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Outcome obesity surgery

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https://www.readbyqxmd.com/read/27914704/kidney-outcomes-three-years-after-bariatric-surgery-in-severely-obese-adolescents
#1
Edward J Nehus, Jane C Khoury, Thomas H Inge, Nianzhou Xiao, Todd M Jenkins, Marva M Moxey-Mims, Mark M Mitsnefes
A significant number of severely obese adolescents undergoing bariatric surgery have evidence of early kidney damage. To determine if kidney injury is reversible following bariatric surgery, we investigated renal outcomes in the Teen-Longitudinal Assessment of Bariatric Surgery cohort, a prospective multicenter study of 242 severely obese adolescents undergoing bariatric surgery. Primary outcomes of urine albumin-to-creatinine ratio and cystatin C-based estimated glomerular filtration rate (eGFR) were evaluated preoperatively and up to 3 years following bariatric surgery...
November 30, 2016: Kidney International
https://www.readbyqxmd.com/read/27906601/association-between-pre-operative-cefazolin-dose-and-surgical-site-infection-in-obese-patients
#2
William J Peppard, David G Eberle, Nathan W Kugler, Danielle M Mabrey, John A Weigelt
BACKGROUND: A fixed dose of cefazolin results in serum concentrations that decrease as body mass increases. Current national guidelines suggest a pre-operative cefazolin dose of two grams may be insufficient for patients ≥120 kg; thus a three gram dose is recommended. These recommendations, however, are based on pharmacokinetic rather than outcome data. We evaluate the efficacy of pre-operative cefazolin two gram and three gram doses as measured by the rate of surgical site infection (SSI)...
December 1, 2016: Surgical Infections
https://www.readbyqxmd.com/read/27902660/preventing-long-term-poor-outcomes-in-the-bariatric-patient-postoperatively
#3
Melissa Cooley
The obesity epidemic in America continues to rise. People are desperately trying to find ways to lose weight successfully and keep the weight off, and many people are turning to bariatric surgery as the only remaining option for morbid obesity. Bariatric surgery is considered to be a viable treatment option for morbid obesity. However, long-term data are revealing that many postsurgical bariatric patients are regaining the weight after 5 years. The purpose of lifelong follow-up appointments in the bariatric patient is to prevent weight regain and poor outcomes...
January 2017: Dimensions of Critical Care Nursing: DCCN
https://www.readbyqxmd.com/read/27901336/robotic-kidney-transplantation-current-status-and-future-perspectives
#4
Angelo Territo, Alex Mottrie, Ronney Abaza, Craig Rogers, Mani Menon, Mahendra Bhandari, Rajesh Ahlawat, Alberto Breda
INTRODUCTION: For the treatment of patients with end-stage renal disease, kidney transplantation is preferred to renal replacement modalities such as hemodialysis and peritoneal dialysis. Although open surgery remains the gold standard, minimally invasive approaches have recently been applied in transplant kidney surgery. Despite growing enthusiasm and potential benefits of robotic kidney transplant, many aspects of this novel technique remain controversial. Aim of this study was to analyze the current status and future developments in robotic-assisted surgery for kidney transplantation...
November 30, 2016: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
https://www.readbyqxmd.com/read/27901287/randomized-trial-of-roux-en-y-gastric-bypass-versus-sleeve-gastrectomy-in-achieving-excess-weight-loss
#5
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/27899815/obesity-in-ibd-epidemiology-pathogenesis-disease-course-and-treatment-outcomes
#6
REVIEW
Siddharth Singh, Parambir S Dulai, Amir Zarrinpar, Sonia Ramamoorthy, William J Sandborn
Incidence of IBD is rising in parallel with overweight and obesity. Contrary to conventional belief, about 15-40% of patients with IBD are obese, which might contribute to the development of IBD. Findings from cross-sectional and retrospective cohort studies are conflicting on the effect of obesity on natural history and course of IBD. Most studies are limited by small sample size, low event rates, non-validated assessment of disease activity and lack robust longitudinal follow-up and have incomplete adjustment for confounding factors...
November 30, 2016: Nature Reviews. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27898680/a-core-outcome-set-for-the-benefits-and-adverse-events-of-bariatric-and-metabolic-surgery-the-bariact-project
#7
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/27896516/the-differential-impact-of-body-mass-index-and-the-feature-of-metabolic-syndrome-on-oncological-outcomes-following-different-surgical-procedures-in-japanese-men-with-prostate-cancer
#8
Masaki Shiota, Ario Takeuchi, Masaaki Sugimoto, Eiji Kashiwagi, Takashi Dejima, Keijiro Kiyoshima, Junichi Inokuchi, Katsunori Tatsugami, Akira Yokomizo, Masatoshi Eto
PURPOSE: This study aimed to examine the differential impact of body mass index and the feature of metabolic syndrome (MetS; obesity, hypertension, diabetes mellitus, and dyslipidemia) on biochemical recurrence (BCR) following radical prostatectomy (RP) treatment for prostate cancer using different surgical procedures. METHODS: This study included 283 Japanese patients with clinically localized prostate cancer who were treated with RP between 2008 and 2012. The prognostic significance of overweight and the feature of MetS were analyzed according to surgical procedures...
November 28, 2016: Annals of Surgical Oncology
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
#9
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/27894747/reduction-of-coagulability-state-one-year-after-bariatric-surgery
#10
Jérémie Thereaux, Fanny Mingant, Charles Roche, Hubert Galinat, Francis Couturaud, Karine Lacut
BACKGROUND: Obese patients are in a hypercoagulable state relative to normal-weight patients. Low-grade inflammation may be a key factor for this condition. OBJECTIVES: Our study aimed to compare the coagulability state of morbidly obese patients before and 1 year after bariatric surgery (BS) using the Thrombin Generation (TG) test, a validated method to assess coagulation in vitro. SETTING: University hospital. METHODS: All patients undergoing BS between September 1, 2014 and April 30, 2015 were eligible for this prospective study (n = 42)...
October 1, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/27891394/obesity-not-necessary-risk-of-symptomatic-cholelithiasis-increases-as-a-function-of-bmi
#11
Bikram Kharga, Barun Kumar Sharma, Varun Kumar Singh, Kumar Nishant, Phuchungla Bhutia, Roshan Tamang, Nitin Jain
INTRODUCTION: Obesity is a well-established risk factor for cholelithiasis. But most of the studies have actually tried to establish the risk of cholelithiasis in overweight and obese people. Very few studies have addressed the issue of cholelithiasis in patients with otherwise normal Body Mass Index (BMI). In this study we have tried to establish if there is any relationship between increasing BMI and cholelithiasis. AIM: To establish a relationship between increasing BMI and risk of cholelithiasis...
October 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27890486/towards-a-multidisciplinary-approach-to-understand-and-manage-obesity-and-related-diseases
#12
REVIEW
Stephan C Bischoff, Yves Boirie, Tommy Cederholm, Michael Chourdakis, Cristina Cuerda, Nathalie M Delzenne, Nicolaas E Deutz, Denis Fouque, Laurence Genton, Carmen Gil, Berthold Koletzko, Miguel Leon-Sanz, Raanan Shamir, Joelle Singer, Pierre Singer, Nanette Stroebele-Benschop, Anders Thorell, Arved Weimann, Rocco Barazzoni
Overnutrition and sedentary lifestyle result in overweight or obesity defined as abnormal or excessive fat accumulation that may impair health. According to the WHO, the worldwide prevalence of obesity nearly doubled between 1980 and 2008. In 2008, over 50% of both men and women in the WHO European Region were overweight, and approximately 23% of women and 20% of men were obese. Comprehensive diagnostic and therapeutic approaches should include nutritional treatment to favor the best metabolic and nutritional outcome, as well as to induce potential disease-specific benefits from selected nutritional regimens...
November 16, 2016: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/27885537/safety-analysis-of-bariatric-patients-undergoing-outpatient-upper-endoscopy-with-non-anesthesia-administered-propofol-sedation
#13
Tyler McVay, John C Fang, Linda Taylor, Alexander Au, Wesley Williams, Angela P Presson, Ragheed Al-Dulaimi, Eric Volckmann, Anna Ibele
BACKGROUND: Non-anesthesia administered propofol (NAAP) has been shown to be a safe and effective method of sedation for patients undergoing gastrointestinal endoscopy. Bariatric surgery patients are potentially at a higher risk for sedation-related complications due to co-morbidities including obstructive sleep apnea. The outcomes of NAAP in bariatric patients have not been previously reported. METHODS: In this retrospective cohort study, severely obese patients undergoing pre-surgical outpatient esophagogastroduodenoscopy (EGD) were compared to non-obese control patients (BMI ≤ 25 kg/m(2)) undergoing diagnostic EGD at our institution from March 2011-September 2015 using our endoscopy database...
November 24, 2016: Obesity Surgery
https://www.readbyqxmd.com/read/27885536/safety-and-outcome-of-laparoscopic-sleeve-gastrectomy-following-removal-of-adjustable-gastric-banding-lessons-from-109-patients-in-a-single-center-and-review-of-the-literature
#14
Niv Pencovich, Guy Lahat, Orit Goldray, Subhi Abu-Abeid, Joseph M Klausner, Shai Meron Eldar
BACKGROUND: Although considered a common bariatric procedure, laparoscopic adjustable gastric banding (LAGB) is associated with high rates of weight loss failure and long-term complications. PURPOSE: The purpose of this study was to re-assess the safety and outcome of conversion of failed LAGB to laparoscopic sleeve gastrectomy (LSG). MATERIALS AND METHODS: One hundred and nine patients underwent conversion from LAGB to LSG (78 females, mean age 43 ± 11...
November 24, 2016: Obesity Surgery
https://www.readbyqxmd.com/read/27885531/evolution-of-liver-steatosis-quantified-by-mr-imaging-and-mr-spectroscopy-in-morbidly-obese-patients-undergoing-sleeve-gastrectomy-short-term-outcomes
#15
María Engracia Alsina, Jaime Ruiz-Tovar, Angela Bernabeu
BACKGROUND: Currently, the standard procedure used to evaluate hepatic steatosis is the liver biopsy. This is an invasive practice that presents inherent risks. Increasing evidence suggests that magnetic resonance imaging (MRI) and MR spectroscopy (MRS) may represent an accurate method to determine the hepatic lipid content. The aim of this study was to evaluate the effect of sleeve gastrectomy on liver steatosis, quantified by MRI and MRS. PATIENTS AND METHODS: A prospective observational study of patients undergoing laparoscopic sleeve gastrectomy was performed...
November 24, 2016: Obesity Surgery
https://www.readbyqxmd.com/read/27878479/total-transthoracic-approach-facilitates-laparoscopic-hepatic-resection-in-patients-with-significant-prior-abdominal-surgery
#16
Suguru Yamashita, Evelyne Loyer, Hyunseon C Kang, Thomas A Aloia, Yun Shin Chun, Reza J Mehran, Cathy Eng, Jeffrey E Lee, Jean-Nicolas Vauthey, Claudius Conrad
BACKGROUND: While the oncologic safety of minimally invasive hepatectomy for colorectal liver metastases (CLM) has been demonstrated, lesions in the postero-superior segments may be challenging.1 (-) 3 For these lesions, a transthoracic approach may be particularly helpful, especially in patients with a hostile/reoperative abdomen or morbid obesity.4 (,) 5 PATIENT: A 43-year-old man with a body mass index of 36.0 who had undergone rectosigmoid resection for primary cancer 5 years ago recurred with a solitary liver metastasis in SVIII...
November 22, 2016: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/27876519/the-effect-of-body-mass-index-on-major-outcomes-after-vascular-surgery
#17
REVIEW
George Galyfos, Georgios I Geropapas, Stavros Kerasidis, Argiri Sianou, Fragiska Sigala, Konstantinos Filis
OBJECTIVE: Obesity has been associated with an increased risk for cardiovascular morbidity and mortality, although pooled evidence in patients undergoing vascular surgery are lacking. The aim of this systematic review was to evaluate the effect of body mass index (BMI) on major postoperative outcomes in patients undergoing vascular surgery. METHODS: A systematic literature review conforming to established criteria to identify eligible articles published before May 2016 was conducted...
November 19, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27875102/obesity-increases-operative-time-in-children-undergoing-laparoscopic-cholecystectomy
#18
T K Pandian, Daniel S Ubl, Elizabeth B Habermann, Christopher R Moir, Michael B Ishitani
INTRODUCTION: Few studies have assessed the impact of obesity on laparoscopic cholecystectomy (LC) in pediatric patients. MATERIALS AND METHODS: Children who underwent LC were identified from the 2012 to 2013 American College of Surgeons' National Surgical Quality Improvement Program Pediatrics data. Patient characteristics, operative details, and outcomes were compared. Multivariable logistic regression was utilized to identify predictors of increased operative time (OT) and duration of anesthesia (DOAn)...
November 22, 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/27870737/the-influence-of-body-mass-index-on-sensorimotor-block-and-vasopressor-requirement-during-spinal-anesthesia-for-elective-cesarean-delivery
#19
T C Ngaka, J F Coetzee, R A Dyer
BACKGROUND: It has been suggested that the dose requirement for spinal anesthesia (SA) is lower in obese patients for cesarean delivery (CD). In this prospective, observational, noninferiority study, we tested the hypothesis that obesity would not have a clinically important effect on vasopressor requirements or block height. METHODS: Two groups of 25 parturients, group O (body mass index [BMI] >40 kg/m) and group N (BMI <32 kg/m) requiring elective CD were recruited...
December 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27866938/ovulation-induction-in-polycystic-ovary-syndrome-current-options
#20
REVIEW
Richard S Legro
There are a variety of effective treatment options to induce ovulation in women with polycystic ovary syndrome (PCOS). The most effective treatments are primarily reproductive and target the hypothalamic-pituitary-ovarian (HPO) axis. Letrozole, an aromatase inhibitor, is headed toward replacing clomiphene, a selective estrogen receptor modulator, as the first-choice option. Metabolic treatments likely work indirectly through the HPO axis. Many metabolic treatments have shown initial promise and later failed (troglitozone or d-chiro-inositol) or disappointed (metformin); further studies are needed of newer agents to treat type 2 diabetes...
September 21, 2016: Best Practice & Research. Clinical Obstetrics & Gynaecology
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