Hair Loss After Laparoscopic Sleeve Gastrectomy.

AIM: The aim of this study was to evaluate the prevalence of hair loss after laparoscopic sleeve gastrectomy (LSG). The effects of variables on the likelihood that patients developed hair loss were also examined. MATERIAL AND METHODS: Fifty patients who underwent LSG were enrolled in this prospective study. Demographics, hematocrit, iron, zinc, folic acid, vitamin B12, total proteins, and albumin were evaluated preoperatively and 6 months postoperatively. RESULTS: Hair loss was observed in 56% of patients and particularly in 46% in females and in 10% in males. Analysis of variance indicated statistical differences for hair loss among the groups with and without hair loss concerning preoperative zinc (p < 0.001), postoperative zinc (p < 0.001), preoperative B12 (p < 0.001), postoperative B12 (p < 0.001), postoperative folic acid (p = 0.039), and postoperative use of supplements (p < 0.001). Patients with hair loss had lower values of zinc preoperatively and postoperatively compared to patients without hair loss (0.61 vs 0.81 mcg/ml) (0.46 vs 0.73 mcg/ml) and also lower values of vitamin B12 preoperatively and postoperatively compared to patients without hair loss (243.04 vs 337.41 pg/ml) (261.54 vs 325.68 pg/ml). Interestingly, the zinc levels were normal preoperatively and lower to normal levels postoperatively and the levels of vitamin B12 were lower than normal values preoperatively in patients with hair loss. Patients with hair loss had mean lower levels of postoperative folic acid of 8 ng/ml. CONCLUSION: The prevalence of hair loss was 56% 6 months after LSG. Preoperative monitoring and counseling of these micronutrients may be a preventive and therapeutic measure.

Current knowledge and perception of bariatric surgery among Greek doctors living in Thessaly.

INTRODUCTION: The purpose of this study was to assess doctors' knowledge, current conceptions, and clinical practice regarding obesity and bariatric surgery. METHODS: A self-administered survey was administered to 500 doctors with varying medical specialties in public and private practice. RESULTS: The response rate was 60%. Most participants (77.3%) were in private practice. Although almost half of the participants could define morbid obesity and obesity-related comorbidities, only 8.7% felt educated about bariatric surgery. Participants had little knowledge of various types of bariatric procedures. A minority of doctors (24.7%) knew of the existence of a bariatric center in their area. Only 21.3% of doctors had referred a patient to a bariatric center. Reasons for non-referral included lack of interest in bariatric surgery (37.3%), patient refusal (35.3%), increased operative fees (17.3%), lack of confidence in bariatric surgery (6.3%), and lack of access to a nearby bariatric center (3.7%). The majority of doctors were interested in learning more about bariatric surgery and related guidelines, but they remained reluctant to conduct patients' postoperative follow-ups. CONCLUSION: The penetration of bariatric surgery in the medical community remains limited, despite its proven effectiveness in facilitating sustained weight loss and resolving several obesity-related comorbidities. A great effort should be made to inform health-care providers about the evolution of bariatric procedures, the potential benefits they offer, and the existence of certified bariatric centers. This will allow doctors to provide optimum health care to patients who could benefit from bariatric surgery.

Ursodeoxycholic Acid in the Prevention of Gallstone Formation After Bariatric Surgery: an Updated Systematic Review and Meta-analysis.

We aim to review the available literature on obese patients treated with ursodeoxycholic acid (UDCA) in order to prevent gallstone formation after bariatric surgery. A systematic literature search was performed in PubMed, Cochrane library, and Scopus databases, in accordance with the PRISMA guidelines. Eight studies met the inclusion criteria incorporating 1355 patients. Random-effects meta-analysis showed a lower incidence of gallstone formation in patients taking UDCA. Subgroup analysis reported fewer cases of gallstone disease in the UDCA group in relation to different bariatric procedures, doses of administered UDCA, and time from bariatric surgery. Adverse events were similar in both groups. Fewer patients required cholecystectomy in UDCA group. No deaths were reported. The administration of UDCA after bariatric surgery seems to prevent gallstone formation.

Impact of Bariatric Surgery on Metabolic and Gut Microbiota Profile: a Systematic Review and Meta-analysis.

We aim to review the available literature on obese patients treated with bariatric procedures, in order to assess their effect on the metabolic and gut microbiota profiles. A systematic literature search was performed in PubMed, Cochrane library, and Scopus databases, in accordance with the PRISMA guidelines. Twenty-two studies (562 patients) met the inclusion criteria. This study points to significant amelioration of postoperative levels of glucose, insulin, triglycerides, total cholesterol, LDL, HDL, HOMA-IR, food intake, and diabetes remission. Branched-chain amino acids (BCAAs) decreased, while trimethylamine-n-oxide (TMAO); glucagon-like peptide 1, 2 (GLP-1, GLP-2); and peptide YY (PYY) increased postoperatively. Postoperative gut microbiota was similar to that of lean and less obese objects. Well-designed randomized trials are necessary to further assess the host metabolic-microbial cross-talk after bariatric procedures.