Plasma presepsin in determining gastric leaks following bariatric surgery

2019 ◽  
Vol 44 (4) ◽  
pp. 565-573
Author(s):  
Sinan Binboga ◽  
Nilgun Isiksacan ◽  
Pinar Kasapoglu ◽  
Elif Binboga ◽  
Murat Koser ◽  
...  
Keyword(s):  
Morbid Obesity ◽  
Sleeve Gastrectomy ◽  
White Blood Count ◽  
Surgical Interventions ◽  
Neutrophil Lymphocyte Ratio ◽  
Reactive Protein ◽  
Stapler Line

Abstract Background To be able to prevent morbid obesity in the long-term, laparoscopic sleeve gastrectomy (LSG) is one of the most effective surgical interventions. However, leakage and bleeding from the stapler line are significant complications. The aim of this study was to determine the role of the levels of plasma presepsin in the detection of stapler leakage. Materials and methods The study included 300 patients with LSG due to morbid obesity and 40 control subjects. Before any medical treatment was applied, blood samples were taken from patients at 12 h preoperatively and on days 1, 3, and 5 postoperatively. Evaluation was made of plasma presepsin levels, white blood count (WBC), C-reactive protein (CRP) and neutrophil-lymphocyte ratio (NLR), in all patients with sleeve gastrectomy line leakage. Results The WBC, CRP, NLR and presepsin values measured on days 1, 3 and 5 postoperatively were determined to be higher in patients with leakage compared to those without. The predictive value of presepsin (p = 0.001), CRP (p = 0.001) and NLR (p = 0.001) was determined to be statistically significantly higher than that of WBC (p = 0.01). Conclusion The results of the study suggest that presepsin levels could have a role in the detection and follow-up of stapler line leaks after LSG. Elevated presepsin levels, on postoperative day 1 in particular, could have a key role in the early detection of possible complications which are not seen clinically.

Long-term follow-up and the role of surgery in adolescents with morbid obesity

2005 ◽  
Vol 1 (4) ◽  
pp. 394-398 ◽  
Author(s):  
S BARNETT ◽  
C STANLEY ◽  
M HANLON ◽  
R ACTON ◽  
D SALTZMAN ◽  
...  
Keyword(s):  
Morbid Obesity ◽  
Long Term Follow Up

scholarly journals Sleeve gastrectomy with loop bipartition as a novel procedure for management of type 2 diabetes in obese patients

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
R S Ezz ◽  
M M Abouzeid ◽  
M M Helmy ◽  
M M Elhusseini
Keyword(s):  
Type 2 Diabetes ◽  
Sleeve Gastrectomy ◽  
First Year ◽  
Obese Patients ◽  
Single Anastomosis ◽  
Marked Weight

Abstract Background Amidst the current worldwide epidemic of type 2 diabetes mellitus (T2DM), the global diabetes health burden is projected to reach 522 million in 2030, with much of this increase occurring in developing countries. Aim of the work to evaluate the role of laparoscopic sleeve gastrectomy with loop bipartition (single anastomosis sleeve ileal bypass) as a bariatric and metabolic procedure in control of type 2 diabetes in obese patients. Patients and methods This prospective cohort study included 20 obese adult patients with type 2 DM recently diagnosed within last 5 years. Some of them have other associated comorbidities. They were recruited at department of surgery Ain Shams University. The follow up was obtained during the first year post-operative. Results In this study, complete remission of diabetes was achieved in 75% of the patients by the 3rd post-operative month and in 95% by the end of the study. This was beside marked weight reduction and improvement of lipid profile without causing micronutrients deficiencies during the study period. Conclusion SASI bypass can be one of the most efficient metabolic procedures and could be associated with less risks. The procedure should be considered under investigations until enough long term data are available. Thus it is worth to be explored in research aiming for more data.

scholarly journals POS1140 RISK FACTORS FOR THE DEVELOPMENT OF DIABETES MELLITUS IN PATIENTS WITH GOUT ACCORDING TO A 6-YEAR PROSPECTIVE FOLLOW-UP STUDY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 849.2-849
Author(s):  
O. Sheliabina ◽  
M. Elisеev ◽  
A. Novikova ◽  
M. Chikina
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Family History ◽  
Clinical Manifestations ◽  
Reactive Protein ◽  
Follow Up Study ◽  
Lowering Therapy

Background:Gout is often associated with diabetes mellitus (DM), but the role of serum uric acid (sUA) and urate-lowering drugs in its development in patients with gout remains controversial [1].Objectives:To study risk factors for DM in patients with gout based on the results of long-term prospective follow-up study.Methods:The prospective study included 444 patients with a crystal-verified diagnosis of gout, aged ≥18 years, 49 (11%) women, 395 (89%) men. Patients were followed up at the V.A. Nasonova Research Institute of Rheumatology from 2010 to January 2021, the median follow-up was 6.1 [2.8; 7.8] years. The exclusion criteria were the presence of other rheumatic diseases with symptoms of arthritis, DM. DM was diagnosed on the 1998 WHO criteria. The following parameters were considered as risk factors: gender, family history for diabetes mellitus, body mass index (BMI)>25 kg/m2 and > 30 kg/m2, waist volume ≥88 cm for women and ≥102 cm for men, alcohol consumption > 20 units per week, chronic kidney disease (CKD), intake of diuretics and glucocorticoids, and serum total cholesterol >5 mmol/l, triglycerides>2.25 mmol/l, serum C-reactive protein (CRP) level> 5 mg/l, as well as clinical manifestations of gout: subcutaneous tophi, polyarthritis (simultaneous involvement of ≥5 joints), intake of urate-lowering drugs, sUA (> 480 μmol/L,> 420 μmol/L,> 360 μmol/L,> 300 μmol/L). Statistica 12.0 package was used for statistical data processing.Results:A total of 444 patients were included, the mean age was 51.0±12.9 years, the median follow-up was 6.1 [2.8; 7.8] years. In dynamics: 35 (8%) patients died, 6 (1%) patients were not available, 403 patients were examined (44 (11%) - women and 359 (89%) - men). 290 (72%) patients received urate-lowering therapy (263 (65%) patients used allopurinol, 27 (7%) - febuxostat). The target sUA <360 μmol/L was reached by 165 (41%) patients and <300 μmol/L - by 92 (23%) patients. All patients with sUA<300 μmol/L received urate-lowering therapy, 62 (67%) patients used allopurinol, 17 (18%) - febuxostat, 13 (14%) - uricosuric drugs. Diabetes mellitus was developed in 106 (26%) patients. The factors influencing the risk of developing diabetes were - the presence of diabetes in family history (odds ratio (OR) 2.27, 95% confidence interval (CI) 1.37; 3.76); BMI> 30 kg / m2 (OR 1.79, 95% CI 1.14; 2.80), diuretics (OR 2.32, 95% CI 1.36; 3.96) and sUA> 300 μmol / l (OR 2.89, 95% CI 1.50, 5.56).Conclusion:The risk of developing DM in patients with gout is associated with sUA> 300 μmol/l, which may be one of the probable reasons for choosing this as a target level. Large prospective studies are needed to confirm the antidiabetic effect of urate-lowering drugs.References:[1]Chang HW, Lin YW, Lin MH, Lan YC, Wang RY. Associations between urate-lowering therapy and the risk of type 2 diabetes mellitus. PLoS One. 2019 Jan 7;14(1):e0210085. doi: 10.1371/journal.pone.0210085.Disclosure of Interests:Olga Sheliabina: None declared, Maxim Elisеev Speakers bureau: Berlin Chemie Menarini Group, Novartis International AG, EGIS, Aleksandra Novikova: None declared, Maria Chikina: None declared.

scholarly journals Neutrophil–lymphocyte ratio is a marker of survival and cardiac complications rather than patency following revascularization of lower extremities

2018 ◽  
Vol 23 (5) ◽  
pp. 437-444 ◽  
Author(s):  
Leili Pourafkari ◽  
Catherine Choi ◽  
Reza Garajehdaghi ◽  
Arezou Tajlil ◽  
Hasan H Dosluoglu ◽  
...  
Keyword(s):  
Cardiac Complications ◽  
Cox Regression Analysis ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Artery Disease ◽  
Revascularization Procedures ◽  
Long Term Mortality

The neutrophil–lymphocyte ratio (NLR), as a marker of inflammation, is associated with the severity of peripheral artery disease (PAD). The role of the NLR on predicting future complications after elective revascularization for patients with PAD remains unknown. We aimed to examine the role of the NLR in the development of major adverse limb events (MALE) and the long-term mortality of these patients. We evaluated 1708 revascularization procedures from May 2001 to December 2015 at the Veterans Affairs Western New York Healthcare System from a prospectively maintained vascular database that included demographics, comorbidities and pre-procedural medications. Peri-procedural laboratory findings including complete blood cell count and metabolic panel were further retrieved from the electronic health record. The NLR was calculated, and the patients were categorized into tertiles according to NLR cut-off points. Multivariate Cox regression analysis was performed to determine MALE and 10-year mortality. The primary endpoint of the study was MALE, and the secondary endpoint included 10-year mortality. A total of 1228 patients were included for final analyses. Patients in the third NLR tertile were more likely to experience MALE during the follow-up period ( p<0.001). In addition, fewer patients in tertile 3 survived over the follow-up period compared to tertiles 1 and 2 ( p<0.0001). Patients in tertile 3 tended to be older with a higher frequency of hypertension, diabetes, chronic kidney disease, coronary artery disease and congestive heart failure. Our multivariate analysis demonstrated that the NLR was independently associated with higher rates of MALE in the affected vessels following revascularization procedures. Similarly, the NLR was revealed to be an independent predictor of higher long-term mortality in these patients.

SFR-116 Long term follow-up after laparoscopic sleeve gastrectomy as a final step for the treatment of morbid obesity

2011 ◽  
Vol 7 (3) ◽  
pp. 370
Author(s):  
Flavia Soto ◽  
Vicente Gari ◽  
Javier De La Garza ◽  
Samuel Szomstein ◽  
Raul J. Rosenthal
Keyword(s):  
Morbid Obesity ◽  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Long Term Follow Up

No relation between biomarkers at age 47–49 and aortic diameter after 14–19 years of follow-up – a population-based study

VASA ◽  
2017 ◽  
Vol 46 (4) ◽  
pp. 291-295 ◽  
Author(s):  
Soumia Taimour ◽  
Moncef Zarrouk ◽  
Jan Holst ◽  
Olle Melander ◽  
Gunar Engström ◽  
...  
Keyword(s):  
Population Based ◽  
Aortic Diameter ◽  
Aortic Dilatation ◽  
Population Based Study ◽  
Reactive Protein ◽  
Abdominal Aortic ◽  
Long Term Follow Up ◽  
Old Men

Abstract. Background: Biomarkers reflecting diverse pathophysiological pathways may play an important role in the pathogenesis of abdominal aortic aneurysm (aortic diameter ≥30 mm, AAA), levels of many biomarkers are elevated and correlated to aortic diameter among 65-year-old men undergoing ultrasound (US) screening for AAA. Probands and methods: To evaluate potential relationships between biomarkers and aortic dilatation after long-term follow-up, levels of C-reactive protein (CRP), proneurotensin (PNT), copeptin (CPT), lipoprotein-associated phospholipase 2 (Lp-PLA2), cystatin C (Cyst C), midregional proatrial natriuretic peptide (MR-proANP), and midregional proadrenomedullin (MR-proADM) were measured in 117 subjects (114 [97 %] men) aged 47–49 in a prospective population-based cohort study, and related to aortic diameter at US examination of the aorta after 14–19 years of follow-up. Results: Biomarker levels at baseline did not correlate with aortic diameter after 14–19 years of follow up (CRP [r = 0.153], PNT [r = 0.070], CPT [r = –.156], Lp-PLA2 [r = .024], Cyst C [r = –.015], MR-proANP [r = 0.014], MR-proADM [r = –.117]). Adjusting for age and smoking at baseline in a linear regression model did not reveal any significant correlations. Conclusions: Tested biomarker levels at age 47–49 were not associated with aortic diameter at ultrasound examination after 14–19 years of follow-up. If there are relationships between these biomarkers and aortic dilatation, they are not relevant until closer to AAA diagnosis.

Abusive head trauma (AHT) outcome at long-term follow-up and the role of elective neurosurgical approach: A report of 22 cases

2013 ◽  
Author(s):  
Francesca Menegazzo ◽  
Melissa Rosa Rizzotto ◽  
Martina Bua ◽  
Luisa Pinello ◽  
Elisabetta Tono ◽  
...  
Keyword(s):  
Head Trauma ◽  
Abusive Head Trauma ◽  
Long Term Follow Up
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