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1.
Multimedia | Recursos Multimídia | ID: multimedia-13165

RESUMO

Procure receitas saudáveis e saborosas. Manter um peso corporal saudável é essencial na prevenção da obesidade e do câncer


Assuntos
Dieta Saudável , Peso Corporal Ideal , Planejamento de Cardápio , Neoplasias
2.
Clin Transplant ; 37(12): e15150, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37924498

RESUMO

BACKGROUND: Predicted heart mass (PHM) is a commonly used tool for donor-to-recipient size matching. However, incorporating body weight as part of PHM can be considered problematic given its high variability, and low metabolic nature of fat. We sought to assess whether substituting the actual donor and recipient weight with the ideal body weight (IBW) would affect the association of donor-to-recipient PHM ratio with 1-year and overall survival after heart transplantation. METHODS: The United Network for Organ Sharing (UNOS) database was queried for adult patients who received a primary heart transplant between January 2000 and September 2021. RESULTS: Both PHM and ideal PHM (IPHM) ratios were associated with one-year (PHM: p = .003; IPHM: p = .0007) and overall (PHM: p = .02; IPHM: p = .02) survival. In the continuous analysis with restricted cubic splines, both PHM (p = .0003) and IPHM (p = .00001) were associated with relative hazards of death. CONCLUSION: IPHM is significantly associated with post-transplant survival and may be a useful compliment to PHM.


Assuntos
Transplante de Coração , Peso Corporal Ideal , Adulto , Humanos , Estudos Retrospectivos , Doadores de Tecidos , Sobrevivência de Enxerto
3.
Int J Colorectal Dis ; 38(1): 194, 2023 Jul 12.
Artigo em Inglês | MEDLINE | ID: mdl-37436666

RESUMO

PURPOSE: Ileo-anal pull through (IAPT) is a commonly performed operation for the surgical management of ulcerative colitis. The effect of body weight on outcomes for patients undergoing this operation has not been extensively studied. METHODS: This was a prospective cohort study at a single tertiary care inflammatory bowel disease (IBD) center. A total of 457 patients who were operated on at the Mount Sinai Medical Center between 1983 and 2015 were included. Demographic characteristics, the patients' body weight at the time of IAPT, and postoperative outcome data were collected. RESULTS: For each patient, body weight was calculated as a percentage of the ideal body weight (IBW) for that patient's height. The mean percentage of ideal body weight was 93.9% with a standard deviation of 20%. The range for the population was 53.1 to 175%. Four hundred forty (96%) of the patients had a weight within two standard deviations of the mean, indicating a normal distribution. Seventy-nine patients developed a Clavien-Dindo class III complication necessitating a procedural treatment. The most common of these was a stricture at the anastomotic site (n = 54). Our study identified an association between a percentage of ideal body weight in the lowest quartile of our population and development of an anastomotic stricture. This association was statistically significant on multivariate analysis. CONCLUSION: Low body weight at the time of ileo-anal pull through for treatment of UC may be a risk factor for development of anastomotic stricture requiring dilation.


Assuntos
Colite Ulcerativa , Proctocolectomia Restauradora , Humanos , Colite Ulcerativa/cirurgia , Colite Ulcerativa/complicações , Proctocolectomia Restauradora/efeitos adversos , Peso Corporal Ideal , Constrição Patológica/complicações , Constrição Patológica/cirurgia , Estudos Prospectivos , Complicações Pós-Operatórias/epidemiologia , Estudos Retrospectivos
4.
Nan Fang Yi Ke Da Xue Xue Bao ; 43(3): 460-465, 2023 Mar 20.
Artigo em Chinês | MEDLINE | ID: mdl-37087592

RESUMO

OBJECTIVE: To compare the effect of laryngeal mask airway (LMA) size selection based on ideal and actual body mass on the success rate of first insertion in patients with low body mass index (BMI). METHODS: This study was performed in 137 patients aged 18-60 years with BMI below 18.5 kg/m2, in whom discrepancies occurred in the selection of LMA size based on their actual body mass and the ideal body mass. The patients were randomized divided into ideal body mass group and actual body mass group, in which the size of LMA was selected based on the ideal body mass and their actual body mass, respectively. The success rate of first LMA insertion, overall success rate, fiberoptic visual field grade, leakage pressure, and LMA-related complications of the patients were recorded during the maintenance and recovery of anesthesia. RESULTS: The success rate of first LMA insertion was significantly higher in ideal body mass group than in the actual body mass group (86.8% vs 68.1%, P=0.016). Compared with those in the actual body mass group, the patients in the ideal body mass group used larger LMA (P < 0.005) and had better fiberoptic field scores (P=0.001) and higher airway seal pressure (P < 0.005). The peak inspiratory pressure (P=0.154) or the incidence of LMA-related complications during anesthesia maintenance and recovery did not differ significantly between the two groups (P>0.05). CONCLUSION: The size selection of LMA based on the ideal body mass of the patients, determined according to their height and sex, can significantly improve the success rate of first LMA insertion in patients with low BMI.


Assuntos
Máscaras Laríngeas , Humanos , Máscaras Laríngeas/efeitos adversos , Índice de Massa Corporal , Peso Corporal Ideal , Anestesia Geral , Redução de Peso
5.
Wiad Lek ; 76(3): 568-574, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37057781

RESUMO

OBJECTIVE: The aim: To determine the aerobic and anaerobic productivity of females from the lowland districts of Zakarpattia region, depending on the component composition of body weight. PATIENTS AND METHODS: Materials and methods: A comparative analysis of physical health status of females in the post-pubertal period of ontogenesis, was carried out. Physical health status was assessed by indicators of aerobic and anaerobic productivity depending on the component composition of the body, which was determined by impedance measurement. RESULTS: Results: Physical health of females from the lowland districts depends on the component composition of the body, namely: an excellent level of aerobic productivity is observed in females who have a normal body weight with a high relative fat content and a normal relative content of skeletal muscles, VО2 max rel. > 38 ml·min-1·kg-1; as a result, their physical health exceeds the "critical level" according to H.L. Apanasenko and corresponds to "excellent" according to Ya.P. Pyarnat's criteria. Females from lowland districts who are underweight with a normal relative fat content and a high relative skeletal muscle content have an average level of aerobic productivity, VО2 max rel. < 34 ml·min-1·kg-1; as a result, their physical health is below the "critical level" according to H.L. Apanasenko. CONCLUSION: Conclusions: The presence of fat in females from lowland districts provides energy for muscle work, which contributes to better development of the muscular system. A high level of energy supply due to a high relative fat content determines the excellent physical health status of females from the lowland districts of Zakarpattia.


Assuntos
Composição Corporal , Peso Corporal Ideal , Humanos , Feminino , Anaerobiose , Peso Corporal , Músculo Esquelético
6.
JAMA Netw Open ; 6(3): e231987, 2023 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-36917110

RESUMO

Importance: Ample evidence links obesity to hypertension in youths. However, the association of high normal body mass index (BMI) with obesity and the interaction with different weight trajectories are not well understood. Objective: To examine the hypertension risk associated with high normal BMI for age and different weight trajectories in youths. Design, Setting, and Participants: This retrospective cohort study assessed 801 019 youths aged 3 to 17 years in an integrated health care system in Southern California from January 1, 2008, to February 28, 2015, with a maximum follow-up of 5 years from January 1, 2008, to February 28, 2020. Data analysis was performed from 2018 to 2022. Exposures: Youths were compared by first available (baseline) sex-specific BMI for age and change in the distance to the median BMI for age during the 5-year follow-up. Main Outcomes and Measures: Cox proportional hazards regression models with age as a time scale to assess hypertension risk (based on 2017 Blood Pressure Guidelines by the American Academy of Pediatrics from 3 consecutive independent visits), adjusted for sex, race and ethnicity, socioeconomic status, baseline year, and birth year. Results: A total of 801 019 youths (mean [SD] age, 9.4 [4.6] years; 409 167 [51.1%] female]; 59 399 [7.4%] Asian and Pacific Islanders, 65 712 [8.2%] Black, and 427 492 [53.4%] Hispanic) were studied. Compared with youths with a baseline BMI for age in the 40th to 59th percentiles, the adjusted hazard ratio (aHR) for hypertension within a maximum of 5 years was 1.26 (95% CI, 1.20-1.33) for youths between the 60th and 84th percentiles if they maintained their BMI for age. With every 1-unit annual increase in the distance to the median BMI for age, the aHR increased by 1.04 (95% CI, 1.04-1.05). The aHR was 4.94 (95% CI, 4.72-5.18) in youths with a baseline BMI for age in the 97th percentile or higher who maintained their body weight. Weight gain increased the risk associated with baseline BMI for age in the 97th percentile or higher with an aHR of 1.04 (95% CI, 1.04-1.05) per 1-unit annual increase in the distance to the median BMI for age. The risk associated with weight change was higher in youths living with low to high normal weight and overweight than in youths living with severe obesity. Conclusions and Relevance: In this cohort study of youths, high normal body weight above the 60th percentile of BMI for age was associated with increased risk of hypertension. Weight gain was associated with further increases in hypertension risk. Further research is needed to evaluate the wide range of body weight considered normal in youths and the health risks associated with high normal weight.


Assuntos
Trajetória do Peso do Corpo , Hipertensão , Masculino , Humanos , Feminino , Adolescente , Criança , Estados Unidos , Sobrepeso/complicações , Estudos de Coortes , Peso Corporal Ideal , Estudos Retrospectivos , Fatores de Risco , Índice de Massa Corporal , Obesidade/complicações , Peso Corporal , Aumento de Peso , Hipertensão/epidemiologia , Hipertensão/complicações
7.
Int J Obes (Lond) ; 47(6): 479-486, 2023 06.
Artigo em Inglês | MEDLINE | ID: mdl-36869152

RESUMO

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.


Assuntos
Índice de Massa Corporal , Alterações do Peso Corporal , População do Leste Asiático , Sobrepeso , Pneumonia , Magreza , Adulto , Humanos , População do Leste Asiático/estatística & dados numéricos , Japão/epidemiologia , Sobrepeso/epidemiologia , Sobrepeso/mortalidade , Estudos Prospectivos , Saúde Pública , Fatores de Risco , Magreza/epidemiologia , Magreza/mortalidade , Pneumonia/epidemiologia , Pneumonia/mortalidade , Peso Corporal Ideal
8.
Int J Mol Sci ; 24(5)2023 Mar 02.
Artigo em Inglês | MEDLINE | ID: mdl-36902307

RESUMO

Leptin, which plays a key role in energy homeostasis, is known as a neurotrophic factor possibly linking nutrition and neurodevelopment. Available data on the association between leptin and autism spectrum disorder (ASD) are confusing. The aim of this study was to explore whether plasma levels of leptin in pre- and post-pubertal children with ASD and/or overweightness/obesity differ from those of BMI- and age-matched healthy controls. Leptin levels were determined in 287 pre-pubertal children (mean age 8.09 years), classified as follows: ASD with overweightness/obesity (ASD+/Ob+); ASD without overweightness/obesity (ASD+/Ob-); non-ASD with overweightness/obesity (ASD-/Ob+); non-ASD without overweightness/obesity (ASD-/Ob-). The assessment was repeated in 258 of the children post-pubertally (mean age 14.26 years). There were no significant differences in leptin levels either before or after puberty between ASD+/Ob+ and ASD-/Ob+ or between ASD+/Ob- and ASD-/Ob-, although there was a strong trend toward significance for higher pre-pubertal leptin levels in ASD+/Ob- than in ASD-/Ob-. Post-pubertal leptin levels were significantly lower than pre-pubertal levels in ASD+/Ob+, ASD-/Ob+, and ASD+/Ob- and higher in ASD-/Ob-. Leptin levels, elevated pre-pubertally in the children with overweightness/obesity as well as in children with ASD and normal BMI, decrease with age, in contrast to the increasing leptin levels in healthy controls.


Assuntos
Transtorno do Espectro Autista , Leptina , Criança , Humanos , Adolescente , Peso Corporal Ideal , Obesidade , Puberdade , Índice de Massa Corporal
9.
Ann Pharmacother ; 57(10): 1154-1161, 2023 10.
Artigo em Inglês | MEDLINE | ID: mdl-36642982

RESUMO

BACKGROUND: Intravenous digoxin loading dose recommendations differ between clinical guidelines and Food and Drug Administration packaging for acute rate control. OBJECTIVE: The objective of this study was to assess the safety and efficacy of intravenous digoxin loading in patients who received ≤12 µg/kg and >12 µg/kg of digoxin using ideal body weight (IBW). METHODS: This single center retrospective cohort study with exempt status from the local Institutional Review Board included patients who received intravenous digoxin and had a serum digoxin concentration (SDC) drawn. Digoxin doses >36 hours after the first dose were excluded. Patients who received a total of >12 µg/kg and ≤12 µg/kg IBW were compared. The primary endpoint was frequency of SDCs ≥1.2 ng/mL, which have been shown to be associated with increased mortality. RESULTS: A total of 244 patients were included (144 receiving >12 µg/kg and 100 receiving ≤12 µg/kg). There were significantly more SDC ≥1.2 ng/mL in the >12 µg/kg group than the ≤12 µg/kg group (50.6% vs. 30.0%; adjusted odds ratio, 3.19; 95% confidence interval [CI]: 1.79-5.84), with no difference in rate control failure. Major limitations of the study include retrospective nature and possible selection bias. CONCLUSION AND RELEVANCE: Compared to patients who received digoxin doses ≤12 µg/kg IBW, patients who received >12 µg/kg IBW had higher rates of SDC ≥1.2 ng/mL. This suggests that appropriate weight-based dosing with 8 to 12 µg/kg IBW has the potential to be a safer approach to digoxin loading, rather than frequently used dosing strategies that result in doses >12 µg/kg.


Assuntos
Digoxina , Peso Corporal Ideal , Humanos , Estudos Retrospectivos , Digoxina/efeitos adversos , Peso Corporal
10.
J Thromb Thrombolysis ; 55(4): 680-684, 2023 May.
Artigo em Inglês | MEDLINE | ID: mdl-36715882

RESUMO

Safety and efficacy of direct oral anticoagulants (DOAC) in low weight patients with atrial fibrillation (AF) is unclear due to few low body weight patients enrolled in clinical trials. To assess bleeding and thrombotic event rates for patients with AF that are prescribed apixaban and have a low versus normal body weight. We analyzed patients with AF prescribed apixaban from 2017 to 2020 with at least 12 months of follow-up. Patients were divided into low [< 60 kg (kg)] and normal (60-100 kg) weight cohorts. Bleeding and thrombotic event rates were compared. Poisson regression and Cox proportional hazard models were used to estimate adjusted adverse event rates. A total of 545 patients met inclusion criteria. In the unadjusted analysis, there was an increase in non-major bleeding events requiring an Emergency Department visit more often in the low versus normal weight cohort (10.8 versus 7.4 per 100 patient-years, p = 0.15). Thrombotic event rates also occurred more often in the lower versus normal weight cohort (2.4 versus 0.9 per 100 patient-years, p = 0.09). However, adjusted analysis found no statistically significant difference in bleeding or thrombotic events between low and normal weight cohorts. The adjusted hazard ratio for bleeding was similar between the two weight cohorts. The use of apixaban in low body weight patients was not associated with higher rates of bleeding or thrombotic events, compared to those with normal body weight, after adjusting for potential confounding covariates. Larger studies may offer further insight into the overall safety and efficacy of DOAC therapy in these patients.


Assuntos
Fibrilação Atrial , Acidente Vascular Cerebral , Humanos , Fibrilação Atrial/tratamento farmacológico , Fibrilação Atrial/complicações , Varfarina/uso terapêutico , Anticoagulantes/efeitos adversos , Rivaroxabana/uso terapêutico , Acidente Vascular Cerebral/tratamento farmacológico , Peso Corporal Ideal , Hemorragia/induzido quimicamente , Hemorragia/tratamento farmacológico , Piridonas/efeitos adversos , Magreza/tratamento farmacológico , Administração Oral
11.
Wiad Lek ; 76(12): 2593-2600, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38290022

RESUMO

OBJECTIVE: The aim: to investigate the morphometric characteristics of placentas in women with comorbidity of preeclampsia and obesity compared to women with physiological body weight, and to assess the efficacy of the prophylactic therapy course developed to prevent the occurrence of preeclampsia in pregnant women with obesity. PATIENTS AND METHODS: Materials and methods: 25 biopsy samples of placental tissue were taken from women between 37 and 40 weeks of gestation with a physiological body weight and with class II obesity. The women were divided into five groups of five women in each: the 1st group included women with physiological body weight without obstetric and somatic pathology; the 2nd group involved women with physiological body weight, whose pregnancy was complicated with preeclampsia; the 3rd group was made up of women with class II obesity whose pregnancy was complicated with preeclampsia; the 4th group consisted of women with class II obesity, who received the special prophylactic therapy course, and the 5th group included women with class II obesity, who did not receive the prophylactic therapy course. RESULTS: Results: The analysis of morphometric parameters of placenta samples taken from women with preeclampsia and obesity demonstrates a number of com-pensatory and adaptive changes in placenta under hypoxic conditions, and the most important of them include a significant decrease in the number and the mean diameter of the terminal villi, the reduction of volume of villious tree, an increase in the diameter of the capillaries of terminal villi. The morphometric parameters and histological structure in placenta samples from women with obesity, who received the special the prophylactic therapy course, as well as in placenta samples of the control group were similar to the gestational normative values. CONCLUSION: Conclusions: The morphometric investigation of placenta samples taken from women with comorbidity of preeclampsia and obesity has shown a significant decrease in the mean diameter of the terminal villi and an increase in the diameter of the capillaries of these terminal villi when compared with a group of women with preeclampsia and physiological body weight. The study has also demonstrated the distortion of the percentage ratio of the volume of the intervil¬lous space and the ratio of medium-calibre villi. The combination of these changes indicates a lack of adaptive capabilities in the placenta during preeclampsia under increasing hypoxic condition.


Assuntos
Placenta , Pré-Eclâmpsia , Feminino , Gravidez , Humanos , Placenta/irrigação sanguínea , Pré-Eclâmpsia/patologia , Peso Corporal Ideal , Obesidade/patologia , Hipóxia/patologia
12.
Psicol. ciênc. prof ; 43: e262262, 2023. tab
Artigo em Português | LILACS, Index Psicologia - Periódicos | ID: biblio-1529218

RESUMO

As restrições impostas pela pandemia de covid-19 levaram os serviços de saúde a reorganizarem seu funcionamento, ajustando-se à modalidade remota. A transição repentina e sem o devido preparo técnico impôs desafios adicionais para usuários e profissionais. Para aprimorar as estratégias assistenciais, torna-se imprescindível dar voz aos usuários dos serviços, para que narrem suas experiências e possam manifestar suas facilidades e dificuldades com essa passagem. Este estudo tem como objetivo investigar como os principais cuidadores familiares de pessoas com transtornos alimentares vivenciaram a transição do grupo de apoio para o formato remoto e identificar vantagens e desvantagens percebidas nesse modelo. Estudo clínico-qualitativo, exploratório, realizado em um serviço de atendimento especializado de um hospital terciário. O cenário investigado foi o grupo de apoio psicológico aberto a familiares que, desde o início da pandemia de covid-19, passou a ser oferecido na modalidade online. Participaram do estudo cinco mães e três pais presentes em 13 sessões grupais consecutivas. Entrevistas individuais foram aplicadas com a Técnica do Incidente Crítico logo após o término de cada encontro grupal, totalizando 26 entrevistas audiogravadas, transcritas e submetidas à análise temática. A transição para o online foi vivenciada pelos participantes como um recurso válido para permitir que o grupo funcionasse em tempos de grave crise sanitária. Como vantagens, foram mencionadas: a continuidade do cuidado, maior acessibilidade e facilidade em relação à logística da participação. Como limitações do formato online, foram destacadas: nem todos os familiares contam com conexão de internet de qualidade e possível dificuldade para manusear a tecnologia digital. Apesar dos desafios impostos pela súbita mudança para a modalidade online, na perspectiva dos usuários do serviço os esforços de adaptação foram bem-sucedidos, possibilitando a continuidade do cuidado à saúde mental.(AU)


The constraints imposed by the COVID-19 pandemic led health services to reorganize their operation, adjusting to the online modality. The sudden and unprepared technical transition has imposed additional challenges for both users and professionals. To improve care strategies, it is essential to give voice to services users, so that they can narrate their experiences and express their facilities and difficulties with this transition. This study aims to investigate how main family caregivers of people with eating disorders experienced the transition of the support group to the remote modality and to identify perceived advantages and disadvantages in this model. This is a clinical-qualitative, exploratory study carried out in a specialized care service of a tertiary hospital. The investigated setting was the psychological support group open to family members, which since the beginning of the COVID-19 pandemic has been offered online. Five mothers and three fathers who attended 13 consecutive group sessions participated in the study. Individual interviews were carried out with the Critical Incident Technique shortly after the end of each group meeting with all members, totaling 26 audio-recorded interviews. Data were subjected to thematic analysis. Transition was experienced as a valid resource to maintain the group active in times of a severe health crisis. As advantages of the remote modality were mentioned: continuity of care, greater accessibility, and ease in relation to the logistics of participation. As limitations of the online format were highlighted: not everyone has a good-quality connection to the internet, and difficulty in handling the digital technology. Despite the challenges imposed by the sudden shift to the online modality, from the service users' perspective the adaptation efforts were successful, enabling continuity of mental health care.(AU)


Las limitaciones que impuso la pandemia de la COVID-19 llevaron a los servicios sanitarios a reorganizar su funcionamiento adaptándose a la modalidad remota. El súbito cambio y sin la preparación técnica adecuada implicó retos adicionales a los usuarios y profesionales. Para mejorar las estrategias de atención es fundamental dar voz a los usuarios de los servicios, para que puedan narrar sus experiencias y expresar sus facilidades y dificultades con esta transición. Este estudio pretende investigar cómo han vivido los cuidadores de personas con trastornos alimentarios la transición del grupo de apoyo presencial al formato remoto e identificar las ventajas y desventajas percibidas en este modelo. Se trata de un estudio clínicocualitativo, exploratorio. El escenario investigado fue el grupo de apoyo psicológico abierto a los familiares en la modalidad en línea. Cinco madres y tres padres participaron en 13 sesiones de grupo consecutivas. Se realizaron entrevistas individuales con la técnica de incidentes críticos inmediatamente después de cada reunión del grupo, con un total de 26 entrevistas grabadas en audio, transcritas y sometidas a análisis temático. La transición a la red fue experimentada como un recurso válido para permitir que el grupo funcione en tiempos de crisis sanitaria grave. Las ventajas de la modalidad remota fueron conexión segura en tiempos de confinamiento físico, continuidad, mayor accesibilidad y facilidad en relación con la logística de la participación. Las limitaciones del formato en línea fueron la falta de una conexión de calidad a Internet y la posible dificultad de manejo de la tecnología digital. A pesar de las dificultades impuestas por el cambio repentino a la modalidad en línea, desde la perspectiva de los usuarios del servicio los esfuerzos de adaptación fueron un éxito, lo que permitió seguir con la atención de salud mental.(AU)


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Pais , Grupos de Autoajuda , Transtornos da Alimentação e da Ingestão de Alimentos , Cuidadores , COVID-19 , Ansiedade , Equipe de Assistência ao Paciente , Pacientes , Psicologia , Psicopatologia , Qualidade de Vida , Rejeição em Psicologia , Infecções Respiratórias , Autoavaliação (Psicologia) , Autoimagem , Isolamento Social , Apoio Social , Estresse Fisiológico , Estresse Psicológico , Terapêutica , Magreza , Vômito , Mulheres , Terapia Comportamental , Imagem Corporal , Peso Corporal , Educação Alimentar e Nutricional , Adaptação Psicológica , Mobilidade Ocupacional , Fatores Biológicos , Anorexia , Refluxo Gastroesofágico , Bulimia , Anorexia Nervosa , Aglomeração , Eficácia , Adolescente , Readaptação ao Emprego , Suicídio Assistido , Entrevista , Comportamento Compulsivo , Privacidade , Transtornos de Alimentação na Infância , Aconselhamento , Características Culturais , Morte , Depressão , Diagnóstico , Dieta , Diuréticos , Escolaridade , Meio Ambiente e Saúde Pública , Insuficiência Renal , Bulimia Nervosa , Laxantes , Conflito Familiar , Medo , Comportamento Alimentar , Peso Corporal Ideal , Transtorno da Compulsão Alimentar , Pandemias , Rede Social , Pacotes de Assistência ao Paciente , Nutricionistas , Estudo Clínico , Perfeccionismo , Sistemas de Apoio Psicossocial , Dependência de Alimentos , Revisão Sistemática , Tristeza , Administração das Tecnologias da Informação , Transtorno da Evitação ou Restrição da Ingestão de Alimentos , Gastroenteropatias , Angústia Psicológica , Preconceito de Peso , Teletrabalho , Distanciamento Físico , Psicoterapeutas , Ortorexia Nervosa , Estrutura Social , Fatores Sociodemográficos , Apoio Familiar , Culpa , Mudança das Instalações de Saúde , Aprendizagem , Meios de Comunicação de Massa , Transtornos Mentais , Transtornos Neuróticos , Obesidade
13.
Transplant Cell Ther ; 28(12): 845.e1-845.e8, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-36167308

RESUMO

Cyclophosphamide (CY) is an alkylating agent widely used in the field of oncology and hematopoietic cell transplantation (HCT). It is recommended to use an adjusted body weight with an adjustment factor of 0.25 (ABW25) for dosing of CY in obese patients undergoing HCT. However, evidence based on the pharmacokinetics (PK) of CY to support this recommendation is lacking. We aimed to identify a dosing strategy of CY that achieves equivalent exposures among obese and nonobese patients. The present study is a secondary analysis of a previously conducted observational PK study of phosphoramide mustard (PM), the final cytotoxic metabolite of CY. Data were collected from 85 adults with hematologic malignancy who received a single infusion of CY 50 mg/kg, fludarabine, ± anti-thymocyte globulin, and a single fraction of total body irradiation as HCT conditioning therapy. A previously developed population PK model in these patients was used for simulations. Using individualized PK parameters from that analysis, simulations were performed to assess cumulative exposures of PM (i.e., area-under-the-curve [AUC]) resulting from 8 different dosing strategies according to various measures of body size: (1) "mg/kg" by total body weight (TBW); (2) "mg/kg" by ideal body weight (IBW); (3) "mg/kg" by fat free mass; (4) "mg/m2" by body surface area (BSA); (5) "mg/kg" by TBW combined with ABW25 (TBW-ABW25); (6) "mg/kg" by IBW combined with ABW25 (IBW-ABW25); (7) "mg/kg" by TBW combined with ABW by adjustment factor of 0.50 (TBW-ABW50); and (8) "mg" by fixed-dose. We defined equivalent exposure as the effect of obesity on PM AUC within ±20% from the PM AUC in the nonobese group, where obesity is defined based on TBW/IBW ratio (i.e., nonobese, <1.2; mildly obese, 1.2-1.5; and moderately/severely obese, >1.5). Primary and secondary outcomes were PM AUC0-8hours and PM AUC0-infinity, respectively. In the 85 patients, with the median age of 63 years (range 21-75), 46% were classified as mildly and 25% were moderately/severely obese based on the TBW/IBW ratio. Negative correlations (i.e., higher the extent of obesity, lower the PM AUC) were shown when dosing simulations were based on IBW, TBW-ABW25, and fixed dosing (P < .05). Positive correlations were shown when dosing was simulated by TBW (P < .05). None of the 8 dosing strategies attained equivalent PM AUC0-8hours between patients with versus without obesity, whereas dosing by BSA and TBW-ABW50 attained equivalent PM AUC0-infinity (P < .05). Our study predicted that the recommended ABW25 dose adjustment may result in lower exposure of CY therapy in obese patients than in nonobese. A CY dosing strategy that would result in similar PM concentrations between obese and nonobese was not identified for early exposure (i.e., PM AUC0-8hours). The data suggest though that CY dosing based on "mg/m2" by BSA or "mg/kg" by TBW-ABW50 would result in similar total exposure (i.e., PM AUC0-infinity) and may minimize exposure differences in obese and nonobese patients.


Assuntos
Transplante de Células-Tronco Hematopoéticas , Obesidade , Adulto , Humanos , Adulto Jovem , Pessoa de Meia-Idade , Idoso , Ciclofosfamida/uso terapêutico , Obesidade/terapia , Peso Corporal Ideal , Área Sob a Curva
14.
PLoS One ; 17(8): e0272299, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36001539

RESUMO

Canine obesity is becoming an increasingly prevalent concern among companion animal veterinarians and professionals alike. A number of sociodemographic, dietary, and exercise related variables have been shown to be predictive of a dog's bodyweight, however, all previous surveys designed to address these variables have been focussed on only one area of the world at a time. The objective of this survey was to investigate how an owner's exercise routine influences their dog's exercise routine and which of the owner's dietary and exercise habits influence their perception of their dog's body weight. The survey included respondents across France, Germany, the United Kingdom, Canada and the United States. The survey was distributed online via Qualtrics (Qualtrics XM, Utah, USA) and a total of 3,298 responses were collected, equally distributed across country and between sexes. Comparison of column proportions and multinomial logistic regression were performed in SPSS Statistics (Version 26, IBM Corp, North Castle, New York, USA). Respondents from Germany were more likely to exercise their dog for a longer amount of time, rank the importance of exercise as extremely important, report that their dog is an ideal body weight, and were less likely to report that someone (including a veterinarian) had told them their dog was overweight. Results from linear regression revealed that those who had been told their dog was overweight, those who restrict their dog's food intake to control weight, those who select a weight control diet and those who give their dog more other foods (treats, table scraps, fruits/vegetables) on a daily basis were all less likely to believe that their dog is an ideal body weight. In contrast, only those who reported doing more vigorous exercise themselves or those who reported that their dog performs vigorous exercise were more likely to believe that their dog is an ideal body weight. The results highlight owner's perceptions of healthy weight and the role of nutrition and exercise. Owner's intentions and attitudes towards the value of exercise and promoting an ideal body weight in their dog should be explored, but may require a One Health approach to ensure successful weight management among both dogs and their owners.


Assuntos
Peso Corporal Ideal , Sobrepeso , Animais , Cães , Alemanha , Obesidade/veterinária , Sobrepeso/veterinária , Percepção , Inquéritos e Questionários
15.
Food Funct ; 13(14): 7684-7696, 2022 Jul 18.
Artigo em Inglês | MEDLINE | ID: mdl-35735100

RESUMO

Calorie restriction (CR) is one of the most common approaches for obesity treatment, but whether resuming ad libitum feeding after CR in normal-weight mice can affect excessive weight regain remains poorly studied. To address this issue, male C57BL/6 mice were placed in three groups: a control group (n = 10), a group fed normal diet with 30% CR (n = 20); and a group fed a HF diet (n = 30). After four weeks, the CR group was fed either a normal diet (NDCR, n = 10) or a high-fat diet (HFCR, n = 10) for an additional eight weeks. At the end of the experiment, mice in the HF group ranked in the upper and lower thirds for weight gain were designated as obesity-prone (HFOP, n = 10) and obesity-resistant (HFOR, n = 10), respectively. CR delayed weight regain and visceral fat accumulation. Gut microbiota in the HFCR group were more similar to the HFOR group than the HFOP group, mainly due to reversion of the decreased level of Clostridiales induced by CR. Mediation analysis showed that Clostridiales may delay body weight regain by affecting the interconversion of succinate and fumarate. Random forest and structural equation analyses showed Christensenellaceae were the most important biomarker for alleviation of obesity. In conclusion, CR shapes an obesity-resistant-like gut microbiota profile that may attenuate body weight regain.


Assuntos
Dieta Hiperlipídica , Microbioma Gastrointestinal , Animais , Peso Corporal , Restrição Calórica , Dieta Hiperlipídica/efeitos adversos , Seguimentos , Peso Corporal Ideal , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Obesidade , Aumento de Peso
16.
Transplant Cell Ther ; 28(8): 504.e1-504.e7, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35577325

RESUMO

Because cord blood (CB) units are usually selected based on the cell dose per kilogram, overweight (body mass index [BMI] ≥25 kg/m2to < 30 kg/m2) and obese (30 kg/m2 ≤ BMI) recipients tend to have difficulty in getting appropriate CB units. In general, actual body weight (ABW) is used for CB unit selection. However, ideal body weight (IBW) has been reported to be more closely correlated with successful engraftment after autologous, allogeneic bone marrow, and peripheral blood stem cell transplantation than ABW. We conducted this analysis to clarify the threshold of CD34+ cell doses based on ideal body weight (CD34IBW) and to compare the outcomes among the groups stratified by the threshold according to actual body weight (CD34ABW) and CD34IBW for overweight and obese recipients in cord blood transplantation (CBT). We retrospectively analyzed 650 overweight and obese recipients who received single-unit CBT. To focus on the recipients who received a low CD34+ cell dose/kg, those who received 1.5×105 CD34+ cells/ABW or more were excluded. Using a cut-off of 0.8×105 CD34+ cells/kg, we compared the outcomes in 3 groups with low CD34ABW and low CD34IBW (CD34Low/Low), low CD34ABW but high CD34IBW (CD34Low/High), and high CD34ABW and high CD34IBW (CD34High/High). Hematopoietic recoveries were significantly delayed in the CD34Low/Low group compared with those in the CD34Low/High group (hazard ratio [HR] 0.67 for neutrophil, P < .001; HR 0.72 for platelet, P = .014), whereas those were comparable in the CD34Low/High and CD34High/High groups (HR 1.22 for neutrophil, P = .16; HR 1.29 for platelet, P = .088). Moreover, the CD34Low/High group demonstrated longer overall survival than the CD34Low/Low group (HR 1.48, P = .011) and comparable survival to the CD34High/High group (HR 0.93, P = .68). This finding may address the lack of availability of CB units for some overweight and obese recipients for whom suitable donors are unavailable. Further investigations are warranted to evaluate the appropriateness of ABW and IBW.


Assuntos
Transplante de Células-Tronco de Sangue do Cordão Umbilical , Transplante de Células-Tronco Hematopoéticas , Antígenos CD34 , Peso Corporal , Humanos , Peso Corporal Ideal , Neutrófilos , Obesidade/terapia , Sobrepeso/terapia , Estudos Retrospectivos
17.
Artigo em Inglês | MEDLINE | ID: mdl-35409556

RESUMO

This study aimed to investigate the association between healthy lifestyle (HLS; i.e., diet quality, physical activity, normal weight) and periodontal diseases in Korean adults. Studying this association may help inform future intervention programs aimed at preventing the development of periodontal diseases. Raw data of the Korea National Health and Nutrition Examination Survey (KNHANES) VII (2016-2018) were used. Data from 12,689 adults aged 19 years and over who had a periodontal examination were analyzed. The associations between HLS and periodontal diseases were analyzed using multivariate logistic regression after adjusting for demographic and health factors as covariates. We found that each of the HLS (diet quality, physical activity, normal body weight) practices was significantly associated with periodontal diseases (OR: 1.32, 95% CI: 1.13-1.55; OR: 1.16, 95% CI: 1.04-1.30; OR: 1.26, 95% CI: 1.14-1.40, respectively). In particular, having poor HLS practices was identified as a risk factor for periodontal diseases (OR: 1.54, 95% CI: 1.10-2.15). HLS was associated with periodontal diseases. Thus, in addition to improving oral hygiene-the primary focus in the past-improving HLS should be emphasized for patients with periodontal diseases.


Assuntos
Peso Corporal Ideal , Doenças Periodontais , Adulto , Dieta , Exercício Físico , Estilo de Vida Saudável , Humanos , Inquéritos Nutricionais , Doenças Periodontais/epidemiologia , República da Coreia/epidemiologia
18.
Revista Digital de Postgrado ; 11(1): 331, abr. 2022. tab
Artigo em Espanhol | LILACS, LIVECS | ID: biblio-1417013

RESUMO

El objetivo es comparar el IMC con el porcentaje de grasa corporal y el peso ideal, para complementar el IMC en el diagnóstico de obesidad, de un grupo de adultos. Métodos: estudio descriptivo, transversal, prospectivo y correlacional, en una muestra de 797 adultos con edad entre 17 y 96 años, atendidos en diferentes centros clínicos de Caracas, entre 2015 y 2018. Las variables son: edad, peso, talla y se calcularon el IMC, porcentaje de grasa corporal (PGC) y peso ideal (PI). Se clasificaron por sexo, grupo etáreo y según el IMC en normalidad y obesidad. Se utilizaron dos fórmulas para el PGC: Deurenberg y Regresión; y tres fórmulas para PI: Lorenz, Ramírez et al y Broca. Se obtuvieron medidas descriptivas, asociación, correlación, comparación de promedios y prueba de normalidad, mediante el soware Excel, Epidat.2. Resultados: Promedios de IMC y PGC aumentan hasta los 40 años y disminuye hasta los 79 años, las variables Talla ­ PI Broca, e IMC- PGCR correlacionan bien (r>0,75). Los promedios del IMC, PGCD, PGCR, PI Broca y PI Lorenz, según sexo, son significativos (p<0,000); para el IMC, en Normalidad y Obesidad, los promedios de peso, IMC, PGCD y PGCR son mayores en grupo de Obesidad, y significativos (p<0,000). La prueba de normalidad Shapiro-Francia comprobó que la distribución del IMC, PGCD, PGCR y PI Lorenz, provienen de una población distribuida normalmente (p< 0,000). Conclusiones: el IMC aun cuando es utilizado más frecuentemente para diagnosticar obesidad, clasifica con normalidad, a quienes tienen un alto porcentaje de grasa corporal(AU)


The objective is to compare BMI with the percentage of body fat and ideal weight, to supplement BMI in the diagnosis of obesity, from a group of adults. METHODS: descriptive, cross-cutting, prospective and correlational study, in a sample of 797 adults between 17 and 96 years old, attended in different clinical centers of Caracas, between 2015 and 2018. the variables are: age, weight, size and BMI was calculated, percentage of body fat (BFP) and ideal weight (IW). they were classified by sex, age group and BMI in normality and obesity. Two formulas were used for BFP: Deurenberg and Regression; and three formulas for IW: Lorenz, Ramirez-Lopez et al and Broca. Descriptive measures, association, correlation, average comparison and normality test were obtained, using Excel software, Epidat.2. RESULT: BMI and BFP averages increase to 40 years and decrease to age 79, the variables Size ­ IW Broca, and BMI- BFPR correlate well (r>0.75). e average BMI, BFPD, BFPR, IW Broca and IW Lorenz, depending on gender, are significant (p<0.000); for BMI, in Normality and Obesity, the weight averages, BMI, BFPD and BFPR are higher in the Obesity group, and significant (p<0,000). the Shapiro-France normality test found that the distribution of BMI, BFPD, BFPR and IW Lorenz, comes from a normally distributed population (p< 0.000). CONCLUSIONS: BMI even though it is most commonly used to diagnose obesity, it classifies normally, those with a high percentage of body fat(AU)


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Índice de Massa Corporal , Distribuição da Gordura Corporal , Peso Corporal Ideal , Fatores Socioeconômicos , Peso-Estatura , Composição Corporal , Obesidade
19.
Obesity (Silver Spring) ; 30(5): 1079-1090, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-35357083

RESUMO

OBJECTIVE: This study sought to assess whether diabetes affects coronary microvascular function in individuals with normal body weight. METHODS: Seventy-five participants (30 patients with type 2 diabetes [T2D] who were overweight [O-T2D], 15 patients with T2D who were lean [LnT2D], 15 healthy volunteers who were lean [LnHV], and 15 healthy volunteers who were overweight [O-HV]) without established cardiovascular disease were recruited. Participants underwent magnetic resonance imaging for assessment of subcutaneous, epicardial, and visceral adipose tissue areas, adenosine stress myocardial blood flow (MBF), and cardiac structure and function. RESULTS: Stress MBF was reduced only in the O-T2D group (mean [SD], LnHV = 2.07 [0.47] mL/g/min, O-HV = 2.08 [0.42] mL/g/min, LnT2D = 2.16 [0.36] mL/g/min, O-T2D = 1.60 [0.28] mL/g/min; p ≤ 0.0001). Accumulation of visceral fat was evident in the LnT2D group at similar levels to the O-HV group (LnHV = 127 [53] cm2 , O-HV = 181 [60] cm2 , LnT2D = 182 [99] cm2 , O-T2D = 288 [72] cm2 ; p < 0.0001). Only the O-T2D group showed reductions in left ventricular ejection fraction (LnHV = 63% [4%], O-HV = 63% [4%], LnT2D = 60% [5%], O-T2D = 58% [6%]; p = 0.0008) and global longitudinal strain (LnHV = -15.1% [3.1%], O-HV= -15.2% [3.7%], LnT2D = -13.4% [2.7%], O-T2D = -11.1% [2.8%]; p = 0.002) compared with both control groups. CONCLUSIONS: Patients with T2D and normal body weight do not show alterations in global stress MBF, but they do show significant increases in visceral adiposity. Patients with T2D who were overweight and had no prior cardiovascular disease showed an increase in visceral adiposity and significant reductions in stress MBF.


Assuntos
Doenças Cardiovasculares , Diabetes Mellitus Tipo 2 , Adiposidade , Diabetes Mellitus Tipo 2/complicações , Humanos , Peso Corporal Ideal , Obesidade Abdominal/complicações , Obesidade Abdominal/diagnóstico por imagem , Sobrepeso/complicações , Volume Sistólico , Função Ventricular Esquerda
20.
BMC Cancer ; 22(1): 89, 2022 Jan 21.
Artigo em Inglês | MEDLINE | ID: mdl-35062912

RESUMO

BACKGROUND: The association of obesity with colorectal cancer (CRC) may vary depending on metabolic status. OBJECTIVE: This meta-analysis aimed to investigate the combined impacts of obesity and metabolic status on CRC risk. METHODS: The Scopus, PubMed, and web of sciences databases were systematically searched up to Jun 2021 to find all eligible publications examining CRC risk in individuals with metabolically unhealthy normal-weight (MUHNW), metabolically healthy obesity (MHO), and metabolically unhealthy obesity (MUHO) phenotypes. RESULTS: A total of 7 cohort studies with a total of 759,066 participants were included in this meta-analysis. Compared with healthy normal-weight people, MUHNW, MHO, and MUHO individuals indicated an increased risk for CRC with a pooled odds ratio of 1.19 (95% CI = 1.09-1.31) in MUHNW, 1.14 (95% CI = 1.06-1.22) in MHO, and 1.24 (95% CI = 1.19-1.29) in MUHO subjects. When analyses were stratified based on gender, associations remained significant for males. However, the elevated risk of CRC associated with MHO and MUHO was not significant in female participants. CONCLUSIONS: The individuals with metabolic abnormality, although at a normal weight, have an increased risk for CRC. Moreover, obesity is associated with CRC irrespective of metabolic status.


Assuntos
Peso Corporal , Neoplasias Colorretais/etiologia , Doenças Metabólicas/complicações , Obesidade Metabolicamente Benigna/complicações , Obesidade/complicações , Adulto , Idoso , Índice de Massa Corporal , Estudos de Coortes , Feminino , Humanos , Peso Corporal Ideal , Masculino , Doenças Metabólicas/metabolismo , Pessoa de Meia-Idade , Obesidade/metabolismo , Obesidade Metabolicamente Benigna/metabolismo , Razão de Chances , Fenótipo , Medição de Risco , Fatores de Risco
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