Is Transdermal Multivitamin Patch Effective in Gastric Bypass Patients?

BACKGROUND: Laparoscopic Roux-en-Y gastric bypass (LRYGB) patients are recommended to take multiple oral vitamin supplements daily. Transdermal multivitamin patches are being advertised as an alternative for use in bariatric patients with no data to support their efficacy. The purpose of this study was to evaluate response to daily transdermal use of multivitamin patch after LRYGB and to compare them with a control group of similar patients who used oral supplements. METHODS: A retrospective review was carried out on patients who had LRYGB at a community hospital from February 2015 to February 2019. Patients who had completed preoperative and annual postoperative bariatric laboratory tests were included. They were divided into patch and pill (control) group. RESULTS: Seventeen patients were included in the patch and 27 in the pill group. Patients in each group used either patch or pills for 12 months and they were 1 year post LRYGB. Fourteen patients (82.35%) in patch group and 11 patients (40.74%) in pill group had at least 1 deficiency at annual postoperative blood work (P = .0116). Vitamin D deficiency was seen in 81% patients in patch group vs 36% in the pill group (P = .0092). Statistically significant lower postoperative serum concentrations of vitamin D, B1, and B12 were seen in the patch group. CONCLUSIONS: Multivitamin patch users are more likely to have vitamin D deficiency and lower serum concentration of various vitamins and minerals. Future large studies are needed on the efficacy of multivitamin patches before they can be recommended to bariatric patient population.

Methods for the best evidence synthesis on neck pain and its associated disorders: the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders.

STUDY DESIGN: Best evidence synthesis. OBJECTIVE: To provide a detailed description of the methods undertaken in a systematic search and perform a best evidence synthesis on the frequency, determinants, assessment, interventions, course and prognosis of neck pain, and its associated disorders. SUMMARY OF BACKGROUND DATA: Neck pain is an important cause of health burden; however, the published information is vast, and stakeholders would benefit from a summary of the best evidence. METHODS: The Bone and Joint Decade 2000-2010 Task Force on Neck Pain and its Associated Disorders conducted a systematic search and critical review of the literature published between 1980 and 2006 to assemble the best evidence on neck pain. Citations were screened for relevance to the Neck Pain Task Force mandate, using a priori criteria, and relevant studies were critically reviewed for their internal scientific validity. Findings from studies meeting criteria for scientific validity were synthesized into a best evidence synthesis. RESULTS: We found 31,878 citations, of which 1203 were relevant to the mandate of the Neck Pain Task Force. After critical review, 552 studies (46%) were judged scientifically admissible and were compiled into the best evidence synthesis. CONCLUSION: The Bone and Joint Decade 2000-2010 Task Force on Neck Pain and its Associated Disorders undertook a best evidence synthesis to establish a baseline of the current best evidence on the epidemiology, assessment and classification of neck pain, as well as interventions and prognosis for this symptom. This article reports the methods used and the outcomes from the review. We found that 46% of the research literature was of acceptable scientific quality to inform clinical practice, policy-making, and future research.

A validated method for gas chromatographic analysis of gamma-aminobutyric acid in tall fescue herbage.

Gamma-aminobutyric acid (GABA) is an inhibitory neurotransmitter in animals that is also found in plants and has been associated with plant responses to stress. A simple and relatively rapid method of GABA separation and quantification was developed from a commercially available kit for serum amino acids (Phenomenex EZ:faast) and validated for tall fescue (Festuca arundinacea). Extraction in ethanol/water (80:20, v/v) at ambient temperature yielded detectable amounts of GABA. Clean separation from other amino acids in 28 min was achieved by gas chromatography (GC) with flame ionization detection (FID), using a 30 m, 5% phenyl/95% dimethylpolysiloxane column. The identity of the putative GABA peak was confirmed by GC with mass spectrometric (MS) detection. The relatively small effects of the sample matrix on GABA measurement were verified by demonstrating slope parallelism of GABA curves prepared in the presence and absence of fescue extracts. Limits of quantification and detection were 2.00 and 1.00 nmol/100 microL, respectively. Method recoveries at two different spike levels were 96.4 and 94.2%, with coefficients of variation of 7.3 and 7.2%, respectively.