RESUMEN
OBJECTIVE: We measured markers of acute-phase response and immunological markers in morbid obese patients and in formerly morbid obese patients after a massive weight loss following adjustable gastric banding (GB). SUBJECTS: A total of 49 morbid obese female patients with a body mass index (BMI) above 40 kg/m(2) were investigated during a study period of 6 months. Of these, 24 patients received a gastric banding (GB) and lost a minimum of 20 kg in 1 y (GB group) and 25 patients maintained their weight (obese group). In sum, 13 normal weight subjects (BMI<24 kg/m(2)) were taken for controls. METHOD: Plasma concentration of the acute-phase proteins, C-reactive protein (CRP), orosomucoid, complement factors C3 and C4 and white blood cell count, lymphocyte subsets and serum immunoglobulins were analyzed. RESULTS: Acute-phase proteins were significantly lower in GB compared to morbid obese patients and remained significantly elevated in GB compared to controls. In addition, leukocytes, polymorphonuclear leukocytes and lymphocytes were significantly lower after GB and reached levels comparable to controls (except PMN). No difference in CD3 counts was observed in the three groups. CD4 increased and CD8 decreased in obese and GB patients when compared to controls whereas no statistical difference was found between obese and GB patients. CONCLUSION: Our results confirm the positive effect of GB followed by a massive weight loss without apparent malnutrition. Subclinical chronical inflammation in morbid obese patients leads to irregularities in leukocyte and lymphocyte subsets. These alterations can be positively influenced by GB.
Asunto(s)
Reacción de Fase Aguda , Gastroplastia , Subgrupos Linfocitarios/inmunología , Obesidad Mórbida/cirugía , Proteínas de Fase Aguda/metabolismo , Adulto , Femenino , Estudios de Seguimiento , Humanos , Inmunoglobulinas/sangre , Recuento de Leucocitos , Persona de Mediana Edad , Obesidad Mórbida/sangre , Obesidad Mórbida/inmunología , Periodo Posoperatorio , Pérdida de Peso/inmunologíaRESUMEN
Potentially lethal consequences can quickly occur once the mediastinum is subjected to the ravages of an anaerobic infection. Mediastinitis from odontogenic or deep cervical infections is extremely rare in the era of antibiotic drugs. We have recently encountered five such cases, with a rapid spread of the inflammatory process into the mediastinum resulting in a number of local and systemic complications. All were caused by anaerobic bacteria. Awareness of such complications and early roentgenographic diagnosis lead to prompt surgical drainage, proper antibiotic therapy, and survival after a stormy clinical course. The anatomic pathways between the various fascial planes of the neck and mediastinum will be described.
Asunto(s)
Infecciones Bacterianas/etiología , Infección Focal Dental , Mediastinitis/etiología , Cuello , Adolescente , Adulto , Anciano , Niño , Femenino , Infección Focal Dental/etiología , Humanos , MasculinoRESUMEN
A case of megadolichobasilar artery anomaly (MDBA) with expansion of the internal auditory meatus is presented. There was no associated hearing loss and it is postulated that IAM expansion without hearing loss may occur with this anomaly.