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1.
Vínculo ; 18(2): 1-6, jul.-dez. 2021. ilus
Article in Portuguese | LILACS, INDEXPSI | ID: biblio-1341802

ABSTRACT

Muitos são os problemas orgânicos ou psíquicos que surgem em indivíduos obesos. Diante desse mal-estar gerado pela obesidade, as angústias são relatadas com frequência por pacientes em discursos que giram em torno da alimentação e do corpo, carregados de frustrações que remetem a dietas fracassadas para dar conta da supervalorização de um corpo ideal na sociedade contemporânea. Nesse sentido, foi percebido nos relatos clínicos uma repetição, um ciclo vicioso que os pacientes têm dificuldade de interromper. Grande parte desses sujeitos relataram, nos atendimentos em grupo e individuais, que têm a comida como substituto de "algo", de um "vazio" que precisa ser preenchido, pois comem mesmo sem estarem com fome e com uma sensação de perda do controle sobre o ato. Por essa razão, após esse comportamento repetitivo, têm sentimentos de raiva, vergonha e culpa. Este artigo tem por objetivo investigar o mal-estar observado nas pessoas obesas atendidas individualmente na clínica particular e na instituição privada, bem como nos atendimentos realizados em grupo. Busca-se conhecimentos acerca da angústia em relação ao corpo obeso, com vistas a fomentar discussões embasadas pela orientação psicanalítica, utilizando durante os atendimentos a metodologia freudiana e a balintiana no atendimento de grupo.


Many are the organic or psychic problems that arise in obese individuals. Faced with this discomfort generated by obesity, anxieties are frequently reported by patients in discourses that revolve around diet and the body, loaded with frustrations that refer to failed diets to cope with the overvaluation of an ideal body in contemporary society. In this sense, it was perceived in clinical reports a repetition, a vicious cycle that patients have difficulty interrupting. Most of these subjects reported, in group and individual care, that they have food as a substitute for "something", a "void" that needs to be filled, because they eat even without being hungry and with a sense of loss of control over the act. For this reason, after this repetitive behavior, they have feelings of anger, shame and guilt. This article aims to investigate the discomfort observed in obese people treated individually in the private clinic and private institution, as well as in group care. Knowledge about anguish in relation to the obese body is sought, in order to foster discussions based on psychoanalytic orientation, using the Freudian and Balintian methodology during group care


Muchos son los problemas orgánicos o psíquicos que surgen en personas obesas. Frente a este malestar generado por la obesidad, los pacientes informan con frecuencia ansiedades en discursos que giran en torno a la dieta y el cuerpo, cargados de frustraciones que conducen a dietas fallidas para hacer frente a la sobrevaloración de un cuerpo ideal en la sociedad contemporánea. En este sentido, se percibió en los informes clínicos una repetición, un círculo vicioso que los pacientes tienen dificultades para interrumpir. La mayoría de estos sujetos informaron, en atención grupal e individual, que tienen comida como un sustituto de "algo", un "vacío" que necesita ser llenado, porque comen incluso sin tener hambre y con una sensación de pérdida de control sobre el acto Por esta razón, después de este comportamiento repetitivo, tienen sentimientos de ira, vergüenza y culpa. Este artículo tiene como objetivo investigar las molestias observadas en personas obesas tratadas individualmente en la clínica privada y la institución privada, así como en la atención grupal. Buscamos conocimiento sobre la angustia con respecto al cuerpo obeso, para fomentar discusiones basadas en la orientación psicoanalítica, utilizando durante la metodología freudiana y balintiana en la atención grupal.


Subject(s)
Humans , Anxiety , Bulimia , Hunger , Diet , Emotions , Binge-Eating Disorder , Body Dissatisfaction , Obesity
2.
An. Fac. Cienc. Méd. (Asunción) ; 54(3): 41-50, Dec. 2021.
Article in Spanish | LILACS | ID: biblio-1352904

ABSTRACT

Introducción: El estado nutricional resulta del balance entre la ingesta y las necesidades energéticas de nutrientes del organismo. Objetivos: Determinar la frecuencia, características y determinantes que influyen en el estado nutricional en los niños menores de cinco años. Materiales y métodos: Estudio observacional, transversal, descriptivo con componente analítico. Se estudió a niños menores de 5 años durante agosto y noviembre de 2017. Se midieron variables sociodemográficas del niño y del jefe de familia, los factores que pueden influir en el estado nutricional y las características antropométricas del niño. Resultados: Fueron analizados 230 niños y 213 casas. Edad promedio de los niños 2,4±1,3 años (IC95%, 2,2-2,6); 58,7% fueron niños mayores de 2 años y 51,3% masculino. Los jefes de familias: 64,9% con nivel educativo secundario, 59,7% ama de casa, 46,7% de las familias perciben sueldo mínimo. Frecuencia de desnutrición global 4,2%, desnutrición aguda 2,2%, riesgo de desnutrición 10%. En mayores de dos años frecuencia de 26,7% de sobrepeso, 13,3% de obesidad. Los factores determinantes que influyen en la desnutrición de los niños fueron: hogares con jefes de familias con nivel académico bajo e ingresos menores al sueldo mínimo. Conclusión: La mayoría de las familias son de ingresos bajos y nivel de educación baja; frecuencia de desnutrición inferior a otros estudios, tendencia de exceso de peso, talla baja y los factores determinantes encontrados que influyen en el estado nutricional son los bajos ingresos económicos y el bajo nivel educativo de los jefes de familias.


Introduction: The nutritional state results from the balance between the intake and the energy needs of nutrients of the organism. Objectives: To determine the frequency, characteristics and determinants that influences the nutritional status in children under five years of age. Materials and methods: Observational, cross-sectional, descriptive study with analytical component. Children under 5 years of age were studied during August and November 2017. Sociodemographic variables of the child and the head of the family, the factors that may influence the nutritional status, and the anthropometric characteristics of the child were measured. Results: 230 children and 213 houses were analyzed. Average age of the children 2.4 ± 1.3 years (95% CI, 2.2-2.6); 58.7% were children older than 2 years and 51.3% were male. Heads of families: 64.9% with secondary education, 59.7% housewife, 46.7% of families receive minimum salary. Frequency of global malnutrition 4.2%, acute malnutrition 2.2%, risk of malnutrition 10%. In those over two years of age, the frequency is 26.7% overweight, 13.3% obese. The determining factors that influence the malnutrition of children were: households with heads of families with a low academic level and income below the minimum wage. Conclusion: Most of the families are of low income and low educational level; frequency of malnutrition lower than other studies, trend of excess weight, short stature and the determining factors found that influence nutritional status are low income and low educational level of heads of families.


Subject(s)
Obesity , Child, Preschool , Nutritional Status , Minors , Social Determinants of Health
3.
Article in Spanish | LILACS | ID: biblio-1353033

ABSTRACT

Introducción: la obesidad aumenta el riesgo a padecer de enfermedades crónicas no transmisibles (ECNT) y afecta el curso de enfermedades de origen infeccioso. Objetivo: examinar la literatura sobre cómo influye la obesidad en la gravedad del cuadro clínico de algunas de las enfermedades no transmisibles y transmisibles de mayor impacto en el Perú. Métodos: investigación documental. Se hace un análisis de contenidos de artículos y documentos de estudios desarrollados en diversos contextos asociados a la presencia de obesidad junto con infecciones o ECNT y en base de datos. Resultados: la condición de obesidad alcanzada por malos hábitos de consumo y baja actividad física, es la principal responsable del elevado índice de las ECNT y por consecuente de las tasas de mortalidad. Conclusiones: el exceso de peso afecta al sistema inmunológico, contribuyendo específicamente en los fenómenos exacerbados de respuesta inflamatoria sistémica, determinada por el aumento de secreción de adipocitoquinas, que predispone al organismo a desarrollar y contraer ECNT y enfermedades infecciosas. (AU)


Introduction: Obesity increases the risk of chronic non-communicable diseases (NCDs) and affects the course of diseases of infectious origin. Objective: Reviewing the literature on how obesity influences the severity of the clinical picture of some of the non-communicable and communicable diseases of greatest impact in Peru. Methods:Documentary research, from studies developed in various contexts associated with the presence of obesity along with infections or NCDs. Results: The condition of obesity reached by bad consumption habits and low physical activity is the main responsible for the high rate of NCDs, consequently, mortality. Conclusions: Excess weight affects the immune system, contributing specifically to exacerbated phenomena of a systemic inflammatory response, determined by increased secretion of adipocytokines, which predisposes the body to develop and contract NCDs and infectious diseases. (AU)


Subject(s)
Humans , Virus Diseases , Chronic Disease , Communicable Diseases , Coronavirus , Diabetes Mellitus , Fatty Liver , Neoplasms , Obesity
4.
Iatreia ; 34(4): 365-369, oct.-dic. 2021. graf
Article in English | LILACS | ID: biblio-1350836

ABSTRACT

SUMMARY Introduction: Gastric bypass is one of the strategies that have shown better results in the management of obesity, since this technique is the one that strikes a better balance between risk, side effects and long-term results. It consists in the creation of a gastric reservoir that anastomosis to the jejunum, reducing the size of the gastric chamber and thus the patient tolerates less food and decreasing its intake. One of the less frequent late complications is duodenal perforation. For this reason, we present this case report, according to the CARE guideline. Case presentation: 47-year-old male patient with a history of gastric bypass due to obesity, who consults for sudden onset of abdominal pain. Physical examination showed signs of peritoneal irritation and systemic inflammatory response. Exploratory laparoscopy was performed with suspected hollow viscus perforation, which evidenced a 1 cm ulcer on the anterior aspect of the duodenal bulb, requiring omentoplasty by laparotomy. Conclusions: Perforated duodenal ulcer in patients with a history of gastric bypass is a rare diagnosis. It has a non-specific clinical presentation, which is why exploratory laparoscopy is considered a valid diagnostic and therapeutic strategy.


RESUMEN Introducción: una de las estrategias que han demostrado resultados superiores para el manejo de la obesidad es el bypass gástrico, ya que esta técnica es la que reúne un major equilibrio entre el riesgo, efectos secundarios y los resultados a largo plazo. Consiste en la creación de un reservorio gástrico que se anastomosa al yeyuno, reduciendo el tamaño de la cámara gástrica y haciendo que el paciente tolere menos los alimentos, para que se disminuya la ingesta de estos. Dentro de las complicaciones tardías menos frecuentes se encuentra la perforación duodenal, motivo por el cual se presenta este reporte de caso de acuerdo con la guía CARE. Presentación del caso: hombre de 47 años y antecedente de bypass gástrico por obesidad, que consulta por dolor abdominal de inicio súbito. A la valoración con examen físico con hallazgos de irritación peritoneal y signos de respuesta inflamatoria sistémica. Es llevado a laparoscopia exploratoria con sospecha de perforación de la víscera hueca. Se evidenció una úlcera en la cara anterior del bulbo duodenal de 1 cm que requirió de epiploplastia por laparotomía. Conclusiones: la úlcera duodenal perforada en pacientes con antecedente de bypass gástrico es un diagnóstico poco frecuente con presentación clínica inespecífica, por esto se considera la laparoscopia exploratoria como una estrategia diagnóstica y terapéutica válida.


Subject(s)
Humans , Gastric Bypass , Duodenal Ulcer , Obesity
5.
Braz. j. oral sci ; 20: e211359, jan.-dez. 2021. ilus
Article in English | LILACS, BBO | ID: biblio-1252506

ABSTRACT

Aim: To evaluate the effects of an intervention for the prevention of obesity on the prevalence of dental caries disease in Spanish children. Methods: Two cities participated intervention study nested in a cohort IDEFICS (Identification and prevention of dietary and lifestyle induced health effects in children and infants): Huesca, where there was a 2-year intervention, which encouraged less sugar consumption; and Zaragoza (control). The prevalence of caries was evaluated by examining the 1st permanent molars in the 7-11 age range, using the ICDAS (International Caries Detection and Assessment System). These teeth erupt at 6 years of age and at the baseline (2007-2008) were free of caries because they were not present in the oral cavity. As outcomes, white spots were selected, combining the ICDAS criteria 1 and 2, and untreated caries, combining criteria 4, 5 and 6. Their association with socioeconomic variables, BMI (Body Mass Index), frequency of sugar intake, sex and parents' perceptions of their children, was investigated. To do so, the chi-square test was applied (p<0.05). Results: The sample consisted of 281 children. The prevalence of white spots and untreated caries was higher in Huesca, despite the intervention. There was no association between the outcomes and the variables studied (p>0.05). Conclusion: The intervention for the prevention of obesity did not exert any association with the prevalence of caries in Spanish children


Subject(s)
Humans , Male , Female , Child , Oral Health , Dental Caries/epidemiology , Obesity
6.
Infectio ; 25(4): 262-269, oct.-dic. 2021. tab, graf
Article in English | LILACS, COLNAL | ID: biblio-1286720

ABSTRACT

Abstract Objective: To analyse the clinic characteristics, risk factors and evolution of the first cohort of hospitalised patients with confirmed infection by COVID-19 in 5 Colombian institutions. Materials and methods: Is a retrospective observational study of consecutive hospitalized patients with a diagnosis of COVID-19 confirmed from March 01 to May 30, 2020 in Colombia. Results: A total of 44 patients were included. The median age was 62 years. 43.2% had a history of smoking, while 69.8% were overweight or obese. 88.6% had at least one comorbidity and 52.3% had three or more comorbidities. Hypertension and dyslipidaemia were the most frequent comorbidities (40.9% and 34.1%, respectively). The 30-day mortality rate was 47.7% with a median of 11 days. The composite outcome occurred in the 36.4%. The biomarkers associated with mor tality risk included troponin higher than 14 ng/L (RR: 5.25; 95% CI 1.37-20.1, p = 0.004) and D-dimer higher than 1000 ng/ml (RR: 3.0; 95% CI 1.4-6.3, p = 0.008). Conclusions: The clinical course of SARS-CoV-2 infection in hospitalized Colombian was characterised by a more advanced stage of the infection.


Resumen Objetivo: Analizar las características, clínicas, factores de riesgo, y la evolución de pacientes hospitalizados con infección confirmada por COVID-19 en 5 Institu ciones de Colombia. Material y método: Es un estudio observacional retrospectivo de pacientes consecutivos hospitalizados con diagnóstico de COVID-19 confirmado entre 01 de Febrero de 2020 y 30 de Mayo de 2020 en Colombia. Resultados: Un total de 44 pacientes fueron incluidos. La mediana de edad fue de 62 años y la mayoría del sexo masculino. El 43.2% tenían historia de tabaquismo, mientras que el 69.8% tenían sobrepeso u obesidad. El 88.6% tenían al menos una comorbilidad y el 52.3% tenían tres o más comorbilidades. La hipertensión arterial fue la comorbilidad más frecuente (40.9%), seguido de la dislipidemia (34.1%). La tasa de letalidad a 30 días fue de 47.7% y ocurrió con una mediana de 11 días. El 36.4% presentó el desenlace compuesto. Los biomarcadores asociados con el riesgo de muerte fue troponina > 14 ng/mL (RR:5.25, IC95% 1.37-20.1, p=0.004) y dímero D mayor a 1000 mg/dL (RR: 3.0, IC95% 1.4-6.3, p=0.008). Conclusiones: El curso clínico de la infección por SARS-CoV-2 en colombianos hospitalizados fue un estadio más avanzado de la infección.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Biomarkers , COVID-19 , Patients , Tobacco Use Disorder , Comorbidity , Risk , Risk Factors , Mortality , Colombia , Overweight , Courses , Infections , Obesity
7.
Rev. ADM ; 78(5): 264-269, sept.-oct. 2021. tab, graf
Article in Spanish | LILACS | ID: biblio-1348067

ABSTRACT

Introducción: La mucina salival (Ms) modula otras proteínas salivales que participan en múltiples funciones fisiológicas de la cavidad oral. Los niveles de Ms pueden proporcionar información sobre el estado de inflamación de los tejidos periodontales. Por tanto, el objetivo del presente estudio fue evaluar los niveles Ms en pacientes obesos y no obesos, antes y después del tratamiento periodontal. Material y métodos: Un total de 60 pacientes fueron distribuidos en seis grupos, de acuerdo al índice de masa corporal (IMC) y la gravedad de la enfermedad periodontal (EP). Valores del IMC superiores a 27 correspondían a obesidad. La EP en el momento del diagnóstico se designó como leve, moderada o severa. Se recolectaron muestras de saliva completa, antes (MU-A) y después (MU-D) del tratamiento periodontal. Se evaluaron los niveles de Ms utilizando el método de Azul Alcian. Los resultados se analizaron con el Software InfoStat, mediante estadística descriptiva e inferencial. Resultados: Los valores de MU-A fueron superiores a los contenidos de MU-D (p < 0.0001). Las variaciones entre los pacientes no obesos y obesos fueron mínimas. A medida que aumentó el nivel de la EP, las variables MU-A y MU-D mostraron una disminución progresiva (p = 0.0032). Conclusiones: El nivel de Ms fue mayor en la saliva de los pacientes con EP no tratada. Ms se puede utilizar como marcador inflamatorio para la detección de EP (AU)


Introduction: Salivary mucin (sM) modulates other salivary proteins that participate in multiple physiological functions of the oral cavity. sM levels can provide information on the state of inflammation of the periodontium. Therefore, the objective of the present study was to evaluate sM levels in obese and non-obese patients, before and after periodontal treatment. Material and methods: A total of 60 patients were distributed into six groups, according to the body mass index (BMI) and the severity of the periodontal disease (PD). BMI values higher than 27 corresponded to obesity. PD at the time of diagnosis was designated as mild, moderate, or severe. Complete saliva samples were collected before (MU-B) and after (MU-A) the periodontal treatment. sM levels were evaluated using the Alcian Blue method. The results were analyzed with the InfoStat Software, using descriptive and inferential statistics. Results: MU-B values were higher than MU-A contents (p < 0.0001). Variations between non-obese and obese patients were minimal. As the level of PD increased, the variables MU-A and MU-D showed a progressive decrease (p = 0.0032). Conclusions: The level of sM was higher in the saliva of patients with untreated PD. sM can be used as an inflammatory marker for the detection of PD (AU)


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Periodontal Diseases , Saliva , Mucins/analysis , Obesity/complications , Argentina , Schools, Dental , Biomarkers , Epidemiology, Descriptive , Statistical Analysis , Alcian Blue , Controlled Before-After Studies
8.
Arq. gastroenterol ; 58(3): 316-321, July-Sept. 2021. tab
Article in English | LILACS | ID: biblio-1345286

ABSTRACT

ABSTRACT BACKGROUND AND OBJECTIVE: Considering the association between colorectal cancer (CRC) and both insulin resistance and obesity, and the prominent role of ghrelin in these metabolic disorders, we explored whether plasma levels of ghrelin were associated with CRC. Moreover, in the patients with CRC the possible correlations between ghrelin and insulin, insulin resistance, and body mass index (BMI) as an indicator of obesity were examined. METHODS: A total of 170 subjects, including 82 cases with CRC and 88 controls were enrolled in this study. Plasma levels of ghrelin, insulin, and glucose were measured in all the subjects using ELISA and glucose oxidase methods. Furthermore, insulin resistance was assessed by calculating HOMA-IR index. RESULTS: The cases with CRC had decreased ghrelin levels (P<0.001) and a higher HOMA-IR index (P<0.001) than controls. Interestingly, when CRC patients were stratified based on tumor site, lower ghrelin levels and a higher HOMA-IR index were observed in the patients with either colon or rectal cancer vs. controls too. Additionally, there were an age and BMI-independent negative correlation between ghrelin levels and HOMA-IR (r=-0.365, P<0.05), and an age-independent negative correlation between ghrelin levels and BMI (r=-0.335, P<0.05) in the rectal subgroup. CONCLUSION: Our findings support a role for ghrelin in connection with insulin resistance and obesity in CRC susceptibility; however, it needs to be corroborated by further studies.


RESUMO CONTEXTO E OBJETIVO: Considerando a associação entre câncer colorretal (CCR), a resistência à insulina, à obesidade e o papel proeminente da grelina nessas doenças metabólicas, foi explorado se os níveis plasmáticos de grelina estavam associados ao CCR. Além disso, nos pacientes com CCR foram pesquisadas as possíveis correlações entre a grelina, insulina, resistência insulínica e índice de massa corporal (IMC) como indicadores de obesidade. MÉTODOS: Foram incluídos neste estudo 170 indivíduos, sendo 82 com CRC e 88 controles. Os níveis plasmáticos de grelina, insulina e glicose foram medidos em todos os sujeitos utilizando métodos ELISA e glicose oxidase. Além disso, a resistência à insulina foi avaliada pelo cálculo do índice HOMA-IR. RESULTADOS: Os pacientes com CRC apresentaram redução dos níveis de grelina (P<0,001) e maior índice HOMA-IR (P<0.001) do que os controles. Curiosamente, quando os pacientes com CRC foram estratificados com base no local do tumor, níveis mais baixos de grelina e maior índice de HOMA-IR foram observados nos indivíduos com câncer de cólon ou retal versus controles também. Além disso, houve uma correlação negativa entre idade e IMC independente entre os níveis de grelina e HOMA-IR (r=-0,365, P<0,05) e uma correlação negativa independente da idade entre os níveis de grelina e IMC (r=-0,335, P<0,05) no subgrupo retal. CONCLUSÃO: Nossos achados apoiam o papel da grelina em relação à resistência à insulina e à obesidade na suscetibilidade do CRC; no entanto, ela precisa ser corroborada por estudos posteriores.


Subject(s)
Humans , Insulin Resistance , Colorectal Neoplasms , Body Mass Index , Ghrelin , Obesity/complications
9.
Ludovica pediátr ; 24(1): 15-24, Ene-Jun 2021.
Article in Spanish | LILACS, Redbvs, BINACIS | ID: biblio-1293219

ABSTRACT

Introducción: El puerperio es una etapa determinante para la mujer, sin embargo la atención está focalizada en el recién nacido. Objetivo: Describir las características gineco-obstétricas, nutricionales y clínico-metabólicas de mujeres durante el posparto que asisten al consultorio materno del Instituto de Desarrollo e Investigaciones Pediátricas. Población y Métodos: Se realizó un análisis retrospectivo de las historias clínicas de mujeres que realizaron su primer control entre los 3 y 6 meses posparto en un consultorio materno de un hospital público entre junio 2018 y diciembre 2019. Se analizaron variables sociodemográficas, gineco-obstétricas, nutricionales y clínico-metabólicas. Resultados: Participaron 211 mujeres, edad 26 (21; 31) años, 41,7 % oriundas de países limítrofes. 38,8 % tuvo un embarazo durante la adolescencia, 38,7 % de los partos fue por cesárea y 21,3 % refirió antecedentes de aborto Más de la mitad presentaron sobrepeso-obesidad y alteraciones del perfil lipídico Conclusiones: Las mujeres asistidas durante el postparto en un hospital público presentan alta frecuencia de exceso de peso y alteraciones metabólicas así como historial de cesáreas y embarazo adolescente. El conocimiento de las problemáticas más prevalentes es clave para el diseño de estrategias de prevención e intervenciones oportunas


Introduction: The puerperium is a determining stage for women, however, attention is focused on the newborn. Objective: To describe the gyneco-obstetric, nutritional and clinical-metabolic characteristics of postpartum women who attend the IDIP maternal clinic. Population and methods: A retrospective analysis was carried out of the medical records of women who underwent their first check-up between 3 and 6 months postpartum in a maternal clinic of a public hospital between June 2018 and December 2019 Sociodemographic, gynecological, nutritional, and clinical-metabolic variables were analysed. Results: 211 women participated, age 26 (21; 31) years old, 41.7% from neighbouring countries, 38.8% had a pregnancy during adolescence, 38.7% of deliveries were by caesarean section, and 21.3% reported a history of abortion. More than half presented overweight-obesity and lipid profile alterations. Conclusions: The women assisted during the postpartum in a public hospital present a high frequency of excess weight and metabolic alterations as well as a history of caesarean sections and adolescent pregnancy. Knowledge of the most prevalent problems is key for the design of prevention strategies and timely interventions


Subject(s)
Humans , Female , Postpartum Period , Maternal Nutrition , Maternal Health , Obesity
10.
SOBECC ; 26(3): 156-164, 30-09-2021.
Article in Portuguese | LILACS, BDENF | ID: biblio-1342654

ABSTRACT

: Objetivo: Identificar os diagnósticos de Enfermagem da North American Nursing Diagnosis Association (NANDA Internacional) nos pacientes no pós-operatório de cirurgia bariátrica e relacioná-los com problemas adaptativos propostos por Roy. Método: Estudo exploratório, a partir da técnica de multicasos, realizado em hospital de referência em cirurgias bariátricas no estado do Ceará, no período de novembro a dezembro de 2018. A coleta de dados ocorreu por meio de entrevistas e do exame físico em que se utilizou instrumento estruturado com os quatro modos adaptativos de Roy. Resultados: Neste estudo, foram identificados 21 diagnósticos de Enfermagem, que estiveram ligados aos problemas adaptativos respiração prejudicada, dificuldade para vestir-se, nutrição, sedentarismo, padrão de sono, mastigação, controle da obesidade, baixa autoestima, interação social, organismo saudável, ansiedade, autocuidado, satisfação com aparência, espiritualidade, relacionamento saudável, conhecimento e comunicação. Conclusão: Predominaram diagnósticos de Enfermagem de bem-estar, o que sugere que a realização da cirurgia bariátrica e os resultados obtidos, como perda de peso, aumento da disposição e melhora do estado de saúde, influenciam positivamente no processo de adaptação pós-cirurgia.


: Objective: To identify the nursing diagnoses of the North American Nursing Diagnosis Association (NANDA International) in patients who underwent bariatric surgery, during the postoperative period, and their relation to adaptation problems according to the Roy Adaptation Model. Method: This is an exploratory, multicase study carried out in a reference hospital for bariatric surgeries in the state of Ceará, Brazil, from November to December 2018. Data collection took place through interviews and physical examination using a structured instrument with the four modes of adaptation of the Roy Adaptation Model. Results: In this study, 21 nursing diagnoses were identified, which were related to the following adaptation problems: impaired breathing, difficulty dressing up, nutrition, sedentary lifestyle, sleep pattern, chewing, obesity control, low self-esteem, social interaction, healthy organism, anxiety, self-care, satisfaction with appearance, spirituality, healthy relationship, knowledge, and communication. Conclusion: Wellness nursing diagnoses predominated, which suggests that the performance of bariatric surgery and the obtained results, such as weight loss, increased disposition, and improved health status, positively influence the postoperative adaptation process.


Objetivo: Identificar los Diagnósticos de Enfermería Internacional NANDA en pacientes en el postoperatorio de cirugía bariátrica y relacionarlos con problemas adaptativos del Modelo de Adaptación de Roy. Método: Estudio exploratorio, mediante la técnica multicase, realizado en un hospital de referencia en cirugías bariátricas en el Estado de Ceará, de noviembre a diciembre de 2018. La recolección de datos se realizó a través de entrevistas y examen físico en el que utilizó instrumento adaptado estructurado con los cuatro modos adaptativos de Roy. Resultados: Se identificaron 21 Diagnósticos de Enfermería, los cuales se relacionaron con problemas adaptativos, dificultad para respirar, dificultad para vestirse, nutrición, sedentarismo, patrón de sueño, masticación, control de la obesidad, baja autoestima, interacción social, organismo sano, ansiedad, autocuidado, satisfacción con la apariencia, espiritualidad, relación sana, conocimiento y comunicación. Conclusión: Predominaron los diagnósticos de enfermería de bienestar, lo que sugiere que la realización de la cirugía bariátrica y los resultados obtenidos, como la pérdida de peso, mayor disposición y mejor estado de salud, influyen positivamente en el proceso de adaptación posquirúrgico.


Subject(s)
Humans , Postoperative Period , Nursing Diagnosis , Bariatric Surgery , Perioperative Nursing , Perioperative Period , Obesity
12.
Rev. colomb. cardiol ; 28(4): 366-373, jul.-ago. 2021. tab, graf
Article in Spanish | LILACS, COLNAL | ID: biblio-1351934

ABSTRACT

Resumen La COVID-19 es una enfermedad infecciosa causada por el coronavirus del síndrome respiratorio agudo severo 2 (SARS-CoV-2) que tiene importantes manifestaciones sobre el sistema cardiovascular y respiratorio. Esta enfermedad, descrita en los primeros días de diciembre de 2019 en la ciudad de Wuhan, capital de la provincia de Hubei, en China, tuvo una rápida expansión mundial y fue declarada por la Organización Mundial de la Salud como pandemia el 11 de marzo de 2020. Tiene diferentes presentaciones clínicas, como neumonía, hipoxemia, falla renal, falla multisistémica, compromiso endotelial que lleva a lesiones trombóticas venosas y arteriales, y problemas cardiacos como insuficiencia cardiaca, miocarditis, arritmias e infarto de miocardio de los tipos 1 y 2. La mayoría de las personas presentan una enfermedad leve o no complicada (80%), y otras (20%) pueden desarrollar un cuadro grave con neumonía, síndrome de dificultad respiratoria, choque cardiogénico, trombosis y tormenta de citocinas (el 15% se manejan con oxigenoterapia y el 5% ameritan tratamiento en la unidad de cuidados intensivos). La mortalidad está relacionada con la edad y con la comorbilidad (hipertensión arterial, diabetes mellitus, enfermedades respiratorias, enfermedades cardiacas en general, enfermedades renales y obesidad). El objetivo de esta revisión narrativa es describir las alteraciones metabólicas y la relación de la diabetes mellitus, la obesidad, el síndrome metabólico y la dislipidemia con la morbilidad y la mortalidad vinculadas a la COVID-19.


Abstract COVID-19 is an infectious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and that has important manifestations on the cardiovascular system and respiratory. This disease described in the first days of December 2019 in the city of Wuhan, capital of the province of Hubei, China, with a rapid global expansion and declared by the World Health Organization as a pandemic on March 11, 2020, has different clinical presentations such as pneumonia, hypoxemia, kidney failure, multisystem failure, endothelial involvement leading to venous and arterial thrombotic lesions, and heart problems such as heart failure, myocarditis, arrhythmias, and type 1 and 2 myocardial infarction. Most people have a mild or uncomplicated disease (80%), and others (20%) may develop a severe case with pneumonia, respiratory distress syndrome, cardiogenic shock, thrombosis, and cytokine storm (15% are managed with oxygen therapy and 5% merit treatment in the intensive care unit). Mortality is related to age and comorbidity (high blood pressure, diabetes mellitus, respiratory diseases, heart diseases in general, kidney diseases, and obesity). The objective of this narrative review is to describe the metabolic alterations and the relationship between diabetes mellitus, obesity, metabolic syndrome, and dyslipidemia with the morbidity and mortality associated with COVID-19 infection.


Subject(s)
Humans , Respiratory System , Severe Acute Respiratory Syndrome , COVID-19 , Disease , Diabetes Mellitus , Dyslipidemias , Obesity
13.
Rev. ecuat. pediatr ; 22(2): 1-7, 31 de agosto del 2021.
Article in Spanish | LILACS | ID: biblio-1284501

ABSTRACT

Introducción: La enfermedad de hígado graso no alcohólica se caracteriza por la infiltración grasa mayor al 5% y que en la población pediátrica se encuentra asociada a alteraciones metabólicas adquiridas o congénitas, con alta prevalencia en población hispánica. El objetivo del presente estudio fue establecer la correlación entre el índice de masa corporal y el grado ecográfico de esteatosis hepática en niños y adolescentes asistentes a una consulta de control de salud. Métodos: El presente estudio observacional, analítico, de corte transversal, retrospectivo, se llevó a cabo en pacientes de 2 a 17 años de edad con esteatosis hepática, atendidos en el área de consulta externa del Hospital de Niños Dr. Roberto Gilbert Elizalde , Guayaquil-Ecuador, entre los años 2015 a 2019. Se midió el peso, talla, índice de masa corporal, grado de esteatosis y niveles de AST y ALT. Se estableció un análisis de correlación entre esteatosis como variable dependiente. Resultados: Ingresaron al estudio 77 casos con una media de 11 años y el género femenino representó el 39% de la muestra. No hubo asociación entre el grado ecográfico de esteatosis hepática vs. la edad, género, peso, talla o índice de masa corporal. En el análisis entre los niveles de transaminasas en pacientes con grado ecográfico leve a severo, se observó un ascenso significativo de AST (P=0.003) y medianamente significativo de ALT (P=0.0583). Conclusiones: Este estudio demostró la ausencia de correlación del grado ecográfico de esteatosis con el índice de masa corporal. La detección temprana con las herramientas adecuadas de la esteatosis hepática debe ser una prioridad en el cuidado de los pacientes pediátricos para evitar su progresión a cirrosis hepática, por lo cual se recomienda el uso de transaminasas como método de cribado a los pacientes con factores de riesgo.


Introduction: Nonalcoholic fatty liver disease is characterized by fat infiltration greater than 5% and that in the pediatric population is associated with acquired or congenital metabolic alterations, with a high prevalence in the Hispanic population. The aim of the present study was to establish the correlation between the body mass index and the ultrasound grade of hepatic steatosis in children and adolescents attending a health check-up. Methods: The present observational, analytical, cross-sectional, retrospective study was carried out in patients from 2 to 17 years of age with hepatic steatosis, treated in the outpa-tient area of the "Dr. Roberto Gilbert Elizalde" Children´s Hospital, Guayaquil -Ecuador, between the years 2015 to 2019. Weight, height, body mass index, degree of steatosis and AST and ALT levels were measured. A correlation analysis was established between steatosis as a dependent variable. Results: 77 cases with an average age of 11 years entered the study and the female gender represented 39% of the sample. There was no association between the ultrasound grade of hepatic steatosis vs. age, gender, weight, height, or body mass index. In the analysis be-tween transaminase levels in patients with mild to severe ultrasound grade, a significant rise in AST (P = 0.003) and a moderately significant rise in ALT (P = 0.0583) were observed. Conclusions: This study demonstrated the absence of correlation of the ultrasound grade of steatosis with the body mass index. Early detection of hepatic steatosis with the appropriate tools should be a priority in the care of pediatric patients to avoid its progression to liver cirrhosis, for which the use of transaminases as a screening method is recommended for patients with risk factors.


Introdução: A doença hepática gordurosa não alcoólica é caracterizada por infiltração gordurosa maior que 5% e que na população pediátrica está associada a alterações metabólicas adquiridas ou congênitas, com alta prevalência na população hispânica. O objetivo do presente estudo foi estabelecer a correlação entre o índice de massa corporal e o grau ultrassonográfico de esteatose hepática em crianças e adolescentes em exame de saúde. Métodos: O presente estudo observacional, analítico, transversal e retrospectivo foi realizado em pacientes de 2 a 17 anos com esteatose hepática, atendidos no ambulatório do Hospital de Niños Dr. Roberto Gilbert Elizalde, Guayaquil-Equador, entre os anos de 2015 a 2019. Peso, altura, índice de massa corporal, grau de esteatose e níveis de AST e ALT foram medidos. Uma análise de correlação foi estabelecida entre a esteatose como variável dependente. Resultados: Entraram no estudo 77 casos com idade média de 11 anos e o gênero feminino representou 39% da amostra. Não houve associação entre o grau de ultrassom de esteatose hepática vs. idade, sexo, peso, altura ou índice de massa corporal. Na análise entre os níveis de transaminase em pacientes com grau de ultrassom de leve a grave, um aumento significativo na AST (P = 0,003) e um aumento moderadamente significativo na ALT (P = 0,0583) foram observados. Conclusões: Este estudo demonstrou não haver correlação do grau de esteatose ultrassonográfica com o índice de massa corporal. A detecção precoce da esteatose hepática com as ferramentas adequadas deve ser uma prioridade no atendimento de pacientes pediátricos para evitar sua progressão para cirrose hepática, para a qual o uso de transaminases como método de rastreamento é recomendado para pacientes com fatores de risco.


Subject(s)
Humans , Child, Preschool , Child , Adolescent , Ultrasonography , Non-alcoholic Fatty Liver Disease , Obesity , Child , Alanine Transaminase
14.
Arq. gastroenterol ; 58(2): 139-144, Apr.-June 2021. tab, graf
Article in English | LILACS | ID: biblio-1285330

ABSTRACT

ABSTRACT BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) is the most prevalent liver disease in the world, and its prevalence is increasing alongside obesity. In United States, NAFLD is already the second leading cause of liver transplantation. The spectrum of the disease ranges from simple steatosis, which has a benign course, to steatohepatitis, which may progress to cirrhosis and its complications. The rising of noninvasive methods for diagnosing and staging non-alcoholic steatohepatitis (NASH) and fibrosis decreases the need of liver biopsy, as well as the costs and the occurrence of complications related to it. OBJECTIVE: To analyze the performance of the triglyceride-glucose index to evaluate steatosis, NASH and liver fibrosis in obese patients with NAFLD. METHODS: This is a retrospective cross-sectional study. Every medical record of patients who were candidates for bariatric surgery at a leading hospital in Southern Brazil were analyzed. The triglyceride-glucose index (TyG Index), a method composed only of two simple laboratory tests (serum triglycerides and fasting glucose levels), was performed prior to surgery. The TyG Index performance regarding the anatomopathological findings was evaluated, and the AUROC curve was calculated to evaluate the best cut-off point for diagnosing steatosis, non-alcoholic steatohepatitis and liver fibrosis grade. Also, the NAFLD fibrosis Score (NFS) was evaluated. RESULTS: A total of 423 patients were evaluated. The TyG Index with a cut-off point of 8.76 excluded significant simple steatosis (grade 2-3) in obese patients, with 67.6% sensitivity, 65.1% specificity, 46.3% positive predictive value (PPV), 81.8% negative predictive value (NPV), 65.8% accuracy and 0.66 AUROC (P=0.005). In the evaluation of NASH, the TyG Index with a cut-off point of 8.82 excluded significant NASH (grade 2-3) with 57.3% sensitivity, 58.6% specificity, 33.7% PPV, 78.8% NPV, 58.2% accuracy and 0.58 AUROC (P=0.022). When evaluating liver fibrosis, the TyG Index with a cut-off point of 8.91 showed a sensitivity of 61.8%, a specificity of 62.5%, a PPV of 13.8 and a NPV of 94.4% for exclusion of advanced fibrosis (F3-4), with a 62.4% accuracy and 0.69 AUROC (P<0.001). When analyzing the performance of NFS in the diagnosis of advanced fibrosis, the cut-off point <-1.455 excluded advanced fibrosis with sensitivity of 59.4%, specificity of 51%, PPV of 11%, NPV of 92.4% and accuracy of 51.7%. However, the cut-off point of 0.676 to diagnose advanced fibrosis presented sensitivity of 21.9%, specificity of 83%, PPV of 11.7%, NPV of 91.2% and 77.3% accuracy. The AUROC was 0.54 (P=0.480). CONCLUSION: TyG Index did not perform well in the diagnosis of significant steatosis and NASH. However, it was able to exclude advanced fibrosis in obese patients who are candidates for bariatric surgery.


RESUMO CONTEXTO: A doença hepática gordurosa não-alcoólica (DHGNA) é a doença hepática mais prevalente no mundo. Nos Estados Unidos, a DHGNA já é a segunda causa de transplante hepático. O espectro da doença abrange desde a esteatose simples, que apresenta curso benigno, até esteato-hepatite não-alcoólica (EHNA), que pode progredir para cirrose e suas complicações. O desenvolvimento de métodos não invasivos para o diagnóstico e estadiamento da EHNA e da fibrose hepática visa diminuir a necessidade de biópsia hepática, um procedimento invasivo e não raro associado a complicações. OBJETIVO: Analisar o desempenho do índice triglicerídeo-glicose (TyG Index) para o diagnóstico e estadiamento da DHGNA em pacientes obesos. MÉTODOS: Este é um estudo transversal retrospectivo. Foram analisados todos os prontuários de pacientes candidatos a cirurgia bariátrica em um hospital de referência do Sul do Brasil e calculado o TyG Index, um escore composto por dois exames laboratoriais (triglicerídeos e glicose de jejum), realizados previamente à cirurgia. O desempenho do TyG Index em relação aos achados anatomopatológicos hepáticos foi avaliado, e calculada a curva ROC para avaliação de esteatose simples, EHNA e fibrose hepática. O NAFLD Fibrosis Score (NFS) também foi avaliado. RESULTADOS: Foram avaliados 423 pacientes. O melhor ponto de corte do TyG Index para a exclusão de esteatose simples significativa (grau 2-3) foi de 8,76, com sensibilidade 67,6%, especificidade 65,1%, valor preditivo positivo (VPP) 46,3%, valor preditivo negativo (VPN) 81,8%, acurácia 65,8% e AUROC 0,66 (P=0,005). Na avaliação de EHNA significativa (grau 2-3), o melhor ponto de corte foi de 8,82 com sensibilidade 57,3%, especificidade 58,6%, VPP 33,7%, VPN 78,8%, acurácia 58,8% e AUROC 0,58 (P=0,022). Em relação à fibrose avançada (grau 3-4), o melhor ponto de corte do TyG Index foi de 8,91 com sensibilidade 61,8%, especificidade 62,5%, VPP 13,8%, VPN 94,4%, acurácia 62,4% e AUROC 0,69 (P<0,001). Ao analisarmos o desempenho do NFS no diagnóstico de fibrose avançada, o ponto de corte de <-1,455 excluiu fibrose avançada com sensibilidade 59,4%, especificidade 51%, VPP 11%, VPN 92,4% e acurácia 51,7%. Entretanto, o ponto de corte de 0,676 para fibrose avançada apresentou sensibilidade de 21,9%, especificidade 83%, VPP 11,7%, VPN 91,2% e acurácia 77,3%. A AUROC foi de 0,54 (P=0,480). CONCLUSÃO: O TyG Index não apresentou bom desempenho para o diagnóstico e estadiamento da esteatose simples e da EHNA. Entretanto, foi capaz de excluir fibrose avançada em pacientes obesos candidatos a cirurgia bariátrica.


Subject(s)
Humans , Non-alcoholic Fatty Liver Disease/complications , Non-alcoholic Fatty Liver Disease/pathology , Triglycerides , Biopsy , Cross-Sectional Studies , Retrospective Studies , Glucose , Liver/pathology , Liver Cirrhosis/pathology , Obesity
15.
Rev. cuba. salud pública ; 47(2): e1096, 2021. graf
Article in Spanish | LILACS, CUMED | ID: biblio-1341493

ABSTRACT

Introducción: El sobrepeso y la obesidad en la infancia y la adolescencia se han incrementado a nivel mundial durante las últimas décadas. Este hecho se asocia, principalmente, con la falta de actividad física, hábitos de vida y comportamientos alimenticios poco saludables. Objetivo: Analizar la efectividad de diferentes estudios de intervención escolar llevados a cabo en España para prevenir y tratar la obesidad en niños y niñas. Métodos: Se realizó una estrategia de búsqueda electrónica utilizando las bases de datos PubMed, Medline y SPORTdiscus y los términos school-based intervention, Spain, healthy lifestyle, obesity prevention, physical activity y nutrition childhood obesity y children obesity. Se identificaron 124 artículos y solo 11 cumplieron los criterios de inclusión. Conclusiones: Las intervenciones realizadas por el entorno escolar no fueron eficaces o significativas para cambiar los indicadores antropométricos de los niños, niñas y adolescentes españoles. Sin embargo, las intervenciones escolares unidas a la implicación familiar, pueden ser eficaces para modificar cambios en los hábitos nutricionales, nivel de actividad física y hábitos de vida saludable en la etapa infantojuvenil, ya que son los principales determinantes de obesidad en la infancia. Por último, la consolidación de un adecuado estilo de vida en etapas tempranas puede prevenir la obesidad y sobrepeso en la adultez(AU)


Introduction: Overweight and obesity in childhood and adolescence have increased worldwide in recent decades. This fact is associated mainly with a lack of physical activity, unhealthy lifestyle habits and eating behaviors. Objective: To analyze the effectiveness of different school intervention studies carried out in Spain to prevent and treat obesity in boys and girls. Methods: An electronic search strategy was carried out using the PubMed, Medline and SPORTdiscus databases, under the terms school-based intervention, Spain, healthy lifestyle, obesity prevention, physical activity, nutrition, childhood obesity and children obesity. 124 articles were identified and only 11 met the inclusion criteria. Conclusions: The interventions carried out by school were not effective or significant to change the anthropometric indicators of Spanish children and adolescents. However, school interventions, together with family involvement, can be effective in modifying changes in nutritional habits, level of physical activity and healthy lifestyle habits in the infant-juvenile stage, since they are the main determinants of obesity in childhood. Finally, establishing an adequate lifestyle early can prevent obesity and overweight in adulthood(AU)


Subject(s)
Humans , Child , Adolescent , Food and Nutrition Education , Exercise , Life Style , Obesity/prevention & control
16.
Salud(i)ciencia (Impresa) ; 24(6): 294-303, 06/2021.
Article in Spanish | LILACS | ID: biblio-1343622

ABSTRACT

Kuhn in 1962 establishes the revolutionary character of science: "new scientific theories are not born by verification or falsification, but by substitution." The objective of this review was to analyze the ideas and paradigms through which studies on obesity and its relationship with environmental pollutants, diet and epigenetics have passed, in order to illustrate the current situation of this object of study. Articles were managed in December 2020 from the Web of Science. The strategy was Obesity AND (pollution OR contamination) in the Title field, AND (epigenetic* OR obesity OR food OR nutrition OR diet) in the Themes field. 654 articles were obtained: 577 original investigations and 77 reviews. The documents were exported in BibTeXformat to be quantitatively analyzed with the Bibliometrix program. For the qualitative analysis, review articles were selected in whose titles, keywords and/or abstract, carried the word paradigm*, identifying 19 who underwent content analysis. From 1980 to 2020, four periods were recognized, the first and third are classified as normal science; the second and the fourth, crisis of knowledge or revolution. The evolution of the studies has been differentiated. First, the central theme was environmental pollution and secondarily, obesity. For the second and third period, the epigenetics related to environmental pollution and that associated with obesity are investigated separately and at present, causal relationships between environmental pollutants and obesity, nutrients and epigenetics are hypothesized.


Kuhn en 1962 establece el carácter revolucionario de la ciencia: "las nuevas teorías científicas no nacen por verificación ni por falsación, sino por sustitución". El objetivo de esta revisión fue analizar las ideas y los paradigmas por los que han transitado los estudios sobre obesidad, y su relación con contaminantes ambientales, alimentación y epigenética, con el propósito de ilustrar la situación actual de este objeto de estudio. Se gestionaron artículos en diciembre de 2020 de la Web of Science. La estrategia fue Obesity AND (pollution OR contamination) en el campo Title, AND (epigenetic* OR obesity OR alimentation OR nutrition OR diet) en el campo Themes. Se obtuvieron 654 artículos: 577 investigaciones originales y 77 revisiones. Los documentos se exportaron en formato BibTeX para ser analizados cuantitativamente con el programa Bibliometrix. Para el análisis cualitativo se seleccionaron artículos de revisión en cuyos títulos, palabras clave o resumen llevaran la palabra paradigm*, con lo que se identificaron 19, a los que se les realizó análisis de contenido. De 1980 a 2020 se reconocieron cuatro períodos; el primero y el tercero se clasifican como ciencia normal; el segundo y el cuarto, como crisis de conocimiento o revolución. La evolución de los estudios ha sido diferenciada. Primero, la temática central fue la contaminación ambiental y, de manera secundaria, la obesidad. Para el segundo y el tercer período se investigan por separado la epigenética relacionada con la contaminación ambiental y la asociada con la obesidad, y en la actualidad, se plantean hipótesis de relaciones causales entre contaminantes ambientales y obesidad, nutrientes y epigenética.


Subject(s)
Environmental Pollution , Obesity , World Health Organization , Diet , Environmental Pollutants , Evaluation Studies as Topic , Nutritional Sciences , Epigenomics
17.
Salud(i)ciencia (Impresa) ; 24(6): 289-293, 06/2021. graf., tab.
Article in Spanish | LILACS | ID: biblio-1343450

ABSTRACT

In the population of Manabí, there is a tendency to develop new forms and lifestyles with less energy expenditure and a high degree of stress, and massive consumption of foods rich in saturated fat. An observational, prospective cross-sectional study was carried out with the objective of determining the prevalence of metabolic syndrome in the Las Pampas commune of the Montecristi canton in a sample of 96 people over 30 years of age, whose weight and height were determined calculating the body mass index. Blood pressure, glycaemia, and lipid profile were measured in all of them, after fasting for 12 hours. The data collected from the surveys and the taking of metabolic measurements were tabulated and graphical representations with percentages were made, they were entered into an Access database by a data entry clerk. For the diagnosis of metabolic syndrome, the recommendations of the ALAD 2010 guidelines were taken into account. It is concluded that the risk factors in the population are overweight and obesity, a prevalence of hypertension of 60.42%, and in relation to the syndrome metabolic, female sex predominates with 52%, compared to men with 44%. According to the results obtained, the said results of the project should be indicated to the studied population in order to carry out actions that promote chronic disease prevention campaigns and thus improve the quality of life of the population.


En la población de Manabí existe una tendencia a desarrollar nuevas formas y estilos de vida, con menos gasto de energía y alto grado de estrés, así como un consumo masivo de alimentos ricos en grasas saturadas. Se realizó un estudio observacional, prospectivo, de corte transversal, con el objetivo de determinar la prevalencia de síndrome metabólico en la comuna Las Pampas del cantón Montecristi, en una muestra de 96 personas mayores de 30 años, a las que se les determinaron el peso y la talla, con lo que se calculó el índice de masa corporal. A todos se les midieron la presión arterial, la glucemia y el perfil lipídico, previo ayuno de 12 horas. Los datos recolectados de las encuestas y la toma de medidas metabólicas fueron tabulados y se realizaron representaciones gráficas con porcentajes; se ingresaron a un digitador en una base de datos Access. Para el diagnóstico de síndrome metabólico se tuvieron en cuenta las recomendaciones de las guías ALAD 2010. Se concluye que los factores de riesgo en la población analizada son el sobrepeso y la obesidad, con una prevalencia de hipertensión arterial del 60.42%. En relación con el síndrome metabólico, predomina en el sexo femenino, con un 52%, en comparación con el 44% de los hombres. De acuerdo con los resultados obtenidos, se debe indicar a la población estudiada los resultados del proyecto para poder realizar acciones que promuevan campañas de prevención de enfermedades crónicas y, de esta forma, mejorar la calidad de vida de la población.


Subject(s)
Prevalence , Metabolic Syndrome , Chronic Disease , Risk Factors , Arterial Pressure , Heart Disease Risk Factors , Hypertension , Obesity
18.
Cambios rev. méd ; 20(1): 99-106, 30 junio 2021. tabs.
Article in Spanish | LILACS | ID: biblio-1292979

ABSTRACT

En la actualidad, la obesidad es conside-rada una pandemia, cuya incidencia se ha triplicado en los últimos 30 años, y ha ge-nerado problemas de salud pública cada vez mayores. Tomando como base las guías de la Asociación Americana de Endocrinólogos (AACE), la Sociedad para la Obesidad, la Sociedad Americana de Cirugía Bariátrica y Metabólica (ASMBS), la Asociación para Medicina de la Obe-sidad y la Asociación Americana de Anes-tesiólogos, se realiza el presente docu-mento, con el fin de que se constituya en la hoja de ruta que guíe el procedimiento a seguir en los pacientes que padecen de esta enfermedad crónica y que acuden al Hospital General San Francisco (HGSF)1. La obesidad se caracteriza por el uso de varios medicamentos debido a las co-morbilidades relacionadas: enfermedad cardiovascular, diabetes mellitus tipo 2, enfermedad renal crónica, hígado graso no alcohólico, síndrome metabólico y varios tipos de cánceres2. Este protocolo contiene el más alto nivel de evidencia disponible hasta la fecha, en relación al manejo quirúrgico y no quirúrgico del paciente con diagnóstico de obesidad, incluyendo temas como la identificación de los pacientes candidatos para los pro-cedimientos bariátricos, tipo de proce-dimientos que deberían ser ofertados, el manejo preoperatorio, transoperatorio y el cuidado post operatorio de seguimiento2-4.Desde la publicación por parte de la Ame-rican Society for Metabolic and Bariatric Surgery (ASMBS) en el año 2013 de las guías de manejo del paciente con obe-sidad, se ha evidenciado un incremento significativo en las publicaciones que avalan excelentes resultados para el tra-tamiento de los pacientes con obesidad y con diabetes mellitus tipo 2 mediante la cirugía bariátrica y metabólica 2,5,6. En el año 2016 la publicación del Diabetes Sur-gery Summit (DSS2)7 marca diferencia en el manejo de los pacientes con diabetes mellitus tipo 2, es así que las mismas han crecido sustancialmente y la evidencia demuestra que el manejo metabólico ba-riátrico de estos pacientes es superior al manejo médico y cambios de estilo de vida cuando se evalúa el control glucémico y remisión de las comorbilidades. Con la evaluación previa del equipo mul-tidisciplinario, tendremos información científica del más alto nivel que nos per-mita tener un paciente con recuperación óptima aplicando los criterios de En-hanced Recovery after Bariatric Surgery (ERASB)8. En el Ecuador, la obesidad se ha conver-tido en un problema de salud pública, es así que en la población pediátrica ha au-mentado desde el año 1986 pasando del 8,0% al 26,0% para el año 2012 en el grupo de 11 a 19 años. La prevalencia de sobrepeso y obesidad en población adulta en el Ecuador es del 62,8%, según el sexo es 5,5% mayor en las mujeres (65,5%) que en los hombres (60,0%), y el mayor índice de obesidad y sobrepeso se pre-senta entre la cuarta y quinta décadas de vida, con prevalencias superiores a 73,0%9,10.


Currently, obesity is considered a pan-demic, the incidence of which has tripled in the last 30 years, and has generated in-creasing public health problems. Based on the guidelines of the American As-sociation of Endocrinologists (AACE), the Obesity Society, the American So-ciety for Metabolic and Bariatric Surgery (ASMBS), the Association for Obesity Medicine and the American Association of Anesthesiologists, this document is intended to serve as a roadmap to guide the procedure to be followed in patients suffering from this chronic disease who come to San Francisco General Hospital (HGSF)1.Obesity is characterized by the use of se-veral medications due to related comor-bidities: cardiovascular disease, type 2 diabetes mellitus, chronic kidney disease, non-alcoholic fatty liver disease, meta-bolic syndrome and several types of can-cers2. This protocol contains the highest level of evidence available to date, in relation to the surgical and non-surgical management of the patient with a diag-nosis of obesity, including issues such as the identification of candidate patients for bariatric procedures, type of proce-dures that should be offered, preopera-tive, trans-operative management and fo-llow-up post-operative care2-4.Since the publication by the American So-ciety for Metabolic and Bariatric Surgery (ASMBS) in 2013 of the guidelines for the management of patients with obesity, there has been a significant increase in publications that support excellent results for the treatment of patients with obesity and type 2 diabetes mellitus through bariatric and metabolic surgery2,5,6. In 2016 the pu-blication of the Diabetes Surgery Summit (DSS2)7 makes a difference in the mana-gement of patients with type 2 diabetes mellitus, it is so that the same have grown substantially and the evidence shows that bariatric metabolic management of these patients is superior to medical manage-ment and lifestyle changes when glycemic control and remission of comor-bidities are evaluated. With the previous evaluation of the multidisciplinary team, we will have scientific information of the highest level that will allow us to have a patient with optimal recovery applying the criteria of Enhanced Recovery after Bariatric Surgery (ERASB)8.In Ecuador, obesity has become a public health problem; thus, in the pediatric population it has increased since 1986 from 8,0% to 26,0% in 2012 in the 11 to 19 years age group. The prevalence of overweight and obesity in the adult po-pulation in Ecuador is 62,8%, according to sex is 5,5% higher in women (65,5%) than in men (60,0%), and the highest rate of obesity and overweight occurs between the fourth and fifth decades of life, with prevalences higher than 73,0%9,10.


Subject(s)
Humans , Male , Female , Bariatric Surgery , Weight Reduction Programs , Obesity Management , Nutritional and Metabolic Diseases , Obesity , Body Weight , Weight Loss , Feeding and Eating Disorders , Body Mass Index , Diet, Food, and Nutrition , Metabolism
19.
Cambios rev. méd ; 20(1): 80-86, 30 junio 2021. tabs., graf.
Article in Spanish | LILACS | ID: biblio-1292944

ABSTRACT

INTRODUCCIÓN. La fuga post manga gástrica es una complicación de los proce-dimientos bariátricos quirúrgicos, con prevalencia del 2,1%, en el que se emplea el abordaje endoscópico, describir su seguridad y éxito es relevante. OBJETIVO. Describir el abordaje endoscópico en el manejo de la fuga post manga gástrica. MATERIALES Y MÉTODOS. Revisión bibliográfica y análisis sistemático de artículos científicos. De un total de 384 artículos, 11 publicaciones de texto completo fueron seleccionados; 9 artículos fueron estudios retrospectivos y 2 revisiones sistemáticas. Los términos de búsqueda sobre el tratamiento endoscópico en fuga post manga gástrica se basaron en datos PubMed que cumplieron los criterios: leak, fístula, par-tial gastrectomy, gastrointestinal endoscopy. RESULTADOS. La literatura reportó se-guridad con cero mortalidad y tasa de éxito para sutura endoscópica del 80,0%, over the scope clip 86,3%, drenaje interno endoscópico 83,41%, septotomía endoscópica 100,0%, stents endoscópicos hasta del 95,0% y terapia vacuum endoscópica 87,5%. CONCLUSIÓN. Se evidenció que el abordaje endoscópico en el manejo de la fuga post manga gástrica fue seguro y exitoso; se necesita personal experto en las dife-rentes modalidades terapéuticas reportadas.


INTRODUCTION. Post gastric sleeve leakage is a complication of surgical bariatric procedures, with a prevalence of 2,1%, in which the endoscopic approach is used, describing its safety and success is relevant. OBJECTIVE. To describe the endos-copic approach in the management of post gastric sleeve leak. MATERIALS AND METHODS. Bibliographic review and systematic analysis of scientific articles. From a total of 384 articles, 11 full-text publications were selected; 9 articles were retrospective studies and 2 systematic reviews. Search terms on endoscopic treatment in postgastric sleeve leak were based on PubMed data that met the criteria: leak, fistula, partial gastrectomy, gastrointestinal endoscopy. RESULTS. The literature re-ported safety with zero mortality and success rate for endoscopic suture 80,0%, over the scope clip 86,3%, endoscopic internal drainage 83,41%, endoscopic septotomy 100,0%, endoscopic stents up to 95,0% and endoscopic vacuum therapy 87,5%. CONCLUSION. It was evidenced that the endoscopic approach in the management of post gastric sleeve leak was safe and successful; expert personnel are needed in the different therapeutic modalities reported


Subject(s)
Humans , Endoscopy, Gastrointestinal , Bariatric Surgery , Gastrectomy , Obesity , Sutures , Drainage , Anastomotic Leak , Fistula
20.
Rev. cuba. pediatr ; 93(2): e1417, tab, fig
Article in Spanish | LILACS, CUMED | ID: biblio-1280364

ABSTRACT

Introducción: La asociación de asma y obesidad ha aumentado su prevalencia en los últimos años. Objetivos: Caracterizar a niños y adolescentes asmáticos con obesidad asociada. Métodos: Investigación descriptiva, transversal y prospectiva, 2017-2018, Servicio de Neumología, Hospital Pediátrico Universitario Centro Habana. Se evaluaron 43 pacientes asmáticos entre 5 y 18 años de edad con obesidad exógena asociada. Se exploraron edad, sexo, antecedentes familiares de asma y obesidad, severidad y grado de control del asma. Se realizaron estudios para evaluar el metabolismo lipídico y de los hidratos de carbono. Resultados: La distribución por edades fue similar (escolares, adolescencia temprana y tardía), predominó el sexo masculino en escolares: 11 de 16 (68,7 por ciento) y el femenino en la adolescencia tardía: 12 de 15 (80 por ciento). Se refirieron antecedentes familiares de obesidad en 5 (11,6 por ciento) y asma asociada a obesidad en 26 (60,5 por ciento); la mayoría presentaba asma persistente leve: 38 (88,4 por ciento), no controlados: 28 (65,1 por ciento) y parcialmente controlados 10 (23,3 por ciento). Dos pacientes presentaban intolerancia a los hidratos de carbono (4,7 por ciento), uno de ellos con resistencia a la insulina. La dislipidemia fue el trastorno metabólico más frecuente: colesterol sérico elevado en 23 (53,5 por ciento), LDLc alto en 13 (30,2 por ciento) y HDLc bajo en 10 (23,3 por ciento). Conclusiones: Los niños asmáticos con historia familiar de obesidad tienen alto riesgo de ser también obesos, lo cual puede dificultar el control del asma; son frecuentes en ellos las alteraciones metabólicas(AU)


Introduction: The association of asthma and obesity has increased its prevalence in recent years. Objectives: Characterize asthmatic children and adolescents with associated obesity. Methods: Descriptive, cross-sectional and prospective research, 2017 - 2018, Pneumology Service, Centro Habana University Pediatric Hospital. 43 asthmatic patients from 5 to 18 years old with associated exogenous obesity were assessed. Age, sex, family history of asthma and obesity, severity and degree of asthma control were studied. Studies were conducted to evaluate lipid and carbohydrate metabolism. Results: Age distribution was similar (schoolers, early and late adolescence), predominated male sex in schoolchildren (11 of 16 - 68.7 percent) and the female in late adolescence (12 of 15 -80 percent). Family history of obesity was reported in 5 patients (11.6 percent) and obesity-associated asthma in 26 (60.5 percent); most had mild persistent asthma (38 -88.4 percent) poorly controlled: 28 uncontrolled (65.1 percent) and 10 partially controlled (23.3 percent). Two patients had carbohydrate intolerance (4.7 percent), one of them with insulin resistance. Dyslipidemia was the most common metabolic disorder: serum cholesterol increased in 23 - 53.5 percent, high LDLc in 13 - 30.2 percent, and low HDLc in 10 - 23.3 percent. Conclusions: Asthmatic children with a family history of obesity are also at high risk of being obese, which can make difficult to control asthma; metabolic alterations are common in them(Au)


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Asthma , Age Distribution , Dyslipidemias , Carbohydrate Metabolism , Obesity
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