Abnormal BMI Research Articles

Trace Element Levels and Socio-Demography of Pre-Teen Nigerians with Homozygous Sickle Cell Disorder

Objectives: Homozygous sickle cell disorder (SCD) children are known to have abnormal anthropometric parameters which mostly have been linked with altered zinc status. Alteration in trace element status which occurs from interaction between essential and non-essential elements has not been well studied in SCD. Therefore, the aim of the study is to relate concentrations of Zn, Cd, and Pb with anthropometric parameters. Moreover, it will be established if correlation (interaction) exists between zinc and these two non-essential elements.
 Methods: Twenty-seven SCD patients and 25 age and sex-matched children with hemoglobin genotype HbAA served as test and control groups respectively. Anthropometric parameters and information on demography, dietary zinc status and socio-economic status were obtained. The plasma and red cells obtained from 5 mL of blood were used to determine zinc and heavy metal (Pb, Cd) levels respectively by atomic absorption spectrophotometry. Data were analyzed using Student`s t-test, Chi- square test, and Pearson’s correlation coefficient. P< 0.05 was considered significant.
 Results: There were significant differences in the mean values of mid-upper-arm circumference, weight and BMI. On the other hand, there were no significant differences in mean values of head circumference, height and the trace elements in test and control groups. No association between trace elements and BMI as well as between dietary zinc content and socio-economic status was observed.
 Conclusion: the result of the study suggests there is no correlation between the toxic metals and zinc, and it seems that toxic metals play no role in abnormal BMI that is a common feature of SCD.

Stage 2 Hypertension and Electrocardiogram Abnormality: Evaluating the Risk Factors of Cardiovascular Diseases in Nigeria.

This study evaluated the status of stage 2 hypertension, abnormal ECG and their co-occurrence as possible risk factors of cardiovascular disease and their predictors in a Nigerian University population. A total of 717 subjects participated in this study. Blood pressure (BP), resting electrocardiogram (ECG) and other clinical parameters were measured and categorised according to standard organisational guidelines. Bivariate correlation and multivariate logistic regression model were used to determine covariates and clinical parameter association at a 95 % significant level. Stage 2 hypertension and abnormal ECG respectively occurred in 264 (37 %) and 217 (39.2 %) subjects, with co-occurrence and abnormal BMI in 85 (11.8 %) and 459 (64.8%) subjects, respectively. Sex (p = 0.001) and occupation (p = 0.022) were independently associated with abnormal BP and ECG, respectively, while age was independently associated (p < 0.001) with abnormal BP, ECG and co-occurrence of these conditions. Predictors of stage 2 hypertension and abnormal ECG were sex (adjusted odds ratio [aOR] = 1.652, 95 % CI 1.097-2.488) and occupation (aOR = 0.411, 95 % CI 0.217-0.779), respectively, while age was a predictor for stage 2 hypertension (aOR = 0.065, 95 % CI 0.015-0.283), abnormal ECG (aOR = 0.137, 95 % CI 0.053-0.351) and their co-occurrence (aOR = 0.039, 95 % CI 0.014-0.113). This study shows prevalence rates of these risk factors are on the increase. It also suggests that ECG abnormality is a public health issue among stage 2 hypertensive patients that must be monitored. Therefore, appropriate interventions that prevent and control hypertension and identified risk factors should be put in place in addition to lifestyle changes, regular screening and surveillance.

Clinical outcomes of dental treatment under general anesthesia and its effects on the caries activity and body growth of children: a 2-year retrospective study.

To analyze clinical outcomes of dental treatment under general anesthesia (DGA) and its effects on children's caries activity status and body growth within 2years after the treatment. The case data and 2-year follow-up records of children who underwent DGA from February 2017 to February 2018 were collected and analyzed. The general characteristics of the sample, the success rates of treatment procedures, the caries recurrence rate, the caries activity test scores, and the BMI of all the children were described. The caries activity levels between children with and without caries recurrence at 24months after DGA were compared before and after DGA to explore the relationship between caries activity level and caries recurrence. The correlation between BMI level and caries recurrence was explored using Cox regression analysis. A total of 94 children consisting of 46 boys and 48 girls were included in this study. The average dmft score before DGA was 13.90. Within 2years after the treatment, composite fillings and strip crowns of the anterior teeth achieved similar success rates, around 90%; SSCs showed a similar success rate to composite fillings of posterior teeth (P = 1.000); the clinical success rate of pulpectomy was 90.43%. All the children showed no caries relapse at 1month after DGA. The number of children with caries relapse at 6-, 12-, and 24-month post-treatment was 24 (25.53%), 35 (37.23%), and 53 (56.38%), respectively. The caries activity scores at each follow-up were significantly lower than those before the treatment (P < 0.0001). Children with caries relapse within 2years after DGA showed no significantly different caries activity scores than children without caries relapse before and after the treatment. The proportion of children with normal BMI at 12months after DGA was significantly higher than that before DGA (P = 0.007), and the difference was still very significant at 24months after DGA (P < 0.0001). Statistical results showed a correlation between BMI level before DGA and caries recurrence (P < 0.001). Dental treatment under general anesthesia achieves acceptable clinical outcomes in this study. Children's caries activity scores decrease significantly. Low or high BMI levels before DGA drift towards normal after the treatment. Acceptable outcomes are achieved within 2years after dental treatment under general anesthesia. However, children with abnormal BMI before the treatment tend to have caries relapse.

The Prevalence of Coagulopathy and Associated Factors Among Adult Type II Diabetes Mellitus Patients Attending the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia.

IntroductionDiabetes mellitus is a heterogeneous disorder of metabolism which results hyperglycemic-related atherothrombotic complications. These complications are the leading cause of death in diabetes mellitus patients. Therefore, this study was aimed to determine the prevalence of coagulopathy and associated factors among adult type II diabetes mellitus patients attending at University of Gondar comprehensive specialized hospital.MethodsA facility-based cross-sectional study was conducted among 357 study participants. A questionnaire and a data collection sheet were used to collect the sociodemographic and clinical data, respectively. About 6mL of venous blood samples were collected for coagulation tests and complete blood count. For prolonged coagulation tests, a mixing test was performed. Data were entered into EpiInfo and exported to SPSS for statistical analysis. Then, descriptive statistics were done. A binary and multivariable logistic regression model was used to identify the associated factors. P-value <0.05 was considered as statistically significant.ResultsIn this study, 357 study participants were included. Of them, 52.1% (186) and 80.7% (288) were females and urban residences, respectively. The prevalence of coagulopathy was 26.6% (95% CI: 22.1, 31.5%). Out of this, 12.3% and 8.7% showed shortened PT and aPTT, respectively. In addition, the prevalence of prolonged PT and aPTT were 5.6% and 3.9%, respectively. From the prolonged PT and aPTT, the prevalence of factor deficiency was 95% and 92.8%, respectively. Being female (AOR = 2.06; 95% CI: 1.11–3.85%), abnormal BMI (AOR = 1.94; 95% CI: 1.08–3.50), and educational status of high school (AOR = 0.26; 95% CI: 0.10–0.83%) were significantly associated with hypercoagulation.ConclusionCoagulopathy is an important public health problem among type II diabetes mellitus patients. Being female and having abnormal BMI were associated with hypercoagulation. Therefore, regular monitoring of coagulation parameters is vital to reduce the consequence of coagulopathy.

Awareness and perceived barriers in practicing healthy living to prevent hypertension among young adults in Malaysia

Objective: To investigate the knowledge, attitude, and practice levels and perceived barriers towards healthy living to prevent hypertension among young adults in Malaysia.Methods: Adults aged 18-25 years reside in Malaysia were recruited via convenience sampling. Sociodemographic characteristics, medical knowledge on hypertension (K1), knowledge (K), attitude (A), practice (P) and perceived barriers in practising healthy living to prevent hypertension were assessed. Average scores were categorised into good (80%-100%), upper-moderate (70%-79%), lower-moderate (60%-69%) and poor (<60%). Multivariate analysis was performed to test the difference and relationship of variables. Pearson correlation test was used to test the association of two continuous variables.Results: A total of 1 218 respondents participated in this survey. The mean score of K1 was 54.1%, while the knowledge, attitude, and practice towards healthy living were 82.7%, 78.2%and 68.5% respectively. The prevalence of high salt intake, high fat intakes, low fibre intake, sedentary lifestyle and lack of annual health screening was 83.2%, 81.4%, 70.3%, and 73.2%, respectively. Abnormal BMI was associated with low P scores, while lower socio-economic status, unawareness of self-blood pressure reading and those without family history of hypertension were associated with lower scores in K1, K, A, and P. K1, K, A and P are significantly inter-related. The main perceived barriers included self-proclaimed good fit status, frequent consumption of out-of-home food, and addiction to high salt/fat food.Conclusions: The national strategies for health management should be prioritized in reducing salt and fat, promoting annual health screening, physical activities and fibre intake in this age group.

Associations between Bodyweight and Clinical Outcome in Patients Post-Fontan Procedure: A Systematic Review

Background: Patients born with a single ventricle circulation commonly experience growth failure in early life, which is associated with adverse outcomes in infancy. However, associations between bodyweight or weight trajectory and clinical outcome post-Fontan procedure are yet to be determined. Methods: On the 1st of July 2021, a systematic review was performed in MEDLINE, EMBASE, the Cochrane Library, and Scopus of studies of patients with clinical outcome data post-Fontan procedure and association with bodyweight. Quality of studies was evaluated by Newcastle–Ottawa scale for cohort studies and Joanna Briggs Institute tool for cross-sectional studies. Results: Of 527 studies that underwent title and abstract screening, 15 were selected for final review. An increased risk of adverse post-Fontan outcomes was found for low weight patients, consistent with findings in infants. Whilst there is some evidence to suggest increased mortality in overweight adult patients, studies are conflicting as to whether overweight status is associated with increased heart failure. Increased BMI is associated with diminished exercise capacity and deceased physiological functioning. Negative weight trajectory is associated with adverse outcomes in the peri-Fontan period, whereas a positive weight trajectory is associated with increased Fontan failure in adulthood. Abnormal BMI (high or low) is associated with increased heart failure and poorer performance in quality-of-life scores. Conclusions: Bodyweight is a modifiable risk factor for poor clinical outcome in patients with a single ventricle circulation. Recognizing associations between bodyweight and Fontan pathophysiology may help to define patient-centered exercise and diet interventions that minimize patient morbidity and mortality.

Abstract 9331: Adverse Maternal Fetal Environment Partially Mediates Disparate Outcomes in Hispanic and Non Hispanic Black Infants With Critical Congenital Heart Disease

Introduction: Etiologies of racial and ethnic disparities in critical congenital heart disease (CCHD) outcomes are not fully understood. We sought to determine whether differential exposure to an adverse maternal fetal environment (AMFE) partially explains disparate outcomes. Methods: We included infants with CCHD in a population-based administrative California database (2011-2017). Primary exposure was race/ethnicity. Primary mediator was AMFE, defined as maternal metabolic syndrome (MMS: any diabetes, abnormal BMI, or hyperlipidemia) or maternal placental syndrome (MPS: pre-eclampsia/ eclampsia, gestational hypertension, or placental abruption). Outcomes: days alive out of hospital in first year of life (DAOOH); composite of 1-year mortality or severe morbidity (e.g., ECMO, cardiac arrest, BPD, etc.). Mediation analyses (CCHD severity-adjusted) determined % contribution to outcome for each mediator on pathways between race/ethnicity and outcomes. Results: Included were 2,747 Non-Hispanic (NH) White [REF group], 5,244 Hispanic, and 625 NH Black infants. Hispanic and NH Black infants had higher risk for composite outcome (crude OR, 1.18; crude OR, 1.25 respectively) and fewer DAOOH (-6 &amp; -12 days, respectively). Relative to NH White infants (MMS 28%; MPS 12%), Hispanic infants had higher MMS exposure (43%, OR, 1.89), while NH Black infants had higher MMS (44%, OR, 1.97) &amp; MPS exposure (18%, OR, 1.66). Both MMS exposure (OR, 1.21) and MPS exposure (OR 1.56) were related to composite outcome and fewer DAOOH (-25 &amp; -16 days, respectively). AMFE explained 25% of relationship between NH Black race and composite outcome, and 18% of relationship between Hispanic ethnicity and composite outcome. AMFE explained 16% (NH Black race) and 21% (Hispanic ethnicity) of the association with DAOOH (Table). Conclusions: Increased exposure to AMFE contributes to disparate outcomes in NH Black and Hispanic infants with CCHD. This novel finding merits clinical attention.

The Role of Serum Protein, Haemoglobin, and BMI as Predictors of Postoperative Morbidity and Mortality in Major Surgeries

Background: Pre-operative nutritional assessment is necessary for all patients undergoing surgery in order to prevent post-operative complications. This is because wound healing is an anabolic process requiring adequate protein stores in our body. Serum albumin levels has been found to be a reliable tool in assessing the nutrition when used along with two other parameters namely, haemoglobin and body mass index. It is necessary to provide adequate nutritional support prior surgery for better clinical outcome post-operatively.&#x0D; Objectives: To assess role of pre-operative serum albumin, haemoglobin and BMI as predictors of post-operative morbidity and mortality in major open surgeries.&#x0D; Materials and Methods:Sixty patients more than 18 years of age posted for elective and emergency laparotomy in the general surgery ward were included in this study based upon the inclusion and exclusion criteria. Detailed history, clinical examination, anthropometry and nutritional assessment with pre-operative serum albumin, haemoglobin and BMI were done. Post-surgery the details of the procedure, anaesthesia, duration of surgery, duration of hospital stay and early post-operative complications were studied. The patients were followed up till they got discharged from the hospital. The data obtained was analysed.&#x0D; Results: Maximum number of post-operative complications were in the age group of 40-59 years (36.66%). Seroma followed by surgical site infections were the two most common complications seen among the study population. Most of the complications were seen among patients with serum albumin &lt;3.5gm/dl. Patients with hypoalbuminemia and anaemia had a tendency to develop more post-operative complications and this was found to be statistically significant. (p value &lt;0.05) There was no significant relationship between abnormal BMI and complications in the present study.&#x0D; Conclusion: Pre-operative hypoalbuminemia &lt;3.5gm/dl and anaemia were found to be independent risk factors for post-operative morbidity and mortality in major open surgeries. Although the relationship between BMI and complications was not found to be statistically significant, it is also essential to stabilise BMI prior to surgery for better clinical outcome.

BACTERIAL VAGINOSIS ASSOCIATED WITH THE ABNORMAL BODY MASS INDEX

AbstractBackground: Based on data in RSUD Dr. Soetomo Surabaya, showed that during the 2018 period, bacterial vaginosis was among the top 10 most diseases. One risk factor for bacterial vaginosis is still controversial is the body mass index. The purpose of this study was to determine the association between the incidence of bacterial vaginosis with body mass index in RSUD Dr. Soetomo. Method: The research data used secondary data. This research method was cross sectional with observational analytic research design. The total samples were 158 patients, according to inclusion and exclusion criteria. The sampling technique used purposive sampling. Data analysis used chi square test. Results: The results 158 patients, divided into 79 (50%) patients with BV and 79 (50%) patients without BV. Based on BMI, 88 (55.7%) patients with normal BMI and 70 (44.3%) people with abnormal BMI. Patients with normal BMI were mostly not BV, that was 56 (63.6%) people and 32 (36.4%) people were BV positive. Patients with abnormal BMI were mostly BV, that was 47 (67.1%) people and 23 (32.9%) people did not BV. Statistical analysis showed there was a significant association between the incidence of bacterial vaginosis with body mass index (p= 0.001) with contingency coefficient 0.292. Conclusion: There is associated between the incidence of bacterial vaginosis with body mass index in RSUD Dr. Soetomo in 2017-2018.

Maternal Thinness and Obesity and Customized Fetal Weight Charts

Objective: The aim of the study was to determine if customized fetal growth charts developed excluding obese and underweight mothers (CC_(18.5–25)) are better than customized curves (CC) at identifying pregnancies at risk of perinatal morbidity. Material and Methods: Data from 20,331 infants were used to construct CC and from 11,604 for CC_(18.5–25), after excluding the cases with abnormal maternal BMI. The 2 models were applied to 27,507 newborns and the perinatal outcomes were compared between large for gestational age (LGA) or small for gestational age (SGA) according to each model. Logistic regression was used to calculate the OR of outcomes by the group, with gestational age (GA) as covariable. The confidence intervals of pH were calculated by analysis of covariance. Results: The rate of cesarean and cephalopelvic disproportion (CPD) were higher in LGA_{only by CC}_{_(18.5−25)} than in LGA_{only by CC}. In SGA_{only by CC}_{_(18.5−25)}, neonatal intensive care unit (NICU) and perinatal mortality rates were higher than in SGA_{only by CC}. Adverse outcomes rate was higher in LGA_{only by CC}_{_(18.5−25)} than in LGA_{only by CC} (21.6%; OR = 1.61, [1.34–193]) vs. (13.5%; OR = 0.84, [0.66–1.07]), and in SGA _{only by CC}_{_(18.5−25)} than in SGA_{only by CC} (9.6%; OR = 1.62, [1.25–2.10] vs. 6.3%; OR = 1.18, [0.85–1.66]). Conclusion: The use of CC_(18.5–25) allows a more accurate identification of LGA and SGA infants at risk of perinatal morbidity than conventional CC. This benefit increase and decrease, respectively, with GA.

Multiple sclerosis incidence rate in southern Iran: a Bayesian epidemiological study

BackgroundMultiple Sclerosis (MS) remains to be a public health challenge, due to its unknown biological mechanisms and clinical impacts on young people. The prevalence of this disease in Iran is reported to be 5.30 to 74.28 per 100,000-person. Because of high prevalence of this disease in Fars province, the purpose of this study was to assess the spatial pattern of MS incidence rate by modeling both the associations s of spatial dependence between neighboring regions and risk factors in a Bayesian Poisson model, which can lead to the improvement of health resource allocation decisions.MethodData from 5468 patients diagnosed with MS were collected, according to the McDonald’s criteria. New cases of MS were reported by the MS Society of Fars province from 1991 until 2016. The association between the percentage of people with low vitamin D intake, smoking, abnormal BMI and alcohol consumption in addition to spatial structure in a Bayesian spatio-temporal hierarchical model were used to determine the relative risk and trend of MS incidence rate in 29 counties of Fars province.ResultsCounty-level crude incidence rates ranged from 0.22 to 11.31 cases per 100,000-person population. The highest relative risk was estimated at 1.80 in the county of Shiraz, the capital of Fars province, while the lowest relative risk was estimated at 0.11 in Zarindasht county in southern of Fars. The percentages of vitamin D supplementation intake and smoking were significantly associated with the incidence rate of MS. The results showed that 1% increase in vitamin D supplementation intake is associated with 2% decrease in the risk of MS and 1% increase in smoking is associated with 16% increase in the risk of MS.ConclusionBayesian spatio-temporal analysis of MS incidence rate revealed that the trend in the south and south east of Fars province is less steep than the mean trend of this disease. The lower incidence rate was associated with a higher percentage of vitamin D supplementation intake and a lower percentage of smoking. Previous studies have also shown that smoking and low vitamin D, among all covariates or risk factors, might be associated with high incidence of MS.

The Impact of Common Epidemiological Factors on Gray and White Matter Volumes in Magnetic Resonance Imaging-Is Prevention of Brain Degeneration Possible?

Introduction: The aim of the study was to evaluate the impact of multiple risk factors (age, diabetes, hypertension, hyperlipidemia, BMI, smoking, alcohol) on the gray and white matter volumes as well as on the burden of white matter hyperintensities (WMH).Material and Methods: The study group consisted of 554 subjects (age range: 50–69 yrs, F/M: 367/187) recruited from the larger cohort of the Polish fraction of the Prospective Urban Rural Epidemiological (PURE) study. The participants answered questionnaires about their lifestyle, underwent physical and psychological examination (MoCA test), laboratory blood tests followed by brain MRI. Volumetric measurements of the total gray matter (GMvol), total white matter (WMvol) and WHM (WMHvol) normalized to the total intracranial volume were performed using the Computational Anatomy Toolbox 12 (CAT12) and Statistical Parametric Maps 12 (SPM12) based on 3D T1-weighted sequence. The influence of risk factors was assessed using multiple regression analysis before and after correction for multiple comparisons.Results: Older age was associated with lower GMvol and WMvol, and higher WMHvol (p < 0.001). Smaller GMvol volume was associated with higher WMHvol (p < 0.001). Higher WMHvol was associated with hypertension (p = 0.01) and less significantly with hyperlipidemia (only before correction p = 0.03). Diabetes, abnormal BMI, smoking and alcohol intake did not have any significant impact on GMvol, WMvol or WMHvol (p > 0.05). MoCA score was not influenced by any of the factors.Conclusions: Gray matter loss is strongly associated with the accumulation of WMH which seems to be potentially preventable by maintaining normal blood pressure and cholesterol levels.

Gender Differences in South Indians with Premature Coronary Artery Disease (&lt; 40 Years)—Insights from the PCAD Registry

AbstractIntroduction Coronary artery disease (CAD) follows a different pattern in women and men, more so in the young (&lt; 40 years). The gender differences in the risk factors, clinical presentation and diagnosis need to be understood, so that appropriate and timely treatment can be given.Objective The study contemplates to analyze the gender differences in the presence of major coronary risk factors, clinical presentation, diagnosis and immediate outcomes in patients who present with premature CAD (PCAD).Patients and Methods We evaluated 1,062 consecutive registry patients who presented with diagnosis of PCAD between 2018 to 2019 at our institution after satisfying the inclusion criteria.Results The study analyses 82 females and 980 males. The mean age of females was 35.4 ± 4.68 years and males was 34.2 ± 4.25 years. Males smoked more often (55.1%,p &lt; 0.001). Females more often had abnormal BMI (84.1%,p &lt; 0.001), increased waist-hip ratios (97.6%,p &lt; 0.001), diabetes (35.4%,p &lt; 0.001), dyslipidemia (17.1% vs. 11%) and hypertension (15.9% vs. 11.5%). STEMI was the most common presentation among males (80.4% vs. 71.9%). Majority of females (74.6%) presented 6 hours after index pain. NSTEMI was more common among females (20.7% vs. 16%). Single-vessel involvement was common in both sexes (84.1% in males and 85.2% in females). Obstructive CAD was less common in both groups.Conclusions Conventional risk factors play a major role for CAD in Indians. Smoking was common in males and metabolic syndrome in females. Also, females had a higher threshold for seeking treatment and referral. Measures have to be taken for early diagnosis and referral of females. Recanalized and thrombotic coronaries were common, indicating predominant thrombus burden in the young

Predicting factors for walking ability of postoperative patients with hemiarthroplasty at Wahidin Sudirohusodo Hospital in Makassar

Background: The ability to make early predictors in post-surgery includes health workers preparing patients for outpatient care. The purpose of this study is to determine the factors that influence the ability to walk postoperative hemiarthroplasty patients when patients are admitted. We hypnotized that age, sex, preoperative walking status, time interval between injury to surgery, preoperative hemoglobin level, muscle weakness, muscle atrophy, anxiety level and body mass index would be predictive factors for walking ability post hemiarthroplasty surgery.Method: An descriptive-analytic study with a cross sectional retrospective approach was conducted at the Wahidin Sudirohusodo Hospital in Makassar 2020. Patients with fractures of the proximal femur had undergone hemiarthroplasty surgery and were over 50 years of age at admission from September 2019 to October 2020. Bivariate and multivariate with logistic regression was usedResult: 39 samples according to inclusion criteria were analyzed. Muscle atrophy has a significant correlation with p = 0,04 (p&lt;0,05). Body mass index and muscle atrophy have the most dominant factors for predict walking ability post hemiarthroplasty (EXP (B) 7,282 &amp; EXP (B) 0,083) eventhough not significant statistically (p = 0,116 &amp; p = 0,073)Conclusion: The muscle atrophy variable in this study was the most significant factor in prediction walking ability post hemiarthroplasty surgery. Also, patient with normal BMI will encourage early walk after surgery better than abnormal BMI in the same muscle-wasting condition

The utility of deep brain stimulation surgery for treating eating disorders: A systematic review.

Background: Deep brain stimulation (DBS) has demonstrated preliminary success as a treatment for neuropsychological disorders including obsessive-compulsive disorder and substance use disorder. This systematic review aims to assess the use of DBS in treating eating disorders (EDs) to determine its utility and the extent of adverse effects.Methods: A PubMed search following PRISMA guidelines was executed to find studies encompassing DBS as a treatment of ED. Outcomes were extracted from the literature and summarized while a review of quality was also performed.Results: From a search yielding 299 publications, 11 studies published between 2010 and 2020 were found to fit the inclusion criteria. Out of 53 patients who began with an abnormal BMI before treatment, 22 patients (41.5%) achieved normal BMI on follow-up. Significant neuropsychological improvement was seen in most patients as measured by neuropsychiatric testing and questionnaires.Conclusion: DBS as a treatment for ED may result in significant objective and psychological benefits. Further studies should aim to increase the sample size, standardize follow-up protocol, and standardize the neuropsychiatric tests used to determine psychological and physiological benefits.

Associations of early pregnancy BMI with adverse pregnancy outcomes and infant neurocognitive development

The prevalence of overweight and obesity amongst reproductive women has been increasing worldwide. Our aim was to compare pregnancy outcomes and infant neurocognitive development by different BMI classifications and investigate whether early pregnancy BMI was associated with risks of adverse outcomes in a Southwest Chinese population. We analysed data from 1273 women enrolled in the Complex Lipids in Mothers and Babies (CLIMB) randomized controlled trial in Chongqing, China. Maternal BMI was classified as underweight, normal weight and overweight/obese according to the Chinese, WHO Asian, and WHO European standards. For the adverse pregnancy outcomes, after adjustment for potential confounders, an underweight BMI was associated with increased risk of small for gestational age (SGA) babies, and an overweight/obese BMI was associated with increased risk of maternal gestational diabetes mellitus (GDM), caesarean section (C-section), macrosomia and large for gestational age (LGA) babies. For infant neurocognitive development, 1017 mothers and their children participated; no significant differences were seen in the Mental Development Index (MDI) or the Psychomotor Development Index (PDI) between the three BMI groups. Our findings demonstrate that abnormal early pregnancy BMI were associated with increased risks of adverse pregnancy outcomes in Chinese women, while early pregnancy BMI had no significant influence on the infant neurocognitive development at 12 months of age.

Pre-operative serum albumin and body mass index as predictors of post-operative morbidity and mortality in perforation peritonitis secondary to peptic ulcer disease

Background: Peptic ulcer disease (PUD) affects 4 million people worldwide annually. Perforated peptic ulcer is a serious complication of PUD and patients often present with acute abdomen that carries high risk for morbidity and mortality. This is worsened in patients who are malnourished. The incidence of malnutrition is around 30% in patients with gastrointestinal disease and is frequently unrecognized. Albumin or prealbumin levels may help identify these patients. Obesity is also another cause for morbidity and has deleterious effects on wound healing. Therefore this study was carried out to assess if preoperative serum albumin and body mass index can be used as predictors of morbidity and mortality in patients with perforated peptic ulcers.Methods: 70 patients with peptic perforation peritonitis presented to the hospitals attached to Bangalore Medical College and Research Institute from November 2018 to May 2020 and were included in the study. Pre-operative Serum Albumin and BMI was noted and the patients were followed up for 30 days.Results: Mean albumin level in our study was 3.01. The patients with Serum Albumin &lt;3.5 g/dl have more complications compared to patients with &gt;3.5 g/dl. Morbidity and mortality increases with severity of hypoalbuminemia. This study was statistically significant with a p value &lt;0.05. In our study, we also found that patients with abnormal BMI have more complications than patients with normal BMI but it is statistically insignificant with a p value &gt;0.05.Conclusions: Serum albumin is a good indicator for predicting postoperative morbidity and mortality in peritonitis secondary to peptic ulcer disease.

Contribution of abnormal BMI to adverse health-related quality of life outcomes after a 52-week therapy in patients with SLE.

ObjectivesTo investigate whether abnormal BMI is associated with adverse health-related quality of life (HRQoL) outcome, including severe fatigue, after 52 weeks of standard therapy plus belimumab or placebo in patients with SLE.MethodsWe analysed data from the BLISS-52 (NCT00424476) and BLISS-76 (NCT00410384) trials (n = 1684). Adverse HRQoL was defined as SF-36 scores ≤ the fifth percentile in age- and sex-matched US population-based subjects, and FACIT-F scores <30. We compared BMI groups using the Pearson’s χ2 test, and assessed independence with multivariable logistic regression analysis.ResultsOverweight (BMI ≥25 kg/m2) and obese (BMI ≥30 kg/m2) patients showed increased likelihood to exhibit adverse SF-36 physical component summary (OR: 1.8; 95% CI: 1.4, 2.3; P <0.001 and OR: 2.4; 95% CI: 1.8, 3.2; P <0.001, respectively) and FACIT-F (OR: 1.3; 95% CI: 1.1, 1.6; P = 0.010 and OR: 1.5; 95% CI: 1.2, 2.0; P = 0.002, respectively) scores at week 52. Underweight was associated with adverse SF-36 mental component summary scores, also after adjustment for sex, ancestry, age, disease duration, disease activity, organ damage and prednisone dose during the study period (OR: 2.1; 95% CI: 1.2, 3.6; P = 0.007). Addition of belimumab to standard therapy independently protected against adverse SF-36 general health (OR: 0.8; 95% CI: 0.6, 1.0; P = 0.025) and FACIT-F < 30 (OR: 0.8; 95% CI: 0.6, 1.0; P = 0.018).ConclusionOverweight and obesity contributed to adverse physical and mental HRQoL outcomes after therapeutic intervention in SLE patients, and underweight contributed to adverse mental HRQoL outcome. A protective effect of belimumab against adverse general health and severe fatigue was implicated.

Nutritional Assessment in Patients with Early-Onset Autosomal Dominant Alzheimer's Disease Due to PSEN1- E280A Genetic Variant: A Cross-Sectional Study.

Weight loss and malnutrition are frequent findings in late-onset and sporadic presentations of Alzheimer's Disease (AD). However, less is known about nutritional status in Early-Onset Autosomal Dominant AD (EO-ADAD). To analyze the association between nutritional status and other clinical and sociodemographic characteristics in individuals with a genetic form of EO-ADAD. Cross-sectional study with 75 non-institutionalized participants from a cohort of Autosomal Dominant AD (13 with mild cognitive impairment and 61 with dementia, ages from 38 to 67 years) underwent a structured clinical assessment with emphasis on nutritional status. Primary outcome was nutritional status and it was measured using the Mini Nutritional Assessment (MNA). Patients were categorized according to MNA total score, as undernourished (MNA ≤23.5) and well-nourished (MNA ≥ 24). Sociodemographic and clinical variables identified as potential predictors or confounders of nutritional status were also collected. Undernourishment by MNA was present in 57.3% of the sample. Forty-two percent of participants had abnormal BMI values considered lower than 18.5 or higher than 24.9 kg/m2. Total BMI values were similar in well and undernourished patients (median 24.2 IQR 3.59 and median 23.9 IQR 4.42, respectively, p=0.476). When comparing well and undernourished groups, we found statistically significant differences for variables: severity of dementia (p=0.034), frailty (p=0.001), multimorbidity (p=0.035) and, polymedication (p=0.045). Neither adjusted logistic regression nor the Poisson regression showed that any clinical or sociodemographic variables explained undernourishment. Undernourishment was a frequent finding in our sample of EO-ADAD, especially in later stages of the disease. Patients with polymedication, multimorbidity, frailty and severe dementia show differences in their nutritional status with a tendency to be more frequently undernourished. Further studies with larger sample sizes are needed to establish this association.

Abstract 13468: Effect of Listing Criteria on Transplant Rate and Early Outcomes in Adults With Congenital Heart Disease

Introduction: Heart failure (HF) is the leading cause of death in adults with congenital heart disease (ACHD). Heart transplant (HT) is one of the few options for the treatment of advanced HF in this growing population. In October 2018, the United Network for Organ Sharing (UNOS) implemented a change in organ allocation criteria. The effect of this change on outcomes in ACHD patients (pts) after listing and transplant has not been evaluated. Hypothesis: Change in organ allocation criteria negatively impacts outcomes in ACHD patients. Methods: Data from the Scientific Registry of Transplant Recipients in pts age &gt; 18 years old listed for HT between Oct. 2016 and 0ct. 2019 and followed through March 2020 were analyzed. Pts were grouped by diagnosis (ACHD and non-ACHD) and by the time of listing (pre- and post-change in allocation criteria). Differences in comorbidities, outcomes while listed, and 1-year Kaplan Meier survival post-HT were compared among groups. For comparison, post-change criteria (status 1-6) were equated to pre-change criteria (status 1A, 1B, 2). Results: Over 3 years, 11,931 patients were listed for HT; 459 had a primary diagnosis of ACHD. ACHD was present in 279/7942 pts listed in the 2 years pre-change and 180/3989 pts in the year post-change. ACHD pts listed post-change were less likely to have a history of cardiac surgery (88% vs. 79%, p=0.01) and more likely to have an abnormal BMI (p=0.015) than ACHD pts pre-change. Post-change, ACHD pts were listed at a higher priority status compared to pre-change ACHD. (Figure). The proportion of pts transplanted with ACHD increased slightly pre- and post-change (3.7% vs. 4.1%). There was no difference in 1-year survival in ACHD pts transplanted pre- and post-change (Figure). Conclusions: Recent changes to the UNOS organ allocation policy increased the proportion of ACHD patients transplanted with no change in early post-HT survival.