Interference of wheight loss on cardiovascular risk and type 2 Diabetes 24 months after gastric bypass – cohort retrospective: Interferência da perda de peso no risco cardiovascular e Diabetes tipo 2 24 meses após bypass gástrico – coorte retrospective

Background: Obesity has increased in prevalence and thus has become a public health crisis. The objective of this study was to evaluate the impact of weight loss on the resolution of type 2 diabetes mellitus and cardiovascular risk. Methods: This is a retrospective cohort and descriptive study, involved consulting a database, from March 2018 to March 2019. The subjects were  female and male patients, ≥18 years, who had been submitted to bariatric surgery  from March 2014 to March 2016. The following data were obtained from their  charts: weight, height, age, sex, presence of associated morbidities (type 2 diabetes mellitus, cardiovascular risk), glycated hemoglobina and glucose. The data a presented as the mean and standard deviation, median and interquartile range, or count and percentage. The results were considered statistically significant if p-value ≤0.05. Results: The patients had maintained a substantial percentage of excesso wheight loss (%EWL) during the postoperative period, and the Hb1Ac, glucose, CVR, and metabolic alterations were also reduced. Six months after surgery, group 1 (<70% EWL) and group 2 (≥ 70%) showed reduced Hb1Ac and, glucose and only group 2 showed reduced CVR. From 12 to 18 months after surgery, group 1 showed reduced Hb1Ac. From 18 to 24 months after surgery, group 2 showed reduced CVR and group 1 showed reduced glucose. Conclusion: Bariatric surgery had a positive effect on %EWL and modified the metabolic profile and CVR of patients up to 24 months after gastric bypass, reducing associated comorbidities

Quality of life and body image after bariatric and body contouring surgery

Introduction: The demand for body contouring surgery after bariatric surgery is largely due to dissatisfaction with body image impaired by sagging and excess skin resulting from massive weight loss. This study aimed to evaluate the quality of life and body image of patients undergoing bariatric surgery and body contouring surgery in a private clinic. Method: This cross-sectional study compared 4 groups of 21 patients, matched by body mass index and age before undergoing bariatric surgery. They were divided into times before/after bariatric surgery and before/after body contouring surgery, thus forming groups A, B, C, and D, respectively. The SF-36 questionnaire assessed the quality of life, and the Silhouette Scale proposed by Kakeshita to assess body image. For the significance level, p<0.05 was chosen. Results: There was an improvement in all SF-36 domains after bariatric surgery. Patients who sought body contouring surgery had the lowest mental health component value, with little change after body contouring surgery. Almost all groups overestimated their silhouette, except for the group of 6 months after bariatric surgery, which saw itself as smaller. Conclusion: Bariatric patients seeking body contouring surgery have lower mental health-related quality of life scores that remain lower after body contouring surgery

The use of soy oil deodorization distillate as an alternative source of vitamin E reduced the weight gain of rats

OBJECTIVE: The objective of this study was to determine if the use of soybean oil deodorization distillate as an alternative source of vitamin E, both in natura and neutralized, affected the growth of Wistar rats. The effects on the Food Conversion Ratio and the Net Protein Efficiency Ratio for casein were also determined. METHODS: Recently weaned, male, Specific Pathogen Free rats, fed on the AIN-93G formulated diet, were divided into five experimental groups, each with 10 animals, and supplemented by oral-gastric drip: the control and no protein groups were supplemented with olive oil (placebo); group B was supplemented with crude soybean oil deodorization distillate; group N was supplemented with neutralized soybean oil deodorization distillate and group E was supplemented with EphinalÒ. Groups B, N and E received the vitamin mixture depleted with respect to vitamin E. RESULTS: The weight increases of the rats and the ratios calculated for groups control and E gave higher values than for the other groups (p0.05) between groups B and N with respect to weight gain, showing values 32% lower than for groups control and E. Groups control and E showed the highest values for Protein Efficiency Ratio, 3.9 and 4.0, and for Food Conversion Ratio, 0.38 and 0.41, respectively, showing no significant difference between these two groups. Group B showed lower Protein Efficiency Ratio and Food Conversion Ratio values, 3.0 and 0.26, than group N, 3.5 and 0.32, showing that neutralization of the soybean oil deodorization distillate reduced possible anti-nutritional or toxic effects of this residue. CONCLUSION: It was shown that the use of soybean oil deodorization distillate had a negative effect on the weight gain of rats and on the indexes of diet and protein quality of the casein.OBJETIVO: Verificar se a utilização do destilado da desodorização do óleo de soja in natura e neutralizado como fonte alternativa de vitamina E afetava o crescimento de ratos Wistar, assim como, o quociente de conversão alimentar e o quociente de eficiência líquida da caseína. MÉTODOS: Ratos Specific Pathogen Free, machos, recém-desmamados, receberam dieta segundo a formulação AIN-93G e foram divididos em cinco grupos experimentais, com dez animais cada um, e respectivamente suplementados por gavagem: os grupos-controle e aprotéico foram suplementados com óleo de oliva (placebo); o grupo B, suplementado com destilado da desodorização do óleo de soja bruto; o grupo N, suplementado com destilado da desodorização do óleo de soja neutralizado e o grupo E, suplementado com Ephinalâ. Os grupos B, N e E receberam mistura vitamínica depletada em vitamina E. RESULTADOS: A evolução ponderal dos ratos e os quocientes calculados para os grupos-controles e E apresentaram valores superiores (p0,05), e os valores foram 32% inferiores aos grupos-controle e E. Os grupos-controle e E apresentaram maiores valores de quociente de eficiência protéica líquida, 3,9 e 4,0, e quociente de conversão alimentar, 0,38 e 0,41, respectivamente, não diferindo entre si. O grupo B apresentou menores valores de quociente de eficiência protéica líquida e quociente de conversão alimentar (3,0 e 0,26) em relação ao grupo N (3,5 e 0,32), o que demonstrou que a neutralização do destilado da desodorização do óleo de soja reduziu possíveis efeitos antinutricionais ou tóxicos desse resíduo. CONCLUSÃO: Verificou-se, assim, que o destilado da desodorização do óleo de soja influenciou negativamente a evolução ponderal dos ratos e os índices de qualidade dietética e protéica da caseína.69369

Diretriz Brasileira sobre a Saúde Cardiovascular no Climatério e na Menopausa – 2024

Women, who represent approximately half of the global population according to estimates as of January 2024, may experience signs and symptoms of menopause for at least one-third of their lives, during which they have a higher risk of cardiovascular morbidity and mortality. The effects of menopausal hormone therapy (MHT) on the progression of atherosclerosis and cardiovascular disease (CVD) events vary depending on the age at which MHT is initiated and the time since menopause until its initiation. Beneficial effects on CVD outcomes and all-cause mortality have been observed when MHT was initiated before the age of 60 or within 10 years after menopause. The decision regarding the initiation, dose, regimen, and duration of MHT should be made individually after discussing the benefits and risks with each patient. For primary prevention of postmenopausal chronic conditions, the combined use of estrogen and progestogen is not recommended in asymptomatic women, nor is the use of estrogen alone in hysterectomized women. Hormone-dependent neoplasms contraindicate MHT. For the treatment of genitourinary syndrome of menopause, vaginal estrogen therapy may be used in patients with known cardiovascular risk factors or established CVD. For women with contraindications to MHT or who refuse it, non-hormonal therapies with proven efficacy (antidepressants, gabapentin, and fezolinetant) may improve vasomotor symptoms. Compounded hormonal implants, or "bioidentical" and "compounded" hormones, and "hormone modulation" are not recommended due to lack of scientific evidence of their effectiveness and safety.Mujeres, que representan aproximadamente la mitad de la población mundial según estimaciones de enero de 2024, pueden experimentar signos y síntomas de la menopausia durante al menos un tercio de sus vidas, durante los cuales tienen un mayor riesgo de morbilidad y mortalidad cardiovascular. Los efectos de la terapia hormonal de la menopausia (THM) en la progresión de la aterosclerosis y los eventos de enfermedad cardiovascular (ECV) varían según la edad en que se inicia la THM y el tiempo transcurrido desde la menopausia hasta su inicio. Se han observado efectos beneficiosos en los resultados de ECV y la mortalidad por todas las causas cuando la THM se inició antes de los 60 años o dentro de los 10 años posteriores a la menopausia. La decisión sobre la iniciación, dosis, régimen y duración de la THM debe tomarse individualmente después de discutir los beneficios y riesgos con cada paciente. Para la prevención primaria de condiciones crónicas en la posmenopausia, no se recomienda el uso combinado de estrógeno y progestágeno en mujeres asintomáticas, ni el uso de estrógeno solo en mujeres histerectomizadas. Las neoplasias dependientes de hormonas contraindican la THM. Para el tratamiento del síndrome genitourinario de la menopausia, se puede usar terapia estrogénica vaginal en pacientes con factores de riesgo cardiovascular conocidos o ECV establecida. Para mujeres con contraindicaciones a la THM o que la rechazan, las terapias no hormonales con eficacia demostrada (antidepresivos, gabapentina y fezolinetant) pueden mejorar los síntomas vasomotores. Los implantes hormonales compuestos, o hormonas "bioidénticas" y "compuestas", y la "modulación hormonal" no se recomiendan debido a la falta de evidencia científica sobre su efectividad y seguridad.As mulheres, que representam cerca de metade da população mundial segundo estimativas de janeiro de 2024, podem sofrer com sinais e sintomas da menopausa durante pelo menos um terço de suas vidas, quando apresentam maiores risco e morbimortalidade cardiovasculares. Os efeitos da terapia hormonal da menopausa (THM) na progressão de eventos de aterosclerose e doença cardiovascular (DCV) variam de acordo com a idade em que a THM é iniciada e o tempo desde a menopausa até esse início. Efeitos benéficos nos resultados de DCV e na mortalidade por todas as causas ocorreram quando a THM foi iniciada antes dos 60 anos de idade ou nos 10 anos que se seguiram à menopausa. A decisão sobre o início, a dose, o regime e a duração da THM deve ser tomada individualmente após discussão sobre benefícios e riscos com cada paciente. Para a prevenção primária de condições crônicas na pós-menopausa, não se recomendam o uso combinado de estrogênio e progestagênio em mulheres assintomáticas nem o uso de estrogênio sozinho em mulheres histerectomizadas. Neoplasias hormônio-dependentes contraindicam a THM. Para tratamento da síndrome geniturinária da menopausa, pode-se utilizar terapia estrogênica por via vaginal em pacientes com fatores de risco cardiovascular conhecidos ou DCV estabelecida. Para mulheres com contraindicação à THM ou que a recusam, terapias não hormonais com eficácia comprovada (antidepressivos, gabapentina e fezolinetante) podem melhorar os sintomas vasomotores. Os implantes hormonais manipulados, ou hormônios “bioidênticos” “manipulados”, e a ‘modulação hormonal’ não são recomendados pela falta de evidência científica de sua eficácia e segurança

Vitamin and of the distilled one of the desodorização of the soy oil and under form of fármaco in the prevention to the oxidation of lípides and the decurrent hepática necrosis of deficient diet in cistina for rats

Orientador: Admar Costa de OliveiraDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Engenharia de AlimentosResumo: A finalidade deste trabalho foi avaliar a ocorrência de necrose hepática em ratos Wistar submetidos a dietas deficientes em cistina e vitamina E, ocorrência muito citada em artigos realizados na década de 50. O exame histológico foi utilizado para avaliar a presença de necrose hepática e a análise da oxidação dos lípides hepáticos foi medida pelo método do ácido tiobarbitúrico (TBA). A dosagem de bilirrubina urinária também foi utilizada como indicativo da existência de necrose hepática. As dietas experimentais seguiram a formulação da dieta AIN-93G, utilizandose como fonte protéica o feijão-comum (120/0). A opção pelo feijão-comum foi feita por ser uma fonte de proteína deficiente em aminoácidos sulfurados, principalmente a cistina, e também um dos alimentos mais consumidos pela população brasileira. Foram utilizados ratos Wistar (68,0:f:13,1g) que foram divididos em 5 grupos experimentais: grupo CO (controle), que recebeu dieta AIN-93G contendo feijão-comum como fonte protéica; grupo DE, que recebeu dieta AIN-93G contendo feijão-comum como fonte protéica, porém depletada em cistina e vitamina E; grupo EP, que recebeu dieta AIN-93G contendo feijão-comum como fonte protéica, depletada em cistina e vitamina E, com suplementação de vitamina E através do fármaco EPHINAL@, em quantidade equivalente a 50mg/dia da vitamina; grupo DO, que recebeu dieta AIN-93G contendo feijão-comum como fonte protéica, depletada em cistina e vitamina E com suplementação de vitamina E através do Destilado da Desodorização do Óleo de Soja (DOaS) em quantidade equivalente a 50mg/dia da vitamina; grupo AP (aprotéico), para fins de correção dos dados. A título de monitoramento, durante o período experimental foram avaliados, o ganho de peso dos animais, o Quociente de Eficiência Protéica (PER), o Quociente de Conversão Alimentar (QCA) e a digestibilidade protéica. Houve diferença significativa entre todos os grupos, para o ganho de peso, o PER e o OCA (p<0,05) sendo que os menores valores foram encontrados para os grupos suplementados, possivelmente pela suplementação ter ocasionado saciedade nos animais que, via de conseqüência, ingeriram menos dieta. Com relação à digestibilidade corrigida pela dieta aprotéica, verificou-se que os grupos CO e EP apresentaram o mesmo valor, 59,6%, e superior aos grupos DE e DO que apresentaram valores de 54,5 e 56,40/0 respectivamente, não diferindo significativamente. Aos 40 dias e no final do experimento, 57 dias, os animais tiveram seus fígados dissecados e amostras do lobo lateral esquerdo foram coletadas para exame histológico, sendo o restante dos fígados congelados em nitrogênio líquido e liofilizados para análise de TBA. A análise dos cortes histológicos não apresentou alterações estruturais entre o fígado dos animais dos grupos controle e experimentais. As concentrações de TBA foram significativamente maiores nos animais do grupo DE (46,2:t10,3mg/Kg) quando comparadas às dos demais grupos, o que demonstrou maior nível de oxidação hepática neste grupo. Os grupos suplementados com vitamina E (EP e DO), apresentaram proteção contra a oxidação hepática. Pôde-se, portanto, concluir que utilizando estas condições experimentais, dietas deficientes em aminoácidos sulfurados, especialmente a cistina, não causaram o aparecimento de necrose hepáticaAbstract: The objective of this research was to evaluate the occurrence of hepatic necrosis in Wistar rats fed on diets deficient in cystine and vitamin E, an occurrence cited with frequency in articles published in the fifties. A histological examination was used to evaluate the presence of hepatic necrosis and the anafysis of oxidation of the hepatic fipids was measured by the thiobarbituric acid (TBA) method. The levei of urinary bilirubin was also used as an indication of the existence of hepatic necrosis. The experimental diets were formulated according to the AfN-93G diet, using the common bean (120/0) as the protein source. The common bean was chosen since its protein is deficient in sulfur amino acids, principally in cystine, and is also one of the food items most consumed by the Brazifian population. Wistar rats were used (68.0::t13.1 g) divided into 5 experimental groups: group CO (control), which received the AIN-93G diet containing the common bean as protein source; group DE, which received the AfN-93G diet containing the common bean as protein source, but depleted in cystine and vitamin E; group EP, which received the AIN-93G diet containing the common bean as protein source, depleted in cystine and vitamin E but supplemented by vitamin E in the form of the pharmaceutical EPHINAl@ at a rate equivalent to 50mg/day of the vitamin; group DD, which received the AIN-93G diet containing the common bean as protein source, depleted in cystine and vitamin E but supplemented with vitamin E using deodorized soybean oi! distillate (D80D) at a rate equivalent to 50mg/day of the vitamin; group AP (aproteic), used to correct the data. During the experimental period, the following parameters were monitored: weight gain of the animais, protein efficiency ratia (PER), the food conversion ratio (FCR) and the protein digestibility. There was a significant difference between ali the groups with respect to weight gain, PER and FCR (p<0.05) the lowest values being found for the supplemented groups, possibly because the supplementation provided a feeling of satisfaction to the animaIs who consequently consumed less diet. With respect to digestibility, corrected by the aproteic diet, groups CO and EP showed the same value, 59.6%, greater than groups DE and DO which presented values of 54.5 and 56.40/0 respectively, not differing significantly. After 40 days and at the end of the experiment (57 days) , the livers of animais were dissected and samples from the left lateral lobe collected for the histological examination, the rest of the tiver being frozen in liquid nitrogen and freeze dried for the TBA analysis. The histologycal examination showed that there were no structural alterations in the tiver of the control group, as well as in the experimental animais. The TBA concentration of the group DE (46,2:t10,3mg/Kg) showed a higher levei of hepatic oxidation, when compared with the other groups. The supplemented groups EP and DO presenting protection against oxidation. Thus it can be concluded that under these experimental conditions, diets deficient in sulfur amino aCids, especially in cystine, do not result in the appearance of hepatic necrosisMestradoMestre em Ciência da Nutriçã

Association between crack cocaine use and reduced salivary flow

Abstract Crack cocaine use appears to have an impact on oral conditions. However, changes in the salivary flow among crack users have not been fully clarified. The aim of this study was to compare stimulated salivary flow and the occurrence of hyposalivation between crack users and non-users. A cross-sectional study was conducted involving 40 crack users and 40 controls matched for sex, age, and smoking habits. Interviews were conducted to acquire data on the perception of dry mouth (xerostomia) and drug use. Stimulated salivary flow was determined using the spitting method. A significant reduction in stimulated salivary flow was found among crack users in comparison to non-users (1.02 vs. 1.59 ml/min). A total of 42.5% and 15% of crack users had very low and low stimulated salivary flow, respectively. Moreover, 65% of users reported xerostomia in comparison to 37.5% non-users (p < 0.012). No significant association was found between xerostomia and hyposalivation (p = 0.384). A multivariate analysis revealed that individuals older than 26 years of age, those with a low household income, and crack users (prevalence ratio: 2.59) had a significant association with the occurrence of hyposalivation. A significant association was found between the use of crack and reduced salivary flow. The use of crack was associated with the occurrence of hyposalivation in the multivariate analysis