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1.
Int J Mol Sci ; 24(19)2023 Oct 03.
Artículo en Inglés | MEDLINE | ID: mdl-37834321

RESUMEN

Psoriasis is a chronic, complex, immunological disorder, which may lead to many different systemic complications. Sphingolipids, including ceramide, are bioactive lipids, which take part in the regulation of immune reactions, cell growth, and apoptosis. Twenty psoriatic patients and twenty-eight control subjects were included in the study. Skin (both lesional and non-lesional) and serum samples were collected from both the control group and the psoriatic patients. The levels of sphingosine (SFO), sphingosine-1-phosphate (S1P), sphingomyelin, sphinganine (SFA), sphinganine-1-phosphate (SFA1P), and ceramide (CER) were assessed in both tissue (t) and serum (s) samples using high-performance liquid chromatography (HPLC). We identified elevated serum levels of SFO, S1P, SFA, and SFA1P in psoriatic patients when compared to healthy individuals. As far as the lesional skin and serum of psoriatic patients are concerned, we demonstrated positive associations between CER_t and CER_s, SFA_t and CER_s, and SFO_t and CER_s. Additionally, we found negative correlations in the non-lesional skin and serum of psoriatic patients, including SFO_t vs. SFO_s, CER_t vs. SFA_s, CER_t vs. SFO_s, and SFO_t vs. SFA_s. Finally, we observed a positive correlation between S1P and SFA1P in both the serum samples of psoriatic patients and the serum samples of the control group. In this study, we did not observe any correlations between psoriasis area and severity index (PASI) scores and sphingolipid levels. In conclusion, our findings indicate an interplay between skin and serum lipids in psoriatic patients, which is not observed in healthy individuals.


Asunto(s)
Psoriasis , Esfingolípidos , Humanos , Ceramidas , Piel , Esfingosina
2.
Int J Mol Sci ; 24(14)2023 Jul 12.
Artículo en Inglés | MEDLINE | ID: mdl-37511095

RESUMEN

Psoriasis is a complex chronic immunologically mediated disease that may involve skin, nails, and joints. It is characterized by hyperproliferation, deregulated differentiation, and impaired apoptosis of keratinocytes. Sphingolipids, namely ceramide, sphingosine-1-phosphate, sphingosine, sphingomyelin, and sphinganine-1-phosphate, are signal molecules that may regulate cell growth, immune reactions, and apoptosis. Fifteen patients with psoriasis and seventeen healthy persons were enrolled in the study. Skin samples were taken from psoriatic lesions and non-lesional areas. Tissue concentration of ceramides, sphingosine-1-phosphate, sphingosine, sphingomyelin, and sphinganine-1-phosphate was measured by liquid chromatography. We assessed that all levels of ceramides, sphingosine-1-phosphate, sphingosine, sphingomyelin, and sphinganine-1-phosphate were higher in lesioned psoriatic skin than in non-affected skin. The profile of bioactive lipids in the lesional skin of patients with psoriasis differed significantly from non-involved psoriatic skin and skin in healthy subjects.


Asunto(s)
Psoriasis , Esfingolípidos , Humanos , Esfingosina , Esfingomielinas , Ceramidas/química , Fosfatos
3.
Acta Chir Belg ; 120(2): 116-123, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-30747049

RESUMEN

Background: In general, the three main options for stump closure in laparoscopic appendectomy are clips, endoscopic staplers and endoloops. However, there is no gold standard, especially regarding complicated acute appendicitis which is generally associated with worse outcomes.Objectives: We aimed to assess the outcomes of different stump closure techniques during laparoscopic appendectomies for complicated appendicitisMethods: Our multicenter observational study of 18 surgical units assessed the outcomes of 1269 laparoscopic appendectomies for complicated appendicitis that used the three main stump closure techniques: clips, staplers and endoloops. Groups were compared in terms of peri- and postoperative outcomes.Results: Staplers were superior in terms of overall morbidity (9.79 vs. 3.29% vs. 7.41%, p = .017) and length of stay (4 vs. 3 vs. 4 days, p < .001) respectively for clips, staplers and endoloops. However, no differences in major complication rates, postoperative intraabdominal abscess formation, reintervention rates and readmission rates were found.Conclusion: Although our results show some clinical benefits of staplers for appendix stump closure, they are based on a non-randomized group of patients and are therefore prone to selection bias. Further well-designed trials taking into consideration not only the clinical benefits, but also, the economic aspects of the surgical treatment of complicated acute appendicitis are needed to confirm our results.


Asunto(s)
Apendicectomía , Apendicitis/cirugía , Laparoscopía , Técnicas de Cierre de Heridas , Adulto , Apendicitis/complicaciones , Estudios de Cohortes , Femenino , Humanos , Tiempo de Internación , Masculino , Persona de Mediana Edad , Polonia , Engrapadoras Quirúrgicas , Adulto Joven
4.
Przegl Lek ; 73(9): 610-4, 2016.
Artículo en Polaco | MEDLINE | ID: mdl-29688655

RESUMEN

Background: Recent studies point out the important role of vitamin D in the pathogenesis of many autoimmune diseases, in between psoriasis. Vitamin D regulates function of the dendritic cells, proliferation and maturation of the keratynocytes and lymphocytes T. The aim of the study was to evaluate serum vitamin D (25OHD) concentrations in psoriatic patients in the north-east of Poland and their comparison in the summer and winter period of the year. We also evaluated relationship between 25OHD concentration and disease severity, prevalence of psoriatic comorbidities and laboratory results. Material and Methods: 25OHD serum concentration was evaluated by electrochemiluminescent method in 115 patients with exacerbated plaque type psoriasis. 39 patients were evaluated in the summer and 79 in the winter time. 28 patients from winter group were treated with narrow band ultraviolet B radiation (NB-UVB). The results were compared with 38 healthy persons. Results: 25OHD serum concentrations of psoriatic patients were significantly lower than in the control group (p=0,0003). Vitamin D deficiency was diagnosed in 66% of patients in the summer time and in 63% in winter time; in the control group: 24% during the summer and 71% during the winter. After UVB phototherapy we observed reduction of skin lesions, measured as a significant decline in the Psoriasis Area and Severity Index (PASI) (p<0.001). The serum 25OHD concentration increased (p<0.001). After the treatment 65% of the psoriatic patients reached normal range of 25OHD concentration, 35% of patients were still vitamin D insufficient. We demonstrate positive correlation between increase in 25OHD and number of NB-UVB phototherapy sessions (r=0.38). Conclusions: We have observed vitamin D deficiency both in psoriatic patients and in the control group. Among psoriatic patients the praevalence of deficiency were higher than in the control group, especially during the summer months. Frequent vitamin D defficiency in the groups studied indicates the need of for its supplementation. The 25OHD serum concentrations increased after phototherapy with UVB.


Asunto(s)
Psoriasis/sangre , Vitamina D/sangre , Humanos , Polonia , Psoriasis/radioterapia , Estaciones del Año , Terapia Ultravioleta , Deficiencia de Vitamina D/radioterapia
5.
Postepy Hig Med Dosw (Online) ; 69: 1190-5, 2015 Jan 02.
Artículo en Inglés | MEDLINE | ID: mdl-26561845

RESUMEN

Obesity is a major public health concern that increases the risk of cardiovascular disease, type 2 diabetes and cancer. The incidence of obesity has increased significantly in recent years, not only in adults, but also in adolescents and children. This is evidenced by rapidly developing bariatric surgery, the most effective method of treating morbid obesity. Obesity is a multifactorial disease, and its pathogenesis is not completely understood. Numerous studies have been performed to clarify pathogenetic mechanisms, based mostly on blood and sometimes urine samples. Saliva is easily accessible and can be obtained non-invasively. Our aim was to review studies performed on saliva obtained from obese subjects in order to answer the title question. Obese people have different composition of salivary bacteria. Changes in the concentration of sialic acid, phosphorus and peroxidase activity as well as a lower flow rate of stimulated whole saliva promote dental caries and periodontal disease. Concentrations of salivary uric acid, endocannabinoids and CRP are increased in obesity and may provide a useful index of cardiometabolic risk. Assessment of fasting salivary ghrelin might facilitate choosing the best type of bariatric surgery for a specific patient. A significant decrease in salivary cortisol in women with morbid obesity also seems interesting. There is sufficient evidence to state that the saliva of obese and lean subjects is different. Saliva as an easily accessible research material seems promising, as shown by the few studies performed so far.


Asunto(s)
Obesidad/patología , Saliva/química , Humanos , Saliva/microbiología
6.
Contemp Oncol (Pozn) ; 18(1): 1-6, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-24876814

RESUMEN

Colorectal cancer (CRC) is one of the most frequent human malignant neoplasms. CRC has an estimated incidence of more than 1,000,000 new cases annually worldwide. Approximately one out of three people who develop CRC dies from the disease. Furthermore, CRC often affects inhabitants of industrialized countries in comparison to less developed countries. Several markers of colon cancer, including CEA, CA-19-9, TPS, TAG-72 and lysosomal hydrolases, have been identified and are now being adopted in routine clinical practice. Increased values of these markers are often the first signal of recurrence or metastases, which is useful in prediction and prognosis of clinical outcome of patients with CRC. Determination of the activity of lysosomal exoglycosidases in body fluids may bring some hope of improving diagnosis of colorectal cancer. However, it has to be remembered that currently the most effective diagnostic method of CRC is endoscopy.

7.
Materials (Basel) ; 17(7)2024 Mar 22.
Artículo en Inglés | MEDLINE | ID: mdl-38611968

RESUMEN

This study optimized friction stir welding (FSW) parameters for 1.6 mm thick 2024T3 aluminum alloy sheets. A 3 × 3 factorial design was employed to explore tool rotation speeds (1100 to 1300 rpm) and welding speeds (140 to 180 mm/min). Static tensile tests revealed the joints' maximum strength at 87% relative to the base material. Hyperparameter optimization was conducted for machine learning (ML) models, including random forest and XGBoost, and multilayer perceptron artificial neural network (MLP-ANN) models, using grid search. Welding parameter optimization and extrapolation were then carried out, with final strength predictions analyzed using response surface methodology (RSM). The ML models achieved over 98% accuracy in parameter regression, demonstrating significant effectiveness in FSW process enhancement. Experimentally validated, optimized parameters resulted in an FSW joint efficiency of 93% relative to the base material. This outcome highlights the critical role of advanced analytical techniques in improving welding quality and efficiency.

8.
Sci Rep ; 14(1): 11209, 2024 05 16.
Artículo en Inglés | MEDLINE | ID: mdl-38755394

RESUMEN

Adrenal gland incidentaloma is frequently identified through computed tomography and poses a common clinical challenge. Only selected cases require surgical intervention. The primary aim of this study was to compare the effectiveness of selected machine learning (ML) techniques in proper qualifying patients for adrenalectomy and to identify the most accurate algorithm, providing a valuable tool for doctors to simplify their therapeutic decisions. The secondary aim was to assess the significance of attributes for classification accuracy. In total, clinical data were collected from 33 patients who underwent adrenalectomy. Histopathological assessments confirmed the proper selection of 21 patients for surgical intervention according to the guidelines, with accuracy reaching 64%. Statistical analysis showed that Supported Vector Machines (linear) were significantly better than the baseline (p < 0.05), with accuracy reaching 91%, and imaging features of the tumour were found to be the most crucial attributes. In summarise, ML methods may be helpful in qualifying patients for adrenalectomy.


Asunto(s)
Neoplasias de las Glándulas Suprarrenales , Adrenalectomía , Aprendizaje Automático , Humanos , Neoplasias de las Glándulas Suprarrenales/cirugía , Neoplasias de las Glándulas Suprarrenales/patología , Neoplasias de las Glándulas Suprarrenales/diagnóstico por imagen , Masculino , Adrenalectomía/métodos , Femenino , Persona de Mediana Edad , Anciano , Tomografía Computarizada por Rayos X , Adulto , Algoritmos
9.
Surg Obes Relat Dis ; 19(1): 68-75, 2023 01.
Artículo en Inglés | MEDLINE | ID: mdl-36182567

RESUMEN

BACKGROUND: The growing number of primary bariatric operations has led to an increase in demand for revision surgeries. Higher numbers of revisional operations are also observed in Poland, yet their safety and efficacy remain controversial because of a lack of current recommendations and guidelines. OBJECTIVE: To review risk factors influencing perioperative morbidity. METHODS: A retrospective study was conducted to analyze the results of surgical treatment among 12 Polish bariatric centers. Inclusion criteria were laparoscopic revisional bariatric surgeries and patients ≥18 years of age. The study included 795 patients, of whom 621 were female; the mean age was 47 years (range: 40-55 years). RESULTS: Perioperative morbidity occurred in 92 patients (11.6%) enrolled in the study, including 76 women (82.6%). The median age was 45 years (range: 39-54 years). Statistically significant risk factors in univariate logistic regression models for perioperative complications were the duration of obesity, revisional surgery after Roux-en-Y gastric bypass (RYGB) or adjustable gastric band (AGB), difference in body mass index before revisional surgery and the lowest achieved after primary surgery, and postoperative morbidity of the primary surgery as the cause for revisional bariatric surgery. These factors were included in the multivariate regression model. Revisional surgery after AGB (odds ratio [OR] = 2.18; 95% confidence interval [CI]: 1.28-3.69; P = .004), revisional surgery performed after RYGB (OR = 6.52; 95% CI: 1.98-21.49; P = .002), and revisions due to complication of the primary surgery (OR = 1.89; 95% CI: 1.06-3.34; P = .030) remained independent risk factors for perioperative morbidity. CONCLUSION: Revisional operations after RYGB or AGB and those performed because of postoperative morbidity after primary surgery as the main cause for revisional surgery were associated with a significantly increased risk of postoperative morbidity.


Asunto(s)
Cirugía Bariátrica , Derivación Gástrica , Laparoscopía , Obesidad Mórbida , Humanos , Femenino , Persona de Mediana Edad , Masculino , Polonia/epidemiología , Obesidad Mórbida/cirugía , Obesidad Mórbida/etiología , Estudios Retrospectivos , Reoperación/métodos , Resultado del Tratamiento , Cirugía Bariátrica/efectos adversos , Cirugía Bariátrica/métodos , Obesidad/cirugía , Derivación Gástrica/efectos adversos , Factores de Riesgo , Morbilidad , Laparoscopía/efectos adversos , Laparoscopía/métodos
10.
Wideochir Inne Tech Maloinwazyjne ; 18(3): 379-400, 2023 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-37868279

RESUMEN

Introduction: Over the past three decades, almost every type of abdominal surgery has been performed and refined using the laparoscopic technique. Surgeons are applying it for more procedures, which not so long ago were performed only in the classical way. The position of laparoscopic surgery is therefore well established, and in many operations it is currently the recommended and dominant method. Aim: The aim of the preparation of these guidelines was to concisely summarize the current knowledge on laparoscopy in acute abdominal diseases for the purposes of the continuous training of surgeons and to create a reference for opinions. Material and methods: The development of these recommendations is based on a review of the available literature from the PubMed, Medline, EMBASE and Cochrane Library databases from 1985 to 2022, with particular emphasis on systematic reviews and clinical recommendations of recognized scientific societies. The recommendations were formulated in a directive form and evaluated by a group of experts using the Delphi method. Results and conclusions: There are 63 recommendations divided into 12 sections: diagnostic laparoscopy, perforated ulcer, acute pancreatitis, incarcerated hernia, acute cholecystitis, acute appendicitis, acute mesenteric ischemia, abdominal trauma, bowel obstruction, diverticulitis, laparoscopy in pregnancy, and postoperative complications requiring emergency surgery. Each recommendation was supported by scientific evidence and supplemented with expert comments. The guidelines were created on the initiative of the Videosurgery Chapter of the Association of Polish Surgeons and are recommended by the national consultant in the field of general surgery. The second part of the guidelines covers sections 6 to12 and the following challenges for surgical practice: acute appendicitis, acute mesenteric ischemia, abdominal injuries, bowel obstruction, diverticulitis, laparoscopy in pregnancy and postoperative complications requiring a reoperation.

11.
Pol Przegl Chir ; 95(4): 1-5, 2023 Feb 17.
Artículo en Inglés | MEDLINE | ID: mdl-36808061

RESUMEN

INTRODUCTION: Correct surgical technique and perioperative care are two factors that can reduce the number of complications, improve treatment outcomes and shorten the length of hospital stay. The introduction of enhanced recovery protocols has changed the approach to patient care in some centers. However, there are significant differences among centers, and in some the standard of care has remained unchanged. AIM: the goal of the panel was to develop recommendations for modern perioperative care in accordance with current medical knowledge in order to reduce the number of complications associated with surgical treatment. An additional goal was to optimize and standardize perioperative care among Polish centers. MATERIALS AND METHODS: the development of these recommendations was based on a review of the available literature from the PubMed, Medline and Cochrane Library databases from January 1, 1985 to March 31, 2022, with particular emphasis on systematic reviews and clinical recommendations of recognized scientific societies. Recommendations were formulated in a directive form and were assessed using the Delphi method. RESULTS AND CONCLUSIONS: 34 recommendations for perioperative care were presented. They cover aspects of pre-, intra- and post-operative care. Implementation of the presented rules allows to improve the results of surgical treatment.


Asunto(s)
Procedimientos Quirúrgicos Electivos , Atención Perioperativa , Humanos , Consenso , Atención Perioperativa/métodos , Complicaciones Posoperatorias , Tiempo de Internación
12.
Wideochir Inne Tech Maloinwazyjne ; 18(2): 187-212, 2023 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-37680734

RESUMEN

Introduction: Over the past three decades, almost every type of abdominal surgery has been performed and refined using the laparoscopic technique. Surgeons are applying it for more procedures, which not so long ago were performed only in the classical way. The position of laparoscopic surgery is therefore well established, and in many operations it is currently the recommended and dominant method. Aim: The aim of the preparation of these guidelines was to concisely summarize the current knowledge on laparoscopy in acute abdominal diseases for the purposes of the continuous training of surgeons and to create a reference for opinions. Material and methods: The development of these recommendations is based on a review of the available literature from the PubMed, Medline, EMBASE and Cochrane Library databases from 1985 to 2022, with particular emphasis on systematic reviews and clinical recommendations of recognized scientific societies. Recommendations were formulated in a directive form and evaluated by a group of experts using the Delphi method. Results and conclusions: There are 63 recommendations divided into 12 sections: diagnostic laparoscopy, perforated ulcer, acute pancreatitis, incarcerated hernia, acute cholecystitis, acute appendicitis, acute mesenteric ischemia, abdominal trauma, bowel obstruction, diverticulitis, laparoscopy in pregnancy, and postoperative complications requiring emergency surgery. Each recommendation was supported by scientific evidence and supplemented with expert comments. The guidelines were created on the initiative of the Videosurgery Chapter of the Association of Polish Surgeons and are recommended by the national consultant in the field of general surgery. The first part of the guidelines covers 5 sections and the following challenges for surgical practice: diagnostic laparoscopy, perforated ulcer, acute pancreatitis, incarcerated hernia and acute cholecystitis. Contraindications for laparoscopy and the ERAS program are discussed.

13.
Pol Przegl Chir ; 95(5): 14-39, 2023 Sep 20.
Artículo en Inglés | MEDLINE | ID: mdl-38084044

RESUMEN

One of the target of perioperative tratment in surgery is decreasing intraoperative bleeding, which increases the number of perioperative procedures, mortality and treatment costs, and also causes the risk of transfusion of blood and its components. Trying to minimize the blood loss(mainly during the operation) as well as the need to transfuse blood and its components (broadly understood perioperative period) should be standard treatment for a patient undergoing a procedure. In the case of this method, the following steps should be taken: 1) in the preoperative period: identyfication of risk groups as quickly as possible, detecting and treating anemia, applying prehabilitation, modyfying anticoagulant treatment, considering donating one's own blood in some patients and in selected cases erythropoietin preparations; 2) in the perioperative period: aim for normothermia, normovolemia and normoglycemia, use of surgical methods that reduce bleeding, such as minimally invasive surgery, high-energy coagulation, local hemostatics, prevention of surgical site infection, proper transfusion of blood and its components if it occurs; 3) in the postoperative period: monitor the condition of patients, primarily for the detection of bleeding, rapid reoperation if required, suplementation (oral administration preferred) nutrition with microelements (iron) and vitamins, updating its general condition. All these activities, comprehensively and in surgical cooperation with the anesthesiologist, should reduce the blood loss and transfusion of blood and its components.


Asunto(s)
Anemia , Hemostáticos , Humanos , Hemorragia , Transfusión Sanguínea/métodos , Procedimientos Quirúrgicos Mínimamente Invasivos/métodos
14.
Front Endocrinol (Lausanne) ; 13: 1011043, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36246875

RESUMEN

The aim of the study was to assess the total antioxidant/oxidant status in the plasma and urine of patients with adrenal tumors. The study group consisted of 60 patients (31 women and 29 men) with adrenal masses, classified into three subgroups: non-functional incidentaloma, pheochromocytoma and Cushing's/Conn's adenoma. The number of patients was set a priori based on our previous experiment (α = 0.05, test power = 0.9). Antioxidant activity (Total Antioxidant Capacity (TAC), Total Oxidant Status (TOS), Oxidative Stress Index (OSI)) and antiradical activity (Radical-Scavenging Activity Assay (DPPH), Ferric-Reducing Antioxidant Power (FRAP)) were measured using colorimetric methods. FRAP level was decreased in plasma and urine incidentaloma (p<0.0001), pheochromocytoma (p<0.0001) and Cushing's/Conn's adenoma (p<0.0001), while DPPH antiradical activity only in plasma of patients with adrenal masses (p<0.0001). Plasma TAC was increased in incidentaloma patients (p=0.0192), whereas in pheochromocytoma group (p=0.0343) was decreased. Plasma and urine TOS (p<0.0001) and OSI (p<0.01) were significantly higher in patients with adrenal tumors. In pheochromocytoma patients, plasma and urine TAC (p=0.001; p=0.002), as well as plasma plasma DPPH (p=0.007) and urine FRAP (p=0.017) correlated positively with normethanephrine. We are the first who showed reduced radical scavenging capacity in the plasma/urine of patients with adrenal masses. Nevertheless, plasma TAC was significantly higher in the incidentaloma group compared to controls. Therefore, plasma and urinary antioxidant and antiradical activities depend on the presence of the tumor. Lower levels of TAC, DPPH and FRAP clearly indicate a reduced ability to scavenge free radicals and thus a lack of effective protection against oxidative stress in patients with adrenal tumors. Both plasma and urine redox biomarkers can be used to assess systemic antioxidant status in adrenal tumor patients.


Asunto(s)
Adenoma , Neoplasias de las Glándulas Suprarrenales , Feocromocitoma , Antioxidantes , Biomarcadores , Femenino , Humanos , Masculino , Oxidantes
16.
Surg Obes Relat Dis ; 18(1): 53-60, 2022 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-34736868

RESUMEN

BACKGROUND: Bariatric surgery has relatively low complication rates, especially severe postoperative complications (defined by Clavien-Dindo classification as types 3 and 4), but these rates cannot be ignored. In other than bariatric surgical disciplines, complications affect not only short-term but also long-term results. In the field of bariatric surgery, this topic has not been extensively studied. OBJECTIVES: The aim of the study was to assess the outcomes of bariatric treatment in patients with obesity and severe postoperative complications in comparison to patients with a noneventful perioperative course. SETTING: Six surgical units at Polish public hospitals. METHODS: We performed a multicenter propensity score matched analysis of 206 patients from 6 Polish surgical units and assessed the outcomes of bariatric procedures. A total of 103 patients with severe postoperative complications (70 laparoscopic sleeve gastrectomy [SG] and 33 with laparoscopic Roux en Y gastric bypass [RYGB]) were compared to 103 patients with no severe complications in terms of peri- and postoperative outcomes. RESULTS: The outcomes of bariatric treatment did not differ between compared groups. Median percentage of total weight loss 12 months after the surgery was 28.8% in the group with complications and 27.9% in patients with no severe complications (P = 0.993). Remission rates of both type 2 diabetes mellitus and arterial hypertension showed no significant difference between SG and RYGB (36% versus 42%, P = 0.927, and 41% versus 46%, P = 0.575. respectively). CONCLUSIONS: The study suggests that severe postoperative complications had no significant influence either on weight loss effects or obesity-related diseases remission.


Asunto(s)
Cirugía Bariátrica , Diabetes Mellitus Tipo 2 , Obesidad Mórbida , Cirugía Bariátrica/efectos adversos , Diabetes Mellitus Tipo 2/cirugía , Gastrectomía/efectos adversos , Gastrectomía/métodos , Derivación Gástrica/efectos adversos , Derivación Gástrica/métodos , Humanos , Obesidad Mórbida/complicaciones , Obesidad Mórbida/cirugía , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/cirugía , Estudios Retrospectivos , Resultado del Tratamiento
17.
Wideochir Inne Tech Maloinwazyjne ; 17(2): 372-379, 2022 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-35707336

RESUMEN

Introduction: Revisional surgery is more technically challenging and associated with increased morbidity and mortality. Nevertheless, the frequency of revisional bariatric surgery (RBS) is increasing. Therefore, investigating this group of patients appears to be currently valid. Aim: The objective of this multicenter study was to collect, systematize and present the available data on RBS after surgical treatment of morbid obesity among Polish patients. Material and methods: This multicenter study included a retrospective analysis of a prospectively maintained database. Outcomes included an analysis of the indications for RBS, the type of surgery most frequently chosen as RBS and the course of the perioperative period of treatment among patients undergoing RBS. Results: The group consisted of 799 patients (624 (78.1%) women, 175 (21.9%) men). The mean age was 38.96 ±9.72 years. Recurrence of obesity was the most common indication for RBS. The most frequently performed RBS procedures were one anastomosis gastric bypass (OAGB) - 294 (36.8%) patients, Roux-en-Y gastric bypass (RYGB) - 289 (36.17%) patients and sleeve gastrectomy (SG) - 172 (21.52%) patients. After primary surgery 63.58% of patients achieved sufficient weight loss, but after RBS only 38.87%. Complications were noted in 222 (27.78%) cases after RBS with GERD being the most common - 117 (14.64%) patients. Conclusions: RBS most often concerns patients after SG. The main indication for RBS is weight regain. OAGB and RYGB were the two most frequently chosen types of RBS. Secondary operations lead to further weight reduction. However, RBS are associated with a significant risk of complications.

18.
Postepy Hig Med Dosw (Online) ; 65: 759-63, 2011 Nov 24.
Artículo en Polaco | MEDLINE | ID: mdl-22173440

RESUMEN

Excessive levels of free fatty acids are toxic to cells. The human body has evolved a defense mechanism in the form of small cytoplasmic proteins called fatty acid binding proteins (FABPs) that bind long-chain fatty acids (LCFA), and then refer them to appropriate intracellular disposal sites (oxidation in mitochondria and peroxisomes or storage in the endoplasmic reticulum). So far, nine types of these proteins have been described, and their name refers to the place in which they were first identified or where they can be found in the greatest concentration. The most important FABPs were isolated from the liver (L-FABP), heart (H-FABP), intestine (I-FABP), brain (B-FABP), epidermis (E-FABP) and adipocytes (A-FABP). Determination of H-FABP is used in the diagnosis of myocardial infarction, and L-FABP in kidney lesions of different etiologies. It is postulated that FABPs play an important role in the pathogenesis of metabolic diseases. Elevated levels of A-FABP have been found in the pericardial fat tissue and were associated with cardiac dysfunction in obese people. A rise in A-FABP has been observed in patients with type II diabetes. I-FABP is known as a marker of cell damage in the small intestine. Increased concentration of B-FABP has been associated with human brain tumors such as glioblastoma and astrocytoma, as well as with neurodegenerative diseases (Alzheimer's, Parkinson's) and other disorders of cognitive function. The aim of this work was to present current data on the clinical significance of fatty acid binding proteins.


Asunto(s)
Proteínas de Unión a Ácidos Grasos/metabolismo , Enfermedades Metabólicas/metabolismo , Mitocondrias/metabolismo , Obesidad/metabolismo , Encéfalo/metabolismo , Humanos , Mucosa Intestinal/metabolismo , Riñón/metabolismo , Hígado/metabolismo , Modelos Biológicos , Miocardio/metabolismo , Obesidad/complicaciones
19.
Postepy Hig Med Dosw (Online) ; 65: 752-8, 2011 Nov 23.
Artículo en Polaco | MEDLINE | ID: mdl-22173439

RESUMEN

There were approximately 93,060 deaths from cancers in Poland in 2008, and about 105,000 are predicted for the year 2025. Early detection of cancer is a major problem throughout the world, which is why many researchers are still looking for specific and sensitive markers of malignant tumors. Our work is a review of recent publications on activity of N-acetyl-ß-D-hexosaminidase (HEX) and its isoenzymes A (HEX A) and B (HEX B) as potential markers of malignant tumors. HEX is the most active of the lysosomal exoglycosidases, taking part in degradation of glycoconjugates (glycoproteins, glycolipids, proteoglycans). HEX cleaves N-acetyl-D-glucosamine and N-acetyl-D-galactosamine from non-reducing ends of oligosaccharide chains of glycoproteins, glycolipids and glycosaminoglycans. The activity of HEX, and its isoenzymes A (HEX A) and B (HEX B), was determined by spectrophotometric and isoelectric focusing methods. There was a statistically significant increase in activity of HEX in tumors of the kidney, pancreas, thyroid, colon, ovary, brain, salivary gland, stomach and larynx, which suggests potential applicability of HEX and its isoenzymes in cancer diagnosis.


Asunto(s)
Hexosaminidasa A/metabolismo , Hexosaminidasa B/metabolismo , Neoplasias/metabolismo , Biomarcadores de Tumor/metabolismo , Glucolípidos/metabolismo , Glicoproteínas/metabolismo , Glicosaminoglicanos/metabolismo , Humanos , Isoenzimas/metabolismo , Polonia
20.
Free Radic Biol Med ; 175: 108-120, 2021 11 01.
Artículo en Inglés | MEDLINE | ID: mdl-34390781

RESUMEN

Obesity is a chronic disease of complex etiology. Recent evidence suggests that obesity is caused by inflammation of adipose tissue leading to metabolic disorders, cardiovascular disease and cancer. This is the first study to evaluated the effects of age and gender on redox homeostasis, glutathione metabolism, and oxidative damage to plasma/serum lipids and proteins in morbidly obese patients. The study included 120 (60 men and 60 women) morbidly obese patients with class 3 obesity (BMI > 40 kg/m2), classified into three groups depending on age: 20-39 years (n = 20), 40-59 years (n = 20) and 60 years or older (n = 20). The number of patients was calculated a priori based on our previous experiment. We observed a reduction in serum activity of antioxidant enzymes (↓SOD) and plasma concentration of non-enzymatic antioxidants (↓GSH) in obese patients compared to the lean controls, which further decreased with age. Redox status (↑TAC, ↑TOS and ↓OSI) in morbidly obese men and women was shifted towards oxidation. Moreover, lipid (↑MDA and ↑LOOH) and protein (↑AOPP, ↑AGE and ↑Amadori products) damage products of oxidation and nitrosylation/nitration (↑total NO, ↑S-nitrosothiols, ↑peroxynitrite and ↑nitrotyrosine) were elevated in both genders of morbidly obese patients and were higher in the elderly. Interestingly, the concentrations of oxidative and nitrosative stress markers were generally higher in obese men compared to obese women at the same age. Summarizing, we showed that the total antioxidant/oxidant potential of obese patients is significantly increased and shifted towards oxidation. Obese patients have increased lipid and protein oxidation, glycation and nitration as compared to the lean controls. Disturbances in redox homeostasis increase with age in obese patients. Oxidative and nitrosative stress are more intense in men than in women at the same age.


Asunto(s)
Obesidad Mórbida , Adulto , Anciano , Femenino , Homeostasis , Humanos , Masculino , Estrés Nitrosativo , Oxidación-Reducción , Estrés Oxidativo , Adulto Joven
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