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Bariatric medicine

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https://www.readbyqxmd.com/read/28204931/postero-inferior-pedicle-surgical-technique-for-the-treatment-of-grade-iii-gynecomastia
#1
Sophie Thiénot, Nicolas Bertheuil, Raphaël Carloni, Cécile Méal, Sylvie Aillet, Christian Herlin, Eric Watier
INTRODUCTION: Surgical treatment of Grade III gynecomastia generally utilizes mastectomy techniques and free transplantation of the nipple-areola complex. Moreover, with rising obesity rates and the development of bariatric surgery, an increasing demand for correctional surgery for pseudogynecomastia has been observed, which is comparable to Grade III gynecomastia in terms of its surgical management. Here, we describe an innovative technique to deal with these new demands: fascio-cutaneous flap by postero-inferior pedicle...
February 15, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28061687/new-targets-for-drug-treatment-of-obesity
#2
Georgios Valsamakis, Panagiota Konstantakou, George Mastorakos
Antiobesity medical management has shown unsatisfactory results to date in terms of efficacy, safety, and long-term maintenance of weight loss. This poor performance could be attributed to the complexity of appetite regulation mechanisms; the serious drug side effects; and, crucially, the lack of profile-matching treatment strategies and individualized, multidisciplinary follow-up. Nevertheless, antiobesity pharmacotherapy remains a challenging, exciting field of intensive scientific interest. According to the latest studies, the future of bariatric medicine lies in developing drugs acting at multiple levels of the brain-gut axis...
January 6, 2017: Annual Review of Pharmacology and Toxicology
https://www.readbyqxmd.com/read/28041006/bariatric-surgery-and-psychiatric-care
#3
Sanjeev Sockalingam, Weronika Micula-Gondek, Wynne Lundblad, Alexis M Fertig, Raed Hawa
No abstract text is available yet for this article.
January 1, 2017: American Journal of Psychiatry
https://www.readbyqxmd.com/read/28032175/patient-versus-surgeon-preferences-between-traditional-and-neo-omphaloplasty-in-post-bariatric-abdominoplasty
#4
Maria Gabriela Bonilha Vallim, Davi Reis Calderoni, Marco Antonio Camargo Bueno, Marcos Matias Motta, Rafael de Campos Ferreira Basso, Paulo Kharmandayan
BACKGROUND: Abdominoplasty procedures have been proven highly valuable in promoting better quality of life for post-bariatric surgery patients. The literature reveals that the aspect of the navel is one of the most problematic issues regarding surgical results and many different surgical techniques have been proposed to obtain a satisfactory outcome. However, little is known about patients' preferences regarding these different techniques and their results. The aim of the present study was to compare evaluations made by plastic surgeons and patients of the results of two different techniques-traditional omphaloplasty and neo-omphaloplasty with lateral flaps...
December 28, 2016: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28032161/psychological-and-psychiatric-traits-in-post-bariatric-patients-asking-for-body-contouring-surgery
#5
Chiara Pavan, Massimo Marini, Eleonora De Antoni, Carlotta Scarpa, Tito Brambullo, Franco Bassetto, Annapina Mazzotta, Vincenzo Vindigni
BACKGROUNDS: Obese patients, mainly females, feel uncomfortable and unsatisfied with their physical appearance; they have a wrong perception of their image and consequently diminish their self-esteem, sometimes showing difficulties in functional areas such as work, relationship, social activity. Beside health concerns, improving their appearance and body image are often common motives for weight loss in obese individuals and after weight loss about 30% of bariatric surgery patients undergo plastic surgical correction of excessive skin...
December 28, 2016: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/27930278/for-love-not-money-the-financial-implications-of-surgical-fellowship-training
#6
Paul M Inclan, Adam S Hyde, Michael Hulme, Jeffrey E Carter
Surgical residents cite increased income potential as a motivation for pursuing fellowship training, despite little evidence supporting this perception. Thus, our goal is to quantify the financial impact of surgical fellowship training on financial career value. By using Medical Group Management Association and Association of American Medical Colleges physician income data, and accounting for resident salary, student debt, a progressive tax structure, and forgone wages associated with prolonged training, we generated a net present value (NPV) for both generalist and subspecialist surgeons...
September 2016: American Surgeon
https://www.readbyqxmd.com/read/27921423/-bariatric-surgeries-at-diabetic-patients
#7
Martin Haluzík
A worldwide increase in the prevalence of obesity and type 2 diabetes mellitus along with accompanying chronic, in particular cardiovascular, complications represents one of the leading challenges of current medicine. Despite major advances in diabetes pharmacotherapy, bariatric surgery remains the most effective treatment of diabetes. It not only markedly decreases body weight and improves glucose control but also induces diabetes remission in a significant percentage of patients. According to current recommendations, bariatric surgery is indicated in patients with 3rd degree obesity (even without any complications) or with 2nd degree obesity with complications (e...
2016: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/27913121/loss-of-control-eating-following-sleeve-gastrectomy-surgery
#8
Valentina Ivezaj, Erin E Kessler, Janet A Lydecker, Rachel D Barnes, Marney A White, Carlos M Grilo
BACKGROUND: Postoperative loss-of-control (LOC) eating is related to poorer weight loss outcomes after bariatric surgery, but little is known about LOC eating after sleeve gastrectomy surgery. OBJECTIVES: To examine LOC eating severity and weight loss after sleeve gastrectomy SETTING: University School of Medicine, United States METHODS: Participants were 71 individuals (84.5% female; n = 60) who underwent sleeve gastrectomy surgery within the previous 4 to 9 months and reported LOC eating at least once weekly during the previous 28 days...
October 1, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/27817153/use-of-fentanyl-iontophoretic-transdermal-system-its-ionsys-%C3%A2-in-the-management-of-patients-with-acute-postoperative-pain-a-case-series
#9
Steven Poplawski, Matthew Johnson, Philip Philips, Leopold H J Eberhart, Tilo Koch, Loretta M Itri
Fentanyl iontophoretic transdermal system (ITS) [IONSYS(®), The Medicines Company, Parsippany, NJ, USA] is a needle-free, patient-controlled, postoperative opioid pain management treatment. It is indicated for the short-term management of acute postoperative pain in adults requiring opioid analgesia in the hospital. The safety and effectiveness of fentanyl ITS for acute postoperative pain management has been demonstrated in a range of surgery and patient types studied in seven phase 3 trials (three placebo-controlled trials and four active-comparator trials)...
December 2016: Pain and Therapy
https://www.readbyqxmd.com/read/27749997/dumping-syndrome-after-esophageal-gastric-or-bariatric-surgery-pathophysiology-diagnosis-and-management
#10
REVIEW
A P van Beek, M Emous, M Laville, J Tack
BACKGROUND: Dumping syndrome, a common complication of esophageal, gastric or bariatric surgery, includes early and late dumping symptoms. Early dumping occurs within 1 h after eating, when rapid emptying of food into the small intestine triggers rapid fluid shifts into the intestinal lumen and release of gastrointestinal hormones, resulting in gastrointestinal and vasomotor symptoms. Late dumping occurs 1-3 h after carbohydrate ingestion, caused by an incretin-driven hyperinsulinemic response resulting in hypoglycemia...
January 2017: Obesity Reviews: An Official Journal of the International Association for the Study of Obesity
https://www.readbyqxmd.com/read/27683792/impact-of-vitamin-d-and-calcium-deficiency-in-the-bones-of-patients-undergoing-bariatric-surgery-a-systematic-review
#11
Jefry Alberto Vargas Cabral, Gabriela Pereira de Souza, Juliana de Almeida Nascimento, Luis Fernando Simoneti, Carolina Marchese, Silvia Helena de Carvalho Sales-Peres
Introduction: Bariatric surgery is considered the most effective tool in the control and treatment of severe obesity, but patients undergoing this procedure are at increased risk of developing nutritional deficiencies by limiting the intake and absorption of many nutrients. Objective: To assess the impact of vitamin D deficiency and calcium in bone in patients after gastric bypass in Roux-en-Y, pointing directly at the type of administration, doses and effects after surgery...
2016: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
https://www.readbyqxmd.com/read/27683788/the-role-of-metabolic-surgery-for-patients-with-obesity-grade-i-and-type-2-diabetes-not-controlled-clinically
#12
Josemberg Campos, Almino Ramos, Thomaz Szego, Bruno Zilberstein, Heládio Feitosa, Ricardo Cohen
Introduction: Even considering the advance of the medical treatment in the last 20 years with new and more effective drugs, the outcomes are still disappointing as the control of obesity and type 2 Diabetes Mellitus (T2DM) with a large number of patients under the medical treatment still not reaching the desired outcomes. Objective: To present a Metabolic Risk Score to better guide the surgical indication for T2DM patients with body mass index (BMI) where surgery for obesity is still controversial...
2016: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
https://www.readbyqxmd.com/read/27683777/masticatory-function-of-obese-candidates-to-bariatric-surgery-from-distinct-socioeconomic-classes
#13
Celso Roberto Passeri, Jacira Alves Caracik de Camargo Andrade, Karla Thaíza Tomal, Eduardo Marcucci Pracucho, Livia Paschoalino de Campos, Silvia Helena de Carvalho Sales-Peres
Background: Obesity and metabolic syndrome can be labeled as worldwide outbreak; thus, both have led to serious public health problem. Oral health can be worsened by both, obesity and metabolic syndrome. Tooth loss harms masticatory function, essential status to whom will be submitted to bariatric surgery. Aim: Assess masticatory function of obese candidates to bariatric surgery, who belong to distinct socioeconomic class range, in order to recognize hazard factors and the bias of socioeconomic factor in this context...
2016: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
https://www.readbyqxmd.com/read/27663821/liaison-psychiatry-and-bariatric-surgery-double-standards-what-are-the-possibilities-for-the-systematization-of-the-pre-operative-psychiatric-assessment-in-belgium
#14
Denis Jacques, Christine Reynaert, Nicolas Zdanowicz
BACKGROUND: In the context of health care in Belgium, the psychological or psychiatric opinion of a multidisciplinary team is required in the assessment of bariatric surgery candidates. In clinical practice, a wide variety of liaison psychiatry assessment methods exist. SUBJECTS AND METHODS: On the basis of a post-operative psychiatric comorbidity case report and a literature review on "liaison psychiatry and bariatric surgery" we aim to identify opportunities for the systematization of bariatric pre-surgery psychiatric evaluation...
September 2016: Psychiatria Danubina
https://www.readbyqxmd.com/read/27568470/mechanisms-of-improved-glucose-handling-after-metabolic-surgery-the-big-6
#15
REVIEW
Rebecca L Paszkiewicz, Richard N Bergman
For some time, it has been clear that elevated glucose is detrimental to the organism. A plethora of medicines have been introduced to reduce the fasting and postprandial glucose levels (including insulin, glucagon-like peptide receptor 1 [GLP-1] agonists, and sodium-glucose co-transporter 2 [SGLT2] inhibitors, among others). Although these medications are useful to reduce tissue exposure to glucose, no single compound and no combination have been able to totally normalize the blood sugar. Thus, it was astonishing when it was reported that surgery of the gastrointestinal tract could not only reduce obesity but also normalize the blood sugar...
July 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/27524917/how-do-patients-clinical-phenotype-and-the-physiological-mechanisms-of-the-operations-impact-the-choice-of-bariatric-procedure
#16
REVIEW
Thomas Bächler, Carel W le Roux, Marco Bueter
Bariatric surgery is currently the most effective option for the treatment of morbid obesity and its associated comorbidities. Recent clinical and experimental findings have challenged the role of mechanical restriction and caloric malabsorption as the main mechanisms for weight loss and health benefits. Instead, other mechanisms including increased levels of satiety gut hormones, altered gut microbiota, changes in bile acid metabolism, and/or energy expenditure have been proposed as explanations for benefits of bariatric surgery...
2016: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/27409057/the-role-of-metabolic-surgery-for-patients-with-obesity-grade-i-andclinically-uncontrolled-type-2-diabetes
#17
Josemberg Campos, Almino Ramos, Thomaz Szego, Bruno Zilberstein, Heládio Feitosa, Ricardo Cohen
INTRODUCTION: Even considering the advance of the medical treatment in the last 20 years with new and more effective drugs, the outcomes are still disappointing as the control of obesity and type 2 Diabetes Mellitus (T2DM) with a large number of patients under the medical treatment still not reaching the desired outcomes. OBJECTIVE: To present a Metabolic Risk Score to better guide the surgical indication for T2DM patients with body mass index (BMI) where surgery for obesity is still controversial...
July 7, 2016: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
https://www.readbyqxmd.com/read/27307177/transversus-abdominal-plane-block-for-postoperative-analgesia-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#18
Etrusca Brogi, Roy Kazan, Shantale Cyr, Francesco Giunta, Thomas M Hemmerling
PURPOSE: The transversus abdominal plane (TAP) block has been described as an effective pain control technique after abdominal surgery. We performed a systematic review and meta-analysis of randomized-controlled trials (RCTs) to account for the increasing number of TAP block studies appearing in the literature. The primary outcome we examined was the effect of TAP block on the postoperative pain score at six, 12, and 24 hr. The secondary outcome was 24-hr morphine consumption. SOURCE: We searched the United States National Library of Medicine database, the Excerpta Medica database, and the Cochrane Central Register of Controlled Clinical Studies and identified RCTs focusing on the analgesic efficacy of TAP block compared with a control group [i...
October 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/27301373/leaks-after-laparoscopic-sleeve-gastrectomy-overview-of-pathogenesis-and-risk-factors
#19
REVIEW
Angelo Iossa, Mohamed Abdelgawad, Brad Michael Watkins, Gianfranco Silecchia
BACKGROUND: Leak is the second most common cause of death after bariatric surgery. The leak rate after laparoscopic sleeve gastrectomy (LSG) ranges between 1.1 and 5.3 %. The aim of the paper is to provide an overview of the current pathogenic and promoting factors of leakage after LSG on the basis of recent literature review and to report the evidence based preventive measures. METHODS: Risk factors and pathogenesis of leakage after LSG were examined based on an extensive review of literature and evidence based analysis of the most recent published studies using Oxford centre for evidence-based medicine, 2011, levels of evidence...
September 2016: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/27292926/orthostatic-intolerance-and-autonomic-dysfunction-following-bariatric-surgery-a-retrospective-study-and-review-of-the-literature
#20
REVIEW
Vanessa Ponnusamy, Andrew P Owens, Sanjay Purkayastha, Valeria Iodice, Christopher J Mathias
The prevalence and costs of the obesity epidemic and obesity-related conditions, including diabetes mellitus, is consistently increasing worldwide. Bariatric medicine is attempting to address this with weight loss and exercise programmes, and with increasing frequency, various forms of bariatric surgery. There has been considerable success reported after bariatric surgery but not without. We describe 14 patients with orthostatic intolerance (OI) post bariatric surgery. We report on OI (postural dizziness, palpitations and fainting), the results of cardiovascular autonomic testing and the associated and/or causative findings as well as reviewing the literature to consider the possible mechanisms...
July 2016: Autonomic Neuroscience: Basic & Clinical
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