Weight Regain after Metabolic Surgery: Beyond the Surgical Failure.

Patients undergoing metabolic surgery have factors ranging from anatomo-surgical, endocrine metabolic, eating patterns and physical activity, mental health and psychological factors. Some of the latter can explain the possible pathophysiological neuroendocrine, metabolic, and adaptive mechanisms that cause the high prevalence of weight regain in postbariatric patients. Even metabolic surgery has proven to be effective in reducing excess weight in patients with obesity; some of them regain weight after this intervention. In this vein, several studies have been conducted to search factors and mechanisms involved in weight regain, to stablish strategies to manage this complication by combining metabolic surgery with either lifestyle changes, behavioral therapies, pharmacotherapy, endoscopic interventions, or finally, surgical revision. The aim of this revision is to describe certain aspects and mechanisms behind weight regain after metabolic surgery, along with preventive and therapeutic strategies for this complication.

Intrinsic and environmental basis of aging: A narrative review.

Longevity has been a topic of interest since the beginnings of humanity, yet its aetiology and precise mechanisms remain to be elucidated. Aging is currently viewed as a physiological phenomenon characterized by the gradual degeneration of organic physiology and morphology due to the passage of time where both external and internal stimuli intervene. The influence of intrinsic factors, such as progressive telomere shortening, genome instability due to mutation buildup, the direct or indirect actions of age-related genes, and marked changes in epigenetic, metabolic, and mitochondrial patterns constitute a big part of its underlying endogenous mechanisms. On the other hand, several psychosocial and demographic factors, such as diet, physical activity, smoking, and drinking habits, may have an even more significant impact on shaping the aging process. Consequentially, implementing dietary and exercise patterns has been proposed as the most viable alternative strategy for attenuating the most typical degenerative aging changes, thus increasing the likelihood of prolonging lifespan and achieving successful aging.

Metabolic Adverse Effects of Psychotropic Drug Therapy: A Systematic Review.

This review aimed to investigate the metabolic alterations associated with psychopharmacological treatment of neuropsychiatric disorders, which can significantly impact patients' physical health and overall quality of life. The study utilized the PRISMA methodology and included cross-sectional, retrospective studies, and randomized clinical trials from reputable databases like SCOPUS, CLARIVATE, SCIENCE DIRECT, and PUBMED. Out of the 64 selected studies, various psychotropic drug classes were analyzed, including antidepressants, anticonvulsants, and antipsychotics. Among the antidepressants, such as amitriptyline, Imipramine, and clomipramine, weight gain, constipation, and cardiovascular effects were the most commonly reported metabolic adverse effects. SSRI antidepressants like Fluoxetine, Sertraline, Citalopram, Escitalopram, and Paroxetine exhibited a high prevalence of gastrointestinal and cardiac alterations. Regarding anticonvulsants, valproic acid and Fosphenytoin were associated with adverse reactions such as weight gain and disturbances in appetite and sleep patterns. As for antipsychotics, drugs like Clozapine, Olanzapine, and Risperidone were linked to weight gain, diabetes, and deterioration of the lipid profile. The findings of this review emphasize the importance of continuous monitoring for adverse effects, particularly considering that the metabolic changes caused by psychopharmacological medications may vary depending on the age of the patients. Future research should focus on conducting field studies to further expand knowledge on the metabolic effects of other commonly prescribed psychotropic drugs. Overall, the study highlights the significance of understanding and managing metabolic alterations induced by psychopharmacological treatment to enhance patient care and well-being.

NHANES 2011-2014 Reveals Decreased Cognitive Performance in U.S. Older Adults with Metabolic Syndrome Combinations.

A relationship between metabolic syndrome and cognitive impairment has been evidenced across research; however, conflicting results have been observed. A cross-sectional study was conducted on 3179 adults older than 60 from the 2011-2014 National Health and Nutrition Examination Survey (NHANES) to analyze the relationship between metabolic syndrome and cognitive impairment. In our results, we found that adults with abdominal obesity, high triglycerides, and low HDL cholesterol had 4.39 fewer points in the CERAD immediate recall test than adults without any metabolic syndrome factors [Beta = -4.39, SE = 1.32, 17.75 (1.36) vs. 22.14 (0.76)]. In addition, people with this metabolic syndrome combination exhibited 2.39 fewer points in the CERAD delayed recall test than those without metabolic syndrome criteria [Beta = -2.39, SE = 0.46, 4.32 (0.49) vs. 6.71 (0.30)]. It was also found that persons with high blood pressure, hyperglycemia, and low HDL-cholesterol levels reached 4.11 points less in the animal fluency test than people with no factors [Beta = -4.11, SE = 1.55, 12.67 (2.12) vs. 16.79 (1.35)]. These findings suggest that specific metabolic syndrome combinations are essential predictors of cognitive impairment. In this study, metabolic syndrome combinations that included obesity, fasting hyperglycemia, high triglycerides, and low HDL-cholesterol were among the most frequent criteria observed.

Linfoma no hodgkin de células B precursoras primario óseo multifocal / Non-Hodgkin B-cell precursor multifocal primary bone

Paciente mujer de 9 años natural de Huaura y procedente de Huacho, referida del Instituto de Salud del Niño con tiempo de enfermedadde 1 año y 6 meses (enero 2006), caracterizado por dolor en pierna izquierda que se intensifica con el transcurrir de los meses asociado a claudicación progresiva y fiebre, tratada en centro de salud con analgésicos, posteriormente en Hospital Regional de Huacho, con diagnóstico de artritis reumatoide juvenil y recibió tratamiento con antiinflamatorios no esteroideos y metotrexate. En abril del 2007 presentó intenso dolor en miembro inferior derecho, acudió al Hospital Regional de Huacho, le tomaron radiografía que mostró fractura patológica, le colocaron bota de yeso y la trasladaron al Instituto de Salud del Niño, quienes evidenciaron tumoración en pierna izquierda y fue transferida al INEN por consulta externa de ortopedia y traumatología oncológica el 1 de junio del 2007. En el examen físico de ingreso al INEN se encontraba adelgazada, con férula de yeso tipo bota corta a nivel de la pierna derecha, hipotrofia muscular cuadricipital marcada. La pierna izquierda con desviación en varo de la tibia proximal palpándose tumoración dependiente de planos óseos mal definida, de superficie lisa y dolorosade 8 cm de diámetro. Exámenes de la boratorio muestran Hb12.5g por ciento, DHL (564 U/L). Las radiografías de pierna derecha e izquierda demuestran lesiones que comprometen ladiáfisis y la metáfisis proximal de la tibiaderecha e izquierda. Survey óseo: con lesiones osteolíticas que destruyen el cuello femoraly TAC extremidades con severa infiltración ósea en ambas tibias sin compromiso de las estructuras vasculares. Las radiografía detórax y ecografía abdómino pélvica fueron normales. El mielograma bilateral no evidencia infiltración de células neoplásicas y la citometría de flujo no detecta proliferaciones clonales primarias o secundarias. El informe anátomo patológico de la biopsia incisional de la tibia izquierda fue: Linfoma ....