The reality of an Obesity Surgical Treatment Center in Portugal

Introduction: Obesity surgery is used as the most effective treatment for morbid obesity, with better cost-benefit, less morbidity and mortality. The present study aimed to analyze the results of a surgical center for obesity treatment and integrate them with the most recent scientific evidence. Methods: Retrospective cross-sectional observational study involving 270 patients aged 18 years or older, who underwent bariatric surgery between July 2008 and February 2020 in a private hospital in Portugal. Results: The sample presented an average age of 44 ± 12 years, being mostly female (83.7%). The average pre-surgery Body Mass Index was 41.1 ± 4.9 kg/m2 . The most performed surgery was Gastric Bypass (80.4%), followed by Gastric Banding (14.8%) and Gastric Sleeve (4.8%). One month after surgery, there was a percentage of excess weight lost (% EWL) of 25.2 ± 9.6%. After 6 months, there was an average % EWL of 67.2 ± 23.2%. One year after surgery, the average % EWL was 75.7 ± 25.7%, the average Body Mass Index was 29.3 ± 4.6 kg/m2 and the average weight loss percentage was 29.5 ± 9.4%. Conclusion: Gastric Bypass is the mostly performed surgery, because it is the Gold Standard method for surgical treatment of obesity in this center. On average, all surgeries performed have extremely positive results of excess weight lost. After 1 year, patients maintained an average weight loss percentage of 29.5 ± 9.4%, in line with data presented in a study that estimated an average recorded weight loss percentage of 28.9%. Data like those presented by the American Society for Nutrition (ASN), the Obesity Action Coalition (OAC), the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO), the International Society for the Perioperative Care of the Obese Patient (ISPCOP) and the American Society for Parenteral and Enteral Nutrition (ASPEN) (2019), indicate a target weight loss percentage between 20 and 45%.info:eu-repo/semantics/publishedVersio

Food Intake in Pregnant Women with Gestational Diabetes Mellitus

Rationale: The aim of the present study was to verify the fulfillment of the nutritional requirements of macronutrients of pregnant women diagnosed with Gestational Diabetes Mellitus (GDM) at Lusíadas Lisboa Hospital. Inadequate glycemic control in GDM increases the risk of maternal, fetal and neonatal consequences, in this sense, nutritional therapy is essential during the follow-up of these pregnant women. Methods: Cross-sectional observational study. The study sample included 20 pregnant women diagnosed with GDM. Participants were asked to answer a questionnaire that included relevant data and to complete a three-day food record, for which they gave consent. A statistical analysis was performed with IBM® SPSS® 25. Results: The mean age measured was 35±4 years and 75% of the sample were in the 3º trimester. In the pre-gestational period, the sample had a Body Mass Index (BMI) of 26,2±5,3kg/m2 . The mean fasting capillary blood glucose was 89±9mg/dL and the postprandial was 119±19mg/dL. 75% reached the fasting glycemic objective and 95% the postprandial. It was also found that pregnant women who didn´t meet the goal set for fasting blood glucose, had higher pre-gestational BMI. In terms of macronutrients, it was found that 75% of the sample didn´t reach Total Energy Requirements (TER), 50% didn´t reach protein (1,1g/kg of current weight/day and 15-20% TER), 10% lipid (30% TER) and all carbohydrates (50-55% TER), with only 35% reaching the daily minimum of carbohydrates (175g). It was also found that sample didn´t reach 28g/day of fiber. Conclusions: The present study demonstrated the importance of an individualized nutritional intervention by a nutritionist with pregnant women diagnosed with GDM. The importance of this intervention is based on adherence to an adequate dietary pattern that prevents nutritional deficits, enhances clinical outcomes and contributes to the prevention of the incidence of GDM.info:eu-repo/semantics/publishedVersio

Frutapin, a lectin from Artocarpus incisa (breadfruit): cloning, expression and molecular insights

Artocarpus incisa (breadfruit) seeds contain three different lectins (Frutalin, Frutapin and Frutackin) with distinct carbohydrate specificities. The most abundant lectin is Frutalin, an α-D-galactose-specific carbohydrate-binding glycoprotein with antitumour properties and potential for tumour biomarker discovery as already reported. Frutapin (FTP) is the second most abundant, but proved difficult to purify with very low yields and contamination with Frutalin frustrating its characterization. Here, we report for the first time high-level production and isolation of biologically-active recombinant FTP in E. coli BL21, optimizing conditions with the best set yielding >40 mg/L culture of soluble active FTP. The minimal concentration for agglutination of red blood cells was 62.5 µg/mL of FTP, a process effectively inhibited by mannose. Apo-FTP, FTP-mannose and FTP-glucose crystals were obtained and diffracted X-rays to a resolution of 1.58 (P212121), 1.70 (P3121) and 1.60 (P3121) Å, respectively. The best solution showed four monomers per asymmetric unit. Molecular Dynamics simulation suggested FTP displays higher affinity for mannose than glucose. Cell studies revealed FTP was non-cytotoxic to cultured mouse fibroblast 3T3 cells below 0.5 mg/mL and also capable of stimulating cell migration at 50 µg/mL. In conclusion, our optimized expression system allowed high amounts of correctly-folded soluble FTP to be isolated. This recombinant bioactive lectin will now be tested in future studies for therapeutic potential; for example, in wound healing and tissue regeneration

Verified and potential pathogens of predatory mites (Acari: Phytoseiidae)

Several species of phytoseiid mites (Acari: Phytoseiidae), including species of the genera Amblyseius, Galendromus, Metaseiulus, Neoseiulus, Phytoseiulus and Typhlodromus, are currently reared for biological control of various crop pests and/or as model organisms for the study of predator¿prey interactions. Pathogen-free phytoseiid mites are important to obtain high efficacy in biological pest control and to get reliable data in mite research, as pathogens may affect the performance of their host or alter their reproduction and behaviour. Potential and verified pathogens have been reported for phytoseiid mites during the past 25 years. The present review provides an overview, including potential pathogens with unknown host effects (17 reports), endosymbiotic Wolbachia (seven reports), other bacteria (including Cardinium and Spiroplasma) (four reports), cases of unidentified diseases (three reports) and cases of verified pathogens (six reports). From the latter group four reports refer to Microsporidia, one to a fungus and one to a bacterium. Only five entities have been studied in detail, including Wolbachia infecting seven predatory mite species, other endosymbiotic bacteria infecting Metaseiulus (Galendromus, Typhlodromus) occidentalis (Nesbitt), the bacterium Acaricomes phytoseiuli infecting Phytoseiulus persimilis Athias-Henriot, the microsporidium Microsporidium phytoseiuli infecting P. persimilis and the microsporidium Oligosproridium occidentalis infecting M. occidentalis. In four cases (Wolbachia, A. phytoseiuli, M. phytoseiuli and O. occidentalis) an infection may be connected with fitness costs of the host. Moreover, infection is not always readily visible as no obvious gross symptoms are present. Monitoring of these entities on a routine and continuous basis should therefore get more attention, especially in commercial mass-production. Special attention should be paid to field-collected mites before introduction into the laboratory or mass rearing, and to mites that are exchanged among rearing facilities. However, at present general pathogen monitoring is not yet practical as effects of many entities are unknown. More research effort is needed concerning verified and potential pathogens of commercially reared arthropods and those used as model organisms in research

EPIDEMIOLOGY OF SCORPION ENVENOMATION IN THE STATE OF CEARÁ, NORTHEASTERN BRAZIL

This report is a retrospective study of the epidemiology of scorpion sting cases recorded from 2007 to 2013 in the State of Ceará, Northeastern Brazil. Data were collected from the Injury Notification Information System database of the Health Department of Ceará. A total of 11,134 cases were studied and distributed across all the months of the studied period and they occurred mainly in urban areas. Victims were predominantly 20-29 years-old women. Most victims were bitten on the hand; and received medical assistance within 1-3 hours after being bitten. Cases were mostly classified as mild and progressed to cure. Scorpion envenomation in Ceará is an environmental public health problem that needs to be monitored and controlled throughout the year

Performance indicators for clinical practice management in primary care in Portugal : consensus from a Delphi study

Early OnlineBackground: Performance indicators assessing the quality of medical care and linked to pay for performance may cause disagreement. Portuguese indicators included in recent health care reform are controversial. Objectives: To obtain consensus from opinion leaders in family medicine regarding the performance indicators for practice management used in the evaluation of Family Health Units in Portugal. Methods: Eighty-nine specialists in primary care were invited to answer the following question in an online Delphi study: 'Which performance indicators should be assessed regarding the organization and management of clinical practice in primary care in Portugal?' A Likert scale was used to evaluate validity, reliability, feasibility and sensitivity to change. Twenty-seven experts participated in the second round and achieved a high degree of consensus. Eight categories were created for analysis. Results: The experts suggested the use of existing indicators as well as new indicators. Thirty-nine indicators suggested by the experts are currently in use in Portugal. The assessment of the number of clinical acts performed, the number of administrative acts, and evaluation of the clinical demographic profile achieved a high degree of consensus. The expert panel suggested fifty new indicators. Five categories of these new indicators had a high degree of consensus, and three categories had a low degree of consensus. Conclusion: The expert panel recommended that performance indicators of practice management should first assess the quantity of clinical and administrative activities undertaken. These indicators must take into account the human and financial resources available to the clinic and its demographic context

College of Radiology, Academy of Medicine of Malaysia position on whole body screening CT scans in healthy asymptomatic individuals (2008)

To date, the College of Radiology (CoR) does not see any clear benefit in performing whole body screening computed tomography (CT) examinations in healthy asymptomatic individuals. There are radiation risk issues in CT and principles of screening should be adhered to. There may be a role for targeted cardiac screening CT that derives calcium score, especially for asymptomatic medium-risk individuals and CT colonography when used as part of a strategic programme for colorectal cancer screening in those 50 years and older. However, population based screening CT examinations may become appropriate when evidence emerges regarding a clear benefit for the patient outweighing the associated radiation risks