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https://www.readbyqxmd.com/read/29156483/-interventions-for-assisting-geriatric-patients-with-frailty-before-surgery
#1
Jörn Kiselev
Frailty is a complex syndrome leading to a higher vulnerability in elderly patients, especially during and after surgery. It is characterized by the simultaneous presence of at least three of five phenotypical symptoms: unintentional weight loss, exhaustion, muscle weakness, slow walking speed, and low activity levels. The presence of two of these symptoms is often labelled as pre-frailty.By identifying these symptoms of frailty, medical teams can plan and perform suitable interventions prior to a planned surgery in order to lower these risk factors and to avoid complications, such as delir, hospital re-admission, loss of independence, and increased mortality...
November 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29156189/obesity-in-pregnancy-optimizing-outcomes-for-mom-and-baby
#2
REVIEW
Heidi Dutton, Sarah Jean Borengasser, Laura Marie Gaudet, Linda A Barbour, Erin Joanne Keely
Obesity is common in women of childbearing age, and management of this population around the time of pregnancy involves specific challenges. Weight and medical comorbidities should be optimized both before and during pregnancy. During pregnancy, gestational weight gain should be limited, comorbidities should be appropriately screened for and managed, and fetal health should be monitored. Consideration should be given to the optimal timing of delivery and to reducing surgical and anesthetic complications. In the postpartum period, breastfeeding and weight loss should be promoted...
January 2018: Medical Clinics of North America
https://www.readbyqxmd.com/read/29156186/treatment-of-obesity-in-primary-care
#3
REVIEW
Adam G Tsai, Jocelyn E Remmert, Meghan L Butryn, Thomas A Wadden
This article outlines some of the behavioral, pharmacologic, and surgical interventions available to primary care physicians (PCPs) to help their patients with weight management. Studies on lifestyle modification, commercial weight loss programs, and medical and surgical options are reviewed. Several clinical suggestions on obesity management that PCPs can take back and use immediately in office practice are offered.
January 2018: Medical Clinics of North America
https://www.readbyqxmd.com/read/29156182/obesity-pharmacotherapy
#4
REVIEW
Katherine H Saunders, Devika Umashanker, Leon I Igel, Rekha B Kumar, Louis J Aronne
Although diet, physical activity, and behavioral modifications are the cornerstones of weight management, weight loss achieved by lifestyle modifications alone is often limited and difficult to maintain. Pharmacotherapy for obesity can be considered if patients have a body mass index (BMI) of 30 kg/m(2) or greater or BMI of 27 kg/m(2) or greater with weight-related comorbidities. The 6 most commonly used antiobesity medications are phentermine, orlistat, phentermine/topiramate extended release, lorcaserin, naltrexone sustained release (SR)/bupropion SR, and liraglutide 3...
January 2018: Medical Clinics of North America
https://www.readbyqxmd.com/read/29155023/therapy-related-myeloid-neoplasm-in-an-18-year-old-boy-with-b-lymphoblastic-leukemia
#5
Xin Qing, Eduard Panosyan, ChangjunYue, Ping Ji, Moran Gotesman, Samuel French, Junchao Cai
BACKGROUND: Acute lymphoblastic leukemia (ALL) is the most common pediatric malignancy. Acute myeloid leukemia or myelodysplastic syndrome during the course of ALL is a rare entity. Some of these cases are therapy-related while the others occur due to lineage switch. The correct diagnosis relies on comparing the immunophenotypes and cytogenetic/molecular alterations of the myeloid neoplasm and the ALL. We present the clinical, pathologic and cytogenetic features of a case of an 18-year-old male with prior treatment for B-lymphoblastic leukemia (B-ALL) who developed therapy-related myeloid neoplasm (t-MN) 4-5years after his initial diagnosis of B-ALL...
November 16, 2017: Experimental and Molecular Pathology
https://www.readbyqxmd.com/read/29154433/cardiac-muscle-wasting-in-individuals-with-cancer-cachexia
#6
Anush Barkhudaryan, Nadja Scherbakov, Jochen Springer, Wolfram Doehner
AIMS: Cachexia is a severe complication of cancer that adversely affects the course of the disease and is associated with high rates of mortality. Patients with cancer manifest symptoms, such as fatigue, shortness of breath, and impaired exercise tolerance, which are clinical signs of chronic heart failure. The aim of this study was to evaluate cardiac muscle wasting in cancer individuals. METHODS AND RESULTS: We retrospectively analysed 177 individuals who died of cancer, including 58 lung, 60 pancreatic, and 59 gastrointestinal (GI) cancers, and 42 cancer-free controls who died of other, non-cardiovascular reasons...
November 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/29153024/-diet-treatment-of-classical-galactosemia
#7
Erika Kiss, Lídia Balogh, Péter Reismann
Classical galactosemia is an inherited disorder of the carbohydrate metabolism, most often caused by the deficient activity of the enzyme galactose-1-phosphate-uridyltransferase. Classical galactosemia presents in the neonatal period with life threatening illness after galactose is introduced in the diet. Symptoms and signs include poor feeding, vomiting, and diarrhea, weight loss, jaundice, hypotension, cataracts, hepatosplenomegaly, hepatocellular insufficiency, and encephalopathy. Since 1975 the testing for galactosemia is part of the neonatal screening program in Hungary...
November 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/29151715/obesity-pharmacotherapy-in-patients-with-type-2-diabetes
#8
Scott Kahan, Ken Fujioka
IN BRIEF Patients with obesity and type 2 diabetes are key targets for weight loss. Given the lack of behavioral weight loss in most patients, obesity pharmacotherapy options should be considered in this patient population. This article reviews key pharmacotherapy options for patients with coexisting obesity and type 2 diabetes. Diabetes medications that are associated with weight gain should be avoided in these patients if possible.
November 2017: Diabetes Spectrum: a Publication of the American Diabetes Association
https://www.readbyqxmd.com/read/29151713/treatment-of-obesity-in-patients-with-diabetes
#9
Carolyn T Bramante, Clare J Lee, Kimberly A Gudzune
IN BRIEF More than 90% of patients with diabetes have overweight or obesity. Whereas weight gain and obesity worsen insulin resistance, weight loss slows the progression of diabetes complications. Given the elevated risk for diabetes complications in patients with obesity, clinicians must understand how to treat obesity in their patients with diabetes, including providing counseling and behavioral management, referral to weight loss programs, and medication management. This article summarizes guidelines for diagnosing and managing obesity in people with diabetes...
November 2017: Diabetes Spectrum: a Publication of the American Diabetes Association
https://www.readbyqxmd.com/read/29151367/surveillance-of-the-armed-forces-as-a-sentinel-system-for-detecting-adverse-effects-of-dietary-supplements-in-the-general-population
#10
Harris R Lieberman, Krista G Austin, Emily K Farina
OBJECTIVE: Half the US population takes dietary supplements, but surveillance systems available to regulatory and public health authorities to determine whether specific dietary supplements present a risk are inadequate and numerous severe injuries and deaths have occurred from their consumption. Uniformed military personnel regularly use dietary supplements and are more likely to use potentially dangerous supplements than civilians. Recently, the supplement 1,3-dimethylamylamine (DMAA) was marketed for physical performance-enhancement and weight loss...
November 20, 2017: Public Health Nutrition
https://www.readbyqxmd.com/read/29151175/demographic-clinical-lifestyle-related-and-social-cognitive-correlates-of-physical-activity-in-head-and-neck-cancer-survivors
#11
Laurien M Buffart, Remco de Bree, Martine Altena, Sophie van der Werff, Constance H C Drossaert, Caroline M Speksnijder, Michiel W van den Brekel, Harriët Jager-Wittenaar, Neil K Aaronson, Martijn M Stuiver
PURPOSE: The purpose of the study is to identify demographic, clinical, lifestyle-related, and social-cognitive correlates of physical activity (PA) intention and behavior in head and neck cancer (HNC) survivors using the theory of planned behavior (TPB). METHODS: Data from two cross-sectional studies on correlates of PA in HNC survivors were pooled. Both studies used self-reports to assess PA and social-cognitive correlates. Potential correlates were collected via self-report or medical records...
November 18, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/29149184/health-effects-of-saturated-and-trans-fatty-acid-intake-in-children-and-adolescents-systematic-review-and-meta-analysis
#12
Lisa Te Morenga, Jason M Montez
BACKGROUND: Elevated cholesterol has been linked to cardiovascular disease in adults and preclinical markers of atherosclerosis in children, thus reducing saturated (SFA) and trans-fatty acids (TFA) intake from an early age may help to reduce cholesterol and the risk of cardiovascular disease later in life. The aim of this review is to examine the evidence for health effects associated with reducing SFA and TFA intake in free-living children, adolescents and young adults between 2 to 19 years of age...
2017: PloS One
https://www.readbyqxmd.com/read/29146657/a-randomised-controlled-trial-of-a-duodenal-jejunal-bypass-sleeve-device-endobarrier-compared-with-standard-medical-therapy-for-the-management-of-obese-subjects-with-type-2-diabetes-mellitus
#13
Michael Alan Glaysher, Aruchuna Mohanaruban, Christina Gabriele Prechtl, Anthony P Goldstone, Alexander Dimitri Miras, Joanne Lord, Navpreet Chhina, Emanuela Falaschetti, Nicholas Andrew Johnson, Werd Al-Najim, Claire Smith, Jia V Li, Mayank Patel, Ahmed R Ahmed, Michael Moore, Neil Poulter, Stephen Bloom, Ara Darzi, Carel Le Roux, James P Byrne, Julian P Teare
INTRODUCTION: The prevalence of obesity and obesity-related diseases, including type 2 diabetes mellitus (T2DM), is increasing. Exclusion of the foregut, as occurs in Roux-en-Y gastric bypass, has a key role in the metabolic improvements that occur following bariatric surgery, which are independent of weight loss. Endoscopically placed duodenal-jejunal bypass sleeve devices, such as the EndoBarrier (GI Dynamics, Lexington, Massachusetts, USA), have been designed to create an impermeable barrier between chyme exiting the stomach and the mucosa of the duodenum and proximal jejunum...
November 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/29144812/increased-bone-turnover-in-type-2-diabetes-patients-randomized-to-bariatric-surgery-vs-medical-therapy-at-5-years
#14
Megan R Crawford, Nathan Pham, Leila Khan, James F Bena, Philip R Schauer, Sangeeta R Kashyap
OBJECTIVE: The aim of our study was to determine the 5 year outcomes of bariatric surgery vs. intensive medical therapy on bone turnover in patients with type 2 diabetes (T2DM) from the STAMPEDE trial. METHODS: This is an ancillary investigation of a 5 year randomized control trial at a single tertiary care center involving 95 patients aged 48.5 ± 8 years with obesity (BMI: 36.5±3.6 kg/m(2)) and uncontrolled T2DM (HbA1C: 9.3 ±1.6%). Patients were randomized to intensive medical therapy (IMT; N=25), Roux-en-Y gastric bypass (RYGB; N=37), or sleeve gastrectomy (SG; N=33) for diabetes treatment...
November 16, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/29140269/the-prevalence-of-dietary-supplement-use-among-college-students-a-nationwide-survey-in-japan
#15
Etsuko Kobayashi, Yoko Sato, Keizo Umegaki, Tsuyoshi Chiba
To clarify the prevalence of dietary supplement use among college students, we conducted Internet-based nationwide questionnaire surveys with 157,595 Japanese college students aged between 18 to 24 years old who were registrants of Macromill Inc. (Tokyo, Japan). Among the 9066 respondents (response rate 5.8%), 16.8% were currently using dietary supplements. The prevalence of dietary supplement use did not differ significantly between males (17.1%) and females (16.7%). However, it increased according to their grade (13...
November 15, 2017: Nutrients
https://www.readbyqxmd.com/read/29139277/tailor-management-to-the-patient-with-fibroids
#16
Marie O'Sullivan, Caroline Overton
Fibroids are benign, hormone-dependent tumours of uterine smooth muscle and connective tissue. They are commonly asymptomatic, but can cause symptoms such as heavy menstrual bleeding and pelvic pressure symptoms. Between 20 to 30% of women with heavy menstrual bleeding have fibroids. Fibroids are most prevalent in women aged 30-50 years and there may be a genetic predisposition. They are more common in black women than white women. Other risk factors include obesity and nulliparity. Asymptomatic women should only be referred if their uterus is palpable abdominally, if fibroids distort the uterine cavity or the uterus is larger than 12 cm in length...
March 2017: Practitioner
https://www.readbyqxmd.com/read/29138707/jejunojejunal-intussusception-due-to-metastatic-melanoma-seven-years-after-the-primer
#17
Alexander Giakoustidis, Thomas Goulopoulos, Anastasios Boutis, George Kavvadias, Aristidis Kainantidis, Thomas Zaraboukas, Dimitrios Giakoustidis
Intestinal intussusception in adults is a rare medical condition accounting for less than 5% of all intussusceptions. Herein we present a 45-year-old patient with a history of abdominal pain and loss of weight. CT scan revealed jejunojejunal intussusceptions. The patient was subjected to exploratory operation and small intestine resection due to a mass causing intestinal intussusception. Pathology confirmed suspected diagnosis of metastatic melanoma to small intestine secondary to melanoma, 7 years after the initial manifestation...
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/29136066/unsuspected-lymphomatoid-granulomatosis-in-a-patient-with-antisynthetase-syndrome
#18
Stephanie L Skala, Alexandra C Hristov, Johann E Gudjonsson, May P Chan
Clinical diagnosis of lymphomatoid granulomatosis (LYG) often is difficult, especially in patients with multiple comorbidities. We present a 60-year-old woman with worsening fatigue, night sweats, unintentional weight loss, and dyspnea of 2 weeks' duration. Her medical history was remarkable for recent radiation therapy for recurrent breast cancer and antisynthetase syndrome complicated by interstitial lung disease and controlled with azathioprine. Computed tomography showed ground-glass opacities and nodular infiltrates in all lung lobes, raising concern for radiation pneumonitis and drug toxicity...
October 2017: Cutis; Cutaneous Medicine for the Practitioner
https://www.readbyqxmd.com/read/29135487/update-on-endocrine-aspects-of-childhood-obesity
#19
Charumathi Baskaran, Nurgun Kandemir
PURPOSE OF REVIEW: Although childhood obesity has leveled off in the last decade, 'severe obesity' continues to be on the rise. Various genetic, environmental and hormonal factors contribute to obesity. This article reviews the most current understanding of obesity's multifactorial origin and recent recommendations for its management in childhood and adolescence. RECENT FINDINGS: Epigenetics plays a key role in transmitting obesity risk to offspring. Single-nucleotide polymorphisms at genetic loci for adipokines and their receptors are associated with obesity...
November 11, 2017: Current Opinion in Endocrinology, Diabetes, and Obesity
https://www.readbyqxmd.com/read/29129996/addressing-hypertension-in-the-patient-with-type-2-diabetes-mellitus-pathogenesis-goals-and-therapeutic-approach
#20
Ali A Rizvi
Hypertension is considered a powerful cardiovascular risk factor and is present in up to two-thirds of patients who suffer from diabetes. In the background of an established epidemiological association between lower blood pressure (BP) and improvement in long-term clinical outcomes, several large landmark trials and analyses have attempted to examine the possible benefit of tighter BP control in patients with Type 2 diabetes mellitus. Although aggressive BP targets in patients with diabetes have been advocated for a long time, currently accepted evidence from these studies has led to a general recommendation of systolic BP <140 mmHg and diastolic BP <90 mmHg...
October 2017: European Medical Journal. Diabetes
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