Are vitamin B12 and folate deficiency clinically important after roux-en-Y gastric bypass?

Although iron, vitamin B12, and folate deficiency have been well documented after gastric bypass operations performed for morbid obesity, there is surprisingly little information on either the natural course or the treatment of these deficiencies in Roux-en-Y gastric bypass (RYGB) patients. During a 10-year period, a complete blood count and serum levels of iron, total iron-binding capacity, vitamin B12, and folate were obtained in 348 patients preoperatively and postoperatively at 6-month intervals for the first 2 years, then annually thereafter. The principal objectives of this study were to determine how readily patients who developed metabolic deficiencies after Roux-en-Y gastric bypass responded to postoperative supplements of the deficient micronutrient and to learn whether the risk of developing these deficiencies decreases over time.

Comparison of ischemic and reperfusion injury in canine bowel viability assessment.

The purpose of these experiments was to evaluate two methods of bowel viability assessment in two distinct models of intestinal ischemia. Bowel viability was assessed in 32 dogs by means of three methods: (1) a probe that quantified the intestinal electromyographic (EMG) measurements in millivolts (mV), (2) Doppler ultrasonography, and (3) perfusion fluorometry, which quantified serosal blood flow in indexed dye fluorescence units (dfi). Ischemia was created using one of two methods: (1) a chronic model in which the blood supply to 40 cm of ileum was ligated and viability assessed 24 hours later, or (2) an acute model in which the main superior mesenteric artery was occluded for 3 1/2 hours and then released.

Prophylactic iron supplementation after Roux-en-Y gastric bypass: a prospective, double-blind, randomized study.

Objective: To determine whether prophylactic oral iron supplements (320 mg twice daily) would protect women from iron deficiency and anemia after Roux-en-Y gastric bypass.

Design: Prospective, double-blind, randomized study in which 29 patients received oral iron and 27 patients received a placebo beginning 1 month after Roux-en-Y gastric bypass.

Setting: Tertiary care medical center.

Bacterial translocation after mesenteric ligation in dogs.

These experiments were designed to determine the relationship between translocation of Escherichia coli and viability of ischemic small bowel. Twenty beagles were gavaged with 14C-labeled E. coli at two time intervals (3 and 24 h) prior to ligation of the blood supply to a 40-cm segment of ileum.

Leiomyoma of the external auditory canal.

The differental diagnosis of aural polyps includes both benign and malignant processes, including carcinoma. We present the case of a polyp arising after trauma to the ear. The entire external auditory meatus was occluded, causing a maximal conductive hearing loss on the affected side.