Percutaneous nephrolithotomy in super obese patients (body mass index ≥ 50 kg/m2): overcoming the challenges

2015 ◽  
Vol 117 (2) ◽  
pp. 300-306 ◽  
Author(s):  
Mohamed Keheila ◽  
David Leavitt ◽  
Riccardo Galli ◽  
Piruz Motamedinia ◽  
Nithin Theckumparampil ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Percutaneous Nephrolithotomy ◽  
Obese Patients ◽  
Super Obese

scholarly journals MP33-12 PERCUTANEOUS NEPHROLITHOTOMY IN THE SUPER OBESE: A COMPARISON OF OUTCOMES BASED ON BODY MASS INDEX

2016 ◽  
Vol 195 (4S) ◽  
Author(s):  
Casey A Dauw ◽  
Michael S Borofsky ◽  
Nadya York ◽  
James E Lingeman
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Percutaneous Nephrolithotomy ◽  
Super Obese

Does body mass index impact the efficacy and complication rate of mini-percutaneous nephrolithotomy?

2020 ◽  
pp. 205141582093688
Author(s):  
Hannah Burns ◽  
Nafees Ahmad ◽  
Jane Hendry ◽  
Sarath Nalagatla
Keyword(s):  
Body Mass Index ◽  
Length Of Stay ◽  
Body Mass ◽  
Percutaneous Nephrolithotomy ◽  
Complication Rate ◽  
Clearance Rate ◽  
Obese Patients ◽  
Clearance Rates ◽  
Stone Clearance ◽  
Severely Obese

Aim: This was a retrospective cohort study exploring the efficacy of mini-percutaneous nephrolithotomy in obese patients and whether stone clearance, complication rate and length of stay is impacted by an increasing body mass index. Method: Data was collected retrospectively for all mini-percutaneous nephrolithotomies performed at a single centre over a 21-month period commencing March 2017. The primary outcomes included length of stay, stone clearance rates and complications. Results: Fifty-eight percutaneous nephrolithotomies were undertaken during the study period and of these cases 81% of patients had a body mass index of 25 or greater. The stone clearance rate was 83%. However, severely obese patients were noted to have a lower stone clearance rate. No complications occurred in the normal body mass index cohort. However, there was no difference in the complication rate for the remaining groups. Post-operative stay was approximately 3 days. Conclusion: This study demonstrates that supine mini-percutaneous nephrolithotomies are a safe option in obese patients with no increased risk of serious complication. Whilst stone clearance rates were lower in the severely obese category, clearance was complete in the majority of cases. Level of evidence: 3

scholarly journals Higher body mass index is associated with larger postoperative improvement in patient-reported outcomes following total knee arthroplasty

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
K Giesinger ◽  
JM Giesinger ◽  
DF Hamilton ◽  
J Rechsteiner ◽  
A Ladurner
Keyword(s):  
Body Mass Index ◽  
Total Knee Arthroplasty ◽  
Pain Relief ◽  
Body Mass ◽  
Knee Arthroplasty ◽  
Normal Weight ◽  
World Health ◽  
Obese Patients ◽  
Total Knee ◽  
The Impact

Abstract Background Total knee arthroplasty is known to successfully alleviate pain and improve function in endstage knee osteoarthritis. However, there is some controversy with regard to the influence of obesity on clinical benefits after TKA. The aim of this study was to investigate the impact of body mass index (BMI) on improvement in pain, function and general health status following total knee arthroplasty (TKA). Methods A single-centre retrospective analysis of primary TKAs performed between 2006 and 2016 was performed. Data were collected preoperatively and 12-month postoperatively using WOMAC score and EQ-5D. Longitudinal score change was compared across the BMI categories identified by the World Health Organization. Results Data from 1565 patients [mean age 69.1, 62.2% women] were accessed. Weight distribution was: 21.2% BMI < 25.0 kg/m2, 36.9% BMI 25.0–29.9 kg/m2, 27.0% BMI 30.0–34.9 kg/m2, 10.2% BMI 35.0–39.9 kg/m2, and 4.6% BMI ≥ 40.0 kg/m2. All outcome measures improved between preoperative and 12-month follow-up (p < 0.001). In pairwise comparisons against normal weight patients, patients with class I-II obesity showed larger improvement on the WOMAC function and total score. For WOMAC pain improvements were larger for all three obesity classes. Conclusions Post-operative improvement in joint-specific outcomes was larger in obese patients compared to normal weight patients. These findings suggest that obese patients may have the greatest benefits from TKA with regard to function and pain relief one year post-op. Well balanced treatment decisions should fully account for both: Higher benefits in terms of pain relief and function as well as increased potential risks and complications. Trial registration This trial has been registered with the ethics committee of Eastern Switzerland (EKOS; Project-ID: EKOS 2020–00,879)

scholarly journals Iron Deficiency and Obesity – Are we Diagnosing with Appropriate Indicators?

2018 ◽  
Vol 31 (9) ◽  
pp. 478 ◽  
Author(s):  
Ana Margarida Monteiro ◽  
Vera Fernandes ◽  
Cláudia Matta-Coelho ◽  
Sílvia Paredes ◽  
Maria Lopes Pereira ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Metabolic Syndrome ◽  
Body Mass Index ◽  
Iron Deficiency ◽  
Body Mass ◽  
Obese Patients ◽  
Exclusion Criteria ◽  
Multidisciplinary Consultation ◽  
Deficiency Type

Introduction: We aim to define the iron deficiency prevalence and eventual differences between obese patients with and without metabolic syndrome.Material and Methods: Analysis of patients evaluated at multidisciplinary consultation of obesity in our institution between 2013 and 2015 (n = 260). Iron deficiency: ferritin levels < 15 ng/mL. Exclusion criteria: prior bariatric surgery; lack of ferritin or hemoglobin determinations.Results: We analyzed data from 215 patients (84.2% female) with a mean age of 42.0 ± 10.3 years. The median body mass index was 42.5 (40.0 - 46.8) kg/m2 and 52.1% had metabolic syndrome. Iron deficiency was present in 7.0%, with no differences between genders or between patients with or without metabolic syndrome. Hypertension was associated with lower prevalence of iron deficiency. Type 2 diabetes and hypertension patients had higher levels of ferritin. The multivariate analysis showed that metabolic syndrome and increasing body mass index were predictive of higher risk of iron deficiency while hypertension predicted lower odds of iron deficiency.Discussion: The prevalence of iron deficiency was similar in other published studies. Iron deficiency may be underdiagnosed if based only on ferritin concentrations. In our study, diabetes and hypertension appear to contribute to the increase in ferritin levels described in obesity.Conclusion: Ferritin may not be a reliable index for evaluating iron stores in obese patients, particularly when associated with comorbidities such as type 2 diabetes and hypertension. Further studies are needed to guide the diagnosis and iron supplementation in these patients.

scholarly journals Body Mass Index and Helicobacter pylori among Obese and Non-Obese Patients in Najran, Saudi Arabia: A Case-Control Study

2018 ◽  
Vol 15 (11) ◽  
pp. 2586 ◽  
Author(s):  
Ali Al-Zubaidi ◽  
Abdo Alzobydi ◽  
Saeed Alsareii ◽  
AbdulazizTurky Al-Shahrani ◽  
Naweed Alzaman ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Helicobacter Pylori ◽  
Saudi Arabia ◽  
Body Mass ◽  
Upper Endoscopy ◽  
Obese Patients ◽  
Age And Gender ◽  
Total Prevalence ◽  
And Gender ◽  
Saudi Patients

Objective: We examine obese and non-obese patients with respect to Helicobacter pylori (H. pylori) positive-infection (HPPI) and associated factors, specifically body mass index (BMI). Methods: This study took place in the Department of Endoscopy of a central hospital in the Najran region of Saudi Arabia (SA). A total of 340 obese Saudi patients (BMI ≥ 30 kg/m2) who had undergone diagnostic upper endoscopy before sleeve gastrectomy, were compared with 340 age and gender-matched control patients (BMI < 30 kg/m2) who had undergone diagnostic upper endoscopy for other reasons. Data collected included diagnosis of HPPI. Descriptive and multivariable binary logistic regression was conducted. Results: Mean patient age was 31.22 ± 8.10 years, and 65% were males. The total prevalence of HPPI was 58% (95% CI = 54–61%) with obese patients presenting significantly more HPPI than non-obese patients (66% vs. 50%, OR = 1.98, 95% CI = 1.45–2.70, p < 0.0005). Age and gender did not associate significantly with HPPI (p = 0.659, 0.200, respectively) and increases in BMI associated significantly with increases in HPPI (p < 0.0005). BMI remained a significant factor in HPPI when modelled with both age and gender (OR = 1.022, 95% CI = 1.01–1.03, p < 0.0005). Conclusions: Within the limitations of this study, the significance of HPPI in obese Saudi patients residing in the Najran region in SA was demonstrated alongside the significance role of BMI in HPPI.

Association with Leptin Gene c.-2548 G>A Polymorphism, Serum Leptin Levels, and Body Mass Index in Turkish Obese Patients

2012 ◽  
Vol 65 (2) ◽  
pp. 243-247 ◽  
Author(s):  
Deniz Say Sahin ◽  
Cemil Tumer ◽  
Cemil Demir ◽  
M. Murat Celik ◽  
Mustafa Celik ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Obese Patients ◽  
Serum Leptin

Norepinephrine Dosing in Obese and Nonobese Patients With Septic Shock

2016 ◽  
Vol 25 (1) ◽  
pp. 27-32 ◽  
Author(s):  
John J. Radosevich ◽  
Asad E. Patanwala ◽  
Brian L. Erstad
Keyword(s):  
Body Mass Index ◽  
Septic Shock ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Body Mass ◽  
Secondary Outcome ◽  
Obese Patients ◽  
Hemodynamic Status ◽  
Norepinephrine Infusion ◽  
Nonobese Patients

Background Whether or not norepinephrine infusions for support of hemodynamic status in patients with septic shock should be weight based is unknown. This situation is particularly pertinent in patients who are extremely overweight or obese. Objective To compare dosing requirements and effect of norepinephrine on blood pressure in obese and nonobese patients with septic shock. Methods In a retrospective cohort study, data on adult patients with septic shock who received norepinephrine infusion for support of hemodynamic status in a tertiary care, academic medical center were analyzed. Patients were categorized as obese (body mass index ≥ 30) or nonobese (body mass index &lt; 30). The primary outcome was dosing requirements of norepinephrine at 60 minutes after the start of the infusion. The secondary outcome was the log-transformed ratio of mean arterial pressure to norepinephrine. Results The final cohort consisted of 100 obese and 100 nonobese patients. Mean norepinephrine infusion rate at 60 minutes was 0.09 (SD, 0.08) μg/kg per minute in the obese group and 0.13 (SD, 0.14) μg/kg per minute in the nonobese group (P = .006). The non–weight-based dose at 60 minutes was 9 μg/min in obese patients and 8 μg/min in nonobese patients (P = .72). The log transformed mean arterial pressure to norepinephrine ratio at 60 minutes was 2.5 (SD, 0.9) in obese patients and 2.5 (SD, 0.8) in nonobese patients (P = .54) Conclusions Compared with nonobese patients, obese patients with septic shock require lower weight-based doses of norepinephrine and similar total norepinephrine doses.

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