Comparative Analysis On The Efficacy Of Aerobic Capacity In Cardiac Rehabilitation Obese And Non-Obese Phase Ii Patient

Background: Aerobic Exercise is a host of health benefits to reduce vigor risk and maintain body weight. The purpose of the present investigation is to determine the influence of aerobic exercises on body weight and Metabolic Equivalent of Task (MET) activity among cardiac rehabilitation phase II patients. The objective of the study is to investigate the impact of obesity on the efficacy of aerobic capacity. Methods: Fifteen obese (ten males, five females) and fifteen non-obese (eleven males, four females) participants of phase II cardiac rehabilitation were selected from a tertiary care hospital by their Body Mass Index (BMI). They were divided into two groups by simple random technique. Aerobic exercises were given for 12 weeks for post-CABG cardiac rehabilitation phase II obese and non-obese (healthy and overweight) patients. BMI and the Metabolic equivalent of task activity of cardiac rehabilitation phase II patients are measured by enrolling a patient in 12 weeks of aerobic exercises program. Results: The aerobic exercise shows a positive result in both obese and non-obese patients. Aerobic exercises improved metabolic equivalent of task in both obese(4.6667+_0.65134 ;< 0.05) and non-obese patients (4.6923+_.48038 ;< 0.05) significantly.But aerobic exercises were more effective in enhancing the efficacy of aerobic capacity in obese patients. Conclusion: It is evident that aerobic exercises are more effective for obese patients to maintain or reduces weight. Higher MET activity was observed in obese patients.

Target-controlled Intravenous Analgesia with Remifentanil on Hyoxemia in Obese Patients with Painless Gastroscopy / 医学研究杂志

Objective To explor the safty and the effect of controlled intravenous analgesia with remifentanil on hyoxemia in obese patients with painless gastroscopy.Methods One hundred patients undergoing painless gastroscopy were randomly and equally allocated into 2 groups(50 each).In group R,anesthesia was induced with TCI(target-controlled infusion) of remifentanil,and the target plasma concentration (Cp) of propofol was set at 2ng/ml.In group N,the same volume of saline was continues infusion.MAP,RR and HR were monitored and recorded before the examination(T0),the time point of examination start(T1),gastroscopy go through glottis(T2),at the end of the operation (T3) and 5 min after examination (T4).The effect of sedation was evaluated by Ramsay.Except that,gastroscopy time,the satisfaction of patient,anesthetist and endoscopist were recored.In addition,apnea,bradycardia,hypoxemia,myoclonus,body movement,hypotension and postoperative complications were also recorded.Results Compared with group N,in group R,HR,MAP and rate of body movement were significantly decreased (P ＜ 0.05).Except that,the satisfaction of patient and endoscopist were increased (P ＜ 0.05).Conclusion TCI of remifentanil can provide satisfaction sedation for obese patients with painless gastroscopy with few adverse effects.

Effects of different doses of propofol on cardiac pump function in morbidly obese patients / 实用医学杂志

Objective To compare the effects of different doses of propofol on cardiac pump function in morbidly obese patients. Methods Forty morbidly obese patients undergoing laparoscopic Roux-en-Y gastric by-pass were randomly divided into lean body weight(LBW)group and total body weight(TBW)group,with 20 cases in each group.In LBW group,patients were induced by propofol with a dose according to LBW(kg)×2.0 mg/kg but in TBW group,patients were induced by propofol depending on TBW of the patients.We monitored the changes of left ventricular ejection fraction(LVEF)and stroke volume(SV)in patients before anesthetic induction(T1)and at 1 min(T2)after propofol administration.At the same time,we monitored invasive arterial pressure,noninvasive arterial pressure,BIS,and SpO2.Results Compared with those measured at T1,LVEF and SV were decreased af-ter the induction of anesthesia in the 2 groups(P < 0.05);compared with LBW,TBW had greater influence on LVEF and SV after the induction of anesthesia(P<0.05);compared with those at T1,non invasive arterial blood pressure,invasive arterial blood pressure and mean arterial pressure decreased after theinduction of anesthesia (P<0.05);compared with LBW,TBW had no significant effect on noninvasive arterial blood pressure,invasive arterial blood pressure and mean arterial pressure after the induction of anesthesia(P < 0.05);BIS was less than 50 after the induction of anesthesia in 2 groups. Conclusion Propofol induction with a LBW-dependent dose has less influence on cardiac pump function in morbidly obese patients while ensuring the depth of anesthesia.

Comparison of Muscle Mass Indexes According to Protein Intake in Obese Patients

BACKGROUND: Protein is the most important nutrient for the muscle synthesis and maintenance of muscle mass. However, there have been no studies comparing muscle mass indexes according to protein intake in obese patients. Thus, the present study investigated the hypothesis that high protein intake positively affected muscle mass indexes in obese patients. METHODS: Male (n=50) and female (n=30) obese patients were recruited. Each sex was divided into 2 groups according to their protein intake. Dietary intake, fat-free mass, appendicular skeletal muscle mass, appendicular skeletal muscle mass/height², skeletal muscle index, total bone area, bone mineral count, bone mineral density, total cholesterol, low density lipoprotein cholesterol, high density lipoprotein cholesterol, interleukin-6, tumor necrosis factor α, smoking, alcohol, and exercise were assessed. RESULTS: Fat-free mass, appendicular skeletal muscle mass, and appendicular skeletal muscle mass/height² were significantly higher in obese men in the higher protein intake group, while serum triglyceride was significantly lower in the same group. However, bone indexes and inflammatory cytokines according to protein intake were not significantly different in obese men. Fat-free mass, bone indexes, muscle indexes, blood lipid profiles, and inflammatory cytokines were not significantly different according to protein intake in obese women. CONCLUSION: In this population, increasing protein intake may positively affect fat-free mass, appendicular skeletal muscle mass, appendicular skeletal muscle mass/height², and serum triglyceride in obese men. Therefore, additional studies may be necessary to identify the appropriate level of protein intake required to prevent a decrease in muscle mass, and increase muscle mass in obese patients.

Effect of Metformin on Related Indicators of Obese Patients with Type 2 Diabetes / 中国药房

OBJECTIVE:To observe the effect of metformin on related indicators of obese patients with type 2 diabetes. METHODS:136 obese patients with type 2 diabetes were randomly divided into control group and observation group. All patients were given conventional examination,conventional education about diabetes,diet control and stressed physical exercise. Based on it,control group was given 80 mg Metformin tablet(Ⅱ),once a day,and monitored blood glucose levels,the dosage was adjusted based on fasting blood glucose levels to ensure blood glucose in 3.9-6.1 mmol/L;observation group was given 0.5 g Metformin en-teric-coated tablet,twice a day. The 2 groups were compared after 12 weeks treatment. The glycated hemoglobin (HbA1c),body mass index (BMI),resistin,insulin-like growth factor-1(IGF-1),inflammatory cytokines [interleukin-1β(IL-1β),interleukin-6 (IL-6),tumor necrosis factor-α(TNF-α),high-sensitivity C-reactive protein(hs-CRP)] levels in 2 groups before and after tveat-ment were observed,and the incidence of adverse reactions in 2 groups was recorded. RESULTS:After treatment,resistin,IGF-1, IL-6 and hs-CRP levels in 2 groups were significantly lower than before,and observation group was lower than control group;the differences were statistically significant(P0.05);BMI level in observation group was lower than before and control group,and there was no significant difference in the inci-dence of adverse reactions between 2 groups(P>0.05). CONCLUSIONS:Metformin can effectively improve insulin resistance in obese patients with type 2 diabetes and inhibit the inflammatory reaction.

Weight loss effects of Bariatric Surgery after nutrition education in extremely obese patients* / 한국영양학회지

PURPOSE: This study was planned to determine the characteristics of extremely obese patients during Bariatric surgery and to evaluate how the difference in the number of postsurgical personal nutritional educations they received affected the weight loss. METHODS: This is a retrospective study on the basis of the medical records of extremely obese patients for 15 months after receiving gastric banding. A total of 60 people were selected as the study subjects and they were divided into the Less Educated Group and the More Educated Group according to the average number of personal nutritional educations they received. We investigated both groups to determine the general characteristic, health related lifestyle habits, obesity related complications and symptoms in possession, and eating habits before their surgery, the body composition measurement result, obesity determination indices at 1, 3, 6, 9, 12, and 15 months before and after their surgery, and the biochemical parameters at 6 months before and after their surgery. RESULTS: Body fat and weight showed rapid reduction until 6 months after the surgery, but thereafter reduced slowly depending on the result of body composition measurement. Regarding body fat and weight, the More Educated Group, who received nutrition education more often, showed significantly lower levels than the Less Educated Group at 15 months after surgery. Regarding BMI and degree of obesity, the More Educated Group showed significantly lower levels than the Less Educated Group at 15 months after surgery. Here, we were assured that BMI is reversely proportional to the number of personal nutritional educations at 15 months, which is more outstanding after surgery than before surgery. CONCLUSION: Long-term nutritional education is a key factor for the extremely obese patient in maintaining the effects of Bariatric surgery on weight and body fat reduction onwards. In the next stage, considering the characteristics of the study subjects, adoption of individual nutrition education is recommended for postsurgical prospective arbitration of obesity in order to monitor blood pressure, obesity related complications, symptoms in possession, and how eating habits and health related life habits change, and to judge the actual effect of the nutritional education method at the same time.

Association of insulin resistance and GLP-2 secretion in obesity: a pilot study / Associação entre resistência insulínica e secreção de GLP-2 em obesos: um estudo piloto

OBJECTIVE: The objective of this pilot study was to determine whether glugagon-like peptide 2 (GLP-2) secretion relates to insulin sensitivity (IS) in obese subjects. SUBJECTS AND METHODS: Twenty four obese subjects [body mass index (BMI) 40.0 ± 3.0 kg/m² (mean ± standard deviation)] were included, nine of which were male, age 43 ± 8 years. Twelve subjects had type 2 diabetes, all treated with oral anti-diabetic agents only. The subjects were submitted to standard meal tolerance test (MTT) for dosage of the curves: glucose, insulin, and GLP-2. Insulin sensitivity was measured by HOMA-IR, and OGIS was derived from the MTT. Spearman linear correlations and partial correlations were obtained. RESULTS: There was an inverse relationship between the GLP-2 secretion and IS: HOMA-IR correlated with GLP-2 AUC (R = 0.504; p = 0.012), and OGIS correlated with GLP-2 incremental AUC (R = -0.54; p = 0.054). The correlation persisted after controlling for BMI. CONCLUSION: We found an association of GLP-2 secretion and insulin resistance (IR). The understanding of the underlying mechanisms may provide future directions in the pharmacological manipulation of incretins, and in the treatment of obesity and related metabolic disorders.

OBJETIVO: O objetivo deste estudo piloto foi determinar a relação entre a secreção de glugagon like peptide 2 (GLP-2) e a sensibilidade insulínica (SI) em indivíduos obesos. SUJEITOS E MÉTODOS: Vinte e quatro indivíduos obesos [IMC 40.0 ± 3.0 kg/m² (média ± desvio-padrão)] foram incluídos no estudo, sendo 9 homens, com idade de 43 ± 8 anos. Do total, 12 indivíduos tinham diabetes tipo 2, todos tratados somente com antidiabéticos orais. Os sujeitos foram submetidos ao teste de refeição padrão (MTT) para dosagens das curvas: glicose, insulina e GLP-2. A sensibilidade insulínica foi mensurada pelos HOMA-IR e OGIS, obtidos pelos valores do MTT. As correlações lineares e correlações parciais foram obtidas. RESULTADOS: Observou-se uma relação inversa entre a secreção de GLP-2 e SI: HOMA-IR correlacionou-se com GLP-2 AUC (R = 0,504; p = 0,012) e OGIS correlacionou-se com GLP-2 incremental AUC (R = -0,54; p = 0,054). A correlação persistiu controlando o IMC. CONCLUSÃO: Encontramos uma associação entre a secreção de GLP-2 e a resistência insulínica. A compreensão desses mecanismos poderá direcionar o futuro farmacológico da manipulação de incretinas no tratamento da obesidade e das desordens metabólicas.

Biopolítica e confissão: cenas do grupo terapêutico com pacientes obesos / Biopolitics and confession: scenes of group therapy with obese patients

Este trabalho é baseado numa pesquisa realizada em um hospital público, especializado em cirurgia bariátrica na cidade de Fortaleza- CE e teve como objetivo investigar os discursos que circulam no grupo terapêutico realizado com pacientes diagnosticados obesos e como esses pacientes são subjetivados por esses discursos. A metodologia utilizada foi a observação participante do referido grupo composto por pacientes de ambos os sexos que estavam na fase pré e pós-operatória. Foram analisados dois dispositivos presentes no controle da obesidade: a biopolítica e a confissão. A cirurgia bariátrica funciona como uma estratégia biopolítica que incide sobre o corpo de uma população obesa e a confissão atua como tecnologia de si. Assim, esse trabalho buscou problematizar como o corpo obeso é demarcado por práticas de saber-poder que o constituem. Também se tratou de analisar as resistências ao discurso médico-científico sobre saúde, beleza e boa forma dos corpos.

This work focuses on a research conducted in a Brazilian community hospital specialized in bariatric surgery (in Fortaleza, state of Ceará) with the aim of analyzing therapy group discussions with obese patients and how the patients are subjected by these discussions. The research used participant observation methodology. The group was composed of both male and female patients in the pre- and post-operative periods. Two obesity control devices were analyzed: biopolitics and confession. Bariatric surgery acts as a biopolitical strategy on the obese population body, and confession works as a technology of the self. Therefore, this work questioned how knowledge-power practices determine an obese body. Additionally, the research analyzed the resistance to medical-scientific discussions regarding body health, beauty and fitness.

Biomechanical Factors Associated with Plantar Fasciitis in Non-obese Patients / 대한스포츠의학회지

The purpose of this study was to identify the biomechanical factors that correlate with plantar fasciitis in non-obese patients whose body mass index were below 25 kg/m2. The subjects were non-obese patients who were diagnosed as plantar fasciitis by clinical appearance, physical examination, and ultrasonographic findings (n=48), and non-obese control persons without clinical diagnosis of plantar fasciitis (n=30). The two groups were compared on fat pad thickness, ankle dorsiflexion range of motion (ROM), resting calcaneal stance position (RCSP), incidence of calcaneal spur, and calcaneal pitch. The results showed that, there were statistically significant differences between two groups in ankle dorsiflexion ROM, RCSP, and calcaneal pitch (p<0.05). Multiple logistic regression analysis showed ankle dorsiflexion ROM and RCSP strongly correlated with presence of plantar fasciitis as independent predictors (p<0.05). In conclusion, reduced ankle dorsiflexion ROM and negative RCSP (valgus tendency in rear foot) may be the biomechanical factors associated with plantar fasciitis in non-obese patients.