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1.
World J Gastroenterol ; 23(33): 6049-6058, 2017 Sep 07.
Artigo em Inglês | MEDLINE | ID: mdl-28970720

RESUMO

Colorectal cancer (CRC) is a common health problem, representing the third most commonly diagnosed cancer worldwide and causing a significant burden in terms of morbidity and mortality, with annual deaths estimated at 700000. The western way of life, that is being rapidly adopted in many regions of the world, is a well discussed risk factor for CRC and could be targeted in terms of primary prevention. Furthermore, the relatively slow development of this cancer permits drastic reduction of incidence and mortality through secondary prevention. These facts underlie primary care physicians (PCPs) being assigned a key role in health strategies that enhance prevention and prompt diagnosis. Herein, we review the main topics of CRC in the current literature, in order to better understand its pathogenesis, risk and protective factors, as well as screening techniques. Furthermore, we discuss preventive and screening policies to combat CRC and the crucial role served by PCPs in their successful implementation. Relevant articles were identified through electronic searches of MEDLINE and through manual searches of reference lists.


Assuntos
Neoplasias Colorretais/diagnóstico , Detecção Precoce de Câncer/métodos , Programas de Rastreamento/métodos , Médicos de Atenção Primária/organização & administração , Atenção Primária à Saúde/métodos , Colonoscopia/instrumentação , Colonoscopia/métodos , Neoplasias Colorretais/epidemiologia , Neoplasias Colorretais/prevenção & controle , Neoplasias Colorretais/terapia , Humanos , Incidência , Sangue Oculto , Atenção Primária à Saúde/organização & administração , Prevenção Primária/métodos , Fatores de Risco , Prevenção Secundária/métodos , Tomografia Computadorizada por Raios X
3.
World J Surg ; 39(2): 417-23, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25331726

RESUMO

BACKGROUND: The aim of this study was to evaluate the effects of surgically induced weight loss on the abdominal adipose tissue depots and the metabolic profile in morbidly obese (MO) patients. METHODS: The study was performed with a semi-automated quantification of adipose tissue compartments on single-slice abdominal CT series before surgery, 6 and 12 months after bariatric surgery. Thirty-eight MO patients with mean age of 35.7 ± 10.1 years and mean body mass index (BMI) of 43.6 ± 6.5 kg/m(2) were studied (20 patients underwent gastric banding and 18 patients underwent sleeve gastrectomy). Anthropometric measurements, metabolic and inflammatory parameters were analyzed in each patient. RESULTS: Markedly decreased levels of total abdominal adipose tissue, abdominal subcutaneous adipose tissue (AbSAT) and visceral adipose tissue (VAT) at 6 and 12 months were noted in comparison to the preoperative values. The total % reduction of VAT was significant higher in comparison to the total % reduction of AbSAT at 12 months after bariatric surgery (P < 0.01) with the mean ratio of AbSAT/VAT to increase from 4.1 ± 1.7 preoperatively to 6.2 ± 3.1 at 12 months postoperatively (P < 0.001). In addition, high-sensitivity C-reactive protein (hsCRP) decreased significantly with weight loss after bariatric surgery and the total abdominal lipid loss was related to the decrease in hsCRP. CONCLUSIONS: Significant changes in abdominal lipid deposition occurred in MO patients 6 and 12 months after bariatric surgery. The changes were significantly, correlated with the magnitude of BMI loss. The fat redistribution may contribute to the improvements in metabolic abnormalities.


Assuntos
Proteína C-Reativa/metabolismo , Gordura Intra-Abdominal , Obesidade Mórbida/sangue , Obesidade Mórbida/cirurgia , Gordura Subcutânea Abdominal , Redução de Peso , Adiposidade , Adulto , Índice de Massa Corporal , Feminino , Gastrectomia , Gastroplastia , Humanos , Gordura Intra-Abdominal/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Período Pós-Operatório , Período Pré-Operatório , Estudos Prospectivos , Gordura Subcutânea Abdominal/diagnóstico por imagem , Tomografia Computadorizada por Raios X
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