Laparoscopic Reversal of Roux-en-Y Gastric Bypass with Hand-Sewn Gastro-Gastrostomy and Resection of the Alimentary Limb.

Introduction: Roux-en-Y gastric bypass (RYGB) reversal might be necessary to alleviate refractory surgical or nutritional complications, such as postprandial hypoglycemia, malnutrition, marginal ulceration, malabsorption, chronic diarrhea, nausea and vomiting, gastro-esophageal reflux disease, chronic pain, or excessive weight loss. The surgical technique of RYGB reversal is not standardized; potential strategies include the following: (1) gastro-gastrostomy: hand-sewn technique, linear stapler, circular stapler; (2) handling of the Roux limb: reconnection or resection (if remaining intestinal length ≥ 4 m).

Case Presentation: We demonstrate the surgical technique of a laparoscopic reversal of RYGB with hand-sewn gastro-gastrostomy and resection of the alimentary limb with the aim of improving the patient's quality of life.

Chemical perturbations impacting histone acetylation govern colorectal cancer differentiation.

Dysregulated epigenetic programs that restrict differentiation, reactivate fetal genes, and confer phenotypic plasticity are critical to colorectal cancer (CRC) development. By screening a small molecule library targeting epigenetic regulators using our dual reporter system, we found that inhibiting histone deacetylase (HDAC) 1/2 promotes CRC differentiation and anti-tumor activity. Comprehensive biochemical, chemical, and genetic experiments revealed that on-target blockade of the HDAC1/2 catalytic domain mediated the differentiated phenotype.

Relationship between medication regimen complexity and pharmacist engagement in fluid stewardship.

Disclaimer: In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time.

Update and narrative review of avian influenza (H5N1) infection in adult patients.

The avian influenza is a serious infection caused by influenza virus that is native to birds. Avian influenza remains a global challenge due to high transmission and mortality rates. The highly pathogenic strain of H5N1 resulted in significant outbreaks and deaths globally since the late 1800s.