Navegando por Palavras-chave "Roux-en-Y gastric bypass"
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- ItemSomente MetadadadosEating patterns and food choice as determinant of weight loss and improvement of metabolic profile after RYGB(Elsevier Science Inc, 2017) Dal Molin Netto, Bárbara [UNIFESP]; Earthman, Carrie P.; Farias, Gisele; Masquio, Deborah Cristina Landi [UNIFESP]; Clemente, Ana Paula Grotti [UNIFESP]; Peixoto, Priscilla; Bettini, Solange Cravo; von Der Heyde, Maria Emilia; Dâmaso, Ana Raimunda [UNIFESP]Objective: Significant changes in the preference for different dietary components have been observed after Roux-en-Y gastric bypass (RYGB). The aim of this study was to evaluate the early post-RYGB changes in quality of eating patterns and their relationship to weight loss and metabolic parameters. Methods: The sample was composed of 41 extremely obese individuals undergoing RYGB. Dietary data were collected using a validated food frequency questionnaire in Brazil. A food intake evaluation was conducted with a focus on the frequency of consumption (>= 4 times/wk) of markers for healthy eating and markers for unhealthy eating. Furthermore, anthropometric and metabolic markers were collected before surgery and 6 mo post-RYGB. Results: Compared with baseline, the postsurgery body mass index was reduced by 12.9 kg/m(2), corresponding to an excess weight loss of 63.5%. Blood glucose, insulin, ferritin, cholesterol, low density lipoprotein-cholesterol, triacylglycerol (TG), and hemoglobin were reduced 6 mo after RYGB (P < 0.05). The consumption frequency of many foods defined as unhealthy decreased after surgery (e.g., from 15.4% to 5.1% for pizza and 18% to 0% for hamburger), and some healthy food increased (e.g., from 0% to 5.1% for fish and from 0% to 25.6% for plain yogurt). There was a decrease in the frequency of individuals who reported consuming fruit and vegetables. Conversely, insulin, glucose, and TG levels were positively associated with intake of chocolates/truffles and ice cream/sundaes. Conclusion: Participants in the present study appeared to develop a healthier dietary pattern by 6 mo after RYGB. These results show that a healthier dietary pattern is associated with a significant improvement of metabolic profile and weight loss. (C) 2016 Elsevier Inc. All rights reserved.
- ItemSomente MetadadadosErosive Esophagitis after Bariatric Surgery: Banded Vertical Gastrectomy versus Banded Roux-en-Y Gastric Bypass(Springer, 2011-02-01) Soares Miguel, Gustavo Peixoto; Moreira Coutinho Azevedo, Joao Luiz [UNIFESP]; Oliveira de Souza, Paulo Henrique; Neto, Joao de Siqueira; Mustafa, Felipe; Zambrana, Evelyn Saiter; Carvalho, Perseu Seixas de; Fed Univ Espirito Santo UFES; Universidade Federal de São Paulo (UNIFESP)Obesity is associated with gastroesophageal reflux disease. Roux-en-Y gastric bypass is the most performed bariatric procedure in the world, whereas sleeve gastrectomy is an emerging procedure. Both can be combined with the use of a SilasticA (R) ring. the aim of this study was to compare the evolution of erosive esophagitis (EE) in patients who underwent SilasticA (R) ring gastric bypass (SRGB) and SilasticA (R) ring sleeve gastrectomy (SRSG) after a 1-year postoperative period.We carried out a non-randomized, prospective, controlled clinical study. Sixty-five patients were enrolled based on the following inclusion criteria: female gender, age 20-60 years old, BMI 40-45 and written informed consent. the exclusion criteria were secondary obesity, alcohol or drug use, severe psychiatric disorder, binge-eating of sweets, and previous stomach or bowel surgery. the patients were divided into two groups-33 (51%) underwent SRSG and 32 (49%) patients underwent SRGB. All patients underwent an esophago-gastro-duodenoscopy during the preoperative period and at 12-14 months after the surgery.Preoperatively, 15 patients (23.8%) were found to have EE, six (19.4%) in the SRSG group and nine patients (28.1%) in the SRGB group (p = 0.7795). Postoperatively, there was an increase in the number of patients with EE in the SRSG group to 14 (45.2%) and a decrease in the SRGB group to two (6.3%), giving a total of 16 patients with EE (25.4%; p = 0.0007).After 1 year of follow-up, we observed a worsening evolution of EE in the SRSG group, but improvement in the SRGB group.
- ItemAcesso aberto (Open Access)Estudio comparativo del estado nutricional de la vitamina A en mujeres embarazadas y en mujeres que quedaron embarazadas o no tras el bypass gástrico en Y de Roux(Aula Medica Ediciones, 2018) Cruz, Sabrina; Machado, Suzana Nunes; Cruz, Suelem Pereira da; Pereira, Silvia; Saboya, Carlos [UNIFESP]; Ramalho, AndreaIntroduction: the changes in digestive physiology after Roux-en-Y gastric bypass (RYGB), as well as pregnancy, maximizes the risk of vitamin A deficiency (VAD) and both can result in harm to the mother and child health. Objective: to compare the nutritional status of vitamin A among women who became pregnant or did not after RYGB and in pregnant women who did not undergo surgery, and to assess the impact of VAD on the mother and child health. Methods: this is a cross-sectional study of the analytical type. The women were divided into: group 1 (G1) with 80 pregnant women
- ItemSomente MetadadadosGastric Bypass and Sleeve Gastrectomy: the Same Impact on IL-6 and TNF-alpha. Prospective Clinical Trial(Springer, 2013-08-01) Viana, Elaine Cristina; Araujo-Dasilio, Karine L.; Soares Miguel, Gustavo Peixoto; Bressan, Josefina; Lemos, Elenice Moreira; Moyses, Margareth Ribeiro; Abreu, Glaucia Rodrigues de; Moreira Coutinho de Azevedo, Joao Luiz [UNIFESP]; Carvalho, Perseu Seixas; Passos-Bueno, Maria Rita S.; Valle Errera, Flavia Imbroisi; Bissoli, Nazare Souza; Univ Fed Espirito Santo; Universidade Federal de Viçosa (UFV); Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP); EMESCAM Coll Helth Sci; Univ Vila VelhaDue to the association between the quantity of adipose tissue and concentrations of interleukin-6 (IL-6) and tumor necrosis factor (TNF-alpha), this work aimed to assess the effects of Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) procedures on serum IL-6 and TNF-alpha concentrations.This study evaluated serum IL-6 and TNF-alpha levels, as well as routine anthropometric and biochemical values, before and 1 year post-bariatric surgery. Fifty percent of patients (n = 24) underwent RYGB, and 50 % (n = 24) underwent SG. Prior to bariatric surgery, IL-6 and TNF-alpha mRNA expression levels in subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) were investigated in obese women.There was a significant reduction (p < 0.05) in all anthropometric and routine biochemical measurements in patients in the RYGB and SG groups 1 year post-surgery. the serum concentrations of IL-6 and TNF-alpha were reduced following surgery in both groups (p < 0.05). No differences in the relative expression levels of IL-6 and TNF-alpha were found between SAT and VAT prior to bariatric surgery.RYGB and SG procedures demonstrated a similar impact on adipokine levels in women 1 year post-surgery. Both techniques may improve the course of chronic diseases and the state of inflammation associated with obesity.
- ItemAcesso aberto (Open Access)Motilidade esofágica, sintomas, resultado alimentar e perda de peso após derivação gástrica em Y-de-Roux(Colégio Brasileiro de Cirurgia Digestiva, 2013-06-01) Valezi, Antonio Carlos; Herbella, Fernando [UNIFESP]; Mali-junior, Jorge; Marson, Antonio Cesar; Biazin, Claudio Clementino Camacho; Universidade Estadual de Londrina Departamento de Cirurgia; Universidade Federal de São Paulo (UNIFESP); Universidade Estadual de Londrina Hospital UniversitárioBACKGROUND: Abnormal manometry findings can be found in the obese population. It is controversial if the manometry should be used to choose the adequate operation or if the motility status could predict symptomatic outcomes. AIM: To correlate the esophageal motility with postoperative symptoms, alimentary outcome and weight loss after Roux-en-Y gastric bypass. METHODS: One hundred and fourteen patients were submitted to the operation and were prospectively studied. They had no GERD symptoms or diseases that might interfere with esophageal motor function. One year after surgery patients were interviewed regarding current symptoms and eating habits. RESULTS: Excess weight loss was 66.2 %. Sixty (52.6%) patients had an abnormal manometry. Hypertensive lower esophageal sphincter was found in 18 (16%) patients and hypotonic sphincter in 31 (27%). Dumping syndrome was mentioned by 27 (23.6%) patients and 21 (18.4%) complained of regurgitation. Excellent, good, moderate and poor alimentary outcome was present in 32 (28%), 31 (27.2%), 39 (34.2%), 12 (11.6%) patients, respectively. Sphincter pressure and esophageal amplitude did not correlate with excess weight loss. Its average was significantly higher for patients with hypertensive esophageal amplitude. Regurgitation was more frequent in patients with a hypotensive sphincter. There is no correlation between dumping and sphincter pressure status; between dumping or regurgitation and esophageal amplitude; between alimentary outcomes and sphincter pressure status or esophageal amplitude. CONCLUSION: Esophageal manometry before Roux-en-Y gastric bypass is of limited clinical significance.
- ItemSomente MetadadadosNutrient Intake of Women 3 Years After Roux-en-Y Gastric Bypass Surgery(Springer, 2012-10-01) Torres Rossi, Rosana Gomes de; Amaral dos Santos, Maria Tereza; Suano de Souza, Fabiola Isabel [UNIFESP]; Aquino, Rita de Cassia de; Sarni, Roseli Oselka Saccardo [UNIFESP]; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP); Univ Sao Judas TadeuNutritional deficiencies, especially micronutrient deficiencies, can occur in obese individuals. Surgical treatment may aggravate or cause these deficiencies, depending on the type of procedure, food intake and the use of multivitamins, minerals or other supplements. the objective of the study was to evaluate the nutrient intake of women who had undergone Roux-en-Y gastric bypass (RYGB) surgery.A cross-sectional, controlled study was conducted among 44 women after RYGB (operated-group, OG; mean years post-operation = 3.4) and a control group of 38 healthy women (non-operated group, NOG) matched by age and economic condition. the women reported their dietary intake using a 4-day record. the Dietary Reference Intakes was used as a reference.The macronutrient contributions to dietary energy intake presented an acceptable distribution for proteins and carbohydrates. Lipid intake was high among women in the OG and the NOG (43.2 and 55.3 %, respectively). in the evaluation of micronutrients, a statistically significant difference was observed between the groups for iron, zinc and vitamins B1 and B12. Both groups were at high risk for inadequate calcium intake, and the OG was at risk for inadequate zinc, iron and vitamin B1 intake.The nutrient intake of women who had undergone RYGB is very similar to that of non-operated women, with the exception of a reduced intake of iron, zinc and vitamins B1 and B12, which may be due to the difficulty of consuming meat and a balanced diet. the findings of this study emphasize the importance of appropriate nutritional intervention and the regular use of multivitamin and mineral supplements for these patients.
- ItemSomente MetadadadosPostprandial proximal gastric acid pocket and gastric pressure in patients after gastric surgery(Wiley-Blackwell, 2011-01-01) Herbella, F. A. M. [UNIFESP]; Vicentine, F. P. P. [UNIFESP]; Del Grande, J. C. [UNIFESP]; Patti, M. G.; Universidade Federal de São Paulo (UNIFESP); Univ ChicagoBackgroundAn unbuffered postprandial proximal gastric acid pocket (PPGAP) has been demonstrated in normal individuals (NI) and patients with gastro-esophageal reflux disease (GERD). the role of gastric anatomy and gastric motility in the physiology of the PPGAP remains elusive. This study aims to analyze the correlation of PPGAP with proximal gastric pressure after gastric surgery.MethodsA total of 26 individuals were studied: eight patients after open Roux-en-Y gastric bypass (RYGB) for morbid obesity, six patients after laparoscopic Nissen fundoplication for GERD, seven patients after open subtotal gastrectomy for gastric cancer and five NI. Patients underwent high resolution manometry to identify the location of the lower border of the lower esophageal sphincter (LBLES) and measure gastric pressure 1, 2, 3, 4 and 5 cm below the LBLES, immediately before swallow and after the end of the LES relaxation. A station pull-through pH monitoring was performed in all but NI, from 5 cm below the LBLES to the LBLES in increments of 1 cm in a fasting state and 10 min after a standardized fatty meal.Key ResultsOur results show that: (i) proximal gastric pressures are lower after swallow compared with before swallow in NI; (ii) patients after gastric surgery tend to have higher gastric pressure before and lower after swallow compared with NI and (iii) patients after RYGB with PPGAP have an increased gastric pressure after swallows in the segment where the PPGAP is noticed.Conclusions & InferencesGastric motility may play a role in the genesis of PPGAP in patients after RYGB. the contribution of gastric motility for the genesis of PPGAP is still elusive in other patients.
- ItemSomente MetadadadosPostprandial Proximal Gastric Acid Pocket in Patients after Roux-En-Y Gastric Bypass(Springer, 2010-11-01) Herbella, Fernando A. M. [UNIFESP]; Vicentine, Fernando P. P. [UNIFESP]; Del Grande, Jose C. [UNIFESP]; Patti, Marco G.; Arasaki, Carlos H. [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Univ ChicagoAn unbuffered postprandial proximal gastric acid pocket (PPGAP) has been noticed in normal individuals and patients with gastroesophageal reflux disease (GERD). the role of gastric anatomy in the physiology of the PPGAP remains unclear. It is also unclear whether operations that control GERD, such as Roux-en-Y gastric bypass (RYGB) and Nissen fundoplication, change the PPGAP.This study aims to analyze the presence of PPGAP in patients submitted to RYGB.Fifteen patients who had a RYGB for morbid obesity (mean age 53 years, 14 females, mean time from operation 3 years) were studied. All patients were free of foregut symptoms. Patients underwent a high-resolution manometry to identify the location of the lower border of the lower esophageal sphincter (LBLES). A station pull-through pH monitoring was performed from 5 cm below the LBLES to the LBLES in increments of 1 cm in a fasting state and 10 min after a standardized fatty meal (40 g of chocolate, 50% fat).Acidity was not detected in the stomach of four patients before meal. After meal, PPGAP was not found in eight patients. in three patients, a PPGAP was noted with an extension of 1 to 3 cm.PPGAP is present in a minority of patients after RYGB; this finding may explain part of the GERD control after RYGB and that the gastric fundus may play a role in the genesis of the PPGAP.
- ItemAcesso aberto (Open Access)Relationship between the Nutritional Status of Vitamin A per Trimester of Pregnancy with Maternal Anthropometry and Anemia after Roux-en-Y Gastric Bypass(Mdpi, 2017) Cruz, Sabrina; Matos, Andrea; da Cruz, Suelem Pereira; Pereira, Silvia; Saboya, Carlos [UNIFESP]; Ramalho, AndreaThe aim of this study was to compare the nutritional status of vitamin A per trimester of pregnancy, as well as to assess its influence on pre-pregnancy BMI, total gestational weight gain (TGWG) and presence of anemia in women who had previously undergone Roux-en-Y gastric bypass (RYGB). An analytical, longitudinal and retrospective study comprising 30 pregnant women who had previously undergone RYGB was undertaken. In all trimesters of pregnancy, the serum concentrations of retinol, beta-carotene, stages of vitamin A deficiency (VAD), night blindness (NB), anemia and anthropometric variables were assessed. VAD in pregnancy affected 90% of women, 86.7% developed NB and 82.8% had mild VAD. TGWG above/below the recommended range was related to the low serum concentrations of beta-carotene(p = 0.045) in the second trimester and women with TGWG above the recommended range showed 100% of inadequacy of this nutrient in the third trimester. Among the pregnant women with anemia, 90.9% had VAD and 86.4% had NB. This study highlights the importance of monitoring the nutritional status of vitamin A in prenatal care, due to its relationship with TGWG and the high percentage of VAD and NB found since the beginning of pregnancy. It also reaffirms the use of the cut-off <1.05 mu mol/L for determining VAD.
- ItemSomente MetadadadosRoux-en-Y Gastric Bypass Decreases Pro-inflammatory and Thrombotic Biomarkers in Individuals with Extreme Obesity(Springer, 2015-06-01) Dal Molin Netto, Bárbara [UNIFESP]; Bettini, Solange Cravo; Clemente, Ana Paula Grotti [UNIFESP]; Ferreira, Joana Pereira de Carvalho [UNIFESP]; Boritza, Katia; Souza, Sandy de Fatima; Von der Heyde, Maria Emilia; Earthman, Carrie P.; Dâmaso, Ana Raimunda [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade Federal do Paraná (UFPR); Univ Minnesota Twin CitiesThe low-grade inflammatory state in obesity leads to insulin resistance and endothelial dysfunction, which promote cardiovascular diseases in individuals with obesity. the purpose of this study was to evaluate the early effects of weight loss achieved through bariatric surgery on the inflammatory and prothrombotic states. This study also aimed to identify the role of hyperleptinemia on the prothrombotic state.The sample was composed of 41 extremely obese who underwent Roux-en-Y gastric bypass (RYGB). Anthropometric and clinical data, and biochemical markers of inflammation were collected prior to surgery and 6 months post-RYGB.It was found that plasminogen activator inhibitor-1 (PAI-1) concentrations were higher among extremely obese individuals with hyperleptinemia than in those without hyperleptinemia (p < 0.01).In relation to the baseline, post-surgery body mass index (BMI) was reduced by 12.9 kg/m(2), corresponding to 63.50 % of excess weight loss. Additionally, waist circumference was found to decrease significantly from 126.2 to 101.4 cm. Plasma total cholesterol (p < 0.01), LDL cholesterol (p = 0.02), triglycerides (p < 0.01), and glucose (p = 0.01) were also found to decrease. Pro-inflammatory biomarkers were observed to decrease: PAI-1 by 55.9 +/- 6.0 % (p < 0.01), C-reactive protein (CRP) by 18.8 +/- 3.4 % (p < 0.01), intercellular adhesion molecule-1 (ICAM-1) by 89.9 +/- 5.7 % (p < 0.01), leptin by 27.9 +/- 3.2 % (p < 0.01), and resistin by 69.3 +/- 5.8 % (p < 0.01). Additionally, significant decreases of tumor necrosis factor alpha (TNF-alpha) and leptin/adiponectin ratio were observed. Anti-inflammatory cytokines adiponectin and interleukin-10 (IL-10) were significantly increased (170.7 +/- 82.5 %, p < 0.01; 122.7 +/- 55.1 %, p = 0.02). CRP levels were predictive of ICAM-1 (p = 0.04), and changes in leptin concentrations were associated with decreased PAI-1 levels (p = 0.03).We observed that individuals with obesity that have hyperleptinemia have higher circulating PAI-1 levels, which could indicate increased risk for cardiovascular disease. the biomarkers of inflammation and thrombosis measured in this study decreased after RYGB, suggesting that the surgery may be effective in reducing pro-inflammatory and thrombotic risk in individuals with extreme obesity.