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[PMID]: 26802361
[Au] Autor:Araki M; Ishii T
[Ad] Address:Office of Health and Safety, Hokkaido University, Sapporo Hokkaido, 060-0808, Japan.
[Ti] Title:Providing Appropriate Risk Information on Genome Editing for Patients.
[So] Source:Trends Biotechnol;34(2):86-90, 2016 Feb.
[Is] ISSN:1879-3096
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:Genome editing, represented by CRISPR/Cas9, facilitates somatic and germline gene modifications in many species, including humans. However, one of key issues, off-target mutation deserves special consideration prior to clinical applications. We herein discuss the importance of risk information on genome editing for obtaining legitimate patient consent and social acceptance.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1601
[Js] Journal subset:IM
[St] Status:In-Data-Review

  2 / 4335375 MEDLINE  
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[PMID]: 26802224
[Au] Autor:Rummell CM
[Ad] Address:Summa Health System Summa Akron City Hospital, Bariatric Care Center Akron, Ohio.
[Ti] Title:Comment on: Postoperative marijuana use and disordered eating among bariatric surgery patients.
[So] Source:Surg Obes Relat Dis;12(1):178-9, 2016 Jan.
[Is] ISSN:1878-7533
[Cp] Country of publication:United States
[La] Language:eng
[Pt] Publication type:EDITORIAL
[Em] Entry month:1601
[Js] Journal subset:IM
[St] Status:In-Data-Review

  3 / 4335375 MEDLINE  
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[PMID]: 26802223
[Au] Autor:Beitner MM; Ren-Fielding CJ; Fielding GA
[Ad] Address:New York University School of Medicine, New York, New York. Electronic address: melissa.beitner@nyumc.org.
[Ti] Title:Reducing complications with improving gastric band design.
[So] Source:Surg Obes Relat Dis;12(1):150-6, 2016 Jan.
[Is] ISSN:1878-7533
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Adjustable gastric bands have undergone significant design changes since their introduction. Band diameter, balloon volume, and shape have been modified to create high balloon fill volumes but lower and more evenly distributed pressure on the upper stomach. There have been few comparative studies on complication rates with different band types. OBJECTIVES: To compare complication rates among different types of adjustable gastric bands at a single institution. SETTING: University-affiliated hospital, United States. METHODS: We performed a retrospective cohort study of adult patients with a body mass index≥35.0 kg/m(2) who underwent laparoscopic adjustable gastric banding from January 1, 2001 to December 31, 2007 and were followed for at least 5 years. Primary outcomes of the analysis were complications requiring operative management at our institution within the first 5 years after initial band placement. Reoperative procedures included diagnostic laparoscopy, hiatal hernia repair, band repositioning, replacing the band, removing the band, and converting to another bariatric procedure. RESULTS: For this study, 2711 patients met the inclusion criteria-1827 (67.4%) women and 884 (32.6%) men. Bands initially implanted included first-generation bands, LAP-BAND™ 9.75 cm (24.0%), 10 cm (33.9%) and Vanguard (24.8%) and second-generation bands, AP standard (9.5%) and AP large (7.9%). Four hundred and eighty-five patients experienced complications requiring reoperation. The 5-year follow-up rate was 63.3%. In the first 5 postoperative years there were significantly fewer complications with second-generation bands (10.0% versus 19.5%, P<.0001). Smaller, older bands had the highest complication rates (LAP-BAND 9.75 cm, 28.2%) and complication rates decreased with each successive model. Rates of band removal were not different between first- and second-generation bands. The rate of multiple complications was low at 1.5%. CONCLUSION: First-generation bands are associated with higher complication rates. Our study found that complication rates decreased with each successive model. We can expect that future design modifications will continue improve the performance with the adjustable gastric band. (Surg Obes Relat Dis 2015;0:000-00.) © 2015 American Society for Metabolic and Bariatric Surgery. All rights reserved.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1601
[Js] Journal subset:IM
[St] Status:In-Data-Review

  4 / 4335375 MEDLINE  
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[PMID]: 26802222
[Au] Autor:Abdemur A; Han SM; Lo Menzo E; Szomstein S; Rosenthal R
[Ad] Address:The Bariatric and Metabolic Institute, Cleveland Clinic Florida, Weston, Florida....
[Ti] Title:Reasons and outcomes of conversion of laparoscopic sleeve gastrectomy to Roux-en-Y gastric bypass for nonresponders.
[So] Source:Surg Obes Relat Dis;12(1):113-8, 2016 Jan.
[Is] ISSN:1878-7533
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) as a primary bariatric procedure has gained significant popularity. Conversion to Roux-en-Y gastric bypass (RYGBP) or Roux-en-Y esophagojejunostomy (LRYEJ) has been described as a treatment option for inadequate weight loss after LSG and unresolved co-morbidities or complications such as leak, stricture, and severe gastroesophageal reflux disease (GERD). OBJECTIVES: To determine reasons and outcomes of conversions of LSG to RYGBP. SETTING: Academic Center of Excellence METHODS: Between January 2004 and August 2014, a total of 1118 patients underwent primary LSG for morbid obesity. A retrospective review of a prospectively collected database was conducted for laparoscopic conversions of LSG to RYGBP or LRYEJ, describing reasons and outcomes. RESULTS: Conversion to RYGBP was identified in 30 (2.7%) patients, of whom only 9 (0.8%) were originally from the authors' institution. Of the entire cohort of revisions, 9 (0.8%) had intractable GERD; only 4 (0.4% of total LSGs reviewed) were originally from the authors' institution. Seven (0.6%) patients were revised for inadequate weight loss: 5 (0.4%) originally from the authors' institution, 2 (0.2%) for stricture, and 12 (1.1%) for leak. Both the stricture and the leak patients were referred from outside institutions. All procedures were performed laparoscopically. The additional mean excess weight loss after conversion to RYGBP was 30.9% with no mortalities. CONCLUSIONS: The most common reason for conversion was chronic leak. The conversion rate of LSG to RYGBP due to inadequate weight loss, GERD, and stricture was 1.6% for the entire group, with .8% from the authors' institution. Additional follow-up and studies are needed to define real incidence of GERD after LSG.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1601
[Js] Journal subset:IM
[St] Status:In-Data-Review

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[PMID]: 26686304
[Au] Autor:Romero-Talamás H; Unger CA; Aminian A; Schauer PR; Barber M; Brethauer S
[Ad] Address:Digestive Disease Institute, Section of Bariatric and Metabolic Surgery, Cleveland Clinic, Cleveland, Ohio....
[Ti] Title:Comprehensive evaluation of the effect of bariatric surgery on pelvic floor disorders.
[So] Source:Surg Obes Relat Dis;12(1):138-43, 2016 Jan.
[Is] ISSN:1878-7533
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: The association of pelvic floor disorders (PFD) with obesity is well documented. The spectrum of PFD includes stress urinary incontinence (SUI), urge urinary incontinence (UUI), pelvic organ prolapse (POP), and fecal incontinence (FI). Resolution or improvement of SUI after bariatric surgery has been previously reported. However, the data regarding UUI and other forms of PFD with objective testing are sparse. OBJECTIVES: Prospectively evaluate the effects of bariatric surgery on the prevalence and severity of pelvic floor disorders. SETTING: U.S. Academic Hospital. METHODS: From December 2008 to December 2012, patients who screened positive on a screening questionnaire were asked to participate in the study. Participants completed 3 validated condition-specific questionnaires before surgery and 6-12 months after. A subgroup consented to gynecologic examination (Pelvic Organ Prolapse Quantification [POP-Q] test) and urodynamic testing at similar time points. RESULTS: Seventy-two study patients underwent laparoscopic gastric bypass (n = 65), sleeve gastrectomy (n = 5), and gastric banding (n = 2). Mean BMI decreased from 47.5 to 32.7 kg/m(2) 1 year after surgery (P<.001). Based on questionnaires, the most prevalent PFD was SUI, identified in 60 (83.3%) patients at baseline and 32 (44.4%, P<.001) at follow-up. There was significant improvement in PFD-related symptoms, quality of life, POP, and sexual function at follow-up. Decrease in prevalence of SUI after surgery was also confirmed with urodynamic testing (from 76.9% to 30.8%, P = .01). There was no significant change in prevalence and severity of POP based on POP-Q exam. CONCLUSIONS: Bariatric surgery is associated with a decrease in prevalence and severity of diverse forms of urinary incontinence as well as improvement in quality of life and sexual function of morbidly obese women.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1601
[Js] Journal subset:IM
[St] Status:In-Data-Review

  6 / 4335375 MEDLINE  
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[PMID]: 26621226
[Au] Autor:Teichtahl AJ; Wluka AE; Wang Y; Wijethilake PN; Strauss B; Proietto J; Dixon JB; Jones G; Forbes A; Cicuttini FM
[Ad] Address:Department of Epidemiology and Preventive Medicine, Monash University, School of Public Health and Preventive Medicine, Alfred Hospital, Melbourne, Australia; Baker IDI Heart and Diabetes Institute, Melbourne, Australia....
[Ti] Title:Associations of surgical and nonsurgical weight loss with knee musculature: a cohort study of obese adults.
[So] Source:Surg Obes Relat Dis;12(1):158-64, 2016 Jan.
[Is] ISSN:1878-7533
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Marked weight loss reduces lean body mass and quadriceps thickness. It is unclear whether muscle loss varies according to the method of weight loss. OBJECTIVE: This study compared the association of surgical versus nonsurgical weight loss with change in vastus medialis (VM) properties in obese adults. METHODS: Twenty obese patients (body mass index≥30 kg/m(2)) who lost weight via laparoscopic gastric banding were matched for weight loss with obese patients who lost weight nonsurgically. The thickness and fat infiltration of VM were assessed at baseline and a mean of 2.4 years later. RESULTS: After adjusting for confounders, the annual change in VM thickness was -2.9% in the surgical group and -.5% for the nonsurgical group (P = .02). There was also a tendency toward an increased risk for VM fat infiltration to be reduced when weight loss occurred nonsurgically (OR 5.1, 95% CI .8-32.8; P = .09). CONCLUSIONS: Compared with nonsurgical weight loss, laparoscopic gastric banding was associated with greater VM muscle thickness loss. Relative to laparoscopic gastric banding, there was also a tendency toward an increased risk for VM fat infiltration to be reduced with nonsurgical weight loss. Close attention to preserving muscle properties at the knee when significant amounts of weight loss have occurred is required. Physical therapy may be important in the management of patients after laparoscopic gastric banding in an attempt to preserve skeletal muscle mass.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1601
[Js] Journal subset:IM
[St] Status:In-Data-Review

  7 / 4335375 MEDLINE  
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[PMID]: 26525368
[Au] Autor:Pona AA; Heinberg LJ; Lavery M; Ben-Porath YS; Rish JM
[Ad] Address:University of Missouri-Kansas City, Kansas City, Missouri....
[Ti] Title:Psychological predictors of body image concerns 3 months after bariatric surgery.
[So] Source:Surg Obes Relat Dis;12(1):188-93, 2016 Jan.
[Is] ISSN:1878-7533
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Although studies have associated postoperative weight loss with improvement in body image dissatisfaction, some individuals continue to report body image concerns after bariatric surgery. These concerns are linked to increased depressive symptoms and decreased self-esteem in bariatric populations. OBJECTIVE: This study sought to explore preoperative factors that may predict early body image concerns 3 months after bariatric surgery. SETTING: Academic medical center. METHOD: Data were analyzed from 229 patients evaluated for bariatric surgery who completed a 3-month postoperative psychology appointment and the Minnesota Multiphasic Personality Inventory, Second Edition, Restructured Form (MMPI-2-RF). Scales measuring depression, persecution, self-doubt, and inadequacy were examined. Medical records were reviewed for demographic characteristics, psychotropic medication usage, history of psychological treatment, and current or lifetime depression diagnosis. RESULTS: Patients who preoperatively scored higher on demoralization (F [1, 227] = 35.40, P< .001), low positive emotions (F [1, 227] = 4.18, P< .05), ideas of persecution (F [1, 227] = 15.24, P< .001), self-doubt (F [1, 227] = 27.47, P< .001), and inefficacy (F [1, 227] = 21.34, P< .001) were significantly more likely to report body image concerns 3 months after bariatric surgery. Similarly, body image concerns were more common in patients with a preoperative depression diagnosis (χ(2) = 8.76, P<.01), current psychotropic medication usage (χ(2) = 7.13, P<.01), and history of outpatient therapy (χ(2) = 8.34, P<.01) and psychotropic medication (χ(2) = 9.66, P< .001). CONCLUSION: Bariatric surgery candidates with psychopathology and other psychological risk factors are more likely to report body image concerns early after bariatric surgery. Future research is warranted to determine whether this association remains further out from surgery.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1601
[Js] Journal subset:IM
[St] Status:In-Data-Review

  8 / 4335375 MEDLINE  
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[PMID]: 26507939
[Au] Autor:Kannan U; Ecker BL; Choudhury R; Dempsey DT; Williams NN; Dumon KR
[Ad] Address:Bronx-Lebanon Hospital Center, Bronx, New York. Electronic address: ukannan@bronxleb.org....
[Ti] Title:Laparoscopic hand-assisted versus robotic-assisted laparoscopic sleeve gastrectomy: experience of 103 consecutive cases.
[So] Source:Surg Obes Relat Dis;12(1):94-9, 2016 Jan.
[Is] ISSN:1878-7533
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Laparoscopic sleeve gastrectomy has become a stand-alone procedure in the treatment of morbid obesity. There are very few reports on the use of robotic approach in sleeve gastrectomy. OBJECTIVES: The purpose of this retrospective study is to report our early experience of robotic-assisted laparoscopic sleeve gastrectomy (RALSG) using a proctored training model with comparison to an institutional cohort of patients who underwent laparoscopic hand-assisted sleeve gastrectomy (LASG). SETTINGS: University hospital. METHODS: The study included 108 patients who underwent sleeve gastrectomy either via the laparoscopic-assisted or robot-assisted approach during the study period. Of these 108 patients, 62 underwent LASG and 46 underwent RALSG. The console surgeon in the RALSG is a clinical year 4 (CY4) surgery resident. All CY4 surgery residents received targeted simulation training before their rotation. The console surgeon is proctored by the primary surgeon with assistance as needed by the second surgeon. RESULTS: The patients in the robotic and laparoscopic cohorts did not have a statistical difference in their demographic characteristics, preoperative co-morbidities, or complications. The mean operating time did not differ significantly between the 2 cohorts (121 min versus 110 min, P = .07). Patient follow-up in the LSG and RALSG were 91% and 90% at 3 months, 62% and 64% at 6 months, and 60% and 55% at 1 year, respectively. The mean percentage estimated weight loss (EWL%) at 3 months, 6 months, and 1 year was greater in the robotic group but not statistically significant (27 versus 22 at 3 mo [P = .05] and 39 versus 34 at 6 mo [P = .025], 57 versus 48 at 1 yr [P = .09]). There was no mortality in either group. CONCLUSION: Early results of our experience with RALSG indicate low perioperative complication rates and comparable weight loss with LASG. The concept of a stepwise education model needs further validation with larger studies.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1601
[Js] Journal subset:IM
[St] Status:In-Data-Review

  9 / 4335375 MEDLINE  
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[PMID]: 26499352
[Au] Autor:Chen JC; Lee WJ; Tsou JJ; Liu TP; Tsai PL
[Ad] Address:Division of General Surgery, Department of Surgery, Min-Sheng General Hospital, Taoyuan, Taiwan, ROC; Division of General Surgery, Department of Surgery, Mackay Memorial Hospital, Taipei, Taiwan, ROC; Department of Nursing, Min-Sheng General Hospital, Taoyuan, Taiwan, ROC. Electronic address: jackyk...
[Ti] Title:Effect of probiotics on postoperative quality of gastric bypass surgeries: a prospective randomized trial.
[So] Source:Surg Obes Relat Dis;12(1):57-61, 2016 Jan.
[Is] ISSN:1878-7533
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Gastric bypass surgery is the recommended treatment for severely obese patients. However, postoperative symptomatic gastrointestinal (GI) episodes are common complaints. OBJECTIVES: To determine if administration of probiotics improves symptomatic GI episodes after gastric bypass surgery. SETTING: Hospital-based bariatric center. METHODS: This double-blind, randomized trial was conducted between March 2010 and September 2010 with 60 patients who underwent gastric bypass for severe obesity and experienced postoperative symptomatic GI episodes. Patients were randomly assigned to the probiotics group A (n = 20; 1 g Clostridium butyricum MIYAIRI twice daily); probiotics group B (n = 20; Bifidobacterium longum BB536 twice daily); or digestive enzymes group (n = 20; Aczym, containing 100 mg takadiastase N, 20 mg cellulase AP, 50 mg lipase MY, and 100 mg pancreatin, twice daily). Quality of life was measured using the modified Gastrointestinal Quality of Life Index (mGIQLI) before and after the 2-week intervention. RESULTS: Preintervention patient characteristics and mGIQLI scores were similar among the 3 groups. After the 2-week intervention, the mean mGIQLI score improved from 57.4 to 63.9 points in the entire sample and also within each group for 7 items specifically for 7: excessive passage of gas, foul smell of flatulence, belching, heartburn, abdominal noises, abdominal bloating, and abdominal pain. CONCLUSIONS: Administration of probiotics or digestive enzymes may improve symptomatic GI episodes after gastric bypass surgeries and improve quality of life, at least initially.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1601
[Js] Journal subset:IM
[St] Status:In-Data-Review

  10 / 4335375 MEDLINE  
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[PMID]: 26483070
[Au] Autor:Severino A; Castagneto-Gissey L; Raffaelli M; Gastaldelli A; Capristo E; Iaconelli A; Guidone C; Callari C; Bellantone R; Mingrone G
[Ad] Address:Department of Internal Medicine, Catholic University, Rome, Italy....
[Ti] Title:Early effect of Roux-en-Y gastric bypass on insulin sensitivity and signaling.
[So] Source:Surg Obes Relat Dis;12(1):42-7, 2016 Jan.
[Is] ISSN:1878-7533
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: A large body of literature indicates the rapidity with which Roux-en-Y gastric bypass (RYGB) improves glycemic control. However, the underlying physiologic mechanisms are still a matter of debate. SETTING: Catholic University, School of Medicine, Rome, Italy. METHODS: Ten morbidly obese patients, before and 4 weeks after RYGB, and 10 healthy controls were studied. We measured insulin sensitivity as the homeostasis model assessment-estimated insulin resistance (HOMA-IR) and by the euglycemic hyperinsulinemic clamp, and phosphorylation of protein kinase B (Akt) on Ser473 and Thr308 and of GSK3 α-ß on Ser 9 and Ser21 in skeletal muscle biopsy specimens by Western blot analysis. RESULTS: Obese patients before RYGB displayed reduced insulin sensitivity (M value) and clearance and increased fasting Akt phosphorylation on Ser473 compared with controls. M significantly increased after surgery (from 2.6±0.6 to 2.8±0.7 mg/kg fat free mass/min, P = .026) but remained far below the values in controls (10.0±3.8 mg/kg fat free mass/min, P<.001). Insulin clearance increased from 453.5±117.5 to 555.2±61.6 (P = .00076), becoming similar to that of controls 582.2±59.0 mU/m(2)/min. HOMA-IR decreased from 4.1±0.07 to 2.3±0.5 (P = .004), becoming comparable with controls (2.2±0.9). The hyperphosphorylation of Akt on Ser473 observed at fasting before RYGB was significantly reduced thereafter, becoming similar to that of healthy controls; the other phosphorylation states remained unchanged. CONCLUSIONS: Following RYGB, we found a prompt improvement of hepatic insulin resistance with normalization of hepatic insulin clearance and a small amelioration of whole-body insulin sensitivity. The supranormal levels of Akt Ser473 observed at fast in the skeletal muscle tissue at baseline were normalized after RYGB, and their changes correlated with those of both hepatic and peripheral insulin resistance. Although other mechanisms of action, such as the effect of weight loss and reduced food intake, cannot be excluded, the reduction of muscle Akt hyperphosphorylation on the serine residue can play a role in the early improvement of insulin sensitivity.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1601
[Js] Journal subset:IM
[St] Status:In-Data-Review


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