BackgroundIt is important to know the causes of dyspepsia to establish the therapeutic approach. Dyspepsia is a frequent syndrome in our country, where there are restrictions to endoscopy and high prevalence of Helicobacter pylori (H. pylori) infection. This study aimed to assess the endoscopic findings of the syndrome, in an outpatient screening clinic of a tertiary hospital in São Paulo.MethodsOutpatients with uninvestigated dyspepsia, according to Rome III criteria, answered a dyspepsia questionnaire and underwent esophagogastroduodenoscopy. The Rapid Urease Test was applied to fragments of the antral mucosa and epidemiological data were collected from the studied population. Organic dyspepsia findings were analyzed with different variables to verify statistically significant associations.ResultsThree hundred and six patients were included and 282 were analyzed in the study. The mean age was 44 years and women comprised 65% of the sample. Forty-five percent of the patients reported alarm symptoms. Functional dyspepsia was found in 66% of the patients (20% with normal endoscopy results and 46% with gastritis), 18% had GERD and 13% had ulcers (duodenal in 9% and gastric in 4%). Four cases of gastric adenocarcinoma were identified (1.4%), one without alarm characteristics, 1 case of adenocarcinoma of the distal esophagus and 1 case of gastric lymphoma. The prevalence of H. pylori was 54% and infection, age and smoking status were associated with organic dyspepsia. The age of 48 years was indicative of alarm signs.ConclusionsThe endoscopic diagnosis of uninvestigated dyspepsia in our setting showed a predominance of functional disease, whereas cancer was an uncommon finding, despite the high prevalence of H. pylori. Organic dyspepsia was associated with infection, age and smoking status.
(1) Metabolic syndrome, hyperglycemia, hypertriglyceridemia and D-dimer were positively correlated with arterial measurements, whereas inflammatory and coagulatory markers often exhibited paradoxical association; (2) stratification confirmed that at certain levels of systemic inflammation or body mass index, acute phase proteins and other markers became unreliable or shifted signals; (3) when controlled for blood pressure, PWV was only moderately elevated, and IMT remained normal; (4) taken together, these findings are consistent with a unique interaction between adiposity, inflammation, and cardiovascular risk in seriously obese subjects.
This is the first investigation, to the best of our knowledge, to underscore the correlates of refractory and NOD within the bariatric context. Further studies are recommended as such information could be valuable for patient selection, prognostic scoring, and outcome monitoring.
Diabetes response was confirmed, however with more refractory cases than in bariatric controls, whereas high proportions of NOD occurred. Such dichotomous pattern seems unusual albeit consistent with previous studies.
RESUMO -A gravidez acompanha-se de modificações fisiológicas bem conhecidas nos compartimentos hídricos e energéticos maternos, que se somam a hipertrofias orgânicas e ao aparecimento de um bloco feto-placentário. Conseqüentemente, a composição corporal sofre alterações, porém poucos estudos têm documentado tal fenômeno. O advento da bioimpedância favoreceu a obtenção das informações desejadas de forma prática e segura.OBJETIVOS. Foram os propósitos deste trabalho: registrar as principais variáveis antropométri-cas numa população de gestantes de termo; determinar as medidas de composição corpórea pela bioimpedância; comparar esses achados com os primeiros, assim como com outras metodologias relatadas na literatura. PACIENTES E MÉTODO. A população consistiu de 30 gestantes de termo admitidas no período pré-parto, sem complicações, sofrimento fetal ou gravidez múltipla, e submetidas às seguintes mensurações: Antropometria -Peso, altura, índice de massa corporal, prega cutânea do tríceps, circunferência muscular do braço; Bioimpedância -Gordura corporal, massa magra, água total, água intra e extracelular, terceiro espaço e relação sódio/potássio permutável.RESULTADOS. Observaram-se valores de peso corporal e índice de massa corporal aumentados, porém inteiramente compatíveis com a situação fisiológica das gestantes. A água corpórea total situava-se na mesma faixa percentual de mulheres não-grávidas, tal como já suspeitado por outros autores, porém com indícios de expansão do extracelular e formação de terceiro espaço. A massa gorda elevou-se, porém, também em proporções não muito diferentes do relatado anteriormente em levantamentos antropométricos.CONCLUSÕES. Nas condições do presente trabalho, em que uma equação de bioimpedância para uso geral foi aplicada, o método demonstrou resultados compatíveis com as informações clínicas disponí-veis, as verificações antropométricas e os registros de outros investigadores. Conclui-se que a impedância bioelétrica é um procedimento de avaliação promissor na gravidez, justificando estudos ulteriores com esta metodologia. UNITERMOS: Gravidez de termo. Impedância bioelétrica. Composição corporal. Água corporal. Gordura corporal. Antropometria. Avaliação nutricional. INTRODUÇÃOO período final de gravidez acompanha-se de alterações fisiológicas nos compartimentos hídricos do organismo 1 , ao lado de eventuais déficits e excessos nutricionais [2][3][4] . Surge um conjunto feto-placentário significativo, cujo conteúdo fluido se distingue dos tecidos maternos 5 , assim como hipertrofia de mamas e útero, tudo isto refletindo-se em medidas nutricionais e da composição corpórea.Todavia, embora as curvas de peso na gravidez estejam amplamente documentadas 6 , poucos estudos aferiram as gestantes sob o prisma da composição corporal. Tendo-se em vista a facilidade e segurança da realização de tal propedêutica com o advento da bioimpedância, realizou-se um estudo sistemático desta natureza em gestantes de termo.Foram objetivos do presente trabalho: 1) determinar a composição corpórea em ges...
Triceps skinfold (TS), arm muscle circumference (AMC) and body weight (BW) were studied prospectively in 20 adults, admitted to elective operations on the digestive tract, in order to evaluate these anthropometric parameters in planned surgical procedures performed in non-critically ill, non-stressed patients. Mean duration of the preoperative period was 19.2 days (range 1--38), and of the postoperative period, 14.1 days (range 6--31). Mean changes for BW were, respectively, -0.2% and -2.5%, AMC decreased -0.5% before operation and -3.4% afterwards, and TS was reduced to -1.9% in the preoperative phase, and to -8.4% postoperatively. These results are consistent with minimal anthropometric changes during the presurgical stay, with more striking decreases after operative injury. Postoperative findings were further examined in relationship to degree of surgical trauma and length of postoperative hospitalization. After the arbitrary selection of a 10% reduction as the limit for significant decrease in any of the analysed parameters, the percentage of impaired measurements was determined in the sub-groups of medium and large operations, two consecutive procedures, as well as postoperative stay of 6 to 14 days, 15 to 21 days, and over 3 wks. Decreased parameters comprised 6.0% (2/33) of the observations after moderate surgical manipulation, 27.7% (5/18) after serious trauma, and 66.6% (6/9) after two operations. Simarilarly they represented 2.7% (1/36) of the findings in patients discharged within 2 weeks, 33.3% (4/12) in those staying between 2--3 weeks, and 66.6% (8/12) in the cases remaining for longer periods. Despite the limited sensitivity of anthropometric parameters in the detection of acute moderate changes in body constitution, they were useful in separating the patients undergoing medium surgical injury from those subjected to more severe metabolic stress, when only changes greater than 10% of initial value were considered.
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