Tesis sobre el tema "Obesity – Complications"
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Bell, Lana Michelle. "The medical complications of childhood obesity". University of Western Australia. School of Population Health, 2008. http://theses.library.uwa.edu.au/adt-WU2008.0139.
Texto completoYeung, Chun-yu. "Adipocyte- and epidermal-fatty acid-binding proteins in relation to obesity and its medical complications". Click to view the E-thesis via HKUTO, 2009. http://sunzi.lib.hku.hk/hkuto/record/B44204565.
Texto completoStewart, Victoria Stephanie. "Weight-loss interventions performed to reduce the risk of obesity-related complications". ScholarWorks, 2014. https://scholarworks.waldenu.edu/dissertations/109.
Texto completoBailey, Swneke. "Genetic insights into obesity and its associated metabolic complications: a multiethnic perspective". Thesis, McGill University, 2011. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=104623.
Texto completoL'obésité est devenue une des plus grandes menaces dans la santé publique, étant donné qu'elle est fréquemment co-reliée avec des facteurs de risque du diabète de type 2 (T2D) et de la maladie cardiovasculaire (CVD), et est donc associée à une mortalité accrue. Les facteurs génétiques représentent une partie substantielle de la variation phénotypique de l'obésité, ainsi que des facteurs de risque des maladies vasculaires qui y sont associés. Dans cette thèse, je décris l'identification de plusieurs variants génétiques communs qui prédisposent les porteurs aux complications associées à l'obésité. D'abord, je décris l'identification d'une variation commune dans le gène d'une protéine sécrétée par le tissu adipeux viscéral, visfatin, et démontre l'influence de ces variants sur la variation interindividuelle d'une insulinémie à jeun. Deuxièmement, je décris l'identification d'une interaction entre l'utilisation des thiazolidinediones une classe de médicaments anti-hyperglycémiques, et une variation génétique dans le gène nuclear factor of activated T-cells cytoplasmic component 2 (NFATC2) qui aboutit à l'œdème et potentiellement à l'insuffisance cardiaque congestive. Ensuite, en utilisant un échantillon de la population asiatique du Sud dans la découverte de gènes, j'identifie une nouvelle association entre la variation du gène dipeptidyl peptidase 4 (DPP4), une cible de la médication anti-hyperglycémique basée sur l'incretin, et les niveaux de l'apolipoprotéine B (apoB), un facteur de risque du CVD et un marqueur de la dyslipidémie associée à l'obésité. De plus, en utilisant des différences observées entre les Européens et les Asiatiques du Sud, j'ai pu identifier l'hétérogénéité dans l'association entre DPP4 et apoB causé par l'adiposité. Finalement, je décris une association entre la variation du gène sterol regulatory element binding protein 1 (SREBF1) et l'indice de masse corporelle (BMI) et démontre sa contribution potentielle aux différences de BMI observées parmi différentes ethnicités dans le monde entier. Je présente aussi des données qui suggèrent fortement que ces différences peuvent être dues à une récente sélection positive à ce locus dans des populations humaines. Les découvertes de cette thèse illustrent l'importance des variants génétiques communs dans la pathogenèse de l'obésité, ainsi que les complications qui s'y rattachent et mettent en évidence la régulation de glucose par le tissu adipeux comme étant une caractéristique sous-jacente importante.
Liu, Tsz-chiu y 廖子超. "Lipocalin-2 is a pro-inflammatory adipokine causally involved in obesity-associated endothelial dysfunction". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2010. http://hub.hku.hk/bib/B45589434.
Texto completoKaw, Roop, Priyanka Bhateja, y. Mar Hugo Paz, Adrian V. Hernández, Anuradha Ramaswamy, Loutfi S. Aboussouan y Abhishek Deshpande. "Postoperative Complications in Patients with Unrecognized Obesity Hypoventilation Syndrome Undergoing Elective Non-cardiac Surgery". American College of Chest Physicians, 2015. http://hdl.handle.net/10757/558500.
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Ong, Kwok-leung y 王國良. "Genetic variants of obesity- and inflammation-related genes in hypertension: genetic association studiesusing candidate gene approach". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2010. http://hub.hku.hk/bib/B45200555.
Texto completoStenberg, Erik. "Preventing complications in bariatric surgery". Doctoral thesis, Örebro universitet, Institutionen för medicinska vetenskaper, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-50649.
Texto completoYeung, Chun-yu y 楊振宇. "Adipocyte- and epidermal-fatty acid-binding proteins in relation to obesity and its medical complications". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2009. http://hub.hku.hk/bib/B44204565.
Texto completoFuchs, Florent. "Obésité maternelle et macrosomie foetale : complications et prise en charge obstétricale". Thesis, Université Paris-Saclay (ComUE), 2015. http://www.theses.fr/2015SACLS037/document.
Texto completoBackground: According to WHO, obesity is considered as an "epidemic" condition due to the global growth of its prevalence and its impact on patient health. For pregnant patients, its impact seems equally worrying and its prevalence is now reaching 10% in France. Some complications of obesity in pregnant women have been little studied and particularly the special link with fetal macrosomia.Objectives: To better understand care and obstetric outcome of obese pregnant patients as well as some of their complications such as fetal macrosomia.Methods: Three different sets of data were used to deal with questions regarding obesity and macrosomia. 1) Assessment of feasibility and quality of second trimester ultrasound scan in obese patients was performed through a mono centric case-control study with prospective data collection. 2) A study of risk factors for maternal complications in case of the delivery of a macrosomic child, regardless of maternal obesity and child's birth weight, was conducted as a prospective cohort study including children with birthweight above 4000g in two “Ile de France” maternity wards. 3) Finally, a comparison of the relationship between maternal and/or neonatal complications of pregnancy and obesity was conducted in France (4 type III maternity wards) and in Quebec (data from a randomized study throughout the province) between 2009 and 2011 through a comparative study of two cross-sectional samples of pregnant women (26,973 births in France and 83,545 births in Quebec).Results: 1) Second trimester ultrasound scan in obese pregnant women is feasible, with a success rate of 70.4% (versus 82%; p=0.08). Factors of improvement were: to spend more time at ultrasound (p=0.03), to move the fetus so that its back is in lateral or posterior position (p=0.01) and when ultrasound was performed by experienced sonographers (p=0.03). However, the quality of the image remains significantly lower in the obese population (p=0.001). 2) The occurrence of maternal complications, when attempting vaginal birth of a child of more than 4000g, was 6%. Beyond childbirth weight (p=0.004, attributable risk (AR) = 10%), the risk factors of maternal complications were Asian ethnicity (p=0.04; AR=3%), prolonged labor (> 10h) (p=0.02; AR=12%), and caesarean section during labor (p=0.004; AR=17%). Multiparous women with a previous vaginal delivery of a macrosomic child had a lower risk of maternal complications (p=0.03). 3) The prevalence of obesity was 9.1% in France and 16.8% in Quebec (p <0.001). Obesity was significantly (p <0.0001) associated with, both in France and in Quebec, an increased risk of gestational diabetes, hypertensive disorders of pregnancy, preeclampsia, stillbirth, cesarean delivery and macrosomia. The strength of the association was different in France and Quebec (p of interaction <0.005) for the occurrence of gestational diabetes, hypertensive complications of pregnancy and macrosomia, with a larger increase in complications with body mass index in Quebec compared to France.Conclusion: Understanding some inherent complications of obesity (medical complications of pregnancy, feasibility and quality of ultrasound screening, obstetric complications) is enhanced by the result of this work
Yang, Bo y 杨波. "Role of lipocalin-2 in cardiac dysfunction associated with aging and dietary obesity". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2012. http://hub.hku.hk/bib/B47869641.
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Pharmacology and Pharmacy
Doctoral
Doctor of Philosophy
Sahu, Soumyadip. "Cross-talk of Leptin and Thrombospondin-1 in Atherosclerotic Complications". Kent State University / OhioLINK, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=kent1492525184445034.
Texto completoNewman, Lisa K. "The Association between BMI-for-age and Intra- and Post-General Anesthesia Airway Complications". The Ohio State University, 2012. http://rave.ohiolink.edu/etdc/view?acc_num=osu1337213041.
Texto completoSAKAMOTO, JUNICHI, HIDEKI KASUYA, YOSHITOKU YOSHIDA, MD HARUN-OR-RASHID, KARLYGASH ZHUBANYSHEVA, ZAITUNA HAMIDULLINA, TALSHYN UKYBASOVA y GULZHAN AIMUKHAMETOVA. "THE IMPACT OF MATERNAL OBESITY ON MOTHER AND NEONATAL HEALTH: STUDY IN A TERTIARY HOSPITAL OF ASTANA, KAZAKHSTAN". Nagoya University School of Medicine, 2012. http://hdl.handle.net/2237/16025.
Texto completoSchneck, Anne-Sophie. "Effets de la chirurgie bariatrique sur les complications hépatiques de l’obésité". Thesis, Nice, 2014. http://www.theses.fr/2014NICE4144/document.
Texto completoThe mechanisms responsible for weight loss and improvement of metabolic disturbances have not been completely elucidated. We investigated the effect of sleeve gastrectomy (SG) on body weight, adipose tissue depots, glucose tolerance, and liver steatosis independent of reduced caloric intake in high-fat-diet-induced obese mice. Mice fed a high fat diet were divided into 3 groups: SG, sham-operated ad libitum fed and sham-operated pair fed. SG mice showed improved glucose tolerance and lower levels of liver steatosis. This was associated with a decrease in the ratios of the weight of pancreas, epididymal and inguinal adipose tissues to body weight. Reduced white adipose tissue inflammation, modification of adipose tissue development, and ectopic fat are potential mechanisms that may account for the reduced caloric intake independent effects of SG. We also investigated long-term impact of RYGB surgery on liver complications in morbidly obese patients with NASH. Ten morbidly obese patients with biopsy-proven NASH were followed after RYGB and underwent a second liver biopsy. The median interval between the RYGB and second liver biopsy was 57 months. Clinical and biological data were obtained at baseline and ≥40 months after RYGB. RYGB was associated with significant weight loss, improved hepatic steatosis, resolution of hepatic inflammation and hepatocyte ballooning. Hepatocyte apoptosis, as evaluated by serum K18 fragment improved within the first year and at 57 months. Hepatic fibrosis resolved in 90% of cases. RYGB in morbidly obese patients with NASH is associated with a long-term beneficial impact on hepatic steatosis, inflammation, injury and, possibly, fibrosis
Linné, Yvonne. "Factors affecting weight development after pregnancy - the SPAWN (Stockholm Pregnancy And Women's Nutrition) study /". Stockholm, 2002. http://diss.kib.ki.se/2002/91-7349-405-4/.
Texto completoLeong, Wen Bun. "The impact of obstructive sleep apnoea in extreme obesity : the impact on ethnicity, glycaemia and diabetes related microvascular complications". Thesis, University of Birmingham, 2015. http://etheses.bham.ac.uk//id/eprint/5798/.
Texto completoVoisin, Sarah. "Bioinformatic and Biostatistic Analysis of Epigenetic Data from Humans and Mice in the Context of Obesity and its Complications". Doctoral thesis, Paris 6, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-300751.
Texto completoPatouraux, Stéphanie. "Rôle de l'ostéopontine dans les complications hépatiques induites par l'alcool, l'obésité et l'ischémie-reperfusion". Thesis, Nice, 2014. http://www.theses.fr/2014NICE4134/document.
Texto completoOsteopontin (OPN) is a protein synthesized and secreted by many different types of cells. It plays an important part in the regulation of the inflammatory and immune response. OPN is also pro-fibrogenic, and has anti-apoptotic properties. The nonalcoholic fatty liver disease (NAFLD) and alcoholic liver disease (ALD) are the leading causes of liver disease in France. The range of these complications goes from steatosis to steatohepatitis, fibrosis, cirrhosis and even hepatocellular carcinoma. Adipose tissue plays a significant part on the occurrence and evolution of the NAFLD. We show that OPN facilitates liver’s and adipose tissue’s inflammation in the NAFLD, by facilitating the intake of macrophages, dendritic cells and T cells, and by modulating the polarization of these immune cells. For alcoholic patients, we show that OPN is one of the predictive markers of liver fibrosis. The lesions induced by ischemia-reperfusion (IR) are the main cause of damages occurring during liver’s surgery. The role of OPN in hepatic injury induced by IR has not yet been investigated. My studies demonstrate that OPN could have a protecting role. OPN deficiency in mice (OPN-/-) increases hepatic lesions caused by IR (inflammation, and cell death). OPN could thus partially prevent hepatic injury and inflammation induced by IR. This could be due to its ability to prevent hepatocyte death and production of toxic NO by macrophages. OPN could thus be an important actor in the pathogenesis of chronic liver disease
Rizzolli, Jacqueline. "Obesidade grau III : considerações sobre complicações clínicas e tratamento cirúrgico". reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2005. http://hdl.handle.net/10183/8411.
Texto completoMorbid obesity is a frequent disease with a progressive increase in incidence and associated with high morbid and mortality rates. It is a multifactorial disease, and is usually associated with comorbidities. It is necessary specific treatment to reduce weight, to improve the comorbidities and obtain a better quality of life. The classic treatment, diet and exercise, should be the first choice, especially in cases of recent onset of severe obesity and poor quality previous treatments. Unfortunately, in more than 90% of the patients this kind of treatment will fail. Bariatric surgery is, nowadays, the best option of treatment, but has several risks of complications in the short, medium or long time followup, mostly in patients not followed by a specialized multidisciplinary team. This is a review about morbid obesity, comorbidities, options of treatment and the risks of stay severely obese versus surgical procedures.
Ander, Fredrik. "Perioperative complications in obese patients : A thesis on risk reducing strategies". Doctoral thesis, Örebro universitet, Institutionen för medicinska vetenskaper, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-59411.
Texto completoKerrigan, Angela Mary. "Care of obese women during labour : the development of a midwifery intervention to promote normal birth". Thesis, University of Stirling, 2017. http://hdl.handle.net/1893/27479.
Texto completoHayes, Philip Michael. "Ethnic-specific associations between abdominal and gluteal fat distribution and the metabolic complications of obesity : implications for the use of liposuction". Master's thesis, University of Cape Town, 2011. http://hdl.handle.net/11427/12235.
Texto completoMore than three-quarters (77%) of the 40.5 million people living in South Africa are black African, of which more than 40% are urbanised. Black African women living in urban areas have a significantly higher prevalence (62%) of overweight than urban black males (28%) or white females (53%). It was previously thought that obesity in black South African women was not associated with deleterious metabolic sequelae and was termed "healthy" obesity...
Anth, Marie. "En jämförelse mellan olika tekniker vid trakeal intubering av obesa patienter : - En litteraturstudie". Thesis, Umeå universitet, Institutionen för omvårdnad, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-85483.
Texto completoIssa, Nahla. "Role of inflammation in the pathogenesis of insulin resistance in obesity : specific role of reactive oxygen and reactive nitrogen species". Doctoral thesis, Université Laval, 2016. http://hdl.handle.net/20.500.11794/26581.
Texto completoChronic low-grade inflammation is considered one of the triggers of obesity-associated insulin resistance. Metabolic inflammation goes along with increased oxidative and nitrosative stress, but whether this promotes insulin resistance in obesity remains ill-defined. Thus, the primary objective of this thesis was to study the role of oxidative and nitrosative stress in the development of inflammation mediated insulin resistance and in particular to highlight the role of superoxide anion production, lipid radical generation, and iNOS induction, in mediating tyrosine nitration of insulin signaling proteins and other metabolic dysfunctions associated with obesity. In chapter I, we showed for the first time that treatment of adipocytes with cytokines induced NADPH oxidase-3 (NOX3) expression along with increasing superoxide production. Cytokine treatment also increased lipolysis as indicated by measuring free glycerol release and caused increase in the phosphorylation of hormone sensitive lipase. Interestingly, pharmacological inhibition of NOX activity by Diphenyleneiodonium (DPI) reversed the effect of cytokines on lipolysis and on the phosphorylation of HSL in line with decreasing superoxide production. Specific knockdown of NOX3 gene expression in adipocytes displayed the same effects as those exerted by DPI. These results indicate that NOX3 is the major NOX involved in superoxide production in 3T3L1 adipocytes and a regulator of lipolysis in inflammatory settings. In chapter II, we identified a new role of NOX3 and superoxide production in mediating tyrosine nitration on Akt in FAO hepatic cells. NOX3 expression was increased in primary hepatocytes after cytokine treatment together with an increase in 3-nitrotyrosine. Interestingly, primary hepatocytes isolated from high fat (HF) fed mice displayed more tyrosine nitration when compared to primary hepatocytes isolated from mice on chow diet. Also, we showed for the first time a tendency for high fat feeding to increase tyrosine nitration specifically on Akt. More importantly, two novel tyrosine nitrated sites on Akt1 were identified: tyrosine 152 and tyrosine 38, which seem to play a role in negatively regulating Akt activity when tyrosine nitrated. In chapter III, scavenging lipid radicals by α -(4-Pyridyl-1-oxide)-N-tert-butylnitrone (POBN) reversed the metabolic disorders caused by HF feeding in mice. POBN treated mice exhibited decrease in fat mass when compared to their HF counterparts. This effect was associated with enhanced glucose tolerance and insulin sensitivity. Also, adipose tissue inflammation was alleviated and mitochondrial function was ameliorated, insulin signaling in skeletal muscle was restored and mitochondrial oxidative metabolism was also enhanced. In the liver, POBN treatment prevented fat accumulation and enhanced lipid and glucose metabolism. Together these results highlight the important role of NOX3 generated superoxide in mediating tyrosine nitration in liver and in altering metabolic dysfunction in adipocytes. Also, two important tyrosine nitrated sites on Akt were identified that may possibly be involved in regulating its activity. Finally, the lipid radical scavenger, POBN, displayed anti-obesity effects in HF fed mice and this effect was associated with amelioration of several metabolic parameters.
Lalanne-Mistrih, Marie-Laure. "Caractérisation des profils lipidiques plasmatiques des patients drépanocytaires guadeloupéens SS et SC à l'état stable. Profil lipidique et hémorhéologique des complications du sous-phénotype hyperhémolytique/vasculopatie et hypervisqueux/vaso occlusif. : Profil lipidique et hémorhéologique des complications du sous-phénotype hyperhémolytique/vasculopathie et hypervisqueux/vaso occlusif". Thesis, Antilles, 2019. http://www.theses.fr/2019ANTI0437.
Texto completoPatients with sickle cell disease present a specific, apparently not atherogenic lipidprofile. In 2009, it was discovered that both decreased apolipoprotein AI and HDLcholesterol levels and high triglycerides (HTG), constituted a lipid profile more often associated with pulmonary arterial hypertension. Our thesis consisted in the study, at steady state, of the lipid profiles of SS homozygote (HbS/HbS) and SC heterozygote (HbS/HbC) cohorts of sickle cell patients, followed at the Reference Center of Sickle cell disease, also compared to that of the general population of Guadeloupe (PGG). We also studied hemorheological, hematologic, lipidic and anthropometric markers of SS and SC sickle cell patients, with and without hypertension, and compared the levels of their lipids, according to the presence or absence of a history of complications of the viscous/vasoocclusive phenotype of sickle cell disease: vaso-occlusive crisis (CVO), acute chest syndrome (ACS) and osteonecrosis (OTN). We have shown: * in SS adults : 1) relative HTG compared to SC and PGG; 2)TG> 1.50g/L is an independent risk factor for relative hypertension; 3)when TG>1.50g/L, more history of CVO and ACS; 4) compared with SC adults, their lipid levels are lower, except for both ApoB100 and TG; 5) TG level is independent of hemolysis, fasting blood glucose, sex, abdominal obesity or body mass index; 6) Hemorheological markers and lipid levels were independent inSS and SC; 7) * in SC adults, non-HDL-cholesterol>1.30g/L was more often foundassociated with OTN. In conclusion, this work makes it possible to specify for the firsttime the lipid profile of sickle cell SS and SC adults, both different from that of PGG. Italso helped to isolate two potential lipid biomarkers, associated with a history ofcomplications of the viscous/vasoocclusive phenotype of sickle cell disease, enriching their pathophysiological understanding, independently of previously identified haemorheological disorders. We show for the first time that TG>1.50g/L and Non- HDL-cholesterol>1.30g/L, are more often associated, respectively, with the history of ACS in SS patients and OTN in SC patients
Afonso, Ricardo Alexandre da Silva Santos. "Sensibilidade à insulina pós-prandial: mecanismos fisiológicos e de activação e fisiopatologia na obesidade". Doctoral thesis, Faculdade de Ciências Médicas. Universidade Nova de Lisboa, 2008. http://hdl.handle.net/10362/5102.
Texto completoNguyen, Tu Marie-Sophie. "Effets de l’adiposité sur la microcirculation et les complications cutanées au cours de l’obésité". Thesis, Lyon 1, 2013. http://www.theses.fr/2013LYO10288.
Texto completoObesity and diabetes are associated to skin pathophysiology, particularly the dermal functions involved in maintaining the skin’s mechanical strength. The underlying mechanisms in pressure ulcer during obesity remain unclear. In this study we evaluated the effects of a hypercaloric diet on the cutaneous microcirculation and its consequences on pressure sores. C59Bl6/J mice were fed a high fat and high sugar diet during 2, 4, 12 and 20 weeks. Microvascular properties were assessed by measuring the skin blood flow variations in response to 1) acetylcholine in order to determine the endothelium-dependent vasodilation, 2) sodium nitroprusside in order to determine the endothelium-independent vasodilation, 3) local pressure application in order to determine the pressure-induced vasodilation (PIV). Each model was characterized for metabolic assessment (IPGTT, IPITT), hisological, immune-histological and biochemical measurements. Finally, each model was tested for pressure ulcer incidence with a 85 mmHg pressure application on skin layers. In this study, we found that obesity is a pathology in constant evolution that is associated with many compensatory mechanisms for maintaining vascular functions and for the adaptation of the skin tissue to an inflammatory environment induced by a hypercaloric diet. PIV has become a useful tool for pressure ulcer prediction
Nzeako, Love Chibuihe. "Effectiveness of a 10-Week Weight Reduction Program in a Retail Clinic". ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/4090.
Texto completoDertkigil, Sergio San Juan 1975. "Avaliação por imagem da distribuição da gordura corporal em obesos e suas correlações metabolicas". [s.n.], 2006. http://repositorio.unicamp.br/jspui/handle/REPOSIP/311218.
Texto completoDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas
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Resumo: Introdução A obesidade tem sido considerada uma das mais importantes doenças da atualidade, tanto pela sua crescente prevalência quanto pela sua alta relevância de morbi-mortalidade. A segmentação da gordura em seus diferentes compartimentos vem ganhando importância na tentativa de explicar e influir no prognóstico das alterações metabólicas envolvidas na obesidade. Objetivos Estudar os diferentes tipos de compartimentalização de gordura e correlacionar com suas alterações metabólicas mais freqüentes e relevantes. Material e Métodos Foram avaliados 64 pacientes obesos do ambulatório de obesidade do HC-UNICAMP, através de tomografia computadorizada, para medição das gorduras subcutânea, visceral, infiltração hepática, pancreática e muscular, e correlacionar esses achados da distribuição regional de gordura com os fatores metabólicos clássicos, entre os quais, glicemia de jejum, insulinemia de jejum, HOMA-IR, frações de colesterol, marcadores hepáticos (_GT) e medidas antropométricas. Resultados Foram analisados 64 pacientes, 30 homens e 34 mulheres, que demonstraram diferença estatística entre a área de gordura visceral, densidade hepática e muscular, e apresentaram alta correlação com fatores metabólicos clássicos (HOMA-IR, TG e TG/HDL). A área de gordura subcutânea e a densidade pancreática não apresentaram diferenças estatísticas entre os grupos ou com os fatores metabólicos. Os pacientes com baixa quantidade de gordura visceral e alta quantidade de gordura subcutânea, apresentaram fatores metabólicos de menor risco cardiovascular. Nesses pacientes com padrão subcutâneo a densidade muscular e não gordura visceral ou gordura hepática se correlacionou mais fortemente com esses fatores de risco metabólico. Dos fatores utilizados aquele com melhor correlação com a gordura visceral, gordura hepática e muscular foi o índice TG/HDL. Conclusão A deposição da gordura nos compartimentos visceral e hepático apresentam papel importante na gênese da síndrome metabólica em pacientes obesos viscerais, enquanto em pacientes com deposição subcutânea o depósito muscular apresenta a maior correlação com os fatores metabólicos
Abstract: Introdution During past decades obesity is being considered one of the most important disease, both for raising prevalence and high morbi-mortality. The regional distribution of adiposity into different compartments araises as an important marker for the earlier diagnostic of metabolic syndrome. It is well established a strong association between visceral adiposity and several metabolic abnormalities, including type 2 diabetes mellitus, lipid metabolism impairment, hypertension and impaired inflammatory factors that may contribute to increase the risk of cardiovascular disease. Objective. Study the different types of regional adipose depots and to correlate these depots and the metabolic risk factors. Material e Methods Subjects included sixty four obese volunteers who received medical examination (30 men and 34 women) between 2002 and 2005. Inclusion criteria required the subjects to be nonsmokers, BMI > 30 Kg/m2, age between 18 and 60 years. The subjects were evaluated with computed tomography for measurement of visceral adiposity area, subcutaneous area, hepatic density, pancreatic and muscle density, and correlate them with the metabolic risk factors ( fasting plasma glucose, fasting serum insulin, HOMA-IR, cholesterol fractions, hepatic marker (_GT) and anthropometric measurements. Results Visceral adiposity, hepatic density and muscle density were different in gender and showed high correlation with metabolic factors (HOMA-IR, TG e TG/HDL). Subcutaneous area and pancreatic density did not showed correlation with the metabolic factors. The patients with high subcutaneous depot showed lower metabolic risk factors. In those patients, the muscle depot and not the visceral or liver adiposity had strong correlation with metabolic factors. TG/HDL had the strongest relationship with visceral, liver and muscle depots. Conclusion In obese patients, the regional adiposity, in special visceral and liver depots play important roles in the genesis of metabolic syndrome. In subcutaneous obese patients, the muscle depot has the strongest correlation coefficient with metabolic syndrome
Mestrado
Medicina Experimental
Mestre em Fisiopatologia Médica
Nogues, Perrine. "Impact de l’obésité maternelle sur les fonctions placentaires : rôles de la leptine et de l'adiponectine Maternal obesity alters placental nutrient transport associated with inflammatory status and morphology modifications in human term placenta Maternal obesity influences expression and DNA methylation of the adiponectin and leptin systems in human third-trimester placenta". Thesis, Université Paris-Saclay (ComUE), 2019. http://www.theses.fr/2019SACLV101.
Texto completoThis research investigates the impact of maternal obesity without gestational diabetes on the major functions of the human placenta. Obesity is defined as an excessive accumulation of fat mass and chronic low grade inflammation. Obesity is indicated by a body mass index (BMI) higher than 30 m2/kg. Maternal obesity is associated with health disorders and creates a higher risk for the development of pregnancy complications (pre-eclampsia and gestational diabetes). In addition to obesity having an impact on a pregnant woman, the fetus is also at risk of developing metabolic disorders in adulthood.The placenta is the organ present at the interface between the mother and the fetus. The placenta’s role is to ensure endocrine functions, exchange functions, and immune protection.Leptin and adiponectin are mostly produced by the adipose tissue. Leptin is a key player in satiety, whereas adiponectin displays an insulin-sensitizing effect. Therefore, both are involved in the energy homeostasis and both are well-established as being involved in the control of placental functions.In this research, we investigated the impact of maternal obesity (without gestational diabetes) on the major functions of the human placenta.In a first part, we have shown that maternal obesity leads to i) a lower expression of nutrient transporters, ii) a lower count of immune cells, iii) an alteration of fetal capillaries, and iv) a decrease in the production of pro-inflammatory cytokines and gonadotropic chorionic hormone (hCG) in term placenta.Also covered in this research is that maternal obesity impairs the leptin and adiponectin systems (ligand and receptors) in the human placenta. Our results indicate maternal obesity is associated with a lower expression of the two adipokines receptors; as well as to a modification in the DNA methylation of promoter regions of the genes’ coding for the two hormones and their receptors.The conclusion of the research reveals how maternal obesity affects the endocrine, exchange, and immune functions of the placenta and how this transient organ seems to adapt itself to a harmful maternal environment
Ulrici, Johanna. "Atemwegsassozierte Komplikationen bei übergewichtigen und adipösen Kindern in der Anästhesie". Doctoral thesis, Universitätsbibliothek Leipzig, 2012. http://nbn-resolving.de/urn:nbn:de:bsz:15-qucosa-86764.
Texto completoMilbank, Edward. "Extracellular vesicles as a therapeutic strategy to prevent or reverse obesity and its metabolic complications in the field of nanomedicine Extracellular vesicles: Pharmacological modulators of the peripheral and central signals governing obesity Microparticles from apoptotic RAW 264.7 macrophage cells carry tumour necrosis factor-a functionally active on cardiomyocytes from adult mice". Thesis, Angers, 2016. http://www.theses.fr/2016ANGE0074.
Texto completoActual pharmacological therapies for treating obesity are limited. Promising results on decreasing mice body weight were obtained using a ventromedial nucleus hypothalamic (VMH) stereotaxic injection of a dominant negative isoform of AMPK (AMPK DN). However, DNA-mediated therapeutic potential is hampered by inadequate tissue specific delivery following a systemic injection - more adapted to a bedside approach -. Herein, we developed a nanobiomedicine approach using exosomes - nano-scaled endogenous vesicles containing lipids, proteins and nucleic acids - to deliver DNA in a hypothalamic specific way. Immature dendritic cells were used to generate non inflammatory exosomes. Exosome neuronal targeting aptitudes were achieved by constraining the dendritic cells to express Lamp2b, an exosomal protein, fused to the neuron-specific RVG peptide. Interestingly, DID-labelled Lamp2b-RVG exosomes were found into the mice brain following an intravenous injection. Isolated Lamp2b-RVG exosomes were then loaded by transfection-mediated techniques with AMPK DN under the control of a VMH specific promoter conferring double tissue expression specificity to the exosomes. AMPK DN-loaded exosomes induced a decrease of acetyl-CoA carboxylase phosphorylation in Neu2a neuronal cells in vitro. Furthermore, intravenously injected AMPK DN loaded exosomes induced a decrease of mice body weight following 6 days of treatment, demonstrating the potential of this nanobiomedicine approach
Júnior, Carlos Kiyoshi Furuya. "Efeitos da cirurgia de Fobi-Capella na doença hepática gordurosa não alcoólica (DHGNA): estudo prospectivo de dois anos". Universidade de São Paulo, 2006. http://www.teses.usp.br/teses/disponiveis/5/5147/tde-31102006-142922/.
Texto completoBackground: The incidence of obesity is increasing in western countries at an alarming rate. The National Center for Health Statistics of United Stated estimated in adult population 61% the prevalence of overweight or obesity, and 30% has obesity, and 5 to 6% were classified in severe obesity. In Brazil, the Ministry of Health reported 32.9% the prevalence of overweight or obese in adult brazilian population, and severe obesity 4.8% were men and 11.7% were women. Although nonalcoholic fatty liver disease (NAFLD) has been proved very frequent among morbidly obese patients and the effect of weight loss after bariatric surgery in inflammation and fibrosis related NAFLD is still a matter of debate. The aim of this study was to evaluate the impact of Fobi-Capella surgery in NAFLD in a follow up of 24 months. Methods: Forty patients with body mass index (BMI) IMC > 40 kg/m2 were submitted to Roux-en-Y gastric bypass with intraoperatory liver biopsies between 2001 a 2003, and 18 patients were followed and selected to underwent a liver biopsies after 24 months (700 ± 42 days). Blood biochemical tests and liver histology were compared before and after weight loss. The histological diagnosis of Nonalcoholic fatty liver disease (NAFLD) and Nonalcoholic steatohepatitis (NASH) was analyzed using the classification proposed by Pathology Committee of the NASH Clinical Research Network, which designed and validated a histological feature scoring system that address the characteristics of NASH lesions and a NAFLD activity score (NAS) for use in clinical trials. Eighteen patients with body mass index >40 kg/m2 submitted to Roux-n-Y gastric bypass were enrolled, and wedge liver biopsy was obtained at the operation. After 24 months, patients agreed to be submitted to a percutaneous liver biopsy. Results: The initial average BMI of 18 patientes were 51.7 ± 7 kg/m2. After following 24 months, average BMI was 32.3 ± 6 kg/m2. The average of percent excess body mass index loss was 72.56%. NAFLD was present in all 18 patients at the initial biopsy, NASH in 67% (10 patient had score of NAS ? 5 and two patients with score 4 had some degree of fibrosis) and 33% with steatosis only; 8.3% of patients with NASH has cirrhosis. After 24 months steatosis disappeared in 89% (p < 0,001) and fibrosis disappeared in 60% of the patients (p = 0.020). Hepatocellular ballooning disappeared in 50% (p < 0.001). A slight lobular inflammatory infiltrate remained in 78%, apparently unrelated to fatty degeneration. Since liver biochemical variables AST and ALT had been found within normal limits in 88% and 89%, respectively of patients at initial biopsy, no difference was found 24 months later (p = 1.000). Lipid profile and blood sugar plasma concentration were closer to normal in all patients after 24 months of follow up (p < 0.05). Conclusions: The improvement of metabolic syndrome related a severe obesity after sustained weight loss surgery promoted significant improvement in liver histology. The steatosis, fibrosis and NAS ? 5 were decreased in 89%, 75% and 100% of patients, respectively. None patient had progression of hepatic fibrosis in this series.
Paiva, Leticia Vieira de. "Estado nutricional em gestações de alta risco: complicações do parto, puerpério e análise do consumo dietético". Universidade de São Paulo, 2012. http://www.teses.usp.br/teses/disponiveis/5/5139/tde-13062012-113155/.
Texto completoOBJECTIVE: To assess the association between maternal obesity and the occurrence of delivery and postpartum complications in high risk pregnancies, and to analyze the dietary intake of these pregnant women. METHODS: Prospective and observational study conducted from August 2009 to August 2010, with the following inclusion criteria: admission to the 5th day, maternal age 18-year-old, high-risk pregnancy, single pregnancy, fetus alive at the beginning of labor, birth at the institution, maternal weight measured at birth. Nutritional status in late pregnancy was assessed by body mass index (BMI), and applying the curve Atalah. The patients were classified as: underweight, appropriate, overweight and obesity. The dietary intake was evaluated applying a food frequency questionnaire. The complications of delivery and postpartum, investigated during the hospitalization and 30 days after discharge, were: infection and / or secretion in the surgical wound, urinary tract infection, puerperal infection, fever, hospitalization, antibiotics, and composite morbidity (at least one puerperal complication). RESULTS: We included 374 postpartum women classified by the final BMI: underweight (n=54, 14.4%), appropriate (n=126, 33.7%), overweight (n=105, 28.1%) and obesity (n=89, 23.8%). There was no significant difference in the proportion of cesarean when compared the following groups: underweight and appropriate (68.3%), overweight (76.2%) and obesity (78.6%, P=0.201). Maternal obesity was significantly associated with the following puerperal complications: surgical wound infection (16.8%, P=0.042), urinary tract infection (9.0%, P= 0.004), antibiotic use (12.3%, P<0.001) and composite morbidity (25.6%, P=0.016). The logistic regression model showed that obesity in late pregnancy is an independent variable in predicting the composite morbidity (OR: 2.09, 95% CI: 1.15 to 3.80, P=0.015). The analysis of dietary intake showed average energy consumption similar in the groups: underweight and appropriate (2344 cal/day), overweight (2433 cal/day) and obesity (2450 cal/day, P=0.640). There was no significant difference in the average daily consumption of macro-and micronutrients among the groups studied. CONCLUSION: Maternal obesity at the end of high-risk pregnancy is independently associated with the occurrence of postpartum infectious complications, showing the need for more efficient monitoring of maternal weight gain in these pregnancies
Marques, Emerson Leonildo. "Efeito da perda de peso induzida por cirurgia bariátrica sobre metabolismo cerebral e função cognitiva". Universidade de São Paulo, 2014. http://www.teses.usp.br/teses/disponiveis/5/5135/tde-24102014-104455/.
Texto completoINTRODUCTION: Obesity and Alzheimer\'s disease affect a growing number of people in the world. In recent years, evidence has arisen suggesting that these two illnesses are linked, with obesity being a risk factor for the occurrence of dementia. Alzheimer\'s disease has an unfavorable prognosis, is hard to treat and genetic and environmental factors are involved in the pathogenesis. Obesity is regarded as a modifiable environmental factor and maybe capable of changing the natural prognosis of the disease if controlled at an early stage. Bariatric surgery is the most effective treatment for severe obesity, however the effect of bariatric surgery on cerebral metabolism and cognitive function is not clearly known. OBJECTIVES: Prospectively assess the impact of weight loss caused by bariatric surgery on the cerebral metabolism and cognitive function of the obese. Correlate the cerebral metabolism and cognitive function before and after bariatric surgery with metabolic and inflammatory markers. METHODS: 17 obese women performed computerized positron emission tomography with fluoro-deoxy-glucose (FDG-PET) for the assessment of resting cerebral metabolism (regional glycolytic metabolism), neuropsychological tests to assess cognitive function and doses of metabolic and inflammatory markers before and after bariatric surgery and compared with 16 women of normal weight, eutrophic, paired by age and level of education. Patients with diabetes, those who had used psychotropic medication within three months prior to the assessments, people with current or previous history of severe psychiatric illness and women with a family history of dementia before 70 years of age. The assessments of cerebral metabolism, cognitive function and laboratory doses were conducted before and approximately 6 months after bariatric surgery in the obese women, whereas the women of normal weight were only assessed once. The imaging data was processed using the Statistic Parametric Mapping (SPM version 8) program and the others through the Statistical Analysis System (SAS version 9.3). The data found in the obese women prior to surgery were compared with those after the weight loss, and both were compared to the data taken from the eutrophic women. RESULTS: Women with a mean age of 40.5±9.1 years and mean body mass index (BMI) of 50.1±4.7 kg/m2 when compared to women of the same age group with mean BMI of 22.3±2.1 kg/m2 presented increased cerebral metabolism in some areas, in particular of the posterior cingulate gyrus, with a corrected p value for multiple comparisons of 0.004. However, differences were not found between the groups for the performance of the neuropsychological tests. After weight loss, the cerebral metabolism of the obese women was similar to the eutrophic women and they performed better in the tests to assess executive function (Trail Making Test). CONCLUSION: Studies show that the posterior cingulate gyrus is one of the first areas affected by Alzheimer\'s disease and that having increased regional cerebral metabolism may be deleterious. This condition found in the obese, appears to be reversed after weight loss induced by bariatric surgery, followed by improved executive function and metabolic and inflammatory markers
Bauvin, Pierre. "Modélisation de la stéatose hépatique (NAFLD) et de ses facteurs de risque par apprentissage sur des données de santé". Thesis, Lille 2, 2020. http://www.theses.fr/2020LIL2S028.
Texto completoNon-alcoholic fatty liver disease (NAFLD) is a chronic liver disease which is a combination of simple, slowly progressing steatosis, and non-alcoholic steatohepatitis (NASH), an inflammatory form which accelerates its progression. It is estimated that one in four people in the world is affected by NAFLD, and its prevalence is increasing rapidly, in parallel with the prevalence of its main risk factors: overweight, obesity and type 2 diabetes.This pathology is asymptomatic up to the complications, cirrhosis and liver cancer (hepatocellular carcinoma, HCC), which leads to late diagnosis and a negative impact on the associated morbidity and mortality. Furthermore, the reference diagnosis requires a liver biopsy, an invasive examination that cannot be performed routinely. As a result, the progression of the disease is poorly known and its estimation may suffer from a selection bias, towards patients with significant risk factors, who require a biopsy in the first place. A better understanding would allow the implementation of strategies to reduce its burden.The modelling approach is appropriate to take into account all susceptible patients, without having to carry out a large-scale follow-up study using liver biopsies in patients who are mostly asymptomatic. The objectives of this thesis are to describe and quantify the progression of NAFLD, to predict the associated morbidity and mortality, and to identify the population at risk, using Markov models. To do this, it is necessary to fill in some of the progression parameters via a literature review, to characterise the initial states (population likely to develop NAFLD) and the final states (mortality due to NAFLD), in order to deduce the missing progression parameters between the onset of the disease and mortality, by back-calculation.To exhaustively characterise NAFLD mortality, we identified all patients with cirrhosis or HCC from national hospital databases, representing more than 380,000 patients. We then developed an identification algorithm to determine the etiology underlying the hepatic complication, based on all the stays of the identified patients. This algorithm requires the identification of patients with cirrhosis or HCC of alcoholic or viral origin, to obtain by elimination only NAFLD patients. Once the specific mortality data had been obtained, we estimated the population likely to develop NAFLD, defined as all individuals with overweight or type 2 diabetes, excluding the population of excessive drinkers. We estimated the prevalence and incidence of this population, and modelled its evolution with age and years, based on individual data from surveys representative of the French population.Finally, we quantified the progression of NAFLD, and the impact of risk factors, using two approaches: from the literature, and from biopsy data from more than 1,800 obese patients who were candidates for bariatric surgery, resulting in a tool for predicting the progression of NAFLD in this population. We chose to back-calculate the progression parameters corresponding to the asymptomatic states, which are the most susceptible to selection bias.We obtained a model of the progression of NAFLD, taking into account the dynamic distribution of the population among weight classes and diabetes status, and resulting in the observed statistics of NAFLD deaths. The model takes into account gender, age, year, BMI (body mass index) class, diabetes status and the presence of a genetic polymorphism (PNPLA3 rs738409, C→G) as covariates of progression. It is a tool for assessing the impact of a possible treatment or public health policy on morbidity and mortality
Laude-Trouillard, Marilia. "Complications hépatiques des surcharges pondérales : à propos d'une observation". Montpellier 1, 1998. http://www.theses.fr/1998MON11070.
Texto completoMasters, Heather R. "Maternal Obesity is an Independent Risk Factor for ICU Admission during Hospitalization for Delivery". University of Cincinnati / OhioLINK, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1491559250082122.
Texto completoBoudet, Julie. "Obésité maternelle avant grossesse, allaitement du nourrisson et évolution du poids maternel en post partum". Thesis, Université Paris-Saclay (ComUE), 2018. http://www.theses.fr/2018SACLS022.
Texto completoThe aim of this PhD dissertation was to measure the association of maternal obesity with any breastfeeding (ABF), and exclusive breastfeeding (EBF) durations, taking into account sociodemographic, perinatal and psychosocial factors; and to assess whether in France, in 2012, breasfeeding was associated with a reduction in PPWR during the first year of life, especially among women obese before pregnancy.We used data from the French population-based-birth-cohort Epifane. In 2012, 3,368 mother-infant dyads were included in mainland France. Information concerning infant’s feeding were collected at maternity ward and at 1, 4, 8, and 12 months, and were then used to define breastfeeding durations. Sociodemographic and perinatal factors associated with maternal obesity (Body Mass Index (BMI) before pregnancy ≥30 kg/m2) were identified using a multinomial logistic regression model. Poisson regression models have estimated associations of maternal obesity with ABF and EBF durations. Linear regression models were used to estimate the associations of breastfeeding durations (full breastfeeding (FBF) and partial breastfeeding) with PPWR at 4 and 12 months (defined as the difference between the maternal weight at 4 and 12 months after birth and maternal prepregnancy weight). Risk factors of moderate PPWR (0.1-4.9 kg) and major PPWR (≥5 kg) at 12 months were identified using multinomial logistic regression modelling.Maternal obesity was associated with sociodemographic characteristics and adverse perinatal outcomes. Such patterns varied among primiparous and multiparous women. Furthermore, maternal obesity was associated with a reduced ABF duration, compared to normal-weight, independently of sociodemographic, perinatal and psychosocial factors, and parity. Association of maternal obesity with EBF duration was modified by parity. Among primiparous women, obese women exclusively breastfed as long as normal-weight women, in all adjusted models. Among multiparous women, association between maternal obesity and reduced EBF duration, observed in the crude model and model adjusted on sociodemographic factors, was no more statistically significant when adjusting for perinatal and psychosocial factors.Four months after birth, FBF duration was not associated with PPWR, regardless of prepregnancy BMI class. However, partial breastfeeding duration was associated with an increased PPWR at 4 months among women obese before pregnancy. At 12 months, neither FBF duration nor partial breastfeeding duration was associated with PPWR. Nevertheless, we identified a set of sociodemographic and perinatal risk factors of moderate and major PPWR at 12 months.Maternal obesity was associated with a reduced ABF duration. Furthermore, our work does not confirm the hypothesis of a benefit of breastfeeding durations on PPWR at 4 and 12 months. Finally, our research provides a better understanding of mechanisms involved in the relation between maternal obesity and breastfeeding; the identification of PPWR risk factors opens new prospects of research. In terms of public health, our research reinforces the need to consider sociodemographic, perinatal and psychosocial characterictics of women in the promotion of breastfeeding, especially EBF, and in the interventions aimed at reducing PPWR
Aufrere-Dubourg, Véronique. "Obésité et microalbuminurie". Montpellier 1, 1994. http://www.theses.fr/1994MON11131.
Texto completoPedroso, Juan Carlos Montano [UNIFESP]. "Variáveis hematológicas e perfil do ferro na abdominoplastia após a cirurgia bariátrica". Universidade Federal de São Paulo (UNIFESP), 2011. http://repositorio.unifesp.br/handle/11600/9826.
Texto completoIntrodução: O tratamento da deformidade na parede abdominal resultante do emagrecimento após a cirurgia bariátrica é a abdominoplastia, a qual pode induzir anemia pós-operatória. Além disso, a cirurgia bariátrica promove uma tendência a deficiência de ferro. Baixas reservas de ferro comprometem a eritropoese. Não há estudo avaliando o grau de anemia e sua evolução após a abdominoplastia pós-bariátrica. Objetivo: Avaliar a anemia e sua evolução após a abdominoplastia pós-bariátrica. Métodos: Os valores de hemoglobina, reticulócitos, ferro, ferritina, e índice de saturação da transferrina foram mensurados na véspera da abdominoplastia e na primeira, quarta e oitava semana de pós-operatório. A hemoglobina também foi mensurada com 48h de pós-operatório. Vinte mulheres adultas foram operadas e tiveram seus dados comparados com 12 controles. Resultados: Os níveis de hemoglobina caíram, em média, de 12,98g/dL para 10,8g/dL com 48h. Houve um aumento significante da hemoglobina no sétimo dia com correção de um terço do déficit, sem aumentos significantes posteriores. Houve um aumento dos reticulócitos na primeira semana. O ferro sérico e índice de saturação de transferrina caíram na primeira semana e mantiveram-se baixos. Os níveis de ferritina apresentaram aumento não significante na primeira semana e posteriormente caíram. Nenhuma das pacientes foi transfundida. Conclusão: Os níveis de hemoglobina caíram após a abdominoplastia e demonstraram um aumento na primeira semana de pós-operatório, com correção de um terço do déficit de hemoglobina, porém, não recuperaram por completo na oitava semana. Ao término do seguimento, 45% das pacientes desenvolveram deficiência de ferro e apresentaram déficit de hemoglobina maior que as pacientes que mantiveram estoques de ferro normais
Background: The treatment of the abdominal wall deformity resulted from weight loss after bariatric surgery is a mixed type of abdominoplasty, which can induce post-operative anemia. In addition, bariatric surgery itself promotes a tendency to iron deficiency which could compromise erythropoiesis. To our knowledge, there is no study evaluating the degree of anemia and its recovery after post-bariatric abdominoplasty. Methods: The values of hemoglobin, reticulocytes, iron, ferritin and transferrin saturation index were measured the day prior to abdominoplasty and the first, fourth and eighth weeks after surgery. Hemoglobin was measured within 48h after surgery. Twenty adult women underwent surgery and had their data compared with 12 controls. Results: Hemoglobin levels dropped significantly from 12,98g/dL to 10,8g/dL within 48h. Hemoglobin increased significantly to 11,5g/dL by day seven, with correction of one third of the deficit, without significant increases thereafter. There was an increase in reticulocytes in the first week. Serum iron and transferrin saturation index fell in the first week and remained low. Ferritin levels showed no significant increase in the first week and subsequently fell. None of the patients received blood transfusion. Conclusion: Hemoglobin levels fell from 12,98 g/dL to 10,8 g/dL after abdominoplasty and showed an increase in the first week after surgery, with correction of one third of the deficit, but did not completely recover in the eighth week. At the end of the follow-up, 45% of the patients developed an iron deficiency and had a hemoglobin deficit higher than the patients that maintained normal iron stores.
TEDE
BV UNIFESP: Teses e dissertações
Tardy-Poncet, Brigitte. "Potential roles of TFPI in both thrombotic and hemorrhagic diseases". Thesis, Saint-Etienne, 2012. http://www.theses.fr/2012STET007T/document.
Texto completoTFPI is a multivalent Kunitz-type proteinase inhibitor that directly inhibits FXa and produces FXa-dependent feedback inhibition of the FVIIa–TF complex. It was recently demonstrated that Protein S (PS) plays the role of TFPI cofactor by enhancing the TFPI inhibition of factor Xa in vivo. Approximately 80% of plasma TFPI circulates as a complex with plasma lipoproteins, about 5–20% circulating as free TFPI. Under quiescent conditions, approximately 50–80% of intravascular TFPI is stored in association with the endothelium. Full-length TFPI α carried in platelets constitutes 8-10% of the total amount of TFPI in the blood, corresponding to a quantity comparable to that of soluble full-length TFPI α in the plasma. We searched for resistance to TFPI activity in patients who presented idiopathic venous thrombosis at a young age. Plasma sensitivity to TFPI was evaluated on the basis of diluted prothrombin time (dPT) measured in patients and in control plasma in the presence (W) and absence (Wo) of exogenous TFPI. At the same time, dPT was measured on a reference plasma to establish a normalized ratio termed TFPI NR and defined as (dPT wTFPI/ dPT Wo TFPI) patient or control / (dPT wTFPI/ dPT Wo TFPI) reference plasma. In an initial study, we found that TFPI resistance could be considered as a new coagulation abnormality that could be related to unexplained thrombosis. In a second study, we failed to demonstrate a role of TFPI resistance in patients with venous thrombosis, abnormal TFPI NR being more likely related to the non-respect of preanalytical conditions rather than to an inherited trait. However, in another study, we showed that inherited or acquired PS deficiency was responsible for a TFPI resistance, providing an ex vivo demonstration that PS is the cofactor of TFPI activity. We showed that this TFPI resistance existed throughout pregnancy and that it disappeared when PS returned to normal values after delivery. We evaluated this TFPI resistance as a possible marker of the risk of a gestational vascular complication (GVC) in 72 patients at risk of developing a GVC. TFPI NR did not differ between GVC+ patients (n =15) and GVC– patients (n = 57). High levels of Lipoprotein(a) (Lp(a) have been shown to be an independent risk factor for cardiovascular disease, lowering of these levels not being achievable by any treatment except possibly aspirin. An in vitro study showed that TFPI activity could be inhibited by Lp(a). We did not confirm this TFPI inhibition in vivo in 20 obese patients with coronary insufficiency who had either normal Lp(a) levels (≤ 0.3 g/L; n = 15) or high Lp(a) levels (≥ 0.3 g/L; n = 5) . Moreover, we found no effect of aspirin treatment on Lp(a) whatever the initial level of Lp(a). Haemophilia B patients bleed less than haemophilia A patients. We showed that this difference in bleeding profile could be explained by lower free TFPI levels in haemophilia B patients compared to haemophilia A patients. In an ongoing study, we showed that in haemophilia A patients there was a strong correlation between the different parameters of thrombin generation (TG) and free TFPI. We also showed, in a TG assay performed in platelet-rich plasma (PRP) with a low TF concentration, that LT was sensitive to free TFPI levels whatever the type of haemophilia and whatever theseverity of the disease. We demonstrated that blocking TFPI by an anti-TFPI Antibody (Ab) allows complete correction of the TG profile in PRP. We showed that it is of major importance to perform a TG assay in PRP in order to evaluate the efficacy of anti-TFPI Ab in correcting TG parameters in haemophilia patients
Silva, Leide Irislayne Macena da Costa e. "O efeito intergeracional no peso ao nascer e suas relações com as condições maternas, em crianças nascidas a termo no Hospital Universitário da USP". Universidade de São Paulo, 2014. http://www.teses.usp.br/teses/disponiveis/5/5141/tde-08122014-152936/.
Texto completoBACKGROUND AND OBJECTIVES: Many studies have shown that both parents\' birth weight acts as a predictor for the descendant birth weight, with the correlation more strongly transmitted through maternal line. This suggests that adverse expositions to the mother, from her own intrauterine life until the pre-conception and pregnancy periods, in addition to the inherited genes, influences the size of the offspring at birth. The current preoccupation relates to the intergenerational cycle of low birth weight or increased birth weight between the generations, with all the immediate and long term aggravations that are implied in small birth size for the gestational age and/or low birth weight or large birth size for the gestational age and/or macrosomic. The present research aims to study the correlation between the child\'s birth weight with the mother\'s birth weight, and maternal conditions, in term infants born in the \"Hospital Universitário\" from the University of São Paulo. METHODS: 773 mother-infant binomials were identified (773 children born from 558 mothers) with information on both the baby\'s and the mother\'s birth weight recorded. The information referring to maternal antecedents, pre-natal, parturition and birth anthropometric measures of the infant and the mother were obtained through the registrations of their medical recordes. 83.8% of the mothers were born in the \"Hospital Universitário\". Group studies were constituted, dividing the sample according to birth weight [< 2.500 grams (g) and >= 3.500 grams (g)]. The length at birth was also studied in children <= 47,5cm (lower quartile). Chi-squared test or Fisher\'s exact test, Spearman\'s Rho and Odds-Ratio were performed in order to investigate the relation between the children\'s weight and length at birth and the mothers\' and children\'s variables. RESULTS: The girls (born between 1999 and 2014) were heavier at birth than their mothers (born between 1972 and 1998), with an average increase at birth weight between the generations of 79 grams. The child\'s birth weight < 2.500 grams did not show any correlation with maternal birth weight < 2.500 grams (Fisher 0.264*; Spearman\'s Rho 0.048; OR 2.1 and OR lower 0.7) nor with maternal stature below the lower quartile (< 157cm) (Chi2 sig 0.323; with Spearman\'s Rho 0.036; OR 1.5 and OR lower 0.7). The child\'s low birth weight (< 2.500g) was lightly correlated with drug use by the mother during pregnancy (Fisher 0.083*; Spearman\'s Rho 0.080; OR 4.9 and OR lower 1.0). The child\'s birth weight < 2.500g showed increased correlation with gestational age lower than 38 weeks and 3 days (Chi2 sig 0.002; Spearman\'s Rho 0.113; OR 3.2 and OR lower 1.5). The child\'s weight at birth >= 3.500g showed strong correlation with maternal weight at birth >= 3.500g (Chi2 sig 0; Spearman\'s Rho +0.142; OR 0.5** and OR upper 0.7). It was also revealed that the higher the maternal pre-pregnancy BMI, the stronger the correlation with child\'s birth weight >= 3.500g was [(maternal pre-pregnancy BMI >= 25,0 kg/m2 with Chi2 sig 0.013; Spearman\'s Rho 0.09; OR 1.54 and OR upper 2.17) and (maternal pre-pregnancy BMI >= 30,0 kg/m2 with Chi2 sig 0; Spearman\'s Rho 0.137; OR 2.58 and OR upper 4.26)]. The child\'s weight at birth >= 3.500g was also correlated with Caesarean section (Chi2 sig 0; Spearman\'s Rho +0.132; OR 0.5** and OR upper 0.8). Child\'s length at birth in the lower quartile (<= 47,5cm) was significant in mothers who were born with weight < 3.500g (Chi2 sig 0; Spearman\'s Rho -0.154; OR 3.2** and OR lower 1.8). The child\'s length at birth <= 47,5cm showed strong correlation with drug use by the mother during pregnancy (Chi2 sig 0.004; Spearman\'s Rho 0.105; OR 4.3 and OR lower 1.5). The child\'s length at birth <= 47,5cm showed tenuous correlation with maternal stature in the lower quartile (< 157cm) and with gestational smoking, demonstrated by Chi2 sig 0.012; Spearman\'s Rho 0.091; OR 1.6 and OR lower 1.1 and Chi2 sig 0.012; Spearman\'s Rho 0.091; OR 1.7 and OR lower 1.1, respectively. CONCLUSIONS: The mother\'s weight at birth >= 3.500g and the prenatal overweight or obesity were correlated with the child\'s weight at birth >= 3.500g and increased length at birth of the newborn, coupled with the tendency of increasing birth weight between generations of mothers and daughters. Also, descendants with smaller length at birth are the children of women with the lowest statures. The coexistence of the intergenerational vicious cycle of obesity and of \"growth failure\" was found on the studied population
Borson-Chazot, Françoise. "Analyse de marqueurs intermédiaires pour l'estimation du risque vasculaire au cours de nouvelles approches thérapeutiques : gastroplastie pour obésité sévère et traitement substitutif du déficit en hormone de croissance de l'adulte". Lyon 1, 2000. http://www.theses.fr/2000LYO1T155.
Texto completoHasimoto, Claudia Nishida. "Correlação entre os resultados pré-operatórios de testes cardiopulmonares e a evolução pós-operatória em cirurgia bariátrica". Botucatu, 2016. http://hdl.handle.net/11449/138208.
Texto completoResumo: Introdução: A obesidade é o acúmulo de gordura anormal ou excessiva que representa um risco potencial à saúde. A cirurgia bariátrica consiste em uma alternativa de tratamento cirúrgico da obesidade mórbida, permitindo uma perda de peso expressiva e duradoura com consequente melhoria das comorbidades associadas. A obesidade está associada a alterações da mecânica ventilatória e constitui um fator de risco para o desenvolvimento de complicações pulmonares no pós-operatório de cirurgias abdominais. Objetivo: Verificar se os testes de função respiratória, de força muscular respiratória e de exercícios são capazes de predizer complicações no pós-operatório em pacientes submetidos à cirurgia bariátrica. Método: Foram avaliados 174 pacientes (81% mulheres) submetidos à cirurgia bariátrica, no Hospital das Clínicas da Faculdade de Medicina de Botucatu. Todos os pacientes foram submetidos à medidas antropométricas, testes de espirometria, medida de pico de fluxo expiratório, manovacuometria, teste de caminhada de seis minutos e teste de escada. Os dados foram colhidos no período pré-operatório e correlacionados com as complicações pós-operatórias, incluindo as complicações cardiopulmonares e cirúrgicas. Resultados: A média de idade foi de 41,59 ± 10,70 anos. O índice de massa corpórea variou de 35,44 a 62,79 Kg/m2, com média de 46,74 ± 6,35 Kg/m2. As comorbidades mais prevalentes foram: hipertensão arterial sistêmica, diabetes mellitus, dislipidemia e hipotireoidismo. A taxa de compli... (Resumo completo, clicar acesso eletrônico abaixo)
Abstract: Introduction: Obesity is the accumulation of abnormal or excessive fat which represents a potential health risk. The bariatric surgery consists of an alternative for surgical treatment of morbid obesity, thus allowing significant and lasting weight loss with consequent improvement of the related comorbidities. Obesity is associated with the changes in the ventilatory mechanics and poses a risk factor for the development of pulmonary complications in the post-operative period of abdominal surgeries. Objective: Check whether the respiratory function tests, the respiratory muscle strength and the exercises are able to foresee post-operative complications in patients undergoing bariatric surgery. Methodo: 174 patients (81% women) undergoing bariatric surgery were evaluated at the Clinical Hospital of the Botucatu School of Medicine. All the patients were submitted to anthropometric measures, spyrometry tests, the measurement of peak expiratory flow, manovacuometry, a 6-minute walking test and stair-climbing test. The data were collected in the pre-operative and correlated with the post-operative complications, including both the cardiopulmonary and surgical complications. Results: The average age was 41,59 ± 10,70 years. The BMI (Body Mass Index) varied from 35,44 to 62,79 kg/m2 with an average of 46,74 ± 6,35 kg/m2. The most prevalent comorbidities were: systemic arterial hypertension, diabetes mellitus, dyslipidemia and hypothyroidism. The post-operative complication rate was a... (Complete abstract click electronic access below)
Doutor
"Insulin sensitivity in Chinese: inter-relations with obesity and other components of the metabolic syndrome". 1999. http://library.cuhk.edu.hk/record=b6073143.
Texto completo"June 1999."
Thesis (Ph.D.)--Chinese University of Hong Kong, 1999.
Includes bibliographical references (p. 300-328).
Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web.
Mode of access: World Wide Web.
Libhaber, Carlos David. "The transition from obesity-induced left ventricular hypertrophy to abnormalities of cardiac function". Thesis, 2014.
Buscar texto completo"Up-regulation of heme oxygenase 1 and downstream bilirubin-mediated signaling cascade protect endothelial function in diabetes and obesity". 2013. http://library.cuhk.edu.hk/record=b5884535.
Texto completoThesis (Ph.D.)--Chinese University of Hong Kong, 2013.
Includes bibliographical references (leaves 127-152).
Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web.
Abstracts also in Chinese.
Castro, Alfredo Mendes. "Laparoscopic adjustable gastric band: complications, removal and revision in a portuguese highly differentiated obesity treatment center". Master's thesis, 2015. https://repositorio-aberto.up.pt/handle/10216/88139.
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