Background: Surgical trauma triggers an important postoperative stress response characterized
by significantly elevated levels of cytokines, an event that can favor the
emergence of immune disorders which lead to disturbances in the patient's body
defense. The magnitude of postoperative stress is related to the degree of
surgical trauma. Aim: To evaluate the expression of pro-inflammatory (TNF-α, IFN-γ, IL-1β, and IL-17)
and anti-inflammatory (IL-4) cytokines in patients submitted to conventional and
single-port laparoscopic cholecystectomy before and 24 h after surgery. Methods: Forty women with symptomatic cholelithiasis, ranging in age from 18 to 70 years,
participated in the study. The patients were divided into two groups: 21 submitted
to conventional laparoscopic cholecystectomy and 19 to single-port laparoscopic
cholecystectomy. Results: Evaluation of the immune response showed no significant difference in IFN-γ and
IL-1β levels between the groups or time points analyzed. With respect to TNF-α and
IL-4, serum levels below the detection limit (10 pg/ml) were observed in the two
groups and at the time points analyzed. Significantly higher postoperative
expression of IL-17A was detected in patients submitted to single-port
laparoscopic cholecystectomy when compared to preoperative levels (p=0.0094). Conclusions: Significant postoperative expression of IL-17 was observed in the group submitted
to single-port laparoscopic cholecystectomy when compared to preoperative levels,
indicating that surgical stress in this group was higher compared to the
conventional laparoscopic cholecystectomy.
BackgroundIncretins are hormones produced by the intestine and can stimulate the secretion
of insulin, helping to diminish the post-prandial glycemia. The administration of
an emulsion of palm oil can help in the maintenance of the weight, and can
increase circulating incretins levels. Glutamine increases the concentration of
incretins in diabetic people. Both can help in metabolic syndrome.AimTo analyze the effects of ingestion of palm oil and glutamine in glycemia and in
incretins in patients with diabetes submitted to surgical duodenojejunal exclusion
with ileal interposition without gastrectomy.MethodsEleven diabetic type 2 patients were included and were operated. They were called
to laboratory follow-up without eating anything between eight and 12 hours. They
had there blood collected after the stimulus of the palm oil and glutamine taken
in different days. For the hormonal doses were used ELISA kits.ResultsThe glycemia showed a meaningful fall between the fast and two hours after the
stimulus of the palm oil (p=0,018). With the glutamine the GLP-1 showed an
increase between the fast and one hour (p=0,32), the PYY showed an important
increase between the fast and one hour after the stimulus (p=0,06), the glycemia
showed a meaningful fall after two hours of the administration of the stimulus
(p=0,03).ConclusionPalm oil and glutamine can influence intestinal peptides and glucose
Background : Immunological and inflammatory mechanisms play a key role in the development and
progression of type 2 diabetes mellitus. Aim : To raise the hypothesis that alterations in immunological parameters occur after
duodenojejunal bypass surgery combined with ileal interposition without
gastrectomy, and influences the insulin metabolism of betacells.Methods : Seventeen patients with type 2 diabetes mellitus under clinical management were
submitted to surgery and blood samples were collected before and six months after
surgery for evaluation of the serum profile of proinflammatory (IFN-γ, TNF-α,
IL-17A) and anti-inflammatory cytokines (IL-4, IL-10). In addition, anthropometric
measures, glucose levels and insulin use were evaluated in each patient. Results : No changes in the expression pattern of proinflammatory cytokines were observed
before and after surgery. In contrast, there was a significant decrease in IL-10
expression, which coincided with a reduction in the daily insulin dose, glycemic
index, and BMI of the patients. Early presentation of food to the ileum may have
induced the production of incretins such as GLP-1 and PYY which, together with
glycemic control, contributed to weight loss, diabetes remission and the
consequent good surgical prognosis of these patients. In addition, the control of
metabolic syndrome was responsible for the reduction of IL-10 expression in these
patients. Conclusion : These findings suggest the presence of low-grade inflammation in these patients
during the postoperative period, certainly as a result of adequate glycemic
control and absence of obesity, contributing to a good outcome of surgery.
Purpose: To evaluate respiratory muscle strength (PImax and PEmax) before and 24 and 48 h after conventional and single-port laparoscopic cholecystectomy. Methods: Forty women with symptomatic cholelithiasis (18 to 70 years) participated in the study. The patients were divided into two groups: 21 patients undergoing conventional laparoscopic cholecystectomy and 19 patients undergoing single-port laparoscopic cholecystectomy. Differences were considered to be significant when p<0.05.
Results:The results showed a greater decline in PImax after 24 h in the group submitted to conventional laparoscopic cholecystectomy, with a significant difference between groups (p=0.0308). Conclusion: Recovery of the parameters studied was more satisfactory and respiratory muscle strength was less compromised in the group submitted to single-port laparoscopic cholecystectomy.
Introduction: Diabetes Mellitus (DM) is a multifactorial metabolic disorder. As considered a public health problem needing additional treatment options. Objective: This prospective study aimed at evaluating pulmonary function through spirometry, before and after metabolic surgery without gastric resection in type 2 DM patients. Methods: Sample was composed by 17 type 2 DM females. They were analyzed in pre (24 hours before surgical procedure), immediate post-operative period POST1 (24 hours after surgical procedure) and in the late postoperative period POST2 (two years after surgical procedure). Besides statistical analysis, it was evaluated the following spirometric parameters: forced vital capacity (FVC), forced expiratory volume in the first second (FEV1) and the FEV1 / FVC ratio (%). Results: Spirometric parameters showed a value increase when compared PRE and POS2 values, except for FVC and FEV1, which was not statistically significant. Conclusion: Type 2 DM women submitted to metabolic surgery without gastric resection showed spirometric value increased after two-year surgical procedure, when compared to preoperative period values. It is important additional studies about pulmonary function, diabetic patients and metabolic surgery without gastric resection.
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