Mental disorders and weight change in a prospective study of bariatric surgery patients: 7 years of follow-up

BackgroundLong-term, longitudinal data are limited on mental disorders after bariatric surgery.ObjectiveTo report mental disorders through 7 years postsurgery and examine their relationship with changes in weight and health-related quality of life.SettingThree U.S. academic medical centers.MethodAs a substudy of the Longitudinal Assessment of Bariatric Surgery Consortium, 199 adults completed the structured clinical interview for Diagnostic and Statistical Manual of Mental Disorders, 4^th Edition prior to Roux-en-Y gastric bypass (RYGB) or laparoscopic adjustable gastric band. Participants who completed ≥1 follow-up through 7 years postsurgery are included (n = 173; 86.9%). Mixed models were used to examine mental disorders over time, and among the RYGB subgroup (n = 104), their relationship with long-term (≥4 yr) pre- to postsurgery changes in weight and health-related quality of life, measured with the Short Form-36 Health Survey, and with weight regain from nadir.ResultsCompared with presurgery (34.7%), the prevalence of having any mental disorder was significantly lower 4 years (21.3%; P < .01) and 5 years (19.2%; P = .01), but not 7 years (29.1%; P = .27) after RYGB. The most common disorders were not related to long-term weight loss postRYGB. However, independent of weight change, mood and anxiety disorders, both pre- and postRYGB, were significantly related to less improvement in mental (but not physical) health-related quality of life. Having a concurrent mood disorder appeared to be associated with greater weight regain (6.4% of maximum weight lost, 95% confidence interval, ?.3 to 13.1), but this was not statistically significant (P = .06).ConclusionsBariatric surgery does not result in consistent long-term reductions in mental disorders. Mood disorders may impact long-term outcomes of bariatric surgery.     

Bacitracin attenuates haemolysis-induced insulin degradation during insulin sensitivity testing: Repurposing an old drug for use in metabolic research

Haemolysis of serially collected insulin serum samples frequently causes falsely-low measured concentrations because of the release of intracellular insulin degrading enzyme (IDE). We investigated if bacitracin, an in vitro IDE inhibitor, could prevent haemolysis-induced insulin degradation during insulin sensitivity testing. Blood samples were collected from adults undergoing serial sampling for insulin sensitivity. A dose-finding study measured insulin from experimentally haemolysed samples containing five bacitracin concentrations (0-2.5 g/L) and from non-experimentally haemolysed samples. To confirm the utility of bacitracin in the clinical setting, we compared insulin in samples collected with and without 1 g/L bacitracin from a frequently sampled intravenous glucose tolerance test (FSIVGTT), where haemolysis often occurs accidentally. In the dose-finding study, bacitracin 0.25, 1 and 2.5 g/L all maximally prevented insulin degradation in experimentally haemolysed samples. Among FSIVGTT unintentionally haemolysed samples, insulin concentrations from bacitracin-containing samples were significantly higher than from those without bacitracin (P < .01), and not different from non-haemolysed samples obtained simultaneously from a second intravenous catheter (P = .07). Bacitracin did not significantly alter insulin concentrations in non-haemolysed samples. Bacitracin attenuates haemolysis-associated insulin degradation in clinical samples, enabling a more accurate assessment of insulin sensitivity and glucose homeostasis.     

Oral chronic graft‐versus‐host disease: current pathogenesis,therapy, and research

Optimal management of complex autoimmune diseases requires a multidisciplinary medical team including dentists to care for lesions of the oral cavity. In this review, we discuss the presentation, prevalence, diagnosis, and treatment of oral manifestations in chronic graft‐versus‐host disease (cGVHD), which is a major late complication in patients treated by allogeneic hematopoietic stem cell transplantation. We assess current general knowledge of systemic and oral cGVHD and present general treatment recommendations based on literature review and our clinical experience. Additionally, we review areas where the understanding of oral cGVHD could be improved by further research and address tools with which to accomplish the long‐term goal of providing better health and quality of life to patients with cGVHD.     

Amphistome Species in Cattle in South Coast of Caspian Sea

Background

Knowledge about the amphistomid fauna in Iranian domestic ruminants depends on the studies conducted almost 30 years ago. The last situation in cattle is introduced here in the provinces in south coast of Caspian Sea.

Methods

Amphistomid species were collected from cattle at slaughter houses of the provinces Gilan and Mazanderan in 2010. Median sagittal sections were prepared by the conventional method. Species were identified by the histomorphological pecularities of the muscular argans.

Results

Five amphistomid species, Paramphistomum cevri, P. gotoi, Calicophoron calicophorum, Carmyerius spatiosus and Gastrothylax compressus, recovered. Calicophoron calicophorum is a new species for Iran. Criteria used in identification of the species were illustrated.

Conclusion

Iran has a rich amphistomid fauna and mostly under the influence of oriental conditions.     

Binge eating and weight-related quality of life in obese adolescents

Limited data exist regarding the association between binge eating and quality of life (QOL) in obese adolescent girls and boys. We, therefore, studied binge eating and QOL in 158 obese (BMI ≥ 95th percentile) adolescents (14.5 ± 1.4 years, 68.0% female, 59% African-American) prior to weight-loss treatment. Youth completed an interview to assess binge eating and a questionnaire measure of QOL. Controlling for body composition, binge eating youth (n = 35), overall, reported poorer QOL in domains of health, mobility, and self-esteem compared to those without binge eating (ps < 0.05). Also, girls, overall, reported poorer QOL than boys in activities of daily-living, mobility, self-esteem, and social/interpersonal functioning (ps < 0.05). Girls with binge eating reported the greatest impairments in activities of daily living, mobility, self-esteem, social/interpersonal functioning, and work/school QOL (ps < 0.05). Among treatment-seeking obese adolescents, binge eating appears to be a marker of QOL impairment, especially among girls. Prospective and treatment designs are needed to explore the directional relationship between binge eating and QOL and their impact on weight outcomes.     

胆木中两个新生物碱甙的结构研究

从胆木(Nauclea officinalis Pierre ex Pitard)树干中,分得两个新生物碱甙,分别命名为胆木碱庚(nauclecoside)和胆木碱辛(nauclecosidine)。根据它们的理化性质,光谱数据和化学反应,推断胆木碱庚的结构为Ⅰa,胆木碱辛为Ⅱa。并且还得到一已知碱胆木碱壬,鉴定为喜果甙(vincoside laetam,Ⅲ)。     

差示分光光度法测定牛黄类中成药中胆红素的含量

本文利用胆红素溶液在光照下易氧化变色及其吸收光谱发生显著变化的性质,在波长453 nm处,测其光照前后的吸收度差值(△A),△A与胆红素溶液浓度呈线性关系,对含牛黄的中成药(六应丸,六神丸和牛黄消炎丸)中胆红素进行了定量,并对其它组分进行了光照试验,排除了光照对其它组分的影响,从而确定了此法的可行性。     

Acid-base Properties of Terbutaline in Terms of Protonation Macro- and Microconstants

The acid/base chemistry of terbutaline was characterized at the molecular level in terms of protonation macroconstants and microconstants. The macroconstants were measured by potentiometry and calculated by standard evaluation methods. The stepwise macroconstant values were log K₁ = 11·01, log K₂ = 9·89, and log K₃ = 8·57 at 250°C and 0·2 m ionic strength. The microconstants were deduced using the relationships between macro- and microconstants and an appropriate data set of model compounds (resorcinol and phenylephrine). The molecule of terbutaline contains three ionizable functional groups. In the unprotonated form of the molecule, the two identical phenolate groups are slightly more basic than the secondary amino group, whereas the amino basicity significantly exceeds that of the phenolate site, when the other phenol is protonated. This is due to the large phenolate-phenolate intramolecular interaction. The phenolate-phenolate and the phenolate-amino interactivity parameters were found to be ?1·21 and ?0·41 log E units, respectively.