scholarly journals Weight and Glycemic Control Outcomes of Bariatric Surgery and Pharmacotherapy in Patients With Melanocortin-4 Receptor Deficiency

2022 ◽  
Vol 12 ◽  
Author(s):  
Esphie Grace Fodra Fojas ◽  
Saradalekshmi Koramannil Radha ◽  
Tomader Ali ◽  
Evan P. Nadler ◽  
Nader Lessan
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Glycemic Control ◽  
Therapeutic Interventions ◽  
Control Group ◽  
Short Term ◽  
Melanocortin 4 Receptor ◽  
Significant Difference

BackgroundMelanocortin-4 receptor (MC4R) mutations are the most common of the rare monogenic forms of obesity. However, the efficacy of bariatric surgery (BS) and pharmacotherapy on weight and glycemic control in individuals with MC4R deficiency (MC4R-d) is not well-established. We investigated and compared the outcomes of BS and pharmacotherapy in patients with and without MC4R-d.MethodsPertinent details were derived from the electronic database among identified patients who had BS with MC4R-d (study group, SG) and wild-type controls (age- and sex-matched control group, CG). Short- and long-term outcomes were reported for the SG. Short-term outcomes were compared between the two groups.ResultsSeventy patients were screened for MC4R-d. The SG [six individuals (four females, two males); 18 (10–27) years old at BS; 50.3 (41.8–61.9) kg/m2 at BS, three patients with homozygous T162I mutations, two patients with heterozygous T162I mutations, and one patient with heterozygous I170V mutation] had a follow-up duration of up to 10 years. Weight loss, which varied depending on mutation type [17.99 (6.10–22.54) %] was stable for 6 months; heterogeneity of results was observed thereafter. BS was found superior to liraglutide on weight and glycemic control outcomes. At a median follow-up of 6 months, no significant difference was observed on weight loss (20.8% vs. 23.0%, p = 0.65) between the SG and the CG [eight individuals (four females, four males); 19.0 (17.8–36.8) years old at BS, 46.2 (42.0–48.3) kg/m2 at BS or phamacotherapeutic intervention]. Glycemic control in patients with MC4R-d and Type 2 diabetes improved post-BS.ConclusionOur data indicate efficacious short-term but varied long-term weight loss and glycemic control outcomes of BS on patients with MC4R-d, suggesting the importance of ongoing monitoring and complementary therapeutic interventions.

scholarly journals Short-term skin problems in infants aged 0–3 months affect food allergies or atopic dermatitis until 2 years of age, among infants of the general population

2019 ◽  
Vol 15 (1) ◽  
Author(s):  
Kaori Yonezawa ◽  
Megumi Haruna
Keyword(s):  
Atopic Dermatitis ◽  
Family History ◽  
Food Allergies ◽  
Control Group ◽  
Short Term ◽  
Skin Problem ◽  
Significant Difference ◽  
History Of

Abstract Background This study examined whether infants aged 0–3 months exhibited long-term effects of using a moisturizer skincare intervention and whether a short-term skin problem resulted in the subsequent development of food allergies or atopic dermatitis (AD) until the age of 2 years. Methods This study was a follow-up of a completed randomized control trial (RCT) of moisturizer skincare for infants aged 0–3 months. A self-reported questionnaire was mailed to the parents of children aged 1–2 years who had participated in the RCT. Data were analyzed using a Chi square test, by intention to treat analysis, and by multiple logistic regression. Results Of 155 infants, 22 (14.2%) and 28 (18.1%) had food allergies and AD/eczema until 2 years of age, respectively. No significant difference was seen in food allergies or AD between the group that received moisturizer skincare intervention and the control group. On the contrary, food allergies until 2 years of age were significantly associated with short-term (4–7 days) and long-term (more than 7 days) body skin problems occurring in the first 3 months of life, a family history of AD, and the time of starting complementary food. High value of face transepidermal water loss at 3 months of age was also associated with food allergies. Moreover, a short duration of severe diaper dermatitis during the first 3 months, a family history of AD, and being male were significantly associated with AD/eczema until the age of 2 years. Conclusions After adjusting for family history of AD, a short-term skin problem in the first 3 months of life was significantly associated with the development of food allergies or AD/eczema until the age of 2 years. Prevention or prompt treatment of skin problems in newborns is essential for preventing future allergic diseases. Trial registration This was a follow-up study conducted 2 years after the completed RCT of a moisturizer skincare intervention for early infants, which was registered in the University Hospital Medical Information Network Clinical Trials Registry (UMIN000013260)

Endoscopic sutured gastroplasty in addition to lifestyle modification: short-term efficacy in a controlled randomised trial

Gut ◽  
2020 ◽  
pp. gutjnl-2020-322026
Author(s):  
Vincent Huberty ◽  
Ivo Boskoski ◽  
Vincenzo Bove ◽  
Pauline Van Ouytsel ◽  
Guido Costamagna ◽  
...  
Keyword(s):  
Weight Loss ◽  
Lifestyle Modification ◽  
Controlled Trial ◽  
Randomised Trial ◽  
Body Weight Loss ◽  
Total Body Weight ◽  
Control Group ◽  
Short Term ◽  
Randomised Controlled

ObjectiveEndoscopic suture gastroplasty (ESG) has been developed as an alternative treatment for moderately obese patients. We present our results of a short-term randomised controlled trial on a new suturing technique, the Endomina system (E-ESG, Endo Tools therapeutics, Belgium).DesignEligible patients (body mass index 30–40 kg/m2) were randomised in a 2:1 ratio to receive lifestyle modification plus E-ESG or lifestyle modification alone (control group); dietetic counselling and follow-up were identical. Endpoints included a mean excess weight loss (EWL) of more than 25% 12 months after E-ESG and a 15% EWL difference at 6 months between groups. At 6 months, a cross-over to E-ESG was offered to the control group. All patients were followed for a total of 12 months after E-ESG.ResultsOf the 71 patients included (five male, mean age 40 years), mean EWL at 6 months was significantly higher in the treatment (38.6%, n=45) than in the control group (13.4%, n=21; p<0.001). At 6 months, satiety tests demonstrated a higher decrease in mean volume (41% vs 2.5%, p<0.001), and mean quality of life (QoL) was also higher in the treatment group (52.8 vs 45.1 p<0.05). No procedure-related or device-related severe adverse events were observed. Twelve months follow-up after E-ESG showed a mean EWL of 45.1%, which translated into a total body weight loss of 11.8%.ConclusionsThis study demonstrates that E-ESG is safe and effective, providing a 25% better EWL at 6 months than lifestyle modification alone. This weight loss was maintained and resulted in a significant improvement in QoL up to 18 months after treatment.Trial registration numberNCT03255005.

scholarly journals Efficacy of Surgery Combined with Autologous Bone Marrow Stromal Cell Transplantation for Treatment of Intracerebral Hemorrhage

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Jianxin Zhu ◽  
Yilei Xiao ◽  
Zhongmin Li ◽  
Fabin Han ◽  
Taiwu Xiao ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Barthel Index ◽  
Autologous Bone Marrow ◽  
Control Group ◽  
Short Term ◽  
System Disease ◽  
Therapeutic Benefits ◽  
Neurologic Impairment ◽  
Significant Difference

Bone marrow stromal cells (BMSCs) may differentiate into nerve cells under a certain condition; however, the clinical application for treating nervous system disease remains unclear. The aim is to assess the safety profile, feasibility, and effectiveness of surgery combined with autologous BMSCs transplantation for treating ICH. 206 ICH patients who had received surgical procedure were divided into transplantation (n=110) or control group (n=96). For transplantation group, BMSCs were injected into the perihemorrhage area in the base ganglia through an intracranial drainage tube 5.5 (3.01–6.89) days after surgery, followed by a second injection into the subarachnoid space through lumbar puncture 4 weeks later. Neurologic impairment and daily activities were assessed with National Institute Stroke Scale (NIHSS), Barthel index, and Rankin scale before transplantation and 6 months and 12 months after transplantation. Our results revealed that, compared with control group, NIHSS score and Rankin scale were both significantly decreased but Barthel index was increased in transplantation group after 6 months. Interestingly, no significant difference was observed between 12 months and 6 months. No transplantation-related adverse effects were investigated during follow-up assessments. Our findings suggest that surgery combined with autologous BMSCs transplantation is safe for treatment of ICH, providing short-term therapeutic benefits.

Early clinical results of minimally invasive coracoclavicular ligament reconstruction can be maintained at a minimum of five years’ follow-up

2020 ◽  
Vol 102-B (7) ◽  
pp. 918-924
Author(s):  
Steffen B. Rosslenbroich ◽  
Katharina Heimann ◽  
Jan Christoph Katthagen ◽  
Clemens Koesters ◽  
Oliver Riesenbeck ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Constant Score ◽  
Clinical Results ◽  
Long Term Results ◽  
Short Term ◽  
Ac Joint ◽  
Ac Joint Dislocation ◽  
Significant Difference

Aims There is a lack of long-term data for minimally invasive acromioclavicular (AC) joint repair. Furthermore, it is not clear if good early clinical results can be maintained over time. The purpose of this study was to report long-term results of minimally invasive AC joint reconstruction (MINAR) and compare it to corresponding short-term data. Methods We assessed patients with a follow-up of at least five years after minimally invasive flip-button repair for high-grade AC joint dislocation. The clinical outcome was evaluated using the Constant score and a questionnaire. Ultrasound determined the coracoclavicular (CC) distance. Results of the current follow-up were compared to the short-term results of the same cohort. Results A total of 50 patients (three females, 47 males) were successfully followed up for a minimum of five years. The mean follow-up was 7.7 years (63 months to 132 months). The overall Constant score was 94.4 points (54 to 100) versus 97.7 points (83 to 100) for the contralateral side showing a significant difference for the operated shoulder (p = 0.013) The mean difference in the CC distance between the operated and the contralateral shoulder was 3.7 mm (0.2 to 7.8; p = 0.010). In total, 16% (n = 8) of patients showed recurrent instability. All these cases were performed within the first 16 months after introduction of this technique. A total of 84% (n = 42) of the patients were able to return to their previous occupations and sport activities. Comparison of short-term and long-term results revealed no significant difference for the Constant Score (p = 0.348) and the CC distance (p = 0.974). Conclusion The clinical outcome of MINAR is good to excellent after long-term follow-up and no significant differences were found compared to short-term results. We therefore suggest this is a reliable technique for surgical treatment of high-grade AC joint dislocation. Cite this article: Bone Joint J 2020;102-B(7):918–924.

scholarly journals Management of appendicitis during COVID-19 pandemic; short-term outcomes

2020 ◽  
Vol 65 (4) ◽  
pp. 144-148
Author(s):  
Radhakrishnan Ganesh ◽  
James Lucocq ◽  
Neville Ogbonnia Ekpete ◽  
Noor Ul Ain ◽  
Su Kwan Lim ◽  
...  
Keyword(s):  
Conservative Management ◽  
Short Term ◽  
Mri Scan ◽  
Operative Outcomes ◽  
Uncomplicated Appendicitis ◽  
Significant Difference ◽  
Long Term Follow Up ◽  
Surgical Conditions

Background and aim COVID-19 pandemic has predisposed patients undergoing surgery to post-operative infection and resultant complications. Appendicitis is frequently managed by appendicectomy. After the onset of the pandemic, selected cases of appendicitis were managed with antibiotics which is a recognised treatment option. Our objective was to compare the management of appendicitis and post-operative outcomes between pre- and post-COVID-19. Methods Ninety-six patients were identified from before the onset of the pandemic (November 2019) to after the onset of the pandemic (May 2020). Data were collected retrospectively from electronic records including demographics, investigations, treatment, duration of inpatient stay, complications, readmissions and compared between pre- and post-COVID-19 groups. Results One hundred percent underwent surgical treatment before the onset of pandemic, compared with 56.3% from the onset of the pandemic. A greater percentage of patients were investigated with imaging post-COVID-19 (100% versus 60.9%; p < 0.00001). There was no significant difference in the outcomes between the two groups. Conclusion CT/MRI scan was preferred to laparoscopy in diagnosing appendicitis and conservative management of uncomplicated appendicitis was common practice after the onset of pandemic. Health boards can adapt their management of surgical conditions during pandemics without adverse short-term consequences. Long term follow-up of this cohort will identify patients suitable for conservative management.

scholarly journals GROWTH, NEURODEVELOPMENT IN EXTREMELY LOWBIRTH BABIES AT TWO YEAR OF CORRECTED AGE

2019 ◽  
Vol 3 (5) ◽  
Author(s):  
Dr. Ashok Kumar ◽  
Dr. Kanya Mukhopadhyay ◽  
Dr. Prabhjot Malhi ◽  
Dr. Anil Kumar Bhalla
Keyword(s):  
Birth Weight ◽  
Neurological Examination ◽  
Gestational Age ◽  
Head Circumference ◽  
Control Group ◽  
Case Group ◽  
Significant Difference ◽  
Catch Up

According to national neonatal perinatal data (NNPD) the survival of ELBW babies has improved from 37% in 2000 to 45% in 2002-3 reports. In our neonatal unit in PGIMER the survival of ELBW babies has been 54-56% in last 5 years, however unfortunately there is very scanty reports of long term outcome of ELBW babies from India. There is very scanty report of long term growth outcome of VLBW and ELBW Babies in our country, we reported VLBW and ELBW babies in our follow up had poor catch up growth, though some catch-up was observed at 6 month but subsequent lag in growth probably reflects poor weaning at 1 year.  Infants with extremely low birth weights (ELBWs) are more susceptible to all of the possible complications of premature birth, both in the immediate neonatal period and after discharge from the nursery. These babies are at risk of poor growth and developmental. in the present study a total of 39 cases of ELBW Babies were enrolled during one year study period from July 2011- June2012 attending the neonatal follow up clinic attained 2year±3month of corrected age. Their detail birth data and postnatal illnesses retrieved from their initial hospital files and unit discharge record. A similar number of babies enrolled at 2yrs±3months of age in the control group. In the presence study, we assessed the growth, and neurological out come in extremely low birth baby attained 2yrs±3 months of corrected age. The study population consisted of 39 children of ELBW baby born during 2009 -10 at PGIMER & same number of normal birth weight children at 2yr±3 months of corrected age who satisfied the inclusion and exclusion criteria. These children were enrolled from neonatal follow up clinic who were already undergoing long term follow up. For growth outcome, we used weight, height & head circumference measurement of child, for neurological and developmental outcome used clinical neurological examination and DP-III .Base line demographic characteristics of our ELBW babies (Cases) where as follows.   Mean (S.D) gestational age of  ELBW babies was 29.87±2.3 week. Mean (S.D) birth weight 867±71.1 grams, Mean (S.D) lenght35±2.1cm & head circumference was 25.76±1.9 cm. Mean hospital stay in the ELBW babies was 48.6±19.9 days. Mean birth weight and gestational age of control group where 2684±166.2grm and 39.03±0.9 weeks. At 2year of corrected age we found  - Weight was similar in both in case group & control group. (10.04±1.4 Vs 10.75±1.1). Height and head circumference were smaller in cases than control group. (81.4±4.3 Vs 84.4±3.3 and 45.9±1.6 Vs 46.8±1.5. 5% Babies had cerebral palsy in case group (N=2/39) and none in control group. Gross development score(GDS) in Development profile-III in both study group (cases & controls) was  similar  (72.49±8.08 Vs 73.54±9.3,p=0.596). Significant difference in domains physical (84.5±7.8 Vs.90±3.5, p=0.000) and domains adaptive (81±6.7 Vs. 85.3±5.4,p= 0.003) in cases as compared to controls. There was no difference between SGA and AGA among cases in growth and neurological development. There was no difference between male and female in case group in any parameter .There is very scanty data from our country on longterm follow up of ELBW babies. Our data shows that our ELBW cohort remained small in height and had smaller head circumference though weight was similar as compared to normal control babies.  Key words: ELBW, VLBW, birth weight, neurological examination.

scholarly journals Short-term and long-term comparisons of laparoscopy-assisted proximal gastrectomy with esophagogastrostomy by the double-flap technique and laparoscopy-assisted total gastrectomy for proximal gastric cancer

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0242223
Author(s):  
Tomoko Tsumura ◽  
Shinji Kuroda ◽  
Masahiko Nishizaki ◽  
Satoru Kikuchi ◽  
Yoshihiko Kakiuchi ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Nutritional Status ◽  
Total Gastrectomy ◽  
Proximal Gastrectomy ◽  
Proximal Gastric Cancer ◽  
Short Term ◽  
Flap Technique ◽  
Significant Difference

Background Although proximal gastrectomy (PG) is a recognized surgical procedure for early proximal gastric cancer, total gastrectomy (TG) is sometimes selected due to concern about severe gastroesophageal reflux. Esophagogastrostomy by the double-flap technique (DFT) is an anti-reflux reconstruction after PG, and its short-term effectiveness has been reported. However, little is known about the long-term effects on nutritional status and quality of life (QOL). Methods Gastric cancer patients who underwent laparoscopy-assisted PG (LAPG) with DFT or laparoscopy-assisted TG (LATG) between April 2011 and March 2014 were retrospectively analyzed. Body weight (BW), body mass index (BMI), and prognostic nutritional index (PNI) were reviewed to assess nutritional status, and the Postgastrectomy Syndrome Assessment Scale (PGSAS)-45 was used to assess QOL. Results A total of 36 patients (LATG: 17, LAPG: 19) were enrolled. Four of 17 LATG patients (24%) were diagnosed with Stage ≥II after surgery, and half received S-1 adjuvant chemotherapy. BW and PNI were better maintained in LAPG than in LATG patients until 1-year follow-up. Seven of 16 LATG patients (44%) were categorized as “underweight (BMI<18.5 kg/m2)” at 1-year follow-up, compared to three of 18 LAPG patients (17%; p = 0.0836). The PGSAS-45 showed no significant difference in all QOL categories except for decreased BW (p = 0.0132). Multivariate analysis showed that LATG was the only potential risk factor for severe BW loss (odds ratio: 3.03, p = 0.0722). Conclusions LAPG with DFT was superior to LATG in postoperative nutritional maintenance, and can be the first option for early proximal gastric cancer.

scholarly journals Bariatric Surgery and Brain Health—A Longitudinal Observational Study Investigating the Effect of Surgery on Cognitive Function and Gray Matter Volume

Nutrients ◽  
2020 ◽  
Vol 12 (1) ◽  
pp. 127 ◽  
Author(s):  
Kristin Prehn ◽  
Thorge Profitlich ◽  
Ida Rangus ◽  
Sebastian Heßler ◽  
A. Veronica Witte ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Gray Matter ◽  
Gray Matter Volume ◽  
Neuropsychological Test ◽  
Control Group ◽  
Rapid Weight Loss ◽  
Brain Health ◽  
Matter Volume

Dietary modifications leading to weight loss have been suggested as a means to improve brain health. In morbid obesity, bariatric surgery (BARS)—including different procedures, such as vertical sleeve gastrectomy (VSG), gastric banding (GB), or Roux-en-Y gastric bypass (RYGB) surgery—is performed to induce rapid weight loss. Combining reduced food intake and malabsorption of nutrients, RYGB might be most effective, but requires life-long follow-up treatment. Here, we tested 40 patients before and six months after surgery (BARS group) using a neuropsychological test battery and compared them with a waiting list control group. Subsamples of both groups underwent structural MRI and were examined for differences between surgical procedures. No substantial differences between BARS and control group emerged with regard to cognition. However, larger gray matter volume in fronto-temporal brain areas accompanied by smaller volume in the ventral striatum was seen in the BARS group compared to controls. RYGB patients compared to patients with restrictive treatment alone (VSG/GB) had higher weight loss, but did not benefit more in cognitive outcomes. In sum, the data of our study suggest that BARS might lead to brain structure reorganization at long-term follow-up, while the type of surgical procedure does not differentially modulate cognitive performance.

scholarly journals Long-Term Weight Loss and Metabolic Syndrome Remission after Bariatric Surgery: The Effect of Sex, Age, Metabolic Parameters and Surgical Technique – A 4-Year Follow-Up Study

Obesity Facts ◽  
2019 ◽  
Vol 12 (6) ◽  
pp. 639-652 ◽  
Author(s):  
Vanessa Guerreiro ◽  
João Sérgio Neves ◽  
Daniela Salazar ◽  
Maria João Ferreira ◽  
Sofia Castro Oliveira ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Metabolic Syndrome ◽  
Weight Loss ◽  
Surgical Technique ◽  
Metabolic Parameters ◽  
Follow Up Study

scholarly journals Impact of long-term and short-term therapies on seminal parameters

2013 ◽  
Vol 85 (1) ◽  
pp. 20
Author(s):  
Jlenia Elia ◽  
Norina Imbrogno ◽  
Michele Delfino ◽  
Rossella Mazzilli ◽  
Vincenzo Spinosa ◽  
...  
Keyword(s):  
Antihypertensive Drugs ◽  
Negative Impact ◽  
World Health ◽  
Term Therapy ◽  
Control Group ◽  
Image Analysis System ◽  
Short Term ◽  
Seminal Parameters ◽  
Significant Difference

Aim: The aim of this work was: i) to evaluate the prevalence of male partners of subfertile couples being treated with long/short term therapies for non andrological diseases; ii) to study their seminal profile for the possible effects of their treatments on spermatogenesis and/or epididymal maturation. Methods: The study group was made up of 723 subjects, aged between 25 and 47 years. Semen analysis was performed according to World Health Organization (WHO) guidelines (1999). The Superimposed Image Analysis System (SIAS), which is based on the computerized superimposition of spermatozoa images, was used to assess sperm motility parameters. Results: The prevalence of subjects taking pharmacological treatments was 22.7% (164/723). The prevalence was 3.7% (27/723) for the Short-Term Group and 18.9% (137/723) for the Long-Term Group. The subjects of each group were also subdivided into subgroups according to the treatments being received. Regarding the seminal profile, we did not observe a significant difference between the Long-Term, Short-Term or the Control Group. However, regarding the subgroups, we found a significant decrease in sperm number and progressive motility percentage in the subjects receiving treatment with antihypertensive drugs compared with the other subgroups and the Control Group. Conclusions: In the management of infertile couples, the potential negative impact on seminal parameters of any drugs being taken as Long-Term Therapy should be considered. The pathogenic mechanism needs to be clarified.

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