One Anastomosis Gastric Bypass versus Roux en Y Gastric Bypass as Salvage Technique after Failed Gastric Band: a Retrospective Analysis of 80 Cases

The classical “Roux en Y Gastric Bypass” (RYGBP) is still the standard technique between all the ones being used nowadays. The “One anastomosis gastric bypass” (OAGBP), is an evolution of the “Minigastic bypass” described by Robert Rutledge in 2001, is a well known and progressively frequent but still controversial technique. In our group, after an experience of 10 years using the RYGBP as a salvage surgery after failed gastric banding, in 132 cases, we decided to adopt the OAGBP as our preferential bariatric technique also in this situation. The theoretical main reasons for that shift are related to the increased safety, maximized weight loss, long term weight loss maintenance and reversibility of the operation. Method: Retrospectively we evaluated data of the surgical management of revisional cases for conversion, after failed or complicated gastric bands to gastric bypass. We selected the last 40 cases of each technique since May 2010. Results: All cases were performed by laparoscopy without any conversion. In both groups the conversion has been performed in one single step (17 cases, 42,5%). Data showed lower morbidity with OAGBP (2,5% against 7,5%) and better weight loss in theOAGBP cohort after a median follow up of 16months (67%against 55%) in patients revised after gastric band failure or complications. None had statistic significance (p>0,1) by the chi-square contingency table analysis.Conclusion: It seems to there is a difference in favour of OAGBP for conversion of complicated gastric bands. In this study we didn’t found statistic significance probably because of the short numbers. Prospective and more powerful studies are necessary to evaluate the benefit of the studied procedure

OAGB Bowel Function in Patients With up to 5 Years Follow-Up: Updated Outcomes

Objective: One-anastomosis gastric bypass (OAGB) is considered an effective technique in weight reduction and remission of comorbidities. However, in common with many bariatric and metabolic/bariatric procedures, gastrointestinal side effects are frequently reported, but clinical experience varies. The objective of this study was to analyze the bowel function of patients who undergo OAGB looking at 5-year postoperative outcomes. Method: This study is cross-sectional, descriptive and analytical, developed with individuals undergoing OAGB (n = 208) in yhe period between 2015 and 2020. The time periods evaluated were 1 to 6 months (T1), 6 to 12 months (T2), and 1 to 5 years (T3). Data analysis was performed using SPSS v.28.0, considering a significance level p ≤ 0.05. Results: 114 participants (54.8%), 79.8% women, mean age 47.0 ± 12.6 years, and BMI 40.1 ± 5.6 kg/m2, 51.9% dyslipidemia, 43.6% arterial hypertension, and 19.1% diabetes mellitus. The T1 group had more severe symptoms/nausea than the T2 group. The T2 group had a significantly lower defecation frequency than the T1 and T3 groups. As for the occurrence of diarrhea, associations were not found in the considered groups. The T3 group had a greater severity of constipation associated with greater difficulty in consuming red meat, white meat, rice, vegetables, and salads. Conclusions: Gastrointestinal symptoms are prevalent in the first postoperative months. However, diarrhea was not common. The patient selection policy and surgical technique were decisive in this result. Constipation was prevalent in patients between 1 and 5 postoperative years. It was also prevalent in those who had food intolerance, which from a nutritional point of view is an adverse factor for optimal bowel function.info:eu-repo/semantics/publishedVersio

The Efficacy of LUCAS in Cardiac Arrest

Introduction: Chest compression is the basic technique of cardiopulmonary resuscitation (CPR) in patients with cardiac arrest. The quality and early performance of CPR is critical to improve the prognosis and chances of restoring spontaneous blood flow. Today we have manual compressions and mechanical chest compression devices. Objective: The aim of this study is to clarify the importance of the LUCAS system (The Lund University Cardiac Arrest System) in CPR. Material and methods: A systematic review of the literature by mobilizing the descriptors "Cardiac Arrest", "Lucas Efficacy" and "nursing", using the methodological head. Ten conceivable databases were selected, between 2010-2020, and seven articles were included for analysis. Results and discussion: The results of the studies are different, as four of the studies indicate that LUCAS is fully effective, particularly in fatigue and transport, but two of them do not recognise its full effectiveness. One of the studies mentions that the fact that compression by the automatic device is effective does not necessarily reflect a better result. The vast majority of the studies recognise the need for further studies to make more convincing decisions. Conclusion: Mechanical chest compression devices can improve patient outcome if used appropriately in the event of cardiac arrest. The hemodynamic performance of the LUCAS compression-decompression system is, according to some results, better than manual CPR. However, the quality of the current evidence is not sufficient. Randomised studies are needed to evaluate the effect of mechanical chest compression devices on survival inside or outsider the hospital.info:eu-repo/semantics/publishedVersio

Outcomes of Long Pouch Gastric Bypass (LPGB): 4-Year Experience in Primary and Revision Cases

Background: One of the most important complications of the one anastomosis gastric bypass (OAGB) is enterobilio acid reflux (EBAR). We report the concept of the long pouch Roux-en-Y gastric bypass (LPRYGB) meaning a Roux-en-Y with a long pouch and a 100-cm alimentary limb to avoid EBAR, with a long biliopancreatic limb to increase metabolic effects. Methods: A total of 300 LPRYGB cases in a 4-year period, with a 90% follow-up rate, were analysed. Anthropometric, technical feasibility, morbidity, weight loss and comorbidity outcomes were analysed. Results: The percentage total weight loss (%TWL) was 30.5% at 4 years of follow-up (32.3% in primary and 28.3% in revisions). Six intra-operative (2%) and 28 postoperative complications (9.3%) were seen. Out of this 28 complications, 11 (3.6%) were late complications. Reoperations were performed in 15 patients (5.0%). Clinically relevant EBAR was present in 3 cases only (1%) 4 years after the operation. Conclusions: The LPRYGB combines the main advantages of the OAGB (light restriction and moderate malabsorption) with the anti-reflux effect from the Roux-en-Y diversion.info:eu-repo/semantics/publishedVersio

A study on corrosion resistance of ISO 5832-1 austenitic stainless steel used as orthopedic implant

The ISO 5832-1 austenitic stainless steel used as biomaterial is largely applied in the area of orthopedics, especially in the manufacture of implants, such as temporary or permanent replacement of bone structures. The objective of this study was to evaluate the localized corrosion resistance of the ISO 5832-1 stainless steel used in orthopedic implants by electrochemical tests in two different solutions. The results of this study are of great interest to evaluate the corrosion of metallic implants that can result in the release of corrosion products into bodily fluids causing possible adverse biological reactions. The determination of the chemical elements in the composition of the ISO 5832-1 stainless steel was performed by neutron activation analysis (NAA). The samples for electrochemical tests were grinded with silicon carbide paper up to #4000 finishing, followed by mechanical polishing with diamond paste. The open circuit potential measurements and anodic polarization curves were obtained in solution of 0.90 wt. % of NaCl and of simulated body fluid (SBF). The results indicated that the ISO 5832-1 stainless steel presented a high resistance to crevice corrosion in simulated body fluid solution but high susceptibility to this form of corrosion in the chloride solution. &nbsp

Study of ph effect on AZ31 magnesium alloy corrosion for using in temporary implants

Currently, magnesium alloys are gaining great interest for medical applications due to their degrading properties in the human body ensuring a great biocompatibility. These alloys also provide profitable mechanical properties due similarities with human bone.  However, a difficulty in applying these materials in the biomaterials industries is the corrosion prior to cell healing. The effect of the chemical composition of Mg alloys on their corrosion behavior is well known. In this study, samples of AZ31 magnesium alloy were cut into chips for elemental chemical analysis by neutron activation analysis (NAA). Concentrations of the elements As, La, Mg, Mn, Na, Sb and Zn were determined in the AZ31 alloy. Visualization tests of agar corrosion development in various media, of 0.90% sodium chloride solution (mass), phosphate buffer saline (PBS) and simulated body fluid (SBF) were performed. Visualizations of the effect of agar gel corrosion revealed pH variation during the corrosion process due to the released into the cathode. The highest released of hydroxyl ions occurred in NaCl solution compared to PBS and SBF solutions indicating that NaCl solution was much more aggressive to the alloy compared to the others

Activity of the efflux pump inhibitor SILA 421 against drug-resistant tuberculosis

Organosilicon compounds are efflux pump inhibitors with potency as an antituberculosis drug. Of the organisilicon compounds tested, SILA 421 has been shown to have a highest potency as an antituberculosis drug (1). It shares the common pathways for antimycobacterial killing with other efflux pump inhibitors: it revealed direct in vitro activity against M. tuberculosis (1), it has been shown to modify resistance by inhibiting mdr-1 efflux pumps and has shown to enhance killing of M. tuberculosis by macrophages (1)

pH Modulation of Efflux Pump Activity of Multi-Drug Resistant Escherichia coli: Protection During Its Passage and Eventual Colonization of the Colon

BACKGROUND:Resistance Nodulation Division (RND) efflux pumps of Escherichia coli extrude antibiotics and toxic substances before they reach their intended targets. Whereas these pumps obtain their energy directly from the proton motive force (PMF), ATP-Binding Cassette (ABC) transporters, which can also extrude antibiotics, obtain energy from the hydrolysis of ATP. Because E. coli must pass through two pH distinct environments of the gastrointestinal system of the host, it must be able to extrude toxic agents at very acidic and at near neutral pH (bile salts in duodenum and colon for example). The herein described study examines the effect of pH on the extrusion of ethidium bromide (EB). METHODOLOGY/PRINCIPAL FINDINGS:E. coli AG100 and its tetracycline induced progeny AG100(TET) that over-expresses the acrAB efflux pump were evaluated for their ability to extrude EB at pH 5 and 8, by our recently developed semi-automated fluorometric method. At pH 5 the organism extrudes EB without the need for metabolic energy (glucose), whereas at pH 8 extrusion of EB is dependent upon metabolic energy. Phe-Arg beta-naphtylamide (PAbetaN), a commonly assumed inhibitor of RND efflux pumps has no effect on the extrusion of EB as others claim. However, it does cause accumulation of EB. Competition between EB and PAbetaN was demonstrated and suggested that PAbetaN was preferentially extruded. A K(m) representing competition between PAbetaN and EB has been calculated. CONCLUSIONS/SIGNIFICANCE:The results suggest that E. coli has two general efflux systems (not to be confused with a distinct efflux pump) that are activated at low and high pH, respectively, and that the one at high pH is probably a putative ABC transporter coded by msbA, which has significant homology to the ABC transporter coded by efrAB of Enterococcus faecalis, an organism that faces similar challenges as it makes its way through the toxic intestinal system of the host

Contaminação bacteriana em teclados de computadores utilizados em hospital universitário do nordeste do Brasil

The technological advance allows the insertion of computers in the hospital environment, being neededto the execution of tests, record the patient information or doctor's personal use. Thirtyone samples ofcomputer keyboards from the Hospital "Professor Alberto Antunes", at the Federal University of Alagoas,Brazil (UFAL), were subjected to microbiological analysis in the period from February to June 2011. Thecolonies that were isolated were subsequently morphologically and biochemically analyzed, including by automated method (VITEK®). Among the sectors monitored, the following bacteria were detected:Acinetobacter baumannii (Obstetrical Clinic), Pseudomonas stutzeri (General Medicine and Maternity),P. oryzihabitans (Pediatrics), Enterobacter cancerogenus (Chemotherapy Sector), E. cloacae (NeonatalIntensive Care Unit), Enterococcus faecium (Oncology Nursing Sector), Sphingomonas paucimobilis(Ophtalmology Sector) and  Rhizobium radiobacter (rooming). From these,  P. oryzihabitans, E.cancerogenus and S. paucimobilis showed resistance to antibiotics commonly recommended. Therefore, the hospital computer keyboards can play in the spread of pathogens and should be part of theroutine disinfection of the hospital. Cover with protective film and the adoption of preventive measuressuch as hand washing are important.O avanço tecnológico permitiu a inserção dos computadores no ambiente hospitalar, sendo necessários na solicitação de exames, registro de informações dos pacientes ou para uso pessoal dos médicos.Trinta e um teclados de computadores do Hospital Universitário Professor Alberto Antunes/UFAL foramsubmetidos a análises microbiológicas no período de fevereiro a junho de 2011. As colônias isoladasdas amostras foram analisadas morfobioquímicamente, inclusive por método automatizado (VITEK®).Entre os setores monitorados, foram detectadas as seguintes bactérias: Acinetobacter baumanii (Clí-nica Obstétrica), Pseudomonas stutzeri (Clínica Médica e Maternidade),  P. oryzihabitans (Pediatria),Enterobacter cancerogenus (Setor de Quimioterapia), E. cloacae (UTI Neonatal), Enterococcus faecium(Enfermaria do Setor Oncológico), Sphingomonas paucimobilis (Setor Oftalmológico) e  Rhizobiumradiobacter (Alojamento Conjunto). Destas, P. oryzihabitans, E. cancerogenus e S. paucimobilis apresentaram resistência a antimicrobianos comumente recomendados. Portanto, os teclados de computadores hospitalares podem atuar na disseminação de patógenos, devendo fazer parte da rotina dedesinfecção do ambiente hospitalar. A cobertura com película protetora e a adoção de medidas preventivas como a lavagem das mãos são de grande importância