Background/Objectives: Bariatric surgery improves weight and metabolic health in individuals with severe obesity; however, challenges like gut dysbiosis and nutrient deficiencies persist postoperatively. Probiotic supplementation may enhance recovery by modulating gut microbiota. This updated meta-analysis aimed to assess the effects of probiotics/synbiotics on metabolic, anthropometric, and nutritional outcomes after bariatric surgery. Methods: A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted using PubMed, SCOPUS, Web of Science, and CENTRAL through December 2024. Studies comparing probiotics/synbiotics (which contain both probiotics and prebiotics) versus a placebo in adults post-bariatric surgery were included. Meta-analyses were conducted, with subgroup analyses by surgery type, the timing of the intervention, and probiotic formulation (PROSPERO ID: CRD420251019199). Results: Thirteen RCTs involving 809 patients were included in the analysis. Probiotic use significantly reduced BMI (MD = 0.67, 95% CI: 0.33 to 1.00), HbA1c (MD = −0.19%, 95% CI: −0.36 to −0.01), triglycerides (MD = −16.56 mg/dL), and AST levels (MD = −3.68 U/L), while increasing ALP (MD = 8.12 U/L) and vitamin D (MD = 13.68 pg/mL). Ferritin levels were significantly lower (MD = −18.89 µg/L) in the probiotic group. A subgroup analysis showed enhanced benefits in patients undergoing mini-gastric bypass, with perioperative or synbiotic interventions specifically improving triglycerides, total cholesterol, and HbA1c. Conclusions: Probiotics may offer modest but significant improvements in BMI, glycemic control, lipid profile, liver enzymes, and vitamin D levels after bariatric surgery. These findings support the potential role of probiotics/synbiotics as an adjunct therapy, though further large-scale trials are warranted to confirm long-term benefits.

Background: Adipose-derived extracellular vesicles (adiposomes) are emerging as key mediators of inter-organ communication, yet their molecular composition and role in obesity-related pathophysiology remain underexplored. This study integrates clinical phenotyping with proteomic analysis of visceral adipose-derived adiposomes to identify obesity-linked molecular disruptions. Methods: Seventy-five obese and forty-seven lean adults were extensively profiled for metabolic, inflammatory, hepatic, and vascular parameters. Adiposomes isolated from visceral fat underwent mass spectrometry-based proteomic analysis, followed by differential abundance, pathway enrichment, regulatory network modeling, and clinical association testing. Results: Obese individuals exhibited widespread cardiometabolic dysfunction. Proteomics revealed 64 adiposomal proteins with differential abundance. Upregulated proteins (e.g., CRP, C9, APOC1) correlated with visceral adiposity, systemic inflammation, and endothelial dysfunction. In contrast, downregulated proteins (e.g., ADIPOQ, APOD, TTR, FGB, FGG) were associated with enhanced nitric oxide bioavailability and vascular protection, suggesting loss of homeostatic signaling. Network analyses identified TNF and IL1 as key upstream regulators driving inflammatory and oxidative stress pathways. Decision tree and random forest models accurately classified obesity, hypertension, diabetes, dyslipidemia, and hepatic steatosis (AUC = 0.908–0.994), identifying predictive protein signatures related to complement activation, inflammation, and lipid transport. Conclusion: Obesity alters adiposome proteomic cargo, reflecting and potentially mediating systemic inflammation, metabolic dysregulation, and vascular impairment.

Background: The Airway, Breathing, Circulation, Disability, and Exposure (ABCDE) approach is crucial in emergency care, but there may be variability in adherence among healthcare professionals. Inconsistent application of this approach may lead to variations in patient care quality and outcomes. Identifying the factors influencing adherence can help improve training to ensure more effective application across emergency settings. This study explores the theoretical knowledge of the ABCDE approach among Egyptian resident doctors and medical interns. Methods: An online survey was conducted in Egypt targeting resident doctors and medical interns. Statistical analyses were performed using SPSS 26 and Excel, descriptive statistics and association tests were used to measure the relationship between knowledge and demographic factors. Results: The study included 422 medical residents and interns, with most in university hospitals. The average knowledge score of 59.1% exposed specific gaps in understanding, emphasizing deficiencies in 12 questions answered by less than 50%. Notably, 49.5% acquired ABCDE knowledge from medical school, while 28.2% had ALS/BLS courses. Encouragingly, 91.2% expressed willingness for life support training. Statistical analyses unveiled significant associations between knowledge scores and both medical practice settings and sources of ABCDE knowledge. Surgeons exhibited the lowest knowledge scores among participants, emphasizing the need for tailored interventions across specialties. Conclusion: This study addresses a critical gap in ABCDE approach knowledge among Egyptian resident doctors and medical interns. The study points to the need for focused education, especially for surgeons, to improve emergency care skills and patient outcomes through continued training.

Cardiac amyloidosis is frequently overlooked, leading to delayed diagnosis and underestimation of its true impact on cardiac mortality. Using CDC WONDER (1

Peritoneal dialysis (PD) has become an established treatment modality for end-stage kidney disease (ESKD) in recent years, though catheter dysfunction remains a common issue, often due to adhesions or migration. Laparoscopic surgery is an effective method for addressing these problems with precision and minimal trauma. A rare cause of catheter dysfunction is fimbriae adhesions, where the fimbriae of the fallopian tubes obstruct the catheter. We present a case of a 23-year-old woman with ESKD who transitioned to PD, complicated by catheter blockage within days. Radiographs suggested adhesions and diagnostic laparoscopy revealed fimbriae entangling the catheter. Laparoscopic adhesiolysis and catheter replacement were performed, with the fallopian tubes secured to the ipsilateral ovary to prevent recurrence. Post-surgery, catheter function was restored, and an 18-month follow-up showed no complications. This case highlights the importance of considering fertility preservation in cases of fimbrial adhesions and underscores the value of laparoscopic intervention.