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https://www.readbyqxmd.com/read/28817444/strategies-for-reducing-population-surgical-costs-in-medicare-local-referrals-to-low-cost-hospitals
#1
Hari Nathan, Jyothi R Thumma, Edward C Norton, Justin B Dimick
OBJECTIVE: We sought to assess hospital cost variation for elective inpatient surgical procedures within small geographic areas. SUMMARY BACKGROUND DATA: Previous studies have documented cost variation for inpatient surgical procedures on a national basis, suggesting opportunities for savings. Cost variation within small geographic areas is more relevant to policymakers, providers, and patients, but it has not been studied. METHODS: Using Medicare payment data, we identified elderly patients undergoing 1 of 7 elective inpatient surgical procedures during 2010-2012...
August 16, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28815388/guiding-patients-toward-the-appropriate-surgical-treatment-for-obesity-should-presurgery-psychological-correlates-influence-choice-between-roux-en-y-gastric-bypass-and-vertical-sleeve-gastrectomy
#2
Gretchen E Ames, Michael G Heckman, Nancy N Diehl, Dustin M Shepherd, Allison A Holgerson, Karen B Grothe, Todd A Kellogg, Steven P Bowers, Matthew M Clark
BACKGROUND: Helping patients determine which type of bariatric surgery, Roux-en-Y gastric bypass (RYGB) or vertical sleeve gastrectomy (VSG), may be the best treatment can be challenging. This study investigated psychological correlates and their influence on weight loss for patients who underwent RYGB or VSG. METHODS: Four hundred twenty-two patients (RYGB = 305; VSG = 117) completed screening questionnaires presurgery and underwent surgery between August 2012 and April 2015...
August 16, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28811552/deregulation-of-transcription-factors-controlling-intestinal-epithelial-cell-differentiation-a-predisposing-factor-for-reduced-enteroendocrine-cell-number-in-morbidly-obese-individuals
#3
Bettina K Wölnerhanssen, Andrew W Moran, Galina Burdyga, Anne Christin Meyer-Gerspach, Ralph Peterli, Michael Manz, Miriam Thumshirn, Kristian Daly, Christoph Beglinger, Soraya P Shirazi-Beechey
Morbidly obese patients exhibit impaired secretion of gut hormones that may contribute to the development of obesity. After bariatric surgery there is a dramatic increase in gut hormone release. In this study, gastric and duodenal tissues were endoscopically collected from lean, and morbidly obese subjects before and 3 months after laparoscopic sleeve gastrectomy (LSG). Tissue morphology, abundance of chromogranin A, gut hormones, α-defensin, mucin 2, Na(+)/glucose co-transporter 1 (SGLT1) and transcription factors, Hes1, HATH1, NeuroD1, and Ngn3, were determined...
August 15, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28807141/psychosocial-predictors-of-quality-of-life-and-weight-loss-two-years-after-bariatric-surgery-results-from-the-toronto-bari-psych-study
#4
Sanjeev Sockalingam, Raed Hawa, Susan Wnuk, Vincent Santiago, Matthew Kowgier, Timothy Jackson, Allan Okrainec, Stephanie Cassin
OBJECTIVES: Studies exploring the impact of pre-surgery psychiatric status as a predictor of health related quality of life (QOL) after bariatric surgery have been limited to short-term follow-up and variable use of psychosocial measures. We examined the effect of pre-operative psychiatric factors on QOL and weight loss 2-years after surgery. METHODS: 156 patients participated in this prospective cohort study, the Toronto Bariatric Psychosocial Cohort Study, between 2010 and 2014...
July 2017: General Hospital Psychiatry
https://www.readbyqxmd.com/read/28803396/early-regression-of-carotid-intima-media-thickness-after-bariatric-surgery-and-its-relation-to-serum-leptin-reduction
#5
G Lambert, Marcelo Miranda de Oliveira Lima, A C Felici, J C Pareja, A C J Vasques, F S Novaes, S Rodovalho, F F P Hirsch, J R Matos-Souza, Élinton A Chaim, B Geloneze
PURPOSE: Bariatric surgery (BS) promotes carotid intima-media thickness (C-IMT) regression as early as 6 months post-surgery. To verify whether C-IMT regression occurs even earlier, we aimed at the effect of Roux-en-Y gastric bypass (RYGBP) and biliopancreatic diversion (BPD) on C-IMT 1-2 months and 12 months post-surgery. SUBJECTS/METHODS: Prospective trial. BS was performed on 109 patients either with (RYGBP = 42; BDP = 40) or without type 2 diabetes (RYGBP = 27)...
August 12, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28797697/changes-in-inflammatory-endometrial-cancer-risk-biomarkers-in-individuals-undergoing-surgical-weight-loss
#6
Faina Linkov, Sharon L Goughnour, Tianzhou Ma, Zhongying Xu, Robert P Edwards, Anna E Lokshin, Ramesh C Ramanathan, Giselle G Hamad, Carol McCloskey, Dana H Bovbjerg
OBJECTIVE: Obesity has been strongly linked to endometrial cancer (EC) risk. A number of potential EC risk biomarkers have been proposed, including heightened pro-inflammatory cytokines and adipokines. To evaluate if bariatric surgery can serve as a means for altering levels of such EC risk biomarkers, we investigated changes in these biomarkers after weight loss. METHODS: Blood samples were collected pre-operatively and 6months post-operatively in 107 female bariatric surgery patients aged 18-72years...
August 7, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28776922/efficacy-and-pharmacokinetics-of-subcutaneous-exendin-9-39-in-patients-with-post-bariatric-hypoglycemia
#7
Colleen M Craig, Li-Fen Liu, Thi Nguyen, Candice Price, Justus Bingham, Tracey L McLaughlin
AIM: Post-bariatric hypoglycemia (PBH) is a rare but growing complication of bariatric surgery with severe, debilitating, potentially life-threatening consequences and no safe and effective treatment. Previous studies involving continuous intravenous (IV) infusion of the glucagon-like peptide-1 (GLP-1) receptor antagonist, exendin (9-39) (Ex-9) in patients with PBH have demonstrated efficacy in preventing symptomatic postprandial hypoglycemia. Subcutaneous (SC) injection of Ex-9 would represent a more practical therapeutic approach...
August 4, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28776152/glucose-metabolism-parameters-and-post-prandial-glp-1-and-glp-2-release-largely-vary-in-several-distinct-situations-a-controlled-comparison-among-individuals-with-crohn-s-disease-and-individuals-with-obesity-before-and-after-bariatric-surgery
#8
Daniéla Oliveira Magro, Everton Cazzo, Paulo Gustavo Kotze, Ana Carolina Junqueira Vasques, Carlos Augusto Real Martinez, Elinton Adami Chaim, Bruno Geloneze, José Carlos Pareja, Cláudio Saddy Rodrigues Coy
BACKGROUND: This study aims to compare the post-prandial curves of glucose, insulin, GLP-1, and GLP-2 among individuals with Crohn's disease (CD), obese individuals before and after bariatric surgery, and healthy controls. METHODS: This an exploratory cross-sectional study that involved five groups of patients (two groups of individuals with CD-active and inactive), bariatric patients (pre- and post-surgery, who were their own controls), and a distinct separated control group of healthy volunteers...
August 3, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28774333/cost-utility-analysis-of-bariatric-surgery-compared-with-conventional-medical-management-in-germany-a-decision-analytic-modeling
#9
Oleg Borisenko, Oliver Mann, Anna Duprée
BACKGROUND: The objective was to evaluate cost-utility of bariatric surgery in Germany for a lifetime and 10-year horizon from a health care payer perspective. METHODS: State-transition Markov model provided absolute and incremental clinical and monetary results. In the model, obese patients could undergo surgery, develop post-surgery complications, experience diabetes type II, cardiovascular diseases or die. German Quality Assurance in Bariatric Surgery Registry and literature sources provided data on clinical effectiveness and safety...
August 3, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28770423/perceived-social-support-for-exercise-and-weight-loss-in-adolescents-undergoing-sleeve-gastrectomy
#10
Eleanor Race Mackey, Alexandra Olson, Stephanie Merwin, Jichuan Wang, Evan P Nadler
OBJECTIVES: Bariatric surgery is an effective treatment for youth with severe obesity. However, outcomes are variable and there remains sparse understanding of predictors of weight loss following surgery. The current study examines the role of adolescent-reported pre-operative social support around exercise, binge eating, and exercise to predict excess body mass index (EBMI) loss from 3 to 12 months post-surgery. METHOD: Participants were 101 adolescents ages 12-21 (M age = 16...
August 2, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28765690/diarrhea-after-bariatric-procedures-diagnosis-and-therapy
#11
REVIEW
Yves M Borbély, Alice Osterwalder, Dino Kröll, Philipp C Nett, Roman A Inglin
Diarrhea after bariatric procedures, mainly those with malabsorptive elements including Roux-Y Gastric Bypass and Biliopancreatic Diversion, is common and an essential determinant of quality of life and micro- and macronutrient deficiencies. Bariatric surgery is the only sustainably successful method to address morbid obesity and its comorbidities, particularly gaining more and more importance in the specific treatment of diabetic patients. Approximately half a million procedures are annually performed around the world, with numbers expected to rise drastically in the near future...
July 14, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28762024/risk-factors-for-prolonged-length-of-hospital-stay-and-readmissions-after-laparoscopic-sleeve-gastrectomy-and-laparoscopic-roux-en-y-gastric-bypass
#12
Piotr Major, Michał Wysocki, Grzegorz Torbicz, Natalia Gajewska, Alicja Dudek, Piotr Małczak, Michał Pędziwiatr, Magdalena Pisarska, Dorota Radkowiak, Andrzej Budzyński
BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) and laparoscopic gastric bypass (LRYGB) are most commonly performed bariatric procedures. Laparoscopic approach and enhanced recovery after surgery (ERAS) protocols managed to decrease length of hospital and morbidity. However, there are patients in whom, despite adherence to the protocol, the length of stay (LOS) remains longer than targeted. This study aimed to assess potential risk factors for prolonged LOS and readmissions. METHODS: The study was a prospective observation with a post-hoc analysis of bariatric patients in a tertiary referral university teaching hospital...
July 31, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28760109/bariatric-surgery-in-adolescents-is-routine-nutrient-supplementation-sufficient-to-avoid-anemia-following-bariatric-surgery
#13
Hanna R Goldberg, Vivian L Chin, Jeffrey L Zitsman, Chengchen Zhang, Kristen M Williams, Sharon Oberfield, Ilene Fennoy
BACKGROUND: Anemia following bariatric surgery is a known complication. To prevent nutrient deficiencies, adolescents require multivitamin/mineral supplementation following bariatric surgery. The purpose of this study was to investigate if routine multivitamin/mineral supplementation is sufficient to prevent anemia in adolescents undergoing bariatric surgery, particularly sleeve gastrectomy (SG), a procedure that may induce nutrient malabsorption. METHODS: We conducted a retrospective review of pediatric patients who underwent SG (34 patients) and laparoscopic adjustable gastric banding (LAGB) (141 patients) (January 2006 through December 2013)...
August 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28756049/sociodemographic-and-lifestyle-factors-as-determinants-of-energy-intake-and-macronutrient-composition-a-10-year-follow-up-after-bariatric-surgery
#14
Noora Kanerva, Ingrid Larsson, Markku Peltonen, Anna-Karin Lindroos, Lena M Carlsson
BACKGROUND: Early identification of the potential to adopt a long-term unhealthy diet, could improve weight outcomes for patients having undergone bariatric surgery. OBJECTIVES: We explored whether presurgical sociodemographic and lifestyle characteristics, together with the type of surgery, could predict 10-year changes in dietary intake after bariatric surgery. SETTING: Surgical departments and primary healthcare centers, nationwide. METHODS: Participants were from the Swedish Obese Subjects study, a matched (nonrandomized) prospective trial comparing bariatric surgery with standard care for obese patients...
June 1, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28752920/outcome-of-liver-transplantation-in-patients-with-prior-bariatric-surgery
#15
Mohamed Safwan, Kelly M Collins, Marwan S Abouljoud, Reena Salgia
Non-alcoholic fatty liver disease is becoming the leading cause of disease resulting in liver transplantation (LT). As a result of this trend, more liver transplant candidates are presenting with prior history of bariatric surgery (BS). Over the last decade, 960 patients underwent LT at our institution; 11 (1.1%) had prior BS. Most common type of BS was Roux-en-Y gastric bypass (n=9) with 1 sleeve gastrectomy and 1 jejunoileal bypass. Nine patients underwent LT alone and 2 underwent simultaneous liver-kidney transplantation...
July 28, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28751961/effect-of-bariatric-surgery-on-adiposity-and-metabolic-profiles-a-prospective-cohort-study-in-middle-eastern-patients
#16
Mohsen Mazidi, Peyman Rezaie, Ali Jangjoo, Alireza Tavassoli, Mohammad Taghi Rajabi, Andre Pascal Kengne, Mohsen Nematy
AIM: To investigate changes in adiposity and cardio-metabolic risk profile following Roux-en-Y gastric bypass in patients of Middle Eastern ethnicity with severe obesity. METHODS: This prospective cohort study involved 92 patients who met the indications of bariatric surgery. Post-procedure markers of obesity and cardiometabolic profile were monitored regularly for a year. RESULTS: Mean body mass index decreased by 29.5% from 41.9 to 29.5 kg/m(2) between baseline and 12-mo follow-up, while mean fat mass decreased by 45...
July 15, 2017: World Journal of Diabetes
https://www.readbyqxmd.com/read/28750839/endoscopic-treatment-of-fistulas-after-sleeve-gastrectomy-a-comparison-of-internal-drainage-versus-closure
#17
Diane Lorenzo, Théophile Guilbaud, Jean Michel Gonzalez, Alban Benezech, Anne Dutour, Sandrine Boullu, Stéphane Berdah, Thierry Bège, Marc Barthet
BACKGROUND AND AIMS: Post-sleeve gastrectomy fistulas (PSGF) are major adverse events of bariatric surgery. The endoscopic management strategy evolved from closure to internal drainage (ID) after 2013. The main objective was to evaluate and compare these different approaches. METHODS: This retrospective study included all patients treated for PSGF in a referral center. "Closure" management was defined as initial treatment using covered-metal-stent and/or endoclips...
July 24, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28744976/patient-experiences-of-adjusting-to-life-in-the-first-2%C3%A2-years-after-bariatric-surgery-a-qualitative-study
#18
Y Graham, C Hayes, P K Small, K Mahawar, J Ling
There is currently little research into the experiences of those who have undergone bariatric surgery, or how surgery affects their lives and social interactions. Adopting a constructivist grounded theory methodological approach with a constant comparative analytical framework, semi-structured interviews were carried out with 18 participants (11 female, 7 male) who had undergone permanent bariatric surgical procedures 5-24 months prior to interview. Findings revealed that participants regarded social encounters after bariatric surgery as underpinned by risk...
July 26, 2017: Clinical Obesity
https://www.readbyqxmd.com/read/28734574/early-reduction-of-matrix-metalloproteinase-8-serum-levels-is-associated-with-leptin-drop-and-predicts-diabetes-remission-after-bariatric-surgery
#19
Luca Liberale, Aldo Bonaventura, Federico Carbone, Maria Bertolotto, Paola Contini, Nicola Scopinaro, Giovanni Bruno Camerini, Francesco Saverio Papadia, Renzo Cordera, Giovanni Guido Camici, Franco Dallegri, Gian Franco Adami, Fabrizio Montecucco
BACKGROUND: We aimed at investigating whether the acute abrogation of leptin after bariatric surgery is able to reduce neutrophil activation and potentially affect type 2 diabetes mellitus (T2DM) remission. METHODS: Metabolic and inflammatory parameters (i.e. leptin, IL-6 and neutrophil products) were compared at baseline (before bariatric surgery), one month, one and three years after surgery in morbid obese (MOB) T2DM patients (n=12) and non-MOB controls (n=32)...
July 13, 2017: International Journal of Cardiology
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
#20
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
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