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Post bariatric Surgery Acute Axonal Polyneuropathy: Doing Your Best is Not Always Enough.

ABSTRACT: Neurological complications are frequently recognized with weight reduction surgeries for morbid obesity. The spectrum of peripheral neuropathies complicating the weight loss surgery is wide, and among them, the acute axonal peripheral neuropathy resembling Guillain-Barre syndrome is rare and only less than a dozen cases are reported. We present three cases, which after bariatric surgery developed acute polyneuropathy that rapidly progressed over 4 weeks from the onset. All patients responded to aggressive parenteral Vitamin B1 and B12 replacement therapy. These cases highlight the fact that bariatric surgery although is a promising option to treat morbid obesity; it is certainly not devoid of potential neurological complications due to micronutrient deficiencies. Delay in the diagnosis of acute polyneuropathy may worsen its long-term sequelae. A multidisciplinary team management with careful nutritional monitoring at regular interval is crucial in all patients for early recognition and intervention to avoid these complications after bariatric surgery.

SUBMITTER: Yasawy ZM

PROVIDER: S-EPMC5586130 | biostudies-other | 2017 Jul-Sep

REPOSITORIES: biostudies-other

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Post bariatric Surgery Acute Axonal Polyneuropathy: Doing Your Best is Not Always Enough.

Yasawy Zakia Mohammad ZM Hassan Ali A

Annals of Indian Academy of Neurology 20170701 3

Neurological complications are frequently recognized with weight reduction surgeries for morbid obesity. The spectrum of peripheral neuropathies complicating the weight loss surgery is wide, and among them, the acute axonal peripheral neuropathy resembling Guillain-Barre syndrome is rare and only less than a dozen cases are reported. We present three cases, which after bariatric surgery developed acute polyneuropathy that rapidly progressed over 4 weeks from the onset. All patients responded to ...[more]

PMID: 28904467

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Project description:Bariatric surgery is often the preferred method to resolve obesity and diabetes, with ∼800,000 cases worldwide yearly and high outcome variability. The ability to predict the long-term body mass index (BMI) change following surgery has important implications for individuals and the health care system in general. Given the tight connection between eating habits, sugar consumption, BMI, and the gut microbiome, we tested whether the microbiome before any treatment is associated with different treatment outcomes, as well as other intakes (high-density lipoproteins [HDL], triglycerides, etc.). A projection of the gut microbiome composition of obese (sampled before and after bariatric surgery) and lean patients into principal components was performed, and the relation between this projection and surgery outcome was studied. The projection revealed three different microbiome profiles belonging to lean, obese, and obese individuals who underwent bariatric surgery, with the postsurgery microbiome more different from the lean microbiome than the obese microbiome. The same projection allowed for a prediction of BMI loss following bariatric surgery, using only the presurgery microbiome. The microbial changes following surgery were an increase in the relative abundance of Proteobacteria and Fusobacteria and a decrease in Firmicutes. The gut microbiome can be decomposed into main components depicting the patient's development and predicting in advance the outcome. Those may be translated into the better clinical management of obese individuals planning to undergo metabolic surgery. IMPORTANCE BMI and diabetes can affect the gut microbiome composition. Bariatric surgery has large variabilities in the outcome. The microbiome was previously shown to be a good predictor for multiple diseases. We analyzed here the gut microbiome before and after bariatric surgery and showed the following. (i) The microbiome before surgery can be used to predict surgery outcomes. (ii) The postsurgery microbiome drifts further away from the lean microbiome than the microbiome of the presurgery obese patients. These results can lead to a microbiome-based presurgery decision whether to perform surgery.

Project description:Background: In the absence of an effective vaccine, public health policies are aimed at awareness, and education of the general public in order to contain the quickly spreading COVID-19 pandemic. Most of the recommended precautionary measures are dependent on human behaviors and therefore their effectiveness largely depends on peoples' perception and attitudes toward the disease. This study aimed to assess the level of knowledge, risk perception, and precautionary measures taken in response to COVID-19 in North America. Methods: In this cross-sectional observational study, an online survey targeted to North Americans focused on the public's knowledge of COVID-19, risk perception, and precautionary behaviors taken in response to this pandemic. Descriptive analyses were performed for the whole population and the subgroup analyses contrasted the differences between Americans and Canadians. Results: The cohort comprised 1,264 relatively young participants with an average age of 28.6 ± 9.8 years. The vast majority (>90%) were knowledgeable about COVID-19. Regarding risk perception, about a quarter assumed to be at less risk to contract the disease, and 42.8% considered themselves to be less contagious than others. While the vast majority avoided performing risky behaviors, only a small proportion (13.2%) wore a face mask-which is in line with the public health recommendations of the two countries at the time of data collection. Overall, a larger proportion of Canadian participants (55.8%) were satisfied with the performance of their national public health in response to the current pandemic, compared to their American counterparts (12.2%). Discussion: Data regarding the public's knowledge of COVID-19, risk perception, and behaviors in response to this pandemic is limited. The results of this study highlight that this relatively young and educated sample of North Americans had a high level of knowledge about COVID-19 and a large proportion of them were taking the precautionary measures against this pandemic. However, a significant number of individuals believe to be at less risk of contracting the disease compared to the general population. Educating the public that no one is safe from this disease, could play a role in further limiting risky behaviors and ultimately facilitating disease containment.

Project description:Purpose Physical activity is critical for weight loss maintenance and cardiometabolic disease prevention after metabolic/bariatric surgery (MBS), but few patients meet recommended levels. While difficulties meeting physical activity recommendations are common in the general population, those who have undergone MBS may have unique psychological barriers to activity that impede success, including negative associations with physical activity that are related to a long history with obesity, weight stigma, and physical limitations. This qualitative study aimed to better understand the positive and negative emotional experiences of post-MBS patients with regard to physical activity to inform the development of an emotion-focused intervention to increase physical activity after MBS. Methods Adults who had MBS in the past 2 years completed semi-structured interviews and psychological/behavioral questionnaires. After transcription, a codebook was developed using inductive and deductive methods. Coded data were analyzed using content analysis. Results Participants were 23 adults (78% female). Contexts that contributed to positive emotions during physical activity included an enjoyable type of exercise, social interaction, mindfulness during exercise, and mastery. Contexts that contributed to negative affect were more unique to the MBS population, including all-or-nothing thinking about exercise, using distraction, depression, negative body image, exercising only for weight loss, and the COVID-19 pandemic. Conclusion For most participants, emotional factors were relevant in the decision to be physically active and in their ability to maintain their habits. An intervention that encourages factors that lead to positive affect and addresses factors that lead to negative affect could be effective in increasing physical activity following MBS. Graphical abstract Supplementary Information The online version contains supplementary material available at 10.1007/s11695-021-05807-x.

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Post bariatric Surgery Acute Axonal Polyneuropathy: Doing Your Best is Not Always Enough.

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Post bariatric Surgery Acute Axonal Polyneuropathy: Doing Your Best is Not Always Enough.

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