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Bariatric medicine

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https://www.readbyqxmd.com/read/29378901/gut-as-an-emerging-organ-for-the-treatment-of-diabetes
#1
Martin Haluzik, Helena Kratochvílová, Denisa Haluzíková, Milos Mraz
Increasing worldwide prevalence of type 2 diabetes mellitus and its accompanying pathologies such as obesity, arterial hypertension and dyslipidemia represents one of the most important challenges of current medicine. Despite intensive efforts, high percentage of patients with type 2 diabetes does not achieve treatment goals and struggle with increasing body weight and poor glucose control. While novel classes of antidiabetic medications such as incretin-based therapies and gliflozins have some favorable characteristics compared to older antidiabetics, the only therapeutic option shown to substantially modify the progression of diabetes or to achieve its remission is bariatric surgery...
January 29, 2018: Journal of Endocrinology
https://www.readbyqxmd.com/read/29367876/insulinoma-presenting-with-post-prandial-hypoglycaemia-following-fundoplication
#2
Sarah Y Qian, Matthew J L Hare, Alan Pham, Duncan J Topliss
Insulinomas are rare neuroendocrine tumours that classically present with fasting hypoglycaemia. This case report discusses an uncommon and challenging case of insulinoma soon after upper gastrointestinal surgery. A 63-year-old man presented with 6 months of post-prandial hypoglycaemia beginning after a laparoscopic revision of Toupet fundoplication. Hyperinsulinaemic hypoglycaemia was confirmed during a spontaneous episode and in a mixed-meal test. Localisation studies including magnetic resonance imaging (MRI), endoscopic ultrasound (EUS) and gallium dotatate positron emission tomography ( 68 Ga Dotatate PET) were consistent with a small insulinoma in the mid-body of the pancreas...
2018: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/29341525/-general-internal-medicine%C3%A2-2017-scientific-breakthroughs-in-ambulatory-care
#3
Alexandre Gouveia, Lionel De Alencastro, Yvonne Fierz, Lionel Koehli, Alexandre Béguelin, Olivier Pasche, Kevin Selby, Patrick Bodenmann
Bariatric surgery improves glycemic control in obese patients with diabetes type 2. Dual antiplatelet therapy can be maintained beyond 12 months after a myocardial infarction. Levothyroxine is not beneficial among patients ≥ 65 years that have subclinical hypothyroidism. Prophylactic anticoagulation in lower limb immobilisation should be reserved only for patients with a high risk of thromboembolism. A diagnosis of asthma should be initially confirmed by a spirometry if clinically suspected. A proton pump inhibitor is indicated for patients ≥ 65 years that are treated with aspirin...
January 17, 2018: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29306650/common-weight-loss-procedures-and-their-complications
#4
REVIEW
Maria S Altieri, Brian Wright, Andrew Peredo, Aurora D Pryor
BACKGROUND: As the number of obese patients in the United States continues to grow, there is a parallel increase in the number of bariatric surgery patients. A quarter of these patients will return to the Emergency Department (ED) within the first two years of the index procedure. OBJECTIVE: An understanding of the most common bariatric procedures and their related complications will greatly aide the Emergency Medicine physician in the care of these patients. DISCUSSION: Abdominal pain is the most common reason for bariatric patients to present to the ED and can represent a diagnostic challenge to EM physicians...
December 2, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29285942/-non-alcoholic-fatty-liver-disease-as-a-component-of-the-metabolic-syndrome-and-its-causal-correlations-with-other-extrahepatic-diseases
#5
Tamás Halmos, Ilona Suba
Non-alcoholic fatty liver disease is the most common non-infectious chronic liver-disease in our age, and is a spectrum of all the diseases associated with increased fat accumulation in the hepatocytes. Its development is promoted by sedentary life-style, over-feeding, and certain genetic predisposition. Prevalence in the adult population, even in Hungary is ~30%. In a part of cases, this disease may pass into non-alcoholic steatohepatitis, later into fibrosis, rarely into primary hepatocellular cancer. Fatty liver is closely and bidirectionally related to the metabolic syndrome and type 2 diabetes, and nowadays there is a general consensus that fatty liver is the hepatic manifestation of the metabolic sycndrome...
December 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/29277390/guiding-the-non-bariatric-surgeon-through-complications-of-bariatric-surgery
#6
N Contival, B Menahem, T Gautier, Y Le Roux, A Alves
Complications in bariatric surgery are varied; they are severe at times but infrequent. They may be surgical or non-surgical, and may occur early or late. The goal of this systematic review is to inform and help the attending physician, the emergency physician and the non-bariatric surgeon who may be called upon to manage surgical complications that arise after adjustable gastric band (AGB), sleeve gastrectomy (SG), or gastric bypass (GBP). Data from evidence-based medicine were extracted from the literature by a review of the Medline database and also of the most recent recommendations of the learned societies implicated...
December 22, 2017: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/29212336/-new-directions-in-bariatric-and-metabolic-surgery
#7
Martin Fried
Czech Republic may be counted among the leading European Countries in regards of the level of delivered high quality multidisciplinary care in treatment of obesity and obesity related metabolic diseases. The 1st Faculty of Medicine (Charles University) and the Faculty General Hospital in Prague played the most important role in the development of bariatric and metabolic surgery in the Czech Republic. pCzech bariatric surgery achieves great successes both on national and international levels. Just to mention some of them: M...
2017: Casopís Lékar̆ů C̆eských
https://www.readbyqxmd.com/read/29132230/combination-therapy-for-obesity
#8
John Ph Wilding
Obesity is a chronic disease with serious consequences and although lifestyle modification is considered first line treatment, it is often ineffective, especially in the long term. Relatively few people with obesity will undergo the most effective currently available treatment of bariatric surgery. Pharmacotherapy can bridge the gap between lifestyle modification and surgery, but many monotherapies have only modest efficacy or require high doses with unacceptable side effects. As with many other areas of medicine, combination therapy is now becoming accepted as a way of optimising efficacy for weight management, whilst minimising adverse effects...
November 2017: Journal of Psychopharmacology
https://www.readbyqxmd.com/read/29072080/gettemo-position-statement-on-bariatric-endoscopic-techniques-as-a-voluntary-medicine
#9
Javier Nebreda Durán, Eduard Espinet Coll
Dear Editor, We would like to clarify certain points in the article by C. Dolz et al. entitled "Informed consent in digestive endoscopy - Patient information, endoscopist protection", more specifically regarding the section "Obesity treatments". First, we want to congratulate the authors for their highly relevant yearlong research of the medico-legal aspects of Spanish endoscopy and for sharing their knowledge with endoscopists on a national level. With regard to the endoscopic management of obesity, we consider that the informed consent process should be even more comprehensive than that with other endoscopic techniques...
October 23, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/29058238/bariatric-surgery-resistance-using-preoperative-lifestyle-medicine-and-or-pharmacology-for-metabolic-responsiveness
#10
REVIEW
Nicole M Gilbertson, Andrew S Paisley, Sibylle Kranz, Arthur Weltman, Jennifer L Kirby, Peter T Hallowell, Steven K Malin
Bariatric surgery is an effective and durable treatment for individuals with obesity and its associated comorbidities. However, not all patients meet weight loss and/or cardiometabolic goals following bariatric surgery, suggesting that some people are bariatric surgery resistant. The reason for this resistance is unclear, but potential factors, such as adiposity-derived inflammation, insulin resistance, hyperglycemia, and aerobic fitness prior to surgery, have been related to blunted surgery responsiveness...
October 23, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/29027993/current-pharmacotherapy-for-obesity
#11
REVIEW
Gitanjali Srivastava, Caroline M Apovian
More than one-third of adults in the USA have obesity, which causes, exacerbates or adversely impacts numerous medical comorbidities, including diabetes mellitus and cardiovascular disease. Despite intensive lifestyle modifications, the disease severity warrants further aggressive intervention, including pharmacotherapy, medical devices and bariatric surgery. Noninvasive anti-obesity drugs have thus now resurfaced as targeted adjunctive therapeutic approaches to intensive lifestyle intervention, bridging the gap between lifestyle and bariatric surgery...
October 13, 2017: Nature Reviews. Endocrinology
https://www.readbyqxmd.com/read/28976454/the-gut-and-its-microbiome-as-related-to-central-nervous-system-functioning-and-psychological-well-being-introduction-to-the-special-issue-of-psychosomatic-medicine
#12
Emeran A Mayer, Elaine Y Hsiao
Accumulating evidence indicates bidirectional associations between the brain and the gut microbiome with both top-down and bottom-up processes. This article describes new developments in brain-gut interactions as an introduction to a special issue of Psychosomatic Medicine, based on a joint symposium of the American Psychosomatic Society and the American Gastroenterological Association. Literature review articles indicate that several psychiatric disorders are associated with altered gut microbiota, whereas evidence linking functional gastrointestinal disorders and dysbiosis has not been firmly established...
October 2017: Psychosomatic Medicine
https://www.readbyqxmd.com/read/28935287/past-present-and-future-of-pharmacotherapy-for-obesity
#13
David Benaiges, Juan Pedro-Botet, Juana A Flores-Le Roux, Elisenda Climent, Albert Goday
Conventional treatment for obesity with diet, exercise and bariatric surgery has limitations; thus, it is necessary to have pharmacological tools. In the past, different drugs were marketed that were withdrawn due to safety problems. There are currently 3 drugs approved by the European Medicines Agency (EMA) and the Food and Drug Administration (FDA) for obesity therapy (orlistat, combination of bupropion and delayed-release naltrexone and liraglutide) and two more only authorized by FDA (lorcaserin and the combination of phentermine and extended release topiramate)...
September 18, 2017: Clínica e Investigación en Arteriosclerosis
https://www.readbyqxmd.com/read/28780622/outcomes-after-bariatric-surgery-according-to-large-databases-a-systematic-review
#14
Andrea Balla, Gabriela Batista Rodríguez, Santiago Corradetti, Carmen Balagué, Sonia Fernández-Ananín, Eduard M Targarona
PURPOSE: The rapid development of technological tools to record data allows storage of enormous datasets, often termed "big data". In the USA, three large databases have been developed to store data regarding surgical outcomes: the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP), the Healthcare Cost and Utilization Project (HCUP) National Inpatient Sample (NIS) and the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP)...
August 5, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28739091/laparoscopic-sleeve-gastrectomy-effect-on-long-term-remission-for-morbidly-obese-patients-with-type-2-diabetes-at-5-year-follow-up
#15
Marius Nedelcu, Marcelo Loureiro, Mehdi Skalli, Florence Galtier, Audrey Jaussent, Melanie Deloze, Michel Gagner, Jean Michel Fabre, David Nocca
BACKGROUND: In the short-term, laparoscopic sleeve gastrectomy has been shown to be effective for the treatment of the type 2 diabetes in patients with severe obesity. There are few data with greater follow-up. Our aim was to evaluate the results of laparoscopic sleeve gastrectomy on the control of type 2 diabetes in patients with severe obesity at 5 years at the University Hospital, France. METHODS: From a total of 355 patients with severe obesity operated between January 2006 and June 2010, 52 (15%) had a diagnosis of type 2 diabetes before undergoing laparoscopic sleeve gastrectomy...
October 2017: Surgery
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
#16
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])...
October 2017: Diabetologia
https://www.readbyqxmd.com/read/28733905/glp-1-glucagon-receptor-co-agonism-for-treatment-of-obesity
#17
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...
October 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
#18
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
#19
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...
September 2017: Journal of Thoracic Imaging
https://www.readbyqxmd.com/read/28620542/preconception-consultations-with-maternal-fetal-medicine-for-obese-women-a-retrospective-chart-review
#20
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
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