Effect of photobiomodulation on fatigue in individuals with relapsing-remitting multiple sclerosis: a pilot study.

Multiple sclerosis is an autoimmune disease of the central nervous system characterized by inflammation and destruction of the myelin sheath. Fatigue is one of the main symptoms of this disease, with a negative impact on quality of life and few treatment options. Photobiomodulation is used for several inflammatory conditions and may be beneficial for the treatment of fatigue in individuals with multiple sclerosis. Conduct a pilot study to analyze the effect of photobiomodulation on fatigue in individuals with relapsing-remitting multiple sclerosis. The participants were recruited from the UNINOVE Integrated Health Clinic and randomly allocated to two groups: group 1, administration of photobiomodulation (808 nm, 36 J for 360 s) under the tongue and group 2, administration of photobiomodulation over the radial artery. Fatigue was measured using the Modified Fatigue Impact Scale (MFIS). No significant differences were found regarding the total MFIS score or subscale scores (p < 0.05, two-way ANOVA). Photobiomodulation with the parameters employed in the present study had no effect on fatigue in individuals with multiple sclerosis. ClinicalTrials.gov Identifier: NCT03360487.

The fatty acid profile of adipose tissue as a predictor of the ponderal and inflammatory response in adult women six years after bariatric surgery.

BACKGROUND: Adipose tissue is involved in several metabolic changes. This study investigated the association between the fatty acid (FA) composition of subcutaneous (SAT) and visceral (VAT) adipose tissue pre-surgery and the postsurgical response regarding the evolution of weight and concentrations of tumour necrosis factor alpha (TNF) and interleukin 6 (IL-6) in adult women who underwent Roux-en-Y gastric bypass (RYGB, n = 14) or sleeve gastrectomy (SG, n = 19) at one (T1), three (T3) and six (T6) years after surgery. METHODS: Blood samples were collected to obtain plasma for the measurement of IL-6 and TNF. Anthropometric measurements were performed, collecting samples of VAT and SAT during surgery to assess the FA profiles. RESULTS: Weight loss had a positive correlation with the percentage of VAT-C17:0 (T1, T3) and SAT-C18:2 (T1, T3, T6), and it had a negative correlation with SAT-C22:0 (T1, T3) and VAT-C22:0 (T3). Regarding the inflammatory response, SAT-C14:0 (T6), VAT-C14:0 (T6), SAT-C14:1 (baseline), SAT-C15:0 (T6), SAT-C16:1 (T6), VAT-C16:1 (baseline), SAT-C17:1 (T6), VAT-C17:1 (baseline), VAT-C18:1 (T6), and VAT-C20:1 (T6) exhibited positive correlations with the concentration of IL-6, which were different from the correlations of IL-6 concentrations with SAT-C18:2, VAT-C18:2 (T6), and VAT-C18:3 (T6). The FA SAT-C18:0 (T1) was negatively correlated with TNF concentrations. CONCLUSIONS: Saturated FAs were predominantly proinflammatory, primarily in the late postoperative period. Alternately, the polyunsaturated FAs exhibited anti-inflammatory potential and predicted weight loss. Thus, the FA profile of the adipose tissue of obese adult women may be a predictor of the ponderal and inflammatory response 6 years after bariatric surgery. TRIAL REGISTRATION: This study was approved by the ethics committee of Federal University of Viçosa; Registration n. 17287913.2.0000.5153; Date: 07/05/2013.

Gastric bypass and sleeve gastrectomy: the same impact on IL-6 and TNF-α. Prospective clinical trial.

BACKGROUND: Due to the association between the quantity of adipose tissue and concentrations of interleukin-6 (IL-6) and tumor necrosis factor (TNF-α), this work aimed to assess the effects of Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) procedures on serum IL-6 and TNF-α concentrations. METHODS: This study evaluated serum IL-6 and TNF-α levels, as well as routine anthropometric and biochemical values, before and 1 year post-bariatric surgery. Fifty percent of patients (n = 24) underwent RYGB, and 50 % (n = 24) underwent SG. Prior to bariatric surgery, IL-6 and TNF-α mRNA expression levels in subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) were investigated in obese women. RESULTS: There was a significant reduction (p < 0.05) in all anthropometric and routine biochemical measurements in patients in the RYGB and SG groups 1 year post-surgery. The serum concentrations of IL-6 and TNF-α were reduced following surgery in both groups (p < 0.05). No differences in the relative expression levels of IL-6 and TNF-α were found between SAT and VAT prior to bariatric surgery. CONCLUSIONS: RYGB and SG procedures demonstrated a similar impact on adipokine levels in women 1 year post-surgery. Both techniques may improve the course of chronic diseases and the state of inflammation associated with obesity.

Impacto da atividade física sobre o risco cardiovascular na população adulta de Vitória-ES / Impact of physical activity on cardiovascular risk in adults from Vitória-ES

A atividade física (AF) regular é considerada hábito de vida saudável por reduzir o risco de doenças cardiovasculares. Entretanto, há poucos estudos neste sentido realizados em amostras populacionais. Avaliar o impacto da AF de lazer (AFL), ocupacional (AFO) e mista (AFLO) sobre o risco cardiovascular mensurado pelo escore de Framingham (EF) na população adulta (25-64 anos) de Vitória-ES. Estudo transversal em amostra probabilística (N=1.663; ambos os sexos). Os dados foram coletados por meio de questionário, avaliação clínica e laboratorial (coleta de sangue). A estimativa de gasto calórico semanal em AFL, AFO e AFLO foi feita por meio de entrevista e, dessa forma, 4 grupos foram constituídos: Sedentário (S), AFL, AFO e AFLO. Análises de variância e covariância, bem como testes qui-quadrado e Mantel-Haenszel, foram usados para análise estatística. O grupo AFO apresentou valores inferiores para % gordura (%G), colesterol total (CT) e LDL se comparado ao grupo S. A prevalência de tabagismo foi menor nos grupos AFL (11,5%) e AFLO (10,2%), e maior nos grupos S (26,4%) e AFO(30,2%). O EF e o risco (%) de desenvolvimento de doença arterial coronariana em 10 anos (risco DAC), não ajustados, apresentaram-se menores no grupo AFO (EF= 3; 2,65±6,20; risco DAC= 4; 6,79±6,68%;mediana; média±DP ) se comparado ao grupo S (EF= 5; 3,85±7,07; risco DAC= 6; 8,41±7,74%). Entretanto, após ajuste para idade e CT, o EF e o risco DAC foram menores no grupo AFL (EF:2,54±4,18; risco DAC: 6,55±5,29%; média±DP) se comparado aos grupos S (EF: 3,50±4,17; risco DAC:8,05±5,33%) e AFO (EF: 4,09±4,19; risco DAC: 8,08±5,35%), evidenciando, assim, que as variáveis CT e idade foram as principais determinantes das diferenças iniciais em favor do grupo AFO. O estudo denota impacto positivo da AF de lazer ou laboral na redução do risco cardiovascular populacional.

Regular physical activity (PA) has been considered a healthy habit to reduce thecardiovascular risk. However, there are few studies to determine this association in population-based studies. To evaluate the contribution of leisure-time (LPA), occupational (OPA) and combined physical activity (LOPA) on the cardiovascular risk computed by Framingham score (FS) on the adult population (25-64 y) of Vitória, Brazil. Cross-sectional study in a probabilistic sample (N=1,661; both sexes). Datawere collected by questionnaires and clinical and laboratorial (blood collection) exams. Estimation of week caloric expenditure in LPA, OPA and LOPA were obtained by interview and 4 groups were designed accordingly: Sedentary, LPA, OPA and LOPA. Analysis of variance and covariance, qui-squareand Mantel-Haenszel tests were used for statistical analysis. Before and after adjustment to age, the OPA group showed lower values of body fat, total cholesterol (TC) and LDL-cholesterol compared to the sedentary group. The smoking prevalence was smaller in LPA (11.5%) and LOPA (10.2%) than insedentary (26.4%) and OPA (30.2%) groups. The unadjusted FS and the 10-year risk for coronary heart disease (CHD-risk) were smaller in the OPA (FRS= 3; 2.65±6.20; CHD-risk= 4; 6.79±6.68%; median; mean±SD) compared to the sedentary group (FRS= 5; 3.85±7.07; CHD-risk= 6; 8.41±7.74%). However, after adjustment for age and TC, the FRS and CHD-risk were smaller in the LPA (FR: 2.54±4.18; CHDrisk: 6.55±5.29%; mean±SD) than in the sedentary (FR: 3.50±4.17; CHD-risk: 8.05±5.33%) and OPA (FR: 4.09±4.19; CHD-risk: 8.08±5.35%) groups, showing that age and TC were the main responsible tosupport the initial differences to the OPA group. The study shows positive impact of leisure-time and occupational physical activity to reduce the global cardiovascular risk in the studied population.

Glucose homeostasis and weight loss in morbidly obese patients undergoing banded sleeve gastrectomy: a prospective clinical study.

OBJECTIVE: To assess glucose homeostasis and weight loss in morbidly obese patients undergoing Silastic(R) ring sleeve gas-trectomy. METHODS: This was a prospective clinical study. Thirty-three female patients with a mean body mass index (BMI) of 42.33 +/- 1.50 kg/m(2) (range: 40-45 kg/m(2)), a mean age of 36.7 +/- 9.4 years and a mean waist circumference of 118.7 +/- 5.98 cm were included in this study. Type 2 diabetes mellitus was observed in 11 patients (33.3%), and glucose intolerance was observed in 4 patients (12.1%). Mean plasma fasting glucose levels were 109.77 +/- 44.19 mg/dl (75-320) in the preoperative period. All Silastic(R) ring sleeve gastrectomy procedures were performed by the same surgical team using the same anesthetic technique. The patients were monitored for at least 12 months after surgery. RESULTS: The mean weight of the patients decreased from 107.69 +/- 6.57 kg to 70.52 +/- 9.36 kg (p < 0.001), the mean BMI decreased to 27.4 +/- 2.42 kg/m(2) (p < 0.001), and the mean waist circumference decreased to 89.87 cm +/- 6.66 (p < 0.001) in the postoperative period. Excess BMI loss was 86.5 +/- 14.2%. Fasting glucose levels were reduced to 80.94 +/- 6.3 mg/dl (p < 0.001). Remission of diabetes and glucose intolerance was observed in all patients. CONCLUSION: Silastic(R) ring sleeve gastrectomy was effective in promoting weight loss, waist circumference reduction and control of glucose homeostasis in morbidly obese patients.

Glucose homeostasis and weight loss in morbidly obese patients undergoing banded sleeve gastrectomy: a prospective clinical study

OBJECTIVE: To assess glucose homeostasis and weight loss in morbidly obese patients undergoing Silastic® ring sleeve gastrectomy. METHODS: This was a prospective clinical study. Thirty-three female patients with a mean body mass index (BMI) of 42.33 ± 1.50 kg/m² (range: 40-45 kg/m²), a mean age of 36.7 ± 9.4 years and a mean waist circumference of 118.7 ± 5.98 cm were included in this study. Type 2 diabetes mellitus was observed in 11 patients (33.3 percent), and glucose intolerance was observed in 4 patients (12.1 percent). Mean plasma fasting glucose levels were 109.77 ± 44.19 mg/dl (75-320) in the preoperative period. All Silastic® ring sleeve gastrectomy procedures were performed by the same surgical team using the same anesthetic technique. The patients were monitored for at least 12 months after surgery. RESULTS: The mean weight of the patients decreased from 107.69 ± 6.57 kg to 70.52 ± 9.36 kg (p < 0.001), the mean BMI decreased to 27.4 ± 2.42 kg/m² (p < 0.001), and the mean waist circumference decreased to 89.87 cm ± 6.66 (p < 0.001) in the postoperative period. Excess BMI loss was 86.5 ± 14.2 percent. Fasting glucose levels were reduced to 80.94 ± 6.3 mg/dl (p < 0.001). Remission of diabetes and glucose intolerance was observed in all patients. CONCLUSION: Silastic® ring sleeve gastrectomy was effective in promoting weight loss, waist circumference reduction and control of glucose homeostasis in morbidly obese patients.

Correlaçäo entre diferentes parâmetros de avalliaçäo do estado nutricional de idosos / Correlation of different nutritional assessment parameters in the elderly

O processo natural do envelhecimento promove mudanças anatomicas, funcionais e psicológicas no organismo, com repercursöes sobre as condiçöes de saúde e nutriçäo. O objetivo deste estudo foi determinar o coeficiente de correlaçäo existente entre os diferentes parâmetros antropométricos, bioquímicos e clínicos entre 24 idosos de 65 a 95 anos, residentes num lar em Viçosa (MG), durante quatro meses,( 45,8 porcento homens). A avaliaçäo nutricional foi feita através de medidas antropométricas, bioquímicas e clínicas. Observou-se forte correlaçäo do peso corporal com a massa muscular e fraca correlaçäo com o tecido adiposo tanto periférico quanto central ou abdominal. Forte correlaçäo positiva foi verificada entre o somatório das quatro pregas cutâneas e medida da gordura subcutânea pelo infravermelho próximo (IVP). A avaliaçäo dos parâmetros plasmáticos e hematológicos apresentou fraca correlaçäo e a lipemia sofreu maior influência dos triglicerídeos do que do colesterol. Foi evidenciada ausencia de correlaçäo da pressäo arterial com a frequência cardíaca neste grupo.(au)

Perfil dos diabéticos atendidos em unidades públicas de saúde / Profile of diabetic patients seen in public health units / Perfil de los pacientes diabéticos atendidos en unidades de salud pública

In Brazil, it is estimated that more than 7% of the population has diabetes, according to the new criteria recommended by the American Diabetes Association (1998) for diagnosis. The disease is associated with a sedentary lifestyle, obesity and increasing number of elderly persons. This study aimed to determine the profile of diabetic patients seen in public health services, to be certain interventions aimed at promoting health and improving quality of life. The study included 87 diabetic, 62% female and 38% male. Data were collected by a structured questionnaire and medical records. Most patients (79.3%) suffer from type 2 diabetes. About 41% had cardiovascular complications (30%), renal or visual, of which 80.3% were type 2 diabetics. The occurrence of hypertension and dyslipidemia was found in 24% and 2.5% of patients with cardiovascular complications, respectively. Kidney problems were observed in 5.7% of individuals. Approximately 7% had visual impairment.

No Brasil, estima-se que mais de 7% da população tenha diabetes, de acordo com o novo critério recomendado pela American Diabetes Association (1998) para diagnóstico da doença. A doença está associada ao sedentarismo, obesidade e número crescente da população idosa. Este estudo objetivou traçar o perfil dos diabéticos atendidos em serviços públicos de saúde, para que sejam determinadas intervenções, visando a promoção da saúde e melhoria da qualidade de vida. Participaram do estudo 87 diabéticos, 62% do sexo feminino e 38% do sexo masculino. Os dados foram coletados pela aplicação de questionário estruturado e de prontuário médico. A maioria dos pacientes estudados (79,3%) sofrem de diabetes do tipo 2. Cerca de 41% apresentaram complicações cardiovasculares (30%), renais ou visuais, entre os quais 80,3% eram diabéticos do tipo 2. A ocorrência de hipertensão arterial e dislipidemias foi identificada em 24% e 2,5% dos portadores de complicações cardiovasculares, respectivamente. Problemas renais foram observados em 5,7% dos indivíduos. Aproximadamente 7% do total apresentaram comprometimento visual.

En Brasil, se estima que más del 7% de la población tiene diabetes, según los nuevos criterios recomendados por la Asociación Americana de Diabetes (1998) para el diagnóstico. La enfermedad se asocia a un estilo de vida sedentario, la obesidad y el número cada vez mayor de personas de edad avanzada. Este estudio tuvo como objetivo determinar el perfil de los pacientes diabéticos atendidos en los servicios de salud pública, para ser ciertas intervenciones destinadas a promover la salud y mejorar la calidad de vida. En el estudio participaron 87 diabéticos, 62% mujeres y 38% hombres. Los datos fueron recolectados mediante un cuestionario estructurado y registros médicos. La mayoría de los pacientes (79,3%) sufren de diabetes tipo 2. Alrededor del 41% de complicaciones cardiovasculares (30%), renales o visuales, de los cuales 80,3% eran diabéticos tipo 2. La aparición de la hipertensión y la dislipidemia se encontró en 24% y el 2,5% de los pacientes con complicaciones cardiovasculares, respectivamente. Los problemas renales se observaron en el 5,7% de los individuos. Aproximadamente el 7% tienen discapacidad visual.