RESUMEN
Introduction: Bariatric surgery is routinely performed on obese women of reproductive age, most commonly with the laparoscopic sleeve gastrectomy (SG) and Roux-en-Y gastric bypass procedures (RYGB). This study analyzes the effects of postoperative pregnancy on excess BMI loss percentage (EBMIL%) after SG and RYGB. Methods: A retrospective study was conducted with 191 female patients of reproductive age between 20 and 40 years who underwent SG and RYGB performed at our institution between January 2017 and December 2018. A comparison of the results at 4-year follow-up was performed between patients who became pregnant after bariatric surgery with patients who did not. Results: Among 191 total cases, 32 (16.7%) patients became pregnant within a 4-year follow-up period, and 159 (83.2%) patients did not. The median postoperative body mass index (BMI) in the pregnant group was 33.3 kg/m2 (interquartile range [IQR] 30.1-38.5) and 33.5 kg/m2 (IQR 28.9-38.6) in the nonpregnant group. The mean EBMIL% within a 4-year follow-up in the pregnant group was 50.4% (standard deviation [SD] 23.5) and 55.5% (SD 30.4) in the nonpregnant group. The median weight before surgery in the pregnant group was 112 kg (IQR 107.9-132.2) and 117 kg (IQR 106-132.5) in the nonpregnant group. The median weight after surgery in the pregnant group was 89.5 kg (IQR 79.5-111) and 88.9 kg (IQR 78-103) in the nonpregnant group. There was no significant difference between outcomes. Conclusion: Weight loss maintenance after bariatric surgery is not impacted by postoperative pregnancy within a 4-year follow-up after SG and RYGB.
Asunto(s)
Cirugía Bariátrica , Derivación Gástrica , Laparoscopía , Obesidad Mórbida , Embarazo , Humanos , Femenino , Adulto Joven , Adulto , Obesidad Mórbida/cirugía , Estudios Retrospectivos , Resultado del Tratamiento , Cirugía Bariátrica/métodos , Derivación Gástrica/métodos , Pérdida de Peso , Gastrectomía/métodos , Laparoscopía/métodosRESUMEN
This study presents novel data on the microanatomy and ultrastructure of the omul Coregonus migratorius trunk kidney. Adult individuals of C. migratorius were sampled in the Barguzin Bay of Lake Baikal. Active leuko- and erythropoiesis were found in the interstitium of the mesonephros. For the first time, cells with radially arranged vesicles have been described in the renal interstitium of C. migratorius. The quantitative characteristics of blood cells and ultrastructural parameters of leukocytes reflected the functioning of the non-specific defence system in the organism. The share of the renal interstitium, morphological diversity of the epithelial cells of the nephron tubules, the ultrastructural features of the renal corpuscles and nephron tubules and the number of mitochondria in leukocytes and ion-transporting cells were typical for representatives of the whitefish Coregonus lavaretus complex and thus considered ancestral features of the present-day C. migratorius population reflecting its adaptive potential to living in an ultra-deep Lake Baikal.
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Salmonidae , Animales , Riñón , LagosRESUMEN
There has been an increasing use of hormonal therapy among male-to-female (MtF) transgender individuals. This long-term hormone replacement therapy (HRT) renders MtF individuals a unique patient subgroup in terms of breast cancer risk. This case describes a MtF transgender who presented with a breast lesion concerning for malignancy following hormonal replacement therapy. The patient additionally had a strong family history of breast cancer. Final pathology revealed lobular hyperplasia in the setting of gynecomastia and pseudoangiomatous stromal hyperplasia (PASH). Both pathology findings are rare in biological females, let alone in the setting of hormone replacement therapy in a MtF individual. While the number of reported cases of suspicious breast lesions in this population remains scarce, it presents both a diagnostic and therapeutic challenge due to the nature of the treatment course and the lack of research in this recently growing subgroup of patients.