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Morbid obesity

Matthew J Klebanoff, Jagpreet Chhatwal, Jacob D Nudel, Kathleen E Corey, Lee M Kaplan, Chin Hur
Importance: Severe obesity affects 4% to 6% of US youth and is increasing in prevalence. Bariatric surgery for the treatment of adolescents with severe obesity is becoming more common, but data on cost-effectiveness are limited. Objective: To assess the cost-effectiveness of bariatric surgery for adolescents with obesity using recently published results from the Teen-Longitudinal Assessment of Bariatric Surgery study. Design, Setting, and Patients: A state-transition model was constructed to compare 2 strategies: no surgery and bariatric surgery...
October 26, 2016: JAMA Surgery
Aakash Garg, Deepti Virmani, Sahil Agrawal, Chirag Agarwal, Abhishek Sharma, Giulio Stefanini, John B Kostis
Heart failure with a preserved ejection fraction (HFpEF) is increasingly prevalent and a leading cause of morbidity and mortality worldwide. HFpEF has a complex pathophysiology, with recent evidence suggesting that an interaction of cardiovascular and noncardiovascular comorbidities (e.g. obesity, hypertension, diabetes, coronary artery disease, and chronic kidney disease) induces an inflammatory state that eventually leads to myocardial structural and functional alterations. Current ACCF/AHA guidelines suggest incorporation of biomarkers along with clinical and imaging tools to establish the diagnosis and disease severity in heart failure (HF)...
October 27, 2016: Cardiology
Tania Gallart-Aragón, Carolina Fernández-Lao, Eduardo Castro-Martín, Irene Cantarero-Villanueva, Antonio Cózar-Ibáñez, Manuel Arroyo-Morales
OBJECTIVE: Laparoscopic sleeve gastrectomy (LSG) has demonstrated high long-term effectiveness and major advantages over other techniques. The objective of this study was to analyze changes in physical fitness parameters in morbidly obese patients during 6 months after LSG. METHODOLOGY: We conducted a descriptive observational study with 6-month follow-up in 72 LSG patients, evaluating changes in body mass index (BMI), functional capacity (6-min walking test), hand grip strength (manual dynamometry), flexibility (fingertip-to-floor test), balance (Flamingo test), physical activity level (International Physical Activity Questionnaire, IPAQ), and perception of general physical fitness (International Fitness Scale [IFIS] questionnaire)...
October 25, 2016: Obesity Surgery
Changsheng Zhang, Massimiliano Pirrone, David A E Imber, Jeanne B Ackman, Jacopo Fumagalli, Robert M Kacmarek, Lorenzo Berra
Morbidly obese, critically ill patients are prone to develop hypoxemic respiratory failure and ventilator dependency. The best method for recruiting the lungs of these patients and keeping alveoli open without causing injury remains unclear. We present the case of a 31-year-old patient with severe refractory hypoxemia reversed by lung recruitment maneuvers and subsequent application of positive end-expiratory pressure (PEEP) at a level determined by a decremental PEEP trial. The patient was extubated at a high PEEP level of 22 cm H2O followed by noninvasive ventilatory support after extubation...
October 24, 2016: A & A Case Reports
Varun Agrawal, Jonathan B Wilfong, Christopher E Rich, Pamela C Gibson
Hyperoxaluria after Roux-en-Y gastric bypass (RYGB) increases the risk for kidney injury. Medical therapies for hyperoxaluria have limited efficacy. A 65-year-old female was evaluated for acute kidney injury [AKI, serum creatinine (Cr) 2.1 mg/dl, baseline Cr 1.0 mg/dl]. She did not have any urinary or gastrointestinal symptoms or exposure to nephrotoxic agents. Sixteen months prior to this evaluation, she underwent RYGB for morbid obesity. Her examination was unremarkable for hypertension or edema and there was no protein or blood on urine dipstick...
September 2016: Case Reports in Nephrology and Dialysis
M M Broadney, N Chahal, K A Michels, A C McLain, A Ghassabian, D A Lawrence, E H Yeung
BACKGROUND/OBJECTIVES: Maternal obesity may influence neonatal and childhood morbidities through increased inflammation and/or altered immune response. Less is known about paternal obesity. We hypothesized that excessive parental weight contributes to elevated inflammation and altered immunoglobulin (Ig) profiles in neonates. SUBJECTS/METHODS: In the Upstate KIDS Study maternal pre-pregnancy body mass index (BMI) was obtained from vital records and paternal BMI from maternal report...
October 26, 2016: International Journal of Obesity: Journal of the International Association for the Study of Obesity
Reza Fazl Alizadeh, Zhobin Moghadamyeghaneh, Matthew D Whealon, Mark H Hanna, Steven D Mills, Alessio Pigazzi, Michael J Stamos, Joseph C Carmichael
There are limited data regarding the association between body mass index (BMI) and colorectal surgery outcomes. We sought to evaluate the effect of BMI on short-term surgical outcomes in colon and rectal surgery patients in the United States. The American College of Surgeons National Surgery Quality Improvement Project database was used to identify all patients who underwent colon or rectal resection from 2005 to 2013. Multivariate regression analysis was used to assess the independent effect of BMI on outcomes...
October 2016: American Surgeon
I Iwan-Zietek, B Ruszkowska-Ciastek, M Michalska, E Overskaug, K Goralczyk, S Dabrowiecki, D Rosc
Adipokines regulate glucose homeostasis, insulin sensitivity, lipids metabolism, reproduction, as well as endothelial and platelets function. The study compares the plasma and adipose tissue concentrations of total adiponectin, leptin, leptin receptor and leptin-to-adiponectin ratio (LAR) in morbidly obese patients. Additionally it evaluates selected adipokines (leptin, adiponectin), endothelial markers and LAR depending on the gender in morbidly obese and non-obese subjects. The study involved 51 patients (31 women aged 21 - 60 (mean age of 39) and 20 men aged 24 to 60 (mean age of 41))...
August 2016: Journal of Physiology and Pharmacology: An Official Journal of the Polish Physiological Society
Alastair Fung, Nora Trabulsi, Martin Morris, Richard Garfinkle, Abdulaziz Saleem, Steven D Wexner, Carol-Ann Vasilevsky, Marylise Boutros
BACKGROUND: Laparoscopic colorectal cancer operations in obese patients pose technical challenges that may negatively impact oncologic adequacy. A meta-analysis was performed to assess the oncologic outcomes of laparoscopic colorectal cancer resections in obese compared to non-obese patients. Short- and long-term outcomes were assessed secondarily. METHODS: A systematic literature search was conducted from inception until October 01, 2014. Studies that compared outcomes of laparoscopic colorectal malignant neoplasms in obese and non-obese patients were selected for meta-analysis...
October 24, 2016: Surgical Endoscopy
Matthaios Papadimitriou-Olivgeris, Diamanto Aretha, Anastasia Zotou, Kyriaki Koutsileou, Aikaterini Zbouki, Aikaterini Lefkaditi, Christina Sklavou, Markos Marangos, Fotini Fligou
Background. The objective of this study was to assess the correlation between sepsis, obesity, and mortality of patients admitted to an Intensive Care Unit (ICU). Subjects and Methods. Data of all patients admitted to the ICU of a tertiary hospital during a 28-month period were retrospectively analyzed and included in the study. Results. Of 834 patients included, 163 (19.5%) were obese, while 25 (3.0%) were morbidly obese. Number of comorbidities (P < 0.001), bloodstream infection (P  0.033), and carbapenemase-producing Klebsiella pneumoniae colonization during ICU stay (P  0...
2016: BioMed Research International
Shuab Omer, Lorraine D Cornwell, Ankur Bakshi, Eric Rachlin, Ourania Preventza, Todd K Rosengart, Joseph S Coselli, Scott A LeMaire, Nancy J Petersen, Greg Pattakos, Faisal G Bakaeen
Little is known about the frequency and clinical implications of postoperative atrial fibrillation in military veterans who undergo coronary artery bypass grafting (CABG). We examined long-term survival data, clinical outcomes, and associated risk factors in this population. We retrospectively reviewed baseline, intraoperative, and postoperative data from 1,248 consecutive patients with similar baseline risk profiles who underwent primary isolated CABG at a Veterans Affairs hospital from October 2006 through March 2013...
October 2016: Texas Heart Institute Journal
Jia-Yang Li, Qi-Rong Zou, Xue-Mei Peng
OBJECTIVE: To compare the pharmacokinetics of cisatracurium between normal weight patients and morbidly obese patients. METHODS: Twelve obese ASA I-II patients (BMI≥35 kg/m(2)) undergoing laparoscopic Roux-en-Y gastric bypass and 12 normal weight ASA I-II patients (BMI of 18.5-24 kg/m(2)) undergoing laparoscopic surgery were enrolled. The obese patients were given a cisatracurium dose of 0.15 mg/kg according to the fat-free mass (FFM), and the non-obese patients received a dose of 0...
October 20, 2016: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
Holger Cramer, Meral Sushila Thoms, Dennis Anheyer, Romy Lauche, Gustav Dobos
BACKGROUND: Abdominal obesity is a major risk factor for morbidity and mortality. The aim of this study was to investigate the effect of yoga on waist circumference and other anthropometric and self-reported variables in women with abdominal obesity. METHODS: 60 women with abdominal obesity (waist circumference ≥ 88 cm; body-mass index [BMI] ≥ 25) were randomly allocated in a 2:1 ratio to either a 12-week yoga intervention (n = 40) or a waiting list (n = 20)...
September 30, 2016: Deutsches Ärzteblatt International
Sapan H Shah, Brian E Schwartz, Aaron R Schwartz, Benjamin A Goldberg, Samuel J Chmell
The rate of total knee arthroplasty (TKA) utilization in younger patients (< 65 years old) is increasing. Little is known regarding demographics and in-hospital outcomes in this population. The National Hospital Discharge Survey (NHDS) database was searched using International Classification of Diseases, Ninth Revision (ICD-9) procedure codes for patients admitted to U.S. hospitals for unilateral primary TKA between 2001 and 2010. Patients were separated into young (< 65 years of age) and senior cohorts (≥ 65 years of age)...
October 24, 2016: Journal of Knee Surgery
Lesley Gray, Carol MacDonald
It is a frightening reality for some people to be caught up in the midst of a disaster, alone and vulnerable due to their relative size, shape or weight. A literature search failed to find any empirical reports of data specific to body mass index (BMI) in disaster situations. A handful of largely anecdotal reports described situations in which people categorised as morbidly obese were negatively impacted in disasters because of their size and/or weight. While a small number of toolkits and training resources were found, there remains a paucity of research in relation to obesity and emergency planning or disaster risk reduction...
October 20, 2016: International Journal of Environmental Research and Public Health
David R Just, Brian Wansink
OBJECTIVE: Excessive intake of fast food, soft drinks and candy are considered major factors leading to overweight and obesity. This article examines whether the epidemiological relationship between frequency of intake of these foods and body mass index (BMI) is driven by the extreme tails (+/-2 standard deviations). If so, a clinical recommendation to reduce frequency intake may have little relevance to 95% of the population. METHODS: Using 2007-2008 Centers for Disease Control's National Health and Nutrition Examination Survey, the consumption incidence of targeted foods on two non-continuous days was examined across discrete ranges of BMI...
December 2015: Obesity Science & Practice
Hui-Li Tan, Kok-Gan Chan, Priyia Pusparajah, Acharaporn Duangjai, Surasak Saokaew, Tahir Mehmood Khan, Learn-Han Lee, Bey-Hing Goh
Cardiovascular diseases (CVDs) are among the leading causes of morbidity and mortality in both the developed and developing world. Rhizoma coptidis (RC), known as Huang Lian in China, is the dried rhizome of medicinal plants from the family Ranunculaceae, such as Coptis chinensis Franch, C. deltoidea C.Y. Cheng et Hsiao, and C. teeta Wall which has been used by Chinese medicinal physicians for more than 2000 years. In China, RC is a common component in traditional medicines used to treat CVD associated problems including obesity, diabetes mellitus, hyperlipidemia, hyperglycemia and disorders of lipid metabolism...
2016: Frontiers in Pharmacology
Vasileios Charalampakis, Abd A Tahrani, Ahmed Helmy, Janesh K Gupta, Rishi Singhal
One of the most effective methods to tackle obesity and its related comorbidities is bariatric surgery. Polycystic ovary syndrome (PCOS) and endometrial hyperplasia (EH), which are associated with increased risk of endometrial carcinoma, have been identified as potentially new indications for bariatric surgery. PCOS is the most common endocrine disorder in women in the reproductive age and is associated with several components of the metabolic syndrome such as obesity, insulin resistance and hypertension. EH is a pre-cancerous condition which arises in the presence of chronic exposure to estrogen unopposed by progesterone such as both in PCOS and obesity...
October 17, 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Roger W Byard
No abstract text is available yet for this article.
February 2016: Pathology
Adele Sandra Budiansky, Michael P Margarson, Naveen Eipe
Increasing numbers of patients with morbid obesity are presenting for surgery, and their acute pain management requires an evidence-based clinical update. The objective of this study was to complete a literature review for acute pain management in morbid obesity and provide an evidence-based clinical update with recommendations. Using standardized search terms, in March 2015, we completed a literature search to determine evidence for different acute pain pharmacologic modalities in morbid obesity. For each modality, the highest level of evidence was ascertained, and recommendations for each pharmacologic modality are presented...
September 19, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
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