JOEL FAINTUCH
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Gastroenterologia, Faculdade de Medicina - Docente
8 resultados
Resultados de Busca
Agora exibindo 1 - 8 de 8
- Magnesium Deficiency and Gastric Bypass(2011) FAINTUCH, Joel
- Systemic inflammation and carotid diameter in obese patients: pilot comparative study with flaxseed powder and cassava powder(2011) FAINTUCH, J.; BORTOLOTTO, L. A.; MARQUES, P. C.; FAINTUCH, J. J.; FRANCA, J. I.; CECCONELLO, I.Background: Botanical omega-3 fatty acid (alpha-linolenic acid/ALA) has been shown to alleviate the prothrombotic and proinflammatory profile of metabolic syndrome, however clinical protocols are still scarce. Aiming to focus an obese population, a pilot study was designed. Methods: Morbidly obese candidates for bariatric surgery (n = 29, age 463 +/- 5.2 years), 82.8% females (24/29), BMI 44.9 +/- 5.2 kg/m(2), with C-reactive protein/CRP > 5 mg/L were recruited. Twenty were randomized and after exclusions, 16 were available for analysis. Flaxseed powder (60 g/day, 10 g ALA) and isocaloric roasted cassava powder (60 g/day, fat-free) were administered in a double-blind routine for 12 weeks. Results: During flaxseed consumption neutrophil count decreased and fibrinogen, complement C4, prothrombin time and carotid diameter remained stable, whereas placebo (cassava powder) was associated with further elevation of those measurements. Conclusions: Inflammatory and coagulatory markers tended to exhibit a better outlook in the flaxseed group. Also large-artery diameter stabilized whereas further increase was noticed in controls. These findings raise the hypothesis of a less deleterious cardiovascular course in seriously obese subjects receiving a flaxseed supplement. (Nutr Hosp. 2011;26:208-213) DOI:10.3305/nh.2011.26.1.4974
- Four-Year Hospital Resource Utilization After Bariatric Surgery: Comparison with Clinical and Surgical Controls(2011) HAYASHI, Silvia Yoko; FAINTUCH, Joel; FRANCA, Joao Italo Dias; CECCONELLO, IvanConsumption of healthcare has been shown to diminish after bariatric treatment, but utilization of hospital services has not been well documented. Aiming to assess this question, a retrospective study with females was designed. Yearly outpatient appointments, hospital admissions, emergency department visits, and total biochemical tests during 4 years were registered and compared with the preoperative year. Population (N = 176, all females) comprised 94 bariatric candidates submitted to Roux-en-Y gastric bypass (RYGB; age 41.4 +/- 10.1 years, BMI 52.2 +/- 10.6 kg/m(2)), 34 nonoperated obese controls (age 49.4 +/- 8.3 years, BMI 33.8 +/- 5.5 kg/m(2)), and 48 colorectal surgical controls (age 44.8 +/- 8.6 years, BMI 23.8 +/- 4.7 kg/m(2)). Nonbariatric obese patients were fairly well-matched, moderate differences involving higher age and comorbidities. Surgical controls were similarly aged but suffered from less comorbidities. Obese nonsurgical participants displayed the highest demand for outpatient visits (10.5 +/- 0.9/year, P < 0.001) followed by bariatric and colorectal cases (5.7 +/- 0.2 and 3.5 +/- 0.8, respectively, P = 0.042). Also biochemical measurements were most often required by clinical controls (61.5 +/- 5.1/year, P < 0.001), whereas no difference was detected between bariatric and colorectal patients (28.9 +/- 2.2 and 33.8 +/- 7.7/year, respectively). Elective and emergency admissions were similar for all groups, and part of the postbariatric assistance was related to plastic surgery. RYGB patients needed 45.8% less outpatient visits and 53.0% less laboratory tests than nonoperated moderately obese cases, even including esthetic operations. Results were comparable to those observed after elective colorectal surgery and remained fairly stable during 4 years.
- Systemic Inflammatory Reaction After Silicone Breast Implant(2011) SILVA, Maira M.; MODOLIN, Miguel; FAINTUCH, Joel; YAMAGUCHI, Camila M.; ZANDONA, Cintia B.; CINTRA JR., Wilson; FUJIWARA, Haroldo; CURI, Rui; GEMPERLI, Rolf; FERREIRA, Marcos C.Systemic inflammation after augmentation mammaplasty with modern silicone implants is not currently recognized. In a prospective controlled study, C-reactive protein and other variables were monitored, aiming to test this hypothesis in a young cohort of patients. Females (18-30 years old, BMI = 18.5-30 kg/m(2), N = 52) were consecutively recruited for breast implant (n = 24, Group I) and for abdominal liposuction (n = 28, Group II/Controls). Patients were interviewed at baseline and followed until 6 months after operation. Variables included demographic and clinical information, surgical outcome, inflammatory markers and autoantibodies. Operations were well tolerated, without surgical or infectious complications. Mean prosthesis size was 258 +/- A 21 ml (range = 220-280) and mean aspirate of liposuction was 1972 +/- A 499 ml (range = 1200-3000). Preoperative, 2-month, and 6-month C-reactive protein concentrations for breast implant patients were 1.3 +/- A 1.2, 4.8 +/- A 3.0, and 4.3 +/- A 6.4 mg/l and for liposuction 3.5 +/- A 2.7, 3.5 +/- A 2.1, and 2.2 +/- A 2.2 mg/l, respectively. Change at 2 months was significant (p = 0.001). Autoantibody investigation failed to reveal remarkable aberrations, except for anticardiolipin elevation, which was nearly symmetrical in the two groups. C-reactive protein levels increased after operation and correlated with proinflammatory and procoagulatory indices. A mild increase in anticardiolipin IgM occurred but differences between populations were lacking. Despite excellent cosmetic outcomes and lack of complications, acute phase reaction could signal ongoing immunogenicity of silicone and long-term monitoring is recommended.
- Hip fracture prognosis: could bioimpedance be an alternative to conventional nutritional assessment?(2011) SCHIPER, L.; SADIGURSKY, D.; ROSARIO, D. A. V.; SCHIPER, S. P.; PASSOS, L. C.; FAINTUCH, J.Background: Risk-factors for mortality in hip fractures encompass nutritional status, nominally body mass index, but not body composition. Given the difficulty of anthropometric assessment in bedridden patients a prospective study with bioimpedance analysis was designed. Methods: Elderly patients with hip fracture were consecutively recruited. Biochemical tests, primitive bioimpedance measurements (resistance, reactance and phase angle) and follow-up till one year were targeted. Results: Patients (N = 69, 81.2 +/- 8.1 years old, 72.5% females) stayed in the hospital for 15.5 +/- 17.1 days, and 18.8 %(13/69) required further hospitalization during the ensuing months. Mortality was 11.6% within 30 days, coinciding with hospital mortality, and an additional 11.6% till one year, thus reaching 23.2%. Anemia, hypoalbuminemia and low transferrin, along with elevated glucose and urea were frequent, suggesting undernutrition with metabolic derangements. Reactance, urea and creatinine were different in patients suffering both early and late demise. Resistance, white blood cell count and osteoporosis were risk factors for early mortality only, and anemia exclusively for late mortality. Conclusions: Primitive bioimpedance measurements, which had not been hitherto investigated, were prognostically related to early and late mortality. These markers of disease-related malnutrition and especially reactance should be further studied in patients unfit for anthropometric evaluation due to fracture and immobility.
- Inflammation and Biochemical Features of Bariatric Candidates: Does Gender Matter?(2011) MORAIS, Alvaro A. C.; FAINTUCH, Joel; LEAL, Ana A. D.; NOE, Joao A. B.; BERTOLLO, Diandria M.; MORAIS, Rafael C.; CABRINI, DanieleBackground Accumulated fat is an accepted trigger of inflammation and metabolic syndrome but specific biochemical associations in males and females are still debated. In a prospective study, multiple variables were analyzed to search for gender-related correlations. Methods Bariatric candidates (n=94) were consecutively investigated. Age was 34.9 +/- 10.4 years (68.1% females) and body mass index (BMI) was 40.8 +/- 4.6 kg/m(2). Methods included anthropometrics, inflammatory indices (C-reactive protein (CRP), white blood cell count (WBC), ferritin) and general biochemical profile. Results Ferritin, but not CRP or WBC, was substantially more elevated in males. Serum albumin, uric acid, creatinine, and liver enzymes AST and ALT were also higher in men. Even after BMI was adjusted, all differences remained significant, and several, notably ferritin, withstood waist circumference control. Ferritin and CRP correlated with anthropometrics, glucose-related measurements, and liver enzymes, whereas WBC was only associated with triglycerides in females. Conclusions (1) Males displayed more severe inflammation according to ferritin profile, and also more signs of liver derangement; (2) all differences continued after BMI discrepancies were adjusted for, and ferritin was significant also after control of waist girth; (3) in both genders inflammatory markers often correlated with different anthropometrics, liver enzymes, and markers of glucose homeostasis; and (4) inflammatory and biochemical gender-related dissimilarities might have prognostic implications for cardiovascular risk and other comorbidities, and deserve additional studies.
- Bioimpedance Analysis: Should it be Used in Morbid Obesity?(2011) LEAL, Ana A. D.; FAINTUCH, Joel; MORAIS, Alvaro A. C.; NOE, Joao A. B.; BERTOLLO, Diandria M.; MORAIS, Rafael C.; CABRINI, DanielleObjectives: Questions about reliability of bioimpedance analysis (BIA) in morbidly obese subjects have curtailed its use in this setting, but metabolic implications might reignite the debate. In a prospective study, it was aimed to analyze anthropometric and clinical associations. Methods: Bariatric candidates (n = 94) with or without metabolic syndrome were consecutively investigated. Age was 34.9 +/- 10.4 years (68.1% females), and BMI was 40.8 +/- 4.6 kg m(-2). Methods included single-frequency BIA, anthropometrics, inflammatory indices, and general biochemical profile. Results: Body composition results (water, fat) in females, but not in males, were entirely consistent with the literature. In both genders good association was observed with anthropometrics (BMI, waist circumference), inflammatory indices (ferritin, C-reactive protein) and general biochemical variables. Anthropometric measurements also displayed comparable associations. Multivariate tests including the two sets of measurements indicated no predominance of one method over the other, one complementing the other as metabolic marker. Conclusions: BIA limitations were mostly relevant for males, not females. Despite such discrepancies, good associations with anthropometry were demonstrated for both genders. Correlations with liver enzymes, and indices of protein, carbohydrate, and lipid metabolism could be demonstrated. BIA deserves more investigations concerning liver steatosis and ongoing inflammation, and it could contribute as well, synergistically with anthropometry, to monitor weight loss, body fat shifts, and metabolic risk. Am. J. Hum. Biol. 23: 420-422, 2011. (c) 2011 Wiley-Liss, Inc.
- B-1 cells temper endotoxemic inflammatory responses(2011) BARBEIRO, Denise Frediani; BARBEIRO, Hermes Vieira; FAINTUCH, Joel; ARIGA, Suely K. Kubo; MARIANO, Mario; POPI, Ana Flavia; SOUZA, Heraldo Possolo de; VELASCO, Irineu Tadeu; SORIANO, Francisco GarciaSepsis syndrome is caused by inappropriate immune activation due to bacteria and bacterial components released during infection. This syndrome is the leading cause of death in intensive care units. Specialized B-lymphocytes located in the peritoneal and pleural cavities are known as B-1 cells. These cells produce IgM and IL-10, both of which are potent regulators of cell-mediated immunity. It has been suggested that B-1 cells modulate the systemic inflammatory response in sepsis. In this study, we conducted in vitro and in vivo experiments in order to investigate a putative role of B-1 cells in a murine model of LPS-induced sepsis. Macrophages and B-1 cells were studied in monocultures and in co-cultures. The B-1 cells produced the anti-inflammatory cytokine IL-10 in response to LPS. In the B-1 cell-macrophage co-cultures, production of proinflammatory mediators (TNF-alpha, IL-6 and nitrite) was lower than in the macrophage monocultures, whereas that of IL-10 was higher in the co-cultures. Co-culture of B-1 IL-10(-/-) cells and macrophages did not reduce the production of the proinflammatory mediators (TNF-alpha, IL-6 and nitrite). After LPS injection, the mortality rate was higher among Balb/Xid mice, which are B-1 cell deficient, than among wild-type mice (65.0% vs. 0.0%). The Balb/Xid mice also presented a proinflammatory profile of TNF-alpha, IL-6 and nitrite, as well as lower levels of IL-10. In the early phase of LPS stimulation, B-1 cells modulate the macrophage inflammatory response, and the main molecular pathway of that modulation is based on IL-10-mediated intracellular signaling.