Therapeutic Actions Weight Reduction

NCBI pubmed

Patterns and Correlates of Grip Strength in Older Americans.

Related Articles Patterns and Correlates of Grip Strength in Older Americans. Curr Aging Sci. 2017 Nov 16;: Authors: Forrest K, Williams A, Leeds M, Robare J, Bechard T Abstract BACKGROUND: Muscle strength is a sensitive indicator of morbidity and mortality in older adults. Loss of muscle strength contributes to a decline in physical functioning. Hand grip strength is a simple measurement but correlated with total body muscle strength. This study evaluated the patterns and correlates of grip strength among older adults in the United States. METHODS: The grip strength data were analyzed from the National Health and Nutrition Examination Survey. RESULTS: Individuals (n=1009) aged ≥65 years old who had a grip strength measure were included in this analysis. Age distribution was 31.5%, 27.2%, 16.2%, and 25.0% for 65-69, 70-74, 75-79, and 80+ respectively. Race distribution was 81.1%, 8.3%, 7.1%, and 3.5% for Whites, Blacks, Hispanics, and Asians respectively. The mean grip strength was 71.7kg in males and 44.6kg in females, and declined as age increased (p<.0001). Blacks had the highest grip strength, followed by Whites and Hispanics, and Asians had the lowest measure (p<.0001). Although several variables were found to be correlated with grip strength univariately, after adjusting for gender, age, and race, the factors that remained significantly and independently associated with weak grip strength were lower body weight, not being in good health status, and physical limitations. CONCLUSION: Grip strength reduced as age increased. Blacks and Whites displayed higher grip strength than Asians and Hispanics. General health status, weight status and physical functioning were independently associated with grip strength. These findings suggest that grip strength could be a useful indicator for overall health assessment in older adults. PMID: 29150988 [PubMed - as supplied by publisher]

Psychological Aspects of Obesity in Children and Adolescents.

Related Articles Psychological Aspects of Obesity in Children and Adolescents. Indian J Pediatr. 2017 Nov 18;: Authors: Sagar R, Gupta T Abstract Childhood obesity is multi factorial health condition, so the simple evaluation of body fat will not be sufficed to manage the global epidemic of childhood obesity. Literature consistently provides evidence for physical health risks associated with childhood obesity; however in recent times, mental health of the obese children has also gained attention of the researchers as well as clinicians. Obese children experience number of psycho-social problems that significantly affect their quality of life and wellbeing. Co-morbid psychosocial and emotional problems of obesity generally act as causal or maintaining factors of obesity and thus significantly affect the treatment outcome. Therefore it becomes imperative for the clinicians/pediatricians to broaden their clinical assessment and include screening of important psycho-social factors within the clinical examination of childhood obesity. This article provides an evidence based comprehensive overview about the psychological factors and psychiatric factors (depression, anxiety, eating disorder, stress, body shape concerns, low self esteem) associated with childhood obesity that can further be utilized in the evaluation and management of this epidemic. The article also elaborates the role of current evidence based psychological approaches such as Cognitive Behavior Therapy (CBT) for management of obesity in children and adolescents. CBT techniques combined with lifestyle intervention and involving parents have been recommended by literature repetitively. However, there are a number of environmental, familial and personal barriers that hinder the whole process of weight loss in children. The article also discusses potential strategies to overcome those barriers. PMID: 29150753 [PubMed - as supplied by publisher]

Novel polycondensed biopolyamide generated from biomass-derived 4-aminohydrocinnamic acid.

Related Articles Novel polycondensed biopolyamide generated from biomass-derived 4-aminohydrocinnamic acid. Appl Microbiol Biotechnol. 2017 Nov 17;: Authors: Kawasaki Y, Aniruddha N, Minakawa H, Masuo S, Kaneko T, Takaya N Abstract Biomass plastics are expected to contribute to the establishment of a carbon-neutral society by replacing conventional plastics derived from petroleum. The biomass-derived aromatic amine 4-aminocinnamic acid (4ACA) produced by recombinant bacteria is applied to the synthesis of high-performance biopolymers such as polyamides and polyimides. Here, we developed a microbial catalyst that hydrogenates the α,β-unsaturated carboxylic acid of 4ACA to generate 4-aminohydrocinnamic acid (4AHCA). The ability of 10 microbial genes for enoate and xenobiotic reductases expressed in Escherichia coli to convert 4ACA to 4AHCA was assessed. A strain producing 2-enoate reductase from Clostridium acetobutylicum (ca2ENR) reduced 4ACA to 4AHCA with a yield of > 95% mol mol(-1) and reaction rates of 3.4 ± 0.4 and 4.4 ± 0.6 mM h(-1) OD600(-1) at the optimum pH of 7.0 under aerobic and anaerobic conditions, respectively. This recombinant strain reduced caffeic, cinnamic, coumaric, and 4-nitrocinnamic acids to their corresponding propanoic acid derivatives. We polycondensed 4AHCA generated from biomass-derived 4ACA by dehydration under a catalyst to form high-molecular-weight poly(4AHCA) with a molecular weight of M n = 1.94 MDa. This polyamide had high thermal properties as indicated by a 10% reduction in weight at a temperature of T d10 = 394 °C and a glass transition temperature of T g = 240 °C. Poly(4AHCA) derived from biomass is stable at high temperatures and could be applicable to the production of high-performance engineering plastics. PMID: 29150705 [PubMed - as supplied by publisher]

Immune-Enhancing Formulas for Patients With Cancer Undergoing Esophagectomy: Systematic Review Protocol.

Related Articles Immune-Enhancing Formulas for Patients With Cancer Undergoing Esophagectomy: Systematic Review Protocol. JMIR Res Protoc. 2017 Nov 17;6(11):e214 Authors: Naranjo A, Isenring E, Teleni L Abstract BACKGROUND: Adult patients with an esophageal cancer can potentially be compromised with postoperative leaks or fistulae if patients' nutritional status is in a vulnerable stage. Currently in Australia, there is a growing need for clinicians to know whether use of immune-enhancing formulas (IEFs) containing Arg, omega-3, and RNA are a cost-effective approach compared with isonitrogenous-isocaloric formulas to reduce postoperative infectious complications in esophagectomy patients. Since IEFs may carry higher costs, this has led to inconsistencies in practice among clinicians and hospitals. OBJECTIVE: Our aim is to compile and present the most up-to-date nutrition evidence available regarding the provision of IEFs containing Arg, omega-3, and RNA to help clinicians develop an evidence-based nutrition care plan; identify available evidence of whether an esophagectomy patient should receive IEF; determine the cost-effectiveness and safety of such nutrition; and determine appropriate administration quantity and timing (pre-, peri-, or postesophagectomy). METHODS: This review will include RCTs involving the use of IEFs enriched with Arg, omega-3 polyunsaturated fatty acids, and RNA in the pre-, peri-, or postoperative period (for at least 5-7 days) given orally or via enteral feeding tube, in adult cancer patients undergoing esophageal resection. Lower gastrointestinal, gastric, or head cancer surgery with parenteral nutrition or non-IEF or use of isolated immunonutrient (Arg vs omega-3 vs RNA) will be excluded. Primary outcome comprises postoperative infectious complications. Secondary outcomes (pre/postoperatively) consist of cost-effectiveness, length of stay, survival/mortality, quality of life, nutritional status, percentage of weight loss, and biochemical changes. The risk of bias will be independently assessed by the reviewers, using a domain-based evaluation tool. Blinding will be assessed for subjective and objective outcome measures. Publication bias will be visually assessed by funnel plots. A meta-analysis will be generated by the Review Manager 5.3 software and represented in forest plots. RESULTS: The first results are expected in 2018. Outlining the protocol will ensure transparency for the completed review. CONCLUSIONS: This protocol for a systematic review and meta-analysis will enable a comprehensive appraisal of the literature to help determine whether overall institutional savings are associated with this approach. Findings will form a knowledge base relevant to stakeholders across the health system and researchers who are involved in decision making on evidence-based nutrition care plan pathways for patients undergoing esophagectomy, as well as the use of IEF, timing, and administration quantity. TRIAL REGISTRATION: PROSPERO Registration Number: CRD42017056908; http://www.crd.york.ac.uk/PROSPERO/ display_record.asp? PMID: 29150418 [PubMed]

Do factors related to participation in physical activity change following restrictive bariatric surgery? A qualitative study.

Related Articles Do factors related to participation in physical activity change following restrictive bariatric surgery? A qualitative study. Obes Res Clin Pract. 2017 Nov 14;: Authors: Zabatiero J, Smith A, Hill K, Hamdorf JM, Taylor SF, Hagger MS, Gucciardi DF Abstract AIMS: To explore participants' ability to participate in physical activity (PA), and barriers and facilitators to PA, at 12 months following restrictive bariatric surgery, and how these differed from participants' pre-surgery perceptions. Motivators for PA post-surgery were also explored. METHODS: Qualitative one-on-one in-depth interviews were conducted pre- and 12 months post-surgery. Data were analysed using inductive thematic analysis. RESULTS: Fourteen adults (12 females), with a mean (range) age of 41.4 years (25.0-56.0), body mass index (BMI) of 31.7kg/m(2) (22.3-48.2), and excess weight loss of 66% (2-127) completed both interviews. Lack of participation in PA during the first 3-6 months post-surgery was a common theme. Although participants reported increased ability to participate in PA, attributing this to a reduction in obesity-related physical barriers to PA, many participants reported that some pre-surgery obesity-related barriers to PA remained at 12 months post-surgery. For most participants, pre-surgery non-obesity related barriers to PA also remained at 12 months post-surgery. Facilitators to PA were consistent pre- and post-surgery. Weight loss and improvement in physical appearance were the most common motivators for PA post-surgery. CONCLUSIONS: At 12 months following surgery, many participants reported residual obesity and non-obesity related barriers to PA. These barriers may explain the small, if any, pre- to post-surgery change in PA levels reported by earlier research. Facilitators to PA did not change and post-surgery motivators for PA were mostly esteem-related. These data are relevant to shape interventions aimed at optimising PA in this population. PMID: 29150223 [PubMed - as supplied by publisher]

Esophagectomy After Weight-Reduction Surgery.

Related Articles Esophagectomy After Weight-Reduction Surgery. Thorac Surg Clin. 2018 Feb;28(1):53-58 Authors: Marino KA, Weksler B Abstract Obesity is now epidemic worldwide, and an increasing number of patients have undergone a weight-loss procedure. Although obesity is a risk factor for esophageal cancer, there are few reports on esophagectomy after bariatric procedures. Careful understanding of the patient's gastroesophageal anatomy as a result of the bariatric procedure and attention to the creation of the esophageal replacement conduit are fundamental for the success of esophagectomy after bariatric surgery. PMID: 29150037 [PubMed - in process]

Establishment of rat ankle post-traumatic osteoarthritis model induced by malleolus fracture.

Related Articles Establishment of rat ankle post-traumatic osteoarthritis model induced by malleolus fracture. BMC Musculoskelet Disord. 2017 Nov 17;18(1):464 Authors: Liang D, Sun J, Wei F, Zhang J, Li P, Xu Y, Shang X, Deng J, Zhao T, Wei L Abstract BACKGROUND: Malleolar fracture, which is present in 37-53% of human ankle osteoarthritis (OA), is the most common type of fracture in the ankle joint. In spite of this, no rat animal model has been developed for this type of injury to date. Here, we established a rat ankle post-traumatic OA (PTOA) model induced by malleolar fracture; this model will be useful in ankle OA research. METHODS: Two-month-old male Sprague Dawley (SD) rats were randomized into 2 groups (n = 19 per group): 1) malleolus articular fracture, dislocation, and immediate reduction on the right joints and 2) malleolus articular fracture on the right ankle. The contralateral ankle joints were used as controls. The fracture and healing processes were confirmed and monitored by radiography. Changes in inflammation were monitored in vivo by fluorescence molecular tomography (FMT). Cartilage damage and changes in expression of OA-related genes were analyzed by histology, immunohistochemistry, Real-time quantitative PCR (qPCR) and enzyme-linked immunosorbent assay (ELISA) at 8 weeks post-surgery. RESULTS: X-rays showed that all fractures were healed at 8 weeks post-surgery. A reproducible, mild to moderate degree of OA cartilage damage with reduced aggrecan was detected by histology in all animals in both groups but there was no significant difference between the two groups. Decreased Col-II and increased Col-X and MMP-13 levels were detected by qPCR, immunohistochemistry, ELISA and FMT from both groups cartilage. CONCLUSIONS: Malleolus articular fracture alone induces ankle OA with lesions on the central weight bearing area of the tibiotalar joint in rats. This model will provide a reproducible and useful tool for researchers to study ankle OA. PMID: 29149841 [PubMed - in process]

Protective role of biosynthesized silver nanoparticles against early blight disease in Solanum lycopersicum.

Related Articles Protective role of biosynthesized silver nanoparticles against early blight disease in Solanum lycopersicum. Plant Physiol Biochem. 2017 Nov 10;121:216-225 Authors: Kumari M, Pandey S, Bhattacharya A, Mishra A, Nautiyal CS Abstract Tomato suffers a huge loss every year because of early blight disease. This study focuses on efficient inhibition of Alternaria solani, the causative agent of early blight disease in tomato in vitro and in vivo. Foliar spray of 5 μg/mL of biosynthesized silver nanoparticles in A. solani infected plants resulted in significant increase of 32.58% in fresh weight and 23.52% in total chlorophyll content of tomato as compared to A. solani infected plants. A decrease of 48.57, 30, 39.59 and 28.57% was observed in fungal spore count, lipid peroxidation, proline content and superoxide dismutase respectively in infected tomato plants after treatment with synthesized silver nanoparticles as compared to A. solani infected plants. No significant variation in terms of soil pH, cultured population, carbon source utilization pattern and soil enzymes including dehydrogenase, urease, protenase and β-glucosidase was observed after foliar spray of nanoparticles. It was revealed that direct killing of pathogens, increased photosynthetic efficiencies, increased plant resistance and decrease in stress parameters and stress enzymes are the mechanisms employed by plants and nanoparticles simultaneously to combat the biotic stress. Biosynthesized silver nanoparticles bear the potential to revolutionize plant disease management, though the molecular aspects of increased resistance must be looked upon. PMID: 29149700 [PubMed - as supplied by publisher]

Health effects of saturated and trans-fatty acid intake in children and adolescents: Systematic review and meta-analysis.

Related Articles Health effects of saturated and trans-fatty acid intake in children and adolescents: Systematic review and meta-analysis. PLoS One. 2017;12(11):e0186672 Authors: Te Morenga L, Montez JM Abstract BACKGROUND: Elevated cholesterol has been linked to cardiovascular disease in adults and preclinical markers of atherosclerosis in children, thus reducing saturated (SFA) and trans-fatty acids (TFA) intake from an early age may help to reduce cholesterol and the risk of cardiovascular disease later in life. The aim of this review is to examine the evidence for health effects associated with reducing SFA and TFA intake in free-living children, adolescents and young adults between 2 to 19 years of age. DESIGN: Systematic review and meta-analysis of randomised controlled trials (RCTs) and prospective cohort studies. Study selection, assessment, validity, data extraction, and analysis were undertaken as specified by the Cochrane Collaboration and the GRADE working group. Data were pooled using inverse variance models with random effects. DATA SOURCES: EMBASE; PubMed; Cochrane Central Register of Controlled Trials; LILACS; and WHO Clinical Trial Registry (up to July 2016). ELIGIBILITY CRITERIA FOR SELECTING TRIALS: RCTs involving dietary interventions aiming to reduce SFA or TFA intakes and a control group, and cohort studies reporting the effects of SFA or TFA exposures, on outcomes including blood lipids; measures of growth; blood pressure; insulin resistance; and potential adverse effects. Minimum duration was 13 days for RCTs and one year for cohort studies. Trials of weight loss or confounded by additional medical or lifestyle interventions were excluded. RESULTS: Compared with control diets, there was a highly statistically significant effect of reduced SFA intake on total cholesterol (mean difference (MD) -0.16 mmol/l, [95% confidence interval (CI): -0.25 to -0.07]), LDL cholesterol (MD -0.13 mmol/l [95% CI:-0.22 to -0.03]) and diastolic blood pressure (MD -1.45 mmol/l [95% CI:-2.34 to -0.56]). There were no significant effects on any other risk factors and no evidence of adverse effects. CONCLUSIONS: Advice to reduce saturated fatty acids intake of children results in a significant reduction in total and LDL-cholesterol levels as well as diastolic blood pressure without evidence of adverse effects on growth and development. Dietary guidelines for children and adolescents should continue to recommend diets low in saturated fat. PMID: 29149184 [PubMed - in process]

Adherence to Hunger Training over 6 Months and the Effect on Weight and Eating Behaviour: Secondary Analysis of a Randomised Controlled Trial.

Related Articles Adherence to Hunger Training over 6 Months and the Effect on Weight and Eating Behaviour: Secondary Analysis of a Randomised Controlled Trial. Nutrients. 2017 Nov 17;9(11): Authors: Jospe MR, Taylor RW, Athens J, Roy M, Brown RC Abstract Monitoring blood glucose prior to eating can teach individuals to eat only when truly hungry, but how adherence to 'hunger training' influences weight loss and eating behaviour is uncertain. This exploratory, secondary analysis from a larger randomized controlled trial examined five indices of adherence to 'hunger training', chosen a priori, to examine which adherence measure best predicted weight loss over 6 months. We subsequently explored how the best measure of adherence influenced eating behavior in terms of intuitive and emotional eating. Retention was 72% (n = 36/50) at 6 months. Frequency of hunger training booklet entry most strongly predicted weight loss, followed by frequency of blood glucose measurements. Participants who completed at least 60 days of booklet entry (of recommended 63 days) lost 6.8 kg (95% CI: 2.6, 11.0; p < 0.001) more weight than those who completed fewer days. They also had significantly higher intuitive eating scores than those who completed 30 days or less of booklet entry; a difference (95% CI) of 0.73 (0.12, 1.35) in body-food choice congruence and 0.79 (0.06, 1.51) for eating for physical rather than emotional reasons. Adherent participants also reported significantly lower scores for emotional eating of -0.70 (-1.13, -0.27). Following hunger training and focusing on simply recording ratings of hunger on a regular basis can produce clinically significant weight loss and clinically relevant improvements in eating behaviour. PMID: 29149038 [PubMed - in process]

Perceptions of adults with overweight/obesity and chronic musculoskeletal pain: an interpretative phenomenological analysis.

Related Articles Perceptions of adults with overweight/obesity and chronic musculoskeletal pain: an interpretative phenomenological analysis. J Clin Nurs. 2017 Nov 17;: Authors: Cooper L, Ells L, Ryan C, Martin D Abstract AIMS: To gain insight into the lived experience of adults with overweight/obesity and chronic musculoskeletal pain (CMP). Knowledge gained will inform healthcare professionals about the complexity of the weight-pain relationship and enable more effective engagement with this population BACKGROUND: Quantitative studies show links between weight and pain. Adults with overweight/obesity are more likely to experience comorbidity however, qualitative research describing the complexities of the relationship is limited. METHODS: A purposive sample of adults with overweight/obesity and CMP participated in face-to-face interviews. Interviews were audio-recorded, transcribed verbatim and analysed using IPA. RESULTS: Eighteen adults (16 Female) aged 29-71, BMI ≥25-46 participated in this study. Three superordinate themes emerged: 'pain as a motivator and barrier to weight loss'; 'fear of weight causing more damage'; 'activity is positive'. Pain motivates some individuals to lose weight while simultaneously inhibiting weight-loss efforts. Participants perception that extra pressure caused by their weight further damaged joints contributed to fear and catastrophizing. Fear is often exacerbated by health care professionals' descriptions of musculoskeletal damage, or participants perception of HCPs attitude towards people with overweight/obesity. Conversely, individuals acknowledged the benefits of increased activity. CONCLUSION: Adults with overweight/obesity and CMP in this study identified a bidirectional relationship between their weight and pain, that challenged their weight-loss efforts. Overweight/obesity contributed to fear and catastrophizing, which resulted in avoidance of exercise that would have assisted their weight loss. RELEVANCE TO CLINICAL PRACTICE: Healthcare professionals (HCP) need to understand the complex relationship between weight and pain, and their patients understanding of that relationship. HCP should use therapeutic communication to reduce the fear of weight causing damage, and thus promote physical activities that will contribute to weight loss. It is also important to ensure that the language used with this patient group does not stigmatise individuals, or cause or exacerbate fear of normal movement. This article is protected by copyright. All rights reserved. PMID: 29148620 [PubMed - as supplied by publisher]

Metabolic study of paeoniflorin and total paeony glucosides from Paeoniae Radix Rubra in rats by high performance liquid chromatography coupled with sequential mass spectrometry (UPLC-ESI-MS(n) ).

Related Articles Metabolic study of paeoniflorin and total paeony glucosides from Paeoniae Radix Rubra in rats by high performance liquid chromatography coupled with sequential mass spectrometry (UPLC-ESI-MS(n) ). Biomed Chromatogr. 2017 Nov 17;: Authors: Zhu L, Sun S, Hu Y, Liu Y Abstract A clear understanding of the metabolism of Traditional Chinese Medicine (TCM) is extremely important in their rational clinical application and effective material foundation research. A novel and reliable strategy was performed to find more metabolites of paeoniflorin, determine the metabolites of total paeony glucosides (TPG) by means of determining those metabolites of paeoniflorin, and compare the metabolism differences between paeoniflorin and TPG by intragastric administration. This strategy was characterized as follows: firstly, the rats were divided into two groups (the paeoniflorin group and the TPG group) to find different metabolism mechanism between paeoniflorin and TPG; secondly, UPLC-FT-ICR MS and UPLC-Q-TOF MS(2) were applied to obtain accurate molecular weight and structural information respectively; thirdly, the metabolites were tentatively identified by a combination of data-processing methods including mass defect screening, characteristic neutral loss screening and product ion screening; finally, a comparative study was employed in the metabolism of paeoniflorin and TPG. Based on the strategy, eighteen metabolites of paeoniflorin (including four new compounds) and eleven metabolites of TPG (including two new compounds) were identified respectively. In all of the identified metabolites of paeoniflorin, two metabolites in rat plasma, four metabolites in rat urine and six metabolites in rat feces were found for the first time after paeoniflorin administration, respectively. The results indicated that the hydrolyzation of the ester bond and glucosidic band and the conjugation with glucuronide were the major metabolic pathways of paeoniflorin. It has been the first time to detect the metabolites of paeoniflorin and TPG in rats plasma, urine and feces after intragastric administration. The results may contribute to a better understanding of the metabolism mechanism and providing a scientific rationale for researching the material basis of paeoniflorin and TPG in vivo. PMID: 29148594 [PubMed - as supplied by publisher]

A singular value decomposition linear programming (SVDLP) optimization technique for circular cone based robotic radiotherapy.

Related Articles A singular value decomposition linear programming (SVDLP) optimization technique for circular cone based robotic radiotherapy. Phys Med Biol. 2017 Nov 17;: Authors: Liang B, Li Y, Ran W, Guo B, Xu X, Liu B, Li J, Wu Q, Zhou F Abstract With robot-controlled linac positioning, the robotic radiotherapy system such as CyberKnife significantly increases the freedom in radiation beam placement, but also imposes more challenges on treatment plan optimization. The resampling mechanism in vendor supplied treatment planning system (MultiPlan) could not fully explore the increased beam direction search space. Besides, a sparse treatment plan (using fewer beams) is desired to improve the treatment efficiency. This study proposes a singular value decomposition linear programming (SVDLP) optimization technique for circular collimator based robotic radiotherapy. The SVDLP approach initializes the input beams by simulating the process of covering the entire target volume with equivalent beam taper. The requirements on dosimetry distribution are modeled as hard and soft constraints, and the sparsity of treatment plan is achieved by compressive sensing. The proposed liner programming (LP) model optimizes beam weight by minimizing the deviation of soft constraints while subjecting to hard constraints, with the constraint on the &lt;i&gt;l&lt;/i&gt;&lt;sup&gt;1&lt;/sup&gt; norm of beam weight. A singular value decomposition (SVD) based acceleration technique was developed for the LP model. Based on the degeneracy of influence matrix, the model is first compressed into lower dimension for optimization, and then back-projected to reconstruct the beam weight. After beam weight optimization, the number of beams is reduced by removing the beams with low weight, and optimizing the weight of remaining beams using the same model. This beam reduction technique is further validated by a mixed integer programming (MIP) model. The SVDLP approach was tested on a lung case. The results demonstrate that the SVD acceleration technique speeds up the optimization by a factor of 4.8. And the beam reduction achieves similar plan quality as the globally optimal plan obtained by MIP model, but is 1-2 orders of magnitude faster. Furthermore, the SVDLP approach is tested and compared with MultiPlan on three clinical cases of varying complexities. In general, the plans generated by the SVDLP achieve steeper dose gradient, better conformity and less damage to normal tissues. In conclusion, the SVDLP approach effectively improves the quality of treatment plan due to the use of complete beam search space. The challenging optimization problem with complete beam search space is effectively handled by the proposed SVD acceleration. PMID: 29148432 [PubMed - as supplied by publisher]

Port site hernia after laparoscopic sleeve gastrectomy: a retrospective cohort study of 352 patients.

Related Articles Port site hernia after laparoscopic sleeve gastrectomy: a retrospective cohort study of 352 patients. Updates Surg. 2017 Nov 16;: Authors: Ece I, Yilmaz H, Alptekin H, Yormaz S, Colak B, Sahin M Abstract Port site hernia (PSH) following laparoscopic procedures is a rare but serious complication. The aim of this study was to evaluate the rate of PSH after laparoscopic sleeve gastrectomy (LSG), and the efficacy of closure of the port site as a means of preventing PSH. A retrospective analysis was performed on 386 patients who underwent LSG between December 2009 and January 2015. 352 (91.2%) of the patient were followed up for at least 24 months. In the first 206 patients, the fascial layers of the trocar incisions were not closed, while in the next 146 cases, routine closure of the trocar sites was performed. The patients were reviewed in relation to demographics, comorbidities, complications, percentage of excess weight loss, and rates of PSH. The total cohort consisted of 220 female and 132 male patients with a mean age of 36.2 ± 12.3 years. Demographic data, initial BMI, and comorbidities were similar for the patients in both groups. The closure of the fascia was caused by the prolonged duration of the operation with no significant difference. The unclosed fascial defects were associated with a significantly increased incidence of PSH (1.3 vs. 3.9%, p < 0.05). All of the patients who experienced PSH had at least one comorbidity, and no complication was noted in the fascial closure cases. It was found that the rate of PSH after LSG is not as low as previously thought, and that routine closure of fascial defects at port sites may result in a decreased PSH rate. PMID: 29147959 [PubMed - as supplied by publisher]

Efficacy and Safety of Fully Covered Self-Expanding Metal Stents for Malignant Esophageal Obstruction.

Related Articles Efficacy and Safety of Fully Covered Self-Expanding Metal Stents for Malignant Esophageal Obstruction. Dig Dis Sci. 2017 Nov 17;: Authors: So H, Ahn JY, Han S, Jung K, Na HK, Lee JH, Jeong KW, Kim DH, Choi KD, Song HJ, Lee GH, Jung HY Abstract BACKGROUND: Malignant dysphagia can result in poor nutritional status with severe weight loss. Rapid relief from dysphagia can be achieved with esophageal self-expanding metal stents (SEMSs), a minimally invasive method. In this study, we evaluated the usefulness of SEMSs for malignant dysphagia. METHODS: Between 2012 and 2015, 119 patients with malignant dysphagia underwent esophageal SEMS insertion with endoscopic assistance. Their demographics and clinical outcomes were collected. Factors associated with stent-related complications and patient survival were evaluated. All data were retrospectively analyzed. RESULTS: The mean age of the 119 patients was 64.9 ± 11.6 years, and 25 (21%) were female. Seventy-five patients (63.0%) had squamous carcinoma, majority of which were located in the lower thoracic esophagus (n = 42), followed by middle thoracic esophagus (n = 19) and upper esophagus (n = 10). Eighty patients (67.2%) underwent SEMS insertion at diagnosis. Technical and clinical success rates were 99.2 and 89.9%, respectively. Complications occurred in 47 patients (39.5%); the most common complication was migration (36.3%), followed by pain and obstruction. The median stent patency time was 145 days (95% confidence interval 55.19-234.81 days). Gastric cancer (odds ratio 3.51, 95% confidence interval 1.21-10.15; p = 0.021) and a 20-mm-wide stent (odds ratio 2.922, 95% confidence interval 1.237-6.904; p = 0.015) were risk factors for complications. CONCLUSIONS: SEMSs are effective in palliation of malignant dysphagia. However, stent-related complications should be borne in mind, particularly in patients with gastric cancer with esophageal invasion and with larger width stents. PMID: 29147877 [PubMed - as supplied by publisher]

Isolated pulmonary valve endocarditis: truth or myth?

Related Articles Isolated pulmonary valve endocarditis: truth or myth? J Community Hosp Intern Med Perspect. 2017;7(5):329-331 Authors: Seraj SM, Gill E, Sekhon S Abstract Pulmonary valve (PV) infective endocarditis (IE) is an extremely rare disease that involves normal as well as abnormal valves. This condition mostly occurs in patients with underlying predisposing factors. It could be missed if patients do not present with typical features of right-sided endocarditis or in the absence of classic risk factors. The case presented here did not have any known risk factors for IE until surgery and presented mainly with fever, weight loss, and musculoskeletal symptoms. PMID: 29147479 [PubMed]

The effect of educational intervention on weight loss in adolescents with overweight and obesity: Application of the theory of planned behavior.

Related Articles The effect of educational intervention on weight loss in adolescents with overweight and obesity: Application of the theory of planned behavior. ARYA Atheroscler. 2017 Jul;13(4):176-183 Authors: Mazloomy-Mahmoodabad SS, Navabi ZS, Ahmadi A, Askarishahi M Abstract BACKGROUND: The increased prevalence of overweight and obesity in children and adolescents is associated with type 2 diabetes, hypertension, dyslipidemia, and cardiovascular diseases. The theory of planned behavior (TPB) efficiently explains the ability of perceived behavioral control and possibly attitude to enhance the motivations of the obese people to lose weight. Our aim was to investigate the effect of TPB-based education on weight loss in obese and overweight adolescents. METHODS: In an interventional study, simple random sampling was used to select 86 overweight and obese adolescents aged 13-18 years in the pediatric clinic at the Isfahan Cardiovascular Research Institute. Anthropometric measures and TPB constructs were collected using a researcher-made questionnaire. The questionnaires were filled out before and six weeks after the intervention. Participants received 5 sessions of training based on the constructs of the TPB. RESULTS: A significant increase was observed in the mean score for knowledge and TPB constructs (attitudes, subjective norms, perceived behavioral control, intention, and behavior) six weeks after the educational intervention (P < 0.001). Moreover, significant decrease in body mass index (P < 0.001), weight (P = 0.001), and waist circumference (P < 0.001) of adolescents were found after the educational intervention. CONCLUSION: The TPB-based interventions seem to be effective in losing weight in obese and overweight adolescents. This theory serves as a helpful theoretical framework for health-related behaviors and can be an appropriate pattern to plan for educational interventions. PMID: 29147128 [PubMed]

A Comparison of the Essential Amino Acid Content and the Retention Rate by Chicken Part according to Different Cooking Methods.

Related Articles A Comparison of the Essential Amino Acid Content and the Retention Rate by Chicken Part according to Different Cooking Methods. Korean J Food Sci Anim Resour. 2017;37(5):626-634 Authors: Kim H, Do HW, Chung H Abstract This study set out to identify the changes in the nutrient contents during the chicken cooking process as basic data for the establishment of a national health nutrition policy. Samples were produced using 3 chicken parts (wing, breast, and leg) and 7 cooking methods (boiling, pancooking, pan-frying, deep-frying, steaming, roasting, and microwaving), and the essential amino acid contents, principal components, and retention rates were analyzed. Weight loss was observed in all chicken parts with all cooking methods. The protein and essential amino acid contents of the chicken samples differed significantly according to the part and the cooking method (p<0.01). The protein and essential amino acid contents (g/100 g) of raw and cooked chicken parts showed ranges of 16.81-32.36 and 0.44-2.45, respectively. The principal component analysis (PCA) clearly demonstrated that the cooking methods and chicken parts produced similar trends for the essential amino acid contents. The retention rates of the chicken parts varied with the cooking methods, yielding a minimum value of 83% for isoleucine in a roasted wing, 91% for protein in a steamed breast, and 77% for isoleucine and lysine in a roasted leg. Therefore, the protein and amino acid contents of the roasted breast were higher than those of the other cooked chicken parts. PMID: 29147085 [PubMed]

Maraba virus-vectored cancer vaccines represent a safe and novel therapeutic option for cats.

Related Articles Maraba virus-vectored cancer vaccines represent a safe and novel therapeutic option for cats. Sci Rep. 2017 Nov 16;7(1):15738 Authors: Hummel J, Bienzle D, Morrison A, Cieplak M, Stephenson K, DeLay J, Woods JP, Lichty BD, Bridle BW Abstract Direct killing of malignant cells combined with induction of tumour-specific immune responses makes oncolytic vaccines attractive for cancer therapy. We previously developed a heterologous cancer immunization strategy that utilized a replication-defective adenovirus-vectored primary vaccine encoding a tumour antigen followed by boosting with a replication-competent Maraba virus expressing the same antigen. To assess the safety of oncolytic Maraba virus-based booster vaccines and inform the design of clinical trials, we conducted translational studies in cats, which have immune systems that are similar to people and spontaneously develop cancers of comparable types and etiologies. A dose of Maraba virus up to 2.5 × 10(11) pfu per cat was well-tolerated, with adverse effects limited to mild, transient pyrexia, weight loss, neutropenia, lymphopenia and thrombocytopenia. Maraba viral genomes were present in some urine, stool and most plasma samples up to one week post-infection, but no infectious viruses were recovered. Post-mortem analysis showed one heart, one lung and all spleen samples contained Maraba virus genomes. No replication-competent viruses were recovered from any tissues. Post-mortem histopathological analyses revealed hyperplasia of lymphoid tissues, but no abnormal lesions were attributed to vaccination. This study demonstrated that Maraba virus-vectored cancer vaccines were well-tolerated and supports their use in treating cats. PMID: 29146945 [PubMed - in process]

Rare cause of adrenal insufficiency.

Related Articles Rare cause of adrenal insufficiency. BMJ Case Rep. 2017 Nov 16;2017: Authors: Hii JW, Page MM, Wesseldine A Abstract A 72-year-old man presented with weight loss, night sweats and haemoptysis and was hypotensive. CT imaging showed rapidly enlarging bilateral adrenal masses, and he was found to have primary adrenal insufficiency. An adrenal gland biopsy revealed the rare diagnosis of primary adrenal lymphoma. This unique case highlights possible rare causes of adrenal masses and adrenal insufficiency, their investigation and management principles. PMID: 29146725 [PubMed - in process]
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