Patients with VBG undergoing RYGB should receive attentive treatment and evaluation of associated factors. FT was better after RRYGB than that of PRYGB in the first year however, both were comparable at the fifth year follow-up. The WL in the RRYGB group was acceptable despite being less than that of the PRYGB group. RRYGB in patients with VBG who regained weight showed comparable safety and resolution of associated diseases to that of PRYGB over the 5-year follow-up period. On the other hand, FT scores, odds of late complications, and improvements (in the fifth year) in associated medical conditions were comparable between the two groups. PRYGB group showed significantly lower mean body mass index (over the entire follow-up period), early complications, reintervention rates for late complications, and overall reintervention rates than that of the RRYGB group. PRYGB and RRYGB groups had 558 and 156 patients, respectively, after exclusion of the lost to follow-up patients. Data on weight regain, weight loss (WL), food tolerance (FT), early and late complications, and resolution or improvement in associated medical conditions were analyzed. Patients who underwent PRYGB or RRYGB after VBG from 2008 to 2016 were enrolled. This study compared the 5-year follow-up outcomes of primary (PRYGB) and revision RYGB after VBG (RRYGB). Vertical banded gastroplasty (VBG) is associated with high weight regain Roux-en-Y gastric bypass (RYGB) is used as a revision procedure in patients with VBG experiencing weight regain. This study suggests that pretherapeutic plasmatic uracil assessment, along with 5-FU dosage adjustment, may be beneficial in reducing 5-FU toxicity in real-life patients. DPD-deficient patients received a significantly lower dose of 5-FU (p < 0.001). 1, p < 0.001 at each cycle from 1 to 4) as well as the cumulative score during all courses of treatment (p = 0.028). The median toxicity severity score was higher in the unscreened group for each treatment cycle (0 vs. Among 349 screened patients, 198 treated patients were included. Then, the severity scores (G3 and G4 severity as well as their frequency) of patients who did not benefit from DPD screening were compared with those of patients who benefited from DPD screening for each treatment cycle (from 1 to 4). Using a propensity score, we balanced the factors influencing 5-Fluorouracil (5-FU) toxicity. This matched retrospective study assessed the impact of DPD screening on the reduction of severe side effects and on the management of DPD-deficient patients. A dose reduction of fluoropyrimidine is recommended when uracil concentration is equal to or greater than 16 ng/mL. As of September 2018, French recommendations call for screening for DPD deficiency by plasma uracil quantification prior to all fluoropyrimidine-based chemotherapy. Additionally, this study concludes that the estimated impact in reducing the effects of El Niño on the poverty depends largely on the participation of fishers in its management and highlights the importance of taking a transdisciplinary and cross sector approach to MPA design and management to ensure the potential benefits of MPAs can be realised.ĭihydropyrimidine dehydrogenase (DPD) deficiency is associated with severe fluoropyrimidines-induced toxicity. The results indicate that fishing in Peruvian MPAs could reduce the vulnerability of artisanal fishers to El Niño. The study estimated no significant effect of the MPAs on probability of poverty reduction in two out of three MPAs but a 29% (17% 42%) was detected at one MPA. Therefore, using propensity score matching, we estimated the effect of the El Niño 2015 event on the income of fishers by comparing the poverty levels of fishers with and without access to the MPAs. This study measures the effect on poverty of artisanal fishers of being able to fish in Peruvian MPAs in the face of the El Niño. One possible adaptation strategy to mitigate the negative economic effects of El Niño is the development of Marine Protected Areas (MPAs). In Peru, the fishing sector, particularly artisanal fishing, is one of the most impacted by El Niño phenomenon.
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