Nutritional Management in Bariatric Surgery Patients

The obesity epidemic, mainly due to lifestyle changes in recent decades, leads to serious comorbidities that reduce life expectancy. This situation is affecting the health policies of many nations around the world. Traditional measures such as diet, physical activity, and drugs are often not enough to achieve weight loss goals and to maintain the results over time. Bariatric surgery (BS) includes various techniques, which favor rapid and sustained weight loss. BS is a useful and, in most cases, the best treatment in severe and complicated obesity. In addition, it has a greater benefit/risk ratio than non-surgical traditional therapies. BS can allow the obese patient to lose weight quickly compared with traditional lifestyle changes, and with a greater probability of maintaining the results. Moreover, BS promotes improvements in metabolic parameters, even diabetes remission, and in the quality of life. These changes can lead to an increase of life expectancy by over 6 years on average. The nutrition of people before and after BS must be the subject of indications from a trained staff, and patients must be followed in the subsequent years to reduce the risk of malnutrition and the associated problems. In particular, it is still debated whether it is necessary to lose weight prior to surgery, a procedure that can facilitate the surgeon’s work reducing the surgical risk, but at the same time, lengthens preparation times increasing the risks associated with concomitant pathologies. Furthermore, preventing nutritional deficiencies prior to the intervention can improve the results and reduce short- and long-term mortality.

Impact of COVID-19 Pandemic and Lockdown Measures on the Nutrition Plan Service Cohort

Objective: This study analyses the patients' factors can influence the attitude to follow or not the therapeutic weight-loss plan after national lockdown measures adopted from March 2020 to May 2020. Materials and Methods: Patients that visited a private nutritional center in March 2020 were included in this retrospective observational study. All relevant characteristics were noted. In May 2020, patients who did not attend the follow-up visit were labeled as "abandoned". Variation in Body Mass Index (BMI) was noted in the second visit. Univariate logistic regression was performed to test the influence on dependent variables (lost follow-up). Odds Ratio (OR) was calculated. According to BMI distribution, we performed a Student T-test (α= 0.05) or Wilcoxon test (α= 0.05) to test BMI variation in patients that attended the follow-up visit. A P-value< 0.05 was considered statistically significant. Results: Our population consisted of 77 patients, and 26 patients (33.8%, CI95% 23.4-45.4%) were labelled as "abandoned". Age≥ 54 years old (OR= 8.9048, CI95%:1.888-41.9822, P-value= 0.0057) and suffering from hypertension (OR= 4.8706, CI95%:1.4284-16.6076, Pvalue= 0.0114) were factors associated with the abandon follow-up visits. Wilcoxon test for BMI variation resulted statistically significant (May BMI 29.5 kg/m2 vs March BMI 29.4 kg/m2 , Pvalue= 0.0094). Conclusion: Age and hypertension are related to the risk of abandoning healthcare services after ending the national lockdown. The losing follow-up phenomenon could worsen clinical conditions and reduce life expectancy. An increase in BMI during lockdown should be interpreted as a personal difficulty in complying with therapeutic prescriptions.

The effect of negationism on public health

Negacionism refers to the choice to deny a scientifically proven reality, which can reduce life expectancy and quality of life. Within this context, the uncontrolled trajectory of the COVID-19 Pandemic in Brazil has generated great concern due to the lack of consensus on how to manage the pandemic in a scenario of denial of the seriousness of the disease by the government, since on August 2nd, 2021, there are 556,437 Brazilians killed due to the disease. The denial of COVID-19 and the immunizing agent is another pandemic and turns the current scenario into a syndemic.

Alka Ptonuria Disorder

Alkaptonuria (AKU) is a rare disorder of autosomal recessive inheritance. It is caused by a mutation in a gene that results in the accumulation of homogentisic acid (HGA). Characteristically, the excess HGA means sufferers pass dark urine, which upon standing turns black. This is a feature present from birth. Over time patients develop other manifestations of AKU, due to deposition of HGA in collagenous tissue namely ochronosis and ochronotic osteoarthropathy. Although this condition does not reduce life expectancy, it significantly affects quality of life. The natural history of this condition is becoming better understood, despite gaps in knowledge. Clinical assessment of the condition has also improved along with the development of a potentially disease-modifying therapy. Furthermore, recent developments in AKU research have led to new understanding of the disease, and further study of the AKU arthropathy has the potential to influence therapy in the management of osteoarthritis.

Design of Decision Support System for Food Selection for Diabetes Mellitus Type 2 Using Weighted Product Method (Case Study: Puskesmas Temon II Kulon Progo)

DM is known as cardiovascular disease, but DM is also one of the main causes of kidney disease and blindness under 65 years of age, as well as amputation. DM is also a cause of amputation (which is not caused by trauma), disability, and death. Another effect of diabetes is to reduce life expectancy by 5-10 years. The life expectancy of people with type 2 diabetes mellitus or non-insulin-dependent diabetes mellitus who suffer from serious mental illnesses, such as schizophrenia, is even 20% lower than the general population. The method to be used is the Weighted Product (WP) method. This method is used because the WP is one of the preferred methods for solving complex problems and can produce structured calculations. The ranking result states that the alternative Tempe Boiled with a value of 0.136 is the best suggestion for the user.

Computational Fluid Dynamics Analysis of Nasal Airway Changes after Treatment with C-Expander

The use of the C-expander is an effective treatment modality for maxillary skeletal deficiencies which can cause ailments and significantly reduce life expectancy in late adolescents and young adults. However, the morphological and dynamic effects on the nasal airway have not been reported. The main goal of this study was to evaluate the nasal airway changes after the implementation of a C-expander. A sample of nine patients (8 females, 1 male, age range from 15 to 29 years) was included. The morphology parameters and nasal airway ventilation parameters of pretreatment and posttreatment were measured. All study data were normally distributed. A paired t -test was used to evaluate the changes before and after treatment. After expansion, the mean and standard deviation values of intercanine maxillary width (CMW) and intermolar maxillary width (MMW) increased from 35.75 ± 2.48 mm and 54.20 ± 3.17 mm to 37.87 ± 2.26 mm ( P < 0.05 ) and 56.65 ± 3.10 mm ( P < 0.05 ), respectively. The nasal cavity volume increased from 20320.00 ± 3468.25 mm3 to 23134.70 ± 3918.84 mm3 ( P < 0.05 ). The nasal pressure drop decreased from 36.34 ± 3.99 Pa to 30.70 ± 3.17 Pa ( P < 0.05 ), while the value of the maximum velocity decreased from 6.50 ± 0.31 m/s to 5.85 ± 0.37 m/s ( P < 0.05 ). Nasal resistance dropped remarkably from 0.16 ± 0.14 Pa/ml/s to 0.08 ± 0.06 Pa/ml/s ( P < 0.05 ). The use of C-expander can effectively broaden the area and volume of the nasal airway, having a positive effect in the reduction of nasal resistance and improvement of nasal airway ventilation. For patients suffering from maxillary width deficiency and respiratory disorders, a C-expander may be an alternative method to treat the disease.

Methods of physiotherapy in the treatment of obesity

Currently, there is a significant increase in the prevalence of obesity among children and adolescents of the world population. Overweight and obesity are a global epidemic of humanity. In economically developed countries, including Russia, on average, every third inhabitant has a weight that exceeds the maximum allowed. Russia ranks 15th in the world in the prevalence of overweight and obesity among children and adolescents. Obesity is now considered as a chronic, relapsing disease associated with the development of a number of diseases that reduce life expectancy and reduce its quality. An important factor in demonstrating the urgency of the problem of child and adolescent obesity is its prognostically adverse effect on obesity in adulthood. The lack of targeted detection of overweight and obesity in children and adolescents in Russia accounts for its late diagnosis specialists. Complications of obesity affect the cardio vascular, reproductive, respiratory, nervous system, digestive organs, musculoskeletal system. In connection with the rise of obesity than the early detection of issues and preventive measures to prevent its further progression. Obesity in the early diagnosis and early treatment is a reversible condition. Important role in the treatment of obesity play a non-drug methods - diet, exercise stress, a variety of physical therapy, taking into account individual tolerance and comorbidity. Physiotherapy treatments have not only symptomatic but also the pathogenic effects, eliminating the primary metabolic and neuroendocrine disorders.

Growth hormone, somatomedins and cancer risk

Growth hormone (GH) promotes growth and development in children and is the meaningful co-regulator of the metabolism in adulthood. GH may act directly, through its receptor (GHR), as well as via mediators – insulin-like growth factors: IGF-1, i.e. somatomedin C and IGF-2. Moreover, GH and two growth factors are involved in the mechanisms of cell proliferation, differentiation and survival, hence their oncogenic potential is propounded. Indeed, GH, somatomedins and their receptors are found abundantly in normal and cancer cells in several tissues. It has been shown in animal and human trials that polymorphisms and mutations that increase signal transmission from the GH and IGF-1 receptor are associated with more frequent tumors development and reduce life expectancy. Numerous epidemiological studies have confirmed a clear relationship between GH/IGF-1 level in circulation and a cancer-dependent morbidity and mortality. It dictates caution in case of treatment with use of growth hormone. Such replacement therapy is recommended in cases of GH deficiency. In the common opinion of scientific societies such treatment is generally safe, although in some cases unambiguous opinion in this field cannot be determined yet. On the other hand, on the basis of available evidence, GH cannot be recommended for use by the healthy elderly (ani-aging medicine), bearing in mind that GH decline with age may represent a beneficial adaptation to ageing. Understanding the molecular mechanisms by which GH and GH-dependent growth factors affect cell metabolism and proliferation will allow to use them in oncology in the future.

The Analysis of Social Fears of Today’s Retirees: On the Example of Analysis of Food Consumption Practices

This article discusses the collective fears peculiar to people of the third generation and associated with consumer practices. The author analyses various methodological approaches to the study of fears of Russian and Soviet society. The author draws attention to the fact, that behavior of people of the third age is influenced by various groups of factors. A sociological study was conducted in the period from November 2017 to February 2019. The research method was an interview. The materials of the interview allowed to group consumer fears into three groups. The first group of fears is related to credit practices and banking products. The second group of fears is related to modern technologies. The third group of fears is related to food. The potential danger of food is a constant concern for the third age people. They are convinced that a modern man consumes substandard and harmful products, which provoke the development of many serious diseases and reduce life expectancy. Fears have a multi-layered nature. Pensioners are afraid not only of the toxicity of products, but also of unreliability of the information provided about these products. Consumer fears express deep-rooted attitudes and stereotypes in relation to all new and alien things: fear of new social conditions and norms, fear of market mechanisms of production and distribution of goods, alien forms and symbols of social and cultural life. Fear of all the new finds its continuation in consumer fears.

Atypical Progeroid Syndrome and Partial Lipodystrophy Due to LMNA Gene p.R349W Mutation

Atypical progeroid syndrome (APS) comprises heterogeneous disorders characterized by variable degrees of fat loss, metabolic alterations, and comorbidities that affect skeleton, muscles, and/or the heart. We describe 3 patients that were referred to our center for the suspicion of lipodystrophy. They had precocious aging traits such as short stature, mandibular hypoplasia, beaked nose, and partial alopecia manifesting around 10 to 15 years of age recurrently associated with: (1) partial lipodystrophy; (2) proteinuric nephropathy; (3) heart disease (rhythm disorders, valvular abnormalities, and cardiomyopathy); and (4) sensorineural hearing impairment. In all patients, genetic testing revealed a missense heterozygous lamin A/C gene (LMNA) mutation c.1045 C &gt; T (p.Arg349Trp). Ten patients with LMNA p.R349W mutation have been reported so far, all presenting with similar features, which represent the key pathological hallmarks of this subtype of APS. The associated kidney and cardiac complications occurring in the natural history of the disease may reduce life expectancy. Therefore, in these patients a careful and periodic cardiac and kidney function evaluation is required.