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Category: COVID-19

COVID Vaccines

March 05, 2021 3:50 pm

There are no known contraindications from a weight-loss surgical perspective to prevent a post-surgical patient from getting the COVID vaccines.

A patient who has had a Duodenal Switch, Lap Sleeve Gastrectomy, RNY Gastric Bypass, or revisions to Weight Loss Surgery should have the COVID vaccine. The vaccination should be avoided for a few weeks after surgery. For other possible contraindications, please consult your PCP.

Here is a summary of the vaccines and the details of each one approved as of the publication date.

 

 

 

All about vaccines?

February 14, 2021 2:41 pm

There is a lot of incorrect information on non-medical mass media about vaccines. Vaccines have been instrumental in our well being. As we face the challenge of COVID-19, our medical decisions must be made based on facts. Here are some interesting and concise descriptions of How do vaccines work? How are vaccines developed?  How are vaccines manufactured?   The source of all this information is WHO.

Vitamin D, Immune Responce and COVID-19

January 26, 2021 6:45 pm

Regardless of whether vitamin D protects against COVID-19, adequate levels are important for bone health. “Avoiding vitamin D deficiency is always a goal,” Ross wrote. “If the diet doesn’t include vitamin D fortified milk or natural products like fish, then a supplement of the RDA [recommended dietary allowance] amount (600-1000 IU per day) provides good assurance. I consider this a ‘good idea,’ but I don’t want to leave the impression that diet cannot be sufficient.”
Related articles:     https://www.dssurgery.com/articles/rationale-and-pl…d-guidance-paper/ https://www.dssurgery.com/articles/exploring-links-…ncy-and-covid-19/ https://www.dssurgery.com/articles/does-vitamin-d-d…rity-of-covid-19/ https://www.dssurgery.com/articles/an-estimate-of-t…vitamin-d-levels/ https://www.dssurgery.com/articles/short-term-high-…tudy-shade-study/ https://www.dssurgery.com/articles/association-betw…ovid-19-pandemic/ https://www.dssurgery.com/articles/vitamin-d-supple…elderly-covid-19/ https://www.dssurgery.com/articles/association-of-v…-19-test-results/ https://www.dssurgery.com/articles/sorting-out-whet…es-covid-19-risk/

Vitamin A and Wound healing

December 21, 2020 9:37 am

We have discussed the importance of vitamin A and eyesight at length previously.
Night Blindness – Vitamin A Deficiency
Nyctalopia (Night Blindness) An Early Sign of Vitamin A Deficiency with Video
A recent article discusses the types and function of vitamin A. As with the pandemic of COVID-19 continuous to stress our body and mind, we must stay vigilant with our nutritional status. Therefore, Vitamin supplements are critical in maintaining a robust immune system. For some, oral supplements are adequate; others may require injectable forms. If the oral supplements do not correct the vitamin A levels, please contact your primary care or our office to available vitamin A injections.  

Zoom Group Meeting November 24, 2020

November 24, 2020 4:40 pm

This is a summary of the Zoom Covid-19 meeting from November 24, 2020. The link to the slides is here.Zoom-Leture_11_24-2020 CDC guidelines for wearing masks are available here. Link to CDC website.   What is PCR – Polymerase Chain Reaction:   Types of Vaccines…. “The final two vaccine candidates (from Moderna and BioNTech/Fosun Pharma/Pfizer) are mRNA vaccines. What are those? First it helps to remember that DNA is the gene and RNA gives instructions for certain proteins. So an mRNA vaccine is the instructions for the SARS-CoV2 protein. Once inside the cell, the protein is made and that triggers the immune response. Just like the vector vaccines which use viruses to deliver the protein instructions, here you are delivering the instructions alone. It’s another way of getting the protein made inside of you. Is there any risk of getting COVID-19 or COVID-19-like side effects from these vaccines? When people talk about side effects of a vaccine, people often believe you’re getting a weaker version of the virus and a minor version of the disease. That is not what these things do. Most vaccine side effects — which include anything from a sore arm, to feeling warm to muscle aches — are a sign of the immune response. It’s not that you get a mild form of the disease. That’s important to be clear about. People keep a very close eye because you want to make sure these vaccines are safe.” https://labblog.uofmhealth.org/rounds/top-5-covid-19-vaccine-candidates-explained

What is Corona Virus?

September 17, 2020 1:37 pm

At a highly technical level Viruses are considered non-living materials. Viruses can not replicate and reproduce by themselves. Therfore, they need to attach themselves and penetrate a living organism to allow multiplication. Double Stranded Viruses include smallpox, Chickenpox and Herpes simplex. Single Strand Sositive Sense Virus in varies groups include HIV, and  Corona Virus. Specifically, Corona virus is a Single Strand, Enveloped Helical Virus. The classifications of the viruses are based on their shape and the mechanism of attachment to the host cell. There are differnt classification of virusrs described. Viruses have cuased more death in the human history than any other diseases. However with vaccination, and public health policies we have been able to eliminate certain deadly viruses.

Covid-19 Mutation – Please physically distance and Wear Masks

August 18, 2020 1:16 pm

Introduction:

There is evidence emerging of Covid-19 mutation. This may explain the difference between the severity and intesity of the disease presented in the those geographical locations where the disease  first.

Scientists from The Scripps Research Institute, Jupiter, Florida have identified changes in the Spike protein. This protein is used to bind the virus to host membranes. As we now know Florida is one of the few hot spots of the Covid-19 pandemic.

This has significant implications for the long term strategy needed to control transmission and manage resurrgence.

Until there is effective vaccination or effective treatment available for everyone, prevention by wearing face mask is the most efficient form to avoid transmistion.

Prevention:

The facts are that the most consistent effective preventive measures are wearing face masks and physical distancing.

There are those who may feel invincible and think that you will 1. either not get the disease or even if you get it it will 2-not affect your health.  Lets first remind ourselves that wearing a mask is more to prevent passing the virus that getting it. We should all assume that someone that we come in contact with may already have it. Would you like them to breath the virus toward you ? This then brings the second issue: We do not know what the long term health effect of the virus is for those who develop significant symptoms and those who are asymtphomatic.

The unkown:

Let’s look at other viral infections that provide either no or minimal disease condition at the time of initial exposure only to result in long term health conditions that may result in death. These include hepatitis and HIV exposures and infections. Admitedly  Coronavirus is a differnt family of virus. I am not suggesting that this will behave like other family of the viruses. We just do not have enough information to know what happens to those exposed to the virus (regardless of being asymptotic or not). Could the virus become dormant and over time result in organ injury (lung) like in the case  of hepatitis (liver). Or make a home in our body and have recurrent debilitating infections and symptoms as it is seen with Varicella-zoster virus (VZV) which causes chickenpox and the time of the initial infection and makes residence in our body to reappear later on as herpes zoster (shingles). Will we need a new strain of vaccine every year similar to the flu vaccine?

That is the crux.  We do not know because the COVID virus is new and we do not know the long term effects.

Vitamin D and COVID 19

June 13, 2020 4:40 pm

There has been extensive discussion on the importance of Vitamin D published over the last few years in regards to bone health, immune health and Calcium physiology. The importance of vitmain D and bone structure has been discussed extensively. It is also important in the absorption of Calcium. It further plays role in immune modulation.

What is new is the possible correlation of Vitamin D and COVID 19. Recently it is been shown that low vitamin D may increase the risk of a poor outcome with Covid-19 exposure and infection.

There are different standard recommendation for the Vitamin D levels.

In our practice we aim to maintain a Vitamin D level of 0ver 60 in post weight loss surgical patients.

There are a number of theories as to how the Vitamin D deficiency may play a role in this. An emerging observation is that low Vitamin D may cause abnormal and excessive blood clot formation. Mohammad et. al. in 2019 published a study on the association of low vitamin D and “…Pathogenesis of Thrombosis”

This pathologic blood clot formation in COVID-19 patients may explain the extensive lung injury and  multi system organ failure in some patient. It is also one of the reason that some COVID-19 patients have loss limbs or appendages.

Please follow all supplement recommendations based on your laboratory studies and all COVID-19 recommendations. We would recommend frequent hand washing, surface cleaning, social distancing, and wearing face masks as the most basic precautions and increase precautions based on your health status.

Vitamin D and Covid -19

May 07, 2020 9:24 am

We are all aware of the many roles that Vitamin D plays in our bodies. This includes immune function in addition to all the regulatory roles that Vitamin D plays in several physiologic reactions. There may be a correlation of low Vitamin D and COVID-19 infection increasing death risk as looked at in research articles.

Covid -19 in a subset of patience causes significant lung injury. These patients require mechanical ventilation.

Previously reported publications have suggested a possible correlation between ace inhibitors and increased risk of pulmonary complications of Covid -19. Some researchers suspect that the Covid-19 may be able to enter lung cells by the ACE receptors.

Shown is the initial entry of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) into cells, primarily type II pneumocytes, after binding to its functional receptor, angiotensin-converting enzyme 2 (ACE2). After endocytosis of the viral complex, surface ACE2 is further down-regulated, resulting in unopposed angiotensin II accumulation. Local activation of the renin–angiotensin–aldosterone system may mediate lung injury responses to viral insults. ACE denotes angiotensin-converting enzyme, and ARB angiotensin-receptor blocker. (N Engl J Med 2020; 382:1653-1659)

Vitamin D may positively implact the receptor ACE2. This study, report clear correlation between the high death rate with low vitamin D levels in Covid infected patients. There are limitation to this study that the attached abstract outlines.

Our take home message would be to please make sure you have updated labs and that you are all taking the recommended Vitamin D based on your surgical anatomy and laboratory values, not just an average non-bariatric person recommended dose.

https://www.dssurgery.com/wp-content/uploads/2020/05/manuscript.pdf