High starch intake favours body weight control in neutered and spayed cats living in homes fed ad libitum.

Different starch-to-protein ratios were compared among neutered and spayed domiciled cats. Male and female obese and non-obese cats were fed kibble diets ad libitum for 4 months high in starch (HS (38 % crude protein (CP)): starch 32 %, protein 38 %; DM basis) or high in protein (HP (55 % CP): starch 19 %, protein 55 %) but similar in energy and fat in a crossover design. Physical activity was evaluated using an accelerometer, and body composition (BC), energy expenditure (EE) and water turnover (WT) using the doubly labelled water method. Results were compared in a 2 diet × 2 sex × 2 body condition factorial arrangement. Cats fed the HS (38 % CP) diet maintained a constant body weight, but lean mass (LM) tended to be reduced in female obese but to be increased in male non-obese (P < 0·08) and increased in female non-obese cats (P = 0·01). The HP (55 % CP) diet induced an increase in cat body weight and LM (P < 0·05) without altering BC proportion. EE tended to be higher in males (351 (se 8) kJ/kg0·67/d) than females (330 (se 8) kJ/kg0·67/d; P = 0·06), was unaffected by diet or BC, decreased as age increased (R 2 0·44; P < 0·01) and increased as physical activity increased (R 2 0·58; P < 0·01). WT was higher for the HP (55 % CP) diet (P < 0·01) and increased with EE (R 2 0·65; P < 0·01). The HS (38 % CP) diet favoured body weight control during 4 months of ad libitum feeding. Caution is necessary to balance protein in diets of female obese cats over 5 years, as they may have low energy and food intake, with LM loss.

Mirtazapine versus Megestrol in the Treatment of Anorexia-Cachexia Syndrome in Patients with Advanced Cancer: A Randomized, Double-Blind, Controlled Phase II Clinical Trial.

This study compared mirtazapine with megestrol in the management of cancer-related anorexia-cachexia syndrome in patients with advanced cancer. A randomized, double-blind, controlled clinical trial involving patients with advanced cancer and anorexia-cachexia syndrome was performed. Participants received mirtazapine 30 mg/day or megestrol 320 mg/day for eight weeks. The primary endpoint was the effect of mirtazapine on weight gain and the secondary endpoints were its effect on appetite, muscle strength, physical performance, body composition, adverse events, and medication adherence. Linear regression model with mixed effects was applied and a significance level of 5% was adopted. Fifty-two patients were randomized. Mean age was 65.8 ± 8.4 years. There was weight gain in 52% of the participants in the megestrol group and in 38% in the mirtazapine group after four weeks (p = 0.040). Appetite improved in 92% of the participants in the megestrol group and in 56% in the mirtazapine group after eight weeks (p = 0.007). In the sub-analysis by sex, women showed improvement in appetite (p < 0.001) and weight gain (p < 0.005) in the mirtazapine group, which was not observed in men. Mirtazapine appears to be inferior to megestrol in weight and appetite improvement. However, there may be a difference in the therapeutic response between sexes.

Análise comparativa entre a medida direta e indiretada ventilação voluntária máxima em pacientescom doença pulmonar obstrutiva crônica / Comparative analysis between direct and indirect maximum voluntary ventilation in patients with chronic obstructive pulmonary disease

Objetivo. Verificar a confiabilidade de obter a ventilação voluntária máxima por meio de estimativas com base no volume expiratório forçado no primeiro segundo (VEF1) em pacientes com doença pulmonar obstrutiva crônica. Método. Participaram do estudo 32 pacientes com doença pulmonar obstrutiva crônica, sendo 21 homens, com média de idade de 66 ± 8,3 anos. Todos foram submetidos a espirometria e a prova de ventilação voluntária máxima. Foram utilizados os testes de Friedman e de Wilcoxon para comparar a ventilação em estudo, obtida de modo indireto com o valor encontrado por espirometria. O nível de significância preestabelecido foi 5%. Resultados. Dentre as fórmulas indiretas para estimar a ventilação voluntária máxima, apenas a VEF1 x 40 apresentou aproximação com essa ventilação, obtida diretamente (p < 0,05). Conclusão. A melhor estimativa indireta capaz de substituir a medida direta da ventilação voluntária máxima, em pacientes com doença pulmonar obstrutiva crônica, é a fórmula VEF1 x 40.

Objective. To avaluate the reliability of obtaining the maximum voluntary ventilation via estimate values of the forced expiratory volume in the first second (FEV1) in patients with chronic obstructive pulmonary disease. Method. The population was composed of 32 patients with chronic obstructive pulmonary disease, 21 of which were male, and with a mean age in the range of 66 ± 8.3 years. All the patients undergone espirometry and maximum voluntary ventilation test. Friedman’s and Wilcoxon’s tests were used to compare indirect values of maximum voluntary ventilation with those obtained via espirometry. Values were considered statistically significant if p < 0.05. Results. Amongst the indirect formulae used to estimate the maximum voluntary ventilation only FEV1 x 40 showed an approximation with the directly obtained value of MVV (p < 0.05). Conclusion. Formula FEV1 x 40 is the best indirect estimate capable of replacing the direct measure of maximum voluntary ventilation in patients with chronic obstructive pulmonary disease.