One-Anastomosis Gastric Bypass Versus Roux-en-Y Gastric Bypass as Revisional Surgery After Sleeve Gastrectomy: a Systematic Review and Meta-analysis

The demand for revisional bariatric surgery after sleeve gastrectomy (SG) has increased, but the ideal procedure remains unclear. A systematic review and meta-analysis were performed to compare the outcomes of weight loss and safety of one-anastomosis gastric bypass (OAGB) and Roux-en-Y gastric bypass (RYGB) as revisional procedures for failed SG. Four retrospective comparative studies were included, comprising 499 individuals. Patients submitted to OAGB had a more significant total weight loss (TWL) (MD =  − 5.89%; 95% CI − 6.80 to − 4.97) after revisional surgery. Overall early complication rate was similar between procedures (RD = 0.04; 95% CI: − 0.05 to 0.12). Limited and heterogeneous data prevent meaningful conclusions, but the present analysis suggests that OAGB has a better TWL after revisional surgery.

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Impact of the use of Non-Caloric Sweeteners on the Development and Acceptibility of Sweet Preparations

The aim of this study was to substitute saccharose in culinary preparations—custard-filled profiteroles with chocolate topping, chocolate brownie, chocolate mousse, soft coconut candy, soft chocolate fudge, and diet condensed milk—using two types of sweetener, while observing the behavior and performance of these substances, highlighting the difficulties and other required modifications to ensure the acceptance of the final product. Recipes that produced satisfactory characteristics were analyzed by the affective acceptance test using the nine-point hedonic scale to rate specifics attributes. Preparations attaining 50% of scores greater than or equal to 7 were considered accepted. The preference test (Friedman) was applied to products in which both non-caloric sweeteners yielded satisfactory results. Results were analyzed using ANOVA and Tukey tests. The main differences observed in the modified recipes were reduced viscosity, lower yield, less creaminess, less rising, limited capacity to incorporate air, and lower intensity of color and sweetness. Nevertheless, these characteristics did not affect the acceptance of the preparations since the majority of preparations were well accepted by the tasters. No statistically significant difference in preference was detected. The substitution of saccharose by non-caloric sweeteners resulted in products with good acceptability.     

PDX1-MODY: A rare missense mutation as a cause of monogenic diabetes

Maturity-Onset Diabetes of the Young type 4 is a rare form of diabetes mellitus, caused by mutations in the PDX1 gene. However, only a few mutations in this gene have been associated as a cause of monogenic diabetes up to date. It makes difficult to create a clinical manifestation profile of this disease and, consequently, to improve the therapeutic management for these patients. Here we report a normal weight woman, diagnosed with diabetes mellitus at 27 years old, during her first pregnancy. At the time of the recruitment, she was 40 years old and had a body mass index of 23.9 kg/m², glycated hemoglobin level of 9.6%, and fasting plasma glucose (FPG) of 254 mg/dL. She presented no diabetic complications and she was being treated with insulin. She reported a family history of diabetes mellitus characteristic of an autosomal dominant mode of inheritance. Molecular analysis of the PDX1 gene revealed the missense variant c.532G > A (p.(Glu178Lys)) segregating from the patient to her son, reported as diabetic. It was absent in her healthy daughter. The c.532G > A seems to be a rare variant, absent in human variants databases, and among 86 normoglycemic controls. Eight in silico algorithms classified this variant as probably pathogenic. Additionally, analysis of the evolutionary conservation showed the glutamic acid in the position 178 of PDX-1 protein as conserved among several species. Our findings reinforce the importance of screening rare MODY genes among families with suspicion of monogenic diabetes to help better understand the clinical manifestations of this disease.