Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 14.596
Filtrar
1.
Medicine (Baltimore) ; 100(6): e24309, 2021 Feb 12.
Artigo em Inglês | MEDLINE | ID: mdl-33578526

RESUMO

INTRODUCTION: Morbid obesity (body mass index > 40 kg/m2) is a risk factor for the development of left ventricular systolic dysfunction (LVSD) and can complicate the management of LVSD. Bariatric surgery is increasingly recognized as a safe and effective way to achieve marked weight loss, but studies on improving LVSD populations are limited. We retrospectively analyzed the first case of the Asia-Pacific region with morbid obesity and left ventricular ejection fraction (LVEF) < 50% who underwent bariatric surgery at our medical center. PATIENT CONCERNS: The patient was admitted to the hospital due to progressive weight gain for more than 10 years. The patient used to be in good health. One year before admission, the patient was hospitalized in another hospital due to shortness of breath. After the relevant examination, the patient was diagnosed with dilated cardiomyopathy. DIAGNOSIS: The body mass index of the patient was 45.9 kg/m2, and the patient was diagnosed with morbid obesity. He was diagnosed with dilated cardiomyopathy and cardiac function class IV in another hospital. After completing a preoperative examination, the patient was diagnosed with hyperuricemia, hyperlipidemia, fatty liver disease and severe sleep apnea. INTERVENTIONS: The patient successfully underwent laparoscopic sleeve gastrectomy plus jejunal bypass. OUTCOMES: Six months after the surgery, patient weight lost was 33.6 kg, and the LVEF increased from 31% to 55%. The cardiac function of the patient recovered from class IV to class I, and the patient's hyperuricemia, hyperlipidemia and sleep apnea were significantly improved. CONCLUSION: Bariatric surgery may be a safe and effective intervention for morbidly obese patients with LVSD. Bariatric surgery was associated with an improvement in LVEF. However, the specific mechanism still needs further study.


Assuntos
Cirurgia Bariátrica/efeitos adversos , Cardiomiopatia Dilatada/fisiopatologia , Obesidade Mórbida/cirurgia , Disfunção Ventricular Esquerda/fisiopatologia , Adulto , Ásia/epidemiologia , Cirurgia Bariátrica/métodos , Índice de Massa Corporal , Cardiomiopatia Dilatada/diagnóstico , Humanos , Masculino , Obesidade Mórbida/complicações , Obesidade Mórbida/diagnóstico , Estudos Retrospectivos , Volume Sistólico/fisiologia , Resultado do Tratamento , Disfunção Ventricular Esquerda/etiologia , Função Ventricular Esquerda/fisiologia , Perda de Peso/fisiologia
2.
BMC Surg ; 21(1): 86, 2021 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-33588802

RESUMO

BACKGROUND: This study aimed to reevaluate the learning curve of laparoscopic Roux-en Y gastric bypass (LRYGB) in the modern era while considering a single surgeon's experience. METHODS: From the beginning of our LRYGB practice, all patients who met the regional criteria and underwent primary LRYGB were retrospectively enrolled. Patients with a body mass index (BMI) > 50 kg/m2 were excluded. Those who underwent surgery in 2016-17, 2018 and 2019 by a single surgeon with 10 + years of laparoscopic experience were assigned to groups A, B and C, respectively. The patient demographics and 30-day outcome data, including the operation time, length of stay (LOS), emergency room visits, readmission, and reoperation, were compared among the groups. RESULTS: One hundred and eight patients met the inclusion criteria; 36, 38, and 34 patients were assigned to groups A, B and C, respectively. There were no differences in age, sex distribution or common comorbidities among the groups; however, B had a lower BMI (35.1 kg/m2 vs. 37.0 kg/m2) and a higher rate of hypertension (44.7% vs. 22.2%) than group A. The operation time was markedly reduced (96.1 min and 114.9 min, p < 0.001), and the LOS was shortened (2.2 days and 2.9 days, p < 0.001) in group B compared to group A and remained stationary in group C, with no further reduction in 30-day complications. CONCLUSION: The learning process of LRYGB can be shortened to approximately 30 cases if conducted selectively by experienced laparoscopic surgeons. Further follow-up is required to verify the long-term safety and applicability in other patient subgroups.


Assuntos
Derivação Gástrica , Laparoscopia , Obesidade Mórbida/cirurgia , Humanos , Curva de Aprendizado , Tempo de Internação/economia , Complicações Pós-Operatórias/epidemiologia , Estudos Retrospectivos , Resultado do Tratamento
5.
MMW Fortschr Med ; 163(1): 28, 2021 01.
Artigo em Alemão | MEDLINE | ID: mdl-33464499
6.
Rev Col Bras Cir ; 48: e20202666, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-33503141

RESUMO

INTRODUCTION: bariatric surgery is currently the only treatment that leads to long-term and sustained weight loss and decreased morbidity and mortality in morbidly obese individuals. Roux-en-Y bypass causes weight loss by restricting food intake associated with reduced intestinal absorption, in addition to multiple endocrine and satiogenic effects. Biliopancreatic diversion promotes weight loss mainly due to poor absorption of the nutrients ingested. Both procedures exclude parts of the gastrointestinal tract. OBJECTIVE: to describe four cases of revisional surgery after primary bariatric surgery, due to serious nutritional complications, and to review the literature regarding this subject. METHODS: a retrospective analysis of patients of Unicamps bariatric center database and review of the literatures were performed. RESULTS: four patients were identified, 2 women and 2 men, with a mean age of 48 years. The mean body mass index before revisional surgery was 23.7 kg/m2. Three patients underwent Scopinaro biliopancreatic diversion, and onde patient underwent Roux-en-Y gastric bypass. The revisional surgeries were revision, conversion, and reversion. One patient died. For the review of the literature 12 articles remained (11 case reports and 1 case series). Another five important original articles were included. CONCLUSION: fortunately, revision surgery is rarely necessary, but when indicated it has increased morbidity, It can be revision, reverion or conversion according to the severity of the patient and the primary surgery performed.


Assuntos
Cirurgia Bariátrica/efeitos adversos , Cirurgia Bariátrica/métodos , Desnutrição/etiologia , Obesidade Mórbida/cirurgia , Complicações Pós-Operatórias/cirurgia , Reoperação , Feminino , Derivação Gástrica , Humanos , Laparoscopia , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Estudos Retrospectivos , Resultado do Tratamento
7.
Arq Bras Cir Dig ; 33(3): e1549, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-33470379

RESUMO

BACKGROUND: Strongly associated with obesity, non-alcoholic fatty liver disease is considered the hepatic manifestation of the metabolic syndrome. It presents as simple steatosis and steatohepatitis, which can progress to cirrhosis and its complications. Among the therapeutic alternatives is bariatric surgery. AIM: To compare the effect of the two most frequent bariatric procedures (sleeve and bypass) on liver disease regarding to epidemiological, demographic, clinical and laboratory parameters. METHODS: The results of intraoperative and 12 months after surgery liver biopsies were used. The NAFLD activity score (NAS) was used to assess and compare the stages of liver disease. RESULTS: Sixteen (66.7%) patients underwent Bypass procedure and eight (33.3%) Sleeve. It was observed that the variation in the NAFLD activity score was significantly greater in the Bypass group than in Sleeve (p=0.028) and there was a trend regarding the variation in fibrosis (p=0.054). CONCLUSION: Both surgical techniques were effective in improving the hepatic histology of most operated patients. When comparing sleeve and bypass groups, bypass showed better results, according to the NAS score.


Assuntos
Cirurgia Bariátrica/métodos , Derivação Gástrica/métodos , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Obesidade Mórbida/cirurgia , Perda de Peso , Adulto , Biópsia , Feminino , Gastrectomia , Humanos , Masculino , Pessoa de Meia-Idade , Hepatopatia Gordurosa não Alcoólica/complicações , Hepatopatia Gordurosa não Alcoólica/fisiopatologia , Hepatopatia Gordurosa não Alcoólica/cirurgia , Obesidade Mórbida/complicações , Fatores de Risco , Resultado do Tratamento
8.
Arq Bras Cir Dig ; 33(4): e1553, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-33503113

RESUMO

BACKGROUND: Gastroesophageal reflux (GER) is one of the most common indications for conversion of sleeve gastrectomy (LSG) to laparoscopic Roux-en-Y gastric bypass (LRYGBP). Objective evaluations are necessary in order to choose the best definitive treatment for these patients. AIM: To present and describe the findings of the objective studies for gastroesophageal reflux disease performed before LSG conversion to LRYGBP in order to support the indication for surgery. METHOD: Thirty-nine non-responder patients to proton pump inhibitors treatment after LSG were included in this prospective study. They did not present GER symptoms, esophagitis or hiatal hernia before LSG. Endoscopy, radiology, manometry, 24 h pH monitoring were performed. RESULTS: The mean time of appearance of reflux symptoms was 26.8+24.08 months (8-71). Erosive esophagitis was found in 33/39 symptomatic patients (84.6%) and Barrett´s esophagus in five. (12.8%). Manometry and acid reflux test were performed in 38/39 patients. Defective lower esophageal sphincter function was observed independent the grade of esophagitis or Barrett´s esophagus. Pathologic acid reflux with elevated DeMeester´s scores and % of time pH<4 was detected in all these patients. more significant in those with severe esophagitis and Barrett´s esophagus. Radiologic sleeve abnormalities were observed in 35 patients, mainly cardia dilatation (n=18) and hiatal hernia (n=11). Middle gastric stricture was observed in only six patients. CONCLUSION: Patients with reflux symptoms and esophagitis or Barrett´s esophagus after SG present defective lower esophageal sphincter function and increased acid reflux. These conditions support the indication of conversion to LRYGBP.


Assuntos
Gastrectomia/efeitos adversos , Derivação Gástrica/efeitos adversos , Refluxo Gastroesofágico/etiologia , Laparoscopia/efeitos adversos , Obesidade Mórbida/cirurgia , Adulto , Feminino , Gastrectomia/métodos , Refluxo Gastroesofágico/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos
9.
Cir. Esp. (Ed. impr.) ; 99(1): 4-10, ene. 2021. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-192835

RESUMO

La pandemia SARS-CoV-2 ha tenido un gran impacto en todo el mundo, siendo España uno de los países más afectados. La demora en la cirugía bariátrica puede tener consecuencias fatales, ya que hasta el 50% de los pacientes que se encuentran en lista de espera desarrollan una nueva comorbilidad durante el tiempo que permanecen en ella y el 1,5% de pacientes fallecen mientras esperan la intervención. Es por ello por lo que la cirugía bariátrica no debe demorarse en cuanto la ocupación del hospital por pacientes COVID-19+ disminuya de forma significativa y se disponga de recursos y seguridad suficiente para realizar la cirugía en pacientes con patología benigna. Este documento recoge las principales recomendaciones para los programas de cirugía bariátrica en nuestro país desde el punto de vista tanto de seguridad como de preparación y seguimiento del paciente bariátrico en el contexto de la pandemia SARS-CoV-2


The SARS-CoV-2 pandemic has a great impact worldwide, being Spain one of the most affected countries. The delay in bariatric surgery can have fatal consequences since up to 50% of the patients who are on the waiting list develop a new comorbidity during the time they remain on it and 1.5% of patients die while waiting for the intervention. That is why bariatric surgery should not be delayed, if the occupation of the hospital by COVID-19+ patients decreases significantly, and sufficient resources and safety are available to restart surgery in patients with benign pathology. This document contains the main recommendations for the bariatric surgery programs in our country from the point of view of safety, bariatric patient preparation and follow up during the SARS-CoV-2 pandemia


Assuntos
Humanos , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Pandemias , Obesidade Mórbida/cirurgia , Cirurgia Bariátrica/normas , Prioridades em Saúde/normas , Seleção de Pacientes , Seguimentos , Segurança do Paciente , Fatores de Risco
10.
Adv Exp Med Biol ; 1307: 299-320, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-32072474

RESUMO

Obesity is a major factor in the worldwide rise in the prevalence of type 2 diabetes mellitus. The obesity "epidemic" will require novel, effective interventions to permit both the prevention and treatment of diabetes caused by obesity. Laparoscopic vertical sleeve gastrectomy is a newer bariatric surgical procedure with a lower risk of complications (compared to Roux-en-Y gastric bypass surgery). Based in part on restriction of daily caloric intake, sleeve gastrectomy has a major role in inducing significant weight loss and weight loss is maintained for at least 10 years. Prior studies have supported the utility of the vertical sleeve gastrectomy for the treatment and management of subgroups of individuals with diabetes mellitus. There are reports of 11% to 76.9% of obese individuals discontinuing use of diabetic medications in studies lasting up to 8 years after vertical sleeve gastrectomy. Major ongoing issues include the preoperative determination of the suitability of diabetic patients to undergo this bariatric surgical procedure. Understanding how this surgical procedure is performed and the resulting anatomy is important when vertical sleeve gastrectomy is being considered as a treatment option for diabetes. In the postoperative periods, specific macronutrient goals and micronutrient supplements are important for successful and safer clinical results. An understanding of immediate- and long term- potential complications is important for reducing the potential risks of vertical sleeve gastrectomy. This includes the recognition and treatment of postoperative nutritional deficiencies and disorders. Vertical sleeve gastrectomy is a component of a long term, organized program directed at treating diabetes related to obesity. This approach may result in improved patient outcomes when vertical sleeve gastrectomy is performed to treat type 2 diabetes in obese individuals.


Assuntos
Diabetes Mellitus Tipo 2 , Gastrectomia , Derivação Gástrica , Obesidade Mórbida , Adulto , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/cirurgia , Humanos , Laparoscopia , Obesidade Mórbida/cirurgia , Resultado do Tratamento
11.
Adv Exp Med Biol ; 1307: 321-330, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-32200501

RESUMO

Bariatric surgery is currently the most effective weight loss treatment of severe obesity and its associated comorbidities and is being increasingly used to treat children and adolescents with severe obesity, including those with Type 2 Diabetes (T2D). This review focuses on the conventional management of T2D in children and adolescents, comparison of various types of bariatric surgeries, effect of bariatric surgery on gastrointestinal physiology and metabolism, current literature on the use of bariatric surgery to treat youth with severe obesity and T2D, and the potential complications of bariatric surgery in this population.


Assuntos
Cirurgia Bariátrica , Diabetes Mellitus Tipo 2 , Derivação Gástrica , Laparoscopia , Obesidade Mórbida , Adolescente , Cirurgia Bariátrica/efeitos adversos , Criança , Diabetes Mellitus Tipo 2/cirurgia , Humanos , Obesidade Mórbida/cirurgia , Resultado do Tratamento , Perda de Peso
12.
BMJ Case Rep ; 13(12)2020 Dec 22.
Artigo em Inglês | MEDLINE | ID: mdl-33370962

RESUMO

Portomesenteric thrombosis is an important but rarely reported complication following bariatric surgery. It has been suggested that the incidence of portal vein thrombosis is directly related to many risk factors inherent in the bariatric population as well as factors related to local and systemic effects of laparoscopic surgery. Possible aetiologies vary from systemic inherited hypercoagulable states to a direct inflammatory reaction of portosystemic vessels. Here we present a case report of a 47-year-old obese women who underwent a robotic sleeve gastrectomy with subsequent development of a main portal vein, complete right intrahepatic portal vein and splenic vein thrombosis ultimately found to have a compound mutation of the methylenetetrahydrofolate reductase C677T and A1298C alleles.


Assuntos
Cirurgia Bariátrica/efeitos adversos , Obesidade Mórbida/cirurgia , Complicações Pós-Operatórias/diagnóstico , Procedimentos Cirúrgicos Robóticos/efeitos adversos , Trombose Venosa/diagnóstico , Dor Abdominal/etiologia , Anticoagulantes/administração & dosagem , Cirurgia Bariátrica/métodos , Feminino , Heparina/administração & dosagem , Humanos , Veias Mesentéricas/diagnóstico por imagem , Pessoa de Meia-Idade , Veia Porta/diagnóstico por imagem , Complicações Pós-Operatórias/tratamento farmacológico , Complicações Pós-Operatórias/etiologia , Pirazóis/administração & dosagem , Piridonas/administração & dosagem , Tomografia Computadorizada por Raios X , Trombose Venosa/tratamento farmacológico , Trombose Venosa/etiologia
13.
Rev Fac Cien Med Univ Nac Cordoba ; 77(4): 223-228, 2020 12 01.
Artigo em Espanhol | MEDLINE | ID: mdl-33351384

RESUMO

Introduction: bariatric surgery has proven to be the most effective treatment for weight reduction. The weight regain is expected in any type of surgery, and within them, the roux en Y gastric by pass (GBP) appears to be the one with the lowest weight increase compared to sleeve gastrectomy (SG). Materials and Methods: it was an observational retrospective cohort study. 167 patients undergoing bariatric surgery, GBP and SG, were analyzed between 2012 and 2017. Patients older than 18 years with a diagnosis of type 2 diabetes mellitus and obesity were selected. The main variable, weight (kg), was measured longitudinally at 6 months,1 and 5 years. Results: it was detected that there was weight regain between the first and fifth postoperative year with both techniques used but it was significantly for SG. Conclusion: both types of surgeries achieved significant weight loss, however the regimen existed and was significant for the SG group.


Assuntos
Cirurgia Bariátrica , Derivação Gástrica , Argentina , Diabetes Mellitus Tipo 2/cirurgia , Hospitais , Humanos , Obesidade Mórbida/cirurgia , Estudos Retrospectivos , Resultado do Tratamento , Ganho de Peso
14.
BMC Surg ; 20(1): 329, 2020 Dec 14.
Artigo em Inglês | MEDLINE | ID: mdl-33317506

RESUMO

BACKGROUND: Few articles have studied individuals with prediabetes after sleeve gastrectomy. Bile acid and lipid levels remain inconsistent in postbariatric patients. The purpose of this study was to explore bile acid, glucose, lipid, and liver enzyme changes in patients with different diabetes statuses who underwent sleeve gastrectomy. The impact of bariatric surgery and its potential benefits for prediabetic patients was also discussed. METHODS: A total of 202 overweight and obese patients who underwent bariatric surgery in our hospital between January 2016 and October 2018 were retrospectively reviewed. Patients were divided into prediabetes (n = 32), nondiabetes (n = 144), and diabetes (n = 26) groups and analysed. Glucose and lipid data were collected from medical records at baseline and at each follow-up visit. RESULT: Significant improvements in body weight, glucose and lipid levels, and liver enzymes (P ≤ 0.05) in prediabetic patients were found throughout the first year postoperatively. Improvement in glycaemic control was first seen one month postoperatively, followed by persistent improvement in the next 12 months. Total bile acid (TBA) decreased, which was associated with ALT improvement in prediabetic patients 1-year post-surgery. There were no significant differences in HbA1c, glucose, or triglycerides (TGs) between prediabetic and T2DM patients or between prediabetic and nondiabetic patients at 12 months post-surgery. CONCLUSION: LSG is highly effective at interfering with glucose and lipid levels as well as total bile acid levels in prediabetic patients in the first year postoperatively. Thus, LSG is indeed an alternative for overweight and obese prediabetic patients.


Assuntos
Ácidos e Sais Biliares , Glicemia , Diabetes Mellitus Tipo 2/cirurgia , Gastrectomia/efeitos adversos , Obesidade Mórbida/cirurgia , Estado Pré-Diabético/cirurgia , Adulto , Diabetes Mellitus Tipo 2/sangue , Feminino , Humanos , Laparoscopia , Metabolismo dos Lipídeos , Lipídeos/sangue , Masculino , Pessoa de Meia-Idade , Estado Pré-Diabético/sangue , Estudos Retrospectivos , Resultado do Tratamento
16.
Front Public Health ; 8: 582699, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33313038

RESUMO

Background: From the beginning of March 2020, lockdown regimens prevented patients with obesity from receiving bariatric surgery. Surgical emergencies and oncological procedures were the only operations allowed in public hospitals. Consequently, patients with morbid obesity were put in a standby situation. With the aim at exploring the viewpoint of our future bariatric surgery patients, we built a questionnaire concerning obesity and COVID-19. Method: A total of 116 bariatric surgery candidates were approached using a telephonic interview during the Italian lockdown. Results: Of the total sample, 73.8% were favorable to regular bariatric surgery execution. Forty percent were concerned about their own health status due to the COVID-19 emergency, and 61.1% were troubled by the temporary closure of the bariatric unit. The majority of the sample were eating more. Forty-five percent and the 27.5% of patients reported a worsening of the emotional state and physical health, respectively. Most of the patients (52.2%) considered themselves more vulnerable to COVID-19, especially individuals with class III obesity. Patients who reported an increased consumption of food were younger (43.44 ± 12.16 vs. 49.18 ± 12.66; F = 4.28, p = 0.042). No gender difference emerged. Conclusion: The lockdown had a negative result on Italian patients' psychological well-being and eating habits. The majority of patients would have proceeded with the surgery even during the COVID-19 emergency. Effective management and bariatric surgery should be restarted as soon as possible.


Assuntos
Cirurgia Bariátrica/estatística & dados numéricos , Comportamento Alimentar/psicologia , Saúde Mental , Obesidade Mórbida/cirurgia , Listas de Espera , Adulto , Cirurgia Bariátrica/psicologia , Feminino , Humanos , Entrevistas como Assunto , Itália , Masculino , Pessoa de Meia-Idade , Obesidade Mórbida/psicologia , Pacientes/estatística & dados numéricos , Inquéritos e Questionários
17.
Ter Arkh ; 92(6): 53-59, 2020 Jul 09.
Artigo em Russo | MEDLINE | ID: mdl-33346493

RESUMO

AIM: To study the effect of weight loss in the short term after bariatric surgery (BO) on metabolic parameters and glomerular filtration rate (GFR) in patients with morbid obesity. MATERIALS AND METHODS: We studied 40 adult (over 18 years) patients with morbid obesity who underwent bariatric surgery. Metabolic indices and calculated GFR according to the CKD-EPI formula in patients before and after bariatric surgery were compared. RESULTS: In the whole group of operated patients, the average body mass index (BMI) after surgery decreased from 45.8 to 30.5 kg/m2. In 11 (92%) patients with impaired carbohydrate metabolism, remission of diabetes mellitus was achieved and sugar-lowering drugs were canceled. In patients with baseline GFR90 ml/min/1.73 m2 after surgery, there is a tendency towards a decrease in GFR, probably due to a decrease in hyperfiltration. In patients with baseline GFR90 ml/min/1.73 m2 after surgery, a statistically significant increase in the level of GFR was noted. The greater metabolic efficacy of combined operations (mini-gastric bypass, biliopancreatic diversion) in relation to the correction of carbohydrate and fat metabolism was revealed. CONCLUSION: Obesity is a modifiable risk factor for decreased kidney function and the progression of chronic kidney disease. Bariatric surgery is an effective treatment for morbid obesity. The study proved the positive effect of weight loss after BO on renal function, including by improving the course of diseases associated with obesity.


Assuntos
Cirurgia Bariátrica , Obesidade Mórbida , Insuficiência Renal Crônica , Adulto , Cirurgia Bariátrica/efeitos adversos , Taxa de Filtração Glomerular , Humanos , Obesidade Mórbida/cirurgia , Perda de Peso
18.
Acta Ortop Mex ; 34(1): 47-52, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33231000

RESUMO

INTRODUCTION: Anterior dislocation is a rare complication of total hip arthroplasty (THA). There exist only three cases in the literature. None of them report disassembly of the prosthesis components. We present a morbidly obese woman who suffered an irreducible obturator dislocation of an infected total hip arthroplasty (THA), due to uncontrolled adduction during an early debridement surgery. Following unsuccessful closed reduction attempts, a Vancouver B2 periprosthetic fracture and disassembly of the prosthetic components were observed. Two-stage revision THA was necessary to resolve the infection and restore hip functionality. In obturator dislocation, the femoral head prosthetic can be trapped in the obturator foramen, and this may disassemble the prosthesis components during reduction maneuvers; theres also risk of periprosthetic fracture. This mandate an open reduction of the joint. Patient obesity could be a determining factor for this rare type of hip arthroplasty dislocation. Obturator dislocation is an extremely rare complication of the total hip arthroplasty, whose reductions should be handled with caution given the risks of periprosthetic fractures. In most cases, an open reduction of the joint is required. CLINICAL IMPORTANCE: Our work is likely to be of great interest because it offers tips for the management of this rare complication based on our experience.


Assuntos
Artroplastia de Quadril , Fraturas do Fêmur , Luxação do Quadril , Prótese de Quadril , Obesidade Mórbida , Fraturas Periprotéticas , Artroplastia de Quadril/efeitos adversos , Feminino , Fraturas do Fêmur/cirurgia , Luxação do Quadril/etiologia , Luxação do Quadril/cirurgia , Prótese de Quadril/efeitos adversos , Humanos , Obesidade Mórbida/complicações , Obesidade Mórbida/cirurgia , Fraturas Periprotéticas/etiologia , Fraturas Periprotéticas/cirurgia , Reoperação
19.
Rev Med Liege ; 75(11): 738-741, 2020 Nov.
Artigo em Francês | MEDLINE | ID: mdl-33155448

RESUMO

Obesity is a chronic disease that has become a major public health problem with a prevalence that has doubled in the past two decades in most industrialized and developing countries. Currently, bariatric surgery represents the most effective treatment for extreme or severe overweight (BMI ? 40 kg/m² or ? 35 kg/m2 with weight-related comorbidities). Pre-operative bariatric surgery psychiatric and psychological assessment is essential for various reasons. In addition to the selection of candidates for the operation, its objectives are to prepare patients for future postoperative changes as well as to optimize their psychological and psychiatric care. This article describes a standardized tool, the BIPASS (Bariatric Interprofessional Psychosocial Assessment Suitability Scale), which allows a quality assessment in the field.


Assuntos
Cirurgia Bariátrica , Obesidade Mórbida , Comorbidade , Humanos , Obesidade , Obesidade Mórbida/epidemiologia , Obesidade Mórbida/cirurgia , Resultado do Tratamento
20.
Rev Col Bras Cir ; 47: e20202537, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-33053063

RESUMO

OBJECTIVE: to analyze the effect of vertical gastrectomy on lipid profile and cardiometabolic risk in young women, preoperatively and 6 months after the operation. METHODS: retrospective study, encompassing medical record reviews of women's charts, preoperatively and in six months after the operation. Data collection was performed in the second half of 2015, using a review protocol with questions on the clinical-laboratory profile, anthropometric and laboratory classification of dyslipidemias. Descriptive and inferential analysis were used to treat the variables, using measures of variance, association and linear regression. RESULTS: we analyzed medical records of 114 women undergoing vertical gastrectomy, with a mean age of 33.82±10.92, and with complete high school education. There was a significant reduction of anthropometric data, as well as serum lipid values, six months after the surgical procedure. The coefficients of determination and the results of linear regression, showed that the reduction in serum triglyceride values and increase in high-density lipoprotein have a direct impact on the reduction of the cardiometabolic risk. Regarding the laboratory classification of dyslipidemias, it was observed that the majority presented a significant reduction at the six-month follow-up. Mixed hyperlipidemia showed no significant reduction. The categorized cardiometabolic risk showed a significant reduction in women at risk before vertical gastrectomy. CONCLUSION: at the six-month follow-up, vertical gastrectomy was effective in reducing the serum lipid profile and the cardiometabolic risk of young women when compared to the preoperative data. There was also a different improvement in the laboratory classification of dyslipidemias at the six-month follow-up after the surgical procedure.


Assuntos
Gastrectomia/efeitos adversos , Lipídeos/sangue , Obesidade Mórbida/cirurgia , Doenças Cardiovasculares , Feminino , Humanos , Estudos Retrospectivos , Perda de Peso
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA