Background
Sleeve gastrectomy (SG) is gaining popularity and has become the procedure of choice for many bariatric surgeons. Long-term weight loss failure is not uncommon. The preferred revisional ...procedure for these patients is still under debate.
Objective
The objective of this study was to assess the safety and efficacy of laparoscopic gastric bypass as a revisional surgery for sleeve gastrectomy patients with weight loss failure.
Setting
The study was done at a bariatric surgery center in a university hospital.
Methods
We reviewed our prospectively collected database and identified all patients who underwent conversion of a sleeve gastrectomy to a gastric bypass for weight loss failure. Data on patient demographics, baseline characteristics, and outcomes of bariatric surgery were retrieved.
Results
Twenty-three patients with a mean body mass index (BMI) of 41.6 kg/m2 (range 34.1–50.1 kg/m2) underwent conversion to a gastric bypass. Four patients underwent a gastric band prior to the sleeve gastrectomy, and two patients underwent a re-sleeve gastrectomy prior to conversion to a gastric bypass.
At a mean follow-up of 24 months (range 9–46 months), the average body mass index (BMI) decreased to 33.8 kg/m2 and the excess body mass index loss (EBMIL) was 42.6%. Diabetes, hypertension, dyslipidemia, and obstructive sleep apnea resolved or improved in 44.4, 45.5, 50, and 50% of the patients, respectively. Three patients developed early postop complications (13%), while late complications occurred in four patients (17%).
Conclusion
Converting a sleeve gastrectomy to a gastric bypass for weight loss failure is safe, yet weight loss benefit is limited.
ABSTRACT Auditors must ensure that their audit plans budget sufficient time for key audit steps. Research has shown that insufficient audit time budgets can be detrimental to audit quality. We ...examine whether framing audit steps negatively (e.g., assess whether management's assumptions are not appropriate) increases time budgets—particularly for steps in which the auditor perceives that performance quality is less verifiable, and thus most at risk of being performed with low quality. First, we report the results of analyses indicating that, in practice, audit steps are predominantly framed positively, potentially resulting in smaller time budgets. We then report the results of an experiment in which 50 experienced audit managers budget time for an audit program that tests a Level-3 fair-value estimate. Prior research and Public Company Accounting Oversight Board (PCAOB) inspections indicate that this is a challenging audit area, vulnerable to allegations of low audit quality. The results support our predictions and suggest that reframing audit steps negatively would increase audit time budgets—an audit quality indicator—particularly for less-verifiable steps.
Strategically chosen ventricular tachycardia (VT)/ventricular fibrillation (VF) detection and therapy parameters aimed at reducing shock deliveries were proven effective in studies that utilized ...single manufacturer devices with a follow-up of up to 1 year. Whether these beneficiary effects can be generalized to additional manufacturers and be maintained for longer periods is to be determined. Our aim was to evaluate the durability and applicability of the programming of strategic implantable cardioverter-defibrillators (ICDs) of various manufacturers, which is aimed at reducing the shock delivery burden in primary prevention ICD recipients.
A retrospective analysis of prospectively collected data of 300 ICD recipients of various manufacturers was conducted; 160 devices were strategically programmed to reduce shocks and 140 were not. The primary endpoint was the composite of death and appropriate shocks. Additional outcomes were inappropriate shocks, syncope events, and non-sustained VTs. At a median follow-up of 24 months, 19 patients died, 31 received appropriate shocks, and 41 received inappropriate shocks. Multivariate analysis showed that strategic programming dedicated to shock reduction was associated with a 64% risk reduction in the primary endpoint hazard ratio (HR): 0.13-0.93; P = 0.03 and a 70% reduction in inappropriate shock deliveries (HR: 0.16-0.72; P = 0.01). Very few syncope events occurred (five patients, 1.6%), and there was no between-group difference in this outcome.
Utilization of strategically chosen VT/VF detection and therapy parameters was found to be effective and safe in ICDs of various manufacturers at a median follow-up period of 2 years among primary prevention patients.
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•Structures of related O-antigens of two C. dublinensis strains were elucidated.•The O-antigens of C. sakazakii G3983 and G3977 differ in the glucosylation pattern.•O-Antigen gene ...clusters of C. sakazakii G3983 and G3977 are identical.•The structural difference is suggested to be due to prophage-carried genes.
Cronobacter spp. are emerging opportunistic human pathogens linked with life-threatening infections predominantly in neonates. O-Antigen (O-polysaccharide) is highly variable and plays an important role in virulence and niche adaptation. In this work, short-chain O-polysaccharides consisting on the average of 2–3 repeating units were obtained by mild acid or mild alkaline degradation of the lipopolysaccharides of C. dublinensis G3983 and G3977 and studied by composition analysis, Smith degradation, and 1H and 13C NMR spectroscopy. The following structures of the O-polysaccharides were established: Display omitted
where R indicates H in strain G3983 or α-d-Glcp in strain G3977, d-Fuc3NAlaAc indicates 3-(N-acetyl-l-alanyl)amino-3,6-dideoxy-d-galactose. Both strains share the O-antigen gene cluster, which is identical to that of C. dublinensis O1 (Foodborne Pathog. Dis.2013, 10, 343–352). The assigned gene functions are in agreement with the O-antigen structure of C. dublinensis G3983, and the side-chain glucosylation of the O-antigen of C. dublinensis G3977 is evidently encoded elsewhere in the genome.
Reaction of 2-chloro-2-(diethoxymethyl)-3-substitutedoxirane or 1-chloro-1-(substituted) -3,3-diethoxypropan-2-one with pyridine-2-thiol in EtOH at 25 °C yields ...3-(diethoxymethyl)-3-hydroxy-2-substituted-2,3-dihydrothiazolo3,2-apyridin-4-ium chlorides, which subsequently, in MeCN at 85°C, transforms into ring-opening products, 2-((2-carboxy-1-(substituted) -2-hydroxyethyl)thio)pyridin-1-ium chlorides. The tetrel (C•••O) and chalcogen (S•••O) bonds are found in the structures of 5 and 6, respectively. Compound 6 is also present in halogen bonding with a short O•••Cl distance (3.067 Å). Both molecules are stabilized in crystal by tetrel, chalcogen, and multiple charge-assisted hydrogen bonds.
This article considers public opinion in the republic of Dagestan on the expansion of hydrocarbon production in the Russian sector of the Caspian Sea. The article reports the findings of a survey (N ...= 956) conducted in 2010 in fourteen rural locations in the republic. Overall, respondents uniformly oppose the proposed expansion of offshore oil and gas production in the Russian sector of the Caspian Sea, seeing little economic benefit from this development and expressing concern about the environmental consequences. These findings resonate with work in geography on resource peripheries and development alternatives available in these locations.
In the paper we study a method of increasing the yield of dehydrogenation products of methylbutenes by virtue of intermediate removal of the hydrogen formed during the dehydrogenation and partial ...compensation of heat losses. In the example of dehydrogenation of methylbutenes into the isoprene, the oxidation of hydrogen on the platinum catalyst charged inside the layer of ferric potassium catalyst for the dehydrogenation of olefins is considered.
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