Higher Abdominal Adiposity Is Associated With Lower Muscle Strength in Chilean Adults.

Handgrip strength (HGS) is a well-established indicator of muscle strength and a reasonable clinical predictor of metabolic health and diseases. This study explores the association between relative muscular strength and abdominal obesity (AO) in healthy Chilean adults. A convenience sample was recruited (n = 976) between 2018 and 2020. The HGS was determined by dynamometry. The anthropometry (weight, height, waist, and mid-arm circumference) and physical activity were also measured. The relative HGS (RHGS) was calculated by dividing the maximum HGS of the dominant hand by the body mass index. The AO was defined as a waist circumference (WC) >88 cm for women, and >102 cm for men. From the sample, 52.6% were women, 56.4% had excessive weight, and 42.7% had AO. The absolute and RHGS were greater in men compared to women (p < 0.001) and were decreased with age in both sexes. We observed a moderate negative correlation between WC and RHGS (rho = -0.54, and rho = -0.53, for men and women, respectively). The RHGS was lower in individuals with AO, independent of age and sex (p < 0.05). For each cm increase in WC, the odds of low RHGS (<25th percentile) increased by 12 and 9% for men and women, respectively. The AO is related to higher odds for low RHGS (OR: 1.72; 95% CI: 1.23-2.41). In our sample of healthy adults, a higher AO was associated with a lower muscle strength measured by dynamometry.

[Calorie and macronutrient intake during the first six months after bariatric surgery]. / Ingesta calórica y de macronutrientes en los primeros seis meses post cirugía bariátrica.

BACKGROUND: Bariatric surgery (BS) is the most effective procedure in the management of obesity, achieving a significant decrease in energy intake. AIM: To measure calorie and macronutrient intake in patients subjected to gastric bypass (GBP) or sleeve gastrectomy (SG). MATERIAL AND METHODS: We studied 53 patients subjected to SG and 27 subjected to GBP, who were in the first, second or sixth postoperative month. A food frequency consumption survey was applied by specialized nutritionists and their nutritional status was assessed. RESULTS: Mean calorie intake in months 1, 2 and 6 were 505, 600 and 829.8 kcal, respectively. A significantly higher intake was observed at month 1 in patients with those subjected to SG, compared with GBP patients. Protein consumption was <60 g/d, except at 6 months in patients with GBP. At months 1, 2 and 6, mean consumption of lipids were 17, 28 and 30 g/day, respectively. The figures for carbohydrates were 42, 31 and 77 g/day, respectively. At month 1, patients with GBP had a higher BMI, equalizing at 6 months with those of SG. At 6 months 37% of patients had a normal body mass index and 17% remained obese. A negative correlation was observed between weight loss and energy intake during the first month (rho: -0.40; p = 0.033). CONCLUSIONS: Patients subjected to BS had a low calorie and macronutrient intake in the first six postoperative months. Their calorie intake is negatively associated with weight loss, mainly during the first postoperative month.

Ingesta calórica y de macronutrientes en los primeros seis meses post cirugía bariátrica / Calorie and macronutrient intake during the first six months after bariatric surgery

Background: Bariatric surgery (BS) is the most effective procedure in the management of obesity, achieving a significant decrease in energy intake. Aim: To measure calorie and macronutrient intake in patients subjected to gastric bypass (GBP) or sleeve gastrectomy (SG). Material and Methods: We studied 53 patients subjected to SG and 27 subjected to GBP, who were in the first, second or sixth postoperative month. A food frequency consumption survey was applied by specialized nutritionists and their nutritional status was assessed. Results: Mean calorie intake in months 1, 2 and 6 were 505, 600 and 829.8 kcal, respectively. A significantly higher intake was observed at month 1 in patients with those subjected to SG, compared with GBP patients. Protein consumption was <60 g/d, except at 6 months in patients with GBP. At months 1, 2 and 6, mean consumption of lipids were 17, 28 and 30 g/day, respectively. The figures for carbohydrates were 42, 31 and 77 g/day, respectively. At month 1, patients with GBP had a higher BMI, equalizing at 6 months with those of SG. At 6 months 37% of patients had a normal body mass index and 17% remained obese. A negative correlation was observed between weight loss and energy intake during the first month (rho: −0.40; p = 0.033). Conclusions: Patients subjected to BS had a low calorie and macronutrient intake in the first six postoperative months. Their calorie intake is negatively associated with weight loss, mainly during the first postoperative month.

Primer consenso chileno de nutricionistas en cirugía bariátrica / First consensus of Chilean nutritionists on bariatric surgery

RESUMEN La cirugía bariátrica (CB) ha demostrado ser una alternativa segura y eficaz para la resolución de la obesidad y sus comorbilidades. Parte del éxito de la CB, radica en el manejo nutricional del paciente, para lo que se requiere de un equipo médico-nutricional, entrenado en nutrición bariátrica, con el objetivo de evitar déficit nutricional y modificar hábitos a largo plazo. En la actualidad, no existe en Chile un consenso sobre el protocolo de manejo nutricional pre y post CB. El objetivo del 1er Consenso Chileno de Nutricionistas en Cirugía Bariátrica, es ser una guía para los nutricionistas que asisten a pacientes bariátricos. Este documento resume el trabajo realizado por los Nutricionistas de Sociedad Chilena de Cirugía Bariátrica y Metabólica (SCCBM), quienes durante 5 años trabajaron en reuniones presenciales y comisiones de estudio, revisando evidencias científicas, guías de tratamiento y recomendaciones de expertos, que fundamentarán las recomendaciones alimentario nutricional para cada tema. El resultado es un documento que homologa criterios para el manejo nutricional de pacientes bariátricos y genera los tópicos mínimos para asegurar la atención nutricional de calidad en los equipos bariátricos chilenos.

ABSTRACT Bariatric surgery (BS) has proven to be a safe and effective alternative for the resolution of obesity and its comorbidities. Part of the success of BS lies in the nutritional management of the patient, for which a medical-nutritional team, trained in bariatric nutrition, is required with the aim of modifying long-term habits and avoiding nutritional deficit. At present, there is no consensus in Chile on the pre-and post-BS nutritional management protocol. The objective of the 1st Consensus of Chilean Nutritionists on Bariatric Surgery is to be a guide for nutritionists who assist bariatric patients. This document summarizes the work done by Nutritionists of the Chilean Society of Bariatric and Metabolic Surgery (SCCBM), who, during 5 years, worked in face-to-face meetings and study commissions, reviewing scientific evidence, treatment guides and expert recommendations, which will support nutritional nutrition recommendations for each topic. The result is a document that standardizes criteria for the nutritional management of bariatric patients and generates the minimum topics to ensure quality nutritional care for Chilean bariatric teams.

Cardiogenic syncope diagnosed as epileptic seizures: the importance of ECG during video-EEG recording.

We describefourpatientswith a previous diagnosis of epilepsy. After reviewing the ECG during the video-EEG recording, cardiogenic syncope, resulting from a cardiac arrhythmia, was identified as the cause of the seizures. Epileptic disorders and cardiogenic syncope may both manifest with convulsions, loss of consciousness, and loss of postural tone, leading to a high level of misdiagnosis. The one-lead ECG during video-EEG monitoring is a key component, which may allow correct diagnosis and treatment.

Bloqueo aurículo-ventricular familiar progresivo tipo I: descripción clínica de una familia / Progressive familial atrio-ventricular block type I: clinical description of a family

Se presenta el caso de una familia con bloqueo aurículo-ventricular, que compromete varias generaciones, con herencia mendeliana autosómica dominante, que afecta de manera progresiva el sistema de conducción cardiaco llevando a síncope y muerte súbita en edades tempranas. Esta entidad corresponde al bloqueo familiar cardiaco progresivo tipo I, descrito principalmente en Suráfrica. El tratamiento con marcapaso definitivo fue exitoso.

We present the case of a family with atrio-ventricular block that involves several generations, with dominant autosomal mendelian inheritance that progressively affects the cardiac conduction system leading to syncope and sudden death in early life. This entity corresponds to progressive familial atrio-ventricular block type I, described mainly in South Africa. Treatment with permanent pacemaker therapy was successful.

Mecanismos de cardiotoxicidad: antineoplásicos, anti-inflamatorios no esteroideos, antipsicóticos, cocaetileno y simpaticomiméticos / Mechanisms of cardiotoxicity: antineoplastics, nonsteroidal anti-inflammatory drugs, antipsychotics, cocaethylene and sympathomimetics

La interacción constante del organismo humano con diferentes sustancias, que incluso en muchas ocasiones se consideran inofensivas, tiene un alto impacto sobre todos los sistemas, siendo el cardiovascular uno de los más afectados. Por lo tanto, es vital reconocer los mecanismos por los cuales estas sustancias ejercen su efecto tóxico sobre este sistema, bien sea afectando la estabilidad de membrana y la función contráctil o generando disfunción de organelos intracelulares y estrés oxidativo. Numerosos estudios han descubierto efectos lesivos de sustancias, como la clozapina y las catecolaminas, que han tenido amplio uso durante largos años. En la actualidad aún se realizan investigaciones que buscan esclarecer los mecanismos cardiotóxicos de medicamentos de formulación común, entre ellos antineoplásicos y anti-inflamatorios no esteroideos (AINE), así como de sustancias de uso habitual que causan adicción, tales como alcohol, cocaína y cocaetileno, su metabolito activo.

The constant interaction of the human body with different substances that are even in many cases considered harmless has a high impact on all systems, being the cardiovascular system one of the most affected. Therefore, it is vital to recognize the mechanisms by which these substances exert their toxic effect on this system, either affecting the membrane stability and the contractile function, or generating intracellular organelles dysfunction and oxidative stress. Numerous studies have found that drugs which have been widely used for many years such as clozapine and catecholamines, have harmful effects. Research is still being done seeking to clarify the cardiotoxic mechanisms of drugs commonly formulated, including anticancer and non steroidal anti-inflammatory drugs (NSAIDs), as well as commonly used substances that cause addiction, such as alcohol, cocaine and cocaethylene, its active metabolite.

Leptin levels and IgF-binding proteins in malnourished children: effect of weight gain.

OBJECTIVES: Although it is well known that leptin reflects body fat content in adults, the regulation of leptin levels during childhood malnutrition is poorly understood. Insulin-like growth factor I (IGF-I) and the IGF-binding proteins (IGFBPs) may play important roles in the regulation of body composition. We investigated the relation between leptin, IGF-I, and IGFBPs in children with protein-energy malnutrition (PEM; before and after recovering 10% of their initial body weights) in comparison with well-nourished children. METHODS: Fifteen PEM and 16 healthy children were studied on admission and after 10% weight gains in the malnourished group. Leptin was measured with radioimmunoassay, IGF-I and IGFBPs were measured with immunoradiometric assay. RESULTS: Patients with PEM had a significantly lower body mass index and percentage of body fat than did the control children. Before weight gain, leptin, IGF-I, and IGFBP-3 were significantly lower and IGFBP-1 was elevated in the malnourished group compared with the control group. Among PEM patients, after 10% weight gains, the levels of leptin, IGF-I, and IGFBP-3 were significantly higher and IGFBP-1 significantly lower compared with the control group. Leptin correlated significantly with IGF-I in the normal children (r(s) = 0.86, P < 0.005). On admission, no correlation was observed between leptin and IGF-I (r(s) = 0.08, P < 0.16) and between leptin and IGFBP-3 (r(s) = 0.02, P < 0.27) in the malnourished group, but those levels improved after 10% recovery of their body weights (r(s) = 0.47, P < 0.002 and r(s) = 0.42, P < 0.005, respectively). In the PEM group, IGF-I correlated significantly with IGFBP-3 when the children gained weight (before: r(s) = 0.006, P < 0.31; after: r(s) = 0.32, P < 0.01). Our study showed results similar to those of anorexia nervosa studies, but the normalization of study variables was obtained in considerable less time for the same weight gain. CONCLUSIONS: The main finding of this study was that, after refeeding with only a 10% weight gain, the PEM children normalized their leptin, IGF-I, and IGFBP-3 levels. These results provide evidence that leptin can function as link between this hormonal response and improved nutrition status.