scholarly journals Longitudinal Gastrectomy for Nonbariatric Indications

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Oluwatobi O Onafowokan ◽  
Aboubakr Khairat ◽  
Mohammad Jamal ◽  
Hemant Chatrath ◽  
Hugo J. R. Bonatti1
Keyword(s):  
Gastric Volvulus ◽  
Normal Weight ◽  
Uneventful Recovery ◽  
Endoscopic Stenting ◽  
Heavy Smoking ◽  
Minimally Invasive Surgical ◽  
Weight One ◽  
Severely Obese ◽  
Longitudinal Gastrectomy ◽  
Peg Tube

Background. Sleeve gastrectomy is the most commonly performed bariatric procedure. Laparoscopic longitudinal gastrectomy (LLG) may be indicated for other indications. Patients and Methods. Two men and two women aged 67, 72, 77, and 80 years underwent LLG for nonbariatric indications with two having normal weight, one being cachectic, and one severely obese. Results. LLG was discussed with patients prior to surgery, but decision for LLG was made during surgery after contemplating other surgical options. A wide sleeve over a 42 French bougie was created with the staple line being oversewn with running 3–0 silk. Indications included a bleeding Dieulafoy lesion that failed endoscopic clipping, fundus gland polyposis found during paraesophageal hernia repair, fundus nodules suspected to be leiomyosarcoma metastases revealing splenosis on final pathology, and significant gastric dilatation associated with organoaxial gastric volvulus. Three patients had an uneventful recovery; the severely obese patient temporarily lost weight but died after two years from a stroke. The last patient developed dysphagia due to an alpha-loop in the sleeve, which was managed by endoscopic stenting. The device subsequently migrated and was laparoscopically removed, with a side-side gastrogastrostomy performed to straighten the alpha-loop. The patient tolerated food better and with overnight PEG tube feeds gained weight but continued heavy smoking. He died after one year from COPD exacerbation. Conclusion. LLG seems to be an appropriate intervention for various gastric pathologies. Training of residents and fellows in the minimally invasive surgical steps of LLG is encouraged.

scholarly journals Most important etiologic factors in the development of genital prolapse

2010 ◽  
Vol 138 (5-6) ◽  
pp. 315-318
Author(s):  
Ljiljana Mladenovic-Segedi ◽  
Dimitrije Segedi
Keyword(s):  
Hormone Replacement Therapy ◽  
Surgical Treatment ◽  
Genetic Factors ◽  
Pelvic Floor Dysfunction ◽  
Hormone Replacement ◽  
Clinical Manifestations ◽  
Genital Prolapse ◽  
Normal Weight ◽  
Severely Obese ◽  
Initiating Factors

Introduction The incidence of genital prolapse depends on numerous factors. The contribution of race, gender and genetic factors is significant. However, additional factors of initiation, promotion and decomposition are necessary if a person with the genetic predisposition to genital prolapse begins to suffer from it. At least 50% of parous women are believed to suffer from genital prolapse of various degrees. Moreover, the prevalence of genital prolapse increases with age. The prevalence of genital prolapse is expected to be even higher in the future due to the extension of the lifespan of women worldwide. Objective The aim of this study was to determine the most common etiologic factors in the development of genital prolapse in the population of Serbia. Methods The study was conducted as prospective and included 50 women who underwent surgical treatment due to the problems caused by genital prolapse. Results Mean age of the women was 58.74 years. Twenty percent of the women had the menstrual cycle, while 80% were in menopause. Mean menopause period was 8.88 years. None of the women used hormone replacement therapy. Mean BMI was 27.395 kg/m2. Twenty-eight percent of the women were of normal weight, while 72% of the women were obese (42% were obese and 30% were severely obese). Ninety-eight percent of the women were parous, and mean parity was 2.08. Mean birth weight of neonates was 3682.77 g. Sixty-four percent of the women did physical labour and lifted heavy objects. Conclusion Vaginal childbirth is one of the most important initiating factors. The most significant promoting factor is obesity and heavy labour. Ageing and entering menopause are the most important factors of decomposition as well as the occurrence of clinical manifestations of the pelvic floor dysfunction. .

scholarly journals In vitro Selection of Probiotics for Microbiota Modulation in Normal-Weight and Severely Obese Individuals: Focus on Gas Production and Interaction With Intestinal Epithelial Cells

2021 ◽  
Vol 12 ◽  
Author(s):  
Alicja Maria Nogacka ◽  
Clara G. de los Reyes-Gavilán ◽  
Silvia Arboleya ◽  
Patricia Ruas-Madiedo ◽  
Ceferino Martínez-Faedo ◽  
...  
Keyword(s):  
Epithelial Cells ◽  
Intestinal Epithelial Cells ◽  
Normal Weight ◽  
Gas Production ◽  
Intestinal Epithelial ◽  
Microbiota Composition ◽  
Severely Obese ◽  
Obese Subjects ◽  
Selection Of

The intestinal microbiota plays important roles in the maintenance of health. Strategies aiming at its modulation, such as probiotics, have received a deal of attention. Several strains have been studied in different in vitro models; however, the correlation of results obtained with the in vivo data has been limited. This questions the usefulness of such in vitro selection models, traditionally relying on over-simplified tests, not considering the influence of the accompanying microbiota or focusing on microbiota composition without considering functional traits. Here we assess the potential of six Bifidobacterium, Lactobacillus and Lacticaseibacillus strains in an in vitro model to determine their impact on the microbiota not just in terms of composition but also of functionality. Moreover, we compared the responses obtained in two different population groups: normal-weight and severely obese subjects. Fecal cultures were conducted to evaluate the impact of the strains on specific intestinal microbial groups, on the production of short-chain fatty acids, and on two functional responses: the production of gas and the interaction with human intestinal epithelial cells. The response to the different probiotics differed between both human groups. The addition of the probiotic strains did not induce major changes on the microbiota composition, with significant increases detected almost exclusively for the species added. Higher levels of gas production were observed in cultures from normal-weight subjects than in the obese population, with some strains being able to significantly reduce gas production in the latter group. Moreover, in obese subjects all the Bifidobacterium strains tested and Lacticaseibacillus rhamnosus GG were able to modify the response of the intestinal cells, restoring values similar to those obtained with the microbiotas of normal-weight subjects. Our results underline the need for the screening and selection of probiotics in a target-population specific manner by using appropriate in vitro models before enrolling in clinical intervention trials.

scholarly journals Severe obesity in children as an independent risk factor for perioperative respiratory adverse events during anaesthesia for minor non-airway surgery, a retrospective observational study

2018 ◽  
Vol 28 (2) ◽  
pp. 83-89
Author(s):  
Kavitha Raghavan ◽  
Daphne Xin Ying Moo ◽  
Zihui Tan
Keyword(s):  
Adverse Events ◽  
Fold Increase ◽  
Normal Weight ◽  
Obese Children ◽  
Medical Comorbidities ◽  
Airway Surgery ◽  
Respiratory Airway ◽  
Obstructive Sleep ◽  
Significant Difference ◽  
Severely Obese

Purpose: The purpose of this article is to quantify grades of obesity and their independent effects on perioperative adverse events in children having ambulatory minor non-airway surgery. Methods: After obtaining ethics committee approval, we selected every tenth child aged 2 to 16 years who was identified as having been a day case between January 2012 and December 2014. Weight groups were defined based on age- and gender-specific body mass index (BMI) cutoff points. A sample size of 1102 was calculated to demonstrate a three-fold increase in the primary outcome measure, perioperative respiratory-airway adverse events, among obese children, with a power of 80% and an alpha error of 5%. Chi-squared and Fisher exact tests were used to compare proportions, and independent sample t tests were used to compare means. Results: Severely obese children had a significantly higher incidence of perioperative respiratory-airway adverse events when compared to normal-weight children despite no difference in respiratory and other comorbidity. Obese children had higher prevalence of overall medical comorbidities and obstructive sleep apnoea when compared to normal-weight children and there was no significant difference in the incidence of perioperative respiratory-airway adverse events and other outcome measures between obese and normal-weight children. Conclusions and recommendations: Severely obese children have a higher risk of perioperative respiratory-airway adverse events even during minor non-airway surgery despite absence of medical comorbidities. We recommend the use of age- and sex- specific BMI cutoffs or BMI percentile charts to identify children who are severely obese to anticipate and prevent major respiratory adverse events.

scholarly journals Pre- and post- prandial appetite hormone levels in normal weight and severely obese women

2009 ◽  
Vol 6 (1) ◽  
pp. 32 ◽  
Author(s):  
Joseph J Carlson ◽  
Amy A Turpin ◽  
Gail Wiebke ◽  
Steven C Hunt ◽  
Ted D Adams
Keyword(s):  
Normal Weight ◽  
Obese Women ◽  
Hormone Levels ◽  
Severely Obese

Severe Obesity: Effects on Foot Mechanics During Walking

1994 ◽  
Vol 15 (1) ◽  
pp. 29-34 ◽  
Author(s):  
Stephen P. Messier ◽  
Angela B. Davies ◽  
Dominic T. Moore ◽  
Shala E. Davis ◽  
Robert J. Pack ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Weight Control ◽  
Severe Obesity ◽  
Normal Weight ◽  
Control Group ◽  
Posterior Aspect ◽  
Adult Females ◽  
Q Angle ◽  
Severely Obese

The purpose of our study was to determine the effects of severe obesity on the foot mechanics of adult females. Twenty-nine adult females between the ages of 20 and 48 years volunteered as subjects for this investigation. The subjects were separated into a severely obese (O) group (body mass index = 41.14 ± 2.61; N = 16) and a normal weight control group (body mass index = 20.84 ± 0.47; N = 13). A Locam camera (100 Hz) positioned perpendicular to the subjects’ posterior aspect was used to film the rearfoot movement of the subjects during the final 15 sec of a 10 min treadmill walk. The O group had a significantly greater touchdown angle ( P = .05), more total eversion range of motion ( P = .001), and a faster maximum eversion velocity ( P < .001). Moreover, analysis of dynamic foot angles indicated that the O group had significantly ( P = .003) more forefoot abduction. Finally, anthropometric data revealed statistically different ( P < .001) Q angle measurements between the O and control groups. The results of this study suggest that severely obese females have significantly greater rearfoot motion, foot angle, and Q angle values than normal weight females.

Severely obese adolescent girls rely earlier on carbohydrates during walking than normal-weight matched girls

2015 ◽  
Vol 33 (18) ◽  
pp. 1871-1880 ◽  
Author(s):  
Olivier Gavarry ◽  
Celine Aguer ◽  
Anne Delextrat ◽  
Gregory Lentin ◽  
Karine Ayme ◽  
...  
Keyword(s):  
Adolescent Girls ◽  
Normal Weight ◽  
Obese Adolescent ◽  
Severely Obese

Perceived discrimination among men and women with normal weight and obesity. A population-based study from Sweden

2010 ◽  
Vol 38 (6) ◽  
pp. 587-596 ◽  
Author(s):  
Lena M. Hansson ◽  
Erik Näslund ◽  
Finn Rasmussen
Keyword(s):  
Socioeconomic Position ◽  
Weight Status ◽  
Severe Obesity ◽  
Perceived Discrimination ◽  
Population Based ◽  
Normal Weight ◽  
Population Based Study ◽  
Men And Women ◽  
Severely Obese ◽  
Interpersonal Discrimination

Aims: We examined whether men and women with obesity reported different types of discrimination to a greater extent than those with normal weight, and explored whether these associations were modified by socioeconomic position. Method: National representative sample of men and women, with normal weight (n = 2,000), moderate obesity (n = 2,461) and severe obesity (n = 557). Participants were identified in a yearly population-based survey (1996—2006) and data on perceived discrimination and potential confounding factors were measured in 2008. Logistic regression models tested whether obesity was associated with perceived lifetime, workplace, healthcare and interpersonal discrimination. Results: The overall response rate was 56%. For men, moderate obesity was associated with workplace discrimination, while severely obese women were more likely to report this sort of discrimination than normal weight women. Severely obese individuals were twice as likely to report healthcare discrimination than normal weight individuals. Women, regardless of weight status group, were in turn twice as likely to report healthcare discrimination as men. Women with severe obesity were significantly more likely to report interpersonal discrimination compared with normal weight women. Socioeconomic position modified the association between weight status and healthcare discrimination. Highly educated individuals with moderate and severe obesity were more likely to report healthcare discrimination than their normal weight counterparts, whereas low educated individuals with normal weight, moderate and severe obesity were equally likely to report discrimination. Conclusions: In this large, population-based study, discrimination was more likely to be reported by obese individuals compared with those of normal weight. The associations, however, varied according to gender and socioeconomic position.

scholarly journals Mesenteroaxial Gastric Volvulus: A Case Report

2021 ◽  
Vol 59 (237) ◽  
Author(s):  
Sampanna Pandey ◽  
Madhav Paudel ◽  
Anuj Parajuli ◽  
Roshan Ghimire ◽  
Asmita Neupane
Keyword(s):  
Differential Diagnosis ◽  
Case Report ◽  
Primary Repair ◽  
Wedge Resection ◽  
Gastric Volvulus ◽  
Exploratory Laparotomy ◽  
Uneventful Recovery ◽  
Atypical Presentation ◽  
Surgical Exploration ◽  
Low Threshold

Gastric volvulus is defined as an abnormal rotation of the stomach. Classical textbook presentation may not always be present. Meticulous assessment and broadened differential diagnosis are thus crucial. Various types have been described in literature. Low threshold for detection with aggressive resuscitation and immediate surgical exploration on suspected incarceration or perforation are mandatory. We report a case of 16-years-female who had atypical presentation of mesenteroaxial gastric volvulus. Emergency exploratory laparotomy with wedge resection and primary repair of stomach with anterolateral gastropexy was performed. She had uneventful recovery with discharge on fifth postoperative day.

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