Evolução da massa corporal magra após 12 meses da cirurgia bariátrica

EFFECTS OF BARIATRIC SURGERY ON KNEE JOINT PAIN

The World Health Organization (WHO) estimates that by 2025 about 2.3 billion adults will be overweight, with more than 700 million obese. Obese patients with joint pain and reduced physical function represent a challenging group to treat effectively.

Objective

To evaluate patients undergoing bariatric surgery and the implications of this surgery on knee joint pain and to conduct anamnesis and apply specific questionnaires to deepen the discussion and elucidate the knee joint symptoms related to obesity.

Methods

Observational cross-sectional study with tabulation and analysis of collected data.

Results

We obtained a significant result when comparing knee pain pre and post-surgery, in which pain increased by 15.8%.

Conclusion

Although worsening or maintenance of pain may occur, this fact is associated to factors such as the increase of functional activities of a joint that was previously in disuse and the loss of muscle mass as a sustainer. We concluded that the improvement of joint pain complaints were mainly due to the reduction of joint overload. Level of Evidence IV, Case Series.

Improvement in lung function and functional capacity in morbidly obese women subjected to bariatric surgery

OBJECTIVE

To determine whether weight loss in women with morbid obesity subjected to bariatric surgery alters lung function, respiratory muscle strength, functional capacity and the level of habitual physical activity and to investigate the relationship between these variables and changes in both body composition and anthropometrics.

METHODS

Twenty-four women with morbid obesity were evaluated with regard to lung function, respiratory muscle strength, functional capacity, body composition, anthropometrics and the level of habitual physical activity two weeks prior to and six months after bariatric surgery.

RESULTS

Regarding lung function, mean increases of 160 mL in slow vital capacity, 550 mL in expiratory reserve volume, 290 mL in forced vital capacity and 250 mL in forced expiratory volume in the first second as well as a mean reduction of 490 mL in inspiratory capacity were found. Respiratory muscle strength increased by a mean of 10 cmH2O of maximum inspiratory pressure, and a 72-meter longer distance on the Incremental Shuttle Walk Test demonstrated that functional capacity also improved. Significant changes also occurred in anthropometric variables and body composition but not in the level of physical activity detected using the Baecke questionnaire, indicating that the participants remained sedentary. Moreover, correlations were found between the percentages of lean and fat mass and both inspiratory and expiratory reserve volumes.

CONCLUSION

The present data suggest that changes in body composition and anthropometric variables exerted a direct influence on functional capacity and lung function in the women analyzed but exerted no influence on sedentarism, even after accentuated weight loss following bariatric surgery.

[Bariatric surgery: its effects for obese in the workplace]

This descriptive exploratory research aims to analyze the effects of bariatric surgery in the lifestyle of people with class III obesity in the workplace, through individual interviews with patients undergoing gastric bypass in gamma-Rouz. Data collection was conducted in June and July, 2011, by means of individual interviews, yielding three Collective Subject Discourse: "More willingness to work" "Life without comorbidities" and "Other effects of bariatric surgery." 30 patients with mean age 44 +/- 12 years old, 24 (80%) female, 19 (63%) performed paid professional activities, 10 (34%) did not work and one (3.3%) students, 23 (96%) hypertension and eight (33%) with a diagnosis of diabetes mellitus were included in the study. Difficulty handling with physical appearance: 13 (43%) and the emotional aspect: 21 (70%). Bariatric surgery positively affected the lifestyle of obese at work with reduction in comorbidities and physical and emotional problems, favoring social and professional reintegration of the individuals.

Bioelectrical impedance vector analysis in obese women before and after bariatric surgery: changes in body composition

OBJECTIVE

Because of the inefficacy of standard methods for the evaluation of body composition of grade III obese individuals, it is difficult to analyze the quality of weight loss after bariatric surgery in these patients. Electrical bioimpedance vector analysis and the RXc graph uses crude resistance (R) and reactance (Xc) values, like components of the Z vector, to monitor variations in body fluid and the nutritional status of obese individuals. Using bioelectrical impedance vector analysis (BIVA) and the RXc graph, the objective of the present study was to evaluate long-term changes in weight and body composition of obese women after Roux-en-Y bariatric surgery.

METHODS

A study was conducted on 43 grade III obese women submitted to bariatric surgery. Anthropometric and bioimpedance (800 mA-50 kHz) data were obtained during the preoperative period and 1, 2, 3, and 4 y after surgery. BIVA was performed by plotting resistance and reactance values corrected for body height (R/H and Xc/H, Ohm/m) as bivariates on the RXc graph. BIVA software was used to plot the vectors of the RXc plane.

RESULTS

Surgery promoted changes in body composition, with a reduction of fat mass and of fat-free mass. During the postoperative period, the vectors demonstrated migration to the right lower quadrant of the graph, corresponding to the classification of cachexia and water retention.

CONCLUSION

Weight loss due to surgery results in an important reduction of fat-free mass characterized by the position of most individuals in the cachexia quadrant throughout the postoperative period.

Low educational status, smoking, and multidisciplinary team experience predict hospital length of stay after bariatric surgery

Objective:

The objective of the present study was to identify new risk factors associated with longer hospitalization following bariatric surgery.

Methods:

Patient clinical, social, and biochemical data in addition to multidisciplinary team experience were analyzed in a cohort that included all patients undergoing bariatric surgery at our hospital. The primary outcome was length of hospital stay (LOS). Mortality was recorded to validate the obesity surgery mortality risk score (OS-MRS).

Results:

This study included 299 sequential patients, 41 ± 10 years of age, and BMI of 50 ± 8 kg/m² who underwent bariatric surgery. Two thirds (196) of patients were hypertensive, a third (86) were diabetic and a third (91) were current or former smokers. Overall, LOS was 8 ± 5 days. The predictors of a longer LOS were smoking (P < 0.05) and less multidisciplinary team experience (P < 0.05). Looking at only the last three years of data, LOS was 6 ± 5 days, and the predictors of a longer LOS were low educational attainment (P < 0.02) and smoking (P < 0.01) but not team experience. The global mortality was 2.6%, with the OS-MRS identifying a high-risk group.

Conclusion:

Excluding the initial learning phase, longer LOS independent predictors were patient low educational attainment and smoking. These predictors can help guide care to reduce complications.