Active clinical trials for "Obesity"

The objectives of the proposed study are to assess the effects of different types, timing, and amount of antibiotic use in the first two years of life with (Specific Aim 1) body mass index (BMI) and obesity at ages 5 and 10 years and (Specific Aim 2) growth trajectories to age 5 years. In Specific Aim 3, the investigators will address how big the effects of antibiotics on obesity are within subgroups of the population, such as different racial/ethnic groups and whether the child's mother got antibiotics while she was pregnant. The data for this study will come from electronic medical records of about 600,000 children from 42 healthcare systems within 10 Clinical Data Research Networks (CDRNs) across the United States. The investigators will get information on antibiotic prescribing in the first two years of life, then "virtually" follow these children to ages 5 and 10 years to see what their BMIs are, and how many of them are obese by clinical standards (i.e., body mass index exceeding the 95th percentile for age and sex). In the main analyses, the CDRNs will not send any individual data to a central site. Rather, using sophisticated computer programs, the study's coordinating center will send "questions to the data," thus protecting the privacy of patients' and the healthcare systems' records. In some analyses, to check how well this "distributed research network" approach works, we will work with individual records whose identifying information has been stripped off ("de-identified data"). In our Secondary Aim, the investigators will employ focus groups of parents and in-depth interviews with clinicians to explore how best to put the findings into everyday practice. Throughout the study, in addition to employing privacy-protecting approaches to analyzing and sharing data, the investigators will adhere to principles of inclusion, patient-centeredness, stakeholder engagement, effective governance, and protection of human subjects. At the end of the two-year project, the investigators will propose avenues for dissemination of the scientific findings and other products.

This study evaluates effect of the Maternal Obesity and/or the By-pass on the Growth and the Nutritional Balance of the Child.The data stemming from mothers presenting obesity or an overweight during their pregnancy and the data stemming from mothers having had a by-pass will be compared with the data stemming from mothers with a normal BMI (Body Mass Index), considered as a reference group. It's the same for the data stemming from newborn children. The newborn children stemming from groups of obese mothers or in overweight will be compared with the data stemming from mothers belonging to the reference group.

Title of Research Program: Ultrasound Guided Axillary Brachial Plexus Block: Influence of Obesity on Block Failure Rate, Performance Time and Incidence of Acute Complications- A prospective observational cohort study Background: Axillary brachial plexus (ABP) block is commonly performed as the primary anesthetic technique to provide surgical anesthesia and postoperative analgesia for elbow, forearm and hand surgery. Compared to general anesthesia, ABP blocks have been shown to result in better pain relief, less nausea and vomiting, shortened length of hospital stay, decreased side effects of opioids painkillers and better patient satisfaction. These beneficial effects of ABP blocks are particularly useful for patients who are overweight or obese as this cohort is at a higher risk of experiencing complications from general anesthesia. Traditionally, nerve blocks have been described technically challenging in obese patients. This may not be true now with availability of high-resolution ultrasonography (US). US imaging also allows doctors the ability to visualize the needle "live" to allow for more accurate needle placement. This allows local anesthetic to be placed more precisely resulting in faster onset anesthesia, decreased local anesthetic drug dosages, reduced complications and higher success rate. Ultrasound guidance has not been used for performing ABP block in previous studies in obese patients. Hypothesis: We hypothesize that the block failure rate is no worse in obese compared to non-obese patients when US guidance is used to perform ABP blocks. Specific Objectives: The primary objective of this study is to evaluate whether obese patients receiving US guided ABP block as their primary anesthetic modality have a block success rate (defined by a Composite Score ≥ 14 at 30 minutes) worse than their non-obese peers. The secondary objective is to evaluate time parameters around ABP performance, incidence of complications and patient satisfaction. Methods: This study will be conducted as an observational quasi-experimental multicenter trial at St. Joseph's Health Care (SJHC), London, ON and the Nova Scotia Health Authority (NSHA) Halifax Infirmary (HI) site, Halifax NS. There will be 250 patients taking part in this study. One hundred and fifty patients have already completed the study in Ontario. The duration of the study at the Halifax Infirmary is 10 months. Healthy patients (aged 18-75 years) scheduled to undergo elbow/ forearm/ or hand surgery will be invited to volunteer in this observational study. A study investigator or resident under direction supervision of a study investigator will perform the ABP block. There is NO experimental drug or treatment in this study. Patient demographics including age, sex, arm circumference, height, weight and Body Mass Index will be recorded. Nerve blocks will be performed in a designated area near operating rooms called the block room. US will be used for identification of the nerves supplying the arm and an ABP block will be performed with a total volume of 30 mL of 0.5% ropivacaine according to a standardized procedure. Measurements of sensory and motor blockage will be recorded every 5 minutes for 30 minutes following the ABP block. Block success will be measured and is defined as a score of ≥ 14 on the Composite Score (CS) within 30 minutes of ABP block completion. According to routine care, all patients will receive a phone call from the investigators 24-48 hours after surgery to inquire about complications. The study follows non-inferiority design to show that the success rate in the obese group is not worse than the non-obese when anesthetized. In non-inferiority trials, both intention to treat and per-protocol analysis are recommended; both approaches should support non-inferiority The student's t-test (unpaired, two tailed) will be used for comparison of the means of continuous, normally distributed data or Mann-Whitney U test as appropriate. Categorical data (success rate, complication rate) are to be analyzed using χ2 test or Fisher's exact test, as appropriate. An interim analysis will not be conducted and set at 0.05 for significance and 95% confidence intervals. Significance/ Importance: This study would provide anesthesiologists additional information to inform their clinical decision-making when dealing with obese patients. To date there are no publications or any registered trials exploring the success rates and technical aspects of ABP blockade in obese patients using US guidance technology for block performance. Therefore, this study is novel and timely for the patient groups.

To investigate: Associations between miRNA and insulin signaling-related gene expressions in abdominal adipose tissues in obese subjects. Differences in miRNAs expressed by intrabdominal omental adipose tissues between genders.

The purposes of the esperience is: to verify the safety of protein sparing modified fast(PSMF) by enteral route ( EMF )performed in cycles of ten days/months for six months to compare EMF with oral PSMF clinically ( appetite control, fat freemass mantainance, polmonary function tests and metabolic pattern) to verify the weight mantainance after 6 months from the treatment suspension

The Canadian population, as is the case in most developed countries, is ageing and becoming increasingly overweight and/or obese. Both ageing and obesity are associated with reduced cognitive performance which can impact adversely on the ability to undertake daily activities and increases the risk of loss of independent living and reduced quality of life. The investigators predict that consumption of ½ cup of pulses per day for 12 weeks will improve cognitive function in older overweight/obese adults and thus decrease the rate of cognitive decline that occurs in this at-risk population.

The purpose of this study is to investigate whether there is a correlation between hip arthroplasty patients' preoperative weight and the patients quality of life and the clinical effect one year postoperatively.

To determine the extent to which a clinical intervention based on the Chronic Care Model (CCM), compared with the usual care control condition, results in a smaller age-associated increase in body mass index (BMI) over a 1 year intervention (primary outcome) and a 1 1/2-year follow-up period.

The purpose of this research study is to find out what effects (good and bad) gastric bypass has on metabolism, including pancreatic insulin secretion. In addition, we will compare the effects of gastric bypass on the metabolism of adults and adolescents to try to determine whether there are greater metabolic and health advantages of performing gastric bypass earlier in life versus waiting until adulthood.

To conduct genetic studies of the metabolic syndrome characterized by very low levels of high density lipoprotein cholesterol (HDL-C), hypertriglyceridemia, and obesity.