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Obesity surgery trial

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https://www.readbyqxmd.com/read/27903151/how-to-manage-the-obese-patient-with-cancer
#1
Andrew G Renehan, Michelle Harvie, Ramsey I Cutress, Michael Leitzmann, Tobias Pischon, Sacha Howell, Anthony Howell
Purpose Obesity (body mass index [BMI] ≥ 30 kg/m(2)) is common among patients with cancer. We reviewed management issues in the obese patient with cancer, focusing on how obesity influences treatment selection (including chemotherapy dosing), affects chemotherapy toxicity and surgical complications, and might be a treatment effect modifier. Methods The majority of evidence is drawn from observational studies and secondary analyses of trial data, typically analyzed in N × 3 BMI categories (normal weight, overweight, and obese) matrix structures...
December 10, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/27901287/randomized-trial-of-roux-en-y-gastric-bypass-versus-sleeve-gastrectomy-in-achieving-excess-weight-loss
#2
M Ignat, M Vix, I Imad, A D'Urso, S Perretta, J Marescaux, D Mutter
BACKGROUND: Robust data on quality of life (QoL) after different techniques of bariatric surgery are sparse. This RCT compared excess weight loss (EWL) and QoL after sleeve gastrectomy versus Roux-en-Y gastric bypass (RYGB). METHODS: Obese patients were assigned randomly to RYGB or sleeve gastrectomy. The primary outcome measure was EWL. Secondary outcomes included QoL, co-morbidity, adverse events, vitamin and glycolipid status. QoL was assessed before and annually after surgery, using the Moorehead-Ardelt Quality of Life Questionnaire II (M-A-QoLQII) and Gastrointestinal Quality of Life Index (GIQLI)...
November 30, 2016: British Journal of Surgery
https://www.readbyqxmd.com/read/27898680/a-core-outcome-set-for-the-benefits-and-adverse-events-of-bariatric-and-metabolic-surgery-the-bariact-project
#3
Karen D Coulman, James Hopkins, Sara T Brookes, Katy Chalmers, Barry Main, Amanda Owen-Smith, Robert C Andrews, James Byrne, Jenny L Donovan, Graziella Mazza, Barnaby C Reeves, Chris A Rogers, Janice L Thompson, Richard Welbourn, Sarah Wordsworth, Jane M Blazeby
BACKGROUND: Bariatric and metabolic surgery is used as a treatment for patients with severe and complex obesity. However, there is a need to improve outcome selection and reporting in bariatric surgery trials. A Core Outcome Set (COS), an agreed minimum set of outcomes reported in all studies of a specific condition, may achieve this. Here, we present the development of a COS for BARIAtric and metabolic surgery Clinical Trials-the BARIACT Study. METHODS AND FINDINGS: Outcomes identified from systematic reviews and patient interviews informed a questionnaire survey...
November 2016: PLoS Medicine
https://www.readbyqxmd.com/read/27895003/effect-on-nitrogen-balance-thermogenesis-body-composition-satiety-and-circulating-branched-chain-amino-acid-levels-up-to-one-year-after-surgery-protocol-of-a-randomized-controlled-trial-on-dietary-protein-during-surgical-weight-loss
#4
Violeta Moizé, Xavier Pi-Sunyer, Josep Vidal, Patricia Miner, Yves Boirie, Blandine Laferrère
BACKGROUND: Bariatric surgery (BS), the most effective treatment for severe obesity, typically results in 40-50 kg weight loss in the year following the surgery. Beyond its action on protein metabolism, dietary protein intake (PI) affects satiety, thermogenesis, energy efficiency, and body composition (BC). However, the required amount of PI after surgical weight loss is not known. The current daily PI recommendation for diet-induced weight loss is 0.8 g/kg ideal body weight (IBW) per day, but whether this amount is sufficient to preserve fat-free mass during active surgical weight loss is unknown...
November 28, 2016: JMIR Research Protocols
https://www.readbyqxmd.com/read/27890688/weight-loss-is-associated-with-improvements-in-cognitive-function-among-overweight-and-obese-people-a-systematic-review-and-meta-analysis
#5
REVIEW
Nicola Veronese, Silvia Facchini, Brendon Stubbs, Claudio Luchini, Marco Solmi, Enzo Manzato, Giuseppe Sergi, Stefania Maggi, Theodore Cosco, Luigi Fontana
Whilst obesity is associated with a higher risk of cognitive impairment, the influence of weight loss on cognitive function in obese/overweight people is equivocal. We conducted a meta-analysis of randomized controlled trials (RCTs) and longitudinal studies evaluating the influence of voluntary weight loss on cognitive function in obese/overweight individuals. Articles were acquired from a systematic search of major databases from inception till 01/2016. A random effect meta-analysis of weight loss interventions (diet, physical activity, bariatric surgery) on different cognitive domains (memory, attention, executive functions, language and motor speed) was conducted...
November 24, 2016: Neuroscience and Biobehavioral Reviews
https://www.readbyqxmd.com/read/27880977/bariatric-surgery-for-nonalcoholic-steatohepatitis-a-clinical-and-cost-effectiveness-analysis
#6
Matthew J Klebanoff, Kathleen E Corey, Jagpreet Chhatwal, Lee M Kaplan, Raymond T Chung, Chin Hur
: Nonalcoholic steatohepatitis (NASH) affects 2-3% of the U.S. population and is expected to become the leading indication for liver transplantation in the next decade. Bariatric surgery may be an effective but expensive treatment for NASH. Using a state-transition model, our analysis aimed to assess the effectiveness and cost-effectiveness of surgery to manage NASH. We simulated the benefits and harms of laparoscopic Roux-en-Y gastric bypass surgery in patients defined by weight class (overweight, mild obesity, moderate obesity, and severe obesity) and fibrosis stage (F0-F3)...
November 23, 2016: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/27867510/effect-of-adding-intrathecal-morphine-to-a-multimodal-analgesic-regimen-for-postoperative-pain-management-after-laparoscopic-bariatric-surgery-a-prospective-double-blind-randomized-controlled-trial
#7
Fatma Adel El Sherif, Ahmed Hassan Othman, Ahmad Mohammad Abd El-Rahman, Osama Taha
BACKGROUND: Pain control after bariatric surgery is a major challenge. Our objective was to study the efficacy and safety of intrathecal (IT) morphine 0.3 mg added to bupivacaine 0.5% for postoperative pain after laparoscopic bariatric surgery. METHODS: After local ethics committee approval, 100 morbidly obese patients scheduled for laparoscopic bariatric surgery were enrolled in this study. Patients were randomly assigned into two groups: Group I received IT 0...
November 2016: British Journal of Pain
https://www.readbyqxmd.com/read/27848247/hospital-rehabilitation-for-patients-with-obesity-a-scoping-review
#8
Jennifer C Seida, Arya M Sharma, Jeffrey A Johnson, Mary Forhan
PURPOSE: To explore the evidence on rehabilitation for hospitalized patients with obesity. METHODS: Medline, Embase, CENTRAL, CINAHL, and PubMed were searched from 1994 to May 2016. Grey literature was hand-searched. Two reviewers independently selected studies examining patients with obesity receiving hospital-based therapy for a physical impairment. One reviewer extracted the data and a second reviewer verified a random sample. RESULTS: Thirty-nine studies (two trials, 37 observational) were included...
November 16, 2016: Disability and Rehabilitation
https://www.readbyqxmd.com/read/27848050/sentinel-lymph-node-based-management-or-routine-axillary-clearance-five-year-outcomes-of-the-racs-sentinel-node-biopsy-versus-axillary-clearance-snac-1-trial-assessment-and-incidence-of-true-lymphedema
#9
Neil Wetzig, Peter Grantley Gill, David Espinoza, Rebecca Mister, Martin R Stockler, Val J Gebski, Owen A Ung, Ian Campbell, John Simes
PURPOSE: To determine whether the benefits of sentinel-node-based management (SNBM) over routine axillary clearance (RAC) persisted to 5 years. METHODS: A total of 1088 women with breast cancer less than 3 cm in diameter and clinically negative axillary nodes were randomized to SNBM with axillary clearance if the sentinel node was positive or RAC preceded by sentinel-node biopsy. The outcomes were: (1) objectively measured change in the volume of the operated and contralateral nonoperated arms; (2) the proportion with an increase in arm volume <15%; and (3) subjectively assessed arm morbidity for the domains swelling, symptoms, dysfunction, and disability...
November 15, 2016: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/27844255/a-vertically-placed-clip-for-weight-loss-a-39-month-pilot-study
#10
Moises Jacobs, Natan Zundel, Gustavo Plasencia, Prospero Rodriguez-Pumarol, Eddie Gomez, James Leithead
BACKGROUND: Morbid obesity remains one of society's significant medical dilemmas. It is rapidly worsening and expected to affect 35% of the US population by the year 2020. Common current bariatric procedures exist and include, but not limited to, the adjustable gastric band, gastric bypass, and the sleeve gastrectomy. Although beneficial to morbidly obese patients, they also alter the patient's anatomy and involve resections, or require maintenance. The goal of the trial is to show a new minimally invasive vertical gastric clip technique that produces significant weight loss but requires no resection, no change in anatomy, and is reversible...
November 14, 2016: Obesity Surgery
https://www.readbyqxmd.com/read/27837387/vitamin-d3-loading-is-superior-to-conventional-supplementation-after-weight-loss-surgery-in-vitamin-d-deficient-morbidly-obese-patients-a-double-blind-randomized-placebo-controlled-trial
#11
Maria Luger, Renate Kruschitz, Christian Kienbacher, Stefan Traussnigg, Felix B Langer, Gerhard Prager, Karin Schindler, Enikö Kallay, Friedrich Hoppichler, Michael Trauner, Michael Krebs, Rodrig Marculescu, Bernhard Ludvik
BACKGROUND: Bariatric patients often suffer from vitamin D deficiency (VDD), and both, morbid obesity and VDD, are related to non-alcoholic fatty liver disease. However, limited data are available regarding best strategies for treating VDD, particularly, in bariatric patients undergoing omega-loop gastric bypass (OLGB). Therefore, we examined the efficacy and safety of a forced vitamin D dosing regimen and intervention effects in liver fibrotic patients. METHODS: In this double-blind, randomized, placebo-controlled trial, 50 vitamin D-deficient patients undergoing OLGB were randomly assigned to receive, in the first month postoperatively, oral vitamin D3 (≤3 doses of 100,000 IU; intervention group) or placebo as loading dose (control group) with subsequent maintenance dose (3420 IU/day) in both groups until 6-month visit...
November 12, 2016: Obesity Surgery
https://www.readbyqxmd.com/read/27837039/low-risk-for-local-and-systemic-complications-after-primary-repair-of-1626-achilles-tendon-ruptures
#12
Nicholas Rensing, Brian R Waterman, Rachel M Frank, Kenneth A Heida, Justin D Orr
INTRODUCTION: Historically, Achilles tendon repairs and other surgeries about the hindfoot have demonstrated a significantly higher rate of wound healing complications and surgical site morbidity. The purpose of this study was to evaluate the comprehensive complication profile and risk factors for adverse short-term, clinical outcomes after primary repair of Achilles tendon ruptures. METHODS: Between the years 2005 and 2014, all cases of primary Achilles tendon repair (Current Procedural Terminology code 27650) entered into the National Surgical Quality Improvement Project (NSQIP) database were extracted for analysis...
November 10, 2016: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/27820740/enhanced-recovery-after-bariatric-surgery
#13
Adrian Alvarez, Basavana G Goudra, Preet Mohinder Singh
PURPOSE OF REVIEW: Enhanced recovery after surgery (ERAS) methodology has demonstrated consistent benefits in patients undergoing colorectal, urological and thoracic surgeries. Principles of these protocols and their advantages are expected to extend into other surgical specialties such as bariatric surgery. In this review, we summarize the components of ERAS protocols for bariatric surgery and present the evidence on the emerging role of ERAS principles in obese patients. RECENT FINDINGS: Many recent trials have evaluated ERAS protocols for bariatric surgery...
November 4, 2016: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27808051/-medical-therapy-versus-bariatric-surgery-of-obese-patients-with-type-2-diabetes
#14
Maria Saur Svane, Kirstine Nyvold Bojsen-Møller, Sten Madsbad
Bariatric surgery induces large and sustainable weight loss in obese patients and improves glycaemic control in patients with Type 2 diabetes. Eleven randomized controlled trials have shown superior glycaemic outcomes after bariatric procedures vs. medical therapy/intensive lifestyle interventions in obese patients with Type 2 diabetes. Furthermore, many patients experience remission of Type 2 diabetes after surgery but relapse may occur during follow-up. Data from observational studies show reduced incidence of micro- and macrovascular complications in addition to reduced cardiovascular and total mortality after surgery...
October 31, 2016: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/27808040/endobarrier-gastrointestinal-liner-delineation-of-underlying-mechanisms-and-clinical-effects
#15
Ulrich Rohde
Bariatric surgery (e.g. Roux-en-Y gastric bypass (RYGB)) has proven the most effective way of achieving sustainable weight losses and remission of type 2 diabetes (T2D). Studies indicate that the effectiveness of RYGB is mediated by an altered gastrointestinal tract anatomy, which in particular favours release of the gut incretin hormone glucagon-like peptide-1 (GLP-1). The EndoBarrier gastrointestinal liner or duodenal-jejunal bypass sleeve (DJBS) is an endoscopic deployable minimally invasive and fully reversible technique designed to mimic the bypass component of the RYGB...
November 2016: Danish Medical Journal
https://www.readbyqxmd.com/read/27806209/the-effectiveness-of-bariatric-surgery-for-chinese-obesity-in-2%C3%A2-years-a-meta-analysis-and-systematic-review
#16
Tianshu Zeng, Yuli Cai, Lulu Chen
AIM: Bariatric surgery is becoming an acceptable option for treatment of obesity worldwide, but there is no systemic review and meta-analysis focusing on obese patients in China. This study is to quantify the overall effects of bariatric surgery for Chinese obesity using up-to-date, comprehensive data. METHODS: We systematically searched MEDLINE, EMBASE, Cochrane Library, ISI Web of Science, and CNKI databases in English and Chinese. The weighted mean difference (MD) and 95% confidence interval (CI) were calculated from the original literature...
November 2, 2016: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
https://www.readbyqxmd.com/read/27788558/lifestyle-interventions-for-weight-loss-in-adults-with-severe-obesity-a-systematic-review
#17
REVIEW
Y Hassan, V Head, D Jacob, M O Bachmann, S Diu, J Ford
Severe obesity is an increasingly prevalent condition and is often associated with long-term comorbidities, reduced survival and higher healthcare costs. Non-surgical methods avoid the side effects, complications and costs of surgery, but it is unclear which non-surgical method is most effective. The objective of this article was to systematically review the effectiveness of lifestyle interventions compared to standard or minimal care for weight loss in adults with severe obesity. MEDLINE, EMBASE, CENTRAL, databases of on-going studies, reference lists of any relevant systematic reviews and the Cochrane Library database were searched from inception to February 2016 for relevant randomized controlled trials (RCTs)...
October 27, 2016: Clinical Obesity
https://www.readbyqxmd.com/read/27784062/cost-effectiveness-of-bariatric-surgery-in-adolescents-with-obesity
#18
Matthew J Klebanoff, Jagpreet Chhatwal, Jacob D Nudel, Kathleen E Corey, Lee M Kaplan, Chin Hur
Importance: Severe obesity affects 4% to 6% of US youth and is increasing in prevalence. Bariatric surgery for the treatment of adolescents with severe obesity is becoming more common, but data on cost-effectiveness are limited. Objective: To assess the cost-effectiveness of bariatric surgery for adolescents with obesity using recently published results from the Teen-Longitudinal Assessment of Bariatric Surgery study. Design, Setting, and Patients: A state-transition model was constructed to compare 2 strategies: no surgery and bariatric surgery...
October 26, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27783367/national-differences-in-remission-of-type-2-diabetes-mellitus-after-roux-en-y-gastric-bypass-surgery-subgroup-analysis-of-2-year-results-of-the-diabetes-surgery-study-comparing-taiwanese-with-americans-with-mild-obesity-bmi-30-35%C3%A2-kg-m-2
#19
Keong Chong, Sayeed Ikramuddin, Wei-Jei Lee, Charles J Billington, John P Bantle, Qi Wang, Avis J Thomas, John E Connett, Daniel B Leslie, William B Inabnet, Robert W Jeffery, Michael G Sarr, Michael D Jensen, Adrian Vella, Leaque Ahmed, Kumar Belani, Joyce L Schone, Amy E Olofson, Heather A Bainbridge, Patricia S Laqua, Judith Korner, Lee-Ming Chuang
BACKGROUND: The purpose of this study is to compare effects of different nations on Roux-en-Y gastric bypass (RYGB) vs. intensive medical management (IMM) in achieving remission of type 2 diabetes mellitus (T2DM). MATERIALS AND METHODS: Between April 2008 and December 2011, this randomized, controlled clinical trial was conducted at four teaching hospitals in the United States and Taiwan involving 71 participants with mild obesity (BMI 30-35 kg/m(2)). Thirty-six of 71 participants were randomly assigned to the RYGB group, and the others were in IMM group...
October 25, 2016: Obesity Surgery
https://www.readbyqxmd.com/read/27771314/acute-pain-management-in-morbid-obesity-an-evidence-based-clinical-update
#20
Adele Sandra Budiansky, Michael P Margarson, Naveen Eipe
Increasing numbers of patients with morbid obesity are presenting for surgery, and their acute pain management requires an evidence-based clinical update. The objective of this study was to complete a literature review for acute pain management in morbid obesity and provide an evidence-based clinical update with recommendations. Using standardized search terms, in March 2015, we completed a literature search to determine evidence for different acute pain pharmacologic modalities in morbid obesity. For each modality, the highest level of evidence was ascertained, and recommendations for each pharmacologic modality are presented...
September 19, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
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