FERNANDA REIS DE AZEVEDO RABELLO
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conferenceObject EFFECT OF INTERMITTENT FASTING ON CYTOKINE (IL-6 AND TNF-ALFA) LEVELS IN KNOCKOUT MICE LDL -/-(2013) AZEVEDO, F. Reis de; MELO, E. Sant'anna; JURADO, M. C.; PASTANA, A. F.; CARAMELLI, B.- Children First Study: how an educational program in cardiovascular prevention at school can improve parents' cardiovascular risk(2013) FORNARI, Luciana S.; GIULIANO, Isabela; AZEVEDO, Fernanda; PASTANA, Adriana; VIEIRA, Carolina; CARAMELLI, BrunoAim: To evaluate whether a multidisciplinary educational program (EP) in cardiovascular prevention (CVP) for children could improve the Framingham cardiovascular risk (FCR) of their parents after one year. Methods and results: This was a prospective community-based study in Brazil during 2010 that randomized students aged 6 to 10 years old to two different approaches to receiving healthy lifestyle information. The control group received written educational material (EM) for their parents about healthy lifestyle. The intervention group received the same EM for parents, and children were exposed to a weekly EP in CVP with a multidisciplinary health team. At onset and end of the study, we collected data from parents and children (weight, height, arterial blood pressure, and laboratory tests). We studied 197 children and 323 parents. Analyzing the parents' FCR we found that 9.3% of the control group and 6.8% of the intervention group had more than a 10% year risk of cardiovascular heart disease (CHD) over the next 10 years. After the children's EP for the year, the intervention group had a reduction of 91% in the intermediate/high FCR group compared with a 13% reduction in the control group, p = 0.002). In the same way, analyzing the FCR of all parents, there was a reduction of the average risk in the intervention group (3.6% to 2.8% respectively, p < 0.001) compared with the control group (4.4% to 4.4%, p = 0.98). Conclusion: An educational program in cardiovascular prevention directed at school-age children can reduce the FCR risk of their parents, especially in the intermediate/high risk categories.
conferenceObject MORPHOLOGIC ALTERATIONS IN KNOCKOUT LDL-/- MICE AORTA SUBJECT TO DIETARY RESTRICTION(2013) MELO, E. S.; AZEVEDO, F. R.; MONTEIRO, L. H.; JURADO, M. C.; GUTIERREZ, P. S.; CARAMELLI, B.- Impact of cardiology referral: clinical outcomes and factors associated with physicians' adherence to recommendations(2014) MARQUES, Andre C.; CALDERARO, Daniela; YU, Pai C.; GUALANDRO, Danielle M.; CARMO, Gabriel A. L.; AZEVEDO, Fernanda R.; PASTANA, Adriana F.; LIMA, Eneas M. O.; MONACHINI, Maristela; CARAMELLI, BrunoOBJECTIVES: Cardiology referral is common for patients admitted for non-cardiac diseases. Recommendations from cardiologists may involve complex and aggressive treatments that could be ignored or denied by other physicians. The purpose of this study was to compare the outcomes of patients who were given recommendations during cardiology referrals and to examine the clinical outcomes of patients who did not follow the recommendations. METHODS: We enrolled 589 consecutive patients who received in-hospital cardiology consultations. Data on recommendations, implementation of suggestions and outcomes were collected. RESULTS: Regarding adherence of the referring service to the recommendations, 77% of patients were classified in the adherence group and 23% were classified in the non-adherence group. Membership in the non-adherence group (p<0.001; odds ratio: 10.25; 95% CI: 4.45-23.62) and advanced age (p = 0.017; OR: 1.04; 95% CI: 1.01-1.07) were associated with unfavorable outcomes. Multivariate analysis identified four independent predictors of adherence to recommendations: follow-up notes in the medical chart (p<0.001; OR: 2.43; 95% CI: 1.48-4.01); verbal reinforcement (p = 0.001; OR: 1.86; 95% CI: 1.23-2.81); a small number of recommendation (p = 0.001; OR: 0.87; 95% CI: 0.80-0.94); and a younger patient age (p = 0.002; OR: 0.98; 95% CI: 0.96-0.99). CONCLUSIONS: Poor adherence to cardiology referral recommendations was associated with unfavorable clinical outcomes. Follow-up notes in the medical chart, verbal reinforcement, a limited number of recommendations and a patient age were associated with greater adherence to recommendations.
conferenceObject SLEEVE GASTRECTOMY WITH TRANSIT BIPARTITION FOR TYPE 2 DIABETES: PRELIMINARY RESULTS OF A RANDOMIZED DOUBLY CONTROLLED TRIAL.(2016) SANTORO, Sergio; AZEVEDO, F. R.; CORREA-GIANNELLI, M. L.; GIANNELLI-NETO, D.; CARAMELLI, B.; CALDERARO, D.conferenceObject THE IMPACT OF BARIATRIC SURGERY ON CARDIOMETABOLIC PROFILE AND ADIPOKINE LEVELS(2016) RABELLO, F. Reis de Azevedo; PEREIRA, S. Santoro dos Santos; CORREA-GIANNELLA, M. L.; GIANNELLA NETO, D.; MELO, E. Sant'Anna; CARAMELLI, B.- A Prospective Randomized Controlled Trial of the Metabolic Effects of Sleeve Gastrectomy with Transit Bipartition(2018) AZEVEDO, Fernanda R.; SANTORO, Sergio; CORREA-GIANNELLA, Maria L.; TOYOSHIMA, Marcos T.; GIANNELLA-NETO, Daniel; CALDERARO, Daniela; GUALANDRO, Danielle M.; YU, Pai C.; CARAMELLI, BrunoPurpose To compare the effects of the sleeve gastrectomy with transit bipartition (SG + TB) procedure with standard medical therapy (SMT) in mildly obese patients with type II diabetes (T2D). Methods This is a prospective, randomized, controlled trial. Twenty male adults, <= 65 years old, with T2D, body mass index (BMI) > 28 kg/m(2) and < 35 kg/m(2), and HbA1c level > 8% were randomized to SG + TB or to SMT. Outcomes were the remission in the metabolic and cardiovascular risk variables up to 24 months. Results At 24 months, SG + TB group showed a significant decrease in HbaA1c values (9.3 +/- 2.1 versus 5.5 +/- 1.1%, P = < 0.05) whereas SMT group maintained similar levels from baseline (8.0 +/- 1.5 versus 8.3 +/- 1.1%, P= NS). BMI values were lower in the SG + TB group (25.3 +/- 2.8 kg/m(2) versus 30.9 +/- 2.5 kg/m(2); P = < 0.001). At 24 months, none patient in SG + TB group needed medications for hyperlipidemia/hypertension. HDL-cholesterol levels increased in the SG + TB group (33 +/- 8 to 45 +/- 15 mg/dL, P< 0.001). After 24 months, the area under the curve (AUC) of GLP1 increased and in the SG + TB group and the AUC of the GIP concentrations was lower in the SG + TB group than in the SMT. At 3 months, SG + TB group showed a marked increase in FGF19 levels (74.1 +/- 45.8 to 237.3 +/- 234 pg/mL; P=0.001). Conclusions SG + TB is superior to SMT and was associated with a better metabolic and cardiovascular profile.
- Effects of intermittent fasting on metabolism in men(2013) AZEVEDO, Fernanda Reis de; IKEOKA, Dimas; CARAMELLI, BrunoThis review analyzes the available literature on the impact of intermittent fasting (IF), a nutritional intervention, on different aspects of metabolism. The epidemic of metabolic disturbances, such as obesity, metabolic syndrome (MS), and diabetes mellitus type 2 has led to an increase in the prevalence of cardiovascular diseases, and affected patients might significantly benefit from modifications in nutritional habits. Recent experimental studies have elucidated some of the metabolic mechanisms involved with IF. Animal models have shown positive changes in glucose (lower plasma glucose and insulin levels) and in lipid metabolism (reduced visceral fat tissue and increased plasma adiponectin level), and an increased resistance to stress. Despite the limited number of samples studied, positive results have been reported on the impact of IF for human health. IF is reported to improve the lipid profile; to decrease inflammatory responses, reflected by changes in serum adipokine levels; and to change the expression of genes related to inflammatory response and other factors. Studies on obese individuals have shown that patient compliance was greater for IF than other traditional nutritional approaches (calorie restriction), and IF was found to be associated with low oxidative stress. Recent reports suggest that IF exerts a positive impact on the metabolic derangements commonly associated with cardiovascular diseases, and that it may be a viable and accessible intervention for most individuals. Therefore, further clinical studies are essential to test the effectiveness of IF in preventing and controlling metabolic and cardiovascular diseases.
- Influência das variáveis nutricionais e da obesidade sobre a saúde e o metabolismo(2012) AZEVEDO, Fernanda Reis de; BRITO, Bruna CristinaInfluence of nutritional variables and obesity on health and metabolism Obesity is a recurring theme in current scientific literature. This can easily be explained by its exponential increase in all layers of society. The popularity of this subject has also given rise to associated questions, which have achieved greater prominence in health-related publications. In order to assess what has been studied in the field of obesity and nutrition, an overview of all articles published on these subjects in some of the main Brazilian scientific journals over the past two years was performed. Among the subthemes selected for this study, those related to childhood obesity attracted attention due to their greater frequency. These were subdivided into: prevalence, intrauterine and breastfeeding influences that may lead to the development of this condition, impact on quality of life, cardiovascular system and metabolism, and possible prevention strategies. Furthermore, issues related to obesity in adults were explored, such as risk factors and new strategies for prevention, with special attention given to the many studies evaluating different aspects of bariatric surgery. Finally, the subject of malnutrition and the impact of the deficiency of specific micronutrients such as selenium, vitamin D, and vitamin B12 were assessed. Based on the results, it was possible to assess the actual importance of obesity and nutrition in health maintenance, and also the several lines of research regarding these issues. Thus, it is essential to create new methods, which must be quick and efficient, to update health professionals involved in the treatment of obesity.
conferenceObject EFFECT OF INTERMITTENT FASTING ON CYTOKINE (IL-6 AND TNF-?) LEVELS IN KNOCKOUT MICE LDL -/-(2013) AZEVEDO, F. Reis de; MELO, E. Sant'anna; JURADO, M. C.; PASTANA, A. F.; CARAMELLI, B.