Comparative effectiveness of Roux-en-Y gastric bypass and sleeve gastrectomy in super obese patients

Abstract Background The disproportionate increase in the super obese (SO) is a hidden component of the current obesity pandemic. Data on the safety and efficacy of bariatric procedures in this specific patient population are limited. Our aim is to assess the comparative effectiveness of the two most common bariatric procedures in the SO. Methods Using the Bariatric Outcomes Longitudinal Database from 2007 to 2012, we compared SO patients (BMI ≥ 50) undergoing laparoscopic Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG). Stepwise logistic regression modeling was used to calculate a propensity score to adjust for patient demographics and comorbidities. Results We identified 50,987 SO patients who underwent RYGB (N = 42,119) or SG (N = 8868). There was no difference in adjusted overall 30-day complication rate comparing RYGB and SG patients (11.5 vs. 11.1 %, p = 0.250). RYGB patients had higher adjusted rates of 30-day mortality (0.3 vs. 0.2 %, p = 0.042), reoperation (4.0 vs. 2.4 %, p 
Source: Surgical Endoscopy - Category: Surgery Source Type: research

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A 58-year-old female presents with a 1-year history of hematochezia, 20-pound weight loss, and increased straining with bowel movements. She denies increased bowel frequency or change in stool caliber. Her medical history is notable for irritable bowel syndrome, but otherwise unremarkable. She has no family history of malignancy and does not take any prescribed medications or supplements. She denies abdominal pain, bone pain, or any symptoms concerning for metastatic disease. Her initial physical examination was notable for an Eastern Cooperative Oncology Group performance status of 0, and presence on digital rectal examin...
Source: International Journal of Radiation Oncology * Biology * Physics - Category: Radiology Authors: Tags: Gray Zone Source Type: research
Authors: Coats AJS PMID: 32077860 [PubMed - in process]
Source: Hong Kong Medical Journal - Category: General Medicine Tags: Hong Kong Med J Source Type: research
Summary: The incidence and prevalence of diabetes continues to increase, and proper understanding of the adverse effects on bone metabolism is important. This review attempts to discuss the pathophysiology of the effects of diabetes and diabetic medications on bone metabolism and bone health. In addition, this review will address the mechanisms resulting in increased fracture risk and delayed bone healing to better treat and manage diabetic patients in the orthopedic clinical setting.
Source: Journal of Orthopaedic Trauma - Category: Orthopaedics Tags: State-of-the-Art Source Type: research
Objective: To determine effects of wearing soft toric silicone hydrogel, rigid gas-permeable (RGP), and mini-scleral lenses on corneal microstructure using confocal microscopy. Method: A prospective cohort study was conducted on 33 neophyte patients fitted with contact lenses (avg. age: 26±7 years) in the tertiary eye center. Patients were instructed to wear soft toric silicone hydrogel, RGP, or mini-scleral lenses based on clinical diagnoses. Inclusion criteria were age greater than 18 years and best-corrected visual acuity ≥3/10. Patients with a history of eye-involving systemic diseases were excluded. Bas...
Source: Eye and Contact Lens: Science and Clinical Practice - Category: Opthalmology Tags: Article Source Type: research
Conclusion: Capillary nonperfusion area in the posterior retina increases with increasing DR severity as measured by swept-source OCTA. Quantitative analysis of retinal nonperfusion on wide-field OCTA may be useful for early detection and monitoring of disease in patients with diabetes and DR.
Source: RETINA - Category: Opthalmology Tags: Original Study Source Type: research
Conclusion: Changes in the choroid may occur before the development of diabetic retinopathy and seem to progress with increasing diabetes mellitus duration despite the absence of diabetic retinopathy and without associated retina thickening. Choroidal thickness could be valuable for screening in diabetic children.
Source: RETINA - Category: Opthalmology Tags: Original Study Source Type: research
Purpose: To compare intraocular pressure, anterior segment optical coherence tomography, and ultrasound biomicroscopy parameters over 3 months after panretinal photocoagulation (PRP) for proliferative diabetic retinopathy after 1 of 2 sittings by conventional laser (half PRP) and a single sitting of Pattern Scan Laser (PASCAL) PRP. Methods: This was a prospective, randomized, interventional study. All tests were performed at baseline, and at 1, 6, and 24 hours, and 1, 4, 8, and 12 weeks after PRP. Results: The intraocular pressure at 1 hour and 6 hours after PRP was significantly raised in both groups. Mean intraoc...
Source: RETINA - Category: Opthalmology Tags: Original Study Source Type: research
Introduction: Metabolic syndrome (MetS) is a constellation of metabolic risk factors, strongly associated with overweight and obesity that predispose to cardiovascular disease.
Source: Nutrition, Metabolism, and Cardiovascular Diseases : NMCD - Category: Nutrition Authors: Source Type: research
Introduction: Bioelectrical impedance vector analysis (BIVA) is a non-invasive method for measuring body composition. The “InForma” trial has been designed to measure improvement of adherence to a healthy diet and/or to increase physical activity in order to promote weight loss in overweight or obese breast cancer survivors. Breast cancer survivors frequently face progressive weight gain and diminution of physical activity.
Source: Nutrition, Metabolism, and Cardiovascular Diseases : NMCD - Category: Nutrition Authors: Source Type: research
Introduction: Restriction in meal timing has emerged as a promising dietary approach for the management of obesity and dysmetabolic diseases.
Source: Nutrition, Metabolism, and Cardiovascular Diseases : NMCD - Category: Nutrition Authors: Source Type: research
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