Sleeve to Colon Fistula: Laparoscopic Conversion to Roux-en-Y Gastric Bypass

alkiviadis.1961 shared this article with you from Inoreader Sleeve to Colon Fistula: Laparoscopic Conversion to Roux-en-Y Gastric Bypass Via Latest Results for Obesity Surgery View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Hair Loss After Metabolic and Bariatric Surgery: a Systematic Review and Meta-analysis

alkiviadis.1961 shared this article with you from Inoreader Hair Loss After Metabolic and Bariatric Surgery: a Systematic Review and Meta-analysis Via Latest Results for Obesity Surgery Abstract Background Hair loss is a common complication after metabolic and bariatric surgery (MBS). There is a lack of published systematic review in the scientific literature on this topic. The aim of this study was to perform a systematic review and meta-analysis on hair loss after MBS in accordance with Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) guidelines. Methods PubMed, CINAHL, EMBASE, Web of Science, SCOPUS, and four Chinese databases were searched. Data were pooled using Review Manager 5.3 and Stata 12.0, and subgroups were performed if necessary and feasible. Results A total of 18 studies (n = 2538) were included. The pooled results showed that the incidence of hair loss after MBS was 57% (95% CI 42–71%). It decreased with longer follow-up times. Hair loss was significantly more common in younger (mean difference (MD), − 2.45; 95% CI, − 4.26 to − 0.64; p = 0.008) women (OR, 3.87; 95% CI, 0.59 to 17.59; p = 0.08). Serum zinc (standardized mean difference (SMD), − 1.13; 95% CI, − 2.27 to 0.01, p = 0.05), folic acid (SMD = − 0.88, 95% CI − 1.29 to − 0.46, p < 0.0001), and ferritin levels (SMD, − 0.22; 95% CI, − 0.38 to − 0.05; p = 0.01), but not serum iron and vitamin B12, were associated with hair loss following MBS. Conclusions Hair loss is common after MBS especially in younger women, and those with low serum levels of zinc, folic acid, and ferritin. Prospective studies on larger cohorts are needed. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Analysis of National Bariatric Surgery Related Clinical Incidents: Lessons Learned and a Proposed Safety Checklist for Bariatric Surgery

alkiviadis.1961 shared this article with you from Inoreader Analysis of National Bariatric Surgery Related Clinical Incidents: Lessons Learned and a Proposed Safety Checklist for Bariatric Surgery Via Latest Results for Obesity Surgery Abstract Background Hundreds of thousands of patient-safety clinical incidents are reported to the National Reporting and Learning System (NRLS) database in England and Wales every year. The purpose of this study was to identify bariatric surgery-related learning points from these incidents. Methods We analysed bariatric surgery-related clinical incidents reported to the NRLS database between 01 April 2005 and 31st October 2020. The authors used their experience to identify learning themes, attribute severity, and design a safety checklist from these reported incidents. Results We identified 541 bariatric surgery-related clinical incidents in 58 different themes. Preoperative, intraoperative, and postoperative incidents represented 30.3% (N = 164), 38.1% (N = 206), and 31.6% (N = 171) incidents respectively. One hundred fifty (27.7%), 244 (45.1%), and 147 (27.2%) incidents were attributed high, medium, and low severity respectively. The most commonly reported high severity theme was the failure of thromboprophylaxis (50; 9.2%). Intraoperative high severity incidents included 17 incidents of stapling of orogastric/nasogastric tubes or temperature probes, 8 missed needles, 8 broken graspers, and 6 incidents of band parts left behind. Postoperatively, the most commonly reported high severity theme was improper management of diabetes mellitus (DM) (35; 6.5%). Medication errors represented a significant proportion of the medium severity incidents. Conclusion We identified 58 specific themes of bariatric surgery-related clinical incidents. We propose specific recommendations for the prevention of each theme and a safety checklist to help improve the safety of bariatric surgery worldwide. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

[Articles] Cetuximab, docetaxel, and cisplatin versus platinum, fluorouracil, and cetuximab as first-line treatment in patients with recurrent or metastatic head and neck squamous-cell carcinoma (GORTEC 2014-01 TPExtreme): a multicentre, open-label, randomised, phase 2 trial

alkiviadis.1961 shared this article with you from Inoreader [Articles] Cetuximab, docetaxel, and cisplatin versus platinum, fluorouracil, and cetuximab as first-line treatment in patients with recurrent or metastatic head and neck squamous-cell carcinoma (GORTEC 2014-01 TPExtreme): a multicentre, open-label, randomised, phase 2 trial Via The Lancet Oncology Although the trial did not meet its primary endpoint, with no significant improvement in overall survival with TPEx versus EXTREME, the TPEx regimen had a favourable safety profile. The TPEx regimen could provide an alternative to standard of care with the EXTREME regimen in the first-line treatment of patients with recurrent or metastatic HNSCC, especially for those who might not be good candidates for up-front pembrolizumab treatment. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Prevalence of colorectal cancer and its precursor lesions in symptomatic patients under 55 years of age undergoing total colonoscopy: results of a large retrospective, multicenter, controlled endoscopy study

alkiviadis.1961 shared this article with you from Inoreader Prevalence of colorectal cancer and its precursor lesions in symptomatic patients under 55 years of age undergoing total colonoscopy: results of a large retrospective, multicenter, controlled endoscopy study Via Latest Results for International Journal of Colorectal Disease Abstract Purpose Colorectal cancer (CRC) is the second most common cancer in Germany. Around 60,000 people were diagnosed CRC in 2016 in Germany. Since 2019, screening colonoscopies are offered in Germany for men by the age of 50 and for women by the age of 55. It is recently discussed if women should also undergo a screening colonoscopy by the age of 50 and if there are any predictors for getting CRC. Methods Colonoscopies of 1553 symptomatic patients younger than 55 years were compared with colonoscopies of 1075 symptomatic patients older than 55 years. We analyzed if there are any significant differences between those two groups in the prevalence of CRC and its precursor lesions or between symptomatic men and women. We evaluated if there is a correlation between abdominal symptoms and the prevalence of CRC. Results In 164/1553 symptomatic patients, 194 (12.5%) polyps were detected. In total, six colorectal carcinomas (0.4%) were detected. There were no significant differences between men and women. In symptomatic patients ≥ 55 years, significantly more polyps were found (p<0.0001; 26.6% vs. 12.5%). Totally, 286 polyps (26.6%) were removed in 1075 symptomatic patients older than 55 years. Anorectal bleeding was the only abdominal symptom being a significant indicator for the prevalence of the occurrence of colon and rectum cancer in both groups (p=0.03, OR=2.73 95%-CI [1.11;6.70]), but with only low sensitivity (44%). Conclusion Due to no significant differences in men and women, we recommend screening colonoscopies also for women by the age of 50. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Recurrent hemorrhage risk associated with medial target medullary artery anastomosis from the periventricular collateral vessel in adult patients with moyamoya disease

alkiviadis.1961 shared this article with you from Inoreader Recurrent hemorrhage risk associated with medial target medullary artery anastomosis from the periventricular collateral vessel in adult patients with moyamoya disease Via Latest Results for BMC Neurology Abstract Background Although the association between periventricular target collateral anastomosis and recurrent ipsilateral hemorrhage has been evaluated in adult patients with moyamoya disease (MMD), no studies have investigated the relationship between target anastomotic territory and recurrent ipsilateral hemorrhage. The goal of this study was to assess this association. Methods Consecutive adult MMD patients who had experienced initial intracranial hemorrhage and undergone conservative treatment were included. Two readers assessed angiographic results to identify the target anastomotic territory (medial medullary artery, lateral medullary artery, multiple medullary arteries, or nonmedullary artery) responsible for the hemorrhage. Cox proportional hazard regression models were used to estimate the risk of recurrent hemorrhage. Results In the 36 hemispheres with initial hemorrhage, the target anastomotic territory was in the anastomotic territory of the medial medullary artery in 10 (27.8%), lateral medullary artery in 15 (41.7%), multiple medullary arteries in 2 (5.6%), and a nonmedullary artery in 9 (25.0%) hemispheres. During 45.1 ± 40.0 months of follow-up, recurrent ipsilateral hemorrhage occurred in 44.4% (16/36) of hemispheres. The target anastomotic territories responsible for the recurrent event were in the anastomotic territory of the medial medullary artery in 9 (56.3%) hemispheres, lateral medullary artery in 6 (37.5%) hemispheres, and multiple medullary arteries in 1 (6.3%) hemisphere. The anastomotic territory of the medial medullary artery was associated with recurrent hemorrhage before (HR = 2.94; 95% CI, 1.07–8.08; p = 0.037) and after (HR = 6.65; 95% CI, 1.32–33.60; p = 0.022) adjustments were made for confounding factors. Conclusions The incidence of recurrent ipsilateral hemorrhage varies with the target anastomotic territory in adult patients with MMD. Medial target medullary artery anastomosis is a significant risk factor for recurrent ipsilateral hemorrhage. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Protracted SARS‐CoV‐2 Pneumonia with Rituximab Treatment: about two cases

alkiviadis.1961 shared this article with you from Inoreader Protracted SARS‐CoV‐2 Pneumonia with Rituximab Treatment: about two cases Via Journal of Medical Virology Abstract Here, we describe two patients, previously treated with rituximab, who presented with a protracted SARS‐CoV‐2 infection with an atypical course. We hypothesized an incomplete viral clearance with persistent pneumonia due to an impaired or delayed humoral response. This article is protected by copyright. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Stool samples versus nasopharyngeal specimens for the initial diagnosis of SARS‐CoV‐2 infection

alkiviadis.1961 shared this article with you from Inoreader Stool samples versus nasopharyngeal specimens for the initial diagnosis of SARS‐CoV‐2 infection Via Journal of Medical Virology Abstract Some practionners are tempted to use stool samples, as an easier alternative to nasopharyngeal specimens (NPS) for initial diagnosis of COVID‐19. This report shows that stool samples cannot be used as alternative to NPS for the initial diagnosis of COVID‐19, but as an additional tool in patients presenting with gastrointestinal symptoms. This article is protected by copyright. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

In vitro activity of itraconazole against SARS‐CoV‐2

alkiviadis.1961 shared this article with you from Inoreader In vitro activity of itraconazole against SARS‐CoV‐2 Via Journal of Medical Virology Abstract Although vaccination campaigns are currently being rolled out to prevent coronavirus disease (COVID‐19), antivirals will remain an important adjunct to vaccination. Antivirals against coronaviruses do not exist, hence global drug repurposing efforts have been carried out to identify agents that may provide clinical benefit to patients with COVID‐19. Itraconazole, an antifungal agent, has been reported to have activity against animal coronaviruses. Using cell‐based phenotypic assays, the in vitro antiviral activity of itraconazole and 17‐OH itraconazole was assessed against clinical isolates from a German and Belgian patient infected with SARS‐CoV‐2. Itraconazole demonstrated antiviral activity in human Caco‐2 cells (EC50 = 2.3 µM; MTT assay). Similarly, its primary metabolite, 17‐OH itraconazole, showed inhibition of SARS‐CoV‐2 activity (EC50 = 3.6 µM). Remdesivir inhibited viral replication with an EC50 = 0.4 µM. Itraconazol e and 17‐OH itraconazole resulted in a viral yield reduction in vitro of approximately 2‐log10 and approximately 1‐log10, as measured in both Caco‐2 cells and VeroE6‐eGFP cells, respectively. The viral yield reduction brought about by remdesivir or GS‐441524 (parent nucleoside of the antiviral prodrug remdesivir; positive control) was more pronounced, with an approximately 3‐log10 drop and >4‐log10 drop in Caco‐2 cells and VeroE6‐eGFP cells, respectively. Itraconazole and 17‐OH itraconazole exert in vitro low micromolar activity against SARS‐CoV‐2. Despite the in vitro antiviral activity, itraconazole did not result in a beneficial effect in hospitalized COVID‐19 patients in a clinical study (EudraCT Number: 2020‐001243‐15). This article is protected by copyright. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Baseline serum exosome‐derived miRNAs predict HBeAg seroconversion in chronic hepatitis B patients treated with peginterferon

alkiviadis.1961 shared this article with you from Inoreader Baseline serum exosome‐derived miRNAs predict HBeAg seroconversion in chronic hepatitis B patients treated with peginterferon Via Journal of Medical Virology Abstract Objective This study aimed to explore the value of baseline serum exosome‐derived miRNAs for predicting HBeAg seroconversion in chronic hepatitis B (CHB) patients treated with peginterferon (Peg‐IFN). Methods A total of 120 treatment‐naïve HBeAg‐positive CHB patients who received Peg‐IFN therapy (48 weeks) were enrolled. Next‐generation sequencing was performed to screen the serum exosomal miRNAs that were associated with Peg‐IFN treatment outcome, and qRT‐PCR was used to validate them. The area under receiver operating characteristic curve (AUROC) was used to evaluate the predictive efficacy of biomarkers. Results Thirty‐three patients (27.5%) achieved HBeAg seroconversion (response group), and 87 patients (72.5%) did not achieve HBeAg seroconversion (non‐response group). In the identification cohort, forty serum exosome‐derived miRNAs were differentially expressed between the response group (4 patients) and the non‐response group (4 patients). In the confirmation cohort, the expression levels of serum exosomal miR‐194‐5p (p < 0.001) and miR‐22‐3p (p < 0.001) were significantly downregulated in the response group (29 patients) compared to the non‐response group (83 patients). Multivariate analysis identified baseline serum exosomal miR‐194‐5p, miR‐22‐3p, alanine aminotransferase (ALT) and HBV DNA as independent predictors of HBeAg seroconversion (all p < 0.05). The AUROCs of serum exosomal miRNAs (0.77 and 0.75 for miR‐194‐5p and miR‐22‐3p, respectively) were higher than that of ALT (0.70) and HBV DNA (0.69). The combination of exosomal miR‐194‐5p and miR‐22‐3p further improved the predictive performance with an AUROC of 0.82. Conclusion Baseline serum exosomal miR‐194‐5p and miR‐22‐3p may serve as novel biomarkers to predict HBeAg seroconversion in CHB patients treated with Peg‐IFN. This article is protected by copyright. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Healthcare disparities among anticoagulation therapies for severe COVID‐19 patients in the multi‐site VIRUS registry

alkiviadis.1961 shared this article with you from Inoreader Healthcare disparities among anticoagulation therapies for severe COVID‐19 patients in the multi‐site VIRUS registry Via Journal of Medical Virology Abstract Here we analyze hospitalized and ICU COVID‐19 patient outcomes from the international VIRUS registry (https://clinicaltrials.gov/ct2/show/NCT04323787). We find that COVID‐19 patients administered unfractionated heparin but not enoxaparin have a higher mortality‐rate (390 of 1,012 = 39%) compared to patients administered enoxaparin but not unfractionated heparin (270 of 1,939 = 14%), presenting a risk ratio of 2.79 (95% C.I.: [2.42, 3.16]; p‐value: 4.45e‐52). This difference persists even after balancing on a number of covariates including demographics, comorbidities, admission diagnoses, and method of oxygenation, with an increased mortality rate on discharge from the hospital of 37% (268 of 733) for unfractionated heparin vs. 22% (154 of 711) for enoxaparin, presenting a risk ratio of 1.69 (95% C.I.: [1.4 2, 2.00]; p‐value: 1.5e‐8). In these balanced cohorts, a number of complications occurred at an elevated rate for patients administered unfractionated heparin compared to patients administered enoxaparin, including acute kidney injury, acute cardiac injury, septic shock, and anemia. Furthermore, a higher percentage of Black/African American COVID patients (414 of 1,294 [32%]) were noted to receive unfractionated heparin compared to White/Caucasian COVID patients (671 of 2,644 [25%]), risk ratio 1.26 (95%CI [1.14, 1.40], p‐value: 7.5e‐5). After balancing upon available clinical covariates, this difference in anticoagulant use remained statistically significant (311 of 1,047 [30%] for Black/African American vs. 263 of 1,047 [25%] for White/Caucasian, p‐value: 0.02, risk ratio 1.18, 95%CI [1.03, 1.36]). While retrospective studies cannot suggest any causality, these findings motivate the need for follow‐up prospective research into the observed racial disparity in anticoagu lant use and outcomes for severe COVID‐19 patients. This article is protected by copyright. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Anti-Inflammatory Investigations of Extracts of Zanthoxylum rhetsa

alkiviadis.1961 shared this article with you from Inoreader Anti-Inflammatory Investigations of Extracts of Zanthoxylum rhetsa Via Hindawi Publishing Corporation Zanthoxylum rhetsa has been consumed in the diet in northern Thailand and also used as a medicament in ancient scripture for arthropathies. Thus, this study aimed to evaluate the activity of various extracts from differential parts of Z. rhetsa via inhibition of inflammatory mediators (NO, TNF-α, and PGE2) in RAW264.7 macrophages. The chemical composition in active extracts was also analyzed by GC/MS. The parts of this plant studied were whole fruits (F), pericarp (P), and seed (O). The methods of extraction included maceration in hexane, 95% ethanol and 50% ethanol, boiling in water, and water distillation. The results demonstrated that the hexane and 95% ethanolic extract from pericarp (PH and P95) and seed essential oil (SO) were the most active extracts. PH and P95 gave the highest inhibi tion of NO production with IC50 as 11.99 ± 1.66 μg/ml and 15.33 ± 1.05 μg/ml, respectively, and they also showed the highest anti-inflammatory effect on TNF-α with IC50 as 36.08 ± 0.55 μg/ml and 34.90 ± 2.58 μg/ml, respectively. PH and P95 also showed the highest inhibitory effect on PGE2 but less than SO with IC50 as 13.72 ± 0.81 μg/ml, 12.26 ± 0.71 μg/ml, and 8.61 ± 2.23 μg/ml, respectively. 2,3-Pinanediol was the major anti-inflammatory compound analyzed in PH (11.28%) and P95 (19.82%) while terpinen-4-ol constituted a major anti-inflammatory compound in SO at 35.13%. These findings are the first supportive data for ethnomedical use for analgesic and anti-inflammatory activity in acute (SO) and chronic (PH and P95) inflammation. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.