Experienced Weight Loss Research Articles

Fecal bacteria transplantation replicates aerobic exercise to reshape the gut microbiota in mice to inhibit high-fat diet-induced atherosclerosis.

Aerobic exercise exerts a significant impact on the gut microbiota imbalance and atherosclerosis induced by a high-fat diet. However, whether fecal microbiota transplantation, based on aerobic exercise, can improve atherosclerosis progression remains unexplored. In this study, we utilized male C57 mice to establish models of aerobic exercise and atherosclerosis, followed by fecal microbiota transplantation(Fig 1a). Firstly, we analyzed the body weight, somatotype, adipocyte area, and aortic HE images of the model mice. Our findings revealed that high-fat diet -induced atherosclerosis mice exhibited elevated lipid accumulation, larger adipocyte area, and more severe atherosclerosis progression. Additionally, we assessed plasma lipid levels, inflammatory factors, and gut microbiota composition in each group of mice. high-fat diet -induced atherosclerosis mice displayed dyslipidemia along with inflammatory responses and reduced gut microbiota diversity as well as abundance of beneficial bacteria. Subsequently performing fecal microbiota transplantation demonstrated that high-fat diet -induced atherosclerosis mice experienced weight loss accompanied by reduced lipid accumulation while normalizing their gut microbiota profile; furthermore it significantly improved blood lipids and inflammation markers thereby exhibiting notable anti- atherosclerosis effects. The findings suggest that aerobic exercise can modify gut microbiota composition and improve high-fat diet-induced atherosclerosis(Fig 1b). Moreover, these beneficial effects can be effectively transmitted through fecal microbiota transplantation, offering a promising therapeutic approach for managing atherosclerosis.

P-557. Weight Change After Switching from Bictegravir/emtricitabine/tenofovir alafenamide in Persons Living with HIV: A Retrospective Cohort Study

Abstract Background Antiretroviral Therapy (ART) has revolutionized the management and outcomes of persons with HIV (PWH). However, ART has undesirable effects such as weight gain, that lead to non-compliance or medication switch. The combination Bictegravir (BIC)/emtricitabine (FTC)/tenofovir alafenamide (TAF) has been associated with weight gain, though most of the data regarding this is not comprehensive.Figure 1:Study Flowchart Methods A retrospective cohort study was performed on 125 patient records to assess the changes in weight, lipid panel and glycosylated hemoglobin (HBA1C) measurements in PWH who were taking BIC/FTC/TAF for at least 1 year then switched to a different combination, compared to those who remained on this regimen, over a period of 3 years (Figure 1). Table 1 M: Male, DMII: Type 2 Diabetes Mellitus, DL: Dyslipidemia, GLP-1: Glucagon-like Peptide-1, VL: Viral Load, NA: Not Applicable Results Out of the 125 records reviewed, 98 (78%) continued BIC/FTC/TAF for 3 years and 27 (22%) were switched to another combination after 1 year, whether cabotegravir/rilpivrine (69%), dolutegravir/lamivudine (18%) or others (13%). The 2 groups had similar baseline mean age, sex, race, metabolic profile, viral load and CD4 counts (Table 1). There was a median weight gain of 1.3 kg after 1 year of treatment with BIC/FTC/TAF. By year 2, there was a median weight loss of 0.8kg in the group who continued the same ART and 0.2 kg in the group who switched treatment (p=0.441). However, by year 3, there was a median weight gain of 0.5 kg in those who continued the same ART and 0.2 kg in those who switched to another combination; p=0.477 (Figure 2). 25/98 (25%) patients who kept same ART experienced weight loss after 2 years, in comparison to 9/26 (34%) of patients who switched treatment (p=0.497). Low-density lipoprotein and HBA1C readings had minimal mean variations between the 2 groups.Figure 2:Change in median weight between the two patient groups after a 3-year follow-up. Conclusion Our data, although of small sample size, shows that while there appears to be no significant weight change while continuing BIC/FTC/TAF as compared to switching to a different regimen. Hence, switching to treatment combinations did not result in weight loss or lower LDL and HBA1C levels. To our knowledge, this is among the few studies to provide real world data on weight change after switching from B/FTC/TAF, which highlights its significance. Disclosures Dima Dandachi, MD, MPH, Gilead Sciences: Grant/Research Support|ViiV Healthcare: Grant/Research Support|ViiV Healthcare: Honoraria

Impact of a virtual cardiology programme for postdischarge patients with cardiovascular disease: a matched cohort analysis

IntroductionTelemedicine programmes have shown promise in reducing hospital readmissions, but varied RPM strategies and study populations have contributed to mixed results. Here, we evaluate a standardised virtual care programme in...

Glucocorticoids on bone remodeling in systemic lupus erythematosus mice.

Systemic lupus erythematosus requires glucocorticoids for management. This study investigates how glucocorticoids influence bone in a SLE mouse model, focusing on bone mineral density (BMD), microstructure, and remodeling markers. MRL/lpr and C57BL/6 mice were administered dexamethasone or saline as a control for 4-weeks. Bone assessments included analyses of BMD, bone structure, and serum levels of RANKL and OPG. Dexamethasone decreased BMD and altered cortical and trabecular bone thickness in both MRL/lpr and C57BL/6 mice. In C57BL/6 mice, cortical bone exhibited increased catabolism while trabecular bone showed signs of increased anabolism, whereas MRL/lpr mice did not show significant changes in bone turnover. Both strains experienced weight loss, with a significant decrease in femur length observed only in C57BL/6 mice. Dexamethasone exacerbated BMD reduction in MRL/lpr mice and halted its increase in C57BL/6 mice. C57BL/6 mice exhibited notable changes in cortical and trabecular bone structure, while MRL/lpr mice didn't. After receiving dexamethasone, both strains showed higher serum RANKL levels, especially in C57BL/6 mice. OPG decreased in both strains. Both glucocorticoids and SLE contribute to abnormal bone remodeling through RANKL/OPG pathway. Glucocorticoid (GC) treatment in a mouse model of systemic lupus erythematosus (SLE) leads to significant changes in bone parameters, including decreased bone mineral density (BMD) and alterations in bone structure. Those change are associated with the modulation of RANKL and OPG expression. Both GC and inflammation in SLE contribute to BMD reduction, and GC may have a certain protective effect on bone in the early stage of chronic inflammation. GC can upregulate RANKL expression and downregulate OPG expression in vivo. During a state of chronic inflammation, RANKL expression increases. However, OPG may not exert a significant influence on inflammatory stimulation.

P1108 Endoscopic Sleeve Gastroplasty for management of Obesity in patient suffer from Inflammatory Bowel Disease

Abstract Background Obesity is a multifactorial, chronic, and relapsing disease, and its prevalence among patients with inflammatory bowel disease (IBD) is increasing, affecting 15–40% of them1,2. Limited data are available on the outcomes of endoscopic sleeve gastroplasty (ESG), a non-malabsorptive, organ-sparing endoscopic procedure, in patients with IBD3,4. Methods We conducted a retrospective review of a prospective dataset of subjects who underwent ESG at a tertiary center, including all subjects affected by IBD. Weight loss and IBD outcomes were assessed during early- and medium-term follow-up. Results Ten subjects (80% women) with IBD (5 with ulcerative colitis and 5 with Crohn’s disease) underwent ESG between October 2019 and May 2024 (mean BMI 37.6 ± 3.75 kg/m², mean age 49.4 ± 12.3 years). Four patients (40%) had previously undergone IBD-related surgery. Seven patients (70%) had received biological therapy, and six (60%) were in clinical remission at the time of ESG. No perioperative adverse events occurred. At the 6-month follow-up, nine subjects experienced total body weight loss (TBWL) of >10%, with a mean excess weight loss (EWL) of 55.9 ± 29.6%. Nine patients reached the 12-month follow-up, with a TBWL of 17.3 ± 10.5% (6 of them with TBWL >10%). At the final follow-up (mean 20.25 ± 3.46 months), the mean TBWL was 12.3 ± 10.2%, and the mean EWL was 38.2 ± 31.8%. Three patients underwent endoscopic revision for recurrent weight gain after a mean of 21 months. Two of these patients reached the 6-month follow-up with a mean TBWL of 9.89 ± 0.15% and EWL of 46.83 ± 1.79%. Overall, eight (80%) patients had no change in their IBD medication, one (10%) required treatment escalation due to loss of response. One subject, affected by chronic kidney disease and with a history of ileocecal resection, required emergency surgery for bowel obstruction caused by an incisional hernia 16 months after ESG. Unfortunately, four months later, he died due to septic shock. At the last follow-up, eight (89%) of the nine patients were in clinical remission, and all patients were in steroid-free remission. Conclusion We present the largest series on ESG in patients with IBD and obesity. Based on these retrospective data, ESG appears to be a promising bariatric procedure for these complex patients due to its safety and efficacy. However, prospective studies and clinical trials are needed to confirm these findings.

Age and sex differences in the relationship of body weight changes with colon cancer risks: A nationwide cohort study

Colon cancer is a significant health concern, and obesity is a well-established risk factor. However, previous studies have mainly focused on assessing body weight as a risk factor for colon cancer at a specific time point. This nationwide cohort study investigated the association between body weight changes, which can fluctuate throughout an individual’s lifespan, and the incidence of colon cancer using the South Korean population database provided by the National Health Insurance Service (NHIS). Participants who underwent biennial health screenings between 2004 and 2006, and had follow-up health check-ups between 2014 and 2016, were included in this study. Body weight changes were categorized as follows: < 5%, decrease 5–20%, decrease > 20%, increase 5–20%, or > 20%. The primary outcome was the incidence of newly diagnosed colon cancer. Statistical analysis was used to examine the relationship between body weight changes and the incidence of colon cancer stratified according to age and sex. The Kaplan–Meier method estimated the cumulative incidence of colon cancer, and Cox proportional hazards models were used to calculate hazard ratios (HR) and 95% confidence intervals (CI), adjusting for confounding factors. The analysis included data from 10,332,397 individuals, with a mean (± SD) age of 45.5 ± 13.1 years, and 54.9% were male. In males with a body mass index (BMI) range of 18–30 kg/m2, both a weight gain of 5–20% (HR 1.07, P > z 0.01 [95% CI 1.02–1.13]) and weight gain > 20% (HR 1.27, P > z 0.03 [95% CI 1.03–1.56]) were associated with an increased risk for colon cancer. In addition, males < 40 years of age exhibited a higher risk for colon cancer with > 20% weight gain (HR 1.65, P > z < 0.001 [95% CI 1.18–2.30]). Whereas, females within the BMI range of 18–30 kg/m2 who exhibited > 20% weight loss demonstrated a reduced risk (HR 0.77, P > z 0.04 [95% CI 0.60–0.98]). Moreover, females ≥ 40 years of age, who experienced weight loss > 20%, exhibited a decreased risk for colon cancer (HR 0.76; P > 0.02 [95% CI 0.60–0.96]). This nationwide cohort study demonstrated a relationship between body weight changes and the incidence of colon cancer, with differences based on sex and age. In particular, avoiding weight gain is crucial for males < 40 years of age, whereas weight loss could be beneficial for females > 40 years of age in reducing the risk of colon cancer.

Glucagon-like-peptide-1 agonist therapy in adults with cystic fibrosis

Glucagon-like-peptide-1 (GLP-1) agonists are commonly used to improve glycemic control and promote weight loss in individuals with type 2 diabetes mellitus (T2DM) and/or obesity. However, there is a paucity of evidence regarding GLP-1 agonist use in people with cystic fibrosis (pwCF). We present 11 people with CF (males: 3, females: 7; age range 24-47; BMI range 25.7-43.7) treated with GLP-1 agonists (semaglutide: 9,tirzepatide: 2) for variable duration (1-50 months). All experienced weight loss on GLP- 1 agonist therapy (median change in weight = -7.2 kg; change in BMI [kg/m2] = -0.9 to -8.1). Eight pwCF showed improvement in percent predicted forced expiratory volume in 1 second (ppFEV1) [change = -5 to + 18] and nine pwCF showed improvement in percent predicted forced vital capacity (ppFVC) [change= +1 to + 26]. Of the 7 pwCF with CFRD, all reduced their insulin quantity (mean, 31.5 % decrease in total daily insulin dose), and glucose time in range improved for most (mean, +11 % increase from baseline). Four pwCF stopped using GLP-1 agonists: 2 due to severe nausea/vomiting, 1 due to lack of perceived benefit, and 1 due to change in insurance coverage. This report is the largest published series to date of pwCF treated with GLP-1 agonist therapy. With the addition of GLP-1 agonists, all individuals experienced weight loss and a reduction in daily insulin dose, and most had improvement in pulmonary function. Future multi-center studies are needed to corroborate the efficacy and safety of these agents in the CF population.

The Impact of Chemotherapy on the Nutritional Status of Breast Cancer Patients.

Breast cancer is one of the most common cancers among Pakistani women. It is mostly diagnosed at stage 2, requiring chemotherapy in certain cases. Chemotherapy is of two types: adjuvant and neoadjuvant. It can be recommended at any stage of cancer, either in early stages to shrink the tumor or in late stages to improve quality of life. The side effects may include weight loss, fatigue, hair loss, sores in the mouth, loss of appetite, nausea, vomiting, difficulty swallowing, throat problems, diarrhea, infections, and anemia, which can deteriorate health. Some women may experience weight gain during treatment, which is a risk factor for cancer recurrence. Chemotherapy has many side effects that can directly affect dietary patterns and worsen nutritional status. This study aimed to evaluate the changes in dietary patterns of breast cancer patients during and after chemotherapy and assess how the side effects of chemotherapy affect their nutritional status. Data were collected from 200 breast cancer patients undergoing chemotherapy at Jinnah Hospital, Lahore, using a questionnaire and the Patient-Generated Subjective Global Assessment (PG-SGA) screening tool. The questionnaire included sociodemographic information, questions about disease, treatment, and dietary recall. PG-SGA was used to screen for malnutrition and assess nutritional status. Data collection occurred from September to December 2023. Most participants were female (99%), married (73.5%), and of low socioeconomic status (60.5%). The common stage of cancer was stage 3, and neoadjuvant chemotherapy was recommended for most participants. Effects on body weight varied, with some experiencing weight loss, others weight gain, and some no change. Side effects such as vomiting, nausea, diarrhea, dry mouth, loss of appetite, altered taste and smell, and anemia were commonly reported. Most participants were moderately malnourished or suspected of malnutrition and needed intervention for symptom management. A majority (82%) were overweight or obese according to BMI, indicating a higher risk of cancer recurrence. Participants' dietary intake mainly consisted of carbohydrate- and protein-rich foods during treatment. The side effects of chemotherapy varied among patients. The impact on body weight also differed, with some experiencing weight loss, others weight gain, and some no change. Regarding nutritional status, most patients were moderately malnourished, while a few were severely malnourished.

Mucosal Immunization with an Influenza Vector Carrying SARS-CoV-2 N Protein Protects Naïve Mice and Prevents Disease Enhancement in Seropositive Th2-Prone Mice.

Background/Objectives: Intranasal vaccination enhances protection against respiratory viruses by providing stimuli to the immune system at the primary site of infection, promoting a balanced and effective response. Influenza vectors with truncated NS1 are a promising vaccine approach that ensures a pronounced local CD8+ T-cellular immune response. Here, we describe the protective and immunomodulating properties of an influenza vector FluVec-N carrying the C-terminal fragment of the SARS-CoV-2 nucleoprotein within a truncated NS1 open reading frame. Methods: We generated several FluVec-N recombinant vectors by reverse genetics and confirmed the vector's genetic stability, antigen expression in vitro, attenuation, and immunogenicity in a mouse model. We tested the protective potential of FluVec-N intranasal immunization in naïve mice and seropositive Th2-prone mice, primed with aluminium-adjuvanted inactivated SARS-CoV-2. Immune response in immunized and challenged mice was analyzed through serological methods and flow cytometry. Results: Double intranasal immunization of naïve mice with FluVec-N reduced weight loss and viral load in the lungs following infection with the SARS-CoV-2 beta variant. Mice primed with alum-adjuvanted inactivated coronavirus experienced substantial early weight loss and eosinophilia in the lungs during infection, demonstrating signs of enhanced disease. A single intranasal boost immunization with FluVec-N prevented the disease enhancement in primed mice by modulating the local immune response. Protection was associated with the formation of specific IgA and the early activation of virus-specific effector and resident CD8+ lymphocytes in mouse lungs. Conclusions: Our study supports the potential of immunization with influenza vector vaccines to prevent respiratory diseases and associated immunopathology.

Gastrointestinal cancer surgery in the elderly: The effects of preoperative oral nutritional supplements - A retrospective study.

The current study aimed to explore the effect of nutritional prehabilitation on the clinical prognosis of elderly patients undergoing abdominal cancer surgery. A retrospective study was conducted, where participants were divided into two groups based on whether they received oral nutritional supplementation at the first outpatient visit. The nutritional prehabilitation group (n=41) adopted a nutritional prehabilitation mode (a standard energy intake of 25-30 kcal/kg· d was recommended). While the control group (n=55) received routine care. All patients underwent laparoscopic surgery according to the National Comprehensive Cancer Network (NCCN) guidelines. Changes in nutritional status, complications, psychological status, symptoms, hospitalization days, and expenditures were compared between the two groups. Both groups of patients experienced weight loss. However, the decline in body weight in the prehabilitation group was less than that in the control group (-1.88 vs. -2.56 kg, p < 0.001). In the comparison of nutritional prehabilitation group and control group, significant improvements were observed in the Hospital Anxiety Scale scores (5 vs. 5, p = 0.01) and MD Anderson Symptom Inventory scores (3 vs. 0, p < 0.001) respectively. The infection rate in the nutritional prehabilitation group was lower than that in the control group (17.1% vs. 36.4%, p = 0.04). Additionally, patients in the nutritional prehabilitation group had significantly fewer hospitalization days at discharge (14.3 vs. 17.1 days, p = 0.03). In elderly patients undergoing abdominal cancer surgery, a nutritional prehabilitation model may help maintain better physical and mental status, reduce infection rates, and shorten hospitalization days.

Perspectives on weight change and antiretroviral therapy from people living with HIV in New York City: A qualitative study.

Some people living with HIV experience weight gain or loss after initiating or switching antiretroviral therapy (ART) regimens. There is limited research on how perceptions of weight change affect health behaviors in this population. We interviewed 61 people living with HIV (aged 23-65; 51% cisgender men, 36% cisgender women, 13% transgender/nonbinary; 87% Black and/or Hispanic) in New York City about their feelings about weight change. Using an inductive thematic approach, we identified four themes: weight changes were attributed to external and internal factors; weight management was seen as an individual responsibility; feeling in control of one's health was linked to body image satisfaction; and one's sense of control related to health behaviors in divergent ways. Low perceived control could interfere with recommended behaviors, but some long-term survivors focused on controlling what they could. Healthcare providers should consider HIV patients holistically and be aware of ART's impact in their daily lives.

Oropharyngeal Dysphagia as The Presenting Symptom of Myasthenia Gravis with Diabetes Mellitus

Background: Oropharyngeal dysphagia may caused by a variety of causes. Myasthenia gravis is a common autoimmune disease affecting the neuromuscular junction. While ocular symptoms are common in myasthenia gravis, bulbar symptoms such as dysarthria and dysphagia are less common. Aim: To present the importance of recognizing atypical presentations of myasthenia gravis and utilizing electromyography in diagnosis when AChR antibody testing is unavailable. Case Presentation: A 57-year-old woman was referred because of progressive dysphagia for both solid and liquid food. She also experienced weight loss, heaviness of the right eyelid, drooling, and chewing difficulty. Medical history revealed diabetes. Vital signs were stable. Physical examination revealed right ptosis without any other neurological deficits. Wartenberg test and dysarthria counting test were positive. Laboratory examination revealed a blood glucose level of 270 mg/dL and an HbA1c level of 9.4%. The barium swallow study revealedno abnormalities. Esophagogastroduodenoscopy revealed esophageal candidiasis. Electromyography showed more than 20% decremental response of the orbicularis oculi muscle. This result is suggestive of neuromuscular junction disorder. Improvement of the condition was achieved after the administration of intravenous steroids and oral pyridostigmine combined with therapeutic plasma exchange. Discussion: Oropharyngeal dysphagia accompanied by ptosis and positive Wartenberg &amp; dysarthria counting test is suggestive of myasthenia gravis. Although an AChR antibody test cannot be performed, significant electromyography alongside relevant clinical presentation is sufficient to diagnose myasthenia gravis. Conclusion: It is crucial to recognize the accompanying signs and symptoms of oropharyngeal dysphagia. EMG may be used to diagnose MG in the appropriate clinical context.

Establishment of a mouse model of ovarian oxidative stress induced by hydrogen peroxide.

Oxidative stress, resulting from environmental changes, significantly affects female fertility. Developing a mouse model to study oxidative stress lays the groundwork for research into human reproductive health and livestock fertility. In this study, we established and evaluated an oxidative stress model by administering hydrogen peroxide (H2O2) to mice. ICR mice of similar age (7-8 weeks old) and average body weight (31.58 ± 1.12 g) were randomly assigned to four groups (A, B, C, and D). Group A served as the control and was injected with a saline solution, while groups B, C, and D received saline solutions containing 0.75%, 1.50%, and 3.0% H2O2, respectively, over one week. We measured the body weights of all mice before and after the experimental period. Our findings showed that the average body weight of mice in groups A and B increased, while groups C and D experienced weight loss. Group C showed a significantly lower average weight gain compared to groups A and B, and group D exhibited an even more pronounced reduction in weight gain. Although group D had a high mortality rate, there was no significant difference in mortality rates among groups B, C, and D. Serum malondialdehyde (MDA) content increased with higher concentrations of H2O2, with a significant difference noted between groups C and A. Catalase (CAT) activity in group B was significantly higher than in group A, while superoxide dismutase (SOD) activity in group C was notably elevated compared to groups A and B. Conversely, glutathione peroxidase (GSH-Px) activity in group C was significantly lower than in both group A and group B. Hematoxylin and eosin (HE) staining revealed changes in ovarian morphology and follicle dynamics. The percentage of atretic follicles in group C was significantly higher than in the control group, and group D had a significantly lower total number of healthy follicles compared to the untreated group. Increased H2O2 content resulted in a reduction of ovary size and an irregular appearance in group D. Based on our findings, treatment with 1.50% H2O2 effectively established an oxidative stress model in mice within 1 week. This model serves as a valuable reference for future clinical studies on oxidative stress and reproductive disorders in female animals and humans.

Relationship Between The Compliance of Antiretroviral Therapy and The Occurrence of Underweight Conditions, Calf Circumference, Handgrip Strength, and Triceps Skinfold in HIV/AIDS Patients at RSSA Malang

Background: Human Immunodeficiency Virus or commonly known as HIV is a virus that infects CD4 cells thereby impaired the human immune system. The number of new HIV cases in Indonesia in 2019 was reported to have reached 50,282 cases and tends to increase from year to year. What often happens in people with HIV/AIDS (PLWHA) tends to experience weight loss accompanied by opportunistic infections that do not occur in normal people. Adherence to therapy is the main factor that must be emphasized by PLWHA in order to achieve treatment success. However, ARV therapy adherence rates are reported to be &lt;80%. This number can be a predictor of therapy failure. One indicator of the success of therapy is when there is clinical improvement in the patient's condition, such as no opportunistic infections or weight gain. Aim: The aim of this study was to determine whether there is a relationship between adherence to antiretroviral therapy and underweight conditions in HIV/AIDS patients. Methods: This study used a cross sectional design with an analytical observational nature and the research subjects were patients at RSSA Malang who visited from June to August 2023. Results: The results of the study showed that there was a significant relationship between adherence to taking ARVs and being underweight (p=0.018) and there was no significant relationship between adherence to taking ARVs with calf circumference, handgrip strength, and triceps skinfold. Conclusion: The conclusion of this study is that the more compliant the patient is with ARV therapy, the higher the increase in body mass index and the smaller the possibility of becoming underweight.

Evidence for SARS-CoV-2 infected Golden Syrian hamsters (Mesocricetus auratus) reducing daily energy expenditure and body core temperature

Golden Syrian hamsters (Mesocricetus auratus) are a well-established animal model for human infections with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) due to their susceptibility to SARS-CoV-2 infection, robust virus replication and pathological manifestations similar to human COVID-19 pneumonia. To investigate the physiological changes upon infection in this animal model, we explored the alterations in daily energy expenditure (DEE), water turnover, body mass, body temperature, and locomotor activity in non-infected and SARS-CoV-2 infected Golden Syrian hamsters for four days post SARS-CoV-2. DEE was measured using the doubly labelled water method, which allows for the accurate estimation of carbon dioxide production and, consequently, energy expenditure in animals. Additionally, we investigated total water intake (TWI), which comprises drinking water, preformed water in food, and metabolic water. Using intraperitoneally implanted data loggers, we also monitored body core temperature and locomotor activity in some of the animals. Here we provide evidence for infected hamsters exhibiting significantly lower DEE and TWI compared to non-infected animals. We also observed an increase in body weight in the non-infected animals, while infected animals experienced weight loss. Further, infected animals showed a significantly decreased body temperature, indicating a generally lowered metabolic rate.

Comparison of Manometric Changes in Achalasia Pre &amp; Post Poem Procedure

Abstract Background Achalasia is characterized by the absence of peristaltic movement in the lower esophageal sphincter, resulting in impaired relaxation during food ingestion. The incidence of achalasia is similar between men and women, affecting approximately 1 in 100,000 individuals annually, with a prevalence of 10 in 100,000 people. It is most commonly diagnosed in individuals between the ages of 30 and 60 years. High-resolution esophageal manometry is considered the gold standard for diagnosis, revealing esophageal body aperistalsis and hypertensive lower esophageal sphincter. While laparoscopic myotomy has been the standard treatment, peroral endoscopic myotomy (POEM) has emerged as a safe and effective alternative with positive short-term and medium-term outcomes. Aim of the Work The aim of this study was to evaluate the changes in esophageal motility following POEM in patients with achalasia by conducting repeated high-resolution esophageal manometry after the procedure. The study focused on patients diagnosed with achalasia using UGI endoscopy, barium swallow, and high-resolution esophageal manometry, with an Eckardt score above 3. Methods A total of 21 patients participated in the study, with a mean age of 35.23±7.2 years. Females accounted for 61.9% of the sample, and the mean height was 164.66±10.5 cm. Clinical symptoms assessed included dysphagia, retrosternal pain, regurgitation, and weight loss. Additionally, previous medical history, pneumatic dilatation, and Heller's myotomy were documented. The type of achalasia was classified as type I or type II. Key parameters of lower esophageal sphincter (LES) relaxation were analyzed pre- and post-POEM. Results All patients presented with dysphagia, retrosternal pain, and regurgitation, while 71.4% experienced weight loss. Four patients (19.1%) had type I achalasia, and 17 patients (80.9%) had type II achalasia. Significant differences were observed between pre-POEM and post-POEM measurements of integrated relaxation pressure (IRP) and LES parameters, as well as Eckardt scores. However, no statistically significant differences were found in weight and LES length between pre- POEM and post-POEM measurements. The type of achalasia did not significantly impact LES parameters pre- and post-POEM. Eckardt score, IRP, and LES length were identified as relevant predictors of the outcome in achalasia patients. Conclusion Peroral endoscopic myotomy (POEM) effectively reduces lower esophageal sphincter pressure in achalasia and partially restores esophageal body motility. It represents an advanced therapeutic- surgical endoscopic procedure with high short-term and medium-term success rates in treating achalasia and other esophageal motor disorders. Adverse events associated with POEM are minor and easily manageable. POEM is considered a safe and feasible treatment option for different types of achalasia. However, the efficacy of POEM may not be reflected by the clinical subtypes of achalasia.

Relationship Between Weight Loss Experience And Subsequent Health Status In Growing Female Judo Athletes

Relationship Between Weight Loss Experience And Subsequent Health Status In Growing Female Judo Athletes

Tonsillectomy Under the Microscope: Is Routine Histopathological Analysis Necessary?

Introduction Tonsillectomy is the most common surgery in otorhinolaryngology worldwide, with many indications in adults and children. Traditionally, all tonsillectomy specimens are routinely submitted for histopathological examination, even in the absence of clinical suspicion of malignancy. This practice has been debated due to its resource implications and the low yield of malignancy in routine cases. In this study, we aim to determine the prevalence of occult malignancy in our population and assess the necessity of histopathology examination after routine tonsillectomies. Methodology This retrospective chart review was conducted on patients who underwent tonsillectomy between January 2018 and December 2019 at a single tertiary care center. The patients were divided into two groups: those undergoing routine tonsillectomy without clinical suspicion of malignancy and those with suspected malignancy based on preoperative evaluation. Results A total of 1857 tonsillectomy cases were analyzed, comprising 1839 routine cases with no suspicion of malignancy and 18 cases where malignancy was suspected. Among the routine cases, 1609 (87.5%) were pediatric patients, and 230 (12.5%) were adult patients. All cases in the suspected malignancy group were adults. In the routine tonsillectomy group, recurrent tonsillitis was the most common indication for surgery, observed in 821 (51.1%) pediatric patients and 160 (69.6%) adult patients. Reactive lymphoid hyperplasia was the most common histopathological finding, present in 1589 (98.8%) pediatric cases and 187 (81.3%) adult cases. No unexpected malignancies were identified in the routine tonsillectomy group (0%). In the suspected malignancy group, reactive lymphoid hyperplasia was identified in 13 cases (72.2%), lymphoma in four cases (22.2%), and squamous cell carcinoma (SCC) in one case (5.6%). All patients diagnosed with lymphoma presented with visible tonsillar lesions and palpable neck lymph nodes, three (75%) exhibited tonsillar asymmetry, and two (50%) reported weight loss. The single patient with SCC had asymmetrical tonsils, a visible tonsillar lesion, and palpable neck lymph nodesand experienced weight loss. Conclusion The study findings demonstrated no cases of unexpected malignancy in routine tonsillectomy specimens, reinforcing the argument that routine histopathological examination may not be necessaryin the absence ofclinical suspicion of malignancy. These results, along with considerations of cost-effectiveness and resource optimization, suggest that histopathological analysis maybe reserved only for cases with clinical indicators of malignancy.

Association Between Body Mass Index Changes and All-Cause Mortality in Parkinson's Disease.

Whether body weight changes are associated with Parkinson's disease (PD) mortality remains uncertain. To investigate the association between changes in body mass index (BMI) and all-cause mortality in patients with PD. This nationwide cohort study enrolled 20,703 individuals with new-onset PD (ICD-10 code: G20 and a rare intractable disease registration code: V124) who underwent health screening program by the Korean National Health Insurance Service within two years from pre- and post-PD diagnosis. We identified nine BMI change groups based on three BMI status: underweight (BMI < 18.5 kg/m2), normal or overweight (18.5 kg/m2≤BMI < 25 kg/m2), and obese (BMI≥25 kg/m2). Of 20,703 individuals, 3,789 (18.0%) died during the follow-up period. Excessive weight loss to underweight in the obese group (hazard ratio [HR] = 3.36, 95% CI:1.60-7.08), weight loss in the normal to overweight group (HR = 2.04, 95% CI:1.75-2.39), sustained underweight status (HR = 2.05, 95% CI:1.67-2.52), and weight gain from underweight to normal or overweight (HR = 1.52, 95% CI:1.15-2.02) were associated with increased mortality. Sustained obese status (HR = 0.80, 95% CI:0.74-0.87) and weight gain in the normal to overweight group (HR = 0.82, 95% CI:0.71-0.95) were associated with reduced mortality. We found that BMI change at diagnosis was associated with mortality in patients with PD. Specifically, being underweight either before or after diagnosis as well as experiencing weight loss, were associated with increased mortality. These findings provide valuable insights for weight management planning in PD, highlighting the importance of individualized approach that consider pre-diagnosis BMI.

Identifying risk factors of dose reduction or treatment discontinuation due to fatigue or gastrointestinal symptoms in patients receiving lenvatinib treatment for hepatocellular carcinoma

Introduction Lenvatinib (LEN) is the standard treatment for hepatocellular carcinoma (HCC). In clinical practice, gastrointestinal (GI) symptoms such as fatigue and loss of appetite often lead to dose reduction or treatment discontinuation. This study aimed to identify the predictors of patients who will experience dose reduction or treatment discontinuation owing to fatigue or GI symptoms during LEN treatment for HCC. Methods We retrospectively identified 99 patients who received LEN at the Ogaki Municipal Hospital (Ogaki, Japan) between April 2018 and December 2023. To investigate the risk factors for treatment discontinuation or dose reduction due to fatigue or GI symptoms during LEN administration, patients were divided into two groups based on whether treatment discontinuation or dose reduction occurred due to fatigue or GI symptoms during LEN administration (37 patients) or not (62 patients). We compared baseline characteristics between the two groups. Results Multivariate analysis revealed that body weight (odds ratio 4.310, 95% confidence interval 1.380–13.500; P = 0.002) was an independent risk factor that significantly contributed to treatment discontinuation or dose reduction owing to fatigue or GI symptoms during LEN administration. The cut-off value calculated using the body weight curve was 55.0 kg. Using this cutoff value, the sensitivity and specificity of body weight to detect treatment discontinuation or dose reduction due to fatigue or GI symptoms during LEN administration were 83.9% and 56.8%, respectively. Conclusion In clinical practice, patients weighing less than 55 kg who start with a full dose will likely experience weight loss or discontinuation during treatment.