Gastric bypass in the treatment of type 2 diabetes in patients with a BMI of 30 to 35 kg/m2.

BACKGROUND: Type 2 diabetes mellitus (T2DM) and class I obesity, which are pandemics of considerable socioeconomic importance, require new treatment modalities due to inadequate control through normal clinical conduct. The aim of the present study was to assess the efficacy and safety of Roux-en-Y gastric bypass (RYGB) in the control of T2DM in patients with a body mass index (BMI) of 30 to 35 kg/m(2). METHODS: An observational, retrospective study was carried out at the Universidade Federal de Pernambuco-Brazil. Between 2002 and 2008, 27 patients were submitted to RYGB for the treatment of uncontrolled T2DM, with a mean follow-up period of 20 months. An assessment was performed of the complete resolution of T2DM [HbA(1c) < 6%/fasting plasma glucose (FPG) < 100 mg/dL/no diabetes medication] and glycemic control. The ethics committee of the university approved the study. RESULTS: RYGB led to the following results: (1) 23% weight reduction (p < 0.001), BMI stabilized at 25.6 kg/m(2) in a mean of 12 months; (2) 46% reduction in glycemia and 27% reduction in HbA(1c) (p < 0.001); (3) 100% improvement in glycemia and 48% resolution of T2DM; (4) glycemic control was 74% without medication and 93% with medication and five patients required medication in addition to RYGB; (5) mean current FPG is 93 mg/dL and HbA(1c) is 6%; and (6) there were no severe complications or deaths. CONCLUSIONS: RYGB is a safe and effective option in the treatment of uncompensated T2DM associated to class I obesity.

[Lymphoma in patients harboring hepatosplenic mansonic schistosomiasis]. / Linfomas em pacientes com a forma hepatoesplênica da esquistossomose mansônica.

BACKGROUND: Correlation between infectious agents and linfoproliferative diseases are more stablished, over all virus and bacteria, through the activation of linfocytes. AIM: To describe six new cases, of a series of 254 patients (2,36%) with mansonic schistosomiasis, in the hepatosplenic form. METHODS: Six patients will be described, amongst the 254 carriers of mansonic schistosomiasis, in the hepatosplenic form, followed in the last 13 years. RESULTS: All the six cases had occurred in women. The histopathologic examinations had evidenced two cases of marginal splenic zone lymphomas, one of great cells with immunoblasts lymphomas, one diffuse lymphomas, a great cells malignant lymphomas, a great not clivads cells, and another case of Hodgkin. Half of the six evolved for the death 4-15 months after the diagnosis. The others three persist in accompaniment in the Oncology Division of the Clinics Hospital. CONCLUSION: The incidence of lymphomas in the 254 mansonic schistosomiasis patients followed in our clinic was of 2,36%. At last, this article intends to call the attention, for the occurrence of lymphomas, in the spleen of patients with mansonic schistosomiasis, in the hepatosplenic form.