Nutritional Implications of Bariatric Surgery on Pregnancy Management-A Narrative Review of the Literature.

One in three women of reproductive age is obese. The mainstay treatment for obesity is bariatric surgery, and the following weight reduction results in a decrease in pregnancy adverse effects, including gestational diabetes mellitus, pregnancy-induced hypertension, and macrosomia. However, nutritional and vitamin deficiencies due to changes in the gastrointestinal tract after bariatric surgery are associated with an increase in the risk of fetal growth retardation and small for gestational-age neonates. The purpose of this review was to analyze the available recent literature on the subject of the management of pregnancy after bariatric surgery. We searched for available articles from 2007 to 2023 and chose articles of the greatest scientific and clinical value. Micronutrient, vitamin, and protein supplementation is recommended in the prenatal period and throughout the pregnancy. It is advised that pregnant women with a history of bariatric surgery should be provided with regular specialist dietary care. There is still a lack of recommendations about the optimum gestational weight gain after different types of bariatric surgery and for patients of different metabolic statuses. Women of reproductive age undergoing bariatric procedures should be provided with appropriate counseling about adequate contraception, the recommended time-to-conception interval, and the positive and negative influence of bariatric surgery on perinatal outcomes.

[Assessment of antagonistic activity in vitro Lactobacillus spp. strains againts Clostridum difficile strains isolated from gastrointestinal tract of patients hospitalized in three hospitals in region Mazovia]. / Ocena antagonistycznego dzialania w warunkach in vitro szczepów z rodzaju Lactobacillus wobec toksynotwórczych szczepów Clostridium difficile wyhodowanych z przewodu pokarmowego pacjentów leczonych w szpitalach na terenie województwa mazowieckiego.

INTRODUCTION: The aim of this study was to evaluate the antagonistic activity of Lactobacillus strains against clinical C. difficile strains isolated from faecal samples of adults patients with diarrhea. A total 61 strains of C. difficile randomly selected isolated in the period 2007-2008 from the gastrointestinal tract of hospitalized patients in three hospitals province Mazovia, Poland. To determination of antagonistic activity ofprobiotic Lactobacillus spp. strains used four reference strains: Lactobacillus plantarum 2017405, Lactobacillus fermentum 353, Lactobacillus acidophilus DSM 21007 and Lactobacillus rhamnosus GG. METHODS: Isolation of C. difficile was performed on selective Columbia agar supplemented with cycloserine/cefoxitine and amphothericin B (CLO medium, bioMérieux, France). The plates were incubated in an anaerobic chamber for 48 h at 37 degrees C. Isolates were identified as C. difficile by the characteristic morphology of the colonies and horse-like odour, green yellow fluorescence under UV. Toxigenicity of of C. difficile strains was determined in PCR to detection of fragments of genes encoding toxin A (tcdA), toxin B (tcdB) and binary toxin (cdtA and cdtB). The study of antagonistic activity four Lactobacillus spp. strains against 61 clinical C. difficile strains was performed according to standard methods. Lactobacillus strains were inoculated on MRS medium and incubated in oxygen-free atmosphere and cut the bars of MRS agar and applied to the plate with cultures of C. difficile strains. RESULTS: Assessment of antagonist activity of Lactobacillus spp. strains was performed by measuring the zone of inhibition of grown of C. difficile strains. The study shows that of probiotic Lactobacillus spp. strains interacted antagonistically in vitro against all toxigenic (A+B+CDT- and A+B+CDT+) of C. difficile strains. CONCLUSIONS: The differences in the antagonistic activity of Lactobacillus spp. strains against different toxigenic clinical C. difficile strains were not observed.

[Assessment of susceptibility of strictly anaerobic bacteria originated from different sources to fluoroquinolones and other antimicrobial drugs]. / Ocena wrazliwosci szczepów bezwzglednych beztlenowców pochodzacych z róznych zródel na fluorochinolony oraz inne leki stosowane w lecznictwie szpitalnym.

INTRODUCTION: During the past 20 years, several studies at a national level in different countries followed resistance trends for Bacteroides sp. and Clostridium difficile. This study analysed antimicrobial susceptibility 73 anaerobic bacteria strains of Bacteroides fragilis group (BFG) and C. difficile to fluoroquinolones and other antimicrobial drugs. METHODS: The strictly anaerobes strains isolated in different hospitals were sent to the Department of Medical Microbiology, Medical Uniwersity of Warsaw, where species determination was carried out with the API20 ANA (bioMerieux SA, Marcy-l'Etoile, France) system. Susceptibility to antimicrobials was determined using E-test. RESULTS: The rates of high resistance to ciprofloxacin and moxifloxacin of BFG was respectively 84% and 31% and among of C. difficile strains respectively 92% and 36%). The percentage of BFG strains resistant to erythromycin and clindamycin were respectively 84% and 46%. The percentage of C. difficile strains resistant to erythromycin and clindamycin was 52%. Reduced level of susceptibility of BFG strains to amoxicillin/clavulanic acid (8%) was confirmed. Resistance to cefoxitin was 16% of BFG strains. All tested strains as well as BFG and C. difficile were susceptible to metronidazole. Was observed reduced leve (EUCAST) of susceptibility of C. difficile strains to vancomycin (13%). CONCLUSIONS. Increasing resistance to various antimicrobial agents is a significant problem in Poland. This demonstrate the need to continue with antibiotic resistance testing and surveys in anaerobic bacteria.