Lithium toxicity after bariatric surgery

2017 ◽  
Vol 41 (S1) ◽  
pp. S491-S491
Author(s):  
L. De Jonge ◽  
S. Petrykiv ◽  
J. Fennema ◽  
M. Arts
Keyword(s):  
Bariatric Surgery ◽  
Drug Absorption ◽  
Case Reports ◽  
Lithium Toxicity ◽  
Vertical Sleeve Gastrectomy ◽  
Careful Monitoring ◽  
Lithium Level ◽  
Before And After ◽  
Life Threatening ◽  
Competing Interest

IntroductionBariatric surgery is globally increasingly being applied in patients with morbid obesity to achieve permanent weight reduction. More than fifty percent of these patients have a psychiatric disorder in their history and over thirty percent take psychotropic medication. The prevalence of bipolar disorder in patients who undergo bariatric surgery is around four percent, and most of them are treated with lithium.Objectives & aimsTo report and discuss the effect of bariatric surgery on changes in lithium absorption.MethodsWe present all published case studies and literature review on lithium toxicity after bariatric surgery.ResultsTo date; only two case-reports were published with dramatic changes in lithium level after vertical sleeve gastrectomy and Roux-en-Y bariatric surgery. Within a period of two to five weeks, the patients were presented to the emergency department with signs of dehydration and acute kidney failure.ConclusionClinicians should be aware of dramatic and possibly even life-threatening pharmacokinetic changes in drug absorption that may occur after bariatric surgery. Careful monitoring and even reduction of lithium dosage before and after surgery could potentially prevent serious complications.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Management of IBD Patients with Current Immunosuppressive Therapy and Concurrent Infections

2015 ◽  
Vol 33 (Suppl. 1) ◽  
pp. 50-56 ◽  
Author(s):  
Jean-François Rahier
Keyword(s):  
Current Practice ◽  
Opportunistic Infections ◽  
Safety Issue ◽  
Case Reports ◽  
Careful Monitoring ◽  
Increased Risk ◽  
Before And After ◽  
Concurrent Infections ◽  
Inflammatory Bowel ◽  
Work Up

In an era of increasing use of immunomodulator therapy and biologics, opportunistic infections (OI) have emerged as a pivotal safety issue in patients with inflammatory bowel disease (IBD). Clinical studies, registries and case reports warn about the increased risk for infections, particularly OIs. Today, the challenge for a physician is not only to manage IBD, but also to recognize, prevent and treat common and uncommon infections. The 2014 European Crohn's and Colitis Organisation (ECCO) guidelines on the management and prevention of OIs in patients with IBD provide clinicians with guidance on the prevention, detection and management of OIs. Proposals may appear radical, potentially changing the current practice, but we believe that the recommendations will help optimize patient outcomes by reducing the morbidity and mortality related to OIs. In this ongoing process, prevention is by far the first and most important step. Prevention of OIs relies on recognition of risk factors for infection, the use of primary or secondary chemoprophylaxis, careful monitoring (clinical and laboratory work-up) before and during the use of immunomodulators, vaccination and education of the patient. Special recommendations should also be given to patients before and after travel.

scholarly journals Evaluation of Blood Glucose before and after Bariatric Surgery

2018 ◽  
Vol 11 (01) ◽  
pp. 030-031
Author(s):  
Ana Martins ◽  
Alexandre Oliveira
Keyword(s):  
Bariatric Surgery ◽  
Blood Glucose ◽  
Informed Consent ◽  
Financial Support ◽  
Case Reports ◽  
Relevant Literature ◽  
Ethics Committee ◽  
Health Science ◽  
Before And After ◽  
Consistent Manner

Abstract For original articles it must be prepared in a structured form containing a maximum of 250 words. It must contain: Background Specific aim Methods Results and Conclusion. For brief communications case reports and review articles the abstract must be structured and limited to 150 words. Enter the words (or keywords) using the DECS - Descriptors in Health Science Bireme http://decs.bvs.br/ available. Three key-words at least are necessary separated by commas. Do not cite references in the abstract. Text: Divide the text according to the type of article (see detailed information on the item of Content Items; no punctuation should follow their titles). The Introduction should make a brief review of relevant literature in order to demonstrate the relevance of the study. Methods must be described so that the reader understands how the search has been conducted. In human research, it is mandatory to inform the existence of informed consent and approval by the medical ethics committee. The results should be presented in a consistent manner and linked to the goals and methods described. Discussion should reiterate the main findings of the manuscript the negative aspects discuss and compare the importance and implications of the findings. The conclusion must be made so that the author refrains from interference or not deductions based on the findings of the study. In original articles the process number of the Committee or the Ethics Committee of the Institution should be informed. Any financial support for research should be disclosed.

The Effects of Bariatric Surgery on Pharmacokinetics of Antidepressants: A Systematic Review

2017 ◽  
Vol 41 (S1) ◽  
pp. S232-S233 ◽  
Author(s):  
L. de Jonge ◽  
S. Petrykiv ◽  
J. Fennema ◽  
M. Arts
Keyword(s):  
Bariatric Surgery ◽  
Drug Absorption ◽  
Antidepressant Drug ◽  
Antidepressant Medication ◽  
In Vivo Studies ◽  
Electrolyte Balance ◽  
Competing Interest ◽  
Type Of Surgery

IntroductionMorbid obesity (BMI ≥ 35) has been associated with mood and anxiety disorders. Regular use of antidepressants is common among patients who are candidate for bariatric surgery. The Roux-en-Y gastric bypass (RYGB) is one of the most common techniques used in bariatric surgery for reducing nutrient absorption. This type of surgery may however result in major changes in drug absorption.Objectives and aimsTo report and discuss the consequences of bariatric surgery on changes in antidepressant drug absorption.MethodsWe present all published in vitro and in vivo studies on antidepressant drug absorption after bariatric surgery.ResultsIn vitro studies showed that only bupropion had a significantly increased dissolution in a post-RYGB environment; venlafaxine and citalopram showed no alteration of dissolution; fluoxetine, paroxetine, sertraline, and amitryptiline had an significantly decreased dissolution in a post RYGB environment. Some in-vivo studies reported that only citalopram and escitalopram had an increased dissolution.ConclusionAfter bariatric surgery, special caution is required in patients using antidepressant medication because of the expected changes in drug absorption, nutritional status, and electrolyte balance.Disclosure of interestThe authors have not supplied their declaration of competing interest.

POSTOPERATIVE COMPLIANCE OF BARIATRIC SURGERY PATIENTS REGARDING THE ASSESSMENT OF SERUM LEPTIN LEVELS AND INSULIN RESISTANCE

2019 ◽  
Vol 49 (1/2019) ◽  
Keyword(s):  
Insulin Resistance ◽  
Bariatric Surgery ◽  
Serum Levels ◽  
Medical Laboratory ◽  
Leptin Resistance ◽  
Obese Patients ◽  
Laboratory Assessment ◽  
Serum Leptin ◽  
Before And After ◽  
Bariatric Patients

Background and aims: Overweight and obese patients who undergo bariatric surgery require a rigorous clinical and paraclinical assessment both before and after the surgery at 3, 6, and 12 months.The present study aims the assessment of serum leptin levels and insulin resistance status in compliant bariatric patients to scheduled medical laboratory assessment at 6 months after surgery. Material and Method: The study included 109 eligible patients selected for bariatric surgery, 48 of whom attended the scheduled visit at 6 months after the surgery. Laboratory assessing regarded the insulin resistance by determining before meal the serum levels of leptin, glucose and insulin, as well as HOMA 1 and HOMA 2 indexes. Results: Patients who underwent bariatric treatment experienced a significant decrease in insulin resistance status. A higher percentage in the preoperative group was recorded in women, feature which was also recorded in the postoperative group that attended the scheduled visit at 6 months after surgery. Age is also an important factor that significantly influences the behavioral adherence to postoperative visits. Conclusions: Insulin resistance status improved significantly in 6 months after bariatric surgery among the fully compliant patients. The percentage of attendance at scheduled visits is higher among women, and decreases with age. Keywords: obesity surgery, leptin resistance, insulin resistance, HOMA index, compliance

scholarly journals Orosensory Perception of Fat/Sweet Stimuli and Appetite-Regulating Peptides before and after Sleeve Gastrectomy or Gastric Bypass in Adult Women with Obesity

Nutrients ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 878
Author(s):  
Arnaud Bernard ◽  
Johanne Le Beyec-Le Bihan ◽  
Loredana Radoi ◽  
Muriel Coupaye ◽  
Ouidad Sami ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Gastric Bypass ◽  
Sleeve Gastrectomy ◽  
Gut Hormones ◽  
Sweet Taste ◽  
Taste Perception ◽  
Taste Sensitivity ◽  
Adult Women ◽  
Before And After ◽  
The Impact

The aim of this study was to explore the impact of bariatric surgery on fat and sweet taste perceptions and to determine the possible correlations with gut appetite-regulating peptides and subjective food sensations. Women suffering from severe obesity (BMI > 35 kg/m2) were studied 2 weeks before and 6 months after a vertical sleeve gastrectomy (VSG, n = 32) or a Roux-en-Y gastric bypass (RYGB, n = 12). Linoleic acid (LA) and sucrose perception thresholds were determined using the three-alternative forced-choice procedure, gut hormones were assayed before and after a test meal and subjective changes in oral food sensations were self-reported using a standardized questionnaire. Despite a global positive effect of both surgeries on the reported gustatory sensations, a change in the taste sensitivity was only found after RYGB for LA. However, the fat and sweet taste perceptions were not homogenous between patients who underwent the same surgery procedure, suggesting the existence of two subgroups: patients with and without taste improvement. These gustatory changes were not correlated to the surgery-mediated modifications of the main gut appetite-regulating hormones. Collectively these data highlight the complexity of relationships between bariatric surgery and taste sensitivity and suggest that VSG and RYGB might impact the fatty taste perception differently.

scholarly journals Visual Analysis of Biomarkers Reveals Differences in Lipid Profiles and Liver Enzymes before and after Gastric Sleeve and Bypass

Obesity Facts ◽  
2021 ◽  
pp. 1-11
Author(s):  
Marijn Marthe Georgine van Berckel ◽  
Saskia L.M. van Loon ◽  
Arjen-Kars Boer ◽  
Volkher Scharnhorst ◽  
Simon W. Nienhuijs
Keyword(s):  
Bariatric Surgery ◽  
Visual Analytics ◽  
Biochemical Markers ◽  
Visual Analysis ◽  
Large Population ◽  
High Volume ◽  
Cholesterol Concentration ◽  
Health State ◽  
Data Set ◽  
Before And After

<b><i>Introduction:</i></b> Bariatric surgery results in both intentional and unintentional metabolic changes. In a high-volume bariatric center, extensive laboratory panels are used to monitor these changes pre- and postoperatively. Consecutive measurements of relevant biochemical markers allow exploration of the health state of bariatric patients and comparison of different patient groups. <b><i>Objective:</i></b> The objective of this study is to compare biomarker distributions over time between 2 common bariatric procedures, i.e., sleeve gastrectomy (SG) and gastric bypass (RYGB), using visual analytics. <b><i>Methods:</i></b> Both pre- and postsurgical (6, 12, and 24 months) data of all patients who underwent primary bariatric surgery were collected retrospectively. The distribution and evolution of different biochemical markers were compared before and after surgery using asymmetric beanplots in order to evaluate the effect of primary SG and RYGB. A beanplot is an alternative to the boxplot that allows an easy and thorough visual comparison of univariate data. <b><i>Results:</i></b> In total, 1,237 patients (659 SG and 578 RYGB) were included. The sleeve and bypass groups were comparable in terms of age and the prevalence of comorbidities. The mean presurgical BMI and the percentage of males were higher in the sleeve group. The effect of surgery on lowering of glycated hemoglobin was similar for both surgery types. After RYGB surgery, the decrease in the cholesterol concentration was larger than after SG. The enzymatic activity of aspartate aminotransferase, alanine aminotransferase, and alkaline phosphate in sleeve patients was higher presurgically but lower postsurgically compared to bypass values. <b><i>Conclusions:</i></b> Beanplots allow intuitive visualization of population distributions. Analysis of this large population-based data set using beanplots suggests comparable efficacies of both types of surgery in reducing diabetes. RYGB surgery reduced dyslipidemia more effectively than SG. The trend toward a larger decrease in liver enzyme activities following SG is a subject for further investigation.

scholarly journals The Impact of Bariatric Surgery on Menstrual Abnormalities—a Cross-Sectional Study

2020 ◽  
Vol 30 (11) ◽  
pp. 4505-4509
Author(s):  
Anna Różańska-Walędziak ◽  
Paweł Bartnik ◽  
Joanna Kacperczyk-Bartnik ◽  
Krzysztof Czajkowski ◽  
Maciej Walędziak
Keyword(s):  
Bariatric Surgery ◽  
Menstrual Cycle ◽  
Cross Sectional Study ◽  
Reproductive Age ◽  
Obese Women ◽  
Sectional Study ◽  
Cross Sectional ◽  
Contraception Use ◽  
Before And After ◽  
The Impact

Abstract Introduction Obesity is associated with hyperestrogenism along with other hormonal abnormalities affecting the menstrual cycle. The most effective and decisive method of obesity treatment is bariatric surgery. The aim of this study was to analyze the impact of bariatric surgery on menstrual cycle, the incidence of menstrual abnormalities, hyperandrogenism manifestation, and contraception use. Materials and Methods It was a cross-sectional study of 515 pre-menopausal women who had undergone bariatric surgery between 1999 and 2017 in a bariatric center. Data was collected via anonymous questionnaire, and the questions covered a 1-year period before the surgery and the last year before questionnaire completion. Results Before the surgery, 38.6% of the patients reported irregular menstruations in comparison with 25.0% after bariatric surgery (RR = 0.65; 95%CI 0.53–0.79). The mean number of menstruations per year did not differ before and after surgery (10.2 ± 3.9 vs 10.4 ± 3.3; p < .45). There were no statistically significant differences in terms of prolonged menstruations, acne, and hirsutism prevalence. A total of 14.4% of patients before surgery reported estrogen-based contraception use in comparison with 15.0% after the surgery (p < .95). There were no significant differences in the frequency of OC use (11.0% before surgery vs 13.6% 12 months after the surgery vs 11.5% at the moment of survey administration; p < 0.46). Conclusion Bariatric surgery improves the regularity of the menstrual cycle in obese women in reproductive age. The lack of any changes in the combined hormonal contraception (CHC) use, especially OC, before and after bariatric surgery may be a result of a possibly low level of contraception counseling.

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