Objective: This study aims to evaluate the effects of omega-3-rich fish oil supplementation with or without physical activity on anti-inflammatory and insulin resistance parameters in obese and type 2 diabetic individuals. Methods: Randomized, double-blind intervention study of omega-3. Adults with obesity and type 2 diabetes mellitus on exclusive use of metformin as a drug to control blood glucose will be included. The Protocol will be based on clinical and nutritional follow-up (supplementation with omega-3) and remote physical activity for eight weeks. Individuals selected for the study will be randomly assigned to one of the following groups: i) omega-3; ii) omega-3 + physical activity; iii) physical activity + placebo; iv) placebo. To analyze the results, biochemical parameters (fasting glucose and insulin, glycosylated hemoglobin, liver enzymes, urea, creatinine, total cholesterol and fractions, triglycerides, CRP, and ferritin) and inflammatory parameters (TNF alpha, IL-1 beta, IL- 6 and IL-10). At the end of the study, it is expected that the intervention associated with omega-3 in the physical activity protocol will promote a reduction in parameters related to insulin resistance, levels of inflammatory cytokines, and anthropometric parameters.
Introduction: Metabolic syndrome (MetS) predicts cardiovascular disease, and patients with this condition and type 2 diabetes have increased albuminuria, significantly impacting cardiovascular mortality and kidney disease progression. A considerable number of interventions to control MetS exist and are considered efficient, including the use of medication and changes in lifestyle. However, which approaches are effective in controlling albuminuria remains unclear. This systematic review protocol aims to map in the available literature whether lifestyle, medication, and surgical intervention for MetS have an impact on reducing albuminuria in adult patients. Methods: The Joanna Briggs Institute methodology for systematic reviews will be followed. Cochrane Database of Systematic Reviews, Scopus, Embase, and MEDLINE/PubMed databases will be used. For the Gray Literature, the DART-Europe E-theses Portal. There will be no language restriction. Studies written after 2009 will be included due to the consensus and definition of metabolic syndrome. This review will include studies considering pharmacological and non-pharmacological treatments for controlling albuminuria in patients with MetS. Studies where MetS is described in children and adolescents, animals, pregnant women, and patients with type 1 diabetes will be excluded. First, the selection will be based on reading the title and summary of the texts retrieved in the search strategy, followed by reading the relevant texts in full by two reviewers. After the selection of the studies, the extraction of the data, analysis, and synthesis will be conducted according to the JBI methodology.
Background: Segments of the digestive tract have specificities of nutrient absorption. The aim of this study was to identify factors related to outcome among patients submitted to intestinal resections in a university hospital. Material and methods: Retrospective, cross sectional study using a semi-structured specific form. A total of 169 medical records of patients submitted to intestinal resection from august 2007 to july 2013 were analyzed. Patients were grouped according to clinical evolution (hospital discharge / death) for analysis of the data. Results: Longer hospitalizations and age over 60 years were associated with a higher mortality rate. Among patients submitted to single (n=148) or multiple (n=21) enterectomy, the mortality rate was 33.8% (n=50 deaths) and 52.4% (n=11 deaths), respectively. Hospital discharge was more common among patients undergoing a single enterectomy. Among patients submitted to single resection, non-description of resected bowel segments increased the mortality rate (p=0.002). Remaining small intestine description was performed for 14 patients, and 11 of these patients met criteria for diagnosis of short bowel syndrome (SBS) (78.6%). SBS patients had a 90.9% mortality rate. For most enterectomized patients, no nutritional status assessment was performed (n=103, 60.9%). Patients classified as malnourished (n=19; 52.8%) had a higher mortality rate (p=0.032). Conclusion: The lack of description of the resected and / or remaining intestinal segments, as well as the non-evaluation of the nutritional status, contributed to the higher mortality rate of patients submitted to resection of bowel segments.
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