JOEL FAINTUCH
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Gastroenterologia, Faculdade de Medicina - Docente
80 resultados
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Agora exibindo 1 - 10 de 80
bookPart Quadros e portais úteis(2023) FAINTUCH, Joel; FAINTUCH, Jacob Jehuda; MISHALY, Asher- Precision medicine: The microbiome and metabolome(2019) FAINTUCH, J.; FAINTUCH, J. J.The microbiome gap, between just data accumulation and theoretical speculations from one side and clinical benefits to the patient from the other, is being rapidly filled. The microbiome is a crucial facet of the individual response to inflammation, cancer, metabolic and degenerative diseases, immunological conditions, neuropsychiatric pathology, diet, xenobiotic processing, surgical interventions, and even environmental stress. With the determination of key microorganisms, enzymes, metabolites, and pathways, advances are rapidly accumulating. Multilayer diagnostic and therapeutical algorithms, bedside microbiomics and metabolomics, new-generation probiotics and postbiotics, phage therapy, and patient-specific fecal transplantation are the foundations of the new era. It is not a distant vision anymore. Many applications are real and ready for clinical use. © 2019 Elsevier Inc. All rights reserved.
- Potential premalignant status of gastric portion excluded after Roux en-Y gastric bypass in obese women: A pilot study(2019) RAVACCI, Graziela Rosa; ISHIDA, Robson; TORRINHAS, Raquel Suzana; SALA, Priscila; MACHADO, Natasha Mendonca; FONSECA, Danielle Cristina; CANUTO, Gisele Andre Baptista; PINTO, Ernani; NASCIMENTO, Viviane; TAVARES, Marina Franco Maggi; SAKAI, Paulo; FAINTUCH, Joel; SANTO, Marco Aurelio; MOURA, Eduardo Guimaraes Hourneaux; ARTIGIANI NETO, Ricardo; LOGULLO, Angela Flavia; WAITZBERG, Dan LinetzkyWe evaluated whether the excluded stomach (ES) after Roux-en-Y gastric bypass (RYGB) can represent a premalignant environment. Twenty obese women were prospectively submitted to double-balloon enteroscopy (DBE) with gastric juice and biopsy collection, before and 3 months after RYGB. We then evaluated morphological and molecular changes by combining endoscopic and histopathological analyses with an integrated untargeted metabolomics and transcriptomics multiplatform. Preoperatively, 16 women already presented with gastric histopathological alterations and an increased pH (>= 4.0). These gastric abnormalities worsened after RYGB. A 90-fold increase in the concentration of bile acids was found in ES fluid, which also contained other metabolites commonly found in the intestinal environment, urine, and faeces. In addition, 135 genes were differentially expressed in ES tissue. Combined analysis of metabolic and gene expression data suggested that RYGB promoted activation of biological processes involved in local inflammation, bacteria overgrowth, and cell proliferation sustained by genes involved in carcinogenesis. Accumulated fluid in the ES appears to behave as a potential premalignant environment due to worsening inflammation and changing gene expression patterns that are favorable to the development of cancer. Considering that ES may remain for the rest of the patient's life, long-term ES monitoring is therefore recommended for patients undergoing RYGB.
- Abnormalities of Reproductive Function in Male Obesity Before and After Bariatric Surgery-A Comprehensive Review(2015) ROSENBLATT, Alberto; FAINTUCH, Joel; CECCONELLO, IvanYoung males represent one of the populations with the steepest increases in the incidence of obesity. They are also prone to significant derangements in sexual health and fertility. Despite a growing number of reports about female reproductive health, in the setting of bariatric surgery, males have received much less attention. In the current review of reproductive abnormalities in severe obese males before and after bariatric surgery, erectile function, hypothalamic-pituitary-gonadal axis status, sex hormones, semen quality, fertility and assisted reproductive techniques, along with analysis of adipokines, gut hormones, and environmental factors are addressed. Available evidence about weight loss benefits, both medical and surgical, are highlighted, along with perspectives for future investigations, which may be relevant for the patient, for the couple, and for the community alike.
- Disability in the post-obese bariatric patient: Old and new problems(2013) FAINTUCH, J.; SOUZA, S. A. F.; FABRIS, S. M.; ROSENBLATT, A.; CECCONELLO, I.Sustained and lifelong weight loss for severely obese people is not anymore an impossible dream, and a Swedish journal has described bariatric surgery as the fairy tale about the ugly duckling (Olbers 2011). Of course this is a bittersweet remark, because although for millions such is an advantageous and even life-saving intervention, all of them have to cope with the post-obesity status. Obesity is a chronic incurable disease and the postobesity status is an attenuated albeit ongoing illness, not a mere sequela. Appropriate follow-up and secondary interventions, be they surgical, clinical, physiatric, dietary, or psycho-social, may be demanded. Obesity entails widespread disorders involving as far away organs, structures, needs and abilities as the teeth, the central nervous system, the gut microbiome, the susceptibility to cancer, the performance at the workplace, and the demand for health care resources. Subsequent weight gain and comorbidity relapse is a permanent possibility, as endogenous and environmental obesogenic stimuli are not suppressed, only weakened. Gastrointestinal restriction and bypass are highly successful maneuvers when correctly indicated and conducted, however, they do not signal the end of the battle. Patients have to be educated and followed for life. It is hoped that such experience along with general public-health initiatives will eventually trickle down to their families, their offspring, and society in general, so that the new generations might be born and nurtured with obesity prevention in mind. © 2013 Springer-Verlag Berlin Heidelberg. All rights are reserved.
- High Frequency of Serum Chromium Deficiency and Association of Chromium with Triglyceride and Cholesterol Concentrations in Patients Awaiting Bariatric Surgery(2014) LIMA, Karla V. G.; LIMA, Raquel P. A.; GONCALVES, Maria C. R.; FAINTUCH, Joel; MORAIS, Liana C. S. L.; ASCIUTTI, Luiza S. R.; COSTA, Maria J. C.Background To our knowledge, the frequency of serum chromium deficiency in patients awaiting bariatric surgery has not been determined. This study was designed to assess chromium concentration and its association with glycemic levels and lipid profile in patients prior to bariatric surgery. Methods This study recruited 73 candidates for bariatric surgery between March and September 2012. Their sociodemographic, anthropometric, and biochemical data were collected. Results Of the 73 patients, 55 (75.3 %) were women (75.34 %). Mean patient age was 37.20 +/- 9.92 years, and mean body mass index was 47.48 kg/m(2) (range, 43.59 to 52.50 kg/m(2)). Chromium deficiency was observed in 64 patients (87.7 %). Correlation analysis showed significant negative relationships between chromium concentration and BMI and zinc concentration and a significant positive relationship between chromium and glycated hemoglobin. Multiple linear regression analysis showed that serum chromium concentration was significantly associated with total cholesterol (beta = 0.171, p = 0.048) and triglyceride (beta = -0.181, p = 0.039) concentrations. Conclusions Serum chromium deficiency is frequent in candidates for bariatric surgery and is associated with total cholesterol and triglyceride concentrations. Early nutritional interventions are needed to reduce nutritional deficiencies and improve the lipid profile of these patients.
- Pancreas and liver uptake of new radiolabeled incretins (GLP-1 and Exendin-4) in models of diet-induced and diet-restricted obesity(2017) SEO, Daniele; FAINTUCH, Bluma Linkowski; OLIVEIRA, Erica Aparecida de; FAINTUCH, JoelIntroduction: Radiolabeled GLP-1 and its analog Exendin-4, have been employed in diabetes and insulinoma. No protocol in conventional Diet-Induced Obesity (DIO), and Diet-Restricted Obesity (DRO), has been identified. Aiming to assess pancreatic beta cell uptake in DIO and DRO, a protocol was designed. Methods: GLP-1-beta Ala-HYNIC and HYNIC-beta Ala-Exendin-4 were labeled with technetium-99m. Four Swiss mouse models were adopted: Controls (C), Alloxan Diabetes Controls (ADC), DIO and DRO. Biodistribution and ex-vivo planar imaging were documented. Results: Radiolabeling yield was in the range of 97% and both agents were hydrophilic. Fasting Blood Glucose (FBG) was 79.2 +/- 8.2 mg/dl in C, 590.4 +/- 23.3 mg/dl in ADC, 234.3 +/- 66.7 mg/dl in DIO, and 96.6 +/- 9.3 in DRO (p = 0.010). Biodistribution confirmed predominantly urinary excretion. DIO mice exhibited depressed uptake in liver and pancreas, for both radiomarkers, in the range of ADC. DRO only partially restored such values. Tc-99m-HYNIC-beta Ala-Exendin-4 demonstrated better results than GLP-1-beta Ala-HYNIC-Tc-99m. Conclusions: 1) Diet-induced obesity remarkably depressed beta cell uptake; 2) Restriction of obesity failed to normalize uptake, despite robust improvement of FBG; 3) HYNIC-beta Ala-Exendin-4 was the most useful marker; 4) Further studies are recommended in obesity and dieting, including bariatric surgery.
- Magnesium Deficiency and Gastric Bypass(2011) FAINTUCH, Joel
bookPart Complicações nuricionais após cirurgia bariátrica(2016) FAINTUCH, Joel; FAINTUCH, Jacob J.- Evolving endoscopic surgery(2014) SAKAI, Paulo; FAINTUCH, JoelSince the days of Albukasim in medieval Spain, natural orifices have been regarded not only as a rather repugnant source of bodily odors, fluids and excreta, but also as a convenient invitation to explore and treat the inner passages of the organism. However, surgical ingenuity needed to be matched by appropriate tools and devices. Lack of technologically advanced instrumentation was a strong deterrent during almost a millennium until recent decades when a quantum jump materialized. Endoscopic surgery is currently a vibrant and growing subspecialty, which successfully handles millions of patients every year. Additional opportunities lie ahead which might benefit millions more, however, requiring even more sophisticated apparatuses, particularly in the field of robotics, artificial intelligence, and tissue repair (surgical suturing). This is a particularly exciting and worthwhile challenge, namely of larger and safer endoscopic interventions, followed by seamless and scarless recovery. In synthesis, the future is widely open for those who use together intelligence and creativity to develop new prototypes, new accessories and new techniques. Yet there are many challenges in the path of endoscopic surgery. In this new era of robotic endoscopy, one will likely need a virtual simulator to train and assess the performance of younger doctors. More evidence will be essential in multiple evolving fields, particularly to elucidate whether more ambitious and complex pathways, such as intrathoracic and intraperitoneal surgery via natural orifice transluminal endoscopic surgery (NOTES), are superior or not to conventional techniques.