RESUMO
Micronutrition is proposed as a global approach for the obese person and aims at satisfying needs in micronutrients through a Mediterranean diet. This diet is associated with a personalized complementation if needed. First of all, a consultation in micronutrition consists of detecting possible deficits (iron, chromium, iodine, vitamins and mineral) with the means of patients history, questionnaires and, if needed, biological measurements. Micronutritional deficits are frequent in obese patients on restrictive diets. The balance in essential fatty acids (omega 3/6) and the content of essential amino acids (tryptophan) are crucial for the obese patients follow-up. Finally, intestinal flora seems to play an important role in the physiopathology in obesity.
Assuntos
Dieta Mediterrânea , Micronutrientes , Obesidade/dietoterapia , Obesidade/tratamento farmacológico , Aminoácidos Essenciais/uso terapêutico , Ácidos Graxos Ômega-3/administração & dosagem , Humanos , Mucosa Intestinal/microbiologia , Micronutrientes/administração & dosagem , Micronutrientes/sangue , Obesidade/sangue , Obesidade/microbiologia , Inquéritos e Questionários , Vitaminas/uso terapêuticoRESUMO
The results of percutaneous automated lumbar nucleotomy in the treatment of lumbar disc herniation were assessed in a series of 39 patients. The technique consists of mechanical decompression of the herniated intervertebral disc without total excision. Only one-space discs were treated by this method. Sciatica was the predominant clinical symptom in 30 cases, and lumbar pain in 9 cases. Good to very good results were obtained in 70% of patients with sciatica and in 55% of patients with lumbar pain. After 4 cases of nucleotomy performed after failure of nucleolysis were excluded, the proportion of very good results rose to 77% in sciatica. Conversely, it seems that a number of failed nucleotomies can be treated by nucleolysis. Nucleotomy is very well tolerated and deserves to be used as first-line treatment of single and radiologically well documented lumbar disc herniations.
Assuntos
Deslocamento do Disco Intervertebral/cirurgia , Vértebras Lombares , Adulto , Feminino , Seguimentos , Humanos , Tempo de Internação , Masculino , Métodos , Pessoa de Meia-Idade , Prognóstico , Recidiva , Estudos RetrospectivosRESUMO
The results of percutaneous automated lumbar nucleotomy in the treatment of lumbar disc herniation were assessed in a series of 39 patients. The technique consists of mechanical decompression of the herniated intervertebral disc without total excision. Only one-space discs were treated by this method. Sciatica was the predominant clinical symptom in 30 cases, and lumbar pain in 9 cases. Good to very good results were obtained in 70% of patients with sciatica and in 55% of patients with lumbar pain. After 4 cases of nucleotomy performed after failure of nucleolysis were excluded, the proportion of very good results rose to 77% in sciatica. Conversely, it seems that a number of failed nucleotomies can be treated by nucleolysis. Nucleotomy is very well tolerated and deserves to be used as first-line treatment of single and radiologically well documented lumbar disc herniations.
