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https://www.readbyqxmd.com/read/29145284/effectiveness-of-bariatric-surgical-procedures-a-systematic-review-and-network-meta-analysis-of-randomized-controlled-trials
#1
Jenny H Kang, Quang A Le
BACKGROUND: Bariatric surgery has proved to be an effective strategy in treating obesity. However, randomized controlled trials (RCTs) of 3 most common bariatric surgery procedures, Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), and laparoscopic adjustable gastric band (LAGB), reported inconsistent results. We performed a systematic review and network meta-analysis to synthesize evidence of effectiveness of the 3 common bariatric procedures from relevant RCTs. METHODS: The present study was a systematic review and network meta-analysis of RCTs...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29144812/increased-bone-turnover-in-type-2-diabetes-patients-randomized-to-bariatric-surgery-vs-medical-therapy-at-5-years
#2
Megan R Crawford, Nathan Pham, Leila Khan, James F Bena, Philip R Schauer, Sangeeta R Kashyap
OBJECTIVE: The aim of our study was to determine the 5 year outcomes of bariatric surgery vs. intensive medical therapy on bone turnover in patients with type 2 diabetes (T2DM) from the STAMPEDE trial. METHODS: This is an ancillary investigation of a 5 year randomized control trial at a single tertiary care center involving 95 patients aged 48.5 ± 8 years with obesity (BMI: 36.5±3.6 kg/m(2)) and uncontrolled T2DM (HbA1C: 9.3 ±1.6%). Patients were randomized to intensive medical therapy (IMT; N=25), Roux-en-Y gastric bypass (RYGB; N=37), or sleeve gastrectomy (SG; N=33) for diabetes treatment...
November 16, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/29143290/increased-free-testosterone-levels-in-men-with-uncontrolled-type-2-diabetes-five-years-after-randomization-to-bariatric-surgery
#3
Nathan H Pham, James Bena, Deepak L Bhatt, Laurence Kennedy, Philip R Schauer, Sangeeta R Kashyap
Hypogonadism frequently occurs in male patients with type 2 diabetes (T2DM) and is linked to insulin resistance and inflammation. Testosterone levels rise acutely in obese patients following bariatric surgery, though long-term changes have not been investigated in a randomized controlled trial. This study evaluated obese men with T2DM randomized to either bariatric surgery or medical therapy. Testosterone, gonadotropins, body composition, insulin sensitivity, and inflammatory markers were evaluated in 32 patients at baseline and at 5 years...
November 15, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/29138076/the-effect-of-obesity-on-clinical-outcomes-following-minimally-invasive-spine-surgery-a-systematic-review-and-meta-analysis
#4
Tao Wang, Chao Han, Hongqiang Jiang, Peng Tian
BACKGROUND: Obesity is associated with increasing morbidity and mortality in many prevalent diseases, especially for lumbar degenerative disease. The relationship between minimally invasive spine (MIS) surgery and perioperative adverse events in obese patients with lumbar degenerative disease has not been well evaluated. METHODS: We conducted a systematic review and meta-analysis to identify relevant studies involving obese patients with MIS surgery in electronic databases, including Web of Science, Embase, PubMed, the Cochrane Controlled Trials Register, and the Cochrane Library up to June 2017...
November 11, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29133606/effects-of-bariatric-surgery-in-obese-patients-with-hypertension-the-gateway-randomized-trial-gastric-bypass-to-treat-obese-patients-with-steady-hypertension
#5
Carlos Aurelio Schiavon, Angela Cristine Bersch-Ferreira, Eliana Vieira Santucci, Juliana Dantas Oliveira, Camila Ragne Torreglosa, Priscila Torres Bueno, Julia Caldas Frayha, Renato Nakagawa Santos, Lucas Petri Damian, Patricia Malvina Noujaim, Helio Halpern, Frederico L J Monteiro, Ricardo Vitor Cohen, Carlos H Uchoa, Marcio Gonçalves de Souza, Celso Amodeo, Luiz Bortolotto, Dimas Ikeoka, Luciano F Drager, Alexandre Biasi Cavalcanti, Otavio Berwanger
BACKGROUND : Recent research efforts on bariatric surgery have focused on metabolic and diabetes mellitus resolution. Randomized trials designed to assess the impact of bariatric surgery in patients with obesity and hypertension are needed. METHODS : In this randomized, single-center, nonblinded trial, we included patients with hypertension (using ≥2 medications at maximum doses or >2 at moderate doses) and a body mass index between 30.0 and 39.9 kg/m(2) Patients were randomized to Roux-en-Y gastric bypass plus medical therapy or medical therapy alone...
November 13, 2017: Circulation
https://www.readbyqxmd.com/read/29112546/european-guidelines-on-perioperative-venous-thromboembolism-prophylaxis-surgery-in-the-obese-patient
#6
Linas Venclauskas, Almantas Maleckas, Juan I Arcelus
: A systematic literature search was performed and patients were selected as obese patients undergoing bariatric surgery or obese patients undergoing nonbariatric surgical procedures. In addition, patients were stratified according to low risk of venous thromboembolism and high risk of venous thromboembolism (age >55 years, BMI >55 kg m, history of venous thromboembolism, venous disease, sleep apnoea, hypercoagulability or pulmonary hypertension). Prophylaxis of venous thromboembolism was analysed depending on the type of modality: compression devices of the lower extremities (including intermittent pneumatic compression and graduated compression stockings), pharmacological prophylaxis or inferior vena cava filters...
November 6, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29108405/gabapentin-given-before-laparoscopic-sleeve-gastrectomy-reduces-postoperative-oxycodone-consumption-in-obese-patients-a-randomized-double-blind-placebo-controlled-trial
#7
Anna Rupniewska-Ladyko, Małgorzata Malec-Milewska, Ewa Kraszewska, Michal Pirozynski
BACKGROUND: Post-operative pain can be prevented. Gabapentin may be effective in this role. Our primary objective was to test the hypothesis that a prophylactic administration of gabapentin in obese patients before surgery has an opioid-sparing effect and reduces postoperative oxycodone consumption more efficiently than placebo. METHODS: The study enrolled 113 patients undergoing laparoscopic sleeve-gastrectomy under general anesthesia. The patients were randomly allocated to the control or gabapentin group and received a single oral dose of gabapentin 1200 mg or a matching placebo 1 h before surgery...
November 6, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29080645/vitamin-d-metabolism-in-bariatric-surgery
#8
REVIEW
Marlene Chakhtoura, Maya Rahme, Ghada El-Hajj Fuleihan
Hypovitaminosis D is common in obese patients and persists after roux-en-Y gastric bypass and sleeve gastrectomy. Several societies recommend screening for vitamin D deficiency before bariatric surgery, and replacement doses of 3000 IU/d and up to 50,000 IU 1 to 3 times per week, in case of deficiency, with periodic monitoring. These regimens are mostly based on expert opinion. Large trials are needed to assess the vitamin D dose response, by type of bariatric surgery, and evaluate the effect on surrogate markers of skeletal outcomes...
December 2017: Endocrinology and Metabolism Clinics of North America
https://www.readbyqxmd.com/read/29071466/cardiovascular-autonomic-effects-of-vagus-nerve-stimulation
#9
REVIEW
Iñigo Garamendi-Ruiz, Juan Carlos Gómez-Esteban
The vagus nerve is responsible for the parasympathetic innervation of the major thoracic and abdominal organs. It also carries sensory afferent fibres from these viscera and reaches different brain structures. These connections have proven useful in the treatment of different diseases. Afferent stimulation of the left vagus nerve is used to treat epilepsy and major depression, and stimulation of the right vagus nerve is being tried for the treatment of heart failure. The device used for the therapy delivers intermittent stimuli...
October 25, 2017: Clinical Autonomic Research: Official Journal of the Clinical Autonomic Research Society
https://www.readbyqxmd.com/read/29071108/the-effect-of-bariatric-surgery-on-serum-25-oh-vitamin-d-levels-a-systematic-review-and-meta-analysis
#10
A Kalani, H Bami, M Tiboni, R Jaeschke, J D Adachi, A N Lau
BACKGROUND: Concerns have emerged about post-operative decreases in calcium and vitamin D following bariatric surgery. This review explores changes in metabolic bone health in persons with obesity undergoing gastric bypass surgery compared to non-surgical controls, providing an updated and comprehensive perspective on the literature. METHODS: An electronic search was conducted in MEDLINE, Pubmed, EMBASE and Cochrane databases to 8 November 2016. Eligible trials included randomized controlled trials or controlled observational studies of patients who have undergone laparoscopic gastric bypass surgery...
September 2017: Obesity Science & Practice
https://www.readbyqxmd.com/read/29063974/is-mini-gastric-bypass-a-rational-approach-for-type-2-diabetes
#11
REVIEW
Reem Abou Ghazaleh, Matthieu Bruzzi, Karen Bertrand, Leila M'harzi, Franck Zinzindohoue, Richard Douard, Anne Berger, Sébastien Czernichow, Claire Carette, Jean-Marc Chevallier
PURPOSE OF REVIEW: Morbid obesity and type-2 diabetes mellitus (T2DM) are both major public health problems. Bariatric surgery is a proven and effective treatment for these conditions; laparoscopic Roux-en-Y gastric bypass (RYGB) is currently the gold-standard treatment. One-anastomosis gastric bypass (OAGB) is described as a simpler, safer, and non-inferior alternative to RYGB to treat morbid obesity. Concerning T2DM, experts of the OAGB procedure report promising metabolic results with good long-term remission of T2DM; however, heterogeneity within the literature prompted us to analyze this issue...
October 24, 2017: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/29045567/individualized-positive-end-expiratory-pressure-in-obese-patients-during-general-anaesthesia-a-randomized-controlled-clinical-trial-using-electrical-impedance-tomography
#12
C Nestler, P Simon, D Petroff, S Hammermüller, D Kamrath, S Wolf, A Dietrich, L M Camilo, A Beda, A R Carvalho, A Giannella-Neto, A W Reske, H Wrigge
Background: General anaesthesia leads to atelectasis, reduced end-expiratory lung volume (EELV), and diminished arterial oxygenation in obese patients. We hypothesized that a combination of a recruitment manoeuvre (RM) and individualized positive end-expiratory pressure (PEEP) can avoid these effects. Methods: Patients with a BMI ≥35 kg m-2 undergoing elective laparoscopic surgery were randomly allocated to mechanical ventilation with a tidal volume of 8 ml kg-1 predicted body weight and (i) an RM followed by individualized PEEP titrated using electrical impedance tomography (PEEPIND) or (ii) no RM and PEEP of 5 cm H2O (PEEP5)...
October 16, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29043548/comparison-of-short-term-effectiveness-and-postoperative-complications-laparoscopic-gastric-plication-vs-laparoscopic-sleeve-gastrectomy
#13
Mohammad Talebpour, Donya Sadid, Atieh Talebpour, Amirsina Sharifi, Farzad Vaghef Davari
INTRODUCTION: Bariatric surgeries are the only effective long-term treatment in obese patients. The innovation of laparoscopic gastric plication (LGP) raised some questions about its effectiveness compared to traditionally used techniques such as laparoscopic sleeve gastrectomy (LSG). We tried to answer some of these questions. MATERIALS AND METHODS: We investigated 70 patients in a randomized clinical trial (IRCT2013123012294N5) from 2012 to 2015. Thirty-five patients were randomly assigned to each LSG or LGP group, using sealed envelope method...
October 17, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/29031374/-prediabetes-definition-and-treatment
#14
REVIEW
Manuel Dolz, Yasmin Dhane
Prediabetes corresponds to high levels of glycaemia on an empty stomach and/or lower tolerance to glucose. It is necessary to detect and treat it in order to prevent type 2 diabetes and its long-term morbidity-mortality. Several clinical trials, based notably on modifying the patient's lifestyle, have shown that prevention is possible. Bariatric surgery could constitute a favoured treatment option in prediabetic obese patients.
October 2017: Soins; la Revue de Référence Infirmière
https://www.readbyqxmd.com/read/29027993/current-pharmacotherapy-for-obesity
#15
REVIEW
Gitanjali Srivastava, Caroline M Apovian
More than one-third of adults in the USA have obesity, which causes, exacerbates or adversely impacts numerous medical comorbidities, including diabetes mellitus and cardiovascular disease. Despite intensive lifestyle modifications, the disease severity warrants further aggressive intervention, including pharmacotherapy, medical devices and bariatric surgery. Noninvasive anti-obesity drugs have thus now resurfaced as targeted adjunctive therapeutic approaches to intensive lifestyle intervention, bridging the gap between lifestyle and bariatric surgery...
October 13, 2017: Nature Reviews. Endocrinology
https://www.readbyqxmd.com/read/29016434/hypoalbuminemia-is-associated-with-septic-revisions-after-primary-surgery-and-post-operative-infection-after-revision-surgery
#16
Krishn Khanna, Paul H Yi, David C Sing, Erik Geiger, Lionel N Metz
STUDY DESIGN: Retrospective Database Review OBJECTIVE.: To determine (1) the relationship between hypoalbuminemia and body mass index (BMI); (2) the association between malnutrition and revision spine surgery for septic reasons; (3) the association between malnutrition and infection after aseptic revision spine surgery. SUMMARY OF BACKGROUND DATA: Although malnutrition has been suggested to increase the risk of infection after spine surgery, evidence supporting this hypothesis is conflicting...
October 9, 2017: Spine
https://www.readbyqxmd.com/read/28986720/the-role-of-metabolic-surgery-in-non-alcoholic-steatohepatitis-improvement
#17
REVIEW
Pedro Paulo Caravatto, Ricardo Cohen
PURPOSE OF REVIEW: Non-alcoholic fatty liver disease (NAFLD) is frequently associated with obesity and overweight. It has a broad spectrum of clinical and histological presentations, such as steatosis, inflammation (known as non-alcoholic steatohepatitis or NASH), fibrosis, and cirrhosis. There is increasing evidence that marked weight loss following bariatric surgery is associated with NASH resolution; however, little is known about the mechanisms that may lead to this beneficial condition and if it is due to weight loss alone...
October 7, 2017: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/28985287/bariatric-surgery-and-hypertension
#18
Jonathan G Owen, Farshid Yazdi, Efrain Reisin
Obesity continues to increase in prevalence worldwide. Hypertension has long been associated with obesity, and weight loss continues to be a first-line therapy in the treatment of hypertension. Lifestyle modification and pharmacologic therapy, however, often meet with treatment failure. Bariatric surgery continues to be the most successful approach to sustained weight loss. This review focuses on the underlying physiologic mechanisms of obesity-hypertension, and the impact of bariatric surgery on the treatment of hypertension...
August 11, 2017: American Journal of Hypertension
https://www.readbyqxmd.com/read/28984091/repeated-alveolar-recruitment-maneuvers-with-and-without-positive-end-expiratory-pressure-during-bariatric-surgery-a-randomized-trial
#19
Ke Wei, Su Min, Jun Cao, Xuechao Hao, Jie Deng
BACKGROUND: Positive end-expiratory pressure (PEEP) is considered essential in protective ventilation, while may lead to hemodynamic impairment. In the present study, we investigated the effect of repeated alveolar recruitment maneuvers (ARMs) with or without additional PEEP on the arterial oxygenation of obese patients who were undergoing bariatric surgery. METHODS: Thirty-six obese adult patients with body mass index (BMI) >40 kg/m2 who were scheduled for laparoscopic sleeve gastrectomy were randomly allocated into three groups: (1) control group, no intraoperative ARMs; (2) ARM+ZEEP group, repeated ARMs every 30 minutes without extra PEEP; or (3) ARM+PEEP group, ARMs followed by 8 cm H2O of PEEP from the onset of pneumoperitoneum...
October 4, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28978344/the-expect-examining-exercise-prostate-cancer-and-circulating-tumour-cells-trial-study-protocol-for-a-randomised-controlled-trial
#20
Gráinne Sheill, Lauren Brady, Emer Guinan, Brian Hayes, Orla Casey, John Greene, Tatjana Vlajnic, Fidelma Cahill, Mieke Van Hemelrijck, Nicola Peat, Sarah Rudman, Juliette Hussey, Moya Cunningham, Liam Grogan, Thomas Lynch, Rustom P Manecksha, John McCaffrey, Lorelei Mucci, Orla Sheils, John O'Leary, Dearbhaile M O'Donnell, Ray McDermott, Stephen Finn
BACKGROUND: Prostate cancer (PrCa) is the second most common cancer in Ireland. Many men present with locally advanced or metastatic cancer for whom curative surgery is inappropriate. Advanced cancer patients are encouraged to remain physically active and therefore there is a need to investigate how patients with metastatic disease tolerate physical activity programmes. Physical activity reduces levels of systemic inflammatory mediators and so an aerobic exercise intervention may represent an accessible and cost-effective means of ameliorating the pro-inflammatory effects of obesity and subsequently decrease poor cancer-specific outcomes in this patient population...
October 4, 2017: Trials
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