RESUMO Racional: As técnicas de endoscopia bariátrica são minimamente invasivas e induzem à redução do volume gástrico para tratar a obesidade. Objetivo: Avaliar a gastroplastia sleeve endoscópica (método Apollo) usando um método de sutura direcionado para a grande curvatura, bem como os cuidados perioperatórios, segurança em dois anos e perda de peso. Método: Estudo prospectivo em um único centro com 154 pacientes (108 mulheres) usando o procedimento endoscópico de gastroplastia sleeve sob anestesia geral com observação do paciente internado durante a noite. Dos 154 pacientes iniciais, 143 estiveram disponíveis para acompanhamento de um mês, 133 durante seis meses, 64 durante 12 meses e 28 completaram a avaliação de 24 meses. O acompanhamento foi realizado por equipe multidisciplinar (nutricionista e psicólogo). Foram avaliados nos resultados as mudanças no IMC, no peso corporal (TWBL), no % de perda do peso corporal inicial (% TBWL) no % de excesso de perda de peso corporal (%EWL) segregado em > ou < 25% e efeitos adversos. Estudos radiológicos contratados orais voluntários foram programados para avaliar a gastroplastia em diferentes tempos após o procedimento. Resultados: A idade média foi de 44,9 anos (23-69). Aos 24 meses após o procedimento a linha de base média do IMC mudou de 38,3 para 30,8 kg/m2. O TBWL, %TBWL e %EWL foram de 21,3 kg, 19,5% e 60,4%, respectivamente, e 85,7% dos pacientes alcançaram o objetivo de >25% EWL. Não houve eventos adversos graves peroperatórios ou durante os 24 meses de acompanhamento. Conclusão: A gastroplastia sleeve endoscópica com monitoramento regular por equipe multidisciplinar pode ser considerado procedimento eficaz, seguro e bem tolerado para o tratamento de pacientes com obesidade, pelo menos nos dois anos de acompanhamento.

ABSTRACT Background: Bariatric endoscopic techniques are minimally invasive and induce gastric volume reduction to treat obesity. Aim: To evaluate endoscopic sleeve gastroplasty (Apollo method) using a suturing method directed at the greater curvature, as well as the perioperative care, two year safety and weight loss. Method: Prospective single-center study over 154 patients (108 females) using the endoscopic sleeve gastroplasty procedure under general anesthesia with overnight inpatient observation. Of the154 initial patients, 143 were available for 1-month of follow-up, 133 for 6-month, 64 for 12-month and 28 completed the 24 month assessment. Follow-up was carried out by a multidisciplinary team (nutritionist and psychologist). Outcomes evaluated were: change in BMI; change in body weight (TBWL); % of loss of initial body weight (%TBWL); % of excess body weight loss (%EWL) (segregated in > or <25% and adverse effects. Voluntary oral contrasted radiological examinations were scheduled to assess the gastroplasty at different times post-procedure. Results: Mean age was 44.9 (23-69) years. At 24 months after the procedure baseline mean BMI change from 38.3 to 30.8 kg/m2. TBWL, %TBWL and %EWL were of 21.3 kg, 19.5% and 60.4% respectively. 85.7% of patients achieve the goal of >25% %EWL. There were no mayor adverse events intraprocedure or during the 24 months of follow-up . Conclusion: Endoscopic sleeve gastroplasty with regular monitoring by a multidisciplinary team can be considered an effective, safe and well tolerated procedure for obesity treatment, at least for two years of follow-up.

Resumen. Diferentes aislamientos del hongo entomopatogeno Beauveria bassiana se cultivaron en medio liquido (YPDA / YDA). Bajo estas condiciones B. bassiana fue capaz de producir y liberar al medio de cultivo una α-amilasa digestiva. Mediante elcctroforesis en geles de isoelectroenfoque (IEF) se logro estimar el punto isoelectrico (pl) de esta banda de actividad en 6.75. No se observaron variaciones en la intensidad de la actividad en esta banda para los diferentes aislamientos. Sin embargo, estos aislamientos mostraron diferencias consistentes en la actividad de la enzima especialmente cuando se utilizaron diferentes concentraciones de conidios de B. bassiana en el medio de cultivo. Este es un metodo simple y sensible para la determinacion de la actividad α-amilasa presento en el medio liquido de B. bassiana, el cual podria usarse satisfactoriamente no solo para la evaluacion de diferentes hongos entomopatogenicos, sino tambien, para hacer una determinacion rapida de posibles variaciones geneticas debidas a la presencia o ausencia de una enzima especifica.

Summary. Different isolates of the entomopathogenic fungus Beauveria bassiana were grown using a liquid medium (YPDA /YDA). Under these conditions B. bassiana was able to release an α-amylase enzyme into the medium. Using electrophoresis on isoelectric focusing (IEF) gels the isoelectric point (pl) of this amylase activity band was estimated at 6.75 using isoelectric focusing (IEF). Variation in the intensity of enzyme activity was not observed in this band for the different isolates. However, these isolates showed consistent differences in the α-amylase activity especially when different concentrations B.bassiana conidia were used in the culture medium. This is a simple and sensitive method to determine α-amylase activity in liquid culture of B. bassiana, which could be used satisfactorily not only to evaluate different fungal entomopathogens, but to make a rapid determination of the possible genetic variants based on the presence or absence of a specific enzyme.

Se estudio el efecto de dos entomonematodos nativos, Heterorhabditis sp. (Rhabditida: HeteroRhabditidae) y Steinernema sp. (Rhabditida: Steinernematidae) en dosificaciones de 125.000, 250.000 y 500.000 Juveniles Infectivos (JI) por plato del arbol sobre poblaciones de la broca del cafe, Hypothenemus hampei. Durante la primera cosecha de cafe del año 2001, no se encontraron diferencias estadisticas entre tratamientos en cuanto al nivel de infestacion por broca en el arbol debido a la alta variabilidad del numero de frutos con los que se inicio el experimento. Para la segunda cosecha de cafe del año 2001, se encontraron porcentajes de mortalidad de broca con las dos especies entre el 53 y el 88%, un mes despues de aplicacion, siendo diferentes esladisticamente (p<0,05) en relacion con el testigo (6%). Cinco de los seis tratamientos evaluados presentaron porcentajes promedios de infestacion por broca en el arbol (PPIA), inferiores al testigo 9,93 ± 1,81 (prom ± E. E), destacandose las aplicaciones de Steinernema sp. (500.000 Jl/plato) con una infestacion por broca de 4,17 ± 0,57 y para Heterorhabditis sp. (250.000 Jl/plato) con una infestacion por broca de 5,62 ± 1,24. Esta reduccion para cada uno de los casos equivale al 58 y 43,4%, respectivamente con relacion al testigo. Dicha disminucion puede explicarse, al observar los porcentajes de mortalidad promedios de estados de broca en frutos del suelo (PMB), que fluctuaron entre el 13,64 y el 42,27% para ambas especies de nematodos. A los 30 dias despues de la aplicacion, esta diferencia es notoria, encontrando diferencias signiflcativas con el testigo (p<0,05). En conclusion estos nematodos penetran los frutos brocados en el suelo, parasitan principalmente estados inmaduros, se reproducen en estos insectos parasitados y reducen poblaciones de broca en los cafetales.

The effect of two native entomopathogenic nematodes Heterorhabditis sp. (Rhabditida: HeteroRhabditidae) and Steinernema sp. (Rhabditida: Steinernematidae) was studied in doses of 125.000, 250.000 and 500.000 infective juvenils (U) per tree base on populations of the coffee berry borer, llypothenemus hampei. During the first coffee harvest of 2001, there were no statistical differences between treatments for infestation level in the tree due to the high variability of the number of fruits with which the experiment began. For the second coffee harvest of 2001, percentage of mortality of the coffee berry borer with the two species was 53 and 88%, a month after their application, statistically different (p<0,05) in relation to the control (6%). Five of the six evaluated treatments had average percentages of borer infestation in the tree (PPIA) lower than the control 9,93 ± 1,81 (mean ± S. E), particularly the applications of Steinernema sp. (500.000 U/plate) with a PPIA of 4,17 ± 0,57 and Heterorhabditis sp. (250.000 U/plate) with PPIA of 5,62 ± 1,24. This reduction is equivalent to 58 and 43,4%, respectively, in relation to the control. This reduction can be explained by observing the mean percentages of mortality of coffee berry borer life stages in fruits on the ground (PMB), which fluctuated between 13,64 and 42,27% for each species of nematodes. Thirty days after application, this difference is well established, with significant differences compared to the control (p<0,05). In conclusion, these nematodes penetrate the fallen fruits on the ground, mainly parasitize immature stages and reproduce in these insects within the fruit to reduce the populations of coffee berry borer in coffee plantations.