Increased gallstone formation after sleeve gastrectomy and the preventive role of ursodeoxycholic acid.

BACKGROUND AND STUDY AIMS: To investigate the incidence of gallstone formation, and the use of Ursodeoxycholic Acid (UDCA), weight loss and serum lipid profile changes following obesity surgery. PATIENTS AND METHODS: Patients who underwent bariatric surgery due to obesity were retrospectively reviewed and divided into 2 groups for their prophylactic UDCA use. Patients who had a previous gallbladder pathology and ones who did not have a preoperative ultrasonography (US) were excluded. The patients who have returned to our clinic for a control ultrasound between 6 and 18 months following the surgery were included in this study, but only if they did not have any gall bladder pathology demonstrated with an US prior to surgery. Body mass index (BMI) and lipid profile measurements were also recorded. RESULTS: Of the 108 patients who had undergone obesity surgery, it is reported that 42 (38.9%) were given UDCA as a preventative medication, and 66 (61.1%) were not prescribed any preventative medications. During the ultrasound controls in the postoperative period between 6 and 18 months after surgery, gallbladder stones were seen in 42 patients (38.9%) and biliary sludge development was detected in 5 patients (4.6%). A total of 47 patients (43.5%) developed gallbladder pathology. Fewer patients who took UDCA developed gallstones when compared with the patients who did not take UDCA (10% vs 33%). Also, there is a correlation between BMI loss rate and the frequency of gallstone development. Though the decrease in triglyceride (TG) levels was higher in patients with gallstone development, this decrease was not statistically significant. CONCLUSIONS: Stone or sludge development in the gallbladder due to rapid weight loss after obesity surgery is quite common. However, we observed that the gallstone development decreased significantly with the prophylactic use of UDCA in patients who had undergone obesity surgery.

The deletion 22q13 syndrome: a new case.

The deletion 22q13.3 syndrome (Phelan-McDermid syndrome) is a chromosome microdeletion syndrome characterized by neonatal hypotonia, global developmental delay, normal to accelerated growth, absent to severely delayed speech, and minor dysmorphic features. Common physical traits include long eye lashes, large or unusual ears, relatively large hands, dysplastic toenails, full brow, dolicocephaly, full cheeks, bulbous nose, and pointed chin. Behavior is autisticlike with decreased perception of pain and habitual chewing or mouthing. The loss of 22q13.3 can result from simple deletion, translocation, ring chromosome formation and less common structural changes affecting the long arm of chromosome 22, specifically the region containing the SHANK3 gene. The present case was referred at the age of 8 months because of delayed psychomotor development, hypotonia and autistic features. Clinical examination showed a small forehead, long eyelashes, epicanthal folds and lowset ears, large and broad hands and feet with short terminal phalanges. He had no eye contact and could not sit without support.

Effectiveness of parvaquone in cattle infected with Theileria annulata.

Parvaquone was used in 13 cattle naturally infected with Theileria annulata. Blood smears and lymph node biopsy smears were taken, stained and examined for the presence of the piroplasm and schizont stages of the parasite respectively. Smears were examined before and on the third, fifth and seventh day after commencement of therapy. Two doses of parvaquone were injected in the neck intramuscularly at 10 mg/kg bodyweight at 48 hour intervals. Of the 13 cattle treated 11 were discharged in fairly good condition and two died of tropical theileriosis on the sixth day after commencement of treatment.