Severity of post-Roux-en-Y gastric bypass dumping syndrome and weight loss outcomes: is there any correlation?

Bariatric surgery; Gastric bypass; Weight lossCirugía bariátrica; Bypass gástrico; Pérdida de pesoCirurgia bariàtrica; Bypass gàstric; Pèrdua de pesPurpose The present research was conducted to evaluate the effect of the severity of dumping syndrome (DS) on weight loss outcomes after Roux-en-Y gastric bypass (RYGB) in patients with class III obesity. Methods The present retrospective cohort study used the dumping symptom rating scale (DSRS) to evaluate the severity of DS and its correlation with weight loss outcomes in 207 patients 1 year after their RYGB. The patients were assigned to group A with mild-to-moderate DS or group B with severe DS. Results The mean age of the patients was 42.18 ± 10.46 years and their mean preoperative BMI 42.74 ± 5.59 kg/m2. The total weight loss percentage (%TWL) in group B was insignificantly higher than that in group A, but besides that was not significantly different in the two groups. Conclusion The present findings suggested insignificant relationships between the presence and severity of DS after RYGB and adequate postoperative weight loss.Open Access Funding provided by Universitat Autonoma de Barcelona

Severity of post-Roux-en-Y gastric bypass dumping syndrome and weight loss outcomes : is there any correlation?

Altres ajuts: acords transformatius de la UABPurpose: The present research was conducted to evaluate the effect of the severity of dumping syndrome (DS) on weight loss outcomes after Roux-en-Y gastric bypass (RYGB) in patients with class III obesity. Methods: The present retrospective cohort study used the dumping symptom rating scale (DSRS) to evaluate the severity of DS and its correlation with weight loss outcomes in 207 patients 1 year after their RYGB. The patients were assigned to group A with mild-to-moderate DS or group B with severe DS. Results: The mean age of the patients was 42.18 ± 10.46 years and their mean preoperative BMI 42.74 ± 5.59 kg/m2. The total weight loss percentage (%TWL) in group B was insignificantly higher than that in group A, but besides that was not significantly different in the two groups. Conclusion: The present findings suggested insignificant relationships between the presence and severity of DS after RYGB and adequate postoperative weight loss

Investigation on effects of ergosan^TM and vibromax^TM in control of white spot disease (WSD) and Vibriosis in shrimp Litopenaeus vannamei

Complementary feedstuff extract from Laminaria digitata and Ascophylum nodosum that containing 1% alginic acids as shrimps stimulating of immune system for control of WSSV is used in this study. The test shrimps Litopenaeus vannamei in larvae stage (Z1-PL1), post larvae stage (PL1-PL10) and juvenile (from 30th day to 40th day) fed by complimentary feedstuff comprised control group. The other condition in test and control group was the same manner. Both groups after 40 days exposed to WSSV by oral inoculation. The clinical sign and mortality recorded for 10 days. The results showed the survival rate of exposed group was higher than the control group and it was significant (p<0/05). The result also show the mortality observed in exposed group 48 hours later than the control group. This study can led us to new methods for control of White spot disease

Multiple hypertrophied tongue lesions in a young hypertensive woman: Multiple endocrine neoplasia type 2B (MEN 2B) syndrome

A 16-year- old girl with history of hypertension was referred to the surgery department due to multiple hypertrophied lesions in both lips and on the lateral sides of the tongue. The lesions have been appeared gradually within the last year and only issued as a cosmetic concern. Which one could not be considered as the differential diagnosis of the patient? neurofibroma neurilemoma Leukoplakia Neuroma Correct answer: This figure demonstrates enlarged lip and hypertrophied tongue lesions which can be seen in neurofibroma, traumatic neuroma, neurilemoma, granular cell tumor, and neuroma; the net diagnosis is made by microscopic examination of a tissue biopsy. Leucoplakia as it is understood by its name is a white plaque with wide range of differential diagnosis; trauma, lichen planus, systemic lupus erythematous (SLE), leukoedema, and malignancy. On retrograde history taking, the patient had a total thyroidectomy due to medullary thyroid carcinoma (MTC) two years ago and right adrenalectomy due to pheochromocytoma last year. What would be the most probable diagnosis? Neurofibromatosis type 1 MEN 2A syndrome MEN 2B syndrome MEN 1 syndrome Correct answer: The classic combination of the mucosal neuroma, MTC, and pheochromocytoma together define the multiple endocrine neoplasia type 2B (MEN 2B). Patients with MEN 2B syndrome also might have marfanoid features. In Neurofibromatosis type 1, neurofibromas, multiple café- au- lait spots, iris hamartomas, skeletal abnormalities, glioma, and cognitive disorders are expected. MEN 2A is identical with MEN 2B but instead of marfanoid features and neuromas, parathyroid hyperplasia is seen. MEN 1 syndrome is characterized by pituitary adenoma, parathyroid hyperplasia, and pancreatic tumor. Due to the high fatality of MTC, early detection of MEN 2B cases and prophylactic thyroidectomy is of great importance and clinical suspicion to MEN 2B by non- endocrinologic features is critical in patients [1]. Currently, growing evidence is affecting our mindset about the clinical picture of MEN 2B syndrome. While MEN 2B patients are classically considered to be tall with marfanoid features, current studies report pediatric patients with proportionate short stature. It is also highlightable that intestinal ganglioneuromatosis associated with MEN 2B, should be considered in the differential diagnosis of Hirschsprung’s disease in children with constipation during early infancy

Multiple scaring cutaneous erosions and hoarseness in a 7- month- old infant

A seven-month-old female infant was referred to the dermatology clinic due to several erosive cutaneous lesions. The lesions were crusted and super-infected (impetiginized), widespread on her face, trunk and, extremities. Multiple atrophic and ice-pick scars were also remarkable, especially on her face, which was attributable to previous lesions. The lesions have been appeared since one- month of age, and have been resolved on their own with atrophic scars. Hoarseness was another notable finding in her physical examination and the physical examination was otherwise normal. The hoarseness had existed since her birth. Lipoid proteinosis or Urbach- Weithe syndrome is a rare autosomal recessive disorder due to mutation in extracellular matrix protein 1&nbsp; (ECM 1) characterized by the deposition of hyaline in cutaneous tissue and mucus membrane of aerodigestive tract (2). Mucocutaneous lesions including palpebral and lingual yellowish nodules, laryngeal complications such as hoarseness and obstruction, and neuro-cognitive disorders including learning difficulties, aggression, loss of fear, memory impairment, and seizures are expected in lipoid proteinosis (3-7)

Eculizumab in Pediatric Kidney Disorders: A Review: Eculizumab in Kidney Disorders

Eculizumab is a humanized monoclonal antibody targeting the C5 (complement 5) memberof complement proteins and inhibiting its cleavage to C5a and C5b. Eculizumab has beenproven to be effective in a wide array of nephrologic, neurologic, and hematologic pediatricdisorders. Kidney disorders, particularly those with immune-mediated pathomechanism,are the most common indications of eculizumab, including atypical hemolytic uremicsyndrome (aHUS), hemolytic uremic syndrome (HUS), membranoproliferativeglomerulonephritis (MPGN), immunoglobulin A (IgA) nephropathy, hematopoietic stemcell transplant-associated thrombotic microangiopathy, and less commonly post-infectiousglomerulonephritis and diffuse proliferative lupus nephritis. In this review, we aimed tosummarize the current evidence on approved and off-label applications of eculizumab andtheir specific considerations in pediatric kidney disorders

Metabolic health's central role in chronic kidney disease progression: a 20-year study of obesity-metabolic phenotype transitions

Abstract This study investigates the risk of chronic kidney disease (CKD) across four metabolic phenotypes: Metabolically Healthy-No Obesity (MH-NO), Metabolically Unhealthy-No obesity (MU-NO), Metabolically Healthy-Obesity (MH-O), and Metabolically Unhealthy-Obesity (MU-O). Data from the Tehran Lipid and Glucose Study, collected from 1999 to 2020, were used to categorize participants based on a BMI ≥ 30 kg/m2 and metabolic health status, defined by the presence of three or four of the following components: high blood pressure, elevated triglycerides, low high-density lipoprotein, and high fasting blood sugar. CKD, characterized by a glomerular filtration rate < 60 ml/min/1.72 m2. The hazard ratio (HR) of CKD risk was evaluated using Cox proportional hazard models. The study included 8731 participants, with an average age of 39.93 years, and identified 734 incidents of CKD. After adjusting for covariates, the MU-O group demonstrated the highest risk of CKD progression (HR 1.42–1.87), followed by the MU-NO group (HR 1.33–1.67), and the MH-O group (HR 1.18–1.54). Persistent MU-NO and MU-O posed the highest CKD risk compared to transitional states, highlighting the significance of exposure during early adulthood. These findings emphasize the independent contributions of excess weight and metabolic health, along with its components, to CKD risk. Therefore, preventive strategies should prioritize interventions during early-adulthood

Chronic constipation and acute small bowel obstruction due to small bowel encapsulation: A case report

Key Clinical Message Peritoneal encapsulation is most of the time asymptomatic and is found incidentally, but when symptomatic it usually presents with bowel obstruction. CT scan is a gold standard for the diagnosis of bowel encapsulation. Abstract Congenital peritoneal encapsulation (CPE), abdominal cocoon syndrome (ACS), and sclerosing encapsulating peritonitis (SEP) are syndromes in which the small bowel is encapsulated. Small bowel encapsulation is usually asymptomatic and rarely presents with small bowel obstruction. In this article, we report a 65‐year‐old man who presented to our hospital with signs and symptoms of small bowel obstruction. He underwent an urgent operation, and small bowel encapsulation was diagnosed. One year after the surgery, all symptoms improved

Clinical features, Diagnosis, and Treatment of COVID-19: A systematic review of case reports and case series

Objectives: The 2019 novel coronavirus (COVID-19) has been declared a public health emergency worldwide. The objective of this systematic review was to characterize the clinical, diagnostic, and treatment characteristics of patients presenting with COVID-19. Methods: We conducted a structured search using PubMed/Medline, Embase, Web of Science and the Cochrane Library to collect both case reports and case series on COVID-19 published up to February 30, 2020. Results: Thirty-four articles were included analyzing a total of 99 patients with a mean age of 46.2 years. The most common presenting symptom in patients who tested positive for COVID-19 was fever, reported in up to 83% of patients from 76.4% of the analyzed studies. Other symptoms including rhinorrhea, dizziness, and chills were less frequently reported. Additionally, in studies which reported C-reactive protein (CRP) measurements (44%), a large majority of patients displayed an elevated CRP (73%). Progression to acute respiratory distress syndrome (ARDS) was the most common complication of patients testing positive for COVID-19 (33%). CT images displayed ground-glass opacification (GGO) patterns (80%) as well as bilateral lung involvement (71.0%). The most commonly used antiviral treatment modalities included, lopinavir (HIV protease inhibitor), arbidiol hydrochloride (influenza fusion inhibitor), and oseltamivir (neuraminidase inhibitor). Conclusions: Development of ARDS may play a role in estimating disease progression and mortality risk. Early detection of elevations in serum CRP, combined with a clinical COVID-19 symptom presentation may be used as a surrogate marker for presence and severity of disease. There is a paucity of data surrounding the efficacy of treatments. There is currently not a well-established gold standard therapy for the treatment of diagnosed COVID-19. Further prospective investigations are necessary