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BACKGROUND: Metabolic and Bariatric surgery (MBS) leads to significant weight loss and improvements in obesity-related comorbidities. However, the impact of MBS on Apolipoprotein B100 (Apo-B100) regulation is unclear. Apo-B100 is essential for the assembly and secretion of serum lipoprotein particles. Elevated levels of these factors can accelerate the development of atherosclerotic plaques in blood vessels. This study aimed to evaluate changes in Apo-B100 levels following MBS. METHODS: 121 participants from the Iranian National Obesity and Metabolic Surgery Database (INOSD) underwent Laparoscopic Sleeve Gastrectomy (LSG) (n = 43), One-Anastomosis Gastric Bypass (OAGB) (n = 70) or Roux-en-Y Gastric Bypass (RYGB) (n = 8). Serum Apo-B100, lipid profiles, liver enzymes, and fasting glucose were measured preoperatively and six months postoperatively. RESULTS: Apo-B100 levels significantly decreased from 94.63 ± 14.35 mg/dL preoperatively to 62.97 ± 19.97 mg/dL after six months (p < 0.01), alongside reductions in total cholesterol, triglycerides, LDL, VLDL, AST, and ALT (p < 0.05). Greater Apo-B100 reductions occurred in non-diabetics versus people with diabetes (p = 0.012) and strongly correlated with baseline Apo-B100 (r = 0.455, p < 0.01) and LDL levels (r = 0.413, p < 0.01). However, surgery type did not impact Apo-B100 changes in multivariate analysis (p > 0.05). CONCLUSION: Bariatric surgery leads to a significant reduction in Apo-B100 levels and improvements in lipid profiles and liver enzymes, indicating a positive impact on dyslipidemia and cardiovascular risk in individuals with high BMI.
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INTRODUCTION AND IMPORTANCE: Gastric mucosal choristoma of the tongue is an extremely rare benign tumor characterized by ectopic gastric mucosa in the tongue. Since first reported in 1927, only around 100 cases have been documented. Herein, we investigated an adult case of Gastric mucosal choristoma who was referred to an ENT clinic with a chief complaint of a solid tumor at the posterior portion of the tongue. CASE PRESENTATION: A 32-year-old female presented with a posterior tongue mass initially noticed years ago that progressed over months. A surgical excision was performed. Microscopic examination revealed a gastric mucosal choristoma, with glandular structures resembling gastric mucosa. The postoperative course was uneventful. CLINICAL DISCUSSION: Lingual gastric choristoma is uncommon but deserves mention due to its rarity. The pathogenesis is unknown but likely represents developmental heterotopia. Clinically, lesions present as asymptomatic tongue nodules often mistaken for more common entities. Thus, histopathology is essential for diagnosis. Microscopy shows gastric mucosa with fundic glands, parietal cells, chief cells, and foveolar epithelium in tongue squamous epithelium. CONCLUSION: Gastric choristoma should be considered when evaluating tongue nodules to guide management. Increased awareness of this rare entity can enable accurate diagnosis and treatment. Complete surgical excision is curative with an excellent long-term prognosis. Further study of pathogenesis can elucidate optimal management.
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INTRODUCTION AND IMPORTANCE: Spontaneous rupture of the urinary bladder (SRUB) secondary to emphysematous cystitis(EC) in diabetic patients is extremely rare. Clinical presentations are often non-specific and display the signs and symptoms of peritonitis. The diagnosis is usually made after exploratory laparotomy. CASE REPORT: A 70-year-old diabetic woman presented to the emergency department with sudden diffuse abdominal pain and hematuria of six hours duration. Physical examination revealed generalized peritonitis. Multi-slice abdominal and pelvic CT scans showed free air and fluid in the abdominal cavity. After proper resuscitation, the patient was transferred to the operating room for exploratory laparotomy. A 2 cm full-thickness bladder rupture was noted at the dome of the bladder, which was repaired. CLINICAL DISCUSSION: We noticed free air in the urinary bladder wall postoperatively in the CT scan, which is the radiological sign of EC. The Pathology result was in concordance with the diagnosis. CONCLUSIONS: SRUB in patients with poorly controlled diabetes and EC is highlighted in this case study. Urinary bladder rupture secondary to EC should be considered When a diabetic patient with a history of urinary symptoms presents with an acute onset of abdominal pain suggestive of peritonitis. Uneventful recovery from SRUB is dependent on early diagnosis and treatment.
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B1 deficiency is a very prevalent complication of bariatric surgery. This study reviews prevalence and symptoms of B1 vitamin deficiency after bariatric surgery. PubMed, Scopus, and Web of Science published were searched up to 10 Feb 2022, with the following keywords: Roux-en-Y gastric bypass, one anastomosis gastric bypass, Omega bypass, Mini bypass, Bariatric surgery OR Bariatric surgery, metabolic surgery, Weight loss surgery, Classic gastric bypass, Loop gastric bypass, Gastric Bypass, thiamine OR thiamin, beriberi, B1. A total of 11 studies examining 1494 patients were included in this meta-analysis. Twenty-seven percent of patients who underwent bariatric surgeries experience vitamin B1 deficiency. Thiamine supplements should be prescribed for the patients for the rest of their lives, and also standard post-surgery follow-ups are necessary in terms of monitoring dietary factors.
