scholarly journals THE ALCOHOL CONSUMPTION IS AMENDED AFTER BARIATRIC SURGERY? AN INTEGRATIVE REVIEW

2016 ◽  
Vol 29 (suppl 1) ◽  
pp. 111-115 ◽  
Author(s):  
Valeria Duarte GREGORIO ◽  
Roselma LUCCHESE ◽  
Ivânia VERA ◽  
Graciele C. SILVA ◽  
Andrecia SILVA ◽  
...  

ABSTRACT Background Bariatric surgery has been an alternative when conservative methods of weight loss fail. Patients undergoing bariatric surgery have an increased risk of up to 6.5% of problems related to alcohol Objective: Integrative review out to analyze the change of alcohol consumption in this public Method: Database was accessed from June of 2015 to January of 2016 by searching "bariatric surgery" AND "alcoholism", and their Portuguese equivalents. ScienceDirect, PubMed, Lilacs and Medline, besides manual search, were searched. To be included, the paper should have been published between 2005-2016 and related to bariatric surgery and alcoholism. Theses, dissertations, unpublished papers, case reports and theoretical studies were excluded, and a database was subsequently composed Results: In 2005 there was only a review of change in alcohol metabolism in patients undergoing bariatric surgery. There were no publications in 2006. In 2007, only one study was published, and it did not meet the inclusion criteria. In 2010, there was an increase of 13% in publications and of 20% in 2012, reaching 40% in 2013 Conclusion: The prevalence and incidence of alcohol consumption in relation to the postoperative time was six months to three years with higher incidence for follow-up treatment by men. Roux-en-Y gastric bypass showed greater association with increased consumption of alcohol during the postoperative period. Alcohol consumption proved to be essential to be faced in bariatric surgery.

Author(s):  
Valeria Duarte GREGORIO ◽  
Roselma LUCCHESE ◽  
Ivânia VERA ◽  
Graciele C. SILVA ◽  
Andrecia SILVA ◽  
...  

ABSTRACT Background: Bariatric surgery has been an alternative when conservative methods of weight loss fail. Patients undergoing bariatric surgery have an increased risk of up to 6.5% of problems related to alcohol. Objetive: To review the literature about the changes on alcohol consumption in this public. Method: Database was accessed from June of 2015 to January of 2016 by searching “bariatric surgery” AND “alcoholism”, and their Portuguese equivalents. Science Direct, PubMed, Lilacs and Medline, besides manual search, were searched. To be included, the paper should have been published between 2005-2016 and related to bariatric surgery and alcoholism. Theses, dissertations, unpublished papers, case reports and theoretical studies were excluded. In 2005 there was only one review of change in alcohol metabolism in patients undergoing bariatric surgery. There were no publications in 2006. In 2007, only one study was published, and it did not meet the inclusion criteria. In 2010, there was an increase of 13% in publications and of 20% in 2012, reaching 40% in 2013. Conclusion: The prevalence and incidence of alcohol consumption in relation to the postoperative time was six months to three years with higher incidence in men. Roux-en-Y gastric bypass showed greater association with increased alcohol consumption during the postoperative period. This and other studies showed that the pattern of alcohol consumption is important to be faced as a problem in bariatric surgery follow-up.


2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 974.3-975
Author(s):  
T. Burkard ◽  
J. Lane ◽  
D. Holmberg ◽  
A. M. Burden ◽  
D. Furniss

Background:Dupuytren disease (DD) is multifactorial, with several genetic and environmental risk factors contributing to disease susceptibility. High body mass index, however, was suggested to be protective of DD.1 The impact of weight loss among obese patients on DD has not been assessed to date.Objectives:To assess the association between bariatric surgery and DD in a secondary care setting.Methods:We performed a propensity score (PS)-matched cohort study using data from Swedish nationwide healthcare registries (patient registry [secondary care], causes of death registry, prescribed drug registry). Patients aged 30-79 years who underwent bariatric surgery between 2006 and 2019 were matched to up to 2 obese bariatric surgery-free patients (called unexposed patients) based on their PS. PS-matching was carried out in risk set sampling to reduce selection bias, within 4 sequential cohort entry blocks to account for time trend biases. The outcome DD was defined as a diagnosis of DD in secondary care or partial or total fasciotomy of wrist or hand. After a 1-year run-in period, patients were followed in an “as-treated” approach. We applied Cox proportional hazard regression to calculate hazard ratios (HR) with 95% confidence intervals (CIs) of incident DD among bariatric surgery patients when compared to obese unexposed patients overall, and in subgroups of age, sex, bariatric surgery type, and by duration of follow-up.Results:A total of 34 959 bariatric surgery patients were PS-matched to 54 769 obese unexposed patients. A total of 71.6% of bariatric surgery patients were women. Bariatric surgery patients had a mean age of 45.5 years and a mean follow-up of 6.9 years. All patient characteristics in obese unexposed patients were highly similar. We observed 126 and 136 severe DD cases among bariatric surgery and obese unexposed patients, respectively. The risk of DD was significantly increased in bariatric surgery patients compared to obese unexposed patients (HR = 1.30, 95% CI 1.02-1.65). The risk of DD was higher in women (HR = 1.36, 95% CI 1.00-1.84) than in men (HR = 1.05, 95% CI 0.70-1.58). Age did not modify the risk of DD among bariatric surgery patients compared to obese unexposed patients. Malabsorptive bariatric surgery yielded an increased risk of DD when compared to obese unexposed patients (HR = 1.33, 95% CI 1.04-1.71), while restrictive bariatric surgery yielded a null result. The risk of DD increased with duration of follow-up (>5 years of follow-up: HR = 1.63, 95% CI 1.14-2.34, null result in earlier follow-up).Conclusion:Our results suggest that substantial weight loss is associated with a latent increased risk of severe DD in an obese population. This observation further strengthens current evidence that high body mass index is protective against DD. The latency of risk increase of DD after bariatric surgery may suggest that slowly adapting metabolic changes may be part of the mechanism of DD emergence.References:[1]Hacquebord JH, Chiu VY, Harness NG. The Risk of Dupuytren Surgery in Obese Individuals. J Hand Surg Am. 2017, 42: 149–55.Acknowledgements:We thank Prof. Dr. Jesper Lagergren (Karolinksa Institutet, Stockholm, Sweden) for hosting Dr. Theresa Burkard for a research stay at the Upper Gastrointestinal Surgery Group and making the data available for use. Furthermore, we thank Dr. Giola Santoni (Karolinksa Institutet, Stockholm, Sweden) for her technical support.Disclosure of Interests:None declared


2020 ◽  
Author(s):  
Yue Zhang ◽  
Jingyi Li ◽  
Nannan Cheng ◽  
Jie Yang ◽  
Lijing Ye ◽  
...  

Abstract Background:We aimed to evaluate the association between alcohol consumption and risk of cancer incidence among rural Chinese adults. Methods: We utilized data from a community-based cohort study in rural China enrolled in 2003 and followed up prospectively up to 2018. Generalized estimating equation models were used to obtain odds ratios (OR) and 95% confidence intervals (CI) to analyze the relationship between alcohol consumption and cancer incidence. Results: After an average of 15 years of follow-up, a total of 9870 adult participants were included in this study. The results of the regression analysis for males showed that former drinkers had a significantly increased risk of cancer compared to never drinkers ([OR]2.46,95%[CI](1.43-4.23)). The cancer risk for current drinkers with heavy alcohol consumption(>400g/week) significantly increased ([OR]1.66,95% [CI] (1.18-2.34))compared to never drinkers. Among current drinkers, for every 100g of alcohol consumed per week, the risk of cancer increased by 15%. Among current drinkers, those aged 53.5 years or older , had a significant increase in the risk of cancer ([OR]1.26,95% [CI](1.12-1.42), for those with triglycerides ≥150 mg/dL, the risk of cancer was even higher ([OR]1.50,95%[CI](1.20-1.88), P for interaction 0.018), and for those with high density lipoprotein cholesterol (HDLC)<40 mg/dL, the risk of cancer increased the greatest ([OR]2.03,95%[CI](1.36-3.04), P for interaction 0.005). Conclusions: Among middle-aged and elderly males in rural China, the risk of cancer significantly increased among former and heavy current drinkers compared with never drinkers. Age, triglycerides, and HDLC may increase the risk of cancer along with alcohol consumption.


2020 ◽  
Vol 4 (15) ◽  
pp. 3639-3647 ◽  
Author(s):  
Zachary Gowanlock ◽  
Anastasiya Lezhanska ◽  
Maeve Conroy ◽  
Mark Crowther ◽  
Maria Tiboni ◽  
...  

Abstract Iron deficiency is a common consequence of bariatric surgery and frequently leads to anemia. Our study reports the incidence and predictors of iron deficiency, iron deficiency anemia (IDA), and IV iron use after bariatric surgery. We conducted a retrospective study of all adult patients who underwent bariatric surgery from January to December 2012 at the regional bariatric surgery center in Hamilton, Ontario, Canada, and were followed for at least 6 months. Time-to-event data were presented as Kaplan-Meier curves. Cox regression analysis was used to identify outcome predictors. A total of 388 patients met the inclusion criteria. Iron deficiency, IDA, and the use of IV iron were reported in 43%, 16%, and 6% of patients, respectively, with a mean follow-up of 31 months. The cumulative incidence of iron deficiency and IDA increased with longer follow-up, and there was a significant increase in IV iron use starting 3 years after surgery. Malabsorptive procedures (hazard ratio [HR], 1.92; 95% confidence interval [CI], 1.20-3.06; P = .006) and low baseline ferritin (HR, 0.96; 95% CI, 0.95-0.97; P &lt; .001) were associated with an increased risk of iron deficiency. Young age (HR, 0.90; 95% CI, 0.82-0.99; P = .028), baseline anemia (HR, 19.6; 95% CI, 7.85-48.9; P &lt; .001), and low baseline ferritin (HR, 0.96; 95% CI, 0.95-0.98; P &lt; .001) were associated with an increased risk of IDA. Our results suggest that IDA is a delayed consequence of bariatric surgery and that preoperative assessment of patient risk may be possible.


2019 ◽  
Vol 152 (Supplement_1) ◽  
pp. S55-S55
Author(s):  
Rayan Saade ◽  
Zhiyan Fu ◽  
Hwajeong Lee

Abstract Objectives Early onset colorectal carcinoma (CRC), defined as CRC detected in patients ≤50 years old, are frequently located in the distal colorectum and are associated with risk factors that are common to adenoma. We examined the risk factors, pathologic features, and clinical implications associated with EOEUA. Methods A retrospective cohort of 154 patients with EOEUA was retrieved. Clinical data were obtained from electronic medical records. A minimum of 12 months follow-up was considered valid follow-up data. Archived pathology slides were evaluated for the presence of high-grade dysplasia (HGD) and Paneth cells (PCs) in adenomatous crypts. Additional pathologic data were retrieved from pathology reports. The patients were stratified into age >50 vs ≤50 years. Fisher’s exact test and Student t test were performed when indicated (P < .05 was considered statistically significant). Results In the ≤50-year group, EOEUAs were common in the rectosigmoid colon compared to >50-year group (41.2% vs 16.8%; P = .025). The association with diabetes, obesity, and alcohol consumption was similar in the two groups, whereas the incidences of hypertension, hyperlipidemia, and smoking were significantly lower in the ≤50-year group. No significant differences in gender distribution, adenoma size, HGD, PC presence, and future adenoma burden were observed between the two groups. Conclusion The association with established risk factors of adenoma to include diabetes, obesity, and alcohol consumption in EOEUA is comparable to that of older patients. In contrast, hypertension, hyperlipidemia, and smoking do not appear to be associated with an increased risk of endoscopically unresectable adenoma in this age group. Similar to early onset CRC, EOEUAs are common in the rectosigmoid, supporting the premise that flexible sigmoidoscopy may be a viable screening alternative in this age group, especially for patients with diabetes, obesity, or alcohol history.


1996 ◽  
Vol 10 (6) ◽  
pp. 369-375 ◽  
Author(s):  
DA Malatjalian ◽  
JB Ross ◽  
CN Williams ◽  
SJ Colwell ◽  
BJ Eastwood

BACKGROUND AND DESIGN: Methotrexate (MTX) hepatotoxicity in psoriatic patients is well recognized, but there are discrepancies in the reported incidence and associated risk factors. This retrospective study describes 104 Nova Scotian patients with psoriasis seen between 1979 and 1990. Patients received MTX over one to 11 years (mean 3.38), with baseline and annual follow-up liver biopsies. Clinical data were obtained by chart review. Statistical analysis evaluated the risks associated with obesity, diabetes, alcohol consumption and duration of therapy, with the histological grade of liver biopsies.RESULTS: Of the 104 patients, 35 were obese, 10 were diabetic and 37 occasionally consumed alcohol. At the end of the study, 21 patients had developed severe hepatic fibrosis (grade IIIB), and three developed liver cirrhosis (grade IV). Significant risk of severe hepatotoxicity is related to diabetes (P=0.02) but not to obesity (P=0.12) or alcohol consumption (P=0.12). All patients with cirrhosis took MTX for two years in standard doses of 20 to 25 mg/week.CONCLUSIONS: In this first Canadian study evaluating MTX hepatotoxicity in psoriatics, the incidence of severe hepatotoxicity is high: 23.1% (24 of 104 patients). This study shows that diabetic patients are particularly at increased risk of MTX hepatotoxicity. Occasional alcohol consumption is not associated with increased risk. Three patients who developed cirrhosis over two years of standard MTX therapy may represent a subset of psoriatics with increased hepatic susceptibility to MTX. Another three patients whose severe hepatic fibrosis had regressed upon discontinuation of MTX, but who developed accelerated recurrence of the severe hepatic fibrosis upon resumption of MTX therapy, also suggest the possibility of unusual sensitivity to the drug. These cases emphasize the need for continuing surveillance, with regular liver biopsies, of psoriatic patients on MTX.


Materials ◽  
2021 ◽  
Vol 14 (8) ◽  
pp. 1980
Author(s):  
Gianni Gallusi ◽  
Antonio Libonati ◽  
Mario Piro ◽  
Virginia Di Taranto ◽  
Edoardo Montemurro ◽  
...  

Objective: The aim of this study was to confirm the hypothesis that patients with one or more amalgam restorations have an increased risk for systemic diseases rather than patients with resin-based restorations. Data: The data search produced an initial 3568 total number of records. All titles and abstract were reviewed by five independent examiners, and only 36 records were selected for full text in depth examination. Out of these, only nine publications matched the inclusion criteria and were included in this systematic review. Sources: Electronic databases (MEDLINE, Scopus, Embase, and Web of Knowledge) were searched up to June 2019. In addition, a manual search was carried out on journals related to this topic. Study selection: All selected human clinical studies compared patients with dental amalgam restorations to patients with non-amalgam restorations on restorative material related diseases/health conditions with at least 50 patients and a reasonable follow up. The systemic effects of dental restorations were analyzed. As for any systemic effects, there was no difference between amalgam and composite restoration. Conclusions: With the limitations of the few available randomized controlled trials (RCTs) on the matter, amalgam restorations, similarly to other modern resin-based materials, were not related to an increased risk of systemic diseases or conditions. Clinical significance: On the basis of the available RCTs, amalgam restorations, if compared with resin-based fillings, do not show an increased risk for systemic diseases. There is still insufficient evidence to exclude or demonstrate any direct influence on general health. The removal of old amalgam restorations and their substitution with more modern adhesive restorations should be performed only when clinically necessary and not just for material concerns. In order to better evaluate the safety of dental amalgam compared to other more modern restorative materials, further RCTs that consider important parameters such as long and uniform follow up periods, number of restorations per patient, and sample populations representative of chronic or degenerative diseases are needed.


2020 ◽  
Vol 9 (12) ◽  
pp. e7791210884
Author(s):  
Tuany Silva do Nascimento ◽  
Alessandro Diogo De Carli ◽  
Edilson José Zafalon ◽  
Paulo Zárate Pereira ◽  
Estêvão Azevedo Melo ◽  
...  

The present study aimed to verify the association between the sedentary behavior and the main disorders in oral health through an integrative review of the literature. Structured searches were carried out in the PUBMED, SCOPUS and SCIELO databases to find the original research studies. An electronic form was used to extract data about author, year, population, measures of evaluation of the outcomes of interest, main results and conclusions of the authors. Of the 216 studies identified in the databases, 12 included the inclusion criteria. Of these, 09 pointed out an association between sedentary behavior and oral health, indicating that such behavior has a negative impact on the oral health of the individuals. Three articles did not relate sedentarism as a risk factor for oral health disorders. Although most studies point to a possible association, there is still needed more well-designed and with longer follow-up studies to confirm sedentary behavior as a risk factor for the development of oral diseases. In the perspective of a dental approach to risk factors in common with systemic diseases, it is advised that clinicians should be aware of the lifestyle adopted by their patients in order to guide them in choosing a healthy lifestyle.


2018 ◽  
Vol 7 (1) ◽  
Author(s):  
Stamatios Petousis ◽  
George Karavas ◽  
Chrysoula Margioula-Siarkou ◽  
Themistoklis Dagklis ◽  
Paraskevi Karapavlidou ◽  
...  

Abstract Background Deficiency of factor XII (FXII) is widely considered to have a detrimental effect on pregnancy. Several reports underline the increased risk for antenatal complications with few published case reports of uncomplicated deliveries. The main objective of our article is to perform a systematic review to highlight pregnancies with severe deficiency of FXII that have been delivered uneventfully, along with presenting our relative case of a woman with severe deficiency of FXII. Materials and methods A systematic review was performed in the Pubmed database. Inclusion criteria were considered to be case reports and case series presenting delivery of uncomplicated pregnancies in women with severe FXII deficiency. Medical records of our patient were also reviewed in terms of signs and symptoms, laboratory and imaging examinations and neonatal outcomes. Results There were 62 abstracts derived while 44 were assessed for eligibility. There were finally three case reports of women with FXII deficiency delivering live newborns and one case series of 12 women with a final outcome of 19 deliveries. Regarding our case presentation, the woman with FXII levels <12%, after a neonatal death because of extreme prematurity (24 weeks + 4 days), was set in regular follow-up and treatment with bemiparin natriate, 3.5 mg/kg and acetylsalicylic acid, 100 mg/day. She finally managed to have her second pregnancy delivered at 38 weeks + 3 days, her third pregnancy ended up as a miscarriage and her fourth pregnancy was also delivered at 37 weeks + 4 days. Conclusion Despite the increased risk for antenatal complications, appropriate follow-up of pregnancies with severe FXII pregnancy may finally lead to an uneventful delivery.


Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Vignan Yogendrakumar ◽  
Andrew M Demchuk ◽  
Richard I Aviv ◽  
David Rodriguez-Luna ◽  
Carlos A Molina ◽  
...  

Background: Baseline volume, spot sign, and coagulation status all predict early hematoma expansion (HE) in intracerebral hemorrhage (ICH). However, the role of ICH location on HE remains unclear. We hypothesized that lobar-located ICH would facilitate HE as it provides a larger potential volume for expansion as compared to deep locations. However, due to the close proximity of critical structures and increased risk of ventricular rupture, we also hypothesized that deep ICH would have a paradoxically increased risk of mortality and morbidity. Our objective was to assess the effect of lobar vs. non-lobar hemorrhage on HE and clinical outcome. Methods: We analyzed data from the prospective multicentre PREDICT study where patients with ICH presenting to hospital under 6 hours of symptom onset received a baseline CT, CTA, 24 hour follow-up CT, and 90-d mRS. ICH location was categorized as lobar vs deep, and primary outcomes were significant HE (>6mL) and poor clinical outcome (mRS >3). Multivariable regression with stepwise selection was used to adjust for relevant covariates. Sensitivity analysis was conducted by expanding the inclusion criteria to include patients who died or were treated with Factor VIIa and/or surgery prior to follow-up CT. Results: Among 302 patients meeting the inclusion criteria, lobar hemorrhage was associated with increased hematoma expansion >6mL (p=0.003), poor clinical outcome (p=0.011) and mortality (p=0.017). When adjusted for covariates, lobar hemorrhage independently predicted significant hematoma expansion (aOR 2.3 [95% CI: 1.2-4.4], p=0.02). Sensitivity analysis included a total of 353 patients and lobar location was no longer significantly associated with poor outcome (p=0.198). This appeared to be related to a higher proportion of IVH in the excluded population (33% Primary vs. 65% Excluded, p<0.001). Conclusion: Lobar hemorrhage led to expansion and poor clinical outcome in the primary analysis population. Sensitivity analysis of the excluded population revealed that deep bleeds are associated with a higher degree of mortality and morbidity, likely due to a higher frequency of IVH. Our findings suggest that baseline ICH location should be considered for risk stratification algorithms.


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