Changes in self-concept and body image during alopecia induced cancer chemotherapy

Alopecia as a result of cancer chemotherapy has been reported to cause changes to the self-concept and body image. In a prospective longitudinal study, self-concept and body image were analysed in 29 patients after histological confirmation of gynaecological malignancy, mainly ovarian cancer, who were assigned to receive a complete-alopecia-inducing PEC combination chemotherapy (cisplatin 50 mg/m², epirubicin 60 mg/m² and cyclophosphamide 500 mg/m² in 1 day every 28 days). The analysis was performed before the commencement of treatment and repeated when alopoecia was complete and after completion of therapy when patients had already experienced regrowth of hair, using the Frankfurt self-concept scales (FSKN) and Frankfurt body concept scales (FKKS). Significant differences were observed in the various evaluation scales FSAP (general ability to solve problems), FSSW (general self-esteem), SGKB (state of health), and SKEF (physical fitness). For all scales the results worsened during chemotherapy but did not return to normal or improve when patients experienced regrowth of hair. It was found that 73.3% of the patients did not feel as self-confident as before treatment and that for 46.6% alopecia was the most traumatic side effect of chemotherapy. Since there is no chemotherapeutic regimen or any other effective treatment that can prevent alopecia, either of the following conclusions can be drawn: the observed differences may not be related exclusively to alopecia, but also associated with coping processes initiated by chemotherapy and perhaps enhanced by alopecia; or the changes persist even after the discontinuation of chemotherapy. Regrowth of hair and other adaptive processes do not normalize or improve the impaired body image and self-concept.     

Creatine kinase in relation to body fat in a Caucasian overweight and obese population

We investigated the association between serum creatine kinase (CK) and body fat mass in an overweight and obese population. In this cross-sectional study, 454 Caucasian overweight and obese individuals recruited from a medical outpatient clinic and via newspaper advertising underwent dual-energy X-ray absorptiometry (DEXA). Serum CK was obtained along with supplementary blood samples. This report is based on a secondary analysis from a previous randomized controlled trial treating obesity with vitamin D₃. Serum CK correlated negatively with body fat mass in men (r?=??.18, p?=?.025) but not in women (r?=??.11, p?=?.069). An insignificant negative trend for logCK across quartiles of fat mass in men was found (p?=?.098). CK did not associate significantly with lean mass, but lean mass correlated positively with fat mass in both groups (p?p?=?.001). These data support the view that circulating CK interacts with obesity in a favourable way independent of its muscular connection in men. CK was not associated with fat mass in women.     

应用行为分阶段转变理论模式干预超重和肥胖成人生活方式的效果评价

目的:应用行为分阶段转变理论对超重和肥胖成人进行生活方式干预,观察分析干预后体重和相关体检结果,如血糖、血脂、总胆固醇等的改变情况,为探索超重和肥胖人群有效防治模式积累经验。方法:采用方便抽样法,选取60名超重和肥胖成人作为研究对象,用自行设计的生活方式调查问卷进行调查,同时施加干预措施。干预一年后对其生活方式以及干预前后体重、腰围、相关生化检测结果进行比较,并进行统计分析。结果:干预后超重肥胖人群生活方式调查问卷得分明显提高,体重、血糖、血脂和总胆固醇都有不同程度降低。结论:应用TTM理论可以指导超重和肥胖人群生活方式改变,并使其体重和相关的体检指标得到改善。     

超重及肥胖不孕患者实施体外受精-胚胎移植综合性护理干预的效果

目的 探讨综合性护理干预对超重及肥胖患者妊娠结局的影响.方法 回顾分析体质指数（BMI）≥23 kg/m2接受IVF-ET治疗的112例不孕患者共125个周期,将其分为达标组和未达标组,比较治疗结局及效果.结果 达标组的临床妊娠率（53.23%）、胚胎种植率（32.31%）、活产率（46.77%）均显著高于未达标组（34.92%,21.37%,26.98%）（P＜0.05）,流产率有减少的趋势,但差异没有统计学意义（P＞0.05）.结论 对准备进行IVF-ET治疗的超重及肥胖患者,进行有效的综合性护理干预是非常有必要的,良好的护理干预可以明显改善妊娠结局,必要时可以延长综合性护理干预的时间.     

The effect of Nigella sativa on appetite,anthropometric and body composition indices among overweight and obese women: A crossover,double-blind,placebo-controlled,randomized clinical trial

ObjectivesObesity is a global concern which is associated with several complications and disease.DesignPresent study is the first crossover, double-blind, placebo-controlled, randomized clinical trial aimed to evaluate the effect of Nigella Sativa (N. sativa) intervention on anthropometric and body composition parameters as well as dietary intake and appetite in a crossover design.MethodForty-five healthy women with obesity or overweight were randomized into two groups of intervention and placebo, and the study conducted in two 8-week periods of intervention separated by a 4-week washout period. Anthropometric and body composition indices and dietary intake were measured. Also, appetite sensation was evaluated via a standard visual analog scale (VAS) questionnaire. Pkcross procedure was performed for statistical analysis using STATA. Cohen’s d effect size was estimated for all outcomes to determine the magnitude of the effects.ResultsSupplementation with 2000 mg of N. sativa oil found to have a considerable increment in the measures of body mass index (P < 0.001, Cohen’s d = 0.5), body weight (P < 0.001, Cohen’s d = 0.6) and waist circumference (P = 0.020, Cohen’s d = 0.4) with a medium effect size measure, and a significant decrease in body fat mass (P = 0.019, Cohen’s d = 0.2), body fat percent (P < 0.001, Cohen’s d = 0.2) and visceral fat area (P = 0.011, Cohen’s d = 0.2) with a small effect size measure.ConclusionThe overall improvements in anthropometric and body composition parameters and a significant decrease in appetite represents the beneficial effects of N. sativa supplements in the treatment of obesity. More studies with different dosages, a larger number of participants, and longer intervention duration are recommended to illustrate the exact effects of N. sativa as a complementary therapy for obesity.     

Effects of lifestyle intervention and metformin on weight management and markers of metabolic syndrome in obese adolescents

PURPOSE: The purposes of this study are threefold: to determine what components of the metabolic syndrome are present in obese adolescents, to determine what differences exist in the effects of lifestyle intervention versus lifestyle intervention plus metformin on weight management and select markers of metabolic syndrome in obese adolescents, and to determine which factors predict weight loss in obese adolescents treated with lifestyle changes and metformin. DATA SOURCES: The study was a secondary data analysis utilizing a retrospective chart review of 63 obese adolescents aged 11 through 18 who were treated for obesity at the LeBonheur Youth Lifestyle Clinic from January 1, 2000, through June 30, 2005. Lifestyle interventions included diet, exercise, and counseling. The medication utilized was metformin. Outcomes evaluated included body mass index, relative body mass index (RBMI), weight, waist and hip circumference, blood pressure, serum lipid levels, fasting plasma glucose, 2-h oral glucose tolerance tests, and insulin levels. Changes in mean values between groups were evaluated using the General Linear Models procedure. Logistic regression was utilized to determine which factors might predict weight loss. CONCLUSIONS: The metformin group (N= 37) tended to be heavier, older, and had more components of the metabolic syndrome than the nonmetformin group (N= 26). All components of the metabolic syndrome were present in both groups (overall prevalence 55%). Both groups had a downward trend in RBMI, a surrogate marker for weight loss, but only the metformin group had a significant loss in RBMI points from baseline to end. There was a trend toward better diastolic blood pressure at 6 months in the metformin group (p= 0.06), which was not seen in the nonmetformin group. The only predictors of weight loss were higher RBMI (those who were heavier lost more) and the absence of type 2 diabetes mellitus (type 2 DM) (those with type 2 DM were less likely to lose 10 or more points in RBMI). IMPLICATIONS FOR PRACTICE: All components of the metabolic syndrome are present in obese adolescents. The use of lifestyle changes and lifestyle changes plus metformin both produce some degree of weight loss, but subjects on metformin in this study lost significantly more RBMI points than those on lifestyle changes alone. Subjects with type 2 DM are less likely to lose weight than those without type 2 DM. Larger studies and studies with subjects more representative of the general population need to be carried out to assist in the development of evidence-based practice guidelines.     

连续性护理对肥胖孕妇孕期体质量增加及产后体质量的影响

目的探讨连续性护理对肥胖孕妇孕期体质量增加及产后体质量的影响。方法选取我院2017年6月至2018年12月72例初产妇为研究对象,按照随机分组原则将其等分为对照组和干预组,对照组接受常规护理,干预组则在对照组基础上接受连续性护理。比较两组孕妇孕期体质量增加值及产后3个月体质量情况。结果干预组孕期体质量增加值、产后3个月体质量均低于对照组,差异有统计学意义(P<0.05)。结论健康的生活方式可以改善肥胖孕妇孕期体质量增加及产后体质量,从而改善妊娠结局、减少并发症发生率。     

An outbreak of body weight dissatisfaction associated with self-perceived BMI and dieting among female pharmacy students

Some reports indicate that in various groups of society living in the highly developed countries a body weight perception and weight satisfaction tend to be inappropriate when compared with body mass index (BMI) calculated from estimated actual weight and height. Thus in present studies a relationship between body weight perceptions, measured actual BMI, gender, and dieting practices in a sample population of pharmacy students in Poland were examined to verify hypothesis that their incorrect self-perception would provoke occasional, seasonal and permanent eating disorders. Height and weight data of 178 pharmacy students (mean age 22.6 ± 2.4 years) in Bydgoszcz, Poland, were collected and validated by completed self-reported questionnaire assessing their self-perceived body weight, desired body weight and past/current dieting practices. Only 34.4% of female and 37.1% of male pharmacy students was satisfied with their current body weight. Statistical analyses revealed significant differences in estimated BMI status (χ² = 28.5; p = 0.0001), desired body weight (χ² = 15.6; p = 0.0004) and past dieting (χ² = 7.6; p = 0.0050) by gender. In the male sub-group of students (n = 27) unclear association (χ² = 6.1; p = 0.046) between measured actual BMI status and self-perceived body weight have been presented. Moreover, in male students a significant relationship (χ² = 4.9; p = 0.0261) between actual BMI status and both past as well as current weight control behavior in the form of dieting practices was exhibited. In case of a sub-group of female students (n = 151) a diffuse association of actual BMI and self-perception of their body weight (χ² = 69.5; p = 0.0001) was obtained. However, a close relation (χ² = 16.9; p = 0.0007) between actual BMI and only past dieting practices was observed in females. Furthermore, in this last sub-group of students the significant relationship (χ² = 53.9; p = 0.0001) between measured actual BMI and desired body weight was also demonstrated. The study showed an evidence of distorted self-perception of body weight in both sub-groups of considered pharmacy students. There was a tendency to overestimate of body weight in female students, and to underestimate in male students. These results suggest common dissatisfaction of body weight, especially among females, who were more often engaged in dieting, despite not being overweight or obese according to measured actual BMI status.     

Impact of lorcaserin on glycemic control in overweight and obese patients with type 2 diabetes: analysis of week 52 responders and nonresponders

Objectives: Treatment guidelines for type 2 diabetes mellitus (T2DM) suggest weight loss as a means to maintain glycemic control. Lorcaserin has been approved for chronic weight management in the United States as an adjunct to a reduced-calorie diet and exercise, and the previous phase 3 Behavioral Modification and Lorcaserin for Obesity and Overweight Management in Diabetes Mellitus (BLOOM-DM) study has shown that, in addition to weight loss, lorcaserin is associated with improvements in glycemic parameters. In this post hoc analysis of the BLOOM-DM trial, the relationship between responder status (patients achieving ≥5% weight loss at Week 52) and glycemic and cardiometabolic parameters is evaluated.

Methods: Data are presented for patients receiving lorcaserin 10 mg twice daily or placebo for 52 weeks.

Results: More than twice as many patients receiving lorcaserin plus diet and exercise counseling were classified as Week 52 responders compared to those receiving diet and exercise counseling alone (37.5% vs. 16.1%, respectively; p < 0.001), and lorcaserin Week 52 responders had greater improvements vs. placebo Week 52 responders in FPG (?38.1 mg/dL vs. ?26.0 mg/dL) and HbA1c (?1.3% vs. ?1.0%). Furthermore, more lorcaserin-treated Week 52 responders decreased the number of concomitant oral antidiabetic medications (OADs) used, and fewer increased the number of OADs used, compared to placebo. Unexpectedly, lorcaserin Week 52 nonresponders also had substantial reductions in glycemic levels, despite very modest weight loss.

Conclusions: These data support lorcaserin use in overweight and obese patients with T2DM to promote weight loss and facilitate glycemic control.

Clinical trial registration: www.clinicaltrials.gov identifier is NCT00603291     

Mastectomy, body image and therapeutic massage: a qualitative study of women's experience

Despite the wealth of literature concerning the impact of breast loss on a woman's body image, sexual and psychological adjustment, there have been few studies within the medical and nursing literature directly quoting a woman's private perspective; how in her words she experiences her changed body. Furthermore, there is a lack of evidence-based interventions for addressing the problem of altered body image (ABI); healthcare professionals often feel at a loss in knowing how to help women cope (Hopwood & Maguire 1988). In this study in-depth interviews were undertaken to explore three women's experiences of breast loss with particular focus on body image issues; a second phase piloted a massage intervention as a means of helping them adjust to living with their changed body image. Listening to their experience, in combination with the therapeutic massage, allowed deep access and insight into the nature of the women's trauma. The experiences of the three women in this study suggest there may be a group of women whose needs are overlooked and who, despite their prosthesis and reassurances that they are disease-free, opt to conceal the problems they have in living with a changed image. The availability of a body-centred therapy might help with certain aspects of adjustment as revealed by this study.     

乳腺癌康复者自我形象的团体接纳与承诺干预方案构建及其初步验证

目的:构建乳腺癌康复者自我形象的心理干预方案,并进行初步验证。方法:以接纳与承诺疗法(ACT)和团体心理干预为主要理论基础,初步构建乳腺癌康复者自我形象的团体接纳与承诺干预方案。对乳腺癌康复者进行心理干预,采用乳腺癌患者自我形象问卷、接纳与行动问卷对患者进行测评。结果:形成了乳腺癌康复者自我形象的团体接纳与承诺干预方案,初步验证其具有可实施性。结论:乳腺癌康复者自我形象的团体接纳与承诺干预方案可应用于临床,用以帮助患者提高自我形象。     

Effect of regional fat loss assessed by DXA on insulin resistance and dyslipidaemia in obese women

Abstract

Objective. To investigate the impact of reduction in total fat mass (FM) and regional FMs on indices of insulin resistance and dyslipidaemia in obese women (BMI > 30 kg/m²) after a 1-year weight loss (WL) program; and, secondly, to investigate the potential predictive effect of baseline insulin resistance on reduction in total and regional FMs. Material and methods. In 35 women with > 4kg weight loss, body composition by DXA (dual X-ray absorptiometry), fasting insulin, C-Peptide, insulin resistance (HOMA-IR), insulin sensitivity (QUICKI), metabolic clearance rate (MCRestOGTT) and serum lipids were assessed. Results. Mean WL was 9.6%; trunk and leg FM were reduced proportionally (14.9–14.7%). Improvement in HOMA-IR was 34.7%, insulin 30.7%, QUICKI 8.6% and MCRest OGTT 74%. The reduction in total, trunk and leg FM were similarly correlated with improvement in indices of insulin resistance (p < 0.001–0.05) and also with initial HOMA-IR (p = 0.000–0.02). In linear regressions improvement in HOMA-IR was similarly related with these FMs (p = 0.008), and initial HOMA predicted loss of trunk FM (p = 0.01). In multivariate analysis improvement in HOMA-IR was explained by loss of total FM (R² = 0.20, p = 0.004); improvement of QUICKI by loss of leg FM (R² = 0.33, p < 0.001). Conclusion. Loss of leg FM and trunk FM had similar importance for the improvement in insulin resistance. Baseline HOMA-IR predicted the potential for reduction in trunk FM.     

Social background, aspects of lifestyle, body image, relations, school situation, and somatic and psychological symptoms in obese and overweight 15-year-old boys in a county in Sweden

OBJECTIVE: To compare lifestyle and health aspects among obese, overweight, and normal-weight 15-year-old boys living in the county of V?stmanland, Sweden. DESIGN: A cross-sectional school-based survey. Setting. All schools in the county of V?stmanland, Sweden. SUBJECTS: A questionnaire was completed anonymously by 989 boys. MAIN OUTCOME MEASURES: The relations between body mass index and social factors, eating habits, physical activity, body image, relations, school situation, use of alcohol, drugs and tobacco, somatic and psychological symptoms in boys. RESULTS: Obese boys had a significant negative outcome in 19 out of 31 items studied compared with normal-weight boys, while the overweight boys had a significant negative outcome in 9 out of 31. The obese boys reported more irregular eating habits than normal-weight boys, were less satisfied with their weight and looks, and had fewer friends. A larger proportion of the obese boys reported that they did not like school, were more absent from school, and had been exposed to more violence. They bullied their schoolmates more often. The obese boys had tried sniffing solvents and used illicit drugs more frequently than their peers. They reported more somatic and psychological symptoms as well as suicidal thoughts and attempts. CONCLUSIONS: Obese 15-year-old boys differed from overweight and normal-weight boys in lifestyle and in the frequency of somatic and psychological symptoms. Early and vigorous intervention is necessary, as they may belong to a risk group that could develop not only medically but also socially negative consequences.     

Effect of loss of regional fat assessed by DXA on insulin resistance and dyslipidaemia in obese men

Abstract

Objective. To investigate the impact of reduction in total fat mass (FM) and regional FMs on indices of insulin resistance and dyslipidaemia in obese men (BMI > 30 kg/m²) after a 1-year weight loss (WL), and secondly, to examine the potential predictive effect of baseline insulin resistance on reduction in total and regional FMs. Material and methods. In nine men with WL > 4 kg, body composition by DXA (dual X-ray absorptiometry) and indices of insulin resistance were assessed: fasting insulin, C-Peptide and HOMA-IR. Insulin sensitivity (QUICKI) and serum lipids were also assessed. Results. Mean WL was 10.8%; Δ trunk and Δ leg FM were reduced by 30.1% and 21.3%, respectively, increasing leg/trunk FM ratio by 13.2%. Improvement in HOMA-IR was 63.1%, insulin 59.1%, and in QUICKI 17.4%. Loss of total FM, trunk FM, and increase in leg/trunk FM ratio were correlated with improvement in HOMA-IR (p < 0.001–0.05). Linear regression analysis of ln-transformed improvements in HOMA-IR was non-significantly related with losses of trunk FM and increases in leg/trunk FM ratio (p = 0.06). Multivariate analysis suggested improvements in fasting insulin and C-Peptide could be explained by leg/trunk FM ratio (R² = 0.60, p = 0.013, R² = 0.37, p = 0.012, respectively) and in HOMA-IR by trunk FM (R² = 0.42, p = 0.06). The loss of FM and change in FM distribution had no effect on serum lipids. Conclusion. Both loss of trunk FM and increase in leg/trunk FM ratio assessed by DXA contribute to the improvement in insulin resistance.     

乳腺癌患者身体意象相关测评工具的研究进展

对乳腺癌患者身体意象的概念、测评工具及目前的应用情况进行综述,并提出测评工具的相关不足与思考,旨在为研究者选择合适的乳腺癌患者身体意象测评工具提供参考,并为开发适合我国乳腺癌患者身体意象测评工具提供借鉴.     

二维斑点追踪技术评估超重及肥胖女性妊娠期胎儿心室收缩功能的研究

目的应用二维斑点追踪技术评价超重及肥胖女性妊娠期胎儿心室收缩功能。 方法选取空军军医大学唐都医院2019年6月至2020年3月单胎妊娠的孕妇80例,所有孕妇均于孕24周行常规胎儿超声心动图及二维斑点追踪成像检查。依据孕前体质量指数（BMI）将研究对象分为正常对照组30例、超重组27例和肥胖组23例。采用常规超声心动图及二维斑点追踪技术,对各组胎儿心脏结构、常规心室舒张及收缩功能指标、全心整体球形指数（GSI）以及左、右心室心内膜整体纵向应变（GLS）和右心室游离壁应变（FWSt）进行评价及比较分析。 结果肥胖组、超重组与正常对照组的胎儿左、右房室横径,心脏面积,心胸面积比及四腔心横径、长径,GSI比较,差异均无统计学意义（P均＞0.05）。各组胎儿二、三尖瓣口血流E/A值及瓣环运动速度e/a值差异均无统计学意义,肥胖组二、三尖瓣瓣环收缩期运动速度s较正常对照组及超重组均降低,差异均有统计学意义（P均＜0.05）。各组胎儿左心室射血分数,左、右心室面积变化率,二尖瓣环收缩期位移及三尖瓣环收缩期位移比较,差异均无统计学意义（P均＞0.05）。左、右心室GLS,及右心室FWSt在正常对照组、超重组、肥胖组均依次逐渐减低,组间差异均有统计学意义（P均＜0.05）。 结论超重女性妊娠可能会使胎儿心肌功能发生改变,左、右心室纵向应变各参数指标可以较好地反映超重及肥胖女性妊娠所引起的胎儿心肌收缩功能改变,有利于孕期随访观察及指导孕妇体重管理。     

Effects of passive body heating on body temperature and sleep regulation in the elderly: a systematic review

Insomnia in the elderly is associated with circadian body temperature changes. Manipulating body temperature prior to sleep onset may improve sleep quality in the elderly. This systematic review analyzed the effect of passive body heating on body temperature and sleep quality. Three studies related to passive body heating for the elderly identified from a computerized database search were evaluated. All of them used crossover designs to examine effects of passive body heating on sleep quality. Passive body heating such as a warm bath immersed to mid-thorax with 40–41°C water for 30 min in the evening could increase rectal body temperature, delay occurrence of body temperature nadir and increase slow wave sleep (deep sleep) in healthy female elderly with insomnia. The elderly also perceived “good sleep” or “quickness of falling asleep” after the bathing condition. Evening warm bath facilitates nighttime sleep for the healthy elderly with insomnia.