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Obesity surgery trial

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https://www.readbyqxmd.com/read/28104497/robot-assisted-surgery-in-gynecologic-cancers
#1
REVIEW
V Zanagnolo, A Garbi, M T Achilarre, L Minig
Robotic-assisted surgery is a technological advancement that facilitates the application of minimally invasive techniques for complex operations in gynecological oncology. The objective of this article is to review the literature regarding the role of robotic-assisted surgery to treat women with gynecologic cancers. The majority of publications on robotic surgery are still retrospective or descriptive in nature, however, the data for managing patients with a robotic assisted approach shows comparable, and at times an improved outcomes compared to both laparoscopy (2D) and laparotomy approaches...
January 16, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28101792/medical-management-of-diabesity-do-we-have-realistic-targets
#2
REVIEW
Joseph M Pappachan, Ananth K Viswanath
PURPOSE OF REVIEW: The global prevalence of "diabesity"-diabetes related to obesity-is increasing steadily over the past few decades because of the obesity epidemic. Although bariatric surgery is an effective treatment option for patients with diabesity, its limited availability, invasiveness, relatively high costs and the potential for surgical and postsurgical complications restrict its widespread use. Therefore, medical management is the only option for a majority of patients with diabesity...
January 2017: Current Diabetes Reports
https://www.readbyqxmd.com/read/28098067/renal-function-in-type-2-diabetes-following-gastric-bypass
#3
Adrian T Billeter, Stefan Kopf, Martin Zeier, Katharina Scheurlen, Lars Fischer, Thilo M Schulte, Hannes G Kenngott, Barbara Israel, Philipp Knefeli, Markus W Büchler, Peter P Nawroth, Beat P Müller-Stich
BACKGROUND: Metabolic surgery for obese patients with type 2 diabetes (T2D) yields short- and long-term remission rates of 60-90%. Its effects on diabetesassociated complications such as neuropathy and nephropathy have not been well studied to date. Hardly any data are available on this subject with respect to moderately obese patients (body mass index [BMI] 25-35 kg/m2) with insulin-dependent T2D. Our previous studies suggest that, in such patients, treatment with a Roux-en-Y gastric bypass (RYGB) improves diabetic neuropathy...
December 9, 2016: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28097332/effect-of-incentive-spirometry-on-postoperative-hypoxemia-and-pulmonary-complications-after-bariatric-surgery-a-randomized-clinical-trial
#4
Haddon Pantel, John Hwang, David Brams, Thomas Schnelldorfer, Dmitry Nepomnayshy
Importance: The combination of obesity and foregut surgery puts patients undergoing bariatric surgery at high risk for postoperative pulmonary complications. Postoperative incentive spirometry (IS) is a ubiquitous practice; however, little evidence exists on its effectiveness. Objective: To determine the effect of postoperative IS on hypoxemia, arterial oxygen saturation (Sao2) level, and pulmonary complications after bariatric surgery. Design, Setting, and Participants: A randomized noninferiority clinical trial enrolled patients undergoing bariatric surgery from May 1, 2015, to June 30, 2016...
January 11, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28077412/microvascular-outcomes-after-metabolic-surgery-moms-in-patients-with-type-2-diabetes-mellitus-and-class-i-obesity-rationale-and-design-for-a-randomised-controlled-trial
#5
Ricardo Vitor Cohen, Tiago Veiga Pereira, Cristina Mamédio Aboud, Pedro Paulo de Paris Caravatto, Tarissa Beatrice Zanata Petry, José Luis Lopes Correa, Carlos Aurélio Schiavon, Mariangela Correa, Carlos Eduardo Pompílio, Fernando Nogueira Quirino Pechy, Carel le Roux
INTRODUCTION: There are several randomised controlled trials (RCTs) that have already shown that metabolic/bariatric surgery achieves short-term and long-term glycaemic control while there are no level 1A of evidence data regarding the effects of surgery on the microvascular complications of type 2 diabetes mellitus (T2DM). PURPOSE: The aim of this trial is to investigate the long-term efficacy and safety of the Roux-en-Y gastric bypass (RYGB) plus the best medical treatment (BMT) versus the BMT alone to improve microvascular outcomes in patients with T2DM with a body mass index (BMI) of 30-34...
January 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28076240/effects-of-bariatric-surgery-on-gout-incidence-in-the-swedish-obese-subjects-study-a-non-randomised-prospective-controlled-intervention-trial
#6
Cristina Maglio, Markku Peltonen, Martin Neovius, Peter Jacobson, Lennart Jacobsson, Anna Rudin, Lena M S Carlsson
OBJECTIVES: To assess the long-term effect of bariatric surgery on the incidence of gout and hyperuricaemia in participants of the Swedish Obese Subjects (SOS) study. METHODS: This report includes 1982 subjects who underwent bariatric surgery and 1999 obese controls from the SOS study, a prospective intervention trial designed to assess the effect of bariatric surgery compared with conventional treatment. None of the subjects had gout at baseline. An endpoint on gout incidence was created based on information on gout diagnosis and use of gout medications through national registers and questionnaires...
October 8, 2016: Annals of the Rheumatic Diseases
https://www.readbyqxmd.com/read/28065734/laparoscopic-roux-en-y-gastric-bypass-in-adolescents-with-severe-obesity-amos-a-prospective-5-year-swedish-nationwide-study
#7
Torsten Olbers, Andrew J Beamish, Eva Gronowitz, Carl-Erik Flodmark, Jovanna Dahlgren, Gustaf Bruze, Kerstin Ekbom, Peter Friberg, Gunnar Göthberg, Kajsa Järvholm, Jan Karlsson, Staffan Mårild, Martin Neovius, Markku Peltonen, Claude Marcus
BACKGROUND: Severe obesity in adolescence is associated with reduced life expectancy and impaired quality of life. Long-term benefits of conservative treatments in adolescents are known to be modest, whereas short-term outcomes of adolescent bariatric surgery are promising. We aimed to compare 5-year outcomes of adolescent surgical patients after Roux-en-Y gastric bypass with those of conservatively treated adolescents and of adults undergoing Roux-en-Y gastric bypass, in the Adolescent Morbid Obesity Surgery (AMOS) study...
January 5, 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/28025609/indications-for-tonsillectomy-stratified-by-the-level-of-evidence
#8
REVIEW
Jochen P Windfuhr
Background: One of the most significant clinical trials, demonstrating the efficacy of tonsillectomy (TE) for recurrent throat infection in severely affected children, was published in 1984. This systematic review was undertaken to compile various indications for TE as suggested in the literature after 1984 and to stratify the papers according to the current concept of evidence-based medicine. Material and methods: A systematic Medline research was performed using the key word of "tonsillectomy" in combination with different filters such as "systematic reviews", "meta-analysis", "English", "German", and "from 1984/01/01 to 2015/05/31"...
2016: GMS Current Topics in Otorhinolaryngology, Head and Neck Surgery
https://www.readbyqxmd.com/read/28025574/intervention-related-increases-in-preoperative-physical-activity-are-maintained-6-months-after-bariatric-surgery-results-from-the-bari-active-trial
#9
D S Bond, J G Thomas, S Vithiananthan, J Unick, J Webster, G D Roye, B A Ryder, H C Sax
Higher preoperative physical activity (PA) strongly predicts higher postoperative PA in bariatric surgery (BS) patients, providing rationale for preoperative PA interventions (PAIs). However, whether PAI-related increases can be maintained postoperatively has not been examined. This study compared PA changes across pre- (baseline, post-intervention) and postoperative (6-month follow-up) periods in participants randomized to 6 weeks of preoperative PAI or standard care control (SC). Of 75 participants initially randomized, 36 (PAI n=22; SC n=14) underwent BS...
December 27, 2016: International Journal of Obesity: Journal of the International Association for the Study of Obesity
https://www.readbyqxmd.com/read/27990787/metabolic-surgery-for-type-2-diabetes-mellitus-experience-from-asia
#10
REVIEW
Wei Jei Lee, Lwin Aung
Type 2 diabetes mellitus (T2DM) is a current global health priority and Asia is the epicenter of this epidemic disease. Unlike in the west, where older population is most affected, the burden of diabetes in Asian countries is disproportionately high in young to middle-age adults. The incidence of diabetic nephropathy is alarmingly high in patients with early onset T2DM, especially in those with poor glycemic control. How to control this chronic and debilitating disease is currently a very important health issue in Asia...
December 2016: Diabetes & Metabolism Journal
https://www.readbyqxmd.com/read/27989851/endoscopic-bariatric-and-metabolic-therapy-surgical-analogues-and-mechanisms-of-action
#11
REVIEW
Pichamol Jirapinyo, Christopher C Thompson
Obesity is a worsening pandemic with numerous related comorbid illnesses. Conservative management including lifestyle modification and medications have limited efficacy. In contradistinction, bariatric surgery is effective, however, with substantial cost and non-negligible morbidity and mortality. As such, a small percentage of eligible patients undergo surgery. Over the past decade, endoscopic bariatric therapies (EBTs) have been introduced as a less invasive option for the treatment of obesity and its related comorbid illnesses...
October 28, 2016: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/27981827/novel-technologies-and-techniques-in-bariatric-surgery
#12
Rafid Rahman, Dan E Azagury
Obesity has been on the rise globally and more people are now clinically obese than ever before in the US. This issue has a significant impact on both health and cost to healthcare systems. Bariatric surgery is efficacious in treatment of obesity but only in late stages of the disease, and there is a requirement for less invasive techniques/devices to treat obesity at earlier stages. Currently a number of these are either in clinical trials or have recently been approved by the FDA for weight loss. This review aims to give an overview of the newer technologies and techniques being used in bariatric surgery...
December 16, 2016: Minerva Chirurgica
https://www.readbyqxmd.com/read/27981458/bariatric-surgery-or-non-surgical-weight-loss-for-idiopathic-intracranial-hypertension-a-systematic-review-and-comparison-of-meta-analyses
#13
REVIEW
James H Manfield, Kenny K-H Yu, Evangelos Efthimiou, Ara Darzi, Thanos Athanasiou, Hutan Ashrafian
BACKGROUND: Idiopathic intracranial hypertension (IIH) is associated with obesity and weight loss by any means is considered beneficial in this condition. OBJECTIVES: This study aims to appraise bariatric surgery vs. non-surgical weight-loss (medical, behavioural and lifestyle) interventions in IIH management. METHODS: A systematic review and meta-analyses of surgical and non-surgical studies. RESULTS: Bariatric surgery achieved 100% papilloedema resolution and a reduction in headache symptoms in 90...
February 2017: Obesity Surgery
https://www.readbyqxmd.com/read/27966066/effects-of-bariatric-surgery-on-liver-function-tests-in-patients-with-nonalcoholic-fatty-liver-disease
#14
Geraldine J Ooi, Paul R Burton, Lisa Doyle, John M Wentworth, Prithi S Bhathal, Ken Sikaris, Michael A Cowley, Stuart K Roberts, William Kemp, Arul Earnest, Paul E O'Brien, Wendy A Brown
OBJECTIVES: Nonalcoholic fatty liver disease (NAFLD) affects over 80% of obese patients and is fueled by the metabolic syndrome. Weight loss is strongly advocated as a central treatment for NAFLD and has been shown to induce histological improvement. We aimed to define the patterns of improvement in NAFLD with weight loss and determine target weight goals for NAFLD resolution. METHODS: A prospective study of 84 morbidly obese patients with NAFLD undergoing bariatric surgery was conducted...
December 13, 2016: Obesity Surgery
https://www.readbyqxmd.com/read/27957699/metabolic-surgery-in-the-treatment-algorithm-for-type-2-diabetes-a-joint-statement-by-international-diabetes-organizations
#15
Francesco Rubino, David M Nathan, Robert H Eckel, Philip R Schauer, K George M M Alberti, Paul Z Zimmet, Stefano Del Prato, Linong Ji, Shaukat M Sadikot, William H Herman, Stephanie A Amiel, Lee M Kaplan, Gaspar Taroncher-Oldenburg, David E Cummings
BACKGROUND: Despite growing evidence that bariatric/metabolic surgery powerfully improves type 2 diabetes (T2D), existing diabetes treatment algorithms do not include surgical options. AIM: The 2nd Diabetes Surgery Summit (DSS-II), an international consensus conference, was convened in collaboration with leading diabetes organizations to develop global guidelines to inform clinicians and policymakers about benefits and limitations of metabolic surgery for T2D. METHODS: A multidisciplinary group of 48 international clinicians/scholars (75% nonsurgeons), including representatives of leading diabetes organizations, participated in DSS-II...
January 2017: Obesity Surgery
https://www.readbyqxmd.com/read/27941519/quality-of-life-among-adults-following-bariatric-and-body-contouring-surgery-a-systematic-review
#16
Jo Gilmartin, Fiona Bath-Hextall, Joan Maclean, Wendy Stanton, Mark Soldin
BACKGROUND: Weight loss following bariatric surgery is associated with significant improvements in obesity-related comorbidities, body satisfaction and psychosocial outcomes, at least in the short term. However, in the context of extreme weight loss, body image and appearance may worsen again because the "excess" or "loose" skin can lead to both functional and profound dissatisfaction with appearance. These concerns have led to an increasing uptake of post-bariatric surgery, "body-contouring" procedures but the implications for quality of life (QoL) have not been thoroughly considered...
November 2016: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/27921198/-metabolic-surgery-or-conservative-measures-as-therapy-of-obese-type%C3%A2-2%C3%A2-diabetics
#17
REVIEW
Udo Jahn, Thomas Schubert, Sibylle Schlepp, Heinz Jürgen Deuber
After bariatric surgery there are some favourable effects on comorbidities of obesity as glucose and lipid metabolism besides weight loss. Therefore surgical measures targeting at improvement of such metabolic disorders especially diabetes type 2 has been called "metabolic surgery". The complexity of its underlying metabolic mechanisms is not yet clear, but restriction of energy and weight loss (maintenance) seem to be the cornerstones.Risks of these procedures which are drawn of the established methods of bariatric surgery are reported to be relatively low in qualified centers...
December 5, 2016: Wiener Medizinische Wochenschrift
https://www.readbyqxmd.com/read/27903151/how-to-manage-the-obese-patient-with-cancer
#18
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
#19
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
#20
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
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