Exploratory analysis of reflective, reactive, and homeostatic eating behaviour traits on weight change during the 18-month NoHoW weight maintenance trial.

Behaviour change interventions for weight management have found varied effect sizes and frequent weight re-gain after weight loss. There is interest in exploring whether differences in eating behaviour can be used to develop tailored weight management programs. This secondary analysis of an 18-month weight maintenance randomised controlled trial (RCT) aimed to investigate the association between individual variability in weight maintenance success and change in eating behaviour traits (EBT). Data was analysed from the NoHoW trial (Scott et al., 2019), which was designed to measure processes of change after weight loss of ≥5% body weight in the previous year. The sample included 1627 participants (mean age = 44.0 years, SD = 11.9, mean body mass index (BMI) = 29.7 kg/m2, SD = 5.4, gender = 68.7% women/31.3% men). Measurements of weight (kg) and 7 EBTs belonging to domains of reflective, reactive, or homeostatic eating were taken at 4 time points up to 18-months. Increases in measures of 'reactive eating' (binge eating, p < .001), decreases in 'reflective eating' (restraint, p < .001) and changes in 'homeostatic eating' (unlimited permission to eat, p < .001 and reliance on hunger and satiety cues, p < .05) were significantly and independently associated with concomitant weight change. Differences in EBT change were observed between participants who lost, maintained, or re-gained weight for all EBTs (p < .001) except for one subscale of intuitive eating (eating for physical reasons, p = .715). Participants who lost weight (n = 322) exhibited lower levels of reactive eating and higher levels of reflective eating than participants who re-gained weight (n = 668). EBT domains can identify individuals who need greater support to progress in weight management interventions. Increasing reflective eating and reducing reactive eating may enhance weight management success.

Predicting dry weight change in Hemodialysis patients using machine learning.

BACKGROUND: Machine Learning has been increasingly used in the medical field, including managing patients undergoing hemodialysis. The random forest classifier is a Machine Learning method that can generate high accuracy and interpretability in the data analysis of various diseases. We attempted to apply Machine Learning to adjust dry weight, the appropriate volume status of patients undergoing hemodialysis, which requires a complex decision-making process considering multiple indicators and the patient's physical conditions. METHODS: All medical data and 69,375 dialysis records of 314 Asian patients undergoing hemodialysis at a single dialysis center in Japan between July 2018 and April 2020 were collected from the electronic medical record system. Using the random forest classifier, we developed models to predict the probabilities of adjusting the dry weight at each dialysis session. RESULTS: The areas under the receiver-operating-characteristic curves of the models for adjusting the dry weight upward and downward were 0.70 and 0.74, respectively. The average probability of upward adjustment of the dry weight had sharp a peak around the actual change over time, while the average probability of downward adjustment of the dry weight formed a gradual peak. Feature importance analysis revealed that median blood pressure decline was a strong predictor for adjusting the dry weight upward. In contrast, elevated serum levels of C-reactive protein and hypoalbuminemia were important indicators for adjusting the dry weight downward. CONCLUSIONS: The random forest classifier should provide a helpful guide to predict the optimal changes to the dry weight with relative accuracy and may be useful in clinical practice.

Weight status change from birth to childhood and the odds of high blood pressure among Chinese children.

Background: It is well documented that birth weight and childhood weight are associated with the blood pressure (BP) levels in childhood. However, the impact of weight status change from birth to childhood on BP among children is less well described. We aimed to assess the association between changes in weight status from birth to childhood and high BP in childhood. Methods and results: Data were obtained from a cross-sectional survey conducted in Jinan, China, and a total of 5,546 children aged 6-17 years were included in this study. Based on the birth weight status [high weight (> 4,000 g) vs. normal weight (2,500-4,000 g)] and childhood weight status during the survey period [high weight (overweight and obesity) vs. normal weight], children were assigned into four groups: persistently normal weight (normal birth weight and normal childhood weight), resolved high weight (high birth weight but normal childhood weight), incident high weight (normal birth weight but high childhood weight), and persistently high weight (high birth weight and high childhood weight). After adjustment for sex and age, BP in childhood was more responsive to current body mass index (BMI) than birth weight. After adjustment for the potential covariates, compared with children who had persistently normal weight from birth to childhood, those with incident high weight (odds ratio [OR] = 3.88, 95% confidence interval [CI] = 3.29-4.57) and persistently high weight (OR = 3.52, 95% CI = 2.71-4.57) were associated with the increased odds of childhood high BP. However, children who had resolved high weight did not have significantly increased odds of high BP in childhood (OR = 0.86, 95% CI = 0.59-1.25). Conclusion: The association of BP with recent BMI was stronger than with birth weight. Children who had incident or persistently high weight from birth to childhood had increased odds of high BP in childhood, whereas the odds was not significantly increased among those with high birth weight but changed to normal weight in childhood. Our findings highlight the importance of maintaining an appropriate weight in the early lifetime for the prevention of high BP and other related diseases, especially for those with high birth weight.

Association of body mass index and weight change with pneumonia mortality in a Japanese population: Japan Public Health Center-based Prospective Study.

BACKGROUND: Accumulating evidence suggests that pneumonia mortality is lower for individuals with high body mass index (BMI) compared to normal BMI, but it remains unclear whether weight change during adulthood influences subsequent mortality due to pneumonia in Asian populations, who have a relatively lean body mass. This study aimed to examine the association of BMI and weight change over 5 years with the subsequent risk of pneumonia mortality in a Japanese population. METHODS: The present analysis included 79,564 Japan Public Health Center (JPHC)-based Prospective Study participants who completed a questionnaire between 1995 and 1998 were followed for death through 2016. BMI was categorized into four groups: underweight (<18.5 kg/m2), normal weight (BMI: 18.5-24.9 kg/m2), overweight (25.0-29.9 kg/m2), and obese (BMI: ≥30.0 kg/m2). Weight change was defined as the difference of body weight between questionnaire surveys with a 5-year interval. Cox proportional hazards regression was used to estimate hazard ratios of baseline BMI and weight change for pneumonia mortality. RESULTS: During a median follow-up of 18.9 y, we identified 994 deaths from pneumonia. Compared with participants with normal weight, an elevated risk was observed among those who were underweight (hazard ratio = 2.29, 95% confidence interval [CI]: 1.83-2.87), whereas a decreased risk was found among those who were overweight (hazard ratio = 0.63, 95% CI: 0.53-0.75). Regarding weight change, the multivariable-adjusted hazard ratio (95% CI) of pneumonia mortality for a weight loss of 5 kg or more versus a weight change of less than 2.5 kg was 1.75 (1.46-2.10), whereas that for a weight gain of 5 kg or more was 1.59 (1.27-2.00). CONCLUSION: Underweight and greater weight change was associated with an increase in the risk of pneumonia mortality in Japanese adults.

Melanocortin Receptors: Emerging Targets for the Treatment of Pigmentation, Inflammation, Stress, Weight Disorders and Sexual Dysfunction.

Melanocortins are tiny protein molecules formed by the post-translational cleavage of proopiomelanocortin. These are bioactive peptides that are responsible for human and lower animal pigmentation patterns, energy homeostasis, and sexual function modulation. These peptides regulate numerous physiological functions by being generated in the central nervous system and peripheral tissues. Melanocortins elicit their varied biological effects by binding to a separate family of G protein, two primary proteolytic enzymes, proconvertases 1 and 2, according to recent research. These breakthroughs have opened up new avenues for research into the role of melanocortins, antagonists, and receptors in a number of physiological activities.

Fluid intake, hydration status and body mass changes in U-15 judo athletes during a training day

Despite numerous studies related to dehydration there is still a lack of scientific literature presenting hydration status and fluid intake of judo athletes during different periods. Therefore, the aim of this study was to investigate, fluid intake, hydration status and body weight changes of young judo athletes during a typical day of training in preparation period. Twenty-two young judo athletes (age: 12 ± 0.7 y, experience: 3.5 ± 1.1) voluntarily participated in this study. Hydration status and weight were examined in the morning, before and immediately after the training. All athletes trained 90 min and they consumed fluids ad libitum during the exercise. According to morning urine specific gravity (USG) values, 81.2% of the athletes were dehydrated while only 18.8% of the athletes were euhydrated. Pre-training urine measurements showed that 63.64% of the athletes presented dehydration and 77.27% of the athletes completed the training in dehydrated condition despite fluid availability during the training. Mean body weight loss during training was -0.64 ± 0.66%. It can be concluded that young judo athletes presented high prevalence of dehydration as indicated by USG values. Most of the athletes were dehydrated during a typical training day and completed the training in more dehydrated conditions compared to pre training values despite ad libitum fluid intake. It is of great importance to evaluate hydration status of the athletes before training to refrain from common practice of fluid restriction for weight loss and adverse effects of a persistent state of fluid deficit on physical and health related state.

Tratamiento ayurveda (Virechana y Basti) y cambios de la microbiota intestinal a nivel de Phylum y especie / Ayurveda Treatment (Virechana and Basti) and Changes of Intestinal Microbiota at Phyla and Species Level

Introducción: Se han analizado terapias ayurvédicas y prácticas médicas para un grupo de pacientes en Japón. La característica del tratamiento ayurvédico es una desintoxicación con una gran cantidad de tratamiento con aceite mediante un masaje con aceite en la superficie del cuerpo y una terapia de purificación con ghee o aceite de hierbas especialmente preparado. Los cambios de la microbiota intestinal durante estos tratamientos no han sido bien estudiados. Mé- LA PRENSA MÉDICA ARGENTINA Ayurveda Treatment (Virechana and Basti) and Changes of Intestinal Microbiota at Phyla and Species Level 79 V.107/Nº 2 todo: Los participantes fueron reclutados de la Clínica Hatai Ayurveda en Tokio. La terapia de Virechana, una terapia de purificación o la terapia de Basti (decocción y enema de aceite) se llevó a cabo en 13 pacientes con diversas manifestaciones. Todos los participantes proporcionaron el detalle de su estilo de vida, hábitos dietéticos, enfermedades pasadas y presentes mediante el cuestionario, y se registró la condición precisa durante la admisión al final del campamento. Se tomaron muestras fecales a la entrada, durante el tratamiento, al alta y tres semanas después para analizar la microbiota intestinal por el gen seqyebcubg 16srRNA. Resultados: el peso corporal disminuyó aproximadamente un 5% con la terapia de Virechana, mientras que no ocurrió con Basti, pero la grasa corporal aumentó un 4% (2,2 kg) en promedio en ambos grupos. Varias manifestaciones clínicas de los participantes mejoraron, especialmente en una erupción cutánea y un cambio atópico. El paciente deprimido también remitió mejoras en sus ganas de vivir. En su mayoría son vegetarianos y tenían más Bacteroides (48.09 ± 7.51%), Firmicutes (38.27 ± 10.82%) y Actinobacteria (3.30 ± 3.58%) que los omnívoros que tenían más Proteobacteria (10.73 ± 4.75%), Fusobacteria (2.40 ± 6.25%) y cianobacterias (0,09 ± 0,24%). Cuando los grupos se dividieron por el consumo de aceite, los usuarios de ghee mostraron más Fusobacterium y menos Firmicutes y Actinobacteria. La terapia con Virechana provocó cambios notables en la microbiota después del pretratamiento, como la disminución de Firmicutes y el aumento de Proteobacterias. A nivel género-especie, destacan el aumento de Enterobacteriaceae y la pérdida de Akkermansia municiphila. Niruha Basti y Matra Basti disminuyeron Firmicutes y aumentaron Proteobacteria (p = 0.096). Fusobacterium también aumentó. Después del alta, la Proteobateria se mantuvo alta, pero Firmicutes regresó al 30% en promedio, oscilando entre el 25% y el 50%. Tres semanas después, la variedad aumentó con Fusobacterium, Verrucomicrobia, Tenericutes y Lentisphaerae. La variedad de especies también aumentó tres semanas después. Conclusión: Varias quejas de los participantes mejoraron por el tratamiento ayurvédico con una gran cantidad de tratamiento de aceite por masaje de aceite de superficie corporal y terapia de purga. Causó cambios en la microbiota intestinal y los metabolitos bacterianos pueden afectar las lesiones cutáneas y la salud mental como la sensación depresiva

Factors associated with falls in hemodialysis patients: a case-control study / Factores asociados a caídas en pacientes hemodializados: un estudio de caso-control / Fatores associados às quedas em pacientes de hemodiálise: um estudo caso-controle

Objective: to identify possible associations between a higher probability of falls among hemodialysis patients and laboratory values, comorbidities, pharmacological treatment, hemodynamic changes, dialysis results and stabilometric alterations. Method: this was a retrospective case-control study with hemodialysis patients. Patients in a hemodialysis unit who had suffered one or more falls were included in the case group. Patients from the same unit who had not suffered falls were the controls. Data were gathered from the patients' clinical history and also from the results of a balance test conducted six months before the study. Results: thirty-one patients were included (10 cases and 21 controls). Intradialytic body weight change was significantly greater among cases (p <0.05). Patients in the case group also presented greater lateral instability after dialysis (p <0.05). Other factors such as high blood pressure, antihypertensives, beta-blockers, and lower heart rates were also associated with falls. Conclusion: a greater intradialytic weight change was associated with an increase in risk of falls. Nursing staff can control these factors to prevent the incidence of falls in dialysis patients.

Objetivo: identificar la posible asociación entre los valores analíticos, comorbilidades, tratamiento farmacológico, cambios hemodinámicos, resultado de la diálisis y alteraciones estabilométricas con una mayor probabilidad de caídas en pacientes en hemodiálisis. Método: estudio retrospectivo de casos y controles en pacientes en hemodiálisis. Se consideraron como casos pacientes de una unidad de hemodiálisis que habían sufrido una o varias caídas. Los controles fueron pacientes de la misma unidad que no sufrieron caídas. Se obtuvieron los datos de la historia clínica de los pacientes y, también, se valoró una prueba de equilibrio realizada 6 meses antes a dichos pacientes. Resultados: se incluyeron 31 pacientes (10 casos y 21 controles). El cambio de peso durante la diálisis fue significativamente mayor en el grupo de personas que sufrieron una caída (p <0,05). Los pacientes que sufrieron una caída presentaron mayor inestabilidad lateral después de la diálisis (p <0.05). Otros factores como la hipertensión arterial, los antihipertensivos, los betabloqueantes y las frecuencias cardiacas más bajas también se relacionaron con las caídas. Conclusión: un mayor cambio de peso intradiálisis se relaciona con mayor riesgo de caídas. El control de estos factores por parte del personal de enfermería podría prevenir la incidencia de caídas en pacientes dializados.

Objetivo: identificar a possível associação entre valores laboratoriais, comorbidades, tratamento farmacológico, alterações hemodinâmicas, resultado da diálise e alterações estabilométricas com uma maior probabilidade de quedas em pacientes de hemodiálise. Método: estudo caso-controle retrospectivo em pacientes de hemodiálise. Foram analisados os casos de pacientes de uma unidade de hemodiálise que sofreram uma ou mais quedas. Os controles foram pacientes da mesma unidade que não sofreram quedas. Os dados foram obtidos a partir do histórico clínico dos pacientes e, também, de um teste de equilíbrio realizado seis meses antes nesses pacientes. Resultados: 31 pacientes foram avaliados (10 casos e 21 controles). A alteração de peso durante a diálise foi significativamente maior no grupo de pessoas que sofreu uma queda (p <0,05). Pacientes que sofreram queda apresentaram maior instabilidade lateral após a diálise (p <0,05). Outros fatores, como hipertensão, anti-hipertensivos, betabloqueadores e frequência cardíaca mais baixa, também foram associados às quedas. Conclusão: uma maior alteração do peso intradialítico está relacionada a um maior risco de quedas. O controle desses fatores pela equipe de enfermagem poderia prevenir a incidência de quedas em pacientes em diálise.

Significados en torno a la experiencia de someterse a una segunda intervención quirúrgica para bajar de peso / MEANING ABOUT THE EXPERIENCE OF SUBMITTING A SECOND SURGICAL INTERVENTION TO LOSE WEIGHT

Diversos motivos inciden en que los pacientes se sometan a cirugía bariátrica para hacer frente a la obesidad. Pese a ser el procedimiento más eficaz contra el exceso de peso, existe una alta tasa de pacientes que después de la cirugía, recuperan un porcentaje importante del peso perdido. Esta re-ganancia de peso genera consecuencias médicas, físicas y psicológico-emocionales; y en muchos casos lleva a que los pacientes vuelvan a someterse a intervenciones quirúrgicas con el objetivo de reactivar la pérdida de peso. No obstante, las re-operaciones no suelen tener la misma eficacia en términos de la pérdida de peso y su mantención. Esta investigación se centra en los significados psicológicos de la experiencia de someterse a más de una intervención quirúrgica para perder peso, con el objetivo de comprender lo que implica este proceso para los pacientes, así como también las repercusiones que trae consigo someterse a más de una intervención de este tipo. La metodología que se utilizó fue cualitativa con un enfoque desde la Teoría Fundamentada y con un alcance descriptivo para comprender lo que deben vivir estos pacientes. Para llevar a cabo esta investigación, se realizaron entrevistas semi-estructuradas a cuatro mujeres y un hombre, quienes previamente se habían sometido a una intervención quirúrgica para perder peso, y luego de unos años y de haber recuperado el peso perdido se sometieron a una cirugía bariátrica. La elección de la segunda intervención se asoció a la creencia que la recuperación de peso se debió principalmente a la técnica de la primera intervención, evaluación que cambia hacia una percepción de bajo control en la alimentación, tras la re-ganancia de peso post-segunda intervención. Se observa niveles importantes de frustración tras esta segunda re-ganancia.

There are several reasons why patients choose to undergo bariatric surgery to cope with obesity. Despite being the most effective procedure against excess weight, there is a high rate of patients who, after surgery, recover a significant percentage of the weight lost. This regain of weight generates medical, physical and psychological-emotional consequences; and in many cases it leads to patients re-undergo surgery with the aim of reactivating weight loss. However, re-operations are usually not as effective in terms of weight loss and weight maintenance. This research focuses on the psychological meanings of a patient's experience of more than one surgical intervention to lose weight, with the aim of understanding what this process implies for patients, as well as the repercussions of obtaining more than one intervention of this type. The specified methodology was qualitative with an approach from the Grounded Theory and with a descriptive scope to understand what these patients must live. To carry out this research, semi-structured interviews were conducted with four women and one man, who had previously undergone surgery to lose weight, and after a few years and having recovered the lost weight, underwent surgery. bariatric The choice of the second intervention was associated with the belief that weight recovery was mainly due to the technique of the first intervention, an evaluation that changes towards a perception of low control in the diet, after the post-weight gain second intervention. Significant levels of frustration are seen after this second regain

Porcentaje de peso perdido y su recuperación en pacientes bariátricos: un análisis desde la perspectiva temporal / Percentage of total weight loss and weight regain in bariatric patients: a time perspective analysis

RESUMEN La perspectiva temporal se ha asociado a hábitos relacionados con salud. Específicamente, el futuro ha sido asociado a cambios en el estilo de vida como la incorporación de ejercicio físico. En cambio, el presente hedonista se ha asociado a la perdida sub-óptima de peso en pacientes bariátricos. Objetivo: Evaluar la relación entre las variables de la perspectiva temporal y el porcentaje de peso total perdido; su mantención o re-ganancia desde el nadir, en pacientes bariátricos. Material y métodos: Se aplicó a 97 pacientes bariátricos el Inventario de la Perspectiva Temporal de Zimbardo y Boyd, y un cuestionario de estilo de vida construido para esta investigación. Resultados: Un mayor porcentaje de peso total perdido se asoció significativamente a futuro (r= 0,221; p<0,05) y desviación del perfil temporal negativo (r= 0,324; p<0,05). La pérdida de peso insuficiente estuvo asociada al presente fatalista (t= −2,16; p= 0,033) y desviación del perfil temporal balanceado (t= −2,81; p= 0,006). La re-ganancia del %PTP se asoció significativamente a la desviación del perfil temporal balanceado (t= −2,09; p= 0,045) y al consumo de dulces (X2= 13,42; p= 0,009). Conclusiones: Una mayor desviación de la perspectiva temporal balanceada y un mayor consumo de dulces se asociaron a una pérdida de peso insuficiente y a la recuperación desde el nadir.

ABSTRACT Background: A person's perspective of time has been associated with health-related habits. Specifically, future has been associated with changes in lifestyle as well the incorporation of physical exercise. In contrast, current hedonism is associated with sub-optimal weight loss in bariatric patients. Aim: To evaluate the relationship between seven variables of a time perspective and percentage of total weight loss; maintenance or weight regain among bariatric patients. Material and Methods: A sample of 97 bariatric patients answered the Inventory of Temporary Orientation and lifestyle questionnaires. Results: A greater percentage of total weight loss was significantly associated with future (r= 0.221; p<0.05) and deviations from negative time profile (r= 0.324; p<0.05). Insufficient weight loss was associated with a fatalistic present (t= −2.16, p= 0.033) and deviations from a balanced time perspective (t= −2.81; p= 0.006). Regaining weight was significantly associated to deviations from a balanced time perspective (t= −2.09; p=0.045) and consumption of sweets (X2= 13.42; p= 0.009). Conclusions: Deviations from a balanced time perspective and consumption of sweets are associated with sub-optimal weight loss and regaining weight.

Changes in weight and body composition among students after entering the university: a systematic review / Cambios en el peso y la composición corporal entre los estudiantes después de ingresar a la universidad: una revisión sistemática

OBJECTIVE: Conduct a literature review to provide an estimate of changes in weight and body composition among university students and evaluate whether these changes are exclusive to the first year of academic life. METHODS: Searches were performed in the PubMed/MEDLINE, Scopus, Web of Science, ScienceDirect, LILACS and SciELO databases for relevant articles published between 2007 and 2018. Only longitudinal studies involving concomitant evaluations of changes in weight and body composition were included. Two independent researchers performed the selection of the articles. RESULTS: Eleven articles met the eligibility criteria and were included in the review. The tendency toward an increase in weight and body fat during academic life was confirmed, especially in the first year. Gains in weight and body fat in the freshman year of university were reported in all studies and ranged from 1.0 to 2.1 kg and 0.7 to 1.3%, respectively. Among the majority of students, the gain in body weight was the result of an increase in body fat. CONCLUSION: University students experience gains in weight and body fat during their academic lives, especially in the first year of university.

OBJETIVO: Realizar una revisión de la literatura para proporcionar una estimación de los cambios en el peso y la composición corporal entre los estudiantes universitarios y evaluar si estos cambios son exclusivos del primer año de la vida académica. MÉTODOS: Se realizaron búsquedas en las bases de datos PubMed/MEDLINE, Scopus, Web of Science, ScienceDirect, LILACS y SciELO para artículos relevantes publicados entre 2007 y 2018. Solo se incluyeron estudios longitudinales que incluyeron evaluaciones concomitantes de cambios en el peso y la composición corporal. Dos investigadores independientes realizaron la selección de los artículos. RESULTADOS: Once artículos cumplieron con los criterios de elegibilidad y se incluyeron en la revisión. La tendencia hacia un aumento en el peso y la grasa corporal durante la vida académica se confirmó, especialmente en el primer año. Las ganancias en peso y grasa corporal en el primer año de la universidad se informaron en todos los estudios y variaron de 1.0 a 2.1 kg y 0.7 a 1.3%, respectivamente. Entre la mayoría de los estudiantes, el aumento en el peso corporal fue el resultado de un aumento en la grasa corporal. CONCLUSION: Los estudiantes universitarios experimentan aumentos de peso y grasa corporal durante su vida académica, especialmente en el primer año de la universidad.

Effects of Body Mass Index (BMI) on complete blood count parameters

Background: Anemia is considered by Worl Health Organization (WHO) as a global health problem. It can be affected by the body mass index of an individual since increasing weight can result in low-grade systemic inflammation and elevation of hepcidin which results in seguestratiion of iron inside a variety of cells including macrophages, hepatocytes and enteroytes and this would lead to the development of what is known as anemia of inflammation. In this study, we aimed to evaluate the effects of BI on complete blood count parameters. Patients and methods: In this crosssectional, retrospective study: the data of 200 overweight and obese male patients aged (18-60 years) were collected. They were grouped according to BMI into everweight and obese: different CBC parameters were noted. Inter group comparison was applied regarding different blood parameters and the relations eith BMI were calculated. Results: The prevalence of anemia was 16%. An extremely significant difference was found in mean white blood cells count in relation to different BMI gropups (p=0.001). A positive linear correlation was found between BMI with RDW, WBS, and platelets. Conclusions: There were effects of increasing BMI on WBC, RDW and platelets (AU)

Revisitando a puboplastia pós-bariátrica / Revisiting Postbariatric Monsplasty

INTRODUÇÃO: O tratamento da região pubiana é parte integrante do reajuste corporal inferior nos pacientes pós-bariátricos, tendo em vista a fisiopatologia e o caráter generalizado das deformidades de contorno após grandes emagrecimentos. O objetivo é apresentar nossa experiência no tratamento de pacientes pós-bariátricos, exclusivamente pela marcação baixa da abdominoplastia com vetores adequados de mobilização tecidual, sem a necessidade de cicatrizes verticais ou oblíquas na região do púbis. MÉTODOS: Foram avaliados retrospectivamente prontuários médicos e registros fotográficos de pacientes submetidos a diferentes abordagens abdominais, com aplicação dos princípios descritos acima no tratamento associado da região pubiana. Incisão cutânea anterior baixa, descolamento cranial angulado em direção ao plano aponeurótico (bisel preservando gordura profunda superior), e manutenção um excedente gorduroso nos bordos superiores para a facilitar a fixação dos retalhos através do Sistema Fascial Superficial. Uma avaliação subjetiva da qualidade dos resultados foi caracterizada por observador único. RESULTADOS: Numa casuística de 126 pacientes consecutivos, a tática empregada possibilitou restabelecer a melhor posição, tônus e formato do púbis em 100% dos casos, cujos resultados foram subjetivamente classificados como bom (40%) ou ótimo (60%). As intercorrências mais frequentemente encontradas na evolução pós-operatória foram pequenas deiscências da sutura (23,8%) e seromas (19%), com boa evolução pelos curativos e punções seriadas. CONCLUSÃO: A tática cirúrgica apresentada, com posicionamento baixo da incisão anterior e aproximação dos retalhos por fixação no sistema fascial superficial e pele, possibilita o tratamento adequado da região pubiana durante as abdominoplastias pós-bariátricas, sem a necessidade de ressecções e cicatrizes adicionais.

INTRODUCTION: The treatment of the pubic region is an integral part of lower body readjustment in post-bariatric patients, considering the pathophysiology and generalized characteristics of contour deformities after a considerable weight loss. The objective is to present our experience in the treatment of post-bariatric patients, exclusively by low marking of abdominoplasty with appropriate tissue mobilization vectors, without the necessity to leave vertical or oblique scars in the pubic region. METHODS: The medical and photographic records of patients subjected to different abdominal approaches were retrospectively evaluated, applying the principles described above in the combined treatment of the pubic region. A low anterior skin incision was created, and angled cranial detachment towards the aponeurotic plane (with the bevel preserving the deep upper fat) and maintenance of excess fat on the upper edges to facilitate the fixation of the flaps through the superficial fascial system were performed. The outcomes' quality was subjectively evaluated by a single observer. RESULTS: In the case series of 126 consecutive patients, the strategy used restored the best position, tone, and shape of the pubis in 100% of the cases; the results were subjectively classified as good (40%) or very good (60%). The complications more frequently found in the post-operative period were small suture dehiscence (23.8%) and seroma formation (19%), with good evolution provided by dressings and serial punctures. CONCLUSION: The surgical strategy presented involving low positioning of the anterior incision and flap alignment in the superficial fascial system and skin by fixation allows the proper treatment of the pubic region during post-bariatric abdominoplasty procedures, without the need for additional resections and scars.

O impacto do peso flutuante sobre fatores de risco cardiovascular em mulheres obesas / The impact of weight cycling on cardiovascular risk factors in obese women

O Peso Flutuante tem como principal característica um ciclo constituído de perda de peso intencional e ganho de peso não intencional, geralmente observado entre indivíduos obesos. O objetivo do estudo foi identificar a prevalência de Peso Flutuante e verificar a evolução das variáveis clínicas, antropométricas e bioquímicas analisadas na população que apresentou flutuação de peso corporal. Foram coletados os dados clínicos (patologias associadas e antecedentes familiares), antropométricos e bioquímicos (glicemia, colesterolemia e trigliceridemia) de 64 mulheres atendidas no ambulatório de nutrição do Hospital Universitário de Sergipe, que se encaixaram nos critérios de inclusão da pesquisa. Foi considerado Peso Flutuante uma oscilação de 5% do peso inicial, entre perda e ganho ou vice-versa. O Peso Flutuante foi identificado em 32,8% das pacientes, sendo a maioria classificada como obesa e sedentária. As pacientes que não apresentaram oscilação do peso corporal praticaram mais atividade física e tiveram maior percentual de antecedentes familiares para obesidade. Foi observado que as mulheres obesas que apresentaram flutuação de peso não obtiveram melhora nas variáveis clínicas, antropométricas e bioquímicas analisadas.

Modificação da pressão arterial e do peso corporal em mulheres hipertensas em uso de terapia hormonal: estudo longitudinal de 10 anos / Modification of blood pressure and body weight in hypertensive women using hormone replacement therapy: a longitudinal study of 10 years

Introdução: A hipertensão arterial sistêmica é um achado frequente entre mulheres que necessitem terapia hormonal (TH). Os objetivos deste estudo foram verificar as modificações do peso corporal, da pressão arterial sistêmica e dos lipídios em mulheres hipertensas usuárias de TH ao longo do tempo. Métodos: Estudo longitudinal prospectivo. Trinta e três mulheres hipertensas com sintomas vasomotores, que consultaram no Ambulatório de Ginecologia Endócrina e Menopausa do Hospital São Vicente de Paulo ­ Passo Fundo/ RS, a partir de janeiro de 1993, participaram do estudo. Receberam TH com estrogênio, ou estrogênio + progestogênio, via oral. Foram examinadas a cada seis meses e durante 10 anos. Verificaram-se a idade, peso corporal (kg), pressão arterial sistólica (PAS) e diastólica (PAD) (mmHg), classes de anti-hipertensivos utilizados, glicemia de jejum (mg/dL), colesterol total e frações (mg/ dL) e triglicerídeos (mg/dL). Compararam-se os valores basais, aos 5 e 10 anos de seguimento, através de testes pareados. Resultados: A idade média foi 48,4 ± 4,8 anos. Houve uma tendência de aumento da PAS aos 5 anos, p=0,054, seguida de uma diminuição aos 10 anos, p=0,003. A PAD diminuiu aos 10 anos, p=0.001. Houve um acréscimo de anti-hipertensivos aos 5 anos de seguimento (p<0,001). As variáveis peso corporal, lipídios e glicemia de jejum não se modificaram ao longo do tempo. Conclusões: O uso de TH oral em pacientes hipertensas requer controle e eventual ajuste anti-hipertensivo em 5 anos. Ao longo de 10 anos de uso, a pressão arterial e o peso corporal mantiveram-se estáveis (AU)

Introduction: High blood pressure is a common finding among women who require hormone replacement therapy (HRT). The aims of this study were to assess changes in body weight, blood pressure, and lipid profile over time in hypertensive women using HRT. Methods: Prospective longitudinal study. Thirty-three hypertensive women with vasomotor symptoms, consulting at the Clinic of Endocrine Gynecology and Menopause of Hospital São Vicente de Paulo in Passo Fundo-RS, as of January 1993 were enrolled. They received estrogen or estrogen + progestogen orally and were examined every six months for 10 years. Age, body weight (kg) , systolic (SBP) and diastolic (DBP ) blood pressure (mmHg), classes of antihypertensive drugs used, fasting plasma glucose (mg/dL), total cholesterol and fractions (mg/dL) and triglycerides (mg/dL) were recorded. We compared the baseline values with those at 5- and 10-year follow-up through paired tests. Results: Mean age was 48.4 ± 4.8 years. There was a trend of increase in SBP at 5 years, p = 0.054, followed by a decrease at 10 years, p = 0.003. DBP decreased at 10 years, p = 0.001. There was an increase of antihypertensive drugs at 5 years of follow-up (p < 0.001 ). Body weight, lipid profile and fasting glucose did not change over time. Conclusions: Over 10 years of use, blood pressure and body weight remained stable. The use of oral HRT in hypertensive patients requires control and possible antihypertensive adjustment at 5 years (AU)

Perda de peso e desnutrição em pacientes com doença de alzheimer em Fortaleza ? CE / Weight loss and malnutrition in patients with Alzheimer disease in Fortaleza-CE

Objetivo: Investigar o estado nutricional e as alterações de peso corporal em pacientes com a doença de Alzheimer atendidos em ambulatório especializado em Fortaleza ? CE, Brasil. Métodos: Trata-se de um estudo do tipo transversal comparativo, com abordagem quantitativa, cuja amostra envolveu idosos com e sem a doença de Alzheimer, que frequentaram ambulatório especializado durante o mês de março de 2009. Para avaliar o estado nutricional, utilizou-se o questionário Mini Avaliação Nutricional (MAN) e a classificação do Índice de Massa Corpórea (IMC) proposta por Lipschitz, enquanto que a alteração de peso foi investigada a partir de formulário pré-estabelecido. Resultados: Analisou-se 58 idosos de ambos os sexos, sendo 29 com Alzheimer (grupo 1) e 29 sem a doença (grupo 2). A perda de peso corporal foi a alteração mais frequente relatada pelos dois grupos, sendo que o percentual foi maior no grupo 1 (62,1%, n = 18) do que no grupo 2 (44,8%, n=13). O grupo 1 apresentou maior prevalência de risco de desnutrição, de acordo com a MAN (55,2%, n=16), e a totalidade dos pacientes classificados como desnutridos pelo IMC (20,7%, n=6). Conclusão: Observa-se, portanto, que a perda de peso e a desnutrição estão presentes na realidade em questão, evidenciando a importância do acompanhamento nutricional precoce na doença de Alzheimer.

Objective: This study aimed to investigate the nutritional status and body weight changes in patients with Alzheimer disease treated at a specialized clinic in Fortaleza-CE, Brazil. Methods: This is a comparative cross-sectional study with a quantitative approach, which involved elderly with and without Alzheimer disease, treated at a specialized clinic during the month of March 2009. To assess the nutritional status, we used the Mini Nutritional Assessment questionnaire (MAN) and the Body Mass Index (BMI) classification proposed by Lipschitz, while the weight change was investigated by a pre-established form. Results: We analyzed 58 elderly men and women, being 29 with Alzheimer disease (Group 1) and 29 without the disease (Group 2). The weight loss was the most frequently weight change reported by the two groups, and the percentage was higher in group 1 (62.1%, n = 18) than in group 2 44.8%, n = 13). The group 1 presented a higher prevalence of risk of malnutrition according to MAN (55.2%, n = 16) and all patients classified as malnourished by BMI (20.7%, n = 6). Conclusion: It is observed, therefore, that the weight loss and malnutrition are present in the reality in question, indicating the importance of early nutritional monitoring in Alzheimer disease.

Liposuction in body-shaping treatment for Kobberling-Dunnigan syndrome / Lipoaspiração no tratamento do contorno corporal na síndrome de Kobberling-Dunnigan

INTRODUCTION: Kobberling-Dunnigan syndrome is characterized by a series of alterations in metabolism and body fat distribution. Body dysmorphism and the Cushingoid appearance may have negative social and psychological impacts on the patient, including difficulty with social adaptation. In such cases, liposuction is used with the aim of improving body contour, with consequent improvements in self-esteem. The results are long lasting when body weight is maintained. CASE REPORT: Liposuction of the back, abdomen, and cervical regions in a woman with Kobberling-Dunnigan syndrome led to significant improvement in her body shape, and the results were maintained nine months postoperatively.

INTRODUÇÃO: A síndrome de Kobberling-Dunnigan caracteriza-se por um conjunto de alterações metabólicas e de distribuição da gordura corporal. O dismorfismo corporal e o aspecto cushingoide trazem repercussões psicológicas e sociais, com dificuldade de ajuste social. Nesses casos, a lipoaspiração é empregada com o objetivo de melhorar o contorno corporal e, consecutivamente, as alterações de autoestima. Os resultados apresentam-se duradouros quando há manutenção do peso. RELATO DO CASO: Paciente do sexo feminino, portadora de síndrome de Kobberling-Dunnigan, submetida a lipoaspiração de dorso, abdome e região cervical, com melhora significativa do contorno corporal e manutenção dos resultados nove meses após a operação.

Intra uterine growth retardation in rats treated with essential oil of rosmarinus officinalis linn

The essential oil of Rosmarinus officinalis L. (EORO) is used in cosmetics, in the food industry and in medicines, presenting antimicrobial and antifungal activity. Aim of the study: to observe maternal toxicity and embryo development after treatment of dams with EORO. Inseminated rats were distributed in four groups (n =15): Control (C) (saline 0.5ml) and treated with 242 (T1), 484 (T2) and 968mg/Kg (T3) of EORO, from the fifth to the seventh dpc and sacrificed on the 15th dpc. Variables analyzed: maternal behavior, body weight gain, food consumption, kidneys, liver and ovaries weight, hemogram, number of corpora lutea, implants, live, dead, malformed fetuses and placenta and fetuses weight. Statistics: Dunnett and Chi-square tests (α=0.05). The EORO higher dose reduced (p<0.05) maternal number of erythrocytes; the haematocrit, hemoglobin concentration and the fetuses body weight. Conclusions: Highest dose of EORO reduce the fetuse´s body weight and induced anemia in the dams.