Hashtag bone: detrimental effects on bone contrast with metabolic benefits one and five years after Roux-en-Y gastric bypass

Bone loss is a potential adverse consequence of rapid and sustained weight loss after bariatric surgery. The aim of the present study was to evaluate the bone mass, body fat distribution, and metabolic parameters in women submitted to Roux-en-Y gastric bypass (RYGB). The study included the following three groups: one group of lean women (control [C] group) and two groups of obese women, one evaluated one year (B1) and the other five years (B5) after RYGB. Dual-energy X-ray absorptiometry and magnetic resonance imaging were used to determine bone mineral density (BMD; lumbar spine, total hip, and femoral neck) and abdominal fat content (subcutaneous [SAT] and visceral [VAT] adipose tissues, and intrahepatic lipids [IHL]). The BMD/body mass index ratio was lower in the B5 compared with the C group at all sites. Serum C-terminal telopeptide of type I collagen (CTX) levels were higher in the B1 and B5 groups compared with the C group. Individuals submitted to RYGB showed greater SAT but similar VAT and IHL values compared with those in the C group. However, the B5 group had higher mean parathyroid hormone levels compared with the other two groups. Individuals submitted to RYGB presented increased levels of CTX and low BMD for body weight than those in the C group, suggesting that bone catabolism is a persistent alteration associated with RYGB. In conclusion, the long-lasting metabolic benefits obtained with RYGB in obesity are counterbalanced by a persistent catabolic effect of the procedure on bone and mineral metabolism.

Muscular function and functional mobility of faller and non-faller elderly women with osteoarthritis of the knee

Falls are a major concern in the elderly population with chronic joint disease. To compare muscular function and functional mobility among older women with knee osteoarthritis with and without a history of falls, 15 elderly women with a history of falls (74.20 ± 4.46 years) and 15 without a history of falls (71.73 ± 4.73 years) were studied. Muscular function, at the angular speed of 60, 120, and 180°/s, was evaluated using the Biodex Isokinetic Dynamometer. The sit-to-stand task was performed using the Balance Master System and the Timed Up and Go test was used to determine functional mobility. After collection of these data, the history of falls was investigated. A statistically significant difference was detected in the time taken to transfer the center of gravity during the sit-to-stand test (means ± SD; non-fallers: 0.35 ± 0.16 s; fallers: 0.55 ± 0.32 s; P = 0.049, Student t-test) and in the Timed Up and Go test (medians; non-fallers: 10.08 s; fallers: 11.59 s; P = 0.038, Mann-Whitney U-test). The results indicated that elderly osteoarthritic women with a history of falls presented altered functional mobility and needed more time to transfer the center of gravity in the sit-to-stand test. It is important to implement strategies to guarantee a better functional performance of elderly patients to reduce fall risks.

Estabilidade articular mecânica e funcional / Mechanic and functional joint stability

A estabilidade articular é um requisito essencial para que um indivíduo realize atividades funcionais e é descrita na literatura por dois tipos de estabilidade, a mecânica e a funcional. Tem-se discutido sobre a relação direta entre os dois tipos de estabilidade, entretanto a falta de correlação entre elas tem sido demonstrada. O objetivo deste estudo foi analisar os fatores que contribuem para a estabilidade mecânica e a estabilidade funcional e discutir arelação entre elas. A estabilidade mecânica é determinada pela geometria articular e pelas propriedades mecânicas dos tecidos que se encontram dentro e ao redor da articulação. Entretanto vários estudos apresentam evidências de que durante a realização de diversas atividades funcionais a rigidez passiva das articulações parece não ser suficientes para garantir sua estabilidade. Estabilidade articular funcional é a condição que permite um desempenho normal de uma articulação durante uma atividade funcional. É promovida pelos fatores contribuintes para a estabilidade mecânica somado a resultante de força que age sobre uma articulação. Durantemuito tempo, e mesmo atualmente, tem-se assumido que testes clínicos de frouxidão positivos são indicativos de instabilidade e conseqüentemente de incapacidade. Entretanto, a maioria dosestudos que avaliou desempenho funcional e frouxidão não encontrou correlação entre estas duas variáveis. Apesar dos testes de frouxidão serem úteis no diagnóstico de uma lesão ligamentar, a sua utilidade na predição do desfecho funcional do indivíduo após a lesão é limitada.

Joint stability is an essential requirement to subject practice functional activities. It is described at literature by two types of stability, the mechanical and the functional. A lot has been discussing about the direct relationship between the two types of stability, however a lack of correlation among them has been demonstrated. The purpose of this study was to analyze the factors that contribute to the mechanical stability and the functional stability of a joint and to discuss the relationship between them. The mechanic stability is determined by the joint geometry and mechanicals properties of the tissues within and around the joint. However, many studies have shown evidences that during the practice of several functional activities the joint passive stiffness is not sufficient to guarantee joint stability. Functional joint stability is the condition of a joint that allows normal performance of the individual during physical activities. It is determined by the factors that contribute to mechanic stability and by resulting forces that act on the joint. For a long time, and even nowadays, it has been assumed that positive clinical laxity test were indicative of instability and consequently of impairment. However, most of the studies that evaluated functional performance and laxity didn’t find association between thesetwo variables. In spite of the usefulness of the tests of laxity in the diagnosis of ligamentar lesion, their capacity of predicting individual’s functional outcome after the lesion is limited.

Transferencia da posicao sentada pra em pe: estudo comparativo entre idosas assintomaticas e idosas com osteoartite e correlacao entre tempo da tarefa e funcao muscular / Sit-to-stand transfer: comparasion between asymptomatic and osteoarthritic elderly women and correlation between movement time and muscle function

Em idosos, a capacidade de se levantar de uma posicao sentada sentada em um menor tempo associa-se a menos comorbidades ec para realizar essa atividade. Forca e potencia de extensores e plexores de joelho sao importantes. ao aumentar a velocidade do levantar

Relacao isquiotibiais/quadriceps em mulheres idosas utilizando o dinamometro isocinetico / Isokinetic hamstring/quadriceps ratio in elderly women

A relacao entre o torque isocinetico maximo dos isquiotibiais e o torque isocinetico maximo do quadriceps (relacao IQT/QUA) e um parametro utilizado para descrever o equilibrio muscular da articulacao do joelho. Uma alteracao desse equilibrio predispoe a articulacao ou o grupo muscular mais fraco a lesao. A obtencao de valores de referencia da relacao IQT/QUA de idosas e importante, p[ois possibilita comparacoes entre individuos dessa faixa etaria. O objetivo deste estudo foi estabelecer valores normativos para a relacao IQT/QUA de idosas nao-institucionalizadas que vivem na regiao metropolitana de Belo Horizonte. Este foi um estudo transversal de uma amostra composta por 47 idosas voluntarias (69,11+-3,64 anos). Como nao houve diferenca estatisticamente significativa entre os membros, foram descritos apenas a media, o desvio padrao, o coeficiente de variacao (CV) e o erro estimado (EE) da relacao IQT/QUA do membro inferior dominante, nas velocidades angulares de (60s e 180s), utilizando o dinamometro isocinetico Biodex System 3 Pro. Na velocidade de 60s, a media foi de 47,95+-10,99(por cento); o Cv, 22,91; e o EE, 6,85. Na velocidade de 180s a media foi 59,59+-13,40(por cento); o Cv, 22,49; e o EE, 6,43. Assim, o valor da relacao foi maior com o aumento da velocidade. Os resultados aqui encontrados, aliados a outros de diferentes regioes, podem ser considerados referencia para idosas vivendo na comunidade, o que podera direcionar a reabilitacao, tornando-a mais efetiva. Alem disso, esses dados permitirao comparacoes com futuros estudos que envolvam populacoes de idosas comunitarias, institucionalizadas ou com alguma doenca

Nadp+ biosynthesis by rats receiving a pellagragenic diet

Rats showing signs of pellagra-like disease associated with gelatin ingestion were injected with [14C}-nicotinic acid into the portal vein and the incorporation of the label into hepatic NAD+ and NADP+ was determined. The quantity of NADP+ synthesized within 1 h after [14C]-nicotine acid injection by the experimental group, supplemented or not with dietary niacin, was 75% lower than that synthesized by the control group fed a casein control diet (141nmol h-1 g-1). The NAD+ and NADP+ contents of the liverof the experimental animals were 245 and 93 *g/g liver, respectively, i. e., significantly lower than those for the controls (597 and 210 *g/g liver, respectively). Dietary supplementation with niacin increased the NAD+ content to 317 */g liver but had no statistical effect on NADP+ content (75 *g/g liver) or NADP+ synthesis (46.5 in the free niacin group vs 37.0 nmol h-1 g-1 in the niacin-supplemented group). Therefore, NAD+ content did not seem to limit NADP+ synthesis. These results that the lower availably of NADP+ is responsible, at least in part, for some metabolic derangements in pellagra-like disease, such as a decrease in the activity of NADP+-dependent enzymes observed in quail muscle