Effects of a 3-Week Inpatient Multidisciplinary Body Weight Reduction Program on Body Composition and Physical Capabilities in Adolescents and Adults With Obesity

BackgroundThe aim of the present study was to examine the short-term changes in body composition and physical capabilities in subjects with obesity during a multidisciplinary inpatient body weight reduction program (BWRP). MethodsOne hundred thirty-nine adolescents (56 boys and 83 girls; BMI: 37.1 +/- 6.5 kg/m(2); Fat Mass, FM: 45.3 +/- 7.2%) and 71 adults (27 males and 44 females; BMI: 44 +/- 4.7 kg/m(2); FM: 51.4 +/- 4.7%) followed a 3-week inpatient BWRP consisting of regular physical activity, moderate energy restriction, nutritional education and psychological counseling. Before (T0) and after the end of the BWRP (T21), body composition was assessed with an impedancemeter, lower limb muscle power with Margaria Stair Climbing Test (SCT), lower limb functionality with Short Physical Performance Battery (SPPB), and the capacity of performing activity of daily living (ADL) with Physical Performance Test (PPT). ResultsAt T21, obese adolescents showed a 4% reduction in body mass (BM) (p < 0.001), associated with a FM reduction in boys (-10%) and girls (-6%) (p < 0.001) and with a 3% reduction in fat-free mass (FFM) recorded only in boys (p = 0.013). Obese adults showed a 5% BM reduction (p < 0.001), associated with a 2% FFM and 9% FM reduction (p < 0.001) in males, and 7% FM reduction in females (p < 0.001). Regarding physical capabilities, at T21 in obese adolescents, PPT score increased by 4% (p < 0.001), SCT decreased by -5% (boys) and -7% (girls) (p < 0.001), while SPPB score did not change significantly. In obese adults at T21, PPT score increased by 9% (p < 0.001), SCT decreased by -16% (p < 0.001) only in females, and SPPB score increased by 7% (males) and 10% (females) (p < 0.01). ConclusionIn conclusion, moderate energy restriction and regular physical activity determine a 4-5% BM reduction during a 3-week inpatient BWRP, improve physical capabilities and induce beneficial changes in body composition in adolescents and adults with obesity

A sistematização de assistência de enfermagem no pós-operatório ortopédico promovendo o autocuidado / The systematization of nursing assistance in the orthopedic post operatory promoting self-care

A sistematização da Assistência de Enfermagem Perioperatória (SAEP) emprega procedimentos destinados ao cuidado para os usuários e familiares. Objetivou-se apresentar um instrumento de cuidados pós-operatório ortopédico, baseado em OREN. Trata-se de um estudo quanti-qualitativo, com o desenvolvimento de instrumento de SAEP ortopédicas, com enfermeiros que oferecem cuidados, na microrregião de São José do Rio Pardo SP, através da aplicação do questionário on-line semiestruturado. Os resultados encontrados foram todos reconhecem a SAEP como ferramenta para a qualidade, auxiliando na identificação e prevenção do comprometimento cirúrgico.  Para a construção da SAEP foram incluídos os itens da identificação: Idade            12,9%, Data /hora 14%, Sexo 8%. Histórico Cirúrgico: Medicamentos administrados      7,3%, SSVV inicio e termino cirurgia 7,3%. Exame físico de PO: Escala de Glasgow 10,2, Hipotermia maligna/ Hiperemia 10,2%. Diagnóstico de enfermagem: Risco de queda          17,5%, Risco para Retenção urinária            7,5%. Resultados Esperados Prevenção do Risco de queda 13,3%. Intervenções de Enfermagem: Prevenir queda e avaliar deambulação25,4%, Ingesta hídrica e de alimentos  7,8%. Foi possível elaborar uma SAEP pós-operatória ortopédica, para auxiliar no cuidado prestado de forma segura, integral e individualizada, prover e prever complicações sem prolongar a permanência dos clientes, além do necessário

Expanding the circularity of plastic and biochar materials by developing alternative low environmental footprint sensors

Flexible screen-printing technology combined with the use of a nano/material coating for improving electrode functionalities boosted the manufacturing of highly sensitive electrochemical sensors addressing the need for fast and easy-to-handle tests in different application fields. However, due to the large-scale production and disposable and single-use nature of these devices, their environmental footprint should be taken into careful consideration. Herein, the innovative reuse of post-consumer polyethene terephthalate (PET) plastics as an alternative substrate coupled with biochar as an environmentally friendly and cost-effective modifier is described as a sustainable alternative for the production of robust electrochemical sensors. The good printability of reused plastics with graphite inks despite the chemical heterogeneity, different crystallinity, and surface roughness was demonstrated using atomic force microscopy and attenuated total reflection Fourier transform infrared spectroscopy. Functionalization with brewers' spent grain biochar enabled the fabrication of highly performing electrochemical sensors for nitrite detection in water having a limit of detection and a limit of quantification of 3.3 nM and 10.3 nM, respectively, with a linear range spanning from 0.01 to 500 &amp; mu;M, and good reproducibility (RSD% 8%). The innovative intervention of the biochar-multilayer system markedly enhanced the electron transfer process at the electrode interface while simultaneously serving as an absorptive material for the investigated analyte. This work lays a foundation for repurposing end-of-life plastics for the electronics industry and presents a customizable reuse strategy aimed to keep the value of plastics in the economy and reduce waste and leakage into the natural environment

HPRTSardinia: a new point mutation causing HPRT deficiency without Lesch–Nyhan disease

AbstractHypoxanthine-guanine phosphoribosyltransferase (HPRT) deficiency always causing hyperuricemia presents various degrees of neurological manifestations, the most severe which is Lesch–Nyhan syndrome. The HPRT gene is situated in the region Xq26-q27.2 and consists of 9 exons. At least 300 different mutations at different sites in the HPRT coding region from exon 1 to exon 9 have been identified. A new mutation in the HPRT gene has been determined in one patient with complete deficiency of erythrocyte activity, with hyperuricemia and gout but without Lesch–Nyhan disease. Analysis of cultured fibroblasts revealed minimal residual HPRT activity mainly when guanine was the substrate. Genomic DNA sequencing demonstrated patient's mother heterozygosity for the mutation and no mutation in her brother. The mutation consists in a C→T transversion at cDNA base 463 (C463T) in exon 6, resulting in proline to serine substitution at codon 155 (P155S). This mutation had not been reported previously and has been designated HPRTSardinia. The mutation identified in this patient allows some expression of functional enzyme in nucleated cells such as fibroblasts, indicating that such cell type may add further information to conventional blood analysis. A multicentre survey gathering patients with variant neurological forms could contribute to understand the pathophysiology of the neurobehavioral symptoms of HPRT deficiency

Mechanical Prevention of Distal Embolization During Primary Angioplasty

Background— Effective myocardial reperfusion after primary percutaneous coronary intervention (PCI) may be limited by distal embolization. We tested the safety, feasibility, and efficacy of the FilterWire-Ex (FW), a distal embolic protection device, as an adjunct to primary PCI. Methods and Results— Fifty-three consecutive patients undergoing primary PCI with FW protection were compared with a matched control group treated by primary PCI alone. Successful FW positioning was obtained in 47 patients (89%) without complications. Histological analysis of the content of the last 13 filters showed multiple embolic debris in all cases. FW use was associated with lower postinterventional corrected TIMI frame count (22±14 versus 31±19; P =0.005) and higher occurrence of grade 3 myocardial blush (66% versus 36%; P =0.006) and early ST-segment elevation resolution (80% versus 54%; P= 0.006). At multivariate analysis, FW use was the only independent predictor of early ST-segment elevation resolution and of grade 3 myocardial blush. FW patients showed lower peak creatine kinase-MB release (236±172 versus 333±219 ng/mL; P =0.013) and greater improvement at 30 days in left ventricular wall motion score index (−0.30±0.19 versus −0.18±0.26; P= 0.008) and ejection fraction (+7±4% versus +4±7%; P =0.012). Conclusions— FW use during primary PCI is feasible and safe. Distal embolization prevention appears to exert a beneficial effect on markers of myocardial reperfusion and on left ventricular function improvement at 30 days

Highly Sensitive Electrodic Materials Based on Pt Nanoflowers Grown on Pt Nanospheres for Biosensor Development

In this work we describe the realization of monometallic nanostructures by two simple electrodeposition steps. The surface of the modified electrode was characterized by scanning electron microscopy that confirms a homogeneous deposition of Pt nanospheres decorated with Pt nanoflowers. The so obtained nanostructured sensor exhibited good amperometric response towards hydrogen peroxide sensing at +0.30 V vs Ag|AgCl|Cl-. Therefore, it is especially useful toward glucose detection with reduced interferences. Glucose oxidase was immobilized onto the nanostructured surface by cross-linking with glutaraldehyde and the biosensor was characterized by chronoamperometric method in phosphate buffer. The biosensor showed a sensitivity of 29 ± 2 μA/(mM cm2). Measurements in cell media reveal that the Pt-Pt hybrid nanostructures are promising for real-time glucose monitoring in real biosample

Differences in spinal postures and mobility among adults with Prader-Willi syndrome, essential obesity, and normal-weight individuals

Introduction: Spinal kinematics/motion are reported to be altered in adolescents and adults with essential obesity, while no information is available in patients with Prader-Willi syndrome so far. The aim of this study was to examine cross-sectionally the characteristics of spinal postures and mobility in 34 patients with PWS, in 35 age- and sex-matched adults with essential obesity, and in 37 normal-weight individuals. Methods: Spinal posture and mobility were assessed using a radiation-free back scan, the Idiag M360 (Idiag, Fehraltorf, Switzerland). Differences in spinal posture and mobility between the three groups were determined using a two-way analysis of variance. Results: Adults with Prader-Willi syndrome had greater thoracic kyphosis [difference between groups (Δ) = 9.60, 95% CI 3.30 to 15.60, p = 0.001], less lumbar lordosis (Δ = -6.50, 95% CI -12.70 to -0.30, p = 0.03) as well as smaller lumbar and hip mobility than those with normal weight. Discussion: Although the characteristics of the spine in patients with Prader-Will syndrome appear to be similar to that found in subjects with essential obesity, Prader-Willi syndrome was found to influence lumbar movements more than thoracic mobility. These results provide relevant information about the characteristics of the spine in adults with Prader-Willi syndrome to be taken into careful consideration in the management of spinal conditions. These findings also highlight the importance of considering the musculoskeletal assessment of spinal postures and approaches targeting spinal and hip flexibility in adults with Prader-Willi syndrome

Changes in the Oswestry Disability Index after a 3-week in-patient multidisciplinary body weight reduction program in adults with obesity

The aim of this study was to examine the short-term changes in disability after an inpatient, multidisciplinary body weight reduction program (BWRP) in adults with obesity. A total of 160 individuals (males: 52, females: 108, BMI > 35 kg/m2) hospitalized for a 3-week multidisciplinary BWRP were recruited into the study. Body composition, lower limb muscle power, fatigue severity, and disability were measured at the beginning and end of the intervention by means of bioimpedance analysis, a stair climbing test (SCT), the Fatigue Severity Scale (FSS), and the Oswestry disability index (ODI), respectively. At the end of the 3-week BWRP, an average body weight reduction of 5.0 kg (CI 95% -5.3; -4.6, p < 0.001) was determined, as well as an improvement in all parameters measured. Clinically meaningful reductions in disability were observed in the moderate disability (Δ = -11.8% CI 95% -14.3; -9.3, p < 0.001) and severe disability (Δ = -15.9% CI 95% -19.6; -12.2, p < 0.001) groups. Reductions in disability were explained only by improvements in the SCT (Δ = -2.7 CI 95% -4.1; -1.4, p < 0.001) and the FSS (Δ = -0.3% CI 95% -0.4; -0.1, p < 0.001). These findings demonstrate the importance of incorporating approaches into a BWRP that increase lower limb muscle power and decrease fatigue severity and thus reduce disability in adults with obesity