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Objective: to review the literature on the relationship between oral health and bariatric surgery in obese individuals. Methods: articles published until March 2021 were searched in the Medline/PubMed, LILACS, BBO, and Web of Science databases. The search used a combination of descriptors related to the words: obesity, bariatric surgery, and oral health. Results: one hundred thirty-five studies were identified in the database search. Of these, 47 were included in this review. The oral changes investigated in the literature for individuals who underwent bariatric surgery were dental caries, tooth wear/erosion, hypersensitivity, periodontal disease, hyposalivation, halitosis, and changes in mastication and oral soft tissue. The evaluated articles showed methodological controversy regarding the study design, follow-up period, sample size, and assessed clinical parameters, which complicated the comparison of studies. Final considerations: there is no consensus in the literature regarding the relationship between oral health and bariatric surgery in obese individuals. Further prospective cohort studies should be conducted to investigate this association better.Keywords: obesity; bariatric surgery; oral health; dental erosion; dental caries.

Sarcopenia is a clinical condition associated with several liver diseases and it includes non-alcoholic fatty liver disease (NAFLD) in its broad spectrum as steatosis, steatohepatitis and fibrosis. However, the criteria to define sarcopenia are diverse, and even those established in consensus have been discussed regarding their performance in making an accurate diagnosis.To evaluate the prevalence of sarcopenia, using different methods, in patients with NAFLD, and its association with clinical-anthropometric parameters.This was an observational study of outpatients with NAFLD. Sarcopenia was defined by the European Working Group Consensus on Sarcopenia in Older People of 2010 (EWGSOP1) and 2018 (EWGSOP2). The skeletal muscle index was used to estimate muscle mass, handgrip strength was assessed using the dynamometer and physical performance by walking a distance of four meters at usual walking speed. The non-invasive fibrosis scores, fibrosis-4 (FIB-4) index and Aspartate aminotransferase to platelet ratio index (APRI), were used to assess the absence and presence of fibrosis.Fifty-seven individuals with NAFLD were evaluated, the mean age (SD) was 52.7 (11.3) years and 75.4% were female. Fibrosis assessed by FIB-4 and APRI was observed in 3.7% and 16.6% of patients with NAFLD, respectively. The diagnosis of sarcopenia was identified only by EWGSOP1 in 3.5% of NAFLD patients, and the prevalence of probable/pre-sarcopenia was higher using the EWGSOP2 consensus at 26.3%, when compared to 1.8% with EWGSOP1. Sarcopenia defined by EWGSOP1, was associated with grade I steatosis, but without overweight (The present study showed that sarcopenia in NAFLD was not predominant in patients without fibrosis, by both diagnostic methods. In addition, the prevalence of probable sarcopenia also depends on the method applied.

A cross-sectional analytical study was conducted to assess how a COVID-19 pandemic interfered with the mental health of students in higher education in Bahia and to check for the presence of anxious and depressive symptoms through a questionnaire. Students were adapted virtually to respond anonymously about sociodemographic characteristics, lifestyle, health-related aspects and a pandemic. To assess the symptoms of anxiety and depression, the Hospital Anxiety and Depression Scale (HAD) was used. The data were trained in SPSS. In total, 1,213 students were acquired. Most altered their health behavior with worsening sleep quality, increased use of medication to sleep, decreased frequency of physical activities. Anxious and depressive symptoms were present in 66.1% and 54.4% of undergraduate and graduate students, respectively, associated with social isolation, uncertainty about the future, difficulties in family relationships, financial loss, fear of being infected and of being infected. other people and loss of a family member due to COVID - 19. In view of the evidence of psychological distress, it is necessary to develop measures so that students can adopt more positive behaviors and reduce much of the impacts left by this pandemic.

Introduction: nutritional deficiencies, hormonal changes and severe weight loss after Roux-en-Y Gastric Bypass (RYGB) can promote changes in bone metabolism which may lead to a reduction in bone mineral density (BMD). Objective: to investigate the prevalence of osteopenia/osteoporosis and factors associated with BMD in pre-menopausal women who underwent RYGB. Methodology: a cross-sectional study conducted with secondary data of patients followed-up in a specialized center for obesity treatment. Variables studied: biochemical and anthropometric data, body composition by multifrequency bioimpedance and BMD of the lumbar spine (LS), total femur (TF) and femur neck (FN) by dual-energy X-ray absorptiometry. For statistical analysis, the SPSS® software and a 5% significance level were utilized. Results: seventy-two (72) pre-menopausal women were evaluated. Mean age, BMI and mean post-surgery time was 38.7±6.5 years, 25.8±2.5 kg/m² and 13.1±1.7 months, respectively. The prevalence of osteopenia in at least one of the densitometry sites was 13.9%, with LS being the most frequent site. A lower LS BMD was associated with greater weight loss, higher percentage of body fat before surgery and lower post-surgery serum vitamin D levels. There was a positive correlation between skeletal muscle mass index adjusted for height in the pre-surgery period and LS BMD (r=0.361; p=0.010) and TF (r=0.404; p=0.004). Conclusion: a relevant prevalence of osteopenia was detected in pre-menopausal women after RYGB, mainly in the LS.

SUMMARY OBJECTIVE: This study aims to evaluate the role of anthropometric clinical indicators of visceral adiposity as predictors of NAFLD, identifying the cutoff points based on gender. METHODS: This was a cross-sectional study conducted in patients with or without NAFLD. Waist circumference (WC), body mass index (BMI), waist-to-height ratio (WHtR), Conicity Index (C Index), and lipid accumulation product (LAP) were evaluated. RESULTS: A total of 107 individuals were evaluated, of which 46.7% were diagnosed with NAFLD. Individuals with NAFLD presented higher values of WC, BMI, C Index, LAP, and WHtR when compared with those without NAFLD (p

Introdução: Os cuidados paliativos são uma abordagem multidisciplinar que visa melhorar a qualidade de vida dos pacientes que enfrentam uma doença potencialmente fatal. O conhecimento dos graduandos da área de saúde sobre cuidados paliativos é importante para a adequada prestação dessa assistência. Objetivo: Avaliar o conhecimento geral sobre cuidados paliativos de graduandos de medicina, enfermagem, fisioterapia, psicologia e serviço social do estado da Bahia. Método: Estudo transversal, com alunos de graduação da área de saúde da Bahia, aplicação de questionário eletrônico contendo perguntas sobre o perfil sociodemográfico e acadêmico dos alunos e seu nível de conhecimento sobre cuidados paliativos. As variáveis foram expressas em mediana e amplitude interquartil. O teste do qui-quadrado de Pearson foi usado para comparar os grupos com melhor e pior conhecimento. Para testar a correlação entre as variáveis, foi utilizado o teste de Spearman. P

SUMMARY OBJECTIVE: To evaluate the association between muscle mass depletion and compromising of the cell membrane integrity and clinical–anthropometric characteristics in patients with nonalcoholic fatty liver disease. METHODS: This observational study evaluated waist circumference, body mass index, and waist-to-height ratio in patients with nonalcoholic fatty liver disease. Skeletal mass index corrected by weight and impairment of cell membrane integrity were assessed using bioelectrical impedance analysis. RESULTS: In 56 patients, muscle mass depletion was observed in 62.5% and cell membrane impairment in 28.6%. The metabolic syndrome and elevated aspartate aminotransferase were the only clinical factors associated with mass depletion (p0.05). CONCLUSIONS: The prevalence of mass depletion and cell membrane impairment was higher in patients with nonalcoholic fatty liver disease. The muscle mass depletion was associated with central obesity, aspartate aminotransferase elevated, and metabolic syndrome; however, the phase angle is not associated with clinical and anthropometric data.

Background: Obesity is associated with lower levels of 25-hydroxyvitamin D [25(OH)D] and higher cardiovascular risk related to metabolic syndrome (MetS). Our purpose was to investigate if there is ...

Introduction: Metabolic Associated Fatty Liver Disease (MAFLD) is a clinic-pathological condition commonly associated with metabolic syndrome (MS) and this association is frequently found in severely obese. Objective: To compare clinical and histological characteristics of MAFLD in obese with and without MS. Methodology: Cross-sectional study with severely obese patients diagnosed with MAFLD between Sep/2014 and May/2015. MAFLD was diagnosed by liver biopsy during bariatric surgery. MS diagnosis was based on the International Diabetes Federation criteria. Statistical analyses were performed using chi-square and t tests. P

SUMMARY OBJECTIVE To evaluate the prevalence of nonalcoholic fatty liver disease (NAFLD) in patients with HIV/AIDS. METHODS The systematic review included articles indexed in MEDLINE (by PubMed), Web of Science, IBECS, and LILACS. Studies eligible included the year of publication, diagnose criteria of NAFLD and HIV, and were published in English, Portuguese, or Spanish from 2006 to 2018. The exclusion criteria were studies with HIV-infection patients and other liver diseases. Two reviewers were involved in the study and applied the same methodology, according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). RESULTS One hundred and sixteen papers were selected, including full articles, editorial letters, and reviews. Twenty-seven articles were excluded because they did meet the inclusion criteria. A total of 89 articles were read, and 13 were considered eligible for this review. Four case series used imaging methods to identify NAFLD, and nine included histology. The prevalence of NAFLD in HIV-patients ranged from 30%-100% and, in nonalcoholic steatohepatitis (NASH), from 20% to 89%. A positive association between dyslipidemia, insulin resistance, and body mass index was observed. There was no agreement between the studies that evaluated the relationship between antiretroviral drugs and NAFLD. CONCLUSION This systematic review showed a high prevalence of NAFLD in HIV-patients, which was associated with metabolic risk factors. The possible association between antiretroviral therapy and NAFLD needs further studies. RESUMO OBJETIVO Avaliar a relevância da doença hepática gordurosa não alcoólica (DHGNA) em pacientes com HIV / AIDS. MÉTODOS A revisão sistemática foi realizada utilizando instrumentos de busca de material científico indexado, incluindo MEDLINE (pela PubMed), Web of Science, IBECS e LILACS. Estudos elegíveis incluíram o ano de publicação, critérios para diagnostico de DHGNA e HIV, publicados em inglês, português e espanhol, entre 2006 a 2018. Os critérios de exclusão incluíram estudos com pacientes com outras doenças do fígado. Dois revisores foram envolvidos na pesquisa dos artigos e o PRISMA (Preferred Reporting Items for Systematic Reviews and Meta - Analyses) foi utilizado nas análises. RESULTADOS Cento e dezesseis artigos foram selecionados, 27 excluídos porque não preencheram critérios de inclusão e assim, 89 foram lidos pelos investigadores. Desses, 13 artigos foram incluídos na revisão. Quatro séries de casos utilizaram métodos por imagens para identificação de DHGNA e nove estudos utilizaram biópsia hepática. A prevalência de DHGNA em pacientes com HIV variou de 30% a 100% e esteato-hepatite não alcoólica (EHNA) entre 20% e 89%. Na avaliação das principais variáveis estudadas, observou-se a associação positiva entre dislipidemia, resistência à insulina e índice de massa corporal. Não houve concordância entre os artigos que avaliaram a relação dos antiretrovirais com a DHGNA. CONCLUSÕES A presente revisão sistemática sugere elevada prevalência de DHGNA em pacientes infectados com HIV. DHGNA nesses pacientes foi associada principalmente a fatores metabólicos. A possível associação entre terapia antiretroviral e DHGNA nesses pacientes vem sendo discutida, mas são necessários mais estudos para estabelecer essa associação.

A assistência nutricional passou por mudanças inesperadas na pandemia da COVID-19. O objetivo deste artigo é descrever a assistência nutricional de pacientes admitidos em unidade de terapia intensiva nos primeiros quinze meses desta pandemia. Trata-se de uma coorte retrospectiva de pacientes críticos com COVID-19 admitidos em hospital de referência, entre março/2020 a junho/2021. Foram avaliadas características clínicas (queixas, comorbidades, tempo de internamento e evolução), nutricionais (diagnóstico nutricional e dieta prescrita na admissão) e a procedência do paciente. Para análise dos dados foi utilizado o pacote estatístico Statistical Package for the Social Sciences. As variáveis categóricas foram descritas por frequência simples absoluta e relativa e as quantitativas por média e desvio padrão ou mediana e intervalo interquartílico. Foram estudados 643 pacientes com média (desvio padrão) de idade de 63 (16) anos, sendo 374 (58,2%) do sexo masculino. Hipertensão arterial foi a comorbidade mais frequente (61,1%), seguida por diabetes mellitus (41,4%). Dificuldade respiratória (79,8%) e febre (48,7%) foram as queixas mais referidas. O tempo de permanência no hospital teve como mediana (intervalo interquartílico) 11 (6 – 18) dias e 570 (85,6%) dos pacientes foram a óbito. Apenas 300 (46,7%) pacientes tinham registro de diagnóstico nutricional, dentre eles, 207 (69,0%) foram diagnosticados com excesso de peso e 35 (11,7%) com desnutrição. Os resultados demonstraram a deficiência da assistência nutricional em pacientes críticos com COVID-19 nos primeiros 15 meses da pandemia. Sugerimos um modelo de avaliação nutricional que pode contribuir para uma melhor assistência nutricional em situações catastróficas, como a vivenciada nesta pandemia.

Introduction: The global prevalence of metabolic syndrome (MS) among people living with HIV/AIDS varies from 20% to 33%. Objective: to estimate the prevalence of metabolic syndrome and associated factors in a group of HIV-infected patients on antiretroviral therapy. Methods: This is a cross-sectional study with HIV-infected patients from a reference center in Bahia, Brazil. We evaluated clinical, socio-demographic and anthropometric data. MS was defined according to the guidelines of International Diabetes Federation. Results: We evaluated 152 patients with mean age of 47.3±11.6 years, 59.2% male. The main comorbidities detected were diabetes (3.3%) hypertriglyceridemia (9.3%) and metabolic syndrome (MS,38.2%). Patients with MS were predominantly women (55.2% vs 31.9%; p=0.005), older [52.1 (10.4) vs 44.3 (11.3); p Conclusion: Almost half of the HIV-infected patients in Bahia presents with MS which seems to be driven by classical risk factors.

Background Obesity is a risk factor for several chronic diseases, and scientific evidence suggests an association between obesity and oral diseases. In this study, the authors estimated the prevalence of risk factors for caries, dental erosion, and periodontal disease in a group of obese patients referred for bariatric surgery. Methods The authors invited obese patients who were referred for bariatric surgery at a private center for treatment of obesity to participate in this study. The patients answered a questionnaire about their sociodemographic data, general and oral health histories, dietary habits, and oral health care behavior. Results The authors evaluated a total of 255 participants; 200 (78.4%) were women, the median (interquartile range) age was 36.0 (30.0-43.0) years, and the median (interquartile range) body mass index was 39.7 (37.6-43.5) kilograms per square meter. The authors observed a high prevalence of risk factors for dental erosion; 78.4% of the participants consumed acidic foods daily, and 92.2% consumed acidic beverages daily. With respect to risk factors for caries, 38.5% of the participants reported high sucrose intake, and 59.6% preferred sweet beverages and foods with sucrose. Almost 13% of the participants reported having or having had dental mobility, and 59.6% reported having or having had gingival bleeding, suggesting a history of periodontal disease. Conclusions Obese patients referred for bariatric surgery are exposed to risks of experiencing oral diseases and should be evaluated by a dentist. Practical Implications Knowing the risk factors for oral diseases in obese patients is important in raising awareness about these risk factors, as well as to prevent complications in the oral cavity.

The objective was to critically analyze studies that evaluated the predictive capacity of indicators of visceral adiposity in non-alcoholic fatty liver disease (NAFLD). The bibliographic research was carried out using the electronic database PubMed, LILACS and SciELO, references of selected articles. Although we found few studies, they have already used several indicators of visceral adiposity as waist circumference, waist-to-hip ratio, waist-to-height ratio, Lipid accumulation product, Body Shape Index, Body Roundness Index and most them were good predictors of NAFLD. Thus, the anthropometric indicators may contribute for the diagnosis of NAFLD in a simple, low-cost and non-invasive way, allowing early therapeutic measures to prevent the evolution to non-alcoholic steatohepatitis.

Summary Objective: In liver diseases, hyperferritinemia (HYF) is related to injured cells in acquired and genetic conditions with or without iron overload. It is frequent in patients with nonalcoholic fatty liver disease (NAFLD), in which it is necessary to define the mean of HYF to establish the better approach for them. The present study evaluated the significance of elevated ferritin in patients with NAFLD and steatohepatitis (NASH). Method: The review was performed using search instruments of indexed scientific material, including MEDLINE (by PubMed), Web of Science, IBECS and LILACS, to identify articles published in Portuguese, English and Spanish, from 2005 to May, 2016. Studies eligible included place and year of publication, diagnose criteria to NAFLD, specifications of serum ferritin measurements and/or liver histopathologic study. Exclusion criteria included studies with patients with alcohol consumption ≥ 20 g/day and other liver diseases. Results: A total of 11 from 30 articles were selected. It included 3,564 patients and they were cross-sectional, retrospective, case series and case-control. The result's analyses showed in 10 of these studies a relationship between ferritin elevated serum levels and NAFLD/NASH with and without fibrosis and insulin resistance. Conclusion: Hyperferritinemia in patients with NAFLD/NASH is associated more frequently with hepatocellular injury than hemochromatosis. These data suggest the relevance to evaluate carefully HYF in patients with NAFLD/NASH to establish appropriate clinical approach. Resumo Objetivo: A hiperferritinemia (HPF) está associada à agressão hepatocelular nas doenças do fígado e à sobrecarga de ferro, em doenças genéticas e adquiridas. A HPF é frequente em pacientes com doença hepática gordurosa não alcoólica (DHGNA) e é necessário definir seu significado para estabelecer as melhores condutas para esses indivíduos. Esta revisão avaliou o significado da HPF em portadores de DHGNA e esteato-hepatite não alcoólica (EHNA). Método: A busca de artigos foi realizada através do PubMed (Medline), Web of Science e Lilacs, e foram selecionados aqueles publicados em português, inglês e espanhol de 2005 a maio de 2016. Os artigos foram elegíveis quando informavam data e local da publicação, critérios diagnósticos para DHGNA, especificações das dosagens de ferritina sérica e/ou estudo histopatológico. Foram excluídos os artigos cujos pacientes relataram ingestão alcoólica ≥ 20 g/dia ou eram portadores de outras doenças do fígado. Resultados: Foram selecionados 11 de 30 artigos, totalizando 3.564 pacientes. Os artigos eram de corte transversal, retrospectivos, série de casos e caso-controles. Em dez artigos, observou-se correlação entre alteração de ferritina e DHGNA/EHNA com e sem fibrose hepática e resistência à insulina. Conclusão: Hiperferritinemia em pacientes com DHGNA/EHNA se associa com maior frequência à agressão hepatocelular do que com sobrecarga de ferro hepático. Os resultados da revisão sugerem a necessidade de um maior cuidado na interpretação da elevação da ferritina sérica em pacientes com DHGNA/EHNA para o estabelecimento de condutas clínicas apropriadas.

Introduction: The prevalence of arterial hypertension (AH) in HIV-patients is highly variable and its association with antiretroviral therapy (ART) is controversial. Objective: To estimate the prevalence of AH and associated factors in HIV-patients on ART. Methods: This cross-sectional study was conducted in HIV-patients attended in a referral center in Salvador, Brazil. We evaluated clinical, socio-demographic and anthropometric data. Student's ttests or Mann-Whitney's and Pearson's chi-square tests were used to compare the groups. Values of p Results: We evaluated 196 patients (60.7% male) with a mean age of 46.8 ± 11.7 years and a mean body mass index of 24.9 ± 5.3 kg / m2. The median elapsed time since HIV diagnosis and ART use was 11.8 (4.4 - 18.1) and 7.2 (2.7 - 15.3) years, respectively. The prevalence of AH was 41.8%. For individuals > 50 years old, there was a significant association between the increased abdominal circumference and AH and patients ≤ 50 years old presented significant association between AH and overweight, increased abdominal circumference and number of previous ART regimens. After multivariate analysis, age [OR:1.085; 95% CI 1,039 – 1,133], overweight [OR: 4.205; 95% CI 1,841 – 9,606], family history of AH [OR: 2.938; 95% CI 1,253 – 6.885], increased abdominal circumference [OR: 2.774; 95% CI 1.116 – 6.897] and life-time number of ART regimens used [OR: 3.842; 95% CI 1.307 – 11.299] remained associated with AH. Conclusion: AH was highly prevalent and was associated not only with classical risk factors for arterial hypertension, but also with specific ART regimens.

espanolIntroduccion: los pacientes obesos presentan un perfil inflamatorio y metabolico que provoca estres oxidativo y dano celular. El angulo de fase es un indicador de integridad celular que se ha propuesto como parametro pronostico de los cambios del perfil metabolico. Objetivo: investigar la posible asociacion entre el angulo de fase y los parametros metabolicos en pacientes obesos. Material y metodo: estudio transversal de pacientes obesos adultos que asistieron a una clinica especializada entre 2014 y 2016. Todos los pacientes tenian ≥ 18 anos de edad y un indice de masa corporal ≥ 35 kg/m2. Todos los datos se obtuvieron de los registros medicos y formaron parte del protocolo clinico. Los pacientes se dividieron en dos grupos usando un punto de corte para el angulo de fase, y los grupos se compararon usando la prueba de Kruskal-Wallis o del chi cuadrado para las variables cuantitativas y categoricas, respectivamente. Las correlaciones se identificaron mediante el analisis de correlacion de Spearman y el de Pearson. Todas las diferencias entre grupos se consideraron estadisticamente significativas si p ≤ 0.05. Resultados: se observo un angulo de fase bajo en el 30,5 % de los 141 pacientes incluidos en el estudio. Encontramos una asociacion entre el angulo de fase bajo y la presencia de hiperuricemia (p = 0.018) cuando se ajusto para la circunferencia de la cintura, la disglucemia, la hipertension arterial y la hiperuricemia. No hubo correlacion entre el angulo de fase y los componentes de la composicion corporal. Conclusiones: el angulo de fase presenta asociacion con los niveles plasmaticos de acido urico pero no con otros parametros metabolicos. EnglishIntroduction: obese patients present an inflammatory and metabolic profile that leads to oxidative stress and cellular damage. Phase angle is an indicator of cellular integrity and has been proposed as a prognostic parameter for changes in the metabolic profile. Objective: to investigate the possible association between phase angle and metabolic parameters in obese patients. Material and method: this was a cross-sectional study of adult obese patients who attended a specialized clinic between 2014 and 2016. All patients were ≥ 18 years of age, with a body mass index ≥ 35 kg/m2. All data were obtained from medical records and made part of the clinical protocol. Patients were divided into two groups using a cutoff point for phase angle, and the groups were compared using the Kruskal-Wallis or Chi-squared test for quantitative and categorical variables, respectively. Correlations were identified by Spearman’s and Pearson’s correlation analyses. All between-group differences were considered statistically significant at p ≤ 0.05. Results: a low phase angle was present in 30.5 % of the 141 patients enrolled in the study. We found an association between low phase angle and presence of hyperuricemia (p = 0.018) when adjusted for waist circumference, dysglycemia, arterial hypertension, and hyperuricemia. There was no correlation between phase angle and the components of body composition. Conclusions: there is an association of phase angle with uric acid levels, but not with other metabolic parameters.

The aim of this report is to present the clinical case of a patient with severe symptoms of dentinal hypersensitivity after bariatric surgery. A 40-year-old woman had a complaint of hypersensitivity in all teeth after bariatric surgery to treat morbid obesity. The patient had multiple sites of gingival recession associated with pain symptoms that were characteristic of dentinal hypersensitivity. Subepithelial connective tissue grafting was performed, using either coronal flap displacement techniques or a tunnel-type approach, at the sites of gingival recession and/or dentinal hypersensitivity. Surgery resulted in gains of keratinized mucosa and root surface coverage as well as regression of pain. Patients who undergo bariatric surgery should be monitored for development of oral health-related complications.

Introduction. Obesity correlates with nonalcoholic fatty liver disease (NAFLD) and occurs in 90 to 100% of severely obese individuals (body mass index [BMI] > 35 kg/m2). Coffee consumption (CC) has been associated with reduced progression of fibrosis in both hepatitis C infection and NAFLD; however, this topic is still under discussion when this liver disease affects severely obese individuals. Objective. To assess the association between CC, insulin resistance (IR) and histological NAFLD morbid obese patients. Material and methods. Cross-sectional study, including obese individuals undergoing bariatric surgery, liver biopsy and histological diagnosis between September 2013 and August 2014. The patients were classified into 3 groups according to their weekly CC: 0- 239.9 mL; 240-2099.9 mL and ≥ 2100 mL. Results. A total of 112 obese individuals were included (BMI = 41.9 ± 4.3 kg/m2), with a mean age of 34.7 ± 7.4 years; 68.6% were women. CC was reported by 72.3% of patients. There were no statistical significant differences between groups regarding the presence of IR (84.8% vs. 74.2% vs. 75.9%; p = 0.536). Progressively higher percentages of individuals with normal liver histology were observed (14.7% vs. 21.9% vs. 24.3%). NASH (65.7% vs. 70.3% vs. 57.5%) were observed among those who consumed greater coffee volumes (p = 0.812). In conclusion, obese individuals with elevated CC exhibited lower frequencies of NASH, although with no statistical significance in this sample.

Introdução:A obesidade é um importante problema de saúde pública e está relacionada com fatores genéticos, ambientais e hábitos alimentares.Objetivo:Descrever os hábitos alimentares de pacientes obesos encaminhados a cirurgia bariátrica.Métodos:Estudo descritivocom pacientes do Núcleo de Tratamento e Cirurgia da Obesidade entre 2014 e 2016, Salvador-Bahia. Utilizou-se dados dos prontuários obtidos antes da cirurgia. As variáveis foram: dados antropométricos (índice de massa corporal), sociodemográficos e hábitos alimentares. Foram coletados dados através de um questionário auto aplicado na consulta inicial. Para análise dos dados foi utilizado o programa estatístico SPSS for Windows® 20.0. A comparação das variáveis qualitativas foi realizada utilizando o teste qui-quadrado de Pearson. Foram considerados significantes valores de p< 0,05. Resultados:Foram avaliados 542 pacientes, a maioria do sexo feminino, com média de idade e índice de massa corporal de 35,9 ± 9,8 anos e 41,5 ±4,9kg/m2 respectivamente. Verificou-se que adultos jovens realizavam menos o desjejum (65,1% x 75,4%; p= 0,011) e ingeriammaior volume das refeições (90,7% x 81,1%; p=0,007) comparado com os mais velhos.O turno que sentiam mais fome era a noite (58,3%), e o hábito de acordar para comer foi mais frequente nos homens do que nas mulheres (31,2% x 21,6%; p=0,029). Destacou-se que os pacientes tinham preferência por cereais e massas (62,4%), seguido de carne e ovos (58,1%). Conclusão:Foi evidenciado diferença quanto aos hábitos alimentares em relação ao sexo e idade mostrando a importância dessas informações para construção de um plano alimentar individualizado.

Bipolar disorder (BD) affects the social functioning and quality of life (QoL) of its patients. This study aimed to investigate whether there is an association between social support (SS), and suicidal behavior in BD I patients compared to healthy controls; secondarily, we evaluated the influence of QoL on those variables. A total of 119 euthymic outpatients with BD I, 46 of whom had attempted suicide (SAs) and 73 who had not (non-SAs), were compared to 63 healthy controls, through the Medical Outcomes Study Social Support Scale and World Health Organization's Quality of Life Instrument. No differences were noted in SS and QoL between SAs and non-SAs. Compared to healthy controls, non-SAs showed lower values in the positive social interaction domain of SS, and the patients, as a whole, showed lower values in affectionate and positive social interaction domains of SS. Compared to healthy controls, SAs had lower values in the environmental domain of QoL, and the patients, as a whole, had lower values in the environmental, social, and psychological domains of QoL. There was positive correlation between SS and QoL. Although BD is a disabling disease, patients receive inadequate SS. Interventions that may alter the SS in these patients should be investigated.

The dysfunction of the lower urinary tract (DTUI) is an abnormal pattern of the urinary control with loss of coordinated capacity storage, stocking and elimination of urine. In order to assess the impact of lower urinary tract dysfunction in their child’s caregivers, this series was performed to evaluate 30 cases of caregivers of children with voiding disorders. Applied HAD scales and SF-36. Of these, 60% (n = 18) had anxiety symptoms and 43.3% (n = 13) depressive symptoms. Despite the scale items of quality of life was above average, the items pain, general health, vitality, emotional limitations and mental health measures were below the average. Thus, the effect of voiding dysfunction in parents of children affects the mood and quality of life in their daily lives.

OBJETIVE: To evaluate the correlation of gamma-glutamyl transferase (GGT) activity to the presence and number of abnormalities of the metabolic syndrome (MS). SUBJECT AND METHODS: We have studied 353 women consecutively admitted into the obesity outpatient unit, aged 39.0 ± 11.4 years and body mass index 41.3 ± 7.3kg/m2. All patients were asymptomatic, had no history of alcohol abuse or liver disease. National Cholesterol Education Program - Adult Treatment Panel III criteria for diagnosing MS were applied. RESULTS: The frequency of the MS was 50.7% in the patients. The frequency of elevated GGT activity was higher in patients with MS than without it (32% versus 20%, p= 0.05). The average GGT concentration in patients with the MS was significantly higher than in non SM patients (52.8 ± 42.3U/L; Md: 40.0 versus 40.1 ± 28.8U/L; Md: 33.0, p= 0.0001). It was also higher in patients with each one abnormality of the MS, when compared to those without it. In patients with association of three abnormalities of the MS, the mean GGT activity was 51.0 ± 39.2U/L (Md: 36.0); in those with four, 50.8 ± 50.4U/L (Md: 40.5); and five, 64.8 ± 32.3U/L (Md: 61.0). There were positive correlations between GGT and glucose, triglycerides or blood pressure (systolic and diastolic). CONCLUSION: GGT activity was associated to the presence and the number of abnormalities of the MS, as well as to each one abnormality of the MS in obese women.

A síndrome da apnéia e hipopnéia obstrutiva do sono (SAHOS) caracteriza-se por episódios repetitivos de obstrução das vias aéreas superiores durante o sono, usualmente associada à interrupção do mesmo e queda da saturação da oxihemoglobina. A análise cefalométrica tem sido considerada como importante método diagnóstico fornecendo características craniofaciais, como espaço aéreo posterior da faringe, comprimento da língua e posição do osso hióide os quais podem predispor os pacientes a SAHOS. O propósito dessa revisão é apresentar tópicos anatômicos possíveis de serem observados através da análise cefalométrica e que podem predispor à oclusão das vias aéreas superiores (VAS).Obstructive sleep apnea and hypopnea syndrome (OSAHS) are characterized by repeated pauses in breathing during sleep, usually associated with sleep interruption and decreased oxyhemoglobin saturation. Cephalometric analysis has become an important method in diagnosis, reporting specific craniofacial characteristics such as posterior air pharyngeal space, tongue length and hyoid position, which may predispose some people to develop SAHOS. The purpose of this revision is to present several anatomic aspects by cephalometric analysis that may have a predisposition to the development of upper airway occlusion.

Background Previous studies have reported high rates of depression and anxiety in HTLV-1 infected individuals with the neurological disease and in the asymptomatic phase. No study has investigated the rates in individuals that already show bladder symptoms without severe neurological changes; that is, during the oligosymptomatic phase. The present study investigated patients in this intermediate form on the spectrum of the infection. Methodology/Principal Findings Participants answered a sociodemographic questionnaire, the Mini International Neuropsychiatric Interview Brazilian Version 5.0.0 (MINI PLUS) and the Hospital Anxiety and Depression Scale (HADS). Data analysis was performed in STATA statistical software (version 12.0). Depressive disorder was the most frequent comorbidity. Current depressive disorder was higher in the group of overactive bladder subjects (11.9%), and lifelong depression was more frequent in the HAM/TSP group (35%). The three groups had similar frequencies of anxiety disorders. Increased frequency and severity of anxiety and depression symptoms were observed in the overactive bladder group. Conclusion/Significance The results suggest that individuals with overactive bladders need a more thorough assessment from the mental health perspective. These patients remain an understudied group regarding psychiatric comorbidities.

Introduction: Population aging is a global reality. In Brazil, it is so expressive and in 2050 is estimated that the number of men and women over 80 years old can overcome the 20-24 years old population and also children under 14 years old. Metabolic syndrome is defined as a set of cardiovascular risk factors, detection and intervention in this age group may decrease cardiovascular mortality. We aimed to estimate the prevalence of metabolic syndrome (MS) in elderly patients in a northeastern Brazilian city. Method: This is a quantitative, observational, cross-sectional and population-based study. The population consisted of non-institutionalized individuals aged> 60 years old, attended in the Family Health Strategy (FHS) and residents in Cajazeiras, PB, Brazil. For the diagnosis of metabolic syndrome we considered the criteria recommended by the International Federation of Diabetes. Results: We studied 351 elderly patients with 72.4+8.7 years old and 66.1% were female. The prevalence of MS was 69.8% and the most frequent criterion was increased waist circumference (82.6%), followed by high triglycerides (81.5%) and low HDL-cholesterol (80.6%). We observed a statistically significant positive association between MS and women [OR: 1.38 (95% CI: 1.18 to 1.63)] and housing in urban areas [OR: 1.23 (1.02 to 1.48)]. Conclusion: There is a high prevalence of MS among the elderly mainly in women and those living in urban areas.

ContextoA gordura mesenterica e drenada pelo sistema venoso portal, estando relacionada a sindrome metabolica, que e um importante fator de risco para doenca de infiltracao gordurosa do figado.ObjetivosGraduar a espessura do tecido adiposo visceral e correlacionar com o grau de doenca de infiltracao gordurosa do figado atraves do exame ultrassonografico.MetodosForam estudados 352 individuos, avaliando-se idade, genero, medidas da espessura da gordura subcutânea e tecido adiposo visceral, a presenca e o grau de doenca de infiltracao gordurosa do figado. Foi analisada a relacao independente entre tecido adiposo visceral e doenca de infiltracao gordurosa do figado, e a regressao linear foi utilizada para prever a tecido adiposo visceral pela espessura da gordura subcutânea.ResultadosA idade media de 225 (63,9%) mulheres e 127 (36,1%) homens foi 47,5 ± 14,0 (18-77) anos, 255 individuos apresentaram exames normais, 97 apresentaram doenca de infiltracao gordurosa do figado assim distribuidos: 37 grau 1, 32 grau 2 e 28 grau 3. A espessura da gordura subcutânea variou de 0,26 e 3,50 cm, com uma media de 1,3 ± 0,6 cm e a tecido adiposo visceral variou de 0,83 a 8,86 cm, com uma media de 3,6 ± 1,7 cm. A regressao linear demonstrou que para cada aumento de 1 cm da espessura da gordura subcutânea o tecido adiposo visceral aumentara 0,9 cm.ConclusaoO tecido adiposo visceral medido por ultrassonografia e um instrumento util e parece ser capaz de estimar o risco de doenca de infiltracao gordurosa do figado.

A long-term follow-up study used sequential liver biopsy specimens to evaluate fibrosis and signs of steatohepatitis in a large number of severely obese patients undergoing bariatric surgery, and found that bariatric surgery reduces steatosis in most patients. There are some important lessons to be learnt from the findings of this study and some unanswered questions for further investigation.

Made available in DSpace on 2022-04-28T18:56:56Z (GMT). No. of bitstreams: 0 Previous issue date: 2011-07-01 Objective: The objective of the study was to compare the functional and aesthetic results of fractured orbital wall reconstruction with an auricular cartilage graft or absorbable polyacid copolymer. Materials and Methods: Twenty patients with blow-out orbital fracture/orbital floor associated or not with the medial wall were assessed by the same craniofacial surgical group. All were evaluated preoperatively and postoperatively by an ophthalmologist for diplopia, enophthalmos, exophthalmos, sensitivity, ophthalmic reflexes, intraocular pressure, and visual field.The patients were subjected to a preoperative facial multislice computed tomographic scan, repeated 6 months after surgery. Eight patients underwent reconstruction with an auricular cartilage graft, and 12 patients, with blade absorbable polyacid copolymer. Subtarsal access was used for all patients. Results: Two patients showed temporary ectropion, 1 in each group. All patients presented satisfactory ocular function, and all tests revealed good orbital delineation, orbital symmetry, periorbital sinus individualization, and reduction of blow-out. Conclusions: The blow-out orbital wall reconstruction can be performed with the use of an auricular cartilage or with a blade absorbable copolymer without differences regarding functional or aesthetic complications and sequelae. © 2011 by Mutaz B. Habal, MD. Clinica AMO Institution Apto. 503, Avenida Paulo VI 2200, Pituba 41810001, Salvador Bahia Hospital da Bahia Faculdade de Tecnologia e Ciencias Medical Faculty University of Bahia University of Sao Paulo