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Bariatric medicine

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https://www.readbyqxmd.com/read/28733906/the-advanced-diarem-score-improves-prediction-of-diabetes-remission-1%C3%A2-year-post-roux-en-y-gastric-bypass
#1
Judith Aron-Wisnewsky, Nataliya Sokolovska, Yuejun Liu, Doron S Comaneshter, Shlomo Vinker, Tal Pecht, Christine Poitou, Jean-Michel Oppert, Jean-Luc Bouillot, Laurent Genser, Dror Dicker, Jean-Daniel Zucker, Assaf Rudich, Karine Clément
AIMS/HYPOTHESIS: Not all people with type 2 diabetes who undergo bariatric surgery achieve diabetes remission. Thus it is critical to develop methods for predicting outcomes that are applicable for clinical practice. The DiaRem score is relevant for predicting diabetes remission post-Roux-en-Y gastric bypass (RYGB), but it is not accurate for all individuals across the entire spectrum of scores. We aimed to develop an improved scoring system for predicting diabetes remission following RYGB (the Advanced-DiaRem [Ad-DiaRem])...
July 21, 2017: Diabetologia
https://www.readbyqxmd.com/read/28733905/glp-1-glucagon-receptor-co-agonism-for-treatment-of-obesity
#2
REVIEW
Miguel A Sánchez-Garrido, Sara J Brandt, Christoffer Clemmensen, Timo D Müller, Richard D DiMarchi, Matthias H Tschöp
Over a relatively short period, obesity and type 2 diabetes have come to represent a large medical and economic burden to global societies. The epidemic rise in the prevalence of obesity has metabolic consequences and is paralleled by an increased occurrence of other diseases, such as diabetes, cancer and cardiovascular complications. Together, obesity and type 2 diabetes constitute one of the more preventable causes of premature death and the identification of novel, safe and effective anti-obesity drugs is of utmost importance...
July 21, 2017: Diabetologia
https://www.readbyqxmd.com/read/28725962/optimal-positioning-of-the-nipple-areola-complex-in-men-using-the-mohrenheim-estimated-tangential-tracking-line-mett-line-an-intuitive-approach
#3
Tobias R Mett, Nicco Krezdorn, Rosalia Luketina, Maria K Boyce, Helga Henseler, Ramin Ipaktchi, Peter M Vogt
INTRODUCTION: The reconstruction of the body shape after post-bariatric surgery or high-grade gynecomastia involves, besides skin tightening, the repositioning of anatomical, apparent landmarks. The surgeon usually defines these during the preoperative planning. In particular, the positions of the nipple-areola complexes (NAC) should contribute to the gender-appropriate appearance. While in the female breast numerous methods have been developed to determine the optimal position of the NACs, there are only a few, metric and often impractical algorithms for positioning the nipples and areoles in the male...
July 19, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28622165/thoracic-imaging-after-bariatric-surgery
#4
Samuel J Galgano, Sushilkumar K Sonavane, Rupan Sanyal, Satinder P Singh, Christine O Menias, Sanjeev Bhalla
Obesity and its association with long-term health problems constitutes one of the major challenges in medicine. Though diet regulation and exercise are the primary treatment strategies, surgery is the most reliable long-term solution. Although bariatric surgical complications continue to decline, prompt recognition is essential to optimize patient outcomes. Despite their relative rarity, it is important to recognize thoracic complications, as several of these can result in severe morbidity and mortality. This article describes common bariatric surgical procedures performed, their expected postoperative appearances, and intrathoracic complications...
June 15, 2017: Journal of Thoracic Imaging
https://www.readbyqxmd.com/read/28620542/preconception-consultations-with-maternal-fetal-medicine-for-obese-women-a-retrospective-chart-review
#5
Charlotte M Page, Elizabeth S Ginsburg, Randi H Goldman, Chloe A Zera
BACKGROUND: Obesity is associated with impaired fertility and pregnancy complications, and preconception weight loss may improve some of these outcomes. The purpose of this study was to evaluate the quality and effectiveness of Maternal Fetal Medicine (MFM) preconception consults for obese women. METHODS: We performed a retrospective chart review examining 162 consults at an academic medical center from 2008 to 2014. The main outcome measures included consultation content - e...
2017: Fertility Research and Practice
https://www.readbyqxmd.com/read/28567473/body-contouring-after-massive-weight-loss-a-personal-integrated-approach
#6
Manuel Maia, Diana Costa Santos
BACKGROUND: After massive weight loss, patients typically presented with skin redundancy, which causes enormous esthetic, physical, medical and psychological problems. The growing number of patients with these sequelae triggered an increase in the search for body contouring procedures, which in turn produced an important development in the post-bariatric reconstructive surgery. METHODS: The author describes the principles of a personal approach in post-bariatric reconstructive surgery...
May 31, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28488092/laparoscopic-gastric-banding-game-over
#7
Jerome Dargent
The laparoscopic adjustable gastric banding (LAGB) procedure has been used in bariatric surgery for over 20 years, and despite its initial success, it has been most often criticized for causing adverse effects, lacking efficacy, and frequently requiring revision. Evidence-based medicine supports these criticisms, and the LAGB is no longer considered by most bariatric surgeons worldwide to be a standard operation. While we have to admit that its associated food tolerance issues and variable efficacy make the LAGB less desirable for most patients, time will tell whether the current armamentarium of bariatric procedures are still too aggressive and new safer procedures still need to be developed...
August 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28474243/-preoperative-fasting-period-of-fluids-in-bariatric-surgery
#8
P Simon, U-C Pietsch, R Oesemann, A Dietrich, H Wrigge
BACKROUND: Aspiration of stomach content is a severe complication during general anaesthesia. The DGAI (German Society for Anesthesiology and Intensive Care Medicine) guidelines recommend a fasting period for liquids of 2 h, with a maximum of 400 ml. Preoperative fasting can affect the patients' recovery after surgery due to insulin resistance and higher protein catabolism as a response to surgical stress. OBJECTIVES: The aim of the study was to compare a liberal fasting regimen consisting of up to 1000 ml of liquids until 2 h before surgery with the DGAI recommendation...
July 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28456730/usefulness-of-pbpk-modeling-in-incorporation-of-clinical-conditions-in-personalized-medicine
#9
REVIEW
Niloufar Marsousi, Jules A Desmeules, Serge Rudaz, Youssef Daali
Personalized medicine aims to determine the most adequate treatment and dose regimen to obtain the maximum efficacy and minimum side effect by taking into account patients' characteristics. For numerous reasons one being ethical and methodological hurdles in including specific populations in clinical trials, innovative methods for optimization of drugs safety and efficacy in such patients have received increasing interest recently. Physiologically-Based PharmacoKinetic (PBPK) modeling has emerged as a promising approach in designing adequate clinical trials and quantifying anticipated changes in unknown clinical situations...
April 26, 2017: Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28292403/intragastric-balloons-in-clinical-practice
#10
REVIEW
Marianna Papademetriou, Violeta Popov
Cost-effective therapies to address the growing epidemic of obesity are a leading priority in modern medicine. Intragastric balloons (IGBs) are one such option, with increased effectiveness compared with pharmacotherapy and lifestyle and a lower rate of adverse events than bariatric surgery. IGBs are endoscopically placed or swallowed space-occupying devices in the stomach. Three IGB systems were approved in 2015 to 2016 by the Food and Drug Administration for use in the United States, with more devices nearing approval...
April 2017: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/28275047/the-new-biology-and-pharmacology-of-glucagon
#11
REVIEW
T D Müller, B Finan, C Clemmensen, R D DiMarchi, M H Tschöp
In the last two decades we have witnessed sizable progress in defining the role of gastrointestinal signals in the control of glucose and energy homeostasis. Specifically, the molecular basis of the huge metabolic benefits in bariatric surgery is emerging while novel incretin-based medicines based on endogenous hormones such as glucagon-like peptide 1 and pancreas-derived amylin are improving diabetes management. These and related developments have fostered the discovery of novel insights into endocrine control of systemic metabolism, and in particular a deeper understanding of the importance of communication across vital organs, and specifically the gut-brain-pancreas-liver network...
April 2017: Physiological Reviews
https://www.readbyqxmd.com/read/28242319/white-paper-aga-power-practice-guide-on-obesity-and%C3%A2-weight-management-education-and-resources
#12
REVIEW
Andres Acosta, Sarah Streett, Mathew D Kroh, Lawrence J Cheskin, Katherine H Saunders, Marina Kurian, Marsha Schofield, Sarah E Barlow, Louis Aronne
The epidemic of obesity continues at alarming rates, with a high burden to our economy and society. The American Gastroenterological Association understands the importance of embracing obesity as a chronic, relapsing disease and supports a multidisciplinary approach to the management of obesity. Because gastrointestinal disorders resulting from obesity are more frequent and often present sooner than type 2 diabetes mellitus and cardiovascular disease, gastroenterologists have an opportunity to address obesity and provide an effective therapy early...
May 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28220219/-the-way-from-cost-approval-to-bariatric-surgery-analysis-of-resource-utilization-in-a%C3%A2-maximum-care-hospital
#13
F Nickel, C Tapking, U Zech, K Huennemeyer, A T Billeter, P C Müller, H G Kenngott, B P Müller-Stich, L Fischer
BACKGROUND: Morbid obesity is a medical and economic challenge. Patients who have the indications for bariatric surgery face a long way from the first visit until surgery and a high utilization of resources is required. OBJECTIVES: The present study aimed to evaluate labor costs and labor time required to supervise obese patients from their first visit until preparation of a bariatric report to ask for cost acceptance of bariatric surgery from their health insurance...
July 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28204931/postero-inferior-pedicle-surgical-technique-for-the-treatment-of-grade-iii-gynecomastia
#14
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...
June 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28061687/new-targets-for-drug-treatment-of-obesity
#15
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
#16
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
#17
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...
February 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28032161/psychological-and-psychiatric-traits-in-post-bariatric-patients-asking-for-body-contouring-surgery
#18
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
#19
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
#20
REVIEW
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
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