scholarly journals A psychodynamic understanding of obesity in post-bariatric patients

2021 ◽  
Vol 41 (100) ◽  
Author(s):  
Aline Cordeiro dos Santos Gil ◽  
Karyne Santiago Lima ◽  
Mônica Gurjão Carvalho ◽  
Danuta Medeiros
Keyword(s):  
Bariatric Patients ◽  
Psychodynamic Understanding

POSTOPERATIVE COMPLIANCE OF BARIATRIC SURGERY PATIENTS REGARDING THE ASSESSMENT OF SERUM LEPTIN LEVELS AND INSULIN RESISTANCE

2019 ◽  
Vol 49 (1/2019) ◽  
Keyword(s):  
Insulin Resistance ◽  
Bariatric Surgery ◽  
Serum Levels ◽  
Medical Laboratory ◽  
Leptin Resistance ◽  
Obese Patients ◽  
Laboratory Assessment ◽  
Serum Leptin ◽  
Before And After ◽  
Bariatric Patients

Background and aims: Overweight and obese patients who undergo bariatric surgery require a rigorous clinical and paraclinical assessment both before and after the surgery at 3, 6, and 12 months.The present study aims the assessment of serum leptin levels and insulin resistance status in compliant bariatric patients to scheduled medical laboratory assessment at 6 months after surgery. Material and Method: The study included 109 eligible patients selected for bariatric surgery, 48 of whom attended the scheduled visit at 6 months after the surgery. Laboratory assessing regarded the insulin resistance by determining before meal the serum levels of leptin, glucose and insulin, as well as HOMA 1 and HOMA 2 indexes. Results: Patients who underwent bariatric treatment experienced a significant decrease in insulin resistance status. A higher percentage in the preoperative group was recorded in women, feature which was also recorded in the postoperative group that attended the scheduled visit at 6 months after surgery. Age is also an important factor that significantly influences the behavioral adherence to postoperative visits. Conclusions: Insulin resistance status improved significantly in 6 months after bariatric surgery among the fully compliant patients. The percentage of attendance at scheduled visits is higher among women, and decreases with age. Keywords: obesity surgery, leptin resistance, insulin resistance, HOMA index, compliance

scholarly journals Home-Based Exercise Training During COVID-19 Pandemic in Post-Bariatric Patients: a Randomized Controlled Trial

2021 ◽  
Author(s):  
Gersiel Nascimento de Oliveira Júnior ◽  
Karla Fabiana Goessler ◽  
Jhonnatan Vasconcelos Pereira Santos ◽  
Alisson Padilha de Lima ◽  
Rafael Genário ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Exercise Training ◽  
Controlled Trial ◽  
Randomized Controlled ◽  
Home Based ◽  
Bariatric Patients

Post-Bariatric Abdominoplasty: Analysis of 406 Cases With Focus on Risk Factors and Complications

2020 ◽  
Vol 41 (1) ◽  
pp. 59-71 ◽  
Author(s):  
Torsten Schlosshauer ◽  
Marcus Kiehlmann ◽  
Diana Jung ◽  
Robert Sader ◽  
Ulrich M Rieger
Keyword(s):  
Risk Factors ◽  
Wound Healing ◽  
Surgical Technique ◽  
Significant Risk ◽  
Level Of Evidence ◽  
Increased Risk ◽  
Potential Risk Factors ◽  
Wound Healing Problems ◽  
Bariatric Patients

Abstract Background Post-bariatric patients present a surgical challenge within abdominoplasty because of residual obesity and major comorbidities. In this study, we analyzed complications following abdominoplasty in post-bariatric patients and evaluated potential risk factors associated with these complications. Objectives The authors sought to determine the complications and risk factors following abdominoplasty in post-bariatric patients. Methods A retrospective study of patients who underwent abdominoplasty was performed from January 2009 to December 2018 at our institution. Variables analyzed were sex, age, body mass index (BMI), smoking, surgical technique, operative time, resection weight, drain output, and complications. Results A total of 406 patients were included in this study (320 female and 86 male) with a mean age of 44.4 years and a BMI of 30.6 kg/m2. Abdominoplasty techniques consisted of traditional (64.3%), fleur-de-lis technique (27.3%), and panniculectomy without umbilical displacement (8.4%). Overall complications recorded were 41.9%, the majority of these being wound-healing problems (32%). Minor and major complications were found in 29.1% and 12.8% of patients, respectively. A BMI value of ≥30 kg/m2 was associated with an increased risk for wound-healing problems (P = 0.001). The frequency of total complications was significantly related to age (P = 0.007), BMI (P = 0.004), and resection weight (P = 0.001). Abdominoplasty technique tended to influence total complications. Conclusions This study demonstrates in a fairly large sample of post-bariatric patients (n = 406) that abdominoplasty alone can be performed safely, with an acceptable complication rate. Age, BMI, and resection weight are shown to be significant risk factors for total complications. The role of surgical technique needs to be evaluated further. Level of Evidence: 4

Secondary Hyperparathyroidism Among Bariatric Patients: Unraveling the Prevalence of an Overlooked Foe

2021 ◽  
Author(s):  
Fernando M. Mendonça ◽  
João S. Neves ◽  
Maria M. Silva ◽  
Marta Borges-Canha ◽  
Cláudia Costa ◽  
...  
Keyword(s):  
Secondary Hyperparathyroidism ◽  
Bariatric Patients

scholarly journals Psychodynamics of imagination failures: Reflections on the 20th anniversary of 9/11

2021 ◽  
pp. 135050762110097
Author(s):  
Amy L Fraher
Keyword(s):  
Lessons Learned ◽  
Macro Level ◽  
Future Research ◽  
September 11Th ◽  
Empire Building ◽  
Public Inquiry ◽  
The Us ◽  
New Type ◽  
20Th Anniversary ◽  
Psychodynamic Understanding

This article aims to advance the psychodynamic understanding of imagination failures by studying lessons learned in the US government’s public inquiry into September 11th, 2001 (9/11). Analyzing the findings of The 9/11 Report, I theorize that two forms of macro-level hubris—America’s “hubris of empire-building” and Al Qaeda’s “hubris-nemesis complex”—amalgamated in a uniquely generative manner leading to events on 9/11. Previous studies of public inquiries often demonstrate that inquiry reports are monological story-telling performances used to create sense-making narratives that function hegemonically to impose a simplified version of reality to assign blame and depoliticize events in order to facilitate closure after shocking events. In contrast, findings here suggest that by constructing a critical narrative, The 9/11 Report may serve as a new type of public inquiry report that invites learning about the complex factors that underpin crisis. The article concludes by identifying fruitful areas of future research and ways to theorize further about the collective psychodynamics of macro-level hubris and the psychodynamic factors that hinder learning and contribute to imagination failures.

scholarly journals Preoperative Cardiac Diagnostics in Bariatric Patients with Diabetes and Perioperative Morbidity: Results of a Cohort of 258 Patients

2021 ◽  
Author(s):  
Benjamin Stillhard ◽  
B. T. Truc Ngo ◽  
Ralph Peterli ◽  
Thomas Peters ◽  
Romano Schneider ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Myocardial Perfusion ◽  
Cardiac Catheterization ◽  
Myocardial Perfusion Scintigraphy ◽  
Perfusion Scintigraphy ◽  
Perioperative Morbidity ◽  
Obesity And Diabetes ◽  
Patients With Diabetes ◽  
Cardiac Assessment ◽  
Bariatric Patients

Abstract Purpose The combination of obesity and diabetes mellitus are well-known risk factors for cardiovascular complications and perioperative morbidity in metabolic surgery. The aim of this study was to evaluate effectivity and reliability of the cardiac assessment in patients with diabetes prior to bariatric surgery. Setting Private, university-affiliated teaching hospital, Switzerland Material and Methods Retrospective analysis of prospectively collected data on results and consequences of cardiac assessments in 258 patients with obesity and diabetes scheduled for primary bariatric surgery at our institution between January 2010 and December 2018. Results Out of 258 patients, 246 (95.3%) received cardiac diagnostics: 173 (67.1%) underwent stress-rest myocardial perfusion scintigraphy (MPS), 15 (5.8%) patients had other cardiac imaging including cardiac catheterization, 58 (22.5%) patients had echocardiography and/or stress electrocardiography, and 12 (4.7%) patients received no cardiac evaluation. Subsequently, cardiac catheterization was performed in 28 patients (10.9%), and coronary heart disease was detected and treated in 15 subjects (5.8%). Of these 15 individuals, 5 (33.3%) patients had diffuse vascular sclerosis, 8 (53.3%) patients underwent coronary angioplasty and stenting, and 2 (13.3%) patients coronary artery bypass surgery. Bariatric surgery was performed without perioperative cardiovascular events in all 258 patients. Conclusion Our data suggest that a detailed cardiac assessment is mandatory in bariatric patients with diabetes to identify those with yet unknown cardiovascular disease before performing bariatric surgery. We recommend carrying out myocardial perfusion scintigraphy as a reliable diagnostic tool in this vulnerable population. If not viable, stress echocardiography should be performed as a minimum.

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