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Median BMI (median + bmi)
Selected AbstractsEffects of two whole blood systems (DALI and Liposorber D) for LDL apheresis on lipids and cardiovascular risk markers in severe hypercholesterolemiaJOURNAL OF CLINICAL APHERESIS, Issue 6 2007Carsten Otto Abstract LDL apheresis is an extracorporal modality to lower the concentration of atherogenic lipoproteins, e.g., LDL cholesterol. We compared two recently introduced whole-blood LDL apheresis systems inpatients with hypercholesterolemia in a randomized cross-over trial with respect to their effects on lipoproteins as well as on other cardiovascular risk markers. Six patients (4 women, 2 men, median age 62.5 years, median BMI 25.9 kg/m2) on regular LDL apheresis were randomly assigned to receive six weekly treatments with either DALI (Fresenius) or Liposorber D (Kaneka). After 6 weeks, the patients were switched to the other device (again six weekly treatments). Blood was drawn before and immediately after LDL apheresis at three time points (last regular apheresis before the study; after six treatments with DALI and after six treatments with Liposorber D). LDL cholesterol concentration before the sixth apheresis (DALI 129 mg/dL, Liposorber D 132 mg/dL) as well as LDL cholesterol reduction during the sixth apheresis (DALI 68.3% and Liposorber D 68.4%) were similar with the two systems. CRP and fibrinogen concentrations were lower but interleukin-6, myeloperoxidase, and resistin concentrations were higher after the last Liposorber treatment compared with DALI (P < 0.05, respectively). No differences were observed concerning adiponectin, ghrelin, and PYY levels. In conclusion, both devices were highly effective in eliminating atherogenic lipoproteins. CRP and fibrinogen were better eliminated with Liposorber D. However, following Liposorber D, interleukin-6 levels were higher than after DALI possibly indicating an increased inflammatory activation. J. Clin. Apheresis, 2007. © 2007 Wiley-Liss, Inc. [source] Prevalence of obesity among schoolchildren in IranOBESITY REVIEWS, Issue 4 2007S. M. T. Ayatollahi Summary The prevalence of overweight and obesity among schoolchildren aged 6.5,11.5 years in Shiraz (southern Iran) are presented in this paper. The body mass index (BMI) percentiles of these children are compared with the Center for Disease Control and Prevention (CDC) reference data and with the Iranian standard. The data are based on a random multistage sample survey of 2397 healthy school attenders (1268 boys, 1129 girls) living in Shiraz, whose heights and weights were measured in the 2002,2003 academic year. Joint height and weight measurements were obtained for 2195 schoolchildren (91.6%), consisting of 1138 boys (89.7%) and 1057 girls (93.6%). A total of 77 boys (6.8%) and 40 girls (3.8%) were overweight, and the difference between them was significant (P = 0.001). However, obesity was significantly less prevalent in boys (3.3%) than in girls (6.1%) (P = 0.001). Our children's median BMI lie almost on the 38th centile of the CDC reference data, whereas that of their counterparts born more than 10 years ago lay on the 20th centile of their American counterparts, showing the development of children's obesity in a period of less than 15 years in Iran. A positive secular trend in BMI has been seen during the past decade in Iran, suggesting policymakers and health professionals should pay special attention to children's health. [source] Influence of body mass index on prostate-specific antigen failure after androgen suppression and radiation therapy for localized prostate cancerCANCER, Issue 8 2007Jason A. Efstathiou MD Abstract BACKGROUND Increasing body mass index (BMI) is associated with shorter time to prostate-specific antigen (PSA) failure after radical prostatectomy. Whether BMI is associated with time to PSA failure was investigated in men treated with androgen suppression therapy (AST) and radiation therapy (RT) for clinically localized prostate cancer. METHODS The observational prospective cohort study consisted of 102 men with clinically localized prostate cancer who received 70 Gy RT with 6 months of AST on a single arm of a randomized trial between December 1995 and April 2001. Height and weight data were available at baseline for 99 (97%) of the men, from which BMI was calculated. Adjusting for age (continuous) and known prognostic factors including PSA level (continuous), Gleason score, and T-category, Cox regression analyses were performed to analyze whether BMI (continuous) was associated with time to PSA failure (PSA >1.0 ng/mL and increasing >0.2 ng/mL on 2 consecutive visits). RESULTS Median age and median BMI (interquartile range [IQR]) at baseline was 72 (69.1,74.7) years and 27.4 (24.8,30.7) kg/m,2 respectively. In addition to an increasing PSA level (P = .006) and Gleason 8,10 cancer (P = .024), after a median follow-up (IQR) of 6.9 (5.6,8.5) years, an increasing BMI was also significantly associated with a shorter time to PSA failure (adjusted hazard ratio [HR]: 1.10; 95% confidence interval [CI]: 1.01,1.19; P = .026) after RT and AST. CONCLUSIONS After adjusting for known prognostic factors, baseline BMI is significantly associated with time to PSA failure after RT and AST for men with clinically localized prostate cancer. Further study is warranted to assess the impact of an increasing BMI after AST administration on PSA failure, prostate cancer-specific, and all-cause mortality. Cancer 2007. © 2007 American Cancer Society. [source] Laparoscopic emergency and elective surgery for ulcerative colitisCOLORECTAL DISEASE, Issue 4 2008L. Fowkes Abstract Objective, To analyse surgical outcomes of fulminate and medically resistant ulcerative colitis (UC) carried out laparoscopically. Method, A prospective database identified 69 consecutive patients who underwent surgery for UC under the senior author over a 5-year period to April 2006. Results, Thirty-two patients (18 male patients), median BMI 26, underwent laparoscopic subtotal colectomy (LSTC): 22 acute emergencies, 10 refractory to medical therapy and unfit for restorative proctocolectomy. All were receiving iv steroids; azathioprine (7), cyclosporin (5). The median operation time was 135 min (65,280). There was one conversion. Twenty-nine patients have subsequently undergone completion proctectomy and W-pouch formation [24 patients were performed laparoscopically , laparoscopic completion proctectomy (LCP)]; widespread adhesions precluded in five patients. Twenty-six patients underwent restorative laparoscopic proctocolectomy (LRP) , one conversion. Twenty patients underwent W-pouch reconstruction via a Pfannenstiel incision. Six J-pouches were constructed and returned via the ileostomy site. Three underwent a laparoscopic pan-proctocolectomy (LPPC); one conversion. Eight patients underwent open STC. The median time to normal diet was 48 h (1,7 days) for LSTC/LCP and 36 h (1,5 days) for LRP. There were two major complications following LRP, two following LSTC, one following LCP, one following LPPC and five following open surgery. Median hospital stay was 8 days (6,72) for LSTC, 7 days (6,9) for LCP and 5 days (3,45) for LRP. There were six 30-day readmissions following laparoscopic surgery (DVT, reactive depression, ileostomy hold up (2), abdominal pain and high output ileostomy). Conclusion, Laparoscopic subtotal and restorative proctocolectomies in fulminate and medically resistant UC are feasible, safe and largely predictable operations that allow for early hospital discharge. Laparoscopic colectomy facilitates subsequent proctectomy and pouch construction. [source] Laparoscopic proctocolectomy with restorative ileal-anal pouchCOLORECTAL DISEASE, Issue 6 2004T. S. Gill Abstract Objective The aim of the study was to analyse the outcome of restorative proctocolectomy carried out by laparoscopic surgery. Methods A prospectively collected electronic database of all colorectal laparoscopic procedures performed between April 2001 and July 2003 has been used to identify surgical outcomes in 14 consecutive patients who have undergone laparoscopic RPC. Results Fourteen patients (5 male), median BMI 24 kg/m2 have undergone restorative laparoscopic proctocolectomy over a two year period: 13 (ulcerative colitis, one with cancer) and 1 (FAP). The median operation time was 260 min; time has not decreased with experience. There were no intra-operative surgical complications or deaths. Patient controlled analgesia continued for a median of 36 h. The median time to diet was 48 h and median hospital stay 7 days; three patients required nasogastric aspiration for delayed gastric emptying. Eighteen regional lymph nodes were retrieved local to the carcinoma. There was one anastomotic leak. All covering stomas were closed by 6 months (12 by eight weeks). All 14 patients are fully continent, able to suppress urgency and have a median pouch frequency of 4/24 h. None admit to having problems with potency, orgasm sensation, ejaculation, micturition. One lady reports dysparunia. All are highly satisfied with functional outcome and cosmesis. Conclusion We are encouraged to continue to offer our patients the option of a laparoscopic resection. [source] | ||||||||||