ROBERTO DE CLEVA
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
5 resultados
Resultados de Busca
Agora exibindo 1 - 5 de 5
conferenceObject Exercise Suppresses The Ubiquitin-proteasome System In The Skeletal Muscle Of Obese Women Following Bariatric Surgery(2020) GIL, Saulo; GUALANO, Bruno; DANTAS, Wagner S.; MURAI, Igor H.; GHOSH, Sujoy; SHINJO, Samuel K.; MEREGE-FILHO, Carlos; TEODORO, Walcy R.; PEREIRA, Rosa Maria; BENATTI, Fabiana B.; SA-PINTO, Ana L. de; LIMA, Fernanda; CLEVA, Roberto de; SANTO, Marco A.; KIRWAN, John P.; ROSCHEL, Hamilton- Outpatient Screening of Health Status Among Postbariatric Patients during the COVID-19 Pandemic in Sao Paulo, Brazil(2020) GOESSLER, Karla Fabiana; NICOLETTI, Carolina Ferreira; REZENDE, Diego Augusto Nunes; SIECZKOWSKA, Sofia Mendes; ESTEVES, Gabriel Perri; GENARIO, Rafael; OLIVEIRA JUNIOR, Gersiel Nascimento de; MEIRELES, Kamila; PINTO, Ana Jessica; NAKAHARA-MELO, Michele; CLEVA, Roberto de; SANTO, Marco Aurelio; KIRWAN, John; ROSCHEL, Hamilton; GUALANO, Bruno
conferenceObject Exercise Training Improves Cardiac Autonomic Responses In Obese Women Undergoing Bariatric Surgery(2020) ROSCHEL, Hamilton; GIL, Saulo; PECANHA, Tiago; DANTAS, Wagner; MURAI, Igor; SHINJO, Samuel K.; MEREGE-FILHO, Carlos; PEREIRA, Rosa Maria Rodrigues; BENATTI, Fabiana B.; PINTO, Ana Lucia de Sa; LIMA, Fernanda R.; CLEVA, Roberto; SANTO, Marco A.; REZENDE, Diego A. N.; KIRWAN, John P.; GUALANO, Bruno- Bariatric surgery in the elderly: a randomized prospective study comparing safety of sleeve gastrectomy and Roux-en-Y gastric bypass (BASE Trial)(2020) PAJECKI, Denis; DANTAS, Anna Carolina Batista; KANAJI, Ana Lumi; OLIVEIRA, Daniel Riccioppo Cerqueira Ferreira de; CLEVA, Roberto de; SANTO, Marco AurelioBackground: The aging population along with the obesity epidemic has increased the number of older patients undergoing bariatric surgery. Nevertheless, there is still conflicting data regarding surgical safety in this population. Objectives: The aim of this study was to compare the surgical morbidity of laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB) for older patients. Setting: University hospital, Sao Paulo, Brazil. Methods: We performed a prospective randomized clinical trial from September 2017 to May 2019. Obese patients aged >= 65 years were randomized to LSG or LRYGB. Data collection included demographic information, body mass index (BMI), and co-morbidities. We assessed readmission, postoperative complications, and mortality. Complications were scored according to Clavien-Dindo classification. Results: A total of 36 patients, with a BMI between 35.5 and 52.8 kg/m(2) were randomized to either LSG (18 patients) or LRYGB (18 patients). The overall complication rate was similar between LSG and LRYGB (3 versus 7, P=.13). Severe complication was more prevalent in LRYGB patients but had no statistically significant difference (0 versus 3, P=.07). Each group had 1 readmission and there was no mortality in 90-day follow-up. Conclusions: Morbidity and mortality rates of bariatric surgery are low in elderly obese patients. Despite not statistically significant, LSG had a lower rate of severe complications compared with LRYGBin this population setting.
- Exercise-Induced Increases in Insulin Sensitivity After Bariatric Surgery Are Mediated By Muscle Extracellular Matrix Remodeling(2020) DANTAS, Wagner S.; ROSCHEL, Hamilton; MURAI, Igor H.; GIL, Saulo; DAVULURI, Gangarao; AXELROD, Christopher L.; GHOSH, Sujoy; NEWMAN, Susan S.; ZHANG, Hui; SHINJO, Samuel K.; NEVES, Willian das; MEREGE-FILHO, Carlos; TEODORO, Walcy R.; CAPELOZZI, Vera L.; PEREIRA, Rosa Maria; BENATTI, Fabiana B.; SA-PINTO, Ana L. de; CLEVA, Roberto de; SANTO, Marco A.; KIRWAN, John P.; GUALANO, BrunoExercise seems to enhance the beneficial effect of bariatric (Roux-en-Y gastric bypass [RYGB]) surgery on insulin resistance. We hypothesized that skeletal muscle extracellular matrix (ECM) remodeling may underlie these benefits. Women were randomized to either a combined aerobic and resistance exercise training program following RYGB (RYGB + ET) or standard of care (RYGB). Insulin sensitivity was assessed by oral glucose tolerance test. Muscle biopsy specimens were obtained at baseline and 3 and 9 months after surgery and subjected to comprehensive phenotyping, transcriptome profiling, molecular pathway identification, and validation in vitro. Exercise training improved insulin sensitivity beyond surgery alone (e.g., Matsuda index: RYGB 123% vs. RYGB + ET 325%;P <= 0.0001). ECM remodeling was reduced by surgery alone, with an additive benefit of surgery and exercise training (e.g., collagen I: RYGB -41% vs. RYGB + ET -76%;P <= 0.0001). Exercise and RYGB had an additive effect on enhancing insulin sensitivity, but surgery alone did not resolve insulin resistance and ECM remodeling. We identified candidates modulated by exercise training that may become therapeutic targets for treating insulin resistance, in particular, the transforming growth factor-beta 1/SMAD 2/3 pathway and its antagonist follistatin. Exercise-induced increases in insulin sensitivity after bariatric surgery are at least partially mediated by muscle ECM remodeling.