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1.
Obes Surg ; 29(8): 2553, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31175556

RESUMO

Due to a metadata tagging error the name of author Andrés Esteban San Martín was indexed incorrectly. The author's given name is Andrés Esteban and his family name is San Martín.

2.
Obes Surg ; 29(8): 2548-2552, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-30993573

RESUMO

BACKGROUND: Obesity is a global health problem that also affects older adults. In Chile, as in most of the developing countries, more than half of older adults are overweight or obese, and bariatric surgery may be riskier for this group. The aim of this study is to compare our experience in patients over 60 years of age with a control group to determine associated surgical morbidity and mortality. METHODS: Case-control study of bariatric surgeries performed between 2006 and 2017 in our institution. Patients aged ≥ 60 years for the case group versus control group for patients ≤ 50 years selected randomly, matched by body mass index, type 2 diabetes, hypertension, dyslipidemia, surgical technique, and gender (ratio 1:2). Primary endpoint was surgical morbidity, 30-day readmission, and mortality. RESULTS: Seventy-two patients in case group were matched with 144 patients in control group. Surgical complications rate was the same for both groups. No differences were observed in the conversion to open surgery rate or 30-day readmission rate. There was no mortality in this series. CONCLUSION: In this case-control study, being elderly does not increase the risk of morbidity and mortality associated with bariatric surgery.


Assuntos
Envelhecimento/fisiologia , Cirurgia Bariátrica/efeitos adversos , Obesidade Mórbida/epidemiologia , Obesidade Mórbida/cirurgia , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Adulto , Fatores Etários , Idoso , Cirurgia Bariátrica/métodos , Cirurgia Bariátrica/mortalidade , Cirurgia Bariátrica/estatística & dados numéricos , Índice de Massa Corporal , Estudos de Casos e Controles , Chile/epidemiologia , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/etiologia , Diabetes Mellitus Tipo 2/mortalidade , Diabetes Mellitus Tipo 2/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Morbidade , Obesidade/complicações , Obesidade/epidemiologia , Obesidade/mortalidade , Obesidade/cirurgia , Obesidade Mórbida/complicações , Obesidade Mórbida/mortalidade , Sobrepeso/epidemiologia , Sobrepeso/etiologia , Sobrepeso/mortalidade , Sobrepeso/cirurgia , Readmissão do Paciente/estatística & dados numéricos , Complicações Pós-Operatórias/mortalidade , Fatores de Risco
3.
Obes Surg ; 28(11): 3466-3473, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30069859

RESUMO

INTRODUCTION: Sleeve gastrectomy with jejunal bypass (SGJB) and Roux-en-Y gastric bypass (RYGB) has shown good results with respect to type 2 diabetes mellitus (T2D) remission in our institution. In this study, we compared the efficacy and safety of SGJB versus RYGB in terms of T2D remission up to 3 years postoperatively. MATERIALS AND METHODS: A retrospective cohort study of two groups of patients with T2D who underwent SGJB or RYGB. All patients were matched by age, presurgical body mass index (BMI), glycated hemoglobin (HbA1c), and diabetes duration. Complete remission was defined as HbA1c of < 6%, fasting plasma glucose (FPG) of < 100 mg/dL, and no antidiabetic drugs. RESULTS: In total, 57 and 55 patients in the SGJB and RYGB groups, respectively, met the inclusion criteria. The diabetes remission rate was similar between the SGJB and RYGB groups at 1 year postoperatively (69.2 vs. 64.7%) and 3 years postoperatively (56.1 vs. 58.8%). There were no significant differences in HbA1c or FPG at 1 or 3 years between the two groups. Additionally, weight loss and other metabolic parameters were similar between the groups. Clinical chemistry values were similar at 12 months except for hematocrit and calcium, which were significantly lower in the RYGB group. There were no differences in surgical complications. CONCLUSIONS: Both procedures showed similar results in terms of T2D remission and other metabolic markers at 3 years. Hematocrit and calcium were significantly higher in the SGJB than RYGB group. SGJB is as effective and safe as RYGB in obese patients with T2D.


Assuntos
Diabetes Mellitus Tipo 2 , Gastrectomia/estatística & dados numéricos , Derivação Gástrica/estatística & dados numéricos , Obesidade Mórbida , Índice de Massa Corporal , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/cirurgia , Hemoglobinas Glicadas/análise , Humanos , Obesidade Mórbida/epidemiologia , Obesidade Mórbida/cirurgia , Estudos Retrospectivos
4.
Genet Mol Biol ; 38(1): 30-6, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25983621

RESUMO

Cerebrotendinous Xanthomatosis (CTX), a rare lipid storage disorder, is caused by recessive loss-of-function mutations of the 27-sterol hydroxylase (CYP27A1), producing an alteration of the synthesis of bile acids, with an accumulation of cholestanol. Clinical characteristics include juvenile cataracts, diarrhea, tendon xanthomas, cognitive impairment and other neurological manifestations. Early diagnosis is critical, because treatment with chenodeoxycholic acid may prevent neurological damage. We studied the CYP27A1 gene in two Chilean CTX patients by sequencing its nine exons, exon-intron boundaries, and cDNA from peripheral blood mononuclear cells. Patient 1 is a compound heterozygote for the novel substitution c.256-1G > T that causes exon 2 skipping, leading to a premature stop codon in exon 3, and for the previously-known pathogenic mutation c.1183C > T (p.Arg395Cys). Patient 2 is homozygous for the novel mutation c.1185-1G > A that causes exon 7 skipping and the generation of a premature stop codon in exon 8, leading to the loss of the crucial adrenoxin binding domain of CYP27A1.

5.
Rev Med Chil ; 142(5): 616-22, 2014 May.
Artigo em Espanhol | MEDLINE | ID: mdl-25427019

RESUMO

Cerebrotendinous xanthomatosis (CTX) is a rare autosomal recessive disease, caused by genetic deficiency of the 27-hydroxylase enzyme (encoded by CYP27A1). It plays a key role in cholesterol metabolism, especially in bile acid synthesis and in the 25-hydroxylation of vitamin D3 in the liver. Its deficiency causes reduced bile acid synthesis and tissue accumulation of cholestanol. Clinical manifestations are related to the presence of cholestanol deposits and include tendon xanthomas, premature cataracts, chronic diarrhea, progressive neurologic impairment and less frequently coronary heart disease, early onset osteoporosis and abnormalities in the optic disk and retina. An early diagnosis and treatment with quenodeoxycholic acid may prevent further complications, mainly neurological manifestations. This review summarizes cholesterol metabolism related to bile acid synthesis, physiopathology, biochemistry and treatment of cerebrotendinous xanthomatosis.


Assuntos
Xantomatose Cerebrotendinosa , Ácido Quenodesoxicólico/uso terapêutico , Diagnóstico Precoce , Humanos , Xantomatose Cerebrotendinosa/diagnóstico , Xantomatose Cerebrotendinosa/tratamento farmacológico , Xantomatose Cerebrotendinosa/genética , Xantomatose Cerebrotendinosa/fisiopatologia
6.
Rev. méd. Chile ; 142(5): 616-622, mayo 2014. ilus, tab
Artigo em Espanhol | LILACS | ID: lil-720671

RESUMO

Cerebrotendinous xanthomatosis (CTX) is a rare autosomal recessive disease, caused by genetic deficiency of the 27-hydroxylase enzyme (encoded by CYP27A1). It plays a key role in cholesterol metabolism, especially in bile acid synthesis and in the 25-hydroxylation of vitamin D3 in the liver. Its deficiency causes reduced bile acid synthesis and tissue accumulation of cholestanol. Clinical manifestations are related to the presence of cholestanol deposits and include tendon xanthomas, premature cataracts, chronic diarrhea, progressive neurologic impairment and less frequently coronary heart disease, early onset osteoporosis and abnormalities in the optic disk and retina. An early diagnosis and treatment with quenodeoxycholic acid may prevent further complications, mainly neurological manifestations. This review summarizes cholesterol metabolism related to bile acid synthesis, physiopathology, biochemistry and treatment of cerebrotendinous xanthomatosis.


Assuntos
Humanos , Xantomatose Cerebrotendinosa , Ácido Quenodesoxicólico/uso terapêutico , Diagnóstico Precoce , Xantomatose Cerebrotendinosa/diagnóstico , Xantomatose Cerebrotendinosa/tratamento farmacológico , Xantomatose Cerebrotendinosa/genética , Xantomatose Cerebrotendinosa/fisiopatologia
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