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Archives of Surgery (Chicago, Ill. :... Apr 2003
Review
Topics: Diabetes Complications; Gastric Bypass; Humans; Jejunoileal Bypass; Obesity; Obesity, Morbid; Prevalence
PubMed: 12686520
DOI: 10.1001/archsurg.138.4.357 -
Phlebology Dec 2022Obesity affects over two-thirds of the Australian population and is associated with increased risk of venous leg ulceration (VLU). Management is challenging to both...
BACKGROUND/AIMS
Obesity affects over two-thirds of the Australian population and is associated with increased risk of venous leg ulceration (VLU). Management is challenging to both patients and staff. Surgical treatment of superficial venous incompetence in patients with VLU reduces ulcer healing time and recurrence, but this has not yet been investigated in patients with obesity. We aimed to determine in patients with VLU and morbid obesity if their ultrasound pattern of superficial venous incompetence was like those patients without morbid obesity.
METHODS
Consecutive patients attending the outpatient leg ulcer clinic from January to December 2019 were eligible for inclusion if they had an active or healed VLU. Age, gender, BMI, and ulcer sidedness were collected from the electronic medical record and assessed against findings of venous duplex ultrasound. Primary outcome was the proportion of patients with morbid obesity with superficial venous incompetence. Secondary outcomes included the proportion of patients with morbid obesity who were investigated with a duplex ultrasound, and any presence of deep venous incompetence.
RESULTS
Of 231 patients that attended 156 were eligible for inclusion. 103 patients had full data and were used for the primary outcome analysis. There were 29 patients (28.2%) with morbid obesity. They were younger than those without morbid obesity (69.0 vs 73.0 years, .026) with no difference in gender, active or healed ulcer classification (CEAP C5/6), or ulcer sidedness. We found no difference in the proportion of patients with morbid obesity with superficial venous incompetence on ultrasound (72.4% vs 79.7%, .423). Patients with morbid obesity were equally as likely to undergo ultrasound investigation (73.2% vs 75.8%, .748).
CONCLUSIONS
In patients with VLU there appeared no difference in the proportion of patients with morbid obesity with superficial venous incompetence. Directed studies are needed to determine the effectiveness of intervention in this patient population.
Topics: Humans; Ulcer; Obesity, Morbid; Wound Healing; Australia; Varicose Ulcer; Venous Insufficiency
PubMed: 36259760
DOI: 10.1177/02683555221130923 -
Journal of the American Association of... Oct 2017
Topics: Humans; Nurse Practitioners; Nurse's Role; Obesity, Morbid; Weight Reduction Programs
PubMed: 29024551
DOI: 10.1002/2327-6924.12515 -
Journal of Visceral Surgery Feb 2015Increasing rate of obesity was reported in HIV-infected patients in USA. In France, no data are available to date. Bariatric surgery is the best option for morbid... (Review)
Review
Increasing rate of obesity was reported in HIV-infected patients in USA. In France, no data are available to date. Bariatric surgery is the best option for morbid obesity in general population but few data exist in HIV-infected patients. We describe the prevalence of obesity in France in HIV-infected patients. The prevalence of obesity is 15.1% in women and 5.3% in men. Moreover, we described our experience and point of view in the management of HIV infected patients with morbid obesity. Prospective studies are needed for an optimal management of HIV-infected patients with morbid obesity.
Topics: Bariatric Surgery; Female; France; HIV Infections; Humans; Male; Obesity, Morbid; Prevalence
PubMed: 25662869
DOI: 10.1016/j.jviscsurg.2014.12.001 -
The Proceedings of the Nutrition Society Nov 2010Obesity has been described as the health crisis of the 21st century. It is a chronic lifelong medical condition, whose pattern often starts in childhood, and is... (Review)
Review
Obesity has been described as the health crisis of the 21st century. It is a chronic lifelong medical condition, whose pattern often starts in childhood, and is demographically worsening in every developed country. The cost of treating the many medical conditions associated with obesity threatens to overwhelm healthcare resources. Medical treatments produce at most no more than 10% weight loss in the severely obese, with high failure rates. In this article, we review the available evidence regarding long-term reduction in weight, reduced mortality and improvement in most, if not all, obesity-related comorbidities. There is a need for daily multivitamins and extra minerals, especially with gastric bypass, and nutritional deficiencies of vitamins D and B12, Ca, Fe and folate need monitoring and prevention. Currently there is no medical therapy on the near horizon that will match the effect of surgery, which, if done safely, remains the only effective therapy. Bariatric surgery is cost effective, and health providers should embrace the development and rapid expansion of services.
Topics: Bariatric Surgery; Cost-Benefit Analysis; Deficiency Diseases; Humans; Obesity, Morbid; Postoperative Complications; Weight Loss
PubMed: 20441667
DOI: 10.1017/S0029665110001515 -
The Journal of Allergy and Clinical... 2018
Topics: Angioedema; Bariatric Surgery; Cetirizine; Factor XII; Female; Humans; Middle Aged; Obesity, Morbid; Omalizumab; Recurrence; Wounds and Injuries
PubMed: 30033921
DOI: 10.1016/j.jaip.2018.05.009 -
Deutsches Arzteblatt International Nov 2023The prevalence of morbid obesity (BMI >35 kg/m2) has risen steadily in recent decades. With the corresponding rise in the number of bariatric operations,... (Review)
Review
BACKGROUND
The prevalence of morbid obesity (BMI >35 kg/m2) has risen steadily in recent decades. With the corresponding rise in the number of bariatric operations, anesthesiologists deal with this patient group more commonly than before, particularly in specialized centers.
METHODS
This review is based on publications retrieved by a selective search in PubMed, including current guidelines and recommendations issued by specialist societies, as well as expert opinion.
RESULTS
In the anesthesiological care of morbidly obese patients, a preoperative assessment and risk stratification are just as important as the thoughtful selection of the anesthesia technique, the drugs used and their dosage, and perioperative management. A thorough understanding of the pathophysiological changes and comorbidities of morbid obesity and the associated risks is essential. The risk of pulmonary complications such as respiratory failure, hypoxia, and apnea is markedly higher in morbidly obese patients, especially those with obstructive sleep apnea. Short-acting, less lipophilic anesthetic drugs are particularly useful, as is multimodal pain therapy for the avoidance of high opiate doses. The indication for intensified postoperative monitoring depends on the patient's preexisting illnesses, the type of anesthesia, and the type of surgical procedure. Regional anesthetic techniques should be used if possible.
CONCLUSION
The perioperative care of morbidly obese patients presents special challenges. The anesthesiologist must be aware of potential comorbidities, specific risks, and pathophysiological changes in order to provide adequate care to this patient group.
Topics: Humans; Obesity, Morbid; Anesthesia; Hypoxia; Comorbidity; Perioperative Care; Postoperative Complications
PubMed: 37874129
DOI: 10.3238/arztebl.m2023.0216 -
Obesity Surgery Apr 2002The surgery to place the implantable gastric stimulator (IGS) is described. (Review)
Review
BACKGROUND
The surgery to place the implantable gastric stimulator (IGS) is described.
METHODS
There are two implantable components to the IGS. One is the electrical stimulator itself, which is placed in the anterior abdominal wall. It is connected to a bipolar lead that is positioned in the muscle wall of the stomach. We describe the procedure that is necessary to safely place the components.
RESULTS
4 patients have been implanted using techniques that were developed and refined around the world. There were no operative deaths. All procedures were successfully completed laparoscopically. Two (2/4) connections required revision because the leads were not fully inserted into the header of the generator.
CONCLUSIONS
The operation to implant the IGS is safe and simple to perform. Attention to technical details is essential.
Topics: Digestive System Surgical Procedures; Electric Stimulation Therapy; Electrodes, Implanted; Humans; Obesity, Morbid; Stomach
PubMed: 11969103
DOI: 10.1007/BF03342142 -
Cirugia Espanola Oct 2013Morbid obesity is a serious health problem whose prevalence is increasing. Expensive co-morbidities are associated to these patients, as well as a reduction in the... (Review)
Review
Morbid obesity is a serious health problem whose prevalence is increasing. Expensive co-morbidities are associated to these patients, as well as a reduction in the survival. Bariatric surgery resolves the co-morbidities (type 2 diabetes mellitus, 86.6%; cardiovascular risk, 79.0%; obstructive sleep apnea syndrome, 83.6%; hypertension, 61.7%), reduces the mortality rate (among 31-40%), and increases the morbid obese patients survival over a 10-years period. It provides significant savings for the National Health System. The obese patients consume a 20% plus of health resources and 68% plus of drugs than general population. Bariatric surgery requires an initial investment (diagnosis-related group cost: 7,468 €), but it is recovered in a cost-effectiveness ratio of 2.5 years. Significant savings are obtained from the third year. To the direct economic benefits associated with reduced health expenditures it should be added an increase in tax collection (sick leave and unemployment reduction is estimated in 18%, with a productivity increase of 57% for self-employed people). Bariatric surgery is one of the most cost-effective procedures in the healthcare system.
Topics: Bariatric Surgery; Cost-Benefit Analysis; Economic Recession; Humans; Obesity, Morbid
PubMed: 23628503
DOI: 10.1016/j.ciresp.2013.02.004 -
Surgical Endoscopy Apr 2009
Topics: Bariatric Surgery; Health Care Costs; Humans; Obesity, Morbid; United States
PubMed: 19184201
DOI: 10.1007/s00464-008-0325-y