OBJECTIVE:To determine whether preoperative inspiratory muscle training is able to attenuate the impact of surgical trauma on the respiratory muscle strength, in the lung volumes, and diaphragmatic excursion in obese women undergoing open bariatric surgery.DESIGN:Randomized controlled trial.SETTING:Meridional Hospital, Cariacica/ES, Brazil.SUBJECTS:Thirty-two obese women undergoing elective open bariatric surgery were randomly assigned to receive preoperative inspiratory muscle training (inspiratory muscle training group) or usual care (control group).MAIN MEASURES:Respiratory muscle strength (maximal static respiratory pressure – maximal inspiratory pressure and maximal expiratory pressure), lung volumes, and diaphragmatic excursion.RESULTS:After training, there was a significant increase only in the maximal inspiratory pressure in the inspiratory muscle training group. The maximal expiratory pressure, the lung volumes and the diaphragmatic excursion did not show any significant change with training. In the postoperative period there was a significant decrease in maximal inspiratory pressure in both the groups. However, there was a decrease of 28% in the inspiratory muscle training group, whereas it was 47% in the control group. The decrease in maximal expiratory pressure and in lung volumes in the postoperative period was similar between the groups. There was a significant reduction in the measures of diaphragmatic excursion in both the groups.CONCLUSION:The preoperative inspiratory muscle training increased the inspiratory muscle strength (maximal inspiratory pressure) and attenuated the negative postoperative effects of open bariatric surgery in obese women for this variable, though not influencing the lung volumes and the diaphragmatic excursion.

The insertion of the Veress needle in the abdominal midline, at the umbilicus, poses serious risk to the life of patients. Therefore, further studies should be conducted to investigate alternative sites for Veress needle insertion.

INTRODUCTION:Obesity can cause deleterious effects on respiratory function and impair health and quality of life. OBJECTIVE: To evaluate the effects of obesity on the pulmonary function of adult women. METHODS: An obese group, constituted of 20 women between 20 and 35 years old with a BMI of 35 -49.99 kg/m 2 who were non-smokers and sedentary and had no lung disease were recruited. The non-obese group consisted of 20 women between 20 and 35 years old who were sedentary and non-smokers and had no lung disease and a body mass index between 18.5 and 24.99 kg/m 2 . Spirometry was performed in all subjects. The statistical analysis consisted of parametric or non-parametric tests, depending on the distribution of each variable, considering p < 0.05 to be statistically significant. RESULTS:The obese group presented a mean age of 25.85 ± 3.89 years and a mean BMI of 41.1 ± 3.46 kg/m 2 , and the non-obese group presented a mean age of 23.9 ± 2.97 years and a mean body mass index of 21.91 ± 1.81 kg/m 2 . There were no significant differences between the obese group and the non-obese group as to the age, vital capacity, tidal volume, forced vital capacity, and forced expiratory volume in one second. However, the obese group presented a greater inspiratory reserve volume (2.44 ± 0.47 L vs. 1.87 ± 0.42 L), a lower expiratory reserve volume (0.52 ± 0.32 L vs. 1.15 ± 0.32 L), and a maximal voluntary ventilation (108.5 ± 13.3 L/min vs. 122.6 ± 19.8 L/min) than the non-obese group, respectively. CONCLUSION: The alterations evidenced in the components of the vital capacity (inspiratory reserve volume and expiratory reserve volume) suggest damage to the chest mechanics caused by obesity. These factors probably contributed to a reduction of the maximal voluntary ventilation.

RYGB and SG procedures demonstrated a similar impact on adipokine levels in women 1 year post-surgery. Both techniques may improve the course of chronic diseases and the state of inflammation associated with obesity.

RESUMOObjetivos: Avaliar o impacto da cirurgia bariátrica na síndrome metabólica (SM) e quais os critérios que mais contribuíram para sua remissão após cirurgia. A evolução da leucometria também foi analisada. ABSTRACTCan Bariatric Surgery Cure Metabolic Syndrome? Objectives: To evaluate the impact of bariatric surgery on the metabolic syndrome (MS) and what are the criteria that contribute the most for its exclusion after surgery. The progress of leucometry was also analyzed. Methods and procedures: 47 obese women with MS were evaluated. All patients were operated with the Roux-en-Y vertical gastric bypass technique, with the insertion of a contention ring on the gastro-jejune anastomosis (Fobi-Capella). Patients were evaluated before and on the first year post-surgery. Results: Fasting glucose presented a relevant decrease at 3 months after surgery. After 12 months, all 20 patients who had DM2 or altered fasting glucose presented normal levels of fasting glucose and glicated hemoglobin, and none of them was using any anti-diabetic drug. Triglycerides levels were reduced by 49.2%, whereas HDL-cholesterol increased by 27.2%. Systolic and diastolic blood pressures were reduced by an average of 28.7 and 20.8 mmHg, respectively. Leucocytes counting fell from 7671/µL to 6156/µL. Fasting glucose, triglycerides, DBP, SBP and HDL-cholesterol were the variables that contributed most for the reduction of MS. At the end of the first year, elimination of MS occurred in 80.9% of the patients. Discussion: Bariatric surgery reduces resistance to insulin and consequently the cardiovascular risk factors.