Sleep study, respiratory mechanics, chemosensitive response and quality of life in morbidly obese patients undergoing bariatric surgery: a prospective, randomized, controlled trial

<p>Abstract</p> <p>Background</p> <p>Obesity is a major public health problem in both developed and developing countries alike and leads to a series of changes in respiratory physiology. There is a strong correlation between obesity and cardiopulmonary sleep disorders. Weight loss among such patients leads to a reduction in these alterations in respiratory physiology, but clinical treatment is not effective for a long period of time. Thus, bariatric surgery is a viable option.</p> <p>Methods/Design</p> <p>The present study involves patients with morbid obesity (BMI of 40 kg/m²or 35 kg/m²to 39.9 kg/m²with comorbidities), candidates for bariatric surgery, screened at the Santa Casa de Misericórdia Hospital in the city of Sao Paulo (Brazil). The inclusion criteria are grade III morbid obesity, an indication for bariatric surgery, agreement to participate in the study and a signed term of informed consent. The exclusion criteria are BMI above 55 kg/m², clinically significant or unstable mental health concerns, an unrealistic postoperative target weight and/or unrealistic expectations of surgical treatment. Bariatric surgery candidates who meet the inclusion criteria will be referred to Santa Casa de Misericórdia Hospital and will be reviewed again 30, 90 and 360 days following surgery. Data collection will involve patient records, personal data collection, objective assessment of HR, BP, neck circumference, chest and abdomen, collection and analysis of clinical preoperative findings, polysomnography, pulmonary function test and a questionnaire on sleepiness.</p> <p>Discussion</p> <p>This paper describes a randomised controlled trial of morbidly obese patients. Polysomnography, respiratory mechanics, chemosensitive response and quality of life will be assessed in patients undergoing or not undergoing bariatric surgery.</p> <p>Trial Registration</p> <p>The protocol for this study is registered with the Brazilian Registry of Clinical Trials - ReBEC (RBR-9k9hhv).</p

Homens e violência conjugal: uma análise de estudos brasileiros Men and conjugal violence: an analysis of Brazilian studies

O estudo analisou qualitativamente 54 textos brasileiros sobre homens e violência conjugal, relacionados a atividades de pesquisa ou de intervenção. Primeiramente caracterizou-se o material quanto aos temas abordados, ao foco principal e ao tipo de texto. A seguir fizeram-se sínteses e análises das principais considerações dos textos a partir dos eixos temáticos encontrados: diferentes inteligibilidades da problemática, magnitude da violência conjugal, sentidos de homens relacionados à violência e intervenções e/ou políticas junto a homens agressores. A análise teve como parâmetro o ramo de discussões nacionais e internacionais que se esforça por ultrapassar a polêmica em torno da definição do problema como "violência de gênero" ou "violência conjugal", cunhando sobretudo o pressuposto de que existem diversos estilos de conjugalidade violenta. Concluiu-se que a maior unanimidade dos estudos é pensar a problemática como questão relacional de gênero. Defendeu-se, por fim, a ideia de que a escolha da melhor abordagem articuladora entre os polos da polêmica ainda demanda mais investigações, com metodologias qualitativas junto a atores de diferentes camadas e grupos sociais. Quanto às intervenções, propõem-se investimentos no maior número possível de alternativas, valorizando a singularidade dos casos.<br>This study consisted of a qualitative analysis of 54 Brazilian texts about men and conjugal violence related to research or intervention activities. Initially, the material was divided up according to the topics under scrutiny, the main focus and the type of text. Analysis and synthesis of the main considerations of the texts, based on the thematic points revealed, was then carried out. This included the different approaches to the problem, the magnitude of conjugal violence, the attitudes of men vis-à-vis violence and interventions and/or policies towards male aggressors. The parameter for the analysis was the national and international debate seeking to overcome the controversy surrounding the definition of the problem as "gender violence" or conjugal violence," essentially fostering the hypothesis of various types of violent conjugal relationships. It was concluded that the unanimous outcome of the study was to view the problem as a gender relationship issue. Lastly, it was argued that the choice of the best approach between the poles of the controversy requires further investigation using qualitative methodologies together with players from different classes and social backgrounds. With respect to further intervention, it was considered necessary to examine a broad gamut of alternatives emphasizing the singular nature of the cases