Hypoxia is a condition during which the body or specific tissues are deprived of oxygen. This phenomenon can occur in response to exposure to hypoxic environmental conditions such as high-altitude, or because of pathophysiological conditions such as obstructive sleep apnea. Circumstances such as these can restrict supply or increase consumption of oxygen, leading to oxyhemoglobin desaturation and tissue hypoxia. In certain cases, hypoxia may lead to severe health consequences such as an increased risk of developing cardiovascular diseases and type 2 diabetes. A potential explanation for the link between hypoxia and an increased risk of developing cardiovascular diseases lies in the disturbing effect of hypoxia on circulating blood lipids, specifically its capacity to increase plasma triglyceride concentrations. Increased circulating triglyceride levels result from the production of triglyceride-rich lipoproteins, such as very-low-density lipoproteins and chylomicrons, exceeding their clearance rate. Considerable research in murine models reports that hypoxia may have detrimental effects on several aspects of triglyceride metabolism. However, in humans, the mechanisms underlying the disturbing effect of hypoxia on triglyceride levels remain unclear. In this mini-review, we outline the available evidence on the physiological responses to hypoxia and their impact on circulating triglyceride levels. We also discuss mechanisms by which hypoxia affects various organs involved in the metabolism of triglyceride-rich lipoproteins. This information will benefit scientists and clinicians interested in the mechanistic of the regulatory cascade responsible for the response to hypoxia and how this response could lead to a deteriorated lipid profile and an increased risk of developing hypoxia-related health consequences.

OBJECTIVE: To describe a safe technique for abdominal sacrocolpopexy that does not dissect and place the graft in the retroperitoneal space. MATERIALS AND METHODS:All medical records of patients undergoing abdominal sacrocolpopexy with or without concomitant procedures between the period of January 1999 and December 2003 were reviewed after obtaining approval of the Institutional Review Board at the University of Colorado. Thirty-two charts were completely available for review. All procedures were performed by the same surgeon and a senior resident. The surgery in all cases utilized titanium bone tacks or permanent suture, polypropylene graft attached to the sacrum, the vaginal apex, and no dissection of the retroperitoneal space. Extracted data included patient demographics, operating time, blood loss, mean hospital stay, and presence or absence of complications. Follow-up time ranged from six months to three years. RESULTS:The mean age of patients undergoing abdominal sacrocolpopexy was 62.4. Race of the patients was 60% Hispanic, 30% Caucasian, 15% African American, and 5% other. Eighteen patients had abdominal sacrocolpopexy with paravaginal repair; ten patients had abdominal sacrocolpopexy with paravaginal repair, and a procedure including suburethral sling, Burch procedure, or transobturator approach; of these patients, ten also underwent posterior colporrhaphy. Two patients underwent vaginal hysterectomy, and two had abdominal hysterectomies. Hospital stay, blood loss, operating time and complications were analyzed in each group. There was one case of post-operative ileus. There were no bowel obstructions, no peritonitis or any wound dehiscences in any of the patients. Three abdominal wound infections were noted. One patient who had undergone sacrocolpopexy paravaginal repair, hysterectomy and posterior repair had a graft erosion with sepsis at five month postoperatively. There have been no recurrent prolapse noted. CONCLUSIONS:While this is not a randomized trial comparing techniques, our technique compared with literature reports did not have a higher complication rate. Placement of the graft in the retroperitoneal space has a theoretical advantage; we found no complications related to bowel obstruction in any patients, and blood loss was minimal. When performing abdominal sacrocolpopexy, placement of the graft intraperitoneal was not associated with increased complication rates. OBJECTIVE:Our objective was to evaluate the effect of obesity on the outcome of the transobturator tape (TOT). METHODS:We prospectively evaluated all women who had the TOT procedure between October 2003 and August 2004. Intraoperative and postoperative complications were recorded. Subjective cure was determined by a negative answer to the question "Do you experience urine leakage related to physical activity, coughing, or sneezing?" The women were divided into three groups based on body mass index (BMI): nonobese (BMI Ͻ 30 kg/m2), obese (30 kg/m2 Յ BMI Ͻ 35 kg/m2), and very obese (BMI Ն 35 kg/m2). Data were analyzed using Chi-sq...