The association between chronotype, food craving and weight gain in pregnant women.

BACKGROUND: This cross-sectional study investigated the association between chronotype, food craving and weight gain in pregnant women. METHODS: In total, 245 pregnant women attending the public health service in Brazil were included. Chronotype was derived from the time of mid-sleep time on free days, with a further correction for calculated sleep debt, and higher scores on this variable indicate a tendency to eveningness. A Food Craving Questionnaire Trait and State assessment was performed, and weight gain was calculated. Generalised linear models were used to determine the association between the variables under analysis. RESULTS: Evening types presented higher anticipation of relief from negative states and feelings as a result of eating as a usual behaviour compared to morning (P = 0.013) and non-evening types (P = 0.028); less intense desire to eat as a sporadic behaviour compared to morning (P = 0.012) and non-evening types (P = 0.009); and less anticipation of positive reinforcement that may result from eating as a sporadic behaviour than non-evening types (P = 0.022). We also found a significant association between chronotype score and anticipation of relief from negative states and feelings as a result of eating (P = 0.004); anticipation of positive reinforcement that may result from eating (P = 0.013) as a usual behaviour; weight gain during the early gestational period (P = 0.024); and intense desire to eat (P = 0.045) as a sporadic behaviour. CONCLUSIONS: We conclude that evening chronotype was associated with the food craving trait. Pregnant women who tend to eveningness are more likely to gain weight in the early gestational period.

Clubfoot: a cord retainer.

Using a cord to retain the surgically corrected clubfoot replaces the need for repeated plaster casts and prolonged orthotics. Cords of braided polyester or nylon suture material 0.5 mm in diameter (a pair or more) were stretched between the fifth metatarsal and the lower metaphysis of the fibula. The required strength of the cord was judged from the initial range of motion (ROM) of the ankle and subtalar joints, and a factor derived from the body weight. The mean follow-up in five patients was 26.8 months (range 18-33 months). The peroneal muscles recovered an average of 9 months (range 7-11 months). Our one failure was caused by inaccurate estimation of cord strength.

Retrofibular transfer of tibialis posterior to control residual adduction deformity of clubfoot.

The tibialis posterior muscle was transferred behind the fibula through the peroneal muscles and anchored in the fourth intermetatarsal cleft as an adjuvant step in postero-medial release to control the adduction deformity of the forefoot in clubfeet. The results of this procedure were compared after five years with conventional methods, including postero-medial release alone, in ten identical bilateral clubfeet. The immediate and late correction of the adductus deformity were significantly improved by this additional operation.