Determinants of postpartum weight retention according to skin color among women in Rio de Janeiro, Brazil]

OBJECTIVE: To investigate factors associated with postpartum weight retention according to skin color in the city of Rio de Janeiro, Brazil, as part of the effort to help control overweight and obesity. METHODS: We carried out a cohort study with data collection at four points after delivery: 15 days, 2 months, 6 months, and 9 months. The 450 participants (15 to 45 years of age) were recruited from a maternity center and a city health center in Rio de Janeiro. Postpartum weight retention was defined as the dependent variable. The following covariates were investigated: maternal age, marital status, ability to read a letter, smoking, monthly family income, number of children, age at first delivery, a score for physical activity at work, and a score for physical activity during leisure time. The data were analyzed using multivariate linear mixed-effects models for longitudinal data. RESULTS: The factors that remained associated with postpartum weight retention for white women were time after delivery (beta = -0.0061, P = 0.0002), marital status (married/single beta = -0.9279, P = 0.0457), and age at first delivery (beta = -0.1553, P = 0.0364). The factors for brown women were time after delivery (beta = -0.0062, P < 0.0001), marital status (married/single beta = -0.6000, P = 0.0145), and work physical activity score (beta = -0.1068, P = 0.0003). The factors for black women were smoking (beta = -1.4635, P = 0.0535) and score for physical activity during leisure time (beta = -0.2422, P = 0.0145). CONCLUSIONS: The factors associated with postpartum weight retention were different for the three skin-color categories. Nevertheless, the data do not indicate the need for different interventions for the three skin-color groups. That is particularly true because the physical activity scores were among the variables associated with weight retention, and any initiative to control obesity should take physical activity into consideration. On the other hand, given the socioeconomic differences among the three skin-color categories, new studies should be developed to investigate in more detail the pattern of postpartum weight retention according to skin color.     

Central nervous system metastases of a pulmonary epitheloid haemangioendothelioma.

The case of a 55-yr-old male with a right pleural effusion and multiple bilateral nodules is reported. A diagnostic thoracothomy was necessary to obtain a definitive histological diagnosis. During the postoperative course, the subject's neurological condition deteriorated and multiple cerebral mass lesions were discovered. The pathological analysis of both lung and cerebral tumours revealed an atypical endothelial cell proliferation; vascular immunohistochemical markers, such as factor VIII and CD34, were strongly positive. His general condition remained poor and the patient died 18 months after the initial diagnosis. The final diagnosis was pulmonary epitheloid haemangioendothelioma with synchronous central nervous system dissemination, the first time the authors believe that association has been reported. Little is known of the prognosis and treatment of these tumours, due to their rarity. Negative prognostic factors appear to be the presence of symptoms, pleural effusion or multifocal presentations. Treatment should include surgical resection if possible; chemotherapy appears to have little effect. Watchful waiting is an acceptable option, especially in asymptomatic patients.     

Oxidative markers in children with severe obesity following low‐calorie diets supplemented with mandarin juice

Aim: To evaluate the effect of supplementing a hypocaloric diet with mandarin juice, a food with a high content of antioxidants (vitamin C, flavonoids and carotenoids), on biomarkers of oxidant/antioxidant status of severe obese children. Methods: Forty obese children were randomized into two groups pair‐wise in a 4‐week controlled intervention study. Both groups followed a hypocaloric diet. One group received additionally a supplementation of 500 mL of 100% mandarin juice daily. Clinical data, anthropometry, dietary intake and fasting blood samples were collected at baseline and after the intervention. Lipid peroxidation was assessed by circulating levels of malondialdehyde, and protein oxidation was determined by the concentration of plasma carbonyl groups. The antioxidant defence was evaluated by red cell‐reduced glutathione and plasma levels of α‐tocopherol and vitamin C. Results: The supplemented group experienced a decrease in the levels of malondialdehyde (?9.6%, p = 0.014) and carbonyl groups (?36.1%, p = 0.006) and an increase in antioxidants (α‐tocopherol +16.1%, p = 0.006, glutathione +36.1%, p < 0.0001, and vitamin C + 94.6%, p < 0.0001). Conclusion: The mandarin juice consumption with a reduced calorie diet positively affects the antioxidant defence and produces a decrease in biomarkers of oxidative stress in obese children.     

Psychiatric care of coronary artery disease in a cardiac rehabilitation unit

The present work describes the psychiatric intervention in the Ramón y Cajal Hospital (Madrid) Cardiac Rehabilitation Program for Coronary Disease patients. The psychopathological concepts in relation to coronary heart disease are reviewed and studied in the foregoing acute and rehabilitation phases. The evaluation and therapeutic intervention methods are related in detail. Finally, results obtained in 90 patients who were treated in the past 3 years are analyzed. We mainly focused on the psychological risk factors and the psychosocial aspects.