Estado nutricional al inicio del embarazo, ganancias ponderales y retención de peso al año de paridas / Nutritional Condition at the Beginning of Pregnancy, Weight Gains and Weight Retention One Year after Delivery

Introducción: El embarazo es una etapa de riesgo de obesidad persistente después del parto, entre otras causas, es secundario al estado nutricional al inicio del embarazo y a las ganancias de peso por encima de lo recomendado. Objetivo: Describir las ganancias de peso gestacionales por categorías nutricionales y su asociación con la retención de peso al año del parto. Métodos: Se realizó un estudio observacional de corte transversal en 100 mujeres al año del parto, pertenecientes a tres áreas de salud del municipio Santa Clara, en el periodo comprendido de julio 2016 a julio 2017. Se revisaron los tarjetones de las embarazadas para recoger el peso en kg a la captación, su evaluación nutricional según el índice de masa corporal en la primera consulta y el peso al final de la gestación. Las mismas fueron visitadas en su domicilio al año de paridas; se recogieron datos generales, se midió la talla de pie, el peso corporal y la circunferencia de la cintura. Se calcularon los índices de masa corporal y cintura/talla. Resultados: Predominó la condición de peso adecuado a la captación (67,08 por ciento). El 82,87 por ciento de las mujeres retuvo peso al año de paridas; con mayor frecuencia en las obesas (90,0 por ciento) y sobrepeso (83,01 por ciento) según su estado nutricional a la captación. Todas las mujeres tuvieron índice cintura/talla por encima de 0,50 al año de paridas. Conclusiones: Las mujeres con mayores ganancias por encima de lo recomendado, tienen menor capacidad de recuperación del peso corporal al año de paridas(AU)

Introduction: Pregnancy is a period of persistent obesity risk after delivery. Among other causes, it is secondary to the nutritional status at the beginning of pregnancy and to gaining weight above the recommended. Objective: To describe gestational weight gains by nutritional categories and their association with weight retention one year after delivery. Methods: An observational and cross-sectional study was conducted with 100 women one year after delivery and from three health areas of Santa Clara Municipality, in the period from July 2016 to July 2017. Their pregnancy identification cards were reviewed to collect their weight in kilograms at the time pregnancy was identified, nutritional evaluation based on the body mass index at the first office visit, and the weight at the end of pregnancy. They were paid home visits one year after delivery. General data were collected, foot size, body weight, and waist circumference were measured. Body mass and waist/height indexes were calculated. Results: The weight condition adequate to the time pregnancy was identified (67.08 percent). 82.87 percent of women retained weight one year after delivery, more frequently in obese (90.0 percent) and overweight (83.01 percent) women according to their nutritional status at the time pregnancy was identified. All women had waist/height index above 0.50 one year after delivery. Conclusions: Women with weight gains higher than recommended have less capacity to recover their body weight one year after delivery(AU)

High Serum Levels of Thyroid-Stimulating Hormone and Sustained Weight Gain in Patients with Thyroid Cancer Undergoing Radioiodine Therapy

BACKGROUND AND OBJECTIVES: The extent of weight gain and its association with clinical factors in patients undergoing radioiodine therapy for differentiated thyroid cancer remain unclear. We analyzed clinical factors related to sustained weight gain after serum thyroid-stimulating hormone (TSH) stimulation for radioiodine (I-131) therapy. MATERIALS AND METHODS: The study population included 301 adult patients who underwent total thyroidectomy followed by radioiodine therapy and visited the thyroid clinic regularly. Group 1 received a single radioiodine therapy treatment, while group 2 received multiple radioiodine treatment. Data on transient weight gain, defined as weight gain that resolved (±5%) within 1 year after radioiodine therapy, were collected from medical records. Sustained weight gain was defined as body mass index after treatment (BMI(post)) - BMI before treatment (BMI(pre)) ≥2 kg/m2 more than 1 year following radioiodine therapy. Subjective symptoms were scored by questionnaire. Logistic regression analysis was performed using various clinical and laboratory factors to identify risk factors associated with sustained weight gain. RESULTS: Two hundred and fifty-nine (86%) patients showed transient weight gain and 23 (8%) patients showed sustained weight gain. TSH at therapy and T4-on TSH differed significantly in all patients and in the patients in group 1 with sustained weight gain. The proportion of patients with basal BMI≥25 kg/m2 in group 1 with sustained weight gain also differed significantly. Univariate analysis revealed that high serum levels of TSH at therapy (≥100 µIU/mL) and hypercholesterolemia were associated with sustained weight gain in group 1. Multivariate analysis showed that TSH at therapy levels ≥100 µIU/mL was associated with sustained weight gain in group 1. Of 283 patients remaining after excluding those with insufficient TSH suppression during follow-up, T4-on TSH levels were lower in the sustained weight gain group compared to those without sustained weight gain. TSH at therapy levels ≥100 µIU/mL were significantly associated with sustained weight gain in multivariate analysis. CONCLUSION: Most patients (86%) had transient weight gain after TSH at therapy, while 8% of patients showed sustained weight gain. Univariate and multivariate analysis revealed relatively high TSH levels (≥100 µIU/mL) to be a risk factor for patients that received a single dose of radioiodine therapy. Insufficient T4 dose was not associated with sustained weight gain.

Estimação do valor energético da pastagem e simulação de parâmetros do desempenho produtivo de novilhas em pasto / Estimation of pasture energy value and simulation of productive performance of heifers under grazing

Estimaram-se o valor energético das forrageiras e o consumo de matéria seca por novilhas, em função do ganho de peso, criadas em pastagens de capim-elefante (Pennisetum purpureum Schum. cv. Napier) e capim-mombaça (Panicum maximum, cv. Mombaça), manejadas sob sistema rotacionado, mediante amostras tomadas via extrusa esofágica. As amostras relativas ao terceiro, segundo e primeiro dias de ocupação foram utilizadas para determinar os teores matéria seca, proteína bruta, extrato etéreo, fibra em detergente neutro, fibra em detergente ácido, lignina e cinzas para calcular os nutrientes digestíveis totais (NDT). Os valores do NDT preditos pelo sistema americano (NRC) e os estimados a partir do ganho de peso foram comparados com ajustamento de modelo de regressão linear simples. Os ganhos médios de peso diário foram de 0,649kg e de 0,590kg, respectivamente, para o capim-elefante e para o capim-mombaça, o que resultou na rejeição da hipótese de nulidade, ou seja, resultou em ausência de equivalência entre os valores preditos pelo sistema e os observados. A incorporação do fator empírico de correção (0,85) em substituição ao valor (0,667) proposto pelo NRC minimizou a ocorrência deste comportamento viesado.

Elephantgrass (Pennisetum purpureum, Schum. cv. Napier) and mombaçagrass (Panicum maximum, cv. Mombaça) pastures were evaluated under rotational grazing with samplings taken by esophageal extrusa. The energy value of grasses and the dry matter intake of heifers as a function of the weight gains were estimated. Samples relating to the third, second, and first days of the occupation period were used to determine the dry matter (DM), crude protein (CP), ether extract (EE), organic matter (OM), neutral detergent fiber (NDF), and acid detergent fiber (ADF) to calculate the total digestible nutrients (TDN). The TDN values predicted by the American System (NRC) and those estimated from heifers weight gains were compared with adjustment of simple linear regression. The average weight gains were 0.649 and 0.590kg, respectively, for elephantgrass and mombaçagrass, that resulted in the rejection of nullity hypothesis, which means, it resulted in absence of similarity among values predicted by the system and those observed. The incorporation of the empirical factor (0.85) replacing the value (0.667) proposed by NRC resulted in better estimation.