The impact of Aprepitant on Nausea and Vomiting following Laparoscopic Sleeve Gastrectomy: A Blinded Randomized Controlled Trial.

INTRODUCTION: Laparoscopic sleeve gastrectomy (LSG) is associated with postoperative nausea and vomiting (PONV). We aimed to compare the effects of aprepitant on the incidence of PONV after LSG. METHODS: In this double-blind, randomized controlled trial, the case group received the standard care regimen for PONV (dexamethasone 10 mg, ondansetron 4 mg, and metoclopramide 10 mg) plus prophylactic oral aprepitant 80 mg 1 h preoperatively. The control group received standard care plus a placebo. Comparative analyses using the Rhodes index were performed at 0, 6, 12, and 24 h postoperatively. RESULTS: A total of 400 patients (201 in the aprepitant group and 199 in the placebo group) underwent LSG. The groups were homogeneous. The aprepitant group experienced less PONV: early, 69 (34.3%) vs. 103 (51.7%), p ≤ 0.001; 6 h, 67 (33.3%) vs. 131 (65.8%), p ≤ 0.001; 12 h, 41 (20.4%) vs. 115 (57.8%), p ≤ 0.001; and 24 h, 22 (10.9%) vs. 67 (33.7%), p ≤ 0.001. Fewer patients in the aprepitant group vomited: early, 3 (1.5%) vs. 5 (2.5%), p = 0.020; 6 h, 6 (3%) vs. 18 (9%), p = 0.020; 12 h, 2 (1%) vs. 17 (8.5%), p = 0.006; and 24 h, 1 (0.5%) vs. 6 (3%), p = 0.040. Patients in the aprepitant group required less additional PONV medication: early, 61 (30.3%) vs. 86 (43.2), p = 0.008; 6 h, 7 (3.5%) vs. 34 (17%), p = 0.001; 12 h, 6 (3%) vs. 31 (15.6%), p ≤ 0.001; and 24 h, 5 (2.5%) vs. 11 (5.5%), p ≤ 0.001. CONCLUSIONS: Prophylactic aprepitant improved PONV between 0 h (early) and 24 h postoperatively in patients undergoing LSG.

Laparoscopic Sleeve Gastrectomy (LSG) in a Patient With Situs Inversus Totalis (SIT): A Case Report.

Obesity is associated with several preventable health issues, such as diabetes mellitus and hypertension. Bariatric surgery has shown potential in treating obesity. Laparoscopic sleeve gastrectomy (LSG) is one of several bariatric surgical techniques gaining popularity as a primary procedure. Situs inversus totalis (SIT) is an uncommon hereditary abnormality that can present challenges in laparoscopic surgery due to the mirror-image anatomy. We present the case of a 54-year-old female with a body mass index (BMI) of 54.36 kg/m2. She was diagnosed with SIT and had no other known diseases, medication use, or allergies. We performed a conventional LSG, modifying the original trocar port positions to match the anatomy. LSG is a safe and effective procedure for patients with SIT. Preoperative diagnosis can help reduce the risk of complications by facilitating proper surgical planning.

Surface-Enhanced Raman Analysis of Underlaying Colorants on Redyed Hair.

Forensic examination of hair evidence can help with establishing a connection between a suspect and a crime scene or demonstrate the absence of such connections. Currently, it is primarily done by a subjective microscopic examination which can only elucidate the species of origin and, if human, the part of the body the hair came from. Several years ago, surface-enhanced Raman spectroscopy (SERS) was proposed for advanced forensic analysis of hair ( Kurouski , D. ; Van Duyne , R. P. In situ detection and identification of hair dyes using surface-enhanced Raman spectroscopy (SERS) . Anal. Chem. 2015 , 87 , 2901 - 2906 . DOI: 10.1021/ac504405u ). It was shown that SERS could be used to determine whether hair was dyed or not and even reveal what commercial hair colorant was used. Expanding upon those findings, we show that SERS is capable of probing the original colorant even if hair was redyed afterward. Specifically, we were able to detect and identify the underlaying blue semipermanent colorant on hair redyed by both black semipermanent and black permanent colorants. We also demonstrate that original black permanent colorant could be detected by SERS if the hair was recolored by blue semipermanent dye. However, it could not if the hair was recolored by another (blue or black) permanent dye. We also provide experimental evidence that SERS can be used to detect the dye on hair colored more than two months prior to its spectroscopic examination. These experimental findings substantially expand capabilities of SERS in forensics.