Inflammatory response measured by body temperature, C-reactive protein and white blood cell count 1, 3, and 5 days after laparotomic or laparoscopic gastric bypass surgery.

BACKGROUND: Morbid obesity is a chronic inflammatory condition due to the production of several cytokines from the adipose tissue. However, what happens with some of these parameters the first days after surgery is unknown. Therefore, the objective of the present study was to determine, through a prospective and descriptive study, the behavior of the C-reactive protein (CRP), the white blood cell count, and the body temperature prior to a gastric bypass and for 5 days afterwards. METHODS: A total of 156 patients with morbid obesity were included in this prospective study. There were 120 women and 36 men, with a mean age of 41 years and a body mass index of 43 kg/m(2). They were submitted either to a laparotomic resectional gastric bypass or to a laparoscopic gastric bypass. Body temperature was measured every 8 h during 5 days. CPR and white blood cells were measured at the first, third, and fifth day after surgery. RESULTS: All patients had a normal postoperative course. Body temperature showed no change. White blood cells increased significantly at the first and third day after surgery but normalized by the fifth day. However, the third day after surgery, laparotomic gastric bypass patients showed a significantly greater increase in the total white blood cell count as well as in segmented neutrophil cells compared to laparoscopic surgery patients. CRP exhibited a similar increase and was more pronounced after a laparotomic approach. CONCLUSION: During the 5 days after gastric bypass, a significant increase in white blood cells and CRP was observed. The increase was significantly greater after a laparotomic bypass compared to the laparoscopic approach.

Sarcoma de kaposi clásico: metastasis pulmonar en relación a un caso inmunocompetente / Classical kaposis sarcoma: lung metastasis in relation a case an inmunocompetent

El Sarcoma de Kaposis define una lesión reticuloendotelial angiógena que se presenta como lesión marrón púrpura principalmente en extremidades inferiores por debajo de las rodillas o en región perubucal, cuya forma de presentación clásica epidemiológicamente afecta a edades avanzadas, a deferencia de los observados en pacientes con algún grado de inmunocompromiso. Desde el punto de vista epidemiológico se conocen cuatro tipos de Sarcoma de Kaposi, a saber: Clásico, Africano Endénico, Epidémico relacionado al SIDA y al asociado a Terapia Inmunosupresora. Es un tumor que predomina en el sexo masculino con una relación 10:1, que se ha documentado principalmente al Sur y al Este de Europa y Africa. Se han propuesto etiologías vasculares e infecciosas, siendo esta última la más aceptada, involucrando al Herpes virus o al Citomegalovirus. El compromiso pulmonar por Sarcoma de Kaposi es excepcional. Se han informado 6 casos, 5 de ellos con algún grado de inmunocompromiso, bien sea por patología relacionada al SIDA o por inmunosupresión post-quimioterapia de transplante renal. Hemos podido documentar un caso de compromiso pulmonar de Sarcoma de Kaposi en pacientes inmunocompetente, por lo que el presente caso en cuestión sería el segundo caso reportado bajo tales condiciones