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The Independent Associations between Walk Score ® and Neighborhood Socioeconomic Status, Waist Circumference, Waist-To-Hip Ratio and Body Mass Index Among Urban Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15061226. [PMID: 29891778 PMCID: PMC6025475 DOI: 10.3390/ijerph15061226] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 06/03/2018] [Accepted: 06/08/2018] [Indexed: 01/13/2023]
Abstract
Background: Environmental and policy factors can influence weight status via facilitating or discouraging physical activity and healthy diet. Despite mixed evidence, some findings suggest that the neighborhood built environment, including “walkability”, is associated with overweight and obesity. Most of these findings have measured body mass index (BMI), yet other weight status measures including waist circumference (WC) and waist-to-hip (W-H) ratio are also predictive of health outcomes, independent of BMI. Our study aim was to estimate the associations between walkability, measured using Walk Score®, and each of WC, W-H ratio, and BMI among urban Canadian adults. Methods: In 2014, n = 851 adults recruited from 12 structurally and socioeconomic diverse neighborhoods (Calgary, Alberta, Canada) provided complete data on a physical activity, health and demographic questionnaire and self-reported anthropometric measures (i.e., height and weight, WC and hip circumference). Anthropometric data were used to estimate WC, W-H ratio, and BMI which were categorized into low and high risk in relation to their potential adverse effect on health. WC and BMI were also combined to provide a proxy measure of both overall and abdominal adiposity. Multivariable logistic regression models estimated odds ratios (OR) and 95% confidence intervals (CI) for associations between each weight status outcome and Walk Score®. Results: A one-unit increase in Walk Score® was associated with lower odds of being high-risk based on WC (OR = 0.99; 95%CI 0.97⁻0.99). Notably, those residing in socioeconomically disadvantage neighborhoods had significantly higher odds of being high risk based on WC, BMI, and WC-BMI combined compared with advantaged neighborhoods. Conclusions: Interventions that promote healthy weight through the design of neighborhoods that support and enhance the effect of physical activity and diet-related interventions could have a significant population health impact.
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Pitts SI, Maruthur NM, Langley GE, Pondo T, Shutt KA, Hollick R, Schrag SJ, Thomas A, Nichols M, Farley M, Watt JP, Miller L, Schaffner W, Holtzman C, Harrison LH. Obesity, Diabetes, and the Risk of Invasive Group B Streptococcal Disease in Nonpregnant Adults in the United States. Open Forum Infect Dis 2018; 5:ofy030. [PMID: 29977953 PMCID: PMC6016410 DOI: 10.1093/ofid/ofy030] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Revised: 12/22/2017] [Accepted: 04/24/2018] [Indexed: 02/06/2023] Open
Abstract
Background Rates of invasive group B Streptococcus (GBS) disease, obesity, and diabetes have increased in US adults. We hypothesized that obesity would be independently associated with an increased risk of invasive GBS disease. Methods We identified adults with invasive GBS disease within Active Bacterial Core surveillance during 2010–2012 and used population estimates from the Behavioral Risk Factor Surveillance System to calculate invasive GBS incidence rates. We estimated relative risks (RRs) of invasive GBS using Poisson analysis with offset denominators, with obesity categorized as class I/II (body mass index [BMI] = 30–39.9 kg/m2) and class III (BMI ≥ 40.0 kg/m2). Results In multivariable analysis of 4281 cases, the adjusted RRs of invasive GBS disease were increased for obesity (class I/II: RR, 1.52; 95% confidence interval [CI], 1.14–2.02; and class III: RR, 4.87; 95% CI, 3.50–6.77; reference overweight) and diabetes (RR, 6.04; 95% CI, 4.77–7.65). The adjusted RR associated with class III obesity was 3-fold among persons with diabetes (95% CI, 1.38–6.61) and nearly 9-fold among persons without diabetes (95% CI, 6.41–12.46), compared with overweight. The adjusted RRs associated with diabetes varied by age and BMI, with the highest RR in young populations without obesity. Population attributable risks of invasive GBS disease were 27.2% for obesity and 40.1% for diabetes. Conclusions Obesity and diabetes were associated with substantially increased risk of infection from invasive GBS. Given the population attributable risks of obesity and diabetes, interventions that reduce the prevalence of these conditions would likely reduce the burden of invasive GBS infection.
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Affiliation(s)
- Samantha I Pitts
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Nisa M Maruthur
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.,Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, Maryland
| | - Gayle E Langley
- Respiratory Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Tracy Pondo
- Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kathleen A Shutt
- Infectious Diseases Epidemiology Research Unit, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Rosemary Hollick
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Stephanie J Schrag
- Respiratory Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Ann Thomas
- Oregon Public Health Division, Portland, Oregon
| | - Megin Nichols
- New Mexico Department of Public Health, Santa Fe, New Mexico
| | | | - James P Watt
- California Department of Public Health, Richmond, California
| | - Lisa Miller
- University of Colorado School of Public Health, Aurora, Colorado
| | | | | | - Lee H Harrison
- Infectious Diseases Epidemiology Research Unit, University of Pittsburgh, Pittsburgh, Pennsylvania.,Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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103
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Ozlu E, Uzuncakmak TK, Takır M, Akdeniz N, Karadag AS. Comparison of cutaneous manifestations in diabetic and nondiabetic obese patients: A prospective, controlled study. North Clin Istanb 2018; 5:114-119. [PMID: 30374476 PMCID: PMC6191549 DOI: 10.14744/nci.2017.68553] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Accepted: 12/21/2017] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE Obesity is known to be a risk factor for many diseases including dermatological problems. Here, we aimed to determine the cutaneous manifestations in obese patients and the frequency of the accompanying dermatoses and to investigate the effect of diabetes mellitus in obese patients on cutaneous manifestations compared with the control group. METHODS Our study included a total of 600 adults: 450 obese volunteers and 150 healthy volunteers. The number of diabetic obese patients was 138 (30%), whereas that of nondiabetic obese patients was 312 (70%). A detailed dermatological examination was performed for each case, and accompanying dermatoses were compared. RESULTS The mean body mass index (BMI) in the obese patients and control group was 37.22 kg/m2 and 22.23 kg/m2, respectively. The most common dermatoses in the obese patients were, according to their frequency: striae distensae (291 patients, 64.7%), acrochordon (236 patients, 52.4%), acanthosis nigricans (213 patients, 47.3%), plantar hyperkeratosis (209 patients, 46.4%), and venous insufficiency (202 patients, 44.9%). Although hirsutism was more frequently observed in the nondiabetic obese group than in the diabetic obese group, stasis dermatitis was less frequently observed (p<0.05). CONCLUSION We found that many dermatoses are more frequently observed in the obese patients than in the controls. We observed that the effect of obesity on skin is different from that of diabetes mellitus and that cutaneous manifestations of obesity occur more frequently. More extensive, comprehensive, and advanced studies on this subject are required.
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Affiliation(s)
- Emin Ozlu
- Department of Dermatology, Faculty of Medicine, Duzce University, Duzce, Turkey
| | - Tugba Kevser Uzuncakmak
- Department of Dermatology, Istanbul Medeniyet University, Goztepe Training and Research Hospital, Istanbul, Turkey
| | - Mumtaz Takır
- Department of Endocrinology and Metabolism, Istanbul Medeniyet University, Istanbul, Turkey
| | - Necmettin Akdeniz
- Department of Dermatology, Faculty of Medicine, Istanbul Medeniyet University, Istanbul, Turkey
| | - Ayse Serap Karadag
- Department of Dermatology, Faculty of Medicine, Istanbul Medeniyet University, Istanbul, Turkey
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104
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Dietary Control of Skin Lipid Composition and Microbiome. J Invest Dermatol 2018; 138:1225-1228. [DOI: 10.1016/j.jid.2017.12.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 11/29/2017] [Accepted: 12/07/2017] [Indexed: 11/18/2022]
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105
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Hao D, Olugbodi A, Udechukwu N, Donato AA. Trauma-induced adiposis dolorosa (Dercum's disease). BMJ Case Rep 2018; 2018:bcr-2017-223869. [PMID: 29592996 DOI: 10.1136/bcr-2017-223869] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
We present a case of a 39-year-old man who presented with chronic bilateral upper extremity pain associated with innumerable angiomyolipomas that developed 5 years after a motor vehicle accident involving his upper extremities. Our case notes the rare nature of painful adipose tissue deposits and the diagnostic challenges.
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Affiliation(s)
- David Hao
- Internal Medicine, Reading Hospital and Medical Center, West Reading, Pennsylvania, USA
| | | | - Nneka Udechukwu
- Internal Medicine, Reading Hospital and Medical Center, West Reading, Pennsylvania, USA
| | - Anthony A Donato
- Internal Medicine, Reading Hospital and Medical Center, West Reading, Pennsylvania, USA
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106
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Melvin A, O'Rahilly S, Savage DB. Genetic syndromes of severe insulin resistance. Curr Opin Genet Dev 2018; 50:60-67. [PMID: 29477938 DOI: 10.1016/j.gde.2018.02.002] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 01/29/2018] [Accepted: 02/05/2018] [Indexed: 01/04/2023]
Abstract
Insulin resistance underpins the link between obesity and most of its associated metabolic disorders including type 2 diabetes, fatty liver disease, dyslipidaemia and cardiovascular disease. Despite its importance and extensive scientific endeavour, its precise molecular pathogenesis remains unclear. Monogenic syndromes of extreme insulin resistance, whilst rare in themselves, can provide unique insights into the pathogenesis of human insulin resistance. Severe insulin resistance syndromes are broadly classified into three categories: lipodystrophies, primary insulin signalling defects or complex syndromes including severe insulin resistance. Genetically confirmed classification has facilitated the identification of robust diagnostic biochemical features accelerating accurate clinical diagnosis. Interestingly the biochemical features of lipodystrophies are far more closely aligned to what is seen in prevalent forms of insulin resistance than those of primary insulin signalling defects, suggesting that lipodystrophy could be a relevant model for common disease. This assertion is supported by genome-wide association data indicating that SNPs associated with fasting hyperinsulinemia and metabolic dyslipidaemia, are strongly associated with a subtle reduction in hip fat, suggesting that subtle forms of lipodystrophy are likely to be a significant contributor to prevalent insulin resistance.
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Affiliation(s)
- A Melvin
- Metabolic Research Laboratory, Wellcome Trust MRC Institute of Metabolic Science, University of Cambridge, Cambridge, UK
| | - S O'Rahilly
- Metabolic Research Laboratory, Wellcome Trust MRC Institute of Metabolic Science, University of Cambridge, Cambridge, UK
| | - D B Savage
- Metabolic Research Laboratory, Wellcome Trust MRC Institute of Metabolic Science, University of Cambridge, Cambridge, UK.
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107
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Leptin regulates the pro-inflammatory response in human epidermal keratinocytes. Arch Dermatol Res 2018; 310:351-362. [PMID: 29468452 DOI: 10.1007/s00403-018-1821-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 01/22/2018] [Accepted: 02/13/2018] [Indexed: 12/29/2022]
Abstract
The role of leptin in cutaneous wound healing process has been suggested in genetically obese mouse studies. However, the molecular and cellular effects of leptin on human epidermal keratinocytes are still unclear. In this study, the whole-genome-scale microarray analysis was performed to elucidate the effect of leptin on epidermal keratinocyte functions. In the leptin-treated normal human keratinocytes (NHKs), we identified the 151 upregulated and 53 downregulated differentially expressed genes (DEGs). The gene ontology (GO) enrichment analysis with the leptin-induced DEGs suggests that leptin regulates NHKs to promote pro-inflammatory responses, extracellular matrix organization, and angiogenesis. Among the DEGs, the protein expression of IL-8, MMP-1, fibronectin, and S100A7, which play roles in which is important in the regulation of cutaneous inflammation, was confirmed in the leptin-treated NHKs. The upregulation of the leptin-induced proteins is mainly regulated by the STAT3 signaling pathway in NHKs. Among the downregulated DEGs, the protein expression of nucleosome assembly-associated centromere protein A (CENPA) and CENPM was confirmed in the leptin-treated NHKs. However, the expression of CENPA and CENPM was not coupled with those of other chromosome passenger complex like Aurora A kinase, INCENP, and survivin. In cell growth kinetics analysis, leptin had no significant effect on the cell growth curves of NHKs in the normal growth factor-enriched condition. Therefore, leptin-dependent downregulation of CENPA and CENPM in NHKs may not be directly associated with mitotic regulation during inflammation.
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108
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Ibuki A, Kuriyama S, Toyosaki Y, Aiba M, Hidaka M, Horie Y, Fujimoto C, Isami F, Shibata E, Terauchi Y, Akase T. Aging-like physiological changes in the skin of Japanese obese diabetic patients. SAGE Open Med 2018; 6:2050312118756662. [PMID: 29449943 PMCID: PMC5808963 DOI: 10.1177/2050312118756662] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Accepted: 01/09/2018] [Indexed: 12/28/2022] Open
Abstract
Objective: Obesity-associated diabetes causes aging-like changes to skin physiology in animal models, but there have been no clinical studies focusing on human obese diabetic patients. The purpose of this study was to examine the hypothesis that obesity-associated diabetes accelerates aging-like skin changes in Japanese people. Methods: This cross-sectional study enrolled obese-diabetes patients (body mass index ≥ 25 kg m−2) and healthy volunteers (body mass index < 25 kg m−2) as controls. Skin physiology parameters relating to aging (stratum corneum hydration, transepidermal water loss, skin pH, advanced glycation end-products, and dermal collagen density) were evaluated in the two groups. Results: About 37 subjects participated (16 in a control group and 21 in an obese-diabetes group). Age was not significantly different between the groups. The stratum corneum hydration level was significantly lower in the obese-diabetes group. Transepidermal water loss and levels of advanced glycation end-products were significantly higher in this group. Skin pH was not significantly different between groups. Dermal collagen density decreased in the obese-diabetes group. Conclusion: We showed that obese-diabetes patients have decreased stratum corneum hydration, increased transepidermal water loss, higher skin advanced glycation end-products and decreased dermal collagen fiber density compared with normal-weight subjects. These results indicate that the ordinary age-related physiological skin changes seen in the elderly can also occur in obese-diabetes patients aged in their 40s.
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Affiliation(s)
- Ai Ibuki
- Department of Biological Science and Nursing, School of Medicine, Yokohama City University, Yokohama, Japan
| | - Shoko Kuriyama
- Department of Biological Science and Nursing, School of Medicine, Yokohama City University, Yokohama, Japan
| | - Yukiko Toyosaki
- Department of Biological Science and Nursing, School of Medicine, Yokohama City University, Yokohama, Japan
| | - Misaki Aiba
- Department of Biological Science and Nursing, School of Medicine, Yokohama City University, Yokohama, Japan
| | - Moeko Hidaka
- Department of Biological Science and Nursing, School of Medicine, Yokohama City University, Yokohama, Japan
| | - Yoshiko Horie
- Department of Biological Science and Nursing, School of Medicine, Yokohama City University, Yokohama, Japan
| | - Chihiro Fujimoto
- Department of Biological Science and Nursing, School of Medicine, Yokohama City University, Yokohama, Japan
| | | | - Eriko Shibata
- Department of Endocrinology and Diabetes, Yokohama City University Hospital, Yokohama, Japan
| | - Yasuo Terauchi
- Department of Endocrinology and Diabetes, Yokohama City University Hospital, Yokohama, Japan
| | - Tomoko Akase
- Department of Biological Science and Nursing, School of Medicine, Yokohama City University, Yokohama, Japan
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109
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Deep Inferior Epigastric Perforator Versus Free Transverse Rectus Abdominis Myocutaneous Flap: Complications and Resource Utilization. Ann Plast Surg 2018; 78:516-520. [PMID: 28052051 DOI: 10.1097/sap.0000000000000936] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Abdominal based breast reconstruction exists in a continuum from pedicled transverse rectus abdominis myocutaneous (TRAM) flap to deep inferior epigastric perforator (DIEP) free flap. DIEP flap has the advantage of complete rectus abdominis sparing during harvest, thus decreasing donor site morbidity. Aim of this study is to determine whether the surgical advantages of the DIEP flap impact postoperative outcomes versus the free TRAM flap (fTRAM). METHODS We reviewed the Nationwide Inpatient Sample database (2010-2011) for all cases of DIEP and fTRAM breast reconstruction. Inclusion criteria were: female sex and patients undergoing DIEP or fTRAM total breast reconstruction. Male sex was excluded from the analysis. We examined demographic characteristics, hospital setting, insurance information, patient income, comorbidities, postoperative complications (including reoperation, hemorrhage, hematoma, seroma, myocardial infarction, pulmonary embolus, wound infection, and flap loss), length of stay, and total charges (TCs). Bivariate and multivariate analyses were performed to identify independent risk factors of increased length of stay and TCs. RESULTS Fifteen thousand eight hundred thirty-six cases were identified. Seventy percent were white, 97% were insured, and 83% of patients were treated in an academic teaching hospital setting. No mortalities were recorded. The DIEP cohort was more likely to be obese (P = 0.001). Free TRAM cohort was more likely to suffer pneumonia (P < 0.001; odds ratio [OR], 3.7), wound infection (P = 0.001; OR, 1.7), and wound dehiscence (P < 0.001; OR, 4.3). Type of reconstruction did not appear to affect risk of revision, hemorrhage, hematoma, seroma, or flap loss. Total charges were higher in the DIEP group (P < 0.001). Multivariate analysis demonstrated that fTRAM was an independent risk factor for increased length of stay (P < 0.001; OR, 1.6), and DIEP was an independent risk factor for increased TCs (P < 0.01; OR, 1.5). There was no significant difference in postoperative complications. CONCLUSIONS The fTRAM cohort was more likely to develop surgical site complications and have an increased length of stay, but TCs were higher for the DIEP group.
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110
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Uzuncakmak TK, Akdeniz N, Karadag AS. Cutaneous manifestations of obesity and themetabolic syndrome. Clin Dermatol 2018; 36:81-88. [DOI: 10.1016/j.clindermatol.2017.09.014] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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111
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Abstract
SummaryIntroduction: Varicose veins affect up to 40 % of men and up to 51 % of women. The patho-physiology of primary varicosis (chronic venous insufficiency, CVI) is poorly understood. Here, the available data on possible endocrine mechanisms in healthy and varicose veins are reviewed.Methods: An extensive literature search was conducted in PubMed using the following key words: Chronic venous insufficiency, CVI, chronic venous disease, CVD, varicosis, saphenous vein, pathogenesis, hormone.Results: Several theories ranging from incompetence of the valves to functional, biological or morphologic changes in different layers of the vein wall have been proposed. However, an increasing body of evidence suggests that endocrine mechanisms might be involved in the pathogenesis of primary varicosis. In this respect a growing number of hormones (e.g. estrogen, progesterone, relaxin-2, and oxytocin) and their receptors have been linked to primary varicosis in experimental, pharmacological and histological studies.Conclusion: In summary, endocrine-based mechanisms seem to play a role in the pathogenesis of primary varicosis. This opens up the perspective for pharmacological treatments targeting the various described endocrine regulatory networks.
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112
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Tehranchinia Z, Mahboubianfar A, Rahimi H, Saedi N. Fractionated CO 2 Laser in the Treatment of Striae Alba in Darker Skinned Patients - A Prospective Study. J Lasers Med Sci 2017; 9:15-18. [PMID: 29399305 DOI: 10.15171/jlms.2018.04] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Introduction: In recent years, the positive effect of fractional CO2 laser on increasing collagen fibers, and consequently its effect on treating striae has been suggested. The present study aims to assess the effectiveness of CO2 fractional laser 10600-nm in the treatment of striae alba. Methods: In this prospective clinical trial, 2 treatment sessions of fractional CO2 laser with 4-week interval was given to 30 patients with striae alba. Cutaneous resonance running time (CRRT) was measured at baseline and at week 4 and 3 months after the last session of laser therapy. The level of improvement was assessed by 2 independent dermatologists and patients after 3 months of follow up. Results: 16.7% of patients had moderate improvement, 63.3% had minimal improvement, and 20% had no improvement. A statistical significant difference was found in median CRRT during the study (P < 0.0001). The median CRRT levels were significantly higher in week 4 and 3 months after the last treatment compared to the baseline (both P < 0.001). Likewise, a significant increase was observed in median CRRT level from week 4 till the end of study (P < 0.001). Evaluation of participant satisfaction revealed that 10% were very satisfied, 10% satisfied, 3.3% slightly satisfied, and 76.7% unsatisfied. Conclusion: Striae alba remain a challenging condition to treat. The treatment of striae alba with CO2 fractional laser results in minimal improvement with mild side effects.
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Affiliation(s)
- Zohreh Tehranchinia
- Skin Research Center, Shahid Behehshti University of Medical Sciences, Tehran, Iran
| | | | - Hoda Rahimi
- Skin Research Center, Shahid Behehshti University of Medical Sciences, Tehran, Iran
| | - Nazanin Saedi
- Department of Dermatology, Thomas Jefferson University, Philadelphia, PA, USA
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113
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Fruh SM. Obesity: Risk factors, complications, and strategies for sustainable long-term weight management. J Am Assoc Nurse Pract 2017; 29:S3-S14. [PMID: 29024553 PMCID: PMC6088226 DOI: 10.1002/2327-6924.12510] [Citation(s) in RCA: 303] [Impact Index Per Article: 43.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 07/20/2017] [Accepted: 07/25/2017] [Indexed: 12/15/2022]
Abstract
Background and Purpose The aims of this article are to review the effects of obesity on health and well‐being and the evidence indicating they can be ameliorated by weight loss, and consider weight‐management strategies that may help patients achieve and maintain weight loss. Methods Narrative review based on literature searches of PubMed up to May 2016 with no date limits imposed. Search included terms such as “obesity,” “overweight,” “weight loss,” “comorbidity,” “diabetes,” cardiovascular,” “cancer,” “depression,” “management,” and “intervention.” Conclusions Over one third of U.S. adults have obesity. Obesity is associated with a range of comorbidities, including diabetes, cardiovascular disease, obstructive sleep apnea, and cancer; however, modest weight loss in the 5%–10% range, and above, can significantly improve health‐related outcomes. Many individuals struggle to maintain weight loss, although strategies such as realistic goal‐setting and increased consultation frequency can greatly improve the success of weight‐management programs. Nurse practitioners have key roles in establishing weight‐loss targets, providing motivation and support, and implementing weight‐loss programs. Implications for Practice With their in‐depth understanding of the research in the field of obesity and weight management, nurse practitioners are well placed to effect meaningful changes in weight‐management strategies deployed in clinical practice.
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Affiliation(s)
- Sharon M Fruh
- College of Nursing, University of South Alabama, Mobile, Alabama
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114
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Sobhan M, Farshchian M. Associations between body mass index and severity of psoriasis. Clin Cosmet Investig Dermatol 2017; 10:493-498. [PMID: 29200884 PMCID: PMC5703160 DOI: 10.2147/ccid.s147236] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Objective Compared with healthy people, overweight and obesity are more commonly found among those suffering from skin conditions such as psoriasis. The present study was an attempt to survey the relationship between obesity and intensity of psoriasis. Patients and methods A total of 42 patients with psoriasis who were referred to Farshchian Hospital, Hamadan, participated in this cross-sectional descriptive–analytical study. Patients were classified into mild, moderate and severe based on the intensity of the disease measured by Psoriasis Area and Severity Index (PASI). Body mass index (BMI), waist size, age, gender, smoking and drinking habits of the participants were measured and compared. Results A total of 15 (35.07%) patients had mild psoriasis, 9 (21.4%) patients had moderate psoriasis and 18 (42.9%) patients suffered from severe psoriasis. Mean BMI of mild psoriasis patients was 25.86±5.93 kg/m2, and this figure for the moderate and severe psoriasis patients was 30.85±3.77 kg/m2 and 26.96±5.68 kg/m2, respectively (P=0.096). Mean waist size of the mild psoriasis patients was 91.54±11.49 cm, and for moderate and severe patients, it was 99±8.39 cm and 92.17±10.73 cm, respectively (P=0.211). Conclusion The results of this study showed no significant difference between mean value of body mass index, waist size, age and gender in mild, moderate and severe groups of the psoriasis patients.
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Affiliation(s)
- Mohammadreza Sobhan
- Psoriasis Research Center, Department of Dermatology, Farshchian Hospital, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mahmoud Farshchian
- Psoriasis Research Center, Department of Dermatology, Farshchian Hospital, Hamadan University of Medical Sciences, Hamadan, Iran
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115
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Hao RH, Yang TL, Rong Y, Yao S, Dong SS, Chen H, Guo Y. Gene expression profiles indicate tissue-specific obesity regulation changes and strong obesity relevant tissues. Int J Obes (Lond) 2017; 42:363-369. [PMID: 29151593 DOI: 10.1038/ijo.2017.283] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 10/12/2017] [Accepted: 10/30/2017] [Indexed: 12/16/2022]
Abstract
BACKGROUND With the growing evidence that other tissues, apart from adipose, could have strong relevance to obesity, it is necessary to comprehensively understand the relationship between obesity and other tissues, and to point out the most relevant tissues. METHODS There were 549 participants with 20 different tissue types involved in this study. We firstly employed both Spearman's correlation test and WGCNA (weighted correlation network analysis) to identify body mass index (BMI)-related genes. Subsequently, we performed enrichment analyses with obesity genes and pathways to see the different regulation patterns among tissues. In addition, we compared obesity genes identified by genome-wide association studies (GWAS) with BMI-related genes to find the overlapping proportion in each tissue. Finally, we integrated preceding results to identify six strong obesity relevant tissues and indicate three categories to represent different obesity relevant tissues. RESULTS Statistical analyses revealed diverse BMI-related genes and tissue-specific enrichment patterns among tissues. Comparison between BMI-related genes and GWAS findings showed tissue-specific expression changes of GWAS genes. Ultimately, six tissues that showed predominant performance in enrichment analyses and significantly embraced GWAS genes were referred to as strong obesity relevant tissues, including adipose, esophagus, nerve, pancreas, pituitary and skin. We also proposed three categories to represent different obesity relevant tissues. CONCLUSIONS We performed the first study to investigate the BMI-related gene expression changes across 20 tissues at the same time. With valid data analyses and comparison with GWAS findings, our study provides a holistic view of how different tissues correlate with obesity, and proposes target tissues for obesity pathogenesis investigation.
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Affiliation(s)
- R-H Hao
- Key Laboratory of Biomedical Information Engineering of Ministry of Education, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, PR China
| | - T-L Yang
- Key Laboratory of Biomedical Information Engineering of Ministry of Education, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, PR China
| | - Y Rong
- Key Laboratory of Biomedical Information Engineering of Ministry of Education, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, PR China
| | - S Yao
- Key Laboratory of Biomedical Information Engineering of Ministry of Education, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, PR China
| | - S-S Dong
- Key Laboratory of Biomedical Information Engineering of Ministry of Education, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, PR China
| | - H Chen
- Key Laboratory of Biomedical Information Engineering of Ministry of Education, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, PR China
| | - Y Guo
- Key Laboratory of Biomedical Information Engineering of Ministry of Education, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, PR China
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116
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Awazawa M, Gabel P, Tsaousidou E, Nolte H, Krüger M, Schmitz J, Ackermann PJ, Brandt C, Altmüller J, Motameny S, Wunderlich FT, Kornfeld JW, Blüher M, Brüning JC. A microRNA screen reveals that elevated hepatic ectodysplasin A expression contributes to obesity-induced insulin resistance in skeletal muscle. Nat Med 2017; 23:1466-1473. [DOI: 10.1038/nm.4420] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Accepted: 09/11/2017] [Indexed: 01/21/2023]
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117
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Dąbrowska AK, Spano F, Derler S, Adlhart C, Spencer ND, Rossi RM. The relationship between skin function, barrier properties, and body-dependent factors. Skin Res Technol 2017; 24:165-174. [PMID: 29057509 DOI: 10.1111/srt.12424] [Citation(s) in RCA: 173] [Impact Index Per Article: 24.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2017] [Indexed: 01/28/2023]
Abstract
BACKGROUND Skin is a multilayer interface between the body and the environment, responsible for many important functions, such as temperature regulation, water transport, sensation, and protection from external triggers. OBJECTIVES This paper provides an overview of principal factors that influence human skin and describes the diversity of skin characteristics, its causes and possible consequences. It also discusses limitations in the barrier function of the skin, describing mechanisms of absorption. METHODS There are a number of in vivo investigations focusing on the diversity of human skin characteristics with reference to barrier properties and body-dependent factors. RESULTS Skin properties vary among individuals of different age, gender, ethnicity, and skin types. In addition, skin characteristics differ depending on the body site and can be influenced by the body-mass index and lifestyle. Although one of the main functions of the skin is to act as a barrier, absorption of some substances remains possible. CONCLUSIONS Various factors can alter human skin properties, which can be reflected in skin function and the quality of everyday life. Skin properties and function are strongly interlinked.
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Affiliation(s)
- A K Dąbrowska
- Laboratory for Biomimetic Membranes and Textiles, Empa, Swiss Federal Laboratories for Materials Science and Technology, St. Gallen, Switzerland.,Laboratory for Surface Science and Technology, Department of Materials, ETH Zürich, Zürich, Switzerland
| | - F Spano
- Laboratory for Biomimetic Membranes and Textiles, Empa, Swiss Federal Laboratories for Materials Science and Technology, St. Gallen, Switzerland
| | - S Derler
- Laboratory for Biomimetic Membranes and Textiles, Empa, Swiss Federal Laboratories for Materials Science and Technology, St. Gallen, Switzerland
| | - C Adlhart
- Institute of Chemistry and Biotechnology, Zurich University of Applied Sciences, ZHAW, Wädenswil, Switzerland
| | - N D Spencer
- Laboratory for Surface Science and Technology, Department of Materials, ETH Zürich, Zürich, Switzerland
| | - R M Rossi
- Laboratory for Biomimetic Membranes and Textiles, Empa, Swiss Federal Laboratories for Materials Science and Technology, St. Gallen, Switzerland
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118
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Bahali AG, Onsun N, Su O, Ozkaya DB, Dizman D, Topukcu B, Uysal O. The relationship between pruritus and clinical variables in patients with psoriasis. An Bras Dermatol 2017; 92:470-473. [PMID: 28954093 PMCID: PMC5595591 DOI: 10.1590/abd1806-4841.20175402] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Accepted: 06/12/2016] [Indexed: 11/30/2022] Open
Abstract
Background Pruritus is the most commonly occurring subjective symptom of dermatological
disease. Published data on both prevalence and intensity of pruritus in
psoriasis is limited. Objective In this study we aimed to investigate the prevalence of pruritus and its
relation with psoriasis area severity index, body mass index and presence of
systemic disease in patients with psoriasis. Methods We analyzed data of psoriatic patients diagnosed in our psoriasis outpatient
clinic between March 2013 and June 2014 collected retrospectively from
PSR-TR registration system. Results In total, 880 patients were analyzed. Pruritus was more prominent in female
patients. This difference was statistically significant. No significant
associations were found between age of patients, clinical type of disease
and pruritus. The itching was more common in patients with higher body mass
index. Presence of pruritus was correlated significantly with severity of
psoriasis. Five hundred and sixty of 880 patients had no systemic disease.
The presence of pruritus was not related with presence of systemic disease.
Existence of systemic disease with psoriasis has minimal effect on
pruritus. Study Limitations We did not evaluate intensity of pruritus. Conclusions Pruritus is not mentioned within the classical symptoms of psoriasis.
Pruritus in psoriasis is a very unpleasant symptom with great potential to
impair patient's quality of life and may exacerbate psoriasis as a Koebner
phenomenon.
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Affiliation(s)
- Anil Gulsel Bahali
- Department of Dermatology, Medical Faculty, Bezmialem Vakif University - Istanbul, Turquia
| | - Nahide Onsun
- Department of Dermatology, Medical Faculty, Bezmialem Vakif University - Istanbul, Turquia
| | - Ozlem Su
- Department of Dermatology, Medical Faculty, Bezmialem Vakif University - Istanbul, Turquia
| | - Dilek Biyik Ozkaya
- Department of Dermatology, Medical Faculty, Bezmialem Vakif University - Istanbul, Turquia
| | - Didem Dizman
- Department of Dermatology, Ardahan State Hospital - Ardahan, Turkey
| | - Bugce Topukcu
- Department of Dermatology, Medistate Hospital - Istanbul, Turquia
| | - Omer Uysal
- Department of Biostatistics, Medical Faculty, Bezmialem Vakif University - Istanbul, Turquia
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119
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Abstract
Originally coined as "syndrome X" in 1988 by Gerald Reaven (1928), the metabolic syndrome (MetS) encompasses a constellation of risk factors, the coincidence of which amounts to an increased cardiovascular and diabetic risk. Rising numbers of dermatoses are being recognized as cutaneous markers of MetS. Dermatologists should look beyond treating the cutaneous condition and quantify the associated increase in cardiovascular risk. The original dermatosis associated with obesity was acanthosis nigricans-described in 1889 by Paul Gerson Unna (1850-1929) and Sigmund Pollitzer (1859-1937). Over the last 20 years, clear associations between psoriasis, hidradenitis suppurativa, and MetS have also emerged. Several studies have shown synergistic improvement in the cutaneous pathology after treatment of components of MetS. This suggests common causalities and is a burgeoning area of research. We review the available evidence about the genetics underlying psoriasis, hidradenitis suppurativa, and acanthosis nigricans. Despite the strong clinical associations, the underlying genetic basis for a link to MetS remains unclear.
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Affiliation(s)
- Emma Fanning
- Department of Medicine, St James Hospital, Trinity College Dublin, Dublin, Ireland
| | - Donal O'Shea
- Department of Endocrinology, St Vincent's University Hospital, University College Dublin, Dublin, Ireland.
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120
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Interactions between Neighbourhood Urban Form and Socioeconomic Status and Their Associations with Anthropometric Measurements in Canadian Adults. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2017; 2017:5042614. [PMID: 29056976 PMCID: PMC5605799 DOI: 10.1155/2017/5042614] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Accepted: 08/06/2017] [Indexed: 02/01/2023]
Abstract
Neighbourhood-level socioeconomic composition and built context are correlates of weight-related behaviours. We investigated the relations between objective measures of neighbourhood design and socioeconomic status (SES) and their interaction, in relation to self-reported waist circumference (WC), waist-to-hip ratio, and body mass index (BMI) in a sample of Canadian adults (n = 851 from 12 Calgary neighbourhoods). WC and BMI were higher among residents of disadvantaged neighbourhoods, independent of neighbourhood design (grid, warped grid, and curvilinear street patterns) and individual-level characteristics (sex, age, education, income, dog ownership, marital status, number of dependents, motor vehicle access, smoking, sleep, mental health, physical health, and past attempts to modify bodyweight). The association between neighbourhood-level SES and WC was modified by neighbourhood design; WC was higher in disadvantaged-curvilinear neighbourhoods and lower in advantaged-grid neighbourhoods. Policies making less obesogenic neighbourhoods affordable to low socioeconomic households and that improve the supportiveness for behaviours leading to healthy weight in low socioeconomic neighbourhoods are necessary.
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121
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Makihara H, Hidaka M, Sakai Y, Horie Y, Mitsui H, Ohashi K, Goshima Y, Akase T. Reduction and fragmentation of elastic fibers in the skin of obese mice is associated with altered mRNA expression levels of fibrillin-1 and neprilysin. Connect Tissue Res 2017; 58:479-486. [PMID: 27892729 DOI: 10.1080/03008207.2016.1255205] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
AIM OF THE STUDY Our previous research suggested that obesity induces structural fragility in the skin. Elastic fibers impart strength and elasticity. In this study, we determined whether elastic fibers decrease in the skin of obese mice. MATERIALS AND METHODS To confirm alterations in elastic fiber content due to obesity, we used spontaneously obese model mice (TSOD) and control mice (TSNO). Furthermore, to evaluate the elastin structure and gene expression dependent on the severity of obesity, an obesity-enhanced mouse model was developed by feeding a high fat diet to TSOD (TSOD-HF). Back skin samples were stained with hematoxylin and eosin and Elastica van Gieson for microscopic examination, and the samples were stained for immunohistochemical analysis of neprilysin. Gene expression levels were determined using a real-time PCR system. RESULTS The abundance of elastic fibers beneath the epidermis was remarkably reduced and fragmented in TSOD as compared with TSNO. Fibrillin-1 mRNA levels in TSOD were significantly suppressed compared with those in TSNO, whereas neprilysin mRNA levels and immunohistochemical expression in TSOD were significantly increased, as compared with those in TSNO. The reduction of elastic fibers was enhanced and the expression levels of elastic fiber formed factors were significantly suppressed in TSOD-HF, as compared with those in the TSOD. CONCLUSIONS The abundance of elastic fibers was reduced and fragmented in obesity, suggesting that the reduction in elastic fibers is initially caused by increased neprilysin and decreased fibrillin-1 expression, which may inhibit formation and stabilization of elastic fibers, resulting in skin fragility in obesity.
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Affiliation(s)
- Hiroko Makihara
- a Department of Molecular Pharmacology and Neurobiology , Yokohama City University Graduate School of Medicine , Yokohama , Japan.,b Department of Biological Science and Nursing , Yokohama City University Graduate School of Medicine , Yokohama , Japan
| | - Moeko Hidaka
- b Department of Biological Science and Nursing , Yokohama City University Graduate School of Medicine , Yokohama , Japan
| | - Yui Sakai
- b Department of Biological Science and Nursing , Yokohama City University Graduate School of Medicine , Yokohama , Japan
| | - Yoshiko Horie
- b Department of Biological Science and Nursing , Yokohama City University Graduate School of Medicine , Yokohama , Japan
| | - Hideaki Mitsui
- c Department of Pathology , Yokohama City University Graduate School of Medicine , Yokohama , Japan
| | - Kenichi Ohashi
- c Department of Pathology , Yokohama City University Graduate School of Medicine , Yokohama , Japan
| | - Yoshio Goshima
- a Department of Molecular Pharmacology and Neurobiology , Yokohama City University Graduate School of Medicine , Yokohama , Japan
| | - Tomoko Akase
- b Department of Biological Science and Nursing , Yokohama City University Graduate School of Medicine , Yokohama , Japan
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122
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Eskelinen S, Sailas E, Joutsenniemi K, Holi M, Koskela TH, Suvisaari J. Multiple physical healthcare needs among outpatients with schizophrenia: findings from a health examination study. Nord J Psychiatry 2017; 71:448-454. [PMID: 28497707 DOI: 10.1080/08039488.2017.1319497] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Despite the abundant literature on physical comorbidity, the full range of the concurrent somatic healthcare needs among individuals with schizophrenia has rarely been studied. AIMS This observational study aimed to assess the distressing somatic symptoms and needs for physical health interventions in outpatients with schizophrenia, and factors predicting those needs. METHODS A structured, comprehensive health examination was carried out, including a visit to a nurse and a general practitioner on 275 outpatients with schizophrenia. The required interventions were classified by type of disease. Logistic regression was used to assess the influence of sociodemographic factors, lifestyle, functional limitations, factors related to psychiatric disorder, and healthcare use on the need for interventions. RESULTS In total, 44.9% of the patients (mean age 44.9 years) reported somatic symptoms affecting daily life; 87.6% needed specific interventions for a disease or condition, most commonly for cardiovascular, dermatological, dental, ophthalmological, and gastrointestinal conditions, and for altered glucose homeostasis. Smoking and obesity predicted significantly a need of any intervention, but the predictors varied in each disease category. Strikingly, use of general practitioner services during the previous year did not reduce the need for interventions. CONCLUSIONS Health examinations for outpatients with schizophrenia revealed numerous physical healthcare needs. The health examinations for patients with schizophrenia should contain a medical history taking and a physical examination, in addition to basic measurements and laboratory tests. Prevention and treatment of obesity and smoking should be given priority in order to diminish somatic comorbidities in schizophrenia.
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Affiliation(s)
- Saana Eskelinen
- a Kellokoski Hospital , Tuusula , Finland.,b Mental Health Unit , National Institute for Health and Welfare , Helsinki , Finland
| | | | - Kaisla Joutsenniemi
- c Psychiatry , University of Helsinki and Helsinki University Hospital , Helsinki , Finland
| | - Matti Holi
- c Psychiatry , University of Helsinki and Helsinki University Hospital , Helsinki , Finland
| | - Tuomas H Koskela
- d Department of General Practice , University of Tampere , Tampere , Finland
| | - Jaana Suvisaari
- b Mental Health Unit , National Institute for Health and Welfare , Helsinki , Finland
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123
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Dornuf F, Martín-Mateos P, Duarte B, Hils B, Bonilla-Manrique OE, Larcher F, Acedo P, Krozer V. Classification of skin phenotypes caused by diabetes mellitus using complex scattering parameters in the millimeter-wave frequency range. Sci Rep 2017; 7:5822. [PMID: 28724970 PMCID: PMC5517582 DOI: 10.1038/s41598-017-06034-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 06/06/2017] [Indexed: 11/30/2022] Open
Abstract
The pathological skin phenotype caused by hyperglycemia is an important indicator for the progress of diabetes mellitus. An early detection of diabetes assures an early intervention to regulate the carbohydrate metabolism. In this publication a non-invasive detection principle based on the measurement of complex scattering parameters in the millimeter-wave frequency range is presented. The measurement principle provides evidence of the applicability for the identification of different glycemic states in animal models. The method proposed here can be used to predict diabetes status in animal models and is interesting for application on humans in view of safeness of millimeter-wave radiation. Furthermore the complex scattering parameters give important information about the anatomic varieties between the analyzed skin samples of the different mice strains. In contrast to other methods, our approach is less sensitive to skin variations between animals.
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Affiliation(s)
- Fabian Dornuf
- Physics Institute, Goethe University Frankfurt am Main, 60438, Frankfurt am Main, Germany.
| | - Pedro Martín-Mateos
- Department of Electronics Technology, Universidad Carlos III de Madrid, Leganes, Madrid, 28911, Spain
| | - Blanca Duarte
- Epithelial Biomedicine Division, CIEMAT, Avenida Complutense 40, Madrid, 28040, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Madrid, Spain
| | - Bernhard Hils
- Physics Institute, Goethe University Frankfurt am Main, 60438, Frankfurt am Main, Germany
| | | | - Fernando Larcher
- Epithelial Biomedicine Division, CIEMAT, Avenida Complutense 40, Madrid, 28040, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Madrid, Spain.,Department of Bioengineering, Universidad Carlos III de Madrid, Leganes, Madrid, 28911, Spain.,Instituto de Investigaciones sanitarias de la Fundación Jimenez Diaz (IIS-FJD), Madrid, Spain
| | - Pablo Acedo
- Department of Electronics Technology, Universidad Carlos III de Madrid, Leganes, Madrid, 28911, Spain
| | - Viktor Krozer
- Physics Institute, Goethe University Frankfurt am Main, 60438, Frankfurt am Main, Germany
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124
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Melvin A, Stears A. Severe insulin resistance: pathologies. PRACTICAL DIABETES 2017. [DOI: 10.1002/pdi.2116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Audrey Melvin
- National Severe Insulin Resistance Service, Wolfson Diabetes and Endocrinology Department; Addenbrooke's Hospital; Cambridge UK
- Metabolic Research Laboratories, Wellcome Trust MRC Institute of Metabolic Science; University of Cambridge; Cambridge UK
| | - Anna Stears
- National Severe Insulin Resistance Service, Wolfson Diabetes and Endocrinology Department; Addenbrooke's Hospital; Cambridge UK
- Metabolic Research Laboratories, Wellcome Trust MRC Institute of Metabolic Science; University of Cambridge; Cambridge UK
- Institute of Metabolic Science; Addenbrooke's Hospital; Cambridge UK
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125
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Shah A, Alhusayen R, Amini-Nik S. The critical role of macrophages in the pathogenesis of hidradenitis suppurativa. Inflamm Res 2017; 66:931-945. [PMID: 28656364 DOI: 10.1007/s00011-017-1074-y] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2017] [Accepted: 06/21/2017] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Hidradenitis suppurativa (HS) is a painful chronic inflammatory disease with a prevalence between 1 and 4% of general population. The pathogenesis of HS long eluded scientists, but growing evidence suggests that it is a consequence of inflammatory dysregulation. FINDINGS Recent studies suggest that dysregulated immune response to skin flora and overexpression of inflammatory cytokines leads to chronic skin inflammation seen in HS. Macrophages are the most numerous inflammatory cells found in HS infiltrates and release numerous pro-inflammatory cytokines such as IL-23, and IL-1β and TNF-α, exacerbating the inflammation and contributing to the pathogenesis of HS. Furthermore, in HS, there is dysregulated function of other immune players closely associated with macrophage function including: matrix metalloproteases (MMP) 2 and 9 overexpression, toll-like receptor upregulation, impaired Notch signalling, NLRP3 inflammasome upregulation, and dysregulated keratinocyte function. Lifestyle factors including obesity and smoking also contribute to macrophage dysfunction and correlate with HS incidence. CONCLUSIONS The overexpression of pro-inflammatory cytokines and subsequent efficacy of anti-cytokine biologic therapies highlights the importance of managing macrophage dysfunction. Future therapies should target key molecular drivers of macrophage dysfunction such as TLR2 and NLRP3 overexpression.
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Affiliation(s)
- Ahmed Shah
- Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Raed Alhusayen
- Faculty of Medicine, University of Toronto, Toronto, Canada.,Division of Dermatology, University of Toronto, Toronto, Canada.,Sunnybrook Health Science Center, Sunnybrook Research Institute, Toronto, Canada
| | - Saeid Amini-Nik
- Faculty of Medicine, University of Toronto, Toronto, Canada. .,Department of Surgery, University of Toronto, Toronto, Canada. .,Department of Laboratory Medicine and Pathobiology (LMP), University of Toronto, Toronto, Canada. .,Sunnybrook Health Science Center, Sunnybrook Research Institute, Toronto, Canada.
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126
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Striae Distensae: Preventative and Therapeutic Modalities to Improve Aesthetic Appearance. Dermatol Surg 2017; 43:635-648. [DOI: 10.1097/dss.0000000000001079] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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127
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Monteiro Rodrigues LM, Palma L, Santos O, Almeida MA, Bujan J, Tavares L. Excessive Weight Favours Skin Physiology - Up to a Point: Another Expression of the Obesity Paradox. Skin Pharmacol Physiol 2017; 30:94-101. [PMID: 28423379 DOI: 10.1159/000464338] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 02/17/2017] [Indexed: 01/23/2023]
Abstract
BACKGROUND/AIMS Recently classified as an epidemic by the WHO, obesity (as well as the state of being overweight) clearly affects significant populations across all ages. The relationship between obesity and some diseases (e.g. cardiovascular ones) is known, although many paradoxes remain to be explained. Very little information is available, however, regarding its impact on skin physiology and skin disease. This study aims to examine the influence of excessive weight on epidermal hydration and transepidermal water loss, key variables of skin water balance and skin biomechanics. METHODS A convenience sample of 89 healthy female volunteers was selected and divided into 4 groups, according to their BMI (body mass index), as normal (control), overweight, obese (I and II), and morbid. Skin physiology was quantitatively assessed in all individuals in 4 anatomical areas using non-invasive biometrical analysis by reference instrumentation. Descriptive and comparative statistics were applied, adopting a confidence level of 95%. RESULTS A non-linear alteration for all variables was detected as a function of BMI. CONCLUSION Results suggest that excessive weight might favour skin performance within certain limits, reflecting a particular adaptation of the skin to the weight gain and body contour.
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128
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Ndiaye M, Taleb M, Diatta B, Diop A, Diallo M, Diadie S, Seck N, Diallo S, Ndiaye M, Niang S, Ly F, Kane A, Dieng M. Les étiologies des intertrigos chez l’adulte : étude prospective de 103 cas. J Mycol Med 2017; 27:28-32. [DOI: 10.1016/j.mycmed.2016.06.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Revised: 05/29/2016] [Accepted: 06/01/2016] [Indexed: 01/12/2023]
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129
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Bogdan C, Iurian S, Tomuta I, Moldovan M. Improvement of skin condition in striae distensae: development, characterization and clinical efficacy of a cosmetic product containing Punica granatum seed oil and Croton lechleri resin extract. Drug Des Devel Ther 2017; 11:521-531. [PMID: 28280300 PMCID: PMC5338857 DOI: 10.2147/dddt.s128470] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Striae distensae are a frequent skin condition associated with pregnancy, weight change or lack of skin elasticity. The aim of this research was to obtain a topical product containing herbal active ingredients with documented antioxidant and anti-inflammatory activity (Punica granatum seed oil and Croton lechleri resin extract) and demonstrate its positive effect on prevention and treatment of striae distensae. First, the cream base formulation was optimized through experimental design. Secondly, the cream containing the two active ingredients was investigated in an interventional nonrandomized clinical trial. The clinical outcome was assessed through biophysical parameters and ultrasonographic evaluation. The state of the skin was evaluated by biophysical measurements and ultrasonography at the beginning of the study and after 3 and 6 weeks. The experimental design was successfully used to set the best ranges for the technological and formulation factors to obtain a cosmetic formulation with optimal characteristics. The study of clinical efficacy on the optimal formulation revealed an increase in the dermis thickness, hydration and elasticity values in both groups after 6 weeks of cream application. The new oil-in-water cream containing P. granatum seed oil and C. lechleri resin extract can be helpful in the prevention or improving of skin changes associated with striae.
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Affiliation(s)
| | - Sonia Iurian
- Department of Pharmaceutical Technology and Biopharmacy, Faculty of Pharmacy, University of Medicine and Pharmacy Iuliu Haţieganu, Cluj-Napoca, Romania
| | - Ioan Tomuta
- Department of Pharmaceutical Technology and Biopharmacy, Faculty of Pharmacy, University of Medicine and Pharmacy Iuliu Haţieganu, Cluj-Napoca, Romania
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130
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Lőrincz K, Haluszka D, Kiss N, Gyöngyösi N, Bánvölgyi A, Szipőcs R, Wikonkál NM. Voluntary exercise improves murine dermal connective tissue status in high-fat diet-induced obesity. Arch Dermatol Res 2017; 309:209-215. [PMID: 28180933 DOI: 10.1007/s00403-017-1715-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 12/20/2016] [Accepted: 01/10/2017] [Indexed: 01/10/2023]
Abstract
Obesity is a risk factor for several cardiovascular and metabolic diseases. Its influence on the skin is less obvious, yet certain negative effects of adipose tissue inflammation on the dermis have been suggested. Excess weight is closely associated with sedentary behavior, so any increase in physical activity is considered beneficial against obesity. To investigate the effects of obesity and physical exercise on the skin, we established a mouse model in which mice were kept either on a high-fat diet or received standard chow. After the two groups achieved a significant weight difference, physical exercise was introduced to both. Animals were given the opportunity to perform voluntary exercise for 40 min daily in a hamster wheel for a period of 8 weeks. We evaluated the status of the dermis at the beginning and at the end of the exercise period by in vivo nonlinear microscopy. Obese mice kept on high-fat diet lost weight steadily after they started to exercise. In the high-fat diet group, we could detect significantly larger adipocytes and a thicker layer of subcutaneous tissue; both changes started to normalize after exercise. Nonlinear microscopy revealed an impaired collagen structure in obese mice that improved considerably after physical activity was introduced. With the ability to detect damage on collagen structure, we set out to address the question whether this process is reversible. With the use of a novel imaging method, we were able to show the reversibility of connective tissue deterioration as a benefit of physical exercise.
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Affiliation(s)
- Kende Lőrincz
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 41 Mária Street, Budapest, 1085, Hungary
| | - Dóra Haluszka
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 41 Mária Street, Budapest, 1085, Hungary.,Institute for Solid State Physics and Optics of Wigner RCP, Budapest, Hungary
| | - Norbert Kiss
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 41 Mária Street, Budapest, 1085, Hungary.,Institute for Solid State Physics and Optics of Wigner RCP, Budapest, Hungary
| | - Nóra Gyöngyösi
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 41 Mária Street, Budapest, 1085, Hungary
| | - András Bánvölgyi
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 41 Mária Street, Budapest, 1085, Hungary
| | - Róbert Szipőcs
- Institute for Solid State Physics and Optics of Wigner RCP, Budapest, Hungary.,R&D Ultrafast Lasers Ltd, Budapest, Hungary
| | - Norbert M Wikonkál
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 41 Mária Street, Budapest, 1085, Hungary.
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131
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Kumar S, Kelly AS. Review of Childhood Obesity: From Epidemiology, Etiology, and Comorbidities to Clinical Assessment and Treatment. Mayo Clin Proc 2017; 92:251-265. [PMID: 28065514 DOI: 10.1016/j.mayocp.2016.09.017] [Citation(s) in RCA: 783] [Impact Index Per Article: 111.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Revised: 09/12/2016] [Accepted: 09/21/2016] [Indexed: 12/11/2022]
Abstract
Childhood obesity has emerged as an important public health problem in the United States and other countries in the world. Currently 1 in 3 children in the United States is afflicted with overweight or obesity. The increasing prevalence of childhood obesity is associated with emergence of comorbidities previously considered to be "adult" diseases including type 2 diabetes mellitus, hypertension, nonalcoholic fatty liver disease, obstructive sleep apnea, and dyslipidemia. The most common cause of obesity in children is a positive energy balance due to caloric intake in excess of caloric expenditure combined with a genetic predisposition for weight gain. Most obese children do not have an underlying endocrine or single genetic cause for their weight gain. Evaluation of children with obesity is aimed at determining the cause of weight gain and assessing for comorbidities resulting from excess weight. Family-based lifestyle interventions, including dietary modifications and increased physical activity, are the cornerstone of weight management in children. A staged approach to pediatric weight management is recommended with consideration of the age of the child, severity of obesity, and presence of obesity-related comorbidities in determining the initial stage of treatment. Lifestyle interventions have shown only modest effect on weight loss, particularly in children with severe obesity. There is limited information on the efficacy and safety of medications for weight loss in children. Bariatric surgery has been found to be effective in decreasing excess weight and improving comorbidities in adolescents with severe obesity. However, there are limited data on the long-term efficacy and safety of bariatric surgery in adolescents. For this comprehensive review, the literature was scanned from 1994 to 2016 using PubMed using the following search terms: childhood obesity, pediatric obesity, childhood overweight, bariatric surgery, and adolescents.
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Affiliation(s)
- Seema Kumar
- Division of Pediatric Endocrinology and Metabolism, Mayo Clinic, Rochester, MN.
| | - Aaron S Kelly
- Department of Pediatrics and Department of Medicine, University of Minnesota, Minneapolis
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132
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Lifestyle and Environmental Influences on Skin. LIFESTYLE MEDICINE 2017. [DOI: 10.1016/b978-0-12-810401-9.00028-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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133
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Udechukwu NS, Fleischer AB. Higher Risk of Care for Hidradenitis Suppurativa in African American and Non-Hispanic Patients in the United States. J Natl Med Assoc 2017; 109:44-48. [DOI: 10.1016/j.jnma.2016.09.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Revised: 09/02/2016] [Accepted: 09/05/2016] [Indexed: 10/20/2022]
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134
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Gupta M. Cutaneous manifestations of obesity in children: A prospective study. INDIAN JOURNAL OF PAEDIATRIC DERMATOLOGY 2017. [DOI: 10.4103/2319-7250.193004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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135
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Gorlanov IA, Zaslavskiy DV, Leina LM, Milyavskaya IR. Obesity related skin disorders. VESTNIK DERMATOLOGII I VENEROLOGII 2016. [DOI: 10.25208/0042-4609-2016-92-6-20-26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Obesity is a serious global problem. In recent years, it has been an increase in patients with obesity. In a review of literature presents data on the effect of obesity on the skin. It is responsible for the development of a number of dermatological diseases, including acantosis nigricans, akrohordony, follicular hyperkeratosis, infectious diseases of the skin. Against the background of obesity worsens psoriasis. The connection between obesity and atopic dermatitis.
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Zhang MX, Chen CY, Fang QQ, Xu JH, Wang XF, Shi BH, Wu LH, Tan WQ. Risk Factors for Complications after Reduction Mammoplasty: A Meta-Analysis. PLoS One 2016; 11:e0167746. [PMID: 27936188 PMCID: PMC5147968 DOI: 10.1371/journal.pone.0167746] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Accepted: 11/19/2016] [Indexed: 11/19/2022] Open
Abstract
Background Reduction mammoplasty (RM) is a proven method of treating macromastia, but the risk factors for postoperative complications have not been clearly identified. Through this meta-analysis, the authors aimed to identify the risk factors of RM complications. Methods An extensive search of the literature describing complications after RM was performed using the PubMed Central, Embase, and Cochrane databases. The following risk factors were extracted: age, body mass index (BMI), tissue resection weight per breast (TRW), smoking and radiation therapy. Odds ratios (OR) were pooled with 95% confidence intervals (CI) to evaluate the relationship between these risk factors and complications after RM. Results A total of 16 unique studies including 10 593 patients were included in the final analysis. It showed that there was a significant difference in complications in BMI ≥30 kg/m2 (OR 0.73; 95% CI: 0.61–0.89, p = 0.001) and smoking (OR 1.56; 95% CI: 0.98–2.49, p = 0.06). Infection in those with BMI ≥30 kg/m2 showed a significant difference (OR 0.68; 95% CI: 0.52–0.89, p = 0.004), as well as wound dehiscence in smokers (OR 2.73; 95% CI: 1.60–4.67, p = 0.0002) and infection in irradiated breasts (OR 20.38; 95% CI: 3.42–121.35, p = 0.0009). However, there was no significant difference in age ≥50 years (OR 0.96; 95% CI: 0.71–1.29, p = 0.78), combined TRW ≥1000 g (OR 1.04; 95% CI: 0.43–2.50, p = 0.93). Conclusions BMI ≥30 kg/m2 and smoking increase the risk of complications. Persons who are obese or irradiated are more likely to develop infections, and smokers experienced a higher incidence of wound dehiscence than did nonsmokers. However, patients aged ≥50 years and TRW ≥1000 g are not associated with complications from RM.
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Affiliation(s)
- Min-Xia Zhang
- Department of Plastic Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, P.R China
- Department of Plastic Surgery, The Fourth Affiliated Hospital, College of Medicine, Zhejiang University, Yiwu, Zhejiang Province, P.R China
| | - Chun-Ye Chen
- Department of Plastic Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, P.R China
- Department of Plastic Surgery, The Fourth Affiliated Hospital, College of Medicine, Zhejiang University, Yiwu, Zhejiang Province, P.R China
| | - Qing-Qing Fang
- Department of Plastic Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, P.R China
- Department of Plastic Surgery, The Fourth Affiliated Hospital, College of Medicine, Zhejiang University, Yiwu, Zhejiang Province, P.R China
| | - Ji-Hua Xu
- Department of Plastic Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, P.R China
| | - Xiao-Feng Wang
- Department of Plastic Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, P.R China
- Department of Plastic Surgery, The Fourth Affiliated Hospital, College of Medicine, Zhejiang University, Yiwu, Zhejiang Province, P.R China
| | - Bang-Hui Shi
- Department of Plastic Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, P.R China
- Department of Plastic Surgery, The Fourth Affiliated Hospital, College of Medicine, Zhejiang University, Yiwu, Zhejiang Province, P.R China
| | - Li-Hong Wu
- Department of Plastic Surgery, The Fourth Affiliated Hospital, College of Medicine, Zhejiang University, Yiwu, Zhejiang Province, P.R China
| | - Wei-Qiang Tan
- Department of Plastic Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, P.R China
- Department of Plastic Surgery, The Fourth Affiliated Hospital, College of Medicine, Zhejiang University, Yiwu, Zhejiang Province, P.R China
- * E-mail:
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Skin Manifestations of Insulin Resistance: From a Biochemical Stance to a Clinical Diagnosis and Management. Dermatol Ther (Heidelb) 2016; 7:37-51. [PMID: 27921251 PMCID: PMC5336429 DOI: 10.1007/s13555-016-0160-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Indexed: 12/18/2022] Open
Abstract
Worldwide, more than 1.9 billion adults are overweight, and around 600 million people suffer from obesity. Similarly, ~382 million individuals live with diabetes, and 40–50% of the global population is labeled at “high risk” (i.e., prediabetes). The impact of these two chronic conditions relies not only on the burden of illnesses per se (i.e., associated increased morbidity and mortality), but also on their increased cost, burden of treatment, and decreased health-related quality of life. For this review a comprehensive search in several databases including PubMed (MEDLINE), Ovid EMBASE, Web of Science, and Scopus was conducted. In both diabetes and obesity, genetic, epigenetic, and environmental factors overlap and are inclusive rather than exclusive. De facto, 70–80% of the patients with obesity and virtually every patient with type 2 diabetes have insulin resistance. Insulin resistance is a well-known pathophysiologic factor in the development of type 2 diabetes, characteristically appearing years before its diagnosis. The gold standard for insulin resistance diagnosis (the euglycemic insulin clamp) is a complex, invasive, costly, and hence unfeasible test to implement in clinical practice. Likewise, laboratory measures and derived indexes [e.g., homeostasis model assessment of insulin resistance (HOMA-IR-)] are indirect, imprecise, and not highly accurate and reproducible tests. However, skin manifestations of insulin resistance (e.g., acrochordons, acanthosis nigricans, androgenetic alopecia, acne, hirsutism) offer a reliable, straightforward, and real-time way to detect insulin resistance. The objective of this review is to aid clinicians in recognizing skin manifestations of insulin resistance. Diagnosing these skin manifestations accurately may cascade positively in the patient’s health by triggering an adequate metabolic evaluation, a timely treatment or referral with the ultimate objective of decreasing diabetes and obesity burden, and improving the health and the quality of care for these patients.
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Koh YK, Lee JH, Kim EY, Moon KR. Acanthosis Nigricans as a Clinical Predictor of Insulin Resistance in Obese Children. Pediatr Gastroenterol Hepatol Nutr 2016; 19:251-258. [PMID: 28090470 PMCID: PMC5234421 DOI: 10.5223/pghn.2016.19.4.251] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Revised: 09/21/2016] [Accepted: 10/24/2016] [Indexed: 02/07/2023] Open
Abstract
PURPOSE This study aimed to evaluate the utility of acanthosis nigricans (AN) severity as an index for predicting insulin resistance in obese children. METHODS The subjects comprised 74 obese pediatric patients who attended the Department of Pediatrics at Chosun University Hospital between January 2013 and March 2016. Waist circumference; body mass index; blood pressure; fasting glucose and fasting insulin levels; lipid profile; aspartate transaminase, alanine transaminase, glycated hemoglobin, C-peptide, and uric acid levels; and homeostatic model assessment insulin resistance (HOMA-IR) and quantitative insulin check sensitivity index (QUICKI) scores were compared between subjects with AN and those without AN. Receiver operating characteristic curves were used to investigate the utility of the AN score in predicting insulin resistance. HOMA-IR and QUICKI were compared according to AN severity. RESULTS The With AN group had higher fasting insulin levels (24.1±21.0 mU/L vs. 9.8±3.6 mU/L, p<0.001) and HOMA-IR score (5.74±4.71 vs. 2.14±0.86, p<0.001) than the Without AN group. The AN score used to predict insulin resistance was 3 points or more (sensitivity 56.8%, specificity 83.9%). HOMA-IR scores increased with AN severity, from the Without AN group (mean, 2.15; 95% confidence interval [CI], 1.72-2.57) to the Mild AN (mean, 4.15; 95% CI, 3.04-5.25) and Severe AN groups (mean, 7.22; 95% CI, 5.08-9.35; p<0.001). CONCLUSION Insulin resistance worsens with increasing AN severity, and patients with Severe AN (AN score ≥3) are at increased risk of insulin resistance.
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Affiliation(s)
- Young Kwon Koh
- Department of Pediatrics, Chosun University School of Medicine, Gwangju, Korea
| | - Jae Hee Lee
- Department of Pediatrics, Chosun University School of Medicine, Gwangju, Korea
| | - Eun Young Kim
- Department of Pediatrics, Chosun University School of Medicine, Gwangju, Korea
| | - Kyung Rye Moon
- Department of Pediatrics, Chosun University School of Medicine, Gwangju, Korea
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139
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The Effects of Dietary Macronutrient Balance on Skin Structure in Aging Male and Female Mice. PLoS One 2016; 11:e0166175. [PMID: 27832138 PMCID: PMC5104383 DOI: 10.1371/journal.pone.0166175] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2016] [Accepted: 10/23/2016] [Indexed: 12/16/2022] Open
Abstract
Nutrition influences skin structure; however, a systematic investigation into how energy and macronutrients (protein, carbohydrate and fat) affects the skin has yet to be conducted. We evaluated the associations between macronutrients, energy intake and skin structure in mice fed 25 experimental diets and a control diet for 15 months using the Geometric Framework, a novel method of nutritional analysis. Skin structure was associated with the ratio of dietary macronutrients eaten, not energy intake, and the nature of the effect differed between the sexes. In males, skin structure was primarily associated with protein intake, whereas in females carbohydrate intake was the primary correlate. In both sexes, the dermis and subcutaneous fat thicknesses were inversely proportional. Subcutaneous fat thickness varied positively with fat intake, due to enlarged adipocytes rather than increased adipocyte number. We therefore demonstrated clear interactions between skin structure and macronutrient intakes, with the associations being sex-specific and dependent on dietary macronutrient balance.
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LEE GC, HALL RG, BOYD NK, DALLAS SD, DU LC, TREVIÑO LB, RETZLOFF C, TREVIÑO SB, LAWSON KA, WILSON JP, OLSEN RJ, WANG Y, FREI CR. Predictors of community-associated Staphylococcus aureus, methicillin-resistant and methicillin-susceptible Staphylococcus aureus skin and soft tissue infections in primary-care settings. Epidemiol Infect 2016; 144:3198-3204. [PMID: 27489019 PMCID: PMC9150203 DOI: 10.1017/s0950268816001709] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Revised: 07/07/2016] [Accepted: 07/12/2016] [Indexed: 11/05/2022] Open
Abstract
Skin and soft tissue infections (SSTIs) due to Staphylococcus aureus have become increasingly common in the outpatient setting; however, risk factors for differentiating methicillin-resistant S. aureus (MRSA) and methicillin-susceptible S. aureus (MSSA) SSTIs are needed to better inform antibiotic treatment decisions. We performed a case-case-control study within 14 primary-care clinics in South Texas from 2007 to 2015. Overall, 325 patients [S. aureus SSTI cases (case group 1, n = 175); MRSA SSTI cases (case group 2, n = 115); MSSA SSTI cases (case group 3, n = 60); uninfected control group (control, n = 150)] were evaluated. Each case group was compared to the control group, and then qualitatively contrasted to identify unique risk factors associated with S. aureus, MRSA, and MSSA SSTIs. Overall, prior SSTIs [adjusted odds ratio (aOR) 7·60, 95% confidence interval (CI) 3·31-17·45], male gender (aOR 1·74, 95% CI 1·06-2·85), and absence of healthcare occupation status (aOR 0·14, 95% CI 0·03-0·68) were independently associated with S. aureus SSTIs. The only unique risk factor for community-associated (CA)-MRSA SSTIs was a high body weight (⩾110 kg) (aOR 2·03, 95% CI 1·01-4·09).
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Affiliation(s)
- G. C. LEE
- College of Pharmacy, The University of Texas at Austin, Austin, TX, USA
- Pharmacotherapy Education and Research Center, School of Medicine, The University of Texas Health Science Center, San Antonio, TX, USA
| | - R. G. HALL
- Texas Tech University Health Sciences Center, School of Pharmacy, Dallas, TX, USA
- Dose Optimization and Outcomes Research (DOOR) Program, Dallas, TX, USA
| | - N. K. BOYD
- College of Pharmacy, The University of Texas at Austin, Austin, TX, USA
- Pharmacotherapy Education and Research Center, School of Medicine, The University of Texas Health Science Center, San Antonio, TX, USA
| | - S. D. DALLAS
- Department of Clinical Laboratory Sciences, School of Health Professions, University of Texas Health Science Center, San Antonio, TX, USA
| | - L. C. DU
- South Texas Ambulatory Research Network, The University of Texas Health Science Center, San Antonio, TX, USA
| | - L. B. TREVIÑO
- South Texas Ambulatory Research Network, The University of Texas Health Science Center, San Antonio, TX, USA
| | - C. RETZLOFF
- South Texas Ambulatory Research Network, The University of Texas Health Science Center, San Antonio, TX, USA
| | - S. B. TREVIÑO
- South Texas Ambulatory Research Network, The University of Texas Health Science Center, San Antonio, TX, USA
| | - K. A. LAWSON
- College of Pharmacy, The University of Texas at Austin, Austin, TX, USA
| | - J. P. WILSON
- College of Pharmacy, The University of Texas at Austin, Austin, TX, USA
| | - R. J. OLSEN
- Department of Clinical Pathology and Genomic Medicine, Methodist Research Institute, Houston, TX, USA
| | - Y. WANG
- Department of Biology, The University of Texas San Antonio, San Antonio, TX, USA
| | - C. R. FREI
- College of Pharmacy, The University of Texas at Austin, Austin, TX, USA
- Pharmacotherapy Education and Research Center, School of Medicine, The University of Texas Health Science Center, San Antonio, TX, USA
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Shook B, Rivera Gonzalez G, Ebmeier S, Grisotti G, Zwick R, Horsley V. The Role of Adipocytes in Tissue Regeneration and Stem Cell Niches. Annu Rev Cell Dev Biol 2016; 32:609-631. [PMID: 27146311 PMCID: PMC5157158 DOI: 10.1146/annurev-cellbio-111315-125426] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Classically, white adipose tissue (WAT) was considered an inert component of connective tissue but is now appreciated as a major regulator of metabolic physiology and endocrine homeostasis. Recent work defining how WAT develops and expands in vivo emphasizes the importance of specific locations of WAT or depots in metabolic regulation. Interestingly, mature white adipocytes are integrated into several tissues. A new perspective regarding the in vivo regulation and function of WAT in these tissues has highlighted an essential role of adipocytes in tissue homeostasis and regeneration. Finally, there has been significant progress in understanding how mature adipocytes regulate the pathology of several diseases. In this review, we discuss these novel roles of WAT in the homeostasis and regeneration of epithelial, muscle, and immune tissues and how they contribute to the pathology of several disorders.
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Affiliation(s)
- Brett Shook
- Department of Molecular, Cellular and Developmental Biology, Yale University, New Haven, Connecticut 06520;
| | - Guillermo Rivera Gonzalez
- Department of Molecular, Cellular and Developmental Biology, Yale University, New Haven, Connecticut 06520;
| | - Sarah Ebmeier
- Department of Molecular, Cellular and Developmental Biology, Yale University, New Haven, Connecticut 06520;
| | | | - Rachel Zwick
- Department of Molecular, Cellular and Developmental Biology, Yale University, New Haven, Connecticut 06520;
| | - Valerie Horsley
- Department of Molecular, Cellular and Developmental Biology, Yale University, New Haven, Connecticut 06520;
- Department of Dermatology, Yale University, New Haven, Connecticut 06520
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142
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Demirci K, Bilen N, Şikar Aktürk A, Odyakmaz Demirsoy E, Cantürk Z, Çağlayan Ç, Bayramgüler D, Kıran R. Erişkin Obez Hastalarda Dermatolojik Bulgular. KOCAELI ÜNIVERSITESI SAĞLIK BILIMLERI DERGISI 2016. [DOI: 10.30934/kusbed.358623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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143
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Tirgar-Tabari S, Sharbatdaran M, Manafi-Afkham S, Montazeri M. Hyperprolactinemia and Hirsutism in Patients Without Polycystic Ovary Syndrome. Int J Trichology 2016; 8:130-4. [PMID: 27625565 PMCID: PMC5007919 DOI: 10.4103/0974-7753.188998] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Hirsutism is one of the most important diseases that lead women to refer to dermatology clinic. Hyperprolactinemia is one of the causes of hirsutism. The aim of this study was to determine prolactin (PRL) levels in hirsute women. Materials and Methods: In this cross-sectional study, hirsute patients were evaluated. For all of the patients, 2 or 3 days after mense starting, hormone level tests were performed, and 200 patients that had not polycystic ovary syndrome enrolled to the study. A questionnaire of history and physical examination were performed. Data have been analyzed with SPSS version 21. Results: Hyperprolactinemia were seen in 25 patients (12.5%). There was no significant relation between marital statuses, galactorrhoea, positive family history, and infertility with hyperprolactinemia. But significant relation was seen between irregular mense and hyperprolactinemia. Conclusion: Although hyperprolactinemia is the rare cause of hirsutism, the prevalence of hyperprolactinemia was high in our study. Thus, PRL level in hirsute patients should be evaluate.
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Affiliation(s)
- Soudabeh Tirgar-Tabari
- Department of Dermatology, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran
| | - Majid Sharbatdaran
- Department of Pathology, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran
| | - Sara Manafi-Afkham
- Department of Internal Medicine, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Mohammad Montazeri
- Young Researchers Club, Islamic Azad University, Babol Branch, Babol, Iran
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144
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Karagiannidis I, Nikolakis G, Zouboulis CC. Endocrinologic Aspects of Hidradenitis Suppurativa. Dermatol Clin 2016; 34:45-9. [PMID: 26617357 DOI: 10.1016/j.det.2015.08.005] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Hidradenitis suppurativa (HS) is a chronic inflammatory skin disorder of unknown etiology. The role of hormones in HS remains unclear, but the observation of premenstrual flares, female predominance, and improvement during pregnancy suggest a hormonal/metabolic background. The reported positive effects of antiandrogen therapy supports a possible role of androgens. The predominant onset of the disease years after puberty may indicate a metabolic disorder. Obesity contributes significantly to HS pathogenesis; diabetes, dyslipidemia, the metabolic syndrome, and polycystic ovarian syndrome are among the commonest comorbidities. More studies are required to clarify a potential hormonal dysregulation in HS.
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Affiliation(s)
- Ioannis Karagiannidis
- Departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center, Auenweg 38, 06847 Dessau, Germany
| | - Georgios Nikolakis
- Departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center, Auenweg 38, 06847 Dessau, Germany
| | - Christos C Zouboulis
- Departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center, Auenweg 38, 06847 Dessau, Germany.
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145
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Burrus MT, Werner BC, Park JS, Perumal V, Cooper MT. Achilles Tendon Repair in Obese Patients Is Associated With Increased Complication Rates. Foot Ankle Spec 2016; 9:208-14. [PMID: 26459362 DOI: 10.1177/1938640015609983] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
UNLABELLED Objective The objective of the present study is to utilize a national database to examine the association between obesity and postoperative complications after primary Achilles tendon repair. Methods The PearlDiver database was queried for patients undergoing primary Achilles repair using CPT 27650. Excision of a Haglund's deformity or tendon transfer were exclusion criteria. Patients were then divided into obese (body mass index [BMI] > 30 kg/m(2)) and nonobese (BMI < 30 kg/m(2)) cohorts using ICD-9 codes. Complications within 90 days postoperatively were assessed using ICD-9 and CPT codes. Results In all, 18 948 patients who underwent primary Achilles tendon repair were identified from 2005 to 2012. Overall, 2962 patients (15.6%) were coded as obese or morbidly obese. Obese patients had significantly higher rates of postoperative wound complications (odds ratio [OR] = 2.1; P < .0001), infection (OR = 1.8; P < .0001), venous thromboembolism (VTE; OR = 1.8; P = .001), and medical complications (OR = 3.9; P < .0001) compared with nonobese patients after primary Achilles tendon repair. Additionally, obese patients had a significantly lower rate of ankle stiffnesassociated with a significantly higher risk of s (OR = 0.4; P < .0001) compared with nonobese patients. Conclusion Obesity is associated with a significantly higher risk of wound complications, infection, VTE, and medical complications after primary Achilles tendon repair. LEVELS OF EVIDENCE Prognostic, Level II: Retrospective study.
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Affiliation(s)
- M Tyrrell Burrus
- Department of Orthopaedic Surgery (MTB, BCW), University of Virginia Health System, Charlottesville, VirginiaDivision Head, Foot and Ankle Service, Department of Orthopaedic Surgery (JSP), University of Virginia Health System, Charlottesville, VirginiaFoot and Ankle Service, Department of Orthopaedic Surgery (VP, MTC), University of Virginia Health System, Charlottesville, Virginia
| | - Brian C Werner
- Department of Orthopaedic Surgery (MTB, BCW), University of Virginia Health System, Charlottesville, VirginiaDivision Head, Foot and Ankle Service, Department of Orthopaedic Surgery (JSP), University of Virginia Health System, Charlottesville, VirginiaFoot and Ankle Service, Department of Orthopaedic Surgery (VP, MTC), University of Virginia Health System, Charlottesville, Virginia
| | - Joseph S Park
- Department of Orthopaedic Surgery (MTB, BCW), University of Virginia Health System, Charlottesville, VirginiaDivision Head, Foot and Ankle Service, Department of Orthopaedic Surgery (JSP), University of Virginia Health System, Charlottesville, VirginiaFoot and Ankle Service, Department of Orthopaedic Surgery (VP, MTC), University of Virginia Health System, Charlottesville, Virginia
| | - Venkat Perumal
- Department of Orthopaedic Surgery (MTB, BCW), University of Virginia Health System, Charlottesville, VirginiaDivision Head, Foot and Ankle Service, Department of Orthopaedic Surgery (JSP), University of Virginia Health System, Charlottesville, VirginiaFoot and Ankle Service, Department of Orthopaedic Surgery (VP, MTC), University of Virginia Health System, Charlottesville, Virginia
| | - M Truit Cooper
- Department of Orthopaedic Surgery (MTB, BCW), University of Virginia Health System, Charlottesville, VirginiaDivision Head, Foot and Ankle Service, Department of Orthopaedic Surgery (JSP), University of Virginia Health System, Charlottesville, VirginiaFoot and Ankle Service, Department of Orthopaedic Surgery (VP, MTC), University of Virginia Health System, Charlottesville, Virginia
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Guervil DJ, Kaye KS, Hassoun A, Cole P, Huang XY, Friedland HD. Ceftaroline fosamil as first-line versus second-line treatment for acute bacterial skin and skin structure infections (ABSSSI) or community-acquired bacterial pneumonia (CABP). J Chemother 2016; 28:180-6. [PMID: 25817579 DOI: 10.1179/1973947815y.0000000010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
The Clinical Assessment Program and Teflaro(®) Utilization Registry (CAPTURE) is a multicenter registry study of acute bacterial skin and skin structure infection (ABSSSI) and community-acquired bacterial pneumonia (CABP) patients treated with ceftaroline fosamil in the US. Data for this analysis were collected between August 2011 and February 2013 at US study centres by randomly ordered chart review. Clinical success rates among ABSSSI patients were >81% when ceftaroline fosamil was used as first- or second-line therapy, including monotherapy and concurrent therapy. Among CABP patients, clinical success rates were >77% among first-line and second-line patients and patients who received first-line concurrent therapy or second line monotherapy or concurrent therapy. For CABP patients treated with ceftaroline fosamil as first-line monotherapy, the clinical success rate was 70%. Ceftaroline fosamil is an effective treatment option for patients with ABSSSI or CABP with similar clinical success rates when used as first-line or second-line treatment.
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Affiliation(s)
- David J Guervil
- a Infectious Diseases, Memorial Hermann-Texas Medical Center , Houston , TX , USA
| | - Keith S Kaye
- b Detroit Medical Center, Wayne State University , Detroit, MI, USA
| | - Ali Hassoun
- c Alabama Infectious Disease Center , Huntsville , AL , USA
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147
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Fleischer AB. Characterization of obesity rates for dermatologic ambulatory office visits to United States physicians. J DERMATOL TREAT 2016; 28:181-185. [PMID: 27241466 DOI: 10.1080/09546634.2016.1187707] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Obesity continues to increase in the United States (US) and elsewhere, with a number of published dermatologic associations. The purpose of this study was to characterize obesity among US office visits for dermatologic diseases. METHODS Data from the 2005 to 2011 National Ambulatory Medical Care Survey (NAMCS) and National Hospital Ambulatory Medical Care Survey (NHAMCS) were searched for the most common dermatologic diagnoses for which body mass index (BMI) could be classified. RESULTS For all dermatologic patient visits, 10% were underweight, 36.5% were normal weight, 23.8% were overweight and 29.7% were obese. Increasing age predicted the yearly increased likelihood of obesity (OR 1.02; 95% CI 1.01, 1.02; p < 0.0001). Logistic regression controlling for age, sex, race and dataset found that in addition to age, NHAMCS dermatologic diagnosis patients were more likely to be obese than NAMCS patients (OR 1.22; 95% CI 1.03, 1.45; p = 0.02). Specific diseases were found to have the highest obesity rates, including psoriasis, hidradenitis suppurativa and acanthosis nigricans. CONCLUSION A large proportion of dermatologic diagnosis patients are obese, and awareness could lead to interventions that may improve their disease and decrease risks of comorbidities.
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Affiliation(s)
- Alan B Fleischer
- a Department of Surgery , University of Kentucky College of Medicine , Lexington , KY , USA
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148
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Armstrong S, Lazorick S, Hampl S, Skelton JA, Wood C, Collier D, Perrin EM. Physical Examination Findings Among Children and Adolescents With Obesity: An Evidence-Based Review. Pediatrics 2016; 137:e20151766. [PMID: 26817935 DOI: 10.1542/peds.2015-1766] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/05/2015] [Indexed: 11/24/2022] Open
Abstract
Overweight and obesity affects 1 in 3 US children and adolescents. Clinical recommendations have largely focused on screening guidelines and counseling strategies. However, the physical examination of the child or adolescent with obesity can provide the clinician with additional information to guide management decisions. This expert-based review focuses on physical examination findings specific to children and adolescents with obesity. For each physical examination element, the authors define the finding and its prevalence among pediatric patients with obesity, discuss the importance and relevance of the finding, describe known techniques to assess severity, and review evidence regarding the need for additional evaluation. The recommendations presented represent a comprehensive review of current evidence as well as expert opinion. The goal of this review is to highlight the importance of conducting a targeted physical examination during pediatric weight management visits.
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Affiliation(s)
| | | | - Sarah Hampl
- Children's Mercy Hospital and Center for Children's Healthy Lifestyles and Nutrition, Kansas City, Missouri
| | - Joseph A Skelton
- Wake Forest School of Medicine, Winston-Salem, North Carolina; and
| | - Charles Wood
- University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina
| | - David Collier
- East Carolina University, Greenville, North Carolina
| | - Eliana M Perrin
- University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina
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149
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Jura M, Kozak LP. Obesity and related consequences to ageing. AGE (DORDRECHT, NETHERLANDS) 2016; 38:23. [PMID: 26846415 PMCID: PMC5005878 DOI: 10.1007/s11357-016-9884-3] [Citation(s) in RCA: 245] [Impact Index Per Article: 30.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Accepted: 01/26/2016] [Indexed: 04/17/2023]
Abstract
Obesity has become a major public health problem. Given the current increase in life expectancy, the prevalence of obesity also raises steadily among older age groups. The increase in life expectancy is often accompanied with additional years of susceptibility to chronic ill health associated with obesity in the elderly. Both obesity and ageing are conditions leading to serious health problems and increased risk for disease and death. Ageing is associated with an increase in abdominal obesity, a major contributor to insulin resistance and the metabolic syndrome. Obesity in the elderly is thus a serious concern and comprehension of the key mechanisms of ageing and age-related diseases has become a necessary matter. Here, we aimed to identify similarities underlying mechanisms related to both obesity and ageing. We bring together evidence that age-related changes in body fat distribution and metabolism might be key factors of a vicious cycle that can accelerate the ageing process and onset of age-related diseases.
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Affiliation(s)
- Magdalena Jura
- Institute of Animal Reproduction and Food Research, Polish Academy of Science, ul. Tuwima 10, 10-748, Olsztyn, Poland.
| | - Leslie P Kozak
- Institute of Animal Reproduction and Food Research, Polish Academy of Science, ul. Tuwima 10, 10-748, Olsztyn, Poland.
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150
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Wali V, Wali VV. Assessment of Various Biochemical Parameters and BMI in Patients with Skin Tags. J Clin Diagn Res 2016; 10:BC09-11. [PMID: 26894056 PMCID: PMC4740583 DOI: 10.7860/jcdr/2016/15994.7062] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Accepted: 11/24/2015] [Indexed: 01/18/2023]
Abstract
INTRODCTION Acrochordon or fibroepithelial polyp, commonly known as Skin tags (STs) are one of the most common benign skin condition, consisting of skin projecting from the surrounding skin, usually occurring on the eyelids, neck and axillae. Studies have found an association of STs with conditions such as obesity, diabetes mellitus and atherogenic lipid profile. Abdominal obesity and the consequent insulin resistance are said be important contributing factors for diabetes, dyslipidaemia and cardiovascular disease. AIM To highlight the association of lipid profile, BMI, glucose, HbA1c and leptin levels in patients with STs. MATERIALS AND METHODS This was a case control study conducted at tertiary care hospital in South India from April 2013 to May 2014. The cases were chosen those who are having minimum of 3 STs attending the dermatology clinic. A total of 171 patients were screened, out of which 126 satisfied the criteria for inclusion and were included in the final analysis. The significance of the difference between the groups was assessed by Student t-test (two tailed, independent) to find the significance on continuous scale between two groups on metric parameters, between cases and controls and p-value of <0.05 were considered as statistically significant. RESULTS Maximum cases were in males and in age group of 41-50 years. There was significant association between STs and triglycerides, low density lipoprotein, very low density lipoprotein cholesterol and leptin levels. Other parameters were also altered but no statistically significant difference was seen. CONCLUSION STs are associated with change in markers of obesity and dyslipidaemia. Patients with STs need suitable interventions like weight reduction, smoking cessation, change in dietary habits. STs may also play a role in early diagnosis of metabolic syndrome.
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Affiliation(s)
- Vinod Wali
- Associate Professor, Department of Biochemistry, Smt Kashibai Navale Medical College & General Hospital, Narhe, Pune, India
| | - Vishal V. Wali
- Assistant Professor, Department of Dermatology, M R Medical College, Kalaburgi, India
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