Navegando por Palavras-chave "bariatric surgery"
Agora exibindo 1 - 8 de 8
Resultados por página
Opções de Ordenação
- ItemAcesso aberto (Open Access)Aspectos do acompanhamento psiquiátrico de pacientes obesos sob tratamento bariátrico: revisão(Faculdade de Medicina da Universidade de São Paulo, 2011-01-01) Gordon, Pedro Caldana; Kaio, Glauber Higa [UNIFESP]; Sallet, Paulo Clemente; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP)BACKGROUND: In recent decades, several longitudinal studies show the efficacy of bariatric surgery on long-term weight control and reductions in mortality due to clinical complications associated with obesity. However, studies also show significantly increased mortality due to suicide and impulsive behavior, for reasons largely unknown, which demonstrates the paucity of information concerning the clinical management of bariatric patients. This study aims to synthesize the current state of knowledge regarding the psychiatric care of bariatric patients. METHOD: A selective review of literature involving articles indexed on Medline and PubMed up to June 2010, using the terms: bariatric surgery, psychiatry, binge eating, follow-up, and outcome. RESULTS: The literature is somehow consensual in which there is no absolute psychiatric contraindication for bariatric surgery, although the preoperative evaluation is of extreme importance for the diagnosis and treatment of any psychiatric disorder, to assure adherence to the multidisciplinary approach, improved quality of life and possibly a better prognosis after surgery. Among the most prevalent disorders in this population is the binge-eating disorder (BED), which is associated with lower weight loss and poor quality of life, especially when present in the postoperative period. In the postoperative follow-up one should also be alert to the emergence of impulsive symptoms, including abuse of alcohol and other substances. DISCUSSION: Several studies indicate high prevalence of mental disorders and psychopathology in the population of bariatric patients. Although most patients experience adequate weight control and improved quality of life in the medium and long term, some patients develop abnormal behavior relating to dysfunctional eating patterns, abuse of alcohol and other substances, and complications associated with impulsive behavior, which suggests etiological hypotheses involving from neurochemistry to psychosocial theories. For all these reasons, it is of fundamental importance that mental health professionals to integrate the teams that evaluate and monitor the bariatric patients.
- ItemAcesso aberto (Open Access)Cuidados intensivos para pacientes em pós-operatório de cirurgia bariátrica(Associação de Medicina Intensiva Brasileira - AMIB, 2007-06-01) Sanches, Giselle Domingues [UNIFESP]; Gazoni, Fernanda M. [UNIFESP]; Konishi, Renata Koda [UNIFESP]; Guimarães, Hélio Penna [UNIFESP]; Vendrame, Letícia Sandre [UNIFESP]; Lopes, Renato Delascio [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); AMIB-AMB; Instituto Dante Pazzanese de CardiologiaBACKGROUND AND OBJECTIVES: Obesity is an epidemic disease reaching more than 300 million people all over the world. Its prevalence has increased during the past few years and according to some studies its mortality in the critically ill patient seems to be much higher, especially among patients who were submitted to surgery. This study has as objective to discuss some particularities of managing obese patients in the intensive care unit after bariatric surgery. CONTENTS: The rate of obese patient in the ICU ranges from 9% to 26% and the increase in the number of bariatric surgeries has raised the number of obese patients in the ICU. It is important to know the physiopathology of obesity and to treat its particularities during the postoperative care. Such as pulmonary restriction, that causes an increase in pulmonary complications, coronary artery disease and thromboembolic events. CONCLUSIONS: The number of patients that undergo to bariatric surgery has increased; therefore, the number of obese patients in the ICU has also risen. Different physiological events and complications in obese patients are challenges to clinical practice. The knowledge of obese physiopathology helps in the managing routine procedures and complications after bariatric surgery.
- ItemSomente MetadadadosEffects of weight loss induced by gastric surgery on left ventricular mass and blood pressure in severe obese patients(Elsevier B.V., 2003-05-01) Aranha, Luciana Silveira [UNIFESP]; Faria, Alessandra Nunes [UNIFESP]; Matos, Maria Isabel Rodrigues de [UNIFESP]; Arasaki, Carlos Haruo [UNIFESP]; Carvalho, Kenia Mara [UNIFESP]; Ferreira, Sandra Roberta Gouveia [UNIFESP]; Zanella, Maria Teresa [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
- ItemAcesso aberto (Open Access)Evaluation of quality of life in severely obese patients after bariatric surgery carried out in the public healthcare system(Sociedade Brasileira de Endocrinologia e Metabologia, 2012-02-01) Khawali, Cristina [UNIFESP]; Ferraz, Marcos Bosi [UNIFESP]; Zanella, Maria Teresa [UNIFESP]; Ferreira, Sandra Roberta Gouvea [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP)OBJECTIVES: To assess QoL of obese patients in the Brazilian public healthcare system, before and after bariatric surgery, and to determine the appropriateness of the Moorehead-Ardelt Questionnaire II (M-A-QoLQII) compared with the Short-Form Health Survey (SF-36). SUBJECTS AND METHODS: Forty-one severe obese patients in a waiting-list, and 84 patients who underwent bariatric surgery were included. Correlations were tested and reliability determined by the Cronbach's coefficient. RESULTS: BMI differed between the pre- and post-surgery groups (52.3 ± 8.3 kg/m² vs. 32.5 ± 6.4 kg/m², p < 0.001). The latter showed better scores in the SF-36 domains than in the pre-surgery. SF-36 and M-A-QoLQII categories were correlated (r = 0.53, 0.49 and 0.47, for vitality, mental health, and general health domains, p < 0.001). In the logistic regression, age, previous BMI, and loss of excess weight were associated with functional capacity. CONCLUSIONS: The outcomes of bariatric surgery obtained in a Brazilian public healthcare center were successful. M-A-QoLII represents a useful tool to assess surgery outcomes, including QoL.
- ItemSomente MetadadadosIncidence of lower limbs deep vein thrombosis after open and laparoscopic gastric bypass: A prospective study(Springer, 2008-01-01) Brasileiro, Aldo L.; Miranda, Fausto [UNIFESP]; Ettinger, Joao E. M. T. M.; Castro, Aldemar A.; Pitta, Guilherme B. B.; Moura, Liberato K. de; Azaro, Euler; Moura, Marcelo L. de; Mello, Carlos A. B.; Fahel, Edvaldo; Figueiredo, Luiz F. P. de [UNIFESP]; Hosp Sao Rafael; Escola Ciencias Med Alagoas; Hosp Cidade; Hosp Sao Rafael Hosp Cidade; Universidade Federal de São Paulo (UNIFESP)Background Lower limbs deep vein thrombosis (DVT) and pulmonary embolism (PE) are major causes of morbidity and mortality and are even higher in bariatric patients. the longer operative time and higher immobility in these patients increase the DVT risk. Although deaths after bariatric surgery have been reported, there is no consensus regarding the prophylaxis of DVT. This study's objective is to determine the incidence of lower limbs DVT in patients submitted to Roux-en-Y-gastric bypass (RYGBP) under prophylaxis by enoxaparin.Methods Patients with body mass index (BMI) equal to or higher than 35 kg/m(2) who submitted to RYGBP by laparotomy or laparoscopy using 40 mg/day of enoxaparin for 15 days were recruited between October 2004 and August 2005. Individuals with previous DVT and heparin allergy were excluded. Patients were tested for DVT using color Doppler ultrasound performed before surgery and on the second and fifth weeks after surgery.Results the study population included 136 patients, with 126 concluding the protocol. There were 79% (100/126) of female patients aged 19 to 65 years old, with mean of 40 2 years SD=10 and BMI between 35 and 61 kg/m(2), mean of 43 kg/m(2) (SD=5). All patients who submitted to RYGBP were divided as 55% (69/126) by laparoscopy and 45% (57/ 126) by laparotomy. the incidence rate of lower limbs DVT was 0.79% (1/126).Conclusion the low incidence rate of DVT found in our study suggests that obesity might not be a major risk factor for venous thromboembolism in patients submitted to RYGBP.
- ItemSomente MetadadadosIntervenção da fisioterapia respiratória na função pulmonar de indivíduos obesos submetidos a cirurgia bariátrica. Uma revisão(Soc Portuguesa Pneumologia, 2010-03-01) Tenorio, Luis Henrique Sarmento; Lima, Anna Myrna Jaguaribe de; Brasileiro-Santos, Maria do Socorro [UNIFESP]; Universidade Federal de Pernambuco (UFPE); Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP); Universidade Federal da Paraíba (UFPB)Introduction: Obesity, considered a new worldwide epidemic, is characterised by excess adipose tissue and contributes to a series of chronic diseases and increased mortality. Obesity associated to surgical procedure in these patients makes respiratory physiotherapy a must to recover lung function and prevent postoperative pulmonary complications. Aims: To assess the effects of respiratory physiotherapy on the lung function of obese patients undergoing weight loss surgery. Material and methods: We conducted a literature review October 2008-June 2009 of data which had been published over the last thirty years and which was available on the Medline, Pubmed ans Scielo databases. Conclusion: Pre- and postoperative respiratory physiotherapy is vital for patients undergoing weight loss surgery irrespective of technique used, as it can prevent pulmonary complications inherent in the surgical procedure and aid lung function recovery.
- 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 MetadadadosWillingness to pay as patient preference to bariatric surgery(Wiley-Blackwell, 2014-03-01) Khawali, Cristina [UNIFESP]; Ferraz, Marcos B. [UNIFESP]; Zanella, Maria T. [UNIFESP]; Ferreira, Sandra R. G.; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP)Background An obesity epidemic is spreading worldwide. in addition to comorbidities, social and emotional problems contribute to reduce the quality of life (QoL) of obese people. Considering the heterogeneity of outcomes from clinical and surgical approaches, it is recommended that severely obese patients participate in their treatment decisions. This study evaluated preferences of severely obese patients for obesity surgical treatment using the willingness to pay (WTP) and to assess the impact of the presence of some clinical disorders, socioeconomic conditions and QoL on their decisions. Methods the selected patients were invited to answer the WTP questionnaire using two formats of contingent valuation questions: dichotomous choice (yes/no) and a bidding game. the answers were correlated with clinical features, QoL assessed by the SF-36 and the Moorehead-Ardelt Quality of Life Questionnaire II, Brazilian socioeconomic classification, and family and personal incomes. Results the group of patients who accepted the first bid was older and had higher frequency of sleep apnoea when compared to those who rejected the offer. A significant correlation between the bidding game value and family income was found (r=0.28; P<0.02). in the logistic regression model, socioeconomic classification and sleep apnoea were shown to be independently associated with acceptance the bid. Conclusions Sleep apnoea was the comorbidity that most influenced the acceptance in dichotomous choice for bariatric surgery, probably due to the deleterious effects on daily activities induced by sleep disturbances. Our findings also suggest that the frequency of surgical procedures is below the preference of the obese population in Brazil.