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1.
J Autism Dev Disord ; 50(3): 935-948, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31813108

RESUMO

The use of alternative interventions, such as gluten-free and casein-free (GFCF) diets, is frequent due to limited therapies for Autism Spectrum Disorder (ASD). Our aims were to determine the influence of a GFCF diet on behavior disorders in children and adolescents diagnosed with ASD and the potential association with urinary beta-casomorphin concentrations. Thirty-seven patients were recruited for this crossover trial. Each patient consumed a normal diet (including gluten and casein) for 6 months and a GFCF diet for another 6 months. The order of the intervention (beginning with normal diet or with GFCF diet) was assigned randomly. Patients were evaluated at three time-points (at the beginning of the study, after normal diet and after GFCF diet). Questionnaires regarding behavior and autism and dietary adherence were completed and urinary beta-casomorphin concentrations were determined at each time-point. No significant behavioral changes and no association with urinary beta-casomorphin concentrations were found after GFCF diet. A 6-month GFCF diet do not induce significant changes in behavioral symptoms of autism and urinary beta-casomorphin concentrations. Further studies with a long follow-up period similar to ours and including placebo and blinding elements are needed to identify better those respondents to GFCF diets.

2.
Nutr Hosp ; 33(3): 251, 2016 Jun 30.
Artigo em Espanhol | MEDLINE | ID: mdl-27513480

RESUMO

La detección de la desnutrición hospitalaria continúa de plena actualidad en la literatura médica y, a pesar de que desde hace dos décadas dejó de ser un tema novedoso, constituye un elemento recurrente en la bibliografía y motivo de abordajes monográficos en congresos y reuniones científicas.


Assuntos
Hospitais , Transtornos Nutricionais/diagnóstico , Humanos , Desnutrição/diagnóstico , Desnutrição/terapia , Transtornos Nutricionais/terapia
3.
Obes Surg ; 26(8): 1836-42, 2016 08.
Artigo em Inglês | MEDLINE | ID: mdl-26661106

RESUMO

BACKGROUND: Specific data is needed to safely expand bariatric surgery and to preserve good surgical outcomes in response to the non-stop increase in obesity prevalence worldwide. OBJECTIVE: The aims of this study are to provide an overview of the baseline characteristics, type of surgery, and 30-day postoperative morbidity and mortality in patients undergoing bariatric surgery in Spanish public hospitals, and evaluate changes throughout the 2000-2014 period. MATERIAL AND METHODS: This is a descriptive study using data from the RICIBA, a computerized multicenter and multidisciplinary registry created by the Obesity Group of the Endocrinology and Nutrition Spanish Society. Three periods according to the date of surgery were created: January 2000 to December 2004 (G1), January 2005 to December 2009 (G2), and January 2010 to December 2014 (G3). RESULTS: Data from 3843 patients were available (44.8 ± 10.5 years, a 3:1 female-to-male ratio, 46.9 ± 8.2 kg/m(2)). Throughout the 15-year period assessed, candidate patients for bariatric surgery were progressively older and less obese, with an increase in associated comorbidities and in the prevalence of men. The global trend also showed a progressive decrease in Roux-en-Y gastric bypass, the most performed bariatric procedure (75.1 % in G1, 69.3 % in G2, and 42.6 % in G3; p < 0.001), associated with a parallel increase in sleeve gastrectomy (0.8 % in G1, 18.1 % in G2, and 39.6 % in G3; p < 0.001). An overall mortality rate of 0.3 % was reported. CONCLUSIONS: Data from Spain is similar to data observed worldwide. Information recorded in the National Registries like RICIBA is necessary in order to safely expand bariatric surgery in response to increasing demand.


Assuntos
Cirurgia Bariátrica/estatística & dados numéricos , Obesidade Mórbida/cirurgia , Cirurgia Bariátrica/métodos , Cirurgia Bariátrica/tendências , Comorbidade , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade Mórbida/mortalidade , Período Pós-Operatório , Prevalência , Sistema de Registros , Espanha/epidemiologia
4.
Environ Res ; 136: 435-40, 2015 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-25460665

RESUMO

The aim of the present study was to assess the relationship between serum concentrations of several persistent organic pollutants and insulin resistance markers in a cohort of women with a history of gestational diabetes mellitus. ∑POPs was computed as the sum of individual serum POP concentrations. No statistically significant associations were found between levels of any POP and fasting glucose. However, polychlorinated biphenyl (PCB) congeners 138 and 180 were positively associated with 2-h glucose levels and PCB 180 also with fasting immunoreactive insulin (IRI). We also found a positive association of p,p'- dichlorodiphenyldichloroethylene (p,p'- DDE), PCBs (138, 153, and 180), hexachlorobenzene, and ∑POPs with 2-h IRI. Serum concentrations of PCBs (138, 153, and 180), hexachlorobenzene, and ∑POPs were also positively associated with homeostasis model assessment (HOMA2-IR) levels. Moreover, p,p'- DDE, PCBs (138, 153 and 180), hexachlorobenzene, and ∑POPs were negatively associated with Insulin Sensitivity Index (ISI-gly) levels. No significant association was found between glycated hemoglobin and the concentrations of any POP. The removal of women under blood glucose lowering treatment from the models strengthened most of the associations previously found for the whole population. Our findings suggest that exposure to certain POPs is a modifiable risk factor contributing to insulin resistance.


Assuntos
Biomarcadores/sangue , Diabetes Gestacional/sangue , Poluentes Ambientais/sangue , Resistência à Insulina , Compostos Orgânicos/sangue , Estudos de Coortes , Feminino , Humanos , Gravidez
5.
Vitam Horm ; 92: 259-69, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23601428

RESUMO

A better understanding of the prognostic factors of low bone mass in anorexia nervosa (AN) and development of effective therapeutic strategies is critical. In order to determine which clinical, biochemical, and/or hormonal parameters could be related to bone mineral density (BMD), 47 female AN patients were classified according to the WHO osteoporosis criteria at lumbar spine (LS). This was a cross-sectional study of 16 AN women with osteoporosis criteria and 31without. Control group was 25 healthy, normal-weight, age-matched women. We assessed BMD using dual-energy X-ray absorptiometry at the LS and body composition. We measured serum fasting cortisol, estradiol, insulin-like growth factor-1 (IGF-1), leptin, sex hormone-binding globulin, albumin and retinol binding protein levels. The prevalence of osteoporosis was 34% and osteopenia 19% at the LS. The AN group with osteoporosis had lower IGF-1 and estradiol levels (both p<0.001), lower serum leptin (p<0.02), and higher cortisolemia (p<0.03) levels compared with AN group without osteoporosis. The BMD and T-score at LS was inversely related to the duration of amenorrhea (p<0.02) and directly related to body mass index (BMI, p<0.002), total fat mass (p<0.03), serum IGF-1 (p<0.01), and estradiol levels (p<0.001) in AN patients. We conclude that AN women with a significant BMD loss have a high risk of developing osteoporosis. A low BMD is a consequence of hormonal alterations which include hypoestrogenism, hypoleptinemia, hypercortisolism, and decreases in IGF-1 levels, as well as a low BMI and fat mass.


Assuntos
Anorexia Nervosa/metabolismo , Densidade Óssea/fisiologia , Osteoporose/metabolismo , Adolescente , Feminino , Humanos , Adulto Jovem
6.
Med. clín (Ed. impr.) ; 135(6): 274-279, jul. 2010. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-84169

RESUMO

El diagnóstico de anorexia nerviosa (AN) se hace habitualmente en la adolescencia, por lo que la osteoporosis es una complicación relevante al incidir en una etapa crítica del desarrollo esquelético. Hasta un 50% de las pacientes con AN presenta una densidad mineral ósea alterada en el momento del diagnóstico, con riesgo de fracturas precoces o en la vida adulta. Se afecta fundamentalmente el hueso trabecular y los factores de mal pronóstico son el diagnóstico tardío, la persistencia de la amenorrea y del peso bajo. Las bases actuales del tratamiento serían la ganancia de peso, la recuperación de las menstruaciones y la suplementación con calcio y vitamina D. La densitometría ósea es una prueba diagnóstica necesaria en el estudio y en el seguimiento de las pacientes. La atención primaria debe identificar y derivar de forma precoz a unidades especializadas para mejorar el pronóstico de la enfermedad (AU)


The prevalence of anorexia nervosa has increased in recent years and a large proportion of patients with this disorder have low bone density at diagnosis and, therefore, an increased risk of early and late fractures. The mechanism of bone loss in anorexia nervosa is not well understood, yet it likely includes hypogonadism, alterations of the GH-IGF-1 axis and hypercortisolism. DEXA is the most effective tool for assessing and monitoring bone density in these patients, and it is important to improve or at least stabilize bone metabolism in those with low bone mass. No agent has yet been proven to be effective in improving bone density. However, sustained weight recovery and menses besides an adequate intake of calcium and vitamin D are recommended to optimize the conditions in which bone mass accrual may occur (AU)


Assuntos
Humanos , Feminino , Deficiência de Minerais , Anorexia Nervosa/complicações , Fraturas Ósseas/etiologia , Densidade Óssea/fisiologia , Hipogonadismo/complicações , Hiperfunção Adrenocortical/complicações
7.
Med Clin (Barc) ; 135(6): 274-9, 2010 Jul 17.
Artigo em Espanhol | MEDLINE | ID: mdl-19631350

RESUMO

The prevalence of anorexia nervosa has increased in recent years and a large proportion of patients with this disorder have low bone density at diagnosis and, therefore, an increased risk of early and late fractures. The mechanism of bone loss in anorexia nervosa is not well understood, yet it likely includes hypogonadism, alterations of the GH-IGF-1 axis and hypercortisolism. DEXA is the most effective tool for assessing and monitoring bone density in these patients, and it is important to improve or at least stabilize bone metabolism in those with low bone mass. No agent has yet been proven to be effective in improving bone density. However, sustained weight recovery and menses besides an adequate intake of calcium and vitamin D are recommended to optimize the conditions in which bone mass accrual may occur.


Assuntos
Anorexia Nervosa/metabolismo , Doenças Ósseas Metabólicas/etiologia , Osso e Ossos/metabolismo , Fraturas Ósseas/epidemiologia , Minerais/metabolismo , Osteoporose/etiologia , Tecido Adiposo/metabolismo , Adolescente , Adulto , Anorexia Nervosa/complicações , Anorexia Nervosa/tratamento farmacológico , Anorexia Nervosa/terapia , Densidade Óssea , Conservadores da Densidade Óssea/uso terapêutico , Doenças Ósseas Metabólicas/tratamento farmacológico , Doenças Ósseas Metabólicas/metabolismo , Cálcio/uso terapêutico , Síndrome de Cushing/etiologia , Síndrome de Cushing/metabolismo , Fraturas Ósseas/etiologia , Hormônios Esteroides Gonadais/metabolismo , Hormônios Esteroides Gonadais/uso terapêutico , Humanos , Hipogonadismo/etiologia , Hipogonadismo/metabolismo , Peptídeos e Proteínas de Sinalização Intercelular/metabolismo , Leptina/fisiologia , Masculino , Osteoporose/tratamento farmacológico , Osteoporose/metabolismo , Vitamina D/uso terapêutico , Adulto Jovem
8.
Aten Primaria ; 39(1): 7-11, 2007 Jan.
Artigo em Espanhol | MEDLINE | ID: mdl-17286917

RESUMO

OBJECTIVE: To know the social profile of Andalusian urban adolescents and analyse the similarities and differences they have with those at risk of presenting with eating disorders. DESIGN: Cross-sectional community study. Stratified cluster sampling. SETTING: Public and private education institutions in Andalusian cities with more than 100 000 inhabitants (Sevilla, Malaga, Granada, Cordoba, Cadiz, Huelva, Almeria, Jaen, Algeciras, and Jerez). PARTICIPANTS: Pupils from 12 to 16 years, attending an academic course in the year 2002-2003 (N=1667). MAIN MEASUREMENTS: To compare the results of the sample with adolescents who are at risk of presenting with eating disorders (those who scored more than 20 in the 26-item Eating Attitudes Test [EAT-26]) we used the chi2 test for the nominal variables and the Spearman rho for the interval variables, with a significance level of P=.05. RESULTS: There were no differences between either group as regards family structure, friend relationships, academic performance, and sporting activities. The differences centred on disciplinary practices, the number of friends diagnosed with an eating behavioural disorder, the objectives for practicing sports, and the type of diet that they followed. The subjects who scored highest on the EAT-26 were those who had a higher body mass index and a lower social status. CONCLUSIONS: It appears that diet changes are a response to certain social conditions. It would be speculative to include subjects who obtain high EAT-26 scores in the population at risk of anorexia.


Assuntos
Dieta , Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , Adolescente , Criança , Estudos Transversais , Feminino , Humanos , Fatores Socioeconômicos , Espanha , População Urbana
9.
Aten. prim. (Barc., Ed. impr.) ; 39(1): 7-11, ene. 2007. tab
Artigo em Espanhol | IBECS | ID: ibc-051580

RESUMO

Objetivo. Conocer el perfil social de los adolescentes urbanos andaluces y analizar las similitudes y diferencias que muestran con los que están en riesgo de presentar trastornos alimentarios. Diseño. Estudio transversal, comunitario. Muestra estratificada por conglomerados. Emplazamiento. Centros educativos públicos y privados de ciudades andaluzas de más de 100.000 habitantes (Sevilla, Málaga, Granada, Córdoba, Cádiz, Huelva, Almería, Jaén, Algeciras y Jerez). Participantes. Alumnado de 12 a 16 años, escolarizado en el curso académico 2002-2003 (n = 1.667). Mediciones principales. Para comparar los resultados de la muestra con los adolescentes que están en riesgo de presentar trastornos alimentarios (los que puntúan más de 20 en la Escala de Actitud Alimentaria 26 [EAT-26]) utilizamos el test de la χ2 para las variables nominales y la correlación de rho de Spearman para las variables de intervalo, con un nivel de significación de p < 0,05. Resultados. No hay diferencias significativas entre ambos grupos con respecto a la estructura familiar, la relación de amistad, el rendimiento académico y las prácticas deportivas. Las diferencias se centran en las prácticas disciplinarias, el número de amigos y amigas diagnosticados de trastorno de la conducta alimentaria, los objetivos para practicar deporte y el tipo de dieta que realizan. Las personas que puntúan más alto en el EAT-26 son las que tienen mayor índice de masa corporal y menor posición social. Conclusiones. Es conveniente contemplar las alteraciones alimentarias como una respuesta a determinadas condiciones sociales. Resulta aventurado considerar como incluidas en población de riesgo de anorexia a las personas que obtienen altas puntuaciones de la EAT-26


Objective. To know the social profile of Andalusian urban adolescents and analyse the similarities and differences they have with those at risk of presenting with eating disorders. Design. Cross-sectional community study. Stratified cluster sampling. Setting. Public and private education institutions in Andalusian cities with more than 100 000 inhabitants (Sevilla, Malaga, Granada, Cordoba, Cadiz, Huelva, Almeria, Jaen, Algeciras, and Jerez). Participants. Pupils from 12 to 16 years, attending an academic course in the year 2002-2003 (N=1667). Main measurements. To compare the results of the sample with adolescents who are at risk of presenting with eating disorders (those who scored more than 20 in the 26-item Eating Attitudes Test [EAT-26]) we used the χ2 test for the nominal variables and the Spearman rho for the interval variables, with a significance level of P=.05. Results. There were no differences between either group as regards family structure, friend relationships, academic performance, and sporting activities. The differences centred on disciplinary practices, the number of friends diagnosed with an eating behavioural disorder, the objectives for practicing sports, and the type of diet that they followed. The subjects who scored highest on the EAT-26 were those who had a higher body mass index and a lower social status. Conclusions. It appears that diet changes are a response to certain social conditions. It would be speculative to include subjects who obtain high EAT-26 scores in the population at risk of anorexia


Assuntos
Masculino , Feminino , Adolescente , Humanos , Anorexia Nervosa/epidemiologia , Comportamento do Adolescente , Comportamento Alimentar , Bulimia/epidemiologia , Atitude Frente a Saúde , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Condições Sociais/estatística & dados numéricos , População Urbana , Estudos Prospectivos
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