DENIS PAJECKI
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
10 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 10
bookPart Avaliação e preparo do paciente para cirurgia bariátrica e metabólica(2016) PAJECKI, Denis; OLIVEIRA, Daniel Riccioppo Cerqueira Ferreira de; SANTO, Marco Aurelio; KAWAMOTO, FlavioconferenceObject FALL PREVALENCE AND BONE METABOLISM IN OBESE ELDERLY PATIENTS UNDERGOING BARIATRIC SURGERY(2016) SANTO, M. A.; KANAJI, A. L.; ANDRADE, J. P.; PAJECKI, D.; CLEVA, R. de- Weight Regain After Gastric Bypass: Influence of Gut Hormones(2016) SANTO, Marco Aurelio; RICCIOPPO, Daniel; PAJECKI, Denis; KAWAMOTO, Flavio; CLEVA, Roberto de; ANTONANGELO, Leila; MARCAL, Lia; CECCONELLO, IvanThe Roux-en-Y gastric bypass (RYGB) is the gold standard bariatric operation. However, a major concern in late follow-up is the substantial weight regain. Understanding the role of gastrointestinal hormone secretion in this situation is relevant. The aim of the present study was to evaluate the influence of gastrointestinal hormones comparing postprandial secretion of ghrelin, glucose-dependent insulinotropic polypeptide (GIP), glucagon-like peptide 1 (GLP-1), and leptin between patients with weight regain and those with favorable weight control. Twenty-four patients with follow-up from 27 to 59 months were divided into two groups according to sustained weight loss: group A (14 patients) had sustained weight losses, and group B (10 patients) had significant weight regain. Basal serum levels of ghrelin, GIP, GLP-1, and leptin after fasting and 30, 60, 90, and 120 min after a standard meal were measured. There was no difference in the ghrelin secretion. There was a difference in the GIP secretion, with a higher percentage increase in 30 min in group A (330 % x 192.2 %; p = 0.01). There were also differences in the GLP-1 secretion, with higher increases in absolute (p = 0.03) and percentage values after 30 min in group A (124 % x 46.5 %; p = 0.01). There was also a difference between baseline leptin values, with higher levels in group B (p = 0.02). The secretion of gut hormones in patients with weight regain after RYGB is different from that in patients with satisfactory weight outcome. After meal stimulation, reduced levels of GIP and GLP-1 may indicate the influence of gut hormones in the process of weight regain.
- Use of noninvasive markers to predict advanced fibrosis/cirrhosis in severe obesity(2016) CLEVA, Roberto de; DUARTE, Livio Fiolo; CRENITTE, Milton Roberto Furst; OLIVEIRA, Claudia Pinto Marques de; PAJECKI, Denis; SANTO, Marco AurelioBackground: Nonalcoholic steatohepatitis is observed in 25%-55% of patients with severe obesity and in 2%-12% with bridging fibrosis or cirrhosis. There is currently no noninvasive test for the diagnosis of severe liver fibrosis before bariatric surgery. Objectives: To determine the best noninvasive test for predicting advanced liver disease in patients with severe obesity. Setting: University tertiary care hospital, Brazil. Methods: A cross-sectional retrospective study was conducted with 699 patients with severe obesity undergoing bariatric surgery: 568 without a biopsy (nonbiopsy cohort) and 131 patients who had undergone an intraoperative liver biopsy. The tissues were subjected to histologic diagnosis (Brunt criteria) and classified as advanced fibrosis (stages 3 and 4) or no significant fibrosis (absence of nonalcoholic steatohepatitis and stages 1 or 2). The following predictive indices of cirrhosis were calculated in all patients: aspartate aminotransferase/alanine aminotransferase ratio (AAR), age platelet (AP) index, aminotransferase-to-platelet ratio index (APRI), cirrhosis discriminant score (CDS), and hepatitis C antiviral long-term treatment against cirrhosis (HALT-C). The cutoff values, sensitivity, specificity, and areas under the receiver operating characteristic curves (AUROCs) were calculated for patients with biopsies. Results: The AUROC of the AAR, AP, APRI, CDS, and HALT-C model for predicting advanced fibrosis or cirrhosis were, respectively, .522, .88, .99, .905, and .921. The calculated cutoff values, sensitivity, and specificity, respectively, were as follows: AAR: .94, .7, .45; AP 5, .7, .93; APRI .44, 1.0, .97; CDS 6, .7, .97; and HALT-C: .76, 1.0, .77. Conclusion: APRI index was the best predictor of advanced liver disease in patients with severe obesity. (Surg Obes Relat Dis 2016;12:862-867.) (C) 2016 American Society for Metabolic and Bariatric Surgery. All rights reserved.
- Letter to ""Pharmacotherapy in conjunction with diet and exercise program for the treatment of weight recidivism or weight loss plateau post-bariatric surgery: a retrospective review""(2016) PAJECKI, Denis; SANTO, Marco Aurelio; MANCINI, Marcio Correa
conferenceObject MANAGEMENT OF GASTROINTESTINAL LEAKS AFTER BARIATRIC SURGERY(2016) SANTO, M. A.; MOTA, F. C.; PAJECKI, D.; RICCIOPPO, D.; KAWAMOTO, F.; JOAQUIM, H.; BATISTA, A. C.; CLEVA, R.bookPart Complicações pós-operatórias em cirurgia bariátrica e metabolica(2016) PAJECKI, Denis; KAWAMOTO, Flavio; JOAQUIM, Henrique Dametto Giroud; SANTO, Marco AurelioconferenceObject CHARACTERISTICS OF PATIENTS UNDERGOING BARIATRIC SURGERY IN A BRAZILIAN MEDICAL SCHOOL HOSPITAL(2016) OGASSAVARA, N. C.; DIAS, J. G. M.; PAJECKI, D.; SANTO, M. A.; TESS, B. H.conferenceObject REVISION OF SLEEVE GASTRECTOMY TO ROUX-EN-Y GASTRIC BYPASS DUE TO SEVERE GASTROESOPHAGEAL REFLUX.(2016) PAJECKI, D.; PUZZO, D. B.; SANTO, M. A.conferenceObject SAFETY AND EFFECTIVENESS OF SLEEVE GASTRECTOMY IN ADOLESCENT PATIENTS(2016) SANTO, M. A.; DANTAS, A. C.; PAJECKI, D.; OLIVEIRA, D. R. C. F.; KAWAMOTO, F. M.; JOAQUIM, H. D. G.; MOTA, F. C.; MANCINI, M. C.