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S. Nicola in Bari und seine architektonische Nachfolge : ein Bautypus des 11.-17. Jahrhunderts in Unteritalien und Dalmatien /Kappel, Kai. January 1996 (has links)
Texte remanié de: Diss.--Mainz, 1993. / Bibliogr. p. 360-386. Index.
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Studien zur normannisch-italischen Diplomatick.Salomon, Richard George, January 1907 (has links)
Inaug-diss. - Berlin.
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Studien zur normannisch-italischen Diplomatick.Salomon, Richard George, January 1907 (has links)
Inaug-diss. - Berlin.
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Studien zur normannisch-italienischen Diplomatik Teil I, Kap. IV,1 : die Herzogsurkunden für Bari /Salomon, Richard, January 1907 (has links)
Thesis--Berlin. / Vita. Includes bibliographical references.
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Politiques et outils de planification territoriale sur l'insécurité urbaine en Italie : le cas du plan stratégique de l'aire métropolitaine de Bari / Politiche e strumenti di pianificazione territoriale sull’insicurezza urbana in Italia : il caso del piano strategico dell’area metropolitana di Bari / The politics and tools for territorial planning regarding urban insecurity in Italy : the case of the Strategic Plan of the Bari Metropolitan AreaBellino, Luigi 28 October 2013 (has links)
Cette thèse propose une étude de l’évolution des politiques et des outils d’aménagementdu territoire sur l’insécurité urbaine, à l’aune du cas du Plan Stratégique Métropole Terrede Bari (PSMTB), qui comprend 31 communes de la Région Pouilles, en Italie.L’insécurité constitue une question cruciale pour les villes. L’unsafety, qui inclue desaspects de la marginalité urbaine, n’est pas sans renvoyer au système des perceptionsindividuelles et collectives. Si dans le passé l’Etat était le garant de la sécurité, leprocessus de globalisation et les poussés à décentralisation en ont considérablement réduitle rôle. Dès années 1990, les Maires italiens, bien que dépourvus de « pouvoirs »effectifs, sont considérés comme les responsables de la sécurité locale. Dans d’autres paysont été élaborés des outils de « prévention », qui sont peu utilisés en Italie, mais quisollicitent pour autant une évaluation critique. Alors que les solutions visant l’insécuritéurbaine ne produisent que de modestes résultats, les banlieues en quête d’identité sontl’objet de politiques d’inclusivité sociale, qui se déclinent par des outils d’aménagementaxés sur la requalification et la régénération urbaines, d’une part. D’autre part, laplanification stratégique se réfère à une échelle métropolitaine dénommée Area Vasta. Sibien le PSMTB a inclus la question de la sécurité, à l’égard d’un territoire où le rôle de lacriminalité est devenu envahissant, sa mise en place a fait recours à des financementscommunautaires, lesquels d’après nous en ont pénalisé ses aboutissements. Notrehypothèse est que le PSMTB, n’a pas une projectualité stratégique et est une occasionmanquée pour la réalisation d’un plan de la sécurité urbaine de l’aire métropolitaine deBari. / This study proposes to reconstruct the evolution of the politics and the tools of urbanplanning concerning urban insecurity by studying the Strategic Plan of the Bari MetropoliArea (PSMTB), including 31 municipalities in the Italian Apulian Region. Insecurityconstitutes a fundamental question for the cities. Unsafety, which includes severalconditions of urban degradation, also refers to individual and collective perceptions. If, inthe past, the State guaranteed security, the globalized processes and the tending towardsthe administrative decentralization, have, in part, diminished the role of the State. Sincethe 1990s, the Italian mayors, though not having any effective “power”, do have theresponsibility for the local security. In other countries, “models” of prevention have beendeveloped, but seldom applied in Italy, which, however, should be considered withcritique. While the solutions regarding security have produced modest results, in theperipheries with no “recognition”, urban politics have begun to show interest in thepopulation by applying urban requalification projects and regeneration programs.Furthermore, strategic planning refers to the scale of Area vasta. The PSMTB hasincluded the question of urban security in a territory where organized crime is pervasive.Its Plan has a tight connection with the EU’s financial aid; however, this has penalized itssuccess. Our hypothesis is that the PSMTB, in the end, was not strategic after all. It hasconstituted a lacking opportunity for a virtual plan of urban security on the metropolitanscale.
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Influ?ncia da obesidade na percep??o da idade facialValente, Denis Souto 25 May 2017 (has links)
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Previous issue date: 2017-05-25 / Background- Perception of facial age is a health biomarker. Bariatric surgery provides benefits to obese people. Knowledge is scarce about the role of obesity in facial age.
Objectives- The aim of this study is to verify whether there is a change in the perception of facial age when comparing people with morbid obesity before surgery and one year after the procedure, along with normal weight controls.
Methods- Through a prospective cohort, subjects with morbid obesity were reassessed after undergoing bariatric surgery. In a transversal study, these individuals were compared to people of normal weight. Seven plastic surgeons estimated the age of each subject based solely on their photographs. The difference in each age perceived was calculated.
Results- Before surgery the mean facial age perception was 40.8 years and after was 43.7 years (p = 0.004). In the control group a mean difference of -1.03 years was observed, different from morbid obesity (p = 0.045) and after bariatric surgery (p = 0.001). Men over 40 years of age, with a preoperative body mass index between 40 kg and 49.9 kg/m2, weight greater than 127.65 kg before surgery, and the percentage loss of excess weight greater than 75.13%, demonstrated greater perceived facial aging.
Conclusion- Bariatric surgery produces facial aging. Morbidly obese people and individuals who have undergone bariatric surgery appear to be older than people who have always been thin. / Introdu??o- A percep??o da idade facial ? um biomarcador de sa?de. A cirurgia bari?trica proporciona benef?cios para pessoas obesas. O conhecimento ? escasso acerca do papel da obesidade na idade facial.
Objetivos- Verificar se existe modifica??o na percep??o da idade facial ao comparar pessoas com obesidade m?rbida antes da cirurgia e um ano ap?s a realiza??o desta, bem como controles de peso normal.
M?todos- Atrav?s de uma coorte prospectiva os sujeitos com obesidade m?rbida foram reavaliados ap?s passarem pela cirurgia bari?trica. No estudo transversal estes mesmos indiv?duos foram comparados com pessoas de peso normal. Sete cirurgi?es pl?sticos presumiram a idade de cada sujeito somente atrav?s de suas fotografias. Foi calculada a diferen?a de cada idade percebida.
Resultados- Antes da cirurgia a m?dia de percep??o da idade facial foi de 40,8 anos e ap?s foi de 43,7 anos (p=0,004). No Grupo controle se observou a diferen?a na percep??o da idade facial de -1,03 anos sendo diferente da obesidade m?rbida (p= 0,045) e ap?s a cirurgia (p=0,001). Homens, maiores de 40 anos, ?ndice de massa corporal pr?-operat?rio entre 40 e 49,9 kg/m2, peso maior do que 127,65 kg antes da cirurgia, perda de peso menor do que 43,15 kg e perda do percentual de excesso de peso maior do que 75,13% apresentaram maior envelhecimento facial.
Conclus?o- A cirurgia bari?trica produz envelhecimento facial. Pessoas com obesidade m?rbida e indiv?duos que se submeteram a cirurgia bari?trica aparentam ter mais idade do que pessoas que sempre foram magras.
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Reganho de peso ap??s cirurgia bari??trica em mulheres: estudo da din??mica familiarMenezes, C??cero Nunes 25 July 2017 (has links)
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Previous issue date: 2017-07-25 / Obesity is considered a worldwide epidemic, while grade III obesity is one of the most deadly diseases in the world. Research shows that the number of obese people in Brazil is 20.8% and reaches 36.9% worldwide. Today there are several treatments for the disease, and bariatric surgery the most effective method to control obesity and its comorbidities. However, weight regain accounts for about 7% to 50% of patients undergoing surgery. According to the systemic perspective, there are mutual influences between the individual and his primary system of development, which is the family. This system can be a context of health and also illness of its members. Thus, it is understood that the family can have influence in the emergence, as well as in the prevention and treatment of several diseases. Consistent with the need for a better understanding of this phenomenon and the search for more effective solutions, the present study had as its main objective: to understand how the family dynamics of adults submitted to bariatric surgery may or may not influence the weight regain after surgery. The specific objectives were: to identify aspects of the family structure, such as rules of relationship, types of borders and communication among its members; Know the family history, regarding the onset and development of obesity, treatments and context of the decision to do surgery and post-surgical period; To describe the family food pattern in the period before and after bariatric surgery, identifying the quality and amount of food and familiar situations involving food. Identify possible influences of other social systems (church, work school, health services) in the regain or not of weight by the women after the bariatric surgery. The qualitative methodology was privileged through the case study. Two families residing in Administrative Regions of the Federal District participated in the study, with adult women who underwent bariatric surgery; One of the patients presented a regain of weight above 10% in relation to the minimum weight reached after bariatric surgery while the other did not. Two meetings were held with each family, using a semi-structured interview script and the construction of the family genogram. The information collected was analyzed according to the interpretive constructive method, and discussed based on the family systemic approach. The results showed that in the patients family who presented a significant weight regain family boundaries and rules are diffuse and there are difficulties in the differentiation in relation to the extended family, and there is ambiguity in understanding the rules; In the patients family who did not have a weight regain there are clear rules of relationship and definition of the roles of their members; In both cases we observed the multifactorial aspect of obesity, since in addition to the genetic factors some characteristics of the family dynamics may have contributed in both cases; Adherence to treatment and family and social support contributed to the current picture of the cases studied. The data presented reinforce the importance of including the family and the social support network in the prevention, treatment and follow-up of obese patients before and after bariatric surgery. / A obesidade ?? considerada uma epidemia mundial, enquanto a obesidade grau III ?? uma das doen??as que mais matam no mundo. Pesquisas mostram que o n??mero de pessoas obesas no Brasil ?? de 20,8% e chega a 36,9% em todo o mundo. Hoje j?? existem v??rios tratamentos para a doen??a, sendo a cirurgia bari??trica o m??todo mais eficazes no controle da obesidade e de suas comorbidades. No entanto, o reganho de peso atinge cerca de 7 a 50% dos pacientes submetidos ?? cirurgia. De acordo com a perspectiva sist??mica, h?? influ??ncias m??tuas entre o indiv??duo e seu sistema prim??rio de desenvolvimento, que ?? a fam??lia. Este sistema pode ser um contexto de sa??de e tamb??m de adoecimento dos seus membros. Assim, entende-se que a fam??lia pode ter influ??ncia no surgimento, bem como na preven????o e tratamento de v??rias doen??as. Consoante com a necessidade de uma melhor compreens??o sobre esse fen??meno e a busca de solu????es mais eficazes, o presente estudo teve como objetivo principal: compreender como a din??mica familiar de adultos submetidos ?? cirurgia bari??trica pode influenciar ou n??o no reganho de peso p??s cirurgia. Os objetivos espec??ficos foram: identificar aspectos da estrutura familiar, como as regras de relacionamento, tipos de fronteiras e comunica????o entre seus membros; conhecer a hist??ria familiar, no que diz respeito ao in??cio e desenvolvimento da obesidade, tratamentos e contexto da decis??o de fazer a cirurgia e per??odo p??s-cir??rgico; descrever o padr??o alimentar da fam??lia no per??odo anterior e posterior ?? cirurgia bari??trica, identificando a qualidade e quantidade de alimentos e situa????es familiares envolvendo a alimenta????o; Identificar poss??veis influ??ncias de outros sistemas sociais (igreja, escola trabalho, servi??os de sa??de) no reganho ou n??o de peso pelas mulheres ap??s a cirurgia bari??trica. Privilegiou-se a metodologia qualitativa por meio do estudo de caso. Participaram da pesquisa duas fam??lias residentes em Regi??es Administrativas do Distrito Federal, com mulheres adultas que foram submetidas ?? cirurgia bari??trica; uma das pacientes apresentou reganho de peso acima de 10% em rela????o ao peso m??nimo alcan??ado ap??s a cirurgia bari??trica enquanto a outra n??o. Foram realizados dois encontros com cada fam??lia, utilizando um roteiro de entrevista semiestruturado e a constru????o do genograma familiar. As informa????es levantadas foram analisadas de acordo com o m??todo construtivo interpretativo, e discutidas com base na abordagem sist??mica da fam??lia. Os resultados mostraram que na fam??lia da paciente que apresentou significativo reganho de peso as fronteiras e regras familiares s??o difusas e h?? dificuldades na diferencia????o em rela????o ?? fam??lia extensa, e existe ambiguidade na compreens??o das regras; na fam??lia da paciente que n??o teve reganho de peso existem regras claras de relacionamento e defini????o dos pap??is de seus membros; em ambos os casos observamos o aspecto da multifatorialidade da obesidade, pois al??m dos fatores gen??ticos algumas caracter??sticas da din??mica familiar podem ter contribu??do nos dois casos; a ades??o ao tratamento e o apoio familiar e social contribu??ram para que o quadro atual dos casos estudados. Os dados apresentados refor??am a import??ncia da inclus??o da fam??lia e da rede de apoio social na preven????o, tratamento e acompanhamento de pacientes obesos antes e ap??s a cirurgia bari??trica.
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Evolu??o dos sintomas de compuls?o alimentar um ano ap?s cirurgia bari?trica e sua correla??o com a perda de pesoLuiz, Luciano Billodre 29 February 2016 (has links)
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Previous issue date: 2016-02-29 / Background- Bariatric surgery is the most effective treatment for obesity class II and III. However, some patients do not get the desired results or initially lose and then regain the weight lost. To identify this symptom early on and treat these individuals adequately remains a challenge. As binge eating directly affects the food intake, the study of this symptom and its relation to bariatric surgery and its results is increasing, because it appears to have an influence on the observed results. Objectives- The purpose of our study is to see how the variation in the intensity of the BE- measured by the Binge Eating Scale (BES)- interferes in the %EWL one year after YRGB. Methods- We conducted a transversal study with 149 patients older than 18 years who were evaluated one year after performing YRGB. The variation in the intensity of binge eating was measured through the difference of the BES score pre and postoperative. Results- The variation of one unit in the BES implies an inverse variation of 0, 41% of %EWL (p <0, 05). The coefficient of correlation between the variation symptoms BE and the %EWL is -0,186 (p=0,033). The coefficient of correlation between the intensity of BE symptoms one year after surgery and the %EWL is -0,353 (p <0,001). Conclusions- There is a correlation between the variation in intensity of the BE one year after YRGB and the %EWL. The correlation between the BE and the %EWL is greater after the surgery than it is at the preoperative stage. / Introdu??o- A cirurgia bari?trica ? a ferramenta mais eficaz para o tratamento e controle da obesidade classe II e III. Entretanto, alguns pacientes n?o obt?m o resultado desejado ou reganham peso. Identificar precocemente e tratar estes indiv?duos continua sendo um desafio. Como a compuls?o alimentar interfere diretamente na ingesta alimentar, o estudo deste sintoma e sua rela??o com a cirurgia bari?trica vem aumentando, pois parece influenciar nos resultados da mesma. Objetivos- O objetivo do nosso estudo ? verificar como a varia??o da intensidade da compuls?o alimentar, aferidos pela escala de compuls?o alimentar peri?dica (ECAP), interfere na percentagem de perda do excesso de peso (%PEP) um ano ap?s cirurgia bari?trica. M?todos- Realizamos um estudo transversal com 149 pacientes, maiores de 18 anos, que foram avaliados um ano ap?s realizarem cirurgia bari?trica no Hospital S?o Lucas da PUCRS. A varia??o dos sintomas de compuls?o alimentar foi aferida atrav?s da diferen?a do escore da ECAP do p?s e do pr?-operat?rio, Delta ECAP. Resultados- A varia??o de uma unidade na ECAP implica em uma varia??o inversa de 0,41 %PEP (p<0,05) (IC de -0,78 a -0,02). O coeficiente de correla??o entre a varia??o dos sintomas de compuls?o alimentar e a %PEP ? de -0,186 (p=0,033). O coeficiente de correla??o entre a intensidade dos sintomas de compuls?o alimentar um ano ap?s a cirurgia e a %PEP ? de -0,353 (p<0,001). Conclus?o- Existe uma correla??o entre a varia??o da intensidade dos sintomas de compuls?o alimentar um ano ap?s cirurgia bari?trica e a %PEP. A correla??o entre a intensidade da compuls?o alimentar e a %PEP ? maior ap?s a cirurgia do que no pr?-operat?rio.
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Estimativa do custo do tratamento ambulatorial e cir?rgico da obesidade no Sistema ?nico de Sa?de brasileiroZubiaurre, Paula Rosales 10 March 2017 (has links)
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Previous issue date: 2017-03-10 / Introduction: The prevalence of obesity has tripled in the last four decades in
the world, from 4.8% in 1975 to 12.8% in 2014. In Brazil, there was an increase of
6.3% in the prevalence of obesity from 2006 to 2014. The Brazilian Unified Health
System had an annual cost of US$ 2.1 billion with outpatient procedures and
hospitalizations. Ten percent of this cost was exclusively spent to treat obesity. The
aim of this study was to compare the costs of medical and surgical treatment of severe
obesity at centers of excellence for the treatment of obesity funded by the Brazilian
Unified Health System. We also intended to estimate the direct and indirect costs.
Methods: We conducted an observational, population-based, multicenter study
estimating the costs and loss of productivity during 12 months related to obese patients
treated at public centers of excellence for obesity.
Results: Our sample included 274 patients, 140 patients were allocated to the
surgical group and 134 patients were in medical group, with a female predominance in
both groups. The surgical group had a higher morbidity rate than the medical group.
The surgical group had a lower direct cost (Int$ 1,671.38 vs. Int$ 1,763.71). Three
years after the surgery, the indirect cost of medical treatment was higher than the
surgical treatment.
Conclusion: This study showed that the total costs were higher in the surgical
group in the first 2 years after surgery; however, from the third year on there was a
significant decrease in costs, reaching lower costs than the medical group.
Around 80% of the population studied in the female gender, which reflects a worldwide
reality of gender distribution. Indirect costs, which reflect obesity impacts on the labor
market, accounted for around 20% of total costs. / Introdu??o: A preval?ncia de obesidade triplicou nas ?ltimas quatro d?cadas
em termos mundiais, passando de 4,8% em 1975 para 12,8% em 2014. No Brasil
houve um incremento de 6,3% na preval?ncia de obesidade de 2006 para 2014. O
sistema p?blico de sa?de brasileiro demonstrou um custo anual com procedimentos
ambulatoriais e hospitaliza??es de US$2,1 bilh?es, dado que 10% seria a fra??o
atribu?vel exclusivamente ? obesidade. O objetivo do presente estudo foi comparar os
custos do tratamento cl?nico e cir?rgico da obesidade grave em centros de refer?ncia
para o tratamento da obesidade do Sistema ?nico de Sa?de Brasileiro e estimar os
custos diretos e indiretos.
M?todos: Estudo observacional, de base populacional, multic?ntrico, que
estimou a utiliza??o de recursos de sa?de e a perda de produtividade no per?odo de
12 meses de indiv?duos obesos em acompanhamento em centros de refer?ncia para
o tratamento da obesidade no SUS.
Resultados: Foi inclu?do um total de 274 pacientes, sendo 140 pacientes no
grupo cir?rgico e 134 pacientes no grupo cl?nico, com predom?nio do sexo feminino
em ambos os grupos. Mostrou-se que o grupo cir?rgico possui uma carga de
morbidade maior que o grupo cl?nico. O grupo cir?rgico apresentou um custo direto
menor (R$ 2.785,64 versus R$ 2.939,70). Ap?s o terceiro ano de p?s-operat?rio o
custo indireto do tratamento cl?nico j? ? superior ao tratamento cir?rgico.
Conclus?o: O presente estudo evidenciou que os custos totais foram maiores
no grupo cir?rgico nos primeiros 2 anos de p?s-operat?rio, por?m a partir do terceiro
ano houve uma diminui??o significativa, atingindo n?veis inferiores ao do grupo cl?nico.
Em torno de 80% da popula??o estudada ? do g?nero feminino, o que reflete a
realidade mundial da distribui??o de g?neros. Os custos indiretos, que refletem
impactos da obesidade no mercado de trabalho, representaram em torno de 20% dos
custos totais.
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Microbiota intestinal : impacto das interven??es para sobrepeso ou obesidadeSeganfredo, Fernanda Braga 06 September 2017 (has links)
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Previous issue date: 2017-09-06 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Background: Obesity is a worldwide concern of growing proportions, that increases both
morbidity and mortality of patients, despite having economic impact. Imbalances in the gut
microbiota - the bacteria that inhabit the intestines - are central to the pathogenesis of obesity.
Objectives: To assess the association between the gut microbiota and weight loss in
overweight/obese adults and its potential manipulation as a target for treating obesity.
Methodology: This study is a systematic review review that identified studies using the
keywords ?overweight? or ?obesity? and ?microbiota? and related terms. Results: 43 papers
were identified. Among these studies, 17 used dietary interventions, 11 used bariatric surgery
and 15 used microbiota manipulation. The studies differed in their methodologies as well as
their intervention lengths. Restrictive diets decreased the microbiota abundance, correlated
with nutrient deficiency rather than weight loss and generally reduced the butyrate producers
Firmicutes, Lactobacillus sp. and Bifidobacterium sp. The impact of surgical intervention
depended on the given technique and showed a similar effect on butyrate producers, in
addition to increasing the presence of the Proteobacteria phylum, which is related to changes
in the intestinal absorptive surface, pH and digestion time. Probiotics differed in strain and
duration with diverse effects on the microbiota, and they tended to reduce body fat. Prebiotics
had a bifidogenic effect and increased butyrate producers, likely due to cross-feeding
interactions, contributing to the gut barrier and improving metabolic outcomes. Conclusions:
All of the interventions under consideration had impacts on the gut microbiota, although they
did not always correlate with weight loss. These results show that restrictive diets and
bariatric surgery reduce microbial abundance and promote changes in microbial composition
that could have long-term detrimental effects on the colon. In contrast, prebiotics might
restore a healthy microbiome and reduce body fat. / Contexto: A obesidade ? uma doen?a de incid?ncia crescente mundialmente, que aumenta a
morbidade e mortalidade dos pacientes, al?m de ter impacto na economia. O desequil?brio na
microbiota intestinal - microrganismos que habitam o intestino humano - ? apontado como
importante na patog?nese dessa doen?a. Objetivos: Avaliar a associa??o entre microbiota
intestinal e perda ponderal em pacientes com sobrepeso ou obesidade, e a possibilidade do uso
de terapias que tenham como alvo a microbiota intestinal no tratamento dessas condi??es.
Metodologia: Este trabalho ? uma revis?o sistem?tica que identificou estudos utilizando os
termos ?sobrepeso? ou ?obesidade? e ?microbiota? ou termos relacionados. Resultados: Foram
identificados 43 estudos. Dentre esses, 17 utilizaram interven??es nutricionais, 11 realizaram
cirurgia bari?trica e 15 usaram manipula??o direta da microbiota intestinal (prebi?ticos,
probi?ticos ou simbi?ticos). Os estudos apresentaram metodologias e interven??es (tipo e
dura??o) heterog?neas. Interven??es nutricionais restritivas reduziram a abund?ncia
microbiana, correlacionada especialmente com defici?ncia de nutrientes, e n?o diretamente
com perda de peso; al?m de apresentarem tend?ncia a redu??o dos grupos bacterianos
produtores de butirato, como Firmicutes, Lactobacillus sp. e Bifidobacterium sp.. O impacto
das interven??es cir?rgicas (cirurgia bari?trica) depende da t?cnica escolhida e apresenta o
mesmo efeito nos grupos bacterianos produtores de butirato, adicionalmente aumentando a
abund?ncia do filo Proteobacteria, o que est? relacionado com modifica??es na superf?cie
absorptiva intestinal, pH e tempo de digest?o. O uso de probi?ticos variou entre os estudos
inclu?dos, com diferen?as na dura??o da suplementa??o e cepas utilizadas, resultando em
impacto diverso na microbiota, com tend?ncia a redu??o da gordura corporal. O uso de
prebi?ticos apresentou efeito bifidog?nico e consequente aumento dos grupos bacterianos
produtores de butirato, provavelmente relacionado a alimenta??o cruzada entre as esp?cies,
contribuindo para manuten??o da barreira intestinal e melhora dos desfechos metab?licos.
Conclus?es: Todas as interven??es consideradas apresentaram impacto na microbiota,
entretanto nem sempre correlacionado a perda ponderal. Esses resultados mostram que
interven??es nutricionais restritivas e cirurgia bari?trica reduzem a abund?ncia microbiana e
promovem mudan?as na microbiota intestinal que podem ser prejudiciais a sa?de do c?lon a
longo prazo. Em contraste, o uso de prebi?ticos pode restaurar uma microbiota saud?vel e
reduzir gordura corporal.
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