RESUMO
BACKGROUND AND AIMS: Computed tomography, which uses ionizing radiation and expensive software packages for analysis of scans, can be used to quantify abdominal fat. The objective of this study is to measure abdominal fat with 3T MRI using free software for image analysis and to correlate these findings with anthropometric and laboratory parameters in adolescents. METHODS: This prospective observational study included 24 overweight/obese and 33 healthy adolescents (mean age 16.55 years). All participants underwent abdominal MRI exams. Visceral and subcutaneous fat area and percentage were correlated with anthropometric parameters, lipid profile, glucose metabolism, and insulin resistance. Student's t test and Mann-Whitney's test was applied. Pearson's chi-square test was used to compare proportions. To determine associations Pearson's linear correlation or Spearman's correlation were used. RESULTS: In both groups, waist circumference (WC) was associated with visceral fat area (P = 0.001 and P = 0.01 respectively), and triglycerides were associated with fat percentage (P = 0.046 and P = 0.071 respectively). In obese individuals, total cholesterol/HDL ratio was associated with visceral fat area (P = 0.03) and percentage (P = 0.09), and insulin and HOMA-IR were associated with visceral fat area (P = 0.001) and percentage (P = 0.005). CONCLUSIONS: 3T MRI can provide reliable and good quality images for quantification of visceral and subcutaneous fat by using a free software package. The results demonstrate that WC is a good predictor of visceral fat in obese adolescents and visceral fat area is associated with total cholesterol/HDL ratio, insulin and HOMA-IR.
Assuntos
Gordura Abdominal/diagnóstico por imagem , Gordura Intra-Abdominal/diagnóstico por imagem , Imageamento por Ressonância Magnética , Obesidade/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Gordura Abdominal/patologia , Adolescente , Antropometria , Glicemia , Composição Corporal , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Resistência à Insulina/genética , Masculino , Obesidade/patologia , Software , Gordura Subcutânea/diagnóstico por imagem , Gordura Subcutânea/patologia , Circunferência da CinturaRESUMO
O presente capítulo tem como objetivos a explanação, classificação, abordagem e manejo da dor crônica na prática médica. Foi escolhido dada sua importância no dia-a-dia do profissional de saúde. Este capítulo está dividido em introdução, classificação, neurofisiologia da dor, apresentação do paciente com dor crônica, tratamento e conclusão.
Our aim in this chapter is to explain, classify, assess and manage chronic pain in medical practice. The topic was chosen due to its relevance in daily health care practice. This chapter is divided into introduction, classification, pain neurophysiology, the patient presented with chronic pain, treatment and conclusion.
Assuntos
Dor , Analgesia , Dor CrônicaRESUMO
O tratamento adequado do paciente queimado não se limita apenas em melhorar sua sobrevida, mas também na recuperação do aspecto funcional e estético da área acometida. Esse conceito é indispensável, sobretudo no manejo de queimaduras em áreas especiais, como em queimaduras de mão, que exigem uma abordagem inicial precoce e especifica objetivando preservar sua função.
Proper treatment of burn patients is not limited only to improve survival, but also the recovery of functional and aesthetic appearance of the affected area. This concept is essential, especially in the management of burns in special areas, such as hand burns, requiring an early initial approach and specifies aiming to preserve its function.
