Sustainable Production of Propionic acid and Derivatives on Industrial Scale.

Propionic acid is, after acetic, formic and 2-ethylhexanoic acids, the fourth largest industrially produced carboxylic acid in terms of capacity. In the last decades the technology to produce propionic acid has evolved and more efficient, i. e. more sustainable processes, based on the hydroformylation of ethylene to propionaldehyde and subsequent oxidation with O2 to propionic acid are capturing the growing capacity for this product. For this reason, a perspective is given on developments in sustainable production of propionic acid and derivatives on industrial scale, which is based on a recently published chapter on the same topic in the Ullmann' Encyclopedia of Industrial Chemistry.

Sustainability in Industrial Processes.

Thoughts of Claudia Ley, Editor-in-Chief of Ullmann's Encyclopedia of Industrial Chemistry, and Henrique Teles, board member of ChemSusChem and Ullmann's Encyclopedia, on the progress that is being made in industrial chemistry, which is as important as progress made in academia.

Impact of air pollution on the health of the older adults during physical activity and sedentary behavior: A systematic review.

BACKGROUND: Air pollution, in addition to presenting health risks, can impact the practice of physical activity (PA) and sedentary behavior (SB) in older adults. This study analyzed the impact of air pollution on the health of older adults during PA and SB, through a systematic review. METHODS: A keyword and reference search was performed in PubMed, SCOPUS, SPORTDiscus, and Web of Science. Predetermined selection criteria included study designs: interventions or experiments, retrospective or prospective cohort studies, cross-sectional studies and case-control studies; population: older adults aged 60 years or older; exposures: specific air pollutants (particulate matter (PM), nitrogen dioxide (NO2), ozone (O3), carbon monoxide (CO), sulfur dioxide (SO2), black carbon (CN), ultrafine particles (PU), nitrogen oxides (NOx) and biomass fuels) indoors and outdoors; and outcomes: physical activity and/or sedentary behavior. RESULTS: The beneficial effects of PA were attenuated or harmed in 11 studies, showing negative impacts on the health of the older adults, mainly by PM2.5 pollutants. On the other hand, in 10 studies the effects of PA were greater than the negative effects of air pollutants, with a greater frequency in relation to PM2.5. In general, even the articles presenting controversial results suggest that practicing PA in polluted environments is more favorable to the health of older adults than remaining in SB. DISCUSSION AND CONCLUSIONS: On the one hand, air pollution negatively impacted the health of the older adults during PA practices, while on the other hand, PA can mitigate the negative effects of pollutants on the health of older adults during the practices. Evidence shows that practicing PA in environments with low concentrations of pollutants can provide gains and reduce health risks. Remaining in SB in environments with high levels of air pollution worsens the health of older adults.

Effects of resistance training on sleep of patients with fibromyalgia: A systematic review.

This study investigated the effects of resistance training (RT) on the sleep quality of patients with fibromyalgia (FM), through a systematic review. The search was carried out in the PubMed, Embase, Scopus, and Web of Science databases. Initially, 148 studies were found, of which six were included for qualitative analysis. Four studies showed significant improvement in sleep after RT. Compared to other exercise modalities, RT proved to be superior to flexibility training and equivalent to aerobic exercise. Interventions lasted from 4 to 21 weeks, the weekly frequency ranged from two to three times, and the intensity ranged from 40% to 80% 1RM, with exercises for the major muscle groups. RT is an intervention that can be used to treat FM, however, more studies are needed to verify its effectiveness in improving sleep.

Effects of resistance training on the physical symptoms and functional capacity of patients with fibromyalgia: a systematic review and meta-analysis of randomized clinical trials.

BACKGROUND: Resistance training (RT) has become an important topic for the treatment of fibromyalgia (FM); however, there are still controversies regarding its ability to significantly improve physical symptoms and a lack of adequate recommendations for evidence-based practice. AIM: The aim of this study is to analyze the effects of RT on the physical symptoms of patients with FM through a systematic review with meta-analysis. METHODS: We conducted a systematic review of randomized controlled trials in June 2022, according to PRISMA recommendations. The searches were carried out on the databases PubMed, Embase, Science Direct, Web of Science, PEDro, CINAHL, SciELO, and Google Scholar for gray literature, and the protocol was recorded in PROSPERO. Studies that evaluated patients with FM undergoing an RT program lasting more than 2 weeks and that analyzed physical health were selected. To carry out the meta-analysis, the recommendations of the Cochrane Handbook for Systematic Reviews of Interventions were followed. RESULTS: In total, 13 studies were included for qualitative analysis and nine for meta-analysis. Regarding meta-analysis, a favorable improvement was found for pain ([MD = - 10.22 (95% CI: - 18.86 to - 1.58; I2: 64%; P for heterogeneity: 0.003)]; very low quality of evidence {QoE}), fatigue ([SMD = - 0.39 (95% CI: - 0.61 to - 0.17; I2: 0%; P = 0.91)]; moderate QoE), and muscle strength ([SMD = 0.94 (95% CI: 0.02 to 1.85; I2: 93%; for heterogeneity: < 0.0001)]; very low QoE) and improvement in functional capacity ([MD = 18.75 (95% CI: 4.27 to 33.22; I2: 39%; P = 0.19)]; low QoE), in the general comparison. CONCLUSION: RT was effective in reducing pain and fatigue and increasing strength and functional capacity; however, due to the quality of the evidence, more studies are needed.

COVID-19 in the Perioperative Period of Cardiovascular Surgery: the Brazilian Experience.

INTRODUCTION: We investigated the clinical course and outcomes of patients submitted to cardiovascular surgery in Brazil and who had developed symptoms/signs of coronavirus disease 2019 (COVID-19) in the perioperative period. METHODS: A retrospective multicenter study including 104 patients who were allocated in three groups according to time of positive real time reverse transcriptase-polymerase chain reaction (RT-PCR) for the SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2): group 1, patients who underwent cardiac surgery > 10 days after positive RT-PCR; group 2, patients with a positive RT-PCR within 10 days before or after surgery; group 3, patients who presented positive RT-PCR > 10 days after surgery. The primary outcome was mortality and secondary outcomes were postoperative complications, intensive care unit (ICU) length of stay, and postoperative days of hospitalization. RESULTS: The three groups were similar with respect to age, the European System of Cardiac Operative Risk Evaluation score, and comorbidities, except hypertension. Postoperative complications and death were significantly higher in groups 2 and 3 than in group 1, and no significant difference between groups 2 and 3 was seen. Group 2 showed a high prevalence of surgery performed as an urgent procedure. Although no significant differences were observed in ICU length of stay, total postoperative hospitalization time was significantly higher in group 3 than in groups 1 and 2. CONCLUSION: COVID-19 affecting the postoperative period of patients who underwent cardiovascular surgery is associated with a higher rate of morbidity and mortality. Delaying procedures in RT-PCR-positive patients may help reduce risks of perioperative complications and death.

COVID-19 in the perioperative period of cardiovascular surgery: the brazilian experience

Abstract Introduction: We investigated the clinical course and outcomes of patients submitted to cardiovascular surgery in Brazil and who had developed symptoms/signs of coronavirus disease 2019 (COVID-19) in the perioperative period. Methods: A retrospective multicenter study including 104 patients who were allocated in three groups according to time of positive real time reverse transcriptase-polymerase chain reaction (RT-PCR) for the SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2): group 1, patients who underwent cardiac surgery > 10 days after positive RT-PCR; group 2, patients with a positive RT-PCR within 10 days before or after surgery; group 3, patients who presented positive RT-PCR > 10 days after surgery. The primary outcome was mortality and secondary outcomes were postoperative complications, intensive care unit (ICU) length of stay, and postoperative days of hospitalization. Results: The three groups were similar with respect to age, the European System of Cardiac Operative Risk Evaluation score, and comorbidities, except hypertension. Postoperative complications and death were significantly higher in groups 2 and 3 than in group 1, and no significant difference between groups 2 and 3 was seen. Group 2 showed a high prevalence of surgery performed as an urgent procedure. Although no significant differences were observed in ICU length of stay, total postoperative hospitalization time was significantly higher in group 3 than in groups 1 and 2. Conclusion: COVID-19 affecting the postoperative period of patients who underwent cardiovascular surgery is associated with a higher rate of morbidity and mortality. Delaying procedures in RT-PCR-positive patients may help reduce risks of perioperative complications and death.

Did social isolation due to COVID-19 interfere with the quality of sleep and excessive daytime sleepiness in individuals with grade III obesity about to enter a surgical prehabilitation program? An observational study.

Social isolation (SI) can have negative effects on health, although little is known about the SI consequences on patients with grade III obesity and even less if they are entering a prehabilitation program. OBJECTIVE: the present study analyzes the effects of SI determined by the SARS-CoV-2 pandemic in people with grade III obesity who about to enter a prehabilitation program for bariatric surgery. METHODS: Five patients with grade III obesity who entered a prehabilitation program or which had to be stopped on March 17th, 2020 were evaluated. Excessive daytime sleepiness (EDS) (Epworth Sleepiness Scale - ESS) and sleep quality (SQ) (Pittsburgh Sleep Quality Index - PSQI) were investigated. Data collection took place in the week before the SI government decree and after 30 and 90 days of SI. Statistical analysis was performed using SPSS 20.0 and GraphPad Prism 8.0. The Friedman test was used to verify the difference between the times and a significance level of p < 0.05 was adopted. RESULTS: with SI, EDS improved by 8 points after 30 days and 3 points after 90 days (p < 0.05). The PSQI did not change (p = 0.819). CONCLUSION: the SI improved the EDS of individuals with grade III obesity entering the prehabilitation program, but did not change complementing their SQ. The improvement in EDS may be related to a longer daily sleep time provided by the SI and the lower number of daily work commitments. Measures to improve the SQ of these patients should be considered, including remote forms.

Can optoelectronic plethysmography be used to evaluate the thoracoabdominal kinematics of people with morbidly obesity? A systematic review.

BACKGROUND: Optoelectronic Plethysmography (OEP) is an effective method for evaluating thoracoabdominal kinematics. However, little is known about the viability and use the OEP in people with obesity. OBJECTIVE: Summarize information on the use and feasibility of OEP in the assessment of thoracoabdominal kinematics in people with obesity. METHODS: Studies were identified through PubMed, EMBASE, Science Direct, Web of Science and Scopus databases in the February 2021. RESULTS: Six studies met the inclusion criteria. The studies used the OEP to assess abdominal and thoracic mobility in obese people of different BMI, using the default setting. No study reported the impossibility of using OEP in people with obesity. CONCLUSION: Has been shown that it is possible to use the OEP in people with obesity with a BMI of up to 50 kg/m2. More studies are needed to demonstrate the feasibility of the method in people with a BMI greater than this value.

Effects of air pollution on health: A mapping review of systematic reviews and meta-analyses.

BACKGROUND: There has been a notable increase in knowledge production on air pollution and human health. OBJECTIVE: To analyze the state of the art on the effects of air pollution on human health through a mapping review of existing systematic reviews and meta-analyses (SRs and MAs). METHODS: The systematic mapping review was based on the recommendations for this type of scientific approach in environmental sciences. The search was performed using PubMed, Web of Science, Scopus, Cinahl, and Cochrane Library databases, from their inception through June 2020. RESULTS: Among 3401 studies screened, 240 SRs and MAs satisfied the inclusion criteria. Five research questions were answered. There has been an overall progressive increase in publications since 2014. The majority of the SRs and MAs were carried out by researchers from institutions in China, the US, the UK, and Italy. Most studies performed a meta-analysis (161). In general, the reviews support the association of air pollution and health outcomes, and analyzed the effects of outdoor air pollution. The most commonly investigated health outcome type was the respiratory (mainly asthma and COPD), followed by cardiovascular outcomes (mainly stroke). Particulate matter (with a diameter of 2.5 µm (PM2.5) and 10 µm (PM10) or less) and nitrogen dioxide (NO2) were the most widely investigated pollutants in the reviews. The general population was the most common sample in the reviews, followed by children, and adults. The majority of the reviews investigated health outcomes of respiratory diseases in children, as well as cardiovascular diseases in all ages. Combining health outcomes and air pollutants, PM2.5 was included in a higher number of reviews in eight health outcomes, mainly cardiovascular diseases. DISCUSSION: The majority of SRs and MAs showed that air pollution has harmful effects on health, with a focus on respiratory and cardiovascular outcomes. Future studies should extend the analysis to psychological and social aspects influenced by air pollution.

Relationship between handgrip strength, peripheral muscle strength, and respiratory muscle endurance in women with fibromyalgia: a cross-sectional study / Relação entre força de preensão manual, força muscular periférica e resistência muscular respiratória em mulheres com fibromialgia: um estudo transversal

Fibromyalgia (FM) is a disease characterized by generalized and chronic musculoskeletal pain. It is common, the presence of other symptoms such as fatigue, depression, sleep disorders, leading patients to adopt a sedentary lifestyle. Objective: Verify the muscular and respiratory strength of women with FM. Method: Is a cross-sectional study that evaluated 41 women with clinical diagnosis of FM. We analyzed handgrip strength (HS), the strength of the lower limbs, and respiratory muscle endurance using the spirometric maneuver. Results: Patients with FM had a significant reduction in HS, both in the dominant and non-dominant upper limb. Furthermore, peripheral muscle strength in the lower limbs was reduced because on average, participants exceeded the normative five-repetition sit-to-stand test times stipulated for the age groups. Approximately two-thirds of the sample had maximal voluntary ventilation values below the lower limit of normality. We detected inverse and moderate correlation between peripheral muscle strength and HS of non-dominant upper limb (r= −0.472; p= 0.002) and inverse and weak correlation with the HS of dominant upper limb (r= −0.374; p= 0.016); weak correlations between respiratory muscle endurance and HS of dominant upper limb (r= 0.299; p= 0.058), HS of non-dominant upper limb (r= −0.317; p= 0.043), and peripheral muscle strength (r= −0.372, p= 0.017); and strong correlation between HS of dominant upper limb and non-dominant upper limb (r= 0.899; p<0.001). Conclusion: Women with FM present with reduced muscle strength in the upper and lower limbs, as well as lower respiratory muscle resistance.

A Fibromialgia (FM) é uma doença caracterizada por dor musculoesquelética generalizada e crônica. É comum a presença de outros sintomas como fadiga, depressão, distúrbios do sono, levando os pacientes a adotarem um estilo de vida sedentário. Objetivo: Verificar a força muscular e respiratória de mulheres com FM. Método: Estudo transversal que avaliou 41 mulheres com FM. Analisamos a força de preensão manual (FPM), a força de membros inferiores e a resistência dos músculos respiratórios por meio da manobra espirométrica. Resultados: Pacientes com FM tiveram redução significativa da FPM, tanto no membro superior dominante quanto não dominante. A força muscular periférica dos membros inferiores foi reduzida porque, em média, os participantes excederam tempos normativos do teste de levantar e sentar estipulados para as faixas etárias. Aproximadamente dois terços da amostra apresentavam valores máximos de ventilação voluntária abaixo do limite inferior da normalidade. Detectamos correlação inversa e moderada entre força muscular periférica e FPM do membro superior não dominante (r= −0,472; p= 0,002) e correlação inversa e fraca com a FPM do membro superior dominante (r= −0,374; p= 0,016); correlações fracas entre resistência muscular respiratória e FPM do membro superior dominante (r= 0,299; p= 0,058), FPM do membro superior não dominante (r= -0,317; p= 0,043) e força muscular periférica (r= -0,372, p= 0,017); e forte correlação entre FPM de membro superior dominante e membro superior não dominante (r= 0,899; p<0,001). Conclusão: Mulheres com FM apresentam redução da força muscular de membros superiores e inferiores, bem como da resistência dos músculos respiratórios inferiores.

Effects of resistance training on the mental health of patients with fibromyalgia: a systematic review.

Fibromyalgia is a chronic disease characterized by generalized skeletal muscle pain and the presence of mental disorders is common among patients. As there is no cure, several treatment alternatives have been investigated, including the practice of resistance training. Thus, the aim of the current study is to analyze the effects of resistance training on the mental health of patients with fibromyalgia. This is a systematic review of the literature that followed the recommendations of the PRISMA statement. The search for articles occurred in May 2020 in the databases PubMed, Embase, Science Direct, Web of Science, PEDro, and CINAHL, as well as Google Scholar for gray literature. The protocol was recorded in PROSPERO and assessment of quality was performed using the Cochrane tool. In total, 481 studies were found in the database searches, of which seven were included in the analysis. The only variables investigated in studies related to mental health were depression and anxiety. The results demonstrate that resistance training reduces symptoms of depression and anxiety in patients with fibromyalgia. It is concluded that resistance training is efficient to improve the mental health of patients with fibromyalgia, reducing depression and anxiety. The main limitation is that few variables related to mental health were analyzed. Key Points • Resistance training improves the mental health of patients with FM. • The most commonly studied variables related to mental health are depression and anxiety. • The study protocols are similar, starting with low-intensity training and gradually increasing the intensity.

Efficient epoxidation over dinuclear sites in titanium silicalite-1.

Titanium silicalite-1 (TS-1) is a zeolitic material with MFI framework structure, in which 1 to 2 per cent of the silicon atoms are substituted for titanium atoms. It is widely used in industry owing to its ability to catalytically epoxidize olefins with hydrogen peroxide (H2O2), leaving only water as a byproduct1,2; around one million tonnes of propylene oxide are produced each year using this process3. The catalytic properties of TS-1 are generally attributed to the presence of isolated Ti(IV) sites within the zeolite framework1. However, despite almost 40 years of experimental and computational investigation4-10, the structure of these active Ti(IV) sites is unconfirmed, owing to the challenges of fully characterizing TS-1. Here, using a combination of spectroscopy and microscopy, we characterize in detail a series of highly active and selective TS-1 propylene epoxidation catalysts with well dispersed titanium atoms. We find that, on contact with H217O2, all samples exhibit a characteristic solid-state 17O nuclear magnetic resonance signature that is indicative of the formation of bridging peroxo species on dinuclear titanium sites. Further, density functional theory calculations indicate that cooperativity between two titanium atoms enables propylene epoxidation via a low-energy reaction pathway with a key oxygen-transfer transition state similar to that of olefin epoxidation by peracids. We therefore propose that dinuclear titanium sites, rather than isolated titanium atoms in the framework, explain the high efficiency of TS-1 in propylene epoxidation with H2O2. This revised view of the active-site structure may enable further optimization of TS-1 and the industrial epoxidation process.

Synthesis of Mono- and Dinuclear Vanadium Complexes and Their Reactivity toward Dehydroperoxidation of Alkyl Hydroperoxides.

Several vanadium(V) complexes with either dipic-based or Schiff base ligands were synthesized. The complexes were fully characterized by elemental analysis, IR, 1H, 13C, and 51V NMR spectroscopy, as well as mass spectrometry and X-ray diffraction. Furthermore, they were tested toward their catalytic deperoxidation behavior and a significant difference between 4-heptyl hydroperoxide and cyclohexyl hydroperoxide was observed. In the case of 4-heptyl hydroperoxide, the selectivity toward the corresponding ketone was higher than with cyclohexyl hydroperoxide. DFT calculations performed on the vanadium complex showed that selective decomposition of secondary hydroperoxides with vanadium(V) to yield the corresponding ketone and water is indeed energetically feasible. The computed catalytic path, involving cleavage of the O-O bond, hydrogen transfer, release of ketone/water, and finally addition of hydroperoxide, can proceed without the generation of radical species.

Industrial Applications of Gold Catalysis.

Gold catalysis has recently found its first large-scale applications in the chemical industry. This Minireview provides a critical analysis of the success factors and of the main obstacles that had to be overcome on the long way from the discovery to the commercialization of gold catalysts. The insights should be useful to researchers in both academia and industry working on the development of tomorrow's gold catalysts to tackle significant environmental and economic issues.

Clean Transformation of Ethanol to Useful Chemicals. The Behavior of a Gold-Modified Silicalite Catalyst.

Upon addition of gold to silicalite-1 pellets (a MFI-type zeolite), the vapor phase oxidation of ethanol could be addressed to acetaldehyde or acetic acid formation. By optimizing the catalyst composition and reaction conditions, the conversion of ethanol could be tuned to acetaldehyde with 97% selectivity at 71% conversion or to acetic acid with 78% selectivity at total conversion. Considering that unloaded silicalite-1 was found to catalyze the dehydration of ethanol to diethylether or ethene, a green approach for the integrated production of four important chemicals is herein presented. This is based on renewable ethanol as a reagent and a modular catalytic process.

BARIATRIC SURGERY IN THE ELDERLY: RESULTS OF A MEAN FOLLOW-UP OF FIVE YEARS.

BACKGROUND: Surgical treatment of obesity in the elderly, particularly over 65, remains controversial; it is explained by the increased surgical risk or the lack of data demonstrating its long-term benefit. Few studies have evaluated the clinical effects of bariatric surgery in this population. AIM: To evaluate the results of surgical treatment of obesity in patients over 60 years, followed for an average period of five years. METHOD: This was a retrospective study evaluating 46 patients, 60 years or older, who underwent surgical treatment of obesity, by conventional gastric bypass technique (laparotomy). The average age was 64 years (60-71), mean BMI of 49.6 kg/m2 (38-66), mean follow-up of 5.9 years; 91% of patients were hypertensive, 56% diabetics and 39% had dyslipidemia. RESULTS: The incidence of complications (major and minor) in patients under 65 years was 26% and over 65 years 37% (p=0.002). There were no deaths in the group with less than 65 years and there were two deaths (12.5%) over 65 years. The average loss of overweight over 65 years or less was 72% vs 68% (p=0.56). There was total control of the diabetes mellitus in 77% and partial in 23%, with no difference between groups. There was improvement in arterial hypertension in 56% of patients, also no difference between groups. The average LDL levels did not differ between the pre and postoperative (106 mg/dl to 102 mg/dl), an increase of HDL (56 mg/dl to 68 mg/dL) and reduced triglyceride levels (136 mg/dl to 109 mg/dl). There was no statistical difference in the variation of the cholesterol fractions and triglycerides between the groups. Two patients in the group with less than 65 years died in late follow-up, of brain tumor and pneumonia, three and five years after bariatric surgery, respectively. CONCLUSIONS: Surgical morbidity and mortality were higher in patients over 65 years, and this group had the same benefits observed in patients lower 65 years for weight loss and comorbidities control.

BARIATRIC SURGERY IN THE ELDERLY: RESULTS OF A MEAN FOLLOW-UP OF FIVE YEARS / CIRURGIA BARIÁTRICA EM IDOSOS: RESULTADOS DE SEGUIMENTO DE CINCO ANOS

Background: Surgical treatment of obesity in the elderly, particularly over 65, remains controversial; it is explained by the increased surgical risk or the lack of data demonstrating its long-term benefit. Few studies have evaluated the clinical effects of bariatric surgery in this population.Aim: To evaluate the results of surgical treatment of obesity in patients over 60 years, followed for an average period of five years. Method: This was a retrospective study evaluating 46 patients, 60 years or older, who underwent surgical treatment of obesity, by conventional gastric bypass technique (laparotomy). The average age was 64 years (60-71), mean BMI of 49.6 kg/m2 (38-66), mean follow-up of 5.9 years; 91% of patients were hypertensive, 56% diabetics and 39% had dyslipidemia. Results: The incidence of complications (major and minor) in patients under 65 years was 26% and over 65 years 37% (p=0.002). There were no deaths in the group with less than 65 years and there were two deaths (12.5%) over 65 years. The average loss of overweight over 65 years or less was 72% vs 68% (p=0.56). There was total control of the diabetes mellitus in 77% and partial in 23%, with no difference between groups. There was improvement in arterial hypertension in 56% of patients, also no difference between groups. The average LDL levels did not differ between the pre and postoperative (106 mg/dl to 102 mg/dl), an increase of HDL (56 mg/dl to 68 mg/dL) and reduced triglyceride levels (136 mg/dl to 109 mg/dl). There was no statistical difference in the variation of the cholesterol fractions and triglycerides between the groups. Two patients in the group with less than 65 years died in late follow-up, of brain tumor and pneumonia, three and five years after bariatric surgery, respectively. Conclusions: Surgical morbidity and mortality were higher in patients over 65 years, and this group had the same benefits observed in patients lower 65 years for weight loss and comorbidities control.

Racional: O tratamento cirúrgico da obesidade em idosos, em particular nos indivíduos com mais de 65 anos, permanece controverso; seja pelo risco cirúrgico aumentado ou pela ausência de dados que demonstrem seu benefício em longo prazo.Objetivo: Avaliar os resultados do tratamento cirúrgico em pacientes com mais de 60 anos, seguidos por um período médio de cinco anos. Método: Estudo retrospectivo que avaliou 46 pacientes com 60 anos ou mais, submetidos ao bypass gástrico convencional (laparotomia). A idade média foi de 64 anos (60-71), IMC médio de 49,6 kg/m2 (38-66), tempo médio de seguimento de 5,9 anos. Pacientes eram hipertensos eram 91%, diabéticos 56% e 39% tinham dislipidemia.Resultados: A incidência de complicações (maiores e menores) nos com menos de 65 anos foi de 26% e com mais de 65 anos de 37% (p=0,002). Não houve óbitos no grupo com menos de 65 anos e houve dois óbitos (12,5%) no com mais de 65. A perda média de excesso de peso nos pacientes com mais ou menos de 65 anos foi de 72% x 68% (p=0,56). Houve controle total do diabete melito em 77% dos pacientes e parcial em 23%, sem diferença entre os grupos com mais ou menos de 65 anos. Houve melhora da hipertensão arterial em 56% dos pacientes também sem diferença entre os grupos. Os níveis médios de LDL não variaram entre o pré e pós-operatório (106 mg/dl para 102 mg/dl), houve aumento do HDL (56 mg/dl para 68 mg/dl) e redução do triglicérides (136 mg/dl para 109 mg/dl). Não houve diferença estatística na variação das frações de colesterol e triglicerídeos entre os grupos. Dois pacientes do grupo com menos de 65 anos morreram no seguimento tardio por tumor cerebral e pneumonia, três e cinco anos após a cirurgia bariátrica, respectivamente. Conclusões: A morbimortalidade cirúrgica nos pacientes com mais de 65 anos foi maior. Mas, os acima de 65 tiveram os mesmos benefícios observados nos com menos de 65 anos, em relação à perda de peso e controle de comorbidades.