Although there is no indication for surgery taking only into account the glycemic
condition, results have shown that benefits can be obtained in glycemic control with
bariatric surgery.Aim: To compare the glycemic behavior among type 2 diabetic and non-diabetic patients
within 48 h after bariatric surgery, and clarify whether there is a reduction in
blood glucose level in obese patients with diabetes before the loss of weight
excess. Methods: Descriptive epidemiological study with prospective cohort design with 31 obese
patients undergoing Roux-en-Y gastric bypass and sleeve gastrectomy. The patients
were controlled with hemoglucotests in different periods of time: preoperative,
postoperative and each 6 h after surgery for 48 h. Results: Average ambulatory blood glucose in diabetics was 120.7±2.9 mg/dl vs 91.8±13.9
mg/dl in the nondiabetic. After 48 h there was decrease in diabetics to 100.0±17.0
mg/dl (p=0.003), while the non-diabetic group did not change significantly
(102.7±25.4 mg/dl; p=0.097). There were no differences between the surgical
techniques. There were no death. Conclusions: Diabetic patients significantly reduced blood glucose after surgery regardless
of the use of exogenous insulin or oral hypoglycemic agents.
Arterial puncture, better known as catheterization, has become an important diagnostic tool in recent years. For its realization, generally the option is the Seldinger technique, which is considered today the safest and most often used procedure. This technique allows the insertion of large-caliber or multiple-lumen catheters in the vessel. Arterial catheterization helps in several exams, for instance, mesenteric angiography and cardiac output assessment, and contributes in cineangiocoronariography procedures. We report the case of a 67-year-old male patient who was submitted to cineangiocoronariography and evolved with enterorrhagia due to pelvic hematoma. Throughout the patient's care, a conservative treatment was chosen. The progression of the patient was uneventful and then the patient was discharged. It is very hard to determine which arterial segment was injured; however, as the hematoma was located predominantly in the pelvic region, it is believed that an injury occurred at the internal iliac artery, or directly at the bifurcation of the common iliac artery. Furthermore, it is assumed that a catheter kinking occurred during its progression, due to any tortuosity or to the presence of an atheromatous plaque, thus favoring the occurrence of the more distal lesion, rather than the proximal one. We decided to report this case because of its high degree of rarity, with a scarce number of papers in the literature related to the topic. Thus, with the description of this report we believe that other medical teams will have facilitated their decision-making process, when facing a similar case.
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