Study objective-To determine the aspects of quality of life that are aVected by weight in the general population, to develop a specific questionnaire (OSQOL) that can measure with reliability and validity the impact of overweight and obesity on well being, and to compare the results with those obtained using a well known generic tool (the "SF 36" scale). Design-Cross sectional survey with matched control group. Setting-Community. Patients-A permanent survey base of approximately 10 000 representative ordinary households were screened for weight and height. Five hundred subjects were randomly drawn from the sub-sample of adult people with a body mass index equal or greater than 27. A control sample of 500 subjects matched for sex, age, and employment status was drawn from the nonobese population. Main results-A short specific Quality Of Life scale, the OSQOL, was produced that comprises 11 items belonging to four independent dimensions. Using this scale and the SF36, it was found that: (1) moderately obese subjects (27 < BMI <30) did not significantly diVer from the control group except for physical capacity; (2) in the group of obese subjects with a BMI >30, quality of life seemed to be impaired for five of nine dimensions of the SF36 compared with the control population, all related to physical consequences of obesity. This population essentially perceived itself in terms of poor general health.
Chronic ulcers are a significant and common cause of morbidity and mortality worldwide. They disrupt the epidermis and dermis, resulting in a loss of barrier function. Keloids and hypertrophic scars (benign cutaneous tumors) represent an abnormal healing response. These fibroproliferative disorders are characterized by an overabundance of collagen and accumulation of extracellular matrix due to an imbalance between synthesis and degradation, culminating in excessive scarring. The objectives of this study were to evaluate and compare noninvasive biophysical methods for the measurement of outstanding quantitative parameters of scars and chronic ulcers, and to establish correlations between the parameters measured and the results of conventional subjective clinical evaluations. The development of new technologies, based on ultrasonography and laser Doppler, makes possible new dermatological evaluation methods. Fifteen patients (6 females and 9 males) with 15 chronic ulcers (4 diabetic ulcers, 10 venous ulcers and 1 pressure ulcer) and 30 patients (19 females and 11 males) with 30 scars (25 hypertrophic and 5 keloids) were included in this study. Clinical evaluation was performed by a dermatologist, an aesthetic surgeon and an endocrinologist. Biophysical measurements were used to assess local blood flow by laser Doppler flowmetry (Moor DRT4), thickness and echogenicity by high frequency ultrasonography (20 MHz, Dermascan C) and ulcer linear dimensions by image analysis. Our results show that blood flow within the ulcers and scars was higher than within normal skin. Also, skin thickness of chronic ulcers was decreased when compared to normal skin; the thickness of hypertrophic scars, but not of keloids, was increased in comparison to normal skin, and presented the possibility of measuring wound and scar surfaces with precision. In summary, this pilot study established the feasibility of measuring various biophysical parameters and adapted their potential utility to research on wounds.
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