Search results for: Kypros Nicolaides

Authors: Nicolas Galazis, Nikolina Docheva, Constantinos Simillis, Kypros Nicolaides

Abstract:

Background: Obese women are at increased risk for many pregnancy complications, and bariatric surgery (BS) before pregnancy has shown to improve some of these. Objectives: To review the current literature and quantitatively assess the obstetric and neonatal outcomes in pregnant women who have undergone BS. Search Strategy: MEDLINE, EMBASE and Cochrane databases were searched using relevant keywords to identify studies that reported on pregnancy outcomes after BS. Selection Criteria: Pregnancy outcome in firstly, women after BS compared to obese or BMI-matched women with no BS and secondly, women after BS compared to the same or different women before BS. Only observational studies were included. Data Collection and Analysis: Two investigators independently collected data on study characteristics and outcome measures of interest. These were analysed using the random effects model. Heterogeneity was assessed and sensitivity analysis was performed to account for publication bias. Main Results: The entry criteria were fulfilled by 17 non-randomised cohort or case-control studies, including seven with high methodological quality scores. In the BS group, compared to controls, there was a lower incidence of preeclampsia (OR, 0.45, 95% CI, 0.25-0.80; p=0.007), GDM (OR, 0.47, 95% CI, 0.40-0.56; P<0.001) and large neonates (OR 0.46, 95% CI 0.34-0.62; p<0.001) and a higher incidence of small neonates (OR 1.93, 95% CI 1.52-2.44; p<0.001), preterm birth (OR 1.31, 95% CI 1.08-1.58; p=0.006), admission for neonatal intensive care (OR 1.33, 95% CI 1.02-1.72; p=0.03) and maternal anaemia (OR 3.41, 95% CI 1.56-7.44, p=0.002). Conclusions: BS as a whole improves some pregnancy outcomes. Laparoscopic adjustable gastric banding does not appear to increase the rate of small neonates that was seen with other BS procedures. Obese women of childbearing age undergoing BS need to be aware of these outcomes.

Keywords: bariatric surgery, pregnancy, preeclampsia, gestational diabetes, birth weight

Procedia PDF Downloads 407

Authors: Hussain Jiffry, Kypros Pilakoutas, Reyes Garcia Lopez

Abstract:

This study examines the effect of tsunami loads on reinforced concrete (RC) frame buildings analytically. The impact of tsunami wave loads and waterborne objects are analyzed using a typical substandard full-scale two-story RC frame building tested as part of the EU-funded Ecoleader project. The building was subjected to shake table tests in bare condition and subsequently strengthened using Carbon Fiber Reinforced Polymers (CFRP) composites and retested. Numerical models of the building in both bare and CFRP-strengthened conditions are calibrated in DRAIN-3DX software to match the test results. To investigate the response of wave loads and impact forces, the numerical models are subjected to nonlinear dynamic analyses using force-time history input records. The analytical results are compared in terms of displacements at the floors and the 'impact point' of a boat. The results show that the roof displacement of the CFRP-strengthened building reduced by 63% when compared to the bare building. The results also indicate that strengthening only the mid-height of the impact column using CFRP is more efficient at reducing damage when compared to strengthening other parts of the column. Alternative solutions to mitigate damage due to tsunami loads are suggested.

Keywords: tsunami loads, hydrodynamic load, impact load, waterborne objects, RC buildings

Procedia PDF Downloads 456