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Bariatric medicine

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https://www.readbyqxmd.com/read/29730162/the-readmission-contradiction-toward-clarifying-common-misconceptions-about-bariatric-readmissions-and-quality-improvement
#1
Anthony Petrick, Shannon A Brindle, Ellen Vogels, James Dove, David Parker, Jon Gabrielsen
BACKGROUND: Efforts to improve quality in U.S. medicine have included reimbursement penalties for readmissions. OBJECTIVES: This study's first phase measured readmissions after initial bariatric surgery and analyzed surgical outcomes secondarily. The second phase aimed to identify nonclinical factors associated with bariatric readmissions. SETTING: Rural U.S. academic hospital. METHODS: This retrospective study analyzed a prospective database of patients undergoing initial Roux-en-Y gastric bypass or sleeve gastrectomy between May 1, 2007 and April 30, 2015...
February 21, 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/29725979/obesity-management-task-force-of-the-european-association-for-the-study-of-obesity-released-practical-recommendations-for-the-post-bariatric-surgery-medical-management
#2
Luca Busetto, Dror Dicker, Carmil Azran, Rachel L Batterham, Nathalie Farpour-Lambert, Martin Fried, Jøran Hjelmesæth, Johann Kinzl, Deborah R Leitner, Janine M Makaronidis, Karin Schindler, Hermann Toplak, Volkan Yumuk
Bariatric patients may face specific clinical problems after surgery, and multidisciplinary long-term follow-up is usually provided in specialized centers. However, physicians, obstetricians, dieticians, nurses, clinical pharmacists, midwives, and physical therapists not specifically trained in bariatric medicine may encounter post-bariatric patients with specific problems in their professional activity. This creates a growing need for dissemination of first level knowledge in the management of bariatric patients...
May 4, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29713650/application-of-metabolomics-to-study-effects-of-bariatric-surgery
#3
REVIEW
Paulina Samczuk, Michal Ciborowski, Adam Kretowski
Bariatric surgery was born in the 1950s at the University of Minnesota. From this time, it continues to evolve and, by the same token, gives new or better possibilities to treat not only obesity but also associated comorbidities. Metabolomics is also a relatively young science discipline, and similarly, it shows great potential for the comprehensive study of the dynamic alterations of the metabolome. It has been widely used in medicine, biology studies, biomarker discovery, and prognostic evaluations. Currently, several dozen metabolomics studies were performed to study the effects of bariatric surgery...
2018: Journal of Diabetes Research
https://www.readbyqxmd.com/read/29683555/clinical-obesity-services-in-public-hospitals-in-australia-a-position-statement-based-on-expert-consensus
#4
E Atlantis, N Kormas, K Samaras, P Fahey, P Sumithran, S Glastras, G Wittert, K Fusco, R Bishay, T Markovic, L Ding, K Williams, I Caterson, V Chikani, P Dugdale, J Dixon
We aimed to describe the current state of specialist obesity services for adults with clinically severe obesity in public hospitals in Australia, and to analyse the gap in resources based on expert consensus. We conducted two surveys to collect information about current and required specialist obesity services and resources using open-ended questionnaires. Organizational level data were sought from clinician expert representatives of specialist obesity services across Australia in 2017. Fifteen of 16 representatives of current services in New South Wales (n = 8), Queensland (n = 1), Victoria (n = 2), South Australia (n = 3), and the Australian Capital Territory (n = 1) provided data...
June 2018: Clinical Obesity
https://www.readbyqxmd.com/read/29608433/effects-of-education-and-health-literacy-on-postoperative-hospital-visits-in-bariatric-surgery
#5
Stephen T Mahoney, Dahlia Tawfik-Sexton, Paula D Strassle, Timothy M Farrell, Meredith C Duke
BACKGROUND: Hospital readmissions following bariatric surgery are high and it is necessary to identify modifiable risk factors to minimize this postoperative cost. We hypothesize that lower levels of education and health literacy are associated with increased risks of nonadherence, thus leading to increased emergency department (ED) visits and preventable readmissions postoperatively. METHODS: Bariatric surgery patients presenting between October 2015 and December 2016 were administered a preoperative questionnaire that measured education level and the Rapid Estimate of Adult Literacy in Medicine-Short Form (REALM-SF) health literacy test...
April 2, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29604606/exploring-student-nurses-attitudes-towards-those-who-are-obese-and-whether-these-attitudes-change-following-a-simulated-activity
#6
Janet Hunter, Karen Rawlings-Anderson, Tracy Lindsay, Tracey Bowden, Leanne M Aitken
BACKGROUND: As the prevalence of obesity increases worldwide the field of bariatric medicine has emerged, focussing on the causes, prevention and treatment of obesity. People who are obese regularly face bias from healthcare professionals, which can negativity impact on care delivery and patient outcomes. The introduction of bariatric empathy suits into simulated practice may enable student nurses to appreciate the needs of, and influence their attitudes towards, obese people. OBJECTIVES: The aim of this study was to explore student nurses' attitudes towards those who are obese and whether these attitudes change following a simulated activity...
June 2018: Nurse Education Today
https://www.readbyqxmd.com/read/29597235/practical-issues-in-vitamin-d-replacement
#7
Robert A Adler
Practical clinical guidance for vitamin D assessment and management relies on a strong evidence base, but unfortunately there are many deficiencies in our current knowledge. For the general population the Institute of Medicine recommendations are likely to provide adequate vitamin D levels without harms. Thus, most adults should ingest 600-800 IU (international units) in diet and supplements with up to 4,000 IU daily likely to be safe. In certain populations, such as those with osteoporosis or after bariatric surgery, it is important to know the levels of circulating 25-hydroxyvitamin D, but general screening has not been shown to improve health...
2018: Frontiers of Hormone Research
https://www.readbyqxmd.com/read/29561573/-centers-for-bariatric-medicine-why-and-how
#8
Jean-Marie Mégevand, Laurence Vignaux, Raffi Maghdessian, François Pralong
Obesity is a chronic, complex and relapsing disease. Because of this complexity, work up and follow up of affected patients implicate different specialists, working in synergy to diagnose and treat obesity and its complications. This follow up is specialized, and should be available in integrated centers of bariatric medicine offering all modalities of treatments with proven efficacy, whether medical, surgical or psychotherapeutical.
March 21, 2018: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29561192/provider-practice-habits-and-barriers-to-care-in-obesity-management-in-a-large-multicenter-health-system
#9
Rebecca Simon, Sharon W Lahiri
OBJECTIVE: To identify provider recommendations and barriers in obesity management in a multicenter academic health system with extensive weight-loss management resources. METHODS: A 26-question online survey was sent to attending physicians, trainees, and advanced practice providers in primary care specialties (internal medicine, family medicine, women's health) and endocrinology. RESULTS: The survey response rate was 26% (111/430). Of respondents, 50% were internal medicine, 24% family medicine, 16% women's health, and 9% endocrinology...
April 2018: Endocrine Practice
https://www.readbyqxmd.com/read/29464536/a-specialized-medical-management-program-to-address-post-operative-weight-regain-in-bariatric-patients
#10
Gitanjali Srivastava, Cynthia Buffington
INTRODUCTION: Although bariatric surgery results in massive weight loss, weight regain over time up to as much as 25% is not uncommon. Weight regain in this population often leads to long-term weight loss failure and non-compliance in clinical follow-up and program recommendations. METHODS: We analyzed early weight outcomes at 3 and 6 months of 48 bariatric patients referred to an individualized, multidisciplinary medical management program at the Center for Obesity Medicine (COM) to address weight regain in 2015 and compared to a group of matched non-bariatric patients...
February 20, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29378901/gut-as-an-emerging-organ-for-the-treatment-of-diabetes-focus-on-mechanism-of-action-of-bariatric-and-endoscopic-interventions
#11
REVIEW
Martin Haluzík, Helena Kratochvílová, Denisa Haluzíková, Miloš Mráz
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...
April 2018: Journal of Endocrinology
https://www.readbyqxmd.com/read/29367876/insulinoma-presenting-with-post-prandial-hypoglycaemia-following-fundoplication
#12
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
#13
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
#14
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...
March 2018: 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
#15
REVIEW
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
#16
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...
February 2018: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/29212336/-new-directions-in-bariatric-and-metabolic-surgery
#17
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
#18
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
#19
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...
December 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
#20
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...
December 2017: Obesity Surgery
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