Management of Nutritional Complications

2019 ◽  
pp. 247-256
Author(s):  
Michael Choi ◽  
Liz Goldenberg ◽  
Alfons Pomp
Keyword(s):  
Nutritional Complications

OP270 Why The Haute Autorité de Santé Rejects the Widespread Use Of “Mini-Bypass”/One Anastomosis Gastric Bypass For Obesity In France

2020 ◽  
Vol 36 (S1) ◽  
pp. 4-4
Author(s):  
Jean-Charles Lafarge ◽  
Denis-Jean David ◽  
Cédric Carbonneil
Keyword(s):  
Esophageal Cancer ◽  
Gastric Bypass ◽  
Adverse Events ◽  
Severe Obesity ◽  
One Anastomosis Gastric Bypass ◽  
Close Monitoring ◽  
Efficacy And Safety ◽  
Multicenter Rct ◽  
Nutritional Complications

IntroductionOne anastomosis gastric bypass (OAGB) has become a widespread technique over the last few years in France, without any prior assessment and despite existing controversies among bariatric surgeons. An older bypass technique for treating obesity, the Roux-en-Y gastric bypass (RYGB), is available and reimbursed, having been assessed and approved for use in 2005. In 2019, the French Haute Autorité de Santé (HAS) assessed OAGB for the treatment of severe and massive obesity. This assessment, the first in the world, was undertaken for OAGBs carried out with a 200- or 150-centimeter biliopancreatic-limb (BP-limb) length.MethodsA systematic review (SR) of the literature and consultation of a working group consisting of both healthcare professionals (clinician and surgeons) and patients were carried out. The primary aim of our assessment was to determine whether the OAGB technique can replace RYGB. The efficacy and safety profile of OAGB was compared with RYGB in adult patients with massive, severe obesity. Complications and postoperative follow up specific to OAGB were identified.ResultsThe three selected randomized controlled trials (RCTs) could not confirm the superiority or the non-inferiority of OAGB, compared with RYGB, on the selected efficacy endpoints of weight loss, resolution of comorbidities, and quality of life. Adverse events reported for OAGB included severe nutritional complications and bile reflux that could potentially lead to lower esophageal cancer. In one RCT, the frequency of serious adverse events in the OAGB group was almost two times higher than in the RYGB group.ConclusionsHAS considered that OAGB carried out with a longer (200 centimeter) BP-limb is not a validated technique for the surgical treatment of massive, severe obesity. Thus, it cannot be considered an alternative to RYGB. There were insufficient data available on OAGB performed with a 150-centimeter BP-limb. Thus, HAS recommended undertaking a multicenter RCT to assess the efficacy and safety of OAGB. Patients who have already undergone OAGB should receive the same follow up as patients who have received RYGB, including close monitoring for nutritional complications and lower esophageal cancer and an endoscopic examination five years after surgery.

Nutritional Complications of HIV Infection

2020 ◽  
pp. 137-141
Author(s):  
Donald P. Kotler
Keyword(s):  
Hiv Infection ◽  
Nutritional Complications

scholarly journals Medication in AN: A Multidisciplinary Overview of Meta-Analyses and Systematic Reviews

2019 ◽  
Vol 8 (2) ◽  
pp. 278 ◽  
Author(s):  
Corinne Blanchet ◽  
Sébastien Guillaume ◽  
Flora Bat-Pitault ◽  
Marie-Emilie Carles ◽  
Julia Clarke ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Systematic Reviews ◽  
Psychiatric Symptoms ◽  
Future Research ◽  
Evidence Based ◽  
Open Label ◽  
Online Databases ◽  
The 1960S ◽  
Meta Analyses ◽  
Nutritional Complications

Drugs are widely prescribed for anorexia nervosa in the nutritional, somatic, and psychiatric fields. There is no systematic overview in the literature, which simultaneously covers all these types of medication. The main aims of this paper are (1) to offer clinicians an overview of the evidence-based data in the literature concerning the medication (psychotropic drugs and medication for somatic and nutritional complications) in the field of anorexia nervosa since the 1960s, (2) to draw practical conclusions for everyday practise and future research. Searches were performed on three online databases, namely MEDLINE, Epistemonikos and Web of Science. Papers published between September 2011 and January 2019 were considered. Evidence-based data were identified from meta-analyses, if there were none, from systematic reviews, and otherwise from trials (randomized or if not open-label studies). Evidence-based results are scarce. No psychotropic medication has proved efficacious in terms of weight gain, and there is only weak data suggesting it can alleviate certain psychiatric symptoms. Concerning nutritional and somatic conditions, while there is no specific, approved medication, it seems essential not to neglect the interest of innovative therapeutic strategies to treat multi-organic comorbidities. In the final section we discuss how to use these medications in the overall approach to the treatment of anorexia nervosa.

Gastrointestinal and Nutritional Complications After Bariatric Surgery.

2007 ◽  
Vol 102 (11) ◽  
pp. 2571-2580 ◽  
Author(s):  
G. Anton Decker ◽  
James M. Swain ◽  
Michael D. Crowell ◽  
James S. Scolapio
Keyword(s):  
Bariatric Surgery ◽  
Complications After Bariatric Surgery ◽  
Nutritional Complications

Metabolic and Nutritional Complications of Renal Transplantation

2007 ◽  
Vol 17 (1) ◽  
pp. 97-102 ◽  
Author(s):  
Francis Dumler ◽  
Cristina Kilates
Keyword(s):  
Renal Transplantation ◽  
Nutritional Complications

Complications of Ascaris lumbricoides infection: case reports from south western Uganda

1991 ◽  
Vol 65 (4) ◽  
pp. 286-288 ◽  
Author(s):  
J. B. Mpairwe
Keyword(s):  
Intestinal Obstruction ◽  
Ascaris Lumbricoides ◽  
Case Reports ◽  
Common Complication ◽  
Review Of The Literature ◽  
Nutritional Complications ◽  
Western Uganda

ABSTRACTTwo cases of intestinal obstruction due to Ascaris lumbricoides infection are reported from Ishaka Adventist Hospital, in south western Uganda. One was a male aged two and a half years and another was a female aged twenty. They were both treated surgically with good results. A review of the literature also revealed that intestinal obstruction due to A. lumbricoides is a common complication, though other surgical and nutritional complications also seem to be common, they are less reported.

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