Acute Cerebellitis and Myeloradiculitis Associated With SARS-CoV-2 Infection in Common Variable Immunodeficiency-A Case Report.

The role of the adaptive immune system in mediating COVID-19 is largely unknown. Therefore, it is difficult to predict the clinical course in patients with common variable immunodeficiency (CVID), a disease characterized by dysfunctional lymphocytes and impaired antibody production. We report a case of SARS-CoV-2 infection presenting as isolated neurological symptoms in a patient with CVID. The patient subsequently improved following steroids, intravenous immunoglobulin, and convalescent plasma (CP). The latter has been shown to be safe and efficacious in treating COVID-19 in patients with primary immunodeficiency. Recent data suggest that the mechanism of CNS injury in COVID-19 may be due to immunological dysregulation rather than direct viral-mediated injury. This case exemplifies the complex interaction between the brain, the immune system, and the SARS-CoV-2 virus.

Safety of one-stage conversion surgery after failed gastric band: our experience and review of the literature.

The laparoscopic adjustable gastric band (AGB) has fallen out of favor due to poor long-term weight loss and frequent complications. Many patients stand to benefit from elective conversion of AGB to more durable procedures such as sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB). Whether it is safer to perform this conversion in one or two stages, however, remains controversial. We performed an IRB-approved review of prospectively collected data from all one-stage band conversions performed at our institution from January 2012 to December 2017. Patients were separated into two groups: those who underwent conversion to either a RYGB or SG. Demographics, indications, and outcomes of each group were compared using Fisher's exact test, Mann-Whitney rank sums, and chi-squared tests. Outcomes were recorded within a 1-year follow-up period and compared to published outcomes for one-stage band conversions. Thirty-eight patients were included for analysis. Average age and BMI were was 50.8 years and 41.1 kg/m2, respectively. The average operative time (164 min, 105-258 min) and length of stay (2.2 days, 1-5 days) did not differ between indication and procedure performed. Overall, early (< 30 day) and late (> 30 day) major complication rates were 7.9% and 5.3%, respectively. There were no leaks and no deaths. Within a 1-year postoperative period, seven re-interventions were performed. Elective one-stage band conversion to RYGB or SG can be performed safely.