RESUMEN
BACKGROUND: The aim of this study was to evaluate evolution of ultra-processed food intake and recurrent weight gain in patients who underwent Roux-en-Y gastric bypass. MATERIALS AND METHODS: This study is an observational longitudinal study that evaluated patients who underwent metabolic and bariatric surgery at four time points: before surgery and at 3, 12, and 60 months after surgery. Anthropometric and dietary intake data were collected through two 24-h dietary recalls. All foods consumed were classified according to degree of processing. Recurrent weight gain was considered the difference between current weight and nadir weight. RESULTS: The sample consisted of 58 patients with a mean age of 38.7 ± 8.9 years and 68% female. After 60 months, mean excess weight loss and recurrent weight gain were 73.6 ± 27.2% and 22.5 ± 17.4%. Calorie and macronutrient intake decreased significantly between the pre-surgery period, and 3 and 12 months post-surgery; however, there was no significant difference after 60 months. In relation to food groups or macronutrients, no difference was observed between the pre-surgery period and 60 months post-surgery. The contribution of unprocessed or minimally processed foods to calorie intake gradually decreased after 3 months post-surgery. CONCLUSION: The profile of dietary intake after 60 months of metabolic and bariatric surgery tends to approach that of the pre-surgery period. The contribution of unprocessed and minimally processed foods to calorie intake decreased after 60 months, while ultra-processed food contribution increased.
Asunto(s)
Ingestión de Energía , Derivación Gástrica , Obesidad Mórbida , Aumento de Peso , Humanos , Femenino , Adulto , Masculino , Estudios Longitudinales , Obesidad Mórbida/cirugía , Derivación Gástrica/estadística & datos numéricos , Pérdida de Peso/fisiología , Comida Rápida/estadística & datos numéricos , Recurrencia , Persona de Mediana Edad , Alimentos ProcesadosRESUMEN
Previous studies from this laboratory showed that both acute and chronic hyponatremia impaired active brain buffering. These studies were performed to determine whether correcting the plasma sodium restored normal buffering in hyponatremic rats. Acute (1- and 2-day) and chronic (7- and 14-day) hyponatremia was induced in male Sprague-Dawley rats by constant desmopressin administration combined with a liquid diet. Plasma sodium was corrected by stopping desmopressin for 6 h, substituting solid chow, and allowing free access to water. Studies were performed 24 h later. Uncorrected hyponatremic rats who continued to receive desmopressin and liquid diet served as controls. Brain pH was determined by [31P]NMR in rats anesthetized with N2O and paralyzed with pancuronium. Brain buffering was determined by the response to CO2 loading. Resting brain pH was the same in corrected and uncorrected rats, but the two groups responded differently to CO2 loading. Thus, 55 min after ventilation with 20% CO2, corrected rat brain pH was 0.13 pH units higher than in uncorrected rats despite statistically similar changes in CO2 tension and arterial pH in both groups. Moreover, 15 min into recovery from CO2 exposure, brain pH in corrected rats overshot resting pH by 0.07, whereas no overshoot occurred in uncorrected rats. Buffering in corrected rats was identical to that shown previously in normonatremic rats. The complete restoration of late-phase buffering achieved by normalizing the plasma sodium of hyponatremic rats indicates that at least some portion of active hydrogen ion transport is sodium dependent in the brain.
Asunto(s)
Química Encefálica , Hiponatremia/metabolismo , Sodio/sangre , Enfermedad Aguda , Animales , Química Encefálica/efectos de los fármacos , Tampones (Química) , Dióxido de Carbono , Enfermedad Crónica , Desamino Arginina Vasopresina/toxicidad , Dieta , Concentración de Iones de Hidrógeno , Hiponatremia/inducido químicamente , Hiponatremia/terapia , Masculino , Ratas , Ratas Sprague-DawleyRESUMEN
To study whether acute or chronic hyponatremia alters blood-brain barrier (BBB) permeability, rats made hyponatremic by constant desmopressin acetate infusion were studied by NMR spectroscopy and imaging. On constant volume ventilation and nitrous oxide, acute (1- and 2-day) and chronic (7- and 14-day) hyponatremic and normonatremic controls were infused with 0.25 M HCl. Despite reducing blood pH by at least 0.35 in < 50 min, brain pH, measured by 31P NMR, was unaffected in any group. As a second test of BBB function, gadolinium-DTPA (Gd-DTPA) was injected intravenously in these five groups. Coronal slice 1H NMR images obtained before and after Gd-DTPA showed image intensity changes in multiple areas outside brain, but neither control nor hyponatremic rats showed any differences in cortex, white matter or cerebellum. To ascertain whether the threshold for BBB disruption was altered, hypertonic mannitol (1.5, 2.0 or 3.0 mL) was injected rapidly into one internal carotid artery and pre- and post-Gd-DTPA images obtained. In both control and hyponatremic rats only the largest dose caused detectable Gd-DTPA leakage into brain. Thus, BBB function appears intact in both acute and chronic hyponatremia since neither H+ nor GD-DTPA penetrated the barrier and resistance to mannitol disruption was unaffected by hyponatremia.
Asunto(s)
Barrera Hematoencefálica/fisiología , Hiponatremia/fisiopatología , Enfermedad Aguda , Animales , Encéfalo/efectos de los fármacos , Encéfalo/metabolismo , Enfermedad Crónica , Medios de Contraste/farmacocinética , Modelos Animales de Enfermedad , Gadolinio DTPA , Ácido Clorhídrico/farmacología , Concentración de Iones de Hidrógeno , Hiponatremia/metabolismo , Infusiones Intraarteriales , Inyecciones Intravenosas , Espectroscopía de Resonancia Magnética/métodos , Masculino , Manitol/farmacología , Compuestos Organometálicos/farmacocinética , Ácido Pentético/farmacocinética , Fósforo , Ratas , Ratas Sprague-DawleyRESUMEN
We diagnosed infections from human parvovirus B19 in three patients by using dot-blot hybridization and a polymerase chain reaction to detect B19 DNA and using an enzyme immunoassay to detect IgG and IgM to B19. For 5 months a 5-year-old boy with acute lymphoblastic leukemia in remission had anemia without reticulocytes or bone marrow erythrocyte precursors. His serum lacked IgG and IgM to B19 but contained B19 DNA. He received gamma globulin intravenously (0.4 gm/kg/day for 5 days); his viremia promptly cleared and reticulocytosis developed. A 14-year-old boy with acute lymphoblastic leukemia in remission had fever, rash, neutropenia (less than 300 leukocytes/mm3), and a hemophagocytic syndrome lasting 3 weeks. His serum contained IgM to B19 and B19 DNA. Without therapy, IgG to B19 developed; although low levels of B19 DNA persisted, the leukocyte count returned to normal. In a 19-year-old patient with systemic lupus erythematosus and hemolytic anemia, an aplastic crisis lasted 2 weeks. Her serum lacked IgG and IgM to B19 but contained B19 DNA. Without therapy, IgG and IgM to B19 appeared, viremia diminished, and reticulocytosis occurred. These patients illustrate the varied manifestations of chronic B19 infections, the importance of DNA detection for diagnosis, and the possible efficacy of gamma globulin therapy.
Asunto(s)
Tolerancia Inmunológica , Infecciones por Parvoviridae/diagnóstico , Adolescente , Adulto , Preescolar , ADN Viral/análisis , Femenino , Humanos , Técnicas para Inmunoenzimas , Lupus Eritematoso Sistémico/complicaciones , Masculino , Infecciones por Parvoviridae/etiología , Infecciones por Parvoviridae/inmunología , Infecciones por Parvoviridae/terapia , Reacción en Cadena de la Polimerasa , Leucemia-Linfoma Linfoblástico de Células Precursoras/complicaciones , gammaglobulinas/uso terapéuticoRESUMEN
This 26-month prospective study monitored 104 children from one day care center (DCC), and their families, for cytomegalovirus (CMV) infections. Among the children, 14 different strains of CMV were identified by restriction endonuclease analysis of the viral DNA of isolates. Three of these strains infected 44 DCC children and apparently were transmitted within the DCC environment. Only children younger than 3 years of age acquired the DCC-associated CMV strains. Of 75 seronegative children in this age group, 34 acquired DCC-associated CMV strains, and four were infected with unique strains. Among 23 children older than 3 years of age, none acquired the DCC-associated strains, although six were infected with unique strains. Of 18 seronegative mothers, six acquired CMV infections within 3 to 7 months after their children became infected; the strains were identical to those isolated from their children and were DCC associated. Four fathers, three seropositive mothers, and two caretakers also shed DCC-associated strains of CMV. None of the 31 mothers whose children were not infected shed CMV. There was no apparent CMV-associated morbidity. These results prove the frequent transmission of CMV within the DCC environment and from DCC children to their parents. They further suggest that caretakers do acquire CMV from DCC children.
Asunto(s)
Guarderías Infantiles , Infecciones por Citomegalovirus/transmisión , Cuidado del Niño , Preescolar , Citomegalovirus/genética , Citomegalovirus/aislamiento & purificación , Femenino , Humanos , Lactante , Masculino , Padres , Estudios ProspectivosRESUMEN
During a 3-year period, cytomegalovirus (CMV) was recovered from the urine of 35 hospitalized newborn infants (15 with congenital and 20 with acquired infections). Two of the infants with acquired infections lacked maternal antibody to CMV (seronegative) and received transfusions from multiple seropositive blood donors. After seronegative blood products were used exclusively for seronegative low birth weight (less than 1300 gm) infants, none of 154 seronegative infants acquired CMV. CMV was recovered from one seronegative nurse who became infected during the study period. EcoRl digestion of the DNA of the nurse's isolate and of 34 of the 35 infant isolates revealed that no two were identical. LBW seropositive infants were randomized to receive either seronegative blood products or blood products from random donors; there was no significant difference in the number of acquired CMV infections. There were no deaths among 18 infants with acquired CMV infection. Hepatosplenomegaly and worsening bronchopulmonary dysplasia developed in one LBW infant. These results prove that nosocomial transmission of CMV did not occur frequently during the 3-year period.
Asunto(s)
Infección Hospitalaria , Infecciones por Citomegalovirus/transmisión , Citomegalovirus/aislamiento & purificación , ADN Viral/análisis , Anticuerpos Antivirales/análisis , Peso al Nacer , Transfusión Sanguínea , Citomegalovirus/inmunología , Infecciones por Citomegalovirus/epidemiología , Infecciones por Citomegalovirus/mortalidad , Humanos , Lactante , Recién Nacido , Unidades de Cuidado Intensivo Neonatal , Estudios ProspectivosAsunto(s)
Meningitis/tratamiento farmacológico , Moxalactam/uso terapéutico , Infecciones por Salmonella/tratamiento farmacológico , Sepsis/tratamiento farmacológico , Farmacorresistencia Microbiana , Femenino , Humanos , Recién Nacido , Moxalactam/farmacología , Recurrencia , Salmonella typhimurium/efectos de los fármacosAsunto(s)
Dieta , Neoplasias del Sistema Digestivo/etiología , Carbohidratos de la Dieta/administración & dosificación , Carbohidratos de la Dieta/metabolismo , Grasas de la Dieta/administración & dosificación , Grasas de la Dieta/metabolismo , Neoplasias del Sistema Digestivo/metabolismo , Femenino , Humanos , MasculinoRESUMEN
Infants with respiratory distress syndrome are especially prone to pneumothorax and pneumomediastinum as a complication of their disease. In a retrospective clinical analysis of a consecutively delivered population of infants with RDS the data suggested that the less premature infant with RDS was apparently more at risk to develop pulmonary rupture. This clinical observation was confirmed in postmortem studies in premature rabbits. The most immature group of lungs were relatively resistant to pulmonary rupture, owing to high surface forces. Toward term, surface forces were decreased as were lung tissue elastic forces, which predisposed to rupture at lower pressures.
Asunto(s)
Edad Gestacional , Pulmón/embriología , Neumotórax/embriología , Síndrome de Dificultad Respiratoria del Recién Nacido/embriología , Animales , Peso Corporal , Modelos Animales de Enfermedad , Femenino , Humanos , Recién Nacido , Tamaño de los Órganos , Embarazo , ConejosRESUMEN
Determination of the erythrocyte sedimentation rate in capillary blood can be of value in identifying neonates with infection. The normal values for the method described here range from 1 mm/l hour at 12 hours of age to 17 mm/l hour at 14 days of age. Most noninfected neonates with moderate to severe RDS or with other serious illness had values well within the normal range. Infected patients had marked elevations, and the majority of values returned to normal with clinical improvement. Coombs-positive ABO hemolytic disease was also responsible for elevated values. In about half of the infected patients the rise was not seen until 24 to 48 hours after clinical symptoms first appeared. The ESR can be useful in the nursery as a preliminary step in the laboratory evaluation of the sick neonate. Serial determinations may be of aid in identifying the infected infant when the results of bacteriologic cultures are obscured by antibiotic therapy.