Prospective and randomized comparison of two techniques of staple line reinforcement during open Roux-en-Y gastric bypass: oversewing and bioabsorbable Seamguard®.

Aims: Surgical staple line dehiscence usually leads to severe complications. Several techniques and materials have been used to reinforce this stapling and thus reduce the related complications. The objective was to compare safety of two types of anastomotic reinforcement in open gastric bypass.

Clinical predictors of different grades of nonalcoholic fatty liver disease.

Background: Nonalcoholic fatty liver disease (NAFLD) is one of the comorbidities related to obesity. Liver biopsy has been used as the "gold standard" for the diagnosis, grading, and prognosis of obese patients. The objective of the present study was to evaluate clinical predictors of more advanced stages of NAFLD.

Factors related to weight loss up to 4 years after bariatric surgery.

Background: Gastric bypass is the bariatric surgery most frequently performed in the world. It is responsible for sustainable weight loss, resolution of comorbidities, and improvement of quality of life. However, weight loss is not homogeneous, at times being insufficient in some patients.

Routine abdominal drains after Roux-en-Y gastric bypass: a prospective evaluation of the inflammatory response.

Background: Despite the extensive published data regarding the use of drains in surgery, it is still controversial. Most bariatric surgeons use drains as routinely. However, drains have sometimes have been shown to be unhelpful and even to increase the anastomotic leak rates.

Early identification of infectious complications in bariatric surgery by the determination of peritoneal and systemic cytokines.

Background: Obesity has become a global epidemic and bariatric surgery is one of the therapeutic tools to deal with it. Postoperative complications can occur, such as staple line dehiscence and anastomotic leaks, leading to increased patient mortality. The diagnosis of these complications is frequently difficult.

Nutritional course of patients submitted to bariatric surgery.

Background: Surgical treatment has proved to be effective for weight loss, improving the quality of life of obese individuals. However, metabolic and nutritional deficiencies may occur during the late postoperative period. The objective of the present study was to assess the metabolic and nutritional profile of grade III obese individuals for 12 months after Roux-en-Y gastric bypass (RYGBP).

Intestinal bacterial overgrowth after Roux-en-Y gastric bypass.

The aim of the present study was to report the occurrence of serious subnutrition, associated to intestinal bacterial overgrowth, in two patients submitted to bariatric surgery. Two female patients (body mass index, 49 and 50 kg/m(2), respectively) were submitted to Y-en-Roux gastric bypass. The first patient evolved a 52% loss of body weight within 21 months after surgery; the other, a 34% loss of initial body weight within 15 months after surgery, results corresponding, respectively, to 62 and 45 kg weight losses.

Influence of meal time on salivary circadian cortisol rhythms and weight loss in obese women.

Objective: We aimed to determine the influence of meal time on salivary circadian cortisol rhythms and weight loss in obese women.

Methods: Twelve obese subjects (body mass index >40 kg/m(2)) were hospitalized for 64 d and then randomly assigned to one of three 18-d stages with a 5-d interval between stages. In stage 1, the subjects received a hypocaloric diet (1000 kcal/d) portioned into five meals per day.

Total nitrogen and free amino acid losses and protein calorie malnutrition of hemodialysis patients: do they really matter?

Background/aims: Protein calorie malnutrition (PCM) in patients on hemodialysis (HD) is multifactorial; however, HD per se induces nutrient losses. The aim of the present study was to characterize the losses of total nitrogen (TN) and free amino acids (FAs) through the dialysate and to determine the relationship between this loss and PCM, food ingestion, and the characteristics of the hemodialyzer in patients on HD.

Methods: In a prospective study, 21 patients submitted to low-flux HD 3 times a week were evaluated within a period of 6 months regarding nutritional status, dietary calorie and protein intake, and losses through the dialysate of TN, FA, and urea nitrogen (UN).