Improvement in binge eating and alexithymia predicts weight loss at 9-month follow-up of the lifestyle modification program.

PURPOSE: The aim of this longitudinal study was to examine the extent to which improved levels of binge eating (BE) behaviors, alexithymia, self-esteem, and psychological distress would predict a reduction in body mass at 9-month follow-up, following a lifestyle modification program for weight loss in obese or overweight patients. METHODS: A convenience sample of 120 obese or overweight patients were recruited. Body mass index (BMI), binge eating (BES), levels of alexithymia (TAS-20), perceived stress (PSS), depressive symptoms (SDS), and self-esteem (RSE) were assessed during their first medical examination (T1), and after a weight-loss treatment period of 9 months (T2). RESULTS: Compared with unimproved patients, improved patients reported a significant decrease in binge eating (p = 0.04) and perceived stress symptoms (p = 0.03), and a significant improvement in self-esteem (p = 0.02) over time. After controlling for gender, self-esteem, depressive symptoms, and perceived stress, baseline BMI (OR = 1.11, 95% CI [1.04,1.19]), ΔBES (OR = 0.99, 95% CI [0.98,0.99]), and ΔTAS-20 (OR = 1.03, 95% CI [1.01,1.05]) significantly and independently predicted a ≥ 5% reduction in body mass from baseline. CONCLUSIONS: Our finding supports the suggestion to consider psychological outcomes such as emotional aspects and dysfunctional eating behaviors when planning a weight loss programs to prevent a negative outcome. LEVEL OF EVIDENCE:  Level III, case-control analytic study.

What is the "weight" of body mass index on sexual functioning in women? A mediation model.

PURPOSE: It is well known that body mass index (BMI) affects how individuals perceive their well-being and that obese individuals tend to report poorer levels of subjective health status. The aim of this study was to compare subjects with and without FSD and to examine the direct and indirect impact of BMI on female sexual dysfunction (FSD) in overweight/obese and normal-weight women. METHODS: A cross-sectional study was conducted on 186 overweight/obese and 233 normal-weight women. FSD assessed with the Female Sexual Function Index (FSFI) was investigated in relation to body satisfaction assessed with the Body Uneasiness Test (BUT-A) and self-esteem assessed with the Rosenberg Self-Esteem scale (RSE). RESULTS: No difference in the prevalence of FSD was found between overweight/obese (44.4%) and normal-weight women (55.6%), even though significant between-group differences in body image were found. Structural Equation Modelling (SEM) showed that BMI contribute to FSD only through the mediating role of body dissatisfaction and self-esteem. CONCLUSIONS: The present results support the notion that sexual functioning is not related directly to BMI in women but to a more complex interactions of body weight, satisfaction with one's own body image, and levels of self-esteem. Clinicians should take into account that for women having a good sexual life seems not related to body weight but to the way their body weight is perceived within the context of self-image. LEVEL OF EVIDENCE: Level III, case-control analytic study.

Uterine Wound Healing: A Complex Process Mediated by Proteins and Peptides.

Wound healing is the process by which a complex cascade of biochemical events is responsible of the repair the damage. In vivo, studies in humans and mice suggest that healing and post-healing heterogeneous behavior of the surgically wounded myometrium is both phenotype and genotype dependent. Uterine wound healing process involves many cells: endothelial cells, neutrophils, monocytes/macrophages, lymphocytes, fibroblasts, myometrial cells as well a stem cell population found in the myometrium, myoSP (side population of myometrial cells). Transforming growth factor beta (TGF-ß) isoforms, connective tissue growth factor (CTGF), basic fibroblast growth factor (bFGF), platelet-derived growth factor (PDGF), vascular endothelial growth factor (VEGF), and tumor necrosis factor alpha (TNF-ß) are involved in the wound healing mechanisms. The increased TGF- ß1/ß3 ratio reduces scarring and fibrosis. The CTGF altered expression may be a factor involved in the abnormal scars formation of low uterine segment after cesarean section and of the formation of uterine dehiscence. The lack of bFGF is involved in the reduction of collagen deposition in the wound site and thicker scabs. The altered expression of TNF-ß, VEGF, and PDGF in human myometrial smooth muscle cells in case of uterine dehiscence, it is implicated in the uterine healing process. The over-and under-expressions of growth factors genes involved in uterine scarring process could represent patient's specific features, increasing the risk of cesarean scar complications.

Pelvic adhesion and gonadotropin-releasing hormone analogue: effects of triptorelin acetate depot on coagulation and fibrinolytic activities.

The study investigated the impact of gonadotropin-releasing hormone analogue (GnRH-a) on coagulation and fibrinolytic activities and its effectiveness in the prevention of pelvic adhesion after myomectomy. Thirty-two infertile women underwent myomectomy followed by adhesion evaluation surgery with a second-look laparoscopy. Before myomectomy, 15 women were treated with triptorelin acetate for 3 months and 17 received no treatment. Plasminogen activator inhibitor (PAI), thrombin activatable fibrinolysis inhibitor (TAFI), protein C (PC), plasminogen, α2-antiplasmin were determined by enzyme-linked immunosorbent assays and the activity of coagulation factors V and VIII by coagulometric methods. Patients treated with GnRH-a showed significant decrease in PAI, TAFI, factors V, and VIII (P < .05) and increased PC (P < .05), but no significant change in plasminogen and α2-antiplasmin levels compared with control group. The incidence, extent, and severity of adhesions were significantly lower in GnRH-a-treated patients compared with control group (P < .05), suggesting a possible critical role of the GnRH-a therapy in preventing postoperative adhesion development.

Avaliaçäo, em mandíbulas secas, da confiabilidade das medidas nas tomografias lineares / Evaluation, in dry mandibles, of the measurements accuracy in linear tomography

O objetivo deste studo foi avaliar a confiabilidade da tomografia linear realizada com o equipamento de raio-x Vera View Scope X-600 (MORITA Co.) e de um sistema de digitalizaçäo indireta desta imagem tomográfica (DentScan DentView - APICA Co.). A amostra consistiu em 20 hemimandíbulas humanas secas que foram radiografadas. A área selecionada para o exame foi a 1,5cm para distal do limite anterior do forame mental, tendo como requisito ser esta edentada. As tomografias foram digitalizadas e medidas através da escala do programa digital. Com o uso de um paquímetro eletrônico digital (STARRETT), foram realizadas mediçöes sobre as tomografias originais e as hemimandíbulas seccionadas na regiäo proposta para o exame. Foram comparados os valores obtidos nas mediçöes das tomografias com aqueles dos espécimes mandibulares, e os resultados demonstraram näo haver diferenças estatísticas significantes entre as mediçöes e as comparaçöes realizadas. A tomografia linear foi considerada um exame seguro, preciso e viável para a avaliaçäo de implantes na regiäo posterior de mandíbula. A sua digitalizaçäo pode ser utilizada como um recurso para melhorar o diagnóstico

Seios maxilares / Maxillary sinusis

Em Odontologia, as relaçöes anatomotopográficas das estruturas dentárias com os seios maxilares säo muito importantes, pois as afecçöes dos seios maxilares podem estar relacionadas aos processos patológicos originados na regiäo periapical dos dentes superiores, bem como as doenças que afetam os seios maxilares, que säo muitas, de complexidade variada, podem repercutir nos dentes. Estas relaçöes também têm inestimável valor em cirurgia bucal, por advertirem as perigosas complicaçöes da abertura da cavidade e da introduçäo acidental dos restos dentários, que posteriormente daräo motivo a delicadas intervençöes cirúrgicas. Com o objetivo de melhorar os conhecimentos e os métodos radiográficos utilizados para visualizaçäo do seio maxilar neste trabalho foram abordados os aspectos relacionados a localizaçäo dos seios maxilares, sua relaçäo com os outros seios paranasais, funçöes, pneumatizaçäo, embriologia, anatomia, relaçäo dos dentes com o soalho dos seios maxilares, dimensöes e capacidade. Quanto ao aspecto radiográfico, foram citadas as incidências mais utilizadas para a visualizaçäo dos seios maxilares e alguns dados sobre tomografia computadorizada, cuja técnica representa um avanço no diagnóstico por imagens