A decade of bariatric surgery. What have we learned? Outcome in 520 patients from a single institution.

BACKGROUND: Today a variety of bariatric surgical procedures is available and, currently, it is difficult to identify the most effective option based on patient characteristics and comorbidities. Aim of this retrospective study is to evaluate the efficacy of four different techniques; Intragastric Balloon (IB), Laparoscopic Adjustable Gastric Banding (LAGB), Laparoscopic Sleeve Gastrectomy (LSG) and Laparoscopic Mini Gastric Bypass (LMGB), performed in our unit along ten years. PATIENTS AND METHODS: Starting from January 2005, 520 patients, 206 men (39.6%) and 314 women (60.4%) were treated at our institution. Among patients candidate to bariatric surgery 145 underwent IB, 120 underwent LAGB, 175 underwent LSG and 80 underwent LMGB. Follow up rate was 93.1% for IB at 6 months; 74.1% and 48% for LAGB at 36 and 60 months respectively; 72.8% and 58.1% for LSG at 36 and 60 months respectively; and 84.2% for LMGB at 36 months. RESULTS: The period 2005-2014 has been considered. Mortality was 1/520 patients (0.19%). The excess weight loss rate (EWL%) has been 32.8 for IB at six months, 53.7 for LAGB and 68.1 for LSG, at 60 months respectively and 79.5 for LMGB at 36 months. Early major postoperative complications requiring surgery were 0.6% for IB and 1.1% for LSG whereas late major postoperative complications were 1.2% for IB, 4.1% for LAGB and 0.5% for LSG. Diabetes resolution rate was 0 for LAGB, 76.9% for LSG and 80% for LMGB at 36 months. CONCLUSIONS: If more invasive procedures as LSG or LMGB may entail higher operative and peroperative risks, conversely, in skilled hands their efficacy remains undisputed, especially in the long term, presenting a very low rate of major complications. In general, the efficacy of a bariatric surgery unit seems improved by the capability to offer both different primary procedures and re-do surgery.

An early onset of acute renal failure in a young woman with obesity and infertility who underwent gastric balloon positioning. A case report.

INTRODUCTION: Although intragastric balloons have been in use for several years to achieve weight reduction in obese patients, acute renal failure after gastric balloon positioning is reported in few studies CASE REPORT: A 32-year-old white infertile woman undergone Bioenterics Intragastric Balloon (BIB) positioning in an attempt to weight loss and improve her fertility status. After only six days of persisting vomiting acute renal failure was found. A complete recovery of renal function was obtained after 14 days. CONCLUSION: Acute renal failure was due to persistent vomiting leading to dehydration. Physicians involved in BIB patients management must consider the possibility of major complications in all hyperemetic subjects. BIB removal, with a concomitant intravenous fluid replacement and minerals or vitamins supplementation has to be taken into account as an emergency procedure.

Influence of the breeding system on the escape response of red-legged partridges (Alectoris rufa).

This study aimed to determine the influence of the breeding system on the escape response of red-legged partridges comparing 147 free-born partridges captured in the wild (W) and 164 partridges from a commercial hunting farm with an intensive production system (F). All birds were individually released to the natural environment using wooden cages; the escape response was recorded with a high resolution video camera and 4 behavior parameters were analyzed: reaction time or latency, escape type, angle at the moment of flight start, and distance flown. There were significant differences on the mean reaction time depending on the origin of the partridges: 0.43 s, with a maximum of 9 s, for the W and 52.90 s, with a maximum of 120 s, in 32.3% of the F birds. Only one of the W partridges (0.68%) escaped by walking, whereas all the other W birds, and 69.5% of the F partridges, flew; the differences in the type of escape reaction between origins were significant. Considering the angle of flight start, the differences were also significant because 98.6% of W partridges showed less than 45 degrees angles, whereas 37.7% of F birds showed angles of more than 45 degrees. Thus, we can conclude that the breeding system has a great influence on the escape response of the red-legged partridges. The intensive management production systems used on the commercial game farms produced obvious changes in the escape reaction of the red-legged partridges, and this could explain the low ability of these birds to integrate and to survive in the wild due to the high predation pressure they undergo when they are used in repopulation processes.

Inversion of sucrose by immobilized beta-fructooxidase in an integral reactor.

Experimental runs on the inversion of sucrose by means of immobilized beta-fructooxidase are reported. External mass-transfer and axial dispersion phenomena have been analyzed. It has been observed that external mass-transfer plays a significative role in the overall kinetics, while axial dispersion phenomena are negligible.

Diffusional limitations in liquid-phase reactions catalyzed by enzymes immobilized on porous supports: sucrose inversion by beta-fructooxidase immobilized on IRA-93 resin.

An experimental procedure has been proposed to study liquid-phase reactions catalyzed by enzymes immobilized on porous supports. The kinetic behavior can be assessed by experimental runs which allow a separate evaluation of the internal diffusion, the surface kinetics, and the fluid-particle mass transfer. The method has been applied in the study of sucrose inversion by beta-fructooxidase immobilized on IRA-93 resin.