RESUMO
Obesity is a serious disorder in almost the entire world. It is an important risk factor for a series of conditions that affect and threaten health. Currently, bariatric surgery is the most effective treatment for morbid obesity, and in addition to the resulting weight loss, it reduces morbidity in this population. There has been a significant increase in the number of obese patients operated on. Despite the success of bariatric surgery, an important group of patients still present with major postoperative complications. In order for endoscopy to effectively contribute to the diagnosis and treatment of complications deriving from obesity surgery, the gastroenterologist must be aware of the particularities involved in bariatric surgery. The present article is a review of the resulting anatomic aspects of the main surgical techniques employed, the most common postoperative symptoms, the potential complications, and the possibilities that endoscopic diagnosis and treatment offer. Endoscopy is a growing and continuously evolving method in the treatment of bariatric surgery complications. The aim of this review is to contribute to the preparation of gastroenterologists so they can offer adequate endoscopic diagnosis and treatment to this high-risk population.
Assuntos
Cirurgia Bariátrica/métodos , Endoscopia/métodos , Gastroenterologistas , Complicações Pós-Operatórias/terapia , Humanos , Obesidade Mórbida/cirurgia , Complicações Pós-Operatórias/diagnóstico por imagemRESUMO
This study investigated how proteins of the insulin signaling cascade could modulate insulin resistance after dexamethasone (Dexa) treatment and aerobic training. Rats were distributed into 4 groups: sedentary control (SC), sedentary+Dexa (SD), trained control (TC), and trained+Dexa (TD), and underwent aerobic training for 70 days or remained sedentary. Dexa was administered during the last 10 days (1 mg · kg(-1) per day i. p.). After 70 days, an intraperitoneal glucose tolerance test (ipGTT) was performed. Protein levels of IRS-1, AKT, and PKC-α in the tibialis anterior (TA) muscle were identified using Western blots. Dexa treatment increased blood glucose and the area under the curve (AUC) of ipGTT. Training attenuated the hyperglycemia and the AUC induced by Dexa. Dexa reduced IRS-1 (- 16%) and AKT (- 43%) protein level with no changes in PKC-α levels. Moreover, these effects on IRS-1 and AKT protein level were prevented in trained animals. These results show for the first time that aerobic exercise prevented reductions of IRS-1 and AKT level induced by Dexa in the TA muscle, suggesting that aerobic exercise is a good strategy to prevent Dexa-induced peripheral insulin resistance.
Assuntos
Dexametasona/farmacologia , Resistência à Insulina , Condicionamento Físico Animal , Animais , Glicemia/metabolismo , Western Blotting , Peso Corporal/efeitos dos fármacos , Teste de Tolerância a Glucose , Proteínas Substratos do Receptor de Insulina/metabolismo , Músculos/efeitos dos fármacos , Músculos/metabolismo , Tamanho do Órgão/efeitos dos fármacos , Fosforilação/efeitos dos fármacos , Ratos , Ratos WistarRESUMO
Bothrops alternatus venom was intramuscularly inoculated (3mg/kg) into 12 dogs, 30 to 65 days old. Spontaneou bleeding commenced twenty minutes later. Blood samples obtained 3 and 20 minutes after venom inoculation presented spontaneuous clotting formation. Plasmatic fibrinogen decreased within 3 minutes. Partial thromboplastin time (PTT) and one-stage prothrombin time (PT) were found. Plasma did not coagulate 40 minutes after inoculation. Platelet counts did not vary but their function was altered. Histopathology pointed out severe muscular necrosis and massive hemorrhage in the inoculation area. Regional ganglia showed intense hemorrhage. The 45 and 65-day-old animals showed alveolar thickening of the septum and generalized congestion, but the 30-day-old animals showed thrombosis of small arteries and arterioles. Renal lesions were different with the age. Cortical tubular necrosis was present in puppies, and intense cortical tubular hydropic degeneration was present in adult dogs. Thymus hemorrhage and necrosis were present.
Assuntos
Animais , Cães , Bothrops , Mordeduras de Serpentes/sangue , Venenos de Crotalídeos/sangue , Fatores de Coagulação Sanguínea , Tempo de Tromboplastina Parcial , Contagem de Plaquetas , Mordeduras de Serpentes/patologiaRESUMO
Bothrops alternatus venom was inoculated in gastrocnemius muscle of mice between 18 and 20g. The dose was 50 micrograms in 0.1 ml in ClNa 0.85% solution. Groups of 5 animals were sacrified between 3, 6 and 12 hours after inoculation. Hystopathology was performed with muscle and different organs fixed with Bouin. The venom reproduced a local inflammatory reaction. Histopathology observations of muscle revealed myolytic and coagulative necrosis. There and six hours after inoculation, hepatocellular degeneration and tumefaction in area of central veins was observed. In kidneys there were cortical congestion and hydropic tumefaction of proximal and distal tubules. There were no anormality in heart, lung and brain.