A Cluster of Polyneuropathy and Wernicke-Korsakoff Syndrome in a Bariatric Unit

Chaves, Luiz Cláudio; Faintuch, Joel; Kahwage, Salomão; Alencar, Francisco de Assis

doi:10.1381/096089202321088093

Cited by 158 publications

(24 citation statements)

References 17 publications

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“…19–21. When persistent, it may precipitate protein-calorie malnutrition as well as Wernicke’s encephalopathy 22,23. In the current series, somewhat higher than average values were found, with an increasing tendency up to 6 months.…”

Section: Discussioncontrasting

confidence: 47%

A Higher Meal Frequency May be Associated with Diminished Weight Loss after Bariatric Surgery

Ribeiro

Costa

Faintuch

et al. 2009

Clinics

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OBJECTIVEThis study aimed to investigate the relationship between meal frequency, the occurrence of vomiting and weight loss among patients submitted to Roux-en-Y gastric bypass up to 9 months after surgery.METHODSFemale patients (n = 80) were followed at 3-month intervals for 9 months. Weight, BMI, 24-hour dietary recall, drug consumption and vomiting episodes were recorded and compared with nutritional outcome.RESULTSThe BMI values at 3, 6 and 9 months were 45.1 ± 9.7, 39.9 ± 7.6 and 35.4 ± 8.2 kg/m2, respectively. The corresponding choleric intakes were 535.6 ± 295.7, 677.1 ± 314.7 and 828.6 ± 398.2 kcal/day, and the numbers of daily meals were 5.0 ± 2.5, 4.7 ± 1.8 and 4.9 ± 1.0, respectively. The peak of vomiting episodes occurred within 6 months; however, patients tolerated this complication despite its high prevalence. A significant negative correlation between weight loss and diet fractioning, but not vomiting, was observed throughout the entire postoperative period (P = 0.001).CONCLUSIONS1) Frequent small meals were associated with a reduction in weight loss after gastric bypass and a decrease in vomiting episodes at 6 months, and 2) vomiting did not interfere with nutritional outcome. Unless required because of vomiting or other reasons, multiple small meals may not be advantageous after such intervention.

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Section: Discussioncontrasting

confidence: 47%

A Higher Meal Frequency May be Associated with Diminished Weight Loss after Bariatric Surgery

Ribeiro

Costa

Faintuch

et al. 2009

Clinics

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“…Alcoholism is not directly responsible for vitamin B1 deficiency; its effects are related to the complications of liver cirrhosis such as problems to the gastrointestinal tract with low absorption rate at the mucosal level and consequent malnourishment [12]. Apart from alcohol, a lot of other conditions causing malnutrition and decreased thiamine absorption such as gastrointestinal surgical procedures (including gastric bypass surgery, gastrojejunostomy, gastrectomy, and colectomy) [13–18], therapy with intragastric balloon [19], hyperemesis gravidarum [20, 21], terminal tumor [22], chemical therapy [23, 24], allogenic stem cell transplantation [25], AIDS [26], anorexia nervosa [27], fasting [28], starvation [29], hemodialysis [30], pancreatitis [31], wrong formula feeding [32], parenteral nutrition, hyperalimentation [33, 34], and prolonged intravenous glucose infusion [35] have been reported as predisposing factors.…”

Section: Aetiopathogenesismentioning

confidence: 99%

MR Imaging Findings in Alcoholic and Nonalcoholic Acute Wernicke’s Encephalopathy: A Review

Manzo

Gennaro

Cozzolino

et al. 2014

BioMed Research International

127

138

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Wernicke's encephalopathy (WE) is a severe neurological syndrome caused by thiamine (vitamin B1) deficiency and clinically characterized by the sudden onset of mental status changes, ocular abnormalities, and ataxia. Apart from chronic alcoholism, the most common cause of WE, a lot of other conditions causing malnutrition and decreasing thiamine absorption such as gastrointestinal surgical procedures and hyperemesis gravidarum must be considered as predisposing factors. Due to its low prevalence and clinical heterogeneity, WE is often misdiagnosed, leading to persistent dysfunctions and, in some cases, to death. Nowadays, MR imaging of the brain, showing T2 and FLAIR hyperintensities in typical (thalami, mammillary bodies, tectal plate, and periaqueductal area) and atypical areas (cerebellum, cranial nerve nuclei, and cerebral cortex), is surely the most important and effective tool in the diagnostic assessment of WE. The aim of this paper is to propose a state of the art of the role of MR imaging in the early diagnosis of this complex disease.

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“…In WLS patients, it can occur early in the postoperative period, when weight loss is most rapid, or after prolonged vomiting caused by a variety of factors [114]. Bacterial overgrowth seen after some BPD and JIB procedures is also associated with thiamine deficiency [115].…”

Section: Multidisciplinary Teamsmentioning

confidence: 99%