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Extracellular vesicles via Paracoccidioides pathogenic species transfer polysaccharide along with reveal ligands pertaining to DC-SIGN receptors.
Purpose In the management of bariatric surgery follow-up, a multidisciplinary approach allows to evaluate the weight loss maintenance and the dietary and lifestyle changes adherence. The main aim of this study is to create and to validate a questionnaire (eating behavior after bariatric surgery (EBBS)) to objectivize the compliance to dietary/lifestyle suggestions after bariatric surgery. Materials and methods An observational retrospective monocentric clinical trial was carried out at the Bariatric Surgery Unit of Modena, Italy. All weight-related data of bariatric surgery patients collected during the multidisciplinary post-surgical path were recorded. EBBS questionnaire and three validated psychological tests were administered. EBBS includes 11 questions concerning food (domain A), drinks (B), behaviors (C), and lifestyle (S). All data analyzed in the study were collected during the same visit. Results In 41 enrolled patients (52.2 + 11.9 years), the total weight loss after surgery was 44.87 + 18.37 kg (- 35.40 + 11.60%), with a weight loss maintenance of 86.92 + 14.30%. The EBBS questionnaire showed a good internal validity (Cronbach's alpha 0.743, Hotelling's T-square test p less then 0.001). The S domain was directly related with the percentage of weight loss maintained (p = 0.048), suggesting that the frequent physical activity and the periodic weight self-check are the most predictive behaviors to obtain weight control. None of the psychological questionnaires appeared related to the weight trend. Conclusions We validated for the first time a 11-item self-filling questionnaire allowing to quantify the adaption to dietary/lifestyle suggestions provided after bariatric surgery. EBBS questionnaire could be a useful tool both in clinical and research setting to monitor the patient's adherence to post-surgical indications and to identify predictive factors for bariatric surgery efficacy.Purpose Report the analysis from a single center series of consecutive primary sleeve gastrectomy (SG) on the factors affecting weight loss at long term. Materials and methods Patients submitted to primary SG with a follow-up of 7 years were screened. Weight loss was evaluated with %excess weight loss (%EWL) and %excess BMI loss (%BMIL). Weight regain (WR) was defined as in increase of 25% of the obtained %EWL and insufficient weight loss (IWL) as loss less then 50% EWL. Eating behaviors were evaluated with 7 days record (7dR). All the variables potentially affecting the weight loss were cross-matched for correlation. The study population was divided in three groups group A (WR), group B (IWL), and group C (sustained weight loss) for comparative analysis. selleck Results A total of 86 patients (21 M/65 F) with a preoperative BMI of 47.08 ± 6.15 kg/m2 were evaluated. Cumulative 7 years weight loss was as follows 61.66 ± 22.69% EWL and 32 ± 9% EBMIL. A total of 4.6% had an IWL while 27.9% a WR. The analysis showed a significant difference among the daily calories and fats consuming, number of meals, physical activity, grazing/sweet eating habits, and adherence to follow-up (p less then 0.05) between groups A and C. Cox hazard demonstrated a significant risk (p less then 0.05) to WR in case of adherence to follow-up shorter than 48 months, high daily calories, and fats intake (hazard ratio (HR) range 5-9). Eight patients (9.3%) had a surgical revision. Conclusion Our data demonstrated that long-term results (7 years) of SG are strongly related to eating habits and patient's behaviors.Purpose Distinct anatomical rearrangements of the gastrointestinal tract achieved by various types of bariatric surgery cause changes in nutrient intake and gut microbiota. The contribution of such gut microbiota changes to remission of type 2 diabetes (T2D) remains unclear. Aim We examined gut microbiota changes following banded Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG) in a randomised study, in relation to T2D remission. Materials and methods Whole-metagenome shotgun sequencing was carried out on paired stool samples at pre- and 1-year post-surgery collected from 44 participants with T2D randomised to banded Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG). Taxonomic composition and predicted functional potential of the gut bacteria were identified using HUMANn2, and annotated using MetaCyc. Five-day dietary records (analysed using FoodWorks v8.0), body weight and diabetes status were recorded at both time points. Results RYGB participants had higher percentage excess weight loss than SG (p = 0.01), even though dietary intake was similar at 1-year post-surgery. Similar proportions achieved diabetes remission (HbA1c less then 48 mmol/mol without medications) after either RYGB (68%) or SG (59%). RYGB resulted in increased abundances of Firmicutes and Proteobacteria, while SG resulted in increased Bacteroidetes. Pre-surgery, an increased abundance of Eubacteriaceae (p = 0.01) and Alistipes putredinis (p = 0.01) was observed in those who went on to remit from T2D post-surgery. Following surgery, Lachnospiraceae (p = 0.04) and Roseburia (p = 0.01) species were more abundant in those who had achieved T2D remission. Conclusions Specific stool bacterial taxa may signal likelihood of T2D remission after bariatric surgery which is potentially mediated by increases in Lachnospiraceae and Roseburia.Purpose Obstructive sleep apnea syndrome is a clinical sleep disorder defined by total or partial airflow restraint during sleep that results in fragmented sleep and hypoxemia, impacting negatively with cognitive functioning. This review was conducted on studies investigating structural brain alteration and cognitive impairment in obstructive sleep apnea syndrome. Method We searched on PubMed databases and screening references of included studies and review articles for additional citations. From initial 190 publications, only 17 met search criteria and described the cognitive impairment in obstructive sleep apnea syndrome. Results Findings showed that patients with this syndrome had worse performance than healthy controls in attention, memory, and executive functions, showing specific neuroanathomical features. Cognitive impairment is also related to the severity of pathology. Treatment could improve certain cognitive aspects. Conclusions Cognitive deficits seem to be mainly attributable to decreased daytime vigilance and nocturnal hypoxemia.
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