The Experts below are selected from a list of 360 Experts worldwide ranked by ideXlab platform
Frits J Berends - One of the best experts on this subject based on the ideXlab platform.
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secondary surgery after sleeve gastrectomy roux en y gastric bypass or biliopancreatic diversion with duodenal switch
Surgery for Obesity and Related Diseases, 2015Co-Authors: Jens Homan, Bark Betzel, Edo O Aarts, Kees Van Laarhoven, Ignace M C Janssen, Frits J BerendsAbstract:Abstract Background Laparoscopic sleeve gastrectomy (LSG) has gained popularity as a stand-alone procedure with good short-term results for weight loss. However, in the long-term, weight regain and other complications are reported. Demand for secondary surgery is rising, partly for these reasons. Objectives To review the indications and effects of secondary surgery, biliopancreatic diversion with duodenal switch (BPD/DS) versus laparoscopic Roux-en-Y gastric bypass (LRYGB), after LSG. Methods Data from all patients who underwent revision of LSG was retrospectively analyzed, concerning data on indications for secondary surgery, weight loss, and complications. Results 43 Patients underwent secondary surgery after LSG; 25 BPD/DS and 18 LRYGB, respectively. Main indications for secondary surgery were inadequate weight loss (n = 17 [40%]) and weight regain (n = 8 [19%]). For these indications, the median excess weight loss was greater for BPD/DS (59% [range 15–113]) compared to LRYGB (23% [range -49–84]) ( P = .008) after 34 months (range 14–79). In case of dysphagia or gastroesophageal reflux disease the complaints resolved after converting to LRYGB. BPD/DS patients were more likely to develop a short-term complication and Vitamin Deficiencies compared to LRYGB. Conclusions Secondary surgery of LSG to BPD/DS or LRYGB is feasible with slightly more complications after BPD/DS. Conversion to LRYGB is preferred in cases of dysphagia or gastroesophageal reflux disease. In cases of weight regain or insufficient weight loss after LSG, patients had better weight loss with a BPD/DS; however, this procedure has the risk of complications, such as severe Vitamin Deficiencies.
Said Farhat - One of the best experts on this subject based on the ideXlab platform.
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wernicke s encephalopathy three weeks after sleeve gastrectomy
Surgery for Obesity and Related Diseases, 2014Co-Authors: Rawan Saab, Mansour El Khoury, Said FarhatAbstract:Following bariatric surgeries for management of morbid obesity, less nutrients are absorbed, giving rise to complications due to Vitamin Deficiencies with frequently dramatic consequences. Neurologic complications resulting from folate, Vitamin B12, and thiamine Deficiencies have been estimated to occur in up to 16% of cases and present within weeks to months following bariatric surgery. Among bariatric surgeries, Roux-en-Y gastric bypass has been the most associated with such Deficiencies due to both restrictive and malabsorptive components. Complications are less seen with restrictive surgeries. We report a case of rapid Wernicke's encephalopathy due to a thiamine deficiency in a young female patient following Sleeve gastrectomy (SG).
Khosro Farhad - One of the best experts on this subject based on the ideXlab platform.
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current diagnosis and treatment of painful small fiber neuropathy
Current Neurology and Neuroscience Reports, 2019Co-Authors: Khosro FarhadAbstract:Small fiber neuropathy (SFN) could cause significant morbidity due to neuropathic pain and autonomic dysfunction. SFN is underdiagnosed and the knowledge on the condition is limited among general public and health care professionals. This review is intended to enhance the understanding of SFN symptoms, causes, diagnostic tools, and therapeutic options. There is evidence of SFN in up to 40% patients with fibromyalgia. The causes of SFN are glucose metabolism defect, dysimmune, gluten sensitivity and celiac disease, monoclonal gammopathy, Vitamin Deficiencies, toxic agents, cancer, and unknown etiology. Auto-antibodies targeting neuronal antigens trisulfated heparin disaccharide (TS-HDS) and fibroblast growth factor 3 (FGFR3) are found in up to 20% of patients with SFN. Treatment of SFN includes treating the etiology and managing symptoms. SFN should be considered in patients with wide-spread body pain. The search for known causes of SFN is a crucial step in disease management.
Marc C Patterson - One of the best experts on this subject based on the ideXlab platform.
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scurvy and rickets masked by chronic neurologic illness revisiting psychologic malnutrition
Pediatrics, 2007Co-Authors: James M Noble, Arthur M Mandel, Marc C PattersonAbstract:The North American epidemic of overeating, combined with a sedentary lifestyle, has led to a growing prevalence of obesity, diabetes, and the "metabolic syndrome" in children. Excessive caloric intake does not imply adequate nutrition, and Vitamin-deficiency syndromes still occur in some American children. Here we describe cases of scurvy and Vitamin D deficiency in 2 children with cognitive disorders. Thorough dietary histories suggested the diagnosis in each patient and, had they been obtained at presentation, would likely have obviated invasive diagnostic workup, unnecessary stress to the patients and their families, and significant functional disability. Overnutrition and malnutrition may coexist, particularly among those with abnormal cognition or autistic spectrum disorders. Classic nutritional Deficiencies must not be omitted from the differential diagnosis. A comprehensive dietary history and screening for Vitamin Deficiencies in at-risk children are important aspects of preventive health care and are essential for prompt diagnosis and treatment.
Jens Homan - One of the best experts on this subject based on the ideXlab platform.
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secondary surgery after sleeve gastrectomy roux en y gastric bypass or biliopancreatic diversion with duodenal switch
Surgery for Obesity and Related Diseases, 2015Co-Authors: Jens Homan, Bark Betzel, Edo O Aarts, Kees Van Laarhoven, Ignace M C Janssen, Frits J BerendsAbstract:Abstract Background Laparoscopic sleeve gastrectomy (LSG) has gained popularity as a stand-alone procedure with good short-term results for weight loss. However, in the long-term, weight regain and other complications are reported. Demand for secondary surgery is rising, partly for these reasons. Objectives To review the indications and effects of secondary surgery, biliopancreatic diversion with duodenal switch (BPD/DS) versus laparoscopic Roux-en-Y gastric bypass (LRYGB), after LSG. Methods Data from all patients who underwent revision of LSG was retrospectively analyzed, concerning data on indications for secondary surgery, weight loss, and complications. Results 43 Patients underwent secondary surgery after LSG; 25 BPD/DS and 18 LRYGB, respectively. Main indications for secondary surgery were inadequate weight loss (n = 17 [40%]) and weight regain (n = 8 [19%]). For these indications, the median excess weight loss was greater for BPD/DS (59% [range 15–113]) compared to LRYGB (23% [range -49–84]) ( P = .008) after 34 months (range 14–79). In case of dysphagia or gastroesophageal reflux disease the complaints resolved after converting to LRYGB. BPD/DS patients were more likely to develop a short-term complication and Vitamin Deficiencies compared to LRYGB. Conclusions Secondary surgery of LSG to BPD/DS or LRYGB is feasible with slightly more complications after BPD/DS. Conversion to LRYGB is preferred in cases of dysphagia or gastroesophageal reflux disease. In cases of weight regain or insufficient weight loss after LSG, patients had better weight loss with a BPD/DS; however, this procedure has the risk of complications, such as severe Vitamin Deficiencies.
