Comment on: Internal Hernias in Pregnant Females with Roux-en-Y Gastric Bypass: A Systematic Review

Internal hernias are well-recognized complications of Roux-en-Y gastric bypass (RYGB) surgery that arise in consequence of procedure induced mesenteric defects1, 2.
Source: Surgery for Obesity and Related Diseases - Category: Surgery Authors: Source Type: research

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Acyl-ghrelin administration increases food intake, body weight, and blood glucose. In contrast, mice lacking ghrelin or ghrelin receptors (GHSRs) exhibit life-threatening hypoglycemia during starvation-like conditions, but do not consistently exhibit overt metabolic phenotypes when given ad libitum food access. These results, and findings of ghrelin resistance in obese states, imply nutritional state dependence of ghrelin’s metabolic actions. Here, we hypothesized that liver-enriched antimicrobial peptide-2 (LEAP2), a recently characterized endogenous GHSR antagonist, blunts ghrelin action during obese states and pos...
Source: Journal of Clinical Investigation - Category: Biomedical Science Authors: Source Type: research
Ghrelin is a key signal driving energy seeking and storage in order to reverse energy deficit. In line with this view, the metabolic status of an organism predicts sensitivity to ghrelin, with fasting increasing and obesity decreasing ghrelin sensitivity, respectively. However, the mechanism responsible for controlling this sensitivity is unknown. In this issue of the JCI, Mani and colleagues show that plasma levels of plasma liver-enriched antimicrobial peptide-2 (LEAP2), a recently identified hormone that antagonizes the ghrelin receptor, are inversely correlated with those of plasma acyl-ghrelin under conditions of both...
Source: Journal of Clinical Investigation - Category: Biomedical Science Authors: Source Type: research
In a society where physical activity is limited and food supply is abundant, metabolic diseases are becoming a serious epidemic. Metabolic syndrome (MetS) represents a cluster of metabolically related symptoms such as obesity, hypertension, dyslipidemia, and carbohydrate intolerance, and significantly increases type 2 diabetes mellitus risk. Insulin resistance and hyperinsulinemia are consistent characteristics of MetS, but which of these features is the initiating insult is still widely debated. Regardless, both of these conditions trigger adverse responses from the pancreatic β cell, which is responsible for produci...
Source: Journal of Clinical Investigation - Category: Biomedical Science Authors: Source Type: research
ABSTRACT OBJECTIVE To analyze the impact of the Hospital-Acquired Conditions (HAC) in women in the puerperal and pregnancy cycle during length of stay. METHODS This cross-sectional study was conducted with 113,456 women, between July 2012 and July 2017, in Brazil ’ s national hospitals of the supplementary healthcare networks and philanthropists accredited to the Unified Health System (SUS). Data on hospital discharges were collected using the Diagnosis-Related Groups (DRG Brasil ®) system. All DRGs of the major diagnostic category 14 (MDC14), including pregnancy, childbirth and puerperium, were included. The imp...
Source: Revista de Saude Publica - Category: International Medicine & Public Health Source Type: research
CONCLUSIONS Antepartum peregrination suffers interference from the mother ’ s socioeconomic characteristics, the type of prenatal care received and the source of funding for childbirth.RESUMO OBJETIVO Analisar as caracter ísticas maternas e da assistência pré-natal associadas à peregrinação no anteparto entre gestantes de um estado do Nordeste brasileiro. MÉTODOS Estudo quantitativo e transversal, com abordagens descritiva e analítica, vinculado à pesquisa Nascer em Sergipe, realizada entre junho de 2015 e abril de 2016. Foram avaliadas 768 puérpera...
Source: Revista de Saude Publica - Category: International Medicine & Public Health Source Type: research
There is emerging evidence of a relationship between short sleep duration and poor quality of sleep with overweight and obesity. This has been clearly demonstrated in adults and there is increasing evidence of this relationship in children and adolescents. One area that needs more study is whether sleep patterns early in life are important for the development of subsequent obesity. This may be complicated because sleep in infants is more fragmented because it is interspersed with feedings. In this volume of The Journal, Tuohino et al report the results of their study that evaluated whether shorter sleep duration at 3 and 8...
Source: The Journal of Pediatrics - Category: Pediatrics Authors: Tags: The Editors' Perspectives Source Type: research
Improved fertility following a Roux-en-Y gastric bypass (RYGB) can lead to pregnancy and increase the risk of internal herniation. A developing fetus and symptoms of pregnancy can mask the diagnosis and delay intervention, leading to deleterious maternal and fetal consequences. The aim of this systematic review is to summarize the literature regarding internal hernias during pregnancy, their management, and patient outcomes. A comprehensive literature search was undertaken on PubMed and Google Scholar to identify cases of internal hernias presenting during pregnancy after RYGB.
Source: Surgery for Obesity and Related Diseases - Category: Surgery Authors: Tags: Review article Source Type: research
Bariatric surgery has become of the most effective solutions for sustained weight loss in the world [1]. Laparoscopic Roux-en-Y gastric bypass (LRYGB) is one of the most common procedures for treatment of morbid obesity. Females are more likely to undergo a bariatric procedure for weight loss. While significant and sustained weight loss is the primary advantage to bariatric surgery, other positive outcomes include improved fertility in women [2]. This improved fertility can increase the chances of pregnancy.
Source: Surgery for Obesity and Related Diseases - Category: Surgery Authors: Tags: Review articles Source Type: research
Background: Management of abdominal pain in a pregnant patient with a history of Roux-en-Y gastric bypass presents unique challenges. Internal hernias are the most common cause of small bowel obstruction after LRYGBP. Internal hernia can result in closed loop obstruction, bowel necrosis, gastric perforation, and death. Presentation: A 29-year-old female 30-week pregnancy with a history of laparoscopic Roux-en-Y gastric bypass 5 years ago. She had a 24 hours of LUQ pain with vomiting. Her pain was attributed initially to UTI.
Source: Surgery for Obesity and Related Diseases - Category: Surgery Authors: Source Type: research
AbstractBariatric surgery is most commonly carried out in women of childbearing age. Whilst fertility rates are improved, pregnancy following bariatric surgery poses several challenges. Whilst rates of many adverse maternal and foetal outcomes in obese women are reduced after bariatric surgery, pregnancy is best avoided for 12 –24 months to reduce the potential risk of intrauterine growth retardation. Dumping syndromes are common after bariatric surgery and can present diagnostic and therapeutic challenges in pregnancy. Early dumping occurs due to osmotic fluid shifts resulting from rapid gastrointestinal food t...
Source: Obesity Surgery - Category: Surgery Source Type: research
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