The asplenia [Ivemark] syndrome (AS) is the association of congenital absence of the spleen with a variety of visceral abnormalities, predominantly of the cardiovascular system. Varying degrees of malrotation and malfixation of the bowel are common in this condition, and the occurrence of catastrophic gastric volvulus due to malfixation of the bowel has been reported. With the improvement in long-term outlook for these patients with modern cardiac surgery and prophylactic antibiotics, the intra-abdominal anomalies have become increasingly significant. This paper draws attention to the prophylactic treatment of gastric malfixation in the AS through the presentation of two cases in which gastropexy was performed.
The asplenia [Ivemark] syndrome (AS) is the association of congenital absence of the spleen with a variety of visceral abnormalities, predominantly of the cardiovascular system. Varying degrees of malrotation and malfixation of the bowel are common in this condition, and the occurrence of catastrophic gastric volvulus due to malfixation of the bowel has been reported. With the improvement in long-term outlook for these patients with modern cardiac surgery and prophylactic antibiotics, the intra-abdominal anomalies have become increasingly significant. This paper draws attention to the prophylactic treatment of gastric malfixation in the AS through the presentation of two cases in which gastropexy was performed.
Objectives Obesity has been identified as a risk factor for vitamin D deficiency. Those seeking bariatric surgery for obesity treatment have an additional risk for low vitamin D levels post-op due to factors that affect compliance with taking supplemental vitamins and minerals. As personalized nutrition (PN) may change behaviors and have an impact on health outcomes, this study will examine the relationships among genetic variants that predispose individuals to vitamin D deficiency, PN, knowledge of the risk of vitamin D deficiency, and supplemental vitamin adherence in patients who have undergone bariatric surgery. Methods This will be a one year cross-sectional study with approximately 50 participants with severe obesity having bariatric surgery. Inclusion criteria will include subjects aged 18 years and older seeking sleeve gastrectomy at The Advanced Bariatric Surgery Center in Lubbock, Texas. Exclusion criteria will be those who are not candidates for surgery and nicotine, alcohol, and/or drug dependency. The data collected will include buccal swab genetic tests, two assays for vitamin D receptor (VDR) single polymorphisms (SNPs), vitamin D levels, diet and vitamin and mineral adherence, and dual-energy X-ray absorptiometry (DEXA) scans. This information will be analyzed and compared to patients’ outcomes at pre-op and post-op appointments. Results N/A. Conclusions Upon completing this study, we expect to have identified how micronutrient genetic testing can be used in conjunction with PN to improve the bariatric surgery population's vitamin D levels. This outcome can further nutrition education and PN to improve overall health knowledge and interventional outcomes on critical nutritional parameters. Furthermore, the results could potentially produce greater adherence to vitamin and mineral regimens, and improve bone density among individuals who have undergone bariatric surgery. Funding Sources This study was funded by start-up funds from Texas Tech University.
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