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https://www.readbyqxmd.com/read/28456730/usefulness-of-pbpk-modeling-in-incorporation-of-clinical-conditions-in-personalized-medicine
#1
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. Physiologically-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
#2
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
#3
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 Unfortunately, many anti-obesity drugs have been withdrawn from market due to adverse side effects.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...
April 17, 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
#4
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...
April 7, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28303504/do-bariatric-patients-follow-dietary-and-lifestyle-recommendations-during-the-first-postoperative-year
#5
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...
March 16, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28176219/large-buffering-effect-of-the-duodenal-bulb-in-duodenal-switch-a-wireless-ph-metric-study
#6
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...
February 7, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28174231/should-bariatric-surgery-be-performed-in-adolescents
#7
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
#8
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
https://www.readbyqxmd.com/read/28050789/weight-loss-and-nutritional-outcomes-10-years-after-biliopancreatic-diversion-with-duodenal-switch
#9
Philippe Topart, Guillaume Becouarn, Jacques Delarue
BACKGROUND: Biliopancreatic diversion with duodenal switch (BPD/DS) is the most effective bariatric surgical procedure, but major concerns exist about the nutritional consequences. OBJECTIVES: The study reported weight loss and nutritional outcomes of 80 patients with a follow-up of at least 10 years. SETTING: The follow-up was conducted at a university hospital as well as in a private practice institution in France. METHODS: Eighty patients operated on between February 2002 and May 2006 were reviewed...
January 4, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/27988455/delayed-diagnosis-of-wernicke-encephalopathy-with-irreversible-neural-damage-after-subtotal-gastrectomy-for-gastric-cancer-a-case-of-medical-liability
#10
Pamela Tozzo, Luciana Caenazzo, Daniele Rodriguez, Matteo Bolcato
INTRODUCTION: Wernicke's encephalopathy (WE) is a neurological syndrome caused by thiamine deficiency, and clinically characterized by ophthalmoplegia, ataxia and acute confusion. In developed countries, most cases of WE have been seen in alcohol misusers. Other reported causes are gastrointestinal tract surgery, hyperemesis gravidarum, chronic malnutrition, prolonged total parenteral nutrition without thiamine supplementation, and increased nutrient requirements as in trauma or septic shock...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27927032/emerging-drugs-for-the-treatment-of-obesity
#11
Christoffer Martinussen, Kirstine Nyvold Bojsen-Moller, Maria Saur Svane, Thomas Fremming Dejgaard, Sten Madsbad
The increasing prevalence of obesity represents a huge threat to public health and the current pharmacological treatment options are limited. Bariatric surgery is by far the most effective treatment for severe obesity, highlighting the urgent need for new and improved drug therapies. Areas covered: Based on the physiological regulation of energy homeostasis, pharmacological strategies to treat obesity are evaluated with focus on drugs in phase 2 and 3 clinical development. The potential impact of these drugs on current treatment standards and the barriers for development are discussed and set in a historical perspective of previous antiobesity medications...
December 16, 2016: Expert Opinion on Emerging Drugs
https://www.readbyqxmd.com/read/27896648/clinical-and-metabolic-effects-of-biliopancreatic-diversion-persist-after-reduction-of-the-gastric-pouch-and-elongation-of-the-common-alimentary-tract-preliminary-report-in-a-series-of-patients-with-a-10-year-follow-up
#12
Valerio Ceriani, Francesco Cetta, Tiziana Lodi, Ferdinando Pinna, Antonio E Pontiroli
BACKGROUND: Biliopancreatic diversion (BPD) is a bariatric technique burdened, in some instances, by clinical evidence of malabsorption and malnutrition, and by intractable diarrhea. OBJECTIVE: The objective of this study was to assess metabolic and nutritional effects on patients undergoing BPD and BPD plus revisional surgery because of side effects. METHODS: Thirty-five consecutive BPD patients underwent revisional surgery (elongation of the common limb from 50 to 200 cm and reduction of the gastric pouch from 500 to 40 ml) after a median 48-month period [48...
June 2017: Obesity Surgery
https://www.readbyqxmd.com/read/27768400/single-anastomosis-sleeve-ileal-bypass-new-step-in-the-evolution-of-bariatric-surgeries
#13
Tamer M S Salama, Karim Sabry, Yaser El Ghamrini
PURPOSE: Single anastomosis sleeve ileal bypass (SASI) procedure appears as a new metabolic and bariatric surgery based on Santoro's operation, in which a sleeve gastrectomy is followed by a side-to-side gastroileal anastomosis. The study is aimed to evaluate the short-term outcomes of laparoscopic single anastomosis sleeve ileal bypass with respect to postoperative weight loss and metabolic and nutritional effects on patients. METHODS: Forty-five morbidly obese patients with a mean age of 31...
October 21, 2016: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
https://www.readbyqxmd.com/read/27686232/predictive-value-of-c-reactive-protein-for-complications-post-laparoscopic-roux-en-y-gastric-bypass
#14
Murray R Williams, Samuel McMeekin, R Jonathan T Wilson, Glenn V Miller, Fiona E Langlands, Wingzou Wong, Mark Peter, Mathew S Giles
BACKGROUND: Laparoscopic roux-en-Y gastric bypass (LRYGB) has gained increasing popularity as the primary procedure of choice for the management of patients with morbid obesity. Despite the advances, a few patients will still develop complications and predicting these early complications in morbidly obese patients can prove to be difficult. Radiological investigations have limited diagnostic value and have associated side effects and cost. We propose that C-reactive protein (CRP) is a useful predictor for early postoperative complications...
March 2017: Obesity Surgery
https://www.readbyqxmd.com/read/27511809/the-management-of-anovulatory-infertility-in-women-with-polycystic-ovary-syndrome-an-analysis-of-the-evidence-to-support-the-development-of-global-who-guidance
#15
REVIEW
Adam H Balen, Lara C Morley, Marie Misso, Stephen Franks, Richard S Legro, Chandrika N Wijeyaratne, Elisabet Stener-Victorin, Bart C J M Fauser, Robert J Norman, Helena Teede
BACKGROUND: Here we describe the consensus guideline methodology, summarise the evidence-based recommendations we provided to the World Health Organisation (WHO) for their consideration in the development of global guidance and present a narrative review on the management of anovulatory infertility in women with polycystic ovary syndrome (PCOS). OBJECTIVE AND RATIONALE: The aim of this paper was to present an evidence base for the management of anovulatory PCOS...
November 2016: Human Reproduction Update
https://www.readbyqxmd.com/read/27438859/dbs-for-obesity
#16
REVIEW
Ruth Franco, Erich T Fonoff, Pedro Alvarenga, Antonio Carlos Lopes, Euripides C Miguel, Manoel J Teixeira, Durval Damiani, Clement Hamani
Obesity is a chronic, progressive and prevalent disorder. Morbid obesity, in particular, is associated with numerous comorbidities and early mortality. In patients with morbid obesity, pharmacological and behavioral approaches often have limited results. Bariatric surgery is quite effective but is associated with operative failures and a non-negligible incidence of side effects. In the last decades, deep brain stimulation (DBS) has been investigated as a neurosurgical modality to treat various neuropsychiatric disorders...
July 18, 2016: Brain Sciences
https://www.readbyqxmd.com/read/27324638/the-role-of-metabolic-surgery-on-blood-pressure-control
#17
REVIEW
Carlos Aurelio Schiavon, Luciano F Drager, Luiz A Bortolotto, Celso Amodeo, Dimas Ikeoka, Otávio Berwanger, Ricardo Vitor Cohen
Obesity and hypertension are growing epidemics in the modern world. Lifestyle changes and medical treatment for obesity have disappointing long-term results and albeit drugs for hypertension are usually very effective, the necessity of multiple pills and frequent side effects make the adherence to treatment a huge challenge for healthcare systems. Bariatric/metabolic surgery is a very effective treatment and an exponential number of studies have been showing its positive impact beyond weight loss, mainly on type 2 diabetes...
August 2016: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/27178615/understanding-excess-skin-in-postbariatric-patients-objective-measurements-and-subjective-experiences
#18
Christina Biörserud, Torsten Olbers, Trude Staalesen, Anna Elander, Monika Fagevik Olsén
BACKGROUND: Excess skin is a well-known side effect of massive weight loss after bariatric surgery. However, there is a lack of longitudinal follow-ups. OBJECTIVES: The primary aims of this study were to investigate the development and amount of excess skin after laparoscopic Roux-en-Y gastric bypass and to relate objective results to subjective experiences. SETTING: University hospital. METHODS: From 2009 to 2012, 200 patients were included and assessed with respect to excess skin before and 18 months after bariatric surgery...
August 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/27150339/remission-of-type-2-diabetes-in-patients-undergoing-biliointestinal-bypass-for-morbid-obesity-a-new-surgical-treatment
#19
Gianmattia Del Genio, Michel Gagner, Paolo Limongelli, Salvatore Tolone, Dimitri Pournaras, Carel W le Roux, Luigi Brusciano, Anna Licia Mozzillo, Federica Del Genio, Ludovico Docimo
BACKGROUND: Nutrient interaction with the mid-gut may play a role in improving type 2 diabetes mellitus (T2D) after bariatric surgery. However, Roux-en-Y gastric bypass, biliopancreatic diversion, and sleeve gastrectomy include diversion of food from the duodenum and/or partial gastrectomy. Biliointestinal bypass (BIBP) was introduced to eliminate the major side effects of jejunoileal bypass. It does not involve any change to the anatomy of the stomach or the duodenum. A prospective evaluation of the role of BIBP in glycemic control has not been reported...
May 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/27072022/commercial-very-low-energy-meal-replacements-for-preoperative-weight-loss-in-obese-patients-a-systematic-review
#20
REVIEW
Lynda J Ross, Siobhan Wallin, Emma J Osland, Muhammed Ashraf Memon
BACKGROUND: This systematic review assessed feasibility and effectiveness of preoperative meal replacements to improve surgical outcomes for obese patients. METHODS: PRISMA guidelines were followed and electronic databases searched for articles between January 1990 and March 2015. RESULTS: Fifteen studies (942 participants including 351 controls) were included, 13 studies (n = 750) in bariatric patients. Adverse effects and dropout rates were minimal...
June 2016: Obesity Surgery
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