Primary Gangrenous Cutaneous Mold Infections in a Patient With Cancer and Neutropenia.

Background: Opportunistic fungal infections caused by Aspergillus and Candida followed by infections with Fusarium, Rhizopus, Mucor, and Alternaria species are an important cause of morbidity and mortality in patients with hematological malignancies. Cutaneous mucormycosis infections are rare, and the incidence, outcomes, and factors associated with survival in the setting of hematological malignancies are not clear.

Methods: A literature search was conducted for all cases of primary cutaneous mold infections in patients with hematological malignancy, of which 50 cases were found.

Long-term outcome of 254 complex incisional hernia repairs using the modified Rives-Stoppa technique.

Background: Repair of complex incisional hernias poses a major challenge.

Aim: The aim of this study was to review the outcomes of the modified Rives-Stoppa repair of complex incisional hernias using a synthetic prosthesis.

Methods: We reviewed patients undergoing a modified Rives-Stoppa repair of complex incisional hernias from 1990 to 2003.

Sexual abuse survivors and psychiatric hospitalization after bariatric surgery.

Background: Some investigators have postulated that a history of being the victim of childhood sexual abuse may impact outcome of bariatric surgery.

Methods: In this retrospective chart review, we examined the electronic medical records of 152 adults with morbid obesity who underwent Roux-en-Y gastric bypass and who had a weight recorded in their medical record or reported in a follow-up surgery at 2 years after the RYGBP. The purpose of this retrospective chart review was to examine the relationship between psychosocial factors assessed preoperatively and the percent of excess weight lost (%EWL) at 2 years after bariatric surgery.

A two-decade spectrum of revisional bariatric surgery at a tertiary referral center.

Background: Ineffective weight loss or complications of previous bariatric surgery often require revisional bariatric procedures. Our aim was to define the indications, operative approach, and outcomes of revisional bariatric procedures during 2 decades at a tertiary center.

Methods: From our prospective database (n = 1584), including 1985-2004, 218 patients (14%) underwent revisional bariatric procedures.

The malabsorptive very, very long limb Roux-en-Y gastric bypass for super obesity: results in 257 patients.

Background: For the past 11 years, we have used a malabsorptive form of Roux-en-Y gastric bypass (RYGB), the "very, very long limb" RYGB, for selected patients with BMIs >50 kg/m(2) and in highly selected patients with BMI <50 kg/m(2). This modified distal gastric bypass establishes a 100-cm common channel (for digestion and absorption) and a "very, very" long Roux limb of 400 to 500 cm.

Methods: To determine long-term efficacy and complications, we followed prospectively 257 consecutive patients; 188 (73%) participated in a postoperative survey.

Unsatisfactory weight loss after vertical banded gastroplasty: is conversion to Roux-en-Y gastric bypass successful?

Background: In 1991, the National Institutes of Health sanctioned 2 operations for treatment of morbid obesity: vertical banded gastroplasty (VBG) and Roux-en-Y gastric bypass (RYGB). Long-term results with VBG are disappointing. We wondered whether patients who had "adapted" to the VBG anatomy and had regained weight would lose weight after conversion to RYGB.