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1.
Arq. gastroenterol ; 54(1): 60-64, Jan.-Mar. 2017. tab
Artigo em Inglês | LILACS-Express | ID: biblio-838819

RESUMO

ABSTRACT BACKGROUND -In recent decades, the high prevalence of obesity in the general population has brought serious concerns in terms of public health. Contrarily to conventional treatment involving dieting and physical exercising, often ineffective in generating long term results, bariatric opera­tions have been an effective method for sustained weight loss in morbidly obese individuals. The Bariatric Analysis and Reporting Outcome System (BAROS) is an objective and recognized system in the overall evaluation of results after bariatric surgery. OBJECTIVE To investigate results concerning a casuistic of morbidly obese patients undergoing bariatric surgery over a 2-year follow-up in terms of weight loss, related medical conditions, safety and changes in quality of life. METHODS A total of 120 obese (17 male and 103 female) patients, who underwent bariatric surgery, were assessed and investigated using the BAROS system after a 2- year follow-up. RESULTS Patients obtained a mean excess weight loss of 74.6 (±15.9) % and mean body mass index reduction of 15.6 (±4.4) Kg/m2. Pre-surgical comorbidities were present in 71 (59%) subjects and they were totally (86%) or partially (14%) resolved. Complications resulting specifically from the surgical procedure were observed in 4.2% of cases (two bowel obstructions requiring re-operation, and three stomal stenosis treated with endoscopic dilation). Sixteen subjects (13% of total number of patients) presented minor clinical complications managed through outpatient care. The final scores for the BAROS questionnaire showcased excellent to good results in 99% of cases (excellent 44%, very good 38%, good 23%, acceptable 1%). CONCLUSION According to the BAROS questionnaire, bariatric surgery is a safe and effective method for managing obesity and associated clinical comorbidities, allowing for satisfactory results after a 2-year follow-up. Future studies should address other clinical and psychosocial variables that impact outcome as well as allow for longer follow-ups.


RESUMO CONTEXTO Nas últimas décadas, a alta prevalência de obesidade na população geral trouxe grandes preocupações para a saúde pública. Contrariamente ao tratamento convencional envolvendo dieta e atividade física, quase sempre inefetivo em gerar resultados a longo prazo, a cirurgia bariátrica vem se mostrando um método efetivo de perda de peso mantida em indivíduos com obesidade mórbida. O Bariatric Analysis and Reporting Outcome System (BAROS) é um sistema reconhecido e objetivo para a avaliação global de resultados depois de cirurgia bariátrica. OBJETIVO Investigar os resultados referentes à casuística de pacientes obesos mórbidos submetidos à cirurgia bariátrica em um período de 2 anos em termos de perda de peso, condições clínicas relacionadas, segurança e qualidade de vida. MÉTODOS Um total de 120 pacientes obesos (17 masculinos e 103 femininos) admitidos consecutivamente durante período de 4 meses para cirurgia bariátrica foram avaliados e investigados usando o sistema BAROS após 2 anos de evolução. RESULTADOS Os pacientes apresentaram redução média percentual de excesso de peso de 74,6 (±15,9) % e redução média de índice de massa corporal de 15,6 (±4,4) Kg/m2. Comorbidades pré-cirúrgicas estavam presentes em 71 (59%) pacientes e em todos eles foram total (86%) ou parcialmente (14%) resolvidas. Complicações resultantes especificamente do procedimento cirúrgico foram observadas em 4,2% dos casos (duas obstruções intestinais exigindo reoperação e três estenoses anastomóticas resolvidas com dilatação endoscópica). Dezesseis (13%) pacientes apresentaram complicações clínicas menores resolvidas com manejo clínico ambulatorial. Os escores totais do BAROS classificaram os resultados como excelente até bom em 99% dos casos (44% excelente, 38% muito bom e 23% bom) e aceitável em 1% dos casos. CONCLUSÃO De acordo com o questionário BAROS, a cirurgia bariátrica se mostrou segura e efetiva no controle da obesidade e de comorbidades clínicas associadas, permitindo satisfação geral dos pacientes após 2 anos de seguimento. Estudos futuros deverão também investigar outras variáveis clínicas e psicossociais de possível impacto na evolução e por períodos de seguimento mais longos.

2.
Arq Gastroenterol ; 54(1): 60-64, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28079242

RESUMO

BACKGROUND:: -In recent decades, the high prevalence of obesity in the general population has brought serious concerns in terms of public health. Contrarily to conventional treatment involving dieting and physical exercising, often ineffective in generating long term results, bariatric opera-tions have been an effective method for sustained weight loss in morbidly obese individuals. The Bariatric Analysis and Reporting Outcome System (BAROS) is an objective and recognized system in the overall evaluation of results after bariatric surgery. OBJECTIVE: - To investigate results concerning a casuistic of morbidly obese patients undergoing bariatric surgery over a 2-year follow-up in terms of weight loss, related medical conditions, safety and changes in quality of life. METHODS: - A total of 120 obese (17 male and 103 female) patients, who underwent bariatric surgery, were assessed and investigated using the BAROS system after a 2- year follow-up. RESULTS: - Patients obtained a mean excess weight loss of 74.6 (±15.9) % and mean body mass index reduction of 15.6 (±4.4) Kg/m2. Pre-surgical comorbidities were present in 71 (59%) subjects and they were totally (86%) or partially (14%) resolved. Complications resulting specifically from the surgical procedure were observed in 4.2% of cases (two bowel obstructions requiring re-operation, and three stomal stenosis treated with endoscopic dilation). Sixteen subjects (13% of total number of patients) presented minor clinical complications managed through outpatient care. The final scores for the BAROS questionnaire showcased excellent to good results in 99% of cases (excellent 44%, very good 38%, good 23%, acceptable 1%). CONCLUSION: - According to the BAROS questionnaire, bariatric surgery is a safe and effective method for managing obesity and associated clinical comorbidities, allowing for satisfactory results after a 2-year follow-up. Future studies should address other clinical and psychosocial variables that impact outcome as well as allow for longer follow-ups.


Assuntos
Cirurgia Bariátrica/psicologia , Obesidade Mórbida/cirurgia , Satisfação do Paciente/estatística & dados numéricos , Qualidade de Vida , Adulto , Cirurgia Bariátrica/efeitos adversos , Feminino , Humanos , Masculino , Estudos Retrospectivos , Inquéritos e Questionários , Fatores de Tempo , Resultado do Tratamento , Perda de Peso
3.
Eur Arch Psychiatry Clin Neurosci ; 265(2): 167-70, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-24831601

RESUMO

Glycogen synthase kinase-3B (GSK-3B) is involved with important neuronal processes such as cell survival, gene regulation, mood and cognitive performance. This enzyme is inactivated by phosphorylation at the phospho-Ser9 site. We compared GSK-3B levels in patients with schizophrenia to a health control group. The levels of phosphorylated and total GSK-3B in platelets of ten drug-free patients, ten long-term olanzapine treated patients and 20 healthy controls were determined by means of an enzyme immunoassay kit. In drug-free patients, GSK-3B levels were accessed again after 8 weeks on treatment with olanzapine. At baseline, drug-free patients presented lower phosphorylated and total GSK-3B levels than healthy controls (p < 0.05). After 8 weeks on olanzapine treatment, phosphorylated and total GSK-3B levels were significantly increased (p < 0.01). Reduced phospho-Ser9-GSK-3B in schizophrenia may disrupt signal-transduction pathways and influence crucial cellular processes, such as transcription, apoptosis, stress response and cell proliferation. Further studies should clarify whether the increment of GSK-3B phosphorylation by olanzapine is related to its antipsychotic effects.


Assuntos
Antipsicóticos/uso terapêutico , Benzodiazepinas/uso terapêutico , Plaquetas/enzimologia , Quinase 3 da Glicogênio Sintase/metabolismo , Esquizofrenia/sangue , Esquizofrenia/tratamento farmacológico , Adulto , Plaquetas/efeitos dos fármacos , Feminino , Regulação Enzimológica da Expressão Gênica/efeitos dos fármacos , Humanos , Masculino , Pessoa de Meia-Idade , Olanzapina , Fosforilação/efeitos dos fármacos , Escalas de Graduação Psiquiátrica , Estatísticas não Paramétricas , Fatores de Tempo
4.
Obes Surg ; 24(10): 1647-55, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-24682805

RESUMO

BACKGROUND: A significant proportion of patients who undergo bariatric surgery fail to achieve enduring weight loss. Previous studies suggest that psychosocial variables affect postoperative outcome, although this subject is still considered unclear. The purpose of this study is to further investigate the impact of psychosocial variables on Roux-en-Y gastric bypass (RYGB) outcomes over long-term follow-up. MATERIALS AND METHODS: Individuals eligible for bariatric surgery were evaluated using validated psychopathological scales and the Temperament and Character Inventory in a specialized clinic for bariatric treatment. Adult patients who had RYGB were selected for the study. Percent of excess weight loss (%EWL) was measured after surgery at 6 months, 1 year, 2 years, and on the last clinical observation. RESULTS: This study included 333 subjects who had RYGB. Before surgery, mean age was 35.4 years (±9.5) and mean BMI was 43.3 kg/m(2) (±4.8). Higher baseline age and BMI were associated with lower %EWL across endpoints, although this association diminished over time. Follow up at 2 years and on the last clinical observation demonstrated that lower scores on the persistence personality variable and lower body dissatisfaction before surgery predicted lower %EWL. CONCLUSIONS: Psychosocial variables and personality traits assessed during preoperative evaluation significantly predicted weight loss after bariatric surgery. Greater impact was observed in long-term follow-up at 2 years. These findings provide guidance in identifying patients at risk for worse outcomes and designing interventions to improve long-term weight loss.


Assuntos
Derivação Gástrica/psicologia , Obesidade Mórbida/cirurgia , Personalidade , Adulto , Feminino , Seguimentos , Derivação Gástrica/efeitos adversos , Derivação Gástrica/reabilitação , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade Mórbida/psicologia , Inventário de Personalidade , Prognóstico , Psicometria , Temperamento , Resultado do Tratamento , Perda de Peso
5.
Inflammation ; 37(1): 142-5, 2014 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-24005899

RESUMO

Neuropeptides are an extremely conserved arm of neurobiology. Despite their effects as neurohormones and neurotransmitters, a multitude of other effects have been described, putting in evidence their importance as regulators of immune responses, such as chemotaxis, oxidative burst, pro-inflammatory signaling, and many others. The effects of neuropeptides in the pathophysiology of sepsis, however, remain poorly investigated. A prospective cohort study to investigate the effects of neuropeptides in sepsis was carried out. Here, we describe that neuropeptides are downregulated during septic shock. We propose that it may be a protective mechanism of the host to avoid further inflammatory injury.


Assuntos
Inflamação/fisiopatologia , Neuropeptídeos/biossíntese , Choque Séptico/fisiopatologia , Estudos de Coortes , Regulação para Baixo , Humanos , Hidrocortisona/sangue , Melatonina/sangue , Neurotensina/sangue , Ocitocina/sangue , Estudos Prospectivos , Substância P/sangue , alfa-MSH/sangue
7.
Rev. psiquiatr. clín. (São Paulo) ; 29(5): 228-236, 2002. tab
Artigo em Português | LILACS | ID: lil-332630

RESUMO

A classificacao das psicoses endogenas de Leonhard permite a constituicao de subpopulacoes amostrais mais homogeneas sob o ponto de vista clinico e prognostico. O presente artigo constitui uma revisao sintetica dos principais...


Assuntos
Humanos , Esquizofrenia , Transtornos Psicóticos/classificação , Eletrofisiologia , Neurofisiologia , Neuropsicologia , Prognóstico , Psicofarmacologia , Esquizofrenia , Transtornos Psicóticos/genética
8.
Rev. psiquiatr. clín. (São Paulo) ; 29(5): 237-247, 2002. tab
Artigo em Português | LILACS | ID: lil-332631

RESUMO

Os autores discutem os principais achados de neuroimagem envolvendo diagnosticos das psicose endogenas de Karl Leonhard, enfatizando a hipotese de que os aspectos clinicos e nosologicos possam oferecer subtipo mais homogeneos a investigacao neurofisiologica. Os estudos com...


Assuntos
Humanos , Diagnóstico por Imagem/métodos , Esquizofrenia , Transtornos Psicóticos/classificação , Tomografia Computadorizada de Emissão/métodos , Tomografia Computadorizada por Raios X
9.
Rev. psiquiatr. clín. (São Paulo) ; 29(3): 135-149, 2002. tab
Artigo em Português | LILACS | ID: lil-318006

RESUMO

O artigo apresenta uma sintese dos subtipos nosologicos descritos por Karl Leonhard na sua classificacao das psicoses endogenas, comumente arrolados sob o diagnostico de esquizofrenia ou transtorno esquizofrenico nos sistemas diagnosticos internacionais (DSM e CID). Leonhard subdivide as doencas do espectro esquizofrenico em ....


Assuntos
Esquizofrenia , Transtornos Psicóticos/classificação , Diagnóstico Diferencial , Esquizofrenia , Transtornos Psicóticos/diagnóstico
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