bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of Fat Storage between Fischer 344 and Obesity‐Resistant Lou/C Rats Fed Different Diets**
Authors: Héliès Jean‐Marie , Diane Abdoulaye , Langlois Allan , Larue‐Achagiotis Christiane , Fromentin Gilles , Tomé Daniel , Mormède Pierre , Marissal‐Arvy Nathalie 
Published: April 2008

AbstractObjective: We aimed to characterize further the Lou/C (LOU) and Fischer 344 (F344) rat strains for nutritional traits to validate their use as contrasting strains for molecular genetic studies.Research Methods and Procedures: Five batches of LOU and F344 rats were used to measure caloric intake, weight gain, and body composition when fed a chow diet, a self‐selection diet (together with the study of preferences for macronutrients), hypercaloric diets, and a chow diet in a cold environment.Results: Despite a higher caloric intake when fed a chow diet, LOU rats showed a lower weight gain, final body weight, and percentage of fat tissue, together with a higher percentage of carcass weight, than F344 rats. When fed a self‐selection diet, LOU males ingested less protein and more fat than F344 males, and the reverse was observed for females. In this condition, feed efficiency was reduced in LOU but increased in F344 rats compared with the chow diet. Diet‐induced obesity was observed in F344 rats but not in LOU rats fed hypercaloric diets. In a cold environment, both LOU and F344 rats displayed an increased percentage of brown adipose tissue compared with control groups, together with a higher caloric intake.Discussion: The study shows robust nutritional differences between the LOU rat, a lean strain with a low feed efficiency and resistant to diet‐induced obesity, and the contrasting F344 rat strain. It also shows the interest in these strains for studying the genetic components of resistance to obesity.
Criteria for Patient Selection and Multidisciplinary Evaluation and Treatment of the Weight Loss Surgery Patient
Authors: Saltzman Edward , Anderson Wendy , Apovian Caroline M. , Boulton Hannah , Chamberlain Alison , Cullum‐Dugan Diana , Cummings Susan , Hatchigian Edward , Hodges Barbara , Keroack Christopher R. , Pettus Mark , Thomason Phyllis , Veglia Linda , Young Lorraine S. 
Published: April 2008

AbstractObjective: To provide evidence‐based guidelines for patient selection and to recommend the medical and nutritional aspects of multidisciplinary care required to minimize perioperative and postoperative risks in patients with severe obesity who undergo weight loss surgery (WLS).Research Methods and Procedures: Members of the Multidisciplinary Care Task Group conducted searches of MEDLINE and PubMed for articles related to WLS in general and medical and nutritional care in particular. Pertinent abstracts and literature were reviewed for references. Multiple searches were carried out for various aspects of multidisciplinary care published between 1980 and 2004. A total of 3000 abstracts were identified; 242 were reviewed in detail.Results: We recommended multidisciplinary screening of WLS patients to ensure appropriate selection; preoperative assessment for cardiovascular, pulmonary, gastrointestinal, endocrine, and other obesity‐related diseases associated with increased risk for complications or mortality; preoperative weight loss and cessation of smoking; perioperative prophylaxis for deep vein thrombosis and pulmonary embolism (PE); preoperative and postoperative education and counseling by a registered dietitian; and a well‐defined postsurgical diet progression.Discussion: Obesity‐related diseases are often undiagnosed before WLS, putting patients at increased risk for complications and/or early mortality. Multidisciplinary assessment and care to minimize short‐ and long‐term risks include: comprehensive medical screening; appropriate pre‐, peri‐, and postoperative preparation; collaboration with multiple patient care disciplines (e.g., anesthesiology, pulmonary medicine, cardiology, and psychology); and long‐term nutrition education/counseling.
Best Practice Guidelines on Informed Consent for Weight Loss Surgery Patients
Authors: Sabin James , Fanelli Robert , Flaherty Helen , Istfan Nawfal , Mariner Wendy , Barnes Janet Nally , Pratt Janey S.A. , Rossi Laura , Samour Patricia 
Published: April 2008

AbstractObjective: To provide evidence‐based guidelines on informed consent and the education that underlies it for legally competent, severely obese weight loss surgery (WLS) patients.Research Methods and Procedures: We conducted a systematic review of the scientific literature published on MEDLINE between 1984 and 2004. Three articles focused on informed consent for WLS; none was based on empirical studies. We summarized each paper and assigned evidence categories according to a grading system derived from established evidence‐based models. We also relied on informed consent and educational materials from six WLS programs in Massachusetts. All evidence is Category D. Recommendations were based on a review of the available literature, informed consent materials from WLS programs, and expert opinion.Results: This Task Group found that the informed consent process contributes to long‐term outcome in multiple ways but is governed by limited legal requirements. We focused our report on the legal and ethical issues related to informed consent, i.e., disclosure vs. comprehension. Recommendations centered on the importance of assessing patient comprehension of informed consent materials, the content of those materials, and the use of active teaching/learning techniques to promote understanding.Discussion: Although demonstrated comprehension is not a legal requirement for informed consent in Massachusetts or other states, the members of this Task Group found that the best interests of WLS patients, providers, and facilities are served when clinicians engage patients in active learning and collaborative decision making.
Best Practice Recommendations for Anesthetic Perioperative Care and Pain Management in Weight Loss Surgery
Authors: Schumann Roman , Jones Stephanie B. , Ortiz Vilma E. , Connor Kathleen , Pulai Istvan , Ozawa Edwin T. , Harvey Alan M. , Carr Daniel B. 
Published: April 2008

AbstractObjective: To develop evidence‐based recommendations that optimize the safety and efficacy of perioperative anesthetic care and pain management in weight loss surgery (WLS) patients.Research Methods and Procedures: This Task Group examined the scientific literature on anesthetic perioperative care and pain management published in MEDLINE from January 1994 to March 2004. We also reviewed additional data from other sources (e.g., book chapters). The search yielded 195 abstracts, of which 35 references were reviewed in detail. Task Group consensus was used to provide recommendations when evidence in the literature was insufficient.Results: We developed anesthesia practice and patient safety advisory recommendations for preoperative evaluation, intraoperative management, and postoperative care and pain management of WLS patients. We also provided suggestions related to medical error reduction and systems improvements, credentialing, and future research.Discussion: Obesity‐related comorbidities including obstructive sleep apnea place WLS patients at increased risk for complications perioperatively. Regarding perioperative safety and outcomes, conclusive evidence beyond the accepted standard of care in the reviewed literature is limited. Few reports specifically address the perioperative needs of severely obese patients. In this advisory, we synthesize current knowledge and make best practice recommendations for perioperative care and pain management in WLS patients. These recommendations require periodic review as further medical knowledge and evidence evolve.
Best Practices for Perioperative Nursing Care for Weight Loss Surgery Patients
Authors: Mulligan Ann , Young Lorraine S. , Randall Sheldon , Raiano Carol , Velardo Priscilla , Breen Catherine , Bushee Laura 
Published: April 2008

AbstractObjective: To describe the unique nursing responsibilities involved in providing nursing care to severely obese weight loss surgery patients and to develop evidence‐based guidelines for safe patient care.Research Methods and Procedures: We performed a systematic review of the scientific literature using MEDLINE and CINAHL. A specific search of nursing journals from 1985 to 2004 identified 134 articles; 16 were found to be pertinent. These were reviewed in detail and used in the context of this report. The quality of the evidence was graded according to a system derived from established evidence‐based models. Recommendations were developed from published evidence and expert opinion.Results: This Task Group found that safe and competent nursing care requires assessment of, and provision for, the complex physical and psychological needs of weight loss surgery patients. We developed evidence‐based guidelines for preoperative, perioperative, and postoperative care that address risk factors unique to severely obese patients. We also addressed issues related to the use of proper body mechanics and positioning to avoid on‐the‐job injury to nursing staff.Discussion: We found that patient safety is best served when nurses are specifically trained to deal with the physical, medical, and psychosocial needs of severely obese patients and when they play an integral role in the multidisciplinary healthcare team. This role should start with a patient's first contact with the system and continue through discharge and follow‐up. Special attention needs to be paid to the widespread bias and discrimination that severely obese individuals often experience.
Best Practice Guidelines in Pediatric/Adolescent Weight Loss Surgery
Authors: Apovian Caroline M. , Baker Christina , Ludwig David S. , Hoppin Alison G. , Hsu George , Lenders Carine , Pratt Janey S.A. , Forse R. Armour , O'Brien Adrienne , Tarnoff Michael 
Published: April 2008

AbstractObjective: To establish evidence‐based guidelines for best practices in pediatric/adolescent weight loss surgery (WLS).Research Methods and Procedures: We carried out a systematic search of English‐language literature in MEDLINE on WLS performed on children and adolescents. Key words were used to narrow the field for a selective review of abstracts. Data were extracted, and evidence categories were assigned according to a grading system based on established evidence‐based models. Eight pertinent case series, published between 1980 and 2004, were identified and reviewed. These data were supplemented with expert opinions and literature on WLS in adults.Results: Recommendations focused on patient safety, reduction of medical errors, systems improvements, credentialing, and future research. We developed evidence‐based criteria for eligibility, assessment, treatment, and follow‐up; recommended surgical procedures based on the best available evidence; and established minimum guideline requirements for data collection.Discussion: Lack of adequate data and gaps in knowledge were cited as important reasons for caution. Physiological status, comprehensive screening of patients and their families, and required education and counseling were identified as key factors in assessing eligibility for surgery. Data collection and peer review were also identified as important issues in the delivery of best practice care.
Data Collection Systems for Weight Loss Surgery: An Evidence‐Based Assessment
Authors: Hutter Matthew M. , Crane Martin , Keenan Maureen , Snow Roger L. , Schneider Benjamin E. , Cella Robert J. 
Published: April 2008

AbstractObjective: To evaluate the existence and efficacy of data collection systems for weight loss surgery (WLS) and establish evidence‐based guidelines for the development of a statewide WLS registry in Massachusetts.Research Methods and Procedures: We conducted two systematic searches of English language literature in MEDLINE. The first was on data collection registries related to WLS; the second was an expanded search encompassing other surgical fields (e.g., cardiac and thoracic surgery) and registries (i.e., cancer). Fourteen articles were found to be pertinent. Data were extracted, and evidence categories were assigned according to a grading system based on established evidence‐based models. Recommendations were derived from these literature reviews and expert opinion.Results: This task group found that there are no standardized data collection systems for WLS in Massachusetts (or any other states) and no mandated reporting of WLS‐specific outcomes. We described existing WLS databases and systems in other surgical fields. Recommendations focused on the importance and feasibility of data collection for WLS and the need to conduct a pilot study and explore options for creating a statewide WLS database.Discussion: A statewide WLS data collection system would optimize patient care by enabling the collection, analysis, and dissemination of best practice data. A broad‐based effort is needed to meet challenges involved in defining and implementing such a system.
Changes in Insulin Secretion and Glucose Metabolism Induced by Dexamethasone in Lean and Obese Females
Authors: Besse Christine , Nicod Nathalie , Tappy Luc 
Published: April 2008

AbstractObjective: In healthy lean individuals, changes in insulin sensitivity occurring as a consequence of a 2‐day dexamethasone administration are compensated for by changes in insulin secretion, allowing glucose homeostasis to be maintained. This study evaluated the changes in glucose metabolism and insulin secretion induced by short‐term dexamethasone administration in obese women.Research Methods and Procedures: Eleven obese women with normal glucose tolerance were studied on two occasions, without and after 2 days of low‐dose dexamethasone administration. A two‐step hyperglycemic clamp (7.5 and 10 mM glucose) with 6, 6 2H2 glucose was used to assess insulin secretion and whole body glucose metabolism. Results were compared with those obtained in a group of eight lean women.Results: Without dexamethasone, obese women had higher plasma insulin concentrations in the fasting state, during the first phase of insulin secretion, and at the two hyperglycemic plateaus. However, they had normal whole body glucose metabolism compared with lean women, indicating adequate compensation. After dexamethasone, obese women had a 66% to 92% increase in plasma insulin concentrations but a 15.4% decrease in whole body glucose disposal. This contrasted with lean women, who had a 91% to 113% increase in plasma insulin concentrations, with no change in whole body glucose disposal.Discussion: Dexamethasone administration led to a significant reduction in whole body glucose disposal at fixed glycemia in obese but not lean women. This indicates that obese women are unable to increase their insulin secretion appropriately.
Pediatricians’ Own Weight: Self‐perception, Misclassification, and Ease of Counseling
Authors: Perrin Eliana M. , Flower Kori B. , Ammerman Alice S. 
Published: April 2008

AbstractObjectives: Pediatricians underdiagnose overweight and feel ineffective at counseling. Given the relationship between physicians’ health and health habits and counseling behaviors, we sought to determine the 1) percentage of pediatricians who are overweight; 2) accuracy of pediatricians’ own weight status classification; and 3) relationship between weight self‐perception and perceived ease of obesity counseling.Research Methods and Procedures: This study was a cross‐sectional, mail survey of North Carolina pediatricians that queried about their weight status and ease of counseling. Accuracy of pediatricians’ self‐classification of weight status was compared with BMIs derived from self‐reported height and weight. Using logistic regression, controlling for potential confounding variables, we examined the association between weight perception and ease of counseling.Results: The unadjusted response rate was 62%, and the adjusted response rate was 71% (n = 355). Nearly one‐half (49%) of overweight pediatricians did not identify themselves as such. Men had greater adjusted odds of misclassifying overweight than women [odds ratio (OR), 3.61; 95% confidence interval (CI) = 1.81, 7.21]. Self‐classified “thin” pediatricians had nearly six times the odds of reporting more counseling difficulty as a result of their weight than “average” weight pediatricians (OR = 5.69; 95% CI = 2.30, 14.1), and self‐identified “overweight” pediatricians reported nearly four times as great counseling difficulty as “average” weight physicians (OR = 3.84; 95% CI = 1.11, 13.3), after adjustment for self‐reported BMI weight status and other potential confounders.Discussion: The roles that physician weight misclassification and self‐perception potentially play in influencing rates of obesity counseling warrant further research.
Knee Structural Alteration and BMI: A Cross‐sectional Study
Authors: Ding Changhai , Cicuttini Flavia , Scott Fiona , Cooley Helen , Jones Graeme 
Published: April 2008

AbstractObjective: To describe the associations among BMI, knee cartilage morphology, and bone size in adults.Research Methods and Procedures: A cross‐sectional convenience sample of 372 male and female subjects (mean age, 45 years; range, 26 to 61 years) was studied. Knee articular cartilage defect score (0 to 4) and prevalence (defect score of ≥2), volume, and thickness, as well as bone surface area and/or volume, were determined at the patellar, tibial, and femoral sites using T1‐weighted fat‐saturation magnetic resonance imaging. Height, weight, BMI, and radiographic osteoarthritis were measured by standard protocols.Results: In multivariate analysis in the whole group, BMI was significantly associated with knee cartilage defect scores (β: +0.016/kg/m2 to +0.083/kg/m2, all p < 0.05) and prevalence (odds ratio: 1.05 to 1.12/kg/m2, all p < 0.05 except for the lateral tibiofemoral compartment). In addition, BMI was negatively associated with patellar cartilage thickness only (β = −0.021 mm/kg/m2; p = 0.039) and was positively associated with tibial bone area (medial: β = +7.1 mm2/kg/m2, p = 0.001; lateral: β = +3.2 mm2/kg/m2, p = 0.037). Those who were obese also had higher knee cartilage defect severity and prevalence and larger medial tibial bone area but no significant change in cartilage volume or thickness compared with those of normal weight.Discussion: This study suggests that knee cartilage defects and tibial bone enlargement are the main structural changes associated with increasing BMI particularly in women. Preventing these changes may prevent knee osteoarthritis in overweight and obese subjects.
Additive Interactions of Maternal Prepregnancy BMI and Breast‐feeding on Childhood Overweight
Authors: Li Chaoyang , Kaur Harsohena , Choi Won S. , Huang Terry T.‐K. , Lee Rebecca E. , Ahluwalia Jasjit S. 
Published: April 2008

AbstractObjective: To examine the interactions of maternal prepregnancy BMI and breast‐feeding on the risk of overweight among children 2 to 14 years of age.Research Methods and Procedures: The 1996 National Longitudinal Survey of Youth, Child and Young Adult data in the United States were analyzed (n = 2636). The weighted sample represented 51.3% boys, 78.0% whites, 15.0% blacks, and 7.0% Hispanics. Childhood overweight was defined as BMI ≥95th percentile for age and sex. Maternal prepregnancy obesity was determined as BMI ≥30 kg/m2. The duration of breast‐feeding was measured as the weeks of age from birth when breast‐feeding ended.Results: After adjusting for potential confounders, children whose mothers were obese before pregnancy were at a greater risk of becoming overweight [adjusted odds ratio (OR), 4.1; 95% confidence interval (CI), 2.6, 6.4] than children whose mothers had normal BMI (<25 kg/m2; p < 0.001 for linear trend). Breast‐feeding for ≥4 months was associated with a lower risk of childhood overweight (OR, 0.6; 95% CI, 0.4, 1.0; p = 0.06 for linear trend). The additive interaction between maternal prepregnancy obesity and lack of breast‐feeding was detected (p < 0.05), such that children whose mothers were obese and who were never breast‐fed had the greatest risk of becoming overweight (OR, 6.1; 95% CI, 2.9, 13.1).Discussion: The combination of maternal prepregnancy obesity and lack of breast‐feeding may be associated with a greater risk of childhood overweight. Special attention may be needed for children with obese mothers and lack of breast‐feeding in developing childhood obesity intervention programs.
Obesity and the Use of Health Care Services
Authors: Bertakis Klea D. , Azari Rahman 
Published: April 2008

AbstractObjective: This study investigated differences in the use of health care services and associated costs between obese and nonobese patients.Research Methods and Procedures: New adult patients (N = 509) were randomly assigned to primary care physicians at a university medical center. Their use of medical services and related charges was monitored for 1 year. Data collected included sociodemographics, self‐reported health status using the Medical Outcomes Study Short Form‐36, evaluation for depression using the Beck Depression Index, and measured height and weight to calculate BMI.Results: Obese patients included a significantly higher percentage of women and had higher mean age, lower mean education, lower mean health status, and higher mean Beck Depression Index scores. Obese patients had a significantly higher mean number of visits to both primary care (p = 0.0005) and specialty care clinics (p = 0.0006), and a higher mean number of diagnostic services (p < 0.0001). Obese patients also had significantly higher primary care (p = 0.0058), specialty clinic (p = 0.0062), emergency department (p = 0.0484), hospitalization (p = 0.0485), diagnostic services (p = 0.0021), and total charges (p = 0.0033). Controlling for health status, depression, age, education, income, and sex, obesity was significantly related to the use of primary care (p = 0.0364) and diagnostic services (p = 0.0075). There was no statistically significant relationship between obesity and medical expenditures in any of the five categories or for total charges.Discussion: Obesity is a chronic condition requiring long‐term management, with an emphasis on prevention. If this critical health issue is not appropriately addressed, the prevalence of obesity and obesity‐related diseases will continue to grow, resulting in escalating use of health care services.