Frequency of cardiovascular risk factors before and 6 and 12 months after bariatric surgery.

OBJECTIVE: To compare the frequency of cardiovascular risk factors (CVRFs) in obese patients of the Brazilian Unified Health System (Sistema Único de Saúde - SUS) with indication of bariatric surgery during the preoperative period and after the sixth month and the first year of the procedure. METHODS: An observational, longitudinal, prospective, and analytical study was performed, with consecutive selection of obese patients with indication for surgery referred to preoperative cardiac evaluation. The protocol consisted of: medical history, physical examination, electrocardiogram, echocardiogram, and biochemical analysis. This study analyzed the following variables: weight, body mass index (BMI), waist circumference (WC), systemic arterial hypertension (SAH), diabetes mellitus type 2(DM), dyslipidemia (high LDL cholesterol; low HDL cholesterol; hypertriglyceridemia), and metabolic syndrome (MS). The chi-squared test and the Tukey-Kramer method were used for statistical analysis. RESULTS: The sample was composed of 96 obese people, among which 86 were women, aged between 18 and 58 years old (median 35 years old). At the end of six months, significant reductions of 88%, 95%, 71%, 89%, and 80% in the frequency of SAH, high LDL cholesterol, hypertriglyceridemia, DM, and MS could already be observed. A significant and small reduction in the frequency of low HDL cholesterol (24%) and abnormal WC (31%) was observed only at the end of 12 months. After six months and one year, weight and BMI experienced reductions of 33.4kg and 44.3kg, and 13.1kg/m(2) and 17.2kg/m(2), respectively. CONCLUSION: The positive impact on weight loss and the reduction in BMI, WC, and in the frequency of CVRFs are already extremely significant after six months and remain so one year after bariatric surgery.

Hepatocarcinoma: estudo de 4 casos / Hepatocarcinoma: 4 cases studied

Analisamos quatro casos de hepatocarcinoma em 13 anos, no Hospital Universitario da Universidade Federal de Alagoas. O tempo do aparecimento do 1 sintoma a procura de auxilio medico variou de 2 a 7 meses, com media de 4 meses. As queixas iniciais mais comuns foram: dor abdominal e emagreciment(100%); tumoraçao abdominal (75%). Ao exame fisico todos pacientes tinham hepatomegalia.. Houve antecedentes de transfusao de sangue, esquistossomose, portador cronico de virus da hepatite B, alcoolismo e uso denanticonceptivos orais.O diagnostico definitivo foi feito em 50% dos casos pela biopsia laparoscopica;25% por laparotomia exploradora e biopsia; e 25% por biopsia transparietohepatica.Em face do estagio adiantado em que se apresentaram, em todos os casos, nao foi instituido tratamento adequado. Concluimos portanto, a necessidade de se desenvolver meios para diagnostico precoce dessa patologia, em nosso meio