scholarly journals Chewing and swallowing in obese individuals referred to bariatric surgery/gastroplasty - a pilot study

Revista CEFAC ◽  
2019 ◽  
Vol 21 (5) ◽  
Author(s):  
Ana Cláudia Andrade Rocha ◽  
Natália Oliveira de Souza Conceição ◽  
Laura Davison Mangilli Toni
Keyword(s):  
Bariatric Surgery ◽  
Research Group ◽  
Speech Therapy ◽  
Muscle Tension ◽  
Case Series ◽  
Tongue Pressure ◽  
Cross Sectional ◽  
Therapy Assessment ◽  
Stomatognathic System ◽  
Post Surgery

ABSTRACT Objective: to describe the chewing and swallowing pattern of obese individuals indicated for bariatric surgery/gastroplasty before the procedure, using standardized clinical protocols. Methods: a cross-sectional descriptive case-control study that presents preliminary data for a larger investigation. Eight participants matched for age and sex were divided into two groups (four in the research group and four as controls) and submitted to clinical speech therapy assessment using the “Questionnaire on eating behavior and the anatomofunctional conditions of the stomatognathic system” from the Expanded Protocol of Orofacial Myofunctional Evaluation with Scores (OMES-E) and the maximum tongue pressure test. Results: when compared to controls, participants from the research group exhibited a predominantly unilateral chewing preference; reported that they just “swallowed food”; repeated swallowing of liquid and solid foods, with facial muscle tension; increased cheek volume and the presence of flaccidity; shorter meal and chewing times; increased tension of the lips, mentalis and facial muscles at rest and during swallowing; predominance of insufficient ability with associated movements and/or tremors during lip, tongue, jaw and cheek movements; and lack of knowledge regarding speech therapy. Conclusion: orofacial myofunctional dysfunctions were more frequent in patients from the research group when compared to controls. A need to increase the number of participants in this case series and conduct a post-surgery reassessment, in order to provide a longitudinal description of the chewing and swallowing pattern, was verified.

Clinical factors correlated with vitamin D deficiency in patients with obesity scheduled for bariatric surgery: A single center experience

2020 ◽  
Vol 90 (3-4) ◽  
pp. 346-352
Author(s):  
Vincenzo Pilone ◽  
Salvatore Tramontano ◽  
Carmen Cutolo ◽  
Federica Marchese ◽  
Antonio Maria Pagano ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Serum Vitamin ◽  
Inverse Correlation ◽  
Model Assessment ◽  
Cross Sectional ◽  
Serum Vitamin D ◽  
Female Sex ◽  
Vitamin D Levels

Abstract. We aim to assess the prevalence of vitamin D deficiency (VDD) in patients scheduled for bariatric surgery (BS), and to identify factors that might be associated with VDD. We conducted a cross-sectional observational study involving all consecutive patients scheduled for BS from 2017 to 2019. The exclusion criteria were missing data for vitamin D levels, intake of vitamin D supplements in the 3 months prior to serum vitamin D determination, and renal insufficiency. A total of 206 patients (mean age and body mass index [BMI] of 34.9 ± 10.7 years, and 44.3 ± 6.99 kg/m2, respectively) met the inclusion criteria and were enrolled for data analysis. VDD (<19.9 ng/mL), severe VDD (<10 ng/mL), and vitamin D insufficiency (20–29.9 ng/mL) were present in 68.8 %, 12.5 %, and 31.2 % of patients, respectively. A significant inverse correlation was found between vitamin D levels and initial BMI, parathyroid hormone, and homeostatic model assessment of insulin resistance (r = −0.280, p < 0.05; r = −0.407, p = 0.038; r = −0.445, p = 0.005), respectively. VDD was significantly more prevalent in patients with higher BMI [−0.413 ± 0.12, CI95 % (−0.659; −0.167), p = 0.006], whereas no significant association between hypertension [−1.005 ± 1.65, CI95 % (−4.338; 2.326), p = 0.001], and diabetes type 2 (T2D) [−0.44 ± 2.20, CI95 % (−4.876; 3.986), p = 0.841] was found. We observed significant association between female sex and levels of vitamin D [6.69 ± 2.31, CI95 % (2.06; 11.33), p = 0.006]. The present study shows that in patients scheduled for BS, VDD deficiency is common and was associated with higher BMI, and female sex.

scholarly journals Cardio-Pulmonary Sequelae in Recovered COVID-19 Patients: Considerations for Primary Care

2021 ◽  
Vol 12 ◽  
pp. 215013272110237
Author(s):  
Zouina Sarfraz ◽  
Azza Sarfraz ◽  
Alanna Barrios ◽  
Radhika Garimella ◽  
Asimina Dominari ◽  
...  
Keyword(s):  
Primary Care ◽  
Primary Infection ◽  
Clinical Laboratory ◽  
Point Of Care ◽  
Case Reports ◽  
Case Series ◽  
Infectious Complications ◽  
Care Physician ◽  
Cross Sectional ◽  
Infection Period

Background: Current literature lacks characterization of the post-recovery sequelae among COVID-19 patients. This review characterizes the course of clinical, laboratory, radiological findings during the primary infection period, and the complications post-recovery. Primary care findings are presented for long-COVID care. Methods: Adhering to PRISMA guidelines, 4 databases were searched (PubMed, Embase, CINAHL Plus, Scopus) through December 5, 2020, using the keywords “COVID-19 and/or recovered and/or cardiovascular and/or long-term and/or sequelae and/or sub-acute and/or complication.” We included published peer-reviewed case reports, case series, and cross-sectional studies providing the clinical course of COVID-19 infection, and cardiopulmonary complications of patients who recovered from COVID-19, while making healthcare considerations for primary care workers. Results: We identified 29 studies across 9 countries including 37.9% Chinese and 24.1% U.S. studies, comprising 655 patients (Mean Age = 45) with various ethnical backgrounds including Asian and European. Based on the WHO COVID-19 severity classification scale, initial disease severity was mild for 377 patients and severe for 52 patients. Treatments during primary infection included corticosteroids, oxygen support, and antivirals. The mean value (in days) for complication onset after acute recovery was 28 days. Complete blood counts and RT-PCR tests were the most common laboratory results described. In 22 of the studies, patients showed signs of clinical improvement and were prescribed medications such as anticoagulants or corticosteroids. Conclusion: Post-recovery infectious complications are common in long-COVID-19 patients ranging from mild infections to life-threatening conditions. International thoracic and cardiovascular societies need to develop guidelines for patients recovering from COVID-19 pneumonia, while focused patient care by the primary care physician is crucial to curb preventable adverse events. Recommendations for real-time and lab-quality diagnostic tests are warranted to establish point-of-care testing, detect early complications, and provide timely treatment.

scholarly journals Perioperative nutrition care and dietetic practices in the scope of bariatric surgery in Saudi Arabia using adapted protocols for evaluation

2021 ◽  
Vol 9 ◽  
pp. 205031212110361
Author(s):  
Elham Abbas Aljaaly
Keyword(s):  
Bariatric Surgery ◽  
Saudi Arabia ◽  
Care Process ◽  
Cross Sectional Survey ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Nutrition Risk ◽  
Nutrition Care ◽  
Management Protocol ◽  
Perioperative Nutrition

Objectives: This study evaluates the availability of perioperative nutritional care protocols and the practices of bariatric registered dietitians in Saudi Arabia. The primary outcomes of the study were conducted using an adapted American survey “with permission.” Methods: A cross-sectional survey of a selected 32 dietitians providing bariatric services completed a self-administered online questionnaire from 12 hospitals in Jeddah, Saudi Arabia. Results: All surveyed dietitians were females, mainly Saudi nationals (93.9%, n = 30), and accredited by the Saudi Commission for Health Specialties (93.8%, n = 30). Only 37.5% (n = 6) of the dietitians were specialized in bariatric surgery. Perioperative common practices of dietitians included a conduct of screening for nutrition risk before (44%, n = 14) and after surgery (62.5%, n = 20) and applied a nutrition management protocol that is mainly based on the application of nutrition care process (62.5%, n = 20). Dietitians (81%, n = 26) reported the importance of having standardized protocols for nutritional management of patients undoing bariatric surgery, where 69% (n = 22) confirmed the availability of pre-operative written protocols in hospitals and 75% (n = 24) confirmed the existence of post-operative protocols. Pre-operative practices included using approaches for weight loss before surgery, for example, very low and low-calorie diet. Dietitians (25%, n = 8) see two to ten patients per month. The sleeve gastrectomy procedure is the most often performed surgery. Conclusion: This is the first study to evaluate the perioperative nutrition care protocols and practices related to bariatric surgery in Saudi Arabia. Perioperative bariatric protocols are available, but some dietitians are not aware of their availability and contents. Researchers emphasize the importance of creating national protocols by the Saudi Credentials Body to standardize practices within the field.

scholarly journals Associations between Pre-Bariatric High-Sensitivity C-Reactive Protein and Post-Surgery Outcomes

Diagnostics ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 721
Author(s):  
Tannaz Jamialahmadi ◽  
Mohsen Nematy ◽  
Simona Bo ◽  
Valentina Ponzo ◽  
Ali Jangjoo ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Morbid Obesity ◽  
Weight Loss ◽  
Success Rate ◽  
Liver Stiffness ◽  
High Sensitivity ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Post Surgery ◽  
Hs Crp

Background: Obesity is a chronic inflammatory condition associated with increased circulating levels of C-reactive protein (CRP). Bariatric surgery has been reported to be effective in improving both inflammatory and liver status. Our aims were to elucidate the relationships between pre-surgery high sensitivity-CRP (hs-CRP) values and post-surgery weight loss and liver steatosis and fibrosis in patients with severe obesity undergoing Roux-en-Y gastric bypass. Methods: We conducted an observational prospective study on 90 individuals with morbid obesity, who underwent gastric bypass. Anthropometric indices, laboratory assessment (lipid panel, glycemic status, liver enzymes, and hs-CRP), liver stiffness and steatosis were evaluated at baseline and 6-months after surgery. Results: There was a significant post-surgery reduction in all the anthropometric variables, with an average weight loss of 33.93 ± 11.79 kg; the mean percentage of total weight loss (TWL) was 27.96 ± 6.43%. Liver elasticity was significantly reduced (from 6.1 ± 1.25 to 5.42 ± 1.52 kPa; p = 0.002), as well as liver aminotransferases, nonalcoholic fatty liver disease fibrosis score (NFS) and the grade of steatosis. Serum hs-CRP levels significantly reduced (from 9.26 ± 8.45 to 3.29 ± 4.41 mg/L; p < 0.001). The correlations between hs-CRP levels and liver fibrosis (elastography), steatosis (ultrasonography), fibrosis-4 index, NFS, and surgery success rate were not significant. Regression analyses showed that serum hs-CRP levels were not predictive of liver status and success rate after surgery in both unadjusted and adjusted models. Conclusions: In patients with morbid obesity, bariatric surgery caused a significant decrease in hs-CRP levels, liver stiffness and steatosis. Baseline hs-CRP values did not predict the weight-loss success rate and post-surgery liver status.

Malaria among migrants in a university hospital in Colombia during 2018: A case series

2020 ◽  
pp. 004947552098130
Author(s):  
Fabián R Carreño-Almánzar ◽  
Adán Coronado-Galán ◽  
Sonia A Cala-Gómez ◽  
Agustín Vega-Vera
Keyword(s):  
Latin American ◽  
Previous History ◽  
Case Series ◽  
Cross Sectional Study ◽  
Imported Malaria ◽  
University Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
History Of ◽  
Clinical Profiles

Imported malaria has increased in Colombia since 2015 and has been attributed to migrants coming from Venezuela. We present a series of malaria cases, nested in a retrospective cross-sectional study between 2017 and 2018, aimed at calculating the prevalence of medical diseases among immigrants in a University Hospital in Colombia. Among 154 immigrants admitted for medical causes between 2017 and 2018, 8 were diagnosed with malaria, all due to Plasmodium vivax. Of these, seven had uncomplicated malaria, five had a previous history of malaria, one was critically ill, but none died. We highlight that, similar to other case series of imported malaria, Latin American migrants were young, with similar clinical profiles, having a low proportion of severe cases, and P. vivax was the most frequent cause.

scholarly journals Measuring Knowledge, Attitudes, and Barriers to Medication Adherence in Potential Bariatric Surgery Patients

2021 ◽  
Author(s):  
Emanuela Bianciardi ◽  
Claudio Imperatori ◽  
Marco Innamorati ◽  
Mariantonietta Fabbricatore ◽  
Angelica Maria Monacelli ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Binge Eating ◽  
Treatment Effectiveness ◽  
Self Report ◽  
General Level ◽  
Psychiatric Interview ◽  
Obesity Epidemic ◽  
Post Surgery ◽  
Final Sample ◽  
The Status

Abstract Background Bariatric surgery is an effective treatment for the obesity epidemic, but the poor attendance and adherence rates of post-surgery recommendations threaten treatment effectiveness and health outcomes. Preoperatively, we investigated the unique contributions of clinical (e.g., medical and psychiatric comorbidities), sociodemographic (e.g., sex, age, and educational level), and psychopathological variables (e.g., binge eating severity, the general level of psychopathological distress, and alexithymia traits) on differing dimensions of adherence in a group of patients seeking bariatric surgery. Methods The final sample consisted of 501 patients (346 women). All participants underwent a full psychiatric interview. Self-report questionnaires were used to assess psychopathology, binge eating severity, alexithymia, and three aspects of adherence: knowledge, attitude, and barriers to medical recommendations. Results Attitude to adherence was associated with alexithymia (β = ˗2.228; p < 0.001) and binge eating disorder (β = 0.103; p = 0.047). The knowledge subscale was related to medical comorbidity (β = 0.113; p = 0.012) and alexithymia (β = −2.256; p < 0.001); with age (β = 0.161; p = 0.002) and psychiatric comorbidity (β =0.107; p = 0.021) manifesting in the barrier subscale. Conclusion We demonstrated that alexithymia and psychiatric and eating disorders impaired adherence reducing attitude and knowledge of treatment and increasing the barriers. Both patient and doctor can benefit from measuring adherence prior to surgery, with a qualitative approach shedding light on the status of adherence prior to the postsurgical phase when the damage regarding adherence is, already, done.

Psychological distress in patients undergoing urological surgery: A cross-sectional study

2021 ◽  
pp. 205141582110140
Author(s):  
Nuala Murray ◽  
Charles O’Connor ◽  
Rhona Dempsey ◽  
Sean Liew ◽  
Helen Richards ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Repeated Measures ◽  
Depression Scale ◽  
University Hospital ◽  
Anxiety And Depression ◽  
Hospital Anxiety ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Post Surgery ◽  
Oncological Patients

Purpose: The purpose of this study was to evaluate the psychological distress of urological and uro-oncological patients undergoing surgery. Methods: Patients who presented to Mercy University Hospital from October 2019–May 2020 were consecutively recruited. Demographic and clinical characteristics including age, gender, marital status, type of surgery (uro-oncology or general urology), endoscopy or open surgery were gathered. Mood was evaluated using the Hospital Anxiety and Depression Scale prior to admission, prior to discharge and 6 weeks post-surgery. Results: A total of 118 participants (79.7% male) completed the Hospital Anxiety and Depression Scale prior to admission, prior to discharge and at 6 weeks post-surgery. Forty patients (33.9%) underwent uro-oncology-related surgery. At pre-admission 39 patients (33%) fell into a possible-probable clinical category for anxiety and 15 (12.7%) for depression. Older patients had significantly lower anxiety levels than younger patients ( p⩽0.01). There were no differences between patients undergoing uro-oncology or more general urology surgery and levels of anxiety or depression. Repeated measures analysis of variance with age as a covariate indicated no significant differences in Hospital Anxiety and Depression Scale anxiety scores over time. There was a statistically significant reduction in Hospital Anxiety and Depression Scale depression scores over the three assessment time points ( p=0.004). Conclusion: Over one-third of patients were experiencing moderate to severe levels of psychological distress pre-surgery – higher than levels previously reported in uro-oncological patients. Surprisingly, there was no difference in anxiety and depression scores in uro-oncology and urology patients. Psychological distress in both uro-oncology and more general urology patients should be considered in the surgical setting. Level of evidence Moderate

scholarly journals Surgical management of Encapsulating Peritoneal Sclerosis (EPS) in children: international case series and literature review

2021 ◽  
Author(s):  
Videha Sharma ◽  
Zia Moinuddin ◽  
Angela Summers ◽  
Mohan Shenoy ◽  
Nicholas Plant ◽  
...  
Keyword(s):  
Case Series ◽  
Wound Management ◽  
Supplementary Information ◽  
Operative Morbidity ◽  
Post Surgery ◽  
Paediatric Patients ◽  
Stoma Formation ◽  
Gut Function ◽  
Health And Development ◽  
Secondary Closure

Abstract Background Encapsulating Peritoneal Sclerosis (EPS) is a rare phenomenon in paediatric patients with kidney failure treated with peritoneal dialysis (PD). This study highlights clinical challenges in the management of EPS, with particular emphasis on peri-operative considerations and surgical technique. Methods Retrospective analysis of all paediatric patients with EPS treated at the Manchester Centre for Transplantation. Results Four patients were included with a median duration of 78 months on PD. All patients had recurrent peritonitis (> 3 episodes), and all had symptoms within three months of a change of dialysis modality from PD to haemodialysis or transplant. In Manchester, care was delivered by a multi-disciplinary team, including surgeons delivering the adult EPS surgical service with a particular focus on nutritional optimisation, sepsis control, and wound management. The surgery involved laparotomy, lavage, and enterolysis of the small bowel + / − stoma formation, depending on intra-abdominal contamination. Two patients had a formal stoma, which were reversed at three and six months, respectively. Two patients underwent primary closure of the abdomen, whereas two patients had re-look procedures at 48 h with secondary closure. One patient had a post-operative wound infection, which was managed medically. One patient’s stoma became detached, leading to an intra-abdominal collection requiring re-laparotomy. The median length of stay was 25 days, and patients were discharged once enteral feeding was established. All patients remained free of recurrence with normal gut function and currently two out of four have functioning transplants. Conclusions This series demonstrates 100% survival and parenteral feed independence following EPS surgery. Post-operative morbidity was common; however, with individualised experience-based decision-making and relevant additional interventions, patients made full recoveries. Health and development post-surgery continued, allowing the potential for transplantation. Graphical abstract A higher resolution version of the Graphical abstract is available as Supplementary information

scholarly journals Should we care about Plasmodium vivax and HIV co-infection? A systematic review and a cases series from the Brazilian Amazon

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Paola López Del-Tejo ◽  
Nadia Cubas-Vega ◽  
Cecilia Caraballo-Guerra ◽  
Bernardo Maia da Silva ◽  
Jefferson da Silva Valente ◽  
...  
Keyword(s):  
Systematic Review ◽  
Plasmodium Vivax ◽  
Vivax Malaria ◽  
Tertiary Care ◽  
Case Series ◽  
Brazilian Amazon ◽  
Outcome Data ◽  
Malaria Episode ◽  
Tertiary Care Centre ◽  
Cross Sectional

Abstract Background Malaria and HIV are two important public health issues. However, evidence on HIV-Plasmodium vivax co-infection (HIV/PvCo) is scarce, with most of the available information related to Plasmodium falciparum on the African continent. It is unclear whether HIV can change the clinical course of vivax malaria and increase the risk of complications. In this study, a systematic review of HIV/PvCo studies was performed, and recent cases from the Brazilian Amazon were included. Methods Medical records from a tertiary care centre in the Western Brazilian Amazon (2009–2018) were reviewed to identify HIV/PvCo hospitalized patients. Demographic, clinical and laboratory characteristics and outcomes are reported. Also, a systematic review of published studies on HIV/PvCo was conducted. Metadata, number of HIV/PvCo cases, demographic, clinical, and outcome data were extracted. Results A total of 1,048 vivax malaria patients were hospitalized in the 10-year period; 21 (2.0%) were HIV/PvCo cases, of which 9 (42.9%) had AIDS-defining illnesses. This was the first malaria episode in 11 (52.4%) patients. Seven (33.3%) patients were unaware of their HIV status and were diagnosed on hospitalization. Severe malaria was diagnosed in 5 (23.8%) patients. One patient died. The systematic review search provided 17 articles (12 cross-sectional or longitudinal studies and 5 case report studies). A higher prevalence of studies involved cases in African and Asian countries (35.3 and 29.4%, respectively), and the prevalence of reported co-infections ranged from 0.1 to 60%. Conclusion Reports of HIV/PvCo are scarce in the literature, with only a few studies describing clinical and laboratory outcomes. Systematic screening for both co-infections is not routinely performed, and therefore the real prevalence of HIV/PvCo is unknown. This study showed a low prevalence of HIV/PvCo despite the high prevalence of malaria and HIV locally. Even though relatively small, this is the largest case series to describe HIV/PvCo.

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