MARCO AURELIO SANTO
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Gastroenterologia, Faculdade de Medicina - Docente
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/35 - Laboratório de Nutrição e Cirurgia Metabólica do Aparelho Digestivo, Hospital das Clínicas, Faculdade de Medicina
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/35 - Laboratório de Nutrição e Cirurgia Metabólica do Aparelho Digestivo, Hospital das Clínicas, Faculdade de Medicina
15 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 15
conferenceObject Reduced Transcobalamin I Gene Expression Following Roux-en-Y Gastric Bypass Surgery Can Contribute to B12 Deficiency(2015) SALA, Priscila; MACHADO, Natasha; BELARMINO, Giliane; ISHIDA, Robson; GUARDA, Ismael; GIANNELLA-NETO, Daniel; SANTO, Marco Aurelio; MOURA, Eduardo; SAKAI, Paulo; SILVA, Ismael; YE, Jianping; HEYMSFIELD, Steven; WAITZBERG, Dan- Surgical options in type 2 diabetes(2015) PAJECKI, D.; RICCIOPPO, D.; KAWAMOTO, F.; SANTO, M. A.The onset of type 2 diabetes is characterized by a nonreversible complex cycle that includes severe deleterious effects on glucose metabolism. Obesity, but mainly visceral adipose tissue accumulation, is an important factor in this process. The goals of diabetes management in clinical practice, despite the improvement over the years, are often not met. In the last 20 years, based on observations of bariatric surgery series that have shown great improvement of type 2 Diabetes in morbid obese patients, metabolic surgery has emerged as a therapeutic possibility. In 2011 the International Diabetes Federation released its position statement mentioning that bariatric surgery was an accepted option for T2DM patients with BMI > 35 kg/m2 and might be considered an alternative therapy for patients with BMI ≤ 35 kg/m2 who do not respond to standard medical therapy. Metabolic/bariatric surgery includes the application of conventional bariatric procedures (Roux-en-Y gastric bypass, biliopancreatic diversion, sleeve gastrectomy) and the introduction of new procedures (ileal interposition, intestinal bipartition) designed with the specific aim of having metabolic effects, irrespective of causing massive weight loss. The reversal of T2DM occurs due to mechanisms such as the increase in insulin sensitivity associated with an improvement in beta-cell function, including recovering the first phase of insulin secretion. This recovery is a consequence of the increase of GLP-1 production, and change in circulating bile acids. Remission of diabetes is observed on the first postoperative days after the operation. © Springer International Publishing Switzerland 2015.
- Psychiatric Disorders Among Obese Patients Seeking Bariatric Surgery: Results of Structured Clinical Interviews(2015) DUARTE-GUERRA, Leorides Severo; COELHO, Bruno Mendonca; SANTO, Marco Aurelio; WANG, Yuan-PangObesity and psychiatric disorders are burdensome health problems commonly observed in general population and clinical samples. However, non-standardized assessment and small size of the sample might hamper conclusions of the investigations. The objective of this study is to replicate previous findings on frequency of psychiatric disorders and associated factors among obese patients seeking bariatric surgery, assessed through standardized interview. The sample was comprised of 393 treatment-seeking obese patients (79.1 % women; mean age 43.0 years, mean BMI 47.8 kg/m(2)) recruited from a university-based bariatric center. Trained clinicians ascertained the psychiatric diagnosis of the participants through structured clinical interview for DSM-IV Axis I diagnosis (SCID-I). The current rate of any psychiatric disorders was 57.8 % (58.5 % men vs. 57.6 % women). The current anxiety disorders were the most frequent diagnosis (46.3 %) among those participants with current disorder. Age and educational level were associated with the likelihood of presenting current psychiatric disorders. The lifetime rate of any psychiatric disorders was 80.9 % (81.7 men vs. 80.7% women). Lifetime affective disorders were the most frequent diagnosis (total 64.9%; bipolar disorders 35.6% and depressive disorders 29.3%). About half of the sample presented 3 or more concurrent disorders among those respondents presenting any lifetime psychiatric disorders. Psychiatric disorders are frequent conditions among obese patients before bariatric surgery. Systematic assessment of patients in the pre-surgical phase is recommended. Prognostic implications of psychiatric disorders on surgery outcome should be demonstrated in follow-up study.
conferenceObject ANEMIA BEFORE AND AFTER BARIATRIC SURGERY: PREVALENCE AND EVOLUTION ON LONG-TERM FOLLOW UP(2015) SANTO, Marco; FUKUMOTO, Miwa; KANASHIRO, Newton; CURADO, Taina; DANTAS, Anna; JOAQUIM, Henrique; GARMS, Alan; RICCIOPPO, Daniel; CLEVA, Roberto; CECCONELLO, IvanconferenceObject LATE POSTOPERATIVE OUTCOME OF ROUX-EN-Y GASTRIC BYPASS IN MORBIDLY OBESE PATIENTS - ANALYSIS OF THE INFLUENCE OF GASTROINTESTINAL HORMONES IN WEIGHT REGAIN(2015) SANTO, Marco; RICCIOPPO, Daniel; PAJECKI, Denis; KAWAMOTO, Flavio; JOAQUIM, Henrique; CLEVA, Roberto; ANTONANGELO, Leila; MARCAL, Lia; GARMS, Alan; CECCONELLO, IvanconferenceObject ROBOTIC REVISIONAL GASTRIC BYPASS: POUCH ""REDO"" AND HIATAL HERNIA REPAIR(2015) PAJECKI, Denis; SANTO, Marco Aurelio; PUZZO, Daniel Bauab; JOAQUIM, Henrique; RICCIOPPO, Daniel- Correlation between Body Composition and Walking Capacity in Severe Obesity(2015) SANTAREM, G. Correia de Faria; CLEVA, R. de; SANTO, Marco Aurelio; BERNHARD, Biaseto; GADDUCCI, Alexandre Vieira; GREVE, Julia Maria D'Andrea; SILVA, Paulo Roberto SantosBackground Obesity is associated with mobility reduction due to mechanical factors and excessive body fat. The six-minute walk test (6MWT) has been used to assess functional capacity in severe obesity. Objective To determine the association of BMI, total and segmental body composition with distance walked (6MWD) during the six-minute walk test (6MWT) according to gender and obesity grade. Setting University of Sao Paulo Medical School, Brazil; Public Practice. Methods Functional capacity was assessed by 6MWD and body composition (%) by bioelectrical impedance analysis in 90 patients. Results The mean 6MWD was 514.9 +/- 50.3 m for both genders. The male group (M: 545.2 +/- 46.9 m) showed a 6MWD higher (p = 0.002) than the female group (F: 505.6 +/- 47.9 m). The morbid obese group (MO: 524.7 +/- 44.0 m) also showed a 6MWD higher (p = 0.014) than the super obese group (SO: 494.2 +/- 57.0 m). There was a positive relationship between 6MWD and fat free mass (FFM), FFM of upper limps (FFM_UL), trunk (FFM_TR) and lower limbs (FFM_LL). Female group presented a positive relationship between 6MWD and FFM, FFM_UL and FFM_LL and male group presented a positive relationship between 6MWD and FFM_TR. In morbid obese group there was a positive relationship between 6MWD with FFM, FFM_UL, FFM_TR and FFM_LL. The super obese group presented a positive relationship between 6MWD with FFM, FFM_TR and FFM_LL. Conclusions Total and segmental FFM is associated with a better walking capacity than BMI.
- Two port video-assisted gastrostomy and jejunostomy: technical simplification and clinical results(2015) VOLPE, Paula; DOMENE, Carlos Eduardo; SANTO, Marco Aurélio; CECCONELLO, IvanBACKGROUND: Patients presenting upper gastrointestinal obstruction, difficulty or inability in swallowing, may need nutritional support which can be obtained through gastrostomy and jejunostomy. AIM: To describe the methods of gastrostomy and jejunostomy video-assisted, and to compare surgical approaches for video-assisted laparoscopy and laparotomy in patients with advanced cancer of the esophagus and stomach, to establish enteral nutritional access. METHODS: Were used the video-assisted laparoscopic techniques for jejunostomy and gastrostomy and the same procedures performed by laparotomies. Comparatively, were analyzed the distribution of patients according to demographics, diagnosis and type of procedure. RESULTS: There were 36 jejunostomies (18 by laparotomy and 17 laparoscopy) and 42 gastrostomies (21 on each side). In jejunostomy, relevant data were operating time of 132 min vs. 106 min (p=0.021); reintroduction of diet: 3.3 days vs 2.1 days (p=0.009); discharge: 5.8 days vs 4.3 days (p= 0.044). In gastrostomy, relevant data were operative time of 122.6 min vs 86.2 min (p= 0.012 and hospital discharge: 5.1 days vs 3.7 days (p=0.016). CONCLUSION: The comparative analysis of laparotomy and video-assisted access to jejunostomies and gastrostomies concluded that video-assisted approach is feasible method, safe, fast, simple and easy, requires shorter operative time compared to laparotomy, enables diet start soon in compared to laparotomy, and also enables lower length of stay compared to laparotomy.
- ENDOSCOPIC CHANGES RELATED TO GASTROESOPHAGEAL REFLUX DISEASE: COMPARATIVE STUDY AMONG BARIATRIC SURGERY PATIENTS(2015) SANTO, Marco Aurelio; QUINTANILHA, Sylvia Regina; MIETTI, Cesar Augusto; KAWAMOTO, Flavio Masato; MARSON, Allan Garms; CLEVA, Roberto deBackground:Obesity is correlated with several comorbidities, including gastroesophageal reflux disease. Its main complications are detectable by endoscopy: erosive esophagitis and Barrett's esophagus.Aim: To correlate erosive esophagitis and hiatal hernia with the degree of body mass index (BMI).Method: Was performed a retrospective analysis of 717 preoperative endoscopic reports of bariatric patients. Fifty-six (8%) presented hiatal hernia, being 44 small, nine medium and five large. Esophagitis was classified by Los Angeles classification.Results: There was no correlation between the presence and dimension of hiatal hernia with BMI. One hundred thirty-four (18.7%) patients presented erosive esophagitis. Among them, 104 (14.5%) had esophagitis grade A; 25 (3.5%) grade B; and five (0.7%) grade C. When considering only the patients with erosive esophagitis, 77.6% had esophagitis grade A, 18.7% grade B and 3.7% grade C. Were identified only two patients with Barrett's esophagus (0,28%).Conclusion: There was a positive correlation between the degree of esophagitis with increasing BMI.
conferenceObject SURGICAL APPROACH FOR PERSISTENT MARGINAL ULCER AFTER BARIATRIC SURGERY(2015) PAJECKI, Denis; ALVES, Aline Marcilio; KAWAMOTO, Flavio; JOAQUIM, Henrique; MACACARI, Rodrigo; SANTO, Marco Aurelio