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https://www.readbyqxmd.com/read/27906717/spectrum-of-postoperative-complications-in-pulmonary-hypertension-and-obesity-hypoventilation-syndrome
#1
Roop K Kaw
PURPOSE OF REVIEW: The purpose of this review is to identify chronic pulmonary conditions which may often not be recognized preoperatively especially before elective noncardiac surgery and which carry the highest risk of perioperative morbidity and mortality. RECENT FINDINGS: This review discusses some of the most recent studies that highlight the perioperative complications, and their prevention and management strategies. SUMMARY: Pulmonary hypertension is a well recognized risk factor for postoperative complications after cardiac surgery but the literature surrounding noncardiac surgery is sparse...
November 30, 2016: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27896647/changes-in-non-diabetic-comorbid-disease-status-following-laparoscopic-vertical-sleeve-gastrectomy-lvsg-versus-laparoscopic-roux-en-y-gastric-bypass-lrygb-procedures-a-systematic-review-of-randomized-controlled-trials
#2
Emma Osland, Rossita Mohamad Yunus, Shahjahan Khan, Breda Memon, Muhammed Ashraf Memon
PURPOSE: Laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic vertical sleeve gastrectomy (LVSG) have been proposed as cost-effective strategies to manage obesity-related chronic disease. The aim of this systematic review was to study the peer review literature regarding postoperative nondiabetic comorbid disease resolution or improvement reported from randomized controlled trials (RCTs) comparing LVSG and LRYGB procedures. MATERIAL AND METHODS: RCTs comparing postoperative comorbid disease resolution such as hypertension, dyslipidemia, obstructive sleep apnea, joint and musculoskeletal conditions, gastroesophageal reflux disease, and menstrual irregularities following LVSG and LRYGB were included for analysis...
November 28, 2016: Obesity Surgery
https://www.readbyqxmd.com/read/27876332/long-term-results-after-sleeve-gastrectomy-a-systematic-review
#3
REVIEW
Žygimantas Juodeikis, Gintautas Brimas
Sleeve gastrectomy (SG) has become one of the most commonly used bariatric procedures worldwide. However, data regarding long-term results remain insufficient. The aim of this study was to review the long-term results after SG. We conducted a comprehensive literature search of Medline and the Cochrane Library for articles published until May 2016 on the long-term results (>5 yr) after SG. Studies representing outcomes of SG were included if they reported≥5-year results that contained at least one outcome of interest-weight loss, co-morbidities, long-term complications, or quality of life-and SG was performed as a primary procedure...
October 17, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/27846159/laparoscopic-sleeve-gastrectomy-outcomes-of-750-patients-a-2-5-year-experience-at-a-bariatric-center-of-excellence
#4
Hasan Altun, Burcin Batman, Salim D Uymaz, Rahmi K Serin, Serpil Salman, Yelda Tayyareci, Ferah Ece, Tugce Hurkal, Didem Dal
Laparoscopic sleeve gastrectomy (LSG) is gaining popularity worldwide. This retrospective cohort study evaluated the outcomes of a large cohort of patients with obesity who underwent LSG in a Bariatric Center of Excellence. All consecutive patients who underwent LSG between July 2013 and April 2016 were identified retrospectively. Preoperative and postoperative variables and comorbidities were recorded. The study consisted of 750 patients. Their mean age was 37.4 years; 72% were women, and the mean body mass index was 42...
November 14, 2016: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/27784526/abdominal-elephantiasis-nostras-verrucosa-an-underrecognized-disorder
#5
Derek Ho, Eve J Lowenstein
Case 1 A 60-year-old African American man presented with a medical history of morbid obesity (weighing more than 550 lb), benign prostatic hyperplasia, hyperlipidemia, gynecomastia, atrial fibrillation, hypertension, chronic obstructive pulmonary disease, psoriasis, sleep apnea, and cardiomegaly. His size has limited his ability to clean himself properly. He experiences chronic and recurrent skin irritation and cellulitis possibly secondary to intertriginous superinfection, lymphedema, and venous stasis. On examination, his abdomen showed heavy skinfolding with hyperpigmentation, cobblestone and velvety changes, thickening and fibrotic induration of the skin, focal areas of redness, and tenderness on palpation (Figure 1A and 1B)...
2016: Skinmed
https://www.readbyqxmd.com/read/27755119/sympathetic-nerves-and-hypertension-in-stress-sleep-apnea-and-caregiving
#6
Michael G Ziegler, Milos Milic
PURPOSE OF REVIEW: The sympathetic nervous system (SNS) mediates short-term increases in blood pressure. Evidence that psychosocial stress leads to chronic hypertension is mixed. The SNS activation found in obstructive sleep apnea (OSA), caregiving for a severely demented spouse, and obesity more specifically address whether SNS activation might lead to the metabolic syndrome and hypertension. RECENT FINDINGS: Obesity is associated with both increased SNS electrical activity and plasma norepinephrine...
January 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/27754274/sy-17-4-neuro-immune-communication-in-hypertension-a-new-therapeutic-angle
#7
Mohan Raizada
Hypertension (HTN) is the most prevalent modifiable risk for cardiovascular disease (CVD) and disorders directly influencing CVD (i.e. obesity, diabetes, chronic kidney disease, obstructive sleep apnea, etc.). About one billion people worldwide have HTN, with American adults having 90% lifetime risk of developing HTN. Despite aggressive campaign for lifestyle changes and advances in drug therapy, HTN remains an immense health, emotional, and economic challenge. This is due, in part, to the fact that ∼50% of HTN patients' blood pressure remains uncontrolled and ∼20% of HTN patients are resistant to or require > antihypertensive drugs...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27753839/sy-06-3-role-of-surgical-treatment-of-morbid-obesity
#8
Wei-Jei Lee
Obesity is a pan-endemic health problem in both developed and developing countries, in both western and eastern countries. It increases risk for many common diseases, including type 2 diabetes, dyslipidemia, hypertension, obstructive sleep apnea, heart disease, stroke, asthma, osteoarthritis, cancers and depression etc.. Although the incidence of obesity in Asia is relatively low, Asian patients tend to have similar incidence of obesity related metabolic syndrome at lower BMI level comparing to Caucasians because of central obesity...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27748200/statins-may-prevent-atherosclerotic-disease-in-osa-patients-without-co-morbidities
#9
Domenico Maurizio Toraldo, Michele De Benedetto, Luana Conte, Francesco De Nuccio
Obstructive sleep apnea (OSA) is characterized by repetitive interruptions of breathing, causing a Chronic Intermittent Hypoxia (CIH) that can be a key step in the development and progression of cardiovascular diseases. Nowadays, in fact, there is scientific evidence showing the close relationship between OSA and atherosclerosis, even in those patients who do not show co-morbidities such as hypertension, diabetes, high levels of low-density lipoprotein (LDL), cigarette smoking and obesity, which normally are able to activate the endothelium...
October 7, 2016: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/27709487/long-term-outcomes-in-patients-with-morbid-obesity-and-type-1-diabetes-undergoing-bariatric-surgery
#10
Nuria Vilarrasa, Miguel Angel Rubio, Inka Miñambres, Lillian Flores, Assumpta Caixàs, Andrea Ciudin, Marta Bueno, Pedro Pablo García-Luna, María D Ballesteros-Pomar, Marisol Ruiz-Adana, Albert Lecube
BACKGROUND: This study aims to describe the long-term outcomes of bariatric surgery in a cohort of patients with type 1 diabetes (T1DM). METHODS: Thirty-two patients with T1DM and initial BMI of 41.3 ± 4.8 kg/m(2) were studied, 18.7 % undergoing duodenal switch (DS), 34.4 % gastric bypass, and 46.9 % sleeve gastrectomy and followed-up after surgery for 4.6 ± 2.6 years. Changes in BMI, HbA1c, insulin requirements, evolution of comorbidities, and microvascular complications were registered annually after surgery...
October 5, 2016: Obesity Surgery
https://www.readbyqxmd.com/read/27666686/-obstructive-sleep-apnea-syndrome-osas-and-bone
#11
Daisuke Inoue
Obstructive sleep apnea syndrome(OSAS)is a sleep disorder characterized by repetitive upper airway collapse during sleep, causing frequent hypoxia and sleep disturbance. Known risk factors of OSAS include obesity, male sex and smoking. OSAS has been linked to various comorbidities such as hypertension, cardiovascular diseases and diabetes. Recent evidence also indicates that OSAS is associated with vitamin D insufficiency, increased bone resorption and bone loss. Thus, although increased fracture rate has not been demonstrated, OSAS is now recognized as a risk factor of osteoporosis...
2016: Clinical Calcium
https://www.readbyqxmd.com/read/27643271/sy-17-4-neuro-immune-communication-in-hypertension-a-new-therapeutic-angle
#12
Mohan Raizada
Hypertension (HTN) is the most prevalent modifiable risk for cardiovascular disease (CVD) and disorders directly influencing CVD (i.e. obesity, diabetes, chronic kidney disease, obstructive sleep apnea, etc.). About one billion people worldwide have HTN, with American adults having 90% lifetime risk of developing HTN. Despite aggressive campaign for lifestyle changes and advances in drug therapy, HTN remains an immense health, emotional, and economic challenge. This is due, in part, to the fact that ∼50% of HTN patients' blood pressure remains uncontrolled and ∼20% of HTN patients are resistant to or require > antihypertensive drugs...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27642934/sy-06-3-role-of-surgical-treatment-of-morbid-obesity
#13
Wei-Jei Lee
Obesity is a pan-endemic health problem in both developed and developing countries, in both western and eastern countries. It increases risk for many common diseases, including type 2 diabetes, dyslipidemia, hypertension, obstructive sleep apnea, heart disease, stroke, asthma, osteoarthritis, cancers and depression etc.. Although the incidence of obesity in Asia is relatively low, Asian patients tend to have similar incidence of obesity related metabolic syndrome at lower BMI level comparing to Caucasians because of central obesity...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27634799/association-of-kidney-disease-with-obstructive-sleep-apnea-in-a-population-study-of-men
#14
Robert J Adams, Sarah L Appleton, Andrew Vakulin, Patrick J Hanly, Stephen P McDonald, Sean A Martin, Carol J Lang, Anne W Taylor, R Doug McEvoy, Nick A Antic, Peter G Catcheside, Andrew D Vincent, Gary A Wittert
STUDY OBJECTIVES: To determine the relationship between obstructive sleep apnea (OSA) and chronic kidney disease (CKD). Previous population studies of the association are sparse, conflicting and confined largely to studies of administrative data. METHODS: Cross-sectional analysis in unselected participants of the Men Androgens Inflammation Lifestyle Environment and Stress (MAILES) study, aged >40 y. Renal data were available on 812 men without a prior OSA diagnosis who underwent full in-home polysomnography (Embletta X100) in 2010-2011...
September 9, 2016: Sleep
https://www.readbyqxmd.com/read/27620392/obstructive-sleep-apnea-with-objective-daytime-sleepiness-is-associated-with-hypertension
#15
Rong Ren, Yun Li, Jihui Zhang, Junying Zhou, Yuanfeng Sun, Lu Tan, Taomei Li, Yun-Kwok Wing, Xiangdong Tang
Subjective daytime sleepiness is considered a significant risk factor of hypertension in patients with obstructive sleep apnea (OSA). In this study, our goal was to examine the joint effect on hypertension of OSA and objective daytime sleepiness measured by the multiple sleep latency test (MSLT). A total of 1338 Chinese patients with OSA and 484 primary snorers were included in the study. All subjects underwent 1 night polysomnography followed by MSLT. The MSLT values were classified into 3 categories: >8 minutes, 5 to 8 minutes, and <5 minutes...
November 2016: Hypertension
https://www.readbyqxmd.com/read/27594992/laparoscopic-sleeve-gastrectomy-using-a-synthetic-bioabsorbable-staple-line-reinforcement-material-post-operative-complications-and-6-year-outcomes
#16
Mahdi Saleh, Manikandar S Cheruvu, Krishna Moorthy, Ahmed R Ahmed
BACKGROUND: Gastric leak after laparoscopic sleeve gastrectomy (LSG) is a serious complication. Currently, the literature lacks long-term outcomes in LSG and leak rates after reinforcement of the staple line. The aims are two-fold: to present leak rates from using staple line reinforcement and six year outcomes of LSG in relation to resolution of obesity-related comorbidities and long-term weight loss. MATERIALS AND METHODS: This is a single-institution, retrospectively reviewed study of 204 patient case files...
September 2016: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/27583421/diagnosis-and-treatment-of-obstructive-sleep-apnea-in-adults
#17
Michael Semelka, Jonathan Wilson, Ryan Floyd
Obstructive sleep apnea is a common disorder that causes patients to temporarily stop or decrease their breathing repeatedly during sleep. This results in fragmented, nonrestful sleep that can lead to symptoms such as morning headache and daytime sleepiness. Obstructive sleep apnea affects persons of all ages, with an increasing prevalence in those older than 60 years. The exact prevalence is unknown but is estimated to be between 2% and 14%. There are many health conditions associated with obstructive sleep apnea, including hypertension, coronary artery disease, cardiac arrhythmias, and depression...
September 1, 2016: American Family Physician
https://www.readbyqxmd.com/read/27513968/anesthetic-management-for-cesarean-delivery-in-a-patient-with-pulmonary-emboli-pulmonary-hypertension-and-right-ventricular-failure
#18
Shaun Patel, Krystal L Weierstahl, Sonalee Shah, Christina W Fidkowski
The maternal mortality rate for parturients with severe pulmonary hypertension is 30% to 50%. General, epidural, and combined low-dose spinal-epidural anesthesia have been used successfully for cesarean deliveries in patients with pulmonary hypertension. We describe a cesarean delivery performed using an intrathecal catheter in a 25-year-old morbidly obese (body mass index, 82 kg/m) woman (gravida 3, para 2 at 32 weeks of gestation) who had severe pulmonary hypertension, right ventricular failure, pulmonary emboli, and obstructive sleep apnea...
October 1, 2016: A & A Case Reports
https://www.readbyqxmd.com/read/27508564/-op-8b-06-hypotensive-therapy-in-patients-with-obstructive-sleep-apnoea
#19
P Talarowska, A Segiet, M Rozanska, O Mozenska, D A Kosior
OBJECTIVE: Obstructive sleep apnea (OSA) is the most common sleep-related breathing disorder. Individuals with OSA are at increased risk of cardiovascular diseases such as arterial hypertension (HTN), heart failure, stroke and pulmonary hypertension. Detailed data regarding hypotensive therapy and its effectiveness in patients with HTN and OSA are lacking. The aim of the study was to characterize in details hypotensive therapy in patients with HTN and OSA. DESIGN AND METHOD: We retrospectively analyzed 1270 patients who were treated in our outpatient sleep apnea clinic...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27478683/sleep-disorders-and-cardio-renal-disease-implications-for-minority-populations
#20
Judith Giunta, Moro O Salifu, Samy I McFarlane
Obesity is a major public health problem that is reaching pandemic proportion. Currently two thirds of the American population is either overweight or obese and worldwide, 39% of the population is overweight and 13% are considered obese [1,2]. This rapid rise in obesity is associated with increased in diabetes mellitus type 2 (DM2), hypertension (HTN), chronic kidney disease (CKD) and cardiovascular diseases (CVD), the major killer of adults in the USA. Parallel to this epidemic is the rapid rise of sleep disorders such as Obstructive Sleep Apnea (OSA)...
2016: Epidemiology: Current Research
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