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Zhao S, Li R, Zhou J, Sun L, Sun Q, Wang W, Wang D. Comparison of robotic versus laparoscopic surgery for visceral obesity in mid-low rectal cancer: a propensity-matched analysis. J Robot Surg 2024; 18:178. [PMID: 38642232 DOI: 10.1007/s11701-024-01945-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 04/06/2024] [Indexed: 04/22/2024]
Abstract
Obesity is becoming more and more common, and measuring visceral fat area (VFA) is a useful diagnostic technique for visceral obesity (VO). The purpose of this research is to compare the surgical results of robotic versus laparoscopic rectal surgery, with a focus on assessing the benefits of the latter method for treating both VO and mid-low rectal cancer. Patients receiving laparoscopic or robotic anterior rectal excision at Northern Jiangsu People's Hospital's general surgery department were included in the retrospective analysis. 242 people in all took part in the study; 121 cases were assigned to the robotic surgery (RS) group and another 121 cases to the laparoscopic surgery (LS) group. In comparison to LS, our results show that RS led to a shorter period for the recovery of bowel function (p = 0.03), a shorter hospital stay (p < 0.001), a smaller intraoperative blood loss (p < 0.001), and a shorter time until the commencement of oral intake (p = 0.041). However, there were no statistically significant differences between the two groups in terms of the indices of histopathologic specimens, the proportion of temporary loop ileostomy, and the incidence of early postoperative problems (p > 0.05). When patients with VO undergo surgery for rectal cancer, RS has the added benefit of accelerating patient recovery while producing results that are similar to LS in the near run.
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Affiliation(s)
- Shuai Zhao
- Clinical Teaching Hospital of Medical School, Northern Jiangsu People's Hospital, Nanjing University, Yangzhou, China
| | - Ruiqi Li
- Clinical Teaching Hospital of Medical School, Northern Jiangsu People's Hospital, Nanjing University, Yangzhou, China
| | - Jiajie Zhou
- Clinical Teaching Hospital of Medical School, Northern Jiangsu People's Hospital, Nanjing University, Yangzhou, China
| | - Longhe Sun
- Department of General Surgery, Taizhou Fourth People's Hospital, Taizhou, China
| | - Qiannan Sun
- Department of General Surgery, Northern Jiangsu People's Hospital, Yangzhou, China
- Yangzhou Key Laboratory of Basic and Clinical Transformation of Digestive and Metabolic Diseases, Yangzhou, China
| | - Wei Wang
- Department of General Surgery, Northern Jiangsu People's Hospital, Yangzhou, China
| | - Daorong Wang
- Clinical Teaching Hospital of Medical School, Northern Jiangsu People's Hospital, Nanjing University, Yangzhou, China.
- Department of General Surgery, Northern Jiangsu People's Hospital, Yangzhou, China.
- Yangzhou Key Laboratory of Basic and Clinical Transformation of Digestive and Metabolic Diseases, Yangzhou, China.
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2
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Kays Mohammed Ali Y, Dolin TG, Damm Nybing J, Lykke J, Hvid Linden F, Høgh-Schmidt E, Sørensen TIA, Christensen JF, Nielsen YJW, Stenfatt Larsen J, Madsbad S, Sidenius Johansen J, Svane MS, Lang Lehrskov L. Change in abdominal obesity after colon cancer surgery - effects of left-sided and right-sided colonic resection. Int J Obes (Lond) 2024; 48:533-541. [PMID: 38172335 PMCID: PMC10978490 DOI: 10.1038/s41366-023-01445-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 11/29/2023] [Accepted: 12/06/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND Excess abdominal visceral adipose tissue (VAT) is associated with metabolic diseases and poor survival in colon cancer (CC). We assessed the impact of different types of CC surgery on changes in abdominal fat depots. MATERIAL AND METHODS Computed tomography (CT)-scans performed preoperative and 3 years after CC surgery were analyzed at L3-level for VAT, subcutaneous adipose tissue (SAT) and total adipose tissue (TAT) areas. We assessed changes in VAT, SAT, TAT and VAT/SAT ratio after 3 years and compared the changes between patients who had undergone left-sided and right-sided colonic resection in the total population and in men and women separately. RESULTS A total of 134 patients with stage I-III CC undergoing cancer surgery were included. Patients who had undergone left-sided colonic resection had after 3 years follow-up a 5% (95% CI: 2-9%, p < 0.01) increase in abdominal VAT, a 4% (95% CI: 2-6%, p < 0.001) increase in SAT and a 5% increase (95% CI: 2-7%, p < 0.01) in TAT. Patients who had undergone right-sided colonic resection had no change in VAT, but a 6% (95% CI: 4-9%, p < 0.001) increase in SAT and a 4% (95% CI: 1-7%, p < 0.01) increase in TAT after 3 years. Stratified by sex, only males undergoing left-sided colonic resection had a significant VAT increase of 6% (95% CI: 2-10%, p < 0.01) after 3 years. CONCLUSION After 3 years follow-up survivors of CC accumulated abdominal adipose tissue. Notably, those who underwent left-sided colonic resection had increased VAT and SAT, whereas those who underwent right-sided colonic resection demonstrated solely increased SAT.
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Affiliation(s)
- Younes Kays Mohammed Ali
- Department of Endocrinological Research, Copenhagen University Hospital -Amager and Hvidovre, Hvidovre, Denmark
- Department of Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Troels Gammeltoft Dolin
- Department of Medicine, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark
- CopenAge, Copenhagen Center for Clinical Age Research, University of Copenhagen, Copenhagen, Denmark
| | - Janus Damm Nybing
- Department of Radiology, Copenhagen University Hospital - Bispebjerg, Copenhagen, Denmark
| | - Jakob Lykke
- Department of Surgery, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark
| | - Frederik Hvid Linden
- Department of Radiology, Copenhagen University Hospital - Bispebjerg, Copenhagen, Denmark
| | - Erik Høgh-Schmidt
- Department of Radiology, Copenhagen University Hospital - Bispebjerg, Copenhagen, Denmark
| | - Thorkild I A Sørensen
- Novo Nordisk Foundation Center for Basic Metabolic Research and Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Jesper Frank Christensen
- Centre for Physical Activity Research, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Department of Sports Science and Clinical Biomechanics, Faculty of Health Sciences at the University of Southern Denmark, Odense, Denmark
- Digestive Disease Center, Bispebjerg Hospital, Copenhagen, Denmark
| | - Yousef J W Nielsen
- Department of Radiology, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark
| | - Jim Stenfatt Larsen
- Department of Oncology, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark
| | - Sten Madsbad
- Department of Endocrinological Research, Copenhagen University Hospital -Amager and Hvidovre, Hvidovre, Denmark
| | - Julia Sidenius Johansen
- Department of Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Medicine, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark
- Department of Oncology, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark
| | - Maria Saur Svane
- Department of Endocrinological Research, Copenhagen University Hospital -Amager and Hvidovre, Hvidovre, Denmark
- Department of Gastrointestinal Surgery, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark
| | - Louise Lang Lehrskov
- Centre for Physical Activity Research, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.
- Department of Oncology, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark.
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3
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Ren J, Li Y, Zhang X, Xiong M, Zhang H, An L, Cao Y, Xia S, Luo G, Tian Y. Correlation between metabolic syndrome and periurethral prostatic fibrosis: results of a prospective study. BMC Urol 2024; 24:38. [PMID: 38347470 PMCID: PMC10863095 DOI: 10.1186/s12894-024-01413-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 01/22/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND Prostatic fibrosis, characterized by the accumulation of myofibroblasts and collagen deposition, is closely associated with LUTS and may lead to mechanical obstruction of the urethra. Additionally, Metabolic Syndrome (MetS), characterized by central obesity, high blood sugar, lipid metabolism disorders, and hypertension, is increasingly recognized as a proinflammatory condition linked to prostate inflammation. METHODS Clinical data from 108 subjects who underwent transurethral resection of the prostate or bipolar plasmakinetic enucleation of the prostate were prospectively collected between June 2021 and August 2022. Patients were divided in two groups according to whether or not they had a diagnosis of MetS. Specimens were stained with Masson trichrome and the periurethral prostatic fibrosis extent was evaluated using quantitative morphometry. RESULTS Forty-three patients (39.8%) were diagnosed with MetS. Patients with MetS showed a significantly greater extent of prostatic fibrosis than the others (68.1 ± 17.1% vs. 42.5 ± 18.2%, P < 0.001), and there was a positive correlation between the number of positive MetS parameters and the extent of prostatic fibrosis (R2 = 0.4436, P < 0.001). Multivariate regression analysis revealed that central obesity (B = 2.941, 95% confidence interval, 1.700-3.283), elevated fasting glucose (B = 1.036, 95% confidence interval, 0.293-1.780), reduced HDL cholesterol (B = 0.910, 95% confidence interval, 0.183-1.636) and elevated triglycerides (B = 1.666, 95% confidence interval, 0.824-2.508) were positively correlated to prostatic fibrosis. Elevated blood pressure, however, was unrelated to prostatic fibrosis (B = 0.009, 95% confidence interval, -0.664-0.683). CONCLUSIONS The present findings suggest that prostatic fibrosis is positively correlated with MetS and its components including central obesity, elevated fasting glucose, reduced high density lipoprotein cholesterol and elevated triglycerides.
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Affiliation(s)
- Jingwen Ren
- Department of Urology, Guizhou Provincial People's Hospital, Guiyang, China
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yuanyuan Li
- Department of Urology, Guizhou Provincial People's Hospital, Guiyang, China
- Guizhou University School of Medicine, Guiyang, China
| | | | - Min Xiong
- Department of Urology, Guizhou Provincial People's Hospital, Guiyang, China
| | - Heng Zhang
- Department of Urology, Guizhou Provincial People's Hospital, Guiyang, China
| | - Lingyue An
- Department of Urology, Guizhou Provincial People's Hospital, Guiyang, China
| | - Ying Cao
- Guizhou University School of Medicine, Guiyang, China
| | - Shujie Xia
- Department of Urology, Shanghai General Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Guangheng Luo
- Department of Urology, Guizhou Provincial People's Hospital, Guiyang, China
- Guizhou University School of Medicine, Guiyang, China
| | - Ye Tian
- Department of Urology, Guizhou Provincial People's Hospital, Guiyang, China.
- Guizhou University School of Medicine, Guiyang, China.
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Xu HW, Fang XY, Chen H, Chang SJ, Ren CX, Ge XY, Wang SJ. The Effects of Abdominal Obesity and Sagittal Imbalance on Sacroiliac Joint Pain After Lumbar Fusion. Pain Physician 2024; 27:59-67. [PMID: 38285036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2024]
Abstract
BACKGROUND Postoperative sacroiliac joint pain (SIJP) is a common manifestation of failed back surgery syndrome after a posterior lumbar interbody fusion (PLIF). However, there is currently no consensus on the risk factors for SIJP after PLIF. OBJECTIVES We explored the effects of abdominal obesity and sagittal imbalance on SIJP after PLIF. STUDY DESIGN This is a prospective observational cohort study. SETTING This study occurred at the Department of Spinal Surgery at a hospital affiliated with a medical university. METHODS A total of 401 patients who underwent PLIF from June 2018 to June 2021 were enrolled in this study. 36 patients experienced postoperative SIJP. In contrast, a matched group comprised 72 non-SIJP patients. We used 1:2 propensity score matching to compare obesity features and sagittal spine parameters in the 2 groups. Inflammatory cytokines and visual analog scale (VAS) scores were measured in the SIJP group. RESULTS A total of 36 patients (8.98%) experienced SIJP during the follow-up. Compared with the non-SIJP group, patients with postoperative SIJP had a higher body mass index (BMI), greater abdominal obesity, a higher incidence of pelvic incidence-lumbar lordosis greater than 10°, and a higher incidence of a sagittal vertical axis greater than 5 cm (P < 0.05). Receiver operating characteristic curve analysis showed that the area under the curve for waist circumference was greater than that for BMI (0.762 vs. 0.650, P = 0.049). Logistic regression analysis revealed that the risk factors for SIJP were abdominal obesity, a pelvic incidence-lumbar lordosis of greater than 10°, and a sagittal vertical axis greater than 5 cm (P < 0.05). In patients with SIJP, interleukin 6, tumor necrosis factor-α, and VAS scores were higher in the abdominal obesity group than in the non-abdominal obesity group (P < 0.05). LIMITATIONS There was no uniform diagnosis of SIJP, so the incidence rate of SIJP might not be accurate. CONCLUSIONS The significant predictors of SIJP were abdominal obesity and sagittal imbalance. Patients with abdominal obesity showed higher levels of inflammatory markers and pain intensity. More attention should be paid to body shape and the angle of correction of lumbar lordosis before lumbar surgery.
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Affiliation(s)
- Hao-Wei Xu
- Department of Spinal Surgery, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Xin-Yue Fang
- Department of Spinal Surgery, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Hao Chen
- Department of Spinal Surgery, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Sheng-Jie Chang
- Department of Spinal Surgery, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Chang-Xu Ren
- Department of Spinal Surgery, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Xiao-Yong Ge
- Department of Spinal Surgery, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Shan-Jin Wang
- Department of Spinal Surgery, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China; Institute of Spinal Diseases, Jinggangshan University, Jiangxi, China; Department of Orthopedic, Shanghai East Hospital, Ji'An Hospital, Jiangxi, China
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Cordeiro A, Pereira SE, Saboya CJ, Ramalho A. Vitamin D Supplementation and Its Relationship with Loss of Visceral Adiposity. Obes Surg 2022; 32:3419-3425. [PMID: 35953634 DOI: 10.1007/s11695-022-06239-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 07/29/2022] [Accepted: 08/04/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE An inverse relationship between vitamin D (VD) nutritional status and obesity is frequent, and the distribution of body fat is an important aspect to assess the risks of obesity-related metabolic dysfunction. The purpose of the study was to evaluate the relationship between serum VD concentrations and body fat reduction after 12 months of bariatric surgery, using two different vitamin D3 (VD3) supplementation protocols. MATERIAL AND METHODS A randomized controlled trial consisted of 41 patients divided into G1 (800 IU/day) and G2 (1800 IU/day) according to the VD3 supplementation. At baseline (T0) and follow-up (T1), 25(OH)D, waist circumference (WC), visceral adiposity index (VAI), body adiposity index (BAI), and waist/height ratio (WHtR) were evaluated. RESULTS In T0, the mean of 25(OH)D was lower in G2 compared to that in G1 (22.6 vs 23.6 ng/mL; p = 0.000). At T1, it had a significant increase in G2 (32.1 vs 29.9 ng/mL; p = 0.000), with 60% sufficiency. A significant negative correlation was observed between VAI, BAI, and WHtR with 25(OH)D in G2 (r = - 0.746, p = 0.024; r = - 0.411, p = 0.036; r = - 0.441, p = 0.032) after surgery. Higher mean changes from baseline of visceral fat loss, represented by VAI, were observed in G2 (176.2 ± 149.0-75.5 ± 55.0, p = 0.000). CONCLUSION Patients submitted to the 1800 IU/day protocol, 12 months after the surgical procedure, had a higher percentage of sufficient vitamin D levels compared to those submitted to the 800 IU/day protocol. Additionally, higher dose supplementation promoted a significant improvement in VAI.
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Affiliation(s)
- Adryana Cordeiro
- Center for Research On Micronutrients, Federal University of Rio de Janeiro (NPqM/UFRJ), Rio de Janeiro, 21941-902, Brazil.
| | - Silvia Elaine Pereira
- Center for Research On Micronutrients, Federal University of Rio de Janeiro (NPqM/UFRJ), Rio de Janeiro, 21941-902, Brazil
- Multidisciplinary Center for Bariatric and Metabolic Surgery, Rio de Janeiro, 22280-020, Brazil
| | - Carlos José Saboya
- Multidisciplinary Center for Bariatric and Metabolic Surgery, Rio de Janeiro, 22280-020, Brazil
| | - Andrea Ramalho
- Center for Research On Micronutrients, Federal University of Rio de Janeiro (NPqM/UFRJ), Rio de Janeiro, 21941-902, Brazil
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6
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Mahroum N, Zoubi M, Watad A, Amital H, Haik J, Shoenfeld Y. Conceptual Paper: Abdominoplasty and Liposuction in Systemic Sclerosis. Isr Med Assoc J 2021; 23:373-375. [PMID: 34155851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Surgical interventions in patients with systemic sclerosis (SSc), in particular plastic procedures, might cause undesired consequences. Notably, liposuction seems to possess greater risk as adipose tissue has been shown to play an important role in treating wounds and ulcers in patients with SSc. While anticentromere antibodies were found to be correlated with vasculopathy in SSc, patients with SSc and anticentromere antibodies might be more vulnerable to surgical wound complications following liposuction. A 46-year-old female patient, who had been diagnosed with SSc at the age of 31 years, had antinuclear as well as anticentromere antibodies. She underwent abdominoplasty with liposuction and developed severe skin necrosis of the abdomen following the procedure and at the site of liposuction. The correlation with anticentromere and the role of liposuction in skin necrosis in SSc are presented.
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MESH Headings
- Abdominoplasty/adverse effects
- Abdominoplasty/methods
- Adipose Tissue/immunology
- Antibodies, Antinuclear/blood
- Cicatrix/diagnosis
- Cicatrix/etiology
- Contraindications, Procedure
- Female
- Humans
- Lipectomy/adverse effects
- Lipectomy/methods
- Middle Aged
- Necrosis/etiology
- Necrosis/immunology
- Necrosis/surgery
- Obesity, Abdominal/complications
- Obesity, Abdominal/diagnosis
- Obesity, Abdominal/surgery
- Reoperation/adverse effects
- Reoperation/methods
- Scleroderma, Systemic/complications
- Scleroderma, Systemic/immunology
- Scleroderma, Systemic/surgery
- Skin/pathology
- Surgery, Plastic/adverse effects
- Surgery, Plastic/methods
- Surgical Wound Dehiscence/diagnosis
- Surgical Wound Dehiscence/etiology
- Surgical Wound Dehiscence/surgery
- Treatment Outcome
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Affiliation(s)
- Naim Mahroum
- Department of Medicine B, Sheba Medical Center, Tel Hashomer, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Magdi Zoubi
- Department of Medicine B, Sheba Medical Center, Tel Hashomer, Israel
| | - Abdulla Watad
- Department of Medicine B, Sheba Medical Center, Tel Hashomer, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Howard Amital
- Department of Medicine B, Sheba Medical Center, Tel Hashomer, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Josef Haik
- Department of Plastic and reconstructive Surgery, Sheba Medical Center, Tel Hashomer, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Institute for Health Research, University of Notre Dame Australia, Fremantle, Western Australia, Australia
| | - Yehuda Shoenfeld
- Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Israel
- Ariel University, Ariel, Israel
- Laboratory of the Mosaics of Autoimmunity, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Vas K, Besenyi Z, Urbán S, Badawi A, Pávics L, Erős G, Kemény L. Efficacy and safety of long pulse 1064 and 2940 nm lasers in noninvasive lipolysis and skin tightening. J Biophotonics 2019; 12:e201900083. [PMID: 31008550 PMCID: PMC7065637 DOI: 10.1002/jbio.201900083] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 04/16/2019] [Accepted: 04/18/2019] [Indexed: 05/04/2023]
Abstract
Noninvasive body shaping is becoming a growing demand. The aim of this study was to investigate the efficacy and safety of the combined treatments of 1064 nm Nd:YAG and 2940 nm Er:YAG in noninvasive lipolysis and skin tightening. Ten females were enrolled, and all women's side of the waist or the lower part of the abdomen were treated. In the first step, the 1064 nm Nd:YAG was used. As a second step, the 2940 nm Er:YAG laser was applied. Each woman was treated four times, once every 2 weeks. The effects were determined by comparative photo documentation, waist circumference measurement, two-dimensional B-mode ultrasonography and low-dose native computer tomography (CT), whereas body fat was monitored with bioelectric impedance. The tissue firmness was measured by ultrasound shear wave elastography. Combined laser treatment significantly reduced waist circumference and total body fat. Ultrasonography has revealed that the treatment considerably decreased fat thickness and improved skin stiffness in the treated region. Subcutaneous fat volume, measured by low-dose CT, displayed a moderate decrease in the waist region. The combined 1064 nm Nd:YAG and 2940 nm Er:YAG laser treatment results in the reduction of fat tissue and tightens the skin as confirmed by objective measurements.
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Affiliation(s)
- Krisztina Vas
- Department of Dermatology and AllergologyUniversity of SzegedSzegedHungary
| | | | - Szabolcs Urbán
- Department of Nuclear MedicineUniversity of SzegedSzegedHungary
| | - Ashraf Badawi
- Department of Dermatology and AllergologyUniversity of SzegedSzegedHungary
- National Institute of Laser Enhanced SciencesCairo UniversityGizaEgypt
| | - László Pávics
- Department of Nuclear MedicineUniversity of SzegedSzegedHungary
| | - Gábor Erős
- Department of Dermatology and AllergologyUniversity of SzegedSzegedHungary
| | - Lajos Kemény
- Department of Dermatology and AllergologyUniversity of SzegedSzegedHungary
- MTA‐SZTE Dermatological Research GroupUniversity of SzegedSzegedHungary
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8
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Abstract
Diabetes mellitus and obesity are closely interrelated and pose a major burden on health care in terms of morbidity and mortality. Weight loss has favorable metabolic benefits for glycemic control and improvement of metabolic syndrome. Bariatric surgery (BS) is the most effective treatment for weight loss with durable results as compared to lifestyle modification. BS procedures have been associated with significant reduction in abdominal obesity, metabolic syndrome components, and glycemic control requiring fewer medications. Long-term risks of surgery include nutritional deficiencies, osteoporosis, bone fractures, and hyperinsulinemic hypoglycemia, which need to be carefully balanced with metabolic benefits for individual patients.
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Affiliation(s)
- Sidra Azim
- Department of Endocrinology, Diabetes, and Metabolism, Cleveland Clinic, 9500 Euclid Avenue (F-20), Cleveland, OH 44195, USA
| | - Sangeeta R Kashyap
- Department of Endocrinology, Diabetes, and Metabolism, Cleveland Clinic, 9500 Euclid Avenue (F-20), Cleveland, OH 44195, USA.
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9
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Meena VP, Seenu V, Sharma MC, Mallick SR, Bhalla AS, Gupta N, Mohan A, Guleria R, Pandey RM, Luthra K, Vikram NK. Relationship of adipocyte size with adiposity and metabolic risk factors in Asian Indians. PLoS One 2014; 9:e108421. [PMID: 25251402 PMCID: PMC4177391 DOI: 10.1371/journal.pone.0108421] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Accepted: 08/27/2014] [Indexed: 11/18/2022] Open
Abstract
Background Enlargement of adipocyte is associated with their dysfunction and alterations in metabolic functions. Objectives We evaluated the association of adipocyte size of subcutaneous and omental adipose tissue with body composition and cardiovascular risk factors in Asian Indians. Methodology Eighty (40 males and 40 females) non-diabetic adult subjects undergoing elective abdominal surgery were included. Pre-surgery evaluation included anthropometric measurements, % body fat by bioimpedance, abdominal fat area at L2–3 level (computed tomography) and biochemical investigations (fasting blood glucose and insulin, lipids and hsCRP). During surgery, about 5 grams each of omental and subcutaneous adipose tissue was obtained for adipocyte size determination. Results Females had higher BMI, % body fat, skinfold thickness, total and subcutaneous abdominal fat area as compared to males. Overweight was present in 42.5% and 67.5%, and abdominal obesity in 5% and 52.5% males and females, respectively. Subcutaneous adipocyte size was significantly higher than omental adipocyte size. Omental adipocyte size correlated more strongly than subcutaneous adipocyte size with measures of adiposity (BMI, waist circumference, %BF), total and subcutaneous abdominal fat area and biochemical measures (fasting glucose, total cholesterol, triglycerides and HOMA-IR), the correlations being stronger in females. The correlation of adipocyte size with metabolic parameters was attenuated after adjusting for measures of adiposity. Conclusion Omental adipocyte size, though smaller than the subcutaneous adipocyte size, was more closely related to measures of adiposity and metabolic parameters. However, the relationship was not independent of measures of adiposity.
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Affiliation(s)
- Ved Prakash Meena
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - V. Seenu
- Department of Surgical Disciplines, All India Institute of Medical Sciences, New Delhi, India
| | - M. C. Sharma
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | | | - Ashu Seith Bhalla
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India
| | - Nandita Gupta
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India
| | - Anant Mohan
- Departments of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India
| | - Randeep Guleria
- Departments of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India
| | - Ravindra M. Pandey
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Kalpana Luthra
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, India
| | - Naval K. Vikram
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
- * E-mail:
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Salamin G, Pelletier C, Poirier P, Després JP, Bertrand O, Alméras N, Costerousse O, Brassard P. Impact of visceral obesity on cardiac parasympathetic activity in type 2 diabetics after coronary artery bypass graft surgery. Obesity (Silver Spring) 2013; 21:1578-85. [PMID: 23585195 DOI: 10.1002/oby.20089] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2011] [Accepted: 08/15/2012] [Indexed: 11/11/2022]
Abstract
OBJECTIVE The association between adiposity and heart rate variability (HRV) in patients with type 2 diabetes (T2D) after coronary artery bypass graft surgery (CABG) is not well documented. We evaluated the associations between indices of adiposity and HRV in patients with T2D with CABG and quantified the relationships of the volume of visceral (VVAT) and subcutaneous adipose tissue (VSAT) to HRV. DESIGN AND METHODS One hundred and thirty-five men with T2D who underwent CABG participated in this study. HRV, BMI, waist circumference (WC), VVAT, and VSAT were measured. Correlations between indices of HRV and adiposity were evaluated and predictors of HRV modulation were identified. Patients were then divided into quartiles of VVAT and VSAT to further evaluate the influence of adiposity on HRV. RESULTS Subjects were 65 ± 7 years old (mean ± SD) with a BMI of 30 ± 4 kg/m(2) and a WC of 105 ± 10 cm. BMI (r = -0.19) and WC (r = -0.25) were inversely correlated with low frequencies. VVAT correlated negatively with SD normal-to normal (SDNN) (r = -0.22, P < 0.01), indices of cardiac parasympathetic activity [rMSSD (r = -0.27), NN50 (r = -0.22), pNN50 (r = -0.26; all P < 0.05], and with low (r = -0.37) and high frequencies (r = -0.20; all P < 0.01). Patients with the lowest VVAT had the highest cardiac parasympathetic activity (P < 0.05). VVAT remained the best predictor of cardiac parasympathetic activity after adjustments for confounding parameters (P < 0.01). CONCLUSION An increase in visceral adiposity, not BMI, seems to be associated with lower HRV in patients with T2D who had a CABG procedure.
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Affiliation(s)
- Guillaume Salamin
- Département de kinésiologie, Faculté de médecine, Université Laval, Québec, Canada
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Komaroff AL. Ask the doctor. I[ve heard bariatric surgery can reduce type 2 diabetes. How about type 1? Harv Health Lett 2012; 38:2. [PMID: 23346622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
MESH Headings
- Bariatric Surgery
- Diabetes Mellitus, Type 1/complications
- Diabetes Mellitus, Type 1/prevention & control
- Diabetes Mellitus, Type 1/surgery
- Diabetes Mellitus, Type 2/complications
- Diabetes Mellitus, Type 2/prevention & control
- Diabetes Mellitus, Type 2/surgery
- Diet, Diabetic
- Diet, Reducing
- Exercise
- Humans
- Obesity, Abdominal/etiology
- Obesity, Abdominal/prevention & control
- Obesity, Abdominal/surgery
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Kim MK, Lee HC, Kwon HS, Baek KH, Kim EK, Lee KW, Song KH. Visceral obesity is a negative predictor of remission of diabetes 1 year after bariatric surgery. Obesity (Silver Spring) 2011; 19:1835-9. [PMID: 21738235 DOI: 10.1038/oby.2011.205] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Our aim was to identify preoperative anthropometric and clinical parameters that predict the remission of diabetes after Roux-en-Y gastric bypass (RYGB). Fifty severely obese Korean patients with type 2 diabetes underwent RYGB. Visceral and abdominal subcutaneous fat area (SFA) was assessed using computed tomography before and 6 and 12 months after RYGB. Remission was defined as a glycated hemoglobin (A(1C)) level <6.5% and a fasting glucose concentration <126 mg/dl for 1 year or more without the use of medication. The visceral-to-SFA ratio decreased from 0.60 ± 0.30 to 0.53 ± 0.29 (P = 0.001) after 6 months and decreased further to 0.42 ± 0.24 (P < 0.001) after 12 months. Thirty-four of the 50 patients (68%) had remission of diabetes (remission group). Compared with patients in the nonremission group, patients in the remission group had a shorter duration of diabetes and lower preoperative A(1C) level, and were less likely to use insulin preoperatively. Preoperative BMI did not differ in two groups. However, the preoperative visceral-to-SFA ratio was greater in the nonremission group compared with the remission group (0.79 ± 0.29 vs. 0.53 ± 0.26, P = 0.003). Finally, the preoperative visceral-to-SFA ratio was an independent predictor of the remission of diabetes after RYGB in multiple stepwise logistic regression analysis. In conclusion, our data suggest that visceral adiposity negatively influence the likelihood of the patient experiencing the remission of diabetes after RYGB.
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MESH Headings
- Adiposity
- Adult
- Algorithms
- Bariatric Surgery
- Body Mass Index
- Cohort Studies
- Diabetes Mellitus, Type 2/diet therapy
- Diabetes Mellitus, Type 2/drug therapy
- Diabetes Mellitus, Type 2/etiology
- Diabetes Mellitus, Type 2/therapy
- Diet, Diabetic
- Diet, Reducing
- Exercise
- Female
- Follow-Up Studies
- Humans
- Hypoglycemic Agents/therapeutic use
- Intra-Abdominal Fat/pathology
- Logistic Models
- Male
- Middle Aged
- Obesity, Abdominal/diet therapy
- Obesity, Abdominal/pathology
- Obesity, Abdominal/physiopathology
- Obesity, Abdominal/surgery
- Prospective Studies
- Remission Induction
- Subcutaneous Fat, Abdominal/pathology
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Affiliation(s)
- Mee Kyoung Kim
- Department of Internal Medicine, The Catholic University of Korea, Seoul, Korea
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Volokh MA, Gubochkin NG, Shapovalov VM, Kushtan II, Perevozov VV. [Surgical complications following operative treatment of abdominal obesity in type 2 diabetes mellitus patients]. Vestn Khir Im I I Grek 2011; 170:18-21. [PMID: 21506349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Results of surgical treatment of 211 patients consisting of 109 patients with DM2 and 102 patients without DM2 were studied. All patients underwent lipoaspiration or abdominoplasty. The aim was to assess the influence of type 2 diabetes mellitus on the frequency and structure of complications after surgery. The risk of anemia and local complications increases after surgical correction of abdominal obesity which are temporary and do not have significant influence on the clinical outcome. There were no cases of clinical manifestations of pulmonary embolism and fat embolism.
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Dronov AI, Fedoruk VI, Roshchina LA. [Simultaneous operations with abdominal plastics]. Klin Khir 2009:39-40. [PMID: 20218367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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