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Unplanned weight loss

Kris M Mogensen, Clare M Horkan, Steven W Purtle, Takuhiro Moromizato, James D Rawn, Malcolm K Robinson, Kenneth B Christopher
BACKGROUND: We hypothesized that preexisting malnutrition in patients who survived critical care would be associated with adverse outcomes following hospital discharge. METHODS: We performed an observational cohort study in 1 academic medical center in Boston. We studied 23,575 patients, aged ≥18 years, who received critical care between 2004 and 2011 and survived hospitalization. RESULTS: The exposure of interest was malnutrition determined at intensive care unit (ICU) admission by a registered dietitian using clinical judgment and on data related to unintentional weight loss, inadequate nutrient intake, and wasting of muscle mass and/or subcutaneous fat...
May 1, 2017: JPEN. Journal of Parenteral and Enteral Nutrition
Aly Elbahrawy, Alexandre Bougie, Mohammad Albader, Rajesh Aggarwal, Sebastian Demyttenaere, Amin Andalib, Olivier Court
BACKGROUND: Weight recidivism after Roux-en-Y gastric bypass (RYGB) is a common problem. Often, this weight loss failure or regain may be due to a wide gastrojejunostomy (GJ). We evaluated the feasibility and safety of a novel approach of laparoscopic wedge resection of gastrojejunostomy (LWGJ) for a wide stoma after RYGB associated with weight recidivism. METHODS: This is a single-center retrospective study of a prospectively collected database. We analyzed outcomes of patients with weight recidivism after RYGB and a documented wide GJ (>2 cm) on imaging, who underwent LWGJ between 11/2013 and 05/2016...
May 3, 2017: Obesity Surgery
Patty Lakenman, Karen Ottens-Oussoren, Jill Witvliet-van Nierop, Donald van der Peet, Marian de van der Schueren
RATIONALE: It has been shown that early nutrition intervention improves nutrition status (NS) and treatment tolerance in patients with esophageal cancer. However, it remains unknown whether pretreatment parameters of NS are associated with treatment modifications (TMs) during neoadjuvant chemoradiation (CR) in patients who are intensively nutritionally supervised during treatment. METHODS: All outpatients with esophageal cancer who were scheduled for CR in the VU medical center from 2006-2015 were included...
April 1, 2017: Nutrition in Clinical Practice
Yih-Lin Chung, Newman N M Pui
PURPOSE: The aim of this study was to identify patient-centered, mucositis-associated adverse impact factors and events that might confound physician-assessed oral mucositis (OM) in head and neck cancer (HNC) patients receiving chemoradiotherapy. METHODS: This was a post hoc analysis of a previously conducted randomized trial to determine the efficacy of 5% phenylbutyrate mouthwash in preventing chemoradiotherapy-induced OM. This analysis identified patient-centered symptomatic, observable, and measurable factors that may confound physician scoring of the severity of OM during chemoradiotherapy...
March 28, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Winnie Sun, Diane M Doran, Walter P Wodchis, Elizabeth Peter
BACKGROUND: In an era of a rapidly aging population who requires home care services, clients must possess or develop therapeutic self-care ability in order to manage their health conditions safely in their homes. Therapeutic self-care is the ability to take medications as prescribed and to recognize and manage symptoms that may be experienced, such as pain. The purpose of this research study was to investigate whether therapeutic self-care ability explained variation in the frequency and types of adverse events experienced by home care clients...
March 14, 2017: BMC Health Services Research
Priyadarshani Galappatthy, Jayan D D Jayasinghe, Sampath C Paththinige, Rezvi M H Sheriff, Lalith S Wijayaratne
OBJECTIVES: To compare the pregnancy outcomes and contraceptive practices in systemic lupus erythematosus (SLE), rheumatoid arthritis (RA) and women with no chronic illness (WNCI) in a tertiary care referral center in Colombo, Sri Lanka. METHODS: Patients with SLE satisfying American College of Rheumatology criteria for diagnosis and history of pregnancies were recruited from university lupus clinic, National Hospital of Sri Lanka (NHSL). Age-matched women with history of pregnancy and RA were recruited from the rheumatology clinic, NHSL and WNCI from a surgical clinic...
February 16, 2017: International Journal of Rheumatic Diseases
Anne Jouinot, Clara Vazeille, Jean Philippe Durand, Olivier Huillard, Pascaline Boudou-Rouquette, Romain Coriat, Jeanne Chapron, Nathalie Neveux, Jean Pascal De Bandt, Jerome Alexandre, Luc Cynober, Francois Goldwasser
BACKGROUND & AIMS: Alterations of nutritional and performance status (PS) are associated with higher risk of chemotherapy toxicity. Increased resting energy expenditure (REE) is frequent in cancer patients and may contribute to cachexia. We investigated whether abnormal energetic metabolism could predict early acute limiting toxicities (ELT) of anticancer treatments. METHODS: In this observational monocentric study, REE was measured by indirect calorimetry before treatment initiation...
January 19, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
Teresa E Brown, Merrilyn D Banks, Brett G M Hughes, Charles Y Lin, Lizbeth M Kenny, Judith D Bauer
BACKGROUND: The optimal method of tube feeding for patients with head and neck cancer remains unclear. A validated protocol is available that identifies high-nutritional-risk patients who would benefit from prophylactic gastrostomy tube placement. Adherence to this protocol is ultimately determined by clinical team discretion or patient decision. OBJECTIVE: The study aim was to compare outcomes after adherence and nonadherence to this validated protocol, thus comparing a prophylactic and reactive approach to nutrition support in this patient population...
December 13, 2016: Journal of the Academy of Nutrition and Dietetics
I Dedes, L Schäffer, R Zimmermann, T Burkhardt, C Haslinger
AIM: To evaluate the outcome of a cesarean myomectomy (CM) versus a cesarean delivery (CD) alone in women with uterine myomas and the risk factors for adverse outcomes. METHODS: A retrospective cohort study of all women undergoing CDs with uterine leiomyomatas and singleton pregnancies was performed. Patients with known risk factors for hemorrhage were excluded. Measured adverse outcome parameters included estimated blood loss, drop in hemoglobin levels (pre/postoperatively), operation time, and the use of additional uterotonics...
January 2017: Archives of Gynecology and Obstetrics
Gail C Rampersaud, Andrew Sokolow, Abigail Gruspe, James C Colee, Gail P A Kauwell
OBJECTIVE: To evaluate the impact of educational text messages (TMs) on folate/folic acid knowledge and consumption among college-aged women, and to evaluate the impact of providing folic acid supplements on folate/folic acid intake among college-aged women. PARTICIPANTS: A total of 162 women (18-24 years) recruited from a university. METHODS: The protocol included 3 study visits and a 6-week intervention for 4 groups: control; TM only; supplement only; and TM+supplement...
August 2016: Journal of American College Health: J of ACH
Marissa A Gowey, Jennifer Reiter-Purtill, Jennifer Becnel, James Peugh, James E Mitchell, Meg H Zeller
OBJECTIVE: Severe obesity is the fastest growing pediatric subgroup of excess weight levels. Psychological dysregulation (i.e., impairments in regulating cognitive, emotional, and/or behavioral processes) has been associated with obesity and poorer weight loss outcomes. The present study explored associations of dysregulation with weight-related variables among adolescent and young adult (AYA) females with severe obesity. METHODS: Fifty-four AYA females with severe obesity (MBMI = 48...
April 1, 2016: Appetite
Fabio Garofalo, Ronald Denis, Omar Abouzahr, Pierre Garneau, Radu Pescarus, Henri Atlas
BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) is becoming one of the most popular bariatric procedures because of its short operative time, good resolution of comorbidities, excellent weight loss, and low complications rate. However, the safety of LSG as a day-surgery procedure has not yet been widely documented. METHODS: A retrospective analysis of a prospectively collected bariatric database, in a single institution, between August 2012 and February 2015, yielded 980 patients who underwent LSG; 328 patients (33...
July 2016: Obesity Surgery
Shota Ikegami, Jun Takahashi, Shugo Kuraishi, Masayuki Shimizu, Toshimasa Futatsugi, Masashi Uehara, Kayo Horiuchi, Shigetaka Shimodaira, Hiroyuki Kato
STUDY DESIGN: Retrospective observational study OBJECTIVE.: To clarify the efficacy of recombinant human erythropoietin-beta (EPO-beta) injections during autologous blood donation (ABD) before spinal deformity surgery in children and teenagers. SUMMARY OF BACKGROUND DATA: ABD is preferred for spinal deformity surgery. A few studies have assessed the usefulness of preoperative ABD with EPO-beta in anemic patients. METHODS: Fifty-six spinal deformity surgery patients (41 females, 15 males; median age: 15 yrs; range, 5-19 yrs) underwent preoperative ABD...
November 2015: Spine
Xu-Sheng Qiu, Xin Zheng, Hong-fei Shi, Yan-cheng Zhu, Xia Guo, Hai-jun Mao, Guang-yue Xu, Yi-xin Chen
BACKGROUND: Osteomyelitis is a challenge for orthopaedic surgeons. There is a lack of scientific evidence to guide treatment. The purpose of this study was to report the clinical outcome of unplanned retention of antibiotic-impregnated cement spacer (ACS) in the management of osteomyelitis. METHODS: Eight patients (7 with tibial infections and 1 with a calcaneal infection) with osteomyelitis received radical debridement and insertion of an ACS into the bone defect as the definitive management...
2015: BMC Musculoskeletal Disorders
Caroline Mariano, Grant Williams, Allison Deal, Shani Alston, Ashley Leak Bryant, Trevor Jolly, Hyman B Muss
BACKGROUND: Geriatric assessment (GA) is an important tool for management of older cancer patients; however, GA research has been performed primarily in the outpatient setting. The primary objective of this study was to determine feasibility of GA during an unplanned hospital stay. Secondary objectives were to describe deficits found with GA, to assess whether clinicians recognized and addressed deficits, and to determine 30-day readmission rates. MATERIALS AND METHODS: The study was designed as an extension of an existing registry, "Carolina Senior: Registry for Older Patients...
July 2015: Oncologist
Chad M Bailey, Christoph Troppmann, Jennifer Kuo, Michael S Wong
BACKGROUND: Patients with end-stage renal disease evaluated for renal transplantation are frequently declined secondary to obesity and decreased functional status. As a result, many of these patients lose weight intentionally in an effort to gain candidacy on the transplant waiting list. This frequently produces a panniculus encompassing the lower abdominal surgical site used for renal transplantation. These patients are declined for renal transplantation secondary to predictable wound-healing complications...
May 2015: Annals of Plastic Surgery
Pragatheeshwar Thirunavukarasu, Sartaj Sanghera, Smit Singla, Kristopher Attwood, Steven Nurkin
BACKGROUND: With improvement in survival, elective surgical procedures are being increasingly performed on patients with metastatic disease. We aimed to study the association of pre-operative unintentional weight loss (UWL) with operative outcomes in this patient population. METHODS: We extracted data on all patients with disseminated cancer undergoing elective surgeries between 2005 and 2011 from the National Surgical Quality Improvement Program (NSQIP), along with the Current Procedure Terminology (CPT) codes...
June 2015: International Journal of Surgery
Sarah Maheux-Lacroix, Madeleine Lemyre, Vanessa Couture, Gabrielle Bernier, Philippe Y Laberge
BACKGROUND AND OBJECTIVE: Ambulatory total laparoscopic hysterectomy (TLH) could lead to significant cost savings, but some fear the effects of what could be premature postsurgical discharge. We sought to estimate the feasibility and safety of TLH as an outpatient procedure for benign gynecologic conditions. METHODS: We report a prospective, consecutive case series of 128 outpatient TLHs performed for benign gynecologic conditions in a tertiary care center. RESULTS: Of the 295 women scheduled for a TLH, 151 (51%) were attempted as an outpatient procedure...
January 2015: JSLS: Journal of the Society of Laparoendoscopic Surgeons
John N Morris, Elizabeth P Howard, Knight Steel, Robert Schreiber, Brant E Fries, Lewis A Lipsitz, Beryl Goldman
BACKGROUND: Older adults remain the highest utilization group with unplanned visits to emergency departments and hospital admissions. Many have considered what leads to this high utilization and the answers provided have depended upon the independent measures available in the datasets used. This project was designed to further understanding of the reasons for older adult ED visits and admissions to acute care hospitals. METHODS: A secondary analysis of data from a cross-national sample of community residing elderly, 60 years of age or older, and most of whom received services from a local home-care program was conducted...
2014: BMC Health Services Research
M D Barber, L Williams, E D C Anderson, G T Neades, C Raine, O Young, D Kulkarni, I Young, J M Dixon
INTRODUCTION: The use of acellular dermal matrix (ADM) has transformed the technique of implant-based breast reconstruction. It offers the option of a one-stage procedure and is felt to have benefits in cosmetic outcome but the medium and long-term outcomes are unknown. METHODS: All cases where ADM was used in a breast reconstructive procedure in the Edinburgh Breast Unit from its initial use on 7/7/2008 to 31/7/2012 were reviewed retrospectively. Follow up was completed to 30/11/2012...
January 2015: European Journal of Surgical Oncology
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