Ideal Body Weight (ideal + body_weight)

Distribution by Scientific Domains

Selected Abstracts

An obesity drug sibutramine reduces brain natriuretic peptide (BNP) levels in severely obese patients

D. Taner Ertugrul
Summary Objectives:, Sibutramine is a selective inhibitor of the reuptake of monoamines. Plasma levels of brain natriuretic peptide (BNP) appear to be inversely associated with body mass index (BMI) in subjects with and without heart failure for reasons that remain unexplained. The aim of this study was to investigate the possible influence of sibutramine treatment on BNP levels in severely obese patients. Methods:, Fifty-two severely obese female patients with BMI > 40 kg/m2 were included to this study. The women were recommended to follow a weight-reducing daily diet of 25 kcal/kg of ideal body weight. During the treatment period, all patients were to receive 15 mg of sibutramine once a day. Blood chemistry tests were performed before the onset of the medication and after 12 weeks of treatment. Results:, None of the subjects was withdrawn from the study because of the adverse effects of sibutramine. Body weight (108.8 ▒ 13.3 kg vs. 101.7 ▒ 15.6 kg, p < 0.001), BMI (44.6 ▒ 4.6 kg/m2 vs. 41.8 ▒ 5.7 kg/m2, p < 0.001) and BNP [8.6 (0.5,49.5) ng/l vs. 3.1 (0.2,28.6) ng/l, p = 0.018] levels were significantly decreased after 12 weeks of sibutramine treatment. Total cholesterol (5.19 ▒ 0.90 mmol/l vs. 4.82 ▒ 1.05 mmol/l respectively; p < 0.001), low-density lipoprotein-cholesterol (3.26 ▒ 0.86 mmol/l vs. 2.99 ▒ 0.40 mmol/l respectively; p = 0.008), levels were significantly decreased; however, there was no significant alteration in high-density lipoprotein-cholesterol and triglyceride levels. Conclusion:, This study has shown a decrease in BNP levels which may lead to improvement in cardiac outcome after sibutramine treatment. Further randomised studies are needed to be conducted to clarify the relationship between sibutramine and BNP. [source]

Cognitive Impairment and Mortality in Older Primary Care Patients

Timothy E. Stump MA
OBJECTIVE: To assess the impact of cognitive impairment on mortality in older primary care patients after controlling for confounding effects of demographic and comorbid chronic conditions. DESIGN: Prospective cohort study. SETTING: Academic primary care group practice. PARTICIPANTS: Three thousand nine hundred and fifty-seven patients age 60 and older who completed the Short Portable Mental Status Questionnaire (SPMSQ) during routine office visits. MEASUREMENTS: Cognitive impairment measured at baseline using the SPMSQ, demographics, problem drinking, history of smoking, clinical data (including weight, cholesterol level, and serum albumin), and comorbid chronic conditions collected at baseline; survival time measured during the 5 to 7 years after baseline. RESULTS: Eight hundred and eighty-six patients (22.4%) died during the 5 to 7 years of follow-up. Cognitive impairment was categorized as having no impairment (84.3%), mild impairment (10.5%), and moderate-to-severe impairment (5.2%) based on SPMSQ score. Chi-square tests revealed that patients with moderate-to-severe impairment were significantly more likely to die compared with patients with mild impairment (40.8% vs 21.5%) and those with no impairment (40.8% vs 21.4%). No significant difference in crude mortality was found between patients with no impairment and those with mild impairment. After analyzing time to death using the Kaplan-Meier method, patients with moderate-to-severe cognitive impairment were at increased risk of death compared with those with no or mild impairment (Log-rank ,2 = 55.5; P < .0001). Even in multivariable analyses using Cox proportional hazards to control for confounding factors, compared with those with no impairment, moderately-to-severely impaired patients had an increased risk of death, with a hazard ratio (HR) of 1.70. Increased risk of death was also associated with older age (HR = 1.03 for each year), a history of smoking (HR = 1.48), having a serum albumin level <3.5 g/L (HR = 1.29), and weighing less than 90% of the ideal body weight (HR = 1.98). Outpatient diagnoses associated with increased mortality risk were diabetes mellitus, coronary artery disease, congestive heart failure, cerebrovascular disease, cancer, anemia, and chronic obstructive pulmonary disease (HR range 1.36,1.67). Factors protective of mortality risk included female gender (HR = 0.67) and black race (HR = 0.73). CONCLUSIONS: Moderate-to-severe cognitive impairment is associated with an increased risk of mortality, even after controlling for confounding effects of demographic and clinical characteristics. Mild cognitive impairment is not associated with mortality risk, but a longer follow-up period may be necessary to identify this risk if it exists. [source]

The effect of weight loss by energy restriction on metabolic profile and glucose tolerance in ponies

S. Van Weyenberg
Summary In nine initially obese ponies, a weekly weight loss according to 1% of their ideal body weight was evaluated for its impact on insulin sensitivity and metabolic profile. Weight loss was obtained solely through energy restriction, initially at 70% of maintenance energy requirements, but to maintain constant weight loss, feed amount had to be decreased to 50% and 35% of maintenance energy requirement during the course of the trial. An oral glucose tolerance test (OGTT) was performed at weeks 0, 10 and 17. Fasted blood samples were taken on weeks 0, 3, 10, 17 for analysis of triglycerides (TG), non-esterified fatty acids (NEFA), creatine phosphokinase (CPK), lactate dehydrogenase (LDH), T3, T4 and leptin. Total average weight loss was 18.2%. When the OGTT was performed at weeks 0, 10 and 17, ponies had lost 0.22%, 9.9% and 16.3% of their initial weight respectively. Weight loss was associated with a decreased AUC for glucose and insulin. Moreover, greater % weight loss was associated with a significantly lower glucose peak and a lower area under the curve (AUC glucose). The lower glucose response after an OGTT in lean ponies was not the result of an increased insulin secretion, but an improved insulin sensitivity. Restricted feeding led to mobilization of TG and NEFA and to a reduced basal metabolism, with lower LDH, CPK, T3 and leptin. In conclusion: in obese Shetland ponies, weight loss at a rate of 1% of ideal body weight per week through restricted energy intake, ameliorated insulin sensitivity. [source]

Sex differences in weight perception and nutritional behaviour in adults with cystic fibrosis

S. Walters
Introduction Good nutritional status in cystic fibrosis (CF) is associated with improved clinical status and survival. In some conditions where dietary and pharmacological treatment are important (e.g. diabetes), a combination of eating disorders and failure of treatment compliance has been reported. Cases of eating disorders have been reported in CF. Societal pressures on young women to remain slim may compromise optimum clinical management as women are content to remain underweight. Objective To determine whether women have different perception of their weight than men with CF and whether this manifests in different nutritional behaviour. Methods Confidential postal questionnaire to 1870 adults with CF in 1994 known to the Association of Cystic Fibrosis Adults (UK). Participants were asked their own weight and height, and their perception of their weight. Very underweight was defined as < 85% ideal body weight, underweight as 85,94%, normal weight as 95,104%, overweight as 105,114% and very overweight as 115% and over. Results A significantly higher proportion of women than men who are very underweight (29% vs. 11%) or underweight (41% vs. 15%) saw themselves as being of normal weight or overweight. Conversely, a significantly higher proportion of men than women who were normal weight (42% vs. 19%) saw themselves as underweight. All P -values < 0.01. A significantly higher proportion of people who perceived themselves to be underweight were taking oral or enteral food supplements compared with those who did not (77% vs. 30%, P < 0.05). Multiple logistic regression showed that perception of self as underweight was the strongest predictor of taking oral or enteral food supplements (adjusted odds ratio 2.42), even after adjustment for age, sex, overall severity score, body mass index, and seeing a dietitian in the last year. Conclusion Young women with CF tend to overestimate their weight, and young men with CF underestimate their weight when compared with their actual body weight. Perception of self as underweight is reflected in nutritional behaviour, being a significant predictor of taking oral and enteral food supplements. People working with young patients with CF should be aware of these sex differences in weight perception, and work with young women and young men with CF to achieve a realistic perception of body weight and realistic nutritional goals. There is a need for further research into body image, weight perception, eating behaviour and adherence to pancreatic enzyme supplementation and oral and enteral food supplementation in young patients with CF. [source]

Depth of anaesthesia monitoring in obese patients: a randomized study of propofol,remifentanil

Background: In obese patients, depth of anaesthesia monitoring could be useful in titrating intravenous anaesthetics. We hypothesized that depth of anaesthesia monitoring would reduce recovery time and use of anaesthetics in obese patients receiving propofol and remifentanil. Methods: We investigated 38 patients with a body mass index ,30 kg/m2 scheduled for an abdominal hysterectomy. Patients were randomized to either titration of propofol and remifentanil according to a cerebral state monitor (CSM group) or according to usual clinical criteria (control group). The primary end point was time to eye opening and this was assessed by a blinded observer. Results: Time to eye opening was 11.8 min in the CSM group vs. 13.4 min in the control group (P=0.58). The average infusion rate for propofol was a median of 516 vs. 617 mg/h (P=0.24) and for remifentanil 2393 vs. 2708 ,g/h (P=0.04). During surgery, when the cerebral state index was continuously between 40 and 60, the corresponding optimal propofol infusion rate was 10 mg/kg/h based on ideal body weight. Conclusion: No significant reduction in time to eye opening could be demonstrated when a CSM was used to titrate propofol and remifentanil in obese patients undergoing a hysterectomy. A significant reduction in remifentanil consumption was found. [source]

Treatment of so-called idiopathic follicular mucinosis with hydroxychloroquine

S.W. Schneider
Summary There exists no treatment of choice for follicular mucinosis (FM). Historically two distinct entities of FM have been proposed: FM of children and young adults not associated with other diseases (,idiopathic' FM), and FM in elderly patients associated with mycosis fungoides and SÚzary syndrome (,lymphoma-associated' FM). Nowadays it is suggested that ,idiopathic' FM might represent a localized form of cutaneous T-cell lymphoma. Six patients with ,idiopathic' FM were treated with hydroxychloroquine (HCQ) at a dose of 200 mg three times daily for 10 days followed by a dose adjusted to the ideal body weight, usually 200 mg twice daily. All patients showed an improvement of ,idiopathic' FM already after 6 weeks and a complete remission with full hair regrowth after 2,5 months of HCQ therapy. In all patients no relapse occurred during follow up of between 3 and 23 years and no patient developed lymphoma. We conclude that HCQ is a highly effective therapy without significant side-effects in the treatment of so-called ,idiopathic' FM. [source]