31651840

RESUMEN

BACKGROUND: Patients with simple obesity suffer from poor quality of life, as well as high risk of hypertension, diabetes, cardiovascular, and cerebrovascular accidents. Lots of Clinical trials suggested that acupuncture is beneficial for simple obesity, and it aims to gather solid evidence in order to provide reliable reference in establishing guidelines for acupuncture treatment of simple obesity in this study. METHODS: Relevant databases including Cochrane Library, PubMed, Cochrane Central Register of Controlled Trials, Medline University Resource Center, Chinese Biomedical Literature Service System, and China National Knowledge Infrastructure will be retrieved from January 1950 to November 2018. Two authors will screen studies independently according to the inclusion and exclusion criteria and extract the data in a form of sheet. Quality evaluations and bias risk assessments will be performed for the methodology of included studies. Dichotomous data will be analyzed using odds ratio (OR), and continuous data using mean differences. Network meta-analysis will be conducted by using Stata 14.0. The Development and Evaluation approach will be used to rate the certainty of the evidence of estimates derived from meta-analysis. The primary outcome is body mass index (BMI), and the secondary outcomes are triglycerides, total cholesterol, low-density lipoprotein-cholesterol, effective rate, adverse effects, and recurrence rate. Trial registration number is CRD42019117387. RESULTS: Based on current evidence, this review will rank the efficacy and safety of the various acupuncture regimen in decreasing BMI, triglycerides, total cholesterol of patients with simple obesity, and to summarize a prioritization regimen. CONCLUSION: This evidence may be useful for clinicians, patients, and guideline-makers to select the optimum proposal of acupuncture for the simple obesity treatment.


Asunto(s)
Terapia por Acupuntura/métodos , Obesidad/terapia , Adulto , Índice de Masa Corporal , Colesterol/sangre , Protocolos Clínicos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Metaanálisis en Red , Proyectos de Investigación , Revisiones Sistemáticas como Asunto , Resultado del Tratamiento , Triglicéridos/sangre
8.
Medicine (Baltimore) ; 98(43): e17598, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31651867

RESUMEN

Emerging evidences had reported the positive relationship between obesity and intraocular pressure (IOP). The aim of the present study was to investigate the association between hepatic steatosis and IOP in an adult Taiwanese population.Seven thousand seven hundred twelve males and 6325 females who received a health examination at the Tri-Service General Hospital during the period from 2010 to 2016 were included in this study.IOP was measured by noncontact tonometry. Hepatic steatosis was diagnosed by abdominal ultrasound examination. Multivariate regression analyses were used to assess the associations among various anthropometric parameters and IOP.After adjusting for pertinent covariables, hepatic steatosis had a closer association with increased IOP than percentage body fat, body mass index, or waist circumference (ß = 0.017, 95% confidence interval [CI] = 0.006, 0.028). This relationship remained significant among males in the study population (ß = 0.015, 95% CI = 0.001, 0.029). Furthermore, hepatic steatosis was significantly correlated with increased risk of high IOP (odd ratios = 1.235, 95% CI = 1.041-1.465).Our study highlights that hepatic steatosis is a better index for assessing the relationship with increased IOP than other anthropometric parameters. Underlying pathophysiological mechanisms regulating the association between hepatic steatosis and increasing IOP and even the risk of glaucoma should be examined in further studies.


Asunto(s)
Índice de Masa Corporal , Hígado Graso/fisiopatología , Presión Intraocular/fisiología , Circunferencia de la Cintura/fisiología , Adulto , Antropometría , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Oportunidad Relativa , Taiwán/epidemiología , Tonometría Ocular
9.
Am Surg ; 85(10): 1159-1161, 2019 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-31657315

RESUMEN

There are conflicting views regarding techniques for repair of small umbilical hernias (UHs). Here, we compare the recurrence rate in primary repair with that reported for mesh repair by examining a single surgeon's practice at a large medical center with a comprehensive electronic medical record. A six-year retrospective review of primary UH repairs between January 2012 and December 2017 at Kaiser Permanente Los Angeles Medical Center was undertaken. Patients were identified through a database search of the electronic medical record. The primary endpoint of UH recurrence was examined; median follow-up was 3.4 years. Primary, elective UH repair was performed in 244 patients; 71 per cent of hernias were small (<2 cm). The total number of recurrences was seven (3%). The t test analysis showed significant differences in the average size of hernia defects between those with recurrences (2 cm) and those without (1.4 cm), P < 0.05. Primary repair affords low infection and recurrence rates, comparable to those reported for mesh repair. Our single-surgeon/large-volume study contributes to the evidence that primary UH repair is a safe and durable method, with low risk of recurrence. The use of absorbable monofilament suture, and selection for lower BMI and smaller hernia sizes proved to be effective.


Asunto(s)
Hernia Umbilical/cirugía , Herniorrafia/estadística & datos numéricos , Mallas Quirúrgicas/estadística & datos numéricos , Adulto , Factores de Edad , Anciano , Índice de Masa Corporal , California , Femenino , Hernia Umbilical/patología , Herniorrafia/efectos adversos , Herniorrafia/métodos , Hospitales de Alto Volumen/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Recurrencia , Estudios Retrospectivos , Fumadores/estadística & datos numéricos , Mallas Quirúrgicas/efectos adversos , Suturas , Técnicas de Cierre de Heridas
10.
Am Surg ; 85(10): 1162-1165, 2019 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-31657316

RESUMEN

The risk factors and associated conditions of median arcuate ligament syndrome (MALS) have not been well characterized in the literature. In this study, we aim to investigate the presentation and outcomes of MALS patients with an emphasis on the prevalence of other uncommon disorders. To this end, data of patients with MALS who underwent surgery between 2013 and 2018 were collected and compiled into a retrospective database and analyzed. Eleven patients were identified. Seven of these eleven patients underwent diagnostics to evaluate gastric emptying. Five of these seven patients (71.4%) had radiographic evidence of delayed gastric emptying. Four of the eleven patients (36.4%) were found to have anatomic abnormalities of their visceral vasculature. Two of the eleven patients (18.2%) were found to have connective tissue disorders, both with Ehlers-Danlos syndrome. Three of the eleven (27.3%) had a diagnosis of postural orthostatic tachycardia syndrome. This is the first case series reporting on an association between MALS and delayed gastric emptying. We also explored the relationship between MALS and visceral vascular abnormalities, Ehlers-Danlos syndrome, and postural orthostatic tachycardia syndrome. It is notable that these conditions are more prevalent in the MALS population than in the general population, suggesting a possible pathophysiologic relationship.


Asunto(s)
Síndrome de Ehlers-Danlos/complicaciones , Vaciamiento Gástrico , Gastroparesia/complicaciones , Síndrome del Ligamento Arcuato Medio/complicaciones , Síndrome del Ligamento Arcuato Medio/fisiopatología , Síndrome de Taquicardia Postural Ortostática/complicaciones , Adulto , Índice de Masa Corporal , Diagnóstico Diferencial , Síndrome de Ehlers-Danlos/diagnóstico , Femenino , Gastroparesia/diagnóstico , Humanos , Tiempo de Internación/estadística & datos numéricos , Masculino , Síndrome del Ligamento Arcuato Medio/diagnóstico , Síndrome del Ligamento Arcuato Medio/cirugía , Cuidados Preoperatorios , Estudios Retrospectivos , Factores de Riesgo , Resultado del Tratamiento , Vísceras/irrigación sanguínea
11.
Niger J Clin Pract ; 22(10): 1356-1364, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31607724

RESUMEN

Aims: The study aimed to assess the percentage difference of hand dimensions and their correlation with grip and pinch strength among school children in Saudi Arabia. Materials and Methods: Anthropometric measurements, hand dimensions, grip, and pinch strength measurements were obtained from 200 healthy schoolchildren in both genders aged 6-16 years. A Jamar electronic handgrip dynamometer was used to measure handgrip strength in kg. Pinch dynamometer was used to measure the two-point pinch strength, three-point pinch strength and lateral pinch strength in kg. Hand circumference was measured following hand arch at the maximum palm level. Hand span from the tip of the thumb to the tip of the little finger with the hand opened as broad as possible. Hand length from the tip of the middle finger to the midline of the distal wrist crease. Palm length from the distal wrist crease to the base of the middle finger. Results: The percentage of difference of hand dimensions between both the genders was statistically significant. Both handgrip and pinch strength were significantly correlated with anthropometric measurements and hand dimensions. Body mass index had mild correlation with both handgrip strength and pinch strength (P < 0.05). Age, hand circumference, hand span, hand length and palm length had moderate to strong correlation with both grip and pinch strength (P < 0.01). Conclusion: The current study provides a source of perspective reference values in clinical settings for hand dimensions. The present study showed significant correlations with handgrip and pinch grip strengths among schoolchildren in Saudi Arabia.


Asunto(s)
Fuerza de la Mano/fisiología , Mano/anatomía & histología , Fuerza de Pellizco/fisiología , Adolescente , Factores de Edad , Antropometría , Estatura , Índice de Masa Corporal , Niño , Femenino , Dedos/fisiología , Humanos , Masculino , Valores de Referencia , Arabia Saudita
12.
Arq Bras Cir Dig ; 32(3): e1453, 2019.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-31644673

RESUMEN

BACKGROUND: : Bariatric surgery promotes significant weight loss and improvement of associated comorbidities; however, nutrients deficiencies and weight regain may occur in the middle-late postoperative period. AIM: To investigate nutritional status in 10 years follow-up. METHODS: : Longitudinal retrospective study in which anthropometric, biochemical indicators and nutritional intake were assessed before and after one, two, three, four, five and ten years of Roux-en Y gastric bypass through analysis of medical records. RESULTS: : After ten years there was a reduction of 29.2% of initial weight; however, 87.1% of patients had significant weight regain. Moreover, there was an increase of incidence of iron (9.2% to 18.5%), vitamin B12 (4.2% to 11.1%) and magnesium deficiency (14.1% to 14.8%). Folic acid concentrations increased and the percentage of individuals with glucose (40.4% to 3.7%), triglycerides (38% to 7.4%), HDL cholesterol (31 % to 7.4%) and uric acid (70.5% to 11.1%) abnormalities reduced. Also, there is a reduction of food intake at first year postoperative. After 10 years, there was an increase in energy, protein and lipid intake, also a reduction in folid acid intake. CONCLUSIONS: : Roux-en Y gastric bypass is an effective procedure to promote weight loss and improve comorbidities associated with obesity. However, comparison between postoperative period of five and 10 years showed a high prevalence of minerals deficiency and a significant weight regain, evidencing the need for nutritional follow-up in the postoperative period.


Asunto(s)
Derivación Gástrica/rehabilitación , Estado Nutricional/genética , Obesidad/cirugía , Fenotipo , Adulto , Índice de Masa Corporal , Femenino , Ácido Fólico/sangre , Estudios de Seguimiento , Humanos , Hierro/sangre , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Trastornos Nutricionales/sangre , Trastornos Nutricionales/etiología , Obesidad/complicaciones , Periodo Posoperatorio , Estudios Retrospectivos , Resultado del Tratamiento , Vitamina B 12/sangre , Pérdida de Peso
13.
Zhonghua Fu Chan Ke Za Zhi ; 54(10): 654-659, 2019 Oct 25.
Artículo en Chino | MEDLINE | ID: mdl-31648440

RESUMEN

Objective: To explore the relationship between hemoglobin (Hb) level during the first trimester of pregnancy and gestational diabetes mellitus (GDM). Methods: A total of 1 276 participants, who underwent scheduled prenatal examination and normal singleton delivery at the Fifth People's Hospital of Shanghai and Hospital of Intergrated Chinese and Western Medicine in Minhang District, from January 2016 to May 2018 were included. There were 99 cases of GDM (GDM group) and 1 177 cases of normal (control group) pregnant women.Based on the serum Hb level during the first trimester of pregnancy, participants were divided into three groups, 236 cases of low Hb level group (Hb<110 g/L), 868 cases of normal Hb level group (110 g/L≤Hb<130 g/L), and 172 cases of high Hb level group (Hb≥130 g/L). Maternal clinical data were collected, including Hb level during the first trimester of pregnancy, three-point blood glucose (BG) of oral glucose tolerance test (OGTT) and fasting insulin during the second trimester of pregnancy. Homeostasis model assessment of insulin resistance index (HOMA-IR) and homeostasis model assessment of pancreatic ß cell function index (HOMA-ß) were used to evaluate insulin resistance and pancreatic ß cell function. Results: (1) Hb level during the first trimester of pregnancy in GDM group was significantly higher than that in control group [(123±10),(119±11) g/L, P<0.05]. There were no significant difference in gravidity, parity, index of liver and renal function (all P>0.05). (2) Pre-pregnancy body mass index (BMI), 1-hour BG and 2-hour BG of OGTT were significantly increased in the high Hb level group during the first trimester of pregnancy, which were (23±4) kg/m(2), (7.3±2.0) mmol/L, and (6.5±1.4) mmol/L (P<0.05), respectively. The pre-pregnancy BMI, 1-hour BG and 2-hour BG of the normal or low Hb level group were (22±3) kg/m(2), (6.7±1.6) mmol/L, (6.1±1.2) mmol/L; (22±3) kg/m(2), (6.5±1.5) mmol/L, (5.9±1.1) mmol/L, respectively. There were no statistically significant difference in levels of fasting blood glucose, fasting insulin, HOMA-IR and HOMA-ß within 3 groups (all P>0.05). (3) In the high Hb level group, prevalence of pregnancy overweight or obesity and GDM were the highest, which were 37.2%(64/172) and 15.1%(26/172), respectively; the differences were statistically significant (all P<0.05). (4) The serum Hb level in the first trimester was positively related with pre-pregnancy BMI (r=0.130, P<0.05), 1-hour BG (r=0.129, P<0.05), 2-hour BG (r=0.134, P<0.05), fasting insulin (r=0.096, P<0.05), and HOMA-IR (r=0.101, P<0.05).Logistic regression indicated that Hb≥130 g/L during the first trimester of pregnancy was an independent risk factor for GDM (OR=2.799, 95%CI: 1.186-6.604; P<0.05). Conclusion: The high level of Hb (Hb≥130 g/L) during the first trimester of pregnancy is associated with GDM.


Asunto(s)
Glucemia/análisis , Diabetes Gestacional/diagnóstico , Intolerancia a la Glucosa/diagnóstico , Prueba de Tolerancia a la Glucosa , Hemoglobinas/análisis , Resistencia a la Insulina , Primer Trimestre del Embarazo/sangre , Adulto , Grupo de Ascendencia Continental Asiática , Glucemia/metabolismo , Índice de Masa Corporal , China/epidemiología , Diabetes Gestacional/sangre , Diabetes Gestacional/epidemiología , Femenino , Humanos , Incidencia , Embarazo , Factores de Riesgo
14.
Acta Gastroenterol Belg ; 82(3): 397-400, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31566327

RESUMEN

BACKGROUND AND AIMS: Early prediction of severe acute pancreatitis (SAP)would be helpful for triaging patients to the appropriate level of care and intervention. The aim of this study is to compare the performance of the Change in Amylase And Body mass index (CAB) score and BISAP score for predicting SAP. PATIENTS AND METHODS: A total of 406 with AP were enrolled. The age, gender, body mass index(BMI), blood urea nitrogen determined at the time of admission and serum amylase determined on day 1 and day 2 after hospitalization were collected and analyzed statistically. RESULTS: Multivariable analysis confirmed that blood urea nitrogen (OR 1.06; 95%CI 1.03-1.09) and percentage change in amylase day 2 (OR 0.75; 95%CI 0.65-0.87) were independently associated with development of SAP. No statistically significant association was observed between BMI (OR 1.04; 95%CI 0.951.13) and severity of acute pancreatitis. The area under the receiver operating characteristic curve for Body mass index (BMI), percentage change in amylase day 2, BISAP score and CAB score were 0.57±0.05, 0.68±0.04, 0.84±0.03 and0.53±0.05, respectively. CONCLUSION: BISAP is more accurate for predicting the severity of acute pancreatitis than the CAB score.


Asunto(s)
Amilasas/sangre , Nitrógeno de la Urea Sanguínea , Índice de Masa Corporal , Pancreatitis/diagnóstico , Índice de Severidad de la Enfermedad , Enfermedad Aguda , Biomarcadores/sangre , Humanos , Pancreatitis/clasificación , Pancreatitis/patología , Admisión del Paciente/estadística & datos numéricos , Valor Predictivo de las Pruebas , Pronóstico , Curva ROC , Estudios Retrospectivos
15.
Medicine (Baltimore) ; 98(39): e16788, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31574794

RESUMEN

BACKGROUND: The aim of this study was to observe the effect and safety of Heyan Kuntai Capsule (HYKT) on glucose and lipid metabolism in patients with polycystic ovary syndrome (PCOS). METHODS: Hundred patients with PCOS were randomly divided into HYKT group (n = 50) and placebo groups (n = 50) in which the individuals were treated with HYKT and its placebo continuously for 6 months. Meanwhile, all participants received health education (such as exercise and diet). The primary outcomes were serum sex hormone levels, a series of blood lipid, fasting and postprandial 2 hours blood glucose. Body mass index (BMI), waist-hip ratio (WHR), insulin, homeostatic model assessment of insulin resistance (HOMA-IR), and insulin-sensitive index (ISI) were also observed. In addition, adverse events were recorded to evaluate the drug safety. RESULTS: After treatment, the BMI and WHR of all the patients were decreased. The fasting and postprandial 2 hours blood glucose levels were significantly declined when treated with HYKT, which were not observed in the placebo group. Similarly, serum sex hormones including luteinizing hormone (LH), LH/follicle-stimulating hormone (FSH), and testosterone were lowered after treated with HYKT instead of the placebo. Besides, blood lipids outcomes such as total cholesterol, triglyceride, and low-density lipoprotein cholesterol, as well as insulin and HOMA-IR were decreased with significance in HYKT group when compared with those in the placebo group, whereas high-density lipoprotein cholesterol and ISI increased obviously. CONCLUSION: HYKT showed the effect on ameliorating the glucose and lipid metabolism disorder and improving insulin resistance and increase insulin sensitivity of PCOS patients, which is similar to insulin sensitizing agent.


Asunto(s)
Glucemia/metabolismo , Medicamentos Herbarios Chinos/efectos adversos , Medicamentos Herbarios Chinos/uso terapéutico , Lípidos/sangre , Síndrome del Ovario Poliquístico/sangre , Síndrome del Ovario Poliquístico/tratamiento farmacológico , Adolescente , Adulto , Índice de Masa Corporal , Método Doble Ciego , Estradiol/sangre , Femenino , Hormona Folículo Estimulante/sangre , Humanos , Insulina/sangre , Resistencia a la Insulina , Hormona Luteinizante/sangre , Prolactina/sangre , Testosterona/sangre , Relación Cintura-Cadera , Adulto Joven
16.
Medicine (Baltimore) ; 98(39): e16965, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31574795

RESUMEN

This study presents the postoperative pregnancy rate of women with recurrent endometriosis and evaluates the predictive value of the endometriosis fertility index (EFI) for the pregnancy.A total of 107 women who wished to conceive after surgery for recurrent endometriosis from January 2007 to December 2016 were included. The EFI score was calculated postoperatively. The receiver operator characteristic (ROC) curve was plotted to determine the most promising contributor to predicting pregnancy, and Kaplan-Meier (K-M) analysis was used to estimate the cumulative pregnancy rate (CPR).A total of 61 pregnancies were registered in 58 women and the remaining 49 patients failed to become pregnant. The EFI score was strongly associated with the postoperative fertility prognosis. The CPRs during the first 2 and 3 years postoperatively were 51.86% and 66.38%, respectively, and increased to 71.98% within the first 5 years postoperatively in patients with EFI scores ≥5. However, the CPR was 26.00% during the first 2 years after surgery in individuals with EFI scores <5, and there was no increase in the CRP thereafter.Women suffering from recurrent endometriosis still experienced a probability of natural pregnancy, especially patients with EFI scores ≥5. The EFI score had good predictive power for postoperative pregnancy in these patients.


Asunto(s)
Endometriosis/cirugía , Fertilización , Índice de Masa Corporal , Endometriosis/complicaciones , Femenino , Estudios de Seguimiento , Humanos , Infertilidad Femenina/diagnóstico , Infertilidad Femenina/etiología , Infertilidad Femenina/terapia , Estimación de Kaplan-Meier , Valor Predictivo de las Pruebas , Embarazo , Índice de Embarazo , Curva ROC , Recurrencia , Técnicas Reproductivas Asistidas , Estudios Retrospectivos
17.
Medicine (Baltimore) ; 98(40): e16950, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31577697

RESUMEN

BACKGROUND: Anorexia is a common cause of malnutrition and is associated with negative effects on the quality of life (QOL) for patients with cancer. Management of appetite is the key to improving both the QOL and the prognosis for such patients. Yukgunja-tang (YGJT) is a traditional herbal medicine extensively prescribed in Korea as a remedy for various gastrointestinal syndromes. Currently, no standardized herbal medicine treatment exists for patients with cancer who are suffering from anorexia after surgery, chemotherapy, and/or radiotherapy. For that reason, this study aims to examine the efficacy and the safety of using YGJT to treat anorexia in such patients and to establish whether or not YGJT can be recommended as the primary therapy. METHODS: We will enroll 52 cancer patients diagnosed with anorexia. The enrolled participants will be randomly allocated to 2 groups: The control group will receive nutrition counseling, and the YGJT group will receive nutrition counseling and be administered YGJT at a dose of 3 g twice a day for 4 weeks (a total of 56 doses of 3.0 g per dose). The primary outcome of this study is the change in the score on the anorexia/cachexia subscale (A/CS) of the Functional Assessment of Anorexia/Cachexia Therapy (FAACT). The secondary outcomes are the changes in the FAACT score with the A/CS score excluded, the score on the Visual Analogue Scale (VAS) for appetite, the weight and the body mass index (BMI), and laboratory tests for compounds such as leptin, tumor necrosis factor-α (TNF-α), ghrelin, and IL-6. All variables related to the safety assessment, such as vital signs, electrocardiography results, laboratory test results (CBC, chemistry, urine test), and adverse events, will be documented on the case report form (CRF) at every visit. CONCLUSION: This study is the first randomized controlled trial to investigate the efficacy and the safety of using YGJT for treating patients with cancer-related anorexia in Korea. We designed this study based on previous research about YGJT. This study will serve as a pilot and provide data for planning further clinical trials on herbal medicine and cancer-related anorexia. TRIAL REGISTRATION: Clinical Research Information Service (CRIS), Republic of Korea, ID: KCT0002847. Registered retrospectively on 3 April 2018.


Asunto(s)
Anorexia/tratamiento farmacológico , Anorexia/etiología , Caquexia/tratamiento farmacológico , Caquexia/etiología , Medicamentos Herbarios Chinos/uso terapéutico , Neoplasias/complicaciones , Adulto , Anciano , Anciano de 80 o más Años , Apetito , Índice de Masa Corporal , Peso Corporal , Método Doble Ciego , Medicamentos Herbarios Chinos/administración & dosificación , Medicamentos Herbarios Chinos/efectos adversos , Femenino , Pruebas Hematológicas , Humanos , Masculino , Persona de Mediana Edad , Proyectos Piloto , Calidad de Vida , República de Corea , Proyectos de Investigación , Adulto Joven
18.
Medicine (Baltimore) ; 98(40): e17218, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31577712

RESUMEN

Health examination is an important method for early detection of people with different risk of stroke. This study estimates the risk of stroke and identify risk factors for people who underwent health examinations at the Health Examination Center at West China Hospital, Sichuan University from July 2014 to February 2018.A total of 31,464 people were recruited in this study and divided into 3 groups (low risk, moderate risk, and high risk) according to risk of stroke. We explored possible factors associated with the risk of stroke by using multivariable stepwise logistic regression analysis.Among the participants, 17,959 were at low risk, 11,825 were at moderate risk, and 1680 were at high risk. Age, smoking, alcohol consumption, body mass index, uric acid, diastolic pressure, systolic pressure, triglycerides, low-density lipoprotein cholesterol, glucose, and brachial-ankle pulse wave velocity (baPWV) were independent significant risk factors for stroke, whereas high-density lipoprotein cholesterol was an independent protective factor for stroke. Interestingly, with increasing age, the percentage of people at moderate or high risk of stroke was increased. The percentages of people at moderate and high risk of stroke were also increased with respect to the stages of baPWV.This study showed that >40% of the participants were at moderate or high risk of stroke, especially the older participants. Several factors were related to the risk of stroke, especially baPWV. Some preventive action may be adopted early, and more attention can be paid to the health examination population.


Asunto(s)
Examen Físico/estadística & datos numéricos , Accidente Cerebrovascular/epidemiología , Adulto , Factores de Edad , Consumo de Bebidas Alcohólicas/epidemiología , Índice Tobillo Braquial , Presión Sanguínea , Índice de Masa Corporal , China/epidemiología , Fumar Cigarrillos/epidemiología , Estudios Transversales , Femenino , Humanos , Estilo de Vida , Lípidos/sangre , Masculino , Persona de Mediana Edad , Medición de Riesgo , Factores de Riesgo , Factores Sexuales , Factores Socioeconómicos
19.
Medicine (Baltimore) ; 98(40): e17238, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31577715

RESUMEN

INTRODUCTION: Arteriovenous fistula (AVF) is the preferred vascular access for hemodialysis due to its higher patency and lower infection rate. However, its suboptimal maturation rate is a major weakness. Although substantial risk factors for AVF maturation failure have been disclosed, modifiable risk factors remain unknown. During the AVF maturation process, an elevated luminal pressure is required for outward remodeling; however, excessively high luminal pressure may also be detrimental to AVF maturation, which remains to be defined. We hypothesized that higher AVF luminal pressure is harmful to its maturation, and investigate its potential as a modifiable factor to improve AVF maturation. METHODS AND ANALYSIS: This prospective study includes patients undergoing surgical creation for a native AVF. The exclusion criteria were as follows: age <20 years, inability to sign an informed consent, and failure to create a native AVF due to technical difficulties. Demographic and laboratory profiles will be collected before AVF surgery. Vascular sonography will be performed within 1 week of AVF creation to measure the diameters, flow rates, and flow volumes of AVF and its branched veins. The pressure gradient within AVF will be estimated from the blood flow rates using the modified Bernoulli equation. The primary outcome is spontaneous AVF maturation defined as provision of sufficient blood flow for hemodialysis within 2 months of its creation without any interventional procedures. The secondary outcome is assisted AVF maturation, which is defined as AVF maturation within 2 months from its creation aided by any interventional procedure before the successful use of AVF. DISCUSSION: While contemporary theory for AVF maturation failure focuses on disturbed wall shear stress, complicate assumptions and measurement preclude its clinical applicability. AVF luminal pressure, which may be manipulated pharmaceutically and surgically, may be a target to improve the outcome of AVF maturation. TRIAL REGISTRATION: This study has been registered at the protocol registration and results system. The Protocol ID: NCT04017806.


Asunto(s)
Derivación Arteriovenosa Quirúrgica/métodos , Diálisis Renal/métodos , Grado de Desobstrucción Vascular/fisiología , Remodelación Vascular/fisiología , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Índice de Masa Corporal , Fumar Cigarrillos/epidemiología , Comorbilidad , Femenino , Hemodinámica/fisiología , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Insuficiencia Renal/etiología , Insuficiencia Renal/terapia , Proyectos de Investigación , Factores de Riesgo , Factores Sexuales , Taiwán , Factores de Tiempo , Adulto Joven
20.
Medicine (Baltimore) ; 98(40): e17361, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31577733

RESUMEN

Limbs muscle wasting is a common disorder in patients with chronic obstructive pulmonary disease (COPD) that limits daily activities and exercise intolerance, especially in males. The present study aimed to estimate the prevalence of appendicular skeletal muscle mass (ASM) in male patients with stable COPD. In addition, factors associated with parameters of ASM were also investigated.We recruited 116 male patients with stable COPD from the outpatient clinic between September 2016 and December 2017. For each patient, we obtained demographic characteristics and measured post-bronchodilator forced expiratory volume in 1 second, symptoms, exacerbations history, and ASM. ASM was defined as the sum of the muscle masses of the 4 limbs.Appendicular skeletal muscle mass index (ASMI) in male patients with stable COPD was 8.2 ±â€Š0.9 kg/m, and the prevalence of low skeletal muscle mass was 7.8% (9 of 116 patients). Multiple linear-regression analysis showed that body mass index, occupation, fat-free mass index, and the modified medical research council scale were significantly correlated with ASMI. Compared with nonexercise group, lower limb muscle mass and ASM were significantly improved in physical exercise group.Underweight, retirement, fat-free mass depletion, and severe dyspnea are all risk factors for ASM in male patients with stable COPD. Our findings also justify the importance of exercise training in improving ASM.


Asunto(s)
Músculo Esquelético/patología , Enfermedad Pulmonar Obstructiva Crónica/patología , Anciano , Anciano de 80 o más Años , Índice de Masa Corporal , Pesos y Medidas Corporales , Estudios Transversales , Ejercicio , Humanos , Modelos Lineales , Persona de Mediana Edad , Pruebas de Función Respiratoria , Índice de Severidad de la Enfermedad , Factores Socioeconómicos
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