Efficacy of adjuvant weight loss medication after bariatric surgery

Background: Some patients do not achieve optimal weight loss or regain weight after bariatric surgery. In this study, we aimed to determine the effectiveness of adjuvant weight loss medications after surgery for this group of patients. Setting: An academic medical center. Methods: Weight changes of patients who received weight loss medications after bariatric surgery from 2012 to 2015 at a single center were studied. Results: Weight loss medications prescribed for 209 patients were phentermine (n = 156, 74.6%), phentermine/topiramate extended release (n = 25, 12%), lorcaserin (n = 18, 8.6%), and naltrexone slow-release/bupropion slow-release (n = 10, 4.8%). Of patients, 37% lost>5% of their total weight 1 year after pharmacotherapy was prescribed. There were significant differences in weight loss at 1 year in gastric banding versus sleeve gastrectomy patients (4.6% versus .3%, P = .02) and Roux-en-Y gastric bypass versus sleeve gastrectomy patients (2.8% versus .3%, P = .01).There was a significant positive correlation between body mass index at the start of adjuvant pharmacotherapy and total weight loss at 1 year (P = .025). Conclusion: Adjuvant weight loss medications halted weight regain in patients who underwent bariatric surgery. More than one third achieved>5% weight loss with the addition of weight loss medication. The observed response was significantly better in gastric bypass and gastric banding patients compared with sleeve gastrectomy patients. Furthermore, adjuvant pharmacotherapy was more effective in patients with higher body mass index. Given the low risk of medications compared with revisional surgery, it can be a reasonable option in the appropriate patients. Further studies are necessary to determine the optimal medication and timing of adjuvant pharmacotherapy after bariatric surgery

Damak ve parafarengeal bölgeden kaynaklanan farklı iki dev pleomorfik adenom olgusu

Pleomorphic adenoma is the most common of minor salivary gland tumors. Pleomorphic adenoma of minor salivary glands are commonly located on the palate nevertheless rarely may originate from the parapharyngeal region. Pleomorphic adenomas on the palate show slow growth over the years. The tumors that originate from the parapharyngeal region could reach great dimensions. In this case report, an orphan and neglected geriatric patient who had giant pleomorphic adenoma on the palate and a young patient with a giant pleomorphic adenoma that was excised by transcervical approach without additional surgical procedures at the parapharyngeal region, were presented.Minör tükürük bezi kaynaklı tümörler arasında en sık görü- len pleomorfik adenomdur. Minör tükürük bezi kaynaklı pleomorfik adenom en sık damakta görülüp, parafarengeal bölgede nadiren karşımıza çıkar. Damak pleomorfik adenomları yıllar içinde yavaş büyüme gösterirler. Parafarengeal bölgeden kaynaklananlar büyük boyutlara ulaşabilirler. Bu makalede kimsesiz ve bakımsız kalmış geriatrik bir hastada damak bölgesinde yerleşik oldukça büyük boyutlara gelmiş pleomorfik adenom olgusu ile genç bir hastada yine oldukça büyük boyutlara ulaşmış ve ek cerrahi prosedüre ihtiyaç kalmadan transservikal yaklaşımla çıkartılabilmiş plemorfik adenom olgusu sunuldu

Grisel’s Syndrome: A Rare Complication following Adenotonsillectomy

Grisel’s syndrome is a nontraumatic atlantoaxial subluxation which is usually secondary of an infection or an inflammation at the head and neck region. It can be observed after surgery of head and neck region. Etiopathogenesis has not been clearly described yet, but increased looseness of paraspinal ligament is thought to be responsible. Patients typically present with painful torticollis. Diagnosis of Grisel’s syndrome is largely based on suspicion of the patient who has recently underwent surgery or history of infection in head and neck region. Physical examination and imaging techniques assist in diagnosis. Therefore, clinicians should be aware of acute nontraumatic torticollis after recently applied the head and neck surgery or undergone upper respiratory tract infection. In this paper, a case of an eight-year-old male patient who had Grisel’s syndrome after adenotonsillectomy is discussed with review of the literature

Polybutylene Succinate (PBS) - Polycaprolactone (PCL) Blends Compatibilized with Poly(ethylene oxide)-block-poly( propylene oxide)-block-poly(ethylene oxide) (PEO-PPO-PEO) Copolymer for Biomaterial Applications

This study reports the preparation and characterization of Polybutylene Succinate (PBS)-Polycaprolactone (PCL) melt blends (10-40 wt.% PCL) in the presence of a compatibilizer, in order to explore their potential use as a biomaterial. The thermal transitions, as well as the crystallinity of the polymer blends were analyzed by Differential Scanning Calorimetry, the thermomechanical properties were analyzed via Dynamic Mechanical Analysis and phase morphologies were characterized by Scanning Electron Microscopy. Degradation profiles of the blends were analyzed in PBS buffer solution at pH 7.4 at 37 degrees C via pH measurements. Cytotoxicity of the PBS/PCL films were tested by MTS assay

Down Syndrome Patients in the Pediatric Emergency Department

Objective: The purpose of this study was to evaluate Down syndrome (DS) cases presenting to the pediatric emergency department and to compare them with DS cases with clinical presentations for routine check-ups. Method: DS patients presenting to the pediatric emergency department of a tertiary hospital between 01.10.2018 and 31.03.2019 (group 1) and DS patients presenting for routine clinical check-ups (group 2) were included in the study. Patients’ demographic data (age and gender), weight, height ad head circumference measurements, and data for general health were examined. Results: Forty-one patients (13 girls, 28 boys) with a mean age of 50.24±48.4 (1-163) months were enrolled in group 1, and 49 cases (17 girls, 32 boys) with a mean age of 52.94±50.1 (1-168) months in group 2. Cases in group 1 had higher rates of heart disease (p=0.004), drug use for heart disease (p=0.038), thyroid disease (0.001), and drug use for thyroid disease (p=0.001) compared to group 2, while engagement in sporting activity was significantly higher among cases in group 2 (p=0.32) than in group 1. There was no difference between the groups in terms of anthropometric measurements. Conclusion: DS cases presenting to the pediatric emergency department differ from DS cases presenting for routine check-ups in terms of general health status and accompanying diseases. Pediatric practitioners can be more knowledgeable about cases with DS who are admitted to the emergency department

Polybutylene Succinate (PBS) – Polycaprolactone (PCL) Blends Compatibilized with Poly(ethylene oxide)- block

This study reports the preparation and characterization of Polybutylene Succinate (PBS)-Polycaprolactone (PCL) melt blends (10-40 wt.% PCL) in the presence of a compatibilizer, in order to explore their potential use as a biomaterial. The thermal transitions, as well as the crystallinity of the polymer blends were analyzed by Differential Scanning Calorimetry, the thermomechanical properties were analyzed via Dynamic Mechanical Analysis and phase morphologies were characterized by Scanning Electron Microscopy. Degradation profiles of the blends were analyzed in PBS buffer solution at pH 7.4 at 37 degrees C via pH measurements. Cytotoxicity of the PBS/PCL films were tested by MTS assay

Relationship Between Ocular Surface Disease Index, Dry Eye Tests, and Demographic Properties in Computer Users

Objectives: The aim of the present study is to evaluate the ocular surface disease index (OSDI) in computer users and to investigate the correlations of this index with dry eye tests and demographic properties. Materials and Methods: In this prospective study, 178 subjects with an age range of 20-40 years and who spent most of their daily life in front of the computers were included. All participants underwent a complete ophthalmologic examination including basal secretion test, tear break-up time test, and ocular surface staining. In addition, all patients completed the OSDI questionnaire. Results: A total of 178 volunteers (101 female, 77 male) with a mean age of 28.8±4.5 years were included in the study. Mean time of computer use was 7.7±1.9 (5-14) hours/day, and mean computer use period was 71.1±39.7 (4-204) months. Mean OSDI score was 44.1±24.7 (0-100). There was a significant negative correlation between the OSDI score and tear break-up time test in the right (p=0.005 r=-0.21) and the left eyes (p=0.003 r=-0.22). There was a significant positive correlation between the OSDI score and gender (p=0.014 r=0.18) and daily computer usage time (p=0.008 r=0.2). In addition to this, there was a significant positive correlation between the OSDI score and ocular surface staining pattern in the right (p=0.03 r=0.16) and the left eyes (p=0.03 r=0.17). Age, smoking, type of computer, use of glasses, presence of symptoms, and basal secretion test were not found to be correlated with OSDI score. Conclusions: Long-term computer use causes ocular surface problems. The OSDI were found to be correlated with tear break-up time test, gender, daily computer usage time, and ocular surface staining pattern in computer users. (Turk J Ophthalmol 2014; 44: 115-8