Mg depletion is common in poorly controlled patients with type 2 diabetes, especially in those with neuropathy or coronary disease. More prolonged use of Mg in doses that are higher than usual is needed to establish its routine or selective administration in patients with type 2 diabetes to improve control or prevent chronic complications.
RESUMOAs alterações do estado nutricional (desnutrição e obesidade) são relacionadas com sérios agravos para a saúde. O presente trabalho de revisão da literatura tem por objetivo descrever os principais métodos de avaliação do estado nutricional, com finalidade de facilitar o diagnóstico dos problemas nutricionais e acompanhar intervenções dietoterápicas. Descreve o método clínico, detalha aspectos da antropometria e os exames laboratoriais utilizados em avaliação do estado nutricional. Relaciona alguns dos principais índices múltiplos, utilizados tanto com fins diagnósticos e prognósticos. Informa a respeito da impedância bioelétrica, completando abordagem sobre os méto-dos convencionais, além de descrever as principais vantagens e desvantagens dos métodos não-convencionais. Finaliza com revisão sobre a situação nutricional da população brasileira, através da análise de dados obtidos em três inquéritos populacionais (1974, 1989, 1997). Nutritional disorders (undernutrition and obesity) are associated to increases in morbidity and mortality. This paper consists on a review of literature with the purpose of describing the main methods of nutritional assessment, in order to facilitate the diagnosis of nutritional disorders and the follow-up of dietetics interventions. It describes the clinical method, details procedures of anthropometry and laboratory evaluation and enrolls some of the multiple indices used for diagnosis and prognosis. Information about bioelectric impedance is given. Some aspects of non-conventional methods are reminded. Nutritional status of the Brazilian population is discussed, using the analysis of data collected from three populational surveys (1974, 1989, and 1997). (1), para manter a composição e funções adequadas do organismo (2), resultando do equilíbrio entre ingestão e necessidade de nutrientes (1). As alterações do estado nutricional contribuem para aumento da morbi-mortalidade. Assim sendo, a desnutrição predispõe a uma série de complicações graves, incluindo tendência à infecção, deficiência de cicatrização de feridas, falência respi- ratória (3), insuficiência cardíaca, diminuição da sín-tese de proteínas a nível hepático com produção de metabólitos anormais, diminuição da filtração glomerular e da produção de suco gástrico (4). Por outro lado, o sobrepeso e a obesidade são fatores de risco para variado número de agravos à saúde, dos quais os mais freqüentes são doença isquêmica do coração, hipertensão arterial, acidente vascular cerebral, diabetes mellitus tipo 2, colelitíase, osteoartrite (especialmente de joelhos), neoplasia maligna de mama pós-menopausa e de endométrio, esofagite de refluxo, hér-nia de hiato e problemas psicológicos (5,6). AVALIAÇÃO DO ESTADO NUTRICIONALOs objetivos da avaliação do estado nutricional são: a) identificar os pacientes com risco aumentado de apresentar complicações associadas ao estado nutricional (CAN), para que possam receber terapia nutricional adequada (1,7-9); b) monitorizar a eficácia da intervenção dietoterápica (1,9).Esta avaliação pode...
FNAB-Tg improves the diagnostic performance of FNAB-C in LN metastases, even when the latter is unable to diagnose the metastases. For that reason, FNAB-Tg should be included in the monitoring of DTC.
Oxytocin (OT) is a neuropeptide synthesized in the paraventricular (PVN) and supraoptic nuclei (SON) in the hypothalamus. Although OT is more commonly known for its role in the milk-ejection reflex, in recent years research has indicated that OT participates in the expression of social behavior, memory processing, modulation of fear, and stress responses. The demonstration that OT influences affiliative behaviors, such as parental care and reproduction, and decreases anxiety has lead to speculations that it may have a role in mood disorders. Evidence from pharmacologic studies, pointing out the modulation of the OT system by serotonin, has argued in favor of OT as a mediator of serotonin reuptake inhibitors (SSRIs) antidepressant properties. In the present study, we investigated the distribution and overlap of OT-labeled cells and serotonin transporter (5-HTT) immunoreactive (IR) fibers in the Macaque hypothalamus, utilizing immunocytochemical and double-immunofluorescent techniques. Consistent with previous reports, the distribution of OT-labeled cells in the hypothalamus is confined to the PVN and SON. In these nuclei, we demonstrate that the distribution of 5-HTT-labeled fibers follows the distribution of OT-labeled cells. Overlap of OT-labeled neurons and 5-HTT-IR fibers occurs in the parvicellular, magnocellular, dorsal, and posterior subdivisions of the PVN. In the SON, 5-HTT-labeled fibers and OTlabeled cells overlap in the ventromedial subdivision and in the 'capsular' part of the dorsolateral SON. These findings provide neuroanatomic support for the idea that SSRIs' therapeutic effects on social affiliation and anxiety may be mediated in part through components of the OT system. Neuropsychopharmacology (2007) 32, 977-988.
BackgroundTo evaluate the effect of magnesium (Mg) replacement on insulin resistance and cardiovascular risk factors in women with metabolic syndrome (MS) without diabetes.MethodsThis 12-week clinical randomized double-blind study compared the effects of 400 mg/day of Mg with those of a placebo (n = 72) on fasting glucose, insulin, HOMA-IR, lipid profile and CRP. Mg was measured in serum (SMg) and in mononuclear cells (MMg).ResultsHypomagnesemia (SMg < 1.7 mg/dL) was seen in 23.2% of patients and intracellular depletion in 36.1% of patients. The MMg means were lower in patients with obesity (0.94 ± 0.54 μg/mg vs. 1.19 ± 0.6 μg/mg, P = 0.04), and insulin resistance (0.84 ± 0.33 μg/mg vs. 1.14 ± 0.69 µg/mg, P < 0.05). Mg replacement did not alter SMg (1.82 ± 0.14 mg/dL vs. 1.81 ± 0.16 mg/dL, P = 0.877) and tended to increment MMg (0.90 ± 0.40 μg/mg vs. 1.21 ± 0.73 μg/mg, P = 0.089). HOMA-IR did not alter in interventions nor in placebo group (3.2 ± 2.0 to 2.8 ± 1.9, P = 0.368; 3.6 ± 1.9 to 3.2 ± 1.8, respectively), neither did other metabolic parameters.ConclusionSerum and intracellular Mg depletion is common in patients with MS; however, Mg replacement in recommended dosage did not increase significantly Mg levels, neither reduced insulin resistance or metabolic control.
Data concerning the effects of GnRHa on weight gain are scarce. Objective: To assess the variation of the body mass index (BMI) in girls during GnRHa treatment for idiopathic central precocious puberty (CPP). Patients and Methods: Semestral anthropometric data from 176 girls treated with goserelin or leuprorelin were analyzed. Results: BMI z-score increased from 1.5 ± 0.1 SD before treatment (n = 176) to 1.7 ± 0.2 SD after 24 months (n = 61, ρ = 0.008). In girls with normal weight before treatment, this variation was greater (n = 112,0.2 ± 0.1 SD, ρ = 0.01) than in those who were overweight (n = 63, -0.9 ± 0.2 SD, ρ = 0.7). In the goserelin group the weight change adjusted for bone age was greater (n = 28, 0.4 ± 0.1 SD) than in the leuprorelin group (n = 5, 0.04 ± 0.1 SD, ρ = 0.05). Conclusions: A slight increase in BMI was noted, mainly in girls with normal weight before treatment. The influence of different GnRHa on weight must be further investigated.We studied the BMI follow-up of girls treated with GnRHa for CPP. PATIENTS AND METHODSThe aim of this longitudinal retrospective study was to evaluate semestral changes in BMI of 176 Brazilian girls treated with GnRHa for idiopatic central precocious puberty (ICPP), regularly seen at a public health reference center (CEDEBA) in the state of Bahia, Brazil, during a 6-year period (1998)(1999)(2000)(2001)(2002)(2003)(2004).
The relationship between breastfeeding and the loss of weight gained during pregnancy remains unclear. This study aimed to investigate the association between breastfeeding and maternal weight changes during 24 months post-partum. We studied a dynamic cohort comprising 315 women living in two cities in the state of Bahia, Brazil. The outcome variable was change in the post-partum weight; the exposure variable was the duration and intensity of breastfeeding. Demographic, socio-economic, environmental, reproductive and lifestyle factors were integrated in the analysis as covariates. The data were analysed using multiple linear regression and linear mixed-effects models. The average cumulative weight loss at 6 months post-partum was 2.561 kg (SD 4.585), increasing at 12 months (3.066 kg; SD 5.098) and decreasing at 18 months (1.993 kg; SD 5.340), being 1.353 kg (SD, 5.574) at 24 months post-partum. After adjustment, the data indicated that for every 1-point increase in breastfeeding score, the estimated average post-partum weight loss observed was 0.191 kg at 6 months (P = 0.03), 0.090 kg at 12 months (P = 0.043), 0.123 kg at 18 months (P < 0.001) and 0.077 kg at 24 months (P = 0.001). Based on these results, we concluded that despite the low expressiveness, the intensity and duration of breastfeeding was associated with post-partum weight loss at all stages of the study during the 24-month follow-up.
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