Bariatric Surgery

Weight loss is commonly recommended for gout, but the magnitude of the effect has not been evaluated in a systematic review. The aim of this systematic review was to determine benefits and harms associated with weight loss in overweight and obese patients with gout. We searched six databases for longitudinal studies, reporting the effect of weight loss in overweight/obese gout patients. Risk of bias was assessed using the tool Risk of Bias in Non-Randomised Studies of Interventions. The quality of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation. From 3991 potentially eligible studies, 10 were included (including one randomised trial). Interventions included diet with/without physical activity, bariatric surgery, diuretics, metformin or no intervention. Mean weight losses ranged from 3 kg to 34 kg. Clinical heterogeneity in study characteristics precluded meta-analysis. The effect on serum uric acid (sUA) ranged from -168 to 30 μmol/L...

To identify: 1. The percentage of bariatric procedures that are revisions; 2. What proportion of bariatric revision procedures in public hospitals are for patients whose primary weight loss procedure occurred in a private hospital; 3. The age, sex and level of socioeconomic disadvantage of patients needing revisions. An analysis of patient level admission data from the Integrated South Australian Activity Collection (ISAAC) was performed. Data were collected on all revisions for weight loss related procedures at all South Australian public and private hospitals, between 2000-2015 using the ISAAC codes for revision procedures. 12,606 bariatric procedures occurred in hospitals; ∼27% of which represent a revision (n=3366). Of these revisions, ∼82% occurred in a private hospital (n=2771), and ∼18% occurred in a public hospital (n=595). Of the 595 revisions in a public hospital, 51% of patients had their original bariatric procedure performed in a private hospital. The majority of patien...

The effects of body mass index (BMI) on ventricular repolarization in young men have not been studied in detail. The QT and JT intervals are measured to estimate the duration of the ventricular repolarization. As new repolarization parameters, the time intervals between the J point to the apex of the T wave (JTa), the apex and the end of T wave (TaTe) may be associated with arrhythmogenesis in clinical conditions. The aim of this study was to compare ventricular repolarization parameters in overweight and normal weight healthy young men. Thirty-six overweight men (BMI--26.3+/-1.5 kg/m2, mean age--20.6+/-1.5 years) and 149 men within normal limits (BMI--21.9+/-1.5 kg/m2, mean age--20.4+/-1.4 yrs) were included in this cross-sectional controlled study. The body mass index of 25 to 29.9 kg/m2 was defined as overweight and scores of 18.5 to 24.9 kg/m2 were accepted as normal. Ventricular repolarization parameters including QT, JT, JTa, TaTe, RR intervals duration and heart rate-correcte...

Background: The recent substantial increase in the number of obese surgeries performed in Sweden has raised concerns about the budget impact. Objective: Our aim in this paper is to present an assessment of the budgetary impact of different policies for surgical intervention for obese and overweight subjects from a healthcare perspective in Sweden. Methods: The model simulates the annual expected treatment costs of obesity related diseases and surgery in patients of different sex, age and Body Mass Index (BMIMI). Costs evaluated are costs of surgery plus the excess treatment costs that an obese patient has over and above the treatment costs of a normal-weight patient. The diagnoses that are included for costs assessment are diabetes and cardiovascular disease since these diagnoses are the principal diagnoses associated with obesity. Four different scenarios over the number of surgical operations performed each year are simulated and compared: (1) no surgical operation, (2) 3 000 surg...

Background:The rising trend in the prevalence of obesity has during the past decades become a major public health concern in many countries, as obesity may lead to comorbidities and death. A frequent used marker for obesity is the Body Mass Index (BMI). The cost of treatment for obesity related diseases has become a heavy burden on national health care budget in many countries. While diet and exercise are the cornerstones of weight management, pharmaco­therapy is often needed to achieve and maintain desired weight loss.  In some cases of extreme obesity, bariatric surgery may be recommended. It is expected to increase by 50% in Sweden.Objective: The overall objective was to develop a cost-effectiveness model using the best available evidence to assess the cost-effectiveness of gastric bypass (GBP) surgical treatments for obesity in adult patients, in comparison with conventional treatment (CT), in Sweden from a healthcare perspective. With the model we also seeked to identify the lo...

The single-anastomosis duodenal switch procedure is a type of duodenal switch that involves a loop anastomosis rather than traditional Roux-en-Y reconstruction. To date, there have been no multicenter studies looking at the complications associated with post-pyloric loop reconstruction. The aim of the study was to report the incidence of complications associated with loop duodeno-ileostomy (DI) following single-anastomosis duodenal switch (SADS) procedures. Mixed of private and teaching facilities. The medical records of 1328 patients who underwent primary SADS procedure (single-anastomosis duodeno-ileal bypass with sleeve gastrectomy or stomach intestinal pylorus-sparing surgery) by 17 surgeons from 3 countries (United States, Spain, and Australia) at 9 centers over a 6-year period were retrospectively reviewed, and their results were compared with articles in the literature. Mean preoperative body mass index was 51.6 kg/m. Of 1328 patients, 123 patients received a linear stapled d...

Crohn's disease (CD) following bariatric surgery has been previously described. It is not clear whether the clinical entity is due to rapid metabolism of fat, change in the bacterial milieu of the bowel, the loss of defense mechanisms of the stomach, or even a coincidence. To present observations which might serve to sort out these various etiologies. We present 5 cases of colitis, ileocolitis or enteritis, some with fistula formation, with clinical onset following bariatric surgery and add these to the 7 cases previously identified as CD reported elsewhere. We provide the clinical features of these 12 cases to reconcile with causative mechanisms. It remains possible that the onset of CD (or other inflammatory bowel disease) precedes the bariatric surgery which then accelerates the clinical manifestations described. Furthermore, without controls the association could remain a coincidence. We review the evidence for release of proinflammatory cells and cytokines contained in fat ...

Introduction: Obesity has become a growing public health problem, and bariatric surgery is considered the most effective treatment for weight loss and remission of comorbidities in cases of severe obesity. However, there is growing concern about the increased risk of developing alcohol use disorders among patients undergoing these procedures. The relationship between bariatric surgery and alcoholism is complex, involving metabolic and psychological changes that can increase susceptibility to alcoholism. This article reviews the incidence, risk factors and clinical implications of alcohol use after bariatric surgery, highlighting the importance of post-operative monitoring to improve long-term results and quality of life for patients. Method: This study uses a bibliographic review with 23 sources of information, consulted in databases such as Pubmed, Scielo, VHL and NCBI, using keywords such as "obesity", "bariatric surgery", "behavioral disorders", "anxiety" and " alcoholism." After selecting the material, there was a detailed analysis of the texts, review by all authors and consensus on the selection. The selected works, published between 2012 and 2024. Discussion: The relationship between bariatric surgery and the increased risk of post-surgical alcoholism is complex and multifactorial. Psychiatric factors, such as depression and anxiety, along with neurobiological and metabolic changes, may contribute to this phenomenon. Different types of bariatric surgery, such as Roux-en-Y gastric bypass, are associated with anatomical and metabolic changes that may increase susceptibility to alcohol. Early psychological and metabolic monitoring can play a crucial role in preventing and managing post-surgical alcoholism. These findings highlight the importance of a multidisciplinary and preventive approach in the care of patients undergoing bariatric surgery.

BackgroundPrevious studies have investigated weight loss caused by exercise following bariatric surgery. However, in most cases, the training program is poorly reported; the exercise type, volume, and intensity are briefly mentioned; and the sample size, selection criteria, and follow-up time vary greatly across studies.PurposeThe EFIBAR study aims to investigate over 1 year the effects of a 16-week supervised exercise program, initiated immediately after bariatric surgery, on weight loss (primary outcome), body composition, cardiometabolic risk, physical fitness, and quality of life in patients with severe/extreme obesity.Material and MethodsThe EFIBAR study is a parallel-group, superiority, randomized controlled trial (RCT), comprising 80 surgery patients. Half of the participants, randomly selected, perform a 16-week supervised exercise program, including both strength and aerobic training, starting immediately after the surgery (7–14 days). For each participant, all primary and ...