Alexandre Vontobel Padoin

Introduction: Roux-en-Y gastric bypass demonstrates high efficacy in reversing vitamin D deficiency and improving the lipid profile in obese patients, thereby reducing cardiovascular risks. The high prevalence of dyslipidemia and cardiovascular risk associated with obesity constitute a serious public health problem, a scenario significantly exacerbated by vitamin D deficiency. Objective: To evaluate the correlation between serum vitamin D levels and the lipid profile in patients with obesity undergoing Roux-en-Y gastric bypass. Methods: A retrospective study in which data were collected at baseline (0) and at 6 and 12 months postoperatively during the periods 2018–2019 and 2021–2022. All patients underwent Roux-en-Y gastric bypass. Patients were divided into Group 1 (pre-pandemic) and Group 2 (post-pandemic). Preoperatively, participants were classified according to vitamin D status as sufficient, deficient, or insufficient. Data were organized in Excel 2010, with variables described using frequencies. Longitudinal variability was assessed using Generalized Estimating Equations (GEE), and Pearson's correlation was used, with a significance level of p<0.05. Results: The study evaluated 246 patients who underwent gastric bypass (100 in Group 1 and 146 in Group 2). Preoperative vitamin D deficiency affected approximately 48% to 50% of the patients. At 6 and 12 months post-surgery, the vast majority of patients showed improvement in vitamin D levels. Conclusion: Roux-en-Y gastric bypass is highly effective in reversing vitamin D deficiency and optimizing the lipid profile. Both conditions improve in parallel due to weight loss and overall metabolic improvement, reinforcing the importance of continuous monitoring.

Reading is an essential skill intrinsically linked to children’s academic and social success throughout development (Burgess & Cutting, 2023; Peng & Kievit, 2020; Rasinski et al., 2005). Difficulti...

Objectives: This protocol aims to explore the relationship between lifestyle and brain health biomarkers, assess the effects of a multifaceted intervention, and identify factors linked to brain resilience in middle-aged adults. Methods: Adults aged 40–59 years from Porto Alegre, RS, Brazil without neurodegenerative or severe psychiatric disorders will be included. The study consists of 3 phases: (1) online questionnaires assessing 7 brain health domains (general health, physical activity, cognition, social life, purpose, sleep, and nutrition); (2) clinical and functional assessments through biomarker collection, using instruments such as a P-WALK 2.0 baropodometric platform, a Cybex isokinetic dynamometer, an InBody 770, an OMRON sphygmomanometer, the Short Physical Performance Battery, and the Timed Up and Go test; (3) a 16-week randomized trial with 4 weekly sessions of strength and aerobic training. Post-intervention assessments will be conducted. Statistical analyses will include t-tests, ANOVA, regressions, and normality tests, using IBM SPSS Statistics, with significance set at p < 0.05. The study has been approved by the Institutional Research Ethics Committee (No. 7.323.434) and was funded by the National Council for Scientific and Technological Development (CNPq). Expected results: Brain health biomarkers should improve, especially in individuals with lower cognitive reserve, and we expect to identify modifiable factors associated with neuropsychological decline. Relevance: Midlife is a critical window for targeting brain health due to its relevance in preventing neurodegenerative diseases. This study seeks to support public health strategies promoting cognitive resilience.

Introduction Colorectal cancer is the third most common malignant neoplasm worldwide, with ∼ 150 thousand new cases each year. Screening policies have brought significant progress due to the possibility of early diagnosis and polyp resection. Therefore, there is a need for continuous evaluation of the quality of colonoscopies based on well-established criteria in the literature. Materials and Methods The present retrospective study assesses the quality of colonoscopies performed at a tertiary hospital, comparing resident physicians with their preceptors. A total of 422 preceptor exams and 115 resident exams were evaluated, with a comparison of the adenoma detection rate, cecal intubation rate, examination time, and bowel preparation quality. Results The adenoma detection rate in the exams performed by preceptors was of 46.9%, while in those performed by residents, it was of 35.2% (p = 0.038). The cecal intubation rate was of 98.6% in the preceptor group and of 94.8% in the resident group (p = 0.025). The median total examination time was of 13 minutes and 42 seconds in the preceptor group and of 19 minutes and 22 seconds in the resident group (p < 0.005). Conclusion During their training, resident physicians perform an adequate number of colonoscopies, which enables them to achieve adenoma detection rates, cecal intubation and examination times within the limits proposed by the literature.

Cirurgia bariátrica é um tratamento eficaz para obesidade mórbida. Alguns fatores psicológicos podem impactar no resultado pós-operatório relacionado a perda de peso. Investigar a influência das expectativas e motivações pré-operatórias e presença de outros transtornos psicológicos que tem potencial de estarem ligados ao desfecho desfavorável foi o objetivo desta pesquisa. Este estudo retrospectivo, caso controle considerou 44 casos de fracasso para 88 controles de sucesso numa amostra randomizada de pacientes operados num serviço de referência de um Hospital Escola. Os resultados revelaram que expectativas relacionadas a diminuição do preconceito social e melhoria da capacidade e condições de trabalho estão associadas a resposta insatisfatória na perda do excesso de peso esperada neste procedimento cirúrgico. Falhas em tratamentos prévios para controle da obesidade foram apontadas como indicador favorável relacionado ao sucesso na perda de peso pós cirurgia. E não houve associação de outros transtornos psicológicos com o resultado de fracasso.

Background: The aim of this study was to evaluate the influence of the body mass index (BMI) on laboratory, clinical outcomes and treatment costs of assisted reproduction, as there are still controversial and inconclusive studies on this subject. Methods: This research was retrospective cohort study, including women undergoing assisted reproduction in a Reproductive Medicine Center between 2013 and 2020. The participants were divided into groups according to BMI (kg/m²): Group 1 < 25; Group 2, 25–29.9 and Group 3, ≥ 30. A total of 1753 in vitro fertilization (IVF) fresh embryo transfer (ET) cycles were included for assisted reproduction outcomes analysis and 1869 IVF-ET plus frozen embryo transfer (FET) for cumulative pregnancy analysis. Results: As higher the BMI, higher was the proportion of canceled IVF cycles (G1 (6.9%) vs. G2 (7.8%) vs. G3 (10.4%), p = 0.002) and gonadotropin’s total dose (IU) and treatment costs (G1 (1685 ± 595, U$ 683,02) vs. G2 (1779 ± 610, U$ 721,13) vs. G3 (1805 ± 563, U$ 764,09), p = 0.001). A greater number of mature oocytes was observed in G1 and G2 (6 [6.4–7.0] vs. 6 [5.6–6.6] vs. 4 [4.6–6.7], p = 0.011), which was not found in oocyte maturity rate (p = 0.877). A significant linear tendency (p = 0.042) was found in cumulative pregnancy rates, pointing to worse clinical outcomes in overweight and obese patients. Conclusion: These findings highlight the importance of considering the higher treatment costs for these patients, beyond all the well-known risks regarding weight excess, fertility, and pregnancy, before starting IVF treatments.

In spontaneous pregnancies, maternal weight and gestational diabetes are independent risk factors for macrosomia and large-for-gestational-age newborns. Furthermore, maternal body mass index (BMI) of ≥25 kg/m² is associated with worse neonatal vitality, classified as an Apgar score of < 7 at the fifth minute of life. However, few studies have evaluated the influence of BMI on perinatal outcomes in pregnancies resulting from assisted reproduction. Therefore, this study aimed to analyze whether the perinatal outcomes of assisted reproduction are influenced by BMI. This was a retrospective cohort study performed at a reproductive medicine center. Patients undergoing assisted reproduction (2013–2020) were divided into three groups according to their BMI (kg/m²): group 1, < 25; group 2, 25–29.9, and group 3, ≥30. In total, 1753 in vitro fertilization embryo transfer cycles were analyzed. Data were expressed as mean ± standard deviation or frequency (%). The analysis of variance and chi-square test were performed for comparison. To determine the participants and number of cycles for these analyses, generalized estimating equations were used, considering p < 0.05. In groups 1, 2, and 3, the rates of live birth were 33.5, 32.3, and 29.9% (p = 0.668); preeclampsia were 2.9, 6.1, and 6.3% (p = 0.268); small-for-gestational-age newborns were 23, 23.2, and 21.7% (p = 0.965); macrosomia were 1.9, 0.9, and 2.7% (p = 0.708); Apgar score > 7 at the fifth minute were 97.6, 98.2, and 100% (p = 0.616); and preterm birth were 29.6, 30.1, and 35.1% (p = 0.970), respectively. In conclusion, although the three groups had similar perinatal outcomes in this study, the study population was too small for conclusive results. The higher the BMI, the lower the chances of clinically relevant LBR and the higher the chances of premature labor and preeclampsia.