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Bariatric medicine

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https://www.readbyqxmd.com/read/29212336/-new-directions-in-bariatric-and-metabolic-surgery
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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...
October 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28488092/laparoscopic-gastric-banding-game-over
#16
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
#17
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
#18
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. Physiological-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
#19
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
#20
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
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