Comment on long-term outcomes of metabolic and bariatric surgery in adolescents with severe obesity with a follow-up of at least 5 years: a systematic review

Abstract Several types of psychological treatment for posttraumatic stress disorder (PTSD) are considered well established and effective, but evidence of their long-term efficacy is limited. This systematic review and meta-analysis aimed to investigate the long-term outcomes across psychological treatments for PTSD. MEDLINE, Cochrane Library, PTSDpubs, PsycINFO, PSYNDEX, and related articles were searched for randomized controlled trials with at least 12 months of follow-up. Twenty-two studies (N = 2638) met inclusion criteria, and 43 comparisons of cognitive behavioral therapy (CBT) were available at follow-up. Active treatments for PTSD yielded large effect sizes from pretest to follow-up and a small controlled effect size compared with non-directive control groups at follow-up. Trauma-focused treatment (TFT) and non-TFT showed large improvements from pretest to follow-up, and effect sizes did not significantly differ from each other. Active treatments for comorbid depressive symptoms revealed small to medium effect sizes at follow-up, and improved PTSD and depressive symptoms remained stable from treatment end to follow-up. Military personnel, low proportion of female patients, and self-rated PTSD measures were associated with decreased effect sizes for PTSD at follow-up. The findings suggest that CBT for PTSD is efficacious in the long term. Future studies are needed to determine the lasting efficacy of other psychological treatments and to confirm benefits beyond 12-month follow-up.

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Abstract 16013: Evidence for Improvement in NYHA Class and Freedom From Hospitalization in Bariatric Surgery Patients With an Established Diagnosis of Heart Failure

Circulation ◽

10.1161/circ.142.suppl_3.16013 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Michael W Foster ◽

Sara E Badenhausen ◽

Colleen Tewksbury ◽

Noel N Williams ◽

J Eduardo Rame ◽

...

Keyword(s):

Heart Failure ◽

Bariatric Surgery ◽

Weight Loss ◽

Medical Record ◽

Median Time ◽

Severe Obesity ◽

Nyha Class ◽

High Volume ◽

Metabolic And Bariatric Surgery

Introduction: Heart failure patients with severe obesity endure significant morbidity and frequent hospitalizations. Bariatric surgery is proven to provide durable weight loss for those with severe obesity, but the clinical impact and safety of these procedures among patients with heart failure has not been well-demonstrated. Methods: We conducted a medical record query of patients who have a previous diagnosis of heart failure (HFpEF and HFrEF) and underwent subsequent Roux-En-Y gastric bypass or laparoscopic sleeve gastrectomy at a high-volume metabolic and bariatric surgery center. We compared clinical, demographic, and echocardiographic data captured just prior to the bariatric procedure to the most recent data available in the medical record for each patient. Results: There were 50 patients (88% had HFpEF) included in this study. Time from HF diagnosis to most recent follow-up ranged from 0.2 to 20.3 years (median 6.7 years) and there was no recorded mortality. The median time from HF diagnosis to surgery was 2.3 years and median time from surgery to recent follow-up was 2.9 years. Post-operative median decrease in BMI was 8.8 kg/m 2 , HF hospitalizations were 0.4 per patient year (PPY) to 0.15 PPY, p=0.008, and median NYHA Class was II pre-op and I post-op, p=0.048). LVEF, LVESD, and LVEDD were not significantly changed post-operatively (Table 1). Conclusion: Weight loss following bariatric surgery for patients with HF led to improvements in NYHA Class, fewer hospitalizations for HF, and was not associated with perioperative mortality. It is reasonable to consider bariatric surgery for this patient population, but further prospective investigation is warranted.

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Impact of postoperative complications on long-term outcomes of patients following surgery for gastric cancer: A systematic review and meta-analysis of 64 follow-up studies

Asian Journal of Surgery ◽

10.1016/j.asjsur.2019.10.007 ◽

2020 ◽

Vol 43 (7) ◽

pp. 719-729

Author(s):

Jian Li ◽

Yao Zhang ◽

Deng-Min Hu ◽

Tu-Ping Gong ◽

Run Xu ◽

...

Keyword(s):

Gastric Cancer ◽

Systematic Review ◽

Postoperative Complications ◽

Meta Analysis ◽

Long Term Outcomes ◽

Follow Up Studies

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Prevalence and progression of incidental terminal ileitis on non-diagnostic colonoscopy: a systematic review and meta-analysis

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjab030 ◽

2021 ◽

Author(s):

Manasi Agrawal ◽

Mario Bento-Miranda ◽

Samantha Walsh ◽

Neeraj Narula ◽

Jean-Frederic Colombel ◽

...

Keyword(s):

Systematic Review ◽

Prevalence Rate ◽

Meta Analysis ◽

Significant Heterogeneity ◽

Long Term Outcomes ◽

Diagnostic Colonoscopy ◽

Terminal Ileitis ◽

Pooled Prevalence

Abstract Background Incidentally-diagnosed terminal ileitis (IDTI) has been reported among asymptomatic persons undergoing non-diagnostic colonoscopy. The purpose of our study was to determine the prevalence and long-term outcomes of asymptomatic terminal ileitis. Methods We performed a systematic review using three biomedical databases (Medline, Embase and Web of Science) and relevant scientific meeting abstracts. We identified observational studies that reported the prevalence of IDTI in adults undergoing screening or polyp surveillance colonoscopy and/or the long-term outcomes of such lesions. A random-effects meta-analysis was conducted to determine the pooled prevalence rate of IDTI. The progression of IDTI to overt Crohn’s disease (CD) was also described. Results Of 2,388 eligible studies, 1,784 were screened after excluding duplicates, 84 were reviewed in full text, and 14 studies were eligible for inclusion. Seven studies reported the prevalence of IDTI in 44,398 persons undergoing non-diagnostic colonoscopy, six studies reported follow-up data, and one study reported both types of data. The pooled prevalence rate of IDTI was 1.6% (CI 0.1–21.8%) with significant heterogeneity (I 2 = 99.7). Among patients who had undergone non-diagnostic colonoscopy and had follow-up data (range 13–84 months reported in five studies), progression to overt CD was rare. Conclusion IDTI is not uncommon on non-diagnostic colonoscopies. Based on limited data, the rate of its progression to overt CD seems low, and watchful waiting is likely a reasonable strategy. Further long-term follow-up studies are needed to inform the natural history of incidental terminal ileitis, factors that predict progression to CD, and therapeutic implications.

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