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Bariatrics

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https://www.readbyqxmd.com/read/28738340/novel-positional-devices-for-the-treatment-of-positional-obstructive-sleep-apnea-and-how-this-relates-to-sleep-surgery
#1
Madeline J L Revesloot, Linda Benoist, Peter van Maanen, Nico de Vries
If untreated, obstructive sleep apnea (OSA) develops as a gradual progressive disease. In the early stage of the disease most patients with OSA are positional. The archetypical patient might progress from simple positional snoring via positional early-stage mild disease to less positional moderate and finally nonpositional severe OSA. At first, the apnea-hypopnea index (AHI) is high only in the supine position, and later is high in all sleeping positions. The phenomenon is reversible. After partial effective treatment, patients with severe OSA can reverse to less severe positional OSA or, in other words, the AHI drops more in the lateral position than in supine position...
2017: Advances in Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28737553/complications-after-body-contouring-surgery-in-postbariatric-patients
#2
Alejandra García Botero, Miguel García Wenninger, Dario Fernández Loaiza
INTRODUCTION: Over recent years, body contouring procedures in postbariatric patients have been in exponentially growing demand resulting in high complication rates rendering a variety of ciphers in the literature. OBJECTIVE: The purpose of this study is to determine the complication rate in patients who have undergone body contouring surgery after bariatric surgery between June 2012 and March 2015 at Hospital de San José. METHODS: A cohort study including 153 individuals who underwent a total of 198 body contouring procedures after massive weight loss following bariatric surgery was conducted...
July 22, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28736384/-revisional-surgery-for-nonstandard-gastric-bypass-a-case-report
#3
Yu Gao, Zhi-Gang Ke, Jian-Guo Liu, Wei-Dong Tong
Bariatric surgery is the most effective treatment for obesity with or without type 2 diabetes mellitus and its complications. With the growing incidence of type 2 diabetes mellitus, the number of hospitals performing bariatric surgery and surgical cases increase substantially. The problems in operation standardization, quality control of operation and postoperative management of the patients cause the failure in weight loss, hypoglycemia and severe complications, and revisional surgery is often required to correct the condition...
July 20, 2017: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
https://www.readbyqxmd.com/read/28735376/the-socio-economic-impact-of-bariatric-surgery
#4
Arendse Tange Larsen, Betina Højgaard, Rikke Ibsen, Jakob Kjellberg
INTRODUCTION: A recurring argument for bariatric surgery is cost savings due to sustained weight loss and reductions in comorbidities. However, studies prompting this argument tend to focus only on health care costs, and in some of them, cost changes after surgery have been modelled. The aim of this study was to generate real-world evidence on the socio-economic impact of bariatric surgery, by evaluating the effect on both direct and indirect costs. MATERIALS AND METHODS: Using real-world data from national registries, predictions of health care costs, social transfer payments and income were performed for a surgically treated individual and compared to those for a similar but non-surgically treated individual 3 years before and after surgery...
July 22, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28735375/perioperative-practices-concerning-one-anastomosis-mini-gastric-bypass-a-survey-of-210-surgeons
#5
Kamal K Mahawar, Kuldeepak Singh Kular, Chetan Parmar, Michael Van den Bossche, Yitka Graham, William R J Carr, Brijesh Madhok, Conor Magee, Sanjay Purkayastha, Peter K Small
BACKGROUND: There is currently little evidence available on the perioperative practices concerning one anastomosis/mini gastric bypass (OAGB/MGB) and no published consensus amongst experts. Even the published papers are not clear on these aspects. The purpose of this study was to understand various perioperative practices concerning OAGB/MGB. METHODS: Bariatric surgeons from around the world were invited to participate in a questionnaire-based survey. Only surgeons performing this procedure were included...
July 22, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28735374/changes-in-global-transcriptional-profiling-of-women-following-obesity-surgery-bypass
#6
Marcela Augusta de Souza Pinhel, Natalia Yumi Noronha, Carolina Ferreira Nicoletti, Bruno Affonso Parente de Oliveira, Cristiana Cortes-Oliveira, Vitor Caressato Pinhanelli, Wilson Salgado Junior, Ana Julia Machry, Wilson Araújo da Silva Junior, Dorotéia Rossi Silva Souza, Júlio Sérgio Marchini, Carla Barbosa Nonino
BACKGROUND: Differential gene expression in peripheral blood mononuclear cells (PBMCs) after Roux-en-Y gastric bypass (RYGB) is poorly characterized. Markers of these processes may provide a deeper understanding of the mechanisms that underlie these events. The main goal of this study was to identify changes in PBMC gene expression in women with obesity before and 6 months after RYGB-induced weight loss. METHODS: The ribonucleic acid (RNA) of PBMCs from 13 obese women was analyzed before and 6 months after RYGB; the RNA of PBMCs from nine healthy women served as control...
July 22, 2017: Obesity Surgery
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
#7
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/28734462/effect-of-bariatric-surgery-on-emergency-department-visits-and-hospitalizations-for-atrial-fibrillation
#8
Yuichi J Shimada, Yusuke Tsugawa, Carlos A Camargo, David F M Brown, Kohei Hasegawa
Atrial fibrillation (AF) and obesity are major health problems in the United States. However, little is known about whether bariatric surgery affects AF-related morbidities. This study investigated whether bariatric surgery is associated with short-term and long-term changes in the risk of emergency department (ED) visits or hospitalizations for AF. We performed a self-controlled case series study of obese adults with AF who underwent bariatric surgery by using population-based ED and inpatient databases in California, Florida, and Nebraska from 2005 to 2011...
June 27, 2017: American 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
#9
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
https://www.readbyqxmd.com/read/28733905/glp-1-glucagon-receptor-co-agonism-for-treatment-of-obesity
#10
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...
July 21, 2017: Diabetologia
https://www.readbyqxmd.com/read/28733222/molecular-classification-of-hepatocellular-adenoma-in-clinical-practice
#11
REVIEW
Jean-Charles Nault, Valérie Paradis, Daniel Cherqui, Valérie Vilgrain, Jessica Zucman-Rossi
Incidental liver lesion depicted on preoperative imaging for bariatric surgery (BMI = 42) in a 34 year-old woman with oral contraceptive use of 15 years, normal blood liver tests and high CRP (11 mg/L, Nl <6). MRI showed a 6 cm liver nodule in segment V close to the gallbladder. The nodule was moderately hyperintense on T1 (in-phase) and showed a marked and heterogeneous drop in signal intensity on opposedphase sequence suggesting the presence of fat. On T2, the nodule was heterogeneous, hyperintense at the periphery and hypointense in most of the central part...
July 18, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28731054/does-bariatric-surgery-prevent-progression-of-diabetic-retinopathy
#12
Y Chen, J P Laybourne, M T Sandinha, N Mw de Alwis, P Avery, D H Steel
PurposeTo assess the changes in diabetic retinopathy (DR) in type 2 diabetes (T2DM) patients post bariatric surgery and report on the risk factors that may be associated with it.Patients and methodsRetrospective observational study of T2DM patients who underwent bariatric surgery in a UK specialist bariatric unit between 2009 and 2015. Preoperative and postoperative weight, HbA1c, and annual DR screening results were collected from medical records. Patients with preoperative retinal screening and at least one postoperative retinal screening were eligible for analysis...
July 21, 2017: Eye
https://www.readbyqxmd.com/read/28730984/bariatric-surgery-tourism-hidden-costs-how-canada-is-not-doing-its-part-in-covering-bariatric-surgery-under-the-canada-health-act
#13
Michel Gagner
Many Canadians seek medical treatment outside our borders. Waiting times, rather than lack of expertise, are the number one culprit, and with globalization of health care, the number of patients who travel to obtain medical care will continue to rise. Though the provinces have covered the costs of complications from surgeries performed abroad for many years, complications from bariatric surgery performed abroad have been receiving negative attention. This commentary discusses associated costs and questions how the Canada Health Act should be covering bariatric procedures...
August 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/28730276/effect-of-patient-reported-smoking-status-on-short-term-bariatric-surgery-outcomes
#14
Michael Inadomi, Rahul Iyengar, Ilana Fischer, Xing Chen, Emily Flagler, Amir A Ghaferi
INTRODUCTION: Preoperative patient screening is a major contributor to the remarkable safety of bariatric surgery. Smoking status is a modifiable patient risk factor, and smoking cessation is associated with improved outcomes in surgical patients. However, the length of smoking cessation necessary to optimize bariatric surgery patient outcomes is not yet defined. We sought to explore the relationship between patient-reported smoking status and short-term bariatric surgery outcomes. METHODS: Using prospectively collected data from the MBSC registry, we evaluated the effects of patient-reported length of tobacco abstinence on 30-day surgical outcomes...
July 20, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28728833/unexplained-abdominal-pain-in-morbidly-obese-patients-after-bariatric-surgery
#15
Annouk S Pierik, Usha K Coblijn, Christel A L de Raaff, R N van Veen, Willem F van Tets, Bart A van Wagensveld
BACKGROUND: There is an overall complication rate of 6.3%-10% after bariatric surgery. After ruling out anatomic/physical causes, there is a substantial group of patients who develop unexplained postsurgical abdominal pain. OBJECTIVES: To inventory the prevalence of unexplained abdominal pain after laparoscopic Roux-en-Y gastric bypass or laparoscopic sleeve gastrectomy and to determine predictive factors for unexplained abdominal pain. SETTING: Obesity Center Amsterdam, Amsterdam, the Netherlands...
July 3, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28726146/an-odyssey-of-complications-from-band-to-sleeve-to-bypass-definitive-laparoscopic-completion-gastrectomy-with-distal-esophagectomy-and-esophagojejunostomy-for-persistent-leak
#16
Hideo Takahashi, Andrew T Strong, Alfredo D Guerron, John H Rodriguez, Matthew Kroh
INTRODUCTION: Anastomotic leaks are uncommon yet potentially devastating complications after bariatric surgery. While the initial management includes resuscitation and sepsis control, the definitive management often requires endoscopic or surgical interventions. Surgical revision of the initial surgery may be necessary for chronic non-healing fistula. PATIENTS AND METHODS: The patient is a 45-year-old female with history of laparoscopic adjustable gastric banding who underwent band removal and conversion to a sleeve gastrectomy (SG) due to her failed weight loss, which resulted in a leak at gastroesophageal junction...
July 19, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28726145/robotic-gastric-bypass-may-lead-to-fewer-complications-compared-with-laparoscopy
#17
Dimitrios Stefanidis, Savannah B Bailey, Timothy Kuwada, Connie Simms, Keith Gersin
BACKGROUND: Robotic technology leads to improved visualization and precision over laparoscopy but also higher cost of care. The benefits of this technology to patient outcomes are controversial. Our objective was to assess whether the application of robotic surgery to Roux-en-Y gastric bypass (RYGB) would lead to improved patient outcomes. METHODS: A prospectively collected database at a bariatric center of excellence was reviewed for all RYGB procedures performed by one surgeon between 2007 and 2015...
July 19, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28726143/endoscopic-management-of-post-laparoscopic-sleeve-gastrectomy-stenosis
#18
Valérie Deslauriers, Amélie Beauchamp, Fabio Garofalo, Henri Atlas, Ronald Denis, Pierre Garneau, Radu Pescarus
BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) is the most popular bariatric surgery worldwide. Gastric sleeve stenosis is the most common postoperative complication, occurring in up to 3.9% of the cases. Current treatment options include endoscopic treatments, such as dilatations and stent placement as well as surgical revisions such as laparoscopic Roux-en-Y gastric bypass (LRYGB), wedge gastrectomy or seromyotomy. METHODS: A retrospective analysis of our prospectively collected therapeutical endoscopy database was performed between January 2014 and February 2017...
July 19, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28725979/effect-of-weight-loss-after-bariatric-surgery-on-thyroid-stimulating-hormone-levels-in-patients-with-morbid-obesity-and-normal-thyroid-function
#19
João Sérgio Neves, Sofia Castro Oliveira, Pedro Souteiro, Jorge Pedro, Daniela Magalhães, Vanessa Guerreiro, Rita Bettencourt-Silva, Maria Manuel Costa, Ana Cristina Santos, Joana Queirós, Ana Varela, Paula Freitas, Davide Carvalho
BACKGROUND: Several studies have reported that morbid obesity is associated with increased thyroid-stimulating hormone (TSH) levels. However, it is not clear what is the impact of bariatric surgery on postoperative thyroid function. The aim of this study was to evaluate the effect of weight loss after bariatric surgery on TSH levels in euthyroid patients with morbid obesity. METHODS: We performed a retrospective observational study of 949 euthyroid patients (86...
July 19, 2017: Obesity Surgery
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
#20
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
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