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1.
Mult Scler ; 24(9): 1196-1204, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-28669275

RESUMO

BACKGROUND: Visual recovery after optic neuritis (ON) used to be defined as good, although patients frequently complain of poor vision. METHODS: We carried out a prospective study on 38 consecutive patients with acute ON followed monthly for 6 months and evaluated high- and low-contrast visual acuity (HCVA and LCVA, respectively), quality of vision (National Eye Institute Visual Function Questionnaire-25 (NEI-VFQ-25)), visual fields, and retinal thickness by spectral domain optical coherence tomography (OCT). RESULTS: We found significant impaired LCVA and color vision in ON eyes 6 months after acute ON, which impact on quality of life. LCVA and color vision were correlated with the thicknesses of the ganglion cell and inner plexiform layer (GCIPL; 2.5% LCVA r = 0.65 and p = 0.0001; color vision r = 0.75 and p < 0.0001) and that of the peripapillary retinal nerve fiber layer (pRNFL; LCVA r = 0.43 and p = 0.0098; color vision r = 0.62 and p < 0.0001). Linear regression models that included the change in the GCIPL and pRNFL thicknesses from baseline to month 1 after onset explained 47% of the change in 2.5% LCVA and 67% of the change of color vision acuity. When adjusting for the value of visual acuity at baseline, predictors of the change in vision from baseline to month 6 achieved similar performance for all three types of vision (HCVA, LCVA, and color vision). CONCLUSION: Monitoring retinal atrophy by OCT within the first month after ON onset allows individuals at a high risk of residual visual impairment to be identified.


Assuntos
Neurite Óptica/complicações , Neurite Óptica/patologia , Retina/patologia , Transtornos da Visão/etiologia , Transtornos da Visão/patologia , Adulto , Atrofia/diagnóstico por imagem , Atrofia/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Retina/diagnóstico por imagem , Tomografia de Coerência Óptica , Transtornos da Visão/diagnóstico por imagem
2.
J Neurol ; 263(4): 695-702, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26860093

RESUMO

Monitoring disease burden is an unmeet need in multiple sclerosis (MS). Identifying patients at high risk of disability progression will be useful for improving clinical-therapeutic decisions in clinical routine. To evaluate the role of visual field testing in non-optic neuritis eyes (non-ON eyes) as a biomarker of disability progression in MS. In 109 patients of the MS-VisualPath cohort, we evaluated the association between visual field abnormalities and global and cognitive disability markers and brain and retinal imaging markers of neuroaxonal injury using linear regression models adjusted for sex, age, disease duration and use of disease-modifying therapies. We evaluated the risk of disability progression associated to have baseline impaired visual field after 3 years of follow-up. Sixty-two percent of patients showed visual field defects in non-ON eyes. Visual field mean deviation was statistically associated with global disability; brain (normalized brain parenchymal, gray matter volume and lesion load) and retinal (peripapillary retinal nerve fiber layer thickness and macular ganglion cell complex thickness) markers of neuroaxonal damage. Patients with impaired visual field had statistically significative greater disability, lower normalized brain parenchymal volume and higher lesion volume than patients with normal visual field testing. MS patients with baseline impaired VF tripled the risk of disability progression during follow-up [OR = 3.35; 95 % CI (1.10-10.19); p = 0.033]. The association of visual field impairment with greater disability and neuroaxonal injury and higher risk of disability progression suggest that VF could be used to monitor MS disease burden.


Assuntos
Esclerose Múltipla/diagnóstico , Esclerose Múltipla/patologia , Transtornos da Visão/etiologia , Encéfalo/patologia , Estudos de Coortes , Progressão da Doença , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Esclerose Múltipla/complicações , Tomografia de Coerência Óptica , Testes de Campo Visual , Campos Visuais
3.
Nutr Hosp ; 29(3): 479-90, 2014 Mar 01.
Artigo em Espanhol | MEDLINE | ID: mdl-24558988

RESUMO

INTRODUCTION: Caffeine and catechins contained in green tea may have a thermogenic effect favoring weight and body fat loss. The aim of this study is to evaluate the magnitude of the effect of green tea or its extracts (caffeine and catechins) on body weight and body composition. MATERIAL AND METHODS: A systematic review and meta-analysis was conducted to determine the magnitude of the effect of green tea or its extracts on body weight (kg), body mass index (BMI) (kg/m2), fat mass (%), and waist and hip circumference (cm). We included studies published between 2000 and 2013, retrieved from PubMed/Medline with the following characteristics: randomized controlled trials (RCTs) of parallel groups (intervention and placebo), randomized, double-blind, and a minimum 12-week follow-up, in healthy individuals of either gender, 18 years or older, with a BMI of 25-40 kg/m2. Quality and risk of bias was assessed for every included study, and the statistical analysis was performed with the Crochrane Collaboration RevMan 5.1.6 software, according to the random effects model with a confidence interval of 95% (95%). It was established that the effect was statistically significant at p < 0.05, and the homogeneity of the studies was assessed using the I2 index. RESULTS: The search strategy retrieved 154 studies, of which only five could be included in the quantitative analysis. The analysis revealed a not statistically significant mean difference (MD) in weight loss in the analyzed sample and subgroups: Asian individuals -0.81 kg (95% CI: -2.76 to 1.13; P = 0.41; I2 = 0%, n = 210), Caucasians -0.73 kg (95% CI: -3.22 to 1.75; P = 0.45; I2 = 0%; n = 91), as well as in the sample as a whole: -0.78 kg (95% CI: -2.31 to 0.75; P = 0.32; I2 = 0%; n = 301). No statistically significant decrease was revealed in BMI in the analyzed sample and subgroups: Asian individuals -0.65 (95% CI: -1.85 to 0.54; P = 0.29; I2 = 0%; n = 71), -0.21 Caucasians (95% CI: -0.96 to 0.53; P = 0.58; I2 = 22%; n = 91), as well as in the sample as a whole: -0.31 kg (95% CI: -0.88 to 0.27; P = 0.30; I2 = 0%; n = 162), nor for the waist circumference 0.08 cm (95% CI: -0.39 to 0.55; P = 0.73; I2 = 3%; n = 301) or hip (95% CI: -1.14 to 0.93; P = 0.85; I2 = 0%; n = 210). In the evaluation of the effect on the percentage of fat mass (FM%), MD was found not statistically significant for population subgroups: Asian individuals -0.76 (95% CI: -1.59 to 0.08; P = 0.08; I2 = 0%; n = 169), Caucasians -0.76 (95% CI: -2.22 to 0.70; P = 0.31; I2 = 36%; n = 93), but a small, although statistically significant, decrease in the overall effect was found -0.76 (95% CI: -1.44 to -0.09; P = 0.03; I2 = 0%; n = 260). DISCUSSION: The statistically significant effect of green tea on the FM% of the entire sample was not clinically relevant, a fact also highlighted in the results of other meta-analysis. CONCLUSION OF THE AUTHORS: Green tea or gree tea extracts intake or its extracts exerts no statistically significant effect on the weight of overweight or obese adults. There is a small effect on the decrease in the percentage of fat mass, but it is not clinically relevant.


Introducción: La cafeína y las catequinas contenidas en el té verde podrían tener un efecto termogénico que favorece la pérdida de peso y de grasa corporal. El objetivo del presente estudio es evaluar la magnitud del efecto del té verde o de sus extractos (cafeína y catequinas) sobre el peso corporal y la composición corporal. Material y métodos: Se realizó una revisión sistemática y metaanálisis para determinar la magnitud del efecto del té verde o de sus extractos sobre el peso corporal (kg), índice de masa corporal (IMC) (kg/m2), masa grasa (%), y perímetro de cintura (cm), o de cadera (cm). Se incluyeron estudios publicados entre los años 2000 y 2013, recuperados de PubMed/Medline con las siguientes características: ensayos controlados aleatorizados (ECA) de grupos paralelos (intervención y placebo), con asignación aleatoria, doble cegado, y un seguimiento mínimo de 12 semanas, en individuos sanos de cualquier género, de edades superiores a los18 años, con IMC de 25-40 kg/ m2. De cada estudio incluido se estableció su calidad y riesgo de sesgos, y se realizó el análisis estadístico, con el software RevMan Crochrane Collaboration 5.1.6, según el modelo de efectos aleatorios con un intervalo de confianza del 95% (IC 95%). Se estimó que el efecto era estadísticamente significativo en p < 0,05, y se evaluó la homogeneidad de los estudios mediante el índice I2. Resultados: La estrategia de búsqueda recuperó 154 estudios, de los cuales solamente 5 pudieron ser incluidos en el análisis cuantitativo. El análisis reveló una diferencia media (DM) estadísticamente no significativa de pérdida de peso, tanto en el análisis de subgrupos: individuos asiáticos -0,81 kg (95% IC: -2,76 a 1,13; P = 0,41; I2 = 0%; n = 210), individuos caucásicos -0,73 kg (95% IC: -3,22 a 1,75; P = 0,45; I2 = 0%; n = 91); como en su conjunto: -0,78 kg (95% IC: -2,31 a 0,75; P = 0,32; I2 = 0%; n = 301). Tampoco se observó una DM estadísticamente significativa de disminución del IMC, tanto en el análisis de subgrupos: individuos asiáticos -0,65 (95% IC: -1,85 a 0,54; P = 0,29; I2 = 0%; n = 71), individuos caucásicos -0,21 (95% IC: -0,96 a 0,53; P = 0,58; I2 = 22%; n = 91); como en su conjunto: -0,31 kg (95% IC: -0,88 a 0,27; P = 0,30; I2 = 0%; n = 162), ni para el perímetro de cintura 0,08 cm (95% IC: -0,39 a 0,55; P = 0,73; I2 = 3%; n = 301) o cadera (95% IC: -1,14 a 0,93; P = 0,85; I2 = 0%; n = 210). En la evaluación del efecto sobre el porcentaje de masa grasa (%MG), no se halló una DM estadísticamente significativa para los subgrupos de población: individuos asiáticos -0,76 (95% IC: -1,59 a 0,08; P = 0,08; I2 = 0%; n = 169), individuos caucásicos -0,76 (95% IC: -2,22 a 0,70; P = 0,31; I2 = 36%; n = 93); pero sí una pequeña, aunque estadísticamente significativa, disminución en su conjunto -0,76 (95% IC: -1,44 a -0,09; P = 0,03; I2 = 0%; n = 260). Discusión: El efecto estadísticamente significativo del té verde sobre el %MG de toda la muestra no fue clínicamente relevante, hecho remarcado en los resultados de otros metaanálisis. Conclusión de los autores: La ingesta de té verde o de sus extractos no ejerce efectos estadísticamente significativos sobre el peso de adultos con sobrepeso u obesidad. Se observa un pequeño efecto sobre la disminución del porcentaje de masa grasa, pero no es clínicamente relevante.


Assuntos
Composição Corporal/efeitos dos fármacos , Peso Corporal/efeitos dos fármacos , Extratos Vegetais/farmacologia , Chá , Humanos , Obesidade/tratamento farmacológico , Sobrepeso/tratamento farmacológico , Extratos Vegetais/uso terapêutico
4.
Nutr. hosp ; 29(3): 479-490, 2014. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-120614

RESUMO

Introducción: La cafeína y las catequinas contenidas en el té verde podrían tener un efecto termogénico que favorece la pérdida de peso y de grasa corporal. El objetivo del presente estudio es evaluar la magnitud del efecto del té verde o de sus extractos (cafeína y catequinas) sobre el peso corporal y la composición corporal. Material y Métodos: Se realizó una revisión sistemática y metaanálisis para determinar la magnitud del efecto del té verde o de sus extractos sobre el peso corporal (kg), índice de masa corporal (IMC) (kg/m2), masa grasa (%), y perímetro de cintura (cm), o de cadera (cm). Se incluyeron estudios publicados entre los años 2000 y 2013, recuperados de PubMed/Medline con las siguientes características: ensayos controlados aleatorizados (ECA) de grupos paralelos (intervención y placebo), con asignación aleatoria, doble cegado, y un seguimiento mínimo de 12 semanas, en individuos sanos de cualquier género, de edades superiores a los18 años, con IMC de 25-40 kg/ m2. De cada estudio incluido se estableció su calidad y riesgo de sesgos, y se realizó el análisis estadístico, con el software RevMan Crochrane Collaboration 5.1.6, según el modelo de efectos aleatorios con un intervalo de confianza del 95% (IC 95%). Se estimó que el efecto era estadísticamente significativo en p < 0,05, y se evaluó la homogeneidad de los estudios mediante el índice I2. Resultados: La estrategia de búsqueda recuperó 154 estudios, de los cuales solamente 5 pudieron ser incluidos en el análisis cuantitativo. El análisis reveló una diferencia media (DM) estadísticamente no significativa de pérdida de peso, tanto en el análisis de subgrupos: individuos asiáticos -0,81 kg (95% IC: -2,76 a 1,13; P = 0,41; I2 = 0%; n = 210), individuos caucásicos -0,73 kg (95% IC: -3,22 a 1,75; P = 0,45; I2 = 0%; n = 91); como en su conjunto: -0,78 kg (95% IC: -2,31 a 0,75; P = 0,32; I2 = 0%; n = 301). Tampoco se observó una DM estadísticamente significativa de disminución del IMC, tanto en el análisis de subgrupos: individuos asiáticos -0,65 (95% IC: -1,85 a 0,54; P = 0,29; I2= 0%; n = 71), individuos caucásicos -0,21 (95% IC: -0,96 a 0,53; P = 0,58; I2 = 22%; n = 91); como en su conjunto: -0,31 kg (95% IC: -0,88 a 0,27; P = 0,30; I2 = 0%; n = 162), ni para el perímetro de cintura 0,08 cm (95% IC: -0,39 a 0,55; P = 0,73; I2 = 3%; n = 301) o cadera (95% IC: -1,14 a 0,93; P = 0,85; I2 = 0%; n = 210). En la evaluación del efecto sobre el porcentaje de masa grasa (%MG), no se halló una DM estadísticamente significativa para los subgrupos de población: individuos asiáticos -0,76 (95% IC: -1,59 a 0,08; P = 0,08; I2 = 0%; n = 169), individuos caucásicos -0,76 (95% IC: -2,22 a 0,70; P = 0,31; I2 = 36%; n = 93); pero sí una pequeña, aunque estadísticamente significativa, disminución en su conjunto -0,76 (95% IC: -1,44 a -0,09; P = 0,03; I2 = 0%; n = 260). Discusión: El efecto estadísticamente significativo del té verde sobre el %MG de toda la muestra no fue clínicamente relevante, hecho remarcado en los resultados de otros metaanálisis. Conclusión de los autores: La ingesta de té verde o de sus extractos no ejerce efectos estadísticamente significativos sobre el peso de adultos con sobrepeso u obesidad. Se observa un pequeño efecto sobre la disminución del porcentaje de masa grasa, pero no es clínicamente relevante (AU)


Introduction: Caffeine and catechins contained in green tea may have a thermogenic effect favoring weight and body fat loss. The aim of this study is to evaluate the magnitude of the effect of green tea or its extracts (caffeine and catechins) on body weight and body composition. Material and methods: A systematic review and metaanalysis was conducted to determine the magnitude of the effect of green tea or its extracts on body weight (kg), body mass index (BMI) (kg/m2), fat mass (%), and waist and hip circumference (cm). We included studies published between 2000 and 2013, retrieved from PubMed/Medline with the following characteristics: randomized controlled trials (RCTs) of parallel groups (intervention and placebo), randomized, double-blind, and a minimum 12-week follow-up, in healthy individuals of either gender, 18 years or older, with a BMI of 25-40 kg/m2. Quality and risk of bias was assessed for every included study, and the statistical analysis was performed with the Crochrane Collaboration RevMan 5.1.6 software, according to the random effects model with a confidence interval of 95% (95%). It was established that the effect was statistically significant at p < 0.05, and the homogeneity of the studies was assessed using the I2 index. Results: The search strategy retrieved 154 studies, of which only five could be included in the quantitative analysis. The analysis revealed a not statistically significant mean difference (MD) in weight loss in the analyzed sample and subgroups: Asian individuals -0.81 kg (95% CI: -2.76 to 1.13; P = 0.41; I2 = 0%, n = 210), Caucasians -0.73 kg (95% CI: -3.22 to 1.75; P = 0.45; I2 = 0%; n = 91), as well as in the sample as a whole: -0.78 kg (95% CI: -2.31 to 0.75; P = 0.32; I2 = 0%; n = 301). No statistically significant decrease was revealed in BMI in the analyzed sample and subgroups: Asian individuals -0.65 (95% CI: -1.85 to 0.54; P = 0.29; I2 = 0%; n = 71), -0.21 Caucasians (95% CI: -0.96 to 0.53; P = 0.58; I2 = 22%; n = 91), as well as in the sample as a whole: -0.31 kg (95% CI: -0.88 to 0.27; P = 0.30; I2 = 0%; n = 162), nor for the waist circumference 0.08 cm (95% CI: -0.39 to 0.55; P = 0.73; I2 = 3%; n = 301) or hip (95% CI: -1.14 to 0.93; P = 0.85; I2 = 0%; n = 210). In the evaluation of the effect on the percentage of fat mass (FM%), MD was found not statistically significant for population subgroups: Asian individuals -0.76 (95% CI: -1.59 to 0.08; P = 0.08; I2 = 0%; n = 169), Caucasians -0.76 (95% CI: -2.22 to 0.70; P = 0.31; I2 = 36%; n = 93), but a small, although statistically significant, decrease in the overall effect was found -0.76 (95% CI: -1.44 to -0.09; P = 0.03; I2 = 0%; n = 260). Discussion: The statistically significant effect of green tea on the FM% of the entire sample was not clinically relevant, a fact also highlighted in the results of other meta-analysis. Conclusion of the authors: Green tea or gree tea extracts intake or its extracts exerts no statistically significant effect on the weight of overweight or obese adults. There is a small effect on the decrease in the percentage of fat mass, but it is not clinically relevant (AU)


Assuntos
Humanos , Peso Corporal , Cafeína/farmacocinética , Catequina/farmacocinética , Sobrepeso/tratamento farmacológico , Obesidade/tratamento farmacológico , Chenopodium ambrosioides , Tecido Adiposo
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