Increase In Abdominal Circumference Research Articles

Ascitis en el paciente no cirrótico

Ascites, defined as the abnormal accumulation of fluid in the peritoneal cavity, is mainly due to cirrhosis and portal hypertension (PHT). However, in 20% of cases, it is not related to these diseases. Given its varied etiology, it is essential to study it in order to determine therapeutic management. The pathophysiology of non-cirrhotic ascites is not usually related to cirrhosis-associated PHT, and understanding these mechanisms facilitates the etiologic diagnosis. Symptoms include abdominal distension, weight gain, postprandial fullness, and even dyspnea. The physical examination may be normal in cases of very mild ascites. An increase in abdominal circumference may be identified in more advanced or severe cases and signs associated with the underlying disease may also appear. The International Club of Ascites classification categorizes it according to the amount and abdominal distension. The initial evaluation includes a medical history, physical examination, abdominal ultrasound, and ascitic fluid analysis. Diagnostic paracentesis is crucial for identifying the cause, analyzing characteristics of the fluid such as its appearance and content, especially the protein concentration and the serum ascites albumin gradient, which will allow differentiating the different causes. In Western countries, the most frequent causes are tumor and heart diseases while in developing countries, infectious diseases, especially tuberculosis, are the most prevalent.

Immature Ovarian Teratoma: A Case Report

We report the case of a 21-year-old single woman who presented with a high-grade immature teratoma revealed by a progressive increase in abdominal circumference, operated on immediately, and in whom we opted for active surveillance instead of adjuvant chemotherapy, Through this observation and the review of the literature, we will be able to discuss and discover what an immature teratoma is and mainly see the indications for adjuvant chemotherapy in high-grade cases, the type of chemotherapy and the modalities of active surveillance.

Protocolo diagnóstico y terapéutico de la flatulencia y la distensión abdominal recurrente

The sensation of abdominal bloating may be accompanied by the objectifiable sign of abdominal distension, which entails an increase in abdominal circumference. It is the most common digestive symptom and the second most common functional gastrointestinal disorder (FGID). Flatulence refers to the expulsion of excess and/or excessively foul-smelling gas through the rectum. There are no validated consensus guidelines for the diagnosis and treatment of abdominal distension. A good differential diagnosis is important. It should start with a comprehensive case history that provides guidance on its origin and allows for detecting alarm signs and ruling out underlying organic pathology. The study should be completed with additional tests guided by clinical suspicion and according to the severity of the case. In regard to treatment, targeted action can be taken when there is an organic cause. In its absence, it is necessary to focus on reducing factors that favor abdominal distension. There are hygienic and dietary recommendations, drug treatment, and visceromotor reflex reeducation.

Assessment of groundnut milk intake on nutritional status and some biochemical indices of normal rats

Groundnut milk also known as peanut milk, is an increasingly popular based beverage that serves as a potential alternative to cow’s milk. It is rich in essential nutrients such as proteins, healthy fats, vitamins, and minerals but limited research has explored its effect on nutritional status and biochemical indices. Therefore, this study assessed the effect of groundnut milk intake on nutritional status and some biochemical indices of Wistar rats. The Wistar rats (n=20), with body weight ≤50g were randomly divided into four groups of five rats each: Group 1 served as control. Groups 2, 3, and 4 were administered groundnut milk at daily doses of 247.2, 494.3, and 988.6 mg/kg respectively for eight weeks. Significant increase in abdominal circumference (P<0.005) between groups was observed. However, increase in the BMI and thoracic circumference between groups were insignificant (P>0.05). The levels of TC, TG and LDL-c were decreased significantly (P<0.005). However, HDL-c showed no significant difference. The decrease in atherogenic index, atherogenic coefficient and cardiac risk ratio indices were insignificant (P>0.05). The groundnut milk had no effect on serum total protein, adiponectin, and albumin while it increased serum leptin level significantly (P<0.005). The blood glucose levels of group 2, 3 and 4 were lowered dose-dependently (P<0.005) compared to the control. Groundnut milk showed no effect on liver and kidney-to-body weight ratio (P>0.05), but showed effect on heart-to-body weight ratio (P<0.005). The ratio of food and water intake of groups 2, 3, and 4 decreased significantly (P<0.005) compared to the control group. The results revealed that groundnut milk could play a positive role nutritionally and positively influence lipid profile, glucose, and leptin levels in a dose-related manner.

Use of Stent in Choledochocholedochostomy for Pediatric Liver Transplantation Secondary to Hepatoblastoma: A Case Report

BACKGROUND: Hepatoblastoma is a malignant tumor with an insidious clinical presentation, however, it is characterized by an increase in abdominal circumference. In addition, there is PRETEXT staging based on the degree of liver involvement, which ranges from I to IV, of these, for stage IV the treatment of choice is liver transplantation. In addition, the use of stents in the the choledocho – choledochostomy has been tried to reduce post-transplant complications, with variable results. THE CASE: A 18-month-old female with a diagnosis of PRETEXT IV hepatoblastoma and a history of receiving 11 cycles of chemotherapy (CTX) with SIOPEL-3HR scheme, subsequently initiates protocol to receive liver transplantation for being an ideal candidate and PRETEXT IV staging, received from a related living donor. During surgery, it was decided to place a biodegradable stent to perform the choledocho – choledochostomy. She also had hemorrhagic shock grade IV secondary to blood loss, which was successfully resolved. In her first two days post-transplantation she presented adequate flows by Doppler ultrasound and liver enzymes with a downward trend, which remained with the same trend, and she was discharged on day 26 post-transplantation. The following month, she received a cycle of adjuvant CTX with SIOPEL-3HR scheme, without complications. One month later she presented cholestasis and jaundice, so the stent was removed. Currently free of disease, functional graft, and adequate psychomotor development. CONCLUSION: Although the use of a stent was intended to prevent complications such as biliary obstruction, since it is the most feared complication during liver transplantation, this was not the case of the patient, so it could be considered that it continues to be a controversial technique. Also, the use of chemotherapy after transplantation is important to be free of disease since clinical studies have shown an increase in patient survival.

FRI220 Primary Bilateral Macronodular Adrenal Hyperplasia: A Rare Cause Of Cushing Syndrome

Abstract Disclosure: Y. Ortiz: None. A.M. Aviles Melendez: None. M.M. Mangual Garcia: None. J.M. Garcia-Mateo: None. Primary bilateral macronodular adrenal hyperplasia (PBMAH) is a highly heterogenous entity whose pathophysiology remains largely unclear, representing less than 2% of Cushing syndrome (CS) cases, which leads to a challenging diagnosis. Many patients have a mild clinical picture and remain undiagnosed until abdominal imaging for unrelated reasons reveals bilateral adrenal enlargement. Hereby, we describe the case of a patient presented with abdominal pain and clinical hypercortisolism due to PBMAH. Case of a 42-year-old female with past medical history of arterial hypertension, referred for evaluation due to bilateral adrenal masses found on abdominal CT scan performed after patient presented with abdominal discomfort. On initial evaluation, patient refers a 50 pounds weight gain, increase in abdominal circumference, muscle weakness and sudden onset of facial and abdominal hair growth. Physical examination reveals dorsocervical fat pad, proximal muscle weakness, moon facies, facial and abdominal hirsutism. Abdominal CT scan with adrenal protocol showed bilateral adrenal lesions, with largest measuring 2.8 and 3.9 cm on the left side, with attenuation of 16 and 7.4 Hounsfield units. The absolute and relative washouts for the first were 76.6% and 61.6%, and for the second 73.5% and 67.1%, both consistent with adenomas. Laboratory results showed late night salivary cortisol levels of 4.60 ug/dl and 4.80 ug/dl, values which may be high or even normal due to ineffective steroidogenesis on PBMAH. Other labs consisted of low dose 1 mg dexamethasone suppression test: 4.80 ug/dl, and ACTH level: 9.60 pg/ml, which confirms clinical hypercortisolism, indeterminate for ACTH-independent cause. Desmopressin test was not performed, since levels may not be fully suppressed in PBMAH due to ectopic production by adrenal glands, leading to an erroneous diagnosis of ACTH-dependent CS. DHEA level of 618 ug/dl can also be increased, which could lead to a diagnosis of adrenocortical carcinoma. Considering risk of recurrence, risk for adrenal insufficiency, and lower documented complications, unilateral left-sided adrenalectomy was chosen as the best surgical treatment, despite bilateral adrenalectomy being the gold standard for diagnosis. Surgical pathology report showed Adrenocortical adenoma with associated myelolipomatous foci of 7.5 cm in greatest dimension. Despite limited data regarding unilateral adrenalectomy, it appears to convey clinical and biochemical benefits in most cases. Initial remission reported reaches more than 90% with low risk of recurrence between 10-15%. Adrenal insufficiency, despite the presence of residual hyperplastic adrenal tissue, occurs in about one-third of patients and is usually transient. Our case is a great example of the importance of individualization of management options based on therapy benefits, and decreased risks of future complications. Presentation: Friday, June 16, 2023

68/m-Satiety, increase in abdominal circumference, abdominal pain : Preparation for the medical specialist examination: part45

68/m-Satiety, increase in abdominal circumference, abdominal pain : Preparation for the medical specialist examination: part45

Triponderal mass index and markers of metabolic risk in children and adolescents with obesity

Background and objectiveTriponderal mass index (TMI) would estimate excess adiposity better than body mass index (BMI), maintaining stable values during childhood. This work aims to determine the correlation between TMI and markers of metabolic risk as well as set values of TMI that are related to an increase of metabolic risk. Material and methodsMulticenter, observational, cross-sectional and prospective study in children under 14 years of age with obesity. Variables: age, sex, pubertal stage, weight, height, abdominal circumference, BMI, TMI, basal glucose and insulin, HOMA index, blood pressure, lipoprotein profile, transaminases and uric acid. BMI and TMI were expressed according to the values of the Barcelona Longitudinal Study. Statistical analysis was performed with the SPSS® program. Results199 patients (50.3% male), age 11.08 (2.48) years, TMI 19.68 (2.36) kg/m3. Correlation between TMI and abdominal circumference (r 0.571; p 0), insulin (r 0.198; p 0.005), HOMA index (r 0.189; p 0.008) and HDL-c (r −0.188; p 0.008) was observed. IMT>20.15kg/m3 was associated with insulin ≥15 mIU/mL (p 0.029) and IMT>20.36kg/m3 with HDL-c <40mg/dl (p 0.023). ConclusionsTMI was correlated with increase of abdominal circumference, insulin and HOMA index and decrease of HDL-c. IMT>20kg/m3 can be associated with increased insulin and decreased HDL-c. Therefore, the IMT seems to be a useful parameter in the assessment of pediatric patients with obesity.

Distal intestinal obstruction syndrome in a child with cystic fibrosis

The aim of the study – to analyze the clinical case of a child with distal intestinal obstruction syndrome in cystic fibrosis. A 9.5 year old patient was admitted to the Gastroenterology Department of the Republican Specialized Scientific and Practical Center of Pediatrics with complaints of an increase in abdominal circumference, increased peristalsis, weakness, lethargy, swelling in the limbs, loose stools, and weight loss. From the anamnesis: from the age of 6 years it was observed periodic vomiting, not associated with food intake. At the age of 8 years, the condition worsened, bloating joined the vomiting. At the place of residence, the diagnosis was made “Acute intestinal obstruction. Volvulus of the sigmoid colon”. Over the next 6 months, the condition was relatively satisfactory, and then stool disorders began – 3–4 times a day and bloating. Considering the presence of steatorrhea, changes in the pancreas on ultrasound and MSCT, the child was referred to a geneticist, the result of a sweat test was 86.0 mEq/l. The diagnosis was made: Cystic fibrosis, mixed form. Syndrome of distal intestinal obstruction. Partial intestinal obstruction. Severe PEI, celiac disease and HIV were excluded. On the background of the therapy, the child’s condition improved relatively. Within a month after discharge, the condition was satisfactory, and then worsened again. After 3 months, the girl was re-hospitalized with the same complaints. After consulting the surgeons, recommendations were given to perform the operation due to the appearance of signs of partial lower intestinal obstruction, but the relatives signed a voluntary refusal of the operation, the child was taken home against receipt. The girl was discharged with the final diagnosis: Cystic fibrosis, mixed form, severe course. Syndrome of distal intestinal obstruction. Partial lower intestinal obstruction. Syndrome of exudative enteropathy, severe PEI. The girl died 2 weeks after discharge. Distal intestinal obstruction syndrome (DIOS) may be misunderstood by those who are not familiar with cystic fibrosis. Pediatric gastroenterologists, surgeons should be alert when this condition is detected in combination with other symptoms indicating cystic fibrosis.

Abdominal Circumference Contributes to Absence of Wasting in Brazilian Children

A number of population groups in Latin America show high prevalences of stunting (low height-for-age) despite very low rates of wasting (weight-for-height deficits). One possible explanation for this phenomenon is an increase in abdominal circumference, which would affect children's weights but not their heights. This study was designed to describe the abdominal circumferences of a group of poor children from Northeast Brazil, and to relate these to their weight-for-weight z-score. Children (n = 252) participating in a government growth monitoring program were studied. The prevalence of stunting (below -2 SD) was 26.2%, but only 1.2% were wasted. Abdominal circumferences increased with age up to 36 mo, followed by a slight decline after 48 mo. Abdominal circumference was the anthropometric measurement most closely associated with weight-for-height, with a coefficient of determination of 41%. Even after adjusting for arm circumference, abdominal circumference continued to explain 16% of the variation in weight-for-height. Despite slight differences in measurement techniques, the study children had consistently larger abdominal girths than a sample of North American children. These findings must be verified by replication but highlight a possible contribution of abdominal circumference in the determination of levels of wasting.

Índice de masa triponderal y marcadores de riesgo metabólico en niños y adolescentes con obesidad

Background and objectiveTriponderal mass index (TMI) would estimate excess adiposity better than body mass index (BMI), maintaining stable values during childhood. This work aims to determine the correlation between TMI and markers of metabolic risk as well as set values of TMI that are related to an increase of metabolic risk. Material and methodsMulticenter, observational, cross-sectional and prospective study in children under 14 years of age with obesity. Variables: age, sex, pubertal stage, weight, height, abdominal circumference, BMI, TMI, basal glucose and insulin, HOMA index, blood pressure, lipoprotein profile, transaminases and uric acid. BMI and TMI were expressed according to the values of the Barcelona longitudinal study. Statistical analysis was performed with the SPSS* program. ResultsOne hundred and ninety-nine patients (50.3% male), age 11.08 (2.48) years, TMI 19.68 (2.36)kg/m3. Correlation between TMI and abdominal circumference (r=0.571; p=0), insulin (r=0.198; p=0.005), HOMA index (r=0.189; p=0.008) and HDL-c (r=−0.188; p=0.008) was observed. IMT>20.15kg/m3 was associated with insulin≥15mIU/ml (p=0.029) and IMT>20.36kg/m3 with HDL-c<40mg/dl (p=0.023). ConclusionsTMI was correlated with increase of abdominal circumference, insulin and HOMA index and decrease of HDL-c. IMT>20kg/m3 can be associated with increased insulin and decreased HDL-c. Therefore, the IMT seems to be a useful parameter in the assessment of pediatric patients with obesity.

Effects of Longitudinal Changes in Lifestyle-Related Risk Factors on the Incidence of Major Adverse Cardiac and Cerebrovascular Disease in Young Adults.

Metabolic syndrome (MetS) is one focus of healthcare system reform in Japan. We examined the effects of changes in individual risk factors over time on the incidence of major adverse cardio-cerebrovascular events (MACCE) in adults under the age of 50 years. Study participants under the age of 50 with neither hypertension nor hyperglycemia at baseline were analyzed. We used a parametric proportional hazard model to determine the effect of changes in abdominal circumference, blood pressure, serum lipids, and blood glucose on the incidence of MACCE.A total of 6,125 women and 6,403 men were subject to the analyses. The incidence rate of MACCE per 1,000 person-years was 1.17 for women and 2.42 for men. In men under the age of 50, an increase in abdominal circumference was associated with an increase in MACCE incidence (hazard ratio per 1 cm increase: 1.10; 95% confidence interval [CI], 1.04-1.17), whereas no statistically significant association was observed in women. Compared with Visit 1, if the abdominal circumference increased by 4 cm at Visit 3, the hazard ratio for developing MACCE was approximately 1.5 (hazard ratio 1.48; 95% CI, 1.18-1.86). In men under the age of 50, increases in abdominal circumference and systolic blood pressure were associated with an increased risk of developing MACCE, regardless of the degree of obesity at baseline. Therefore, encouraging young adults to improve their health before developing MetS may reduce the risk of MACCE.

Post-Supravaginal Hysterectomy for Bladder Flap Hematoma in P3A0 Preterm Delivery by Cesarean Section due to Fetal Distress

Introduction: Bladder flap hematoma (BFH) is a rare complication of cesarean section (CS). BFH appears between the bladder and the lower uterine segment (LUS) when the visceral peritoneal is closed during traditional CS techniques and decreased uterine contractions. Surgery is the treatment of choice for the management of peritoneal closure in CS and the decrease in uterine contractions that cause BFH.Case Presentation: A 35-year-old G3P2A0 underwent a cesarean delivery due to fetal distress. CS was performed with the visceral peritoneal sutured as in the traditional technique. Six hours after CS, there was an increase in abdominal circumference, muscle defenses, hypotension, tachycardia, anemia, and leukocytosis. She had to undergo repeated laparotomy with acute abdomen after CS and hysterectomy because uterine atony was found.Conclusions: BFH can be caused by peritoneal closure during CS and decreased uterine contractions or uterine atony. Although there is no standard protocol for management, surgical approaches for cases with infection or bleeding and hysterectomy are performed to save the patient’s life from uterine atony.

THE INCREASED RISK OF RANDOM BLOOD GLUCOSE, BODY MASS INDEX AND ABDOMINAL CIRCUMFERENCE IN THE SCHIZOPHRENIC PATIENTS USING CLOZAPINE AND QUETIAPINE

&#x0D; The use of atypical antipsychotics often causes an increase in blood glucose levels, body mass index (BMI) and abdominal circumference. This study aims to identify the increased risk of random blood glucose, BMI and abdominal circumference in the schizophrenic patients using clozapine and quetiapine. This cohort study involved 35 schizophrenic patients (19 patients used clozapine and 16 patients used quetiapine). The measurement of random blood glucose BMI and abdominal circumference was done in the zero month, the first month and the second month. The average of random blood glucose, BMI and abdominal circumference were analyzed using Wilcoxon and Chi-square. In the use of clozapine, there is a significant increase in the average of random blood glucose between the first month and the second month (p=0.1) with the difference of 6.37 mg/dl, there is an increase average in BMI between the first month and the second month (p=0.03) with the difference of 0.18 kg/m² and an average increase in abdominal circumference between the zero month and the first month (p=0.04) with the difference of 1.47 cm, between the first month and the second month (p=0.02) with the difference of 1.94 cm. In the use of quetiapine, a significant increase in abdominal circumference between the first month and the second month (p=0.02) with the difference 1.38 cm. The use of clozapine has more risk in increasing random blood glucose (OR 2.00: CI 95% 0.41-9.76), BMI (OR 2.78: CI 95% 0.69-11.10) and abdominal circumference (OR 3.61: CI 95% 0.89-14.64) compared to the use of quetiapine. The use of clozapine has more risk in increasing blood glucose, BMI and abdominal circumference compared to the use of quetiapine.&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D;

The Biological Synthesis and the Function of Mucin 2 in Pseudomyxoma Peritonei.

Excessive mucus secretion is the most prominent feature of pseudomyxoma peritonei (PMP), which often leads to significant increase in abdominal circumference, intractable abdominal pain, progressive intestinal obstruction, abdominal organ adhesions, and cachexia. Excessive mucus secretion is also the main cause of death. Cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) is the recommended treatment for PMP. However, recurrence is frequently observed even after CRS and HIPEC, presenting similar clinical manifestations. Mucin 2 (MUC2) is the main type of mucin in PMP and plays a key role in the progressive sclerosis of mucus. To comprehensively demonstrate the biosynthetic process and molecular features of MUC2 and to provide new directions for the development of PMP mucolytic strategies, this review systematically summarizes the molecular biology of MUC2, including MUC2 gene structure, transcription, translation, post-translational modification, tertiary structure, and factors regulating mucus viscoelasticity. The results show that MUC2 is a highly glycosylated protein, with glycan accounts for 80% to 90% of the dry weight. The assembly pattern of MUC2 is highly complicated, presenting a bead-like filament. Salt concentration, pH, mucin concentration and trefoil factor family may contribute to the increase in mucus viscoelasticity and sclerosis, which could be used to develop drugs to soften or even dissolve mucus in the future.

Uterine stump leiomyosarcoma after sub-total hysterectomy: a case report

Introduction: Uterine sarcomas considered as one of the aggressive tumors of uterine malignancies. It is one of the mesenchymal tumors that originate from smooth muscle of the uterus which is a rare tumor that accounts for 2% to 5% of all uterine malignancies. Very few cases are reported in the literature. Our patient has a unique history of Pelvic-Abdominal swelling reaching xiphisternum level after subtotal hysterectomy one year ago. Abnormal genital bleeding not responding to medical treatment is the usual presentation in uterine sarcoma like in our patient. We report an original case report of an abnormal sequence of this rare tumor arising from the uterine stump after subtotal hysterectomy. Case presentation: A 42-year-old nulliparous woman presented to our gyne-oncology unit in El-Galaa Maternity Teaching Hospital in June 2020 with a significant rapid increase in abdominal circumference, symptoms caused by abdominal pressure (vomiting and constipation) and abnormal genital bleeding after laparotomic sub-total hysterectomy one year ago. Tumor marker CA-125 was raised, LDH was raised and a MRI scan showed a huge mass arising from the pelvis. An exploratory laparotomy was performed and the histopathology report confirmed the diagnosis of uterine leiomyosarcoma weighing around 22kg. Conclusion: Because of their rarity, uterine sarcomas are not suitable for screening. Diagnosis by histopathologic examination and surgery is the only treatment. Pre-operative MRI with contrast for abdomen and pelvis is highly recommended to exclude abdomen metastatic sarcoma if the tumor is confined to the pelvis only.

Self-reported periconception weight loss attempts do not alter infant body composition.

Maternal obesity increases the risk for adverse infant outcomes; therefore, achieving an optimal body mass index before conception is recommended. Periconceptional maternal weight loss, however, has been associated with adverse outcomes for the fetus, including altered body composition in animal studies. It is not clear whether periconception weight loss alters infant body composition in humans. The aim of this study was to compare body composition in offspring of women who attempted to lose or maintain weight in the periconception period. Women who delivered a healthy term infant were grouped according to attempt to lose weight. Infant body composition was determined by air displacement plethysmography and anthropometric measurements. In a cohort of 73 women, 27 attempted to lose weight and 46 maintained weight in the periconception period. Infant birth weight, percent body fat, and head and arm circumference were not altered by maternal attempts to lose weight. Infant abdominal circumference was increased in the offspring of women who attempted to lose weight in the periconception period. Infant percent body fat was increased in overweight and obese mothers and in female infants. The results of this study showed that attempts to lose weight in the periconception period do not significantly alter infant body composition. The increase in abdominal circumference may indicate a difference in fat distribution in offspring of women who attempted to lose weight, which may increase their risk for future metabolic and cardiovascular disease.

A maternal "mixed, high sugar" dietary pattern is associated with fetal growth.

This study examined associations between a maternal “mixed, high sugar” dietary pattern during pregnancy and ultrasound‐determined fetal growth in 495 urban African women and explored whether these associations were independent of maternal baseline body mass index (BMI) and gestational weight gain (GWG). Linear mixed effects modelling (LMM) was used to test the associations between maternal mixed, high sugar dietary pattern score, baseline BMI (kg/m2), and GWG (kg/week) and the following fetal growth outcomes: (a) biparietal diameter (cm), (b) head circumference (cm), (c) abdominal circumference (cm), and (d) femur length (cm). In the pooled LMM, a +1 standard deviation (SD) increase in the mixed, high sugar dietary pattern score was associated with higher biparietal diameter (0.03 cm/+1 SD; p = .007), head circumference (0.07 cm/+1 SD; p = .026), abdominal circumference (0.08 cm/+1 SD; p = .038), and femur length (0.02 cm/+1 SD; p = .015). Although these associations were independent of maternal BMI and GWG, higher baseline BMI was independently and positively associated with abdominal circumference (0.03 cm/+1 kg/m2; p = .011) and femur length (0.01 cm/+1 kg/m2; p = .007) and 1 kg/week greater GWG was associated with a 0.82 cm increase in abdominal circumference (p = .007). In urban African settings, where preconception maternal obesity prevalence is high and processed, high sugar diets are common, improving maternal dietary intake and BMI prior to conception should be prioritised for optimising pregnancy and birth outcomes as well as longer‐term offspring health. In addition, dietary management strategies during pregnancy may be beneficial in facilitating healthy fetal growth.

Prenatal exposure to parabens affects birth outcomes through maternal Glutathione S-Transferase (GST) Polymorphisms

TPS 743: Health effects in pregnancy, Exhibition Hall, Ground floor, August 26, 2019, 3:00 PM - 4:30 PM Background/Aim: Human exposure to parabens is very common in daily life by using personal care products. These chemicals are associated with poor birth outcomes. However, modifying effects of polymorphism in glutathione S-transferases (GST) gene remain unexplored. Therefore, the aim of this study was to investigate the effect of genetic polymorphisms on the association of prenatal exposure to parabens with birth outcomes. Methods: We plan to recruit more than 300 women during 3rd stage pregnancy between 2017 and 2019 in Korean pregnant women, called The Mother And Kids Environmental health (MAKE) Study. We measured parabens (Methyl-paraben (MeP), Ethyl-paraben (EtP), Propyl-paraben (PrP)) concentrations in maternal urine samples, also collected information on birth outcome, socio-economic status, and consumption habits of consumer products. Multivariate linear regression was used to examine whether the association between prenatal exposure to parabens and birth outcomes (gestational age, birth weight, body length, head circumference and abdominal circumference) varied by maternal GST genes. Results: The adjusted geometric means for urinary concentrations of MeP, EtP, and PrP were 13.96, 9.45, and 1.70 ng/mL, respectively. Parabens were positively associated with weight and abdominal circumference at birth. In particular, MeP and PrP showed significant association with an increase in abdominal circumference (MeP, ß=0.355, p=0.02; PrP, ß=0.376, p=0.02) adjusting for potential confounders. Prenatal exposure to parabens showed significantly positive association with abdominal circumference in mother of GST null genotype (MeP, ß=0.634, p=0.02; EtP, ß=0.546, p=0.05; PrP, ß=0.618, p=0.04). Conclusions: This study reported the association between prenatal parabens exposure and birth outcomes. We also found that GST polymorphism might affect the association between prenatal parabens exposure and abdominal circumference, suggesting the effect of genetic susceptibility on the relation between prenatal parabens exposure and abdominal circumference.

A new device to prevent fascial retraction in the open abdomen \u2013 proof of concept in vivo

BackgroundAn open abdomen is often necessary for survival of patients after peritonitis, compartment syndrome, or in damage control surgery. However, abdominal wall retraction relieves delays and complicates abdominal wall closure. The principle of the newly fascia preserving device (FPD) is the application of anteriorly directed traction on both fascial edges over an external support through a longitudinal beam to relieve increased abdominal pressure and prevent fascial retraction.MethodsTwelve pigs were randomly divided into two groups. Both groups underwent midline laparotomy under general anesthesia. Group one was treated with the new device, group two served as controls. The tension for closing the abdominal fascia was measured immediately after laparotomy as well as at 24 and 48 h. Vital parameters and ventilation pressure were recorded. Post mortem, all fascial tissues were histologically examined.ResultsAll pigs demonstrated increases in abdominal circumference. In both groups, forces for closing the abdomen increased over the observation period. Concerning the central closing force after 24 h we saw a significant lower force in the FPD group (14.4 ± 3 N) vs. control group (21.6 ± 5.7 N, p < 0.001). By testing the main effects using an ANOVA analysis we found a significant group related effect concerning closing force and abdominal circumference of the FDP-group vs. control group (p < 0.001; p < 0.001). The placement of the device on chest and pelvis did not influence vital parameters and ventilation pressure. Histologic exam detected no tissue damage.ConclusionsThis trial shows the feasibility to prevent fascial retraction during the open abdomen by using the new device. Thus, it is expected that an earlier closure of the abdominal wall will be possible, and a higher rate of primary closure will be attained.