Subcutaneous implantable cardioverter defibrillator in children and adolescents: results from the S-ICD “Monaldi care” registry

Journal of Interventional Cardiac Electrophysiology - Implantable cardioverter defibrillators (ICD) are widely accepted therapy in children and adolescents who are survivors of cardiac arrest or...     

Impact of bariatric surgery and weight loss medications in adults with type 1 diabetes in the T1D Exchange Clinic Registry

AimTo investigate the impact of bariatric surgery and weight loss medications in adults with type 1 diabetes.Materials and methodsSubjects enrolled in the T1D Exchange (T1DX) Clinic Registry age ≥ 18 years with a diabetes duration of ≥1 year were included in the analysis (n = 13,501). Data for participants (n = 37) with bariatric surgery after diabetes onset were assessed before and after surgery and also compared to a matched control group. Data for participants who reported the use of FDA-approved weight loss medications (n = 483) were assessed before starting, during use, and after stopping the medications and also compared to a matched control group. Variables of interest included BMI, HbA1c, blood pressure, lipid profile, rates of acute complications. Data were analyzed using linear mixed models.ResultsBariatric surgery resulted in BMI reduction from 38.8 ± 9.1 kg/m² to 33.3 ± 6.7 kg/m² (P = 0.006) and HbA1c reduction from 8.8 ± 1.3% (73 ± 14.2 mmol/mol) to 8.1 ± 1.1% (65 ± 12.0 mmol/mol) (P = 0.05). Weight loss medications were not associated with weight loss or better glycemic control although stopping liraglutide favored weight gain. Both interventions were not associated with a significant change in blood pressure or lipid profile. There were no adverse events associated with the use of weight loss medications.ConclusionsBariatric surgery is effective for weight loss and may improve glycemic control in selected patients. Weight loss medications are not associated with diabetes improvement. A trial with liraglutide may be attempted for weight control, but weight loss medications in general do not show a significant effect.     

Malignant peritoneal mesothelioma a clinical and laparoscopic study of ten cases

Summary A retrospective study of 10 cases of malignant peritoneal mesothelioma from two centers is reported. All cases were initially diagnosed between 1967 and 1986 utilizing laparoscopy and the histologic interpretation of laparoscopic biopsy samples. Subsequently, the original diagnosis was confirmed by two independent pathologists employing both histological and histochemical techniques. In five cases immunohistochemical studies were also performed. The clinical findings and course of the disease were similar to other reported series. Laparoscopic findings of mesothelioma were indistinguishible from metastatic peritoneal neoplasms. However, the presence of homogeneous spreading of nodules, plaques, or fleshy masses on both parietal and visceral peritoneum; the absence of direct or indirect signs of other abdominal neoplasms; and the absence of hepatic metastases or the possible presence of nodules or plaques on Glisson's capsule without any parenchymal involvement, when observed, allowed the laparoscopist to suspect the disease in four of 10 cases. Laparoscopy may be useful in detecting mesothelioma. The diagnosis is mainly morphological, but even morphology has its inherent limitations. Further studies are necessary to improve the diagnostic accuracy of this tumor.A part of this study was presented during the 12th International Congress of Gastroenterology and the 5th International Congress of Gastrointestinal Endoscopy in Lisbon, Portugal, September 16–22, 1984.