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Biomedical subjects

F Contaldo

Publications and source records attributed to F Contaldo.

105 records · Page 6Linked to original sources

Nitrogen loss and urinary creatinine excretion during fasting in massive obesity.

Six (5 f, 1 m) massively obese, otherwise healthy subjects, were submitted for 4 weeks to a very-low-calorie diet (VLCD): 80 kcal, 335 kJ = 2.6 g N/day (17 g protein, 0 CHO and fat). Daily urinary creatinine excretion (UCE) and weekly nitrogen loss (NL) were determined during the whole period of treatment. Both NL and UCE decreased from the second week of treatment indicating a progressive sparing effect on lean body mass (LBM). A positive correlation (r = 0.991, P less than 0.001) was observed between mean daily UCE and NL, indicating that NL during prolonged fasting in obesity is possibly influenced by the lean body mass of the individual.

Adult↗

Obesity and cardiac function.

We studied 10 obese volunteers, mean age 36.5 +/- 10.3 years, who weighed 123.56 +/- 28.7 g and were 69.96 +/- 22.5 kg overweight. The subjects did not have diabetes, arterial hypertension or signs of cardiac and respiratory failure or disease and all underwent right- and left-heart catheterization. cardiac output and stroke volume were high, according to increased oxygen consumption and to the degree of obesity. Ventricular end-diastolic and atrial pressures ranged from normal to high and correlated with body weight, signs of volume overloading and reduced left ventricular (LV) compliance. The mean pulmonary artery pressure was elevated and correlated well with weight, pulmonary resistance being normal; mean aortic pressure did not correlate with weight, and systemic arterial resistance tended to have a negative correlation. The LV function curve showed impaired ventricular function, particularly for the heaviest subjects, in whom Vmax and the ratio of the stroke work index to LV end-diastolic pressure were reduced. These indexes correlated well with each other and both correlated negatively with the degree of obesity. In contrast, maximal dP/dt was normal and did not correlate with excess weight. These observations show that depressed LV function is already present in relatively young obese people, even if they are free from signs of cardiopathy and other associate diseases. The degree of impairment of heart function seems to parallel the degree of obesity.

Adult↗

Evaluation of the safety of very-low-calorie diets in the treatment of severely obese patients in a metabolic ward.

UNLABELLED: Nitrogen balance has been measured in 25 (18 f, 7m) obese non-diabetic patients submitted for four weeks to different versions of very-low-calorie diets (VLCD). Patients were divided into four groups and treated as follows: Gp 1 (6f, 4m) by 80 kcal (0.34 MJ) VLCD (17 g protein [= 2.6 g N], tr CHO and fat); Gp 2 (4f, 1m) by 180 kcal (0.76 MJ) VLCD (40 g protein [= 6.4 g N], 2 fat, tr CHO); Gp 3 (4f, 1m) by 80/180 kcal (0.34/0.76 MJ) VLCD (80 kcal during the 1st and 2nd week and 180 kcal during the 3rd and 4th week with the same nutrients as Gps and 1 and 2, respectively). Gps 1-3 received VLCD which essentially contained only protein. Gp 4 (4f, 1m) was treated by a 'mixed' VLCD containing protein and CHO (80 kcal, as in Gp 1 during the 1st and 2nd week; and 180 kcal, 17 g protein + 25.5 g CHO during the 3rd and 4th week of treatment). Weight loss was similar in Gps 1, 3 and 4 (-11 kg) and lower (-8 kg) in Gp 3. Mean daily nitrogen loss was lower in Gp 2 and 3 (-3.2 and -2.9 g N/day respectively). From the 3rd week of treatment nitrogen loss was reduced in Gps 1 and 2 and virtually absent in Gp 3. In Gp 4 nitrogen loss was persistently high (4.3-5.8 g N/day) during the whole period of observation. IN CONCLUSION: at a very low energy intake of below 200 kcal (0.84 MJ)/day dietary substitution of protein with carbohydrates does not ameliorate the nitrogen balance.

Adult↗

Plasma high density lipoprotein in severe obesity after stable weight loss.

Changes in plasma lipoprotein pattern, with particular attention to high density lipoprotein cholesterol (HDL-C) concentration, were evaluated in 7 (5 female, 2 male) obese patients before and 15 +/- 1 months after they had lost weight (mean 20.7 +/- 3.1 kg), when the patients' food intake had been ad libitum for at least 6 months, and they had been maintaining their weight loss. Plasma low density lipoprotein cholesterol (LDL-C) and very low density lipoprotein triglyceride (VLDL-TG) concentrations were lower than baseline values: on the other hand, plasma HDL-C concentration, which was below normal values before weight reduction, was found to be significantly increased (P < 0.05). These data indicate that, among the favourable changes in plasma lipoprotein pattern, an increase in HDL-C may be achieved after remarkable and stable weight loss in severe obesity.

Adult↗

Left arm thermography in early and maturity onset obesity.

Left-arm thermography and adipose-tissue biopsy of triceps skinfold have been performed in seven patients with obesity of early onset (EO), seven with maturity-onset obesity (MO) and seven non-obese control subjects (C). Obese patients were within the same range for age, physical activity, excess body-fat content and skinfold thickness; mean fat-cell diameter was found to be significantly higher in the group MO than either EO (P less than 0.05) or C subjects (P less than 0.01). Colour thermograms, as evaluated by a well-standardized score system, showed that skin temperature was higher in MO than in EO or C cases (P less than 0.05). The combination of fat-cell hyperplasia and lower thermal losses from the skin, indicative of a lower rate of energy expenditure, may explain the higher frequency of therapeutically refractory cases in EO than MO patients.

Adult↗

Protein-sparing modified fast in the treatment of severe obesity: weight loss and nitrogen balance data.

Nitrogen balance has been measured in 25 (16 f, 9m) patients with severe obesity submitted for four weeks to total fasting (TF) or different versions of protein-sparing modified fast (PSMF). The hospitalized patients, divided into four age-matched groups, were treated as follows:Group 1, were submitted to TF; Group 2 were treated by 80 kcal-PSMF (17 g protein=2.6 g N, traces of fat and carbohydrate); Group 3 were submitted to 180 kcal-PSMF (40 g protein = 6.4 g N, 2 g fat, traces carbohydrate) and Group IV, to 80/180 kcal-PSMF (80 kcal during the 1st and 2nd week and 180 kcal during the 3rd and 4th week of treatment). Weight loss was similar (-11 kg) in Gps 1, 2 and 4; lower (-8 kg) in Gp 3. Mean daily Nitrogen loss was significantly lower (P < 0.05) in Gps 3 and 4 than in Gps 1 and 2. Nitrogen loss was significantly reduced from the 3rd week onward in Gps 1 (P < 0.005), 2 (P < 0.05) and 4 (P < 0.002). During 180 kcal-PSMF nitrogen loss was significantly lower (P < 0.005) only when this dietary regimen was preceded by 80 kcal-PSMF for two weeks (Gp 4). These observations suggest a new approach to the treatment of severe obesity by PSMF and show that is is possible to further reduce the early catabolic phase which commonly arises during this type of therapy.

Adult↗

Predictors of survival in terminal-cancer patients with irreversible bowel obstruction receiving home parenteral nutrition.

Clinical, anthropometric, hematologic, and biochemical variables, evaluated immediately before starting nutritional treatment, were related to survival in 76 terminal-cancer patients with irreversible bowel obstruction receiving home parenteral nutrition. At baseline, abnormally low values were observed in the following percentages of patients: 40.8% for body mass index, 59.2% for serum albumin, 84.2% for hemoglobin, 48.7% for lymphocyte count, and 60% for serum cholesterol. Survival on home parenteral nutrition ranged between 6 and 301 d, with a median of 74 d. Hemoglobin, serum albumin and serum cholesterol were lower in patients with a survival of less than 3 mo. With regard to Karnofsky performance status, median survival times were 63 d for a score below or equal to 50 and 128 d for a score between 60 and 70. Albumin and a Karnofsky score above 50 (but not age, weight, body mass index, lymphocyte count, or cholesterol) emerged (with a positive sign) as predictors of survival. In conclusion, terminal-cancer patients with irreversible bowel obstruction are often malnourished, showing a high prevalence of anemia and hypoalbuminemia. Survival differs widely and can be predicted only to a limited extent from initial values of serum albumin and Karnofsky performance status.

Body Mass Index↗

Onset of obesity in children through the recall of parents: relationship to parental obesity and life events.

Obesity is a multifactorial disease due to the influence of both genetic and environmental factors. Parents of 886 obese patients (427 boys and 459 girls, aged 1-18 years) were investigated by means of a questionnaire in order to study the factors associated with the onset of obesity in children and the relationship to genetic background. At presentation obese patients had a very high mean ideal body weight percent (IBW%) (154 +/- 19%, median 152%, range 120-246). A significantly higher mean IBW% was found in children of obese parents (one obese parent: 158 +/- 21%, median 156%, range 120-246; two obese parents 160 +/- 18%, median 158%, range 123-226) in comparison to children of normal weight parents (150 +/- 18%; median 147%, range 120-235; p = 0.0001 for children of one or two obese parents versus children of normal weight parents). Parents of 414 subjects (46.7%) (Group A) answered that obesity had always been present. The remaining 472 parents (53.3%) (Group B) stated that obesity had had a beginning at a mean age of 5.3 +/- 2.6 years (median 5.0 years, range 1.0-17.0). No difference was found in age at presentation, sex distribution, birth weight and number of obese parents between the two groups. Parents in Group B recalled an event associated with obesity onset in 197 cases (health event: 119 answers, psycho-social event: 78 answers). Genetic background did not influence this pattern of feedback. In conclusion, parents of obese subjects seek medical advice when obesity is severe. Pediatricians should exert strict surveillance on weight from a very young age. The recall in 22% patients of health or psychosocial events at the onset of obesity emphasizes that medical counselling is important when the occurrence of particular events in life may cause erroneous eating habits.

Adolescent↗

[Validity of 5 bioelectric impedance equations for the estimation of lean body mass in women].

Fat free mass (FFM) predicted by five bioelectrical impedance (BIA) available formulae (Segal et al., Lukaski et al., Kushner et al., Deurenberg et al., manufacturer's predictive equation) was compared with densitometrically-determined FFM (as a reference method) in two groups of young women with different anthropometric characteristics. In the farmers (very short and light individuals), none of the studied formulae was able to accurately predict FFM: this latter was overestimated in subjects with low and underestimated in those with high FFM. In the other group (INCAP employees), only values predicted by Lukaski formula were in perfect agreement with FFM, showing no bias depending on FFM changes. In conclusion, the available BIA formulae seem to be specific for population from which they were derived and could not be used on samples from other populations if not cross-validated.

Adolescent↗

[Basal metabolism and postprandial thermogenesis in anorexia nervosa and constitutional leanness].

Body composition and energy expenditure (basal metabolic rate--BMR--and postprandial thermogenesis--PPT) were evaluated in 11 anorectic patients, 16 very lean young women and 26 control female subjects. BMR in absolute terms was severely depressed in the anorectics when compared to the other two groups (p less than 0.01). After adjustment for fat free mass BMR was significantly higher in the lean subjects than the controls (p less than 0.05). PTT was studied for 240 minutes after the ingestion of a 3.56 MJ mixed meal (16% Prot, 50% CHO and 34% Fat) in 7 anorectics, 7 lean and 8 control women. PPT was similar in the anorectics and in the controls, but lower in the lean subjects (p less than 0.05) than in the other two groups. This study shows that a sharp decline in BMR occurs in severely undernourished anorectic patients who, however, have a normal PPT. On the other hand, very lean healthy women tend to have higher BMR but a decreased thermic response to a mixed test meal.

Adipose Tissue↗

[Italian Consensus Conference; overweight, obesity and health (ICC S.O.S. 1991)].

On April 5th and 6th 1991, at the National Research Council (CNR) in Rome, a Consensus Conference on the relationship between Overweight, Obesity and Health was held. The Conference was sponsored by FATMA (Applied Project on Disease Factors of the CNR) and UICO (Italian Society for the Study of Obesity) with the purpose of establishing guidelines for health employees. The development of the Conference followed the methodology set down by OMAR to obtain a rational and significant consensus on the answers to 6 basic questions prepared by the Planning Committee. The questions were the pivotal point of the Conference and were brought to the attention of all the attendees and widely diffused among the medical community; they were proposed with the aim of giving an exhaustive definition of obesity, to investigate its relationship with mortality and morbidity, to highlight its social characterization, to indicate methods of evaluation and recommendations for weight loss, to select groups at risk, and to focus general guidelines for research. After the presentation of the state of the art on 18 topics by experts in the field, the 22 members of the Consensus Panel, impartial experts from a vast area of the scientific community, discussed a draft document representing the answers to the questions, which was subsequently illustrated to the 307 attendees, discussed and then approved. This paper is the definitive document of the Consensus Conference. The introduction explains the reasons which led to the decision to promote the Conference six years after the one held in the United States. The methodology is then set out. The questions are answered in the form of recommendations and backed up by data and scientific demonstrations from the literature.

Adolescent↗