Background: To investigate the effects of obesity on CD47, phosphatidylserine (PS) exposure, and Caspase-8 and Caspase-3 activities in erythrocytes.Methods: The study included 25 morbidly obese patients and 20 healthy people as the control group. We evaluated CD47 expression on the red blood cell (RBC) membrane surface and eryptosis markers such as PS externalization and caspase activity using flow cytometric analyses.Results: CD47 expression on the RBC surface was significantly lower in obese patients than in the control group (P 5 0.000001). We did not find significant differences in the Caspase-3 and Caspase-8 activities between the obese and nonobese control groups. Additionally, we did not find differences in PS exposure on erythrocyte membranes. The fibrinogen levels were higher in the obese group than they were in the control group (P 5 0.00002). Correlations between CD47 expression and body mass index (r 5 20.65; P 5 0.0004), waist circumference (r 5 20.54; P 5 0.0052), and fibrinogen (r 5 0.57; P 5 0.0024) were found. Univariate analyses revealed that body mass index, waist circumference, hip circumference, and fibrinogen levels were potential predictors of CD47 expression. Multivariate analyses found that fibrinogen levels (b 5 0.4708; P 5 0.045) independently predicted CD47 expression.Conclusions: The study demonstrated that CD47 expression is decreased on the surface of RBCs in obese subjects. These changes in CD47 expression on the RBC surface may be an adaptive response to hyperfibrinogenemia associated with obesity. V C 2015 International Clinical Cytometry Society

The necessity of urgent explorative laparotomy as a standard procedure in the treatment of abdominal penetrating wounds is controversial. Mandatory surgical intervention for penetrating abdominal trauma yields a high rate of negative laparotomies in the absence of visceral injuries. Laparoscopy is an alternative diagnostic procedure inspecting the peritoneum for signs of perforation and excluding significant intra-abdominal injuries. Following current guidelines, diagnostic laparoscopy should be used with caution only in selected cases due to the limited amount of reliable data confirming the effectiveness of such treatment. We present a review of the literature analysing the role of diagnostic laparoscopy in abdominal trauma.

Obesity is associated with RBC rheological disturbances expressed by a decrease in RBC deformability, increased total aggregation extent and the alteration of kinetics of RBC aggregation. These results may suggest the necessity of introducing treatment forms to correct erythrocyte rheological properties, which may improve the blood-flow condition in the microcirculation and prevent postoperative complications after bariatric surgery.

Splenic injuries constitute the most common injuries accompanying blunt abdominal traumas. Non-operative treatment is currently the standard for treating hemodynamically stable patients with blunt splenic injuries. The introduction of splenic angiography has increased the possibility of non-operative treatment for patients who, in the past, would have qualified for surgery. This cohort includes mainly patients with severe splenic injuries and with active bleeding. The results have indicated that applying splenic angioembolization reduces the frequency of non-operative treatment failure, especially in severe splenic injuries; however, it is still necessary to perform prospective, randomized clinical investigations.

Background/Objectives The reduction of body mass after bariatric surgery affects energy metabolism and may involve changes in irisin, preptin, and adropin production. Subjects and Methods Fifty-five morbidly obese patients with a mean body mass index (BMI) of 45.7 ± 5.8 kg/m 2 were treated with either laparoscopic sleeve gastrectomy(n = 30) or laparoscopic adjustable gastric banding (n = 25). Forty-six (83.6%) were followed-up 6 months after surgery. The control group included 15 healthy non-obese participants. Anthropometric measurements, lipid profiles, HbA1c, and serum irisin, preptin, and adropin were assessed at baseline and on follow-up. Results The serum concentrations of all three peptides were higher at 6 months than at baseline but only irisin (p = 0.02) and adropin (p = 0.000001) were significantly higher. The increase in preptin was borderline significant (p = 0.051). Changes of serum concentrations of all three peptides were bidirectional. Conclusion Body mass reduction resulting from bariatric procedures may change the production of energy regulating peptides, but not always in a favorable manner.

The results of our study show that BMI did not have any influence on the frequency of anastomotic leakage after anterior rectal resection performed due to cancer.

No abstract

Some studies indicate that obesity is associated with rheological disturbances. Because there are usually sex differences in the type of obesity we decided to evaluate rheological differences between male and female obese patients. We studied 18 morbidly obese men, mean age 43.66 ± 11.32 years, mean body mass index (BMI) 49.82 ± 6.03 kg/m 2 and 20 obese females, mean age 40.6 ± 11.86 years, mean BMI 47.41 ± 8.81 kg/m 2 . Blood and plasma viscosity measurements were performed using a cone-plate viscometer (Brookfield DV-II). Erythrocyte elongation and red blood cell (RBC) aggregation were measured using the Laser-assisted Optical Rotational Cell Analyser (LORCA).Whole blood viscosity and RBC deformability expressed by the elongation index were significantly higher in obese men. We did not observe differences in plasma viscosity, corrected blood viscosity and aggregation parameters among the obese population. Blood viscosity correlated with selected RBC aggregation indices.We conclude that morbidly obese patients presented sex-dependent differences in some rheological properties. This study indicates a relation between erythrocyte aggregation indices and blood viscosity in obese populations.