- Bedside Contribution of Electrical Impedance Tomography to Set Positive End-Expiratory Pressure for ECMO-Treated Severe ARDS Patients. [Journal Article]
- AJAm J Respir Crit Care Med 2017 Jan 19
- CONCLUSIONS: The broad variability in optimal PEEP observed in these severe ARDS patients under ECMO reinforces the need for personalized titration of ventilation settings. EIT may be an interesting non-invasive bedside tool to provide real-time monitoring of the PEEP impact in these patients.
- Pediatric Obesity: Pharmacokinetic Alterations and Effects on Antimicrobial Dosing. [Journal Article]
- PPharmacotherapy 2017 Jan 12
- CONCLUSIONS: Pharmacokinetic studies in obese children are imperative to elucidate drug distribution, clearance, and, consequently, the dose required for effective therapy in these children. Future studies should evaluate the effects of both age and obesity on drug dosing as the incidence of obesity is increasing in pediatric patients. This article is protected by copyright. All rights reserved.
- Integrating intervention targets offered by homeostatic theory. [Journal Article]
- HPHealth Psychol Open 2016; 3(1):2055102916634361
- Marks presents "homeostatic theory" which proposes that weight gain is fostered by a "Circle of Discontent" consisting of body dissatisfaction, negative affect, and overconsumption. This innovative f...
Marks presents "homeostatic theory" which proposes that weight gain is fostered by a "Circle of Discontent" consisting of body dissatisfaction, negative affect, and overconsumption. This innovative framework offers potential intervention approaches, including victim-blaming, stigma, and discrimination, as well as devalorizing the thin-ideal. Our article discusses possible ways that clinical health psychologists based in university settings may be uniquely positioned to consider and implement large-scale programs that have shown great promise for addressing these core issues.
- Weight fluctuation and cancer risk in post-menopausal women: The Women's Health Initiative. [Journal Article]
- CECancer Epidemiol Biomarkers Prev 2017 Jan 09
- CONCLUSIONS: Weight gain and weight cycling were positively associated with risk of breast and endometrial cancer, respectively.These data suggest weight cycling and weight gain increase risk of prevalent cancers in postmenopausal women. Adopting ideal body weight maintenance practices before and after weight loss should be encouraged to reduce risk of incident breast and endometrial cancers.
- Association Between Obesity and Perioperative Morbidity in Open Versus Laparoscopic Sacrocolpopexy. [Journal Article]
- FPFemale Pelvic Med Reconstr Surg 2017 Jan 18
- CONCLUSIONS: Obesity increases the operative time during LSCP. For patients in all BMI groups, LSCP offers the benefit of shorter hospital stays when compared with OSCP.
- Biological, Psychological, and Sociocultural Factors Contributing to the Drive for Muscularity in Weight-Training Men. [Journal Article]
- FPFront Psychol 2016; 7:1992
- The drive for muscularity and associated behaviors (e.g., exercising and dieting) are of growing importance for men in Western societies. In its extreme form, it can lead to body image concerns and h...
The drive for muscularity and associated behaviors (e.g., exercising and dieting) are of growing importance for men in Western societies. In its extreme form, it can lead to body image concerns and harmful behaviors like over-exercising and the misuse of performance-enhancing substances. Therefore, investigating factors associated with the drive for muscularity, especially in vulnerable populations like bodybuilders and weight trainers can help identify potential risk and protective factors for body image problems. Using a biopsychosocial framework, the aim of the current study was to explore different factors associated with drive for muscularity in weight-training men. To this purpose, German-speaking male weight trainers (N = 248) completed an online survey to determine the extent to which biological, psychological, and sociocultural factors contribute to drive for muscularity and its related attitudes and behaviors. Using multiple regression models, findings showed that media ideal body internalization was the strongest positive predictor for drive for muscularity, while age (M = 25.9, SD = 7.4) held the strongest negative association with drive for muscularity. Dissatisfaction with muscularity, but not with body fat, was related to drive for muscularity. The fat-free mass index, a quantification of the actual degree of muscularity of a person, significantly predicted drive for muscularity-related behavior but not attitudes. Body-related aspects of self-esteem, but not global self-esteem, were significant negative predictors of drive for muscularity. Since internalization of media body ideals presented the highest predictive value for drive for muscularity, these findings suggest that media body ideal internalizations may be a risk factor for body image concerns in men, leading, in its most extreme form to disordered eating or muscle dysmorphia. Future research should investigate the relations between drive for muscularity, age, body composition, internalization, dissatisfaction with muscularity and body-related self-esteem using longitudinal study designs. Limitations concern the cross-sectional design of the study, self-reported body composition measures and the homogeneity of the sample.
- Effectiveness of a preoperative exercise and nutritional support program for elderly sarcopenic patients with gastric cancer. [Journal Article]
- GCGastric Cancer 2016 Dec 28
- We established a preoperative exercise and nutritional support program for elderly sarcopenic patients with gastric cancer. Twenty-two gastric cancer patients aged 65 years or older with a diagnosis ...
We established a preoperative exercise and nutritional support program for elderly sarcopenic patients with gastric cancer. Twenty-two gastric cancer patients aged 65 years or older with a diagnosis of sarcopenia according to the algorithm proposed by the European Working Group on Sarcopenia in Older People received our preoperative program. The median duration of the program participation was 16 days. Total calorie and protein intakes were significantly higher after the program than before [29.4 ± 6.9 kcal/kg ideal body weight (IBW) vs 27.3 ± 5.6 kcal/kg IBW, p = 0.049, and 1.3 ± 0.4 g/kg IBW vs 1.1 ± 0.3 g/kg IBW, p = 0.0019, respectively]. Handgrip strength significantly increased after the program (21.2 ± 5.2 kg vs 20.0 ± 5.3 kg, p = 0.022). Likewise, gait speed and skeletal muscle mass index increased, although the differences did not reach statistical significance. Four patients became nonsarcopenic after the program. Postoperative complications were observed in three patients (13.6%); however, none of these complications were severe (Clavien-Dindo grade III or lower). A preoperative exercise and nutritional support program has the potential to reduce sarcopenia and improve postoperative outcome in elderly sarcopenic patients with gastric cancer.
- Safety and Activity of Mirvetuximab Soravtansine (IMGN853), a Folate Receptor Alpha-Targeting Antibody-Drug Conjugate, in Platinum-Resistant Ovarian, Fallopian Tube, or Primary Peritoneal Cancer: A Phase I Expansion Study. [Journal Article]
- JCJ Clin Oncol 2016 Dec 28; :JCO2016699538
- Purpose This phase I expansion cohort study evaluated the safety and clinical activity of mirvetuximab soravtansine (IMGN853), an antibody-drug conjugate consisting of a humanized anti-folate recepto...
Purpose This phase I expansion cohort study evaluated the safety and clinical activity of mirvetuximab soravtansine (IMGN853), an antibody-drug conjugate consisting of a humanized anti-folate receptor alpha (FRα) monoclonal antibody linked to the tubulin-disrupting maytansinoid DM4, in a population of patients with FRα-positive and platinum-resistant ovarian cancer. Patients and Methods Patients with platinum-resistant epithelial ovarian, fallopian tube, or primary peritoneal cancer received IMGN853 at 6.0 mg/kg (adjusted ideal body weight) once every 3 weeks. Eligibility included a minimum requirement of FRα positivity by immunohistochemistry (≥ 25% of tumor cells with at least 2+ staining intensity). Adverse events, tumor response (via Response Evaluation Criteria in Solid Tumors [RECIST] version 1.1), and progression-free survival (PFS) were determined. Results Forty-six patients were enrolled. Adverse events were generally mild (≤ grade 2), with diarrhea (44%), blurred vision (41%), nausea (37%), and fatigue (30%) being the most commonly observed treatment-related toxicities. Grade 3 fatigue and hypotension were reported in two patients each (4%). For all evaluable patients, the confirmed objective response rate was 26%, including one complete and 11 partial responses, and the median PFS was 4.8 months. The median duration of response was 19.1 weeks. Notably, in the subset of patients who had received three or fewer prior lines of therapy (n = 23), an objective response rate of 39%, PFS of 6.7 months, and duration of response of 19.6 weeks were observed. Conclusion IMGN853 exhibited a manageable safety profile and was active in platinum-resistant ovarian cancer, with the strongest signals of efficacy observed in less heavily pretreated individuals. On the basis of these findings, the dose, schedule, and target population were identified for a phase III trial of IMGN853 monotherapy in patients with platinum-resistant disease.
- Intragastric balloon as an adjunct to lifestyle intervention: A randomized controlled trial. [Journal Article]
- IJInt J Obes (Lond) 2016 Dec 26
- Background/objectivesThis trial evaluated the safety and effectiveness of the Orbera™ Intragastric Balloon, as an adjunct to lifestyle intervention.Subjects/methodsIn this multi-center, randomized, o...
Background/objectivesThis trial evaluated the safety and effectiveness of the Orbera™ Intragastric Balloon, as an adjunct to lifestyle intervention.Subjects/methodsIn this multi-center, randomized, open label clinical trial 255 adults with a body mass index 30-40 kg/m(2) were treated and outcomes assessed up to 12 months. Participants were randomized to endoscopic placement of an intragastric balloon plus lifestyle or lifestyle intervention alone. Balloons were removed at 6 months and lifestyle intervention continued for both groups through 12 months. At 9 months, co-primary endpoints were 2 measures of weight loss.ResultsAt 6 months, weight loss was -3.3% of total body weight (-3.2 kgs) in the lifestyle arm versus -10.2% (-9.9 kgs) in the balloon plus lifestyle arm (P<0.001); at 9 months (3 months post balloon removal), weight loss was -3.4% (-3.2 kgs) vs -9.1% (-8.8 kgs, P=<0.001); and at 12 months -3.1% (-2.9 kgs) vs -7.6% (-7.4 kgs, P=<0.001). For the primary endpoints, at 9 months, mean percent loss of weight in excess of ideal body weight (s.d.) at 9 months was 26.5% (20.7) (P=0.32) and 9.7% (15.1) in the balloon and control groups, respectively. Also, 45.6% (36.7, 54.8) of the subjects randomized to the balloon achieved at least 15% loss of weight in excess of ideal body weight greater than the control group (P<0.001). The majority of balloon subjects experienced adverse events; 86.9% nausea, 75.6% vomiting, 57.5% abdominal pain, and 18.8% had their device removed prior to 6 months due to an adverse event or subject request. Five subjects (3.1%) in the balloon group had a gastric abnormality at the time of device removal, no ulcers were found.Conclusions and relevanceIntragastric balloon achieved greater short-term weight loss at 3 and 6 months post balloon removal than lifestyle intervention alone. Adverse gastrointestinal events were common.International Journal of Obesity accepted article preview online, 26 December 2016. doi:10.1038/ijo.2016.229.
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- The Heterogeneity of Obesity: Fitting Treatments To Individuals - Republished Article. [Journal Article]
- BTBehav Ther 2016; 47(6):950-965
- Body weight is regulated by a complex interaction of biological, behavioral, and cultural factors. The population as a whole is at risk for obesity because of increased intake of dietary fat, the con...
Body weight is regulated by a complex interaction of biological, behavioral, and cultural factors. The population as a whole is at risk for obesity because of increased intake of dietary fat, the consumption of calories in fewer meals per day, striking accessibility to palatable foods, and decreased physical activity. This risk may become a reality in individuals with certain biological predispositions (genetic tendency, low metabolic rate, increased fat cell number), specific eating patterns, and susceptibility to the extreme cultural pressure to be lean. These factors must be considered in establishing goals for treatment, which fall into medical and psychosocial categories. This includes defining a "reasonable" as opposed to "ideal" weight. A three-stage process is proposed for identifying the best treatment for an individual. This involves a classification decision, a stepped care decision, and then a matching decision. Criteria are provided for a comprehensive assessment of the overweight individual, and treatment options are reviewed for programs of varying intensity, cost, and risk.