JOEL FAINTUCH
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Gastroenterologia, Faculdade de Medicina - Docente
5 resultados
Resultados de Busca
Agora exibindo 1 - 5 de 5
- Refractory and new-onset diabetes more than 5 years after gastric bypass for morbid obesity(2012) YAMAGUCHI, Camila M.; FAINTUCH, Joel; HAYASHI, Silvia Y.; FAINTUCH, Jacob J.; CECCONELLO, IvanFew studies about long-term glucose homeostasis in bariatric patients are available. In a prospective protocol that included retrospective information, outcome of patients with both impaired and normal fasting blood glucose (FBG) was monitored to assess frequencies and correlates. Patients submitted to Roux-en-Y gastric bypass were classified as group I, elevated FBG, and group II, normal controls. Those in group I with improvement in FBG were defined as responsive and the others as refractory. Group II participants progressing to new-onset diabetes (NOD) or prediabetes represented NOD cases; the remaining were listed as stable controls. FBG was the main endpoint, but HbA1c results were considered, along with diet composition and general biochemical profile. Among 97 selected patients, 51 belonged to group I (52.4 +/- A 10.5 years, 29.6 % males, initial body mass index (BMI) 58.4 +/- A 13.4, current BMI 35.1 +/- A 8.4 kg/m(2)) and 46 to group II (48.2 +/- A 10.5 years, 19.6 % males, initial BMI 55.5 +/- A 8.8, current BMI 33.9 +/- A 6.9 kg/m(2)). Follow-up was 7-9 years, and 31.4 % (16/51) of group I were classified as refractory, whereas 15.2 % (7/46) of the controls converted to NOD. Multivariate analysis pointed out higher current BMI, older age, consumption of antidiabetic drugs, and male gender as features of refractory cases, whereas NOD participants were not significantly different from non-progressing controls. This is the first investigation, to the best of our knowledge, to underscore the correlates of refractory and NOD within the bariatric context. Further studies are recommended as such information could be valuable for patient selection, prognostic scoring, and outcome monitoring.
- C-Reactive Protein Decrease After Postbariatric Abdominoplasty(2012) CINTRA, Wilson; MODOLIN, Miguel; FAINTUCH, Joel; GEMPERLI, Rolf; FERREIRA, Marcus C.In a prospective study, indices of glucose homeostasis, lipid profile, and systemic inflammation were monitored after an aesthetic abdominoplasty, aiming to scrutinize the possible metabolic benefits for abdominal fat removal. Premenopausal females with substantial weight loss (N = 40) undergoing circumferential abdominoplasty (index group, n = 20) or augmentation mammoplasty with mastopexy (controls, n = 20) were recruited. All of them originally underwent Roux-en-Y gastric bypass. Variables included BMI, white blood cell count, C-reactive protein, hemoglobin, total cholesterol and fractions, triglycerides, glucose, and HbA1c. Follow-up reached 20.3 +/- 13.6 months for index cases and 29.5 +/- 17.4 months for controls. The metabolic and inflammatory indices improved after the bariatric surgery. Subsequent monitoring indicated a stable body weight and biochemical profile in both groups. The exceptions were HDL cholesterol and C-reactive protein, which respectively increased and diminished after the abdominoplasty, consistent with an inflammatory and metabolic advantage for this operation. This is the first long-term study in a weight-stable population to point out such a pattern after abdominoplasty.
- Is Intake of Vitamin D and Calcium Important for Cardiovascular Health in Elderly Obese Patients?(2012) SOARES, Patricia A. O.; KOVACS, Cristiane; MOREIRA, Priscila; SALEH, Mohamed H.; MAGNONI, Daniel; FAINTUCH, JoelThere is compelling evidence that bariatric weight loss reduces cardiovascular complications; however, these still tend to be the most common cause of late death after surgical intervention. In a prospective cohort study, correlations of dietary nutrients with indexes of vascular health were sought, with emphasis on vitamin D and calcium. Clinically stable obese outpatient subjects (> 60 years old, N = 44) were interviewed about dietary macro and micronutrients. Nutritional assessment targeted anthropometric and bioimpedance analysis (BIA), hematologic counts, lipid profile, glucose homeostasis, and inflammatory markers. Carotid intima-media thickness (IMT) and brachial flow-mediated dilation (FMD), along with related vascular measurements, were documented, and results were correlated by uni- and multivariate analysis, corrected for known risk factors. IMT, FMD, and also brachial basal flow were positively influenced by vitamin D (P < 0.001). Calcium appeared beneficial for brachial basal flow only (P = 0.010). No association with IMT occurred, and a negative result for FMD was elicited. Also, vitamins A and B12 were advantageous for FMD, whereas iron was deleterious for IMT. Intake of many micronutrients including calcium and vitamin D did not meet recommendations. Vitamin D displayed a beneficial profile regarding vascular health, and more attention to this nutrient should be given, especially concerning obese patients with cardiometabolic risk. Calcium exhibited less straightforward results but deserves focus as well, along with antioxidant vitamin A as well as the B-complex which were mostly deficient in this experience.
- 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.
- Should ascitis volume and anthropometric measurements be estimated in hospitalized alcoholic cirrotics?(2012) SILVA, E. M.; MORAIS, L. C. S. L.; MEDEIROS FILHO, J. E. M.; ASCIUTTI, L. S. R.; ROCHA, H. A. C.; COSTA, Ma J. C.; GONCALVES, Ma C. R.; FAINTUCH, J.Introduction: Ascitis and undernutrition are frequent complications of cirrhosis, however ascitis volume and anthropometric assessment are not routinely documented or considered in prognostic evaluation. In a homogeneous cohort followed during two years these variables were scrutinized, aiming to ascertain relevance for long-term outcome. Methods: Population (N = 25, all males with alcoholic cirrhosis) was recruited among patients hospitalized for uncomplicated ascitis. Exclusion criteria were refractory or tense ascitis, cancer, spontaneous bacterial peritonitis, bleeding varices and critical illness. Measurements included ultrasonographically estimated ascitis volume, dry body mass index/BMI, upper arm anthropometrics, hematologic counts and liver function tests. Results: Population (age 48.3 +/- 11.3 years, BMI 21.1 +/- 3.5 kg/m(2), serum albumin 2.5 +/- 0.8 g/dL) was mostly in the Child-Pugh C category (77.8%) but clinically stable. During the follow-up period of 22.6 +/- 3.8 months, additional hospitalizations numbered 1.7 +/- 1.0 and more than one quarter succumbed. Admission ascitis volume corresponded to 7.1 +/- 3.6 L and dry HMI to 18.3 +/- 3.5 kg/m(2). Child Pugh index was relevant for both mortality and rehospitalization. Nevertheless, similar matches for mortality were documented with ascitis volume and dry BMI, and arm circumference below the 5(th) percentile was highly significantly associated with rehospitalization. Conclusions: A greater association than hitherto acknowledged, between ascitis volume and anthropometric measurements from one side, and long-term rehospitalization and mortality from the other, was demonstrated in male stable alcoholic cirrhodcs. Further studies with alcoholic and other modalities of cirrhosis including women are recommended.