scholarly journals MEDIUM-TERM FOLLOW-UP RESULTS WITH LAPAROSCOPIC SLEEVE GASTRECTOMY

2015 ◽  
Vol 28 (suppl 1) ◽  
pp. 61-64 ◽  
Author(s):  
Almino Cardoso RAMOS ◽  
Eduardo Lemos de Souza BASTOS ◽  
Manoela Galvão RAMOS ◽  
Nestor Tadashi Suguitani BERTIN ◽  
Thales Delmondes GALVÃO ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Sleeve Gastrectomy ◽  
Surgical Treatment ◽  
Surgical Technique ◽  
Body Mass ◽  
The Body ◽  
Morbidly Obese ◽  
Medium Term ◽  
Orthopedic Diseases

Background : The indications for sleeve gastrectomy in the surgical treatment of morbid obesity have increased worldwide. Despite this, several aspects related to results at medium and long term remain in constant research. Aim : To present the experience of sleeve gastrectomy in a center of excellence in bariatric surgery by analyzing clinical outcomes, complications and follow-up in the medium term. Methods : The study included 120 morbidly obese patients who underwent sleeve gastrectomy and who were followed for at least 24 months. Aspects related to surgical technique, surgical complications and clinical outcome were analyzed. Results : Seventy-five patients were women (62.5%) and the average age was 36 years. The body mass index preoperatively ranged from 35.5 to 58 kg/m2(average of 40.2 kg/m2). The length of stay ranged from 1 to 4 days (mean 2.1 days). Comorbidities observed were hypertension (19%), type 2 diabetes mellitus (6.6%), dyslipidemia (7.5%), sleep apnea (16.6%), reflux esophagitis (10%) and orthopedic diseases (7.5%). The mean body mass index and total weight loss percentage with 3, 12, 18 and 24 months were 32.2 kg/m2-19,9%; 29.5 kg/m2-26,5%; 28.2 kg/m2-30,3% and 26.9 kg/m2-32,7%, respectively. Remission of diabetes and dyslipidemia occurred in all patients. In relation to hypertension, there was improvement or remission in 86%. There were only two complications (bronchial pneumonia and dehydration), with good response to clinical treatment. There was no evidence digestive fistula and mortality was zero. Eleven patients (9.1%) had regained weighing more than 5 kg. Conclusion : The sleeve gastrectomy is surgical technique that has proven safe and effective in the surgical treatment of obesity and control of their comorbidities in postoperative follow-up for two years.

Anaesthetic Management of a Super Morbid Obese Patient

2021 ◽  
Vol 8 (32) ◽  
pp. 3039-3042
Author(s):  
Lekshmi Raj Jalaja ◽  
Stuti Lohia ◽  
Priyadarsini Bentur ◽  
Ravi Ramgiri
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Recovery Period ◽  
Well Being ◽  
Anaesthetic Management ◽  
The Body ◽  
World Health ◽  
Morbidly Obese ◽  
Multisystem Disorder ◽  
Increased Risk

‘Obesity’ is defined as a condition with excess body fat to the extent that health and well-being are adversely affected and uses a class system based on the body mass index (BMI), by the world health organization (WHO). Anaesthetic management of morbidly obese is challenging, as there is an increased risk of perioperative respiratory insufficiency and supplemental oxygen must be given throughout recovery period. The incidence of morbid obesity continues to grow and anaesthesiologists are exposed to obese patients presenting for various procedures. The prevalence of obesity is on the upward trend worldwide. Obesity is a multisystem disorder, involving the respiratory and cardiovascular systems, and therefore, undergoing a surgical procedure under anaesthesia may entail a considerable risk. Thus, a multidisciplinary approach is required in treating such patients. Quantification of the extent of obesity is done using the body mass index. BMI is defined as the relationship between weight and height (weight [kg] / height2 [m2 ]).

scholarly journals Comparison of the effects of laparoscopic sleeve gastrectomy in adults and adolescents

2020 ◽  
Vol 7 (3) ◽  
pp. 630
Author(s):  
Burcin Batman ◽  
Hasan Altun
Keyword(s):  
Body Mass Index ◽  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Body Mass ◽  
Insulin Level ◽  
Benefit Evaluation ◽  
Significant Difference ◽  
Adolescents And Adults ◽  
Treatment Of Obesity

Background: Obesity is an increasing problem worldwide regardless of age. Bariatric surgery is highly effective both in the treatment of obesity and in the improvement of obesity-related comorbidities. Laparoscopic sleeve gastrectomy is gaining popularity in both adolescents and the elderly.Methods: A total of 64 patients who underwent laparoscopic sleeve gastrectomy, aged under 19 and older 65 between March 2013 and December 2019 were enrolled in this retrospective study. Demographic characteristics were recorded in all patients.Results: Between March 2013 and December 2019, 64 patients who underwent laparoscopic sleeve gastrectomy were enrolled in this study. Fourty-five patients were smaller than 19 years old and 19 patients were older than 65 years old. After 1-year follow-up, there was a significant improvement in glucose, insulin level, excess weight loss and body mass index in both groups (p<0.001). There was no significant difference in insulin levels (p=0.2) and body mass index (p=0.94) between two groups.Conclusions: Careful patient selection after adequate risk versus benefit evaluation by an expert multidisciplinary team is essential. Laparoscopic sleeve gastrectomy is an effective treatment for obesity and its related comorbidities in both adolescents and adults.

scholarly journals Does Body Mass Index Affect Mortality in Coronary Surgery?

2016 ◽  
Vol 10 (1) ◽  
pp. 240-245 ◽  
Author(s):  
Aristotle D. Protopapas
Keyword(s):  
Body Mass Index ◽  
Morbid Obesity ◽  
Body Mass ◽  
Artery Bypass ◽  
Normal Weight ◽  
The Body ◽  
Morbidly Obese ◽  
Coronary Surgery ◽  
Crude Mortality ◽  
Underweight Patients

Introduction: The Body Mass Index (BMI) quantifies nutritional status and classifies humans as underweight, of normal weight, overweight, mildly obese, moderately obese or morbidly obese. Obesity is the excessive accumulation of fat, defined as BMI higher than 30 kg/m2. Obesity is widely accepted to complicate anaesthesia and surgery, being a risk factor for mediastinitis after coronary artery bypass grafting (CABG). We sought the evidence on operative mortality of CABG between standard BMI groups. Materials and Methodology: A simple literature review of papers presenting the mortality of CABG by BMI group: Underweight (BMI ≤ 18.49 kg/m2), normal weight (BMI 18.5–24.9 kg/m2), overweight (BMI 25.0–29.9 kg/m2), mild obesity (BMI 30.0–34.9 kg/m2), moderate obesity (BMI 35.0–39.9 kg/m2), or morbid obesity (BMI ≥ 40.0 kg/m2). Results: We identified 18 relevant studies with 1,027,711 patients in total. Their variability in size of samples and choice of BMI groups precluded us from attempting inferential statistics. The overall cumulative mortality was 2.7%. Underweight patients had by far the highest mortality (6.6%). Overweight patients had the lowest group mortality (2.1%). The group mortality for morbidly obese patients was 3.44%. Discussion: Patients with extreme BMI’s undergoing CABG (underweight ones more than morbidly obese) suffer increased crude mortality. This simple observation indicates that under nutrition and morbid obesity need be further explored as risk factors for coronary surgery.

Relationship Between Body Mass Index and Robotic Surgery Outcomes of Women Diagnosed With Endometrial Cancer

2011 ◽  
Vol 21 (4) ◽  
pp. 722-729 ◽  
Author(s):  
Susie Lau ◽  
Karen Buzaglo ◽  
Zvi Vaknin ◽  
Sonya Brin ◽  
Rebecca Kaufer ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Endometrial Cancer ◽  
Robotic Surgery ◽  
Body Mass ◽  
Invasive Surgery ◽  
Minimal Invasive Surgery ◽  
Minimal Invasive ◽  
The Body ◽  
Wound Complications ◽  
Morbidly Obese

Objective:This is a prospective evaluation of the outcome of minimal invasive surgery using robotics in function of the body mass index (BMI) of patients.Methods:This is a prospective cohort study of consecutive women undergoing surgery for endometrial cancer at a tertiary care facility since the initiation of a robotic program in December 2007. Surgical and personal outcome variables as well as quality of life and postoperative recovery were assessed using a combination of objective and subjective/self-report questionnaires. Women were divided into 3 groups based on their BMI. Comparative analyses among nonobese (n = 52), obese (n = 33) and morbidly obese (n = 23) women were performed on the outcome measures after surgery.Results:The mean BMI and the range in each of the BMI categories was 25 kg/m2 (18.7-29.4 kg/m2), 34 kg/m2 (30.1-38.4 kg/m2), and 46 kg/m2 (40.0-58.8 kg/m2). Women with higher BMI tended to be more frequently affected with comorbidities such as diabetes (15.4%, 26.0%, and 27.3%, respectively; P = 0.32) and hypertension (55.8%, 69.6%, and 69.7%, respectively; P = 0.19). Despite these differences, surgical console time (P = 0.20), major postoperative complications (P = 0.52), overall wound complications (P = 0.18), and median length of hospitalization in days (P = 0.17) were not statistically different among the 3 groups. Only 5.6% of women needed a mini laparotomy all of which were performed for the removal of their enlarged uterus, which could not be delivered safely via the vagina, at the end of the surgical procedure. There was no increased conversion to laparotomy due to increased BMI. Women in all 3 groups reported rapid resumption of hygiene regimens and chores, little need for narcotic analgesia, and high satisfaction with the procedure.Conclusions:Obese and morbidly obese patients with endometrial cancer are also good candidates for robotic surgery. These women benefit considerably from minimal invasive surgery and have little perioperative complications.

scholarly journals Return to Play After Open Calcaneoplasty for Insertional Achilles Tendinopathy With Haglund Deformity in Competitive Professional Athletes

2021 ◽  
Vol 9 (6) ◽  
pp. 232596712110098
Author(s):  
Kyung Tai Lee ◽  
Jegal Hyuk ◽  
Sung Jae Kim
Keyword(s):  
Body Mass Index ◽  
Surgical Treatment ◽  
Body Mass ◽  
Achilles Tendinopathy ◽  
Return To Play ◽  
Professional Athletes ◽  
Haglund Deformity ◽  
Mean Time ◽  
Insertional Achilles Tendinopathy

Background: Surgical treatment of insertional Achilles tendinopathy with Haglund deformity in highly competitive professional athletes has not been previously investigated. Purpose: To assess clinical outcomes, including return to play (RTP), after surgical treatment of insertional Achilles tendinopathy in professional athletes. Study Design: Case-control study; Level of evidence, 3. Methods: This retrospective study included 20 professional athletes who were surgically treated for insertional Achilles tendinopathy and had at least 2 years of follow-up. An open longitudinal lateral approach was used for the operation, without violation of the Achilles tendon. Outcome evaluation included American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score, subjective patient satisfaction, mean time of return to competition (RTC), and rate of RTP. We defined RTC as return to an official match for at least 1 minute and RTP rate as the percentage of patients who were able to participate in at least 2 full seasons. A subgroup analysis was performed to compare the RTP and no-RTP groups. Results: The AOFAS score improved significantly from preoperatively to the final follow-up (from 65.1 to 88.4; P < .001), and 75% of the patients reported good to excellent satisfaction. The mean time of RTC was 7.45 months (range, 4-18 months), and the rate of RTP was 60%. The RTP group had a significantly lower mean body mass index than did the no-RTP group (22.03 vs 23.86, respectively; P = .005) and faster mean RTC (5.0 vs 11.1 months, respectively; P < .001). Conclusion: Open calcaneoplasty for surgical treatment of insertional Achilles tendinopathy with Haglund deformity in highly competitive professional athletes should be approached cautiously. Our patients had a 7.5-month recovery period before return to their first official match, and only 60% of the patients returned to their sports activity and participated in at least 2 full seasons. Lower body mass index and a faster RTC after surgery were related to longer functional maintenance.

scholarly journals Semi-Markov Modelling of HIV/AIDS Disease Progression

2021 ◽  
Author(s):  
Tilahun Asena ◽  
Ayele Goshu ◽  
Mebratu Senbeta ◽  
Derbachew Teni
Keyword(s):  
Body Mass Index ◽  
Disease Progression ◽  
Body Mass ◽  
Waiting Time ◽  
Time Distribution ◽  
The Body ◽  
Waiting Time Distribution ◽  
Body Mass Index Increase ◽  
Hiv Aids

Abstract Background: HIV/AIDS epidemic continues to be the main challenge in the world. According to United Nations Program on HIV/AIDS (UNAIDS) and the World Health Organization (WHO) reports of 2013, 35 million people were living with HIV worldwide, with 2.1 million new infections and with 1.5 million deaths occurred each year. Among these, 24.7 million lived in sub-Saharan Africa with 1.5 million new infections and 1.1 million AIDS deaths.Method: The main objective of this study is finding factors affecting HIV/AIDS disease progression. This study was conducted to investigate the effect of factors on HIV/AIDS disease progression. Patient follow-up data is obtained at Yirgalim General Hospital. A sample of 370 Patient data from a follow-up cohort is obtained at Yirgalim General Hospital. Multivariate generalized hazard regression model was employed to investigate the disease progression using both time independent and time dependent covariates. Result: The study revealed that the risk of transition differs by patient's body mass index. Increase in the body mass index reduces the risk of transiting into the next worst states. The effects of sex, weight, age and body mass index of patients are significantly associated with AIDS disease progression. The risk of transition differs by patient's body mass index. Increase in the body mass index reduces the risk of transiting into the next worst states. The effect of sex, weight, age and body mass index of patients are significantly associated with AIDS disease progression. The results further revealed that the semi-Markov model with Weibull waiting time distribution has smaller log likelihood and AIC values compared to a semi-Markov model with exponential waiting time distribution.Conclusion: Transition probabilities are highly dependent on the choice of waiting times. We recommend that while choosing waiting time distributions for semi-Marko models one should consider appropriate distributions as waiting time distribution effect have a significant change on the estimated model parameters. In addition, this study recommends that concerned bodies should look at deferent contributing factors of AIDS diseases progression in addition to the ART services administered for slowing the current level of high diseased population in the country.

scholarly journals Short- and medium-term impact of bariatric surgery on the activities of CYP2D6, CYP3A4, CYP2C9, and CYP1A2 in morbid obesity

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Jose Rodríguez-Morató ◽  
Albert Goday ◽  
Klaus Langohr ◽  
Mitona Pujadas ◽  
Ester Civit ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Body Mass Index ◽  
Morbid Obesity ◽  
Body Mass ◽  
Surgical Techniques ◽  
Normal Weight ◽  
Morbidly Obese ◽  
Cyp3a4 Activity ◽  
Medium Term ◽  
The Impact

AbstractMorbid obesity and bariatric surgery induce anatomical, physiological and metabolic alterations that may alter the body’s disposition of drugs. Current literature on this topic is limited and sometimes inconsistent. Cytochrome P450 (CYP) is a superfamily of enzymes that metabolize around 75% of all marketed drugs. The purpose of this study was to evaluate the impact of body mass index and bariatric surgery on CYP activities. Firstly, we evaluated the in vivo activity of 4 major CYP isoenzymes (CYP2D6, CYP3A4, CYP2C9, and CYP1A2) in normal weight, overweight, and morbidly obese individuals. Secondly, we assessed the short- (1 month) and medium-term (6 month) effects of the most commonly employed bariatric surgery techniques (laparoscopic sleeve gastrectomy and Roux-en-Y gastric bypass) on the activity of these enzymes. CYP3A4 activity was lower in morbidly obese individuals, compared to normal-weight controls. Interestingly, bariatric surgery normalized CYP3A4 activity. In comparison with normal-weight controls, morbidly obese individuals had higher CYP2D6 activity, which was only observed in individuals with two functional alleles for this isoenzyme. Neither body mass index nor surgery had significant effects on CYP2C9 and CYP1A2 activities. Overall, no relevant differences in CYP activities were found between surgical techniques. In conclusion, further studies should evaluate whether the observed alterations in CYP3A4 activity will require dose adjustments for CYP3A4 substrates especially in morbidly obese individuals before and after bariatric surgery.

scholarly journals Excess Body Mass Index Loss at 3 Months: A Predictive Factor of Long-Term Result after Sleeve Gastrectomy

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Guillaume Philouze ◽  
Eglantine Voitellier ◽  
Laurence Lacaze ◽  
Emmanuel Huet ◽  
Antoine Gancel ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Sleeve Gastrectomy ◽  
Body Mass ◽  
Linear Regression Analysis ◽  
Limit Value ◽  
Long Term Result ◽  
Long Term Follow Up ◽  
Body Mass Index Loss

Introduction.Laparoscopic Sleeve Gastrectomy (SG) is considered as successful if the percentage of Excess Body Mass Index Loss (% EBMIL) remains constant over 50% with long-term follow-up. The aim of this study was to evaluate whether early % EBMIL was predictive of success after SG.Methods.This retrospective study included patients who had SG with two years of follow-up. Patients had follow-up appointments at 3 (M3), 6, 12, and 24 months (M24). Data as weight and Body Mass Index (BMI) were collected systematically. We estimated the % EBMIL necessary to establish a correlation between M3 and M24 compared to % EBMIL speeds and calculated a limit value of % EBMIL predictive of success.Results.Data at operative time, M3, and M24 were available for 128 patients. Pearson test showed a correlation between % EBMIL at M3 and that at M24 (r=0.74;  p<0.0001). % EBMIL speed between surgery and M3 (p=0.0011) was significant but not between M3 and M24. A linear regression analysis proved that % EBMIL over 20.1% at M3 (p<0.0001) predicted a final % EBMIL over 50%.Conclusions.% EBMIL at M3 after SG is correlated with % EBMIL in the long term. % EBMIL speed was significant in the first 3 months. % EBMIL over 20.1% at M3 leads to the success of SG.

scholarly journals Changes in nutritional status in adolescents surviving leukemia and lymphoma

2020 ◽  
Vol 33 ◽  
Author(s):  
Christy Hannah Sanini BELIN ◽  
Márjory de Camillis BUENO ◽  
Luciane Beitler DA CRUZ ◽  
Simone Geiger de Almeida SELISTRE ◽  
Estela Beatriz BEHLING
Keyword(s):  
Body Mass Index ◽  
Nutritional Status ◽  
Body Mass ◽  
Longitudinal Design ◽  
The Body ◽  
Abdominal Circumference ◽  
Oncological Treatment ◽  
End Of Treatment ◽  
Leukemias And Lymphomas

ABSTRACT Objective To examine the changes in the nutritional status of adolescents aged 10-19 years after a minimum 12 months interval following oncological treatment for leukemias and lymphomas. Methods Longitudinal design quantitative study conducted at Hospital de Clínicas, Porto Alegre. Adolescents aged 10-19 years after a minimum 12 months interval following oncological treatment for leukemias and lymphomas were included. The measures of weight, height, brachial circumference, triceps skinfold thickness, arm muscle circumference and abdominal circumference were collected. Results The sample comprised 50 adolescents who had survived leukemias and lymphomas. In the follow up 38% of the patients were classified as overweight according to the body mass index for their age. There was a significant increase in body mass index for age between the beginning and the end of treatment and follow up (p=0.013) in female individuals, compared to males. The results indicate a reduction in the Z-score means of height for age, with significant differences between the beginning of treatment and follow up (p=0.016); and end of treatment and follow up (p=0.006) in patients of both genders Conclusion The anthropometric indicators show an important frequency of excess weight and increased tricipital skinfold, as well as a significant increase of the body mass index for age and also a growth deficit among the survivors.

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