Review of Metabolic Surgery for Type 2 Diabetes in Patients with a BMI < 35 kg/m2

Bariatric/metabolic surgery is considered an accepted treatment option for type 2 diabetes mellitus (T2DM) with body mass index (BMI)  ≧  35 kg/m2. Mounting evidence also shows that metabolic surgery is effective for T2DM with BMI  <  35 kg/m2. To evaluate current status of metabolic surgery, we reviewed the available clinical studies which described surgical treatment for T2DM with mean BMI  <  35 kg/m2. 18 studies with 477 patients were identified. 30% of the patients was insulin users. The follow-up period ranged from 6 to 216 months. The weight loss effect was reasonable, not excessive. Mean BMI decreased from 30.4 to 24.8 kg/m2. Remission of T2DM was achieved in 64.7% of the patients with fasting plasma glucose and glycated hemoglobin approaching slightly above normal range. Clinical T2DM status was an important factor when selecting the eligible candidates for metabolic surgery. Postoperative complication rate of 10.3% with mortality of 0% in the studies has been acceptable. Even though it would be premature at this point to state that metabolic surgery is an accepted treatment option for T2DM with BMI < 35 kg/m2, it is clear that a high proportion of T2DM patients will derive substantial benefit from metabolic surgery

Feasibility and early outcomes of laparoscopic plicated sleeve gastrectomy: a case-control study

Introduction : Sleeve gastrectomy (SG) continues to gain popularity as a viable weight loss procedure with well-documented outcomes and procedure-specific adverse effects. It has become increasingly indicated for the treatment of morbid obesity. Aim of the research : To compare a novel approach to SG, which aims to reduce SG-specific complications, to the standard SG procedure. Material and methods : Sixteen morbidly obese patients with a mean body mass index (BMI) of 48.5 kg/m 2 ± SD who underwent the novel laparoscopic plicated sleeve gastrectomy (LPSG) were retrospectively studied. The control group included 18 patients who underwent laparoscopic SG. Study and control groups were matched for BMI and gender. Study group patients underwent a partial SG with imbrication of the distal 2/3 of the staple line with 2 cm overlap and 3–4 cm of the pre-pyloric stomach. Control group SG patients had their staple line oversewn without plication. Outcomes at 3, 6 and 12 months were compared and analyzed. Results: There was no statistically significant difference in weight loss at 12 months between the LPSG and SG groups. Postoperative nausea was comparable between the two groups. No major complications were noted in either group. Conclusions: The LPSG is a modification of the standard SG which has comparable outcomes, safety and feasibility. It may lead to a decrease in unwanted complications such as sleeve stricture or obstruction. Further studies on long-term outcomes are needed to assess its value as a bariatric procedure

Concentration and elemental composition of quasi-ultrafine particles in Upper Silesia

The ambient concentrations and elemental composition of particles with aerodynamic diameters between 30 and 108 nm (quasi-ultrafine particles, q-UFP) were studied. The data came from 6 sites in Katowice and Zabrze, big cities in Upper Silesia, where particulate matter was sampled at urban background site and crossroads in Katowice and Zabrze, at highway in Katowice, and at urban road in Zabrze. The ambient concentrations of q-UFP and of 24 q-UFP-bound elements at these six sampling sites have been discussed in the paper. The q-UFP mass concentrations in Upper Silesia did not appear high, they were not higher than in other areas. The percentages of the total mass of the examined elements in the q-UFP mass suggest that in Upper Silesia, within a typical residential area, q-UFP consist mainly of primary matter. At the sites under strong influence of road traffic emissions, where the contributions of the examined elements to the q-UFP mass were small, most probably, carbonaceous matter and elemental carbon build the core q-UFP mass. The majority of the elements in q-UFP are anthropogenic. Clear effects of local PM sources can be seen on the ambient concentrations of q-UFP-bound Al, Si, S, Cl, K, Sc, Ti, V, Cd, Cr, Mn, Co, and Sb

Impact of Municipal, Road Traffic, and Natural Sources on PM10: The Hourly Variability at a Rural Site in Poland

The paper presents data from a monthly campaign studying the elemental composition of PM10, as measured by a specific receptor in Kotórz Mały (Opole Voivodeship)—located in the vicinity of a moderately inhabited rural area—measured in one-hour samples using a Horiba PX-375 analyzer. The hourly variability of SO2, NO, NO2, CO, and O3 concentrations, as well as the variability of meteorological parameters, was also determined. On average, during the entire measurement period, the elements related to PM10 can be arranged in the following order: As &lt; V &lt; Ni &lt; Pb &lt; Cr &lt; Mn &lt; Cu &lt; Ti &lt; Zn &lt; K &lt; Fe &lt; Ca &lt; Al &lt; Si &lt; S. Trace elements, including toxic elements—such as As, V, Ni, Pb, Cr, and Mn—were present in low concentrations, not exceeding 10 ng/m3 (average daily value). These elements had fairly even concentrations, both daily and hourly. The concentrations of the main elements in the PM10, as measured by the receptor, are subject to strong hourly changes related not only to changes in the structures of the sources identified in the statistical analysis, but also to wind speed and direction changes (soil and sand particle pick-up and inflow of pollutants from coal combustion). It has been shown that the transport emissions measured by the receptor can have an intense effect on PM10 in the afternoon

Spider webs in monitoring of air pollution

Biomonitoring is a significant tool of environmental protection strategies. Variety of bioindicators are used worldwide, particularly mosses, lichens and tree leaves. However, they revile many considerable disadvantages, e.g. limitation to vegetative season, moisture demand, exposition to severe weather conditions, limited time of monitoring. Classical impactors, on the other hand, are expensive, cannot be used without supervision and allow only for short-term monitoring. Spider webs, however, reveal features of extraordinary bioindicators. Webs are abundant, easy to collect, costless and can be found all year round, despite vegetative season. Spider silk is a very efficient, non-selective accumulator of contaminants, that allows for long-term monitoring. Thanks to this characteristics, spider webs proved to be immensely useful bioindicators of air pollution. They allow for monitoring of heavy metals, Polycyclic Aromatic Hydrocarbons (PAHs), dioxins, so as assessment of mutagenic activity and anthropopression assessment and indication of dominant source of pollutants. Most of the researches concerning application of spider webs as bioindicators have been conducted in Wrocław, Poland. This paper reviews current knowledge on spider webs in monitoring of air pollution