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Background

Early dumping is a poorly defined and incompletely understood complication after Roux-en-Y gastric (RYGB).

Objective

We performed a mixed-meal tolerance test in patients after RYGB to address the prevalence of early dumping and to gain further insight into its pathophysiology.

Setting

The study was conducted in a regional hospital in the northern part of the Netherlands.

Methods

From a random sample of patients who underwent primary RYGB between 2008 and 2011, 46 patients completed the mixed-meal tolerance test. The dumping severity score for early dumping was assessed every 30 minutes. A sum score at 30 or 60 minutes of ≥5 and an incremental score of ≥3 points were defined as indicating a high suspicion of early dumping. Blood samples were collected at baseline, every 10 minutes during the first half hour, and at 60 minutes after the start.

Results

The prevalence of a high suspicion of early dumping was 26%. No differences were seen for absolute hematocrit value, inactive glucagon-like peptide-1, and vasoactive intestinal peptide between patients with or without early dumping. Patients at high suspicion of early dumping had higher levels of active glucagon-like peptide-1 and peptide YY.

Conclusion

The prevalence of complaints at high suspicion of early dumping in a random population of patients after RYGB is 26% in response to a mixed-meal tolerance test. Postprandial increases in both glucagon-like peptide-1 and peptide YY are associated with symptoms of early dumping, suggesting gut L-cell overactivity in this syndrome.  相似文献   
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International Journal of Clinical Pharmacy - In order to calculate the minimum sterilization process conditions to obtain the generally accepted sterility level (less than 1·10?6...  相似文献   
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Background  

The aims of this study were to examine the extent to which higher intellectual abilities protect higher socio-economic groups from functional decline and to examine whether the contribution of intellectual abilities is independent of childhood deprivation and low birth weight and other socio-economic and developmental factors in early life.  相似文献   
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In the diagnosis of scaphoid fracture, the dynamic phase of the radionuclide bone scan alone has been recommended as an early test. To evaluate the independent reliability of the dynamic and static phases of the 3-phase bone scan in this diagnosis, 3 examiners reviewed the 3-phase bone scans of a series of 60 patients with clinical signs of fracture of the carpal scaphoid and with negative or non-diagnostic initial radiographs. The interpretation was performed independently and without the benefit of additional data. The bone scans were reviewed after 1 year by the same observers. The results were analyzed using kappa statistics. The bone scan was suspicious of fracture of the scaphoid in 15 patients. Irrespective of training and experience, the kappa values of the dynamic bone scan between any 2 observers did not exceed 0.57. The kappa values increased significantly when the static phase of the bone scan was examined (> 0.81). The intraobserver variability showed a similar pattern. We conclude that in suspected scaphoid fracture, the dynamic phase of the radionuclide bone scan alone cannot be used as a reliable diagnostic approach because of the low inter- and intraobserver agreement in the interpretation, irrespective of the experience and training of the observer.  相似文献   
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Defecography in multiple sclerosis patients with severe constipation   总被引:3,自引:0,他引:3  
Gill  KP; Chia  YW; Henry  MM; Shorvon  PJ 《Radiology》1994,191(2):553
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10.
Previous reports in the literature have described correlation of increasing repeat length with severity of the phenotype, in Kennedy syndrome. We describe male siblings with different repeat lengths, with lack of expression of the phenotype in the sibling with the longer repeat length. The phenotype was identical to motor neurone disease. There is variability of expression in Kennedy syndrome and repeat length even in siblings cannot be taken as a conclusive indicator of severity. CAG repeat length cannot be used to predict the natural history of Kennedy disease. The diagnosis of Kennedy syndrome should be considered in male patients presenting with atypical motor neurone disease.  相似文献   
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