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Obesity surgery trial

He-Qun Chen, Zhi-Yong Chen, Feng Zeng, Yang Li, Zhong-Qing Yang, Cheng He, Yao He
PURPOSE: To evaluate and compare flexible ureteroscopy (f-URS) and mini-percutaneous nephrolithotomy (mPNL) for 20-30 mm renal stones in obese patients regarding efficacy and safety. METHODS: Between May 2011 and June 2017, 254 obese patients who had 20-30 mm kidney stone were consecutively included in the study; 106 patients underwent mPNL and 148 underwent f-URS by the same surgeon. The following parameters were retrospectively assessed: patient and stone characteristics, surgical details, perioperative outcomes, and stone-free rates (SFR)...
March 13, 2018: World Journal of Urology
Glaucia Carneiro, Maria T Zanella
OBJECTIVE: To analyze metabolic and hormonal disorders resulting from the association between obesity and obstructive sleep apnea (OSA) syndrome that predispose to cardiovascular diseases and investigate the clinical benefits obtained from treatment approaches for both conditions. METHODS: A literature review between 1997 and 2017 was conducted in the PubMed search database. RESULTS: Obesity is the most important risk factor for OSA, and the progressive increase in its prevalence also affects OSA incidence...
March 10, 2018: Metabolism: Clinical and Experimental
Michele Molinari, Chethan Puttarajappa, Martin Wijkstrom, Armando Ganoza, Roberto Lopez, Amit Tevar
BACKGROUND: Recent studies have reported a significant decrease in wound problems and hospital stay in obese patients undergoing renal transplantation by robotic-assisted minimally invasive techniques with no difference in graft function. OBJECTIVE: Due to the lack of cost-benefit studies on the use of robotic-assisted renal transplantation versus open surgical procedure, the primary aim of our study is to develop a Markov model to analyze the cost-benefit of robotic surgery versus open traditional surgery in obese patients in need of a renal transplant...
March 8, 2018: JMIR Research Protocols
Wilson R Freitas, Luis Vicente Franco Oliveira, Eduardo A Perez, Elias J Ilias, Carina P Lottenberg, Anderson S Silva, Jessica J Urbano, Manoel C Oliveira, Rodolfo P Vieira, Marcelo Ribeiro-Alves, Vera L S Alves, Paulo Kassab, Fabio R Thuler, Carlos A Malheiros
BACKGROUND: Obesity is a worldwide disease related to genetic, environmental, and behavioral factors, and it is associated with high rates of morbidity and mortality. Recently, obesity has been characterized by a low-grade inflammatory state known as inflammome indicated by chronic increases in circulating concentrations of inflammatory markers. The purpose of this study was to evaluate the effect of weight loss induced by surgery for obesity and weight-related diseases on pro-inflammatory cytokine (TNF-α) and anti-inflammatory adipokine (adiponectin) levels, and on an adipose-derived hormone (leptin) in severely obese subjects...
March 1, 2018: Obesity Surgery
Rodrigo B Mansur, Yena Lee, Mehala Subramaniapillai, Elisa Brietzke, Roger S McIntyre
Major depressive disorder and bipolar disorder are highly prevalent and disabling conditions. Cognition is considered a core domain of their psychopathology and a principle mediator of psychosocial impairment, disproportionately accounting for overall illness-associated costs. There are few interventions with replicated evidence of efficacy in treating cognitive deficits in mood disorders. Evidence also indicates that cognitive deficits are associated with obesity and involve significant impairment across multiple domains...
February 23, 2018: Neuropharmacology
Vivek Kumbhari, Stefanie Lehmann, Nadine Schlichting, Marco Heinrich, Yvonne Kullnick, Ulf Retschlag, Markus Enderle, Arne Dietrich, Mouen A Khashab, Anthony N Kalloo, Andreas Oberbach
BACKGROUND AND AIMS: The early improvement in metabolic profile after sleeve gastrectomy (SG) indicates that the significant benefits of metabolic surgery are gastric in origin. We have previously demonstrated that devitalization of the gastric mucosa (without a reduction in gastric volume) in metabolically disturbed obese rats results in an improvement of obesity and its associated comorbidities. The aims of this study were to assess the technical feasibility, efficacy and safety of gastric mucosal devitalization (GMD) in a large animal (porcine) model...
February 21, 2018: Gastrointestinal Endoscopy
Cécile Bétry, Stéphane Thobois, Martine Laville, Emmanuel Disse
Despite a better understanding of obesity pathophysiology, treating this disease remains a challenge. New therapeutic options are needed. Targeting the brain is a promising way, considering both the brain abnormalities in obesity and the effects of bariatric surgery on the gut-brain axis. Deep brain stimulation could be an alternative treatment for obesity since this safe and reversible neurosurgical procedure modulates neural circuits for therapeutic purposes. We aimed to provide a critical review of published clinical and preclinical studies in this field...
February 20, 2018: Obesity Research & Clinical Practice
Bénédicte Gaborit, Pierre-Antoine Moulin, Thierry Bege, Sandrine Boullu, Clara Vincentelli, Olivier Emungania, Pierre-Emmanuel Morange, Stéphane Berdah, Joe-Elie Salem, Anne Dutour, Corinne Frere
Severely obese patients undergoing bariatric surgery (BS) are at increased risk for venous thromboembolism (VTE). How standard low molecular weight heparin (LMWH) regimen should be adapted to provide both sufficient efficacy and safety in this setting is unclear. We aimed to compare the influence of four body size descriptors (BSD) on peak anti-Xa levels in BS obese patients receiving LMWH fixed doses to identify which one had the greatest impact. One hundred and thirteen BS obese patients [median body mass index (BMI), 43...
February 13, 2018: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
Nisha Patel, Aruchuna Mohanaruban, Hutan Ashrafian, Carel Le Roux, James Byrne, John Mason, James Hopkins, Jamie Kelly, Julian Teare
BACKGROUND AND AIMS: Obesity associated with diabetes mellitus is a significant worldwide problem associated with considerable health care costs. Whilst surgical intervention is effective, it is invasive, costly and associated with complications. This study aims to evaluate the safety and efficacy of the EndoBarrier®, a duodenal-jejunal sleeve bypass as an alternative treatment of diabetes mellitus in obese patients. MATERIALS AND METHODS: This was a multi-centre, non-randomised trial recruiting obese patients with type 2 diabetes from three sites in the UK...
February 15, 2018: Obesity Surgery
R El Khoury, C Kabir, V K Maker, M Banulescu, M Wasserman, A V Maker
INTRODUCTION: Conflicting evidence exists from randomized controlled trials supporting both increased complications/fistulae and improved outcomes with drain placement after pancreatectomy. The objective was to determine drain practice patterns in the USA, and to identify if drain placement was associated with fistula formation. METHODS: Demographic, perioperative, and patient outcome data were captured from the most recent annual NSQIP pancreatic demonstration project database, including components of the fistula risk score...
February 12, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Sahar D Al-Shamari, Mohamed Aly ElSherif, Wahiba Hamid, Fahad Hanna
Background: Severe weight loss through means of bariatric surgery has been associated with loss of muscle mass due to lack of absorption of protein. The aim of this RCT is to investigate the effectiveness of protein supplementation in reducing the risk of developing protein malnutrition and muscle wasting in post-bariatric surgery patients in Qatar. Methods and analysis: The study was based at the Department of bariatric and metabolic surgery, Doha metropolitan and regional areas...
2018: Archives of Public Health, Archives Belges de Santé Publique
Manan Pareek, Philip R Schauer, Lee M Kaplan, Lawrence A Leiter, Francesco Rubino, Deepak L Bhatt
The alarming rise in the worldwide prevalence of obesity is paralleled by an increasing burden of type 2 diabetes mellitus. Metabolic surgery is the most effective means of obtaining substantial and durable weight loss in individuals with obesity. Randomized trials have recently shown the superiority of surgery over medical treatment alone in achieving improved glycemic control, as well as a reduction in cardiovascular risk factors. The mechanisms seem to extend beyond the magnitude of weight loss alone and include improvements in incretin profiles, insulin secretion, and insulin sensitivity...
February 13, 2018: Journal of the American College of Cardiology
Rui Lu, Chengcheng Shen, Chunyong Yang, Yan Chen, Juanjuan Li, Kaizhi Lu
BACKGROUND: Although the safety and effectiveness of the short-axis in-plane method has been confirmed for lumbar plexus block, the operation is difficult and has a high rate of epidural spread at the plane of the articular process. Therefore, we developed a new in-plane technique, called the beach chair method, which displays images from the transverse process. We compared the operative difficulty and incidence of epidural spread of the beach chair method with those of the control method (at the plane of the articular process) in this randomized controlled clinical trial...
February 7, 2018: BMC Anesthesiology
A T Billeter, K M Scheurlen, P Probst, S Eichel, F Nickel, S Kopf, L Fischer, M K Diener, P P Nawroth, B P Müller-Stich
BACKGROUND: This study aimed to examine the effect of metabolic surgery on pre-existing and future microvascular complications in patients with type 2 diabetes mellitus (T2DM) in comparison with medical treatment. Although metabolic surgery is the most effective treatment for obese patients with T2DM regarding glycaemic control, it is unclear whether the incidence or severity of microvascular complications is reduced. METHODS: A systematic literature search was performed in MEDLINE, Embase, Web of Science and the Cochrane Central Register of Controlled Trials (CENTRAL) with no language restrictions, looking for RCTs, case-control trials and cohort studies that assessed the effect of metabolic surgery on the incidence of microvascular diabetic complications compared with medical treatment as control...
February 2018: British Journal of Surgery
Akira Umemura, Takayuki Suto, Seika Nakamura, Hisataka Fujiwara, Fumitaka Endo, Hiroyuki Nitta, Takeshi Takahara, Akira Sasaki
BACKGROUND: Both single-incision laparoscopic cholecystectomy (SILC) and needlescopic cholecystectomy (NSC) are superior to conventional laparoscopic cholecystectomy in terms of cosmetic outcome and incisional pain. We conducted a prospective, randomized clinical trial to evaluate the surgical outcome, postoperative pain, and cosmetic outcome for SILC and NSC procedures. METHODS: In this trial, 105 patients were enrolled (52 in the SILC group; 53 in the NSC group)...
January 24, 2018: Digestive Surgery
Sarah Kitson, Neil Ryan, Michelle L MacKintosh, Richard Edmondson, James Mn Duffy, Emma J Crosbie
BACKGROUND: Diagnoses of endometrial cancer are increasing secondary to the rising prevalence of obesity. Obesity plays an important role in promoting the development of endometrial cancer, by inducing a state of unopposed oestrogen excess, insulin resistance and inflammation. It also affects treatment, increasing the risk of surgical complications and the complexity of radiotherapy planning, and may additionally impact on subsequent survival. Weight-loss interventions have been associated with improvements in breast and colorectal cancer-specific survival as well as a reduction in the risk of cardiovascular disease, a frequent cause of death in endometrial cancer survivors...
February 1, 2018: Cochrane Database of Systematic Reviews
Fatima Saleem, Syed W Rizvi
Polycystic ovary syndrome (PCOS) is a pathophysiological disorder affecting reproductive and metabolic indices. PCOS is commonly associated with a high prevalence of insulin resistance and obesity; this association carries an increased risk of developing metabolic syndrome, type 2 diabetes mellitus (T2DM), and cardiovascular disease. Guidelines recommend lifestyle modification, metformin, hormonal contraceptives (HCs), and bariatric surgery as the main treatment options in obese patients with PCOS. Studies are being conducted to test the efficacy of existing treatment options as well as to discover new therapies...
November 13, 2017: Curēus
Qingsong Xie, Jing Zhang, Feng Lu, Hao Wu, Zan Chen, Fengzeng Jian
BACKGROUND: Minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) has been employed in increasing cases compared with open TLIF (Open-TLIF). However, it is uncertain whether the advantages of MI-TLIF can also be specifically applied in obese patients. Therefore, the current study was thereby carried out aiming to compare the outcomes of MI-TLIF with those of Open-TLIF in obese patients with lumbar degenerative diseases. METHODS: Electronic databases were systemically retrieved from construction to May 2017...
January 17, 2018: BMC Musculoskeletal Disorders
Ralph Peterli, Bettina Karin Wölnerhanssen, Thomas Peters, Diana Vetter, Dino Kröll, Yves Borbély, Bernd Schultes, Christoph Beglinger, Jürgen Drewe, Marc Schiesser, Philipp Nett, Marco Bueter
Importance: Sleeve gastrectomy is increasingly used in the treatment of morbid obesity, but its long-term outcome vs the standard Roux-en-Y gastric bypass procedure is unknown. Objective: To determine whether there are differences between sleeve gastrectomy and Roux-en-Y gastric bypass in terms of weight loss, changes in comorbidities, increase in quality of life, and adverse events. Design, Setting, and Participants: The Swiss Multicenter Bypass or Sleeve Study (SM-BOSS), a 2-group randomized trial, was conducted from January 2007 until November 2011 (last follow-up in March 2017)...
January 16, 2018: JAMA: the Journal of the American Medical Association
Sayeed Ikramuddin, Judith Korner, Wei-Jei Lee, Avis J Thomas, John E Connett, John P Bantle, Daniel B Leslie, Qi Wang, William B Inabnet, Robert W Jeffery, Keong Chong, Lee-Ming Chuang, Michael D Jensen, Adrian Vella, Leaque Ahmed, Kumar Belani, Charles J Billington
Importance: The Roux-en-Y gastric bypass is effective in achieving established diabetes treatment targets, but durability is unknown. Objective: To compare durability of Roux-en-Y gastric bypass added to intensive lifestyle and medical management in achieving diabetes control targets. Design, Setting, and Participants: Observational follow-up of a randomized clinical trial at 4 sites in the United States and Taiwan, involving 120 participants who had a hemoglobin A1c (HbA1c) level of 8...
January 16, 2018: JAMA: the Journal of the American Medical Association
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