[show abstract][hide abstract] ABSTRACT: Deficiencies in vitamins and other nutrients are common following the Roux-en-Y gastric bypass (RYGBP), biliopancreatic diversion (BPD) and biliopancreatic diversion with duodenal switch (BPDDS), and may become clinically significant if not recognized and treated with supplementation. This paper presents a review of the current literature and evidence of the most commonly deficient vitamins and minerals following weight loss surgery, including protein, iron, vitamin B12, folate, calcium, the fat-soluble vitamins (A, D, E, K), and other micronutrients. The deficiencies appear to be more substantial following malabsorptive procedures such as BPD, but occur with restrictive procedures as well. The review suggests that further studies are needed to evaluate the clinical significance of the nutritional deficiencies, and to determine guidelines for supplementation.
Obesity Surgery 03/2005; 15(2):145-54. · 3.10 Impact Factor
[show abstract][hide abstract] ABSTRACT: Primary pulmonary artery neoplasms are rare and lethal. Those involving the pulmonary valve are even rarer with only a few reported cases in the literature. The poor prognosis of these neoplasms, despite attempted multimodal therapy, is largely related to delay and difficulty in diagnosis. The case of a 53-year-old woman is described who within one month of suddenly developing shortness of breath was found to have a mass arising from the pulmonary valve and extending through the pulmonary vasculature, requiring extensive surgical resection. She died two weeks postoperatively. The morphological findings of this primary pulmonary artery sarcoma are presented. Diagnosis, treatment, prognosis and literature are reviewed, and consideration of this tumour in the differential diagnosis of other pulmonary diseases is emphasized.
The Canadian journal of cardiology 07/2003; 19(7):843-7. · 3.12 Impact Factor
[show abstract][hide abstract] ABSTRACT: Vertical banded gastroplasty (VBG) is sometimes associated with complications such as pouch obstruction, dilatation, and gastroesophageal reflux. This occasionally requires surgical revision, in many cases to a Roux-en-Y gastric bypass (RYGBP).
A 47-year-old woman with severe obesity developed severe symptoms of stenosis of the pouch outlet and gastroesophageal reflux 15 years after VBG. Laparoscopic conversion to a RYGBP was performed. At 9-month follow-up, she lost an additional 32 kg and had complete resolution of her reflux.
In this patient, laparoscopic re-operative RYGBP produced additional weight loss, and improved gastroesophageal reflux that occurred many years after having a VBG. Laparoscopic conversion of a VBG to RYGBP is feasible, and may confer the benefits of other minimally invasive abdominal procedures to this high-risk patient group.
Obesity Surgery 07/2002; 12(3):408-11. · 3.10 Impact Factor