Among subjects with mild COPD, those with daily-life dyspnea have worse exercise outcomes; distinct lung and thigh muscle morphologic features; and different pulmonary physiologic characteristics at rest and exercise. ΔIC was the main contributor to dyspnea intensity and ΔIC and thigh muscle wasting were determinants of exercise capacity.

Despite data favouring a role of dietary fat in colonic carcinogenesis, no study has focused on tissue n3 and n6 fatty acid (FA) status in human colon adenoma-carcinoma sequence. Thus, FA profile was measured in plasma phospholipids of patients with colorectal cancer (n=22), sporadic adenoma (n=27), and normal colon (n= 12) (control group). Additionally, mucosal FAs were assessed in both diseased and normal mucosa of cancer (n= 15) and adenoma (n=21) patients, and from normal mucosa of controls (n=8). There were no differences in FA profile of both plasma phospholipids and normal mucosa, between adenoma and control patients. There were considerable differences, however, in FAs between diseased and paired normal mucosa of adenoma patients, with increases of linoleic (p=0.02), dihomogammalinolenic (p=0.014), and eicosapentaenoic (p=0.012) acids, and decreases of a linolenic (p=0.001) and arachidonic (p=0.02) acids in diseased mucosa. A stepwise reduction of eicosapentaenoic acid concentrations in diseased mucosa from benign adenoma to the most advanced colon cancer was seen (p=0.009). Cancer patients showed lower a linolenate (p=0.002) and higher dihomogammalinolenate (p=0.003) in diseased than in paired normal mucosa. In conclusion changes in tissue n3 and n6 FA status might participate in the early phases of the human colorectal carcinogenesis. (Gut 1996; 38: 254-259)

In COPD patients the burden of emphysema on CT scan and DLCO predict a clinically meaningful decline in exercise capacity.

Obesity is a chronic disease with an increasing prevalence in all groups of age, and is associated to increased general mortality and cardiovascular risk. The multidisciplinary non surgical approach must be the treatment of choice for obese subjects. However, the results of such approach among subjects with severe or morbid obesity, are unsatisfactory. In this group of patients, bariatric surgery and specifically gastric bypass achieves good long term results, maintaining a low body mass index, reducing complications and improving quality of life. Considering the widespread practice of bariatric surgery in Chile, the Nutrition Unit of the Ministry of Health formed a task force to propose update guidelines for the surgical treatment of obesity. These guidelines were proposed after a thorough literature review and discussion with groups that practice bariatric surgery using defined protocols. This document provides a summarized version of the guidelines. The first section discusses the background for bariatric surgery and the second part give specific recommendations for patient management and the formation of reference centers for surgical management of obesity.

Background-Few studies have evaluated