Obese patients with DM2 undergoing gastric bypass showed improved glycemic control and reduced use of hypoglycemic agents in the short-term.

Background: Roux-en-Y gastric bypass is one of the most common bariatric surgery and leads to considerable weight loss in the first months. Aim: To quantify the main early postoperative complications in patients submitted to the gastric bypass. Method: Observational retrospective cohort. Data of 1051 patients with class II obesity associated with comorbidities or class III obesity submitted to the gastric bypass with 30 days of follow-up starting from the date of the surgery. Results:The age average was 36 years with a predominance of females (81.1%). The mean preoperative body mass index was 43 kg/m². The major complication was fistula (2.3%), followed by intestinal obstruction (0.5%) and pulmonary embolism (0.5%). Death occurred in 0.6% of the cases. Conclusion:In the period of 30 days after surgery the overall complication rate was 3.8%; reoperation was necessary in 2.6% and death occurred in 0.6%. Fistula was the main complication and the leading cause of hospitalization in intensive care unit, reoperation and death.

Introduction: Bariatric surgery (BS) is an effective method for sustained weight loss and better quality of life. However, it has its complications. Among those, peripheral neuropathies are important, although underdiagnosed, complications after the surgery.Objective: The objective of this article is to describe the most prevalent peripheral neuropathies that may happen after BS, especially focusing on small fiber neuropathies, and the main nutritional deficits involved in these neuropathies.Methods: It was made a non-systematic review on Pub-Med/Medline database.Results: 32 articles were included. Conclusion:Further studies are needed to estimate the prevalence of peripheral neuropathies after BS, especially small fiber neuropathy. This lack of epidemiological studies corroborates to the underdiagnosis. We suggest researchers to make a prospective cohort about Small fiber neuropathy after BS.

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ZusammenfassungFragestellung: Wir untersuchten orolinguale Angioödeme bei Schlaganfall-Patienten, die eine intravenöse Thrombolyse erhielten. Material und Methoden: In zwei Zentren wurden von Januar 2004 bis Dezember 2008 Häufigkeit, Ausprägung und Folgen eines orolingualen Angioödems während Thrombolyse mitrt- PA erfasst. In einer Metaanalyse wurde das Risiko für Angioödeme unter ACE-Hemmern berechnet. Ergebnisse: Bei 548 thombolysierten Patienten traten sechs orolinguale Angioödeme auf. Vier dieser Patienten mussten intubiert und beatmet werden. Fünf Patienten nahmen vor Thrombolyse ACE-Hemmer ein. In einer Metaanalyse betrug die Odds ratio 24, das heißt, das Risiko unter ACE-Hemmern während der Thrombolyse mit rt-PA ein orolinguales Angioödem zu bekommen, ist stark erhöht. Schlussfolgerung: Ärzte und Pflegekräfte müssen Patienten während der Thrombolyse engmaschig klinisch überwachen und über die Möglichkeit des zwar seltenen, aber potenziell lebensbedrohlichen orolingualen Angioödems informiert sein.