Rafael Jacques Ramos

Obesity depresses the anti‐inflammatory HSP70 pathway, contributing to NAFLD progression

To evaluate whether reduced activity of the anti‐inflammatory HSP70 pathway correlates with nonalcoholic fatty liver disease (NAFLD) progression and with markers of oxidative stress because obesity activates inflammatory JNKs, whereas HSP70 exerts the opposite effect.

EFFECT OF SIZE OF INTESTINAL DIVERSIONS IN OBESE PATIENTS WITH METABOLIC SYNDROME SUBMITTED TO GASTRIC BYPASS

ABSTRACT Background: There is no consensus on the ideal size of intestinal loops in gastric bypass of bariatric surgeries. Aim: To evaluate the metabolic outcome of patients submitted to gastric bypass with alimentary and biliopancreatic loops of different sizes. Methods: Was conducted a retrospective cohort study in diabetic obese patients (BMI≥35 kg/m2) with metabolic syndrome submitted to gastric bypass. The patients were divided into three groups according to the size of the intestinal loop: group 1, biliopancreatic limb 50 cm length and alimentary limb 100 cm length; group 2 , biliopancreatic limb 50 cm length and alimentary limb 150 cm length; and group 3, biliopancreatic limb 100 cm length and alimentary limb 150 cm length. The effect of gastric bypass with different sizes of intestinal loops in relation to the parameters that define metabolic syndrome was determined. Results: Sixty-three patients were evaluated, and they had a mean age of 44.7±9.4 years. All were diabetics, with 62 (98.4%) being hypertensive and 51 (82.2%) dyslipidemic. The three groups were homogeneous in relation to the variables. In 24 months, there was a remission of systemic arterial hypertension in 65% of patients in group 1, 62.5% in group 2 and 68.4% in group 3. Remission of diabetes occurred in 85% of patients in group 1, 83% in group 2 and 84% in group 3. There was no statistical difference in %LEW between the groups, and waist measurements decreased in a homogeneous way in all groups. The size of loops also had no influence on the improvement in dyslipidemia. Conclusion: Variation in size of intestinal loops does not appear to influence improvement in metabolic syndrome in this group of patients.

Utilização do Sistema Prolene de Hérnia (SPH) para o reparo de hérnias inguinais

OBJETIVO: Aferir complicacoes pos-operatorias imediatas e tardias em pacientes portadores de hernia inguinal, submetidos a correcao cirurgica pela tecnica de Gilbert1, com utilizacao do Sistema Prolene de Hernia (SPH). METODOS: Foram pesquisados todos os pacientes submetidos a herniorrafia inguinal com tela PHS no Hospital Sao Lucas da PUCRS no periodo de janeiro de 2001 ate ourubro de 2006. As informacoes foram coletadas de modo retrospectivo, atraves de contato telefonico e revisao de prontuarios. O protocolo de coleta de dados contemplou os aspectos epidemiologicos, bem como as complicacoes imediatas e tardias. RESULTADOS: Foram incluidos 96 pacientes. Foram identificadas seis (6,25%) complicacoes, em pacientes distintos; nenhuma complicacao com obito. Dois pacientes (2,08%) apresentaram seroma; hematoma foi identificado em um paciente (1,04%); um paciente (1,04%) apresentou infeccao de ferida operatoria. Dois pacientes (2,08%) apresentaram edema escrotal. Apos seguimento medio de 49,25 meses (16-86,12) dois pacientes (2,08%) apresentaram dor cronica e um paciente (1,04%) apresentou recorrencia, com vinte e seis meses de pos-operatorio. CONCLUSAO: O reparo de hernias inguinais com tela PHS e um metodo seguro, eficaz, facilmente reprodutivel e com baixas taxas de complicacoes, recorrencia ou sintomas em longo prazo.