Revisiones_bibliográficas TyO_Web: Tópicos de obesidad / Topics on obesity Buzón

Google+

viernes, 6 de octubre de 2017

Tópicos de obesidad / Topics on obesity Buzón

Octubre 4, 2017. No. 2831

Determinación del volumen sanguíneo en embarazadas obesas y de peso normal: el método del almidón hidroxietilo.

Blood volume determination in obese and normal-weight gravidas: the hydroxyethyl starch method.

Vricella LK1, Louis JM2, Chien E3, Mercer BM3.

Author information

Am J Obstet Gynecol. 2015 Sep;213(3):408.e1-6. doi: 10.1016/j.ajog.2015.05.021. Epub 2015 May 14.

Abstract

OBJECTIVE: The impact of obesity on maternal blood volume in pregnancy has not been reported. We compared the blood volumes of obese and normal-weight gravidas using a validated hydroxyethyl starch (HES) dilution technique for blood volume estimation. STUDY DESIGN: Blood volumes were estimated in 30 normal-weight (pregravid body mass index [BMI] <25 kg/m(2)) and 30 obese (pregravid BMI >35 kg/m(2)) gravidas >34 weeks' gestation using a modified HES dilution technique. Blood samples obtained before and 10 minutes after HES injection were analyzed for plasma glucose concentrations after acid hydrolysis of HES. Blood volume was calculated from the difference between glucose concentrations measured in hydrolyzed plasma. RESULTS: Obese gravidas had higher pregravid and visit BMI (mean [SD]): pregravid (41 [4] vs 22 [2] kg/m(2), P = .001); visit (42 [4] vs 27 [2] kg/m(2), P = .001), but lower weight gain (5 [7] vs 12 [4] kg, P = .001) than normal-weight women. Obese gravidas had similar estimated total blood volume to normal-weight women (8103 ± 2452 vs 6944 ± 2830 mL, P = .1), but lower blood volume per kilogram weight (73 ± 22 vs 95 ± 30 mL/kg, P = .007). CONCLUSION: Obese gravidas have similar circulating blood volume, but lower blood volume per kilogram body weight, than normal-weight gravidas near term.

KEYWORDS: blood volume; hydroxyethyl starch; obesity; obstetric anesthesia

PDF

Obesidad Mórbida y Anestesia: Problemas y Soluciones

Drs. Fernando Altermatt, Verena Brandes

PDF

Diabetes y obesidad. ¿Hay una dieta ideal?

Diabetes with obesity-Is there an ideal diet?

Cleveland Clinic Journal of Medicine 2017 July;84(suppl 1):S4-S14

Zahrae Sandouk, MD M. Cecilia Lansang, MD, MPH

ABSTRACT

For individuals who are overweight or obese, weight loss is effective in preventing and improving the management of type 2 diabetes. Together with other lifestyle factors like exercise and behavior modification, diet plays a central role in achieving weight loss. Diets vary based on the type and amount of carbohydrate, fat, and protein consumed to meet daily caloric intake goals. A number of popular diets are reviewed as well as studies evaluating the effect of various diets on weight loss, diabetes, and cardiovascular risk factors. Current trends favor the low-carbohydrate, low-glycemic index, Mediterranean, and very-low-calorie diets. However, no optimal dietary strategy exists for patients with obesity and diabetes, and more research is needed. Given the wide range of dietary choices, the best diet is one that achieves the best adherence based on the patient's dietary preferences, energy needs, and health status.

PDF