scholarly journals Effect of Weight Loss on Symptoms of Polycystic Ovarian Syndrome among Women of Reproductive Age

2021 ◽  
pp. 1-6
Author(s):  
Anita Dileep ◽  
Manal Ahmed Faek Samy ◽  
Nazneen Hussain ◽  
Sham Zain Alabdind
Keyword(s):  
Weight Loss ◽  
Clinical Improvement ◽  
Polycystic Ovarian Syndrome ◽  
Categorical Variables ◽  
Childbearing Age ◽  
Successful Weight Loss ◽  
The Impact ◽  
Baseline Bmi ◽  
Ovarian Syndrome

<b><i>Background:</i></b> The polycystic ovarian syndrome (PCOS) is a common endocrine disease, which affects women of childbearing age. Its exact etiology is not yet fully understood, but there have been a number of theories and hypotheses which suggested that it is related to multiple factors. However, the most common cause is the insulin resistance, which contributed in development of PCOS and weight gain as well. <b><i>Aim:</i></b> This study aims to assess the impact of weight control on the management of PCOS among obese patients. <b><i>Methods:</i></b> This is a retrospective observational study conducted on 68 obese PCOS women at different primary healthcare centers in Dubai. Patients were included only if they were following a healthy lifestyle, using metformin (750–1,000 mg) for at least 3–9 months, and lost at least 5.0–10.0% of their baseline body weights. The follow-up period was for 1 year based on their medical records. Data were analyzed and represented as mean ± standard deviation of continues measures, while the χ<sup>2</sup> test, independent Student’s <i>t</i> test, and one-way ANOVA test were performed for comparing numerical variables between different groups of categorical variables. <i>p</i> value was considered significant at &#x3c;0.05. <b><i>Results:</i></b> Mean age of the patients was 26.1 ± 6.5 years, and the average baseline BMI was 34.7 ± 4.3 kg/m<sup>2</sup>. The most frequently reported clinical feature of PCOS was irregular menstruation (<i>n</i> = 38, 55.9%). Majority of the patients (80.0%) who had a successful weight loss (median of 8.0 [3, 10] kg) during the 1-year follow-up reported a significant clinical improvement, while those reported no clinical improvement did not actually have a considerable weight loss (median of 4 [2, 5] kg) (<i>p</i> &#x3c; 0.001). Additionally, the duration of treatment of 9 months was significantly respectable for achieving higher weight loss than less durations (<i>p</i> = 0.002). Furthermore, the only factor which contributed to clinical improvement of PCOS was the baseline BMI (<i>p</i> &#x3c; 0.001). <b><i>Conclusion:</i></b> This study demonstrated that following an appropriate care plan by a combination of lifestyle modifications and metformin was effective in achieving a successful weight loss, which resulted in a significant improvement in the clinical features of the PCOS. Further studies are recommended to raise awareness of women regarding the PCOS and to encourage them to communicate with healthcare providers for initiating their self-management care.

scholarly journals Place Work on a Scale: What Do We Know About the Association Between Employment Status and Weight Loss Outcomes After Bariatric Surgery?

2021 ◽  
Author(s):  
Marleen M. Romeijn ◽  
Marlies Bongers ◽  
Daniëlle D.B. Holthuijsen ◽  
Loes Janssen ◽  
François M.H. van Dielen ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Employment Status ◽  
Weight Regain ◽  
Weight Loss Outcomes ◽  
Working Status ◽  
Successful Weight Loss ◽  
Patients Experience ◽  
The Impact

AbstractDespite the initial successful weight loss after bariatric surgery, a significant amount of patients experience weight loss failure and weight regain. Several factors are known to contribute to this, though the impact of employment status is unknown. The objective of this systematic review was to examine the impact of employment status on post-surgical weight loss outcomes. Eight studies were included with a follow-up ranging between 2 and 10 years. Employed patients seemed to present more weight loss (9.0–11.0% EWL, 1.3–1.6% BMI loss) compared to unemployed patients, but none of these numbers were statistically significant. Moreover, there were contrasting findings in terms of weight regain. This review may highlight the importance of working status after bariatric surgery and warrants further investigation on this topic. Graphical abstract

scholarly journals Evaluation of Resting Energy Expenditure in Subjects with Severe Obesity and Its Evolution After Bariatric Surgery

2021 ◽  
Author(s):  
Enzamaria Fidilio ◽  
Marta Comas ◽  
Miguel Giribés ◽  
Guillermo Cárdenas ◽  
Ramón Vilallonga ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Energy Expenditure ◽  
Severe Obesity ◽  
Resting Energy Expenditure ◽  
Successful Weight Loss ◽  
The Impact ◽  
The Relationship ◽  
Resting Energy

Abstract Purpose One major determinant of weight loss is resting energy expenditure (REE). However, data regarding REE is scarce in patients with severe obesity (SO)—BMI>50kg/m2. Most studies used equation in order to estimate REE and not indirect calorimetry (IC) (gold standard). Additionally, there is no reliable data on the impact of bariatric surgery (BS) on REE. Objectives (a) To evaluate the REE in patients with SO; (b) to compare REE measured by IC (mREE) to that calculated by Mifflin St-Jeor equation (eREE); (c) to evaluate the impact of BS on REE and the relationship with evolution post-BS. Material and Methods Single-center observational study including consecutive patients with SO between January 2010 and December 2015, candidates for BS. mREE was determined at baseline, and 1 and 12 months post-BS by IC, using a Vmax metabolic monitor. Results Thirty-nine patients were included: mean age 46.5±11.77 years, 64.1%women. Preoperative mREE was 2320.38±750.81 kcal/day. One month post-BS, the mREE significantly decreased (1537.6 ± 117.46 kcal/day, p = 0.023) and remained unchanged at 12 months (1526.00 ± 123.35 kcal/day; p =0.682). Reduction in mREE after the BS was a predictor of reaching successful weight loss (nadir) and weight regain (5 years follow-up) (AUCROC of 0.841 (95%CI [0.655–0.909], p=0.032) and AUCROC of 0.855 (95% CI [0.639–0.901]), p= 0.027, respectively). eREE was not valid to identify these changes. Conclusion In patients with SO, a significant reduction of mREE occurs 1 month post-BS, unchanged at 12 months, representing the major conditioning of successful weight loss and maintenance post-BS. Graphical abstract

scholarly journals Effect of Lifestyle Intervention on Features of Polycystic Ovarian Syndrome, Metabolic Syndrome, and Intima-Media Thickness in Obese Adolescent Girls

2011 ◽  
Vol 96 (11) ◽  
pp. 3533-3540 ◽  
Author(s):  
Nina Lass ◽  
Michaela Kleber ◽  
Katrin Winkel ◽  
Rainer Wunsch ◽  
Thomas Reinehr
Keyword(s):  
Blood Pressure ◽  
Weight Loss ◽  
Lifestyle Intervention ◽  
Adolescent Girls ◽  
Polycystic Ovarian Syndrome ◽  
Intima Media Thickness ◽  
Obese Adolescent ◽  
Media Thickness ◽  
The Impact ◽  
Ovarian Syndrome

Abstract Context: Polycystic ovarian syndrome (PCOS) is associated with cardiovascular risk factors (CRF). Lifestyle intervention is regarded as therapy of choice even if studies in adolescent girls with PCOS are scarce. Objective: Our objective was to analyze the impact of lifestyle intervention on menses irregularities, hyperandrogenemia, CRF, and intima-media thickness (IMT) in adolescent girls with PCOS. Patients: Patients included 59 obese girls with PCOS aged 12–18 yr. Intervention: Intervention was a 1-yr lifestyle intervention based on nutrition education, exercise training, and behavior therapy. Main Outcome Measures: Menses cycles, IMT, waist circumference, blood pressure, fasting lipids, insulin, glucose, testosterone, dehydroepiandrosterone sulfate, androstenedione, and SHBG were evaluated. Results: In contrast to the 33 girls without weight loss, the 26 girls reducing their body mass index during the lifestyle intervention (by a mean of −3.9 kg/m2) improved most CRF and decreased their IMT (by a mean of −0.01 cm). Testosterone concentrations decreased (by a mean of −0.3 nmol/liter) and SHBG concentrations increased (by a mean of +8 ng/ml) significantly in girls with weight loss in contrast to girls with increasing weight. The prevalence of amenorrhea (−42%) and oligoamenorrhea (−19%) decreased in the girls with weight loss. The changes in insulin in the 1-yr follow-up were significantly correlated to changes in testosterone (r = 0.38; P = 0.002) and SHBG (r = −0.35; P = 0.048). A linear regression model with changes in IMT as dependent variable demonstrated a significant association with changes in blood pressure and weight status but not with changes in testosterone. Conclusions: Weight loss due to lifestyle intervention is effective to treat menses irregularities, normalize androgens, and improve CRF and IMT in obese adolescent girls with PCOS.

scholarly journals 288. Follow-Up Blood Cultures in Gram-Negative Bacteremia: How Do They Impact Outcomes

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S144-S144
Author(s):  
Azza Elamin ◽  
Faisal Khan ◽  
Ali Abunayla ◽  
Rajasekhar Jagarlamudi ◽  
aditee Dash
Keyword(s):  
Clinical Outcomes ◽  
Antibiotic Treatment ◽  
Readmission Rate ◽  
Blood Cultures ◽  
Categorical Variables ◽  
Gram Negative ◽  
Number Of Patients ◽  
Significant Difference ◽  
The Impact

Abstract Background As opposed to Staphylococcus. aureus bacteremia, there are no guidelines to recommend repeating blood cultures in Gram-negative bacilli bacteremia (GNB). Several studies have questioned the utility of follow-up blood cultures (FUBCs) in GNB, but the impact of this practice on clinical outcomes is not fully understood. Our aim was to study the practice of obtaining FUBCs in GNB at our institution and to assess it’s impact on clinical outcomes. Methods We conducted a retrospective, single-center study of adult patients, ≥ 18 years of age admitted with GNB between January 2017 and December 2018. We aimed to compare clinical outcomes in those with and without FUBCs. Data collected included demographics, comorbidities, presumed source of bacteremia and need for intensive care unit (ICU) admission. Presence of fever, hypotension /shock and white blood cell (WBC) count on the day of FUBC was recorded. The primary objective was to compare 30-day mortality between the two groups. Secondary objectives were to compare differences in 30-day readmission rate, hospital length of stay (LOS) and duration of antibiotic treatment. Mean and standard deviation were used for continuous variables, frequency and proportion were used for categorical variables. P-value &lt; 0.05 was defined as statistically significant. Results 482 patients were included, and of these, 321 (67%) had FUBCs. 96% of FUBCs were negative and 2.8% had persistent bacteremia. There was no significant difference in 30-day mortality between those with and without FUBCs (2.9% and 2.7% respectively), or in 30-day readmission rate (21.4% and 23.4% respectively). In patients with FUBCs compared to those without FUBCs, hospital LOS was longer (7 days vs 5 days, P &lt; 0.001), and mean duration of antibiotic treatment was longer (14 days vs 11 days, P &lt; 0.001). A higher number of patients with FUBCs needed ICU care compared to those without FUBCs (41.4% and 25.5% respectively, P &lt; 0.001) Microbiology of index blood culture in those with and without FUBCs Outcomes in those with and without FUBCs FUBCs characteristics Conclusion Obtaining FUBCs in GNB had no impact on 30-day mortality or 30-day readmission rate. It was associated with longer LOS and antibiotic duration. Our findings suggest that FUBCs in GNB are low yield and may not be recommended in all patients. Prospective studies are needed to further examine the utility of this practice in GNB. Disclosures All Authors: No reported disclosures

Abstract 225: A Depression Quality Program and Cardiovascular Disease: Assessing the Impact on Care

2017 ◽  
Vol 10 (suppl_3) ◽  
Author(s):  
Linda Gordon ◽  
Amanda Malecky ◽  
Andrew Althouse ◽  
Nicole Ansani
Keyword(s):  
Usual Care ◽  
Goal Attainment ◽  
Intervention Group ◽  
Phone Call ◽  
Categorical Variables ◽  
Care Group ◽  
Control Group ◽  
Surrogate Outcome ◽  
The Impact

Background: Data demonstrate an adverse association between depression and coronary artery disease prognosis. Therefore, a depression screening program was initiated in the catheterization (cath) lab. The goals were to improve HEDIS depression compliance rates and determine the impact on clinical outcomes. Methods: Adult patients in an inpatient cath lab from 3 cardiology practices were screened for enrollment in a randomized controlled trial. All cath lab patients received a PHQ-9 depression screener. Those who screened positive for depression (score ≥ 10) were randomized to intervention or usual care. The usual care group received a follow-up phone call to re-administer the PHQ-9 at 6-8 weeks and within 210 days of discharge. The intervention group was administered the PHQ-9 and received intensive education at baseline, 6-8 weeks, and within 210 days of discharge. Education included targeted depression information with a mental health care provider and comprehensive disease management education with a cardiovascular nurse practitioner. Outcomes included: differences in HEDIS depression goal attainment; depression response/remission rates; and cardiovascular goals. Differences between groups were tested using chi-squared tests (categorical variables) and t-tests (continuous variables). Results: Baseline characteristics were similar between control (N=43) and intervention (N=40) groups, with the exception of significantly fewer African American patients in the control group (N=2, 4.7%) vs intervention (N=9, 22.5%). Changes in HEDIS goal attainment show that patients in the intervention group were slightly more likely to be referred to a provider to address depression (95.0% vs 86.0%, p=0.314), or receive meds for depression (65.0% vs 51.2%, p=0.219), but these differences are not statistically significant. More patients in the intervention group refused meds for depression compared to control (15.0% vs. 2.3%, p=0.041); have received blood work (65.0% vs 41.9%, p=0.030); and have received follow-up within 210 days (82.5% vs 46.5%, p<0.001). Treatment adjustment rate was higher in the intervention group compared to control (85.0% vs. 65.1%, p=0.037). Hospital readmission rate was similar between groups (p=0.896) and there was no difference in depression remission or response rates (p=0.426). Further, no differences were seen in cardiovascular surrogate outcome parameters, including cholesterol, A1c, CRP, or BNP between groups; except SGOT was significantly different between groups (-5.0 intervention vs 2.0 control p=0.045). Conclusions: These data demonstrate improvements in attaining a surrogate outcome measure of quality (HEDIS goals); however, this does not appear to translate to a significant clinical impact. Quality measures may need to be continuously reassessed to ensure efficiency and effectiveness of care.

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