Obesity Archives - Revista Brasileira de Ginecologia e Obstetrícia
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(3):227-232
07-05-2004
DOI 10.1590/S0100-72032004000300009
PURPOSE: to identify the risk factors associated with the occurrence of surgical site infection (SSI) in surgeries for the treatment of breast cancer. METHODS: the study was conducted on 140 women submitted to treatment of invasive breast cancer during the period from January 2001 to December 2002. SSI was defined as infection occurring up to 30 days after surgery and was related to the operation, according to the standard criteria adopted by the Centers for Disease Control and Prevention (CDC), USA. SSI were considered to be superficial when they involved only the skin and subcutaneous tissue and deep when they involved deep tissues at the site of incision, such as fascia and muscles. The risk factors related to patient were age, hormonal status, staging, body mass index (BMI) and hemoglobin, and the factors related to surgery were type of operation, time of hospitalization, duration of surgery, and formation of seroma and hematoma. Data concerning numerical nonparametric variables were analyzed by the Mann-Whitney test and quantitative variables were analyzed by the Fisher exact test. RESULTS: of the 140 patients studied, 29 (20.7%) presented SSI, which were superficial in 19 (13.6%) and deep in 10 (71%); 111 patients did not present SSI and represented the control group. The risk factors associated with the patient and the disease were locally advanced stage (odds ratio = 27; 95% CI: 1.1-6.5) and obesity, represented by a mean BMI of 32.2 kg/m² in the patients with SSI and a mean BMI of 27.2 kg/m² in the control group (p<0.0001). The factors related to treatment of the disease were the use of neoadjuvant chemotherapy (odds ratio = 2.7 (95% CI: 1.1-6.5), the duration of surgery, whose median value was 165 minutes for the patients who developed the infection and 137 minutes for the control group (p=0.02), and the number of days of use of the postoperative drain, whose median value was 6 days for the patients with SSI and 5 days for the control group (p=0.048). CONCLUSION: on the basis of the identification of risk factors such as advanced stage, neoadjuvant chemotherapy and obesity, preoperative care for these patients should be emphasized. The use of an accurate surgical technique may reduce the impact of other factors such as surgical time and time of use of the drain.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(3):227-232
07-05-2004
DOI 10.1590/S0100-72032004000300009
PURPOSE: to identify the risk factors associated with the occurrence of surgical site infection (SSI) in surgeries for the treatment of breast cancer. METHODS: the study was conducted on 140 women submitted to treatment of invasive breast cancer during the period from January 2001 to December 2002. SSI was defined as infection occurring up to 30 days after surgery and was related to the operation, according to the standard criteria adopted by the Centers for Disease Control and Prevention (CDC), USA. SSI were considered to be superficial when they involved only the skin and subcutaneous tissue and deep when they involved deep tissues at the site of incision, such as fascia and muscles. The risk factors related to patient were age, hormonal status, staging, body mass index (BMI) and hemoglobin, and the factors related to surgery were type of operation, time of hospitalization, duration of surgery, and formation of seroma and hematoma. Data concerning numerical nonparametric variables were analyzed by the Mann-Whitney test and quantitative variables were analyzed by the Fisher exact test. RESULTS: of the 140 patients studied, 29 (20.7%) presented SSI, which were superficial in 19 (13.6%) and deep in 10 (71%); 111 patients did not present SSI and represented the control group. The risk factors associated with the patient and the disease were locally advanced stage (odds ratio = 27; 95% CI: 1.1-6.5) and obesity, represented by a mean BMI of 32.2 kg/m² in the patients with SSI and a mean BMI of 27.2 kg/m² in the control group (p<0.0001). The factors related to treatment of the disease were the use of neoadjuvant chemotherapy (odds ratio = 2.7 (95% CI: 1.1-6.5), the duration of surgery, whose median value was 165 minutes for the patients who developed the infection and 137 minutes for the control group (p=0.02), and the number of days of use of the postoperative drain, whose median value was 6 days for the patients with SSI and 5 days for the control group (p=0.048). CONCLUSION: on the basis of the identification of risk factors such as advanced stage, neoadjuvant chemotherapy and obesity, preoperative care for these patients should be emphasized. The use of an accurate surgical technique may reduce the impact of other factors such as surgical time and time of use of the drain.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(9):625-630
01-19-2003
DOI 10.1590/S0100-72032003000900002
PURPOSE: to evaluate the nutritional condition of pregnant adolescents using the pregestational body mass index (BMI) and the BMI at the end of pregnancy and to establish a possible association with the type of delivery and weight of the newborn child. METHODS: in a descriptive retrospective observational study 558 pregnant teenagers as well as their newborns were evaluated in the Obstetrics outpatient clinic of the Universidade Federal de São Paulo, Brazil (UNIFESP-EPM), from January 1998 to December 2000. The sample consisted of pregnant girls who were between 10 and 19 years old at the time of the first prenatal examination, excluding the teenagers who had preexistent disease and those with incomplete data in their records. Thus, the sample consisted of 300 pregnant teenagers. Qualitative variables are presented as absolute and relative frequency and quantitative variables as mean, standard deviation and range. The correlation between maternal variables (pre-pregnancy BMI and final BMI) and parameters of the newborn (type of delivery and weight) was determined by the c² test and the differences were identified by partitioning of the c² values, with the level of significance set at p < 0.05 (a = 0.05). RESULTS: nutritional deviation was detected in 34.7% of the girls, at the beginning of pregnancy. Of these adolescents, 27.7% presented malnutrition, 4% were overweight and 3% were obese. By the end of the gestational period, BMI of 54.3% of them was normal, 1.3% correponded to malnutrition, 27% to overweight and 17.3% to obesity. The mother's nutritional condition (malnutrition, normal, overweight and obesity) did not affect the method of delivery, either vaginal (80.3%) or cesarean section (19.7%). The patients who reached end of pregnancy with BMI corresponding to malnutrition had 75% of neonates under 2.500 g. CONCLUSIONS: the mother's nutritional status was not related to the type of delivery. BMI corresponding to malnutrition at the end of pregnancy was significantly related to more cases of newborn babies under 2.500 g.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(9):625-630
01-19-2003
DOI 10.1590/S0100-72032003000900002
PURPOSE: to evaluate the nutritional condition of pregnant adolescents using the pregestational body mass index (BMI) and the BMI at the end of pregnancy and to establish a possible association with the type of delivery and weight of the newborn child. METHODS: in a descriptive retrospective observational study 558 pregnant teenagers as well as their newborns were evaluated in the Obstetrics outpatient clinic of the Universidade Federal de São Paulo, Brazil (UNIFESP-EPM), from January 1998 to December 2000. The sample consisted of pregnant girls who were between 10 and 19 years old at the time of the first prenatal examination, excluding the teenagers who had preexistent disease and those with incomplete data in their records. Thus, the sample consisted of 300 pregnant teenagers. Qualitative variables are presented as absolute and relative frequency and quantitative variables as mean, standard deviation and range. The correlation between maternal variables (pre-pregnancy BMI and final BMI) and parameters of the newborn (type of delivery and weight) was determined by the c² test and the differences were identified by partitioning of the c² values, with the level of significance set at p < 0.05 (a = 0.05). RESULTS: nutritional deviation was detected in 34.7% of the girls, at the beginning of pregnancy. Of these adolescents, 27.7% presented malnutrition, 4% were overweight and 3% were obese. By the end of the gestational period, BMI of 54.3% of them was normal, 1.3% correponded to malnutrition, 27% to overweight and 17.3% to obesity. The mother's nutritional condition (malnutrition, normal, overweight and obesity) did not affect the method of delivery, either vaginal (80.3%) or cesarean section (19.7%). The patients who reached end of pregnancy with BMI corresponding to malnutrition had 75% of neonates under 2.500 g. CONCLUSIONS: the mother's nutritional status was not related to the type of delivery. BMI corresponding to malnutrition at the end of pregnancy was significantly related to more cases of newborn babies under 2.500 g.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(7):435-441
10-03-2000
DOI 10.1590/S0100-72032000000700006
Purpose: to describe sociodemographic characteristics of a group of climacteric women in order to discover the frequency and the variables associated with obesity and android profile of body fat distribution. Methods: an observational study was carried out in 518 patients aged 45 to 65 years, in a climacterium outpatient clinic. Age, color, menopausal status, duration of menopause, physical activity, smoking status, diet, alcohol intake, personal and family antecedents of arterial hypertension, diabetes mellitus, cardiovascular disease, dyslipidemia and obesity were considered. Body mass index and the waist/hip ratio were the dependent variables. For the statistical analysis Wilcoxon test, Pearson's correlation coefficient, with a 5% level of significance, and multivariate analysis using regression model were used. Results: more than two thirds of the participants were nonobese with an android profile and postmenopausal. One fourth had physical activity and were smokers; half reported an inadequate diet and one fifth were alcoholics. Patients with an android profile presented higher mean age than women with gynecoid pattern. Personal antecedents of obesity, arterial hypertension, diabetes and family history of diabetes were related to obesity and android pattern. Postmenopausal status was significantly associated with the android profile. Conclusions: the majority of the participants were nonobese with an android profile, white, postmenopausal, sedentary, neither smokers nor alcoholics. The main factors related to obesity and android pattern were personal antecedents of obesity, arterial hypertension, diabetes, family history of diabetes and particularly, postmenopausal status with android profile.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(7):435-441
10-03-2000
DOI 10.1590/S0100-72032000000700006
Purpose: to describe sociodemographic characteristics of a group of climacteric women in order to discover the frequency and the variables associated with obesity and android profile of body fat distribution. Methods: an observational study was carried out in 518 patients aged 45 to 65 years, in a climacterium outpatient clinic. Age, color, menopausal status, duration of menopause, physical activity, smoking status, diet, alcohol intake, personal and family antecedents of arterial hypertension, diabetes mellitus, cardiovascular disease, dyslipidemia and obesity were considered. Body mass index and the waist/hip ratio were the dependent variables. For the statistical analysis Wilcoxon test, Pearson's correlation coefficient, with a 5% level of significance, and multivariate analysis using regression model were used. Results: more than two thirds of the participants were nonobese with an android profile and postmenopausal. One fourth had physical activity and were smokers; half reported an inadequate diet and one fifth were alcoholics. Patients with an android profile presented higher mean age than women with gynecoid pattern. Personal antecedents of obesity, arterial hypertension, diabetes and family history of diabetes were related to obesity and android pattern. Postmenopausal status was significantly associated with the android profile. Conclusions: the majority of the participants were nonobese with an android profile, white, postmenopausal, sedentary, neither smokers nor alcoholics. The main factors related to obesity and android pattern were personal antecedents of obesity, arterial hypertension, diabetes, family history of diabetes and particularly, postmenopausal status with android profile.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(8):481-488
06-24-2001
DOI 10.1590/S0100-72032001000800002
Purpose: to investigate leptin levels in patients with polycystic ovary syndrome (PCOS), and relationships with testosterone, estradiol, follicle-stimulating hormone (FSH) and insulin levels. Methods: transversal study on 40 patients with PCOS divided into two groups: Group I (n = 20)- obese women (body mass index - BMI > or = 28 kg/m²), and Group II (n = 20) - non obese women (BMI <28 kg/m²). Results: BMI was different between the two groups (p=0.04). We observed that leptin concentrations were significantly correlated with BMI (p<0.001). After adjusting for BMI, no correlation between leptin, insulin (p=0.194), FSH (p=0.793), and total (p=0.441) and free (p=0.422) testosterone was found. However, we only observed positive correlations between leptin and estradiol (p=0.043). Conclusions: there is a strong correlation between leptin levels, BMI and estradiol levels in women with PCOS.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(8):481-488
06-24-2001
DOI 10.1590/S0100-72032001000800002
Purpose: to investigate leptin levels in patients with polycystic ovary syndrome (PCOS), and relationships with testosterone, estradiol, follicle-stimulating hormone (FSH) and insulin levels. Methods: transversal study on 40 patients with PCOS divided into two groups: Group I (n = 20)- obese women (body mass index - BMI > or = 28 kg/m²), and Group II (n = 20) - non obese women (BMI <28 kg/m²). Results: BMI was different between the two groups (p=0.04). We observed that leptin concentrations were significantly correlated with BMI (p<0.001). After adjusting for BMI, no correlation between leptin, insulin (p=0.194), FSH (p=0.793), and total (p=0.441) and free (p=0.422) testosterone was found. However, we only observed positive correlations between leptin and estradiol (p=0.043). Conclusions: there is a strong correlation between leptin levels, BMI and estradiol levels in women with PCOS.