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Critical Care Nursing Quarterly 2003The purpose of this article is to discuss the disease of morbid obesity, its causes, and its impact upon an individual's life. Medical personnel must have a clear... (Review)
Review
The purpose of this article is to discuss the disease of morbid obesity, its causes, and its impact upon an individual's life. Medical personnel must have a clear understanding that morbid obesity is a disease largely due to genetic makeup and not a personality defect or lack of control. The intention is to show how morbid obesity contributes to many comorbidities that are costly, decreases quality of life, and is life-threatening. Providing a better understanding will hopefully facilitate more compassionate care among nurses who care for this population.
Topics: Causality; Comorbidity; Cost of Illness; Health Status; Humans; Obesity, Morbid; Quality of Life
PubMed: 12744597
DOI: 10.1097/00002727-200304000-00011 -
The British Journal of Surgery Jun 1995Morbid obesity significantly reduces life span and is associated with much co-morbid pathology. Diet, behavioural therapy and drug therapy are largely unsuccessful.... (Review)
Review
Morbid obesity significantly reduces life span and is associated with much co-morbid pathology. Diet, behavioural therapy and drug therapy are largely unsuccessful. Surgical treatment offers the best hope. This review summarizes the rationale for treatment and the available surgical options.
Topics: Body Weight; Female; Gastric Bypass; Humans; Laparoscopy; Male; Obesity, Morbid; Treatment Outcome
PubMed: 7627499
DOI: 10.1002/bjs.1800820606 -
The New England Journal of Medicine May 2007
Review
Topics: Adult; Bariatric Surgery; Contraindications; Female; Humans; Obesity, Morbid; Postoperative Complications; Practice Guidelines as Topic; Weight Loss
PubMed: 17522401
DOI: 10.1056/NEJMct067019 -
Dermatology Nursing Aug 2002Obesity is one of the nation's most serious health problems. When individuals are overweight, they are at risk for disease, medical complications, and death. Patients... (Review)
Review
Obesity is one of the nation's most serious health problems. When individuals are overweight, they are at risk for disease, medical complications, and death. Patients are considered morbidly obese or bariatric when their weight far exceeds recommended guidelines. Excess weight in these individuals increases morbidity and mortality, and causes numerous care challenges. Nurses caring for bariatric clients should recognize the need to use specialized assessment and management strategies to prevent poor patient outcomes.
Topics: Humans; Nursing Assessment; Obesity, Morbid; Patient Discharge; Pharmaceutical Preparations; Respiratory Tract Diseases; Safety; Skin Care
PubMed: 12240502
DOI: No ID Found -
United European Gastroenterology Journal May 2022Liver transplant (LT) candidates with a body mass index (BMI) over 40 kg/m have lower access to a liver graft without clear explanation. Thus, we studied the impact of...
UNLABELLED
Liver transplant (LT) candidates with a body mass index (BMI) over 40 kg/m have lower access to a liver graft without clear explanation. Thus, we studied the impact of obesity on the waiting list (WL) and aimed to explore graft proposals and refusal.
METHOD
Data between January 2007 and December 2017 were extracted from the French prospective national database: CRISTAL. Competing risk analyses were performed to evaluate predictors of receiving LT. Competitive events were (1) death/WL removal for disease aggravation or (2) improvement. The link between grade obesity, grafts propositions, and reason for refusal was studied.
RESULTS
15,184 patients were analysed: 10,813 transplant, 2847 death/dropout for aggravation, 748 redirected for improvement, and 776 censored. Mortality/dropout were higher in BMI over 35 (18% vs. 14% 1 year after listing) than in other candidates. In multivariate analysis, BMI>35, age, hepatic encephalopathy, and ascites were independent predictors of death/dropout. Candidates with a BMI ≥ 35 kg/m had reduced access to LT, without differences in graft proposals. However, grafts refusal was more frequent especially for 'morphological incompatibility' (14.9% vs. 12.7% p < 0.01).
CONCLUSION
BMI over 35 kg/m reduces access to LT with increased risk of dropout and mortality. Increased mortality and dropout could be due to a lower access to liver graft secondary to increased graft refusal for morphological incompatibility.
Topics: Humans; Liver Transplantation; Obesity, Morbid; Prospective Studies; Risk Assessment; Waiting Lists
PubMed: 35470965
DOI: 10.1002/ueg2.12226 -
AORN Journal Apr 2003Obesity recently has been called an epidemic. In the United States, more than 60% of adults are overweight. Although obesity and morbid obesity share numerous... (Review)
Review
Obesity recently has been called an epidemic. In the United States, more than 60% of adults are overweight. Although obesity and morbid obesity share numerous etiological factors (eg, genetic, environmental, psychosocial, economic), accepted treatment options differ. Morbid obesity requires urgent and definitive correction to treat both current and possible future complications and to help prevent a probable shortened lifespan. Generally, it is accepted that nonsurgical approaches to weight loss for a person who is morbidly obese are unsuccessful. This Home Study describes the major surgical procedures currently available to treat morbid obesity and discusses the information that nurses need to know about perioperative care of patients who are morbidly obese.
Topics: Energy Intake; Gastroplasty; Humans; Obesity, Morbid; Patient Care Planning; Patient Selection; Perioperative Nursing
PubMed: 12705735
DOI: 10.1016/s0001-2092(06)60799-0 -
Nephrology (Carlton, Vic.) Aug 2022Obesity is associated with glomerular hyperfiltration which may precede the development of overt renal damage. Few studies evaluated the link between inflammasome...
AIM
Obesity is associated with glomerular hyperfiltration which may precede the development of overt renal damage. Few studies evaluated the link between inflammasome signalling and hyperfiltration. The aim is to evaluate the relationship between IL1-β/Caspase-1, insulin sensitivity and hyperfiltration in subjects with severe obesity, before and after weight loss.
METHODS
Forty-six patients with BMI > 35 kg/m , without type-2-diabetes or hypertension, were evaluated at baseline and 6 months after bariatric surgery with oral glucose tollerance test, bioimpedance analysis and blood tests. The eGFR was calculated according to EPIcr-cys formula and insulin sensitivity by Oral Glucose Insulin Sensitivity. IL-1β/Caspase-1 were measured with the ELISA-kit. HF was defined as eGFR ≥ 140 ml/min (non-indexed for BSA).
RESULTS
Sixteen subjects at baseline had hyperfiltration, with a higher insulin resistance, BMI, lean mass and plasma levels of IL-1β/Caspase-1. After surgery, there was a reduction in BMI and improvement in insulin resistance in all patients. However, in 8 of 16 patients hyperfiltration persisted and IL-1β/Caspase-1 levels did not decrease (3.22 ± 0.79 vs. 3.13 ± 1.03 and 23.7 ± 12.1 vs. 20.6 ± 9.1, pre vs. post, pg/ml), while cytokines normalized in all the other patients in parallel with the eGFR. In a logistic regression model, correcting for the main covariates, lean mass and IL-1β before surgery (p = .01 and p = .03, respectively), were the only predictors of hyperfiltration.
CONCLUSION
Weight loss is effective in reducing hyperfiltration in most, but not all patients. Hyperfiltration remains unchanged in subjects who do not have a reduction in IL-1β/Caspase-1, suggesting a pathogenetic role of the inflammasome signalling in the early stages of nephropathy.
Topics: Caspases; Glomerular Filtration Rate; Glucose; Humans; Inflammasomes; Insulin Resistance; Obesity, Morbid; Renal Insufficiency, Chronic; Weight Loss
PubMed: 35681274
DOI: 10.1111/nep.14077 -
Current Problems in Surgery Sep 1998
Review
Topics: Behavior Therapy; Diet, Reducing; Energy Intake; Gastroplasty; Humans; Obesity, Morbid
PubMed: 9745619
DOI: 10.1016/s0011-3840(98)80009-9 -
World Journal of Gastroenterology Apr 2017Laparoscopic sleeve gastrectomy (LSG) has reached wide popularity during the last 15 years, due to the limited morbidity and mortality rates, and the very good weight...
Laparoscopic sleeve gastrectomy (LSG) has reached wide popularity during the last 15 years, due to the limited morbidity and mortality rates, and the very good weight loss results and effects on comorbid conditions. However, there are concerns regarding the effects of LSG on gastroesophageal reflux disease (GERD). The interpretation of the current evidence is challenged by the fact that the LSG technique is not standardized, and most studies investigate the presence of GERD by assessing symptoms and the use of acid reducing medications only. A few studies objectively investigated gastroesophageal function and the reflux profile by esophageal manometry and 24-h pH monitoring, reporting postoperative normalization of esophageal acid exposure in up to 85% of patients with preoperative GERD, and occurrence of de novo GERD in about 5% of cases. There is increasing evidence showing the key role of the surgical technique on the incidence of postoperative GERD. Main technical issues are a relative narrowing of the mid portion of the gastric sleeve, a redundant upper part of the sleeve (both depending on the angle under which the sleeve is stapled), and the presence of a hiatal hernia. Concomitant hiatal hernia repair is recommended. To date, either medical therapy with proton pump inhibitors or conversion of LSG to laparoscopic Roux-en-Y gastric bypass are the available options for the management of GERD after LSG. Recently, new minimally invasive approaches have been proposed in patients with GERD and hypotensive LES: the LINX Reflux Management System procedure and the Stretta procedure. Large studies are needed to assess the safety and long-term efficacy of these new approaches. In conclusion, the recent publication of pH monitoring data and the new insights in the association between sleeve morphology and GERD control have led to a wider acceptance of LSG as bariatric procedure also in obese patients with GERD, as recently stated in the 5 International Consensus Conference on sleeve gastrectomy.
Topics: Gastrectomy; Gastroesophageal Reflux; Humans; Obesity, Morbid; Postoperative Complications
PubMed: 28428706
DOI: 10.3748/wjg.v23.i13.2269 -
Nutrition in Clinical Practice :... Aug 2005Morbid obesity (body mass index >40 kg/m2 or >35 kg/m2 in the presence of an severe-obesity-related comorbid disease) is increasing in frequency in the United States and... (Review)
Review
Morbid obesity (body mass index >40 kg/m2 or >35 kg/m2 in the presence of an severe-obesity-related comorbid disease) is increasing in frequency in the United States and worldwide. This population has a variety of medical and surgical disorders that result in hospitalizations. It is not unexpected to encounter these patients on the nutrition support service. The obesity comorbid diseases that may increase complications related to nutrition support are present in greater frequency and severity in the morbidly obese population than in the nonobese population. To reduce these potential complications, strategies of hypocaloric nutrition have been advocated for obese patients, and this study focuses specifically on the morbidly obese subset.
Topics: Comorbidity; Diet, Reducing; Dietary Proteins; Energy Intake; Humans; Nutritional Requirements; Nutritional Support; Obesity, Morbid; Severity of Illness Index
PubMed: 16207688
DOI: 10.1177/0115426505020004480