Publications by authors named "Saeed Shoar"

115 Publications

Clinical Features and Outcomes of Community-Acquired Pneumonia Caused by Influenza.

Open Forum Infect Dis 2021 Apr 8;8(4):ofaa622. Epub 2021 Apr 8.

Baylor College of Medicine, Houston, Texas, USA.

Background: Long regarded as the second most common cause of community-acquired pneumonia (CAP), has recently been identified with almost equal frequency as pneumococcus in patients hospitalized for CAP. The literature lacks a detailed description of the presentation, clinical features, laboratory and radiologic findings, and outcomes in pneumonia.

Methods: During 2 prospective studies of patients hospitalized for CAP, we identified 33 patients with pneumonia. In order to provide context, we compared clinical findings in these patients with findings in 36 patients with pneumococcal pneumonia identified during the same period. We included and analyzed separately data from patients with viral coinfection. Patients with coinfection by other bacteria were excluded.

Results: pneumonia occurred in older adults who had underlying chronic lung disease, cardiac conditions, and alcohol use disorder, the same population at risk for pneumococcal pneumonia. However, in contrast to pneumococcal pneumonia, patients with pneumonia had less severe infection as shown by absence of septic shock on admission, less confusion, fewer cases of leukopenia or extreme leukocytosis, and no deaths at 30 days. Viral coinfection greatly increased the severity of , but not pneumococcal pneumonia.

Conclusions: We present the first thorough description of pneumonia, show that it is less severe than pneumococcal pneumonia, and document that viral coinfection greatly increases its severity. These distinctions are lost when the label CAP is liberally applied to all patients who come to the hospital from the community for pneumonia.
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http://dx.doi.org/10.1093/ofid/ofaa622DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8028099PMC
April 2021

Recurrent coronavirus diseases 19 (COVID-19): A different presentation from the first episode.

Clin Case Rep 2021 Feb 23. Epub 2021 Feb 23.

Department of Clinical Research Scientific Writing Corporation Houston TX USA.

A 31-year-old Caucasian male developed reinfection with SARS-CoV-2, 2 ½ months after an initial episode of ICU admission for respiratory support due to COVID-19. The second episode was in the form of malaise, aphthous gingival ulcer, and desquamating palmar lesion.
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http://dx.doi.org/10.1002/ccr3.3967DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8013608PMC
February 2021

ICU admission and outcome of patients with COVID-19: Does ICU stay improve survival?

Authors:
Saeed Shoar

Heart Lung 2021 May-Jun;50(3):470. Epub 2021 Jan 26.

Department of Clinical Research, ScientificWriting Corporation, 3403 Garth Rd., Houston, TX, United States. Electronic address:

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http://dx.doi.org/10.1016/j.hrtlng.2021.01.017DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7837627PMC
April 2021

D-dimer and poor clinical outcome in patients with COVID-19: lessons from meta-analysis of case-control studies.

Authors:
Saeed Shoar

Heart Lung 2021 Mar-Apr;50(2):298. Epub 2021 Jan 12.

Department of Clinical Research, ScientificWriting Corporation, 3403 Garth Rd., Ste#1305, Baytown, TX, United States. Electronic address:

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http://dx.doi.org/10.1016/j.hrtlng.2021.01.004DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7803148PMC
March 2021

Intrathoracic gastric fistula after bariatric surgery: a systematic review and pooled analysis.

Surg Obes Relat Dis 2021 Mar 7;17(3):630-643. Epub 2020 Nov 7.

Department of Surgery, Metropolitan Hospital Center, New York Medical College, New York, NY.

Even in the hands of highly experienced bariatric surgeons, perioperative complications are inevitable. Of these, leaks and fistulas are amongst the scariest complications. Intrathoracic gastric fistulas (ITGF) can be associated with serious morbidity, mostly when cases are misdiagnosed or detected with delay. This is a systematic review of the literature to investigate the clinical and surgical outcomes of morbidly obese adult patients with a confirmed diagnosis of ITGF following bariatric surgery. A pooled analysis of 25 articles, encompassing 76 patients with post-bariatric ITGF, showed that the clinical outcome depends on the initial presentation, timing of the diagnosis in relation to symptom onset, and prompt and effective treatment. Any septic or unstable patient must undergo urgent surgical intervention, while stable patients might tolerate a step-up approach and watchful waiting for nonsurgical treatment. Among those who undergo surgery, treatment failure and the mortality rate are substantially high. Contingent upon a prompt management strategy, patients with postbariatric ITGF can generally have a favorable outcome in the long term.
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http://dx.doi.org/10.1016/j.soard.2020.10.030DOI Listing
March 2021

Effect of pre-existing left bundle branch block on post-procedural outcomes of transcatheter aortic valve replacement: a meta-analysis of comparative studies.

Am J Cardiovasc Dis 2020 15;10(4):294-300. Epub 2020 Oct 15.

The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai NY, USA.

Background: As an established procedure for patients with aortic valve stenosis and a high surgical risk profile, transcatheter aortic valve replacement (TAVR) can be associated with conductance abnormalities. However, data regarding the impact of pre-existing left bundle branch block (LBBB) on post-TAVR outcome is scarce.

Objectives: We conducted this meta-analysis to pool available data in the literature on the impact of pre-existing LBBB on the clinical outcomes of patients undergoing TAVR.

Methods: We queried Medline/PubMed, Scopus, and Cochrane Library to identify comparative studies of patients with and without a pre-existing LBBB undergoing TAVR for aortic stenosis. Risk ratio (RR) and the corresponding 95% confidence interval (95% CI) were estimated to measure the effect of pre-existing LBBB on developing post-procedure stroke, permanent pacemaker implantation (PPM), or moderate/severe aortic regurgitation (AR).

Results: Data of three clinical trials encompassing 4,668 patients undergoing TAVR were included in this meta-analysis. Patients with pre-existing LBBB prior to TAVR had an increased risk of developing moderate/severe AR (RR = 1.04 [0.79-1.37]; P = 0.77), stroke (RR = 1.72 [0.61-4.85]; P = 0.31), and a need for PPM implantation (RR = 4.43 [0.43-45.64]; P = 0.21) following TAVR.

Conclusion: Preexisting LBBB seems to increase the risk of developing stroke, aortic regurgitation, and the need for a permanent pacemaker implantation. However, due to scarcity of data and high heterogeneity among the current studies, further clinical trials are warranted.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7675150PMC
October 2020

Etiology of community-acquired pneumonia in adults: a systematic review.

Pneumonia (Nathan) 2020 5;12:11. Epub 2020 Oct 5.

Medical Care Line (Infectious Disease Section), Michael E. DeBakey Veterans Affairs Medical Center, 2002 Holcombe Boulevard, Room 4B-370, Houston, TX 77030 USA.

Background: The etiology of community-acquired pneumonia (CAP) has evolved since the beginning of the antibiotic era. Recent guidelines encourage immediate empiric antibiotic treatment once a diagnosis of CAP is made. Concerns about treatment recommendations, on the one hand, and antibiotic stewardship, on the other, motivated this review of the medical literature on the etiology of CAP.

Methods: We conducted a systematic review of English-language literature on the etiology of CAP using methods defined by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched PubMed using a combination of the keywords 'pneumonia', 'CAP', 'etiology', 'microbiology', 'bacteriology', and 'pathogen'. We examined articles on antibiotics that were develop to treat pneumonia. We reviewed all 'related articles' as well as studies referenced by those that came up in the search. After we excluded articles that did not give sufficient microbiological data or failed to meet other predetermined criteria, 146 studies remained. Data were stratified into diagnostic categories according to the microbiologic studies that were done; results are presented as the percentage in each category of all cases in which an etiology was established.

Results: remains the most common cause of CAP although declining in incidence; this decline has been greater in the US than elsewhere. is the second most common cause of CAP, followed by and Gram negative bacilli. The incidence of all bacteria as causes of CAP has declined because, with routine use of PCR for viruses, the denominator, cases with an established etiology, has increased. Viruses were reported on average in about 10% of cases, but recent PCR-based studies identified a respiratory virus in about 30% of cases of CAP, with substantial rates of viral/bacterial coinfection.

Conclusion: The results of this study justify current guidelines for initial empiric treatment of CAP. With pneumococcus and continuing to predominate, efforts at antibiotic stewardship might be enhanced by greater attention to the routine use of sputum Gram stain and culture. Because viral/bacterial coinfection is relatively common, the identification of a virus by PCR does not, by itself, allow for discontinuation of the antibiotic therapy.
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http://dx.doi.org/10.1186/s41479-020-00074-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7533148PMC
October 2020

Etiology of community-acquired pneumonia in adults: a systematic review.

Pneumonia (Nathan) 2020 5;12:11. Epub 2020 Oct 5.

Medical Care Line (Infectious Disease Section), Michael E. DeBakey Veterans Affairs Medical Center, 2002 Holcombe Boulevard, Room 4B-370, Houston, TX 77030 USA.

Background: The etiology of community-acquired pneumonia (CAP) has evolved since the beginning of the antibiotic era. Recent guidelines encourage immediate empiric antibiotic treatment once a diagnosis of CAP is made. Concerns about treatment recommendations, on the one hand, and antibiotic stewardship, on the other, motivated this review of the medical literature on the etiology of CAP.

Methods: We conducted a systematic review of English-language literature on the etiology of CAP using methods defined by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched PubMed using a combination of the keywords 'pneumonia', 'CAP', 'etiology', 'microbiology', 'bacteriology', and 'pathogen'. We examined articles on antibiotics that were develop to treat pneumonia. We reviewed all 'related articles' as well as studies referenced by those that came up in the search. After we excluded articles that did not give sufficient microbiological data or failed to meet other predetermined criteria, 146 studies remained. Data were stratified into diagnostic categories according to the microbiologic studies that were done; results are presented as the percentage in each category of all cases in which an etiology was established.

Results: remains the most common cause of CAP although declining in incidence; this decline has been greater in the US than elsewhere. is the second most common cause of CAP, followed by and Gram negative bacilli. The incidence of all bacteria as causes of CAP has declined because, with routine use of PCR for viruses, the denominator, cases with an established etiology, has increased. Viruses were reported on average in about 10% of cases, but recent PCR-based studies identified a respiratory virus in about 30% of cases of CAP, with substantial rates of viral/bacterial coinfection.

Conclusion: The results of this study justify current guidelines for initial empiric treatment of CAP. With pneumococcus and continuing to predominate, efforts at antibiotic stewardship might be enhanced by greater attention to the routine use of sputum Gram stain and culture. Because viral/bacterial coinfection is relatively common, the identification of a virus by PCR does not, by itself, allow for discontinuation of the antibiotic therapy.
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http://dx.doi.org/10.1186/s41479-020-00074-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7533148PMC
October 2020

Meta-analysis of Cardiovascular Events and Related Biomarkers Comparing Survivors Versus Non-survivors in Patients With COVID-19.

Am J Cardiol 2020 11 8;135:50-61. Epub 2020 Sep 8.

Department of Medicine (Cardiology), Central Arkansas Veterans Healthcare System, University of Arkansas for Medical Sciences, Little Rock, AR. Electronic address:

Since the emergence of the coronavirus disease 19 (COVID-19), a number of studies have reported the presence of cardiovascular diseases in affected patients and linked them with a higher risk of mortality. We conducted an online search in Medline/PubMed to identify original cohorts comparing data between survivors and non-survivors from COVID-19. The presence of cardiovascular events and related biomarkers were compared between the 2 groups. Data on 1,845 hospitalized patients with COVID-19 were pooled from 12 comparative studies. The overall mortality rate in relation to COVID-19 was 17.6%. Men aged > 50 years old were more likely to die from COVID-19. Significant co-morbidities contributing to mortality were hypertension, diabetes mellitus, smoking, a previous history of cardiovascular disease including chronic heart failure, and cerebrovascular accidents. A significant relationship was observed between mortality and patient presentation with dyspnea, fatigue, tachycardia, and hypoxemia. Cardiovascular disease-related laboratory biomarkers related to mortality were elevated serum level of lactate dehydrogenase, creatine kinase, brain natriuretic peptide, and cardiac troponin I. Adverse cardiovascular disease-related clinical events preceding death were shock, arrhythmias, and acute myocardial injury. In conclusion, severe clinical presentation and elevated biomarkers in COVID-19 patients with established risk factors can predict mortality from cardiovascular causes.
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http://dx.doi.org/10.1016/j.amjcard.2020.08.044DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7477637PMC
November 2020

Regarding the publication "Rivaroxaban versus warfarin in patients with non-valvular atrial fibrillation and stage IV-V chronic kidney disease".

Am Heart J 2020 05 6;223:110. Epub 2020 Mar 6.

Department of Surgery, Metropolitan Hospital Center, New York Medical College, Manhattan, NY.

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http://dx.doi.org/10.1016/j.ahj.2020.03.001DOI Listing
May 2020

Corona virus disease-19 (COVID-19) presenting as conjunctivitis: atypically high-risk during a pandemic.

Cont Lens Anterior Eye 2020 06 27;43(3):211-212. Epub 2020 Apr 27.

Department of Clinical Research, Scientific Writing Corporation, 6345 Garth Rd., Ste#110, P.B.#109, Baytown, TX, 77521, United States. Electronic address:

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http://dx.doi.org/10.1016/j.clae.2020.04.010DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7184016PMC
June 2020

Letter to the Editor Concerning "Glycosylated Hemoglobin as a Surrogate for the Prediction of Cardiovascular Events in Cardiovascular Outcome Trials Comparing New Antidiabetic Drugs to Placebo".

Cardiology 2020 30;145(6):388-389. Epub 2020 Apr 30.

Department of Surgery, Metropolitan Hospital Center, New York Medical College, Manhattan, New York, USA.

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http://dx.doi.org/10.1159/000507507DOI Listing
June 2020

Independent risk factors for ICU mortality after left ventricular assist device implantation.

Artif Organs 2020 02 10;44(2):193-194. Epub 2019 Nov 10.

HCA Houston Healthcare, Gulf Coast Division, Houston, Texas.

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http://dx.doi.org/10.1111/aor.13576DOI Listing
February 2020

Night eating syndrome: a psychiatric disease, a sleep disorder, a delayed circadian eating rhythm, and/or a metabolic condition?

Expert Rev Endocrinol Metab 2019 09 19;14(5):351-358. Epub 2019 Sep 19.

Clinical Research Scientist, ScientificWriting Corporation , Houston , TX , USA.

: Night Eating Syndrome (NES) refers to an abnormal eating behavior which presents as evening hyperphagia consuming >25% calorie intake and/or nocturnal awaking with food ingestion which occurs ≥2 times per week. Although the syndrome has been described more than seven decades ago, the literature has been growing slowly on its etiology, diagnosis, and treatment. : The proposed treatment options for NES are all at a case-study level. Moreover, our understanding of its etiology, comorbidities, and diagnosis is still premature. We performed a literature review in Medline/PubMed to identify all the studies proposing a management plan for NES and summarized all the existing data on its diagnosis and treatment. : To date, none of the proposed treatment options for NES have been promising and long-term data on its efficacy is lacking. The slow growth of evidence on this debilitating but underreported condition may be due to unawareness among clinicians, under-reporting by patients, and unrecognized diagnostic criteria. Objective screening of symptoms during office visits especially for patients at a high-risk for NES will identify more patients suffering from the syndrome.
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http://dx.doi.org/10.1080/17446651.2019.1657006DOI Listing
September 2019

Banded versus nonbanded Roux-en-Y gastric bypass: a systematic review and meta-analysis of randomized controlled trials.

Surg Obes Relat Dis 2019 May 3;15(5):688-695. Epub 2019 Apr 3.

Bariatric and Metabolic Institute, Department of General Surgery, Cleveland Clinic, Cleveland, Ohio. Electronic address:

Background: Bariatric surgery is remarkably effective in achieving weight loss and improving obesity-related co-morbidities; however, efforts still continue to improve its long-term outcomes. Particularly, banded Roux-en-Y gastric bypass (RYGB) has been scrutinized in comparison to standard (nonbanded) RYGB in terms of benefits and postoperative complications.

Objectives: This study aims to compare the safety and efficacy of banded versus nonbanded RYGB.

Setting: Meta-analysis of randomized controlled trials (RCTs).

Methods: A meta-analysis of high-quality studies that compared banded and nonbanded RYGB was conducted through February 2019 by systematically searching multiple electronic databases. Published RCTs comparing these 2 procedures were included to pool the data on excess weight loss, food tolerability, and postoperative complications.

Results: Three RCTs were eligible to be included in this meta-analysis, comprising a total of 494 patients (247 in each group). Two of the RCTs provided 2-year postoperative data, and 1 study reported 5-year outcome. Age ranged from 21 to 50 years, and body mass index ranged from 42 to 65 kg/m. Percentage of excess weight loss was significantly greater with banded RYGB than with nonbanded RYGB (mean difference 5.63%; 95% CI 3.26-8.00; P < .05). Postoperative food intolerance, emesis, and dysphagia were more common after banded RYGB (odds ratio 3.76; 95% CI 2.27-6.24; P < .001). Nevertheless, major postoperative complications did not significantly differ between the 2 groups.

Conclusion: Findings of this meta-analysis of RCTs indicate that in a medium-term follow-up, excess weight loss with banded RYGB would be 5% greater than that with the nonbanded RYGB (about 1 point difference in body mass index) at the expense of more food intolerance and postoperative vomiting; however, the frequency of postoperative complications would not be significantly different.
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http://dx.doi.org/10.1016/j.soard.2019.02.011DOI Listing
May 2019

Letter to Editor regarding "preoperative liver shrinking diet for bariatric surgery may impact wound healing: A randomized controlled trial".

Surg Obes Relat Dis 2019 04 26;15(4):669-670. Epub 2018 Oct 26.

Imam Khomeini Complex Cancer Institute, Division of Surgical Oncology, Department of Surgery, Tehran University of Medical Science, Tehran, Iran.

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http://dx.doi.org/10.1016/j.soard.2018.10.018DOI Listing
April 2019

Comment on long-term outcomes of metabolic and bariatric surgery in adolescents with severe obesity with a follow-up of at least 5 years: a systematic review.

Surg Obes Relat Dis 2019 02 14;15(2):349-350. Epub 2019 Jan 14.

Imam Khomeini Complex Cancer Institute, Division of Surgical Oncology, Department of Surgery, Tehran University of Medical Science, Tehran, Iran.

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http://dx.doi.org/10.1016/j.soard.2019.01.004DOI Listing
February 2019

Alteration Pattern of Taste Perception After Bariatric Surgery: a Systematic Review of Four Taste Domains.

Obes Surg 2019 05;29(5):1542-1550

Cancer Institute, Imam Khomeini Hospital Complex, Division of Surgical Oncology, Department of Surgery, Tehran University of Medical Science, Tehran, Iran.

Background: Efforts continue to understand the underlying mechanism of weight loss after bariatric surgery. Taste perception has shown to be a contributing factor. However, the alteration pattern in different taste domains and among bariatric procedures has not been sufficiently investigated.

Objectives: To study the alteration pattern in the perception of four taste domains after different bariatric procedures.

Settings: Private Research Institute, USA.

Methods: A systematic review was conducted to pool available data in the literature on post-operative changes in the perception of sensitivity to four taste domains after Roux-en-Y gastric bypass (RYGB), laparoscopic sleeve gastrectomy (LSG), and adjustable gastric banding (AGB).

Results: Our study showed that bariatric surgery is associated with significant change in sensitivity to all four taste domains especially salt taste, sweetness, and sourness. LSG patients showed an increased sensitivity to all four taste domains. However, RYGB patients had a variable alteration pattern of taste perception but more commonly a decreased sensitivity to sweetness and an increased sensitivity to salt taste and sourness. Additionally, AGB patients had a decreased sensitivity to sweetness, salt taste, and sourness.

Conclusion: Bariatric surgery is associated with taste change in a way which results in less preference for high-calorie food and possibly reduced calorie intake. This may explain one of the mechanisms by which bariatric surgery produces weight loss. However, data are heterogeneous, the potential effect dilutes over time, and the alteration varies significantly between different procedures.
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http://dx.doi.org/10.1007/s11695-019-03730-wDOI Listing
May 2019

Letter to the editor on "Suspicious Index in Lyme Carditis (SILC): Systematic review and proposed new risk score".

Clin Cardiol 2018 12 5;41(12):1617-1618. Epub 2018 Dec 5.

Clinical Research Scientist and Consultant, ScientificWriting Corp, Houston, Texas.

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http://dx.doi.org/10.1002/clc.23122DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6489911PMC
December 2018

Letter to Editor on "Taste Changes after Bariatric Surgery: a Systematic Review".

Obes Surg 2019 01;29(1):309-310

Imam Khomeini Complex Cancer Institute, Division of Surgical Oncology, Department of Surgery, Tehran University of Medical Science, Tehran, Iran.

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http://dx.doi.org/10.1007/s11695-018-3584-2DOI Listing
January 2019

Outcomes of Bariatric Surgery Versus Medical Management for Type 2 Diabetes Mellitus: a Meta-Analysis of Randomized Controlled Trials.

Obes Surg 2019 03;29(3):964-974

Department of Surgery, College of Medicine, University of Oklahoma, 4502 E 41st Street, Tulsa, OK, 74135, USA.

Introduction: Bariatric surgery improves type 2 diabetes (T2D) in obese patients. The sustainability of these effects and the long-term results have been under question.

Objective: To compare bariatric surgery versus medical management (MM) for T2D based on a meta-analysis of randomized controlled trials (RCTs) with 2 years of follow-up.

Material And Methods: Seven RCTs with at least 2-year follow-up were identified. The primary endpoint was remission of T2D (full or partial). Four hundred sixty-three patients with T2D and body mass index > 25 kg/m were evaluated.

Results: After 2 years, T2D remission was observed in 138 of 263 patients (52.5%) with bariatric surgery compared to seven of 200 patients (3.5%) with MM (risk ratio (RR) = 10, 95% CI 5.5-17.9, p < 0.001). Subgroup analysis of the Roux-en-Y gastric bypass (RYGB) showed a significant effect size at 2 years in favor of RYGB over MM for a higher decrease of HbA1C (0.9 percentage points, 95% CI 0.6-1.1, p < 0.001), decrease of fasting blood glucose (35.3 mg/dl, 95% CI 13.3-57.3, p = 0.002), increase of high-density lipoprotein (HDL) (12.2 mg/dl, 95% CI 7.6-16.8, p < 0.001), and decrease of triglycerides (32.4 mg/dl, 95% CI 4.5-60.3, p = 0.02). Four studies followed patients up to 5 years and showed 62 of 225 patients (27.5%) with remission after surgery, compared to six of 156 patients (3.8%) with MM (RR = 6, 95% CI 2.7-13, p < 0.001).

Conclusion: This meta-analysis shows a superior and persistent effect of bariatric surgery versus MM for inducement of remission of T2D. This benefit of bariatric surgery was significant at 2 years and superior to MM even after 5 years. Compared with MM, patients with RYGB had better glycemic control and improved levels of HDL and triglycerides.
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http://dx.doi.org/10.1007/s11695-018-3552-xDOI Listing
March 2019

Portomesentric and splenic vein thrombosis (PMSVT) after bariatric surgery: a systematic review of 110 patients.

Surg Obes Relat Dis 2018 01 14;14(1):47-59. Epub 2017 Sep 14.

The Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, Ohio.

Background: Portomesenteric and splenic vein thrombosis (PMSVT) is a rare but potentially serious complication after bariatric surgery. No study has systematically analyzed its incidence and risk factors.

Objectives: To pool the data regarding PMSVT after bariatric surgery and determine its incidence and risk factors.

Methods: A meta-analysis and systematic review was conducted to retrieve studies on PMSVT after bariatric surgery.

Results: A total of 41 eligible studies including 110 patients with postbariatric PMSVT were enrolled; the estimated incidence rate based on 13 studies was .4%. The use of oral contraception was reported in 35.4% of patients, previous surgery in 61.1%, smoking in 37.2%, and history of coagulopathy in 43%. PMSVT mostly occurred after sleeve gastrectomy (78.9%) and within the first postoperative month (88.9%). Pneumoperitoneum pressure was>15 mm Hg in 6% of patients. The portal vein was the most commonly affected vessel (41.5%). Prothrombin 20210 mutation and protein C/S deficiency were the most common thrombophilic conditions. Unfractionated heparin (59.1%), vitamin K antagonists (50.9%), and low molecular weight heparin (39.1%) were the most common treatments for PMSVT. The morbidity and mortality rates for postbariatric PMSVT were 8.2% and 3.6%, respectively.

Conclusion: PMSVT usually occurs within the first postoperative month and is mostly reported after sleeve gastrectomy. The portal vein is the most commonly involved vessel. A previous hypercoagulable state can be an important risk factor. Most patients can be treated with anticoagulation therapy. Further studies with comprehensive data review of patient information are required.
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http://dx.doi.org/10.1016/j.soard.2017.09.512DOI Listing
January 2018

Single-Incision Laparoscopic Colectomy with Complete Mesocolic Excision Versus Multiport Laparoscopic Colectomy for Colon Cancer.

Dis Colon Rectum 2017 11;60(11):e631

1Division of Colorectal Surgery, Houston Methodist Hospital, Houston, Texas 2Department of Surgery, Cancer Institute, Imam Khomeini Hospital Complex, Tehran, University of Medical Sciences, Tehran, Iran 3Department of Medicine, Shahid Beheshti Hospital, Kashan University of Medical Sciences, Kashan, Iran.

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http://dx.doi.org/10.1097/DCR.0000000000000937DOI Listing
November 2017

Is Infection a Risk Factor for Prostatitis? A Case-Control Study in a Referring Tertiary Care Center.

Iran J Pathol 2016 ;11(4):323-327

Dept. of Pathology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.

Background: The optimal treatment is not possible yet for chronic prostatitis due to the unknown etiology of the diseases. We aimed to investigate the association of infection with chronic prostatitis.

Methods: In this prospective case-control study that conducted in Imam Hospital Complex affiliated to Tehran University of Medical Sciences in Tehran, Iran from 2014 to 2015, patients with diagnosis of chronic prostatitis according to the criteria of National Institute of Health (NIH) were enrolled. Control group constituted of consecutive healthy patients. Blood samples were obtained for each patient and control and evaluated for serum levels of anti IgG, A. Data analysis was carried out using SPSS, version 18. Values of <0.05 were considered statistically significant.

Results: Mean ± SD age of patients was 59.5 ± 3.08 yr in the case group and 56.88 ± 3.20 yr in the control group with no significant difference (>0.05). Mean ± SD levels of anti IgG and IgA in the control group were 9.36 ± 7.45 U/ml and 6.25 ± 7.29 U/ml, respectively compared with 20.94 ± 16.98 U/ml and 18.63 ± 15.65 U/ml in the case group, respectively both of which revealed statistically significant (<0.05).

Conclusion: Chronic prostatitis is associated with infection. Both anti IgG and IgA are increased in patients with chronic prostatitis. Therefore, treatment of HP infection could be effective in the prostatitis cure.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5563929PMC
January 2016

Single Anastomosis Duodeno-Ileal Switch (SADIS): A Systematic Review of Efficacy and Safety.

Obes Surg 2018 01;28(1):104-113

Bariatric and Metabolic Institute, Department of Surgery, The Brooklyn Hospital Center, Icahn School of Medicine at Mount Sinai, Brooklyn, NY, 11201, USA.

Background: Owing to the possibility of weight regain after the long-term follow-up of gastric bypass patients and because of the high morbidity of biliopancreatic diversion with duodenal switch, single-anastomosis duodeno-ileal switch (SADIS) has emerged as a rescue procedure in bariatric surgery.

Objective: The purpose of this review is to summarize the literature data on SADIS.

Setting: University Hospital, NY.

Methods: A comprehensive literature review was performed through October 2016 to identify English studies on SADIS performed in human subjects. Outcomes of interest were technical considerations, postoperative complications, weight loss outcome, comorbidity resolution rate, and nutritional deficiency after SADIS.

Results: A total of 12 studies including 581 SADIS patients (217 males and 364 females) were included. SADIS was a primary procedure in 508 patients (87.4%) and a conversion procedure in 73 patients (12.6%). The length of common limb was 300 cm in 54.2%, 250 cm in 23%, and 200 cm in 13.4% of patients. Anastomosis technique was a linear stapler in 26.7% and a hand sewn suture technique in 73.3% of patients. Diarrhea was the most common complication (1.2%). The average %EWL was 30% at 3 months, 55% at 6 months, 70% at 1 year, and 85% at 2 years. Co-morbidity resolution rate was 74.1% for type 2 diabetes mellitus, 96.3% for hypertension, 68.3% for dyslipidemia, 63.3% for obstructive sleep apnea, and 87.5% for GERD. Overall, vitamin A, selenium, and iron deficiency were the most common nutritional deficiencies with the possibility of the protein malnutrition in up to 34% of the patients when measured.

Conclusion: As a modified bariatric procedure, SADIS has promising outcomes for weight loss and comorbidity resolution in morbidly obese patients. When measured, there was a high prevalence of macro-nutrient deficiencies following SADIS. There is a high technical variability, and long-term data are required before any meaningful conclusion can be made.
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http://dx.doi.org/10.1007/s11695-017-2838-8DOI Listing
January 2018

Letter to the editor regarding "weight regain in patients with symptoms of post-bariatric surgery hypoglycemia".

Surg Obes Relat Dis 2017 11 19;13(11):1935-1936. Epub 2017 Jul 19.

Department of Bariatric and Metabolic Surgery, The Brooklyn Hospital Center, Icahn School of Medicine at Mount Sinai, Brooklyn, New York.

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http://dx.doi.org/10.1016/j.soard.2017.07.010DOI Listing
November 2017