scholarly journals Role of Preoperative Esophagogastroduodenoscopy (EGD) in Bariatric Treatment

2021 ◽  
Vol 10 (13) ◽  
pp. 2982
Author(s):  
Regina Sierżantowicz ◽  
Jerzy R. Ładny ◽  
Krzysztof Kurek ◽  
Jolanta Lewko
Keyword(s):  
Bariatric Surgery ◽  
Body Weight ◽  
Sleeve Gastrectomy ◽  
Gastrointestinal Tract ◽  
Odds Ratio ◽  
Control Group ◽  
Obese Patients ◽  
Routine Examination ◽  
Normal Body Weight

Background: The recommendations for routine preoperative esophagogastroduodenoscopy (EGD) in patients qualified for bariatric surgeries are still a matter of debate. The aim of this study was to analyze the pathologies on preoperative EGD in patients qualified for bariatric surgeries. Materials and Methods: This study included 222 patients, divided into two groups. The obesity group consisted of patients with obesity (BMI ≥ 40 kg/m2), for whom EGD was a routine part of the preparation for laparoscopic sleeve gastrectomy (LSG). The control group of patients with normal body weight (BMI) qualified for EGD because of gastrointestinal ailments. Results: Regarding preoperative EGD in patients qualified for bariatric surgeries, we analyzed the prevalence of endoscopic pathologies in various gastrointestinal tract segments. Patients with obesity were shown to present with esophageal pathologies significantly more often than persons in the control group (n = 23, 20.91% vs. n = 12, 10.91%, p = 0.042). The odds ratio of esophageal pathologies in patients with obesity versus the control group equaled 2.15 (95%CI: 1.01–4.59). In turn, the odds ratio of duodenal pathologies in patients from the control group was 3.31 (95%Cl: 1.16–9.47), which means that persons from this group were approximately three times more likely to be diagnosed with those pathologies compared to obese patients. Moreover, patient sex was a significant predictor of duodenal pathologies, with an odds ratio of 4.03 (95%CI: 1.53–10.61). Conclusions: Preoperative EGD can identify a broad spectrum of pathologies in obese patients, which suggests a routine examination before bariatric surgery.

scholarly journals New glance at pathogenesis of type 2 diabetes mellitus: incretin and antiincretin systems.

2011 ◽  
Vol 14 (3) ◽  
pp. 26-29 ◽  
Author(s):  
Ekaterina Alekseevna Shestakova
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Bariatric Surgery ◽  
Type 2 Diabetes Mellitus ◽  
Body Weight ◽  
Gastrointestinal Tract ◽  
Glycemic Status ◽  
Decrease Body Weight

Type 2 diabetes mellitus (T2 DM) is often seen in patients with obesity. Bariatric surgery, aimed to decrease body weight, can often help those patientsto improve glycemic status. After some of bariatric operations patients reach normoglycemia in few days, the fact that cant be explained onlyby reduction in weight. Recent trials revealed that the reorganization of gastrointestinal tract provides hypoglycemic effect of such operations. Thisarticle explains the role of proximal and distal gut in pathophysiology of T2 DM.

scholarly journals Erradicación del Helicobacter pylori en pacientes obesos pre-cirugía bariátrica

2020 ◽  
Vol 50 (1) ◽  
Author(s):  
Oscar Laudanno ◽  
Gabriel Ahumarán ◽  
Marcelo Thomé ◽  
Pablo Gollo ◽  
Marina Khoury
Keyword(s):  
Bariatric Surgery ◽  
Helicobacter Pylori ◽  
Odds Ratio ◽  
Independent Risk Factor ◽  
Eradication Rate ◽  
The Body ◽  
Control Group ◽  
Obese Patients ◽  
Concomitant Therapy ◽  
H Pylori

Many bariatric surgeons recommend routine Helicobacter pylori (H. pylori) screening as a part of the workup for bariatric surgery. Some studies suggested that obese patients have a lower eradication rate and the Body Mass Index could be independent risk factor for this failure. Objective. To evaluate the H. pylori eradication of a 14 days Quadruple Concomitant therapy in obese patients undergoing bariatric surgery compared against a control group. Material and Methods. Prospective study included 76 patients undergoing bariatric surgery and 75 control patients with a normal BMI and dyspepsia. Results. In the obese group, the eradication rate was 69% whereas in the control group was 89%. p < 0.05, Odds ratio 3.18 (CI 1.35-7.45). The distribution of age, gender, smoking and diabetes did not differ significantly between the two groups. Conclusions. Obese patients showed a significantly lower eradication of H. pylori than controls to a two weeks Quadruple Concomitant therapy.

scholarly journals The role of endoluminal interventions in the preparation of high-risk patients with super-obesity for bariatric surgery

2021 ◽  
Author(s):  
O. Y. Ioffe ◽  
M. S. Kryvopustov ◽  
O. P. Stetsenko ◽  
T. V. Tarasiuk ◽  
Y. P. Tsiura
Keyword(s):  
Bariatric Surgery ◽  
Body Mass Index ◽  
Morbid Obesity ◽  
High Risk ◽  
Intragastric Balloon ◽  
Conservative Therapy ◽  
Control Group ◽  
Obese Patients ◽  
Super Obesity

Obesity causes increased morbidity, disability and mortality rates as well as affects the quality of life. Given the known risks to the patient’s health, the International Federation for the Surgery of Obesity and Metabolic Disorders pays special attention to the problem of morbid obesity (body mass index ≥ 40 kg/m2), with particular emphasis on super‑obesity (body mass index ≥ 50 kg/m2). Objective is to investigate the role of endoluminal interventions in the preparation of super obese patients with high risk of surgical and anaesthesia‑related complications for bariatric surgery. Materials and methods. From 2011 to 2018, 97 patients with morbid obesity and high risk of surgery and anaesthesia‑related complications (ASA PS III — IV) underwent a course of treatment at the clinical setting of the Department of General Surgery No2 of Bohomolets National Medical University. The treatment was carried out in 2 stages. In the main group (n = 60), the first stage of treatment included the intragastric balloon placement for a term of 6 months. The control group (n = 37) received a six‑month conservative therapy. In the second stage of treatment the patients of both groups underwent a surgical procedure for the morbid obesity management. Results. The outcomes of the first stage of treatment showed that the patients, who underwent the intragastric balloon placement, had statistically significantly (p < 0.001) higher mean the percentage of excess weight loss (% EWL) than the patients who received conservative therapy. In the main group, the average ASA PS score, which is identified as an anaesthetic and surgical risk indicator, decreased from 3.28 (95 % confidence interval (CI) 3.17 — 3.40) to 2.15 (95 % CI 2.06 — 2.24, p < 0.001), and in the control group — from 3.24 (95 % CI 3.10 — 3.39) to 3.14 (95 % CI 2.96 — 3.31, p > 0.05). Conclusions. The results of the study provide strong evidence that the intragastric balloon placement for a term of 6 months reduces surgical and anaesthetic risks, contributes to the improved function of the cardiovascular and respiratory systems as well as gives a boost to carbohydrate metabolism, and, therefore, can be suggested for the preparation of super obese patients with high risk of surgical and anaesthesia‑related complications for bariatric surgery.  

Tryptophan-Niacin Metabolism in Rat with Puromycin Aminonucleoside-Induced Nephrosis

2006 ◽  
Vol 76 (1) ◽  
pp. 28-33 ◽  
Author(s):  
Yukari Egashira ◽  
Shin Nagaki ◽  
Hiroo Sanada
Keyword(s):  
Body Weight ◽  
Urinary Excretion ◽  
Enzyme Activities ◽  
Treated Group ◽  
Control Group ◽  
Puromycin Aminonucleoside ◽  
Low Level ◽  
Key Enzyme

We investigated the change of tryptophan-niacin metabolism in rats with puromycin aminonucleoside PAN-induced nephrosis, the mechanisms responsible for their change of urinary excretion of nicotinamide and its metabolites, and the role of the kidney in tryptophan-niacin conversion. PAN-treated rats were intraperitoneally injected once with a 1.0% (w/v) solution of PAN at a dose of 100 mg/kg body weight. The collection of 24-hour urine was conducted 8 days after PAN injection. Daily urinary excretion of nicotinamide and its metabolites, liver and blood NAD, and key enzyme activities of tryptophan-niacin metabolism were determined. In PAN-treated rats, the sum of urinary excretion of nicotinamide and its metabolites was significantly lower compared with controls. The kidneyα-amino-β-carboxymuconate-ε-semialdehyde decarboxylase (ACMSD) activity in the PAN-treated group was significantly decreased by 50%, compared with the control group. Although kidney ACMSD activity was reduced, the conversion of tryptophan to niacin tended to be lower in the PAN-treated rats. A decrease in urinary excretion of niacin and the conversion of tryptophan to niacin in nephrotic rats may contribute to a low level of blood tryptophan. The role of kidney ACMSD activity may be minimal concerning tryptophan-niacin conversion under this experimental condition.

scholarly journals Efficacy of laparoscopic sleeve gastrectomy for patient with morbid obesity and type 1 diabetes mellitus: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Hidetaka Ichikawa ◽  
Hirofumi Imoto ◽  
Naoki Tanaka ◽  
Hiroaki Musha ◽  
Shojiro Sawada ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Bariatric Surgery ◽  
Morbid Obesity ◽  
Body Weight ◽  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Hba1c Level ◽  
Insulin Dose ◽  
Body Weight Loss

Abstract Background Bariatric surgery is effective for the treatment of patients with morbid obesity and type 2 diabetes mellitus (T2DM), for body weight loss and glycemic control. However, in Japan, there has been no previous report of the effectiveness bariatric surgery in a case of morbid obesity associated with acute onset type 1 diabetes mellitus (T1DM), in which pancreatic β-cells were destroyed and endogenous insulin was depleted. Case presentation A 36-year-old woman with morbid obesity and T1DM, diagnosed when she was 6 years, was admitted for bariatric surgery. At her first consultation, she had a body weight of 106.7 kg and a body mass index of 42.2 kg/m2. Her HbA1c level was 9.0%, with a required daily insulin dose of 75 units. She underwent laparoscopic sleeve gastrectomy. At 1 year after surgery, her body weight had decreased to 81.0 kg and her body mass index to 32.2 kg/m2. In addition, her daily required dose of insulin had decreased to 24 units, with an improvement in her HbA1c level to 7.7%. Conclusions Although further evidence needs to be accumulated, including long-term outcomes, laparoscopic sleeve gastrectomy may provide an effective treatment for patients with morbid obesity and T1DM for body weight loss, improvement in HbA1c level, and insulin dose reduction.

scholarly journals POS0358 EVALUATION OF THE EFFECT OF mTOR EXPRESSION ON THE CLINICAL MANIFESTATIONS OF KNEE OSTEOARTHRITIS IN OBESE AND NORMAL WEIGHT PATIENTS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 409.2-409
Author(s):  
E. Strebkova ◽  
E. Tchetina ◽  
L. Alekseeva
Keyword(s):  
Body Weight ◽  
Knee Pain ◽  
Mammalian Target Of Rapamycin ◽  
Clinical Manifestations ◽  
Normal Weight ◽  
Womac Pain ◽  
Obese Patients ◽  
Normal Body ◽  
Knee Oa ◽  
Normal Body Weight

Background:Currently, a large number of molecular biological and genetic markers are known to be involved in the development of osteoarthritis (OA). The mammalian target of rapamycin (mTOR) signaling pathway is responsible for chondrocyte proliferation, cartilage matrix production, and cell growth. OA is characterized by increased mTOR synthesis, which is accompanied by an increase in proliferative activity and destruction of chondrocytes. Obesity is an important factor in the progression of knee OA. The study of mTOR expression in patients with OA and obesity is an urgent task in the development of personalized OA therapy.Objectives:To determine the expression of mTOR in patients with knee OA in combination with obesity and normal body weight. To evaluate the effect of mTOR on the clinical manifestations of OA in patients with different body mass index (BMI).Methods:The study included 73 female patients aged 45-65 y.o. with Kellgren-Lawrence stage II-III knee OA. The patients were divided into 2 groups: group 1 (n=50) with obesity (BMI > 30 kg / cm2) and group 2 (n=23) with normal or increased body weight (BMI < 30 kg/cm2). The average age of patients with obesity is 56.5 ± 5.87 years, without obesity - 58.7 ± 5.43 years. Clinical manifestations were evaluated by a WOMAС. RNA was isolated from the patients ‘ blood samples, which was used to determine the expression of mTOR.Results:Patients with knee OA with and without obesity did not differ in age. OA develops at an earlier age in obese patients, than in non-obese patients (p < 0.001). Patients from 1 group had a high BMI > 30 kg/m2 at the onset of OA. Obese patients had more severe knee OA is significantly more often detected: Kellgren-Lawrence stage III was determined in 10% of obese patients and in 4.35% - without obesity (p < 0.001). Significantly higher values of the WOMAC index pain, stiffness, joint functional failure, and total WOMAC were observed in obese patients (p = 0.006, p = 0.039, p = 0.037, and p = 0.014, respectively). Obese patients had higher VAS pain scores (p < 0.05) compared to patients with a lower BMI. Obese patients had a higher mTOR expression (p < 0.05) of 8.02±8.62, compared to non-obese patients. High mTOR expression was associated with VAS knee pain (r=0.78; p < 0.05) and WOMAC pain (r=0.89; p<0.05) in obese patients (Table 1).Table 1.Correlation of m-TORParametersmTOR (1 group, n=50)mTOR (2 group, n=23)Body weightр > 0,05р > 0,05Pain (VAS)r=0,78; р<0,05p = 0,07; r = 0,45Pain (WOMAC)r=0,89; р<0,05р > 0,05Total WOMACр > 0,05р > 0,05Conclusion:Our study showed that patients with obesity and knee OA have higher rates of mTOR expression, compared to patients with normal body weight. High mTOR expression correlates with the severity of knee pain in obese patients. Thus, the evaluation of mTOR expression in obese patients and knee OA plays an important role in predicting the severity of clinical manifestations of OA, and may influence the choice of personalized therapy tactics for such patients.Disclosure of Interests:None declared

Comments on the updated recommendations of the American College of Rheumatology (ACR) for the treatment of gout. Lifestyle (part 2)

2021 ◽  
Vol 15 (2) ◽  
pp. 83-88
Author(s):  
M. S. Eliseev
Keyword(s):  
Body Weight ◽  
Food Habits ◽  
The Other ◽  
Obese Patients ◽  
American College Of Rheumatology ◽  
The Russian Federation ◽  
The One ◽  
Effective Drugs ◽  
First Time

Updated ACR recommendations for the treatment of gout concerning lifestyle are discussed. Factors related to a lifestyle, above all food habits, for many years were of leading importance in the treatment of patients with gout, even after application of effective drugs. The authors of the updated ACR recommendations for the first time offered to reconsider the role of environmental factors in the genesis of gout and objectively assess the possibility of its non-drug treatment. On the one hand, regardless of the activity of the disease, the need for restrictions of the alcohol, purine-rich products and fructose-containing beverages, as well as the decrease of body weight in obese patients and vitamin C usage unviability are confirmed. On the other hand, these recommendations are conditional. Their new version of ACR recommendations is significantly different from both its previous version and other international and national recommendations, including recommendations on the diagnosis and treatment of gout used in the Russian Federation.

scholarly journals The Role of Three‐Dimensional Magnetic Resonance Elastography in the Diagnosis of Nonalcoholic Steatohepatitis in Obese Patients Undergoing Bariatric Surgery

Hepatology ◽  
2019 ◽  
Vol 71 (2) ◽  
pp. 510-521 ◽  
Author(s):  
Alina M. Allen ◽  
Vijay H. Shah ◽  
Terry M. Therneau ◽  
Sudhakar K. Venkatesh ◽  
Taofic Mounajjed ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Magnetic Resonance ◽  
Nonalcoholic Steatohepatitis ◽  
Three Dimensional ◽  
Magnetic Resonance Elastography ◽  
Obese Patients

scholarly journals Studying the Role of C-Reactive Protein in Patients with Sleeve Gastrectomy in Baghdad

2021 ◽  
Vol 3 (1) ◽  
pp. 55-60
Author(s):  
Mohammed Abbas Fadil ◽  
Raya Ezat Maroof ◽  
Moayed Abbas Fadil
Keyword(s):  
Sleeve Gastrectomy ◽  
Healthy Person ◽  
Control Group ◽  
C Reactive Protein ◽  
Serum Samples ◽  
Reactive Protein ◽  
Medical City ◽  
Healthy Control ◽  
And Control

Obesity and severe obesity are increasing serious health problems with an epidemic percentage in most countries. In Sleeve gastrectomy, a part of the stomach structure is removed, limiting its capacity by about two to three. A total of thirty blood samples were collected from patients with obesity and the result was compared with healthy person throughout the time from November 2019 to September 2020. Before sleeve gastrectomy and after more than 6 months of sleeve surgery, the sample was collected from the Medical City/Baghdad Teaching Hospital, the withdrawal was again taken at home to have pre and post sleeve gastrectomy, Patient age ranged between [20-46] years for obese patients and healthy control. Then the serum samples were obtained from patients and control group to screen for C-reactive protein by agglutination method. The result of the present study found that the positivity of CRP in pre-operation is higher than that of post-operative with high significance [P<0.005].

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