ABSTRACT
Background: Bariatric surgery (BS) is the most effective procedure in the management of obesity, achieving a significant decrease in energy intake. Aim: To measure calorie and macronutrient intake in patients subjected to gastric bypass (GBP) or sleeve gastrectomy (SG). Material and Methods: We studied 53 patients subjected to SG and 27 subjected to GBP, who were in the first, second or sixth postoperative month. A food frequency consumption survey was applied by specialized nutritionists and their nutritional status was assessed. Results: Mean calorie intake in months 1, 2 and 6 were 505, 600 and 829.8 kcal, respectively. A significantly higher intake was observed at month 1 in patients with those subjected to SG, compared with GBP patients. Protein consumption was <60 g/d, except at 6 months in patients with GBP. At months 1, 2 and 6, mean consumption of lipids were 17, 28 and 30 g/day, respectively. The figures for carbohydrates were 42, 31 and 77 g/day, respectively. At month 1, patients with GBP had a higher BMI, equalizing at 6 months with those of SG. At 6 months 37% of patients had a normal body mass index and 17% remained obese. A negative correlation was observed between weight loss and energy intake during the first month (rho: −0.40; p = 0.033). Conclusions: Patients subjected to BS had a low calorie and macronutrient intake in the first six postoperative months. Their calorie intake is negatively associated with weight loss, mainly during the first postoperative month.
Subject(s)
Humans , Obesity, Morbid/surgery , Gastric Bypass , Bariatric Surgery , Energy Intake , Treatment Outcome , Eating , GastrectomyABSTRACT
RESUMEN La cirugía bariátrica (CB) ha demostrado ser una alternativa segura y eficaz para la resolución de la obesidad y sus comorbilidades. Parte del éxito de la CB, radica en el manejo nutricional del paciente, para lo que se requiere de un equipo médico-nutricional, entrenado en nutrición bariátrica, con el objetivo de evitar déficit nutricional y modificar hábitos a largo plazo. En la actualidad, no existe en Chile un consenso sobre el protocolo de manejo nutricional pre y post CB. El objetivo del 1er Consenso Chileno de Nutricionistas en Cirugía Bariátrica, es ser una guía para los nutricionistas que asisten a pacientes bariátricos. Este documento resume el trabajo realizado por los Nutricionistas de Sociedad Chilena de Cirugía Bariátrica y Metabólica (SCCBM), quienes durante 5 años trabajaron en reuniones presenciales y comisiones de estudio, revisando evidencias científicas, guías de tratamiento y recomendaciones de expertos, que fundamentarán las recomendaciones alimentario nutricional para cada tema. El resultado es un documento que homologa criterios para el manejo nutricional de pacientes bariátricos y genera los tópicos mínimos para asegurar la atención nutricional de calidad en los equipos bariátricos chilenos.
ABSTRACT Bariatric surgery (BS) has proven to be a safe and effective alternative for the resolution of obesity and its comorbidities. Part of the success of BS lies in the nutritional management of the patient, for which a medical-nutritional team, trained in bariatric nutrition, is required with the aim of modifying long-term habits and avoiding nutritional deficit. At present, there is no consensus in Chile on the pre-and post-BS nutritional management protocol. The objective of the 1st Consensus of Chilean Nutritionists on Bariatric Surgery is to be a guide for nutritionists who assist bariatric patients. This document summarizes the work done by Nutritionists of the Chilean Society of Bariatric and Metabolic Surgery (SCCBM), who, during 5 years, worked in face-to-face meetings and study commissions, reviewing scientific evidence, treatment guides and expert recommendations, which will support nutritional nutrition recommendations for each topic. The result is a document that standardizes criteria for the nutritional management of bariatric patients and generates the minimum topics to ensure quality nutritional care for Chilean bariatric teams.
Subject(s)
Humans , Postoperative Period , Diet , Micronutrients , Nutrients , Bariatric Surgery/rehabilitation , Guidelines as TopicABSTRACT
Se presenta el caso de una familia con bloqueo aurículo-ventricular, que compromete varias generaciones, con herencia mendeliana autosómica dominante, que afecta de manera progresiva el sistema de conducción cardiaco llevando a síncope y muerte súbita en edades tempranas. Esta entidad corresponde al bloqueo familiar cardiaco progresivo tipo I, descrito principalmente en Suráfrica. El tratamiento con marcapaso definitivo fue exitoso.
We present the case of a family with atrio-ventricular block that involves several generations, with dominant autosomal mendelian inheritance that progressively affects the cardiac conduction system leading to syncope and sudden death in early life. This entity corresponds to progressive familial atrio-ventricular block type I, described mainly in South Africa. Treatment with permanent pacemaker therapy was successful.
Subject(s)
Death, Sudden , Genetics , Heart BlockABSTRACT
La interacción constante del organismo humano con diferentes sustancias, que incluso en muchas ocasiones se consideran inofensivas, tiene un alto impacto sobre todos los sistemas, siendo el cardiovascular uno de los más afectados. Por lo tanto, es vital reconocer los mecanismos por los cuales estas sustancias ejercen su efecto tóxico sobre este sistema, bien sea afectando la estabilidad de membrana y la función contráctil o generando disfunción de organelos intracelulares y estrés oxidativo. Numerosos estudios han descubierto efectos lesivos de sustancias, como la clozapina y las catecolaminas, que han tenido amplio uso durante largos años. En la actualidad aún se realizan investigaciones que buscan esclarecer los mecanismos cardiotóxicos de medicamentos de formulación común, entre ellos antineoplásicos y anti-inflamatorios no esteroideos (AINE), así como de sustancias de uso habitual que causan adicción, tales como alcohol, cocaína y cocaetileno, su metabolito activo.
The constant interaction of the human body with different substances that are even in many cases considered harmless has a high impact on all systems, being the cardiovascular system one of the most affected. Therefore, it is vital to recognize the mechanisms by which these substances exert their toxic effect on this system, either affecting the membrane stability and the contractile function, or generating intracellular organelles dysfunction and oxidative stress. Numerous studies have found that drugs which have been widely used for many years such as clozapine and catecholamines, have harmful effects. Research is still being done seeking to clarify the cardiotoxic mechanisms of drugs commonly formulated, including anticancer and non steroidal anti-inflammatory drugs (NSAIDs), as well as commonly used substances that cause addiction, such as alcohol, cocaine and cocaethylene, its active metabolite.