MedWorm: Bariatric Surgery

Is Life Better After Surgical Weight Loss?

Medscape Today Headlines — Fri, 19 Mar 2010 18:08:09 +0100

If you are under the impression that bariatric surgery is a quick-fix for a poor quality of life, you should read this research report. Medscape Nurses (Source: Medscape Today Headlines)

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The Effect of Surgical Weight Reduction on Left Ventricular Structure and Function in Severe Obesity.

Obesity — Thu, 18 Mar 2010 00:00:00 +0100

Authors: Hsuan CF, Huang CK, Lin JW, Lin LC, Lee TL, Tai CM, Yin WH, Tseng WK, Hsu KL, Wu CC The aim of this study was to examine the effect of surgical weight reduction on cardiac structure and function and to seek the determinants of these changes. Sixty-six severely obese adults (BMI >/=35 kg/m(2)) who received bariatric surgery underwent echocardiographic examination before and 3 months after surgery. At 3 months after surgery, BMI and systolic blood pressure (BP) decreased (43.3 +/- 6.3 to 34.1 +/- 5.6 kg/m(2), P < 0.001, and 146 +/- 12 to 130 +/- 14 mm Hg, P < 0.001, respectively). In left ventricular (LV) geometry, the relative wall thickness (RWT) and LV mass index decreased significantly (0.43 +/- 0.05 to 0.35 +/- 0.05, P < 0.001, and 50 +/- 11 to 39 +/- 11 g/m(2.7...

Copper deficiency myelopathy

Journal of Neurology — Mon, 15 Mar 2010 17:54:51 +0100

Abstract Acquired copper deficiency has been recognised as a rare cause of anaemia and neutropenia for over half a century. Copper deficiency myelopathy (CDM) was only described within the last decade, and represents a treatable cause of non-compressive myelopathy which closely mimics subacute combined degeneration due to vitamin B12 deficiency. Here, 55 case reports from the literature are reviewed regarding their demographics, aetiology, haematological and biochemical parameters, spinal imaging, treatment and outcome. The pathophysiology of disorders of copper metabolism is discussed. CDM most frequently presented in the fifth and sixth decades and was more common in women (F:M = 3.6:1). Risk factors included previous upper gastrointestinal surgery, zinc overlo...

Physical activity and weight loss following bariatric surgery

Obesity Reviews — Mon, 15 Mar 2010 00:00:00 +0100

In conclusion, observational evidence of self-reported physical activity suggests that physical activity increases after bariatric surgery and that physical activity is associated with surgically induced weight loss. However, these findings warrant further evaluation using objective measures of physical activity and testing in controlled trials. (Source: Obesity Reviews)

Autologous Augmentation-Mastopexy After Bariatric Surgery: Waste Not Want Not!

Aesthetic Plastic Surgery — Sun, 14 Mar 2010 12:31:30 +0100

Conclusion Autologous augmentation-mastopexy provides a robust augmentation, giving more natural ptotic breasts while avoiding the cost and potential complications of implant augmentation. The increased lateral flank scarring is well tolerated by these patients, with the additional benefit of reducing flank fullness. Content Type Journal ArticleCategory Innovative TechniquesDOI 10.1007/s00266-010-9479-9Authors Daniel J. A. Thornton, Pinderfields General Hospital Aberford Road WF1 4DG Wakefield UKLe Roux Fourie, Pinderfields General Hospital Aberford Road WF1 4DG Wakefield UK Journal Aesthetic Plastic SurgeryOnline ISSN 1432-5241Print ISSN 0364-216X (Source: Aesthetic Plastic Surgery)

American Society of Bariatric Physicians Discourages the Use of the "Pregnancy Hormone" in Weight Loss Regimens

PRWeb: Medical Pharmaceuticals — Wed, 10 Mar 2010 16:45:28 +0100

Medical society has found HCG hormone is ineffective at producing weight loss (PRWeb Mar 9, 2010) Read the full story at http://www.prweb.com/releases/2010/03/prweb3671534.htm (Source: PRWeb: Medical Pharmaceuticals)

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RecoverCare Enhances Management Team

HSMN NewsFeed — Wed, 10 Mar 2010 15:54:19 +0100

Kevin McKim Appointed President Ryan Schmidt to Join Company as Chief Operating Officer LOUISVILLE, Ky., March 10 (HSMN NewsFeed) -- RecoverCare, LLC, a leading distributor of wound care and bariatric equipment and solutions to the acute and long t... Devices, Wound Care, PersonnelRecoverCare (Source: HSMN NewsFeed)

Stroke Volume Variation as a Guide to Fluid Administration in Morbidly Obese Patients Undergoing Laparoscopic Bariatric Surgery

Obesity Surgery — Wed, 10 Mar 2010 15:38:36 +0100

Conclusion Obese patients coming for laparoscopic bariatric surgery may not require excessive fluid. Intraoperative fluid requirement is the same as for nonobese patients. SVV is a valuable guide for fluid application in obese patients undergoing bariatric surgery. Content Type Journal ArticleCategory Clinical ResearchDOI 10.1007/s11695-009-0070-xAuthors Anil Kumar Jain, Sir Ganga Ram Hospital, Sir Ganga Ram Hospital Marg Department of Anaesthesiology, Pain, and Perioperative Medicine New Delhi 110060 IndiaAmitabh Dutta, Sir Ganga Ram Hospital, Sir Ganga Ram Hospital Marg Department of Anaesthesiology, Pain, and Perioperative Medicine New Delhi 110060 India Journal Obesity SurgeryOnline ISSN 1708-0428Print ISSN 0960-8923 (Source: Obesity Surgery)

Temporary Restoration of Digestive Continuity After Laparoscopic Gastric Bypass to Allow Endoscopic Sphincterotomy and Retrograde Exploration of the Biliary Tract

Obesity Surgery — Wed, 10 Mar 2010 15:38:33 +0100

Abstract The prevalence of morbid obesity is rapidly increasing worldwide. As surgery has been recognized to be the only effective treatment for morbid obesity, the number of bariatric procedure realized each year has dramatically increased. Among all the surgical options, gastric bypass in considered as the gold standard. A possible drawback of this operation is the difficult access to the excluded proximal intestinal tract and, consequently, to the biliary tract. As gallstone formation may be frequent after a rapid weight loss induced by surgery, surgeons could be frequently asked to face the need of exploration of the biliary tree after anatomical changes induced by this kind of surgery. Many technical solutions, mainly based on a combined laparoscopic and endoscopic ap...

Dietary Habits and Body Weight at Long-Term Following Biliopancreatic Diversion

Obesity Surgery — Wed, 10 Mar 2010 15:38:32 +0100

This study aims to evaluate the role of simple carbohydrates and alcohol intake in determining weight of stabilization at long-term following malabsorptive bariatric surgery. Material and Methods Sixty patients at more than 2 years following biliopancreatic diversion (BPD) were submitted to an alimentary interview for evaluating the daily consumption of simple sugar, fruits, ice-cream, sweets, and caloric and alcoholic beverages. Eating behavior was assessed by Three Factors Eating Questionnaire. Results The mean estimated daily energy consumption intake was 2,852 kcal, with a mean daily intake of simple carbohydrates of 89 g that represented 12% of the total energy intake. The current body weight was positively and independently r...

Sweet Eating: A Definition and the Development of the Dutch Sweet Eating Questionnaire

Obesity Surgery — Wed, 10 Mar 2010 15:38:31 +0100

Conclusion A shortcoming of this study is that the results may not be applicable to males and to non-Western populations. The definition and the questionnaire may be useful in future research regarding sweet eating and bariatric surgery outcomes in morbidly obese patients. Content Type Journal ArticleCategory Clinical ResearchDOI 10.1007/s11695-010-0094-2Authors Margot van den Heuvel, Research & Development, Ra-Medical, Obesity Centre Beverwijk Beverwijk The NetherlandsRogier Hörchner, Research & Development, Ra-Medical, Obesity Centre Beverwijk Beverwijk The NetherlandsAnneke Wijtsma, Research & Development, Ra-Medical, Obesity Centre Beverwijk Beverwijk The NetherlandsNoufissa Bourhim, Research & Development, Ra-Medical, Obesity Centre Beverwijk Beverwijk The Net...

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Influence of Lys656asn Polymorphism of Leptin Receptor Gene on Surgical Results of Biliopancreatic Diversion

Journal of Gastrointestinal Surgery — Wed, 10 Mar 2010 15:25:48 +0100

Conclusion Weight loss was higher in mutant group (Lys656Asn and Asn656Asn) than wild-type group (Lys656Lys) after bariatric surgery. Carriers of the allelic variant (Asn) had higher basal weight. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s11605-010-1181-3Authors Daniel Antonio de Luis, University of Valladolid Institute of Endocrinology and Nutrition, Medicine School. Unit of Investigation and Endocrinology Department, Hospital Rio Hortega Valladolid 47130 SpainRocio Aller, University of Valladolid Institute of Endocrinology and Nutrition, Medicine School. Unit of Investigation and Endocrinology Department, Hospital Rio Hortega Valladolid 47130 SpainManuel González Sagrado, University of Valladolid Institute of Endocrinology and Nutrition, Me...

The Obesity and Cancer Connection

Bariatric Nursing and Surgical Patient Care — Wed, 10 Mar 2010 04:01:28 +0100

Bariatric Nursing and Surgical Patient Care Mar 2010, Vol. 5, No. 1: 1-2. (Source: Bariatric Nursing and Surgical Patient Care)

Relationship between insulin resistance, inflammation and liver cell apoptosis in patients with severe obesity

Diabetes/Metabolism Research and Reviews — Wed, 10 Mar 2010 00:00:00 +0100

In obesity, insulin resistance appears frequently after activation of proinflammatory molecules. Caspase-generated cytokeratin-18 (CK-18) fragments are produced during the apoptosis of hepatic cells. The main objective in the present study is to investigate the relationship between insulin resistance and caspase-generated CK-18 fragments in patients with severe obesity.Sixty-two patients selected for bariatric surgery were clinically studied (sex, age, weight, waist diameter, body mass index, arterial pressure and type 2 diabetes mellitus) and analytic parameters were measured in blood (glucose concentration, cholesterol, triglycerides, insulin, glycosylated hemoglobin, aspartate aminotransferase, alanine aminotransferase, high-sensitivity C-reactive protein, adiponectin, interleukin 6, in...

The Innovation in Primary and Community Care Conference

NHS Networks — Tue, 09 Mar 2010 16:49:20 +0100

will showcase the latest information on technology driven primary care developments; with particular reference to telehealth and the T Health Programme. The conference will be your chance to engage in open discussions with primary care product developers across a range of subjects including bariatric care, integrated patient records, remote diagnostics and sensors and assistive technology collaborations. Places are free of charge. For more information on the event or to book your place visit the medilink website. (Source: NHS Networks)

Applying Middle-Range Nursing Theory to Bariatric Surgery Patients: Experiencing Transitions

Bariatric Nursing and Surgical Patient Care — Tue, 09 Mar 2010 12:37:23 +0100

Bariatric Nursing and Surgical Patient Care Mar 2010, Vol. 5, No. 1: 35-43. (Source: Bariatric Nursing and Surgical Patient Care)

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The Permanente Medical Group, Richmond Medical Center

Bariatric Nursing and Surgical Patient Care — Tue, 09 Mar 2010 12:37:06 +0100

Bariatric Nursing and Surgical Patient Care Mar 2010, Vol. 5, No. 1: 23-27. (Source: Bariatric Nursing and Surgical Patient Care)

Postdischarge Issues with Postbariatric Surgery

Bariatric Nursing and Surgical Patient Care — Tue, 09 Mar 2010 12:37:05 +0100

Bariatric Nursing and Surgical Patient Care Mar 2010, Vol. 5, No. 1: 3-13. (Source: Bariatric Nursing and Surgical Patient Care)

Ethical Realities of Bariatric Nursing: A Case Study Approach to Real World Dilemmas Part Four: Balancing Benefit and Burden

Bariatric Nursing and Surgical Patient Care — Tue, 09 Mar 2010 12:37:01 +0100

Bariatric Nursing and Surgical Patient Care Mar 2010, Vol. 5, No. 1: 29-33. (Source: Bariatric Nursing and Surgical Patient Care)

Putting Your Hands on the Resource: A Major Conference Benefit

Bariatric Nursing and Surgical Patient Care — Tue, 09 Mar 2010 12:37:01 +0100

Bariatric Nursing and Surgical Patient Care Mar 2010, Vol. 5, No. 1: 85-88. (Source: Bariatric Nursing and Surgical Patient Care)

Clinical Q&A

Bariatric Nursing and Surgical Patient Care — Tue, 09 Mar 2010 12:37:00 +0100

Bariatric Nursing and Surgical Patient Care Mar 2010, Vol. 5, No. 1: 83-84. (Source: Bariatric Nursing and Surgical Patient Care)

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Safe Intrahospital Transport of Critically Ill Obese Patients

Bariatric Nursing and Surgical Patient Care — Tue, 09 Mar 2010 12:36:55 +0100

Bariatric Nursing and Surgical Patient Care Mar 2010, Vol. 5, No. 1: 65-70. (Source: Bariatric Nursing and Surgical Patient Care)

Safe “Handoffs” for the Morbidly Obese

Bariatric Nursing and Surgical Patient Care — Tue, 09 Mar 2010 12:36:51 +0100

Bariatric Nursing and Surgical Patient Care Mar 2010, Vol. 5, No. 1: 71-74. (Source: Bariatric Nursing and Surgical Patient Care)

Nursing Mentorship Goes International

Bariatric Nursing and Surgical Patient Care — Tue, 09 Mar 2010 12:36:50 +0100

Bariatric Nursing and Surgical Patient Care Mar 2010, Vol. 5, No. 1: 81-82. (Source: Bariatric Nursing and Surgical Patient Care)

Interview of Mary Ann Wilson, RN, host of DVT Awareness in Motion

Bariatric Nursing and Surgical Patient Care — Tue, 09 Mar 2010 12:36:47 +0100

Bariatric Nursing and Surgical Patient Care Mar 2010, Vol. 5, No. 1: 15-22. (Source: Bariatric Nursing and Surgical Patient Care)

Medical Home Concept: Policy Implications for an Integrated Approach in Obesity Management

Bariatric Nursing and Surgical Patient Care — Tue, 09 Mar 2010 12:36:47 +0100

Bariatric Nursing and Surgical Patient Care Mar 2010, Vol. 5, No. 1: 89-91. (Source: Bariatric Nursing and Surgical Patient Care)

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Obesity and Sleep Disorders: Implications for Bariatric Patients

Bariatric Nursing and Surgical Patient Care — Tue, 09 Mar 2010 12:36:45 +0100

Bariatric Nursing and Surgical Patient Care Mar 2010, Vol. 5, No. 1: 75-79. (Source: Bariatric Nursing and Surgical Patient Care)

The Lived Experience of Individuals following Roux-en-Y Gastric Bypass Surgery: A Phenomenological Study

Bariatric Nursing and Surgical Patient Care — Tue, 09 Mar 2010 12:36:43 +0100

Bariatric Nursing and Surgical Patient Care Mar 2010, Vol. 5, No. 1: 57-64. (Source: Bariatric Nursing and Surgical Patient Care)

Gut microbiome-derived metabolites characterize a peculiar obese urinary metabotype

International Journal of Obesity — Tue, 09 Mar 2010 00:00:00 +0100

Authors: R Calvani, A Miccheli, G Capuani, A Tomassini Miccheli, C Puccetti, M Delfini, A Iaconelli, G Nanni & G Mingrone (Source: International Journal of Obesity)

Clinical Nurse Specialist - Obesity/Bariatric Surgery

Society for Endocrinology — Mon, 08 Mar 2010 12:00:00 +0100

Added via www.healthjobsuk.com Cambridge University Hospitals NHS Trust are looking to recruit a Clinical Nurse Specialist to provide an effective and efficient obesity nursing service to both medical and surgical patients in the Addenbrooke's Hospital site. The successful applicant will be provided with training and development should they have no prior experience in obesity management, and will be a registered Nurse who is passionate about caring for patients' psychological and emotional needs as well as their physical ones, providing high-quality, dignified care. The deadline for applications is 24 March. Further information is available by following the link below.Further details (Source: Society for Endocrinology)

Effects of Lifestyle Measures, Antiobesity Agents, and Bariatric Surgery on Serological Markers of Inflammation in Obese Patients

Mediators of Inflammation — Sun, 07 Mar 2010 15:59:41 +0100

Overweight and obesity are highly prevalent in developed countries and are also becoming more frequent in the developing world. Overweight and obese patients have elevated levels of several inflammatory markers and this inflammatory state might contribute to their increased vascular risk. We summarize the effects of lifestyle changes, antiobesity agents, and bariatric surgery on serological inflammatory markers in overweight and obese patients. Most studies showed a decrease in inflammation with all 3 interventions. However, it remains to be established whether the decrease in inflammatory markers induced by lifestyle changes or (where indicated) with antiobesity agents or bariatric surgery will translate into reduced vascular morbidity and mortality in overweight and obese patients. (Sour...

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Intraoperative Fluid Replacement and Postoperative Creatine Phosphokinase Levels in Laparoscopic Bariatric Patients

Obesity Surgery — Wed, 03 Mar 2010 08:07:14 +0100

Conclusions Conservative (15 ml/kg) versus liberal (40 ml/kg) intraoperative IVF administration did not change the incidence of RML in patients undergoing laparoscopic bariatric operations. Since the occurrence of RML in this patient population is relatively high, postoperative CK levels should be routinely obtained in patients at special risk. Content Type Journal ArticleCategory Clinical ResearchDOI 10.1007/s11695-010-0092-4Authors Daniel B. Wool, Stanford University School of Medicine Department of Surgery Stanford CA 94305 USAHarry J. M. Lemmens, Stanford University Medical Center Department of Anesthesia, H 3580 Stanford CA 94305 USAJay B. Brodsky, Stanford University Medical Center Department of Anesthesia, H 3580 Stanford CA 94305 USAHouman Solomon,...

Surgical Site Infections Following Bariatric Surgery in Community Hospitals: A Weighty Concern?

Obesity Surgery — Wed, 03 Mar 2010 08:07:12 +0100

Conclusions Inadequate dosing of vancomycin prophylaxis prior to BS is associated with increased risk of SSI. If vancomycin is used for prophylaxis, the appropriate dose should be calculated using actual bodyweight rather than lean bodyweight in accordance with Infectious Disease Society of America recommendations. Content Type Journal ArticleCategory Clinical ResearchDOI 10.1007/s11695-010-0105-3Authors Joshua T. Freeman, Duke University Medical Center Duke Infection Control Outreach Network (DICON) DUMC 3605 Durham NC 27710 USADeverick J. Anderson, Duke University Medical Center Duke Infection Control Outreach Network (DICON) DUMC 3605 Durham NC 27710 USAMatthew G. Hartwig, Duke University Medical Center Division of Surgery Durham NC 27710 USADaniel J. Sexton, Duk...

Psychosocial correlates of binge eating in Hispanic, African American, and Caucasian women presenting for bariatric surgery.

Eating Behaviors — Tue, 02 Mar 2010 20:22:47 +0100

This study sought to (a) compare the prevalence and severity of binge eating symptomatology and BED diagnosis in Hispanic, African American, and Caucasian women presenting for gastric bypass surgery, (b) examine the impact of depressive symptoms and stress on binge eating symptomatology, and (c) investigate whether ethnicity moderated any relationship between depression, stress, and binge eating. Results indicated that Hispanic women exhibited equal rates of binge eating symptomatology, BED, and depressive symptomatology as African American and Caucasian women. However, Caucasian women exhibited greater binge eating symptomatology than African American women, and African American women endorsed greater levels of stress than Caucasian women. Across all ethnic groups, depressive symptomatolo...

Short-Term Carbohydrate-Restricted Diet for Weight Loss in Severely Obese Women

Obesity Surgery — Tue, 02 Mar 2010 10:07:22 +0100

Conclusion Short-term RD was more efficient than CD regarding quick weight loss and waist circumference reduction, which may favor gastroplasty. Also, RD did not lead adverse metabolic effects. Content Type Journal ArticleCategory Clinical ResearchDOI 10.1007/s11695-010-0110-6Authors Andresa de Toledo Triffoni-Melo, University of São Paulo Department of Internal Medicine, School of Medicine of Ribeirão Preto Ribeirão Preto SP BrazilIngrid Dick-de-Paula, University of São Paulo Clinical Hospital, School of Medicine of Ribeirão Preto Ribeirão Preto SP BrazilGuilherme Vannucchi Portari, Federal University of Triangulo Mineiro Faculty of Nutrition Uberaba MG BrazilAlceu Afonso Jordao, University of São Paulo Nutrition and Metabolism, Department of Internal Medicin...

Wernicke's Encephalopathy After Laparoscopic Roux-en-Y Gastric Bypass: A Misdiagnosed Complication

Obesity Surgery — Tue, 02 Mar 2010 10:07:21 +0100

Abstract Malabsorptive syndromes and micronutrient deficiencies represent well-known long-term complications of bariatric surgery. Wernicke's encephalopathy (WE), a neurologic manifestation of thiamine deficiency, has been classically associated with alcoholism or severe malnutrition, but rarely reported after bariatric surgery. Herein, we describe the case of a 27-year-old woman that developed WE 10 months after laparoscopic Roux-en-Y gastric bypass for morbid obesity that was initially misdiagnosed with a consequent retard in the appropriate treatment. Although only a few sporadic cases have been reported in the literature, all surgeons and physicians involved in the care of bariatric patients must be aware of this potentially serious complication. Content Type ...

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Endoscopic removal of dysfunctioning rings or bands after restrictive bariatric procedures

Gastrointestinal Endoscopy — Mon, 01 Mar 2010 00:00:00 +0100

This study demonstrates the need and documented potential for GI surgeons and gastroenterologists to work together. Through a collaborative paradigm, we can partner toward providing optimal care for the bariatric patient. Blero et al describe a case series of postoperative bariatric surgery patients who sustained complications of surgical foreign body (SFB) migrations, which were treated endoscopically. Their case series describes a thoughtful, tiered, and safe approach to dealing with these complications. (Source: Gastrointestinal Endoscopy)

Gastroesophageal Reflux Disease and Obesity

Gastroenterology Clinics of North America — Mon, 01 Mar 2010 00:00:00 +0100

Gastroesophageal reflux disease (GERD) is a common condition, with multifactorial pathogenesis, affecting up to 40% of the population. Obesity is also common. Obesity and GERD are clearly related, both from a prevalence and causality association. GERD symptoms increase in severity when people gain weight. Obese patients tend to have more severe erosive esophagitis and obesity is a risk factor for the development of Barrett's esophagus and adenocarcinoma of the esophagus. Patients report improvement in GERD when they lose weight and there are several reports suggesting a decrease in GERD symptoms after bariatric surgery. At present, there is little evidence that obesity has any effect on the efficacy of antisecretory therapy, with conflicting data on surgical outcomes. This review attempts ...

Preoperative Gastrointestinal Assessment Before Bariatric Surgery

Gastroenterology Clinics of North America — Mon, 01 Mar 2010 00:00:00 +0100

This article discusses the factors that a gastroenterologist should assess before the surgery. (Source: Gastroenterology Clinics of North America)

Endoscopic Retrograde Cholangiopancreatography in Patients with Roux-en-Y Anatomy

Gastroenterology Clinics of North America — Mon, 01 Mar 2010 00:00:00 +0100

This article discusses the different options available for endoscopists who are faced with the need to perform endoscopic retrograde cholangiopancreatography in patients after Roux-en-Y reconstruction, with special emphasis on those after RYGB. (Source: Gastroenterology Clinics of North America)

Postoperative Metabolic and Nutritional Complications of Bariatric Surgery

Gastroenterology Clinics of North America — Mon, 01 Mar 2010 00:00:00 +0100

Bariatric surgery has become an increasingly important method for management of medically complicated obesity. In patients who have undergone bariatric surgery, up to 87% with type 2 diabetes mellitus develop improvement or resolution of their disease postoperatively. Bariatric surgery can reduce the number of absorbed calories through performance of either a restrictive or a malabsorptive procedure. Patients who have undergone bariatric surgery require indefinite, regular follow-up care by physicians who need to follow laboratory parameters of macronutrient as well as micronutrient malnutrition. Physicians who care for patients after bariatric surgery need to be familiar with common postoperative syndromes that result from specific nutrient deficiencies. (Source: Gastroenterology Clinics ...

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The Surgical Treatment of Metabolic Disease and Morbid Obesity

Gastroenterology Clinics of North America — Mon, 01 Mar 2010 00:00:00 +0100

The disease of obesity has continued to increase in the United States. Obesity is defined as a body mass index (BMI) greater than 30 kg/m2. In 1991, the National Institute of Health Consensus Panel on Gastric Surgery for Severe Obesity defined the population who would most likely benefit from bariatric surgery. These same criteria continue to be used today to determine which patients should undergo metabolic and weight loss surgery. These recommendations include patients who have a BMI greater than 35 kg/m2 with significant comorbid conditions such as diabetes, hypertension, or obstructive sleep apnea; and patients who have a BMI greater than 40 kg/m2 with or without any significant comorbid conditions because they have a significant increased risk for developing these conditions. (Source:...

Short- and Long-Term Surgical Follow-Up of the Postbariatric Surgery Patient

Gastroenterology Clinics of North America — Mon, 01 Mar 2010 00:00:00 +0100

Follow-up of the large numbers of patients undergoing bariatric surgery poses problems for surgical programs and for internists who care for morbidly obese patients. Early surgical follow up is concentrated on the perioperative period to ensure healing and care for any surgical complications. It is especially important to treat persistent vomiting to avoid thiamine deficiency. Subsequently, monitoring weight loss and resolution of comorbidities assumes more importance. Identification and management of nutritional deficiencies and other unwanted consequences of surgery may become the responsibility of internists if the patient no longer attends the office of the operating surgeon. The long-term goal is to avoid weight regain and deficiencies, especially of protein, iron and vitamin B12, and...

Interactions between obesity and obstructive sleep apnea: implications for treatment.

Chest — Mon, 01 Mar 2010 00:00:00 +0100

Authors: Romero-Corral A, Caples SM, Lopez-Jimenez F, Somers VK Obstructive sleep apnea (OSA) adversely affects multiple organs and systems, with particular relevance to cardiovascular disease. Several conditions associated with OSA, such as high BP, insulin resistance, systemic inflammation, visceral fat deposition, and dyslipidemia, are also present in other conditions closely related to OSA, such as obesity and reduced sleep duration. Weight loss has been accompanied by improvement in characteristics related not only to obesity but to OSA as well, suggesting that weight loss might be a cornerstone of the treatment of both conditions. This review seeks to explore recent developments in understanding the interactions between body weight and OSA. Weight loss helps reduce OSA severity a...

Roux-en-Y Benefits in Teens Plateau at 6 Months

Internal Medicine News — Mon, 01 Mar 2010 00:00:00 +0100

ORLANDO — Bariatric surgery produces rapid, dramatic improvements in obese adolescents, but after the first 6 months post surgery these patients appear to hit a wall and further gains in their clinical status usually do not occur, according to a follow-up study of 44 patients. (Source: Internal Medicine News)

Bariatric Risks Higher at Centers of Excellence

Family Practice News — Mon, 01 Mar 2010 00:00:00 +0100

Major Finding: Risk-adjusted rates of serious complications in bariatric surgery were 4.0% at designated Centers of Excellence, compared with 2.7% at other hospitals. (Source: Family Practice News)

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Gastric Banding Improves Weight, QOL in Teens: The study provides more level 1 evidence that bariatric surgery trumps nonsurgical treatment.

Family Practice News — Mon, 01 Mar 2010 00:00:00 +0100

Gastric banding allowed extremely obese adolescents to achieve a more substantial and durable weight loss than did an intensive lifestyle modification program, based on results of a prospective clinical trial with 50 adolescents. (Source: Family Practice News)

Psychotropic Drug Use in 31% Seeking Bariatric Surgery

Clinical Psychiatry News — Mon, 01 Mar 2010 00:00:00 +0100

Major Findings: Depressive symptoms were reported by 76% of adolescents seeking bariatric surgery. (Source: Clinical Psychiatry News)

Bariatric Surgery Can Lead to Remission of Type 2 Diabetes

Clinical Psychiatry News — Mon, 01 Mar 2010 00:00:00 +0100

BOSTON — Bariatric surgery can lead to sustained remission of type 2 diabetes and improvements in cardiovascular health that lower the risk for diabetes-specific mortality, according to Dr. Ted D. Adams, a cardiovascular researcher at the University of Utah, Salt Lake City. (Source: Clinical Psychiatry News)

Bariatric Risks Higher at Centers of Excellence

Clinical Endocrinology News — Mon, 01 Mar 2010 00:00:00 +0100

Major Finding: Risk-adjusted rates of serious complications in bariatric surgery were 4.0% at designated Centers of Excellence, compared with 2.7% at other hospitals. (Source: Clinical Endocrinology News)

High Incidence of Appendix Carcinoid Tumors Among Candidates for Bariatric Surgery: Diagnostic and Therapeutic Implications

Obesity Surgery — Fri, 26 Feb 2010 06:47:08 +0100

This study was designed to fill that gap. Between 2000-2008, 558 patients underwent bariatric procedures. Appendectomy was routinely performed in 477 cases. Their charts were retrospectively retrieved and histopathology responses on surgical specimens were recorded. We aimed to assess: incidence of appendix carcinoid tumors (ACTs) and any possible risk-factor; modality of diagnosis (pre-, intra- or post-operatively); impact on the planned bariatric procedure; treatment reserved to such cases. Typical ACTs were diagnosed in 7 patients (1.4%) (median age: 33 years; median BMI: 49 kg/m²; males/females: 1/6). Four were diagnosed intra-operatively. Because of dimensions (<2 cm) and absence of mesoappendiceal or serosal involvement, simple appendectomy was performed duri...

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One Year Improvements in Cardiovascular Risk Factors: a Comparative Trial of Laparoscopic Roux-en-Y Gastric Bypass vs. Adjustable Gastric Banding

Obesity Surgery — Fri, 26 Feb 2010 06:47:07 +0100

Conclusions In this study, both RYGB and LAGB demonstrated significant weight loss and improvements in BCRF at 12 months post-op. RYGB produced significant improvements in a greater number of BCRFs and in some instances the 12-month post-op BCRF values were significantly lower risk in RYGB vs. LAGB patients. Content Type Journal ArticleCategory Clinical ResearchDOI 10.1007/s11695-010-0088-0Authors Gavitt A. Woodard, Stanford University School of Medicine Department of General Surgery 300 Pasteur Drive Stanford CA 94305 USAJoseph Peraza, Stanford University School of Medicine Department of General Surgery 300 Pasteur Drive Stanford CA 94305 USAStephanie Bravo, Stanford University School of Medicine Department of General Surgery 300 Pasteur Drive Stanford CA 9430...

Reduced Phenytoin Levels in an Epileptic Patient following Roux-En-Y Gastric Bypass for Obesity

Obesity Surgery — Fri, 26 Feb 2010 06:47:05 +0100

We report an epileptic patient who had a seizure following gastric bypass, although he had been asymptomatic for 30 years and without any change in his treatment. Phenytoin levels were undetectable despite a high dose. Drugs with a narrow therapeutic range such as phenytoin should be prescribed with caution after bariatric surgery. Content Type Journal ArticleCategory Case ReportDOI 10.1007/s11695-010-0107-1Authors Dimitrios J. Pournaras, Musgrove Park Hospital Department of Bariatric Surgery Taunton TA1 5DA UKDavid Footitt, Musgrove Park Hospital Department of Neurology Taunton TA1 5DA UKDavid Mahon, Musgrove Park Hospital Department of Bariatric Surgery Taunton TA1 5DA UKRichard Welbourn, Musgrove Park Hospital Department of Bariatric Surgery Taunton TA1 5DA UK Journ...

Revision Laparoscopic Gastric Bypass: An Effective Approach Following Failure of Primary Bariatric Procedures

Obesity Surgery — Fri, 26 Feb 2010 06:47:03 +0100

Conclusions The laparoscopic approach to revision Roux-en-Y gastric bypass is safe and effective even in patients with previous open bariatric surgery and is associated with rapid recovery and short hospital stay. Content Type Journal ArticleCategory Clinical ResearchDOI 10.1007/s11695-010-0104-4Authors Numan Hamza, Salford Royal Hospital Stott Lane Salford Manchester UKAmmar Darwish, Manchester Royal Infirmary Manchester UKMohannad B. Ammori, The University of Manchester Manchester UKMuhammad Hasan Abbas, Manchester Royal Infirmary Manchester UKBasil J. Ammori, Salford Royal Hospital Stott Lane Salford Manchester UK Journal Obesity SurgeryOnline ISSN 1708-0428Print ISSN 0960-8923 (Source: Obesity Surgery)

Additional Research on the Cost of Caring for Obese Nursing Home Residents is Critical to Maintaining Adequate Resources in the Long-Term Care Industry

Journal of the American Medical Directors Association — Thu, 25 Feb 2010 16:11:50 +0100

To the Editor: A startling trend in the US population threatens the quality of care available in the long-term care setting. The proportion of nursing home residents who are obese (body mass index > 30) is increasing and now represents approximately 25% of the US nursing home population. Obese residents require specialized bariatric equipment and supplies, which are costly and unavailable in many facilities, and extensive personal care assistance to perform activities of daily living. These equipment and staffing needs present significant challenges for nursing homes now and in the future as the US population ages. This problem is exacerbated in an economic context because, unlike costs, daily reimbursement rates do not vary systematically with size of the resident. (Source: Journal of th...

Can Gastric Bypass Surgery Lead To Diabetes Remission In Non-Obese Patients?

Health News from Medical News Today — Thu, 25 Feb 2010 10:00:00 +0100

Dr. Francesco Rubino, chief of gastrointestinal metabolic surgery at NewYork-Presbyterian Hospital/Weill Cornell Medical Center, is now enrolling overweight and mildly obese patients -- those with a body mass index (BMI) of 28 to 35 -- in a study of gastric bypass surgery aimed at reversing Type 2 diabetes. Because of their non-morbidly obese status, these patients do not qualify for the surgery under current guidelines. Today, gastric bypass, along with other bariatric procedures, can only be prescribed for patients with a BMI of 35 and over... (Source: Health News from Medical News Today)

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Erratum to: An Extremely Late Complication of a Roux-en-Y Jejuno-ileal Bypass

Obesity Surgery — Thu, 25 Feb 2010 08:02:14 +0100

Content Type Journal ArticleCategory ErratumDOI 10.1007/s11695-010-0100-8Authors Nicholas J. Baylem, Queen’s Medical Centre Teaching Fellow in General Surgery Nottingham England UKDimitrios J. Pournaras, Musgrove Park Hospital Clinical Research Fellow in Bariatric Surgery Taunton Somerset England UKIan Ramus, Musgrove Park Hospital Taunton Somerset England UK Journal Obesity SurgeryOnline ISSN 1708-0428Print ISSN 0960-8923 (Source: Obesity Surgery)

Exercise Following Bariatric Surgery: Systematic Review

Obesity Surgery — Wed, 24 Feb 2010 06:55:31 +0100

Abstract The contribution of physical activity on the degree of weight loss following bariatric surgery is unclear. To determine impact of exercise on postoperative weight loss. Medline search (1988–2009) was completed using MeSH terms including bariatric procedures and a spectrum of patient factors with potential relationship to weight loss outcomes. Of the 934 screened articles, 14 reported on exercise and weight loss outcomes. The most commonly used instruments to measure activity level were the Baecke Physical Activity Questionnaire, the International Physical Activity Questionnaire, and a variety of self-made questionnaires. The definition of an active patient varied but generally required a minimum of 30 min of exercise at least 3 days per week. Thirteen ...

Two-Staged Surgery for Metastatic Liver Tumor in Morbidly Obese Individual-Left Hemihepatectomy Following Placement of Laparoscopic Adjustable Gastric Band

Obesity Surgery — Wed, 24 Feb 2010 06:55:31 +0100

Abstract A 47-year-oldmale with a body mass index (BMI) 37.12 kg/m2 was diagnosed with an ill-demarcated tumor within IVB segment of left lobe of the liver. Sixteen months earlier, he underwent laparoscopic gastric banding for morbid obesity (BMI 51 kg/m2). One year after bariatric procedure, he was diagnosed with rectal adenocarcinoma. Following abdominoperineal resection of rectum with total mesorectal excision and 2 months course of adjuvant FOLFOX chemotherapy, he was scheduled for liver resection. Left hemihepatectomy was performed with no major complications; wound discharge was successfully treated in outpatient clinic. Twelve months following surgery, he remains disease free with no evidence of local recurrence, metachronic primary tumor, or distant m...

Bariatric Surgery and the Assessment of Copper and Zinc Nutriture

Obesity Surgery — Wed, 24 Feb 2010 06:55:30 +0100

Content Type Journal ArticleCategory Letter to the EditorDOI 10.1007/s11695-010-0091-5Authors Leslie M. Klevay, University of North Dakota School of Medicine and Health Sciences Department of Internal Medicine 223 27th Avenue South Grand Forks ND 58201 USA Journal Obesity SurgeryOnline ISSN 1708-0428Print ISSN 0960-8923 (Source: Obesity Surgery)

Obesity Diagnosis and Care Practices in the Veterans Health Administration

Journal of General Internal Medicine — Wed, 24 Feb 2010 06:55:23 +0100

CONCLUSIONS Substantial numbers of VHA primary care patients did not have sufficient height or weight data recorded to calculate BMI or have recorded obesity diagnoses when warranted. Receipt of obesity education varied by sociodemographic and clinical factors; providers may need to be cognizant of these when engaging patients in treatment. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s11606-010-1279-zAuthors Polly Hitchcock Noël, VERDICT/South Texas Veterans Health Care System 7400 Merton Minter Blvd (11C6) San Antonio TX 78229-4404 USALaurel A. Copeland, VERDICT/South Texas Veterans Health Care System 7400 Merton Minter Blvd (11C6) San Antonio TX 78229-4404 USAMary Jo Pugh, VERDICT/South Texas Veterans Health Care System 7400 Merton Minter Blv...

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A Review of Weight Loss Following Roux-en-Y Gastric Bypass vs Restrictive Bariatric Surgery: Impact on Adiponectin and Insulin

Obesity Surgery — Tue, 23 Feb 2010 08:01:48 +0100

Conclusions While RYGB surgery appears to more favorably influence body weight and inflammatory markers, data are insufficient to fully understand the impact of bariatric surgery on changes in adiponectin and insulin and related health implications. Long-term research is needed to more thoroughly evaluate inflammatory outcomes following these two bariatric surgery procedures. Content Type Journal ArticleCategory ReviewDOI 10.1007/s11695-010-0089-zAuthors Katrina L. Butner, Virginia Polytechnic Institute and State University Laboratory for Health and Exercise Science and Bone, Osteoporosis, Nutrition, and Exercise Laboratory, Department of Human Nutrition, Foods and Exercise 231-A War Memorial Hall (0351) Blacksburg VA 24061 USASharon M. Nickols-Richardson, The Penns...

Band erosion after laparoscopic gastric banding: a retrospective analysis of 865 patients over 5 years

Surgical Endoscopy — Tue, 23 Feb 2010 07:08:26 +0100

Conclusions The overall incidence of LAGB erosions in our series was 1.96%. This incidence fell with increasing experience to 0.5% after the initial 300 bands were excluded from the analysis (3 band erosions in the last 565 band insertions). However, further increases in incidence are likely with a longer follow-up period. The most common presentation was abdominal pain followed by weight regain and port-site sepsis. In the authors’ hands, laparoscopic omental plugging and band removal through a separate anterior gastrotomy appear to be effective methods for dealing with band erosions. Band erosion is a significant source of morbidity, with at least one-third of the erosion patients in our series not achieving their final goal of weight loss despite appropriate treatment...

Bowel bypass syndrome/bowel-associated dermatosis arthritis syndrome post laparoscopic gastric bypass surgery

Australasian Journal of Dermatology — Mon, 22 Feb 2010 00:00:00 +0100

Bowel bypass syndrome, also known as bowel-associated dermatitis arthritis syndrome, has been described after a range of intestinal bypass procedures. With the increasing trend in laparoscopic gastric bypass surgery, we report an interesting case of bowel-associated dermatitis arthritis syndrome that developed 12 months following this procedure. A 49-year-old woman presented with ulcerating lesions and pustules on the upper and lower limbs, polyarthralgia, fevers and joint effusions. Before the development of these symptoms she was well, with no significant past medical or family history. A skin biopsy taken from the left shin showed superficial to mid-dermal neutrophilic dermatosis, consistent with bowel-associated dermatitis arthritis syndrome. The patient received corticosteroids, antib...

Weight Loss Prior to Bariatric Surgery Is Not a Pre-requisite of Excess Weight Loss Outcomes in Obese Patients

Obesity Surgery — Sat, 20 Feb 2010 06:57:18 +0100

Conclusions This study suggests that weight loss before surgery should not be considered a pre-requisite. Although it can reduce the difficulties of the surgical procedure, advantages for long-term weight loss are not validated. Content Type Journal ArticleCategory Clinical ResearchDOI 10.1007/s11695-010-0083-5Authors Guillaume Becouarn, Clinique de l’Anjou Société de chirurgie Angers FrancePhilippe Topart, Clinique de l’Anjou Société de chirurgie Angers FrancePatrick Ritz, Hôpitaux de Toulouse Pôle cardio-vasculaire et métabolique Toulouse France Journal Obesity SurgeryOnline ISSN 1708-0428Print ISSN 0960-8923 (Source: Obesity Surgery)

Prospective appraisal of a 2-day training course on laparoscopic sleeve gastrectomy: the ELTC experience

Surgical Endoscopy — Sat, 20 Feb 2010 06:50:48 +0100

Conclusion The 2-day LSG course offered participants high-quality novel knowledge and excellent training quality, and exerted impact on their personal career. Content Type Journal ArticleDOI 10.1007/s00464-010-0912-6Authors Emmanuel Leandros, Hippokration Hospital of Athens, Athens Medical School Laparoendoscopic Unit, 1st Department of Propaedeutic Surgery Vasilissis Sofias Avenue 114 11527 Athens GreeceIlias P. Gomatos, Hippokration Hospital of Athens, Athens Medical School Laparoendoscopic Unit, 1st Department of Propaedeutic Surgery Vasilissis Sofias Avenue 114 11527 Athens GreeceManousos M. Konstadoulakis, Hippokration Hospital of Athens, Athens Medical School Laparoendoscopic Unit, 1st Department of Propaedeutic Surgery Vasilissis Sofias Avenue 114 11527 Athens...

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Bariatric Surgery Revisions Higher Risk

Medical Headlines From Ivanhoe.com — Thu, 18 Feb 2010 05:00:00 +0100

(Ivanhoe Newswire) -- Revisional bariatric surgery appears to be associated with a higher risk of complications than the initial bariatric procedure. (Source: Medical Headlines From Ivanhoe.com)

Revisional Bariatric Surgery Appears Safe, Effective

Modern Medicine — Thu, 18 Feb 2010 00:00:00 +0100

Revisional bariatric surgery performed at experienced centers appears safe and effective despite a higher risk of perioperative complications compared to the primary procedures, according to a study in the February issue of the Archives of Surgery. (Source: Modern Medicine)

Maladaptive Eating Patterns, Quality of Life, and Weight Outcomes Following Gastric Bypass: Results of an Internet Survey.

Obesity — Thu, 18 Feb 2010 00:00:00 +0100

Authors: Kofman MD, Lent MR, Swencionis C Bariatric surgery is the most effective treatment for severe obesity. However, evidence suggests that maladaptive eating behaviors such as binge eating, grazing, and a loss of control when eating may impact postsurgical weight outcomes. The current study sought to characterize the weight outcomes, eating patterns, and perceived health-related quality of life of individuals 3-10 years following gastric bypass (GBP) surgery and to assess the relationships between eating behaviors, weight outcomes, and quality of life. Eligible participants (N = 497) completed an Internet survey of their eating behaviors, health-related quality of life, and weight history. Participants self-reported a mean maximum postsurgical loss of 81% of their excess weight an...

Higher Risk for Complications With Revisional Bariatric Surgery Than With Initial Procedure

Medscape Today Headlines — Wed, 17 Feb 2010 17:42:26 +0100

Revisional bariatric surgery is associated with a higher risk for perioperative complications than the primary operation but still appears to be safe and effective when done in experienced centers. Medscape Medical News (Source: Medscape Today Headlines)

[Surgery for diabetes type 2?]

Praxis — Wed, 17 Feb 2010 00:00:00 +0100

Authors: Müller MK, Nocito A, Schiesser M Diabetes mellitus type 2 is a chronic disease with increasing prevalence in western society. Obesity represents a well established risk factor for the development of diabetes mellitus type 2. Several studies on surgical procedures for the treatment of obesity have shown a postoperative reduction of obesity-related co-morbidities. Thus, diabetes mellitus type 2 was shown to resolve or improve in more than 75% of morbidly obese patients (BMI >35) after bariatric surgery. These insights paved the way for the advent of metabolic surgery - a novel field with the goal to improve glucose metabolism in patients with a BMI of less than 35. Encouraging results from mostly observational studies have sparked the interest in the surgical management ...

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Complications Common in Bariatric Revisions (CME/CE)

MedPage Today Pediatrics — Tue, 16 Feb 2010 13:43:12 +0100

About one-third of patients who underwent a revisional bariatric operation at a single center had complications within three months, a prospective case series showed. (Source: MedPage Today Pediatrics)

Study Examines Outcomes After Bariatric Surgery Revisions

Health News from Medical News Today — Tue, 16 Feb 2010 08:00:00 +0100

Revisional bariatric surgery appears to be associated with a higher risk of complications than the initial procedure, according to a report in the February issue of Archives of Surgery, one of the JAMA/Archives journals. Surgical treatment is currently the only effective approach for long-term weight loss in the severely obese, according to background information in the article... (Source: Health News from Medical News Today)

Study Examines Outcomes After Bariatric Surgery Revisions

Cosmetic Medicine / Plastic Surgery News From Medical News Today — Tue, 16 Feb 2010 08:00:00 +0100

Outcomes after bariatric surgery revisions

ScienceDaily Headlines — Tue, 16 Feb 2010 07:00:00 +0100

Revisional bariatric surgery appears to be associated with a higher risk of complications than the initial procedure, according to a new article. (Source: ScienceDaily Headlines)

Repeated Weight-Loss Surgery Carries Added Risks

MedlinePlus Health News — Mon, 15 Feb 2010 21:00:00 +0100

As more people undergo bariatric procedures, use of revisions will grow, study finds Source: HealthDay Related MedlinePlus Topic: Weight Loss Surgery (Source: MedlinePlus Health News)

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Routine Postoperative Gastrografin Studies Are Not Necessary After Laparoscopic Gastric Banding [Correspondence]

Archives of Surgery — Mon, 15 Feb 2010 20:50:41 +0100

(Source: Archives of Surgery)

Routine Postoperative Gastrografin Studies Are Not Necessary After Laparoscopic Gastric Banding--Reply [Correspondence]

Archives of Surgery — Mon, 15 Feb 2010 20:50:41 +0100

(Source: Archives of Surgery)

Revisional Bariatric Surgery: 13-Year Experience From a Tertiary Institution [Original Article]

Archives of Surgery — Mon, 15 Feb 2010 20:50:40 +0100

Conclusion Although revisional bariatric surgery is associated with higher risk of perioperative complications compared with the primary procedures, it appears to be safe and effective when performed in experienced centers. (Source: Archives of Surgery)

Surgery for Obese Children?

NYT > Health — Mon, 15 Feb 2010 20:30:46 +0100

Though still considered experimental, bariatric surgery is fast becoming the next front in the battle against pediatric obesity. (Source: NYT > Health)

Study examines outcomes after bariatric surgery revisions

EurekAlert! - Medicine and Health — Mon, 15 Feb 2010 05:00:00 +0100

(JAMA and Archives Journals) Revisional bariatric surgery appears to be associated with a higher risk of complications than the initial procedure, according to a report in the February issue of Archives of Surgery, one of the JAMA/Archives journals. (Source: EurekAlert! - Medicine and Health)

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Rehabilitation in bariatrics: opportunities for practice and research.

Disability and Rehabilitation — Mon, 15 Feb 2010 00:00:00 +0100

Conclusions. This article describes a process that successfully gathered a diverse group of researchers, clinicians, industries and decision makers for the purpose of collectively advancing the area of bariatric rehabilitation in Canada. PMID: 20156049 [PubMed - as supplied by publisher] (Source: Disability and Rehabilitation)

Threshold for Bariatric Surgery in Teens Lowered

Internal Medicine News — Mon, 15 Feb 2010 00:00:00 +0100

The criteria for selecting obese adolescents as candidates for bariatric surgery have loosened in recent years, and now that the adolescent field has converged on a roughly uniform body mass index standard that's the same as for adults—at least 35 kg/m2 with serious comorbidities or at least 40 kg/m2 in other patients—physicians have begun to consider testing an even more aggressive approach to bariatric surgery in teenagers. (Source: Internal Medicine News)

Substance Use Low in Adolescents Seeking Bariatric Surgery

Internal Medicine News — Mon, 15 Feb 2010 00:00:00 +0100

WASHINGTON — Almost one-third of adolescents approved for bariatric surgery reported using psychotropic medications, but the use of substances was lower than expected, according to data from 82 subjects collected as part of a larger longitudinal study. (Source: Internal Medicine News)

Adolescent Bariatric Surgery Center Passes Surgical Milestone

Health News from Medical News Today — Fri, 12 Feb 2010 09:00:00 +0100

Few treatments are available to help obese adolescents who are unable to lose weight and are already suffering from obesity-related health problems. Laparoscopic adjustable gastric banding (LAGB), an option for adults in the United States since 2001, is showing promise for teens. The Center for Adolescent Bariatric Surgery, which opened at NewYork-Presbyterian Morgan Stanley Children's Hospital in 2006, recently performed its 100th LAGB procedure. "Adolescent obesity continues to be under-treated," says Dr. Charles J.H... (Source: Health News from Medical News Today)

Adolescent Bariatric Surgery Center Passes Surgical Milestone

Cosmetic Medicine / Plastic Surgery News From Medical News Today — Fri, 12 Feb 2010 09:00:00 +0100

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Obesity in adults

Clinical Evidence — Thu, 11 Feb 2010 23:00:00 +0100

New option(s) added for: Diethylpropion New option for which we found one systematic review. The review found less weight loss with diethylpropion compared with phentermine. Data were from one small RCT and effects of diethylpropion in weight loss are unclear. Categorised as Unknown effectiveness. Mazindol New option for which we found no evidence. Categorised as Unknown effectiveness. Bariatric surgery New option for which we found one systematic review. The review identified two RCTs and three cohort studies assessing the effects of various bariatric surgical techniques (gastric banding, gastric bypass, vertical banded gastroplasty, biliopancreatic diversion, and sleeve gastrectomy) in people with morbid obesity. All studies ...

Prevention and Treatment of Peripheral Neuropathy after Bariatric Surgery

Current Treatment Options in Neurology — Thu, 11 Feb 2010 11:41:28 +0100

Opinion statement Given the ever-increasing problem of obesity, it is not surprising that the number of patients who undergo bariatric surgery continues to rise. For patients who have gastric banding, the amount of food they can consume is limited, and nausea and vomiting may further limit nutritional intake early on. More extensive procedures, such as the Roux-en-Y or biliopancreatic diversion with or without a duodenal switch, not only restrict intake but also limit absorption in the small intestine. As a result, deficiencies in vitamins, minerals, and trace elements may develop, leading to a variety of neurologic complications. The peripheral neuropathies best described with a clear-cut cause are an acute, frequently painful neuropathy or polyradiculoneuropathy associat...

Weight-loss surgery doubles in two years

OnMedica Latest News — Thu, 11 Feb 2010 00:00:00 +0100

Bariatric procedures in England follow rise in obesity to record levelsRelated items from OnMedicaWeight-loss device helps obese adolescentsSwine flu cases fall but jabs must continueMany children are obese by the time they start school High salt intake strongly linked to stroke and CVDPoorest Scottish kids do the least exercise (Source: OnMedica Latest News)

Is social support associated with greater weight loss after bariatric surgery?: a systematic review

Obesity Reviews — Thu, 11 Feb 2010 00:00:00 +0100

The objective of this article is to determine impact of post-operative support groups and other forms of social support on weight loss after bariatric surgery. MEDLINE search (1988[ndash]2009) was completed using MeSH terms including bariatric procedures and a spectrum of patient factors with potential relationship to weight loss outcomes. Of the 934 screened studies, 10 reported on social support and weight loss outcomes. Five studies reported on support groups and five studies reported on other forms of social support (such as perceived family support or number of confidants) and degree of post-operative weight loss (total n = 735 patients). All studies found a positive association between post-operative support groups and weight loss. One study found a positive association between marit...

Beyond the BMI: The Search for Better Guidelines for Bariatric Surgery.

Obesity — Thu, 11 Feb 2010 00:00:00 +0100

Authors: Pories WJ, Dohm LG, Mansfield CJ The application of the BMI of >/=35 as the major prerequisite for access to bariatric surgery is no longer appropriate because the index, now incorporated in the requirements of Medicare, Medicaid and most private carriers, does not reflect the degree or distribution of adiposity, it discriminates unfairly on the basis of gender, race, age, fitness, and body fat composition. Further, with increasing evidence that bariatric surgery can also induce full and durable remission of such comorbidities as type 2 diabetes even in patients with BMIs <30, new guidelines must be pursued. PMID: 20150899 [PubMed - as supplied by publisher] (Source: Obesity)

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Latest updates to UK DUETS

Gastroenterology and Liver Diseases Specialist Library - Liver — Wed, 10 Feb 2010 14:07:57 +0100

We have recently added the following uncertainties to UK DUETS: Bariatric surgery for non-alcoholic steatohepatitis in obese patients Chinese herbal medicines for induction of remission in advanced or late gastric cancer Optimal duration of pegatheron plus ribavirin therapy for chronic hepatitis C in patients with HIV Peginterferon plus ribavirin versus no treatment for chronic hepatitis C in patients with HIV Photodynamic therapy using 5-ALA versus porfimer sodium for Barrett's oesophagus Radiofrequency ablation for Barrett's oesophagus and Barrett's dysplasia Radiofrequency ablation versus surgical resection for oligometastatic hepatic metastases of colorectal cancer Radiofrequency ablation versus surgical resection for resectable hepatic metastases of colorectal cancer Radiofrequency ab...

Latest updates to UK DUETS

Gastroenterology and Liver Diseases Specialist Library - Stomach — Wed, 10 Feb 2010 13:09:54 +0100

Latest updates to UK DUETS

Gastroenterology and Liver Diseases Specialist Library - Colon and rectum — Wed, 10 Feb 2010 13:01:24 +0100

Latest updates to UK DUETS

Wed, 10 Feb 2010 12:42:33 +0100

Latest updates to UK DUETS

Gastroenterology and Liver Diseases Specialist Library - Prevention — Wed, 10 Feb 2010 12:31:38 +0100

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The fat of the land: obesity prevention over obesity treatment.

British Journal of Nursing — Wed, 10 Feb 2010 00:00:00 +0100

Authors: Glasper A Professor Alan Glasper looks at the ever-increasing problem of obesity, and the complications involved when caring for a bariatric patient. He examines new healthcare guidance for dealing with these complex nursing problems, and what nurses can do in the fight to prevent obesity. PMID: 20220669 [PubMed - in process] (Source: British Journal of Nursing)

Weight-Loss Surgery Gets a Lift

WSJ.com: Health — Tue, 09 Feb 2010 23:51:04 +0100

Obese teens who underwent weight-loss surgery shed significantly more pounds than those who tried just dieting and exercise in a new study, a finding that may boost interest in bariatric surgery for adolescents. (Source: WSJ.com: Health)

Questions remain on effectiveness of bariatric surgery in adolescents

UT Southwestern Medical Center News — Tue, 09 Feb 2010 23:00:00 +0100

Bariatric Surgery [JAMA Patient Page]

JAMA — Tue, 09 Feb 2010 20:50:50 +0100

(Source: JAMA)

Laparoscopic Adjustable Gastric Banding in Severely Obese Adolescents: A Randomized Trial [Original Contribution]

JAMA — Tue, 09 Feb 2010 20:50:49 +0100

Conclusions Among obese adolescent participants, use of gastric banding compared with lifestyle intervention resulted in a greater percentage achieving a loss of 50% of excess weight, corrected for age. There were associated benefits to health and quality of life. Trial Registration ANZCTR Identifier: 12605000160639 (Source: JAMA)

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Surgical Treatment of Obesity in Adolescence [Editorial]

JAMA — Tue, 09 Feb 2010 20:50:49 +0100

(Source: JAMA)

Latest updates to UK DUETS

Gastroenterology and Liver Diseases Specialist Library - Oesophagus — Tue, 09 Feb 2010 14:12:53 +0100

Latest updates to UK DUETS

Tue, 09 Feb 2010 13:58:03 +0100

Questions Remain On Bariatric Surgery For Adolescents

Cosmetic Medicine / Plastic Surgery News From Medical News Today — Tue, 09 Feb 2010 10:00:00 +0100

Laparoscopic adjustable gastric banding surgery can effectively treat obesity in adolescents and seems to offer a better alternative than gastric bypass surgery, but further study is needed to determine whether it's better than nonsurgical options, a UT Southwestern Medical Center surgeon writes in an editorial in the Feb. 10 issue of the Journal of the American Medical Association... (Source: Cosmetic Medicine / Plastic Surgery News From Medical News Today)

Questions Remain On Bariatric Surgery For Adolescents

Health News from Medical News Today — Tue, 09 Feb 2010 10:00:00 +0100

Laparoscopic adjustable gastric banding surgery can effectively treat obesity in adolescents and seems to offer a better alternative than gastric bypass surgery, but further study is needed to determine whether it's better than nonsurgical options, a UT Southwestern Medical Center surgeon writes in an editorial in the Feb. 10 issue of the Journal of the American Medical Association. "The latest research helps us define which surgical procedure may be preferable, but we are still a long way from settling the question of whether surgery should be used to treat obesity in teens," said Dr... (Source: Health News from Medical News Today)

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Questions remain on bariatric surgery for adolescents

EurekAlert! - Medicine and Health — Tue, 09 Feb 2010 05:00:00 +0100

(UT Southwestern Medical Center) Laparoscopic adjustable gastric banding surgery can effectively treat obesity in adolescents and seems to offer a better alternative than gastric bypass surgery, but further study is needed to determine whether it's better than nonsurgical options, a UT Southwestern Medical Center surgeon writes. (Source: EurekAlert! - Medicine and Health)

The future of bariatrics: endoscopy, endoluminal surgery, and natural orifice transluminal endoscopic surgery

Endoscopy — Sat, 06 Feb 2010 14:26:02 +0100

Endoscopy 2010; 42: 155-162DOI: 10.1055/s-0029-1243876This review considers the evolving role of endoscopic techniques in the treatment of obesity, and developments in minimally invasive procedures in endoscopy, endoluminal surgery and natural orifice transluminal endoscopic surgery (NOTES). Endoscopic approaches that are similar to surgery but less invasive, relying on gastric restriction and/or malabsorption, show some promise. Intragastric injection of botulinum toxin is also considered, as is the role of minimally invasive bariatric endoscopic interventions. Gastrointestinal stimulation with implanted electrodes may have potential in the treatment of obesity and endoscopic applications have a role to play in post-surgical interventions. Evolving research into endosurgical approaches is...

Structural and Functional Changes in Left and Right Ventricles After Major Weight Loss Following Bariatric Surgery for Morbid Obesity

The American Journal of Cardiology — Fri, 05 Feb 2010 13:55:11 +0100

Obesity and bariatric surgery have been associated with changes in ventricular function and structure. The aim of the present study was to assess the long-term changes in left ventricular (LV) and right ventricular (RV) function and structure in patients with morbid obesity—body mass index ≥40 kg/m2 or ≥35 kg/m2 with co-morbidities—who had lost weight after bariatric surgery compared to nonsurgical controls. We reviewed 57 patients with morbid obesity who had undergone gastric bypass surgery and who had undergone echocardiography before and after surgery. A reference group (n = 57) was frequency matched for body mass index (±2 kg/m2), gender, age (±2 years), and follow-up duration (±6 months). After a mean follow-up of 3.6 years, the LV mass and LV mass indexed by height had dec...

TGen And Geisinger Health System Announce Strategic Partnership

Health News from Medical News Today — Fri, 05 Feb 2010 09:00:00 +0100

The Translational Genomics Research Institute (TGen) and Geisinger Health System have announced the signing of a strategic research agreement that provides for a focused look at the gaps in clinical medicine where biomedical research can make a difference. One of the first projects will focus on the causes of obesity, diabetes and other metabolic conditions. Researchers plan to look at the possible genetic reasons why so many Americans are overweight, and why diet, exercise and, specifically, bariatric surgery may fail to significantly reduce excess weight in some patients... (Source: Health News from Medical News Today)

Technique of open laparoscopy for supramesocolic surgery in obese patients

Surgical Endoscopy — Fri, 05 Feb 2010 08:43:19 +0100

Conclusions We present a technique of open laparoscopy in obese patients, systematically used, for supramesocolic surgery. This technique is safe, reproducible, and permits an efficient closure of the abdominal wall. Content Type Journal ArticleCategory TechniqueDOI 10.1007/s00464-009-0872-xAuthors Jean Baptiste Deguines, Université de Picardie Jules Verne Federation of Digestive Surgery, North Hospital Place Victor Pauchet 80054 Amiens Cedex 01 FranceQuentin Qassemyar, Université de Picardie Jules Verne Federation of Digestive Surgery, North Hospital Place Victor Pauchet 80054 Amiens Cedex 01 FranceAbdennaceur Dhahri, Université de Picardie Jules Verne Federation of Digestive Surgery, North Hospital Place Victor Pauchet 80054 Amiens Cedex 01 FranceOlivier Brehant, ...

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Effort, safety, and findings of routine preoperative endoscopic evaluation of morbidly obese patients undergoing bariatric surgery

Surgical Endoscopy — Fri, 05 Feb 2010 08:43:12 +0100

Conclusions Upper gastrointestinal endoscopy can be performed safely. However, careful monitoring and anesthesiological support are required for patients with concomitant diseases and those receiving sedation. Because 80% of the patients with pathological findings were asymptomatic, every morbidly obese patient should undergo endoscopy before bariatric surgery because there may be findings that might change the surgical strategy. Content Type Journal ArticleDOI 10.1007/s00464-010-0893-5Authors M. A. Küper, Tübingen University Hospital Department of General, Visceral and Transplant Surgery Hoppe-Seyler-Strasse 3 72076 Tübingen GermanyT. Kratt, Tübingen University Hospital Department of General, Visceral and Transplant Surgery Hoppe-Seyler-Strasse 3 72076 Tübingen...

Why Patients Lose Weight after Bariatric Operations.

Zentralblatt fur Chirurgie — Fri, 05 Feb 2010 00:00:00 +0100

Authors: Bueter M, Seyfried F, Germer CT The obesity epidemic is in Germany as well as worldwide a major health problem which is associated with increased morbidity and mortality. Bariatric surgery is currently the most effective therapy for significant and sustained weight loss. The most common form of bariatric surgery worldwide is Roux-en-Y gastric bypass surgery. The underlying mechanisms behind the superiority of this procedure are unclear and remain to be elucidated, but recent findings suggest that gastrointestinal hormones play an important role rather than malabsorption or restriction. It appears that gastric bypass surgery alters the physiology of weight regulation and eating behaviour in patients who have undergone the procedure. Gastrointestinal hormones have recently been ...

Case report Learning process by video cases – our first laparoscopic conversion of VBG to CRnYGB including technical problems and complication management

Thu, 04 Feb 2010 14:59:19 +0100

The number of bariatric surgical procedures performed each year is growing worldwide. The techniques and our knowledge have changed and new indications for surgical metabolic procedures have appeared. Patients with type II diabetes, who might also be treated with surgical therapies in the future, exemplify that the number of patients in need of a metabolic procedure might grow enormously. We have learned already that not all of our procedures were well chosen and some do not fit the patients’ needs and behaviour. Some patients need to be re-operated to improve the outcome. Each department has its own re-operation rate and it is known to be as high as 20%. At our metabolic centre at Freiburg University, we see patients after bariatric surgery from various other departments. Sometimes ...

Geisinger And TGen Announce Strategic Partnership To Shape Future Of Personalized Medicine

Health News from Medical News Today — Thu, 04 Feb 2010 09:00:00 +0100

Geisinger Health System and the Translational Genomics Research Institute (TGen) announced the signing of a strategic research agreement that provides a focused look at the gaps in clinical medicine where biomedical research can make a difference. One of the first projects will focus on the causes of obesity, diabetes and other metabolic conditions. Researchers plan to look at the possible genetic reasons why so many Americans are overweight, and why diet, exercise and, specifically, bariatric surgery may fail to significantly reduce excess weight in some patients... (Source: Health News from Medical News Today)

MRI appearance of internal hernia following Roux-en-Y gastric bypass surgery in the pregnant patient

Clinical Radiology — Wed, 03 Feb 2010 15:36:28 +0100

In recent years, there has been a dramatic increase in the number of bariatric surgeries performed for the management of morbid obesity, with Roux-en-Y gastric bypass (RYGB) comprising the most frequent such surgery performed in the United States. A recognized complication of RYGB is the development of a transmesenteric internal hernia, in which a loop of small bowel herniates through a surgically created mesenteric defect. Although an internal hernia in this setting is challenging to diagnose clinically given the non-specific and often subtle presentation, a delay in diagnosis and operative treatment may result in dire consequences, including bowel incarceration, ischaemia, gangrene, sepsis, and possibly death. There has been increasing awareness by the radiology community of the risk of ...

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Influence of Neck Circumference on Respiratory Endurance and Muscle Strength in the Morbidly Obese

Obesity Surgery — Tue, 02 Feb 2010 17:55:45 +0100

Conclusion Although adiposity patterns did not affect inspiratory muscle strength, neck adiposity was associated lower respiratory muscle endurance. Content Type Journal ArticleCategory Clinical ResearchDOI 10.1007/s11695-010-0077-3Authors Marize Jácome Gonçalves, Onofre Lopes University Hospital -Universidade Federal do Rio Grande do Norte Physiotherapy Rua Antônio Lopes Chaves, nº 626 - Casa 15 - Bairro Nova Parnamirim Natal Rio Grande do Norte BrazilSheyla Thatiane Santos do Lago, Onofre Lopes University Hospital -Universidade Federal do Rio Grande do Norte Physiotherapy Rua Antônio Lopes Chaves, nº 626 - Casa 15 - Bairro Nova Parnamirim Natal Rio Grande do Norte BrazilEudes de Paiva Godoy, Onofre Lopes University Hospital–Universidade Federal do Rio Grande ...

Inflammation and Biochemical Features of Bariatric Candidates: Does Gender Matter?

Obesity Surgery — Tue, 02 Feb 2010 07:00:38 +0100

Conclusions (1) Males displayed more severe inflammation according to ferritin profile, and also more signs of liver derangement; (2) all differences continued after BMI discrepancies were adjusted for, and ferritin was significant also after control of waist girth; (3) in both genders inflammatory markers often correlated with different anthropometrics, liver enzymes, and markers of glucose homeostasis; and (4) inflammatory and biochemical gender-related dissimilarities might have prognostic implications for cardiovascular risk and other comorbidities, and deserve additional studies. Content Type Journal ArticleCategory Clinical ResearchDOI 10.1007/s11695-010-0080-8Authors Alvaro A. C. Morais, EMESCAM Medical School Research Center Vitoria ES BrazilJoel Faintuch, S...

Contribution of Genetic and Metabolic Syndrome to Omental Adipose Tissue PAI-1 Gene mRNA and Plasma Levels in Obesity

Obesity Surgery — Tue, 02 Feb 2010 07:00:37 +0100

Conclusion These results suggest that PAI-1 polymorphisms contribute significantly to PAI-1 plasma levels but do not support the notion that omental AT is one of its major source. Content Type Journal ArticleCategory Physiology ResearchDOI 10.1007/s11695-010-0079-1Authors Luigi Bouchard, Université de Montréal Department of Medicine, ECOGENE-21 and Lipid Clinic, Chicoutimi Hospital Saguenay QC CanadaMarie-Claude Vohl, Université Laval Lipid Research Centre, CHUQ Research Centre Quebec QC CanadaStéfane Lebel, Université Laval Department of Surgery Quebec QC CanadaFrédéric-Simon Hould, Université Laval Department of Surgery Quebec QC CanadaPicard Marceau, Université Laval Department of Surgery Quebec QC CanadaJean Bergeron, Université Laval Lipid Research Centr...

Long-Term Results of Gastric Bypass Surgery in Morbidly Obese Type 1 Diabetes Patients

Obesity Surgery — Tue, 02 Feb 2010 07:00:36 +0100

Conclusions RYGB surgery in morbidly obese type 1 diabetes patients leads to a significant and maintained weight loss and results in remarkable improvement in blood glucose control and concomitant disorders. Bariatric surgery should be recommended to significantly obese type 1 diabetes patients as a means of reduction of vascular complications risk. Content Type Journal ArticleCategory Clinical ReportDOI 10.1007/s11695-010-0074-6Authors Leszek Czupryniak, Barlicki University Hospital No 1 Diabetology and Metabolic Diseases Department Kopcinskiego 22 90-153 Lodz PolandMarcin Wiszniewski, Barlicki University Hospital No 1, Medical University of Lodz General and Transplant Surgery Department Lodz PolandDariusz Szymański, Barlicki University Hospital No 1, Medical Univer...

Micro-orifice Metabolic/Bariatric Surgery Under IV Sedation/Local Anesthesia

Obesity Surgery — Tue, 02 Feb 2010 07:00:36 +0100

Conclusions Using the TANTALUSTM System as a metabolic/bariatric surgery prototype model, this study successfully tested the feasibility of micro-orifice surgery, under IV sedation/local anesthesia. This study will be followed by human trials that may offer an alternative approach for the performance of metabolic/bariatric surgery. Content Type Journal ArticleCategory Technical InnovationDOI 10.1007/s11695-010-0081-7Authors Henry Buchwald, University of Minnesota Department of Surgery 420 Delaware Street, SE, MMC 290 Minneapolis MN 55455 USAHector J. Menchaca, University of Minnesota Department of Surgery 420 Delaware Street, SE, MMC 290 Minneapolis MN 55455 USAVan N. Michalek, University of Minnesota Department of Surgery 420 Delaware Street, SE, MMC 290 Minneapolis ...

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Mechanisms facilitating weight loss and resolution of type 2 diabetes following bariatric surgery.

Trends in Endocrinology and Metabolism: TEM — Tue, 02 Feb 2010 00:00:00 +0100

Authors: Karra E, Yousseif A, Batterham RL Bariatric surgery is the most effective treatment modality for obesity, resulting in durable weight loss and amelioration of obesity-associated comorbidities, particularly type 2 diabetes mellitus (T2DM). Moreover, the metabolic benefits of bariatric surgery occur independently of weight loss. There is increasing evidence that surgically induced alterations in circulating gut hormones mediate these beneficial effects of bariatric surgery. Here, we summarise current knowledge on the effects of different bariatric procedures on circulating gut hormone levels. We also discuss the theories that have been put forward to explain the weight loss and T2DM resolution following bariatric surgery. Understanding the mechanisms mediating these beneficial o...

Roles of Gastrointestinal and Adipose Tissue Peptides in Childhood Obesity and Changes After Weight Loss Due to Lifestyle Intervention [Review Article]

Archives of Pediatrics — Mon, 01 Feb 2010 20:51:04 +0100

Childhood obesity is a global epidemic and associated with an increased risk of hypertension, diabetes mellitus, and coronary heart disease, in addition to psychological disorders. Interventions such as bariatric surgery are highly invasive and lifestyle modifications are often unsuccessful because of disturbed perceptions of satiety. New signaling peptides discovered in recent years that are produced in peripheral tissues such as the gut, adipose tissue, and pancreas communicate with brain centers of energy homeostasis, such as the hypothalamus and hindbrain. This review discusses the major known gut- and adipose tissue–derived hormones involved in the regulation of food intake and energy homeostasis and their serum levels in childhood obesity before and after weight loss as well as...

Biodistribution of technetium-99m pertechnetate after Roux-en-Y gastric bypass (Capella technique) in rats.

Acta Cirurgica Brasileira — Mon, 01 Feb 2010 00:00:00 +0100

CONCLUSION: This work contributes to the knowledge that the bariatric surgery RYGB modifies the pattern of biodistribution of Na99mTc-. PMID: 20126880 [PubMed - in process] (Source: Acta Cirurgica Brasileira)

Threshold for Bariatric Surgery in Teens Lowered

Family Practice News — Mon, 01 Feb 2010 00:00:00 +0100

The criteria for selecting obese adolescents as candidates for bariatric surgery have loosened in recent years, say some surgeons, while other surgeons had already applied the looser criteria for several years. Now that the adolescent field has converged on a roughly uniform body mass index standard that's the same as for adults—at least 35 kg/m2 with serious comorbidities or at least 40 kg/m2 in other patients—surgeons have begun to consider testing an even more aggressive approach to bariatric surgery in teenagers. (Source: Family Practice News)

Bariatric Surgeons Lower BMI Bar for Teens

Clinical Endocrinology News — Mon, 01 Feb 2010 00:00:00 +0100

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Roux-en-Y Benefits in Teens Plateau at 6 Months

Pediatric News — Mon, 01 Feb 2010 00:00:00 +0100

Major Finding: There is generally a plateau of weight loss at about 6-12 months in obese teens who have undergone bariatric surgery. (Source: Pediatric News)

Hepatic Gene Expression of Caucasian and African-American Patients with Obesity-Related Non-Alcoholic Fatty Liver Disease

Obesity Surgery — Sat, 30 Jan 2010 18:16:05 +0100

Conclusion African-American patients with biopsy-proven obesity-related NAFLD and NASH have a specific hepatic gene expression pattern that may explain their differences from Caucasian patients with NAFLD in developing progressive liver disease. Content Type Journal ArticleCategory Clinical ResearchDOI 10.1007/s11695-010-0078-2Authors Maria Stepanova, Center for Liver Diseases at Inova Fairfax Hospital Falls Church VA USANoreen Hossain, Inova Health System Betty and Guy Beatty Center for Integrated Research 3300 Gallows Road Falls Church VA 22042 USAArian Afendy, Center for Liver Diseases at Inova Fairfax Hospital Falls Church VA USAKellie Perry, George Mason University Molecular and Microbiology Department, College of Science Falls Church VA USAZachary D. Goodman, Arm...

Early Effects of Gastric Banding (LGB) and of Biliopancreatic Diversion (BPD) on Insulin Sensitivity and on Glucose and Insulin Response after OGTT

Obesity Surgery — Sat, 30 Jan 2010 18:16:05 +0100

Conclusions These data indicate an early effect of BPD different from LGB on insulin sensitivity and on glucose and on insulin response to OGTT, mostly independent of weight loss. Content Type Journal ArticleCategory Clinical ResearchDOI 10.1007/s11695-010-0076-4Authors Antonio E. Pontiroli, Università degli Studi di Milano, 2a Divisione di Medicina Interna Dipartimento di Medicina, Chirurgia e Odontoiatria Ospedale San Paolo, Via A. Di Rudinì 8 20142 Milan ItalyDonatella Gniuli, Università Cattolica del Sacro Cuore Dipartimento di Medicina Interna Policlinico Gemelli, Largo A. Gemelli, 8 00168 Rome ItalyGeltrude Mingrone, Università Cattolica del Sacro Cuore Dipartimento di Medicina Interna Policlinico Gemelli, Largo A. Gemelli, 8 00168 Rome Italy Journal O...

Preliminary Surgical Results of Single-Incision Transumbilical Laparoscopic Bariatric Surgery

Obesity Surgery — Sat, 30 Jan 2010 18:16:04 +0100

Conclusion Our technique can be safely and effectively used for SITU laparoscopic bariatric surgery. This technique will soon be used for advanced abdominal surgeries besides bariatric ones. Content Type Journal ArticleCategory Clinical ReportDOI 10.1007/s11695-009-0071-9Authors Chih-Kun Huang, E-Da Hospital Department of General Surgery 1 E-Da Road, Jiau-shu Tseun, Yan-chau Shiang Kaohsiung County 824 TaiwanJui-Chi Tsai, E-Da Hospital Bariatric & Metabolic International Surgery Center Kaohsiung TaiwanChi-Hsien Lo, E-Da Hospital Bariatric & Metabolic International Surgery Center Kaohsiung TaiwanJer-Yiing Houng, I-Shou University Department of Chemical Engineering and Institute of Biotechnology and Chemical Engineering Kaohsiung County TaiwanYaw-Sen Chen, E-Da Hospital ...

Bariatric Surgery Can Be Safer Than Living With Obesity

Health News from Medical News Today — Sat, 30 Jan 2010 09:00:00 +0100

Bariatric weight-loss surgery may sound dangerous and complicated, but a Geisinger physician warns that the real danger may be a life of obesity. "There are risks associated with bariatric surgery, as there are with any surgical procedure, but the risks associated with the procedure may pale in comparison to the health complications that can be caused by obesity," said Christopher Still, D.O., director of the Geisinger Center for Nutrition and Weight Management... (Source: Health News from Medical News Today)

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Bariatric Surgery Can Be Safer Than Living With Obesity

Cosmetic Medicine / Plastic Surgery News From Medical News Today — Sat, 30 Jan 2010 09:00:00 +0100

Bariatric weight-loss surgery may sound dangerous and complicated, but a Geisinger physician warns that the real danger may be a life of obesity. "There are risks associated with bariatric surgery, as there are with any surgical procedure, but the risks associated with the procedure may pale in comparison to the health complications that can be caused by obesity," said Christopher Still, D.O... (Source: Cosmetic Medicine / Plastic Surgery News From Medical News Today)

Bariatric surgery

International Journal of Surgery — Thu, 28 Jan 2010 00:00:00 +0100

Abstract: Obesity is fast becoming one of the world's leading health problems and together with its many associated medical sequelae significantly increases morbidity and mortality. In this review, we briefly explore the history of bariatric surgery, the benefits of surgery and the various procedures carried out. (Source: International Journal of Surgery)

Nutritional and Pharmacologic Challenges in the Bariatric Surgery Patient

Obesity Surgery — Wed, 27 Jan 2010 19:59:42 +0100

Abstract The purpose of this study was to describe vitamin and nutrient supplement practices and assess medication dosage formulations utilized in patients hospitalized with a history of bariatric surgery. Retrospective pilot study was conducted from January 1, 2006 through December 31, 2007 in patients with a past history of bariatric surgery. Demographic data, vitamin and nutrient supplements, and medication dosage formulations were evaluated upon admission. This was compared to published guidelines. Compliance with the following supplementation was categorized: daily multivitamin, calcium, iron, vitamin B-12, and folic acid. The frequency of non-immediate-release and enteric-coated medication dosage forms was also examined. Discrepancies were identified as lack of one o...

Medical Therapy Delivered By Primary Care Doctors Is Successful In Severe Obesity

Health News from Medical News Today — Wed, 27 Jan 2010 08:00:00 +0100

Despite a general belief among physicians that extreme obesity is too difficult to treat, except with bariatric surgery, researchers at the Pennington Biomedical Research Center have learned a substantial proportion of individuals with extreme obesity can lose 10-percent or more of their body weight through medical treatment that does not include surgery. Furthermore, even though those individuals are still obese, they have improvements in risk factors and other health markers. "This is important, because surgery is not often affordable or reimbursed by insurance," said leading scientist Dr... (Source: Health News from Medical News Today)

Medical Therapy Delivered By Primary Care Doctors Is Successful In Severe Obesity

Obesity / Weight Loss / Fitness News From Medical News Today — Wed, 27 Jan 2010 08:00:00 +0100

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Hill-Rom launches new therapy system

Hospital IT Europe — Tue, 26 Jan 2010 14:36:01 +0100

On stand C Hill-Rom will be launching the new TotalCare Space therapy system which combines the advanced features of the TotalCare family and is specifically designed for the bariatric patient. (Source: Hospital IT Europe)

Bariatric surgery for non-alcoholic steatohepatitis in obese patients

Tue, 26 Jan 2010 12:30:25 +0100

Background Nonalcoholic fatty liver disease (NAFLD) is increasingly recognised as a condition associated with overweight or obesity that may progress to end-stage liver disease. NAFLD histology resembles alcohol-induced liver injury, but occurs in patients with no history of alcohol abuse. NAFLD has a broad spectrum of clinical and histological manifestations, ranging from simple fatty liver to hepatic steatosis with inflammation, advanced fibrosis, and cirrhosis. The inflammatory stage is known as non-alcoholic steatohepatitis (NASH). Recent reports indicate that weight loss induced by bariatric procedures could be beneficial for NASH treatment. Objectives To assess the benefits and harms of bariatric surgery for NASH in obese patients. Search strategy We searched The Cochrane Hepato-Bili...

Fewer Nutrient Deficiencies After Laparoscopic Sleeve Gastrectomy (LSG) than After Laparoscopic Roux-Y-Gastric Bypass (LRYGB)—a Prospective Study

Obesity Surgery — Tue, 26 Jan 2010 07:05:49 +0100

Conclusion Preoperatively, 57% of morbidly obese patients already had a deficiency. Postoperatively, significantly more vitamin B12 and vitamin D deficiencies and hyperparathyroidism were found in patients who had undergone LRYGB. After LSG, folate deficiency was more frequent (but not significantly so). Calcium levels were normal in all patients; therefore, parathyroid hormone and vitamin D3 levels are more sensitive markers for early detection of disorders of calcium metabolism. Iron deficiency anaemia is most efficiently treated by IV therapy. Content Type Journal ArticleCategory Clinical ReportDOI 10.1007/s11695-009-0068-4Authors Simone Gehrer, St. Claraspital Department of Surgery Kleinriehenstrasse 30 4016 Basel SwitzerlandBeatrice Kern, St. Claraspital Departm...

Effect of bariatric surgery on circulating chemerin levels

European Journal of Clinical Investigation — Tue, 26 Jan 2010 00:00:00 +0100

Conclusions We hypothesize that weight-loss induced reduction in circulating chemerin might in conjunction with other factors be associated with diminished recruitment of macrophages in adipose tissue and reduction of subclinical inflammation, which again could partly explain beneficial long-term effects of weight reduction in obese subjects. (Source: European Journal of Clinical Investigation)

Bariatric surgery for non-alcoholic steatohepatitis in obese patients

Gastroenterology and Liver Diseases Specialist Library - Liver — Mon, 25 Jan 2010 16:54:36 +0100

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Non Alcoholic Fatty Liver Disease Is Not the Same between Adolescent and Adult Morbidly Obese Patients

Journal of Surgical Research — Mon, 25 Jan 2010 16:41:31 +0100

Introduction: Non alcoholic fatty liver disease (NAFLD) with histologic pathologies ranging from fatty liver infiltration to steatohepatitis is a hepatic manifestation of the metabolic syndrome affecting the obese patients. It is a risk factor for chronic liver disease with progression to cirrhosis. We test the hypothesis that NAFLD disease severity is more advanced in morbidly obese adult patients because they have longer standing obesity disease compared to adolescent patients toward future goals to identify underlying risk factors. Methods: A prospective clinical preoperative database of morbidly obese adolescent and adult patients undergoing bariatric surgery in a single institution was approved by the IRB. Information were extracted from 29 adolescents (age 14-17, mean +/- SD 16+/-1) ...

Impact of Bariatric Procedures on Serum ALT Levels in Diabetic and Non-Diabetic Patients

Journal of Surgical Research — Mon, 25 Jan 2010 16:40:26 +0100

Background: Alanine aminotransferase (ALT) levels are used to detect Non-Alcoholic Fatty Liver Disease (NAFLD) and have also been associated with an increased risk of metabolic syndrome and particularly type-II diabetes mellitus (T2DM). Even when within normal range, a higher ALT level reflects an increase in the risk of developing T2DM. Bariatric procedures result in significant weight loss. Although many studies have evaluated the impact of these procedures on the resolution of the obesity-related co-morbidities, the impact of these interventions on serum ALT levels (biomarker of metabolic syndrome) has not been well studied. The aim of this study is to evaluate the impact of bariatric interventions on ALT serum levels and compare this effect between patients with and without T2DM. Metho...

Real World Outcomes of Bariatric Surgery

Journal of Surgical Research — Mon, 25 Jan 2010 16:40:26 +0100

Conclusions. In this study, population-based peri-operative safety outcomes were comparable to those reported from large academic centers. While complication rates are lower for patients undergoing lap-band procedures, lap-gastric bypass is more effective for weight loss and related long-term outcomes. (Source: Journal of Surgical Research)

Venous Thromboembolism Complicating Adjustable Gastric Band Surgery Performed in Bariatric Surgery Centers of Excellence (BSCOE): Analysis of Bariatric Outcomes Longitudinal DatabaseTM (BOLDTM)

Journal of Surgical Research — Mon, 25 Jan 2010 16:39:43 +0100

Introduction: Adjustable gastric banding (AGB) is considered one of the lower risk surgical procedures for the treatment of morbid obesity. Typically performed laparoscopically as an ambulatory surgery procedure, the incidence of major complications following AGB such as venous thromboembolism (DVT/PE) is very low. This has raised the question of whether conventional venous thromboembolism prophylaxis therapy (VPX) is necessary for patients undergoing this procedure. Studies to date have lacked the power and clinical focus to properly address this question. We hypothesized that VPX was not critical for good outcomes from AGB. Prospective data entered into BOLD from BSCOE's provide an opportunity to analyze such low frequency events. Methods: Prospective data submitted to BOLD from 538 BSCO...

Center of Excellence Designation and Outcomes of Bariatric Surgery

Journal of Surgical Research — Mon, 25 Jan 2010 16:39:43 +0100

Conclusions: As currently configured, center of excellence designations do not help patients select centers with superior results. Hospital volume is associated with fewer serious complications after bariatric surgery, but equivalent long-term outcomes. (Source: Journal of Surgical Research)

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Foreword

Current Problems in Surgery — Mon, 25 Jan 2010 16:38:22 +0100

Obesity represents a major and growing public health problem both in the United States and internationally. Recent advances in surgical management and the demonstration that weight reduction surgery has multiple other health benefits have resulted in a virtual explosion in the number of these procedures being performed. The complex nature of both the procedures and the pre- and postoperative management of these patients has mandated a sophisticated and evidence-based approach culminating in a national process for certification of bariatric centers of excellence. In this issue of Current Problems in Surgery, Drs. Robert Lim, George Blackburn, and Daniel Jones from the Beth Israel-Deaconess Medical Center in Boston have written a masterful monograph entitled, “Benchmarking Best Practices i...

Recent Advances in Gastroenterology

Gastroenterology — Mon, 25 Jan 2010 00:00:00 +0100

Chris Probert's Recent Advances in Gastroenterology provides a review of recent “hot topics” in gastroenterology. The primary aim of this 220-page review book, as stated by Dr Probert, the book's editor, is to help educate gastroenterology fellows, medical residents, and general practitioners who are developing subspecialty clinics. The book is also intended to help update gastroenterologists in a variety of topics. I believe that Dr Probert and his colleagues have achieved their goals. With respect to general content, including chapters on eosinophilic esophagitis, Barrett's esophagus, bariatric surgery, nonalcoholic fatty liver disease, irritable bowel syndrome, and inflammatory bowel disease is appropriate and necessary given not only the recent advances made in these fields, but al...

Five Questions You Should Ask Your Doctor About Losing Weight

Health News from Medical News Today — Sat, 23 Jan 2010 02:00:00 +0100

The American Society of Bariatric Physicians (ASBP) works with physicians so they're better prepared to deal with society's obesity epidemic. Even though people focus on weight loss more in January than any other month, successful weight loss is a year-round long-term initiative that goes far beyond just diet and exercise. The ASBP has highlighted five questions everyone who needs to lose weight should ask their physician. 1... (Source: Health News from Medical News Today)

Five Questions You Should Ask Your Doctor About Losing Weight

Obesity / Weight Loss / Fitness News From Medical News Today — Sat, 23 Jan 2010 02:00:00 +0100

The American Society of Bariatric Physicians (ASBP) works with physicians so they're better prepared to deal with society's obesity epidemic. Even though people focus on weight loss more in January than any other month, successful weight loss is a year-round long-term initiative that goes far beyond just diet and exercise... (Source: Obesity / Weight Loss / Fitness News From Medical News Today)