Our data confirm that severe obesity is associated with increased TSH. The decrease in TSH was independent of BMI, but occurred in all SH patients. A putative effect of weight reduction on the improvement of SH in all patients may be an additional benefit of bariatric surgery.

These results point out that the severe morbid obesity (BMI>or=60 kg/m(2)) may lead to pulmonary function impairment and presents more prominent pulmonary function gain after massive weight reduction. The possible clinical implications of these results are that PFT abnormalities in subjects with BMI<60 kg/m(2) should probably be interpreted as consequence of intrinsic respiratory disease and that severe morbid obese patients may be encouraged to lose weight to improve their pulmonary function, especially those with concomitant pulmonary disorders.

1) Nonalcoholic steatosis, steatohepatitis and cirrhosis were identified in substantial numbers of morbidly obese patients; 2) Concentration of hydroperoxides was increased in steatohepatitis, consistent with a pathogenetic role for oxidative stress in this condition.

Prader-Willi Syndrome (PWS) is a genetic disorder characterized by hypotonia, mental retardation or learning disability, hyperphagia and compulsive eating due to hypothalamic dysfunction. Obesity is a major cause of increased morbidity and mortality among patients with PWS. Gastric restrictive surgery has been associated with partial breakdown of the staple-line in PWS. We report two patients with PWS associated with morbid obesity and obstructive sleep apnea who underwent biliopancreatic diversion (BPD). A 27-year-old male with BMI 52 kg/m(2) and a 20 year-old female with BMI 64 kg/m(2) underwent BPD. No perioperative complications were observed. After BPD, the male's BMI was 36.7 kg/m(2) at 12 months and the female's BMI was 48.4 kg/m(2) at 28 months, with excess weight loss 58% and 48%, respectively. They developed loose stools associated with eating. These patients have shown a considerable improvement in hypersomnia and respiratory difficulties. BPD proved to be an effective approach to weight loss in PWS, resulting in improvement of sleep apnea, behavior problems and quality of life.

RESUMOObjetivo: Determinar a eficácia e tolerabilidade de 4 substâncias calorigênicas: ioimbina, triiodotironina (T3), combinação efedrinaaminofilina e fenilpropanolamina (FPA). Material, Métodos e Desenho da Pesquisa: 103 mulheres obesas (30 < BMI < 40kg/m 2 ), de 18 a 55 anos, foram submetidas a estudo cego comparativo das 4 substâncias associadas a uma dieta com 1.200 calorias (55% HC, 30% gordura e 15% proteínas). As doses utilizadas foram 8mg de ioimbina, 25mcg de T3, 100mg de aminofilina + 25mg de efedrina e 25mg de FPA. Foi ainda incluído um grupo placebo. Os 4 medicamentos e o placebo foram dados 3 vezes ao dia, antes do desjejum, do almoço e do jantar. O estudo se realizou num período de 12 semanas, para cada paciente e no início e o fim do mesmo foram avaliados peso, composição corpórea por bioimpedân-cia, metabolismo de repouso (por calorimetria), pulso e pressão arterial e eventos adversos. Resultados: Houve perda de peso em todos os grupos, mas o único que perdeu peso significativamente em relação ao grupo placebo foi o que recebeu FPA (p < 0,05). Não houve diferença quanto à composição corpórea e metabolismo de repouso entre os 5 grupos. Conclusão: Em nossa amostra, a FPA se revelou mais eficaz, embora este fato não possa ser atribuído a uma maior queima energéti-ca em repouso, já que não houve diferença apreciável no metabolismo de repouso entre os grupos. ) aged 18 to 55 years-old were assigned to receive in a blind protocol and by random order yohimbine 8mg, triiodothyronine (T3) 25mcg, amminophiline 100mg plus ephedrine 25mcg, phenylpropanolamine (PPA) 25mcg or placebo t.i.d. for 12 weeks. They received a 1,200kcal diet and were evaluated every two weeks for weight, blood pressure, heart rate, adverse events and adherence. Each subject was submitted to bioimpedance and calorimetry analysis in the beginning and in the end of the study. Results: Patients who were taking PPA lost significantly more weight (measured by DBMI) as compared to the other groups in relation to placebo group (p < 0.05). Changes in percentual fat mass, percentual lean body mass and calorimetry analysis showed no significant differences between the groups. Conclusion: PPA can be considered the best drug in respect of short-term weight loss, but we cannot explain this fact on increase in the resting metabolic rate, which was not different among the groups.

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