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1.
Rev. colomb. cir ; 39(3): 396-406, 2024-04-24. fig, tab
Article in Spanish | LILACS | ID: biblio-1553804

ABSTRACT

Introducción. La cirugía bariátrica y metabólica (CBM) es efectiva en lograr pérdida de peso a corto plazo. Sin embargo, existe evidencia limitada en desenlaces clínicos y metabólicos a largo plazo. Métodos. Estudio longitudinal retrospectivo con pacientes llevados a baipás gástrico en Y de Roux (BGYR) o gastrectomía en manga (MG) por laparoscopia en Bogotá, D.C., Colombia, entre 2013 y 2021. El cambio de peso, control de comorbilidades y resultados metabólicos se recopilaron al inicio del estudio, 3, 6 y 12 meses después de cirugía, y anualmente hasta el quinto año. Las tasas de control de comorbilidades se evaluaron mediante la prueba Kaplan-Meier. Se utilizó un modelo de riesgos proporcionales de Cox para evaluar el efecto de covariables en la reganancia de peso. Resultados. De 1092 pacientes con CBM (71,4 % MG y 28,6 % BGYR), 67 % eran mujeres, con mediana de edad 48 años e índice de masa corporal de 35,5 Kg/m2. Después de cinco años de seguimiento, la tasa de control en diabetes mellitus fue 65,5 %, en hipertensión 56,6 % y en dislipidemia 43,6 %. La tasa de reganancia de peso fue 28 %, sin diferencias entre MG vs BGYR (p=0,482). El tiempo promedio hasta peso nadir fue 14 meses. La edad al momento de CBM fue el mejor predictor independiente de reganancia (HR=1,02, IC95% 1,01-1,04), pero con efecto clínico modesto. Conclusión. La CBM es segura y muestra beneficios a largo plazo en la pérdida de peso y control de comorbilidades en población colombiana.


Introduction. Bariatric and metabolic surgery (BMS) has shown its efficacy in achieving short-term weight loss. However, there is limited evidence regarding long-term clinical and metabolic outcomes. Methods. Retrospective longitudinal study with patients who underwent laparoscopic Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) interventions in Bogotá, Colombia, between 2013 and 2021. Weight change, comorbidity control, and metabolic outcomes were collected at the onset, 3-, 6-, and 12-month post-surgery, and annually up to the fifth year. Comorbidity control rates were assessed using the Kaplan-Meier test. A Cox proportional hazards model was used to evaluate the effect of covariates on weight regain. Results. Of 1092 patients with BMS (71.4% SG and 28.6% RYGB), 67% were women, with a median age of 48 years, BMI 35.5 kg/m2. After five years of follow-up, the control rate in diabetes mellitus was 65.5%, in hypertension 56.6%, and dyslipidemia 43.6%. The weight regain rate was 28% with no differences between SG vs RYGB (p=0.482). The mean time to nadir weight was 14 months. Age at the time of BMS was the best independent predictor of weight regain (HR=1.02, 95%CI: 1.01-1.04), but with a modest clinical effect. Conclusion. BMS is safe and shows long-term benefits in weight loss and control of comorbidities in Colombian population.


Subject(s)
Humans , Obesity, Morbid , Gastroplasty , Comorbidity , Gastric Bypass , Weight Loss , Bariatric Surgery
2.
Distúrbios Comun. (Online) ; 35(4): e60491, 31/12/2023.
Article in English, Portuguese | LILACS | ID: biblio-1552923

ABSTRACT

Introdução: O câncer de cavidade oral constitui lesões da superfície da mucosa oral, e, devido às sequelas da doença e de seu tratamento, frequentemente ocorrem quadros de disfagia. Quando a alimentação por via oral se torna impossibilitada, é fundamental a indicação de vias alternativas de alimentação. Objetivo: verificar a ocorrência e os fatores associados ao uso de via alternativa de alimentação após câncer de língua. Método: A busca foi conduzida por dois pesquisadores independentes nas bases de dados Medline (Pubmed), LILACS, SciELO, Scopus, WEB OF SCIENCE e BIREME sem restrição de idioma e localização, no período de 2010 a 2021. Para complementar e evitar viés de risco foi realizada uma busca por literatura cinza no Google Scholar. Critérios de Seleção: A revisão sistemática foi conduzida conforme as recomendações do Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Foram incluídos na pesquisa estudos que obtiveram pontuação ≥ a 6 pontos segundo o protocolo para pontuação qualitativa proposto por Pithon. Resultados: Os estudos mostram que a maioria dos indivíduos com câncer oral desenvolvem uma perda significativa de peso, necessitando de intervenção. O estágio geral da doença é um preditor significativo de perda de peso crítica em pacientes em tratamento. Conclusão: A indicação de via alternativa de alimentação após câncer de língua foi de 19,3% a 68,2%, e os fatores associados a essa indicação de VAA foram o estágio geral, cirurgia associada à terapia adjuvante, má adesão ao tratamento multidisciplinar, presença de complicações e baixa sobrevida. (AU)


Introduction: Oral cavity cancer constitutes lesions on the surface of the oral mucosa and, due to the consequences of the disease and its treatment, dysphagia often occurs. When oral feeding becomes impossible, it is essential to indicate alternative feeding routes. Objective: to verify the occurrence and factors associated with the use of an alternative feeding route after tongue cancer. Method: The search was conducted by two independent researchers in the Medline (Pubmed), LILACS, SciELO, Scopus, WEB OF SCIENCE and BIREME databases without language and location restrictions, from 2010 to 2021. To complement and to avoid risk bias, a search for gray literature on Google Scholar was performed. Selection Criteria: The systematic review was conducted in accordance with the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Studies that scored ≥ 6 points according to the protocol for qualitative scoring proposed by Pithon. Results: Studies show that most individuals with oral cancer develop significant weight loss, requiring intervention. The overall stage of the disease is a significant predictor of critical weight loss in patients undergoing treatment. Conclusion: The indication of an alternative feeding route after tongue cancer was 19.3% to 68.2%, and the factors associated with this indication of AAV were the general stage, surgery associated with adjuvant therapy, poor adherence to multidisciplinary treatment, presence of complications and poor survival. (AU)


Introducción: El cáncer de cavidad oral constituye lesiones en la superficie de la mucosa oral y, debido a las consecuencias de la enfermedad y su tratamiento, es frecuente que se presente disfagia. Cuando la alimentación oral se hace imposible, es imprescindible la indicación de vías alternativas de alimentación. Objetivo: verificar la ocurrencia y los factores asociados al uso de una vía alternativa de alimentación después del cáncer de lengua. Método: La búsqueda fue realizada por dos investigadores independientes en las bases de datos Medline (Pubmed), LILACS, SciELO, Scopus, WEB OF SCIENCE y BIREME, sin restricciones de idioma y ubicación, de 2010 a 2021. Para complementar y Evitar riesgo de sesgo, se realizó una búsqueda de literatura gris en Google Scholar. Criterios de selección: La revisión sistemática se llevó a cabo de acuerdo con las recomendaciones de Elementos de informe preferidos para revisiones sistemáticas y metanálisis (PRISMA). Los estudios que puntuaron ≥ 6 puntos según el protocolo de puntuación cualitativa propuesto por Pithon et al. (2015). Resultados: Los estudios muestran que la mayoría de las personas con cáncer oral desarrollan una pérdida de peso significativa, lo que requiere intervención. El estadio general de la enfermedad es un predictor significativo de pérdida de peso crítica en pacientes que reciben tratamiento. Conclusión: La indicación de vía alternativa de alimentación tras cáncer de lengua varió del 19,3% al 68,2%, y los factores asociados a esta indicación de AAV fueron el estadio general, cirugía asociada a terapia adyuvante, mala adherencia al tratamiento multidisciplinario, presencia de complicaciones y baja supervivencia. (AU)


Subject(s)
Humans , Tongue Neoplasms/complications , Enteral Nutrition , Feeding Methods , Weight Loss , Deglutition Disorders/etiology , Deglutition Disorders/therapy , Nutritional Status
3.
Rev. colomb. cir ; 38(4): 642-655, 20230906. tab, fig
Article in Spanish | LILACS | ID: biblio-1509784

ABSTRACT

Introducción. La cirugía bariátrica es una estrategia válida de tratamiento en obesidad severa. El objetivo de este estudio fue evaluar la reducción de peso y la resolución de comorbilidades comparando dos técnicas quirúrgicas, baipás gástrico en Y de Roux y manga gástrica. Métodos. Estudio descriptivo de tipo analítico que incluyó pacientes con obesidad grados II y III. Se analizaron variables demográficas y perioperatorias, y las comorbilidades asociadas a la obesidad. La reducción del peso se evaluó con el porcentaje de pérdida del exceso de peso. Se realizó un análisis descriptivo univariado, usando medianas, rangos intercuartílicos, frecuencias y proporciones. Se usaron las pruebas de U de Mann-Whitney y Chi cuadrado para el análisis de grupos. Un valor de p<0,05 fue considerado estadísticamente significativo. Resultados. Fueron incluidos 201 pacientes. La mediana del porcentaje de pérdida del exceso de peso a 18 meses fue de 77,4 % para el grupo de baipás gástrico en Y de Roux vs 69,5 % para el grupo de manga gástrica (p=0,14). La mayoría de los pacientes presentaron resolución o mejoría de la hipertensión arterial (76 %), diabetes mellitus (80 %), dislipidemia (73 %), apnea del sueño (79 %) y artropatías (94 %), sin diferencia significativa según la técnica quirúrgica empleada. La tasa de complicaciones mayores fue del 1,9 %. No se presentó mortalidad. La mediana de seguimiento fue 28 meses. Conclusión. El baipás gástrico en Y de Roux y la manga gástrica son procedimientos muy seguros y efectivos para la reducción del exceso de peso y la resolución de las comorbilidades asociadas a la obesidad


Introduction. Bariatric surgery is a valid strategy of treatment for severe obesity. The aim of this study is to evaluate weight loss and resolution of comorbidities comparing two procedures, Roux-en-Y gastric bypass and sleeve gastrectomy. Methods. Descriptive study of analytical type that included patients with obesity grades II and III. Demographic and perioperative variables were analyzed. The weight reduction was evaluated among others with the percentage of excess of body weight loss. Comorbidities associated with obesity were also analyzed. A univariate descriptive analysis was performed, using medians, interquartile ranges, frequencies, and proportions. The Mann-Whitney U and Chi squared tests were used for analysis of groups. A value of p <0.05 was considered statistically significant. Median follow-up was 28 months. Results. A total of 201 patients were included in the analysis. The median percentage of excess of body weight loss at 18 months was 77.4% for Roux-en-Y gastric bypass group vs 69.5% for sleeve gastrectomy group (p=0.14). The majority of patients presented resolution or improvement of hypertension (76%), diabetes mellitus (80%), dyslipidemia (73%), sleep apnea (79%), and arthropathy (94%), without significant differences according to the surgical technique used. Major complication rate was 1.9%. There was not mortality. The median follow-up was 28 months. Conclusion. Roux-en-Y gastric bypass and sleeve gastrectomy are both very safe and effective procedures for excess weight reduction and resolution of comorbidities associated with obesity


Subject(s)
Humans , Gastric Bypass , Bariatric Surgery , Obesity, Morbid , Gastroplasty , Weight Loss , Comorbidity
4.
Femina ; 51(8): 491-496, 20230830. ilus
Article in Portuguese | LILACS | ID: biblio-1512462

ABSTRACT

O objetivo deste estudo é descrever o caso de mulher com síndrome de Meigs e apresentar a revisão narrativa sobre o tema. Paciente do sexo feminino, 30 anos, nulípara, encaminhada ao hospital por massa anexial e história prévia de drenagem de derrame pleural. Evoluiu com instabilidade hemodinâmica por derrame pleural hipertensivo à direita, sendo submetida a drenagem torácica, com citologia do líquido negativa. Após, foi submetida a laparotomia: realizada salpingo-ooforectomia esquerda. A congelação e a análise histopatológica diagnosticaram fibroma ovariano. A citologia ascítica foi negativa. CA-125 elevado, presença de derrames cavitários e exame de imagem suspeito podem mimetizar um cenário de neoplasia maligna de ovário em estágio avançado. Entretanto, na síndrome de Meigs clássica, o tratamento é cirúrgico, sendo o diagnóstico obtido por meio da análise histopatológica do tumor ovariano. O manejo da síndrome de Meigs clássica é cirúrgico e, após a remoção do tumor, o derrame pleural e a ascite desaparecem.


To describe a case of Meigs syndrome and present a narrative review of the condition. Female patient, 30 years old, nulliparous, referred to the hospital due to an adnexal mass and a previous drainage of pleural effusion. She developed hemodynamic instability due to a hypertensive right pleural effusion being submitted to chest drainage, with negative cytology of the fluid. She underwent laparotomy: Left salpingo-oophorectomy was performed and frozen section and histopathological analysis diagnosed an ovarian fibroma. Ascites cytology was negative. Elevated CA-125, presence of cavitary effusions, suspicious imaging exam can mimic a scenario of ovarian cancer at an advanced stage. However, in classical Meigs syndrome, treatment is surgical, and the diagnosis is obtained through histopathological analysis of the ovarian tumor. Classical Meigs syndrome' management is surgical. After tumor removal, pleural effusion and ascites resolve.


Subject(s)
Humans , Female , Adult , Meigs Syndrome/surgery , Meigs Syndrome/diagnosis , Case Reports , Weight Loss , Anorexia/complications , Women's Health , Pelvic Pain , Cough/complications , Dyspnea/complications , Fatigue/complications , Abdomen/physiopathology
6.
Article in Spanish | LILACS, CUMED | ID: biblio-1536314

ABSTRACT

Introducción: El cáncer de páncreas constituye un problema de salud debido al diagnóstico tardío, su agresividad biológica y la ausencia de un tratamiento sistémico efectivo. Objetivo: Caracterizar clínica, epidemiológica, histológica y anatómicamente a pacientes con cáncer de páncreas. Métodos: Se realizó un estudio descriptivo de casos clínicos, en pacientes con cáncer de páncreas que acudieron al Hospital Oncológico Conrado Benítez; de Santiago de Cuba, en el período comprendido diciembre 2017 hasta diciembre 2018. El universo estuvo conformado por el total de los pacientes de ambos sexos, cuya cifra ascendió a 19 que cumplieron con los criterios de inclusión. Resultados: No existió predominio significativo según el sexo, prevaleció el grupo de edades entre 61-70 años en un 31,6 por ciento, el 84,2 por ciento de los pacientes presentó como factor de riesgo la dieta rica en grasas y pobre en verduras y el tabaquismo, en el 63,2 por ciento coexistió la hipertensión arterial, la pérdida de peso fue el signo que sobresalió en el 79,0 por ciento. El 47,4 por ciento se les diagnosticó adenocarcinoma poco diferenciado, siendo la localización más frecuente de los tumores (31,6 por ciento) la cabeza del páncreas. Conclusiones: El cáncer de páncreas es una enfermedad maligna que se relacionada con la edad y sus síntomas se manifiestan tardíamente, se asocia con la presencia de factores de riesgo por lo que es necesario identificarlos precozmente, modificarlos y/o atenuarlos(AU)


Introduction: Pancreatic cancer constitutes a health problem due to late diagnosis, its biological aggressiveness and the absence of effective systemic treatment. Objective: To clinically, epidemiologically, histologically and anatomically characterize patients with pancreatic cancer. Methods: A descriptive study of clinical cases was carried out in patients with pancreatic cancer who attended the Conrado Benítez; Oncological Hospital of Santiago de Cuba, in the period from December 2017 to December 2018. The universe was made up of the total number of patients of both genders, which amounted to 19 meeting the inclusion criteria. Results: There was no significant predominance according to gender, the age group between 61-70 years prevailed in 31.6 percent, 84.2 percent of patients presented as risk factor the diet rich in fat and poor in vegetables and smoking, in 63.2 percent coexisted arterial hypertension, weight loss was the sign that stood out in 79.0 percent. The 47.4 percent were diagnosed with poorly differentiated adenocarcinoma, being the pancreatic head the most frequent location of the tumors (31.6 percent). Conclusions: Pancreatic cancer is an age-related malignant disease and its symptoms manifest late that is associated with the presence of risk factors, so it is necessary to identify them early, modify and/or attenuate them(AU)


Subject(s)
Humans , Male , Female , Pancreatic Neoplasms/epidemiology , Weight Loss , Carcinoma, Pancreatic Ductal/epidemiology , Hypertension/epidemiology , Epidemiology, Descriptive
7.
Arch. latinoam. nutr ; 73(1): 60-73, mar. 2023. tab
Article in English | LILACS, LIVECS | ID: biblio-1427728

ABSTRACT

The incidence of obesity and overweight in the world has been increasing in recent years due to poor diet and lack of physical activity; people suffering obesity and overweight, related with malnutrition due to excess, often resort to calorie restriction diets that are usually not very effective. In this context, intermittent fasting (IF) has become popular due to the possibilities for weight loss that it offers. This diet consists of alternating periods of fasting with unrestricted eating; however, its effectiveness and consequences are unknown to most users. This narrative review analyzes whether intermittent fasting contributes to the improvement of body and metabolic composition. The purpose of the review was to examine the available data on the contribution of intermittent fasting to the improvement of body and metabolic composition, in order to provide information and to define the parameters that condition safe achievement of its benefits. IF dieting triggers adaptive cell responses that cause a decrease in lipid oxidative stress markers in individuals with obesity and prediabetes. Metabolic alterations have been found to go hand in hand with the alteration of circadian rhythms; if IF contributes to this effect, it may assist in treating and preventing obesity and associated diseases. However, there are also disadvantages, such as the loss of lean muscle mass by wasting, and increased hypoglycemia(AU)


La incidencia de obesidad y sobrepeso en el mundo ha ido en aumento en los últimos años debido a la mala alimentación y la falta de actividad física; Las personas que padecen obesidad y sobrepeso, relacionadas con la desnutrición por exceso, suelen recurrir a dietas de restricción calórica que suelen ser poco efectivas. En este contexto, el ayuno intermitente (AI) se ha popularizado debido a las posibilidades de pérdida de peso que ofrece. Esta dieta consiste en alternar períodos de ayuno con alimentación sin restricciones; sin embargo, su eficacia y consecuencias son desconocidas para la mayoría de los usuarios. Esta revisión narrativa analiza si el ayuno intermitente contribuye a la mejora de la composición corporal y metabólica. El objetivo de la revisión fue examinar los datos disponibles sobre la contribución del ayuno intermitente a la mejora de la composición corporal y metabólica, con el fin de aportar información y definir los parámetros que condicionan la consecución segura de sus beneficios. Se ha encontrado que las alteraciones metabólicas van de la mano con la alteración de los ritmos circadianos; si AI contribuye a este efecto, puede ayudar a tratar y prevenir la obesidad y las enfermedades asociadas. Sin embargo, también existen desventajas, como la pérdida de masa muscular magra por atrofia y el aumento de la hipoglucemia(AU)


Subject(s)
Humans , Male , Female , Weight Loss , Overweight , Intermittent Fasting/adverse effects , Obesity , Prediabetic State , Body Composition , Deficiency Diseases , Delivery of Health Care , Hypoglycemia
8.
Rev. méd. Chile ; 151(1): 81-100, feb. 2023. ilus, tab
Article in Spanish | LILACS | ID: biblio-1515424

ABSTRACT

Intermittent fasting (IF) has gained increasing scientific and general attention. Most studied forms of IF include alternate-day fasting, modified alternate-day fasting, and time-restricted eating (TRE). Several cardiometabolic effects of IF have been described in animal models and, to a lesser extent, in humans. This review analyzes the impact of IF on weight loss, glucose metabolism, blood pressure, and lipid profile in humans. A literature search was conducted in the Pubmed/Medline, Scopus, and Google Scholar databases. Controlled observational or interventional studies in humans, published between January 2000 and June 2021, were included. Studies comparing IF versus religious fasting were not included. Most studies indicate that the different types of IF have significant benefits on body composition, inducing weight loss and reducing fat mass. Changes in cardiometabolic parameters show more divergent results. In general, a decrease in fasting glucose and insulin levels is observed, together with an improved lipid profile associated with cardiovascular risk. High heterogeneity in study designs was observed, particularly in studies with TRE, small sample sizes, and short-term interventions. Current evidence shows that IF confers a range of cardiometabolic benefits in humans. Weight loss, improvement of glucose homeostasis and lipid profile, are observed in the three types of IF protocols evaluated.


Subject(s)
Humans , Animals , Cardiovascular Diseases/prevention & control , Intermittent Fasting , Weight Loss , Fasting/physiology , Glucose/metabolism , Lipids
9.
Rev. bras. med. esporte ; 29: e2022_0172, 2023. tab, graf
Article in English | LILACS | ID: biblio-1394831

ABSTRACT

ABSTRACT Introduction: The unregulated development in the current life pattern has strengthened obesity among adolescents, and this problem is becoming more serious. Objective: Compare the impact of two exercise methods on the physical health of obese adolescents. Methods: 24 obese adolescents (12 females; BMI>30% ± 3%; age concentrated between 10 and 16 years) were selected and divided into group I and group II for a 4-week experimental study, and changes in physical fitness and function were recorded. Results: After four weeks of aerobic exercise control (group I), waist circumference, hip circumference, skinfold thickness, and abdominal fold thickness were significantly reduced in boys (p<0.05), and girls' body shape indicators were significantly altered (p<0.05). After four weeks of aerobic exercise combined with resistance training (group II), the effects of weight, BMI, and body size were significant in boys and girls. Conclusion: Aerobic exercise can effectively improve the physical problems of obese adolescents. Under the same external conditions, the effect of aerobic exercise was shown to be more effective when combined with resistance training in the physical improvement of the analyzed group. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.


RESUMO Introdução: O desenvolvimento desregrado no padrão de vida atual fortaleceu a obesidade entre os adolescentes e esse problema está se tornando cada vez mais grave. Objetivo: Comparar o impacto entre dois métodos de exercício na saúde física de adolescentes obesos. Métodos: Foram selecionados 24 adolescentes obesos (12 mulheres; IMC>30% ± 3%; idade concentrada entre 10 e 16 anos) e divididos no grupo I e no grupo II para um estudo experimental de 4 semanas, sendo registradas as alterações no condicionamento e função física. Resultados: Após 4 semanas de controle de exercício aeróbico (grupo I), a circunferência da cintura, circunferência do quadril, espessura da dobra cutânea e espessura da dobra abdominal foram significativamente reduzidas em meninos (p<0,05), e os indicadores de forma corporal das meninas foram significativamente alterados (p<0,05). Após 4 semanas de exercício aeróbico combinado com treinamento de resistência (grupo II), os efeitos do peso, IMC e tamanho do corpo foram significativos em meninos e meninas. Conclusão: O exercício aeróbico pode melhorar efetivamente os problemas físicos dos adolescentes obesos. Sob as mesmas condições externas, o efeito do exercício aeróbico demonstrou-se mais eficaz quando aliado ao treinamento de resistência na melhoria física do grupo analisado. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.


RESUMEN Introducción: El desarrollo desordenado en el patrón de vida actual ha potenciado la obesidad entre los adolescentes y este problema es cada vez más grave. Objetivo: Comparar el impacto de dos métodos de ejercicio en la salud física de adolescentes obesos. Métodos: Se seleccionaron 24 adolescentes obesos (12 mujeres; IMC>30% ± 3%; edad concentrada entre 10 y 16 años) y se dividieron en el grupo I y el grupo II para un estudio experimental de 4 semanas, y se registraron los cambios en la aptitud física y la función. Resultados: Después de 4 semanas de control de ejercicio aeróbico (grupo I), la circunferencia de la cintura, la circunferencia de la cadera, el grosor de los pliegues cutáneos y el grosor de los pliegues abdominales se redujeron significativamente en los niños (p<0,05), y los indicadores de la forma corporal de las niñas se alteraron significativamente (p<0,05). Tras 4 semanas de ejercicio aeróbico combinado con entrenamiento de resistencia (grupo II), los efectos del peso, el IMC y el tamaño corporal fueron significativos en chicos y chicas. Conclusión: El ejercicio aeróbico puede mejorar eficazmente los problemas físicos de los adolescentes obesos. En las mismas condiciones externas, el efecto del ejercicio aeróbico se mostró más eficaz cuando se combinó con el entrenamiento de resistencia en la mejora física del grupo analizado. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.


Subject(s)
Humans , Male , Female , Adolescent , Exercise Therapy/methods , Obesity/therapy , Weight Loss , Body Mass Index , Inspiratory Capacity , Arterial Pressure/physiology , Heart Rate/physiology
10.
Rev. bras. med. esporte ; 29(spe1): e2022_0185, 2023. tab
Article in English | LILACS | ID: biblio-1394853

ABSTRACT

ABSTRACT Introduction Disparate to the development of society, health indices in Chinese college students have shown a pronounced decline in recent years. Government concern over this recent challenge has encouraged research for practical solutions, including optimized physical activity protocols. Objective Explore the effects of an exercise intervention on the health of Chinese university students. Methods Full-time university students (80 males and 55 females) were selected and randomly assigned into two groups. Before and after the experiment, the college students' body composition scale and exercise experience were tested, focusing on the relationship between exercise prescription and changes in physical and mental health indicators. Results The body fat percentage of male and female students decreased significantly after the experiment. After eight weeks of the exercise prescription experiment, the weight of male and female college students was controlled or reduced. The suggested exercise prescription achieved a good moderating effect on the weight of the volunteers. There was a significant difference between the two groups, indicating that the experiment had a beneficial effect on vital capacity (p<0.01). Conclusion The suggested exercise prescription proved to be feasible to guide and intervene in the physical exercise of college students aiming at a beneficial impact on the physical health of college students. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.


RESUMO Introdução Díspares ao desenvolvimento da sociedade, os índices de saúde nos estudantes universitários chineses apresentam uma queda acentuada nos últimos anos. A preocupação governamental sobre esse recente desafio tem incentivado pesquisas para soluções práticas, incluindo protocolos de atividades físicas otimizados. Objetivo Explorar os efeitos da intervenção por exercícios físicos na saúde dos estudantes universitários chineses. Métodos Universitários de período integral (80 homens e 55 mulheres) foram selecionados e distribuídos aleatoriamente em dois grupos. Antes e depois do experimento, foi testada a escala de composição corporal e experiência de exercício dos universitários, com foco na relação entre prescrição de exercício e mudanças nos indicadores de saúde física e mental. Resultados O percentual de gordura corporal de estudantes do sexo masculino e feminino diminuiu significativamente após o experimento. Após 8 semanas de experimento de prescrição de exercícios, o peso de estudantes universitários do sexo masculino e feminino foi controlado ou reduzido. A prescrição de exercícios sugerida alcançou um bom efeito moderador no peso dos voluntários. Houve diferença significativa entre os dois grupos, indicando que o experimento teve efeito benéfico sobre a capacidade vital (p<0,01). Conclusão A prescrição de exercícios sugerida demonstrou-se viável para orientar e intervir no exercício físico dos universitários visando um impacto benéfico sobre a saúde física nos universitários. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.


RESUMEN Introducción A diferencia del desarrollo de la sociedad, los índices de salud de los estudiantes universitarios chinos muestran un fuerte descenso en los últimos años. La preocupación de los gobiernos por este reciente desafío ha fomentado la investigación de soluciones prácticas, entre ellas la optimización de los protocolos de actividad física. Objetivo Explorar los efectos de la intervención de ejercicio en la salud de los estudiantes universitarios chinos. Métodos Se seleccionaron estudiantes universitarios a tiempo completo (80 hombres y 55 mujeres) y se asignaron al azar en dos grupos. Antes y después del experimento, se analizó la escala de composición corporal de los estudiantes universitarios y su experiencia con el ejercicio, centrándose en la relación entre la prescripción de ejercicio y los cambios en los indicadores de salud física y mental. Resultados El porcentaje de grasa corporal de los estudiantes masculinos y femeninos disminuyó significativamente después del experimento. Tras 8 semanas del experimento de prescripción de ejercicio, el peso de los estudiantes universitarios de ambos sexos se controló o redujo. La prescripción de ejercicio sugerida logró un buen efecto moderador en el peso de los voluntarios. Hubo una diferencia significativa entre los dos grupos, lo que indica que el experimento tuvo un efecto beneficioso sobre la capacidad vital (p<0,01). Conclusión La prescripción de ejercicio sugerida demostró ser factible para guiar e intervenir en el ejercicio físico de los estudiantes universitarios apuntando a un impacto beneficioso en la salud física de los estudiantes universitarios. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.


Subject(s)
Humans , Male , Female , Student Health Services , Exercise Therapy , Obesity/therapy , Weight Loss , Body Mass Index , Case-Control Studies
11.
Health Sciences Journal ; : 123-132, 2023.
Article in English | WPRIM | ID: wpr-1005102

ABSTRACT

Introduction@#The demanding nature of medical school causes students to experience stress, anxiety, and depressive episodes that may cause students to gain or lose weight. This study aimed to determine the association of weight changes and stress levels among a private medical school students.@*Methods@#Data were collected two times with an interval of 30 days through on-site measurement of the students’ anthropometrics using a stadiometer and utilization of online survey questionnaires accessed via QR code. Demographics and disease states were identified in the first round of data collection while the Perceived Stress Scale-10 (PSS-10) and identification of stressors was integrated in the second round of data collection. @*Results@#Among the 212 individuals, 69.8% were categorized into having perceived moderate stress levels, 22.2% with high stress, and 8% with low stress. Of the 212 cases, 86 gained weight, 91 lost weight, and 35 had no change in weight. Fear of failure, poor motivation, and difficulty understanding lectures are among the top overall stressors. The study noted that there is a moderate association between stress and weight changes but it is not enough to reach statistical significance (0.161), as the sample size was not reached. The study revealed that the prevailing diseases were Polycystic Ovarian Syndrome, Hypothyroidism, and Hypertension, which have varying degrees of impact on weight change. @*Conclusion@#There is an association between weight changes and stress levels among first to fourth year medical students of a private medical school from A.Y. 2023-2024.


Subject(s)
Weight Gain , Weight Loss , Students, Medical
13.
Chinese Journal of Gastrointestinal Surgery ; (12): 385-388, 2023.
Article in Chinese | WPRIM | ID: wpr-986803

ABSTRACT

With the increasing number of obese patients worldwide, metabolic and bariatric surgery (MBS) has quickly become an effective way to treat obesity and related metabolic diseases such as type 2 diabetes, hypertension, lipid abnormalities, etc. Although MBS has become an important part of general surgery, there is still controversy regarding the indications for MBS. In 1991, the National Institutes of Health (NIH) issued a statement on the surgical treatment of severe obesity and other related issues, which continues to be the standard for insurance companies, health care systems, and hospital selection of patients. The standard no longer reflects the best practice data and lacks relevance to today's modern surgeries and patient populations. After 31 years, in October 2022, the American Society for Metabolic and Bariatric Surgery (ASMBS) and the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO), the world's leading authorities on weight loss and metabolic surgery, jointly released new guidelines for MBS indications, based on increasing awareness of obesity and its comorbidities and the accumulation of evidence of obesity metabolic diseases. In a series of recommendations, the eligibility of patients for bariatric surgery has been expanded. Specific key updates include the following: (1) MBS is recommended for individuals with BMI≥35 kg/m2, regardless of the presence, absence, or severity of co-morbidities; (2) MBS should be considered for individuals with metabolic diseases and BMI 30.0-34.9 kg/m2; (3) the BMI threshold should be adjusted for the Asian population:: BMI≥25 kg/m2 suggest clinical obesity, and BMI ≥ 27.5 kg/m2 population should consider MBS; (4) Appropriately selected children and adolescents should be considered for MBS.


Subject(s)
Adolescent , Child , Humans , Diabetes Mellitus, Type 2/surgery , Bariatric Surgery , Obesity/surgery , Obesity, Morbid/surgery , Weight Loss
14.
Journal of Central South University(Medical Sciences) ; (12): 614-620, 2023.
Article in English | WPRIM | ID: wpr-982329

ABSTRACT

Obesity is a global public health problem that imposes a heavy economic burden on society. The current main strategies for treating obesity include lifestyle interventions, pharmacological treatments, endoscopic treatments and metabolic surgery. With the development of medical technology, weight reduction by intragastric occupancy devices represented by intragastric balloons and intragastric capsules are gradually emerging. Intragastric balloons are used to reduce weight by occupying the volume of the stomach with balloons filled with different volumes of gas or liquid, among which ReShape, Orbera, Obalon, Elipse and Spatz balloons are gradually used in patients with mild to moderate obesity due to their non-invasive, high safety and reusable advantages. Intragastric capsules are recommended in overweight and obese patients for weight loss through hydrogels with transient superabsorbent swelling properties and completely noninvasive. Both approaches achieve weight loss by limiting gastric volume, increasing satiety and reducing food intake. Despite the presence of adverse gastrointestinal events associated with nausea, vomiting, and abdominal distention, they offer new ideas for the non-invasive clinical treatment of obesity.


Subject(s)
Humans , Capsules , Weight Loss , Obesity/surgery , Overweight , Stomach/surgery
15.
ABCD (São Paulo, Online) ; 36: e1755, 2023. tab
Article in English | LILACS | ID: biblio-1505418

ABSTRACT

ABSTRACT BACKGROUND: Weight regain in the postoperative period after bariatric surgery is directly related to the relapse of preoperative comorbidities and a negative impact on the patients' biochemical profile. AIMS: To assess the metabolic impact of weight regain on preoperative comorbidities and on patients' biochemical profiles, in order to show the impact of the complications on the metabolic outcomes of bariatric surgery. METHODS: A retrospective study was carried out with 75 women in the late postoperative period of bariatric surgery who presented pathological weight regain (≥20% of the maximum weight loss). Data of interest consisted of glycemic, lipid, and inflammatory profile measurements at three different moments of evaluation: preoperative period, at the weight nadir (minimum weight), and after weight regain. A multivariate analysis was performed. RESULTS: The mean age was 46.39±12.09 years. Preoperative body mass index was 40.10±4.11 kg/m2. There was an overall increase of 3.36 points in the mean body mass index between the nadir and after regain: from 26.30±3.9 kg/m2 to 29.66±4.66 kg/m2. The mean time to reach the nadir was 18±7.6 months, with an average percentage of excess weight loss of 91.08±11.8%. The median time for pathological weight regain was 48 months, and the mean regain amongst the sample was 8.85±5.65 kg. There was a significant correlation between pathological weight regain and levels of insulin (r=0.351; p<0.011), C-peptide (r=0.303; p<0.011), C-reactive protein (r=0.402; p<0.001), and vitamin D (r=-0.435; p<0.001), the last two being the most influenced by the percentage of weight regained. CONCLUSIONS: The pathological weight regain in the postoperative period of bariatric surgery results in losses in the patients' metabolic and inflammatory profiles. However, the biochemical benefits are sustained up to the preoperative levels of the parameters analyzed.


RESUMO RACIONAL: Reganho de peso no pós-operatório de cirurgia bariátrica está diretamente relacionado à recidiva das comorbidades pré-operatórias e a um impacto negativo no perfil bioquímico desses pacientes. OBJETIVOS: avaliar o impacto metabólico do reganho de peso nas comorbidades pré-operatórias e no perfil bioquímico desses pacientes, a fim de mostrar o impacto das complicações nos desfechos metabólicos finais da cirurgia bariátrica. MÉTODOS: Estudo retrospectivo que analisou 75 mulheres no pós-operatório tardio de cirurgia bariátrica que apresentaram reganho patológico de peso (=20% do máximo de peso perdido). Foram coletados dados referentes às medidas dos perfis glicêmico, lipídico e inflamatório em três momentos distintos de avaliação: no pré-operatório, no nadir de peso (menor peso) e após o reganho ponderal. Foi realizada uma análise multivariada. RESULTADOS: A idade média foi 46.39±12.09 anos. IMC médio pré-operatório foi 40.10±4.11 kg/m2. Houve um aumento de 3,36 pontos no IMC médio entre o nadir e após reganho: de 26.30±3.9 Kg/m2 para 29.66±4.66 Kg/m2. O tempo médio para atingir o nadir foi de 18±7.6 meses, com uma %PEP de 91.08±11.8%. O tempo médio para o reganho patológico foi de 48 meses, e a média de reganho foi 8.85±5.65 kg. Houve correlação significativa entre o reganho patológico e os níveis de insulina (r=0.351; p<0.011), peptídeo C (r=0.303; p<0.011), proteína C reativa (r=0.402; p<0.001) e vitamina D (r=-0.435; p<0.001), sendo os dois últimos os mais influenciados pela porcentagem de reganho de peso. CONCLUSÕES: O reganho de peso patológico no pós-operatório de cirurgia bariátrica resulta em prejuízos ao perfil metabólico e inflamatório dos pacientes. No entanto, os benefícios bioquímicos perduram em relação aos níveis pré-operatórios dos parâmetros analisados


Subject(s)
Humans , Female , Adult , Middle Aged , Postoperative Complications/metabolism , Obesity, Morbid/surgery , Weight Gain , Bariatric Surgery , Weight Loss , Body Mass Index , Nutritional Status , Multivariate Analysis , Retrospective Studies , Comprehensive Metabolic Panel
16.
ABCD (São Paulo, Online) ; 36: e1748, 2023. tab, graf
Article in English | LILACS | ID: biblio-1447014

ABSTRACT

ABSTRACT BACKGROUND: Obesity has reached epidemic proportions among adolescents. Methods, such as bariatric surgery, have become the most effective treatment for patients with classes III and IV obesity. AIM: To evaluate weight loss, comorbidity remission, and long-term results of bariatric surgery in adolescents. METHODS: Study with adolescent patients undergoing bariatric surgery, evaluating laboratory tests, comorbidities, and the percentage of excess weight loss in the preoperative period and at one, two, and five years postoperatively. RESULTS: A total of 65 patients who met the inclusion criteria, with a mean age of 18.6 years, were included in the analysis. In the preoperative period, 30.8% of hypercholesterolemia, 23.1% of systemic arterial hypertension, and 18.4% of type 2 diabetes were recorded, with remission of these percentages occurring in 60, 66.7 and 83.4%, respectively. The mean percentage of excess weight loss was 63.48% after one year of surgery, 64.75% after two years, and 57.28% after five years. The mean preoperative total cholesterol level was 180.26 mg/dL, and after one, two, and five years, it was 156.89 mg/dL, 161.39 mg/dL, and 150.97 mg/dL, respectively. The initial mean of low-density lipoprotein was 102.19mg/dL and after five years the mean value reduced to 81.81 mg/dL. The mean preoperative glycemia was 85.08 mg/dL and reduced to 79.13 mg/dL after one year, and to 76.19 mg/dL after five years. CONCLUSIONS: Bariatric surgery is safe and effective in adolescents, with low morbidity, resulting in a loss of excess weight and long-term stability, improving laboratory tests, and leading to remission of comorbidities, such as diabetes mellitus, hypercholesterolemia, and systemic arterial hypertension.


RESUMO RACIONAL: A obesidade tomou proporções epidêmicas entre adolescentes, e procedimentos como a cirurgia bariátrica tornou-se o tratamento mais efetivo em pacientes com obesidade grau III e IV. OBJETIVOS: Avaliar a perda peso, a remissão de comorbidades, e resultados a longo prazo da cirurgia bariátrica em adolescentes. MÉTODOS: Estudo com pacientes adolescentes submetidos à cirurgia bariátrica, avaliando exames laboratoriais, comorbidades e o percentual de perda de excesso de peso, nos períodos pré-operatório e com 1, 2 e 5 anos de pós-operatório. RESULTADOS: Foram incluídos no estudo 65 pacientes que preencheram os critérios de inclusão, com a média de idade de 18,6 anos. No pré-operatório foram registrados: 30,8% hipercolesterolemia, 23,1% hipertensão arterial sistêmica e 18,4% diabetes tipo 2, ocorrendo remissão destes porcentuais em 60, 66,7 e 83,4%, respectivamente. O percentual médio de perda de excesso de peso após 1 ano foi de 63,48%, após 2 anos foi de 64,75% e após 5 anos foi 57,28%. O valor médio do colesterol total no pré-operatório era de 180,26mg/dL, e após 1 ano, 2 anos e 5 anos foram de 156,89mg/dL,161,39mg/dL e de 150,97mg/dL, respectivamente. A média inicial de lipoproteína de baixa densidade era 102,19mg/dL e após 5 anos o valor médio reduziu para 81,81 mg/dL. O valor médio da glicose pré-operatório era 85,08 mg/dL, após um ano uma média 79,13mg/dL, e com 5 anos 76,19 mg/dL. CONCLUSÕES: A cirurgia bariátrica é segura e eficaz em adolescentes, com baixa morbidade, resultando em uma perda do excesso de peso e estabilidade a longo prazo, melhorando exames laboratoriais e levando a remissão de comorbidades como diabetes mellitus, hipercolesterolemia e hipertensão arterial sistêmica.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Young Adult , Obesity, Morbid/surgery , Laparoscopy/methods , Bariatric Surgery/methods , Pediatric Obesity/surgery , Obesity, Morbid/diagnosis , Weight Loss , Comorbidity , Sex Factors , Retrospective Studies , Treatment Outcome , Pediatric Obesity/diagnosis
17.
Psico (Porto Alegre) ; 54(1): 39156, 2023.
Article in Portuguese | LILACS | ID: biblio-1526379

ABSTRACT

Diversos aspectos psicológicos estão implicados no emagrecimento, incluindo os estilos de comportamentos alimentares: Restrição Cognitiva (RC), Comer Incontrolável (CI) e Comer Emocional (CE). A Psicologia Positiva, por meio da análise de afetos positivos e negativos e das forças de caráter, pode fornecer recursos para um comportamento alimentar saudável. Este estudo analisou os afetos e as forças de caráter em diferentes estilos de comportamento alimentar de adultos que realizaram um programa de emagrecimento. A abordagem foi quantitativa e correlacional, envolvendo 50 participantes. Os instrumentos foram o Questionário sociodemográfico, o Three-Factor Eating Questionnaire, a Escala de Afetos Positivos e Negativos e a Escala de Forças de Caráter. Os resultados indicam que os participantes que experimentaram menores níveis de afetos negativos apresentaram menos CE e CI, enquanto aqueles com menores níveis de afetos positivos relataram mais episódios de CI. Quanto às forças de caráter, pessoas com mais pensamento crítico, modéstia e autorregulação relataram maior controle sobre suas escolhas alimentares. Além disso, aqueles com mais perseverança, inteligência social, esperança e espiritualidade demonstraram menor incidência de CE. E, aqueles que possuem mais perdão, apreciação do belo e esperança demonstraram menor CI. Conclui-se que o desenvolvimento de afetos positivos e de algumas forças de caráter podem favorecer comportamentos alimentares mais saudáveis


Several psychological aspects are implicated in weight loss, among them the eating behavior styles: Cognitive Restriction (CR), Uncontrollable Eating (UE), and Emotional Eating (EE). Through positive and negative affect and cha-racter strengths, Positive Psychology can present resources for healthy eating behavior. This study examined the affect and character strengths of adults who undertook a weight loss program in different eating behavior styles. The approach was quantitative and correlational, involving 50 participants. The instruments were: sociodemographic questionnaire, Three-Factor Eating Questionnaire, Positive and Negative Affects Scale, and Character Strengths Scale. People who experienced lower levels of adverse affects had less EE and UE, and those with lower levels of positive affects reported more episodes of UE. On the strengths of character, people with more critical thinking, modesty, and self-regulation said greater control over their food choices, and people with more perseverance, social intelligence, hope, and spirituality had a lower incidence of EE. Those with more forgiveness, appreciation of beauty, and hope showed less UE. We concluded that the development of positive affects and some character strengths could favor healthier eating behaviors


Varios aspectos psicológicos están implicados en la pérdida de peso, entre ellos los estilos de comportamiento alimentario: la Restricción Cognitiva (RC), la Alimentación Incontrolable (AI) y la Alimentación Emocional (AE), están implicados en la pérdida de peso. La psicología positiva, a través de los afectos positivos y negativos y las fortalezas de carácter, puede presentar recursos para una conducta alimentaria saludable. Este estudio analizó afecto y las fortalezas del carácter en diferentes estilos de conducta alimentaria de adultos que emprendieron un programa de adelgazamiento. El enfoque fue cuantitativo y correlacional, con 50 participantes. Los instrumentos fueron: cuestionario sociodemográfico, Cuestionario de Tres Factores Alimentarios, Escala de Afectos Positivos y Negativos y Escala de Fortalezas de Carácter. Aquellos que experimentaron niveles más bajos de afectos negativos tuvieron menos AE e AI y aquellos con niveles más bajos de afectos positivos informaron más episodios de AI. En cuanto a las fortalezas de carácter, las personas con pensamiento más crítico, modestia y autorregulación reportaron mayor control sobre sus elecciones alimentarias, las personas con más perseverancia, inteligencia social, esperanza y espiritualidad presentaron menor incidencia de AE. Aquellos que tienen más perdón, aprecio por la belleza y esperanza mostraron menos AI. Se concluye que el desarrollo de afectos positivos y algunas fortalezas del carácter puede favorecer conductas alimentarias más saludables


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Feeding Behavior , Weight Loss , Optimism , Psychology, Positive
18.
Rio de Janeiro; s.n; 2023. 242f p. ilus.
Thesis in Portuguese | LILACS | ID: biblio-1532107

ABSTRACT

A posição do Brasil como um dos maiores consumidores de cirurgia plástica no mundo sinaliza a importância da imagem corporal na cultura nacional. O discurso do corpo em forma e saudável, com frequência associado à imagem de celebridades, remete à ideia de um padrão despótico de beleza, sobretudo a feminina, que privilegia a magreza e a juventude. A proliferação de procedimentos estéticos atinge de formas muito diferentes todas as camadas sociais e tem reflexos em outras áreas, como no campo da alimentação. Na linha tênue entre saúde e beleza, são poucos os trabalhos que investigaram questões nutricionais e práticas alimentares na área de cirurgia plástica no país, principalmente com um olhar socioantropológico, capaz de apreender as subjetividades envolvidas no processo. Diante desse contexto, essa tese teve como objetivo compreender a experiência das tentativas de emagrecimento de mulheres que buscam intervenção cirúrgica estética na Santa Casa de Misericórdia do Rio de Janeiro (SCM-RJ) e foram encaminhadas ao Serviço de Nutrição da enfermaria 38 da referida Instituição. Para tal investigação, foram realizadas 16 entrevistas semiestruturadas com mulheres que passaram em algum momento pelo serviço entre 2017 e 2022. Aliás, ainda que o foco da pesquisa seja qualitativo, foi delineado um panorama sociodemográfico das 2.448 pacientes atendidas entre 2003 e 2020 para contextualizar o campo investigado. Através da análise de conteúdo de suas narrativas, busquei capturar valores, ideias e crenças envolvidos na relação dessas mulheres com o corpo e a comida em contraposição à necessidade de mudanças de hábitos imposta pelo desafio do emagrecimento. Isso fez emergir questões muitas vezes invisibilizadas na sociedade e pouco consideradas nas abordagens nutricionais, como: o incômodo corporal feminino diante de uma cultura estética moralizadora que transforma o emagrecimento em sofrimento; o patrulhamento do corpo feminino, chancelado pelo discurso midiático e científico e, muitas vezes, pelos profissionais de saúde; os desafios que as mulheres enfrentam em suas mudanças alimentares assim como o reflexo destas mudanças em suas vidas. Neste processo, as interlocutoras despertaram a atenção para seu corpo e para a comida, construindo o que denominei de redescoberta alimentar. Além disso, surgiram como resultados uma bricolagem de saberes e sabores que evidenciou a capacidade de agência dessas mulheres e a possibilidade da construção de um cuidado que está para além de dietas e cirurgias, ainda que o emagrecimento seja um sofrimento crônico em suas vidas. (AU)


Brazil's position as one of the largest consumers of plastic surgery in the world signals the importance of body image in national culture. The discourse of a fit and healthy body, often associated with celebrity images, points to the idea of a despotic standard of beauty, particularly for women, which emphasizes thinness and youth. The proliferation of aesthetic procedures affects various social strata in different ways and has repercussions in other areas such as the field of nutrition. In the fine line between health and beauty, few studies have investigated nutritional and dietary issues in the field of plastic surgery in Brazil, especially from a socio-anthropological perspective capable of grasping the subjectivities involved in the process. In light of this context, this thesis aimed to understand the experiences of weight loss attempts by women seeking cosmetic surgery referred to the Nutrition Service of Ward 38 of the Santa Casa de Misericordia do Rio de Janeiro (SCM-RJ). For this investigation, 16 semi-structured interviews were conducted, with women who had attended the service at some point between 2017 and 2022. Additionally, although the focus of the research is qualitative, a socio-demographic overview of the 2,448 patients attended to between 2003 and 2020 was outlined, to contextualize the investigated field. Through the content analysis of their narratives, I aimed to capture values, ideas and beliefs involved in these women's relationship with their bodies and food, in contrast to the need for habit changes imposed by the challenge of weight loss. This brought up issues often invisible in society and little considered in nutritional approaches, such as female body discomfort in the face of a moralizing aesthetic culture that turns weight loss into suffering; the patrolling of the female body, endorsed by media and scientific discourse and often by healthcare professionals; the challenges women face in their dietary changes, as well as the reflection of these changes in their lives. In this process, they gave attention to their bodies and food, creating what I termed "nutritional rediscovery". Additionally, a bricolage of knowledge and flavors emerged as a result that highlighted the agency of these women, and the possibility of constructing care beyond diets and surgeries even though weight loss remains a chronic struggle in their lives. (AU)


La posición de Brasil como uno de los mayores consumidores de cirugía plástica del mundo señala la importancia de la imagen corporal en la cultura nacional. El discurso de un cuerpo en forma y saludable, a menudo asociado a la imagen de las celebridades, remite a la idea de un canon despótico de belleza, especialmente de la belleza femenina, que privilegia la delgadez y la juventud. La proliferación de procedimientos estéticos afecta de formas muy distintas a todos los estratos sociales y repercute en otros ámbitos, como en el campo de la alimentación. En la tenue distinción entre salud y belleza, son pocos los trabajos que han investigado cuestiones nutricionales y prácticas dietéticas en el área de la cirugía plástica en el país, principalmente bajo una perspectiva socioantropológica, capaz de aprehender las subjetividades involucradas en el proceso. Frente a ese contexto, esta tesis tuvo como objetivo comprender la experiencia de intentos de pérdida de peso de mujeres que buscan intervención quirúrgica estética en la Santa Casa de Misericórdia do Rio de Janeiro (SCM-RJ) y fueron remitidas al Serviço de Nutrição de la enfermería 38 de esa institución. En la investigación, fueron realizadas 16 entrevistas semiestructuradas a mujeres que pasaron por el servicio en algún momento entre 2017 y 2022. Aunque el enfoque de la investigación sea cualitativo, se esbozó un panorama sociodemográfico de las 2.448 pacientes atendidas entre 2003 y 2020 para contextualizar el campo investigado. A través del análisis de contenido de sus narrativas, busqué capturar valores, ideas y creencias involucrados en la relación de estas mujeres con el cuerpo y la comida frente a la necesidad de cambiar hábitos impuesta por el desafío de la pérdida de peso. Esto dio lugar a cuestiones muchas veces invisibilizadas en la sociedad y poco consideradas en los abordajes nutricionales, como: el malestar corporal femenino ante una cultura estética moralizante que transforma la pérdida de peso en sufrimiento; el patrullaje del cuerpo femenino, avalado por los discursos mediático y el científico y, muchas veces, también por los profesionales de la salud; los desafíos que enfrentan las mujeres en sus cambios dietéticos, así como el reflejo de esos cambios en sus vidas. En ese proceso, las interlocutoras despertaron la atención hacia sus cuerpos y hacia la comida, construyendo lo que llamé redescubrimiento alimentario. Además, surgió como resultado un bricolaje de saberes y sabores, que muestra la capacidad de agencia de esas mujeres y la posibilidad de construir un cuidado que va más allá de dietas y cirugías, aunque la pérdida de peso sea un sufrimiento crónico en sus vidas. (AU)


Subject(s)
Humans , Body Image , Food and Nutrition Education , Weight Loss , Nutritional Sciences , Nursing Care , Quality of Life , Surgery, Plastic , Brazil
19.
Psicol. ciênc. prof ; 43: e261792, 2023. tab
Article in Portuguese | LILACS, INDEXPSI | ID: biblio-1529200

ABSTRACT

O objetivo deste estudo foi compreender como mulheres adultas (acima de 30 anos) diagnosticadas com transtornos alimentares (TAs) vivenciam o adoecer. Trata-se de um estudo qualitativo, descritivo e exploratório, desenvolvido com base no referencial teórico-metodológico da Análise Fenomenológica Interpretativa (AFI). Participaram seis mulheres, com idades entre 34 e 65 anos, atendidas em um serviço especializado. Os dados foram coletados por meio de entrevista aberta, de inspiração fenomenológica, na modalidade remota. As entrevistas foram audiogravadas, transcritas e analisadas seguindo os passos da AFI. Duas categorias temáticas foram identificadas: "Vivendo antes do adoecer" e "Encontrando-se doente." Constatou-se que os sintomas tiveram início anteriormente à vida adulta e que houve dificuldade na confirmação do diagnóstico. Na perspectiva das participantes, conviver com a sintomatologia ficou mais complicado em função de particularidades de manejo dos sintomas na vida adulta, e a idade é percebida como um fator que impacta e dificulta ainda mais a recuperação. As participantes relataram desesperança em relação ao futuro, apesar de a maioria reconhecer melhoras no quadro clínico ao longo do tempo e de valorizar a relação de confiança estabelecida com a equipe multiprofissional.(AU)


This study aimed to understand the experience of illness of adult women (over 30 years) diagnosed with eating disorders (ED). This is a qualitative, descriptive, and exploratory study, using Interpretative Phenomenological Analysis (IPA) as theoretical and methodological framework. A sample of six women aged 34-64 years, assisted in a specialized service, were recruited to complete a phenomenological in-depth open interview. The data were remotely collected. Interviews were audio-recorded, transcribed and analyzed following the IPA. Two thematic categories were identified: "Living before the illness" and "Finding about the illness." It was found that the symptoms started before adulthood and that there was difficulty establishing the diagnosis. Living with the symptoms became more complicated due to particularities of symptom management in adulthood and age is perceived as a factor that impacts recovery and makes it even more difficult. The participants reported hopelessness about the future, although most recognized improvements in the clinical condition over time and valued the trusting relationship they established with the multiprofessional team.(AU)


El objetivo de este estudio fue comprender las experiencias de las mujeres adultas (mayores de 30 años) diagnosticadas con trastornos alimentarios (TA) respecto a la enfermedad. Se trata de un estudio cualitativo, descriptivo y exploratorio, desarrollado a partir del marco teórico y metodológico del Análisis Fenomenológico Interpretativo (AFI). Participaron seis mujeres, con edades de entre 34 y 65 años, atendidas en un servicio especializado. Los datos se recogieron mediante entrevistas abiertas, de inspiración fenomenológica, en la modalidad a distancia. Las entrevistas fueron grabadas en audio, transcritas y analizadas siguiendo los pasos del AFI. Se identificaron dos categorías temáticas: "Vivir antes de enfermar" y "Encontrarse enfermo." Se constató que los síntomas comenzaron antes de la edad adulta y que hubo dificultades de establecer el diagnóstico. La convivencia con síntomas se complicó debido a las particularidades del manejo de los síntomas en la vida adulta y la edad se percibe como un factor que influye y dificulta aún más la recuperación. Los participantes manifestaron desesperanza sobre el futuro, aunque reconocieron mejoras en el cuadro clínico con el paso del tiempo y valoraron la relación de confianza establecida con el equipo multiprofesional.(AU)


Subject(s)
Humans , Female , Adult , Middle Aged , Aged , Anorexia Nervosa , Feeding and Eating Disorders , Bulimia Nervosa , Pandemics , Anxiety , Perceptual Distortion , Appetite , Personal Satisfaction , Psychiatry , Psychology , Psychopathology , Quality of Life , Self-Assessment , Shame , Stomach Diseases , Stress, Psychological , Therapeutics , Thinness , Beauty Culture , Vomiting , Nutrition Rehabilitation , Body Weight , Aging , Menopause , Weight Loss , Family , Comorbidity , Mental Health , Mortality , Interview , Cultural Factors , Dehydration , Transcription Factors, General , Malnutrition , Depressive Disorder , Diagnosis , Diet , Diet Therapy , Emotions , Nutritional Sciences , Laxatives , Feeding Behavior , Binge-Eating Disorder , Bullying , Social Stigma , Physical Appearance, Body , Self-Control , Applied Behavior Analysis , Food Addiction , Rumination, Digestive , Mental Health Recovery , Body-Weight Trajectory , Embarrassment , Avoidant Restrictive Food Intake Disorder , Body-Shaming , Social Representation , Orthorexia Nervosa , Social Status , Guilt , Health Promotion , Mass Media , Mental Disorders , Metabolism , Obesity
20.
Demetra (Rio J.) ; 18: 65401, 2023. ^etab ilus
Article in English, Portuguese | LILACS | ID: biblio-1518642

ABSTRACT

Abordagens comportamentais têm contribuído para a efetividade do tratamento da obesidade. A avaliação do equilíbrio de decisões (ED) para redução de peso, isto é, o equilíbrio entre prós e contras da mudança de comportamento, é estratégica no tratamento, contribuindo para a pactuação de estratégias para o enfrentamento dos desafios. É necessário, porém, utilizar instrumentos válidos para mensurar o ED. Objetivo: Avaliar a qualidade de instrumentos de avaliação do ED para redução do peso corporal visando qualificar o cuidado da pessoa com obesidade no Sistema Único de Saúde (SUS). Métodos: Realizou-se revisão sistemática da literatura sobre o desenvolvimento e a validação de instrumentos em sete bases de dados seguindo a metodologia Cosmin. Variações dos termos psicometria, obesidade e ED foram combinadas com operadores booleanos. Em duplicada e independentemente, duas pesquisadoras realizaram: extração de dados, avaliação da qualidade e síntese de evidências, sendo as divergências solucionadas por consenso. Esta revisão foi registrada na base internacional Prospero (CRD42020197797). Resultados: Identificaram-se cinco estudos, sendo que três realizaram a tradução e adaptação transcultural do mesmo instrumento. Todos os estudos apresentaram ED em duas dimensões (prós e contras), mas usaram métodos duvidosos ou inadequados, e a maioria apresentou evidências científicas de muito baixa qualidade. Conclusões: Os resultados não sustentaram o uso dos instrumentos existentes nem sua tradução e adaptação transcultural, sendo necessário o desenvolvimento de um novo instrumento. Este estudo, ao disponibilizar um instrumento válido para uso no SUS, poderá contribuir para qualificar o cuidado da pessoa com obesidade e deter o crescimento da obesidade no país.


Introduction: Behavioral strategies have been adding to the effectiveness of obesity treatment. And the assessment of the decisional balance (DB) for weight reduction, that is, the balance between expected losses and gains around the behavioral changes, is strategic for managing obesity. The DB assessment may contribute to the agreement on strategies to face the challenges of the treatment. But, there is a need to use a valid instrument to assess the DB. Objective: evaluate the quality of instruments assessing DB for weight reduction to qualify obesity management in the Sistema Único de Saúde ­ SUS (Unified Health System). Methods: A systematic review of studies about instrument development and/or validation was carried out on seven databases using the Cosmin methodology. Terms related to psychometrics, obesity, and DB were combined with Boolean operators to guide the search. Two researchers performed independently and in duplicate: data extraction, quality assessment, and evidence synthesis, and divergences were resolved by consensus. This review was registered in the international database Prospero (CRD42020197797). Results: Five studies were identified. Three of them reported translations and cross-cultural validity of the same instrument. All analyses presented DB in two dimensions (pros and cons, but used doubtful or inadequate methods. Most of the evidence was very low rate. Conclusions: The results did not support the instrument's use, translations, or cross-cultural adaptation. It is necessary to develop a new tool. By providing a valid instrument for use in SUS, this study could contribute to qualifying the care of people with obesity and stopping the growth of obesity in the country.


Subject(s)
Humans , Unified Health System , Weight Loss , Decision Making , Evaluation of Research Programs and Tools , Overweight/therapy , Obesity/therapy , Brazil , Evaluation Studies as Topic , Transtheoretical Model
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