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Obesity surgery trial

Patricia D Freitas, Palmira G Ferreira, Aline G Silva, Rafael Stelmach, Regina M Carvalho-Pinto, Frederico L A Fernandes, Marcio C Mancini, Maria N Sato, Milton A Martins, Celso R F Carvalho
RATIONALE: Clinical control is difficult to achieve in obese patients with asthma. Bariatric surgery has been recommended for weight-loss and to improve asthma control; however, the benefits of nonsurgical interventions have been poorly investigated. OBJECTIVE: To examine the effect of exercise training in a weight-loss program on asthma control, quality of life, inflammatory biomarkers and lung function. METHODS: Fifty-five obese patients with asthma were randomly assigned to either a weight-loss program + exercise (WL+E group, n=28) or a weight-loss program + sham (WL+S group, n=27) group, where the weight-loss program included nutrition (caloric restriction) and psychological therapies...
July 19, 2016: American Journal of Respiratory and Critical Care Medicine
Siva T Gounder, Delendra Rasith Wijayanayaka, Rinki Murphy, Delwyn Armstrong, Richard G Cutfield, David Dw Kim, Michael Graham Clarke, Nicholas J Evennett, Martyn Lee Humphreys, Steven John Robinson, Michael Wc Booth
AIM: To provide a longitudinal analysis of the direct healthcare costs of providing laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB) surgery service in the context of a randomised control trial (RCT) of obese patients with type 2 diabetes in Waitemata District Health Board, Auckland, New Zealand. METHODS: The Waitemata District Health Board costing system was used to calculate costs in New Zealand Dollars (NZD) associated with all pre- and post-operative hospital clinic visits, peri-operative care, hospitalisations and medication costs up to one year after bariatric surgery...
October 14, 2016: New Zealand Medical Journal
Asad J Choudhry, Nadeem N Haddad, Matthew Martin, Cornelius A Thiels, Elizabeth B Habermann, Martin D Zielinski
OBJECTIVE: Given the current rate of obesity in the USA, it has been estimated that close to half of the US adult population could be obese by 2030, resulting in greater demand for bariatric procedures. Our objective was to analyze malpractice litigation related to bariatric surgery. METHODS: We conducted a retrospective review of Westlaw (Thompson Reuters) of all bariatric operations that resulted in the filing of a malpractice claim. Each case was reviewed for pertinent medicolegal information related to the procedure, claim, and trial...
October 11, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Prameela Konda, Di Ai, Carlos E Guerra, Andrea Rodriguez-Restrepo, Reza J Mehran, David Rice, Wayne Hofstetter, Jagtar Heir, Peter Kwater, Vijaya Gottumukkala, Mike Hernandez, Juan P Cata
OBJECTIVE: To identify risks factors associated with acute kidney injury (AKI) after esophageal cancer surgery. DESIGN: This was a retrospective study. SETTING: Single academic center. PARTICIPANTS: Subjects with non-metastatic esophageal cancer. Patients were excluded if they were younger than 18 years and had missing data. MEASUREMENTS AND MAIN RESULTS: Primary outcome of the study was AKI according to AKI Network criteria...
July 21, 2016: Journal of Cardiothoracic and Vascular Anesthesia
Emma Gibbons, Amanda Faith Casey, Keith Z Brewster
BACKGROUND: Rates of morbid obesity are higher for individuals with intellectual disability (ID). Individuals with ID may find nutritional guidelines difficult to follow and many face personal and environmental barriers for physical activity. Bariatric surgery may reduce obesity related health comorbidities while promoting sustained weight loss in diverse populations. Yet no study has reviewed the feasibility of conducting bariatric surgery on individuals with ID. OBJECTIVES: To conduct a scoping review of literature on bariatric procedures performed on individuals with ID...
September 16, 2016: Disability and Health Journal
Stergios A Polyzos, Jannis Kountouras, Christos S Mantzoros
The association of obesity with nonalcoholic fatty liver disease (NAFLD) has been established. Obesity has been linked not only to initial stages of the disease, i.e., simple steatosis (SS), but also to its severity. Form an epidemiologic point of view, both diseases has an increasing prevalence worldwide. From a pathogenetic point of view, obesity and its associate IR contribute to the initial fat accumulation in the hepatocyte (SS), but also to the progression of SS to nonalcoholic steatohepatitis (NASH), NASH-related cirrhosis and hepatocellular carcinoma (HCC)...
October 6, 2016: Minerva Endocrinologica
Nuria Vilarrasa, Miguel Angel Rubio, Inka Miñambres, Lillian Flores, Assumpta Caixàs, Andrea Ciudin, Marta Bueno, Pedro Pablo García-Luna, María D Ballesteros-Pomar, Marisol Ruiz-Adana, Albert Lecube
BACKGROUND: This study aims to describe the long-term outcomes of bariatric surgery in a cohort of patients with type 1 diabetes (T1DM). METHODS: Thirty-two patients with T1DM and initial BMI of 41.3 ± 4.8 kg/m(2) were studied, 18.7 % undergoing duodenal switch (DS), 34.4 % gastric bypass, and 46.9 % sleeve gastrectomy and followed-up after surgery for 4.6 ± 2.6 years. Changes in BMI, HbA1c, insulin requirements, evolution of comorbidities, and microvascular complications were registered annually after surgery...
October 5, 2016: Obesity Surgery
Kun Li, Jianan Zou, Zhibin Ye, Jianzhong Di, Xiaodong Han, Hongwei Zhang, Weijie Liu, Qinggui Ren, Pin Zhang
BACKGROUND: Obesity is an independent risk factor of development and progression of chronic kidney disease (CKD). Data on the benefits of bariatric surgery in obese patients with impaired kidney function have been conflicting. OBJECTIVE: To explore whether there is improvement in glomerular filtration rate (GFR), proteinuria or albuminuria after bariatric surgery. METHODS: We comprehensively searched the databases of MEDLINE, Embase, web of science and Cochrane for randomized, controlled trials and observational studies that examined bariatric surgery in obese subjects with impaired kidney function...
2016: PloS One
Katherine H Saunders, Leon I Igel, Louis J Aronne
As the prevalence of obesity continues to increase, the need for effective long-term treatment strategies for the overweight and the obese is critical. Pharmacology fills a large treatment gap between behavioral therapy, which is insufficient for the majority of patients, and devices and surgery, which are available to only a subset of patients. Naltrexone HCl and bupropion HCl Extended-Release (naltrexone XR/bupropion XR) was approved by the Food and Drug Administration for chronic weight management in 2014...
October 4, 2016: Expert Opinion on Pharmacotherapy
Piotr Kalinowski, Rafał Paluszkiewicz, Tadeusz Wróblewski, Piotr Remiszewski, Mariusz Grodzicki, Zbigniew Bartoszewicz, Marek Krawczyk
BACKGROUND: Sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) cause weight loss and metabolic improvement, but results of published studies are contradictory. OBJECTIVES: The aim of this study was to compare the effects of SG and RYGB on ghrelin, leptin, and glucose homeostasis in a randomized controlled trial. SETTING: University hospital, Poland. METHODS: Seventy-two morbidly obese patients were randomly selected to undergo either SG (n = 36) or RYGB (n = 36)...
August 18, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Maria Grazia Clemente, Claudia Mandato, Marco Poeta, Pietro Vajro
Non-alcoholic fatty liver disease (NAFLD) in children is becoming a major health concern. A "multiple-hit" pathogenetic model has been suggested to explain the progressive liver damage that occurs among children with NAFLD. In addition to the accumulation of fat in the liver, insulin resistance (IR) and oxidative stress due to genetic/epigenetic background, unfavorable lifestyles, gut microbiota and gut-liver axis dysfunction, and perturbations of trace element homeostasis have been shown to be critical for disease progression and the development of more severe inflammatory and fibrotic stages [non-alcoholic steatohepatitis (NASH)]...
September 28, 2016: World Journal of Gastroenterology: WJG
Joana Guimarães, Daniela Pinho, Catarina S Nunes, Carla S Cavaleiro, Humberto S Machado
STUDY OBJECTIVE: Pathophysiological changes after laparoscopic Roux-en-Y gastric bypass may increase the risk of pulmonary complications in morbidly obese patients. The purpose of the study was to assess the impact of immediate postextubation use of Boussignac continuous positive airway pressure (CPAP) on arterial oxygenation in morbidly obese patients undergoing laparoscopic Roux-en-Y gastric bypass. The hypothesis is that the use of CPAP may improve oxygenation in the postoperative period when compared to Venturi mask...
November 2016: Journal of Clinical Anesthesia
Pengcheng Xie, Zhanfang Li, Zhongyi Tian
OBJECTIVE: Pulmonary dysfunction after laparoscopic surgery is commonly seen in the high-risk group of obese patients. To reduce or avoid this complication caused by an improper combination of mechanical ventilation parameters, we conducted the following trial of 3 factors with 3 levels of mechanical ventilation, aimed to obtain the low airway pressure with good ventilator effects. METHODS: Patients were randomly allocated as a sample of cases according to the "30≤weight/height(2)<40" obesity index...
November 2016: Journal of Clinical Anesthesia
Erin A Brennand, Selphee Tang, Colin Birch, Magnus Murphy, Sue Ross, Magali Robert
INTRODUCTION AND HYPOTHESIS: The objective was to evaluate the impact of preoperative body mass index ≥30 on objective and subjective cure rates 5 years after midurethral sling surgery. METHODS: Secondary analysis of the 5-year results of a randomized clinical trial evaluating tension-free vaginal tape vs transobturator tape surgery. Women (n = 176) were classified as obese or non-obese based on preoperative height and weight. Women self-reported symptoms and quality of life, and underwent standardized physical examinations and pad-testing...
September 29, 2016: International Urogynecology Journal
S G Vienberg, S H Jacobsen, D Worm, L E Hvolris, L Naver, T Almdal, D L Hansen, B S Wulff, T R Clausen, S Madsbad, J J Holst, B Andersen
OBJECTIVE: The positive metabolic outcome of Roux-en-Y gastric bypass (RYGB) surgery may involve fibroblast growth factor 21 (FGF21), in both the fasting state and postprandially. We measured the fasting levels of FGF21 before and after bariatric surgery as well as the postprandial FGF21 responses after a glucose load and after a mixed meal. DESIGN: Observational intervention trial. PATIENTS AND MEASUREMENTS: Eight obese, nondiabetic patients underwent RYGB...
September 21, 2016: Clinical Endocrinology
Mohammed Saif Sait, Robin Som, Cynthia Michelle Borg, Avril Chang, Sasindran Ramar
A best evidence topic has been constructed using a described protocol. The three-part question addressed was: In morbidly obese patients undergoing bariatric surgery, when a ventral hernia is picked up in clinic or intraoperatively is concurrent repair of the hernia better than delayed repair after weight loss with regards to complication rates? Using the reported search, 179 papers were found. 5 studies were deemed to be suitable to answer the question. All 5 studies assessed were non randomised studies either retrospective or prospective and the overall quality of these studies was poor...
November 2016: Annals of Medicine and Surgery
Yuko Tsuruta, Laura Q Rogers, Helen Krontiras, William E Grizzle, Andrew D Frugé, Robert A Oster, Heidi R Umphrey, Lee W Jones, Maria Azrad, Wendy Demark-Wahnefried
INTRODUCTION: Obesity is a known risk factor for postmenopausal breast cancer and is associated with poorer prognosis for premenopausal and postmenopausal patients; however, the aetiological mechanisms are unknown. Preclinical studies support weight loss via caloric restriction and increased physical activity as a possible cancer control strategy, though few clinical studies have been conducted. We undertook a feasibility trial among women recently diagnosed with stage 0-II breast cancer hypothesising that presurgical weight loss would be feasible, safe and result in favourable changes in tumour markers and circulating biomarkers...
September 15, 2016: BMJ Open
Emilian Rejane Marcon, S Baglioni, L Bittencourt, C L N Lopes, C R Neumann, M R M Trindade
OBJECTIVE: This trial's objective was to investigate the effect of an exercise program with and without cognitive-behavioral therapy (CBT), compared by a control group, on weight, functional capacity, and cardiometabolic profile of morbidly obese individuals while waiting for bariatric surgery. MATERIALS AND METHODS: This randomized controlled trial investigated the effect of a 4-month low-intensity exercise program (two weekly sessions of 25 min each) on 66 morbidly obese individuals awaiting bariatric surgery...
September 13, 2016: Obesity Surgery
Anne-Marie Gabrielsen, Torbjørn Omland, Mette Brokner, Jan Magnus Fredheim, Jens Jordan, Sverre Lehmann, May Brit Lund, Jøran Hjelmesæth, Dag Hofsø
BACKGROUND: Obesity is a major risk factor for obstructive sleep apnea, impaired pulmonary function and heart failure, but obesity is also associated with paradoxically low levels of serum N-terminal pro-B-type natriuretic peptide (NT-proBNP). In subjects with severe obesity undergoing weight loss treatment, we assessed the associations between changes in severity of obstructive sleep apnea, pulmonary function and serum NT-proBNP levels. METHODS: One-year non-randomized controlled clinical trial...
2016: BMC Research Notes
Dezhi Chen, Jian Song, Yong Zhao, Xun Zheng, Aixi Yu
BACKGROUND: It is controversial whether surgical zipper technique (SZT), a non-invasive method of surgical wound closure, achieves a better outcome of incision healing than intracutaneous sutures (IS) in the surgery. This meta-analysis was performed to systematically analyze whether surgical zipper is superior to suture material for the incision closure. METHODS: Databases and reference lists were searched for randomized controlled trials (RCTs) comparing SZT with IS for the incision closure...
2016: PloS One
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