Impact of a supervised exercise program supporting autonomy on the adoption of an active lifestyle among obese adolescents: a Self-Determination Theory perspective.

AIM: Regular physical activity (PA) practice represents a key component of obesity treatment. Drawing upon Self-Determination Theory, the purpose of this study was twofold. The first aim was to evaluate among obese adolescents the impact of a supervised exercise program supporting autonomy on their motivation to practice PA at the end of the intervention. The second aim was to evaluate the impact of the program on their level of PA one month after the end of the intervention. METHODS: Eighteen obese adolescents (mean age=14.3 years, mean BMI=33.47 kg/m²) were recruited to participate in an 11-week residential obesity treatment program. They received a 45-minute supervised exercise session each week. Motivational regulations were assessed at baseline and at the end of the intervention (via the Exercise Motivation Scale). PA practice was assessed at baseline and one month after the end of the intervention (via the 7-day PA recall interview). RESULTS: The analyses revealed that adolescents' levels of autonomy increased, that their levels of intrinsic motivation tended to increase, and that their level of external regulation tended to decrease. In addition, the participants increased their habitual PA practice one month after the end of the intervention in comparison to baseline. CONCLUSION: This study highlights that supporting autonomy during supervised exercise sessions appears as an effective strategy to promote PA among obese adolescents because it fosters internalization of the behavior.

Nephropathy associated with antiphospholipid antibodies in patients with systemic lupus erythematosus.

BACKGROUND: Nephropathy associated with antiphospholipid antibodies (aPL) has been proposed as a risk factor of worse renal prognosis in patients with systemic lupus erythematosus (SLE). The purpose of the current study was to evaluate the prevalence of aPL-associated nephropathy (aPLN) among patients with lupus nephritis and to describe their functional renal outcome. METHODS: A total of 79 renal biopsies from 77 patients followed at the Hospital Clinic, Spain were analysed. Each renal biopsy was evaluated by a pathologist who was blinded to the aPL status. Thrombotic microangiopathy (TMA), fibrous intimal hyperplasia (FIH), fibrocellular arterial occlusion (FAO), focal cortical atrophy (FCA), and tubular thyroidization as lesions suggestive of aPLN were identified. RESULTS: aPLN was found in nine (11.4%) biopsies. TMA was found in three (33.3%) cases whereas chronic aPLN, represented by FIH and FCA, was found in four (44.4%) and three (33.3%) cases, respectively. A significant association between the presence of aPL and aPLN was found (p = 0.003). Patients with lupus anticoagulant (LA) plus IgG anticardiolipin antibodies (aCL) showed an increased prevalence of aPLN (OR: 3.61, 95% CI 1.28-5.14; p = 0.002). Creatinine levels were significantly increased in patients with aPLN compared with those with aPL without aPLN (p = 0.038). However, no significant difference in complete remission, partial remission, not response, and established renal damage between groups was observed at the end of follow-up. CONCLUSIONS: The aPL have an important role in the pathogenesis of renal lesions in SLE patients. Prospective studies are needed to address the role of aPLN in the long-term outcome of SLE patients with positive aPL.

The effects of low cholesterol, high polyunsaturated fat, and low fat diets on plasma lipid and lipoprotein cholesterol levels in normal and hypercholesterolemic subjects.

The effects of various cholesterol-lowering diets on plasma lipid and lipoprotein cholesterol levels were assessed in normal and hypercholesterolemic subjects. The base-line diet was an ad libitum hospital diet of normal composition. Diet A was a 20% protein, 40% carbohydrate, 40% fat, polyunsaturated:saturated fat ratio 0.1 to 0.3, 250 to 300 mg cholesterol diet, diet B was identical to diet A except that the polyunsaturated/saturated fat ratio was 1.8 to 2.2, and diet C was a 20% protein, 80% carbohydrate, very low fat (5 to 10 g), polyunsaturated/saturated fat ratio 0.1 to 0.3, 150 to 200 mg cholesterol diet. Diet A (low cholesterol) caused mean reductions in plasma, low-density lipoprotein (LDL), and high-density lipoprotein (HDL) cholesterol of 5.9, 5.6, and 6.3%, respectively, in 11 normal subjects. Diet B (low cholesterol, high polyunsaturated fat) caused significant decreases in plasma cholesterol, LDL cholesterol and HDL cholesterol of 17.0, 16.2, and 17.4%, respectively, in 12 normal subjects; and reductions of 11.0, 10.8, and 17.1%, respectively, in 19 hypercholesterolemic subjects. Diet C (low cholesterol, very low fat) produced significant mean decreases in plasma, LDL, and HDL cholesterol of 26.7, 29.9, and 27.9%, respectively, in 11 normal subjects, and in nine hypercholesterolemic patients of 22.6, 27.2, and 28.6%, respectively. The reductions in plasma cholesterol caused by these diets were therefore due to decreases in both LDL and HDL cholesterol with no significant changes in the LDL cholesterol:HDL cholesterol ratio.

Fine-needle aspiration of chromophobe renal-cell carcinoma metastatic to the thyroid gland.

Chromophobe renal cell carcinoma is an unusual variant of renal carcinoma that has less aggressive behavior than clear cell carcinomas. There are few documented cases of metastases, none of which occurred in the thyroid gland. A case is presented of chromophobe renal cell carcinoma metastatic to the thyroid eight years after right nephrectomy, suspected by FNA-biopsy and confirmed histologically. Although metastases of chromophobe renal cell carcinoma are rare, they may also present in thyroid, even many years after primary tumor diagnosis, just like clear cell carcinomas. Even though the FNA cytology of chromophobe renal cell carcinoma has distinctive features, in the context of the thyroid, it can be mistaken for a primary tumor of that organ. In our case, the history of a previous renal tumor was essential in suggesting a metastatic lesion, and histologic and ultrastructural features allowed its precise identification.

[Chronic atrophic gastritis, hypergastinemia and gastric carcinoid tumor]. / Gastritis crónica atrófica, hipergastrinemia y tumor carcinoide gástrico.

We report a case of a gastric carcinoid tumor in an anemic woman with chronic atrophic gastritis and hypergastrinemia. An antrectomy with excision of a carcinoid tumor was performed; afterwards, gastrinemia was normal. Gastric carcinoids were considered uncommon gastric cancers; however, in recent years they have been studied with increasing interest because, as in chronic atrophic gastritis, it has been suggested that they might be produced by prolonged hypergastrinemia associated with therapeutic use of gastric acid supressors. We discuss the gastrin hypothesis, the different clinical types of gastric carcinoids and its therapeutical management.

Models for mesophyll cell arrangement in leaves of ryegrass (Lolium perenne L.).

Three models for mesophyll cell arrangement in leaves of Lolium perenne L. are described. It is shown that mesophyll cells may be represented as spheres packed in a tetragonal lattice. The need to quantify mesophyll cell arrangement is discussed in relation to leaf photosynthesis.The variation on measurements of some anatomical features of leaves is examined and discussed.

The Purkinje cell in olivopontocerebellar atrophy. A Golgi and immunocytochemical study.

Purkinje cells were examined in three familial cases of olivopontocerebellar atrophy (OPCA) by means of the Golgi method, and neurofilament and calcium-binding protein immunocytochemistry. Reduced dendritic arborizations, as seen with different techniques, early formation of axonal spheroids, and abnormal accumulation of phosphorylated neurofilament epitopes in dendrites, somata and axonal spheroids, together with limited formation of proximal spine-like protrusions were the main changes in Purkinje cells. These lesions are unlikely to be the consequence of anterograde degeneration secondary to olivary atrophy, as postulated by some investigators, but probably represent primary damage to Purkinje cells in patients with OPCA. Reduced dendritic arborizations result in a decrease of receptor sites for parallel fibres and deprive granule cells of their main targets. Abnormal accumulation of neurofilaments in somata, dendrites and axonal spheroids may contribute to an abnormal transport and may impair protein turnover in the distal regions of Purkinje cells.

Symptomatic colonic lipoma: differential diagnosis of large bowel tumors.

Symptomatic colonic lipomas, although unusual, continue to present difficulties in the preoperative differential diagnosis between malignant and benign colonic neoplasm. Although new imaging techniques are available, they are frequently diagnosed at laparotomy, and definitive histology is required. Local excision is adequate treatment, but segmental excision may be necessary when there is doubt about the diagnosis, or when a complication occurs.

Fístula periareolar recidivante: técnica del setón / No disponible

La fístula periareolar recidivante de mama es una patología infrecuente, caracterizada por abscesos de repetición en la zona periareolar, con crisis de retención y de fistulización. El uso de la técnica del setón, empleada en el tratamiento de las fístulas anales, facilita el manejo de esta patología, evitando los abscesos de repetición y mejorando la calidad de vida de las pacientes. Al mismo tiempo, permite programar la cirugía electiva manteniendo tutorizado el trayecto fistuloso y minimizando la cantidad de tejido a extirpar(AU)

A breast fistula is an uncommon disease, characterized by subareolar breast abscess with episodes of retention and fistulization. The seton technique, well known in the treatment of anal fistula, is useful in the management of breast fistula, helping to avoid the risk of iterative abscess and improving the quality of life of these patients. Furthermore, it allows the programming of the elective surgery keeping tutorized the fistulous tract, reducing the amount of tissue needed to be removed(AU)