DENIS PAJECKI
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
2 resultados
Resultados de Busca
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- Semen Analysis and Fertility Rates after Bariatric Surgery in Males(2017) ROSENBLATT, Alberto; FAINTUCH, Joel; PAJECKI, Denis; SANTO, Marco Aurelio; FAINTUCH, Salomao; CECCONELLO, IvanBackground: Obesity poses challenges to male reproduction, but the effect of bariatric surgery on semen parameters and fertility is debated. This study evaluates Roux-en-Y gastric bypass (RYGB) influence on these variables. Methods: Seventy-nine sexually active men attempting to conceive with a partner were stratified into four groups: Group 1 (n = 23)-bariatric follow-up >= 5 years; Group 2 (n = 23)-mean bariatric follow-up 2 years; Group 3-obese controls (n = 18); Group 4-lean controls (n = 15). Groups 2, 3, and 4 were matched for age; Groups 1, 2, and 3 were matched for body mass index (BMI). Sexual quality of life questionnaire for males (SQOL-M), fasting blood glucose, C-reactive protein, vitamin D, zinc, total testosterone (TT), and free testosterone (FT), estradiol (E2), sex hormone-binding globulin (SHBG), and semen parameters were investigated. Results: SQOL-M scores increased; vitamin D was low in most of Group 2 and Group 3 participants, negatively correlating with BMI (p < 0.01). TT, FT, and SHBG improved postoperatively; however, E2 remained elevated. Semen aberrations occurred in 57.1% of Group 2 patients and BMI correlated with oligoasthenoteratospermia. Scant bariatric men fathered a child (13.0% preoperatively, 4.3% postoperatively, not significant). Conclusion: Semen abnormalities and subfertility were observed after RYGB, despite improved androgenic profile and SQOL-M. Possible negative impacts of hyperestrogenism and hypovitaminosis D on semen parameters warrant further studies.
- Small-Volume, Fast-Emptying Gastric Pouch Leads to Better Long-Term Weight Loss and Food Tolerance After Roux-en-Y Gastric Bypass(2018) RICCIOPPO, Daniel; SANTO, Marco Aurelio; ROCHA, Manoel; BUCHPIGUEL, Carlos Alberto; DINIZ, Marcio Augusto; PAJECKI, Denis; CLEVA, Roberto de; KAWAMOTO, FlavioAnatomical and functional influences on gastric bypass (GBP) results are often poorly evaluated and not yet fully understood. The purpose of this study is to evaluate the influence of the gastric pouch volume and its emptying rate on long-term weight loss and food tolerance after GBP. Weight loss, food tolerance, pouch volumetry (V) by three-dimensional reconstruction, and pouch emptying rate by 4 h scintigraphy were evaluated in 67 patients. Cutoffs were identified for V and retention percentage (%Ret) at 1 h (%Ret1). From these parameters, the sample was categorized, looking for associations between V, %Ret, weight loss, and food tolerance, assessed by a questionnaire for quick assessment of food tolerance (SS). PO median follow-up time was 47 months; median V was 28 mL; %Ret at 1, 2, and 4 h were 8, 2, and 1%, respectively. There were associations between V <= 40 mL and higher emptying rates up to 2 h (V <= 40 mL: %Ret1 = 6, %Ret2 = 2, p = 0.009; V > 40 mL: %Ret1 = 44, %Ret2 = 13.5, p = 0.045). An association was found between higher emptying speed in 1 h and higher late weight loss (WL), represented by lower percentage of excess weight loss (%EWL) regain (p = 0.036) and higher %EWL (p = 0.033) in the group with %Ret1 <= 12%, compared to the group %Ret1 >= 25%. Better food tolerance (SS > 24), was associated with lower %Ret1 (p = 0.003). Smaller pouch size is associated with a faster gastric emptying, greater WL maintenance, and better food tolerance. These data suggest that a small pouch with rapid emptying rate is an important technical parameter for good outcomes in GBP.