ABSTRACT Objective A large number of studies have used abdominal computed tomography (CT) to quantify body composition, and different software programmes have been used to perform these analyses. Thus, this comparison is important to enable researchers to know the performance of more accessible software. Subjects and methods Fifty-four abdominal CT scans of obese (BMI 30 to 39.9 kg/m2), sedentary adults (24-41 years) patients from a Brazilian single center were selected. Two software programs were compared: Slice-O-Matic (Tomovision, Canada) version 5.0 and OsiriX version 5.8.5. The body composition analysis were segmented using standard Hounsfield unit (HU) (adipose tissue: -190 to +30 and skeletal muscle: -29 to +150) and measured at the mid third lumbar vertebra (L3) level on a slice showing both transversal processes. Bland-Altman limits of agreement analyses were used to assess the level of agreement between Slice-O-Matic and OsiriX. Results A total of fifty-four participants were evaluated, with majority women (69%), mean of age 31.3 (SD 6.5) years and obesity grade I most prevalent (74.1%). The agreement, in Bland-Altman analysis, between Slice-O-Matic and OsiriX analisys for the muscle mass tissue, visceral adipose tissue and subcutaneous adipose tissue were excellent (≥ 0.954) with P-values < 0.001. Conclusion These findings show that Slice-O-Matic and OsiriX softwares agreement in measurements of skeletal muscle and adipose tissue and sarcopenia diagnosis in obese patients, suggesting good applicability in studies with body composition in this population and clinical practice.

Abstract Introduction: Malnutrition in children with cancer is a significant risk factor for negative outcomes, but in the clinical practice setting, it is difficult to pinpoint which factors operate to cause substantial weight loss and malnutrition in a given patient. Appetite-related hormones like ghrelin and leptin are among possible mediators. However, only few studies have examined the role of these hormones in pediatric patients with cancer to date. Thus, the purpose of this study was to systematically review possible changes in the levels of appetite hormones, specially leptin and ghrelin, in pediatric patients with cancer. Material and methods: We systematically reviewed the literature using PubMed, Lilacs and Scielo, as well as manual bibliographical reference search of the studies. According to the Medical Subject Headings of the National Library of Medicine (MeSH), "childhood cancer", "ghrelin" and "leptin" were used as descriptors. Results: Fifteen studies were included in this systematic review published in English, from 2000 to 2015. A total of 863 patients were evaluated, ages ranging from 0 to 21 years, and most of the studies reported on children and adolescents with acute lymphoblastic leukemia (ALL) survivors. Most studies analyzed leptin levels; only two studies evaluated levels of ghrelin. Conclusion: This review confirms that changes in the responses of the ghrelin and leptin hormones in children and adolescents with cancer are quite diverse, probably due to the different types of cancer observed, different treatments performed and biological characteristics of this age group.

Resumen Introducción: la desnutrición en niños con cáncer es un factor de riesgo significativo para resultados negativos, pero en la práctica clínica, es difícil determinar qué factores operan para causar pérdida de peso sustancial y desnutrición en un paciente dado. Entre los posibles mediadores están las hormonas relacionadas con el apetito como la grelina y la leptina. Sin embargo, hasta la fecha, solo unos pocos estudios han examinado el papel de estas hormonas en pacientes pediátricos con cáncer. El propósito de este estudio fue revisar sistemáticamente los posibles cambios en los niveles de hormonas del apetito, especialmente la leptina y la grelina, en pacientes pediátricos con cáncer. Material y métodos: se llevó a cabo una revisión sistemática de la bibliografía empleando PubMed, Lilacs y Scielo, así como la búsqueda bibliográfica manual de referencia de los estudios. Según los encabezamientos médicos de la Biblioteca Nacional de Medicina (MeSH), "cáncer infantil", "grelina" y "leptina" se utilizaron como descriptores. Resultados: en esta revisión sistemática, se incluyeron 15 estudios publicados en inglés de 2000 a 2015. Fueron evaluados un total de 863 pacientes, con edades comprendidas entre 0 y 21 años, y la mayoría de los estudios informaron sobre niños y adolescentes supervivientes de leucemia linfoblástica aguda. La mayoría de los estudios analizaron los niveles de leptina y solo dos estudios evaluaron los niveles de grelina. Conclusión: esta revisión confirma que los cambios en las respuestas hormonales de la grelina y la leptina en niños y adolescentes con cáncer son muy diversos, probablemente debido a los diferentes tipos de cáncer observado, los diferentes tratamientos realizados y las características biológicas de este grupo de edad.

ABSTRACT Body weight is regulated by the ability of hypothalamic neurons to orchestrate behavioral, endocrine and autonomic responses via afferent and efferent pathways to the brainstem and the periphery. Weight maintenance requires a balance between energy intake and energy expenditure. Although several components that participate in energy homeostasis have been identified, there is a need to know in more detail their actions as well as their interactions with environmental and psychosocial factors in the development of human obesity. In this review, we examine the role of systemic mediators such as leptin, ghrelin and insulin, which act in the central nervous system by activating or inhibiting neuropeptide Y, Agouti-related peptide protein, melanocortin, transcript related to cocaine and amphetamine, and others. As a result, modifications in energy homeostasis occur through regulation of appetite and energy expenditure. We also examine compensatory changes in the circulating levels of several peripheral hormones after diet-induced weight loss.