Cambios en el gasto energético de reposo después de la reducción ponderal en mujeres obesas / Changes in the energy expediture at rest after of the ponderal reduction in obese women

Para analizar el efecto de una dieta hipocalórica moderada sobre el peso corporal, masa grasa (por ciento MG), masa libre de grasa (MLG) y el gasto energético de reposo (GER), se estudio a mujeres con sobrepeso u obesidad con índice de masa corporal (IMC)>27,5 kg/m2. Material y métodos: en 34 pacientes (18-45 años), el GER fue medido por calorimetría indirecta (Deltatrac), el porciento MG y MLG por bioimpedanciometría, y la ingesta energética (IE) por registros de 3 días alternos. En 11 de ellas se controló la IE por recordatorio de 24 hs. al 10º día de la indicación de dieta hipocalórica, y se reevaluó el gasto energético de reposo y composición corporal a las 8 semanas. Resultados: x +- ds. Al ingreso (n=34), el IMC fue de 32,2 +- 2,6, el porciento MG de 36,8 +- 4,4. La IE reportada fue de 2.18

Cambios en el gasto energético de reposo después de la reducción ponderal en mujeres obesas / Changes in the energy expediture at rest after of the ponderal reduction in obese women

Para analizar el efecto de una dieta hipocalórica moderada sobre el peso corporal, masa grasa (por ciento MG), masa libre de grasa (MLG) y el gasto energético de reposo (GER), se estudio a mujeres con sobrepeso u obesidad con índice de masa corporal (IMC)>27,5 kg/m2. Material y métodos: en 34 pacientes (18-45 años), el GER fue medido por calorimetría indirecta (Deltatrac), el porciento MG y MLG por bioimpedanciometría, y la ingesta energética (IE) por registros de 3 días alternos. En 11 de ellas se controló la IE por recordatorio de 24 hs. al 10º día de la indicación de dieta hipocalórica, y se reevaluó el gasto energético de reposo y composición corporal a las 8 semanas. Resultados: x +- ds. Al ingreso (n=34), el IMC fue de 32,2 +- 2,6, el porciento MG de 36,8 +- 4,4. La IE reportada fue de 2.184 +- 590 kcal/día (1.185 - 4.339), o de 27,5 +- 6,9 kcal/kg/día (14,45). El GER fue de 18,0 +- 1,3 kcal/kg/día y el balance energético inicial (BE), fue de + 460 +- 586 (-804 a + 2.251)...

Gasto energético de reposo y cuociente respiratorio en mujeres obesas y no obesas / Energy expenditure of rest and rate respiratory in obese and lean women

Un gasto energético de reposo (GER) reducido y un cuociente respiratorio elevado, se han considerado como factores de riesgo de ganancia de peso a largo plazo. Con el objetivo de investigar la frecuencia de estos factores de riesgo, se estudió a 537 mujeres de entre 15 y 45 años antes de iniciar un plan de restricción alimentaria; 452 de ellas con obesidad (OB: IMC > 25) y 85 no obesas (no OB: IMC < 25). El GER y el cuociente respiratorio de ayunas (CRA) fueron medidos por calorimetría indirecta. En 106 mujeres (87 OB y 19 no OB) se midio el porcentaje de masa grasa por impedanciometría bioeléctrica (porcentaje MG). Resultados: se encontró una correlación negativa entre el IMC y CRA (r= -0,113; p < 0,01), y ninguna correlación entre el porciento MG y CRA. Al comparar 4 subgrupos según grado de obesidad (NO OB, OB grado I, II y III), a mayor grado de obesidad mayor es el GER como porcentaje del estimado por Harris y Benedict (GER/GEE por ciento = 90,9, 94,2, 95,8, y 98,5 por ciento... (AU)

Gasto energético de reposo y cuociente respiratorio en mujeres obesas y no obesas / Energy expenditure of rest and rate respiratory in obese and lean women

Un gasto energético de reposo (GER) reducido y un cuociente respiratorio elevado, se han considerado como factores de riesgo de ganancia de peso a largo plazo. Con el objetivo de investigar la frecuencia de estos factores de riesgo, se estudió a 537 mujeres de entre 15 y 45 años antes de iniciar un plan de restricción alimentaria; 452 de ellas con obesidad (OB: IMC > 25) y 85 no obesas (no OB: IMC < 25). El GER y el cuociente respiratorio de ayunas (CRA) fueron medidos por calorimetría indirecta. En 106 mujeres (87 OB y 19 no OB) se midio el porcentaje de masa grasa por impedanciometría bioeléctrica (porcentaje MG). Resultados: se encontró una correlación negativa entre el IMC y CRA (r= -0,113; p < 0,01), y ninguna correlación entre el porciento MG y CRA. Al comparar 4 subgrupos según grado de obesidad (NO OB, OB grado I, II y III), a mayor grado de obesidad mayor es el GER como porcentaje del estimado por Harris y Benedict (GER/GEE por ciento = 90,9, 94,2, 95,8, y 98,5 por ciento...

Inhibition of small intestinal motility by casein: a role of beta casomorphins?

Several aspects on the effect of nutrients on small intestinal motility are not completely understood. We have analyzed changes of motor activity of the canine small bowel following intragastric administration of casein and soy protein. Studies were performed by intraluminal manometry with external transducers and multiple infused catheters with closely spaced registrating sites. Casein was followed by a statistically significant decrease of amplitude and frequency of small intestinal contractions, compared to soy protein. Pretreatment with naloxone suppressed the inhibitory effect of casein, suggesting that stimulation of opioid receptors by beta casomorphins, a product of digestion of casein, might be involved in the motility changes observed.

[Anorexigenic drugs in the treatment of obesity]. / Drogas anorexígenas en el tratamiento de la obesidad.

Obesity is highly prevalent and has several adverse effects on health. Its treatment is thus warranted and must aim to modify dietary and physical activity habits. The opinion of this association is that anorexigenic drugs with cathecolaminergic action (diethylpropion, phentermine, mazindol and phenylpropanolamine) or serotoninergic action (fenfluoramine and fluoxetine) may be used in moderate or severe obesity (BMI > 30 kg/m2) after a complete clinical assessment and in the context of an integral medical treatment. This association recommends a close surveillance of the use of these drugs, specially when formulated as non-proprietary prescriptions.

Gasto energético basal y cuociente respiratorio medido por calorimetría indirecta en mujeres obesas y no obesas / Basal energy expenditure and respiratory quotient measured by indirect calorimetry in obese and non-obese women

Diversos estudios han demostrado que un gasto energético reducido y un cuociente respiratorio elevado favorecen la ganancia de peso, después de un período de dieta y reducción ponderal. El presente estudio se efectuó con el objetivo de evaluar el Gasto Energético Basal (GEB) y el Cuociente Respiratorio (CR), en mujeres con dieta ad-libitum, y su relación con el indice de masa corporal (IMC) y el porcentaje de masa grasa (por ciento MG) como factores de riesgo de obesidad. En 39 mujeres, 32 obesas (X IMC=31.5 . 3.8) y 7 no obesas (IMC=20.7 . 2.5), hubo una correlación positivo significativa entre el IMC y CR (r=0.49; p<0.001) y entre el por ciento MG y CR (r=0.53; p<0.007). No hubo correlación entre el GEB, expresado con masa libre de grasa y por Harris y Benedict, y el IMC y por ciento MG. Estos resultados sugieren que una mayor oxidación de lípidos endógenos en ayuno, podría favorecer el desarrollo de la obesidad.

Gasto energético basal y cuociente respiratorio medido por calorimetría indirecta en mujeres obesas y no obesas / Basal energy expenditure and respiratory quotient measured by indirect calorimetry in obese and non-obese women

Diversos estudios han demostrado que un gasto energético reducido y un cuociente respiratorio elevado favorecen la ganancia de peso, después de un período de dieta y reducción ponderal. El presente estudio se efectuó con el objetivo de evaluar el Gasto Energético Basal (GEB) y el Cuociente Respiratorio (CR), en mujeres con dieta ad-libitum, y su relación con el indice de masa corporal (IMC) y el porcentaje de masa grasa (por ciento MG) como factores de riesgo de obesidad. En 39 mujeres, 32 obesas (X IMC=31.5 . 3.8) y 7 no obesas (IMC=20.7 . 2.5), hubo una correlación positivo significativa entre el IMC y CR (r=0.49; p<0.001) y entre el por ciento MG y CR (r=0.53; p<0.007). No hubo correlación entre el GEB, expresado con masa libre de grasa y por Harris y Benedict, y el IMC y por ciento MG. Estos resultados sugieren que una mayor oxidación de lípidos endógenos en ayuno, podría favorecer el desarrollo de la obesidad. (AU)

[Total parenteral nutrition in severe hyperemesis gravidarum]. / Nutrición parenteral total en hiperemesis gravídica grave.

Eight patients with severe HG, were treated through parenteral nutrition. This treatment was formulated as aminoacid, sucrose solution and fat solution (3 of 8 cases), blended with vitamins electrolites and oligoelements. The procedure lasted 5 at 16 days conforming a total of 77 days. Seven newborns were term delivery, and one case was missed abortion. Like this, there were no complications detected and clinical wellbeing was reached, successfully.

[Indirect calorimetry and nitrogen balance in patients with elective craniotomy]. / Calorimetría indirecta y balance nitrogenado en pacientes con craneotomía electiva.

The aim of this study was to assess resting energy expenditure and nitrogen excretion in patients with cranial injury. In 25 patients subjected to elective craniotomy and 23 healthy volunteers, energy expenditure was measured using indirect calorimetry and compared with estimations according to Harris-Benedict equations. During the second postoperative day, measured energy expenditure in patients was 100 +/- 19% (range 66-185) of estimation and 115 +/- 22% (range 76-159%) of measured values in control subjects. In sedated patients with flaccid muscular paralysis, measured energy expenditure was 82 +/- 12% of estimation and 94 +/- 15% of measured values in control subjects. Urinary urea nitrogen excretion in patients was 10.2 +/- 5.4 g/day and catabolic index was 6.8 +/- 5.1. Patients receiving corticoids had increased urinary urea nitrogen excretion and no differences in measured energy expenditure, compared to patients not receiving this medication. It is concluded that the great variability in measured energy expenditure and its lack of correlation with the degree of catabolism, set forth the need to perform an indirect calorimetry in these patients to plan an adequate nutritional support.

[Protein and energy requirements in patients with severe head injury]. / Requerimientos caloricos y proteicos en pacientes con traumatismoencefalocraneano severo.

The aim of the present study was to assess the effect of severe head injury over resting energy expenditure and nitrogen losses. Eight patients with severe head trauma (mean Glasgow scale of 4.9 +/- 1.6), subjected to emergency craniotomy were studied; four patients had septic complications and none received steroids. Energy expenditure was measured using indirect calorimetry and nitrogen losses were assessed measuring 24 h urea nitrogen excretion on days 1, 4, 7 and 10 of the postoperative period. Twelve healthy males composed the control group. Measured energy expenditure in patients, evaluated in 22 occasions, was 35 +/- 9.8 Kcal/kg/day or 145 +/- 41% of the estimation according to Harris-Benedict equations, compared to 22.0 +/- 4.6 Kcal/kg/day or 89.9 +/- 17.5% in the control group (p < 0.001). 24 h urinary urea nitrogen excretion in patients was 18 +/- 12 g/day (range 5.2-46.9) and the catabolic index was 7.4 +/- 13.5. It is concluded that, due to the great individual variability in measured energy expenditure in these patients and their hypercatabolism, indirect calorimetry and nitrogen balance studies become useful tools to perform an adequate nutritional support.

Dorsomedial thalamotomy as a treatment for terminal anorexia: a report of two cases.

Anorexia nervosa has been considered a compulsive obsessive disorder (OCDS). We present a case report of two patients, male and female, suffering from an extremely severe, chronic and refractory anorectic syndrome. Both patients underwent bilateral stereotactic thalamotomy with involvement of the lamella medialis. Follow-up was 4 year and 2 year, respectively. Both patients have regained weight and improved significantly in terms of their obsessive-compulsive symptoms and in their quality of life. The results suggest that anorexia nervosa may be considered in the OCDS.

Parenteral nutrition in hyperemesis gravidarum.

Hyperemesis gravidarum (HG) is a clinical condition that threatens fetal viability and even the mother's life when the severity of symptoms almost completely prevents the intake of food. Parenteral nutrition (PN) is a possible alternative. We present eight patients with HG. There were 10 PN treatments because two of the patients required the treatment twice. There were 9 central venous and 1 peripheral treatment delivery. The average age of the patients was 27.5 yr. Gestational ages varied from 8 to 19 wk. PN treatments were formulated as amino acid and glucose solutions (fat emulsions in 2 of the 8 cases) blended with vitamins and electrolytes. These treatments lasted 5-16 days. Before PN deliveries were initiated, five of the patients presented some degree of protein-calorie and/or visceral protein malnutrition. All of them showed minor liver dysfunction, which did not change during PN. Newborns were term deliveries, except for one case of missed abortion. Results show that PN constitutes a therapeutic alternative in cases of HG that do not respond to the standard treatment of parenteral hydration and antiemetics. In fact, symptoms disappear promptly, and no significant complications arise.

[Effect of casein on the temporo-spatial organization++ of the contractile activity of the small intestine in the dog]. / Efecto de la caseína en la organización temporo-espacial de la actividad contráctil en el intestino delgado del perro.

Some observations in man and experimental animals have demonstrated that casein decreases intestinal transit speed. However, its effects on intestinal motility have not been studied previously in a systematic fashion. The aim of this work was to study the temporospatial distribution of small bowel motility before and after the administration of calcium caseinate. Studies were performed in fasting dogs using 6 catheters perfused with a pneumo-hydraulic system. After the administration of 300 ml of a 10% solution of calcium caseinate, a global decrease in motor activity was observed, specially of grouped propulsive contractions, they were reduced in 64.9 to 19.5%. On the contrary, a significative increase, in 1.4 to 22%, of individual wave, non propulsive motor activity was observed. These quantitative changes in contractions, specially in their organization and temporo-spatial distribution, may be responsible for the decrease in intestinal transit after the administration of casein.

[Treatment of acute secretory diarrhea with casein: an effect of beta-casomorphins?]. / Tratamiento con caseína en diarrea secretora aguda: una acción de las beta-casomorfinas?

A patient with acute secretory diarrhea refractory to conventional therapy received calcium caseinate as sole nutrient, based on the recognized development of constipation and fecaloma in patients receiving this agent. Complete remission of diarrhea followed within 10 days. An inhibition of intestinal motility mediated by B-casomorphins released after hydrolysis of casein in the intestinal tract may be the mechanism involved in this effect. These exorphins have varying effects upon the opioid receptors of the intestinal tract.

Variances and Covariances of Kendall's Tau and Their Estimation.

We generalize the formulas derived by Daniels and Kendall (1947) for the variance of the sample tau correlation. It is assumed that multivariate data are sampled from a population, and sample taus between pairs of variables are being used to estimate their population counterparts. Expressions for the variance of tau-a are generalized to allow for ties on either variable, and we further provide an expression for the covariance between two taus, including the special case where there is a variable in common. Unbiased estimators of the variance and the covariances are also derived for use in small samples. The variances and covariances of tau-a are used to provide asymptotic variances for tau-b and Somers' d.

Peer-group association and adolescent tobacco use.

Mosbach & Leventhal (1988) examined the relation of cigarette smoking to peer-group identification in rural Wisconsin adolescents. They found that among dirts (problem-prone youth), regulars (average youth), hot-shots (good social or academic performers), and jocks (athletes), youth most likely to smoke were dirts and hot-shots. We performed a replication with a Southern California cohort and also for use of smokeless tobacco. We hypothesized that jocks would be the main users of smokeless tobacco. We identified the same groups and an additional one, skaters (skateboarders or surfers). As Mosbach & Leventhal found, cigarettes were used most by dirts. Contrary to their results, but consistent with other research, we found that hot-shots were least likely to smoke. Contrary to our prediction, we found that skaters and dirts were more likely to use smokeless tobacco than were jocks. Our data show that both tobacco forms are used by problem-prone youth.

Physical features, physical attractiveness, and psychological adjustment among alcohol abuse inpatients.

Relations between specific physical features, attractiveness, and psychological adjustment of alcoholic inpatients were examined. Measures were obtained during the first week of admission and 6 weeks later (within 2 weeks of discharge). The nine physical features assessed formed three factors: face, facial expression, and body. The face factor was more strongly related to history of substance abuse than was either of the other factors. Further, the results suggested that alcoholism-related face features may be responsible for the documented relation between ratings of overall physical attractiveness and ratings of adjustment obtained at admission to a chemical dependency program; however, positive changes in body features less specifically related to a history of substance abuse (posture and grooming) are associated with counselors' ratings of improved patient adjustment over time.

Adolescents' first and most recent use situations of smokeless tobacco and cigarettes: similarities and differences.

This study compared first and most recent use situations of adolescent smokeless tobacco experimenters with those of adolescent cigarette experimenters. Structured, open-ended interviews were conducted with 320 seventh and tenth grade youths in 16 Southern California schools. Students were categorized as nonusers (those who had never experimented with any tobacco product), minimal experimenters (those who had experimented with smokeless tobacco or cigarettes between 1 and 9 times), and persistent experimenters (those who had experimented with smokeless tobacco or cigarettes 10 or more times). The situations reported by smokeless tobacco were similar to those reported by cigarette experimenters. The most important differences between the two groups are highlighted. In particular, smokeless tobacco users seemed less concerned about negative social consequences of use than cigarette smokers. In addition, nonusers' observations of use and implications for prevention and cessation are discussed.

The power of policy: the relationship of smoking policy to adolescent smoking.

This study examined the effects of smoking policy on 4,807 adolescents in 23 schools over a two-county area in California. Amounts and prevalence rates of adolescent smoking were measured with a self-report survey and a biochemical measure; school smoking policy was measured with two independent surveys of school staff. Policy effects were evaluated with multiple and logistic regression analyses controlling for school-level socioeconomic status and environmental support for teaching and administration. Of the 23 schools, 100 percent had a formal written and regularly enforced policy component restricting student smoking on school grounds, 94 percent restricted students leaving school grounds, 65 percent restricted smoking near school grounds, and 57 percent had a smoking prevention education plan. Schools with policies having all four versus less than four components, high versus low emphasis on prevention, and a low versus high emphasis on cessation reported lower amounts of smoking in the last week and in the last 24 hours. Punitive consequences of policy violation had no effect. Results were compared to school staff observations of adolescent smoking, and school archival records of student smoking violations in the last year. Results suggest that school smoking policy is associated with decreased amounts of smoking in adolescents.