JOEL FAINTUCH
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Gastroenterologia, Faculdade de Medicina - Docente
7 resultados
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Agora exibindo 1 - 7 de 7
- 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.
- Bariatric surgery: Current techniques and results(2013) FAINTUCH, J.; SOUZA, S. A. F.; FABRIS, S. M.; CECCONELLO, I.Half a century ago obesity was not a public health problem, however, gastroduodenal ulcers were ubiquitous. Many gastrectomies were conducted at that time and patients eventually lost weight. That is how bariatric surgery commenced, naturally expanding to a variety of techniques and accesses. Success has been both bigger and smaller than expected. Yes, bariatric operations became so popular that they already represent one of the five most performed major operations in some countries. They are followed by strong secondary benefits particularly concerning diabetes remission, to the point that a new subspecialty has arisen, metabolic surgery for diabetes. No, they are not carefree and they have not solved the problem of severe obesity, at least from the epidemiological point of view. They were actually not designed to be a mass treatment. The pursuit of new therapeutic avenues and the reinforcement of old ones is still mandatory, if the worldwide obesity epidemic is to be curtailed. © 2013 Springer-Verlag Berlin Heidelberg. All rights are reserved.
- Systemic inflammation and carotid diameter in obese patients: pilot comparative study with flaxseed powder and cassava powder(2011) FAINTUCH, J.; BORTOLOTTO, L. A.; MARQUES, P. C.; FAINTUCH, J. J.; FRANCA, J. I.; CECCONELLO, I.Background: Botanical omega-3 fatty acid (alpha-linolenic acid/ALA) has been shown to alleviate the prothrombotic and proinflammatory profile of metabolic syndrome, however clinical protocols are still scarce. Aiming to focus an obese population, a pilot study was designed. Methods: Morbidly obese candidates for bariatric surgery (n = 29, age 463 +/- 5.2 years), 82.8% females (24/29), BMI 44.9 +/- 5.2 kg/m(2), with C-reactive protein/CRP > 5 mg/L were recruited. Twenty were randomized and after exclusions, 16 were available for analysis. Flaxseed powder (60 g/day, 10 g ALA) and isocaloric roasted cassava powder (60 g/day, fat-free) were administered in a double-blind routine for 12 weeks. Results: During flaxseed consumption neutrophil count decreased and fibrinogen, complement C4, prothrombin time and carotid diameter remained stable, whereas placebo (cassava powder) was associated with further elevation of those measurements. Conclusions: Inflammatory and coagulatory markers tended to exhibit a better outlook in the flaxseed group. Also large-artery diameter stabilized whereas further increase was noticed in controls. These findings raise the hypothesis of a less deleterious cardiovascular course in seriously obese subjects receiving a flaxseed supplement. (Nutr Hosp. 2011;26:208-213) DOI:10.3305/nh.2011.26.1.4974
- Interference of silicone breast implants on bioimpedance measurement of body fat(2012) YAMAGUCHI, Camila M.; FAINTUCH, Joel; SILVA, Maira M.; MODOLIN, M.; HAYASHI, Silvia Y.; CECCONELLO, I.Background: No study targeting the impact of silicone breast implants on body composition measured by bioimpedance analysis was identified. Objective: Aiming to clarify this question a prospective clinical study was designed. Methods: Adult candidates were submitted to conventional analysis at baseline and two months after the surgical intervention. In addition, unwrapped prostheses were positioned in the axillary cavity before operation and bioimpedance was measured, both with and without application of ultrasound gel for improved conductivity (sham implantation). Results: Patients (N = 20) were young and healthy (26.8 +/- 3.6 years old, BMI 22.1 +/- 3.7 kg/m(2)). In comparison with preoperative results, sham procedures pointed out increased body fat and body resistance (13.2 +/- 5.6 vs 13.6 +/- 5.4 kg, P = 0.017 and 523 +/- 54 vs 569 +/- 53 Omega, P = 0.003, respectively). Two-month follow-up confirmed the same pattern after surgical intervention, with minor discrepancies (13.2 +/- 5.6 vs 13.8 +/- 5.7 kg, P = 0.011 and 523 +/- 54 vs 549 +/- 62 Omega, P = 0.032, respectively). BMI remained stable and did not correlate with bioimpedance changes. Conclusions: Silicone was recognized as adipose tissue. Difference in total body fat (approximately 600 g) was consistent with used amount.
article 6 Citação(ões) na Scopus Rehabilitation needs after bariatric surgery(2013) FAINTUCH, J.; SOUZA, S. A. F.; FABRIS, S. M.; CECCONELLO, I.; CAPODAGLIO, P.Background. Bariatric surgery has grown from an obscure experimental procedure to one of the most popular operations in the world. Such accelerated progress left many gaps, notably concerning subsequent rehabilitation needs of this population. Aim. In the present study, a brief description of both the patients and the interventions is provided, along with potentially disabling features especially concerning the locomotor system, which has received comparatively little attention. Design. Based on reported protocols and actual experience, major issues are addressed. Setting. Bariatric patients are initially managed in the hospital, however long-term and even lifetime needs may be recognized, requiring major lifestyle and physical activity changes. These have to be focused in all settings, inside and outside the healthcare institutions. Population. Initially only adults were considered bariatric candidates, however currently also adolescents and the elderly are admitted in many centers. Results. Bariatric weight loss is certainly successful for remission or prevention of metabolic, cardiovascular and cancer comorbidities. Yet benefits for bones, joints and muscles, along with general physical performance are still incompletely established. This should be no reason for denying continued care to such individuals, within the context of well-designed protocols, as available evidence points toward favorable rehabilitation in the realms of physical, social and workplace activities. Conclusion. The importance of a physiatric curriculum in medical schools has been emphasized. Even more crucial is the presence of such a specialists in obesity and bariatric teams, a requirement recognized in a few countries but not in others. Clinical Rehabilitation Impact. The relevance of obesity as a disabling condition is reviewed, along with the positive changes induced by surgical weight loss. Although obesity alleviation is a legitimate end-point it is not a sufficient one. The shortcomings of such result from the point of view of physical normalization are outlined, and recommendations are suggested.conferenceObject Stabilometric Analysis in Bariatric Surgery Candidates(2013) SOUZA, S. Fabris de; FABRIS, S.; FAINTUCH, J.; BRIENZE, S.; MENDES, E.; CECCONELLO, I.conferenceObject Impact of Two Levels of Severe Obesity on Osteoarticular and Functional Changes of Knee and Foot(2013) SOUZA, S. Fabris de; LUIZ, S. Souza; FAINTUCH, J.; MENDES, E.; CECCONELLO, I.; BRIENZE, S.