Characteristics of Patients Lost to Follow-up after Bariatric Surgery

After bariatric surgery lifelong follow-up is recommended. Evidence of the consequences and reasons for being lost to follow-up (LTFU) is sparse. In this prospective study follow-up data of all patients who underwent bariatric surgery between 2008 and 2017 at a certified obesity centre were investigated. LTFU patients were evaluated through a structured telephone interview. Overall, 573 patients (female/male 70.9%/29.1%), aged 44.1 ± 11.2 years, preoperative BMI 52.1 ± 8.4 kg/m2 underwent bariatric surgery. Out of these, 33.2% had type 2 diabetes mellitus and 74.4% had arterial hypertension. A total of 290 patients were LTFU, of those 82.1% could be reached. Baseline characteristics of patients in follow-up (IFU) and LTFU were comparable, but men were more often LTFU (p = 0.01). Reported postoperative total weight loss (%TWL) and improvements of comorbidities were comparable, but %TWL was higher in patients remaining in follow-up for at least 2 years (p = 0.013). Travel issues were mentioned as the main reason for being LTFU. A percentage of 77.6% of patients reported to regularly supplement micronutrients, while 71.0% stated regular monitoring of their micronutrient status, mostly by primary care physicians. Despite comparable reported outcomes of LTFU to IFU patients, the duration of the in-centre follow-up period affected %TWL. There is a lack of sufficient supplementation and monitoring of micronutrients in a considerable number of LTFU patients

Renal complications in chronic hypoparathyroidism – a systematic cross-sectional assessment

ContextAlthough renal long-term complications are acknowledged in chronic hypoparathyroidism (HPT), standardized investigations are scarce.ObjectiveTo systematically investigate renal complications and their predictors in hypoparathyroid patients compared to matched individuals.DesignProspective observational study in 161 patients with chronic HPT.MethodsPatients received renal ultrasound, clinical and laboratory assessments. An individual 1:3 matching with participants from the German population-based Study of Health in Pomerania was performed.ResultsOf 161 patients (92% postoperative HPT), prevalence of eGFR <60ml/min/1.73m2 was 21%, hypercalciuria 41%. Compared to healthy individuals, HPT patients had a significantly lower eGFR (74.2 vs. 95.7 ml/min/1.73m², p<0.01). Renal ultrasound revealed calcifications in 10% (nephrocalcinosis in 7% and calculi in 3%). Patients with renal calcifications had higher levels of 24-hour urine calcium excretion (8.34 vs. 5.08 mmol/d, p=0.02), spot urine calcium excretion (4.57 vs. 2.01 mmol/L, p=0.01) and urine calcium-to-creatinine ratio (0.25 vs. 0.16, p<0.01) than patients without calcifications. Albumin-corrected calcium, phosphate, calcium-phosphate product, 25-hydroxyvitamin D in serum, eGFR, daily calcium intake or disease duration were not significantly different between these two groups. Including patients receiving rhPTH therapy, a lower serum phosphate concentration (odds ratio 1.364 [95% confidence interval (CI) 1.049-1.776], p<0.05) and a longer disease duration of HPT (odds ratio 1.063 [95% CI 1.021-1.106], p<0.01) were significant predictors for renal calcifications. Excluding patients receiving rhPTH therapy, a higher 24-hour urine calcium excretion (odds ratio 1.215 [95% CI 1.058-1.396], p<0.01) was a significant predictor for renal calcifications but not serum magnesium or disease duration.ConclusionsPrevalence of impaired renal function among patients with chronic HPT is increased and independent from visible renal calcifications. Depending on exclusion of patients with rhPTH therapy, regression analysis revealed disease duration and serum phosphate or disease duration and 24-hour urinary calcium excretion as predictors for renal calcifications.Clin Trials IdentifierNCT0558559

Chirality transfer in metal-­‐catalysed intermolecular addition reactions involving allenes

Allene chemistry in the presence of transition metal complexes is nowadays a very important topic that underpins many challenges and advances in organic synthesis. The amount of research articles covering new transformations of allenes is vast and the development of enantioselective reactions involving allenes has flourished in the last 10-15 years. In this review we cover three important topics in allene chemistry that we feel are timely appropriate for this special issue celebrating the work of Prof Trost: the metal-catalysed reactions involving chirality transfer from chiral allenes to products; the analysis of the possible racemization processes that have been observed in the interaction of some metals with allenes; and the chirality transfer using racemic allenes in reactions catalysed by metal complexes bearing chiral ligands to produce enantioriched products. We have focussed the review on intermolecular addition reactions as they are still much less explored than the intramolecular version

Investigating people’s preferences for car-free city centers: A discrete choice experiment

In the face of climate change and growing health hazards due to air pollution in urban centers, private car use is being increasingly criticized. At the same time, research suggests that there is an unsatisfied demand for modes of transportation other than private cars. In fact, many cities all over Europe have already established car-restricted or car-free areas. This paper uses a discrete choice experiment to learn more about people’s preferences regarding a car-free city center in Berlin, Germany. We find that, given the current infrastructure, around 60% of our respondents are willing to accept a car-free city center. By improving infrastructure for cyclists, willingness to accept a car-free city center strongly increases. Similarly, improving the network of bus stops and train stations as well as rededicating released streets to recreational uses would contribute to a higher acceptance of a car-free city center. Using a random parameters logit model, we have also identified observed and unobserved sources of heterogeneity

Adrenal Insufficiency after Long-term use of Topical Glucocorticoids in Patients with Advanced Cutaneous T-cell Lymphomas: A Case Series

Abstract is missing (Short communication