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cardiomegalia-cuore_ingrossato

L`INGROSSAMENTO DEL CUORE (CARDIOMEGALIA) RISULTA FORTEMENTE ASSOCIATO ALL`OBESITÀ

Una ricerca retrospettiva condotta su circa 500 casi di morte improvvisa ed inaspettata (fonte: Federal University of Sao Paulo, Sao Paulo, Brazil), dimostra che l’ingrossamento del cuore (cardiomegalia) è la principale causa di morte per grave aritmia (50 % circa dei casi studiati) in uomini e donne adulti ed è associata all’obesità.

La Cardiomegalia rappresenta un frequente substrato aritmogeno nelle morti cardiache improvvise in età adulta ed è associata con l`obesità.

Pubblicato in Pathology – The Journal of the Royal College of Pathologists of Australasia
2012 Apr; 44(3):187-91 – Autori: Tavora F, Zhang Y, Zhang M, Li L, Ripple M, Fowler D, Burke A – Fonte: Federal University of Sao Paulo, Sao Paulo, Brazil

BACKGROUND:

Both coronary artery disease (CAD) and cardiomyopathy may present with sudden cardiac death (SCD). It is generally accepted that CAD is the most common cause of SCD in adults, but the frequency of cardiomegaly as a primary or contributing cause is less known.

METHODS:

We retrospectively studied the cardiac findings of all cases of adult SCD attributed to cardiomegaly, severe atherosclerosis, or both, in the absence of specific cardiomyopathy. Association between findings and risk factors was studied.

RESULTS:

There were 484 sudden cardiac deaths, of which 402 met study criteria. Mean age was 49 ± 13 years, with 289 men and 159 African Americans (AAs). Cardiomegaly with presumed hypertensive, multifactorial or unknown cause, was the sole arrhythmogenic substrate in 38% of men and 49% of women (p = 0.003); CAD was the sole cause of SCD in 19% of men and 26% of women, and mixed CAD + cardiomegaly the cause of death in 43% of men and 25% of women. Cardiomegaly was associated by univariate analysis with younger age (46 ± 12 years versus 53 ± 14 for CAD, p < 0.0001), AA race (p = 0.004), and body mass index (p < 0.0001).

CONCLUSIONS:

Among adults with a mean age of about 50 years, cardiomegaly is a frequent cause of sudden cardiac death, and is highly associated with obesity. Cardiomegaly is also frequent in SCD with severe CAD. The causes and classification of cardiomegaly in patients without specific cardiomyopathy, and in patients with and without hypertension or coronary disease need to be better studied.

(C) 2012 Royal College of Pathologists of Australasia.

PMID:  22406485 [PubMed – indexed for MEDLINE]

Approfondimenti:
http://www.ncbi.nlm.nih.gov/pubmed/22406485
http://journals.lww.com/pathologyrcpa/pages/articleviewer.aspx?year=2012&issue=04000&article=00002&type=abstract

 

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La Chirurgia Bariatrica provoca la remissione della dipendenza dal cibo

In un recente studio, i ricercatori del Centro di Nutrizione Umana e Atkins (Centro di Eccellenza della Medicina dell’obesità) della Washington University School of Medicine, St Louis, MO, hanno valutato se la perdita di peso, indotta dall’intervento di Bypass gastrico o di Bendaggio gastrico o di Sleeve gastrectomy, provoca la remissione della dipendenza dal cibo e normalizza i comportamenti alimentari associati con questa condizione, nei pazienti ancora obesi.

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Bariatric surgery-induced weight loss induces remission of food addiction and improves several eating behaviours that are associated with the condition in extreme obesity, according to the study published in the journal Obesity.

Although, bariatric surgery is believed to be one most effective available weight loss therapy for obesity and impacts on patients desire to eat, it is not known whether it can affect food addiction in patients who meet diagnostic criteria for the condition before surgery.

Therefore, researchers from the Center for Human Nutrition and Atkins Center of Excellence in Obesity Medicine, Washington University School of Medicine, St Louis, MO, assessed whether weight loss induced gastric bypass, gastric banding and sleeve gastrectomy induced remission of food addiction, as well as normalising eating behaviours associated with the condition.

They recruited 44 obese patients (39 women, mean BMI48 ± 8) before and after bariatric surgery (after they lost ∼20% of their body weight). Twenty five patients had gastric bypass, 11 gastric banding and eight sleeve gastrectomy).

Food addiction was identified in 14 of 44 subjects (32%) before surgery, with no significant differences in factors that could affect the condition such as age, race, level of formal education, and income level.

They reported that remission of food addiction in 13 of the 14 subjects (93%) and no new cases were identified after surgery. The prevalence of food addiction in this study population decreased from 32% to 2% (p< 0.00001) and reduced the median number of symptoms in all subjects (p< 0.0001).

Surgery was found to decrease food cravings in both groups, but the decrease was greater in patients addicted to food. Unsurprisingly, the addicted patients craved foods more frequently before, but not after surgery. Interestingly, surgery decreased cravings for all types of foods but cravings for starchy foods were still more frequent in in the food addicted group (p=0.009).

“Our findings demonstrate that weight loss can induce remission of food addiction, even though subjects are still obese,” the authors write. “These data suggest that obesity itself does not cause food addiction, but that food addiction is a contributing, but modifiable, risk factor for obesity. Additional studies are needed to determine the mechanism(s) responsible for food addiction remission, and to determine whether the presence of food addiction influences the weight loss efficacy of bariatric surgery.”

Owen Haskins – Caporedattore, Bariatric News

http://www.bariatricnews.net/?q=news/111608/bariatric-surgery-causes-remission-food-addiction
http://onlinelibrary.wiley.com/doi/10.1002/oby.20797/full

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LA CHIRURGIA BARIATRICA PUO` MIGLIORARE LA FUNZIONE RENALE

LA CHIRURGIA BARIATRICA PUO` MIGLIORARE LA FUNZIONE RENALE

 

Secondo uno studio recente, presentato durante la Settimana del Rene (Kidney Week 2014), alla Società Americana di Nefrologia (ASN), presso il Pennsylvania Convention Center di Philadelphia, un gruppo di ricercatori ha esaminato e correttamente evidenziato l’associazione tra la perdita di peso ottenuta dal paziente obeso, dopo un intervento di chirurgia bariatrica e la velocità di filtrazione glomerulare (eGFR) , stimata attraverso l’equazione CKD-EPI.

 

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“Bariatric surgery serves as a good model to examine the effects of weight loss on kidney function. Our findings suggest a beneficial impact on kidney function in patients with and without baseline kidney disease,” said Alex Chang from the Geisinger Medical Center, Pennsylvania.

The association between weight loss and resolution of albuminuria was examined in the subset of patients with baseline albuminuria (albumin/creatinine ratio >=30mg/g) and subsequent ACR quantification. Mixed effects models were used, adjusted for time and baseline weight, allowing intercepts and slopes to vary for each individual.

A total of 3,134 patients were followed for a median of 2.4 years and the mean age was 47.2, 36.6% had diabetes, and 6.4% had eGFR

They noted that every 5kg of weight loss was associated with a 0.50 ml/ min/1.73m2 (95% CI: 0.42 to 0.57; p<0.001) increase in eGFR. The association between weight loss and increased eGFR was stronger in patients with eGFR <60ml/min/1.73m2: 0.89 ml/min/1.73m2 per 5kg decrease (95% CI: 0.63 to 1.15; p<0.001) compared to 0.46 (0.39 to 0.54; p<0.001) for those with eGFR >60 ml/min/1.73m2 (p

“More emphasis should be placed on promoting healthy lifestyles to avoid morbid obesity, and prevent chronic kidney disease,” concluded Chang. “Additional studies using other markers of kidney function are needed to confirm the study’s findings and to examine the effect of weight loss on long-term kidney outcomes.”

Owen Haskins – Caporedattore, Bariatric News

Novembre 2014

http://www.bariatricnews.net/?q=news/111716/bariatric-surgery-could-improve-kidney-function

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