The effects of constant food deprivation, terminated at different times of day were examined with respect to percent body weight loss (%BWL), plasma corticosterone (PC) and plasma glucose (PG). A 19-hour food deprivation paradigm schedule staggered around varying times of the day-night cycle was used. Patterns of %BWL related to nocturnal lipogenesis and diurnal lipolysis showed the greatest loss (10%) occurring at 0700 hr, while in evening hours, there was an increasing pattern of weight loss, with the greatest amount (7%) occurring at 2200 hr. A pattern suggestive of neuroregulatory cycles of glucocorticoid release was evident for PC levels; maximum levels for PC (23.2 μg%) were reported at 0700 hr and at 1900 hr (16.6 μg%). Similar patterns were also noted in PG levels, with respective maximum levels of 138.0 mg% and 125.8 mg% occurring at 0700 hr and 1900 hr. These results indicate that the time of day that a deprivation schedule is initiated and terminated is an important consideration due to the impact of circadian photoperiodism. Time of day should be an essential consideration when utilizing deprivation paradigms.

Although intestinal involvement occurs in more than half of the cases with KS that are HIV positive, it is uncommon in the classical form, as it occurs in approximately 10% of the patients. We present the case of a 60-year-old male patient with a one-year disease time characterized by having violaceous lesions on the feet and the hands, slightly pruritic and 2 months of epigastralgia and constipation with weight loss of approximately 12 percent of his total body weight. In the physical examination multiple violaceous papule-like lesions are shown on the hands and the feet, some coalescing to form plaques. Laboratory tests revealed a mild normocytic normocytic anemia, the serology for viral hepatitis B and C was negative, HIV negative and ELISA test too. An upper endoscopy was performed and multiple maculopapular and erythematous-violaceous lesions were observed in the esoph-agus, the stomach and the duodenum. In the colonoscopy, multiple lesions with similar characteristics in the ileum, throughout the colon and in the rectum were recognized. The biopsy result was compatible with the KS in all lesions and it was confirmed with the positive HVV-8 immunohis-tochemistry. This case highlights the likelihood of presenting GI SK in elderly patients with gastrointestinal compromise and cutaneous findings, HIV negatives as well as the need to realize an adequate discarding by performing endoscopic studies with the biopsies to optimize treatment. / Revisión por pares

Thesis (Masters)--College of Saint Elizabeth, 2010. / Typescript. Available at The College of Saint Elizabeth - Office of Graduate Programs. "March 2010."

Introdução: A verificação periódica do peso corporal (PC), e as mudanças ocorridas ao longo do tempo, embora pouco realizada, é essencial no cuidado em saúde de idosos. A promoção do PC estável dependerá, pois, do conhecimento de fatores que levam tanto ao ganho como a perda de PC na velhice. Objetivos: avaliar as trajetórias de mudança de PC e os fatores relacionados à diminuição ou aumento do PC em idosos, no período de seguimento de 10 anos. Métodos: Essa pesquisa é parte do Estudo SABE (Saúde, Bem-Estar e Envelhecimento), longitudinal de múltiplas coortes, com inclusão de dados da primeira onda iniciada em 2000 e reavaliada em 2006 e 2010: composta por uma amostra probabilística de indivíduos com idade >=60anos (n=571). Mudanças no índice de massa corporal (IMC) <-5% foram consideradas como diminuição no PC e >5% como aumento do PC. Realizou-se modelo de regressão logística múltipla e modelo de regressão linear de efeitos mistos para avaliar longitudinalmente os fatores associados à mudança de PC, e a relação da perda ou ganho com a mortalidade. Resultados: em média o IMC aumentou até os 65 anos e diminuiu após os 75 anos. Na segunda avaliação, em 2006, 34,00% dos participantes diminuíram o PC, e 18,22% aumentaram. Já em 2010 apenas 12,49% dos participantes diminuíram (PC) enquanto quase 40% ganharam. Ao longo dos dez anos, foram associados ao aumento do PC a idade (p<0,001), o consumo de álcool (p<0,05), ter duas ou mais doenças crônicas (p<0,001) e a inatividade física (p<0,001); a diminuição de PC associou-se ao tabagismo (p<0,05), sexo masculino (p<0,001) e relato de diminuição de ingestão no último mês (p<0,001); a mortalidade foi associada a diminuição de PC (p<0,001). Especificamente em 2006, o relato de perda, não intencional, de >3kg (RR: 3,67; p<0,001) foi um fator de risco para diminuição de PC. E em 2010 foram fatores de risco à diminuição de PC, duas ou mais doenças crônicas (RR: 2,28; p<0,05), internação (RR: 3,82; p<0,001), saúde auto avaliada como má (RR: 4,30; p<0,01), diabetes (RR: 1,94; p<0,05), dificuldade de fazer compras (RR: 3,09; p<0,001), relato de diminuição de ingestão ((RR: 3,66; p<0,05), relato de perda, >3kg (RR: 3,37; p<0,001) e dificuldade de mastigar comidas duras (RR: 2,09; p<0,05); o consumo de álcool (RR:0,42; p<0,05) foi um fator protetor à diminuição do PC; e o relato de perda de peso (>3kg) não intencional (RR:0,46; p<0,05) e a dificuldade de engolir bem (RR: 0,44; p<0,05) foram fatores de proteção para o ganho de PC ao longo dos anos avaliados. Conclusão: a diminuição de PC, associada à mortalidade, ocorreu principalmente em idosos mais longevos. Por outro lado, o ganho de PC aumentou entre os anos avaliados. Fatores clínicos, funcionais e de estilo de vida estiveram relacionados a mudança de peso corporal. O monitoramento e prevenção de mudanças do peso corporal de idosos deve fazer parte da rotina de cuidados em saúde. A investigação das consequências da obesidade no envelhecimento é um dos desafios de estudos adicionais. / Introduction. Checking body weight periodically as well as changes occurred through time, although not performed often enough, is essential to take care of the elderly health. The promotion of a stable body weight will depends on factors that leads to body weight increase and its decrease as well. Objectives: To evaluate body weight trajectories of change and the factors that lead to body weight increase or decrease in a ten years period. Methods: This research is part of the SABE (Health, Welfare, and Aging) study, which is longitudinal with several cohorts, and included data of the first wave that began in 2000 and was re-evaluated in 2006 and 2010: Composed of a probabilistic sample of individuals who were 60 years old or older. (n=571). Changes in body mass index: <5% was considered body weight decrease and >5% was considered body weight increase. A multiple logistic regression model and mixed effect linear regression model were used to evaluate longitudinally the factors related to body weight change and its relationship with mortality. Results: In average, the body mass index increased until 65 years and diminished after 75 years. In the second evaluation, in 2006, 34% of the participants diminished their body weight and 18% increased it. However, in 2010 just 12, 5% of the participants decreased their body weight while 40% increased it. In ten years, many factors were associated with the body mass increase, such as age (p<0,001), alcohol consumption (p<0,05), having two or more chronic diseases (p<0,001) and physical activity (p<0,001); body mass decrease was associated with cigarette smoking (p<0,05), male sex (p<0,001) and reporting reduced ingestion in the previous month (p<0,001); mortality was associated with body weight decrease (p<0,001). Specifically in 2006, reporting more than >3kg (RR: 3,67; p<0,001) loss was a risk factor for decreasing body weight. And in 2010 the risk factors for body weight loss were two or more chronic diseases (RR: 2,28; p<0,05), being admitted to the hospital (RR: 3,82; p<0,001), health status being self-evaluated as bad (RR: 4,30; p<0,01), diabetes (RR: 1,94; p<0,05), difficulties to go shopping (RR: 3,09; p<0,001), reporting ingestion decrease ((RR: 3,66; p<0,05), reporting losing more than >3kg (RR: 3,37; p<0,001) and difficulties to chew food (RR: 2,09; p<0,05); alcohol consumption (RR:0,42; p<0,05) was a protective factor to body weight loss; and reporting unintentional weight loss (>3kg) (RR:0,46; p<0,05) and difficulties to swallow (RR: 0,44; p<0,05) were protective factors for body weigh increase along the years which were evaluated. Conclusion: body weight loss, linked with higher morality, was associated with older elderly subjects. On the other hand, body weight gain increased in the period that was analyzed. Clinical factors and lifestyle were related to body weight change. Monitoring and preventing body weight changes among elderly patients should be part of routine health care. The investigation of obesity consequences in the aging process is one of the challenges of academic studies.