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Functional Roux-en-Y Gastric Bypass (F-RYGB), with Preservation of Duodenal Access: Report of Two Revisional Cases of Sleeve Gastrectomy

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Surgical Science 2024年第3期15卷 135-158页

作者： victor Ramos Mussa Dib carlos Augusto Scussel Madalosso Paulo Reis Esselin de Melo Rui Ribeiro Paula Volpe carlos Eduardo Domene victor Dib Institute Manaus Brazil Gastrobese Clinic Passo Fundo Brazil Paulo Reis Institute of Bariatric Surgery Goi&#226nia Brazil Alfredo Nasser University Center (UNIFAN) Goi&#226nia Brazil Lusíadas Amadora Hospital Lisboa Portugal Integrated Center for Advanced Medicine (CIMAMED) S&#227o Paulo Brazil

Objective: This case report aimed to demonstrate a possible neuromuscular effect of Latarjet nerves transection or truncal vagotomy, in association with sleeve gastrectomy plus antrojejunostomy, in order to reproduce a Roux-en-Y gastric bypass (RYGB) mechanistic principles, in patients with previous Sleeve Gastrectomy (SG) who had had weight regain, with or without concomitant gastroesophageal reflux disease (GERD). Background: Sleeve gastrectomy (SG) is one of the most frequently performed bariatric operations worldwide. Nevertheless, weight regain and gastroesophageal reflux disease (GERD) have been consistently demonstrated, in association with this technique, which may require a revisional procedure. RYGB is an option in such a situation but, implies in gastrointestinal exclusions, which represents a shortcoming of this revision. Surpassing this inconvenient would be of great value for the patients. Methods: We describe herein two cases of SG revision for weight regain and GERD, with a follow-up of one year. Gastroesophageal reflux disease was evaluated by validated questionnaire, upper endoscopy, seriography, high resolution manometry (HRM) and impedance pHmetry (I-pHmetry), in the pre and postoperative periods. A re-Sleeve Gastrectomy with antrojejunal anastomosis was done in both cases, after informed consents. The Latarjet nerves were transected in one case, due to a bleeding in the left gastric vessels and a truncal vagotomy was required in the other, to appropriately treat an associated hiatal hernia. Results: In the postoperative evaluation it was observed a pyloric spasm in both cases, during seriography and endoscopy, kept until the one-year follow-up. There was unidirectional contrast flow to the gastrointestinal anastomosis, filling the jejunal limb, in radiologic contrast study. No contrast passed through the pylorus. Nonetheless, the duodenum was kept endoscopically accessible. In the one-year evaluation, weight loss was adequate and GERD resolution

关键词： Roux-en-Y Gastric Bypass Sleeve Gastrectomy Jejuno Gastric Bypass Vagus Nerve Vagotomy Bariatric Surgery

Sleeve Gastrectomy with Duodenal Transit Bipartition (S-DTB): Preliminary Results and Technical Aspects of Its Metabolic Structure

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Surgical Science 2024年第4期15卷 244-264页

作者： Paulo Reis Esselin de Melo Ricardo Zorron victor Ramos Mussa Dib carlos Augusto Scussel Madalosso Rui Ribeiro Thonya Cruz Braga Paula Volpe carlos Eduardo Domene Paulo Reis Institute Goiania GO Brazil Alfredo Nasser University Center (UNIFAN) Goiania GO Brazil Department of Bariatric and Metabolic Surgery CUF Descobertas Hospital Lisbon Portugal victor Dib Institute Manaus AM Brazil Gastrobese Clinic Passo Fundo RS Brazil Lusiadas Amadora Hospital Lisbon Portugal Clianest Group Renaissance Hospital Goiania GO Brazil Integrated Center for Advanced Medicine (CIMAMED) Sao Paulo Brazil

Obesity is a significant and escalating health issue both in Brazil and globally, with over 650 million overweight adults worldwide. The treatment of obesity can be performed clinically, endoscopically or surgically;surgical treatment proves to be safe and more effective in terms of weight loss and long-term maintenance. Objective: This study aimed to monitor the progress of weight loss and comorbidity control in patients undergoing sleeve gastrectomy with duodenal bipartition. Methods: This pilot project involved 8 patients divided into 2 arms. In the first arm, patients underwent sleeve gastrectomy with Roux-en-Y duodenoileal transit bipartition (S-RYDITB), while in the second arm, patients underwent sleeve gastrectomy with Roux-en-Y duodenojejunal transit bipartition (S-RYDJTB). Both procedures involved Roux-en-Y reconstruction without duodenal exclusion. In S-RYDITB, the duodenal-ileal anastomosis was performed 300 cm from the ileocecal valve (ICV), creating a 250 cm common channel and a 50 cm alimentary channel. In S-RYDJTB, a biliopancreatic loop was created 200 cm from the angle of Treitz, with a 1 m alimentary channel. Results: Five patients underwent the procedures, with one undergoing S-RYDITB and four undergoing S-RYDJTB. No adverse events such as hospitalizations, readmissions, reoperations, fistulas, bleeding, pulmonary embolism, diarrhea, dumping syndrome, or hypoglycemia occurred during the study period. The mean length of hospital stay was 2 days. The average BMI decreased from 37.27 kg/m2 preoperatively to 29.48 kg/m2 after 6 months. The significant percentage of weight loss was 21.22%, with excess weight loss of 63.6%. Ninety-five percent remission of comorbidities, including hypercholesterolemia, hypertriglyceridemia, diabetes, hypertension, steatosis, and pre-diabetes. Two patients underwent sleeve gastrectomy with duodenal bipartition using a single anastomosis. Conclusion: Duodenal switch surgery has gained worldwide recog

关键词： Obesity Bariatric Surgery Metabolic Surgery Duodenal Switch

Pyloric Sympathectomy: A Novel Way to Get Pylorus Relaxation? Report of Two Bariatric Cases

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Surgical Science 2024年第6期15卷 381-395页

作者： victor Ramos Mussa Dib carlos Augusto Scussel Madalosso Rui Ribeiro Paulo Reis Esselin de Melo Fernando Fornari victor Dib Institute Manaus Brazil Gastrobese Clinic Passo Fundo Brazil Lusadas Amadora Hospital Lisboa Portugal Paulo Reis Institute Goinia Brazil Alfredo Nasser University Center (UNIFAN) Goinia Brazil Faculdade de Medicina Universidade de Passo Fundo Passo Fundo Brazil Faculdade de Medicina Universidade Federal da Fronteira do Sul Chapec Brazil

Objective: This case report aimed to demonstrate a possible neuromuscular effect of pyloric sympathectomy on the pylorus motility, leading to its permanent relaxation, observed in two bariatric surgical cases, one primary and the other, revisional. Background: Pyloric sphincter is a physiological barrier to free gastric emptying. In sleeve gastrectomy and in Roux-en-Y gastric bypass revisions, that put the remnant stomach in transit, the pylorus can contribute to generate a high intragastric pressure, which could lead to acute gastric fistulas and/or chronic gastroesophageal reflux disease. The possibility of functionally relaxing the pylorus, promoting intragastric pressure reduction, could represent a protective maneuver against these complications. Methods: We describe herein a surgical maneuver applied in two cases of bariatric surgeries, with the intention of facilitating antrum-duodenal region exposure, in a sleeve gastrectomy and in a Roux-en-Y gastric bypass conversion to SADI-S. For this, a ligation of terminal peripyloric vessels was done, allowing a passage of a tape, which surrounded the pylorus, for its traction. In both cases, 30-day and 1-year endoscopic evaluations were done, to assess esophagitis signs, anastomosis healing and anatomical pouch aspect. A clinical evaluation was also done, to assess gastroesophageal symptoms (validated questionnaire). Results: In the postoperative endoscopic evaluations, no esophagitis were observed in any case and the gastric pouches had normal aspect, with the expected anatomical findings, compatible with the surgeries performed. The anastomosis healed without problems, in the revisional case. Interestingly, in both cases, it was observed a complete pyloric sphincter relaxation, which lasted until 1-year endoscopic evaluation. There were no fistulas, nor esophagitis in any of these cases. Clinically, there were no symptoms of gastroesophageal reflux disease (validated questionnaire). Conclusion: The observation of a

关键词： Roux-en-Y Gastric Bypass Sleeve Gastrectomy Sympathectomy Bariatric Surgery

Environmental determinants of social wasp diversity and assemblage structure in an Amazonian archipelagic landscape

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Zoological Research(Diversity and Conservation) 2024年第2期1卷 121-129页

作者： Jose victor Alves Ferreira Alexandre Somavilla Maíra Benchimol Ana Filipa Palmeirim carlos A.Peres Danielle Storck-Tonon Laboratório de Ecologia Aplicada àConservação Universidade Estadual de Santa CruzIlhéus 45662-900Brazil Instituto Nacional de Pesquisas da Amazônia Coordenação de BiodiversidadeManaus 69067-001Brazil CIBIO Centro de Investigação em Biodiversidade e Recursos GenéticosInBIO Laboratório AssociadoCampus de VairãoUniversidade do PortoVairão 4485-661Portugal BIOPOLIS Program in Genomics Biodiversity and Land PlanningCIBIOCampus de VairãoVairão 4485-661Portugal School of Environmental Sciences University of East AngliaNorwich NR47TJUK Instituto Juruá Manaus69057-060Brazil Programa de Pós-Graduação em Ambiente e Sistemas de Produção Agrícola(PPGASP) Universidade do Estado de Mato GrossoTangaráda Serra 78300-970Brazil

Hydropower development has become an important driver of habitat loss and fragmentation across lowland tropical *** ample evidence on the detrimental effects of insular habitat fragmentation on biodiversity,invertebrate taxa,that may be critical to ecosystem functioning,have been *** assessed the assemblage-level responses of social wasps to forest insularization induced by the Balbina Hydroelectric Dam in Central Brazilian *** Malaise trapping,we captured wasps on 27 forest islands and three continuous *** constructed Generalized Linear Models and employed a model selection approach to examine the impact of local variables(fire severity(FIRE)and basal area of pioneer tree species(PIONEER))and landscape-scale variables(amount of habitat(COVER))on patterns of species richness,composition,and body size of wasps.A total of 374 individuals(29 species)were collected across all sampling *** was the main predictor of species richness,while PIONEER was the only variable that explained variation in community composition,with a negative effect on body *** results add evidence to the pervasive impacts of large hydroelectric dams on tropical forest biodiversity,and suggest that social wasps,among other invertebrates,can be used as bioindicators in infrastructure development projects.

关键词： Habitat amount hypothesis Habitat fragmentation Habitat loss Hydroelectric dams Invertebrates

Glacial reconstruction and periglacial dynamics at the end of Late Pleistocene on the surface of Cofre de Perote volcano,México:a climatological retrospective

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Journal of Mountain Science 2023年第9期20卷 2453-2467页

作者： victor SOTO Hugo DELGADO-GRANADOS carlos M.WELSH Kenji YOSHIKAWA Centro de Ciencias de la Tierra Universidad VeracruzanaXalapaVeracruz 91090México Instituto de Geofísica Universidad Nacional Autónoma de MéxicoCiudad de México 04150México Water and Environmental Research Center University of Alaska FairbanksFairbanksAlaska 99775USA

Despite being within the intertropical region of the planet,the Mexican territory still has glacier-covered *** recent decades,important advances have been made in studies on glaciology and periglacial environment in Mexico both for current and past ***,in spite of Cofre de Perote volcano(4200 m a.s.l.)being a strategically located mountain,it has not yet been studied in regards to the glacial and periglacial processes;in fact,those dynamics have modified the mountain massifs in the *** complement the series of studies on glacial history in the high mountain environment of México,this study reconstructs the glacial cover and the periglacial environment of the volcano surface during the final stage of the Late Pleistocene based on climatic retrospective and through the identification of geomorphological *** findings indicate the existence of a large glacier(ice cap)that covered the northern,western,and southern slopes of the mountain;while in the eastern sector there were two small glaciers,one being of cirque type,and the other of valley *** current temperature conditions prevent the occurrence of permanent ice bodies;at the same time,it was found that the periglacial blockfields of the slopes is a legacy of the climatic conditions that prevailed at the end of Late Pleistocene.

关键词： Cofre de Perote Glacial cover Periglacial environment Climatic retrospective Palaeoclimatic modelling

Sex and season explain spleen weight variation in the Egyptian mongoose

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Current Zoology 2019年第1期65卷 11-20页

作者： victor BANDEIRA Emilio Virgos Alexandre AZEVEDO Joao Carvalho Monica V. CUNHA carlos Fonseca Dartment of Biology Centro de Estudos do Ambiente e do Mar (CESAM) University of Aveiro Campus Universitario de Santiago Aveiro 3810-193 Portugal Departamento de Biologia Geologia Fisica y Qufmica Inorganica Area Biodiversidad y Conservacion Escuela Superior de Ciencias Experimentales y Tecnologia (ESCET) Universidad Rey Juan Carlos c/Tulipan s/n Mostoles Madrid E-28933 Spain Leibniz Institute for Zoo and Wildlife Research Alfred-Kowalke-Straβe 17 Berlin 10315 Germany Instituto de Ciencias Biomedicas Abel Salazar R. Jorge de Viterbo Ferreira 228 Porto 4050-313 Portugal Instituto Nacional de Investigaqao Agraria e Veterinaria (INIAV) IP-National Institute for Agrarian and Veterinary Research Rua dos Lagidos Lugar da Madalena Vairao 4485-655 Portugal cE3c-Centre for Ecology Evolution and Environmental Changes Faculdade de Ciencias Universidade de Lisboa Lisboa 1749-016 Portugal BiolSI-Biosystems & Integrative Sciences Institute Faculdade de Ciencias Universidade de Lisboa Lisboa 1749-016 Portugal Wildlife Ecology & Health group (WE&H) and Servei d'Ecopatologia de Fauna Salvatge (SEFaS) Departament de Medicina i Cirurgia Animals Universitat Autonoma de Barcelona 08193-Bellaterra Barcelona Spain

The Egyptia n mon goose (Herpestes ichneumon Linn aeus, 1758) is a medium-sized car nivore that experienced remarkable geographic expansion over the last 3 decades in the Iberian Peninsula. In this study, we investigated the association of species-related and abiotic factors with spleen weight (as a proxy for immunocompete nee) in the species. We assessed the relationship of body con dition, sex, age, seas on, and envir onmental conditi ons with splee n weight established for 508 hunted specimens. Our results indicate that the effects of sex and season outweigh those of all other variables, including body condition. Spleen weight is higher in males than in females, and heavier spleens are more likely to be found in spring, coinciding with the highest period of investment in reproduction due to mating, gestation, birth, and lactation. Coupled with the absence of an effect of body condition, our findi ngs suggest that splee n weight variation in this species is mostly influe need by lifehistory traits linked to reproduction, rather than overall energy availability, winter immunoenhancement, or energy partitioning effects, and prompt further research focusing on this topic.

关键词： body condition carnivore Herpestes ichneumon Iberian Peninsula mongoose spleen weight

Metamorphic disturbances of magnetite chemistry and the Sm-Nd isotopic system of reworked Archean iron formations from NE Brazil

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Geoscience Frontiers 2022年第5期13卷 227-241页

作者： Joice Dias de Moraes Pedro Cordeiro Eduardo Abrahão Filho Juliana Rezende Oliveira carlos victor Rios da Silva Filho Instituto de Geociências Universidade de Brasília(UnB)70910-900 BrasíliaDFBrazil Department of Mining Engineering Pontifical Catholic University of Chile7820436 SantiagoChile

Iron formations are valuable archives of sedimentary conditions and post-depositional ***,geochemical proxies commonly used to determine genetic characteristics can be variably modified during metamorphism and deformation,hampering their use as records of regional geological *** work focuses on strongly reworked magnetite-quartz-rich rocks from the São Josédo Campestre Massif,one of the oldest fragments of preserved crust in South *** genetic classification of these magnetite-quartz-rich rocks is not straightforward because primary assemblages and textures were variably modified by granulite facies metamorphism during a regional Paleoproterozoic migmatization *** address genetic ambiguities,we analyzed their magnetite and pyroxene chemistry,wholerock geochemistry,and Sm-Nd *** chemistry indicates that pyroxene-poor iron formations(Type B)are low in trace elements such as Ti,Al,V,and Mn,suggesting a chemical similarity to iron formations *** contrast,magnetites from pyroxene-enriched Type A iron formations are rich in trace elements and more akin to magnetite crystallized from higher temperature systems,such as skarn and ***^(147)Sm/^(144)Nd of these rocks show substantial variation even at the outcrop scale,indicating a locally-controlled,highly heterogeneous mixture of Archean,Paleoproterozoic,and Neoproterozoic ***,our geochemical tools point out to heterogenous signatures of these magnetitequartz rocks and proxies compatible with both low and high-temperature conditions and age of deposition spanning sources from the Archean to the *** interpret that the studied São Josédo Campestre magnetite-quartz rocks represent Archean iron formations with original magnetite chemistry and isotopic signatures variably modified by metamorphism and by at least one deformation-related hydrothermal *** results contrast with similar examples from China and Greenland where iron formation

关键词： Metamorphic disturbances of magnetite chemistry and the Sm-Nd isotopic system of reworked Archean iron formations from NE Brazil

Role of short-term dispersal on the dynamics of Zika virus in an extreme idealized environment

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Infectious Disease Modelling 2017年第1期2卷 21-34页

作者： victor M.Moreno Baltazar Espinoza Derdei Bichara Susan A.Holechek carlos Castillo-Chavez Simon A.Levin Mathematical Computational and Modeling Sciences CenterArizona State UniversityP.O.Box 873901TempeAZ 85287-3901United States Biodesign Center for Infectious Diseases and Vaccinology Biodesign InstituteArizona State UniversityTempeAZ 85287-5401United States School of Life Sciences Arizona State UniversityTempeAZ 85287-4501United States Department of Mathematics and Center for Computational and Applied Mathematics California State UniversityFullertonCA 92831United States Departamento the Ingenieria Biomedica Universidad de Los AndesBogotaColombia Rector's Office Yachay Tech UniversityUrcuquiEcuador

In November 2015,El Salvador reported their first case of Zika virus(ZIKV)infection,an event followed by an explosive outbreak that generated over 6000 suspected cases in a period of two *** agencies began implementing control measures that included vector control and recommending an increased use of ***,in response to the alarming and growing number of microcephaly cases in Brazil,the importance of avoiding pregnancies for two years was *** this paper,we explore the role of mobility within communities characterized by extreme poverty,crime and ***,the role of short term mobility between two idealized interconnected highly distinct communities is explored in the context of ZIKV *** make use of a Lagrangian modeling approach within a two-patch setting in order to highlight the possible effects that short-term mobility,within highly distinct environments,may have on the dynamics of ZIKV outbreak when the overall goal is to reduce the number of cases not just in the most affluent areas but *** depend on existing mobility patterns,levels of disease risk,and the ability of federal or state public health services to invest in resource limited areas,particularly in those where violence is *** results of simulations in highly polarized and simplified scenarios are used to assess the role of *** quickly became evident that matching observed patterns of ZIKV outbreaks could not be captured without incorporating increasing levels of *** number of distinct patches and variations on patch connectivity structure required to match ZIKV patterns could not be met within the highly aggregated model that is used in the simulations.

关键词： Vector-borne diseases Zika virus Residence times Multi-patch model

First Serological Evidence on Endemicity of HEV Infection in Wild Boar(Sus scrofa) Populations from Portugal

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Virologica Sinica 2018年第2期33卷 197-200页

作者： Daniel Goncalves Joao Pereira-Vaz Vitor Duque victor Bandeira carlos Fonseca Ana Donato Cristina Luxo Ana Miguel Matos Laboratory of Virology Faculty of Pharmacy University of Coimbra 3000-548 Coimbra Portugal Laboratory of Molecular Biology Clinical Pathology UnitHospital and University Centre of Coimbra3000-602 Coimbra Portugal Infectious Diseases Department Hospital and University Centre of Coimbra 3000-075 Coimbra Portugal Biology Department and CESAM University of Aveiro3810-193 Aveiro Portugal Clinical Laboratory Faculty of Pharmacy University of Coimbra 3000-548 Coimbra Portugal Research Centre on Chemical Processes Engineering and Forest Products (CIEPQF) Faculty of Pharmacy University of Coimbra 3030-790 Coimbra Portugal

Increasing number of hepatitis E virus（HEV）infection has been described in industrialized countries,with infection occurring as a sporadic disease,usually associated with travel to endemic regions or small outbreaks... 详细信息

关键词：感染 HEV 血清学葡萄牙野猪证据特性人口