Effectiveness and Safety of a Very Low-Calorie Ketogenic Diet on Weight Regain Following Bariatric Surgery.

PURPOSE: Obesity is one of the major public health problems worldwide and bariatric surgery is considered the gold standard treatment for severe obesity. Although the literature supports the safety and efficacy of the very low-calorie ketogenic diet (VLCKD) in patients with obesity, there is no study analyzing the use in case of failure or weight regain after bariatric surgery. This work has the purpose of assessing the response to a VLCKD (Pnk® method) in this population. METHODS: We have conducted an observational, retrospective, and descriptive study with the analysis of medical charts of private offices where patients were examined between 2014 and 2019, totalizing 11 participants who underwent Roux-en-Y gastric bypass (RYGB) without a reduction of 50% in body weight excess or any weight regain after the surgery. The patients followed the first stage of a commercial weight loss program (Pnk® method) which consists of a VLCKD (600-800 kcal/day), low in carbohydrates and lipids. RESULTS: A significant reduction was observed (p-value < 0.05) in weight, body mass index (BMI), abdominal circumference (AC), and glycated hemoglobin (A1C) post-ketogenic diet. Uric acid, transaminases, urea, and creatinine values did not show differences between pre- and post-ketosis. During the course of the study, no serious adverse events were reported. CONCLUSION: This study has shown that the ketogenic diet can be recommended as an effective and safe treatment for patients who progressed with insufficient weight loss or regain after bariatric surgery.

Agravamento da leucopenia e morte súbita durante o tratamento de Calazar / Leucopena agravation and sudden death during the Calazar treatment

O Calazar é uma doença endêmica no Brasil, principalmente nos estados do nordeste. Eventualmente podem aparecer casos em estados como Säo Paulo, apresentando-se como formas clínicas näo usuais. Neste trabalho analisou-se retrospectivamente quatro casos confirmados que foram internados no Hospital Municipal de Santo André. Analisaram-se aspectos da apresentaçäo clínica e terapêutica. Avaliaram-se os efeitos colaterais do N-Metil glucamina (Glucantime), como piora da leucopenia e até a possibilidade de morte súbita