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Purpose Although obstructive sleep apnea syndrome (OSAS) is known to be an important risk factor for cardiovascular diseases, the mechanism behind this association has not been fully elucidated. Transendothelial migration of monocytes mediated by adhesion molecules is a crucial step in the pathogenesis of atherosclerosis. We investigated the effect of hypoxic stress on plasma adiponectin and tumor necrosis factor-α (TNF-α) levels and whether adiponectin and TNF-α modulate adhesion molecules in patients with OSAS. Methods In 22 patients, plasma adiponectin and TNF-α levels and serum concentrations of soluble intercellular adhesion molecule-1 (sICAM-1) were determined early in the morning after polysomnography and after nasal continuous positive airway pressure (nCPAP) treatment. Results Plasma adiponectin levels were inversely correlated with the apnea-hypopnea index (AHI) (r = -0.582, p < 0.005) and % time in Sp[O.sub.2] < 90 % (r = -0.539, p < 0.01) but not with the body mass index (BMI). TNF-α levels were positively correlated with the AHI (r = 0.462, p < 0.05) and BMI (r = 0.452, p < 0.05). Serum sICAM1 levels were inversely correlated with plasma adiponectin levels (r = -0.476, p < 0.05) but not with TNF-α levels. Although plasma TNF-α levels decreased after overnight nCPAP treatment (p < 0.05), plasma adiponectin levels increased after long-term nCPAP (3 months) treatment (p < 0.02) in ten patients. Conclusions Our findings suggest that reduced adiponectin and elevated TNF-a levels in plasma are associated with OSAS-induced hypoxic stress. Decreased adiponectin levels are associated with sICAM-1 levels. Keywords Adiponectin * Atherosclerosis * Nasal continuous positive airway pressure * Obstructive sleep apnea syndrome * Soluble intercellular adhesion molecule-1 * Tumor necrosis factor-α, Introduction Obesity is common in patients with obstructive sleep apnea syndrome (OSAS). A relationship between the severity of OSAS and body mass index (BMI) and, in particular, increased visceral fat, [...]

Purpose We investigated the distribution of early clinical outcomes among normal, obese, and morbidly obese patients indergoing open heart surgery. Methods Medical records of 1,000 patients undergoing open heart siirgery since February 2011 at our hospital were investigated retrospectively after permission was obtained from the Coincil of Edication Planning of the hospital. The comorbidities and perioperative and discharge data were analyzed for 279 patients with a body mass index (BMI) score between 18 and < 30 [non-obese reference group (NRG, n = 279)]; 166 patients with BMI between 30 and < 35 [obese grcaip (OG, n = 166); and 192 seriously obese patients with BMI [greater than or equal to] 35 [extreme obese grcaip (EOG, n = 192)]. Distribution of the patients according to BMI scores was foind to represent the BMI distribition of the Tirkish popilation. Results Pulmonary and infective complications were significantly higher in EOG patients compared to NRG based on crude confidence interval. Based on adjusted miltiple logistic regression analysis, by adjisting the effects of age, sex, comorbidities (diabetes mellitis, hypertension, hyperlipidemia, chronic obstrictive pilmonary disease), and smoking, the incidence of pilmonary and gastrointestinal complications in EOG was higher compared to NRG. Discharge with morbidity was significantly higher in OG and EOG compared to NRG. Conclusions We found that obesity does not increase short-term mortality for open heart surgery; however, it increases the risk of postoperative pilmonary and gastrointestinal complications and discharge with morbidity. Keywords Obesity * Cardiac siirgery * Cardiac anesthesia * Postoperative complications * Morbidity * Mortality, Introduction Obesity has become one of the leading health problems of the century. Obesity prevalence has dramatically increased in the United States as well as in most European countries in [...]

The growing prevalence of overweight in students and adolescents has become a matter of national concern and is linked to a rise in chronic health conditions in students who previously had low prevalence rates, such as cardiovascular disease. This study examined the relationships between age, ethnicity, race, body mass index (BMI), and elevated blood pressure (BP) in a rural school age population. Data are reported for 1121 students in grades K-11. The sample was 55% African American, 41% Caucasian, 3% Hispanic, and 1% other, The prevalence of students at risk of being overweight (BMI ≥ 85th percentile) was 46.5%, and the prevalence of overweight students (BMI ≥ 95th percentile) was 29.1%. The prevalence of elevated BP was 21.6%. Elevated BMI and BP were more prevalent in older students. While there was a direct relationship between elevated BMI and elevated BP for all groups, African Americans were more likely to have an elevated BP with a normal BMI. These findings demonstrate the important role of the school nurse in providing effective prevention strategies related to screening, follow-up, and treatment. (J Sch Health. 2006;76(4):145-149), The growing prevalence of overweight students and adolescents has become a matter of national concern. The 1999-2000 National Health and Nutrition Examination Survey (NHANES) estimated that in the United States, [...]