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Gladys W Strain, Mehyar H Torghabeh, Michel Gagner, Faith Ebel, Gregory F Dakin, Jonathan S Abelson, Daniel Connolly, Alfons Pomp
BACKGROUND: There is limited information on the multiple long-term effects of the biliopancreatic diversion with duodenal switch (BPD/DS). METHODS: Patients who consented to a BPD/DS from 1999 to 2010 were evaluated for weight change, complications, comorbidity resolution, body composition, quality of life, and depressive symptoms during visits at 1, 3,5, 7, and 9 years. Descriptive statistics, analysis of variance, and pair-wise comparisons were calculated for each of the five follow-up cohorts vs...
September 29, 2016: Obesity Surgery
David H St-Pierre, Julie Martin, Hiroyuki Shimizu, Yuko Tagaya, Takahumi Tsuchiya, Simon Marceau, Laurent Biertho, Marjorie Bastien, Sarah-Maude Caron-Cantin, Serge Simard, Denis Richard, Katherine Cianflone, Paul Poirier
CONTEXT: Nesfatin-1 is a neuroendocrine peptide with potent anorexigenic activity in rodents. The potential role of nesfatin-1 on the regulation of energy balance, metabolic functions and inflammation is currently debated in obese humans. In the present study, nesfatin-1 fluctuations and their associations with metabolic factors were investigated in severely obese patients who underwent biliopancreatic diversion with duodenal switch (BPD/DS) and severely obese controls (SOC). BASIC PROCEDURES: Sixty severely obese patients who underwent BPD/DS and 15 SOC (matched for BMI and age) were included in the study...
September 25, 2016: Peptides
Maher El Chaar, Jill Stoltzfus, Leonardo Claros, Maureen Miletics
INTRODUCTION: Bariatric surgery is the only proven and effective long-term treatment for morbid obesity, with laparoscopic sleeve gastrectomy (LSG) being the most commonly performed weight loss procedure in the USA. Despite its safety and efficacy, LSG's association with both de novo and pre-existing gastroesophageal reflux disease (GERD) remains controversial. METHODS: Therefore, this retrospective study determined the incidence, indications, and outcomes of revisional surgery following LSG in adult patients at our institution from 2010 to 2014...
August 30, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Monica Sethi, Edward Chau, Allison Youn, Yan Jiang, George Fielding, Christine Ren-Fielding
BACKGROUND: There are minimal long-term data on biliopancreatic diversion (BPD) with or without duodenal switch (BPD/DS). OBJECTIVES: To investigate the long-term weight loss, co-morbidity remission, complications, and quality of life after BPD and BPD/DS. SETTING: An academic, university hospital in the United States. METHODS: We conducted a retrospective review of patients who underwent BPD or BPD/DS between 1999 and 2011...
March 9, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Gladys Witt Strain, Faith Ebel, Jamie Honohan, Michel Gagner, Gregory F Dakin, Alfons Pomp, Dympna Gallagher
OBJECTIVE: Concerns about an excessive loss of fat-free mass (FFM) after bariatric surgery prompted this comparison of operated versus matched nonoperated controls regarding FFM. SETTING: University Hospital and University Research Unit in an urban medical center. METHODS: Body composition with bioelectric impedance (Tanita 310, Tanita Corp, Arlington Heights, IL) was measured approximately 2 years after bariatric surgery in weight stable patients and nonoperated weight stable controls matched for body mass index (BMI), gender, and age...
April 6, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Philippe Topart, Guillaume Becouarn
BACKGROUND: Insufficient weight loss (percentage of excess weight loss [%EWL]<50%) is observed in approximately 20% of patients after Roux-en-Y gastric bypass (RYGB). Surgical revision can be performed by various procedures including malabsorptive techniques. Conversion to a biliopancreatic diversion with duodenal switch (BPD/DS) remains a complex technique which cannot always be performed as a one-stage procedure. OBJECTIVES: This study evaluates the conversion of RYGB to BPD/DS using a novel gastric reconstruction technique based on a "hybrid sleeve" using the existing gastrojejunal anastomosis of the RYGB...
February 23, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Stéfane Lebel, Geneviève Dion, Simon Marceau, Simon Biron, Maud Robert, Laurent Biertho
BACKGROUND: Biliopancreatic diversion with duodenal switch (BPD-DS) with a 100-cm common channel has been our treatment of choice for morbid obesity since the early 1990s. This procedure offers excellent long-term weight loss but can be associated with significant side effects. OBJECTIVES: To assess the effect on clinical and nutritional parameters of increasing the common channel to 200 cm. SETTINGS: University-affiliated tertiary care center...
June 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Daniel D Tran, Ifeanyi D Nwokeabia, Stephanie Purnell, Syed Nabeel Zafar, Gezzer Ortega, Kakra Hughes, Terrence M Fullum
BACKGROUND: Weight regain has led to an increase in revision of Roux-en-Y gastric bypass (RYGB) surgeries. There is no standardized approach to revisional surgery after failed RYGB. We performed an exhaustive literature search to elucidate surgical revision options. Our objective was to evaluate outcomes and complications of various methods of revision after RYGB to identify the option with the best outcomes for failed primary RYGB. METHOD: A systematic literature search was conducted using the following search tools and databases: PubMed, Google Scholar, Cochrane Clinical Trials Database, Cochrane Review Database, EMBASE, and Allied and Complementary Medicine to identify all relevant studies describing revision after failed RYGB...
July 2016: Obesity Surgery
Philipp Nett, Yves Borbély, Dino Kröll
BACKGROUND: Malabsorptive bariatric surgery requires life-long micronutrient supplementation. Based on the recommendations, we assessed the number of adjustments of micronutrient supplementation and the prevalence of vitamin and mineral deficiencies at a minimum follow-up of 5 years after biliopancreatic diversion with duodenal switch (BPD-DS). METHODS: Between October 2010 and December 2013, a total of 51 patients at a minimum follow-up of 5 years after BPD-DS were invited for a clinical check-up with a nutritional blood screening test for vitamins and minerals...
October 2016: Obesity Surgery
Jens Homan, Janneke Ruinemans-Koerts, E O Aarts, Ignace M C Janssen, Frits J Berends, Hans de Boer
BACKGROUND: Reduced serum vitamin K levels are frequently observed after biliopancreatic diversion (BPD) and BPD with duodenal switch (BPD/DS). The criteria for treatment are not precisely defined. OBJECTIVES: To assess the effects of standardized vitamin K supplementation in patients who develop vitamin K deficiency after BPD or BPD/DS. SETTING: Teaching hospital specializing in bariatric surgery. METHODS: Serum vitamin K levels, clotting times, and vitamin K-dependent coagulation factors were measured after an overnight fast at baseline and then at 4 days and 1, 4, and 52 weeks after the start of vitamin K supplementation in 10 consecutive patients who had developed severe vitamin K deficiency after BPD or BPD/DS...
February 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Laurent Biertho, Frédéric Simon-Hould, Simon Marceau, Stéfane Lebel, Odette Lescelleur, Simon Biron
BACKGROUND: Biliopancreatic diversion with duodenal switch (BPD-DS) has long been considered as the bariatric procedure with the highest peri-operative and long-term complication rate. However, modern peri-operative care, including laparoscopic and staged-approach, has significantly reduced the complication rate related to this procedure. The goal of this article is to provide an overview of the current outcomes of laparoscopic BPD-DS in a high volume centre. METHODS: All patients who had a laparoscopic BPD-DS with a hand-sewn anastomosis performed between 2011 and 2015 (N = 566) were reviewed...
2016: Annals of Surgical Innovation and Research
Philipp C Nett, Dino Kröll, Yves Borbély
BACKGROUND: Re-sleeve gastrectomy (re-SG) is a possible option to increase weight loss after biliopancreatic diversion with duodenal switch (BPD-DS). We report the feasibility, efficacy and safety of re-SG in patients presenting with long-term weight regain after BPD-DS. METHODS: From October 2010 to December 2013, a total of 17 patients (12 female, 5 male) with a mean age of 42.1 ± 19.4 years underwent re-SG, mainly because of weight regain after BPD-DS. Re-SG was performed laparoscopically over a 32 French stomach tube...
August 2016: Surgical Endoscopy
Audrey Auclair, Julie Martin, Marjorie Bastien, Nadine Bonneville, Laurent Biertho, Simon Marceau, Frédéric-Simon Hould, Simon Biron, Stéfane Lebel, Odette Lescelleur, Jean-Pierre Després, Paul Poirier
BACKGROUND: Severe obesity is often characterized by ectopic fat deposition, which is related to development of type 2 diabetes (T2D). Thus, resolution of T2D may not be linearly associated with weight loss. The importance of ectopic fat reduction after bariatric surgery and T2D resolution is uncertain. OBJECTIVE: The aim of this pilot study is to compare body composition and body fat distribution in severely obese patients with or without T2D after biliopancreatic diversion with duodenal switch (BPD-DS) surgery in relation to diabetes resolution...
August 2016: Obesity Surgery
Salvatore Gentile
The clinical utilization of psychotropic medications in pregnant women represents a significant challenge. Indeed, the risks of untreated severe mental disorders, particularly when complicated by substance-related and addictive disorders, must be carefully balanced against the potential teratogenic risks of pharmacological treatment. In this case, an alcohol addict, diagnosed with borderline personality disorder was treated successfully with several classes of psychotropic agents during the first trimester...
November 2015: Clinical Drug Investigation
Hye Won Park, Yong-Sung Choi, Kyo Sun Kim, Soo-Nyung Kim
BACKGROUND: Chorioamnionitis has recently been reported as a risk factor for various neonatal diseases, including cerebral palsy, bronchopulmonary dysplasia, and necrotizing enterocolitis, but its effect on patent ductus arteriosus (PDA) is unclear. We performed a systematic review and meta-analysis to evaluate the effect of chorioamnionitis on PDA. METHODS: We searched PubMed, EMBASE, Cochrane Library, and KoreaMed databases using the terms: "intrauterine infection" or "maternal infection" or "antenatal infection" or "chorioamnionitis" or "placenta inflammation" or "placenta pathology" or "neonatal outcome" or "neonatal morbidity" or "PDA or patent ductus arteriosus" or "ductus arteriosus," and "prematurity" or "very low birth weight infant...
2015: PloS One
Richard B Corradi
The concept of borderline personality disorder (BPD) remains problematic despite psychiatrists' general familiarity with its DSM diagnostic criteria. The diagnosis of BPD is frequently based simply on the DSM checklist of traits and symptoms without knowledge of their origins or significance. Misdiagnosis is common, as is lack of recognition of the full complexity of this severe personality disorder and the nature of the vulnerabilities that underlie its myriad forms of pathology. The stresses of ordinary life are often too much for people with BPD...
2015: Bulletin of the Menninger Clinic
Sandra H Sulzer, Elizabeth Muenchow, Annabelle Potvin, Jessica Harris, Grant Gigot
BACKGROUND: Borderline personality disorder (BPD) has historically been difficult to diagnose, and laden with stigma, leading to a variety of clinical responses to patients who present with symptoms. AIMS: (1) To understand how clinicians communicate the diagnosis of BPD with patients. (2) To compare these practices with patient communication preferences. (3) To use patient preferences to evaluate clinician practices. METHODS: Semi-structured interviews with mental health care providers and experts (n = 32) were compared with patients (n = 10) and primary patient-written accounts (n = 22)...
2016: Journal of Mental Health
Dan Sucksdorff, Alan S Brown, Roshan Chudal, Elina Jokiranta-Olkoniemi, Susanna Leivonen, Auli Suominen, Markus Heinimaa, Andre Sourander
BACKGROUND: Population-based studies have demonstrated an overrepresentation of bipolar disorder (BPD) in individuals with epilepsy. However, few studies have examined the reverse association, i.e. comorbid epilepsy in individuals selected based on BPD diagnosis. No previous population-based study having examined the co-occurrence of BPD and epilepsy has adjusted for parental psychopathology. Such an adjustment is motivated by population-based studies reporting an overrepresentation of various types of parental psychiatric disorders in both BPD and epilepsy...
December 1, 2015: Journal of Affective Disorders
Alice Hadchouel, Laetitia Marchand-Martin, Marie-Laure Franco-Montoya, Laetitia Peaudecerf, Pierre-Yves Ancel, Christophe Delacourt
Preterm birth is associated with abnormal respiratory functions throughout life. The mechanisms underlying these long-term consequences are still unclear. Shortening of telomeres was associated with many conditions, such as chronic obstructive pulmonary disease. We aimed to search for an association between telomere length and lung function in adolescents born preterm. Lung function and telomere length were measured in 236 adolescents born preterm and 38 born full-term from the longitudinal EPIPAGE cohort. Associations between telomere length and spirometric indices were tested in univariate and multivariate models accounting for confounding factors in the study population...
2015: PloS One
Heli-Kaisa Saarenpää, Marjaana Tikanmäki, Marika Sipola-Leppänen, Petteri Hovi, Karoliina Wehkalampi, Mirjami Siltanen, Marja Vääräsmäki, Anna-Liisa Järvenpää, Johan G Eriksson, Sture Andersson, Eero Kajantie
BACKGROUND AND OBJECTIVES: Lung function attained in young adulthood is 1 of the strongest predictors of obstructive airways disease in later life. Adults born preterm at very low birth weight (VLBW; <1500 g) who have experienced bronchopulmonary dysplasia (BPD) have reduced lung function. We studied the association of lung function in young adulthood with preterm birth at VLBW and with BPD and other prenatal and neonatal conditions. METHODS: We performed spirometry for 160 VLBW subjects (29 with BPD according to Northway criteria) aged 18 to 27 years and 162 term control subjects group-matched for gender, age, and birth hospital...
October 2015: Pediatrics
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