ABSTRACT
As restrições impostas pela pandemia de covid-19 levaram os serviços de saúde a reorganizarem seu funcionamento, ajustando-se à modalidade remota. A transição repentina e sem o devido preparo técnico impôs desafios adicionais para usuários e profissionais. Para aprimorar as estratégias assistenciais, torna-se imprescindível dar voz aos usuários dos serviços, para que narrem suas experiências e possam manifestar suas facilidades e dificuldades com essa passagem. Este estudo tem como objetivo investigar como os principais cuidadores familiares de pessoas com transtornos alimentares vivenciaram a transição do grupo de apoio para o formato remoto e identificar vantagens e desvantagens percebidas nesse modelo. Estudo clínico-qualitativo, exploratório, realizado em um serviço de atendimento especializado de um hospital terciário. O cenário investigado foi o grupo de apoio psicológico aberto a familiares que, desde o início da pandemia de covid-19, passou a ser oferecido na modalidade online. Participaram do estudo cinco mães e três pais presentes em 13 sessões grupais consecutivas. Entrevistas individuais foram aplicadas com a Técnica do Incidente Crítico logo após o término de cada encontro grupal, totalizando 26 entrevistas audiogravadas, transcritas e submetidas à análise temática. A transição para o online foi vivenciada pelos participantes como um recurso válido para permitir que o grupo funcionasse em tempos de grave crise sanitária. Como vantagens, foram mencionadas: a continuidade do cuidado, maior acessibilidade e facilidade em relação à logística da participação. Como limitações do formato online, foram destacadas: nem todos os familiares contam com conexão de internet de qualidade e possível dificuldade para manusear a tecnologia digital. Apesar dos desafios impostos pela súbita mudança para a modalidade online, na perspectiva dos usuários do serviço os esforços de adaptação foram bem-sucedidos, possibilitando a continuidade do cuidado à saúde mental.(AU)
The constraints imposed by the COVID-19 pandemic led health services to reorganize their operation, adjusting to the online modality. The sudden and unprepared technical transition has imposed additional challenges for both users and professionals. To improve care strategies, it is essential to give voice to services users, so that they can narrate their experiences and express their facilities and difficulties with this transition. This study aims to investigate how main family caregivers of people with eating disorders experienced the transition of the support group to the remote modality and to identify perceived advantages and disadvantages in this model. This is a clinical-qualitative, exploratory study carried out in a specialized care service of a tertiary hospital. The investigated setting was the psychological support group open to family members, which since the beginning of the COVID-19 pandemic has been offered online. Five mothers and three fathers who attended 13 consecutive group sessions participated in the study. Individual interviews were carried out with the Critical Incident Technique shortly after the end of each group meeting with all members, totaling 26 audio-recorded interviews. Data were subjected to thematic analysis. Transition was experienced as a valid resource to maintain the group active in times of a severe health crisis. As advantages of the remote modality were mentioned: continuity of care, greater accessibility, and ease in relation to the logistics of participation. As limitations of the online format were highlighted: not everyone has a good-quality connection to the internet, and difficulty in handling the digital technology. Despite the challenges imposed by the sudden shift to the online modality, from the service users' perspective the adaptation efforts were successful, enabling continuity of mental health care.(AU)
Las limitaciones que impuso la pandemia de la COVID-19 llevaron a los servicios sanitarios a reorganizar su funcionamiento adaptándose a la modalidad remota. El súbito cambio y sin la preparación técnica adecuada implicó retos adicionales a los usuarios y profesionales. Para mejorar las estrategias de atención es fundamental dar voz a los usuarios de los servicios, para que puedan narrar sus experiencias y expresar sus facilidades y dificultades con esta transición. Este estudio pretende investigar cómo han vivido los cuidadores de personas con trastornos alimentarios la transición del grupo de apoyo presencial al formato remoto e identificar las ventajas y desventajas percibidas en este modelo. Se trata de un estudio clínicocualitativo, exploratorio. El escenario investigado fue el grupo de apoyo psicológico abierto a los familiares en la modalidad en línea. Cinco madres y tres padres participaron en 13 sesiones de grupo consecutivas. Se realizaron entrevistas individuales con la técnica de incidentes críticos inmediatamente después de cada reunión del grupo, con un total de 26 entrevistas grabadas en audio, transcritas y sometidas a análisis temático. La transición a la red fue experimentada como un recurso válido para permitir que el grupo funcione en tiempos de crisis sanitaria grave. Las ventajas de la modalidad remota fueron conexión segura en tiempos de confinamiento físico, continuidad, mayor accesibilidad y facilidad en relación con la logística de la participación. Las limitaciones del formato en línea fueron la falta de una conexión de calidad a Internet y la posible dificultad de manejo de la tecnología digital. A pesar de las dificultades impuestas por el cambio repentino a la modalidad en línea, desde la perspectiva de los usuarios del servicio los esfuerzos de adaptación fueron un éxito, lo que permitió seguir con la atención de salud mental.(AU)
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Parents , Self-Help Groups , Feeding and Eating Disorders , Caregivers , COVID-19 , Anxiety , Patient Care Team , Patients , Psychology , Psychopathology , Quality of Life , Rejection, Psychology , Respiratory Tract Infections , Self-Assessment , Self Concept , Social Isolation , Social Support , Stress, Physiological , Stress, Psychological , Therapeutics , Thinness , Vomiting , Women , Behavior Therapy , Body Image , Body Weight , Food and Nutrition Education , Adaptation, Psychological , Career Mobility , Biological Factors , Anorexia , Gastroesophageal Reflux , Bulimia , Anorexia Nervosa , Crowding , Efficacy , Adolescent , Employment, Supported , Suicide, Assisted , Interview , Compulsive Behavior , Privacy , Feeding and Eating Disorders of Childhood , Counseling , Cultural Characteristics , Death , Depression , Diagnosis , Diet , Diuretics , Educational Status , Environment and Public Health , Renal Insufficiency , Bulimia Nervosa , Laxatives , Family Conflict , Fear , Feeding Behavior , Ideal Body Weight , Binge-Eating Disorder , Pandemics , Social Networking , Patient Care Bundles , Nutritionists , Clinical Study , Perfectionism , Psychosocial Support Systems , Food Addiction , Systematic Review , Sadness , Information Technology Management , Avoidant Restrictive Food Intake Disorder , Gastrointestinal Diseases , Psychological Distress , Weight Prejudice , Teleworking , Physical Distancing , Psychotherapists , Orthorexia Nervosa , Social Structure , Sociodemographic Factors , Family Support , Guilt , Health Facility Moving , Learning , Mass Media , Mental Disorders , Neurotic Disorders , ObesityABSTRACT
El objetivo es comparar el IMC con el porcentaje de grasa corporal y el peso ideal, para complementar el IMC en el diagnóstico de obesidad, de un grupo de adultos. Métodos: estudio descriptivo, transversal, prospectivo y correlacional, en una muestra de 797 adultos con edad entre 17 y 96 años, atendidos en diferentes centros clínicos de Caracas, entre 2015 y 2018. Las variables son: edad, peso, talla y se calcularon el IMC, porcentaje de grasa corporal (PGC) y peso ideal (PI). Se clasificaron por sexo, grupo etáreo y según el IMC en normalidad y obesidad. Se utilizaron dos fórmulas para el PGC: Deurenberg y Regresión; y tres fórmulas para PI: Lorenz, Ramírez et al y Broca. Se obtuvieron medidas descriptivas, asociación, correlación, comparación de promedios y prueba de normalidad, mediante el soîware Excel, Epidat.2. Resultados: Promedios de IMC y PGC aumentan hasta los 40 años y disminuye hasta los 79 años, las variables Talla PI Broca, e IMC- PGCR correlacionan bien (r>0,75). Los promedios del IMC, PGCD, PGCR, PI Broca y PI Lorenz, según sexo, son significativos (p<0,000); para el IMC, en Normalidad y Obesidad, los promedios de peso, IMC, PGCD y PGCR son mayores en grupo de Obesidad, y significativos (p<0,000). La prueba de normalidad Shapiro-Francia comprobó que la distribución del IMC, PGCD, PGCR y PI Lorenz, provienen de una población distribuida normalmente (p< 0,000). Conclusiones: el IMC aun cuando es utilizado más frecuentemente para diagnosticar obesidad, clasifica con normalidad, a quienes tienen un alto porcentaje de grasa corporal(AU)
The objective is to compare BMI with the percentage of body fat and ideal weight, to supplement BMI in the diagnosis of obesity, from a group of adults. METHODS: descriptive, cross-cutting, prospective and correlational study, in a sample of 797 adults between 17 and 96 years old, attended in different clinical centers of Caracas, between 2015 and 2018. the variables are: age, weight, size and BMI was calculated, percentage of body fat (BFP) and ideal weight (IW). they were classified by sex, age group and BMI in normality and obesity. Two formulas were used for BFP: Deurenberg and Regression; and three formulas for IW: Lorenz, Ramirez-Lopez et al and Broca. Descriptive measures, association, correlation, average comparison and normality test were obtained, using Excel software, Epidat.2. RESULT: BMI and BFP averages increase to 40 years and decrease to age 79, the variables Size IW Broca, and BMI- BFPR correlate well (r>0.75). îe average BMI, BFPD, BFPR, IW Broca and IW Lorenz, depending on gender, are significant (p<0.000); for BMI, in Normality and Obesity, the weight averages, BMI, BFPD and BFPR are higher in the Obesity group, and significant (p<0,000). the Shapiro-France normality test found that the distribution of BMI, BFPD, BFPR and IW Lorenz, comes from a normally distributed population (p< 0.000). CONCLUSIONS: BMI even though it is most commonly used to diagnose obesity, it classifies normally, those with a high percentage of body fat(AU)
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Body Mass Index , Body Fat Distribution , Ideal Body Weight , Socioeconomic Factors , Weight by Height , Body Composition , ObesityABSTRACT
Abstract Introduction Ideal body weight calculation is used in critical medicine for drug dosing and setting ventilation parameters. However, the suggested and used equations were designed on the basis of anthropometric variables that do not represent the Latin American population. Objective To map and present the current evidence on the equations used to calculate ideal weight in patients on mechanical ventilation in intensive care units in Latin America. Material and Methods Exploratory review using the Joanna Briggs Institute method conceived by Arskey / O'Malley. A search was performed in the BVS, LILLACS, REDALYC, Ovid, Google Scholar and Scielo databases using keywords and MeSH terms in Spanish, English, and Portuguese, with no time limitation. The results are presented in descriptive tables. Results Overall, 1126 studies were identified and 1120 were excluded; 6 studies were reviewed and 3 additional studies were identified through a manual search. The studies were published in Chile, Brazil, Mexico, Ecuador, and Peru. In 89%, the ARDS Network equation was used to calculate tidal volume. Acute respiratory distress syndrome was the most reported pathology (33%). Conclusions Adult intensive care units in Latin America use the equation suggested by the ARDS Network, which was designed in a population with different anthropometric characteristics.
Resumen Introducción El cálculo del peso ideal se utiliza en medicina crítica para dosificación de medicaciones y programación de parámetros ventilatorios; sin embargo, las ecuaciones sugeridas y usadas fueron diseñadas con variables antropométricas que no representan la población latinoamericana. Objetivo Mapear y presentar la evidencia actual de las ecuaciones utilizadas para calcular el peso ideal en pacientes con ventilación mecánica en unidades de cuidado intensivo de Latinoamérica. Material y métodos Revisión exploratoria con el método del Instituto Joanna Briggs concebido por Arskey y O'Malley. Se realizó una búsqueda en las bases de datos BVS, LILACS, Redalyc, Ovid, Google Scholar y SciELO con el uso de palabras clave y términos MeSH en idiomas español, inglés y portugués, sin límites de tiempo. Los resultados se presentan de forma descriptiva. Resultados Se identificaron 1.126 estudios, se excluyeron 1.120, se revisaron seis y se encontraron tres adicionales mediante búsqueda manual. Los estudios fueron publicados en Chile, Brasil, México, Ecuador y Perú. En el 89 % se usó la ecuación del ARDS Network para calcular volumen corriente. El síndrome de dificultad respiratoria aguda fue la patología más informada (33 %). Conclusiones En las unidades de cuidado intensivo adulto de Latinoamérica se usa la ecuación sugerida por el ARDS Network diseñada en población con características antropométricas diferentes.
Subject(s)
Humans , Respiration, Artificial , Tidal Volume , Ideal Body Weight , Body Height , Critical Care , Libraries, Digital , Latin AmericaABSTRACT
Abstract Background: Overweight and obesity (O/O) generate lipotoxicity of the cardiac fiber and increase the incidence and progression of aortic valve stenosis. The low cardiac output syndrome (LCOS) is a timing complication after to aortic valve replacement (AVR) surgery. Objective: The objective of the study was to investigate if body mass index (BMI) kg/m2 is a risk factor associated with LCOS and mortality in the post-operative period of AVR. Methods: A historic cohort study was designed, including patients with severe aortic stenosis (SAS), who were subjected to AVR. Results: 152 patients were included, 45 (29.6%), with normal weight (NW), 60 were overweight (39.5%), and 47 obese (30.9%). The prevalence of systemic hypertension (HT) was higher in O/O (p < 0.0001). Incidence of LCOS was 44.7%, being more frequent in the O/O groups compared to the NW group, 43.3%, 68.1%, and 22.2%, respectively, (p < 0.05 in overweight and p < 0.0001 in the obese). Assessing the presence or absence of LCOS associated with BMI as a numerical variable, we found that women, HT, BMI, left ventricular mass, and valve size, were associated with LCOS (p < 0.02, p < 0.02, p < 0.001, p < 0.032, and p < 0.045, respectively). Mortality was higher in patients who had LCOS (p < 0.02). Multivariate model showed that BMI was an independent risk factor for LCOS (odds ratio [OR] 1.21 [95% CI 1.08-1.35], p < 0.001). Conclusion: BMI is a risk factor associated to LCOS in the post-operative period of AVR in patients with SAS.
Resumen Antecedentes: El sobrepeso y la obesidad (O/O) generan lipotoxicidad de la fibra cardíaca y aumentan la incidencia y progresión de la estenosis de la válvula aórtica. El síndrome de bajo gasto cardíaco (SBGC) es una complicación postquirúrgica de la cirugía de reemplazo de válvula aórtica (RVA). Objetivo: Investigar si el índice de masa corporal kg/m2 (IMC) es un factor de riesgo asociado con SBGC y mortalidad en el postoperatorio de RVA. Métodos: Se diseñó un estudio de cohorte histórico, que incluyó pacientes con estenosis aórtica importante (EAI), que fueron sometidos a RVA. Resultados: Se incluyeron 152 pacientes, 45 (29.6%), con peso normal (N), 60 tenían sobrepeso (39.5%) y 47 obesos (30.9%). La prevalencia de hipertensión sistémica (HT) fue mayor en O/O (p < 0.0001). La incidencia de SBGC fue del 44.7%, siendo más frecuente en los grupos O/O en comparación con el grupo N, 43.3%, 68.1%, 22.2% respectivamente, (p < 0.05 en sobrepeso y p < 0.0001 en obesos). Al evaluar la presencia o ausencia de SBGC asociado con el IMC como una variable numérica, encontramos que las mujeres, HT, IMC, masa ventricular izquierda y tamaño de la válvula, se asociaron con SBGC (p < 0.02, p < 0.02, p < 0.001, p < 0.032, p < 0.045, respectivamente). La mortalidad fue mayor en pacientes con SBGC (p < 0.02). El modelo multivariado mostró que el IMC fue un factor de riesgo independiente asociado a SBGC [OR 1.21 (IC 95% 1.08-1.35), p < 0.001]. Conclusión: El IMC es un factor de riesgo asociado a SBGC en el postoperatorio de RVA en pacientes con EAI.
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Aortic Valve Stenosis/surgery , Postoperative Complications/epidemiology , Cardiac Output, Low/epidemiology , Heart Valve Prosthesis Implantation/adverse effects , Postoperative Complications/mortality , Cardiac Output, Low/etiology , Cardiac Output, Low/mortality , Body Mass Index , Incidence , Retrospective Studies , Risk Factors , Cohort Studies , Heart Valve Prosthesis Implantation/methods , Overweight/complications , Ideal Body Weight , Obesity/complicationsABSTRACT
RESUMEN La obesidad es un problema de salud pública, siendo especialmente importante entre mujeres jóvenes. El objetivo de este estudio fue comparar la vivencia corporal, los hábitos saludables y regulación emocional entre mujeres jóvenes chilenas con obesidad y normopeso. El estudio tuvo un enfoque cualitativo, de alcance exploratorio y diseño descriptivo-analítico. Para describir la muestra se usó el Multidimensional Body Self Relations Questionnaire (MBSRQ) que mide imagen corporal, el Dutch Eating Behavior Questionnaire (DEBQ) para evaluar ingesta emocional, y el Derogatis Symptom Checklist (SCL-90), que mide sintomatología psicológica. Se realizaron entrevistas en profundidad, que fueron analizadas utilizando codificación abierta de la Grounded Theory. Los resultados indican que ambos grupos presentan insatisfacción con la forma y peso de sus cuerpos, predominando en las participantes con obesidad al percibir limitaciones corporales. Las mujeres con obesidad describieron que regularon emociones negativas a través de la alimentación. Las participantes normopeso se caracterizaron por hábitos saludables, como actividad física y alimentación balanceada y en ambos grupos valorizan el cuidado del cuerpo y la estética personal, aunque sólo participantes normopeso presentaron conductas de cuidado efectivas.
ABSTRACT Obesity is a public health problem and is especially important among young women. The objective of this study was to compare the body experience, food habits and emotional regulation among young women with and without obesity. The study had a qualitative approach, was exploratory in scope and had a descriptive-analytical design. To describe the sample, the Multidimensional Body Self Relations Questionnaire (MBSRQ) was used to measure body image, the Dutch Eating Behavior Questionnaire (DEBQ) to assess emotional intake, and the Derogatis Symptom Checklist (SCL-90), which measures psychological symptoms. In-depth interviews were conducted, which were analyzed using Grounded Theory's open theory. The results indicated that both groups showed dissatisfaction with the shape and weight of their bodies, with women with obesity reporting perceived body limitations. Women with obesity reported regulating negative emotions through food. Non-obese participants reported healthy habits, such as physical activity and a balanced diet, and in both groups, body care and personal aesthetics were valued, although only non-obese participants reported effective care behaviors.
Subject(s)
Women , Body Image/psychology , Ideal Body Weight , Healthy Lifestyle , ObesityABSTRACT
But : L'objectif de cette étude était d'analyser l'ampleur des principales maladies non transmissibles leurs facteurs de risque communs au Burkina Faso. Matériels et Méthodes : il s'agissait d'une analyse basée sur des données secondaires de l'enquête par étape (STEPS)au Burkina Faso réalisée en 2013. L'analyse a concerné les facteurs de risques comportementaux et métaboliques. Un modèle de régression multiple a été utilisé pour déterminer les facteurs indépendants associés à ces maladies.Résultats : Les variables indépendantes associées aux facteurs de risque comportementaux étaient 1)le jeune âge (OR=0,4423 ; p< 0,001) et le sexe masculin (OR=0,0030 ; p< 0,001)pour le tabagisme, 2)l'âge avancé (OR= 2,01 ; p= 0,0066 et OR=2,18 ; p< 0,001) et le sexe masculin (OR=2,18 ; p< 0,001) pour la consommation et l'usage nocif d'alcool et 3) le jeune âge (OR=0,34 ; p< 0,001)et le milieu urbain(OR=1,57 ; p= 0,0236) pour l'inactivité physique. Les variables indépendantes associées aux facteurs de risque métaboliques étaient 1) le jeune âge (OR=1,33 ; p= 0,0295) et le milieu urbain (OR=0,31 ; p< 0,001) pour le surpoids, 2) le sexe féminin (OR=2,55 ; p= 0,0010) et le milieu urbain (OR= 0,13; p< 0,001) pour l'obésité et 3) l'âge avancé (OR=2,49 ; p< 0,001 et OR= 2,12 ; p= 0,0115) et le milieu urbain (OR=0,47 ; p< 0,001 et OR= 0,49 ;p= 0,0320) pour l'hypertension artérielle et le diabète. Conclusion : Au Burkina Faso, des actions de prévention et de promotion de la santé doivent être accentuées avec une approche multisectorielle pour lutter contre ces facteurs de risque
Subject(s)
Burkina Faso , Ideal Body Weight , Noncommunicable Diseases , Risk FactorsABSTRACT
BACKGROUND: Osteoporosis and osteopenia are characterized by reduced bone mineral density (BMD) and increased fracture risk. Although the risk of fractures is higher in underweight people than in overweight people, the accumulation of body fat (especially abdominal fat) can increase the risk of bone loss. This study aimed to evaluate the association between body fat percentage and BMD in normal-weight middle-aged Koreans. METHODS: This study included 1,992 adults (mean age, 48.7 years; 52.9% women). BMD and body fat were measured using dual-energy X-ray absorptiometry. Multiple linear regression analyses and analysis of covariance were used to assess the association between BMD and body fat. Body fat percentage was grouped by cut-off values. The cut-off values were 20.6% and 25.7% for men with a body mass index of 18.5–22.9 kg/m2, while the cut-off values were 33.4% and 36% for women. RESULTS: Body fat percentage tended to be negatively associated with BMD. Increased body fat percentage was associated with reduced BMD in normal-weight middle-aged adults. The effects of body fat percentage on BMD in normal-weight individuals were more pronounced in men than in women. CONCLUSION: There was a negative correlation between BMD and body fat percentage in middle-aged Korean men and women with normal body weight. This association was stronger in men than in women.
Subject(s)
Adult , Female , Humans , Male , Abdominal Fat , Absorptiometry, Photon , Adipose Tissue , Body Mass Index , Bone Density , Bone Diseases, Metabolic , Ideal Body Weight , Linear Models , Osteoporosis , Overweight , ThinnessABSTRACT
El objetivo de este estudio fue describir y comparar la influencia de factores sociales, específicamente de vínculos cercanos (madre, padre y pareja), sobre la vivencia del cuerpo en mujeres jóvenes con peso normal y con obesidad. Se realizó una investigación exploratoria cualitativa y se analizaron los datos a través de codificación abierta, basada en la Teoría Fundamentada. La muestra estuvo conformada por ocho mujeres, cuatro con obesidad mórbida y cuatro normopeso, entre 20 y 25 años. Los resultados confirman que la insatisfacción corporal está presente en todas las participantes independiente de su peso corporal. Las personas cercanas ejercen presión por la delgadez, la madre estaría más centrada en lo estético, mientras el padre expresaría mayor preocupación por la salud. Las participantes se muestran vulnerables a los mensajes contradictorios de la pareja, generando inseguridad. Sin embargo, la presión de los vínculos cercanos no sería suficiente para generar cambios de hábitos. Se observa ambivalencia entre la valoración de un cuerpo delgado y otro curvilíneo, ideales que se superponen y generan malestar.
The objective of this study was to describe the influence of social factors, specifically close affective bonds (mother, father and couple), on body experience in young women with obesity and normal weight. A qualitative exploratory research was carried out and data were analyzed with Grounded Theory. A sample of eight women between 20 and 25 years old participated, four of them with morbid obesity and four with normal weight. The results confirm that body dissatisfaction is present in all the participants, which is associated with the pressure to be thin exerted by the people close to them. Mothers are more centered on the aesthetic, while fathers seem to have more concern about health. Participants are vulnerable to the couple's conflicting messages, generating insecurity. However, the pressure of the environment does not seem to be enough to change the habits. Ambivalence is observed between the appreciation of a thin body and a curvilinear one at the same time, ideals that overlap and generate discomfort.
Subject(s)
Humans , Female , Adult , Thinness/therapy , Body Image/psychology , Interview , Family Conflict/psychology , Ideal Body Weight , Peer Influence , Body Dissatisfaction/psychology , Obesity/psychologyABSTRACT
PURPOSE: This study examined the effects of parenteral nutrition (PN) on the nutritional status, clinical improvement, and PN-related complications in pediatric patients who had undergone hematopoietic stem cell transplantation (HSCT). METHODS: A retrospective audit of 110 pediatric patients (age≤18), who underwent HSCT from March 2015 to February 2017 was undertaken. The patients were divided into 3 groups based on the ratio of daily calorie supplementation to the daily calorie requirement (ROCS). The clinical factors related to the nutritional status, such as difference in body weight (BW), body mass index (BMI), percent ideal body weight (PIBW), total protein (T.protein), and albumin; the early clinical outcome, such as PN-duration, length of hospitaliaztion (LOH), engraftment day (ED), graft-versus-host disease, sepsis, pneumonia and mucositis; and PN-related complications, including elevation of total bilirubin (T.bil), direct bilirubin (D.bil), aspartate aminotransferase, alanine aminotransferase, glucose and cholesterol levels, and hepatic veno-occlusive disease were analyzed using the electronic medical records. Additional analysis subject to auto-HSCT and allo-HSCT patients was also performed. RESULTS: The very-low-ROCS, low-ROCS, and satisfied-ROCS group were 30 (27.3%), 47 (42.7%), and 33 (30.0%) patients, respectively. The PN-duration (P=0.005, z=−2.271), LOH (P=0.023, z=−2.840), ED (P < 0.001, z=−3.695), T.bil elevation (P < 0.001, z=−3.660), and D.bil elevation (P=0.002, z=−3.064) tended to decrease with increasing ROCS. The difference in the PN-duration (P=0.017), ED (P=0.001), T.bil elevation (P=0.001), and D.bil elevation (P=0.011) in the 3 groups was statistically significant. In the auto-HSCT patients, the change in BW (P=0.031, z=+2.154), PIBW (P=0.029, z=+2.187), and BMI (P=0.021, z=+2.306) tended to increase. In the allo-HSCT patients, the change in T.protein (P=0.022, z=+2.286) increased but the ED (P=0.021, z=−2.304) decreased. CONCLUSION: Aggressive PN supplementation has an effect on maintaining the nutritional status and achieving better early outcomes in pediatric HSCT patients, whereas it has no effect on increasing the PN-related complications.
Subject(s)
Humans , Alanine Transaminase , Aspartate Aminotransferases , Bilirubin , Body Mass Index , Body Weight , Cholesterol , Electronic Health Records , Glucose , Graft vs Host Disease , Hematopoietic Stem Cell Transplantation , Hematopoietic Stem Cells , Hepatic Veno-Occlusive Disease , Ideal Body Weight , Mucositis , Nutritional Status , Parenteral Nutrition , Pediatrics , Pneumonia , Retrospective Studies , SepsisABSTRACT
PURPOSE: The present study is focused on understanding weight perception related with individual- and school-level multifactorial origins, underestimated and overestimated respectively, in normal body weight adolescents. METHODS: Using the 2017 Korea Youth Risk Behavior Web-based Survey data of 45,902 students from 799 secondary schools, a multilevel multinomial logistic regression analysis was performed where adolescents (level1) were nested within schools (level 2). RESULTS: At the school level, the average school body mass index (BMI, kg/m²) and physical education were associated with weight perception among both boys and girls. In boys, geographic areas were associated with weight underestimation. At the individual level, perceived economic status, weekly allowance, BMI (kg/m²), smartphone usage time (hrs/day) and perceived stress were associated with weight perception among both boys and girls. Age, paternal education, academic achievement and alcohol use were associated with weight perception among girls, while part-time job and physical activity were associated with weight perception among boys. CONCLUSION: Our findings underscore the importance of individual- and school-level environments in developing correct weight perception and have implications for school health education to establish healthy lifestyle behaviors for all adolescents.
Subject(s)
Adolescent , Female , Humans , Body Mass Index , Education , Ideal Body Weight , Korea , Life Style , Logistic Models , Motor Activity , Multilevel Analysis , Paternal Age , Physical Education and Training , Risk-Taking , School Health Services , Smartphone , Weight PerceptionABSTRACT
OBJECTIVES: This study was performed to investigate the effect of active nutrition care on feeding and nutritional status of elderly patients receiving long-term enteral tube feeding. METHODS: Subjects included 77 elderly patients who had received enteral nutrition more than one week before admission. Nutrition care was provided to patients supplied less calories than required. Feeding intolerance was examined and managed every day and formula was adjusted to meet nutritional requirement during the first 3 months after admission. Patients were classified into under or over 80% of percent ideal body weight (PIBW) and medical records were used to compare changes in weight,, biochemical indices, and nutritional status during the study. RESULTS: Weight, BMI, triglyceride and total cholesterol in blood, hemoglobin, and hematocrit levels were significantly lower in patients under 80% of the PIBW than in those over 80% of the PIBW at admission. The percentage of supply to required calories was also lower in patients under 80% of the PIBW. After 1 month of nutritional care, supplied volume of formula was significantly increased in patients under 80% of the PIBW. Weight, BMI, and PIBW were increased and there were no differences between groups after 6 months. In addition, the concentrations of triglyceride and total cholesterol in blood, hemoglobin, and hematocrit tended to increase in patients under 80% of the PIBW, leading to no difference between groups after 3 months. CONCLUSIONS: Personalized active nutrition care is effective to increase weight and improve feeding and nutritional status in underweight elderly patients receiving longterm enteral nutrition.
Subject(s)
Aged , Humans , Cholesterol , Enteral Nutrition , Hematocrit , Ideal Body Weight , Malnutrition , Medical Records , Nutritional Requirements , Nutritional Status , Thinness , TriglyceridesABSTRACT
OBJECTIVES: This study was performed to investigate the effect of active nutrition care on feeding and nutritional status of elderly patients receiving long-term enteral tube feeding. METHODS: Subjects included 77 elderly patients who had received enteral nutrition more than one week before admission. Nutrition care was provided to patients supplied less calories than required. Feeding intolerance was examined and managed every day and formula was adjusted to meet nutritional requirement during the first 3 months after admission. Patients were classified into under or over 80% of percent ideal body weight (PIBW) and medical records were used to compare changes in weight,, biochemical indices, and nutritional status during the study. RESULTS: Weight, BMI, triglyceride and total cholesterol in blood, hemoglobin, and hematocrit levels were significantly lower in patients under 80% of the PIBW than in those over 80% of the PIBW at admission. The percentage of supply to required calories was also lower in patients under 80% of the PIBW. After 1 month of nutritional care, supplied volume of formula was significantly increased in patients under 80% of the PIBW. Weight, BMI, and PIBW were increased and there were no differences between groups after 6 months. In addition, the concentrations of triglyceride and total cholesterol in blood, hemoglobin, and hematocrit tended to increase in patients under 80% of the PIBW, leading to no difference between groups after 3 months. CONCLUSIONS: Personalized active nutrition care is effective to increase weight and improve feeding and nutritional status in underweight elderly patients receiving longterm enteral nutrition.
Subject(s)
Aged , Humans , Cholesterol , Enteral Nutrition , Hematocrit , Ideal Body Weight , Malnutrition , Medical Records , Nutritional Requirements , Nutritional Status , Thinness , TriglyceridesABSTRACT
Introdução: às associações entre o índice de massa corporal e a agilidade na infância, não estão bem esclarecidas na literatura. Objetivo: analisar a associação entre os níveis do índice de massa coporal e a agilidade em crianças e adolescentes. Método: estudo transversal com voluntários de 10 a 14 anos. Separados em: grupo com peso normal (PN= 22), grupo com excesso de peso/obesidade (EP/OB= 22). Todos passaram por medidas de antropometria e agilidade. A estatura e massa corporal foram aferidas para determinar o índice de massa corporal utilizando a sugestão da Organização Mundial da Saúde. Para medir a agilidade foi utilizado o teste Shutle Runpor exigir pouca habilidade motra e ter uma boa confiabilidade. Na semana que antecedeu as medidas definitivas, os voluntários foram familiarizados com os procedimentos e com a execução dos testes. Para todos os cálculos estatísticos adotou o nível de significância de (p≤ 0,05). Resultados: houve uma correlação significativamente positiva e moderada entre o índice de massa corporal e os níveis de agilidade no grupo como um todo (r= 0,46; p= 0,03). Já os resultados do teste t, confirmou-se a existência de diferença significativa entre o nível de agilidade do grupo com excesso de peso e obesidade e o grupo com peso normal (p< 0,05). Conclusão: houve correlação significativa entre o índice de massa corporal e os níveis de agilidade na amostra analisada; e que o grupo classificado pelo índice de massa corporal como EP/OB apresentou um nível de agilidade significativamente menor do que o grupo classificado como peso normal(AU)
Introducción: las asociaciones entre el índice de masa corporal y la agilidad en la infancia, no están bien aclaradas en la literatura. Objetivo: analizar la asociación entre los niveles del índice de masa corporal y la agilidad en niños y adolescentes. Método: estudio transversal con voluntarios de 10 a 14 años. Se separaron en: grupo con peso normal (PN= 22), grupo con sobrepeso/obesidad (EP/OB= 22). Todos pasaron por medidas de antropometría y agilidad. La estatura y masa corporal fueron evaluadas para determinar el índice de masa corporal utilizando la sugerencia de la Organización Mundial de la Salud. Para medir la agilidad se utilizó la prueba Shutle Run por exigir poca habilidad motra y tener una buena confiabilidad. En la semana que precedió a las medidas definitivas, los voluntarios se familiarizaron con los procedimientos y la ejecución de las pruebas. Para todos los cálculos estadísticos adoptó el nivel de significancia de (p≤ 0,05). Resultados: hubo una correlación significativamente positiva y moderada entre el índice de masa corporal y los niveles de agilidad en el grupo como un todo (r= 0,46, p= 0,03). Los resultados de la prueba t, confirmaron la existencia de una diferencia significativa entre el nivel de agilidad del grupo con sobrepeso y obesidad y el grupo con peso normal (p< 0,05). Conclusión: hubo correlación significativa entre el índice de masa corporal y los niveles de agilidad en la muestra analizada; el grupo clasificado por el índice de masa corporal como EP/OB presentó un nivel de agilidad significativamente menor que el grupo clasificado como peso normal(AU)
Introduction: The associations between Body Mass Index and child agility are not well understood in the literature. Objective: To analyze the association between Body Mass Index levels and agility in children and adolescents. Methods: cross-sectional study with volunteers aged 10 to 14 years. Separated into: normal weight group (PN= 22), overweight/obese group (EP/OB= 22). All of them underwent anthropometric and agility measurements. Stature and body mass were measured to determine Body Mass Index using the suggestion of the World Health Organization. To measure agility, the Shutle Run test was used because it requires poor motor skills and good reliability. In the week preceding the definitive measures, the volunteers were familiar with the procedures and the execution of the tests. For all the statistical calculations it adopted the level of significance of (p≤ 0.05). Results: There was a significantly positive and moderate correlation between Body Mass Index and agility levels in the group as a whole (r= 0.46, p= 0.03). The results of the t-test confirmed the existence of a significant difference between the agility level of the overweight and obesity group and the normal weight group (p< 0.05). Conclusion: There was a significant correlation between Body Mass Index and agility levels in the sample analyzed; and that the group classified by BMI as EP/OB had a level of agility significantly lower than the group classified asnormal weight(AU)
Subject(s)
Humans , Male , Female , Child , Adolescent , Body Mass Index , Overweight/etiology , Ideal Body Weight , Review Literature as Topic , Cross-Sectional StudiesABSTRACT
Abstract Objective: Thinness can have substantial consequences for child development and health. Adipokines, including leptin and adiponectin, play a significant role in the regulation of important metabolic functions. The aim of this study was to investigate associations between body composition and serum leptin and adiponectin levels in thin and normal-weight children. Methods: The authors examined 100 healthy prepubertal children, who were divided into two subgroups: thin (n = 50) and normal-weight children (n = 50). Body composition was assessed by dual-energy X-ray absorptiometry. Serum concentrations of adipokines were determined by immunoenzymatic assays. Results: Thin children had a similar body height but significantly lower (p < 0.0001) body weight, body mass index, fat mass, lean mass, and bone mineral content compared with normal-weight children. Serum concentrations of leptin were about 2-fold lower (p < 0.0001) in thin vs. normal-weight subjects. Serum levels of total adiponectin, adiponectin multimers, and soluble leptin receptor (sOB-R) were similar in both groups. The leptin/soluble leptin receptor ratio and leptin/adiponectin ratios were lower (p < 0.0001) in thin vs. normal-weight children. In both groups of children, it was found that body composition parameters were positively related with leptin but not with adiponectin levels. Additionally, bone mineral content was positively related with body mass index, fat mass, lean mass, and leptin level in thin and normal-weight children. Conclusions: Prepubertal thin children have disturbances in body composition and adipokine profile. Early recognition of thinness and determination of body composition parameters and adipokine levels can be useful in medical and nutritional care of thin children for the optimization of bone mineral accrual.
Resumo Objetivo: A magreza pode ter consequências substanciais para o desenvolvimento e a saúde das crianças. As adipocinas, inclusive a leptina e a adiponectina, desempenham um papel significativo na regulação de importantes funções metabólicas. O objetivo do estudo foi investigar as associações entre a composição corporal e os níveis séricos de leptina e adiponectina em crianças magras e com peso normal. Métodos: Examinamos 100 crianças pré-púberes saudáveis, divididas em dois subgrupos: crianças magras (n = 50) e com peso normal (n = 50). A composição corporal foi avaliada pelo método de absorciometria de dupla energia de raios X. As concentrações séricas das adipocinas foram determinadas por ensaios imunoenzimáticos. Resultados: As crianças magras apresentaram altura semelhante, porém peso corporal (p < 0,0001), índice de massa corporal (IMC), massa gorda, massa magra e conteúdo mineral ósseo (CMO) significativamente menores em comparação com crianças com peso normal. As concentrações séricas de leptina foram aproximadamente duas vezes mais baixas (p < 0,0001) em indivíduos magros do que em crianças com peso normal. Os níveis séricos de adiponectina total, multímeros de adiponectina e receptor de leptina solúvel (sOB-R) foram semelhantes em ambos os grupos. Os índices de leptina/sOB-R e leptina/adiponectina foram inferiores (p < 0,0001) em crianças magras do que crianças com peso normal. Em ambos os grupos de crianças descobrimos que os parâmetros de composição corporal estavam positivamente relacionados à leptina, porém não aos níveis de adiponectina. Além disso, observamos que o CMO estava positivamente relacionado ao IMC, à massa gorda, à massa magra e ao nível de leptina em crianças magras e com peso normal. Conclusões: As crianças pré-púberes magras têm alterações na composição corporal e no perfil de adipocinas. O reconhecimento precoce da magreza e a determinação dos parâmetros de composição corporal e dos níveis de adipocina podem ser úteis no cuidado médico e nutricional de crianças magras para aprimoramento do acúmulo mineral ósseo.
Subject(s)
Humans , Male , Female , Child , Thinness/blood , Body Composition , Adipokines/blood , Ideal Body Weight , Biomarkers/blood , Absorptiometry, Photon , Immunoenzyme TechniquesABSTRACT
Abstract Objective: To analyze and compare lung function of obese and healthy, normal-weight children and adolescents, without asthma, through spirometry and volumetric capnography. Methods: Cross-sectional study including 77 subjects (38 obese) aged 5-17 years. All subjects underwent spirometry and volumetric capnography. The evaluations were repeated in obese subjects after the use of a bronchodilator. Results: At the spirometry assessment, obese individuals, when compared with the control group, showed lower values of forced expiratory volume in the first second by forced vital capacity (FEV1/FVC) and expiratory flows at 75% and between 25 and 75% of the FVC (p < 0.05). Volumetric capnography showed that obese individuals had a higher volume of produced carbon dioxide and alveolar tidal volume (p < 0.05). Additionally, the associations between dead space volume and tidal volume, as well as phase-3 slope normalized by tidal volume, were lower in healthy subjects (p < 0.05). These data suggest that obesity does not alter ventilation homogeneity, but flow homogeneity. After subdividing the groups by age, a greater difference in lung function was observed in obese and healthy individuals aged >11 years (p < 0.05). Conclusion: Even without the diagnosis of asthma by clinical criteria and without response to bronchodilator use, obese individuals showed lower FEV1/FVC values and forced expiratory flow, indicating the presence of an obstructive process. Volumetric capnography showed that obese individuals had higher alveolar tidal volume, with no alterations in ventilation homogeneity, suggesting flow alterations, without affecting lung volumes.
Resumo Objetivo: Analisar e comparar a função pulmonar de crianças e adolescentes obesos e eutróficos saudáveis, sem asma, pela espirometria e capnografia volumétrica. Métodos: Estudo transversal com 77 indivíduos (38 obesos) entre cinco e 17 anos. Todos fizeram espirometria e capnografia volumétrica. Os obesos repetiram as avaliações após o uso de broncodilatador. Resultados: Na avaliação da espirometria, os indivíduos obesos, quando comparados com o grupo controle, apresentaram menores valores no volume expiratório forçado no primeiro segundo pela capacidade vital forçada (VEF1/CVF) e nos fluxos expiratórios a 75% da CVF e entre 25-75% da mesma (p < 0,05). A capnografia volumétrica demonstrou que os obesos apresentam maior volume produzido de dióxido de carbono e volume corrente alveolar (p < 0,05). Além disso, a relação entre o volume espaço morto e volume corrente, bem como o slope da fase 3 normalizado pelo volume corrente, foi menor nos indivíduos saudáveis (p < 0,05). Esses dados sugerem que a obesidade não altera a homogeneidade da ventilação, mas sim dos fluxos. Ao subdividir os grupos por idade, foi observada maior diferença na função pulmonar entre indivíduos obesos e saudáveis na faixa acima de 11 anos (p < 0,05). Conclusão: Mesmo sem o diagnóstico de asma por critérios clínicos e sem resposta ao uso de broncodilatador, os indivíduos obesos apresentaram menores valores no VEF1/CVF e nos fluxos expiratórios forçados, o que indica a presença de processo obstrutivo. A capnografia volumétrica indicou nos indivíduos obesos maior volume corrente alveolar, sem alterações na homogeneidade da ventilação, o que sugere alteração nos fluxos, sem comprometimento dos volumes pulmonares.
Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Vital Capacity/physiology , Forced Expiratory Volume/physiology , Ideal Body Weight , Lung/physiopathology , Obesity/physiopathology , Spirometry , Case-Control Studies , Tidal Volume , Cross-Sectional Studies , Pulmonary Ventilation/physiology , CapnographyABSTRACT
PURPOSE: This study aims to investigate gender differences in the association between depressive symptoms and weight, weight perception, and body satisfaction among Korean adolescents. METHODS: A secondary data analysis was performed on data from 33,374 adolescents who participated in the 2015 Adolescent Health Behavior Online Survey. They were classified as underweight, normal weight, or overweight/obese; weight perception was classified into perception of being underweight, normal weight, or overweight/obese; and weight satisfaction into desire to gain weight, satisfied, and desire to lose weight. RESULTS: Among boys, perception of being underweight (adjusted odds ratio [AOR]: 1.20, 95% confidence interval [CI]: 1.07~1.35) and desire to gain weight (AOR: 1.45, 95% CI: 1.30~1.62) were associated with depression. Among girls, perception of being overweight or obese (AOR: 1.18, 95% CI: 1.07~1.29) and a desire to lose weight (AOR: 1.30, 95% CI: 1.18~1.42) were associated with depression. CONCLUSION: Gender differences were observed in the association between weight perception and depression in adolescents. The perception of being underweight among boys and the perception of being overweight/overweight among girls were associated with depression. Thus, gender-specific intervention programs to correct weight perception and weight satisfaction are needed in order to relieve depressive symptoms in adolescents.
Subject(s)
Adolescent , Female , Humans , Adolescent Health , Body Weight , Depression , Ideal Body Weight , Odds Ratio , Overweight , Statistics as Topic , Thinness , Weight PerceptionABSTRACT
BACKGROUND: Many clinicians have probably used subjective, unscientific methods for dose reduction to avoid overdose in elderly patients. The aim of this study was to compare several dosing schedules of intravenous dexmedetomidine (DEX) to identify the appropriate dosing schedule within the therapeutic dose range for adequate sedation of elderly patients under spinal anesthesia. METHODS: After administration of spinal anesthesia, a loading dose of DEX was injected over 10 min in three groups with the following dosages: group A, 1.0 μg/kg of actual body weight; group B, 1.0 μg/kg of ideal body weight (IBW); and group C, 0.8 μg/kg of IBW. Then, a maintenance infusion (0.5 μg/kg of each BW/h) was administered. The bispectral index score (BIS), the time required to reach BIS 80, airway obstruction score, and the occurrence of bradycardia were recorded. RESULTS: The changes in the BIS among the groups over time were found to have statistically significant differences (P < 0.001). The times required to reach BIS 80 were 6.1 ± 5.3 min, 5.0 ± 3.6 min, and 11.0 ± 8.6 min in groups A, B, and C, respectively (P < 0.001). The airway obstruction score and the frequency of bradycardia did not have statistically significant differences among the groups. CONCLUSIONS: An initial loading dose of DEX that is 0.8 μg/kg of IBW over 10 min, followed by an infusion rate of less than 0.5 μg/kg of IBW/h may be adequate for sedation in elderly patients receiving spinal anesthesia.
Subject(s)
Aged , Humans , Airway Obstruction , Anesthesia, Spinal , Appointments and Schedules , Body Weight , Bradycardia , Dexmedetomidine , Ideal Body WeightABSTRACT
BACKGROUND: Many clinicians have probably used subjective, unscientific methods for dose reduction to avoid overdose in elderly patients. The aim of this study was to compare several dosing schedules of intravenous dexmedetomidine (DEX) to identify the appropriate dosing schedule within the therapeutic dose range for adequate sedation of elderly patients under spinal anesthesia. METHODS: After administration of spinal anesthesia, a loading dose of DEX was injected over 10 min in three groups with the following dosages: group A, 1.0 μg/kg of actual body weight; group B, 1.0 μg/kg of ideal body weight (IBW); and group C, 0.8 μg/kg of IBW. Then, a maintenance infusion (0.5 μg/kg of each BW/h) was administered. The bispectral index score (BIS), the time required to reach BIS 80, airway obstruction score, and the occurrence of bradycardia were recorded. RESULTS: The changes in the BIS among the groups over time were found to have statistically significant differences (P < 0.001). The times required to reach BIS 80 were 6.1 ± 5.3 min, 5.0 ± 3.6 min, and 11.0 ± 8.6 min in groups A, B, and C, respectively (P < 0.001). The airway obstruction score and the frequency of bradycardia did not have statistically significant differences among the groups. CONCLUSIONS: An initial loading dose of DEX that is 0.8 μg/kg of IBW over 10 min, followed by an infusion rate of less than 0.5 μg/kg of IBW/h may be adequate for sedation in elderly patients receiving spinal anesthesia.
Subject(s)
Aged , Humans , Airway Obstruction , Anesthesia, Spinal , Appointments and Schedules , Body Weight , Bradycardia , Dexmedetomidine , Ideal Body WeightABSTRACT
ABSTRACT Background Obesity is a well known risk factor for the development of metabolic abnormalities. However, some obese people are healthy and on the other hand some people with normal weight have adverse metabolic profile, therefore it can be assumed that there is a difference in physical characteristics amongst these people. The aim of this study was to establish whether there are somatotype differences between metabolically healthy and metabolically obese women who are obese or of normal weight. Subjects and methods Study included 230 women aged 44.76 ± 11.21y. Metabolic status was assessed according to IDF criteria, while somatotype was obtained using Heath & Carter method. Results Significant somatotype differences were observed in the group of women with normal-weight: metabolically healthy women had significantly lower endomorphy, mesomorphy and higher ectomorphy compared to metabolically obese normal-weight women (5.84-3.97-2.21 vs. 8.69-6.47-0.65). Metabolically healthy obese women had lower values of endomorphy and mesomorphy and higher values of ectomorphy compared to ‘at risk’ obese women but the differences were not statistically significant (7.59-5.76-0.63 vs. 8.51-6.58-0.5). Ectomorphy was shown as an important determinant of the favorable metabolic profile (cutoff point was 0.80). Conclusion We concluded that, in addition to fat mass, metabolic profile could be predicted by the structure of lean body mass, and in particular by body linearity.
Subject(s)
Adult , Aged , Female , Humans , Middle Aged , Ideal Body Weight , Metabolome , Obesity/metabolism , Somatotypes , Anthropometry , Blood Glucose/analysis , Body Composition/physiology , Nutritional Status , Obesity, Metabolically Benign/blood , Obesity, Metabolically Benign/classification , Obesity/classification , Risk Factors , Serbia , Triglycerides/analysisABSTRACT
In healthy individuals, energy intake is in balance with energy expenditure, which helps to maintain a normal body weight. The brain's inability to control energy homeostasis underlies the pathology of hyperphagia and obesity. The brain detects body energy excess and deficit by sensing the levels of circulating metabolic hormones and nutrients and by receiving metabolic information from the periphery via the autonomic nervous system. A specialized neuronal network coordinates energy intake behavior and the metabolic processes affecting energy expenditure. Here, we briefly review neuronal mechanisms by which our body maintains energy balance.