Perioperative Outcomes in Patients with and Without Chronic Preoperative Therapeutic Anticoagulation Undergoing Metabolic Surgery at an Academic Medical Center.

Patients on chronic anticoagulation undergoing metabolic surgery represent an increased risk of complications, including both bleeding and thrombotic events, such as deep vein thrombosis (DVT) and pulmonary embolism (PE). The optimal perioperative management of patients who are receiving chronic anticoagulation therapy (CAT) is complex. In the colorectal surgery literature, patients on CAT have a 10% rate of peri-procedural bleeding and a 3% rate of thromboembolism.

Potentially Avoidable Emergency Department Utilization by Persons with Psoriatic Arthritis and Ankylosing Spondylitis: A Population-Based Cohort Study.

Objective: Greater accessibility to ambulatory services may mitigate emergency department (ED) presentations for lower acuity issues. This study examined ED utilization patterns for individuals with psoriatic arthritis (PsA) and ankylosing spondylitis (AS) in a universal access healthcare setting.

Methods: Linked population-based administrative datasets in Alberta, Canada (fiscal years 2008-2017) were assessed for yearly ED visit frequency, timing, triage acuity, most responsible diagnoses, and disposition for persons with PsA and AS.

Obesity, Osteoarthritis, and Myokines: Balancing Weight Management Strategies, Myokine Regulation, and Muscle Health.

Obesity and osteoarthritis (OA) are increasingly prevalent conditions that are intricately linked, with each exacerbating the other's pathogenesis and worsening patient outcomes. This review explores the dual impact of obesity on OA, highlighting the role of excessive weight in aggravating joint degeneration and the limitations OA imposes on physical activity, which further perpetuates obesity. The role of muscle tissue, particularly the release of myokines during physical activity, is examined in the context of OA and obesity.

Combination of Diuretics in States of Resistant Nephrotic Edema: a Case Presentation.

While there remains no universally accepted definition for resistant edema, it is generally acknowledged as edema that fails to respond to maximally administered doses of diuretics. Nephrotic edema is characterized by high levels of proteinuria, notably urinary concentrations of serine proteases, which possess the ability to activate the epithelial sodium channel (ENaC), resulting in persistent fluid retention. Loop diuretics are typically preferred as first-line therapy for hypervolemia.

Short-Term Visual and Refractive Outcomes of Single-Step Transepithelial Photorefractive Keratectomy with Amaris 750S and SmartSurf in Myopia and Astigmatism: A 6-Month Follow-Up Study.

Background: Single-step transepithelial photorefractive keratectomy (TPRK) is a modern refractive surgery technique that offers a no-touch approach for correcting myopia and astigmatism. This study aims to evaluate the short-term visual and refractive outcomes of TPRK in patients with myopia and astigmatism over a 6-month follow-up period.

Methods: This retrospective cohort study included patients who underwent single-step TPRK using the Amaris 750S laser platform with SmartSurf and SmartPulse technologies, targeting a plano refraction.

One-Year Visual and Refractive Outcomes of SmartPulse Technology in Transepithelial Photorefractive Keratectomy for Myopic and Astigmatic Patients.

This study aims to evaluate the efficacy, safety, and predictability of Transepithelial Photorefractive Keratectomy (TPRK) using the SmartPulse technology excimer laser for the correction of myopia and myopic astigmatism, assessing visual and refractive outcomes over a one-year follow-up period. This retrospective cohort study analyzed data from patients who underwent TPRK at the Ophthalmology Department-"Victor Babes" University of Medicine and Pharmacy in Timisoara (Romania), between January 2019 and June 2023. The procedure was performed using the SmartPulse Technology of the SmartSurf AMARIS 750S excimer laser (SCHWIND eye-tech-solutions, Kleinostheim, Germany).

Pre-Operative Gastroesophageal Reflux Does Not Affect 30-Day Outcomes in Patients Undergoing Revisional Bariatric Surgery to Single Anastomosis Duodeno-Ileal Bypass (SADI): An Analysis of 933 Metabolic and Bariatric Accreditation and Quality Improvement Program Patients.

The use of a single anastomosis duodeno-ileal bypass (SADI) as a revisional procedure in patients with pre-operative GERD is not well understood. Thirty-day outcomes in patients with pre-existing GERD undergoing revision with an SADI have not been previously reported. The Metabolic and Bariatric Accreditation and Quality Improvement Program registry was consulted to identify patients undergoing revisional bariatric surgery with an SADI between 2020 and 2021.

Role of prolonged packing in postoperative anorectal abscess management: a systematic review and meta-analysis.

Background: Prolonged packing of anorectal abscess cavities with internal dressings after incision and drainage is frequently used, but the efficacy of this practice remains controversial. Some studies highlight its use in hemostasis and preventing fistula and abscess recurrence, whereas others describe its economic burden and increase in pain. In this systematic review, we examine current evidence on the impact of packing after incision and drainage for anorectal abscesses.

Pain Assessment and Analgesic Requirements after Sleeve Gastrectomy: A Comparison Study of Robotic versus Laparoscopic Approaches.

Sleeve gastrectomy is the most common bariatric procedure worldwide, yet postoperative pain management remains a concern. This study aimed to compare pain medication usage and pain scores between laparoscopic sleeve gastrectomy (LSG) and robotic sleeve gastrectomy (RSG) patients, addressing the potential benefits of RSG in postoperative pain control. A retrospective review of our institutional bariatric surgery registry included 484 patients (435 LSG, 49 RSG) who underwent surgery between September 2015 and November 2020.

Predictors and Outcomes Associated with Bariatric Robotic Delivery: An MBSAQIP Analysis of 318,151 Patients.

: The adoption of robotic bariatric surgery has increased dramatically over the last decade. While outcomes comparing bariatric and laparoscopic approaches are debated, little is known about patient factors responsible for the growing delivery of robotic surgery. A better understanding of these factors will help guide the planning of bariatric delivery and resource allocation.

Impact of hypoalbuminemia on outcomes following pancreaticoduodenectomy: a NSQIP retrospective cohort analysis of 25,848 patients.

Background: Efforts to preoperatively risk stratify and optimize patients before pancreaticoduodenectomy continue to improve outcomes. This study aims to determine the impact of hypoalbuminemia on outcomes following pancreaticoduodenectomy and outline optimal hypoalbuminemia cut-off values in this population.

Methods: The ACS-NSQIP (2016-2021) database was used to extract patients who underwent pancreaticoduodenectomy, comparing those with hypoalbuminemia (< 3.

Ghrelin Expression in Atherosclerotic Plaques and Perivascular Adipose Tissue: Implications for Vascular Inflammation in Peripheral Artery Disease.

Atherosclerosis, a leading cause of peripheral artery disease (PAD), is driven by lipid accumulation and chronic inflammation within arterial walls. : This study investigates the expression of ghrelin, an anti-inflammatory peptide hormone, in plaque morphology and inflammation in patients with PAD, highlighting its potential role in age-related vascular diseases and metabolic syndrome. : The analysis specifically focused on the immunohistochemical expression of ghrelin in atherosclerotic plaques and perivascular adipose tissue (PVAT) from 28 PAD patients.

Obesity, Metabolic Syndrome, and Osteoarthritis Require Integrative Understanding and Management.

Osteoarthritis (OA) is a progressive chronic disease affecting the articular joints, leading to pain and disability. Unlike traditional views that primarily link OA to aging, recent understanding portrays it as a multifactorial degenerative disease of the entire joint. Emerging research highlights metabolic and immune dysregulation in OA pathogenesis, emphasizing the roles of obesity, dyslipidemia, and insulin resistance in altering joint homeostasis.

Persistent hyperbilirubinemia following preoperative biliary stenting in patients undergoing anatomic hepatectomy predicts serious complications.

Background: Biliary obstruction before liver resection is a known risk factor for post-operative complications. The aim of this study was to determine the impact of persistent hyperbilirubinemia following preoperative biliary drainage before liver resection.

Methods: The ACS-NSQIP (2016-2021) database was used to extract patients with cholangiocarcinoma who underwent anatomic liver resection with preoperative biliary drainage comparing those with persistent hyperbilirubinemia (> 1.

Prevalence, Indications, and Complications of Conversional Surgery After Vertical Banded Gastroplasty: A MBSAQIP Analysis.

Purpose: Vertical banded gastroplasty (VBG) was once the most popular bariatric procedure in the 1980's, with many patients subsequently requiring conversional surgery. However, knowledge regarding the prevalence and outcomes of these procedures remains limited. This study aims to determine the prevalence, indications, rate of 30-day serious complications, and mortality of conversional surgery after VBG.

Accessibility gaps of physical supervised consumption sites in Canada motivating the use of overdose response technology/phone based virtual overdose response services: a retrospective cohort study.

Background: Overdose response technology or virtual overdose response services are an evolving complementary harm reduction intervention which may overcome certain accessibility barriers of physical supervised consumption sites (SCS) and overdose prevention sites (OPS). We sought to characterize SCS/OPS accessibility barriers among clients accessing a nationwide overdose response phone-based hotline in Canada.

Methods: We performed a retrospective cohort analysis using anonymized call logs of the National Overdose Response Service (NORS) between December 2020 to July 2023.

Assessing Nutritional Status in Gastric Cancer Patients after Total versus Subtotal Gastrectomy: Cross-Sectional Study.

Gastric cancer (GC) remains a significant global health concern, ranking as the third leading cause of cancer-related deaths. Malnutrition is common in GC patients and can negatively impact prognosis and quality of life. Understanding nutritional issues and their management is crucial for improving patient outcomes.

Recipient microbiome-related features predicting metabolic improvement following fecal microbiota transplantation in adults with severe obesity and metabolic syndrome: a secondary analysis of a phase 2 clinical trial.

Microbial-based therapeutics in clinical practice are of considerable interest, and a recent study demonstrated fecal microbial transplantation (FMT) followed by dietary fiber supplements improved glucose homeostasis. Previous evidence suggests that donor and recipient compatibility and FMT protocol are key determinants, but little is known about the involvement of specific recipient factors. Using data from our recent randomized placebo-control phase 2 clinical trial in adults with obesity and metabolic syndrome, we grouped participants that received FMT from one of 4 donors with either fiber supplement into HOMA-IR responders ( = 21) and HOMA-IR non-responders ( = 8).

Histological reappraisal of IgA nephropathy: the role of glomerular pattern of injury and mesangial complement deposition.

Background: There is a clear need to refine the histological assessment in IgA Nephropathy (IgAN). We sought to investigate the clinical significance of the light microscopy (LM) pattern of glomerular injury and of the intensity of mesangial C3 staining in IgAN.

Methods: We conducted a retrospective, observational study that included all patients with biopsy-proven primary IgAN that had at least 12 months of follow-up.

Nephrotic Syndrome: From Pathophysiology to Novel Therapeutic Approaches.

Nephrotic edema stands out as one of the most common complications of nephrotic syndrome. The effective management of hypervolemia is paramount in addressing this condition. Initially, "the underfill hypothesis" suggested that proteinuria and hypoalbuminemia led to fluid extravasation into the interstitial space, causing the intravascular hypovolemia and activation of neurohormonal compensatory mechanisms, which increased the retention of salt and water.

Characterization of Early Small Bowel Obstructions Following Elective Bariatric Surgery.

Purpose: Small bowel obstruction (SBO) after bariatric surgery is an uncommon but important complication. We sought to characterize bariatric surgery patients who developed SBO, to compare 30-day complications, and to determine the influence of patient and procedure factors on the development of SBO.

Methods And Materials: All data was extracted from the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database using the 2020 operative year.

Effects of dietary fibre on metabolic health and obesity.

Obesity and metabolic syndrome represent a growing epidemic worldwide. Body weight is regulated through complex interactions between hormonal, neural and metabolic pathways and is influenced by numerous environmental factors. Imbalances between energy intake and expenditure can occur due to several factors, including alterations in eating behaviours, abnormal satiation and satiety, and low energy expenditure.