Felipe Monnerat Marino Rosa

EFFECTS OF LONG-TERM ROUX-EN-Y GASTRIC BYPASS ON BODY WEIGHT AND CLINICAL METABOLIC COMORBIDITIES IN BARIATRIC SURGERY SERVICE OF A UNIVERSITY HOSPITAL

ABSTRACT Background: Due to the high failure rate observed in the clinical treatment of morbid obesity an increase in bariatric surgery indications, as an alternative for the control of obesity and comorbidities, is noticeable. Aim: To evaluate the performance of type 2 diabetes mellitus, high blood pressure and dyslipidemia in patients submitted to Roux-en-Y gastric bypass in late follow-up. Methods: Retrospective analysis of 59 patients included in the bariatric surgery program. Anthropometric (height and body weight) and laboratory (LDLc, HDLc, VLDLc, triglyceride -TG - and glucose) data were collected on pre- and postoperative stages, through medical records. Results: Among the patients, 86% were female aged 43±11, of whom 52% had attended high school. The average postoperative time was 7±3 years. During the postoperative period, there were decreases of weight and body mass index, respectively (133±06 kg vs 91±04 kg p<0.05 e 49±74 kg/m2 vs 33±79 kg/m2, p<0.05). In comparison to the preoperative stage, lower concentrations of glucose (101.00±26.99 vs 89,11±15.19, p=0.014), total cholesterol rates (179.00±37,95 vs 167.48±28,50, p=0.016), LDLc (104.30±33.12 vs 91.46±24.58, p=0.016), VLDLc (25.40±11,12 vs 15.68±7.40, p<0.01), and TG (143.35±86.35 vs 82.45±37.39, p<0.01) and higher concentrations of HDLc (43.53±8.23 vs 57.90±15.60, p<0.01) were identified in the postoperative stage. 40% of hypertensive patients were still undergoing high blood pressure treatment during the postoperative stage. There was remission of type 2 diabetes mellitus and dyslipidemia on 81% and 94% of the cases, respectively. Conclusion: Roux-en-Y gastric bypass has proven itself to be an effective long term procedure, promoting weight loss, remission of DM2 and dyslipidemia.

EFEITOS NO LONGO PRAZO DA GASTROPLASTIA REDUTORA EM Y-DE-ROUX SOBRE O PESO CORPORAL E COMORBIDADES CLÍNICO METABÓLICAS EM SERVIÇO DE CIRURGIA BARIÁTRICA DE UM HOSPITAL UNIVERSITÁRIO

Racional: Em funcao do alto grau de falencia que se observa no tratamento clinico da obesidade morbida, observa-se um aumento da procura pela cirurgia bariatrica como alternativa para o controle da obesidade e comorbidades. Objetivo: Avaliar a evolucao do diabete melito tipo 2, da hipertensao arterial sistemica e da dislipidemia em pacientes submetidos a gastroplastia redutora em Y-de-Roux no periodo de pos-operatorio tardio. Metodos: Analise retrospectiva de 59 pacientes inseridos em programa de cirurgia bariatrica. Foram coletados dados antropometricos (altura e peso corporal) e laboratoriais (LDLc, HDLc, VLDLc, triglicerideo -TG - e glicose) nos periodos pre e pos-operatorio por meio de prontuarios medicos. Resultados: Entre os pacientes, 86% eram mulheres com idade de 43±11 anos e 52% tinham cursado o ensino medio. O tempo medio de pos-operatorio foi de 7±3 anos. Houve reducao no peso e no indice de massa corporal no pos-operatorio, respectivamente (133±06 kg vs 91±04 kg p<0,05 e 49±74 kg/m2 vs 33±79 kg/m2, p<0,05). Observou-se concentracoes inferiores no pos-operatorio, comparado com o pre-operatorio, da glicose (101,00±26,99 vs 89,11±15,19, p=0,014), colesterol total (179,00±37,95 vs 167,48±28,50, p=0,016), LDLc (104,30±33,12 vs 91,46±24,58, p=0,016), VLDLc (25,40±11,12 vs 15,68±7,40, p<0,01), e TG (143,35±86,35 vs 82,45±37,39, p<0,01) e maiores de HDLc (43,53±8,23 vs 57,90±15,60, p<0,01 ). No pos-operatorio 40% dos pacientes hipertensos ainda estavam em tratamento para hipertensao arterial sistemica. Houve remissao do diabete melito tipo 2 e da dislipidemia em 81% e 94% dos casos, respectivamente. Conclusao: A gastroplastia redutora em Y-de-Roux mostrou ser procedimento eficaz em longo prazo, com resultados persistentes na perda de peso, remissao do DM2 e da dislipidemia.

Perfil da composição corporal de mulheres com obesidade grau III pelo método de bioimpedância multipolar

OBJECTIVE To analyze a body composition profile in women with class III obesity using the multipolar bioimpedance method. METHODS Thirteen sedentary women aged between 20 and 40 years were evaluated. RESULTS The results show that the patients had a fat percentage of 51.9±1.50 % and lean mass of 48.1±1.50 %. Regarding fat mass and lean mass per body region, figures of 26.3±3.62kg and 26.2±2.91kg in the upper body, 9.1±0.06kg and 8.4±0.14kg in the lower limbs, and 3.3±0.02kg and 7.6±0.01kg in the upper limbs were obtained. Patients had a good symmetry between the left and right sides in both upper and lower limbs, besides of a muscular mass of 32.1±5.08kg, with a muscular mass index of 12.7±1.05kg/m2. CONCLUSION Higher fat accumulation was observed in the upper body region, followed by lower and upper limbs. Total muscular mass was apparently preserved, although sarcopenic obesity was not verified. Since this is a group of people that is still understudied, there is a need for further research on genetic and physical profile and caloric expenditure during exercise and rest.

Study of body composition, physiological variables in Grade III obese submitted to arm ergometer test

Study of body composition, physiological variables in Grade III obese submitted to arm ergometer test Felipe Monnerat Marino Rosa1,2, Renato Vidal Linhares2,4,6*, José Quaresma2, João Regis Ivar Carneiro2, Valéria Bender Braulio2,5, Roberto Simão1,3, Denise Pires de Carvalho2 and José Fernandes Filho1-3 1Programa de Pós Graduação em Educação Física da Universidade Federal do Rio de JaneiroRJ, Brasil 2Hospital Universitário Clementino Fraga Filho Universidade Federal do Rio de Janeiro-RJ, Brasil 3Escola de Educação Física e Desportos, Universidade Federal do Rio de Janeiro-RJ, Brasil 4Laboratório de Biociência do Movimento Humano (LABIMH), Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro-RJ, Brasil 5Laboratório de Nutrologia (LABONUTRO), Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro-RJ, Brasil 6Grupo de Pesquisa em Educação Física Escolar do Colégio Pedro II (GEPEFE), Colégio Pedro II do Rio de Janeiro-RJ, Brasil

Efectos de ejercicio físico agudo con ciclo ergómetro de miembros superiores en individuos con obesidad mórbida

Objective The purpose of this study is to research effects of acute exercise with cycle ergometers adapted for the upper limbs on physiological markers in the morbidly obese. Methods Ten morbidly obese patients participated in the study. They were submitted to thirty minutes of continuous activity on a cycle ergometer adapted to the upper limbs. The following physiological markers were evaluated: systemic arterial pressure, heart rate, the double product, and oxygen saturation. For the statistical analysis, descriptive analysis was used. Results Patients showed a Body Mass Index (BMI) value of 52.1 ± 8.3. Most of the subjects showed a slight reduction in systolic blood pressure (SBP) and diastolic blood pressure (DBP) after physical activity, with SBP before and after physical activity of 135.5±11.4 and 133.5±15.3 mmHg, respectively, and, for DBP, 83±7.5 and 77±7.1 respectively. The average heart rate was 68±10.4 bpm before, 100.6±16.5 bpm during and 80.7±14.5 bpm 1 minute after. The double product (DP) had a mean increase of 29.6±17.1 % in men and 10.4±8.9 % in women when compared with the initial phase. The oxygen saturation showed no mean difference before, during or after activity. Conclusion It can be concluded that acute physical exercise with an upper limbs cycle ergometer in morbidly obese patients does not represent an elevated risk to these patients, being in fact a good intervention to promote health.

Effects of acute exercise with upper body cycle ergometer in individuals with morbid obesity

Objective The purpose of this study is to research effects of acute exercise with cycle ergometers adapted for the upper limbs on physiological markers in the morbidly obese. Methods Ten morbidly obese patients participated in the study. They were submitted to thirty minutes of continuous activity on a cycle ergometer adapted to the upper limbs. The following physiological markers were evaluated: systemic arterial pressure, heart rate, the double product, and oxygen saturation. For the statistical analysis, descriptive analysis was used. Results Patients showed a Body Mass Index (BMI) value of 52.1 ± 8.3. Most of the subjects showed a slight reduction in systolic blood pressure (SBP) and diastolic blood pressure (DBP) after physical activity, with SBP before and after physical activity of 135.5±11.4 and 133.5±15.3 mmHg, respectively, and, for DBP, 83±7.5 and 77±7.1 respectively. The average heart rate was 68±10.4 bpm before, 100.6±16.5 bpm during and 80.7±14.5 bpm 1 minute after. The double product (DP) had a mean increase of 29.6±17.1 % in men and 10.4±8.9 % in women when compared with the initial phase. The oxygen saturation showed no mean difference before, during or after activity. Conclusion It can be concluded that acute physical exercise with an upper limbs cycle ergometer in morbidly obese patients does not represent an elevated risk to these patients, being in fact a good intervention to promote health.

Efeitos do exercício físico agudo em ciclo ergômetro de membros superiores em indivíduos com obesidade mórbida

Objective The purpose of this study is to research effects of acute exercise with cycle ergometers adapted for the upper limbs on physiological markers in the morbidly obese. Methods Ten morbidly obese patients participated in the study. They were submitted to thirty minutes of continuous activity on a cycle ergometer adapted to the upper limbs. The following physiological markers were evaluated: systemic arterial pressure, heart rate, the double product, and oxygen saturation. For the statistical analysis, descriptive analysis was used. Results Patients showed a Body Mass Index (BMI) value of 52.1 ± 8.3. Most of the subjects showed a slight reduction in systolic blood pressure (SBP) and diastolic blood pressure (DBP) after physical activity, with SBP before and after physical activity of 135.5±11.4 and 133.5±15.3 mmHg, respectively, and, for DBP, 83±7.5 and 77±7.1 respectively. The average heart rate was 68±10.4 bpm before, 100.6±16.5 bpm during and 80.7±14.5 bpm 1 minute after. The double product (DP) had a mean increase of 29.6±17.1 % in men and 10.4±8.9 % in women when compared with the initial phase. The oxygen saturation showed no mean difference before, during or after activity. Conclusion It can be concluded that acute physical exercise with an upper limbs cycle ergometer in morbidly obese patients does not represent an elevated risk to these patients, being in fact a good intervention to promote health.

O efeito anti-obesidade da Garcinia cambogia em humanos

Theme: Overweight affects more than one billion people in the world and the Garcinia cambogia´s phytotherapy is cited as a supporting tool for the treatment of obesity, but there are still gaps on dosage effects and side effects. Objective: To review the literature on the effects of Garcinia cambogia in the treatment of obesity. Methodology: A literature´s review was performed through searches in databases from two platforms: PubMed and SciELO, being selected only complete and free full text articles, from last ten years in English or Portuguese. Results and Discussion: There were considered nine articles for discussion, all indexed in PubMed in last years, including five reviews and four clinical trials. There was no consensus about beneficial effect of Garcinia cambogia regarding obesity and comorbidities in Humans. Conclusion: Studies show a positive effect from Garcinia cambogia on obesity control and comorbidity with low possibility to side effect. However there is still no consensus about this effect, dosage or side effect.

Effects of long-term reducing gastroplasty roux-y on body weight and clinical metabolic comorbidities in a bariatric surgery service of a university hospital

Background Obesity is a major public health issue in Brazil and in the world, increasing the rate of mortality due to comorbidities like: type-2 diabetes mellitus (DM2), arterial hypertension (AH), dyslipidemias, among others. Conventional obesity treatments show little effect in the long term, leading to an increase in the search for bariatric surgery as an alternative for the control and healing of comorbidities.