JOEL FAINTUCH
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Gastroenterologia, Faculdade de Medicina - Docente
42 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 42
- 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.
- 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
- 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.
- Prolonged Baby-Nursing-Related Sphygmomanometric Protection: Breast, Brain, Blood Biomolecules, or Bacteria?(2018) FAINTUCH, Joel; FAINTUCH, Salomao
- Does Roux-en-Y gastrectomy for gastric cancer influence glucose homeostasis in lean patients?(2013) HAYASHI, Silvia Y.; FAINTUCH, Joel; YAGI, Osmar K.; YAMAGUCHI, Camila M.; FAINTUCH, Jacob J.; CECCONELLO, IvanCancer gastrectomy seems to benefit type 2 diabetes; however, results are conflicting. In a prospective protocol, including retrospective information, the aim was assessment of changes in glucose profile in patients with both normal and deranged preoperative glucose homeostasis. Patients (N = 164) with curative subtotal or total Roux-en-Y gastrectomy for gastric cancer (n = 92), or Roux-en-Y gastric bypass for morbid obesity (RYGB, n = 72) were preoperatively classified into diabetes (including prediabetes) and control group. Postoperative diabetes outcome was stratified as responsive or refractory, and results in controls were correspondingly defined as stable or new-onset diabetes (NOD), according to fasting blood glucose and HbA1c. Dietary intake and biochemical profile was documented. Statistical methods included analysis of variance, multivariate logistic regression, and propensity score matching according to postoperative weight loss. Age of cancer cases was 67.9 +/- A 11.5 years, 56.5 % males, initial body mass index (BMI) 24.7 +/- A 3.7, current BMI 22.6 +/- A 3.8 kg/m(2), and follow-up 102.1 +/- 51.0 months, whereas in bariatric individuals age was 51.4 +/- A 10.1 years, 15.3 % males, initial BMI 56.7 +/- A 12.2, current BMI 34.8 +/- A 8.1 kg/m(2), and follow-up 104.1 +/- 29.7 months. Refractory disease corresponded to 62.5 % (cancer) versus 23.5 % (bariatric) (P = 0.019), whereas NOD represented 69.2 versus 23.8 % respectively (P = 0.016). Weight loss (Delta BMI) was associated with diabetes response in cancer patients but not with NOD. No difference between subtotal and total gastrectomy was detected. Divergent outcomes (refractory vs. responsive) were confirmed in BMI-similar, propensity-matched cancer gastrectomy patients with preoperative diabetes, consistent with weight-dependent and -independent benefits. Diabetes response was confirmed, however with more refractory cases than in bariatric controls, whereas high proportions of NOD occurred. Such dichotomous pattern seems unusual albeit consistent with previous studies.
- Gut Microbiome Dysbiosis and Immunometabolism: New Frontiers for Treatment of Metabolic Diseases(2018) BELIZARIO, Jose E.; FAINTUCH, Joel; GARAY-MALPARTIDA, MiguelMaintenance of healthy human metabolism depends on a symbiotic consortium among bacteria, archaea, viruses, fungi, and host eukaryotic cells throughout the human gastrointestinal tract. Microbial communities provide the enzymatic machinery and the metabolic pathways that contribute to food digestion, xenobiotic metabolism, and production of a variety of bioactive molecules. These include vitamins, amino acids, short-chain fatty acids (SCFAs), and metabolites, which are essential for the interconnected pathways of glycolysis, the tricarboxylic acid/Krebs cycle, oxidative phosphorylation (OXPHOS), and amino acid and fatty acid metabolism. Recent studies have been elucidating how nutrients that fuel the metabolic processes impact on the ways immune cells, in particular, macrophages, respond to different stimuli under physiological and pathological conditions and become activated and acquire a specialized function. The two major inflammatory phenotypes of macrophages are controlled through differential consumption of glucose, glutamine, and oxygen. M1 phenotype is triggered by polarization signal from bacterial lipopolysaccharide (LPS) and Th1 proinflammatory cytokines such as interferon-gamma, TNF-alpha, and IL-1 beta, or both, whereas M2 phenotype is triggered by Th2 cytokines such as interleukin-4 and interleukin-13 as well as anti-inflammatory cytokines, IL-10 and TGF beta, or glucocorticoids. Glucose utilization and production of chemical mediators including ATP, reactive oxygen species (ROS), nitric oxide (NO), and NADPH support effector activities of M1 macrophages. Dysbiosis is an imbalance of commensal and pathogenic bacteria and the production of microbial antigens and metabolites. It is now known that the gut microbiota-derived products induce low-grade inflammatory activation of tissue-resident macrophages and contribute to metabolic and degenerative diseases, including diabetes, obesity, metabolic syndrome, and cancer. Here, we update the potential interplay of host gut microbiome dysbiosis and metabolic diseases. We also summarize on advances on fecal therapy, probiotics, prebiotics, symbiotics, and nutrients and small molecule inhibitors of metabolic pathway enzymes as prophylactic and therapeutic agents for metabolic diseases.
- Breath Biopsy and Discovery of Exclusive Volatile Organic Compounds for Diagnosis of Infectious Diseases(2021) BELIZARIO, Jose E.; FAINTUCH, Joel; MALPARTIDA, Miguel GarayExhaled breath contains thousand metabolites and volatile organic compounds (VOCs) that originated from both respiratory tract and internal organ systems and their microbiomes. Commensal and pathogenic bacteria and virus of microbiomes are capable of producing VOCs of different chemical classes, and some of them may serve as biomarkers for installation and progression of various common human diseases. Here we describe qualitative and quantitative methods for measuring VOC fingerprints generated by cellular and microbial metabolic and pathologic pathways. We describe different chemical classes of VOCs and their role in the host cell-microbial interactions and their impact on infection disease pathology. We also update on recent progress on VOC signatures emitted by isolated bacterial species and microbiomes, and VOCs identified in exhaled breath of patients with respiratory tract and gastrointestinal diseases, and inflammatory syndromes, including the acute respiratory distress syndrome and sepsis. The VOC curated databases and instrumentations have been developed through statistically robust breathomic research in large patient populations. Scientists have now the opportunity to find potential biomarkers for both triage and diagnosis of particular human disease.