Cobbquinlan4210

The number of bariatric procedures has increased notably, with incidental findings such as gastrointestinal stromal tumors (GISTs) being observed in 2%. The number of studies dealing with incidental findings during bariatric surgery (BS), especially GISTs, is scarce. This review aims to summarize the evidence about GIST diagnosis during BS, and to establish recommendations for the management and follow-up of these patients. A systematic literature search from January 2000 to March 2020 was performed. Retrospective cohort studies, case series, case reports, reviews, and conference abstracts were considered eligible. The present systematic review focused on a descriptive analysis of the data included in the articles selected. The calculated incidence was 0.65%. A change in operative plan was observed in 5% of the cases. In 98% of the cases, GISTs were gastric, with a mean size of 10.3 mm. The mitotic index was less then  5 in 99%. Accordingly, all patients were classified as having a very low or low risk of recurrence. R0 resection was achieved in 100% of cases. The incidence of GISTs in patients with MO submitted to BS is considerably higher than in the general population. The diagnosis is related to the depth of preoperative work, the exhaustiveness of the intraoperative examination, and the meticulousness of the histopathological analysis. Ceralasertib mw Although GISTs have a low risk of recurrence and it was previously unnecessary to modify the surgical technique, we recommend that bariatric surgeons are aware of the diagnosis and management of incidental GISTs.

We assessed the degree of tolerance to different types of food after LSG to provide specific useful advice concerning food intake to these patients during the first postoperative year.

A specific questionnaire measuring tolerance to 59 types of food was completed in postoperative months 1, 3, 6, 9, and 12 in a prospective consecutive cohort of patients who underwent LSG. An ordinal score of tolerance based on the median (Me) and a cumulative link ordinal model (CLOM) analyzing temporal variability in oral tolerance to each type of food were used. Foods with Me values of 3 points or higher and CLOM values of approximately 80% or higher were considered well tolerated.

Sixty-five patients were included in the study. The questionnaire was completed in the first, third, sixth, ninth, and twelfth months by 42 (64%), 44 (67%), 41 (63%), 41 (63%), and 39 (60%) patients, respectively. All kinds of fish were very well tolerated. Regarding meat intake, chicken, turkey, rabbit, and minced meat were well tolerated, whereas lamb, veal, and pork were not. Except for noodles and toasted bread, a poor degree of tolerance during follow-up was found for most carbohydrates. Yogurt, skimmed milk, and cottage cheese were well tolerated. A heterogeneous degree of tolerance was observed for vegetables, with cooked vegetables being well tolerated, and raw vegetables not.

Our study provides individual information on specific foods regarding their degree of tolerance. This information may be useful for advising patients during the first postoperative year after LSG.

Our study provides individual information on specific foods regarding their degree of tolerance. This information may be useful for advising patients during the first postoperative year after LSG.

Cholelithiasis (ChL) is common after bariatric surgery (BS). Laparoscopic cholecystectomy (LC), the preferential treatment, is usually recommended only to symptomatic patients. LC may be, however, beneficial to asymptomatic patients as well. A prerequisite to such a policy is that it must be safe. This study aimed to assess whether, in post-bariatric (Post-Bar) patients who develop gallstones, LC achieves the same results as those reported in the general population.

A cohort of 376 patients undergoing elective LC had their medical records reviewed. Patients were divided into non-bariatric (Non-Bar) and Post-Bar groups, and then compared for characteristics and surgical outcomes.

The study included 367 patients, 292 Non-Bar and 75 Post-Bar. Considering characteristics, Post-Bar patients were younger (44.5 ± 11.8 vs 48.4 ± 14.1) and less symptomatic (2.4% vs 19.8%) and had a higher BMI (32.2 ± 4.8 vs 30.8 ± 4.4) than Non-Bar patients. Regarding surgical outcomes, mortality (none), morbidity (1%, only in Non-Bar patients), readmission (1%, only in Non-Bar patients), conversion to laparotomy (0.6%, only in Non-Bar patients) showed no difference between the groups. Operative time (42.6 ± 14.4min in Non-Bar and 38.2 ± 12.6min in Post-Bar patients) tended to be lower in Post-Bar patients, p = 0.054. Same-day discharge was higher in Post-Bar patients (98.6%) than in Non-Bar patients (90.4%), p = 0.03.

Compared with Non-Bar patients, LC in Post-Bar patients showed not only similar morbimortality, readmissions, and conversions but also even a higher same-day discharge rate and a trend to lower operative times.

Compared with Non-Bar patients, LC in Post-Bar patients showed not only similar morbimortality, readmissions, and conversions but also even a higher same-day discharge rate and a trend to lower operative times.Ensemble statistics are often thought of as a reliable impression of numerous items despite limited capacities to consciously represent each individual. However, whether all items equally contribute to ensemble summaries (e.g., mean) and whether they might be affected by known limited-capacity processes, such as focused attention, is still debated. We addressed these questions via a recently described "amplification effect," a systematic bias of perceived mean (e.g., average size) towards the more salient "tail" of a feature distribution (e.g., larger items). In our experiments, observers adjusted the mean orientation of sets of items varying in set size. We made some of the items more salient or less salient by changing their size. While the whole orientation distribution was fixed, the more salient subset could be shifted relative to the set mean or differ in range. We measured the bias away from the set mean and the standard deviation (SD) of errors, as it is known to reflect the physical range from which ensemble information is sampled.