Routine careful histopathological examination should be performed in sleeve gastrectomy specimens

Introduction: The presence of increased ratio of obesity caused a rapid increase of bariatric surgery practice. In this study, our purpose is to clarify the histopathologic findings of the patients who have experienced this type of bariatric surgery and to learn more about the distinguishable features of laparoscopic sleeve gastrectomy (LSG) specimens and to contribute to the related literature. Methods: A retrospective study was designed with the histopathologic findings from pathology specimens of 109 patients who experienced LSG between April 2014 and May 2016. To collect essential data, we used the database system of our institution that contains all of the selected patients for our study. Results: Overall, the average age was 36.2 years, and 85 were female while 24 were male. The principal histopathologic features were active chronic gastritis in 9, chronic gastritis in 68, atrophy in 5, and intestinal metaplasia in 8 patients. In two patients, gastrointestinal stromal tumor was found and in another patient, neuroendocrine cell hyperplasia was found. In addition to the dominant histopathologic features including chronic and active chronic gastritis, a small percent of patients had clinically significant pathologic findings in the sleeve gastrectomy specimens and this may have an effect on postoperative management and morbidity. Conclusion: Considering these results, having histopathologic examination of the sleeve gastrectomy specimens as a standard procedure is strongly recommended

Testing Ordinal Optimization approach in power distribution system control

This study presents an Ordinal Optimization based approach to the power distribution control problem. Primary task of the distribution control is the minimization of total power losses. Secondarily, it aims at keeping the bus voltages at acceptable values against different loading levels. Control operation is performed by capacitor switchings and on-load tap changer adjustments at substations. This operation involves a large search space with a considerable computational burden. Ordinal Optimization Theory presents proper tools in handling this burden. This theory reduces the size of the problem by defining the "good enough" subsetas the top-m% of the search space, which is obtained through a different procedure of ranking candidate solutions

Ocular surface epithelial thickness changes with SD-OCT in patients treated with oral isotretinoin

AIM: To use in vivo spectral-domain optical coherence tomography(SD-OCT)to investigate ocular surface epithelial thickness changes in patients treated with oral isotretinoin.METHODS: A total of 64 eyes of 64 acne vulgaris patients were enrolled into two group: thirty-two patients received 0.5 mg/kg isotretinoin daily(Group A), and the other 32 patients received 0.8 mg/kg daily(Group B). The central corneal thickness(CCT), central corneal epithelium thickness(CCET), central corneal epithelium basal membrane thickness(CCEBMT), non-epithelial central corneal thickness(NECCT)and bulbar conjunctival epithelium thickness(BCET)were evaluated using SD-OCT at baseline, at the 45th day, at the fourth month of treatment and at the first month after the end of treatment. RESULTS: There were 44 females(68.75%)and 20 males(31.25%)with a mean age of 21.68±3.75y. In both groups, CCET, CCT and BCET were significantly thinner at the 45th day, at the fourth month of the treatment and at the first month after the end of treatment as compared with baseline. CCEBMT decreased significantly at the 45th day and at the fourth month of treatment, but there was no difference between the baseline and the last visit. There were no significant difference in NECCT during and after treatment as compared with the baseline.CONCLUSION:Ocular surface epithelial thickness decreased in patients treated with oral isotretinoin, whereas NECCT was not affected. The decreasing corneal thickness in patients treated with isotretinon is mainly due to epithelial thinning. After a one-month cessation of isotretinoin treatment, CCEBMT returned to the baseline value, and ocular surface epithelial thickness increased

Impact of Obesity on the Metabolic Control of Type 2 Diabetes: Results of the Turkish Nationwide Survey of Glycemic and Other Metabolic Parameters of Patients with Diabetes Mellitus (TEMD Obesity Study)

Background: Obesity is the main obstacle for metabolic control in patients with type 2 diabetes. Turkey has the highest prevalence of obesity and type 2 diabetes in Europe. The effect of obesity on the metabolic control, and the macro-and microvascular complications of patients are not apparent. Objectives: This nationwide survey aimed to investigate the prevalence of overweight and obesity among patients with type 2 diabetes and to search for the impact of obesity on the metabolic control of these patients. We also investigated the independent associates of obesity in patients with type 2 diabetes. Methods: We consecutively enrolled patients who were under follow-up for at least 1 year in 69 tertiary healthcare units in 37 cities. The demographic, anthropometric, and clinical data including medications were recorded. Patients were excluded if they were pregnant, younger than 18 years, had decompensated liver disease, psychiatric disorders interfering with cognition or compliance, had bariatric surgery, or were undergoing renal replacement therapy. Results: Only 10% of patients with type 2 diabetes (n = 4,648) had normal body mass indexes (BMI), while the others were affected by overweight (31%) or obesity (59%). Women had a significantly higher prevalence of obesity (53.4 vs. 40%) and severe obesity (16.6 vs. 3.3%). Significant associations were present between high BMI levels and lower education levels, intake of insulin, antihypertensives and statins, poor metabolic control, or the presence of microvascular complications. Age, gender, level of education, smoking, and physical inactivity were the independent associates of obesity in patients with type 2 diabetes. Conclusion: The TEMD Obesity Study shows that obesity is a major determinant of the poor metabolic control in patients with type 2 diabetes. These results underline the importance of prevention and management of obesity to improve health care in patients with type 2 diabetes. Also, the results point out the independent sociodemographic and clinical associates of obesity, which should be the prior targets to overcome, in the national fight with obesity. (c) 2019 The Author(s) Published by S. Karger AG, Base

Turkish nationwide survEy of glycemic and other Metabolic parameters of patients with Diabetes mellitus (TEMD study)

Aims: Turkey has the highest prevalence of diabetes in Europe. It is therefore essential to know the overall cardiovascular risk and reveal the predictors of metabolic control in Turkish adults with diabetes mellitus