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Bariatric interventions

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https://www.readbyqxmd.com/read/29785665/why-weight-an-analytic-review-of-obesity-management-diabetes-prevention-and-cardiovascular-risk-reduction
#1
REVIEW
L I Igel, K H Saunders, J J Fins
PURPOSE OF REVIEW: In this review, we examine one of the ironies of American health care-that we pay more for disease management than disease prevention. Instead of preventing type 2 diabetes (T2DM) by treating its precursor, obesity, we fail to provide sufficient insurance coverage for weight management only to fund the more costly burden of overt T2DM. RECENT FINDINGS: There is a vital need for expanded insurance coverage to help foster a weight-centric approach to T2DM management...
May 21, 2018: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/29780358/sex-and-gender-differences-in-prevention-of-type-2-diabetes
#2
REVIEW
Jürgen Harreiter, Alexandra Kautzky-Willer
Lifestyle intervention programs are effective in the prevention of type 2 diabetes mellitus (T2DM) in high risk populations. However, most studies only give limited information about the influence of sex and/or gender effectiveness of these interventions. So far, similar outcome was reported for diabetes progression and weight loss. Nevertheless, long-term data on cardiovascular outcome are sparse but favoring women regarding all-cause and cardiovascular mortality. In both men and women, sex hormone imbalances and reproductive disorders are associated with a higher risk of T2DM development...
2018: Frontiers in Endocrinology
https://www.readbyqxmd.com/read/29773763/initial-experience-with-endoscopic-sleeve-gastroplasty-in-poland
#3
Aleksander Sowier, Przemysław Pyda, Anna-Maria Borucka, Sebastian Sowier, Jacek Białecki, Joanna Kapturzak, Stanisław Wójtowicz
INTRODUCTION: Obesity is becoming one of the major public health problems. Bariatric procedures are considered the most effective methods of treating this condition but they are costly and entail a high risk of complications. Thus, there is a need to look for better bariatric treatment solutions. One of the newest, highly promising bariatric methods is endoscopic sleeve gastroplasty (ESG), which is comparably effective to other bariatric procedures in terms of weight loss but at the same time it is much less invasive...
April 30, 2018: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/29769703/preoperative-thyroid-function-and-weight-loss-after-bariatric-surgery
#4
João Sérgio Neves, Pedro Souteiro, Sofia Castro Oliveira, Jorge Pedro, Daniela Magalhães, Vanessa Guerreiro, Maria Manuel Costa, Rita Bettencourt-Silva, Ana Cristina Santos, Joana Queirós, Ana Varela, Paula Freitas, Davide Carvalho
Thyroid function has an important role on body weight regulation. However, the impact of thyroid function on weight loss after bariatric surgery is still largely unknown. We evaluated the association between preoperative thyroid function and the excess weight loss 1 year after surgery, in 641 patients with morbid obesity who underwent bariatric surgery. Patients with a history of thyroid disease, treatment with thyroid hormone or antithyroid drugs and those with preoperative evaluation consistent with overt hypothyroidism or hyperthyroidism were excluded...
May 16, 2018: International Journal of Obesity: Journal of the International Association for the Study of Obesity
https://www.readbyqxmd.com/read/29766353/how-ethical-is-our-current-delivery-of-care-to-patients-with-severe-and-complicated-obesity
#5
REVIEW
Hilary Craig, Carel le Roux, Fiona Keogh, Francis M Finucane
Despite overwhelming evidence that bariatric interventions reduce morbidity and mortality and are cost-effective, access for affected patients is limited. We sought to describe the extent to which health policy makers and publically funded health services have an ethical obligation to provide bariatric care. We conducted a narrative review of the literature pertaining to the efficacy, safety, and cost-effectiveness of bariatric surgical interventions, in the context of the core principles of medical ethics...
May 15, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29764322/biting-the-hands-that-feed-the-alligators-a-case-study-in-morbid-obesity-extremes-end-of-life-care-and-prohibitions-on-harming-and-accelerating-the-end-of-life
#6
Michael J Malinowski
Obesity, recognized as a disease in the U.S. and at times as a terminal illness due to associated medical complications, is an American epidemic according to the Centers for Disease Control and Prevention ("CDC"), American Heart Association ("AHA"), and other authorities. More than one third of Americans (39.8% of adults and 18.5% of children) are medically obese. This article focuses on cases of "extreme morbid obesity" ("EMO")-situations in which death is imminent without aggressive medical interventions, and bariatric surgery is the only treatment option with a realistic possibility of success...
March 2018: American Journal of Law & Medicine
https://www.readbyqxmd.com/read/29761253/endoscopic-interventions-in-the-treatment-of-obesity-and-diabetes
#7
REVIEW
A Ruban, A Uthayakumar, H Ashrafian, J P Teare
Obesity is a global health problem which is on the rise and is strongly associated with the development of type 2 diabetes and other comorbidities. Bariatric surgery is now an established treatment for both these conditions, leading to impressive results in weight loss and glycemic control. More recently, we have seen the development of various endoscopic devices as potential alternatives or adjuncts to bariatric surgery. In this state-of-the-art review, we outline the current landscape of endoscopic treatments available for the management of both obesity and diabetes, including the clinical evidence supporting their use, efficacy, safety, and potential mechanisms of action...
May 14, 2018: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29758052/decreased-circulating-t-regulatory-lymphocytes-in-obese-patients-undergoing-bariatric-surgery
#8
Claudia Agabiti-Rosei, Valentina Trapletti, Silvia Piantoni, Paolo Airò, Angela Tincani, Carolina De Ciuceis, Claudia Rossini, Francesco Mittempergher, Amin Titi, Nazario Portolani, Stefano Caletti, Maria Antonietta Coschignano, Enzo Porteri, Guido A M Tiberio, Paola Pileri, Leonardo Solaini, Rajesh Kumar, Silvia Ministrini, Enrico Agabiti Rosei, Damiano Rizzoni
OBJECTIVE: It has been previously demonstrated that T lymphocytes may be involved in the development of hypertension and microvascular remodeling, and that circulating T effector lymphocytes may be increased in hypertension. In particular, Th1 and Th 17 lymphocytes may contribute to the progression of hypertension and microvascular damage while T-regulatory (Treg) lymphocytes seem to be protective in this regard. However, no data is available about patients with severe obesity, in which pronounced microvascular alterations were observed...
2018: PloS One
https://www.readbyqxmd.com/read/29752665/microcirculatory-improvement-induced-by-laparoscopic-sleeve-gastrectomy-is-related-to-insulin-sensitivity-retrieval
#9
Stefano Ministrini, Chiara Fattori, Maria Anastasia Ricci, Vanessa Bianconi, Rita Paltriccia, Marcello Boni, Maria Teresa Paganelli, Gaetano Vaudo, Graziana Lupattelli, Leonella Pasqualini
AIMS: Microvascular dysfunction is a potential factor explaining the association of obesity, insulin resistance, and vascular damage in morbidly obese subjects. The purpose of the study was to evaluate possible determinants of microcirculatory improvement 1 year after laparoscopic sleeve gastrectomy (LSG) intervention. METHODS: Thirty-seven morbidly obese subjects eligible for bariatric surgery were included in the study. Post-occlusive reactive hyperemia (PORH) of the forearm skin was measured as area of hyperemia (AH) by laser-Doppler flowmetry before LSG and after a 1-year follow-up...
May 12, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29748126/feeding-the-gut-after-revisional-bariatric-surgery-the-fate-of-126-enteral-access-tubes
#10
Andrew T Strong, Hana Fayazzadeh, Gautam Sharma, Kevin El-Hayek, Matthew Kroh, John Rodriguez
BACKGROUND: Revisional bariatric surgery (RBS) is associated with higher complication rates compared with primary bariatric surgery. Feeding tubes (FTs), including gastrostomy and jejunostomy tubes placed during RBS, may serve as a safety net to provide nutrition when oral intake is contraindicated or limited; however, FTs in this setting have not been well investigated. OBJECTIVES: This study aims to determine complications, use, and duration of FTs placed during RBS...
March 9, 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/29743040/a-dissonance-based-intervention-for-women-post-roux-en-y-gastric-bypass-surgery-aiming-at-improving-quality-of-life-and-physical-activity-24-months-after-surgery-study-protocol-for-a-randomized-controlled-trial
#11
Fanny Sellberg, Sofie Possmark, Ata Ghaderi, Erik Näslund, Mikaela Willmer, Per Tynelius, Anders Thorell, Magnus Sundbom, Joanna Uddén, Eva Szabo, Daniel Berglind
BACKGROUND: Roux-en-Y gastric bypass (RYGB) surgery is the most common bariatric procedure in Sweden and results in substantial weight loss. Approximately one year post-surgery weight regain for these patient are common, followed by a decrease in health related quality of life (HRQoL) and physical activity (PA). Our aim is to investigate the effects of a dissonance-based intervention on HRQoL, PA and other health-related behaviors in female RYGB patients 24 months after surgery. We are not aware of any previous RCT that has investigated the effects of a similar intervention targeting health behaviors after RYGB...
May 9, 2018: BMC Surgery
https://www.readbyqxmd.com/read/29732716/treatment-options-for-severe-obesity-in-the-pediatric-population-current-limitations-and-future-opportunities
#12
REVIEW
Justin R Ryder, Claudia K Fox, Aaron S Kelly
OBJECTIVE: Severe obesity is the only obesity classification increasing in prevalence among children and adolescents. Treatment options that produce meaningful and sustained weight loss and comorbidity resolution are urgently needed. METHODS: The purpose of this review is to provide a brief overview of the current treatment options for pediatric severe obesity and offer suggestions regarding future opportunities for accelerating the development and evaluation of innovative treatment strategies...
May 7, 2018: Obesity
https://www.readbyqxmd.com/read/29731022/prediabetes
#13
REVIEW
Aditya K Khetan, Sanjay Rajagopalan
The burden of diabetes is expected to rise from 415 million individuals in 2015 to 642 million individuals by 2040. Most individuals pass through a phase of prediabetes before developing full-blown diabetes. Insulin resistance, impaired incretin action, and insulin hypersecretion are central to the pathophysiology of prediabetes. Individuals older than 40 years of age and other high-risk individuals should be screened for diabetes with fasting plasma glucose and/or hemoglobin A1c. For those diagnosed with prediabetes, the goal of treatment should be restoring euglycemia, because there are data showing that restoring normoglycemia during prediabetes and early diabetes can produce lasting remission...
May 2018: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/29705834/improved-magnesium-levels-in-morbidly-obese-diabetic-and-non-diabetic-patients-after-modest-weight-loss
#14
Solveig Meyer Mikalsen, Anne-Lise Bjørke-Monsen, Jon Elling Whist, Jan Aaseth
Serum magnesium (Mg) is reported to be reduced in individuals with obesity, hypertension, and diabetes mellitus and has been suggested as a marker for metabolic syndrome. We have studied changes in serum Mg concentrations in a group of obese patients (n = 92) with and without diabetes mellitus after weight loss induced by dieting and bariatric surgery. At inclusion, 11% (10/92) of the population had severe Mg deficiency (< 0.75 mmol/L) and median serum Mg was lower in diabetic (n = 20) compared to non-diabetic (n = 72) patients (p = 0...
April 28, 2018: Biological Trace Element Research
https://www.readbyqxmd.com/read/29699916/posttranslational-modification-of-proprotein-convertase-subtilisin-kexin-type-9-is-differentially-regulated-in-response-to-distinct-cardiometabolic-treatments-as-revealed-by-targeted-proteomics
#15
Marie-Soleil Gauthier, Zuhier Awan, Annie Bouchard, Josée Champagne, Sylvain Tessier, Denis Faubert, Katherine Chabot, Pierre Y Garneau, Rémi Rabasa-Lhoret, Nabil G Seidah, Paul M Ridker, Jacques Genest, Benoit Coulombe
BACKGROUND: The proprotein convertase subtilisin/kexin type 9 (PCSK9) is a secreted protein that interacts with the low-density lipoprotein (LDL) receptor at the surface of hepatocytes to regulate circulating LDL cholesterol levels. High circulating PCSK9 levels have been associated with elevated LDL cholesterol. Recently, the Food and Drug Administration of the United States approved new LDL cholesterol-lowering drugs that specifically target the inhibition of PCSK9. Similar to most human proteins, PCSK9 exists in multiple forms as it is the target of posttranslational modifications (PTMs) such as proteolytic cleavage, phosphorylation, and others, which can affect its biological activity...
April 3, 2018: Journal of Clinical Lipidology
https://www.readbyqxmd.com/read/29697537/bariatric-surgery-and-gene-expression-in-the-gut
#16
Priscila Sala, M L Corrêa-Giannella, Dan L Waitzberg
PURPOSE OF REVIEW: The current review provides an overview of recent literature on new findings related to bariatric surgery and gut gene expression. RECENT FINDINGS: Bariatric surgery modulates the expression of intestinal genes. Experimental and clinical investigations have demonstrated the association of gut rearrangement with changes in intestinal expression of genes related to glucose metabolism. Recent data suggest that bariatric surgery also affects expression of genes belonging to other pathways, including nutrient transporters and metabolism of vitamin B12, decreasing pathway-encoding genes that may contribute to vitamin B12 deficiency in the postoperative period...
April 24, 2018: Current Opinion in Clinical Nutrition and Metabolic Care
https://www.readbyqxmd.com/read/29696414/management-of-symptomatic-knee-osteoarthritis-in-obesity-a-survey-of-general-practitioners-opinions-and-practice
#17
Daniel Hill, Andrew Boyd, Tim Board
INTRODUCTION: The aim of this survey was to explore general practitioners' opinions and practices regarding the management of symptomatic knee osteoarthritis in obesity. METHODS: Questionnaires were sent electronically to members of the Royal College of General Practitioners specialty interest groups: GPs with an Interest in Nutrition Group and the Physical Activity and Life Style group. RESULTS: The response rate was 75% (142/190). The majority stated weight loss should be the first-line treatment...
April 25, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/29690917/health-consequences-for-mother-and-baby-of-substantial-pre-conception-weight-loss-in-obese-women-study-protocol-for-a-randomized-controlled-trial
#18
Sarah Price, Alison Nankervis, Michael Permezel, Luke Prendergast, Priya Sumithran, Joseph Proietto
BACKGROUND: Current guidelines for the management of obesity in women planning pregnancy suggest lifestyle modification before conception. However, there is little evidence that lifestyle modification alters pregnancy outcomes. Bariatric surgery results in significant weight loss. This appears to reduce the risk of adverse pregnancy outcomes for the mother but may increase the risk of adverse outcomes for the infant. In order to reduce the risks of obesity-related adverse pregnancy outcomes for both mother and offspring, alternative approaches to the management of obesity in women planning pregnancy are needed...
April 24, 2018: Trials
https://www.readbyqxmd.com/read/29689646/beyond-lifestyle-interventions-exploring-the-potential-of-anti-obesity-medications-in-the-uk
#19
REVIEW
J P H Wilding
In the UK, over one-quarter of the adult population have obesity (body mass index ≥30 kg m-2 ). This has major implications for patients' health and the National Health Service. Despite published studies showing that significant weight loss can be achieved and maintained in primary care, and guidance from the National Institute for Health and Care Excellence, weight management services are inconsistently implemented. This may be due primarily to workload and financial constraints. There is also a lack of belief that specialist weight management services and anti-obesity medications (AOMs) are a viable alternative to bariatric surgery for long-term maintenance of weight loss...
April 24, 2018: Clinical Obesity
https://www.readbyqxmd.com/read/29678127/a-health-economic-model-to-assess-the-cost-effectiveness-of-optifast-%C3%A2-for-the-treatment-of-obesity-in-usa
#20
Mark Nuijten, Agnieszka Marczewska, Krysmaru Araujo Torress, Bahareh Rasouli, Moreno Perugini
OBJECTIVES: Obesity is associated with high direct medical costs and indirect costs resulting from productivity loss. High prevalence of obesity generates a justified need to identify cost-effective weight loss approaches from a payer's perspective. Within the variety of weight management techniques, OPTIFAST® is a clinically recognized and scientifically proven total meal replacement Low Calorie Diet that provides meaningful results in terms of weight loss and reduction in comorbidities...
April 20, 2018: Journal of Medical Economics
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