ABSTRACT
La obesidad es una condición metabólica que se encuentra en constante crecimiento, siendo considerada incluso una "pandemia" en la actualidad. Debido a esto y al gran número de enfermedades a las que se asocia, surge la necesidad de un manejo de esta condición que sea efectivo y saludable a nivel integral. En este contexto, entran a la medicina e investigación científica los conceptos de medicina de estilos de vida y de alimentaciones basadas en plantas, habiendo estas últimas demostrado beneficios en todas estas áreas de la salud, y están siendo parte de varias de las recomendaciones de sociedades científicas actuales. En este artículo, se explicará brevemente qué es la alimentación basada en plantas, explorando los distintos estudios observacionales e intervenciones que fundamentan su uso, y se propondrán algunos mecanismos a través de los cuales provee beneficios en el control del peso corporal, entre los cuales destacan: la saciedad que genera y la baja densidad calórica que la caracteriza, el mayor efecto térmico de las comidas, la modulación favorable de la microbiota intestinal, sus efectos sobre la sensibilidad a la insulina, la ausencia de proteína animal y cómo esto afecta el control de peso corporal, y los efectos que produce sobre la hormona leptina. La alimentación basada en plantas se posiciona como una gran alternativa para la prevención y tratamiento de la obesidad, siendo además un patrón alimentario seguro y saludable. Se espera que en el futuro cada vez más profesionales de la salud consideren esta evidencias y lo incorporen como parte de sus herramientas terapéuticas.
Obesity is a metabolic condition with a continuous increasing rate, being considered today a "pandemic". Due to this and the vast number of diseases it is associated with, there is a need for a treatment of this condition that is both effective and healthy in a comprehensive way. In this context, the concepts of lifestyle medicine and plant-based diets have emerged in medicine and in scientific research, and the latter have demonstrated benefits in all these areas and are being part of several scientific association's recommendations today. In this article, a plant-based diet is briefly defined, and the mechanisms by which this type of diet provides benefits for the control of body weight are explored, including the satiety it generates and its characteristic low caloric density, the higher thermic effect of foods, the positive modulation of the gut microbiota, its effects on the insulin sensitivity, the absence of animal protein and how this affects the body weight, and the effects it has on the leptin hormone. Plant-based diets has been studied both in observational and interventional studies and positioned as a great alternative for the prevention and treatment of obesity, in addition to being a safe and health dietary pattern. We hope that in the future, more health professionals consider this evidence and incorporate it as part of their therapeutic tools.
ABSTRACT
Illness presentation in the elderly may be entirely non-specific, with fatigue, loss of function or the presence of geriatric syndromes. We report a 90 years old male consulting in the emergency room for delirium that persisted throughout hospitalization without finding a cause. During the course of hospitalization mild fever appeared and a left knee swelling became apparent. A synovial fluid aspiration showed a leukocyte count of 360 per field with 60% polymorphonuclear cells. The culture was negative. With a presumptive diagnosis of pseudogout, cochicine and celecoxib were started with remission of the confusional state. The patient was discharged 13 days after admission in good conditions.
Subject(s)
Aged, 80 and over , Humans , Male , Chondrocalcinosis/complications , Delirium/etiology , Knee Injuries/complications , C-Reactive Protein/analysis , Calcium Pyrophosphate , Fever/etiologyABSTRACT
La Diabetes Mellitus tipo 2 (DM2) es un problema de salud pública a nivel mundial, que genera un impacto en la salud de las personas que la padecen, asociándose a diversas patologías y complicaciones, entre ellas la depresión. Objetivo: Determinar la incidencia de depresión, no conocida previamente, en pacientes diabéticos tipo 2 en dos centros de atención. Pacientes y métodos: Estudio descriptivo prospectivo en una muestra de pacientes adultos con más de un año de diagnóstico de DM2, sin antecedentes de depresión actual. Se aplicó escala de Beck, y encuesta sociodemográfica. Se registró Hemoglobina glicosilada (HbA1c), índice de masa corporal (IMC) y circunferencia abdominal. Resultados: De un total de 111 encuestados, el 41 % manifestó síntomas depresivos, sugerentes de un trastorno depresivo mayor, presentándose éstos en un 58,3 por ciento en el género femenino. La incidencia de depresión fue de 12,8 por ciento en un centro privado y 56,9 por ciento en el centro asociado a la armada. Se encontró una asociación no significativa entre depresión e IMC alto, mal control metabólico y viudez. Conclusiones: La incidencia de depresión fue elevada en estos pacientes con diabetes, predominando en el género femenino, obesidad, mal control metabólico, salud no privada y viudez. Es importante indagar sobre síntomas depresivos en pacientes diabéticos por las consecuencias que tiene la depresión en el manejo de la DM2 y la discapacidad que impone sobre el paciente...
Type 2 Diabetes Mellitus is a healthcare problem occurring on a global scale, impacting the lifes of people who suffer from it, and frequently found in association with multiple diseases and complications, depression often among them. Objective: To determine the incidence of undiagnoseddepressionintype2diabetespatientsintwohealthcarecenters. Patients and methods: Prospective descriptive study in adult patients with type 2 diabetes at least 1 year duration, without a current diagnosis of depression, applying the Beck scale and a sociodemographic survey, along with measurements of glycated hemoglobin (HbA1c), body mass index and abdominal circumference. Results: Of a total of 111 patients analyzed, 41 percent manifested depressive symptoms compatible with a diagnosis of major depressive disorder, and of these, 58.3 percent were women. The incidence of depression was 12.8 percent inone private center of health and 56.9 percent in another public health system. No significant association was found between depression and high body mass index, poor metabolic control or widowhood. Conclusions: The incidence of depression was high in patients with diabetes, especially among obese women, those with poor metabolic control, participating in the public system of health and among widows. Its important to question diabetic patients about depressive symptoms due to the consequences that this disease has on the management of DM2 and the resulting disabilities from which the patient may suffer...
Subject(s)
Humans , Male , Adult , Female , Middle Aged , Aged, 80 and over , Diabetes Complications/epidemiology , Depression/epidemiology , /psychology , Age Distribution , Chile , Epidemiology, Descriptive , Incidence , Prospective StudiesABSTRACT
Thyroid dysfunction, whether it be from an increase or decrease in the levels of thyroid hormones, has multiple repercussions in the cardiovascular system which have been associated with an increase in mortality and heightened risk of cardiovascular events. This risk must be taken into consideration when evaluating patients with thyroid dysfunction in order to include strategies that assure a timely diagnosis and treatment of the above-mentioned complications. Similarly, it is necessary to evaluate the thyroid function in patients who present cardiovascular events such as heart failure, arrhythmias, coronary acute syndrome or acute stroke. Some of these alterations will cease with the recovery of euthyroidism. Randomized controlled trials are needed to define the best way to treat these patients, especially in cases of subclinical hypothyroidism, where it is still unknown if treatment with L-thyroxin helps reducing cardiovascular risk...
Subject(s)
Humans , Thyroid Diseases/physiopathology , Cardiovascular System/physiopathologyABSTRACT
El proceso de envejecimiento altera la forma en que los fármacos actúan en el adulto mayor. Cambios tanto en la farmacocinética como la farmacodinamia convierten la prescripción en geriatría en un proceso muy diferente al del adulto joven. El objetivo de este artículo es revisar los cambios fisiológicos del envejecimiento que deben ser considerados para el uso de fármacos en el adulto mayor. Con este fin hemos realizado una revisión bibliográfica de la literatura para generar recomendaciones para la prescripción adecuada en este grupo etario, encasillándolas en listados de fácil uso y acceso sobre medicamentos potencialmente inapropiados, de acuerdo a la calidad de la evidencia disponible y las razones para su evitación en el adulto mayor.
The aging process changes the way in which common drugs act in the elderly. Changes in both the pharmacokinetics and pharmacodynamics make prescribing drugs in geriatrics a process very different from that of the young adult. The aim of this article is to review the physiologic changes that occur with aging and that must be considered when indicating drugs in this age group. For this purpose we conducted a literature review of articles from various journals and textbooks devoted to geriatric medicine in order to extract recommendations for appropriate prescribing in the elderly, represented in easy to use listings of potentially inappropriate medications, according to the quality of evidence and rationale for their avoidance in advanced age.