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https://www.readbyqxmd.com/read/29147478/abdominal-pain-with-a-twist-a-rare-presentation-of-acute-gastric-volvulus
#1
David P Chen, Saqib Walayat, Imran L Balouch, Daniel K Martin, Teresa J Lynch
Acute gastric volvulus is a life threatening condition requiring early diagnosis and aggressive management. Diagnosis of gastric volvulus remains a challenge for clinicians due to variable, non-specific clinical presentation, which requires a high level of suspicion. It should be considered in patients presenting with chest pain and/or epigastric pain, especially in the elderly population. Endoscopic de-rotation could be initially attempted as a therapeutic modality especially in patients who cannot undergo surgery...
2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/29146657/a-randomised-controlled-trial-of-a-duodenal-jejunal-bypass-sleeve-device-endobarrier-compared-with-standard-medical-therapy-for-the-management-of-obese-subjects-with-type-2-diabetes-mellitus
#2
Michael Alan Glaysher, Aruchuna Mohanaruban, Christina Gabriele Prechtl, Anthony P Goldstone, Alexander Dimitri Miras, Joanne Lord, Navpreet Chhina, Emanuela Falaschetti, Nicholas Andrew Johnson, Werd Al-Najim, Claire Smith, Jia V Li, Mayank Patel, Ahmed R Ahmed, Michael Moore, Neil Poulter, Stephen Bloom, Ara Darzi, Carel Le Roux, James P Byrne, Julian P Teare
INTRODUCTION: The prevalence of obesity and obesity-related diseases, including type 2 diabetes mellitus (T2DM), is increasing. Exclusion of the foregut, as occurs in Roux-en-Y gastric bypass, has a key role in the metabolic improvements that occur following bariatric surgery, which are independent of weight loss. Endoscopically placed duodenal-jejunal bypass sleeve devices, such as the EndoBarrier (GI Dynamics, Lexington, Massachusetts, USA), have been designed to create an impermeable barrier between chyme exiting the stomach and the mucosa of the duodenum and proximal jejunum...
November 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/29145294/recurrent-tracheoesophageal-fistula-in-an-adolescent-without-persistent-symptoms-a-case-report
#3
Jun-Hong Lin, Li Deng, Xing Li
RATIONALE: Congenital esophageal atresia (EA) and tracheoesophageal fistula (TEF) ininfants have been treated well with surgery. Approximately 10% of children displayed recurrent fistula. In the present case, we reported recurrent TEF in an adolescent as a complication of EA/TEF in infancy. PATIENT CONCERNS: An infant was diagnosed with gross type C congenital EA and TEF and subsequentlyunderwent repair in early infancy, with division of the TEF and primary esophageal anastomosis...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29145284/effectiveness-of-bariatric-surgical-procedures-a-systematic-review-and-network-meta-analysis-of-randomized-controlled-trials
#4
Jenny H Kang, Quang A Le
BACKGROUND: Bariatric surgery has proved to be an effective strategy in treating obesity. However, randomized controlled trials (RCTs) of 3 most common bariatric surgery procedures, Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), and laparoscopic adjustable gastric band (LAGB), reported inconsistent results. We performed a systematic review and network meta-analysis to synthesize evidence of effectiveness of the 3 common bariatric procedures from relevant RCTs. METHODS: The present study was a systematic review and network meta-analysis of RCTs...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29144812/increased-bone-turnover-in-type-2-diabetes-patients-randomized-to-bariatric-surgery-vs-medical-therapy-at-5-years
#5
Megan R Crawford, Nathan Pham, Leila Khan, James F Bena, Philip R Schauer, Sangeeta R Kashyap
OBJECTIVE: The aim of our study was to determine the 5 year outcomes of bariatric surgery vs. intensive medical therapy on bone turnover in patients with type 2 diabetes (T2DM) from the STAMPEDE trial. METHODS: This is an ancillary investigation of a 5 year randomized control trial at a single tertiary care center involving 95 patients aged 48.5 ± 8 years with obesity (BMI: 36.5±3.6 kg/m(2)) and uncontrolled T2DM (HbA1C: 9.3 ±1.6%). Patients were randomized to intensive medical therapy (IMT; N=25), Roux-en-Y gastric bypass (RYGB; N=37), or sleeve gastrectomy (SG; N=33) for diabetes treatment...
November 16, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/29143893/the-role-of-systemic-therapy-in-resectable-gastric-and-gastro-oesophageal-junction-cancer
#6
REVIEW
Elizabeth Cartwright, David Cunningham
Approximately 20% of patients with cancer of the stomach or gastro-oesophageal junction (GOJ) present with resectable disease. Long-term outcome after surgery alone in these patients is poor, and a combined treatment approach is the standard of care. The two approaches to managing patients with cancer of the GOJ are perioperative chemotherapy or preoperative chemoradiotherapy. Based upon the most recent evidence, patients treated with a perioperative approach and deemed suitable for a triplet regimen should be considered for pre- and post-operative FLOT (5-fluorouracil [5-FU], leucovorin, oxaliplatin and docetaxel) and those suitable for a doublet regimen should be considered for a fluoropyrimidine/platinum combination such as capecitabine and oxaliplatin...
November 16, 2017: Current Treatment Options in Oncology
https://www.readbyqxmd.com/read/29138380/-three-patients-with-gastric-cancer-who-underwent-surgery-during-ramucirumab-treatment
#7
Hayato Omori, Sadayuki Kawai, Rie Makuuchi, Tomoyuki Irino, Masanori Tokunaga, Yutaka Tanizawa, Etsuro Bando, Taiichi Kawamura, Hirofumi Yasui, Masanori Terashima
According to the REGARD and RAINBOW trials, ramucirumab(RAM)was introduced as second-line therapy for advanced or metastatic gastric cancer. RAM may impair wound healing due to the inhibition of angiogenesis; details on the postoperative course of patients who underwent surgery during RAM treatment remain unclear. Between 2011 and 2016, 93 patients with incurable gastric cancer were treated with RAM in our institute. Among them, 3 patients underwent surgery after RAM treatment. Case 1: A 74-year-old man with liver metastasis from gastric cancer was treated with a paclitaxel(PTX)plus RAM regimen...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29138379/-a-case-of-advanced-gastric-cancer-responding-to-neoadjuvant-chemotherapy-with-docetaxel-cisplatin-and-5-fluorouracil-leading-to-a-pathological-complete-response
#8
Keishi Kawasaki, Dan Takeuchi, Takaaki Kaneko, Seiki Miura, Junichiro Kamiya, Yoji Miyahara, Kotaro Yoshimura, Akira Ogata
We report a 72-year-old woman who was initially diagnosed with locally advanced gastric cancer with involvement of the esophagus and pancreas. She received 3 courses of neoadjuvant chemotherapy(NAC)with docetaxel, cisplatin, and 5- fluorouracil(the DCF regimen)and achieved an excellent response. She underwent total gastrectomy with distal pancreatectomy, splenectomy, and D2 lymphadenectomy. Histological examination confirmed a pathological complete response. NAC chemotherapy can down stage/down size the disease and allow some patients to undergo curative radical surgery...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29138180/inhibition-of-vascular-c-jun-n-terminal-kinase-2-improves-obesity-induced-endothelial-dysfunction-after-roux-en-y-gastric-bypass
#9
Petia Doytcheva, Thomas Bächler, Erika Tarasco, Vincenzo Marzolla, Michael Engeli, Giovanni Pellegrini, Simona Stivala, Lucia Rohrer, Francesco Tona, Giovanni G Camici, Paul M Vanhoutte, Christian M Matter, Thomas A Lutz, Thomas F Lüscher, Elena Osto
BACKGROUND: Roux-en-Y gastric bypass (RYGB) reduces obesity-associated comorbidities and cardiovascular mortality. RYGB improves endothelial dysfunction, reducing c-Jun N-terminal kinase (JNK) vascular phosphorylation. JNK activation links obesity with insulin resistance and endothelial dysfunction. Herein, we examined whether JNK1 or JNK2 mediates obesity-induced endothelial dysfunction and if pharmacological JNK inhibition can mimic RYGB vascular benefits. METHODS AND RESULTS: After 7 weeks of a high-fat high-cholesterol diet, obese rats underwent RYGB or sham surgery; sham-operated ad libitum-fed rats received, for 8 days, either the control peptide D-TAT or the JNK peptide inhibitor D-JNKi-1 (20 mg/kg per day subcutaneous)...
November 14, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29137273/programmed-death-ligand-1-and-met-co-expression-is-a-poor-prognostic-factor-in-gastric-cancers-after-resection
#10
Mi Jung Kwon, Kab-Choong Kim, Eun Sook Nam, Seong Jin Cho, Hye-Rim Park, Soo Kee Min, Jinwon Seo, Ji-Young Choe, Hye Kyung Lee, Ho Suk Kang, Kyueng-Whan Min
Programmed death-ligand 1 (PD-L1) plays an essential protein for immune evasion, contributing to tumor development and progression. Recent studies have reported MET as an upregulator for PD-L1 overexpression through an oncogenic pathway. However, an association between PD-L1 expression with MET has not been reported in gastric cancer.The prognostic significance of PD-L1 and its association with Epstein-Barr virus (EBV), microsatellite instability (MSI), and mucin phenotype remain controversial. We performed in situ hybridization for EBV-encoded RNA and immunohistochemistry in tissue microarrays for 394 gastric cancers...
October 10, 2017: Oncotarget
https://www.readbyqxmd.com/read/29137169/pancreatic-exocrine-insufficiency-after-bariatric-surgery
#11
REVIEW
Miroslav Vujasinovic, Roberto Valente, Anders Thorell, Wiktor Rutkowski, Stephan L Haas, Urban Arnelo, Lena Martin, J-Matthias Löhr
Morbid obesity is a lifelong disease, and all patients require complementary follow-up including nutritional surveillance by a multidisciplinary team after bariatric procedures. Pancreatic exocrine insufficiency (PEI) refers to an insufficient secretion of pancreatic enzymes and/or sodium bicarbonate. PEI is a known multifactorial complication after upper gastrointestinal surgery, and might constitute an important clinical problem due to the large number of bariatric surgical procedures in the world. Symptoms of PEI often overlap with sequelae of gastric bypass, making the diagnosis difficult...
November 13, 2017: Nutrients
https://www.readbyqxmd.com/read/29137091/the-effects-of-hypervolemic-infusion-on-microcirculation-perfusion-of-patients-during-laparoscopic-colorectal-surgery
#12
Yunxin Deng, Qianlin Zhu, Buwei Yu, Minhua Zheng, Jue Jin
The aim of this study is to assess the effects of hypervolemic infusion with different solutions on microcirculation perfusion during laparoscopic colorectal surgery.Thirty-six patients were randomly divided into Ringer lactate solution [RL] group, succinylated gelatin injection [Gel] group, and hypertonic saline hydroxyethyl starch 40 injection [HS] group. Hypervolemic infusion was performed during the induction period of general anesthesia. Arterial blood-gas parameters, noninvasive hemodynamics, gastric tonometry values, and central venous pressure (CVP) were compared at baseline (T1); the end of hypervolemic infusion (T2); 5 min (T3), 15 min (T4), 30 min (T5), and 60 min (T6) during pneumoperitoneum; 5 min (T7), 15 min (T8), and 25 min (T9) after pneumoperitoneum...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29136086/intraoperative-oliguria-predicts-acute-kidney-injury-after-major-abdominal-surgery
#13
T Mizota, Y Yamamoto, M Hamada, S Matsukawa, S Shimizu, S Kai
Background: The threshold of intraoperative urine output below which the risk of acute kidney injury (AKI) increases is unclear. The aim of this retrospective cohort study was to investigate the relationship between intraoperative urine output during major abdominal surgery and the development of postoperative AKI and to identify an optimal threshold for predicting the differential risk of AKI. Methods: Perioperative data were collected retrospectively on 3560 patients undergoing major abdominal surgery (liver, colorectal, gastric, pancreatic, or oesophageal resection) at Kyoto University Hospital...
October 9, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29135972/roux-en-y-gastric-bypass-reduces-plasma-cholesterol-in-diet-induced-obese-mice-by-affecting-trans-intestinal-cholesterol-excretion-and-intestinal-cholesterol-absorption
#14
C Blanchard, F Moreau, A Ayer, L Toque, D Garçon, L Arnaud, F Borel, A Aguesse, M Croyal, M Krempf, X Prieur, M Neunlist, B Cariou, C Le May
OBJECTIVE: Bariatric surgery appears as the most efficient therapeutic alternative in morbidly obese patients. In addition to its efficiency to decrease body weight, it also improves metabolic complications associated to morbid obesity, including dyslipidemia. Although the cholesterol-lowering effect varies with the bariatric procedures, the underlying molecular mechanisms remain poorly defined. This study aims to assess the consequence of both restrictive (sleeve gastrectomy; SG) and malabsorptive (Roux-en-Y gastric bypass; RYGB) procedures on cholesterol metabolism in mice...
September 28, 2017: International Journal of Obesity: Journal of the International Association for the Study of Obesity
https://www.readbyqxmd.com/read/29135385/redo-laparoscopic-heller-s-cardiomyotomy-for-recurrent-achalasia-is-laparoscopic-surgery-feasible
#15
Pranav Mandovra, Vishakha Kalikar, Ankur Patel, Roy V Patankar
BACKGROUND: Achalasia cardia is an esophageal motor disorder with raised lower esophageal sphincter (LES) pressure. Minimally invasive procedures have become the procedure of choice compared with conventional open surgery. After the primary surgery, recurrence or persistent symptoms have been noted in almost 10%-20% of cases. MATERIALS AND METHODS: In this case series, we share our experience with a series of 7 patients who presented to us from January 2010 to January 2017 for recurrent symptoms, following Heller's myotomy for achalasia cardia...
November 14, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29135363/total-and-subtotal-laparoscopic-gastrectomy-for-the-treatment-of-advanced-gastric-cancer-morbidity-and-oncological-outcomes
#16
Stefano Olmi, Riccardo Giorgi, Stefano Piero Bernardo Cioffi, Matteo Uccelli, Roberta Villa, Francesca Ciccarese, Bruno Scotto, Giorgio Castello, Gianluca Legnani, Giovanni Cesana
BACKGROUND: A debate is still surrounding the use of laparoscopic surgery for advanced gastric cancer (AGC) related to doubts about the requirements to satisfy oncologic criteria. The aim of this study is to analyze the oncological results, the intraoperative complications, and the short- and medium-term morbidity and mortality in patients with AGC who underwent subtotal laparoscopic gastrectomy (SLG) or total laparoscopic gastrectomy (TLG) with extended lymphadenectomy. MATERIALS AND METHODS: We reviewed medical records of patients who underwent radical gastrectomy for AGC started laparoscopically with the intent of curative surgery, between July 2007 and October 2015...
November 14, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29135095/does-upfront-therapy-with-cytoreductive-surgery-and-hipec-confer-a-survival-benefit-in-patients-with-synchronous-gastric-peritoneal-carcinomatosis-when-compared-with-patients-with-metachronous-gastric-peritoneal-carcinomatosis
#17
Nikolaos Kopanakis, Elias Efstathiou, Dimitrios Sarris, John Spiliotis
Gastric cancer (GC) remains the second leading cause of cancer death worldwide, accounting for 8% of the total cases and 10% of total deaths in 2008. Surgery remains the curative treatment option for GC and the main reason for treatment failure is peritoneal recurrence which, according to the literature, occurs in 40-60% of the cases, despite extensive surgery including D2 lymph node dissection. The hyperthermic intraperitoneal chemotherapy (HIPEC) technique is increasingly used in the treatment of primary and digestive peritoneal carcinomatosis (PC), in association with cytoreductive surgery (CRS)...
September 2017: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
https://www.readbyqxmd.com/read/29134499/correction-to-trend-of-changes-in-serum-albumin-and-its-relation-with-sex-age-and-bmi-following-laparoscopic-mini-gastric-bypass-surgery-in-morbid-obese-cases
#18
Mehrdad Karimi, Ali Kabir, Masoumeh Nejatifar, Abdolreza Pazouki
Due to a production error the bottom portion of Fig. 3 was missing in the version of this article originally published online.
November 13, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/29134298/case-report-of-successful-medical-management-of-progressive-gastric-band-penetration-to-perforation-after-band-insertion-at-bariatric-surgery-documentation-by-12-serial-egds-during-50%C3%A2-months-of-observation
#19
Andrew M Aneese, Sung K Yang, Mitchell S Cappell
No abstract text is available yet for this article.
November 13, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29133606/effects-of-bariatric-surgery-in-obese-patients-with-hypertension-the-gateway-randomized-trial-gastric-bypass-to-treat-obese-patients-with-steady-hypertension
#20
Carlos Aurelio Schiavon, Angela Cristine Bersch-Ferreira, Eliana Vieira Santucci, Juliana Dantas Oliveira, Camila Ragne Torreglosa, Priscila Torres Bueno, Julia Caldas Frayha, Renato Nakagawa Santos, Lucas Petri Damian, Patricia Malvina Noujaim, Helio Halpern, Frederico L J Monteiro, Ricardo Vitor Cohen, Carlos H Uchoa, Marcio Gonçalves de Souza, Celso Amodeo, Luiz Bortolotto, Dimas Ikeoka, Luciano F Drager, Alexandre Biasi Cavalcanti, Otavio Berwanger
BACKGROUND : Recent research efforts on bariatric surgery have focused on metabolic and diabetes mellitus resolution. Randomized trials designed to assess the impact of bariatric surgery in patients with obesity and hypertension are needed. METHODS : In this randomized, single-center, nonblinded trial, we included patients with hypertension (using ≥2 medications at maximum doses or >2 at moderate doses) and a body mass index between 30.0 and 39.9 kg/m(2) Patients were randomized to Roux-en-Y gastric bypass plus medical therapy or medical therapy alone...
November 13, 2017: Circulation
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