RESUMO
BACKGROUND: Although the data on eating behavior after bariatric surgery are substantial, data on "intuitive eating" are lacking. OBJECTIVE: The aim of this study was to evaluate the link between intuitive eating and weight loss after bariatric surgery. METHODS: This cross-sectional study used a self-administered questionnaire freely available on social networks and targeted women who had undergone bariatric surgery. Intuitive eating was evaluated with the Intuitive Eating Scale-2 (IES-2). The 3 questionnaire subscores (Eating for Physical Rather than Emotional Reasons, Reliance on Hunger and Satiety Cues, and Unconditional Permission to Eat) were also analyzed. The relation between IES-2 scores and the relative variation in body mass index [BMI (in kg/m2)] was assessed with linear regression models. Adjusted ß (ßAdj) and standardized ß $( {{\rm{\beta }}_{{\rm{Adj}}}^{{\rm{STD}}}} )$ were reported. RESULTS: We analyzed the responses of 401 women with a mean age of 39 ± 11 y, a mean preoperative BMI of 45.5 ± 7.9, and a mean current BMI of 30.5 ± 7. The mean relative BMI loss was 32.7 ± 12.9%, and the mean IES-2 score was 3.3 ± 0.6. The total IES-2 score was associated with the relative BMI loss, with â¼2.6% BMI loss for each 1-point increase in the IES-2 score [PAdj = 0.007; ßAdj = -2.57 (95% CI: -4.44, -0.70); ${\rm{\beta }}_{{\rm{Adj}}}^{{\rm{STD}}}$= -0.12] after adjusting for elapsed time since surgery and type of surgery. Eating for Physical Rather than Emotional Reasons was the subscore most strongly associated with BMI change after adjustment [PAdj = 0.002; ßAdj = -2.08 (95% CI: -3.37, 0.79); ${\rm{\beta }}_{{\rm{Adj}}}^{{\rm{STD}}}$ = -0.14]. CONCLUSIONS: This study highlights a significant association between intuitive eating and BMI decrease after bariatric surgery. Furthermore, eating behaviors changed with increasing time since surgery. An intuitive nutritional approach may be complementary with bariatric surgery in the postoperative phase, which should prompt complementary prospective studies to evaluate the effectiveness of therapeutic education programs centered on intuitive eating in the postoperative period.
Assuntos
Cirurgia Bariátrica , Comportamento Alimentar/fisiologia , Intuição/fisiologia , Obesidade/cirurgia , Redução de Peso , Adulto , Idoso , Estudos Transversais , Ingestão de Alimentos/psicologia , Emoções , Comportamento Alimentar/psicologia , Feminino , Humanos , Fome , Pessoa de Meia-Idade , Saciação , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Mechanical thrombectomy (MT) in association with intravenous thrombolysis is recommended for treatment of acute ischemic stroke (AIS), with large vessel occlusion (LVO) in the anterior circulation. Because MT is only available in comprehensive stroke centers (CSC), the challenge of stroke organization is to ensure equitable access to the fastest endovascular suite. Our aim was to evaluate the feasibility, efficacy, and safety of MT in patients initially managed in 1 CSC (mothership), compared with patients first managed in primary stroke center (PSC), and then transferred to the CSC for MT (drip-and-ship). METHODS: We retrospectively analyzed 179 consecutive patients (93 in the mothership group and 86 in the drip-and-ship group), with AIS secondary to LVO in the anterior cerebral circulation and a clinical-radiological mismatch (NIHSS ≥ 8 and DWI-ASPECT score ≥5), up to 6 hours after symptoms onset. We evaluated 3-month functional modified Rankin scale (mRS), periprocedural time management, mortality, and symptomatic intracranial haemorrhage (sICH). RESULTS: Despite significant longer process time in the drip-and-ship group, mRS ≤ 2 at 3 months (39.8% versus 44.1%, Pâ¯=â¯.562), Thrombolysis in cerebral infarction 2b-3 (85% versus 78%, Pâ¯=â¯.256), and sICH (7.0% versus 9.7%, Pâ¯=â¯.515) were similar in both group regardless of baseline clinical or radiological characteristics. After multivariate logistic regression, the predictive factors for favorable outcome were age (odds ratio [OR] -5years= 1.32, P < .001), initial NIHSS (OR -5pointsâ¯=â¯1.59, Pâ¯=â¯.010), absence of diabetes (ORâ¯=â¯3.35, Pâ¯=â¯.075), and the delay magnetic resonance imagining-puncture (OR -30minâ¯=â¯1.16, Pâ¯=â¯.048). CONCLUSIONS: Our study showed encouraging results from a regional protocol of MT comparing patients transferred from PSC or brought directly in CSC.
Assuntos
Infarto Encefálico/cirurgia , Prestação Integrada de Cuidados de Saúde/organização & administração , Fibrinolíticos/administração & dosagem , Trombólise Mecânica , Transferência de Pacientes/organização & administração , Regionalização da Saúde/organização & administração , Trombectomia , Tempo para o Tratamento/organização & administração , Idoso , Infarto Encefálico/diagnóstico , Infarto Encefálico/mortalidade , Infarto Encefálico/fisiopatologia , Avaliação da Deficiência , Estudos de Viabilidade , Feminino , Fibrinolíticos/efeitos adversos , Humanos , Infusões Intravenosas , Masculino , Trombólise Mecânica/efeitos adversos , Trombólise Mecânica/mortalidade , Pessoa de Meia-Idade , Recuperação de Função Fisiológica , Estudos Retrospectivos , Fatores de Risco , Trombectomia/efeitos adversos , Trombectomia/mortalidade , Fatores de Tempo , Resultado do TratamentoRESUMO
PURPOSE: The objective of this cross-sectional study was to describe and estimate the prevalence of antipsychotics (AP) in a cohort of addicted patients, and to compare the profiles of addictive patients receiving AP or not. METHODS: We included all adult patients seen at the addiction care center of Montpellier University Hospital, between January 1, 2015, and March 31, 2015. Demographic, clinical, and therapeutic data were collected from the patients' medical records. RESULTS: During the study period, 415 patients were included, with a mean age of 38 ± 10 years. They were mostly men (73.3%), French (54.9%), and unemployed (61.8%). Among the study population, 93 patients (patients treated with AP [trAP], 22.4%) were treated by 111 different AP, mainly cyamemazine (29.0% of treated patients), aripiprazole (20.4%), olanzapine (17.2%), and quetiapine (16.1%), mostly in monotherapy (80.6%) and by oral route (93.2% of AP). Psychiatric history was more frequent in trAP than in those without AP (untrAP) (55.9% vs 35.4% respectively; P < 0.001). Professional activity tended to be less frequent in patients with AP (25.3% vs 38.9%, P = 0.08).When compared with untrAP, trAP consumed more amphetamine (10.8% vs 4.4%; P = 0.02) and tended to consume less opiates (7.5% vs 14.9%; P = 0.06); the consumptions of cannabis (43.0% vs 35.7%; P = 0.20) and cocaine (22.6% vs 16.8%; P = 0.20) were not statistically different.Opiate maintenance therapy was reported in 63.7% of trAP and 68.4% of untrAP (P = 0.41): it consisted of methadone (trAP, 60.3% vs untrAP, 56.5%) and buprenorphine (trAP, 39.7% vs untrAP, 43.5%). CONCLUSIONS: The concomitant management of psychiatric and substance use disorders in the same center may explain the high prevalence of trAP in this study. Cannabis and psychostimulants may have been used in these patients as self-medication for mental disease-related symptoms or adverse effects of APs.