Barboza-González, Paola

Dumping Syndrome (DS) is a significant complication following bariatric surgery, particularly Roux-en-Y gastric bypass (RYGB). This condition is characterised by gastrointestinal and vasomotor symptoms resulting from altered anatomy and hormonal dysregulation, notably accelerated gastric emptying and an exaggerated release of gut peptides. Based on the timing of symptom onset after food ingestion, DS is classified as early (EDS) or late (LDS). The critical roles of peptides such as GLP-1, GIP, insulin, and YY peptide are highlighted, along with the involvement of neuroendocrine pathways in symptom manifestation. Diagnosis relies on a combination of clinical evaluation and dynamic testing, with the oral glucose tolerance test (OGTT) often considered a key reference standard for diagnosis. Initial management involves dietary modifications, emphasising the glycaemic index of foods and meal distribution. In cases where nutritional interventions are insufficient, pharmacotherapy with agents such as acarbose, somatostatin analogues (octreotide and pasireotide), GLP-1 receptor agonists (liraglutide), calcium channel blockers (verapamil), and emerging therapies, including herbal medicine, may be considered. For refractory cases, surgical options like bypass reversal or partial pancreatectomy are reserved, although their efficacy can be variable. Despite advancements in understanding and treating DS, further large-scale, randomised controlled trials are essential to validate novel strategies and optimise long-term management. This review provides an updated and comprehensive overview of the aetiology, pathophysiological mechanisms, diagnostic approaches, and current management strategies for DS.

Purpose: This study aimed to examine the reliability of trunk extensor strength assessment with a functional electromechanical dynamometer (FEMD). Methods: Thirty-one men performed strength assessment at different velocities (V) (V1 = 0.15 m·s−1, V2 = 0.30 m·s−1, V3 = 0.45 m·s−1) and range of movement (R) (R1 = 25% cm; R2 = 50% cm), and isometric contraction at 90º. Reliability was obtained through the intraclass correlation coefficient (ICC), typical error (TE), and coefficient of variation (CV). Results: The absolute reliability provided stable repeatability of the average eccentric strength in the V1R1 condition (CV = 9.52%) and the maximum eccentric strength in V1R1 (CV = 9.63%) and V2R2 (CV = 9.66%). The relative reliability of the trunk extensor’s average strength was good (ICC = 0.77–0.83) for concentric and good (ICC = 0.78–0.85) and moderate (ICC = 0.67–0.74) for eccentric contraction. Also, good (ICC = 0.77–0.81) and moderate (ICC = 0.55–0.74) reliability of the maximum strength were obtained for concentric and eccentric contraction. The most reliable manifestation to evaluate the concentric (CV = 11.33%) and eccentric (CV = 9.52%) strength was the average strength in the V1R1 condition and the maximum strength (CV = 10.29%) to isometric assessment. The average concentric strength in the V2R2 condition (r = 0.69) and the maximum eccentric strength in the V1R1 condition (r = 0.65) were the best related to the maximum isometric strength. Conclusions: FEMD is a highly reliable device to evaluate trunk extensors strength.

Background. The evaluation of the force in internal rotation (IR) and external rotation (ER) of the shoulder is commonly used to diagnose possible pathologies or disorders in the glenohumeral joint and to assess patient’s status and progression over time. Currently, there is new technology of multiple joint isokinetic dynamometry that allows to evaluate the strength in the human being. The main purpose of this study was to determine the absolute and relative reliability of concentric and eccentric internal and external shoulder rotators with a functional electromechanical dynamometer (FEMD). Methods. Thirty-two male individuals (21.46 ± 2.1 years) were examined of concentric and eccentric strength of shoulder internal and external rotation with a FEMD at velocities of 0.3 m s−1 and 0.6 m s−1 . Relative reliability was determined by intraclass correlation coefficients (ICC). Absolute reliability was quantified by standard error of measurement (SEM) and coefficient of variation (CV). Systematic differences across velocities testing circumstances, were analyzed with dependent t tests or repeated measures analysis of variance in case of two or more than two conditions, respectively. Results. Reliability was high to excellent for IR and ER on concentric and eccentric strength measurements, regardless of velocity used (ICC: 0.81–0.98, CV: 5.12–8.27% SEM: 4.06–15.04N). Concentric outcomes were more reliable than eccentric due to the possible familiarization of the population with the different stimuli. Conclusion. All procedures examined showed high to excellent reliability for clinical use. However, a velocity of 0.60 m s−1 should be recommended for asymptomatic male patients because it demands less time for evaluation and patients find it more comfortable.

Background: The functional fitness of older people may be associated with their nutritional status. Aim: To assess the association between of anthropometric measures with functional fitness in older people. Material and Methods: Cross-sectional study conducted in 75 participants aged 65 to 89 years. Body mass index (BMI), waist-to-height ratio (WHtR), fat mass (FM) and skeletal muscle mass index (SMI) were calculated from anthropometric measures. The functional fitness was determined using the Senior Fitness Test battery. Results: BMI and FM indicated obesity, and WHtR indicated cardiometabolic risk in 49%, 55% and 83% of participants, respectively. SMI indicated a low muscle mass in 91% of females. Performance standards of chair stand, arm curl, 2-min step test and 8-foot up-and-go tests were met in 1%, 8%, 1% and 89% of participants, respectively. Significant negative correlations were found between 2-min step test and BMI, WHtR and FM (r = −0.26, −0.31 and −0.48 respectively). Back scratch had a negative correlation with BMI (r = −0.23) and SMI (rho = −0.28). Significant positive correlations were found between 8-foot up-and-go, WHtR (rho = 0.28) and FM (rho = 0.23), and between 2-min step test and SMI (rho = 0.28). The coefficient of determination (R2) between 2-min step test with BMI, WHtR and FM were 0.05, 0.08 and 0.22, respectively, while the R2 between back scratch and BMI was 0.04. Multiple regression models indicated that FM affected the 2-min step test independently of BMI and WHtR (adjusted R2 = 0.22), however age and sex negatively influenced these associations. Conclusions: Functional fitness of older adults is influenced by nutritional anthropometric measures, particularly BMI, WHtR and FM for aerobic capacity, and BMI for upper limb flexibility.