Changes in Health-Related Quality of Life After Gastric Bypass in Patients With and Without Obesity-Related Disease
Conclusions Baseline HRQL was similar in patients with and without obesity-related disease prior to gastric bypass. After surgery, patients with no comorbidity had similar positive changes in HRQL as patients with one or several comorbidities. These findings indicate that other factors than obesity-related disease are at least as important for severely obese patients’ impaired HRQL.
Antipsychotic medications are a vital part of controlling psychosis in schizophrenic patients. However, when those patients live in nursing facilities, we are obligated by CMS to undertake gradual dose reductions of antipsychotic medication if possible. Sometimes, these efforts are successful and sometimes they fail. Antipsychotic medications have many side effects, including sedation, diabetes, hyperlipidemia, weight gain, motor rigidity, impaired gait, and falls. Monitoring of blood glucose, lipids, and extrapyramidal symptoms is mandatory.
Management of diabetes in post-acute settings needs special considerations. Hypoglycemia in the skilled nursing and rehabilitation facilities can lead to readmissions and complications including falls. Current EHR care-sets may not make a distinction between hospital and post-acute settings regarding diabetes management. The current diabetes management care-set in the EHR of our large healthcare system includes checking the blood sugar QID/AC/HS (before breakfast, lunch and dinner, and bedtime).
The geriatric population is at high risk of severe low blood glucose (LBG) events due to diminished homeostatic mechanisms, especially on hypoglycemic medications. Moderate to severe LBG events in these patients can contribute to behavior changes such as agitation, change in level of consciousness, disruption of sleep, instability and increased risk of myocardial infarction, stroke and falls. Rapid recognition and appropriate treatment and prevention of LBG and recurrences can reduce risk for hospitalization in the geriatric population.
Publication date: Available online 25 February 2020Source: Mutation Research/Genetic Toxicology and Environmental MutagenesisAuthor(s): Yu Gao, Ping Wang, Yinping Su, Zhaonan Wang, Lin Han, Jie Li, Yinghua Fu, Fengling Zhao, Quanfu Sun, Yumin Lyu
CONCLUSIONS.: Our results confirm the multidimensional nature of mania. Hyperactivity, increased speech, and thought disorder appear as core features of the clinical construct. The mood experience could be heterogeneous, depending on the co-occurrence of euphoric (elevated mood) and dysphoric (irritability and depressive mood) emotions of varying intensity. Results are also discussed regarding their relationship with other constitutive elements of bipolar disorder, such as mixed and depressive states. PMID: 32093802 [PubMed - in process]
Authors: Lee YM, Park SH, Lee DH Abstract OBJECTIVE: The aim of this paper is to propose a new hypothesis for the role of lipophilic chemical mixtures stored in adipose tissue in the development of dementia. Specifically, we present how the dynamics of these chemicals can explain the unexpected findings from the Action for Health in Diabetes (Look AHEAD) study, which failed to show long-term benefits of intentional weight loss on cognition, despite substantial improvements in many known risk factors for dementia. Moreover, we discuss how the role of obesity in the risk of dementia can change depending on the dynami...
Publication date: Available online 25 February 2020Source: Evaluation and Program PlanningAuthor(s): Tanis J. Walch, Richard R. Rosenkranz, Michaela A. Schenkelberg, Bronwyn S. Fees, David A. Dzewaltowski
Authors: El-Demiry NM, Maged AM, Gaafar HM, ElAnwary S, Shaltout A, Ibrahim S, El-Didy HM, Elsherbini MM Abstract Objective: To evaluate the diagnostic performance of Doppler sonography of umbilical artery (UA), fetal middle cerebral artery (MCA), ductus venosus (DV) &umbilical vein (UV) for prediction of adverse perinatal outcome.Material and Methods: A prospective cohort study conducted on 60 women diagnosed with preeclampsia with severe features divided into two groups based on adverse perinatal outcome.Results: Statistically Significant differences were demonstrated UA PI (1.28 ± 0.23 vs. 0.96 ± 0.21, P
Publication date: Available online 25 February 2020Source: NeuroImage: ClinicalAuthor(s): Bart van den Munckhof, Anne F. Zwart, Lauren C. Weeke, Nathalie H.P. Claessens, Joost D.J. Plate, Alexander Leemans, Hugo J. Kuijf, Heleen C. van Teeseling, Frans S.S. Leijten, Manon J.N. Benders, Kees P.J. Braun, Linda S. de Vries, Floor E. Jansen
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