How reliable is pre-sleeve endoscopy to characterize pathological features?

BACKGROUND: Vertical sleeve gastrectomy is a relatively new bariatric procedure with lower morbidity and mortality than other weight loss surgeries. The predictive values of preoperative esophagogastroduodenoscopy for detecting histopathological abnormalities prior to sleeve gastrectomy have not been clearly described. This study aimed to determine the negative predictive value of preoperative endoscopic biopsies for detecting Helicobacter pylori (H. pylori) infection and other pathological findings. METHODS: This cross-sectional study examined 102 patients who underwent vertical sleeve gastrectomy from January 2023 to November 2023. Preoperative histopathology of esophagogastroduodenoscopy specimens was compared to postoperative ones for H. pylori infection, gastritis, atrophy, and metaplasia. Moreover, gastroesophageal reflux disease symptoms were postoperatively followed for 6 months. RESULTS: The negative predictive value of preoperative esophagogastroduodenoscopy for detecting H. pylori infection, gastritis, metaplasia and atrophy were 95 %, 79 %, 93 %, and 98 %, respectively. In an overall view, for all pathologies, the negative predictive value was 53.4 %. Moderate gastritis and focal metaplasia were significantly underdiagnosed preoperatively (p < 0.001). H. pylori infection and focal metaplasia were significantly more prevalent in females after surgery (p < 0.001). H. pylori infection and gastritis were positively correlated with increased postoperative gastroesophageal reflux disease symptoms (p < 0.001). CONCLUSION: Preoperative endoscopy has a high negative predictive value for detecting H. pylori infection, atrophy, and metaplasia but has suboptimal values for gastritis.

Predictors of Weight Regain and Insufficient Weight Loss According to Different Definitions After Sleeve Gastrectomy: a Retrospective Analytical Study.

BACKGROUND: Weight regain (WR) and insufficient weight loss (IWL) after sleeve gastrectomy (SG) are challenging issues. This study aimed to evaluate the predictors of WR and IWL after SG. METHODS: In this retrospective analytical study, 568 patients who underwent SG at Hazrat-e Rasool General Hospital, Tehran, Iran, between January 2015 and April 2022 were evaluated. A total of 333 patients were included. WR and IWL were evaluated by multiple criteria such as a BMI of > 35 kg/m2, an increase in BMI of > 5 kg/m2 above nadir, an increase in weight of > 10 kg above nadir, percentage of excess weight loss (%EWL) < 50% at 18 months, an increase in weight of > 25% of EWL from nadir at 36 months, and percentage of total weight loss (%TWL) < 20% at 36 months. All participants were followed up for 36 months. RESULT: The univariate analysis showed that preoperative BMI, obstructive sleep apnea, metformin consumption, and grades 2 and 3 fatty liver disease were associated with WR and IWL (P < 0.05). WR or IWL incidence varied (0-19.3%) based on different definitions. The multivariate analysis showed that a preoperative BMI of > 45 kg/m2 [odds ratioAdjusted (ORAdj) 1.77, 95% CI: 1.12-4.11, P = 0.038] and metformin consumption [ORAdj: 0.48, 95% CI: 0.19-0.78, P = 0.001] were associated with WR and IWL after SG, regardless of the definition of WR or IWL. CONCLUSION: This study showed that preoperative BMI of > 45 kg/m2, obstructive sleep apnea, metformin consumption, and grades 2 and 3 of fatty liver disease were associated with WR or IWL.

Remotely detected aboveground plant function predicts belowground processes in two prairie diversity experiments.

Imaging spectroscopy provides the opportunity to incorporate leaf and canopy optical data into ecological studies, but the extent to which remote sensing of vegetation can enhance the study of belowground processes is not well understood. In terrestrial systems, aboveground and belowground vegetation quantity and quality are coupled, and both influence belowground microbial processes and nutrient cycling. We hypothesized that ecosystem productivity, and the chemical, structural and phylogenetic-functional composition of plant communities would be detectable with remote sensing and could be used to predict belowground plant and soil processes in two grassland biodiversity experiments: the BioDIV experiment at Cedar Creek Ecosystem Science Reserve in Minnesota and the Wood River Nature Conservancy experiment in Nebraska. We tested whether aboveground vegetation chemistry and productivity, as detected from airborne sensors, predict soil properties, microbial processes and community composition. Imaging spectroscopy data were used to map aboveground biomass, green vegetation cover, functional traits and phylogenetic-functional community composition of vegetation. We examined the relationships between the image-derived variables and soil carbon and nitrogen concentration, microbial community composition, biomass and extracellular enzyme activity, and soil processes, including net nitrogen mineralization. In the BioDIV experiment-which has low overall diversity and productivity despite high variation in each-belowground processes were driven mainly by variation in the amount of organic matter inputs to soils. As a consequence, soil respiration, microbial biomass and enzyme activity, and fungal and bacterial composition and diversity were significantly predicted by remotely sensed vegetation cover and biomass. In contrast, at Wood River-where plant diversity and productivity were consistently higher-belowground processes were driven mainly by variation in the quality of aboveground inputs to soils. Consequently, remotely sensed functional, chemical and phylogenetic composition of vegetation predicted belowground extracellular enzyme activity, microbial biomass, and net nitrogen mineralization rates but aboveground biomass (or cover) did not. The contrasting associations between the quantity (productivity) and quality (composition) of aboveground inputs with belowground soil attributes provide a basis for using imaging spectroscopy to understand belowground processes across productivity gradients in grassland systems. However, a mechanistic understanding of how above and belowground components interact among different ecosystems remains critical to extending these results broadly.

The effects of neck, core, and combined stabilization practices on pain, disability, and improvement of the neck range of motion in elderly with chronic non-specific neck pain.

BACKGROUND: Chronic non-specific neck pain is the most prevalent neck pain with notable impacts on the quality of life in the elderly. OBJECTIVE: The impacts of the neck, core, and combined stabilization practices on pain, disability, and improvement of the neck range of motion in the elderly with chronic non-specific neck pain were examined. METHOD: A quasi-experimental (open label) study was carried out through a cluster sampling in two phases in Tehran-Iran in 2017. Totally, 102 patients were randomly allocated to three groups of specific neck stabilization, specific core stabilization, and combined practices through envelope method. The intervention took 12 weeks. To measure the severity of pain and neck disability, the visual analog scale (VAS), neck disability index (NDI), and neck pain and disability scale (NPDS) was used. A goniometer was used to measure the range of the motion. To examine data, used SPSS (v.20). RESULT: The results, confirmed a significant decrease in pain over the time in the three therapeutic groups (p = 0.000). In addition, there was a significant difference between neck, core, and combined stabilization groups. Moreover, there was a significant increase in the angle of motion in all treatment groups with different treatment duration (P = 0.000). The highest increase in the angle of motion was after 12 weeks of practice in right lateral flexion (RLF) (p = 0.000). CONCLUSION: Twelve sessions of the neck, core, and combined stabilization practices can alleviate the pain and improve the strength in the elderly with chronic non-specific neck pain. In addition, compared to two other methods, the combined method was a more efficient way to improve the range of motion in patients.

Coupling spectral and resource-use complementarity in experimental grassland and forest communities.

Reflectance spectra provide integrative measures of plant phenotypes by capturing chemical, morphological, anatomical and architectural trait information. Here, we investigate the linkages between plant spectral variation, and spectral and resource-use complementarity that contribute to ecosystem productivity. In both a forest and prairie grassland diversity experiment, we delineated n-dimensional hypervolumes using wavelength bands of reflectance spectra to test the association between the spectral space occupied by individual plants and their growth, as well as between the spectral space occupied by plant communities and ecosystem productivity. We show that the spectral space occupied by individuals increased with their growth, and the spectral space occupied by plant communities increased with ecosystem productivity. Furthermore, ecosystem productivity was better explained by inter-individual spectral complementarity than by the large spectral space occupied by productive individuals. Our results indicate that spectral hypervolumes of plants can reflect ecological strategies that shape community composition and ecosystem function, and that spectral complementarity can reveal resource-use complementarity.

Percutaneous extraction of big kidney stone without fragmentation: The novel technique in percutaneous nephrolithotomy (EN BLOC PCNL).

PCNL is gold standard treatment of pelvis stone more than 2 cm. Since 1970 that PCNL was introduced, multiple methods including mini PCNL, Lap assisted PCNL etc. were used to increase the efficacy and decrease the complications of PCNL in different patients. We describe a new method of PCNL for the first time for extracting 7 cm renal stone without fragmentation, and we called it EN BLOC PCNL. Our technique had no complication and caused lower operative time.

Case report: Removal of a big sewing needle from a boy's urethra from the skin for the first time.

Self-insertion of foreign bodies into the urethra is uncommon urologic emergency which is rarely reported in children. Based on the size and the location of the foreign body, different methods have been introduced for its removal. We removed a big sewing needle from the urethra through the skin without any complication for the first time.

Multi-temporal assessment of grassland α- and ß-diversity using hyperspectral imaging.

While more and more studies are exploring the application of remote sensing in assessing biodiversity for different ecosystems, most consider biodiversity at one point in time. Using several remote-sensing-based metrics, we asked how well remote sensing can detect biodiversity (both α- and ß-diversity) in a prairie grassland across time using airborne hyperspectral data collected in two successive years (2017 and 2018) and at different periods in the growing season (2018). The ability to detect biodiversity using "spectral diversity" and "spectral species" types indeed varied significantly over a 2-yr timespan. Toward the end of the growing season in 2018, the relationship between field- and remote-sensing-based α- and ß-diversity weakened compared to data collected from the same season in the previous year. This contrasting pattern between the two years was likely influenced by prescribed fire, altered weather, and the resulting shifting species composition and phenology. These findings indicate that direct detection of α- and ß-diversity in grasslands should be multi-temporal when possible and should consider the effect of disturbances, climate variables, and phenology. We demonstrate an essential role for airborne platforms in developing a global biodiversity monitoring system involving forthcoming space-borne hyperspectral sensors.

Comparison of three cost effective staining methods for detection of Pneumocystis jirovecii.

Pneumocystis pneumonia due to Pneumocystis jirovecii infection is an emerging health problem not only for HIV-infected patients but also for other immunocompromised patients in many countries. We compared Gomori methenamine silver (GMS), Toluidine Blue O (TBO) and Giemsa staining methods using standard procedures. The sensitivity and specificity of GMS were 100 %. The sensitivity and specificity of TBO were 96 and 100 %, respectively. The sensitivity and specificity of Giemsa stain were 84 and 90 %, respectively. Only GMS had positive and negative predictive values of 100 % while PPV and NPV for TBO were 100 and 90.9 %, and for Giemsa stain were 95.4 and 69.2 %, respectively. Therefore, our results suggest that if TBO or Geimsa stains are used as the primary staining methods in a clinical laboratory, then confirmation with a GMS staining method should be performed to increase the sensitivity and specificity of the final test result.