Causes of revisional surgery, reoperations, and readmissions after bariatric surgery

INTRODUCTION AND OBJECTIVES

Bariatric surgery is the most effective treatment for weight loss, with comorbidity control. With low complication rates, the reasons for reoperation are major complications or weight loss failure/weight regain. Nonsurgical problems can also present, such as anemia, dehydration, chronic pain, and malnutrition, among others. Our aim was to analyze the main causes of revisional surgery, reoperation, and hospital readmission, at a specialized bariatric center.

METHODS

A retrospective study was conducted on patients that underwent bariatric surgery within the time frame of 2012 and 2019. The baseline analysis included demographic, anthropometric, and perioperative data, as well as a sub-analysis of the main readmission causes and complications.

RESULTS

A total of 776 primary surgeries were performed (649 RYGBP, 127 SG, and 10 revisional surgeries), and 99 patients were identified for the study: 10 revisional surgeries, 44 reoperations, and 45 readmissions. The incidence of revisional surgery was 1.2%, reoperation was 5.6%, and readmission 5.8%. Fifty percent of the revisional surgeries were performed due to insufficient weight loss or weight regain; the most frequent causes of reoperation were cholecystitis (38.6%) and internal hernias (9.1%); and the most common causes of readmission were nonspecific abdominal pain (35.5%) and dehydration (24.4%).

CONCLUSION

The most frequent causes of postoperative readmission were nonsurgical events, followed by non-bariatric reoperations, and finally revisional surgeries. There was a low incidence of early reoperations. Knowledge of the abovementioned data is important for identifying higher-risk patients, to prevent major complications.

A Guide to Implementing Inclusive and Accessible Virtual Poster Sessions

Poster sessions are an integral part of conferences because they facilitate networking opportunities and provide a platform for researchers at every career stage to present and get feedback on their work. In Spring 2020, prompted by the rapid transition of the SABER (Society for the Advancement of Biology Education Research) Summer 2020 meeting to an online format, we designed and implemented a no-cost and accessible, asynchronous, and synchronous virtual poster session. Here, we outlined our goals for hosting an inclusive virtual poster session (VPS), demonstrated how a backward design approach can facilitate effective VPS, and described our rationale for adopting an asynchronous/synchronous model using the Padlet and Zoom platforms. We shared our lessons learned to facilitate a second VPS at the SABER 2021 meeting and to assist future poster session organizers in designing engaging, inclusive, and accessible poster sessions. Virtual poster sessions have great potential to improve collaborations and science communication experiences at scientific conferences and in undergraduate classrooms.

[Seroepidemiological study of hepatitis A in Gran Canaria (Spain)]

BACKGROUND

The aim of this study was to assess the seroprevalence and the risk factors of hepatitis A virus (HAV) infection in the population from Gran Canaria (Spain) and to determine at which age pre-vaccination testing would be useful.

METHODS

A transversal observational study of the presence of HAV antibodies (IgG) on serum samples obtained from a population ranging from 8 months to 63 years old was performed between January 1995 and December 1996. IgG anti-HAV were detected by a commercial immunoenzyme assay. The study included 547 persons resident in Gran Canaria. Epidemiological data (age, sex, number of family members, educational level, urban/rural residence and previous history of hepatitis) were gathered through a personal interview. Confusing variables were excluded by mean a multiple logistic regression analysis.

RESULTS

Global prevalence of anti-HAV (IgG) was 36.0% (CI 95% 32.0-40.0). The prevalence of anti-HAV increased significantly with age from 2.3% in children under 4 years until 98.9% in older than 40 years (OR 3956.0; CI 95% 241.7-64,753.5). Only three independent data (age, sex and educational level) were significantly associated with HAV seroprevalence. A previous history of hepatitis A was present only in 4.8% of HAV-positive subjects.

CONCLUSIONS

The low prevalence of anti-HAV (IgG) in persons under 25 years old suggest that in the adolescent population the implementation of universal vaccination programs is recommended even without previous serologic screening. Otherwise, the results suggest that HAV prevaccination screening in our geographical were must be limited to subjects older than 25 years.

The treatment of gout: a case of medical audit?

An assessment of quality of drug control of hyperuricaemia in gouty subjects is reported. Twenty seven of 40 patients were found to be hyperuricaemic. Factors influencing compliance with drug therapy included awareness of the nature of gout and excessive alcohol consumption.

Comparison of azapropazone and naproxen in rheumatoid arthritis

A double-blind crossover trial was carried out in 15 patients with definite rheumatoid arthritis to compare the effectiveness of 1200 mg azapropazone daily and 750 mg naproxen daily, each drug being given for 2 weeks. Patients also received placebo therapy before and between the two treatment periods. The results of subjective and objective assessments showed that both drugs were significantly superior to placebo, but no significant difference could be demonstrated between the two drugs.