Effect of Gastric Bypass Operation on Framingham and Actual Risk of Cardiovascular Events in Class II to III Obesity
Department of Surgery, Vanderbilt University, Nashville, TN 37232-2577, USA. Journal of the American College of Surgeons
(Impact Factor: 5.12).
06/2007; 204(5):776-82; discussion 782-3. DOI: 10.1016/j.jamcollsurg.2006.12.038
Obesity is known to be a major risk factor for cardiovascular diseases. There are few studies in the literature assessing the effect of bariatric procedures on longterm risk of cardiovascular events. The aim of this study was to determine the effect of gastric bypass operation on actual and Framingham risk of coronary heart disease (CHD) events in class II to III obesity.
In a cohort of subjects with class II to III obesity, we used the observed change in CHD risk factors and risk models derived from the Framingham data equation to calculate the predicted 10-year absolute and relative risk of CHD after gastric bypass operation. The risk predicted by the Framingham model was then compared with the actual incidence of CHD events of the cohort.
Five-hundred patients were included in the study. The 1-year mean excess body weight loss was 68.7% +/- 22%. There was a substantial reduction in prevalence of diabetes from 28% to 6% (p = 0.001). Compared with baseline, the average 10-year absolute risk of cardiac events decreased from 5.4% at baseline to 2.7% at 1 year after operation (p = 0.001). A similar risk reduction was observed in subgroups defined by diabetes status and gender. Gastric bypass decreased absolute risk of cardiac events by a mean of 63% (p = 0.0001) in diabetics and 56% (p = 0.001) in male patients. The cohort actual rate of CHD events was 1% (5 of 500). At the 5-year horizon, this was considerably (p = 0.001) lower than the predicted rate before gastric bypass operation.
Gastric bypass operation is effective in reducing actual and the 10-year Framingham risk of CHD events in individuals with class II to III obesity. The major estimated risk reduction was observed in male patients with type 2 diabetes.
Available from: Joao Luiz Moreira Coutinho Azevedo
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ABSTRACT: A new ultrasonic immersion test method for detecting internal flaws in a running steel strip has been developed. A transmitting probe array and a receiving probe array are arranged face-to-face on opposite sides of the strip in water, and two flaw echoes are received by the receiving probe array: (1) Haw echo reflected first at an internal flaw and next at the surface wall of the strip; and (2) Flaw echo reflected first at the back wall of the strip and next at an internal flaw. A linear area in the strip can be tested within a cycle of ultrasonic pulse repetition by integrating the transmission of a line-focused ultrasonic beam (25 MHz in frequency) using all elements in the transmitting probe array at once with the parallel processing of signals received by the receiving probe array. An ultrasonic detection system based on this method was subsequently installed in the No. 6 pickling line at JFE Steel, Chiba District. The steel strip being tested is immersed in water by using six additional deflector rolls. The transmitting probe array and receiving probe array cover the width of the strip so that testing of the entire volume of the strip is realized. It is confirmed that inclusions with a minimum volume of 5 × 10 -5 mm 3 can be detected at a signal-to-noise ratio in the range of 9-10dB. The detection results are rapidly fed back to the steelmaking process to improve steel cleanliness. As a result, steel coils have maintained a high level of internal cleanliness with a dramatic reduction in defects found during the users' manufacturing process.
Journal of the Japan Institute of Metals 01/2002; 1(3). DOI:10.1109/ULTSYM.2002.1193494 · 0.31 Impact Factor
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ABSTRACT: Concrete is a strongly heterogeneous solid including aggregates, cracks and porosity. It represents an important but also very challenging object for ultrasonic non-destructive testing methods. The elastic wave propagation in this material consists of a complex mixture of multiple mode conversion and multiple scattering which results in a "diffusive" energy transport. In order to investigate the effect of aggregates, porosity and reinforcement on the applicability and reliability of different testing methods it is useful to model the ultrasonic wave propagation and scattering process explicitly in the time-domain. The elastodynamic finite integration technique represents a stable and efficient numerical scheme to model ultrasonic wave propagation in elastic solids. In the present paper the two- and three-dimensional EFIT code is used to calculate ultrasonic wave propagation and scattering in various concrete specimens modeling pulse-echo, impact-echo and acoustic emission testing methods. The numerical simulations are presented by means of time-domain signals and time-domain wavefield snapshots.
Ultrasonics Symposium, 2002. Proceedings. 2002 IEEE; 11/2002
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