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Biomedical subjects

N Scopinaro

Publications and source records attributed to N Scopinaro.

At least 55 records · Page 3Linked to original sources
PubMed1995

Obese binge eaters: metabolic characteristics, energy expenditure and dieting.

The study was carried out in two groups of massively obese women with BMI values who were to undergo bariatric surgery. The patients were evaluated for weight variability and for the presence and the frequency of binge eating. Body composition, resting energy expenditure (REE) and metabolic parameters were also measured. When non-bingeing individuals were compared with patients who met Binge Eating Disorder criteria, no differences in body composition, fat distribution, REE values and concentrations of serum lipids, insulin and thyroid hormones were found. On the other hand, weight variability due to reduced diet in the subjects' lifetime was significantly higher. This study does not support the hypothesis that in massively obese women binge eating is somehow induced by a reduced energy expenditure.

Adipose Tissue↗
PubMed1995

Pregnancies in an 18-Year Follow-up after Biliopancreatic Diversion.

BACKGROUND: 239 pregnancies occurred in 1136 women who had undergone biliopancreatic diversion (BPD). METHODS: There were 73 abortions, and 14 pregnancies are presently in their course. The 152 term pregnancies (six twins) occurred in 129 women 2-173 months (mean 42.7) after BPD. Mean age and current excess weight were 31.4 years (20-42) and 29.1%(- 6.9-78.2), and mean excess weight loss was 72.9%(30.4-110.5). RESULTS: Mean weight gain during pregnancy was 6.2 kg (-21-25). In 32 patients (21%), parenteral nutritional support was needed. In all the other patients (79%), the usual supplementations were given. Of the newborns, 122 were delivered at term (84.7%) with a mean weight of 2842.4g (1760-4600g) and a mean length of 48.S cm (43-59 cm), while the 22 preterm babies (15.3%) weighed 2151.1 g (1400-3850 g) and had a length of 44.6 cm (33-56 cm). Forty infants (27.8%) were small for gestational age but 17 of them weighed more than 2500 g. Eleven twins (one, abortion at 26th week) were also delivered, with a mean weight of 2088.6 g (1200-3100 g) and a mean length of 45.6 cm (35-50 cm). Delivery was spontaneous in 85 instances (56%), while vacuum extractor was used in one, and 66 cesarean sections were performed. There were two birth malformations, one infant died after surgery for meconium obstruction and two died from unknown causes. Of the 129 women, 35 had been infertile before BPD. CONCLUSIONS: Disappearance of infertility and decrease of pregnancy risk are to be considered among the beneficial effects of weight reduction following BPD.

Journal Article↗
PubMed1994

Eating disorder inventory in the assessment of psychosocial status in the obese patients prior to and at long-term following biliopancreatic diversion for obesity.

Psychological traits of obese patients, assessed with the Eating Disorder Inventory (EDI), were compared to those of subjects in the long-term following biliopancreatic diversion for obesity (BPD), when body weight has been steadily normal for over 1 year and any preoccupation with dieting and weight has been completely abandoned. The overall results suggest that the stable body weight normalization on a completely free diet does confer considerable psychological benefit on obese individuals. On the basis of the EDI results, post-BPD subjects were divided into weight-preoccupied and not-weight-preoccupied individuals. In the not-weight-preoccupied subjects, the psychosocial status and emotional rectivity were closely similar to those observed in lean control persons, whereas the few weight-preoccupied subjects, in spite of completely normal body weight, showed residual body dissatisfaction and personality traits very similar to those of eating-disordered patients.

Adolescent↗
PubMed1993

Eating behavior following biliopancreatic diversion for obesity: study with a three-factor eating questionnaire.

The eating behavior of obese patients and of subjects who had normalized their body weight following biliopancreatic diversion (BPD) was assessed by a three-factor eating questionnaire (TFEQ), constructed to measure cognitive dietary restraint, the tendency to disinhibition, and susceptibility to hunger. In the obese patients higher values of both disinhibition and hunger score were found than in normoweight persons. In BPD subjects a negative association between the time elapsed from the operation and both the disinhibition and hunger score values was observed. In patients operated more than 2 years before, the eating behavior, as assessed by the TFEQ, was similar to that of normoweight persons. After BPD the operated subjects do not have to respect any dietary advice, the loss of weight and the maintenance of a normal body weight occurring in spite of an absolutely free food consumption. Similarity to the control values of disinhibition and hunger score following BPD suggests that in the long term, when the preoccupation with food and diet is abandoned, a normal eating pattern can be achieved.

Adult↗
PubMed1993

The use of bioelectrical impedance analysis for monitoring body composition changes during nutritional support.

Body composition was measured with bioelectric impedance analysis (BIA) in 30 patients with protein malnutrition following biliopancreatic diversion. Determinations were carried out prior to, during, and at the completion of intravenous nutritional support when the nutritional parameters had completely reverted to normal. Before treatment, body weight (BW), lean body mass (LBM), and body fat (BF) values were similar to those of controls, whereas the total body sodium/total body potassium (TBNa/TBK) and extracellular mass/body cell mass (ECM/BCM) ratios were considerably higher. During the support, no changes in BW, LBM, and BF were demonstrated, although a sharp decrease of TBNa/TBK and ECM/BCM was observed, thus demonstrating improved LBM composition. At the end of parenteral feeding, the BW, LBM, and BF values were similar to those observed before the support, while a further decrease in TBNa/TBK and ECM/BCM demonstrated a recovery towards normal of body composition. The full correspondence between clinical and BIA findings therefore suggests that this method may be valuable for monitoring body composition changes during nutritional support.

Adult↗
PubMed1993

Resting Energy Expenditure in Long-Term Postobese Subjects after Weight Normalization by Dieting or Biliopancreatic Diversion.

Resting energy expenditure (REE) was measured by Indirect calorimetry in three groups of subjects closely matched for body weight (BW) and body composition. Five subjects had reduced from lO3 kg (129-90) to normal BW by dieting. Fourteen subjects had normalized their weight (preop 120 kg, from 168 to 100) following biliopancreatic diversion (BPD). All subjects in both groups had essentially maintained a stable weight for at least 2 years before the study. Ten healthy volunteers who had never been obese served as controls. No differences in REE were observed between post-BPD and control subjects, while lower (p < 0.05) values of REE were found in post-diet subjects. A long-lasting reduction of REE, in spite of a normal body composition, might partly account for the very poor long-term results of conventional dietary treatment. The unreduced REE following BPD may contribute, along with the permanent intestinal malabsorption, to the excellent long-term weight maintenance caused by this surgical procedure.

Journal Article↗
PubMed1993

Wernicke-Korsakoff Encephalopathy Following Biliopancreatic Diversion.

Wernicke-Korsakoff disease with sensory-motor neuropathy was diagnosed in three out of a series of 1,663 patients (0.18%), with onset 2, 3 and 5 months after biliopancreatic diversion. Precipitating factors were vomiting, minimal food intake, anorexia, rapid weight loss, and glucose-containing intravenous feeding. Recovery was partial in two and complete in one of the patients. In the early postop, prophylactic thiamine should be given to the patients with excessively limited eating capacity. Larger doses of thiamine should be instituted parenterally either in the case of suspected Wernicke-Korsakoff encephalopathy or before starting feeding for protein malnutrition.

Journal Article↗
PubMed1993

[Eating behavior and energy expenditure].

The relationships between the resting energy expenditure (REE), measured by indirect calorimetry, and eating behavior, assessed by the "Three Factor Eating Questionnaire" were evaluated. The study was carried out in a group of healthy never-obese subjects and in two groups of formerly obese people, who have maintained a normal weight for more than two years. The subjects of the first formerly obese group had brought their body weight to normal by dieting. The second one comprised subjects following biliopancreatic diversion for obesity (BPD) in the long term, who maintain a normal weight because of the intestinal malabsorption due to the operation regardless of food consumption. In comparison with the other subjects, significantly higher cognitive restraint score values were observed in the post-diet subjects. Furthermore, a negative significant correlation between cognitive restraint and REE was found in the non operated subjects, while such correlation was not present in the BPD subjects. Therefore, in normal people cognitive restraint has to be considered to be related to behavioral-cognitive factors rather than biologically driven by energy requirements.

Adult↗
PubMed1992

Intravenous nutritional support in pregnancy. Experience following biliopancreatic diversion.

11 pregnant women with protein malnutrition following biliopancreatic diversion for obesity were supported by parenteral nutrition (PN). In 2 cases high concentration glucose, lipid emulsions and standard aminoacid mixtures were infused via a central venous catheter; in the other subjects, because oral intake was normal or increased, only aminoacids with or without lipids were administered through a peripheral vein. PN promoted foetal growth and was very well tolerated and totally safe both for mother and infant.

Journal Article↗
PubMed1991

Why the Operation I Prefer is Biliopancreatic Diversion (BPD).

The author discusses why his operation of choice is biliopancreatic diversion (BPD). BPD is the most effective in obtaining long-term weight loss and permits unchanged eating habits. Although BPD is technically demanding, revisions for protein malnutrition or stomal ulcer have not been difficult and have become infrequent. However, lifelong follow-up must be guaranteed.

Journal Article↗
PubMed1988

Malnutrition, nutritional support and total body composition.

The nutritional status and total body composition of 33 patients with malnutrition after biliopancreatic bypass were studied. Body composition was evaluated directly by measurement of water and total sodium and indirectly by measurement of total body potassium. After nutrition with a parenteral nutritional support the conventional nutritional parameters were restored to the normal values (serum albumin and serum transferrin) and the parameters of body composition were markedly improved even though still altered with respect to healthy controls. Serum albumin and serum transferrin were shown to be very reliable indices of malnutrition but their normalization does not necessarily correspond to optimum body composition and thus to optimal normal nutrition.

Amino Acids↗
PubMed1987

Body composition after 'very-little-stomach' biliopancreatic bypass.

The nutritional status prior to and 3 months and 1 year after biliopancreatic bypass surgery was evaluated. The common nutritional indexes (serum albumin and transferin concentrations, daily urinary creatinine excretion and delayed hypersensitivity) were determined. The body compartments were derived from total body water (TBW) and total body sodium (TBNa), measured by dilutional technique, and total body potassium (TBK), calculated from TBW, TBNa, and the ratio of the sodium plus potassium content divided by the water content in a sample of whole blood. Before surgery, obese patients showed a dilatation of both fat an lean compartments with a normal lean body mass (LBM) qualitative composition, as indicated by TBNa/TBW, and TBNa/TBK ratios not greater than those measured in controls. Three months following very-little-stomach biliopancreatic bypass (VLS BPB), a consistent reduction of body weight and body fat were observed. The body cell mass value fell and reached a level closely similar to that found in lean control subjects. LBM showed only a slight decrease. A sharp increase of TBNa/TBW and TBNa/TBK ratios demonstrated a dilatation of the extracellular space. This malnutritional status was not detected by the usual nutritional parameters. One year after VLS BPB surgery, the patients' body composition became very similar to that of lean subjects, though a TBNa greater than that of controls suggested that a slightly expanded extracellular space was still present.

Adult↗