Bariatric surgery in moderately obese patients: a prospective study.

Introduction. Moderate obesity (BMI 30-35 kg/m(2)) affects 25% of the western population. The role of bariatric surgery in this context is currently debated, reserved for patients with comorbidity, as an alternative to conservative medical treatment. We describe our experience in moderately obese patients treated with bariatric surgery. Materials and Methods. Between September 2011 and September 2012, 25 patients with grade I obesity and comorbidities underwent bariatric surgery: preoperative mean BMI 33.2 kg/m(2), 10 males, mean age 42 years. In presence of type 2 diabetes mellitus (T2DM) (56%), gastric bypass was performed; in cases with hypertension (64%) and obstructive sleep apnea (OSA) (12%), sleeve gastrectomy was performed. All operations were performed laparoscopically. Results. Mean follow-up was 12.4 months. A postoperative complication occurred: bleeding from the trocar site was resolved with surgery in local anesthesia. Reduction in average BMI was 6 points, with a value of 27.2 kg/m(2). Of the 14 patients with T2DM, 12 (86%) discontinued medical therapy because of a normalization of glycemia. Of the 16 patients with arterial hypertension, 14 (87%) showed remission and 2 (13%) improvement. Complete remission was observed in patients with OSAS. Conclusions. The results of our study support the validity of bariatric surgery in patients with BMI 30-35 kg/m(2). Our opinion is that, in the future, bariatric surgery could be successful in selected cases of moderately obese patients.

Determination of adenosine deaminase activity and its isoenzymes for diagnosis of pleural effusions.

OBJECTIVE: We aimed to investigate adenosine deaminase (ADA) activity and the activities of its ADA1 and ADA2 isoenzymes in pleural effusions and also sera with different aetiological origins. METHODOLOGY: The pleural effusions of 87 patients were examined. The patients were separated into four groups: transudates, parapneumonic, malignant, and tuberculous effusions. The cases were also designated as tuberculous or non-tuberculous group. Adenosine deaminase activity was determined by the colorimetric method described by Giusti and Galanti. RESULTS: The intermean differences were statistically significant for total ADA, ADA1 and ADA2, except for pleural fluid ADA1 in the malignant group when compared to the tuberculous effusion group. The intermean differences between the tuberculous and non-tuberculous group were statistically significant for all three parameters except for pleural fluid and serum ADA1 activity. The sensitivities of total ADA, ADA1 and ADA2 activities for tuberculosis were 91, 57 and 93%, respectively; their specificities 89, 88 and 92%, respectively; their positive predictive values 82, 70 and 86%; and their diagnostic accuracies 89, 76 and 92%, respectively, in pleural fluid. CONCLUSIONS: Determination of ADA and its isoenzymes can help to differentiate the causes of pleural effusion. Increased ADA2 activity is a striking marker of tuberculous effusions. In contrast, increased ADA1 activity was significantly elevated in parapneumonic effusions.

The effect of propolis extract in experimental chemical corneal injury.

PURPOSE: To investigate the effect of propolis, a natural resin produced by honeybees, in the treatment of alkali-injured rabbit eyes. METHOD: A corneal alkali burn was induced by applying filter paper immersed in 1 N NaOH on the central axis of the right corneas of 24 rabbits for 30 s. The animals were divided into three treatment groups: group 1 (control) was given 0.3% tobramycin and phosphate-buffered solution; group 2 was treated with antibiotic coverage and topical 1% ethanolic extract of propolis; group 3 received antibiotic coverage and topical 1% dexamethasone. The dexamethasone-treated group was maintained as the positive control. Drugs were instilled 4 times a day for 7 days. The corneal inflammation was evaluated by calculating the average inflammatory index obtained from clinical observation of the ciliary hyperemia, central and peripheral corneal edema at 24 h, 48 h, on day 5 and day 7, before sacrificing the animals. Then, the corneas underwent routine histological examination. RESULTS: The effects of dexamethasone and propolis on healing of injured corneas were similar (p>0.05) and significantly better than controls at 24 h (p<0.01, p< 0.05, respectively), and on day 7 (p<0.05) with respect to the inflammatory index. On histological observation, inflammatory cell infiltration was lower as compared to control in both the dexamethasone and propolis groups (p<0.001) and similar with each other (p>0.05). CONCLUSIONS: Our study shows that propolis has an anti-inflammatory effect comparable to dexamethasone in chemical corneal injury.

Butyrylcholinesterase activity and risk factors for coronary artery disease.

The aim of this study was to verify which risk factors for coronary artery disease (CAD) are independently correlated with butyrylcholinesterase (BChE) activity. We studied 88 White individuals (43 males) aged 47.3+/-15.7 years (mean+/-SD; range: 14.0-80.0 years) including 38 with hyperlipidemia, 30 with hypertension and 5 with diabetes mellitus (DM). Simple correlation analysis showed that BChE activity was positively correlated with age, sex, body mass index, hypertension and DM, as well as with triglycerides (TGs), total cholesterol, low-density lipoprotein cholesterol and apolipoprotein B (Apo B). However, after a step-wise multiple regression analysis, the only risk factors for CAD that showed independent correlations with BChE activity were, in descending order of importance, Apo B, TGs and DM. Our findings seem to reinforce suggested associations of BChE activity with lipoprotein synthesis and with hypertension, as well as supporting previous data on the relation of BChE activity with disturbances found in diabetes mellitus.