One-year outcomes of bariatric surgery in older adults: a case-matched analysis based on the Tehran Obesity Treatment Study

Abstract Dietary choices play an important role in disease prevention both through its effect on weight and independent of it. Improving diet can be an effective means of disease prevention among older adults. Participants (n=303) were recruited from the Allegheny County, PA area and received nutritional education in group sessions led by trained community health workers over one year. Diet quality was captured at baseline and final endpoint (either 9 or 13 months) using the Rate Your Plate (RYP) instrument for assessing healthfulness of diet and includes 24 items that can be summed to generate a total quality score. The mean RYP diet quality score improved from baseline (RYP=50.87) to endpoint (RYP=54.85) (p<.001). Over the course of the intervention, 30.9% of participants made enough improvement in diet to move to a better RYP category. A community-based group intervention for older adults was effective in inducing improvements in diet quality.

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Medication Prescribed Within 1 Year Preceding Fall-Related Injuries in Older Adults in Ontario, Canada

Innovation in Aging ◽

10.1093/geroni/igaa057.761 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 236-236

Author(s):

Yu Ming ◽

Aleksandra Zecevic ◽

Richard Booth ◽

Susan Hunter ◽

Andrew Johnson ◽

...

Keyword(s):

Older Adults ◽

Fall Risk ◽

Anatomical Therapeutic Chemical ◽

Group Discussion ◽

Head Injuries ◽

Prescription Medication ◽

Population Based ◽

Age Group ◽

Secondary Health Care ◽

One Year

Abstract Background: The consequences of fall-related injuries are becoming more significant due to ageing societies worldwide. This study aims to provide information on medications prescribed to older adults within one year before they experienced fall-related injury in Ontario, Canada. Methods: A population-based descriptive study of older adults (66 years and older) who experienced fall-related injury was conducted using administrative secondary health care data of Ontario. The percentages of patients prescribed each Anatomical Therapeutic Chemical 4th level medication class and fall-risk increasing drugs one year before their fall-related injuries was summarized. Results: From 2010 to 2014, 288,251 older adults (63.2% females) were admitted to Emergency Department due to fall-related injury, 39.9% were fall-related fractures, 12.6% were head injuries. One year prior to their injury, 48.46% of older adults were prescribed with statins; 35.23% were prescribed with diuretics; 26.84% were prescribed with antidepressants; 25.90% were prescribed with opioids and 16.61% were prescribed with anxiolytics. A higher percentage of females were prescribed with diuretics, antidepressants, and anxiolytics than males. 85 years and older people had higher percentage of prescription of diuretics, antidepressants and antipsychotics than other age group. Discussion: In general, older adults diagnosed with fall-related injuries were prescribed with more opioids, benzodiazepines and antidepressants than other general older adults. There were distinct patterns of prescription medication within each sex and age group (66-74 group, 75-84 group and 85 years and older group). Further association between medications and fall-related injuries need to be established using well-defined cohort studies.

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Caspase-Cleaved Keratin 18 Measurements Identified Ongoing Liver Injury after Bariatric Surgery

Journal of Clinical Medicine ◽

10.3390/jcm10061233 ◽

2021 ◽

Vol 10 (6) ◽

pp. 1233

Author(s):

Felix Hempel ◽

Martin Roderfeld ◽

Lucas John Müntnich ◽

Jens Albrecht ◽

Ziya Oruc ◽

...

Keyword(s):

Bariatric Surgery ◽

Liver Disease ◽

Liver Injury ◽

Response To Treatment ◽

Morbidly Obese ◽

Alcoholic Fatty Liver ◽

Laboratory Parameters ◽

Nafld Fibrosis Score ◽

Keratin 18 ◽

One Year

Bariatric surgery has emerged as an effective treatment option in morbidly obese patients with non-alcoholic fatty liver disease (NAFLD). However, worsening or new onset of non-alcoholic steatohepatitis (NASH) and fibrosis have been observed. Caspase-cleaved keratin 18 (ccK18) has been established as a marker of hepatocyte apoptosis, a key event in NASH development. Thus, ccK18 measurements might be feasible to monitor bariatric surgery patients. Clinical data and laboratory parameters were collected from 39 patients undergoing laparoscopic Roux-en-Y gastric bypass at six timepoints, prior to surgery until one year after the procedure. ccK18 levels were measured and a high-throughput analysis of serum adipokines and cytokines was carried out. Half of the cohort’s patients (20/39) presented with ccK18 levels indicative of progressed liver disease. 21% had a NAFLD-fibrosis score greater than 0.676, suggesting significant fibrosis. One year after surgery, a mean weight loss of 36.87% was achieved. Six and twelve months after surgery, ccK18 fragments were significantly reduced compared to preoperative levels (p < 0.001). Yet nine patients did not show a decline in ccK18 levels ≥ 10% within one year postoperatively, which was considered a response to treatment. While no significant differences in laboratory parameters or ccK18 could be observed, they presented with a greater expression of leptin and fibrinogen before surgery. Consecutive ccK18 measurements monitored the resolution of NAFLD and identified non-responders to bariatric surgery with ongoing liver injury. Further studies are needed to elicit the pathological mechanisms in non-responders and study the potential of adipokines as prognostic markers.

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The Role of Self-Perceptions of Aging for Recovery of Older Adults After a Hospital Stay

Innovation in Aging ◽

10.1093/geroni/igaa057.1970 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 588-588

Author(s):

Anne Blawert ◽

Ellen Freiberger ◽

Susanne Wurm

Keyword(s):

Older Adults ◽

Hospital Stay ◽

Physical Function ◽

Fear Of Falling ◽

Health Events ◽

Self Perceptions ◽

Perceptions Of Aging ◽

One Year ◽

Psychological Pathway

Abstract For older adults, a hospital stay can lead to loss of physical function and frailty. It is therefore important to investigate factors for recovery after hospitalization. Recent studies suggest negative self-perceptions of aging (SPA) as a potential risk factor in the context of serious health events. This ongoing longitudinal study investigates how negative SPA might contribute to worse physical recovery (assessed with the Short Physical Performance Battery) after hospital stay in a sample of 244 German adults aged 75 to 96. Preliminary mediation analysis based on available data of the first 50 participants indicate that negative SPA is related to increased fear of falling after 6 months, which predicts worse physical function one year after hospitalization (indirect effect: B = -0.70, SE = 0.41, p = .09). The results stress the importance of SPA for health recovery in old age and introduce fear of falling as a psychological pathway.

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Evaluation of the Vertical Movement of Ribeiro’s Dermolipoglandular Mammary Flap One Year After Mammaplasties in Post-Bariatric Patients

Aesthetic Surgery Journal ◽

10.1093/asj/sjz188 ◽

2019 ◽

Vol 40 (1) ◽

pp. NP21-NP31 ◽

Cited By ~ 3

Author(s):

Rodrigo P Sizenando ◽

Marco Túlio C Diniz ◽

Paulo Roberto da Costa ◽

Luiz Gustavo S Manhães

Keyword(s):

Bariatric Surgery ◽

Weight Loss ◽

Plastic Surgery ◽

Breast Tissue ◽

Vertical Movement ◽

Level Of Evidence ◽

Significance Level ◽

Areola Complex ◽

Ptotic Breast ◽

One Year

Abstract Background In 1971, Ribeiro isolated a segment in the inferior pole of the ptotic breast, nourished by muscular perforating vessels, and moved it cranially to the posterior region of the remaining detached breast tissue, where it was fixed to the pectoral fascia. This maneuver created a flap with autologous implant function, independent from the rest of the breast’s support, that maintained long-term mammary projection. Objectives The objectives of this study were to measure the vertical movement of this flap 1 year after mammaplasty and to evaluate the factors involved. Methods The sample included 13 patients who had previously undergone bariatric surgery. The position of a titanium marker attached to the Ribeiro flap was compared on chest radiographs taken 1 day and 1 year after the mammaplasty. The significance level was set at 5%. Results All of the titanium markers moved 0.6 cm to 4.1 cm caudally during the study period (average, 2.4 cm ± 1.02 cm). The greater the weight loss after the plastic surgery, the further the marker’s descent. Weight loss between bariatric surgery and plastic surgery, the vertical dimension of the ptotic breast tissue immediately before plastic surgery, the vertical extent of the nipple-areola complex elevation during mammaplasty, the Ribeiro flap thickness and volume, and the breast volume after mammaplasty were not associated with the vertical movement of the flap. Conclusions The Ribeiro flap employed in mammaplasty of patients who previously underwent bariatric surgery undergoes ptosis that is exacerbated by weight loss after mammaplasty. Level of Evidence: 4

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