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      Evaluación de la calidad de vida en pacientes mexicanos con obesidad severa antes y después de cirugía bariátrica Translated title: Quality of life evaluation in Mexican patients with severe obesity before and after bariatric surgery

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          Abstract

          Resumen Introducción: En México no se han utilizado los instrumentos Shorth Form 36 Items (SF-36) ni Baryatric Assesment Reporting Outcomes System (BAROS) para evaluar la calidad de vida (CV) antes y después de la cirugía bariátrica (CB). Objetivo: Describir los cambios en la CV con los cuestionarios SF-36 y BAROS, en pacientes con obesidad severa antes y después de la CB. Métodos: Se recolectaron los datos clínicos y antropométricos de pacientes sometidos a cirugía baríatrica entre 2015 y 2016. Se consideró con significación estadística una p < 0.05. Resultados: Se analizaron 230 pacientes, 98 y 132 antes y después de la CB; la mayoría fue del sexo femenino (81 %). El índice de masa corporal inicial fue de 48 kg/m2 (44-53). La CV medida con el SF-36 demostró un incremento en la puntuación del componente físico de 43 a 54.2 (p < 0.001) y en el componente mental, de 53.3 a 56.6 después de la CB. Con BAROS, en 98.5 % se registraron resultados buenos a excelentes en la CV en los primeros tres meses. Conclusión: Al ser medida con los cuestionarios SF-36 y BAROS se definió que la CV de los pacientes mexicanos con obesidad severa mejora después de la CB.

          Translated abstract

          Abstract Introduction: In Mexico, neither the 36-item Short Form Health Survey (SF-36) nor the Bariatric Analysis and Reporting Outcome System (BAROS) instruments have been used to assess quality of life (QoL) before and after bariatric surgery (BS). Objective: To describe changes in QoL using the SF-36 and BAROS questionnaires in patients with severe obesity before and after BS. Methods: Clinical and anthropometric data of patients undergoing bariatric surgery between 2015 and 2016 were collected. Statistical significance was considered with a p-value < 0.05. Results: 230 patients were analyzed, 98 before and 132 and after BS; most were females (81 %). Initial body mass index was 48 kg/m2 (44-53). SF-36-measured QoL showed an increase in the physical component score from 43 to 54.2 points (p < 0.001), and in the mental component, from 53.3 to 56.6 points after BS. With BAROS, 98.5 % showed good to excellent QoL results within the first three months after BS. Conclusion: When measured with the SF-36 and BAROS questionnaires, QoL of Mexican patients with severe obesity was found to improve after BS.

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          Meta-analysis of the association between body mass index and health-related quality of life among adults, assessed by the SF-36.

          Obesity is associated with impaired overall health-related quality of life but individual studies suggest the relationship may differ for mental and physical quality of life. A systematic review using Medline, Embase, PsycINFO and ISI Web of Knowledge, and random effects meta-analysis was undertaken. Studies were included in the meta-analysis if they were conducted on adults (defined as age >16 years), reported an overall physical and mental component score of the SF-36, and, or both. Heterogeneity was assessed using I(2) statistics and publication and small study biases using funnel plots and Egger's test. Between-study heterogeneity was explored using meta-regression. Eight eligible studies provided 42 estimates of effect size, based on 43,086 study participants. Adults with higher than normal body mass index had significantly reduced physical quality of life with a clear dose-response relationship across all categories. Among class III obese adults, the score was reduced by 9.72 points (95% Confidence Interval 7.24, 12.20, P < 0.001). Mental quality of life was also significantly reduced among class III obese (-1.75, 95% confidence interval -3.33, -0.16, P = 0.031), but was not significantly different among obese (class I and class II) individuals, and was significantly increased among overweight adults (0.42, 95% confidence interval 0.17, 0.67, P = 0.001), compared to normal weight individuals. Heterogeneity was high in some categories, but there was no significant publication or small study bias. Different patterns were observed for physical and mental HRQoL, but both were impaired in obese individuals. This meta-analysis provides further evidence on the impact of obesity on both aspects of health-related quality of life. Copyright © 2013 The Obesity Society.
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            Personality traits and obesity: a systematic review.

            Based on a bio-social-ecological systems model of the development and maintenance of obesity, there has been in the last few years a growing research interest in the association of obesity and personality traits. The aim of the present review was a comprehensive and critical evaluation of the existing literature taking into account the methodological quality of studies to enhance our understanding of personality traits associated with body weight, the development of overweight and obesity as well as the effectiveness of weight loss interventions including bariatric surgery. Personality traits play an important role both as risk as well as protective factors in the development of overweight and obesity. While thus in particular 'neuroticism', 'impulsivity' and 'sensitivity to reward' appear as risk factors, 'conscientiousness' and 'self-control' have been shown to have a protective function in relation to weight gain. Conscientiousness is a measure of regulation of internal urges and self-discipline, and may thus provide a potential source of control over impulsive reward-oriented behaviour. The results of the present review suggest that, within the context of therapeutic weight reduction measures, it is meaningful to identify subgroups of patients for whom specific treatment options need to be developed, such as measures for strengthening self-control skills.
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              Evaluación de la calidad de vida

              Este trabajo hace una revisión sobre la evolución del concepto de calidad de vida. Este concepto ha venido cobrando importancia ya que la mayor sobrevida de la población ha mejorado a expensas de un mayor número de personas con algún grado de discapacidad, y de personas con enfermedades crónicas que padecen los efectos de su enfermedad y del tratamiento. En 1948 la Organización Mundial de la Salud (OMS) definió a la salud como el completo estado de bienestar físico, mental y social, y no sólo la ausencia de enfermedad, con lo cual el término evolucionó, desde una definición conceptual, hasta métodos objetivos, los cuales, mediante cuestionarios o instrumentos generan escalas e índices que permiten medir las dimensiones que conforman el estado de salud. Actualmente, la salud de una persona se evalúa más allá de su capacidad física y se toman en cuenta su contexto social y su salud mental. Las mediciones pueden estar basadas en encuestas directas a los pacientes, con referencia al inicio de la enfermedad, su diagnóstico y a los cambios de síntomas a través del tiempo. Este artículo presenta un inventario de 126 instrumentos utilizados para medir la calidad de vida en diversas poblaciones y enfermedades. Debido a que la calidad de vida se basa en mediciones con una carga variable de subjetividad, se requiere de métodos de evaluación válidos, reproducibles y confiables. El mejor conocimiento de las evaluaciones para medir calidad de vida permitirá incorporar estos instrumentos en la evaluación integral de individuos, en la conducción de ensayos clínicos y en la investigación de servicios de salud.
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                Author and article information

                Journal
                gmm
                Gaceta médica de México
                Gac. Méd. Méx
                Academia Nacional de Medicina de México A.C. (Ciudad de México, Ciudad de México, Mexico )
                0016-3813
                2696-1288
                February 2021
                : 157
                : 1
                : 67-73
                Affiliations
                [4] Ciudad de México orgnameInstituto Mexicano del Seguro Social orgdiv1Centro Médico Nacional Siglo XXI orgdiv2Hospital de Especialidades Mexico
                [2] Ciudad de México orgnameInstituto Mexicano del Seguro Social orgdiv1Centro Médico Nacional Siglo XXI orgdiv2Hospital de Especialidades Mexico
                [3] Ciudad de México orgnameClínica Especializada Condesa orgdiv1Clínica de Adherencia a Antirretrovirales y Polifarmacia México
                [1] Ciudad de México orgnameInstituto Mexicano del Seguro Social orgdiv1Centro Médico Nacional Siglo XXI orgdiv2Hospital de Especialidades Mexico
                Article
                S0016-38132021000100067 S0016-3813(21)15700100067
                10.24875/gmm.20000385
                36655a6b-7aea-443e-abd5-a5fdfa8392d5

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                : 13 June 2020
                : 09 July 2020
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 24, Pages: 7
                Product

                SciELO Mexico

                Categories
                Artículos originales

                Calidad de vida,Cuestionario,Cirugía bariátrica,Obesity,Quality of life,Questionnaire,Bariatric surgery,Obesidad

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