The number of antiseizure medications taken and not the lipid profile was associated with seizure control in adult patients with epilepsy.

Previous studies show changes in lipid metabolism in epilepsy. The aim of this study was to investigate the association between lipid profile and clinical variables in adult patients with epilepsy (APE). Seventy-two APE participated in this pilot study at an outpatient neurology service. The lipid profile (total cholesterol, low-density lipoprotein (LDL) cholesterol, very-low-density lipoproteins (VLDL) cholesterol, high-density lipoprotein (HDL) cholesterol and triglycerides), age at disease onset, disease duration, seizures frequency, and the number of antiseizure medications (ASM) used were investigated. Data were analyzed using the Chi-square, Fisher, Mann-Whitney, Spearman coefficient, and logistic regression tests. There were significant differences in HDL (p = 0.0023) and total cholesterol (p = 0.0452) levels in connection with the number of ASM used. There was a significant difference in seizure control among the different numbers of ASM used (p = 0.0382). Higher HDL values were found in females (p = 0.0170). The logistic regression showed that only the number of ASM used was associated with seizure control (p = 0.0408; OR = 2.800; 95% CI = 1.044; 7.509). The number of ASM taken and not the lipid profile was associated with seizure control in APE.

Lack of validity of free-living physical activity energy expenditure estimated from ActiGraph equations in severely obese women: A doubly labelled water study.

The current study aimed to investigate the validity of three ActiGraph predictive equations that are available to estimate free-living physical activity energy expenditure (PAEE) in women with severe obesity. The study included 20 women with class III obesity (age: 22-38 years). During 14 days of free-living conditions, total energy expenditure was measured using the doubly labelled water method; in addition, participants wore a triaxial accelerometer (model GT3X+) on the hip. The resting metabolic rate was measured by indirect calorimetry. At group level, the Freedson VM3 Combination was found to be more precise (bias = -61 kcal/day) than the Williams Work-Energy (bias = -283 kcal/day) and the Freedson Combination equations (bias = -186 kcal/day) for estimating PAEE. However, the three predictive equations had a wider limit of agreement (Williams Work-Energy [258, -824 kcal/day], Freedson Combination equations [324, -697 kcal/day] and Freedson VM3 Combination [424, -546 kcal/day]), indicating great uncertainty of the estimate. In conclusion, a wide variation was observed in the performance of different ActiGraph equations in estimating free-living PAEE among women with class III obesity. Therefore, our data do not support the use of these equations, and more studies are needed to improve predictive performance in free-living conditions.

Correction to: Agreement Between Body Composition Assessed by Bioelectrical Impedance Analysis and Doubly Labeled Water in Obese Women Submitted to Bariatric Surgery : Body Composition, BIA, and DLW.

The name of author Michele Novaes Ravelli was misspelled in the original article - it is correct here.

Accuracy of total energy expenditure predictive equations after a massive weight loss induced by bariatric surgery.

BACKGROUND AND AIMS: Predictive equations remain the clinical tool of choice to estimate the energy expenditure, however, poor accuracy has been found when applied in patients with severe obesity. The aim of this study was to test the accuracy of the total energy expenditure (TEE) those obtained by predictive equations of resting energy expenditure (REE) times individual estimates of metabolic equivalents (MET), taking as reference the TEE measured by doubly labeled water (DLW), before, six and twelve months after bariatric surgery. SUBJECTS AND METHODS: Twenty class III obese women (age: 29.4 ± 5.1 years; BMI: 44.9 ± 2.5 kg/m2), approved for Roux-en-Y gastric bypass participated in this study. TEE and body composition was measured after administration of a fixed dose of DLW. Predictive equations of REE were selected: Dietary Reference Intake (DRI), World Health Organization, Oxford, Harris-Benedict, Mifflin, De Lorenzo, Lazzer and Muller and their collaborators. The MET values were obtained individually by triaxial accelerometer. RESULTS: The patients showed 65% of excess weight loss. The body fat mass decreased 17% after 1 year of surgery. TEE (2930 ± 525 kcal.day-1) decreased by 20% (p < 0.05) by the sixth postoperative month (2319 ± 430 kcal.day-1), increasing 10% by the twelfth month (2538 ± 336 kcal.day-1). The Harris and Benedict (accuracy: 65%) and DRI equations (accuracy: 60%) yielded better results in the prediction of TEE values at pre-surgery. In the sixth month after surgery, only the equation of Harris and Benedict kept accuracy above 50%. At twelve months post-surgery, only the equation of Lazzer et al. considering body composition showed better prediction (accuracy: 50%) in this period. CONCLUSION: None of the prediction equations tested was accurate for estimating TEE for the 3 periods evaluated; however, while there are no reports of specific equations for class III obese women, the Harris and Benedict x MET and DRI equations, can describe the TEE with acceptable accuracy. After surgery, the best equation to be used will depend if the patient has been treated for weight loss and in which post-treatment period it is used. Registration of clinical trial as an observational study in Brazilian Clinical Trials Registry: RBR-8k5jsj. Universal Trial Number: U1111-1206-0858.

The under-reporting of energy intake influences the dietary pattern reported by obese women in the waiting list for bariatric surgery / A subnotificação do consumo energético influencia os resultados de padrão alimentar relatado por mulheres obesas na fila de espera para cirurgia bariátrica

ABSTRACT Objective To verify the interference of the energy intake under-reporting in the determination of the dietary patterns and nutrient intakes reported by obese women in the waiting list for bariatric surgery. Methods The study included 412 women aged 20 to 45 years with a body mass index ranging from 35 to 60kg/m2 who were on waiting list for bariatric surgery. Data from three reported food intake and physical activity, body weight, and height were used for estimating the reported energy intake, physical activity level, and resting energy expenditure. Subsequently, it was checked the biological plausibility of the reported energy intakes, classifying all participants as plausible reporters or under-reporters. Exploratory factor analysis was used to determine the participants' dietary patterns. The Mann-Whitney test assessed the reported energy and nutrient intakes between plausible reporters and under-reporters groups. The Z-test assessed the variables of plausible reporters or under-reporters in relation to all participants of the study. Results Six dietary patterns were determined for all participants of study. After excluding information from under-reporting women, only two dietary patterns remained similar to those of all participants, while three other dietary patterns presented different conformations from food subgroups to plausible reporters. The reported energy intake did not present difference for the subgroups of fruits, leaf vegetables and vegetables. However, the energetic value reported for the other food subgroups was higher for the plausible reporters. Conclusion The under-reporting of energy intake influenced the determination of dietary patterns of obese women waiting for bariatric surgery.

RESUMO Objetivo Esta pesquisa buscou verificar a interferência da subnotificação do consumo energético na determinação do padrão alimentar e consumo de nutrientes, relatados por mulheres obesas na fila de espera para cirurgia bariátrica. Métodos Participaram do estudo 412 mulheres com idade entre 20 e 45 anos e índice de massa corporal entre 35 e 60 kg/m2, que aguardavam na fila de espera de cirurgia bariátrica. Foram utilizadas informações de três registros do consumo alimentar, da atividade física de 24 horas e do peso corporal e altura, para estimativa da Ingestão Energética Relatada, Nível de Atividade Física e Gasto Energético de Repouso das participantes e subsequente verificação da plausibilidade biológica do consumo energético. As mulheres foram agrupadas em notificadoras plausíveis e subnotificadoras. A análise fatorial exploratória foi utilizada para classificar os padrões alimentares. Os valores relatados de energia e nutrientes entre os grupos de notificadoras plausíveis e subnotificadoras foram avaliados por meio do teste de Mann-Whitney. O Teste de hipótese Z avaliou as variáveis das notificadoras plausíveis ou subnotificadoras em relação a todas as participantes do estudo. Resultados Seis padrões alimentares foram determinados para todas as participantes do estudo. Após excluir as informações das mulheres subnotificadoras, apenas dois padrões alimentares mantiveram-se similares aos de todas as participantes, ao passo que outros três padrões alimentares apresentaram diferentes conformações de subgrupos alimentares para as notificadoras plausíveis. A ingestão energética relatada não apresentou diferença para os subgrupos das frutas, hortaliças e legumes. Porém, o valor energético relatado para os demais subgrupos alimentares foi maior para as notificadoras plausíveis. Conclusão A subnotificação do consumo energético influenciou a determinação de padrões alimentares de mulheres obesas na lista de espera para cirurgia bariátrica.

Changes in Physical Activities and Body Composition after Roux-Y Gastric Bypass Surgery.

PURPOSE: Given the importance of physical activities for health outcomes, it is still unclear whether bariatric surgery per se and the standard care after surgery would result in an increase of physical activity level. This study aimed to determine physical activities preoperatively and at 6 and 12 months postoperatively among female patients who underwent bariatric surgery, and to investigate its relationship with body composition changes. MATERIAL AND METHODS: Thirty-four women who had Roux-Y gastric bypass (RYGB) surgery completed the study. Physical activity was measured objectively for 7 consecutive days by using an ActiGraph GT3X+ accelerometer. Body composition was estimated by using multifrequency bioimpedance analysis. RESULTS: The percentage of time spent in moderate-to-vigorous physical activity (MVPA) changed significantly from preoperatively to 6 months postoperatively; however, no difference was observed at 12 months. No significant changes were detected for other physical activity variables. Multivariable regression analysis suggested that the percentage of time spent in sedentary activity was associated with fat-free mass loss at 6 months (ß = - 0.323; 95% CI = - 0.649 to 0.003) and 12 months (ß = - 0.510; 95% CI = - 0.867 to - 0.154) postoperatively. CONCLUSION: The overall MVPA increased at 6 months post-RYGB surgery; however, this change was not maintained at 12 months. Despite the considerable body mass loss postoperatively, most of the subjects were classified as being physically inactive and did not change their sedentary behavior. These findings indicate that female patients undergoing bariatric surgery should be encouraged to increase their physical activity level.

O estado nutricional na prevenção de úlcera de decúbito em pessoas acamadas / The nutritional prevention of decubitus ulcer in bedridden patients / La prevención nutricional de úlceras por decúbito en pacientes encamados

ntrodução: Um bom estado nutricional é essencial para a cicatrização rápida da úlcera de pressão. Objetivo: Avaliar os resultados de um programa que prevê suplementação protéica como prevenção da úlcera de decúbito (UD) em pacientes domiciliares. Método: Foram analisados 100% da população de pacientes (N=19) atendidos por uma equipe domiciliar, cujas comorbidades apresentadas acarretam maior dependência física (Mal de Parkinson, Acidente Vascular Cerebral (AVC), Demência senil, Mal de Alzheimer), e que não apresentavam UD. O período de avaliação foi de 30 dias a partir da entrada no programa, sendo realizadas Avaliação Nutricional Subjetiva Global, avaliação antropométrica e bioquímica. A análise estatística e a representação dos dados foram realizadas pelos programas Excel e Sigma stat, com as diferenças avaliadas pelo teste t- student pareado ou não, bem como ANOVA. Resultados: A classificação inicial dos pacientes de acordo com a ASG foi de 47,4% bem nutridos e 52,6% com desnutrição moderada. Quanto às medidas antropométricas, a ANOVA não mostrou diferença significativa entre as avaliações do início, após 15 e 30 dias. Em relação à albumina sérica, 63,1% dos pacientes apresentaram melhora ou mantiveram seus índices iniciais e 36,8% apresentaram diminuição em seus níveis iniciais, embora não tenha sido verificada diferença significativa (teste t), entre o início e o final do tratamento nos exames laboratoriais. Conclusão: o cuidado nutricional não resultou em melhora dos parâmetros numéricos do estado nutricional, apesar do atendimento domiciliar contribuir para a diminuição da incidência de complicações decorrentes de mal cuidado físico e nutricional do paciente.

Introduction: A good nutritional status is essential for fast healing of pressure ulcers. Objective: To evaluate the results of a program that provides protein supplementation as prevention of decubitus ulcer (DU) in home patients. Methods: We analyzed 100% of the population of patients (N = 19) enrolled in a home team, whose comorbidities result in greater physical dependence (Parkinson's, stroke (CVA), senile dementia, Alzheimer's), and did not have UD. The evaluation period was 30 days from entry into the program, being held Subjective Global Nutritional Assessment, anthropometric and biochemical assessments. Statistical analysis and data representation were made by the programs Excel and Sigma Stat, with differences tested by paired t-student or not, and ANOVA. Results: The initial classification of patients according to SGA was 47.4% well nourished and 52.6% with moderate malnutrition. Regarding anthropometric measures ANOVA showed no significant difference between evaluations from the beginning, after 15 and 30 days. In relation to serum albumin, 63.1% of patients improved or maintained their initial levels and 36.8% showed a decrease in their initial levels, although not significant (t test) between the beginning and end of treatment in laboratory tests. Conclusion: The nutritional care has not resulted in an improvement of numerical parameters of nutritional status, despite the home care help to reduce the incidence of complications resulting from bad nutrition and physical care of the patient.

Introducción: Un buen estado nutricional es esencial para la curación rápida de las úlceras por presión. Objetivo: Evaluar los resultados de un programa que proporciona los suplementos de proteínas como la prevención de úlceras por decúbito (UD) en pacientes de origen. Métodos: Se analizaron 100% de la población de pacientes (N = 19) inscrito en un equipo local, cuyo co-morbilidades como resultado una mayor dependencia física (Parkinson, accidentes cerebrovasculares (ACV), demencia senil, Alzheimer), y no tenía UD. El período de evaluación fue de 30 días a partir de la entrada en el programa, que se celebra Evaluación Global Subjetiva nutricional, antropometría y evaluaciones bioquímicas. El análisis estadístico y representación de datos fueron utilizados por los programas Excel y Sigma Stat, con diferencias probado por t-pareada estudiante o no, y ANOVA. Resultados: La clasificación inicial de los pacientes según el SGA fue de 47,4% bien nutridos y 52,6% con desnutrición moderada. Respecto a las medidas antropométricas ANOVA no mostró diferencias significativas entre las evaluaciones desde el principio, después de 15 y 30 días. En relación a la albúmina sérica, el 63,1% de los pacientes mejoraron o mantuvieron su nivel inicial y el 36,8% mostró una disminución en sus niveles iniciales, aunque no significativa (prueba t) entre el comienzo y final del tratamiento en pruebas de laboratorio. Conclusión: La atención nutricional no se ha traducido en una mejora de los parámetros numéricos del estado nutricional, a pesar de los cuidados en el hogar ayudan a reducir la incidencia de complicaciones derivadas de la mala nutrición y el cuidado físico del paciente.