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Bariatric Obesity

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https://www.readbyqxmd.com/read/28097332/effect-of-incentive-spirometry-on-postoperative-hypoxemia-and-pulmonary-complications-after-bariatric-surgery-a-randomized-clinical-trial
#1
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/28096522/control-of-food-intake-by-gastrointestinal-peptides-mechanisms-of-action-and-possible-modulation-in-the-treatment-of-obesity
#2
REVIEW
Philip Prinz, Andreas Stengel
This review focuses on the control of appetite by food intake-regulatory peptides secreted from the gastrointestinal tract, namely cholecystokinin, glucagon-like peptide 1, peptide YY, ghrelin, and the recently discovered nesfatin-1 via the gut-brain axis. Additionally, we describe the impact of external factors such as intake of different nutrients or stress on the secretion of gastrointestinal peptides. Finally, we highlight possible conservative-physical activity and pharmacotherapy-treatment strategies for obesity as well as surgical techniques such as deep brain stimulation and bariatric surgery also altering these peptidergic pathways...
January 17, 2017: Journal of Neurogastroenterology and Motility
https://www.readbyqxmd.com/read/28096259/bariatric-surgery-enhances-splanchnic-vascular-responses-in-patients-with-type-2-diabetes
#3
Henri Honka, Jukka Koffert, Saila Kauhanen, Jarmo Teuho, Saija Hurme, Andrea Mari, Andreas Lindqvist, Nils Wierup, Leif Groop, Pirjo Nuutila
Bariatric surgery results in notable weight loss and alleviates hyperglycemia in patients with type 2 diabetes (T2D). In this study, we aimed to characterize the vascular effects of a mixed-meal and of infusion of exogenous glucose-dependent insulinotropic polypeptide (GIP) in the splanchnic region in ten obese patients with T2D before and after bariatric surgery and in ten lean controls. The experiments were carried out on two separate days. Pancreatic and intestinal blood flow (BF) were measured at baseline, 20 and 50 minutes with (15)O-water using positron emission tomography and magnetic resonance imaging (PET/MRI)...
January 17, 2017: Diabetes
https://www.readbyqxmd.com/read/28093508/vertical-sleeve-gastrectomy-reduces-blood-pressure-and-hypothalamic-endoplasmic-reticulum-stress-in-mice
#4
Anne K McGavigan, Zachariah M Henseler, Darline Garibay, Scott D Butler, Sisitha Jayasinghe, Ruth E Ley, Robin L Davisson, Bethany P Cummings
Bariatric surgery, such as vertical sleeve gastrectomy (VSG), causes remarkable improvements in cardiometabolic health, including hypertension remission. However, the mechanisms responsible remain undefined and poorly studied. Therefore, we developed and validated the first murine model of VSG that recapitulates the blood pressure lowering effect of VSG using gold-standard radiotelemetry technology. We used this model to investigate several potential mechanisms, including body weight, brain endoplasmic reticulum (ER) stress signaling and brain inflammatory signaling, all critical contributors to obesity-associated hypertension pathogenesis...
January 12, 2017: Disease Models & Mechanisms
https://www.readbyqxmd.com/read/28092289/the-impact-of-obesity-on-heart-failure
#5
Alexander B Zhai, Haissam Haddad
PURPOSE OF REVIEW: Obesity, a growing global health problem, contributes to the development of heart failure. However, increased BMI seems protective for those with established disease, a phenomenon known as the 'obesity paradox'. In this review, we outline the mechanism through which obesity can contribute to the development of heart failure, explore the concept of obesity paradox, and highlight the challenges that obesity presents for advanced heart failure therapy. RECENT FINDINGS: Although the mechanism underlying the obesity paradox is complex, meta-analysis shows that intentional weight loss through bariatric surgery can indeed improve cardiac structure and function...
January 13, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28091851/operative-treatments-for-reflux-after-bariatric-surgery-current-and-emerging-management-options
#6
Daniela Treitl, Derek Nieber, Kfir Ben-David
Gastroesophageal reflux disease (GERD) is a common disorder that has a well-established connection with obesity. To ameliorate the morbidity associated with obesity, bariatric procedures have become an established pathway to accomplish sustained weight loss. In some procedures, such as with the Roux-en-Y gastric bypass surgery, weight loss is also accompanied by the resolution of GERD symptoms. However, other popular bariatric surgeries, such as the sleeve gastrectomy, have a controversial impact on their effect on reflux...
January 13, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28090354/what-weight-loss-treatment-options-do-geriatric-patients-with-overweight-and-obesity-want-to-consider
#7
M MacMillan, K Cummins, K Fujioka
INTRODUCTION: Since the 1990s, a number of weight loss medications have been removed from the USA and or European market because of adverse events associated with these medications. These medications include fenfluramine (heart valve thickening), sibutramine (cardiovascular risk) and rimonabant (depression). This history may affect a patient's desire to consider weight loss medications as an option for weight management. OBJECTIVE: This descriptive study was designed to observe what treatment options the geriatric patient (age 65 or higher) seeking weight loss would like to consider, as well as the reasons they felt they struggled with overweight or obesity...
December 2016: Obesity Science & Practice
https://www.readbyqxmd.com/read/28089764/promoting-weight-maintenance-with-electronic-health-record-tools-in-a-primary-care-setting-baseline-results-from-the-maintain-pc-trial
#8
Molly B Conroy, Cindy L Bryce, Kathleen M McTigue, Dana Tudorascu, Bethany Barone Gibbs, Diane Comer, Rachel Hess, Kimberly Huber, Laurey R Simkin-Silverman, Gary S Fischer
Maintaining weight loss is a significant challenge in combating obesity. The goal of Maintaining Activity and Nutrition through Technology-Assisted Innovation in Primary Care (MAINTAIN-pc) is to evaluate the use of tools delivered through an electronic health record (EHR) and patient portal, with or without health coach support, to help primary care patients maintain weight loss. EHR tools include flowsheets, standardized surveys, and secure patient messaging. Inclusion criteria were age 18-75years, voluntary 5% weight loss in the past 2years with prior BMI≥25kg/m(2), and no bariatric procedures in past 5years...
January 12, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28089592/stapleless-laparoscopic-sleeve-gastrectomy-preliminary-report
#9
Jose Luis Leyba, Salvador Navarrete Llopis, Salvador Navarrete Aulestia, Ricardo Ochoa, Eliana Azuaje
BACKGROUND: Laparoscopic sleeve gastrectomy (SG) as a single-stage procedure for the treatment of morbid obesity is becoming increasingly popular. In undeveloped countries, the linear staples required to create the sleeve are not always available because of their high cost. As an alternative to the staples, the bipolar vessel sealer device could be used in bariatric surgery to divide and temporarily seal the stomach. SETTINGS: Universidad Central de Venezuela, Caracas, Venezuela...
December 7, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28089437/systems-innovation-model-an-integrated-interdisciplinary-team-approach-pre-and-post-bariatric-surgery-at-a-veterans-affairs-va-medical-center
#10
Dan Eisenberg, Jessica A Lohnberg, Eric P Kubat, Cheryl C Bates, Lauren M Greenberg, Susan M Frayne
BACKGROUND: Provision of bariatric surgery in the Veterans Health Administration must account for obese veterans' co-morbidity burden and the geographically dispersed location of patients relative to Veterans Affairs (VA) bariatric centers. OBJECTIVES: To evaluate a collaborative, integrated, interdisciplinary bariatric team of surgeons, bariatricians, psychologists, dieticians, and physical therapists working in a hub-and-spokes care model, for pre- and post-bariatric surgery assessment and management...
November 15, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28089435/jejunal-gluconeogenesis-associated-with-insulin-resistance-level-and-its-evolution-after-roux-en-y-gastric-bypass
#11
Carolina Gutierrez-Repiso, Sara Garcia-Serrano, Francisco J Moreno-Ruiz, Guillermo Alcain-Martinez, Francisca Rodriguez-Pacheco, Eduardo Garcia-Fuentes
BACKGROUND: Intestinal gluconeogenesis (GNG) may play an important role in glucose homeostasis, but there is little information about the condition in humans. OBJECTIVES: To study the relationship between intestinal GNG and insulin resistance, its association with the evolution of morbidly obese patients after bariatric surgery, and the effect of insulin and or leptin. SETTING: Regional university hospital, Malaga (Spain). METHODS: Jejunal mRNA expression of genes involved in GNG was analyzed in 3 groups of morbidly obese patients who underwent Roux-en-Y gastric bypass: with low insulin resistance (MO-low-IR), with high insulin resistance (MO-high-IR), and with type 2 diabetes treated with metformin (MO-metf-T2D)...
December 2, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28089433/derivation-and-validation-of-a-scoring-system-for-predicting-nonalcoholic-steatohepatitis-in-taiwanese-patients-with-severe-obesity
#12
Chi-Ming Tai, Ming-Lung Yu, Hung-Pin Tu, Chih-Kun Huang, Jau-Chung Hwang, Wan-Long Chuang
BACKGROUND: Nonalcoholic steatohepatitis (NASH) is common in severely obese Asians and may progress to advanced liver disease. Although invasive, liver biopsy is the gold standard for NASH diagnosis. Scoring systems for predicting NASH in obese Asians are scarce. OBJECTIVES: To develop and validate a scoring system to predict NASH in Taiwanese patients with severe obesity. SETTING: University hospital, Taiwan. METHODS: Preoperative clinical and laboratory data were obtained from 180 severely obese patients who underwent bariatric surgery...
December 7, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28087357/early-effect-of-bariatric-surgery-on-urogenital-function-in-morbidly-obese-men
#13
Maha Aleid, Asif Muneer, Sara Renshaw, Jason George, Andrew D Jenkinson, Marco Adamo, Mohamed Elkalaawy, Rachel Batterham, David J Ralph, Majid Hashemi, Selim Cellek
INTRODUCTION: Obesity is an independent risk factor for erectile dysfunction (ED) and lower urinary tract symptoms (LUTS). Bariatric surgery has been shown to improve erectile function and urinary symptoms in medium- to long-term studies (3- to 12-month postoperative follow-up). AIM: To investigate the early effect (1 month postoperatively) of bariatric surgery on ED and LUTS, which has not previously been investigated. METHODS: Morbidly obese men (body mass index > 35 kg/m(2)) undergoing bariatric surgery were asked to complete the International Index of Erectile Function (IIEF) and International Prostate Symptom Score (IPSS) questionnaires before surgery and 1, 3, and 6 months after surgery...
January 10, 2017: Journal of Sexual Medicine
https://www.readbyqxmd.com/read/28087009/improving-kidney-disease-in-obese-adolescents-a-surgical-approach
#14
Ian R Macumber
Obesity has been associated with chronic kidney disease in adult studies, but little data exist in pediatrics. Nehus et al. offer the first study to show that bariatric surgery in severely obese adolescents is associated with improved renal outcomes. Despite limitations, this study provided compelling evidence that aggressive weight loss intervention can improve renal outcomes in young, severely obese subjects. Further investigation is required to determine mechanisms by which this may occur.
February 2017: Kidney International
https://www.readbyqxmd.com/read/28079245/gastric-and-jejunal-histopathological-changes-in-patients-undergoing-bariatric-surgery
#15
Rosemary Simões Nomelini Rodrigues, Élia Cláudia de Souza Almeida, Júverson Alves Terra, Lucinda Calheiros Guimarães, Ana Cristina da Rocha Duque, Renata Margarida Etchebehere
BACKGROUND: - Morbid obesity is a multifactorial disease that is increasingly treated by surgery. OBJECTIVE: - To evaluate gastric histopathological changes in obese, and to compare with patients who underwent gastrojejunal bypass and the jejunal mucosa after the surgery. METHODS: - This is an observational study performed at a tertiary public hospital, evaluating endoscopic biopsies from 36 preoperative patients and 35 postoperative. RESULTS: - In the preoperative group, 80...
January 2017: Arquivos de Gastroenterologia
https://www.readbyqxmd.com/read/28079244/preoperative-multidisciplinary-program-for-bariatric-surgery-a-proposal-for-the-brazilian-public-health-system
#16
Elinton Adami Chaim, José Carlos Pareja, Martinho Antonio Gestic, Murillo Pimentel Utrini, Everton Cazzo
BACKGROUND: - Bariatric surgery has become the gold standard treatment for morbid obesity, but access to surgery remains difficult and low compliance to postoperative follow-up is common. To improve outcomes, enable access and optimize follow-up, we developed a multidisciplinary preoperative approach for bariatric surgery. OBJECTIVE: - To determine the impact of this program in the outcomes of bariatric surgery in the Brazilian public health system. METHODS: - A prospective evaluation of the individuals who underwent a preoperative multidisciplinary program for bariatric surgery and comparison of their surgical outcomes with those observed in the prospectively collected historical database of the individuals who underwent surgery before the beginning of the program...
January 2017: Arquivos de Gastroenterologia
https://www.readbyqxmd.com/read/28079243/serum-levels-of-vitamin-a-visual-function-and-ocular-surface-after-bariatric-surgery
#17
Luana Paula Nogueira de Araújo Brandão, Lucio Vilar, Bernardo Menelau Cavalcanti, Pedro Henrique Amorim Brandão, Tiago Eugênio Faria E Arantes, Josemberg Marins Campos
BACKGROUND: - Bariatric surgery is the most effective treatment for severe obesity, but the surgery increases the risk of developing nutritional deficiencies, such as vitamin A deficiency. In human metabolism, vitamin A plays a role in vision. OBJECTIVE: - To evaluate serum vitamin A, visual function and ocular surface of patients undergoing bariatric surgery. METHODS: - A cross-sectional and analytical study was conduced with 28 patients undergoing bariatric surgery for at least 6 months...
January 2017: Arquivos de Gastroenterologia
https://www.readbyqxmd.com/read/28079242/application-of-baros-questionnaire-in-obese-patients-undergoing-bariatric-surgery-with-2-years-of-evolution
#18
Caetano de Queiroz, José Afonso Sallet, Pedro Gabriel Melo DE Barros E Silva, Luzia da Gloria Pereira de Sousa Queiroz, Jélis Arenas Pimentel, Paulo Clemente Sallet
BACKGROUND: -In recent decades, the high prevalence of obesity in the general population has brought serious concerns in terms of public health. Contrarily to conventional treatment involving dieting and physical exercising, often ineffective in generating long term results, bariatric opera-tions have been an effective method for sustained weight loss in morbidly obese individuals. The Bariatric Analysis and Reporting Outcome System (BAROS) is an objective and recognized system in the overall evaluation of results after bariatric surgery...
January 2017: Arquivos de Gastroenterologia
https://www.readbyqxmd.com/read/28078643/anthropometric-assessment-for-bariatric-procedures-in-the-private-practice-of-a-registered-dietitian-in-colombia
#19
Claudia Carvajal, Patricia Savino, Andrea Ramirez, Martha Grajales, Ricardo Nassar, Natan Zundel
BACKGROUND: Obesity and its consequences have now reached worldwide pandemic proportions. Among treatments, bariatric interventions are the most effective for weight reduction. Here, we describe the change in anthropometric measurements (AMs) of 615 adult bariatric procedure patients seen in the private practice of a registered dietitian (RD) in Bogotá, Colombia. METHODS: Observational retrospective study of AMs recorded between 1996 and 2013 for patients who had laparoscopic sleeve gastrectomy (LSG, n = 290), laparoscopic adjustable gastric banding (LAGB, n = 207), and laparoscopic Roux-EN-Y gastric bypass (LRYGB, n = 36) or the non-surgical gastric balloon (GB, n = 82) procedure...
January 11, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28078641/staple-line-leak-after-primary-sleeve-gastrectomy-risk-factors-and-mid-term-results-do-patients-still-benefit-from-the-weight-loss-procedure
#20
Frank Benedix, Oliver Poranzke, Daniele Adolf, Stephanie Wolff, Hans Lippert, Jörg Arend, Thomas Manger, Christine Stroh
BACKGROUND: Staple line leak after laparoscopic sleeve gastrectomy (LSG) still represents the most feared complication. The purpose of this study was to investigate whether there are factors that increase the risk for a leakage. Furthermore, we aimed to analyze the impact of a leak on weight change and resolution of comorbidities. METHODS: Since 2005, data from obese patients that undergo bariatric procedures in Germany are prospectively registered. For the current analysis, all adult subjects that had undergone primary LSG from 2005 to 2014 were considered...
January 11, 2017: Obesity Surgery
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