30 resultados para MORBID OBESITY
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
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Pós-graduação em Ginecologia, Obstetrícia e Mastologia - FMB
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
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Pós-graduação em Alimentos e Nutrição - FCFAR
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
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Pós-graduação em Ginecologia, Obstetrícia e Mastologia - FMB
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Pós-graduação em Ginecologia, Obstetrícia e Mastologia - FMB
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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Introduction: Obesity is a risk factor for postoperative pulmonary complications. Overweight can alter respiratory mechanics and decrease lung volumes and capacities. Bariatric surgery (BS) has been used as treatment for morbid obesity, but this surgery can lead to respiratory complications. Objective: To evaluate pulmonary function in morbid obese patients undergoing bariatric surgery. Methods: The patients were submitted to pulmonary function testing, including slow and forced vital capacity (SVC and FVC), forced expiratory volume in the first second (FEV1), Tiffenau index (FEV1/FVC), forced expiratory flow 25-75% (FEF25-75%) and maximal inspiratory and expiratory pressure (MIP and MEP). Descriptive analysis was performed. Results: We evaluated 18 patients, mean age of 37.33 ± 11.23 years, height 1.65 ± 0.09 m, weight 125.92 ± 25.24 kg and BMI 46.34 ± 9 20 kg/m2 , SVC 100.64 ± 22.91%, FVC 102.04 ± 21.82%, FEV1 104.85 ± 22.16%, FEV1 /FVC 83.54 ± 6.63% and FEF25-75% 84.47 ± 25.74%, 99.75 ± 24.55 for MIP and MEP 102.12 ± 25.06 cmH2O. Conclusion: The bariatric surgery candidates had normal values for manovacuometry and spirometry.
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Objective To evaluate the prevalence and risk factors of non-alcoholic fatty liver disease (NAFLD) in postmenopausal women.Methods A cross-sectional study was carried involving 188 women (age >= 45 years and amenorrhea >= 12 months) attending the outpatient unit in south-eastern Brazil. Exclusion criteria were liver disease (hepatitis B and C, cholestatic disease, liver insufficiency), use of drugs that affect liver metabolism; alcoholics; AIDS or cancer history; and morbid obesity. NAFLD was diagnosed by abdominal ultrasound. Clinical, anthropometric (body mass index, waist circumference) and biochemical variables were measured.Results Of the 188 women, 73 (38.8%) had NAFLD. Blood pressure, waist circumference, body mass index, LDL cholesterol, triglycerides and glucose were significantly higher in NAFLD patients when compared with women without NAFLD (control group) (p < 0.05). HOMA-IR values indicated insulin resistance only in the NAFLD group (6.1 +/- 4.6 vs. 2.4 +/- 1.4 in control group, p < 0.05). Metabolic syndrome was detected in 93.1% of the women affected by NAFLD, and 46.1% of the control group (p < 0.05). In multivariate analysis, adjusted for age and weight, the variables considered at risk for the development of NAFLD, were: high waist circumference (odds ratio (OR) 1.07, 95% confidence interval (CI) 1.01-1.13), insulin resistance (OR 3.81, 95% CI 2.01-7.13), and presence of metabolic syndrome (OR 8.68, 95% CI 3.3-24.1).Conclusion NAFLD showed a high prevalence among postmenopausal women. The presence of metabolic syndrome, abdominal obesity and IR were indicators of risk for the development of NAFLD.
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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Currently, Roux-en-Y gastric bypass (RYGB) is one of the most widely used bariatric surgeries. Banding the pouch forms a banded gastric bypass operation, an accepted and frequently used variant. Placing a silastic ring around the pouch to band the gastric bypass operation increases the restriction mechanism. However, the ubiquitous use of the banded gastric bypass remains controversial. One of the controversies is the effect of the silastic ring on patients' perception of their well being after surgery because of the frequency of vomiting. A prospective, blindly randomized, comparative trial was undertaken to resolve this controversy. Four hundred subjects scheduled for gastric bypass surgery were randomized into two arms of the trial, 200 with a silastic ring (WR) and 200 without (NR). After 2-year follow-up, the variables associated with the scores of Bariatric Analysis and Reporting Outcome System (BAROS) were analyzed. The initial median weight (125 kg), BMI (47), and age (36 years) were the same in both the NR and WR groups. The median excess weight loss, weight regain, and incidence of vomiting were 71, 10.5, and 7.75 %, respectively, in the NR group vs. 75.4 and 1.1, and 24.4 % in the WR group. The mean QOL score was 79 % in the NR group vs. 80 % in the WR group. After 2-year follow-up, silastic ring placement in the RYGB resulted in greater weight loss and weight stability and a threefold greater incidence of vomiting. There was no difference in the scores in the quality of life analysis.
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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Pós-graduação em Bases Gerais da Cirurgia - FMB