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https://www.readbyqxmd.com/read/29217129/long-alimentary-limb-duodenal-switch-lads-a-short-term-prospective-randomized-trial
#1
Anabelle Cloutier, Stéfane Lebel, Frédéric Hould, François Julien, Simon Marceau, Léonie Bouvet, Serge Simard, Laurent Biertho
BACKGROUND: Biliopancreatic diversion with duodenal switch (BPD-DS) is one of the most effective bariatric surgeries, in terms of weight loss and remission of co-morbidities. It is however associated with a significant risk of protein and nutritional deficiency, as well as gastrointestinal side effects. OBJECTIVES: To assess the effect of increasing the strict alimentary limb on weight loss, nutritional deficiency and quality of life, compared with standard BPD-DS...
November 8, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/29189999/nafld-nash-in-patients-with-type-2-diabetes-and-related-treatment-options
#2
REVIEW
M G Radaelli, F Martucci, S Perra, S Accornero, G Castoldi, G Lattuada, G Manzoni, G Perseghin
Type 2 diabetes may reduce life expectancy and patients' quality of life due to its micro- and macro-vascular complications and to the higher risk of several types of cancer. An emerging important factor is represented by the hepatic involvement; it is recognized that excessive hepatic fat accumulation represents a typical feature of diabetic patients and that it also plays an important pathogenic role. It is now evident that non-alcoholic fatty liver disease (NAFLD), generally perceived as a benign condition, may have on the contrary an important deleterious impact for diabetic patients increasing the risk to develop cardiovascular complications but also serious hepatic diseases, in particular non-alcoholic steatohepatitis (NASH), cirrhosis and hepatocellular carcinoma...
November 30, 2017: Journal of Endocrinological Investigation
https://www.readbyqxmd.com/read/29185185/the-long-term-effects-of-the-adjustable-gastric-band-on-esophageal-motility-in-patients-who-present-for-band-removal
#3
Loic Tchokouani, Anusha Jayaram, Naif Alenazi, Gustavo Fernandez Ranvier, Gina Sam, Subhash Kini
BACKGROUND: During the past decade, laparoscopic adjustable gastric banding (LAGB) was one of the most popular surgical procedures in treating morbid obesity. Long-term effects, specifically on esophageal motility, of LAGB have not been well described in the literature despite the high prevalence of reoperations and post-operative dysphagia. We aimed to characterize esophageal dysmotility after long-term follow-up using data of high-resolution esophageal manometry (HRM) performed in patients who presented for LAGB removal...
November 29, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/29162562/metabolic-effects-of-bariatric-surgery
#4
REVIEW
Piriyah Sinclair, Neil Docherty, Carel W le Roux
BACKGROUND: Obesity can be defined as a chronic subcortical brain disease, as there is an important neurophysiological component to its etiology based on changes in the functioning of those areas of the brain controlling food intake and reward. Extensive metabolic changes accompany bariatric surgery-based treatment of obesity. Consequently, the term "metabolic" surgery is being increasingly adopted in relation to the beneficial effects these procedures have on chronic diseases like type 2 diabetes...
November 21, 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/29132230/combination-therapy-for-obesity
#5
John Ph Wilding
Obesity is a chronic disease with serious consequences and although lifestyle modification is considered first line treatment, it is often ineffective, especially in the long term. Relatively few people with obesity will undergo the most effective currently available treatment of bariatric surgery. Pharmacotherapy can bridge the gap between lifestyle modification and surgery, but many monotherapies have only modest efficacy or require high doses with unacceptable side effects. As with many other areas of medicine, combination therapy is now becoming accepted as a way of optimising efficacy for weight management, whilst minimising adverse effects...
November 2017: Journal of Psychopharmacology
https://www.readbyqxmd.com/read/29033356/intraoperative-analgesia-guided-by-the-analgesia-nociception-index-in-bariatric-surgery-an-unmatched-case-control-study
#6
Lisa Le Gall, Anaëlle David, Pauline Carles, Sébastien Leuillet, Brigitte Chastel, Catherine Fleureau, Antoine Dewitte, Alexandre Ouattara
INTRODUCTION: Analgesia Nociception Index (ANI) has been proposed for the evaluation of the nociception-antinociception balance in the perioperative period. In obese patient, where the management of analgesia may be rendered difficult by pharmacological changes, we hypothesized that the monitoring of analgesia with ANI would reduce intraoperative opioid consumption during bariatric surgery. METHODS: This monocentric, observational, unmatched case-control study aimed to compare perioperative data from obese subjects (body mass index ≥ 35kg...
October 12, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29025827/influence-of-social-deprivation-on-provision-of-bariatric-surgery-10-year-comparative-ecological-study-between-two-uk-specialist-centres
#7
Shivam Bhanderi, Mushfique Alam, Jacob Henry Matthews, Gavin Rudge, Hamish Noble, David Mahon, Martin Richardson, Richard Welbourn, Paul Super, Rishi Singhal
OBJECTIVE: To investigate the effect of residential location and socioeconomic deprivation on the provision of bariatric surgery. DESIGN: Retrospective cross-sectional ecological study. SETTING: Patients resident local to one of two specialist bariatric units, in different regions of the UK, who received obesity surgery between 2003 and 2013. METHODS: Demographic data were collected from prospectively collected databases...
October 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/28906072/-it-just-made-me-feel-so-desolate-patients-narratives-of-weight-gain-following-laparoscopic-insertion-of-a-gastric-band
#8
Frances Marjorie May Lloyd, Alistair Hewison, Nikolaos Efstathiou
AIMS AND OBJECTIVES: To describe the experiences of patients who have failed to maintain weight loss following the insertion of a laparoscopic adjustable gastric band (LAGB) for the treatment of morbid obesity. BACKGROUND: Obesity is a global health problem resulting in physical, psychological and economic problems and presenting challenges for health services. Surgical intervention is an increasingly common approach to treatment; however, some patients do not sustain their weight loss following bariatric surgery and little is known about people's longer-term experiences following LAGB insertion...
September 14, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28870706/bariatric-surgery-in-adolescents-with-severe-obesity-review-and-state-of-the-art-in-france
#9
Régis Coutant, Natacha Bouhours-Nouet, Aurélie Donzeau, Mathilde Fauchard, Anne Decrequy, Jean Malka, Elise Riquin, Marion Beaumesnil, Agnès Sallé, Claire Briet, Philippe Topart, Françoise Schmitt
Severe obesity (body mass index>120% of BMI IOTF-30 cut off) and morbid obesity (BMI>140% of BMI IOTF-30 cut off) affect 5 to 10% of obese adolescents in France. Organic complications can be found in about 50% of these patients, and depressive symptoms in one-third of them. Finally, over 70% will suffer from adult morbid obesity associated with a marked increase in morbidity and mortality. However, the reversion of obesity strongly decreases, and may even cancels, these risks. In controlled randomized studies, lifestyle interventions have limited effectiveness on BMI in children (and none in adolescents)...
September 1, 2017: Annales D'endocrinologie
https://www.readbyqxmd.com/read/28780045/sleeve-gastrectomy-with-duodenojejunal-end-to-side-anastomosis-in-the-treatment-of-type-2-diabetes-the-initial-experiences-in-a-chinese-population-with-a-more-than-4-year-follow-up
#10
Xiaojiao Ruan, Weijian Zhang, Huajie Cai, Ru Zheng, Feizhao Jiang, Hengliang Zhu
BACKGROUND: Gastric bypass has been thought to be associated with a risk of gastric cancer, particularly in Asia. Sleeve gastrectomy with duodenojejunal end-to-side anastomosis (SG-DJESA) was suggested to be a better-designed procedure to avoid this risk, and it also has other advantages. OBJECTIVE: We aimed to evaluate the clinical efficacy and feasibility of SG-DJESA in the treatment of nonobese patients with type 2 diabetes (T2D). SETTING: University Hospital, China...
October 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28743858/triggerable-tough-hydrogels-for-gastric-resident-dosage-forms
#11
Jinyao Liu, Yan Pang, Shiyi Zhang, Cody Cleveland, Xiaolei Yin, Lucas Booth, Jiaqi Lin, Young-Ah Lucy Lee, Hormoz Mazdiyasni, Sarah Saxton, Ameya R Kirtane, Thomas von Erlach, Jaimie Rogner, Robert Langer, Giovanni Traverso
Systems capable of residing for prolonged periods of time in the gastric cavity have transformed our ability to diagnose and treat patients. Gastric resident systems for drug delivery, ideally need to be: ingestible, be able to change shape or swell to ensure prolonged gastric residence, have the mechanical integrity to withstand the forces associated with gastrointestinal motility, be triggerable to address any side effects, and be drug loadable and release drug over a prolonged period of time. Materials that have been primarily utilized for these applications have been largely restricted to thermoplastics and thermosets...
July 25, 2017: Nature Communications
https://www.readbyqxmd.com/read/28601988/surgical-and-advanced-medical-therapy-for-the-treatment-of-type-2-diabetes-in-class-i-obese-patients-a-short-term-outcome
#12
Mohit Bhandari, Winni Mathur, Ravindra Kumar, Arun Mishra, Mahak Bhandari
BACKGROUND: Bariatric surgery, incretin-based therapy (glucagon-like peptide-1 analogues), and sodium-glucose co-transporter 2 (SGLT2) inhibitors have antidiabetic properties in morbidly obese patients. However, their comparative efficacy in treating type 2 diabetes mellitus (T2DM) in class I obese patients specifically in Indian has not been studied yet. This study evaluates and compares the efficacy and side effect of surgical and advanced medical management of T2DM in class I obese patients...
June 11, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28456730/usefulness-of-pbpk-modeling-in-incorporation-of-clinical-conditions-in-personalized-medicine
#13
REVIEW
Niloufar Marsousi, Jules A Desmeules, Serge Rudaz, Youssef Daali
Personalized medicine aims to determine the most adequate treatment and dose regimen to obtain the maximum efficacy and minimum side effect by taking into account patients' characteristics. For numerous reasons, one being ethical and methodological hurdles in including specific populations in clinical trials, innovative methods for optimization of drugs safety and efficacy in such patients have received increasing interest recently. Physiological-based pharmacokinetic (PBPK) modeling has emerged as a promising approach in designing adequate clinical trials and quantifying anticipated changes in unknown clinical situations...
April 26, 2017: Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28440518/-choice-of-bariatric-and-metabolic-surgical-procedures
#14
Hui Liang, Shibo Lin, Wei Guan
Bariatric and metabolic surgery has become the clinical hot topic of the treatment of metabolic syndromes including obesity and diabetes mellitus, but how to choose the appropriate surgical procedure remains the difficult problem in clinical practice. Clinical guidelines of American Society for Metabolic and Bariatric Surgery(ASMBS)(version 2013) introduced the procedures of bariatric and metabolic surgery mainly including biliopancreatic diversion with duodenal switch(BPD-DS), laparoscopic adjustable gastric banding (LAGB), laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic sleeve gastrectomy(LSG)...
April 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28414326/mesenchymal-stem-cells-in-obesity-insights-for-translational-applications
#15
REVIEW
Kenichi Matsushita, Victor J Dzau
Obesity is now a major public health problem worldwide. Lifestyle modification to reduce the characteristic excess body adiposity is important in the treatment of obesity, but effective therapeutic intervention is still needed to control what has become an obesity epidemic. Unfortunately, many anti-obesity drugs have been withdrawn from market due to adverse side effects. Bariatric surgery therefore remains the most effective therapy for severe cases, although such surgery is invasive and researchers continue to seek new control strategies for obesity...
October 2017: Laboratory Investigation; a Journal of Technical Methods and Pathology
https://www.readbyqxmd.com/read/28389846/continuous-transversus-abdominis-plane-blocks-via-laparoscopically-placed-catheters-for-bariatric-surgery
#16
Alfred M Said, Hany A Balamoun
OBJECTIVES: The objective of the present study is to evaluate postoperative analgesic outcome of the continuous bilateral transversus abdominis plane (TAP) block using bupivacaine infusion through an epidural catheter inserted through laparoscopic ports. PATIENTS AND METHODS: Ninety patients assigned for laparoscopic sleeve gastrectomy (LSG) were divided into two equal groups according to postoperative analgesia: Control group received IV morphine, and TAP group received bupivacaine 0...
October 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28303504/do-bariatric-patients-follow-dietary-and-lifestyle-recommendations-during-the-first-postoperative-year
#17
Shiri Sherf Dagan, Andrei Keidar, Asnat Raziel, Nasser Sakran, David Goitein, Oren Shibolet, Shira Zelber-Sagi
BACKGROUND: Data on adherence to postoperative lifestyle recommendations by bariatric patients are scarce. Thus, the aim of this study was to evaluate adherence to selected recommendations during the first year following laparoscopic sleeve gastrectomy (LSG) surgery. METHODS: A prospective cohort study with 12 months of follow-up on 100 LSG patients was conducted. Data were collected at baseline and at 3 (M3), 6 (M6), and 12 (M12) months post-surgery and included anthropometrics, biochemical tests, food intake, food tolerance, common surgery-related side effects, physical activity (PA), supplementation, and number of follow-up meetings with a dietitian...
September 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28176219/large-buffering-effect-of-the-duodenal-bulb-in-duodenal-switch-a-wireless-ph-metric-study
#18
Z Bekhali, J Hedberg, H Hedenström, M Sundbom
INTRODUCTION: Bariatric procedures result in massive weight loss, however, not without side effects. Gastric acid is known to cause marginal ulcers, situated in the small bowel just distal to the upper anastomosis. We have used the wireless BRAVO™ system to study the buffering effect of the duodenal bulb in duodenal switch (DS), a procedure in which the gastric sleeve produces a substantial amount of acid. METHODS: We placed a pre- and a postpyloric pH capsule in 15 DS-patients (seven men, 44 years, BMI 33) under endoscopic guidance and verified the correct location by fluoroscopy...
July 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28174231/should-bariatric-surgery-be-performed-in-adolescents
#19
REVIEW
Andrew J Beamish, Thomas Reinehr
Adolescent obesity has markedly increased worldwide in both its extent and prevalence in recent decades and obesity prevention strategies are failing. As a result, effective treatment strategies are urgently needed. As behavioral and pharmacological treatment approaches have only moderate effects in severe obesity, bariatric surgery has begun to emerge as a treatment option. In this debate article, we offer arguments opposing and supporting bariatric surgery in the treatment of severe obesity in adolescents...
April 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/28061687/new-targets-for-drug-treatment-of-obesity
#20
Georgios Valsamakis, Panagiota Konstantakou, George Mastorakos
Antiobesity medical management has shown unsatisfactory results to date in terms of efficacy, safety, and long-term maintenance of weight loss. This poor performance could be attributed to the complexity of appetite regulation mechanisms; the serious drug side effects; and, crucially, the lack of profile-matching treatment strategies and individualized, multidisciplinary follow-up. Nevertheless, antiobesity pharmacotherapy remains a challenging, exciting field of intensive scientific interest. According to the latest studies, the future of bariatric medicine lies in developing drugs acting at multiple levels of the brain-gut axis...
January 6, 2017: Annual Review of Pharmacology and Toxicology
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