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São Paulo, Brazil

dos Santos M.T.A.,Federal University of ABC | de Souza F.I.S.,Federal University of Sao Paulo | Fonseca F.L.A.,University of Sao Paulo | Lazaretti-Castro M.,Disciplina de Endocrinologia e Ambulatorio de Endocrinologia | Sarni R.O.S.,FMABC
Arquivos Brasileiros de Endocrinologia e Metabologia | Year: 2012

Objective: To evaluate bone turnover markers and bone mineral density (BMD) in women after Roux-en-Y (RYGB) gastric bypass. Subjects and methods: In a cross-sectional study, 48 women post-RYGB after three years, and 41 healthy women were evaluated. Evaluations: body mass index (BMI); physical activity; food intake; serum levels of calcium, phosphorus, magnesium, alkaline phosphatase, C-terminal telopeptide (CTX), intact parathyroid hormone (PTH), 25-hydroxyvitamin D (25OHD), osteocalcin, urinary calcium and BMD. Results: Significantly higher levels were observed for osteocalcin (p < 0.001), CTX (p < 0.001), and PTH (p < 0.001) in the RYGB group when compared with the control group; 250HD deficiency/insufficiency was more frequent in the RYGB group (p = 0.010), even after adjusted for nutritional status, and it was associated with secondary hyperparathyroidism (p = 0.025); there was no difference in BMD between the groups. Energy (p = 0.036) and protein intake (p = 0.004) were lower in the RYGB group. Conclusion: Patients submitted to RYGB showed a significantly higher frequency of vitamin D deficiency, secondary hyperparathyroidism, and increase in bone remodeling markers, with no difference in BMD status. Source

Objective. Describe physical therapy applied to children with cerebral palsy (CP) spastic quadriplegia attended by scholars of Physiotherapy of Faculdade de Medicina do ABC - FMABC. Method. The study included three female patients. The items that made up the evaluation protocol were: identification, use of medication to decrease tone, use of bracing, physical therapist interaction, language type, age of onset and duration of treatment, patterns and postural changes, joint deformities, weight bearing on standing position, the persistence of tonic neck reflexes, ability to scroll, neck control and shoulder girdle. The physiotherapy sessions were followed by registration of the care protocol. Results. The participants had incomplete control cervical and shoulder girdle absent; only one rolled. The objectives of physical therapy elected with more frequently were: inhibit pathological pattern, decrease muscle tone, increased muscle extensibility, increasing neck control, increase mobility and control of shoulder girdle, to stimulate the roll and provide the benefits of standing. The pipes used to accommodate the proposed objectives formed a physiotherapeutic protocol of individualized care. Conclusion. The treatment applied included: pattern of inhibition, maneuvers to decrease spasticity and facilitation of cervical control, the shoulder girdle and roll. Source

Objective. To review the literature about perinatal asphyxia (PA), collecting information about injury mechanisms, consequences, possible neurological sequelae, and early identification. Method. Electronic search of the databases SciELO, BIREME, Medline, selecting 26 articles and three books. Results. The lack of consensus to define perinatal asphyxia justifies the difficulty to establish prevalence data. The current definitions are based on a combination of indicators and not only in low Apgar score. Its pathophysiology is based on hypoxic-ischemic injury, resulting in multiple organ failure and brain damage. The hypoxic-ischemic encephalopathy is the most serious consequence of perinatal asphyxia, which causes neurologic sequelae. The neonatal neurologic assessments assist in the detection of abnormalities, allowing early treatment and optimizing prognosis. However there are few studies that have used such evaluation methods in this population. Conclusion. The literature which addresses the theoretical concepts of the PA, such as diagnosis, risk factors and pathophysiology is much more extensive than the number of studies reporting its consequences. Source

Iampolsky M.N.,FMABC | De Souza F.I.S.,Servico de Nutrologia | Sarni R.O.S.,Servico de Nutrologia | Sarni R.O.S.,University of Sao Paulo
Revista Paulista de Pediatria | Year: 2010

Objective: To evaluate blood pressure levels in children, relating them to body mass index and abdominal circumference. Methods: This cross-sectional prospective study enrolled 1.408 school children, aged between five and ten years and 11 months, in the municipality of Santo Andre, São Paulo, Brazil. The following variables were evaluated: birth weight, weight and height, expressed as body mass index Z score (ZBMI) and height to age Z score (ZH), and waist circumference (WC). Blood pressure was measured once by the same physician. Malnutrition was considered when ZBMI <-2, obesity when ZBMI >+2, short stature when ZH <-2, increased abdominal circumference when >P90 for age and gender, and increased blood pressure when >P90 for age, gender and height. Statistical analysis included chi-square test and Odds Ratio, being significant p<0.05. Results: Mean age was seven years old, and 51% were females. High systolic blood pressure levels were observed in 19% and elevated diastolic blood pressure in 12%. Short stature, malnutrition, obesity and increased abdominal circumference were diagnosed in 2.6%, 3.1%, 7.3% and 13.4%, respectively, of the studied population. The presence of obesity was strongly associated with high systolic (OR 2.1, 95%IC 1.3-3.3; p<0.001) and diastolic blood pressure (OR 2.6, 95%IC 1.6-4.3; p<0.001). Increased abdominal circumference was also an important risk factor for high systolic blood pressure (OR 1.6; 95%IC 1.0-2.5; p=0.027). Conclusions: High blood pressure in children is associated with obesity and increased abdominal circumference. Source

Background: The classical view of adipose tissue as a passive reservoir for energy storage is no longer valid. In the past decade, adipose tissue has been shown to have endocrine functions and the most abundant peptide secreted by adipocytes is adiponectin. Pericardial adipose tissue (PAT) is distributed around coronary arteries and endovascular injury, caused by the presence of intracoronary bare-metal stent (BMS), could promote inflammatory changes in the periadvential fat, contributing to vascular restenosis. Objective: We sought to determine gene expression of inflammatory mediator in pericardial adipose tissue after bare-metal stent implantation and vascular restenosis that had been referred to operative treatment. Methods: Paired samples of PAT were harvested at the time of elective coronary artery bypass surgery (CABG) in 11 patients (n=22), one sample was obtained of the tissue around BMS area and another sample around coronary artery without stent. Local expression of adiponectin was determined by real-time polymerase chain reaction (RTPCR) using Taq DNA polymerase. Results: In two samples, there was no gene expression of adiponectin. We are able to identify adiponectin in 20 samples, however, the pattern of gene expression were heterogeneous.We did not notice specificity when we compared PAT obtained near BMS area or far from BMS area. Conclusion: There were no correlation between adiponectin gene expression and presence of BMS. Source

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