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Prevention and treatment of nutritional complications after bariatric surgery.
Nuzzo, A, Czernichow, S, Hertig, A, Ledoux, S, Poghosyan, T, Quilliot, D, Le Gall, M, Bado, A, Joly, F
The lancet. Gastroenterology & hepatology. 2021;(3):238-251
Abstract
Obesity and the corresponding burden of related diseases is a major public health issue worldwide that is reaching pandemic proportions. Bariatric surgery is the only intervention that has been shown to result in substantial and lasting weight loss, and a decrease in overall mortality for patients with severe obesity. Consequently, the population of patients having undergone this procedure is increasing. Multifactorial weight-dependent and independent mechanisms underlying metabolic diseases could also drive preventable, but potentially life-threatening, long-term nutritional complications. However, given post-bariatric patients are prone to functional gastrointestinal symptoms and substantial weight loss, nutritional complications might be challenging. This Review is focused on the prevention and treatment of nutritional complications after bariatric surgery in the clinical setting.
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2.
Metabolic diagnoses of recurrent stone formers: temporal, geographic and gender differences.
Huynh, LM, Dianatnejad, S, Tofani, S, Carrillo Ceja, R, Liang, K, Tapiero, S, Jiang, P, Youssef, RF
Scandinavian journal of urology. 2020;(6):456-462
Abstract
BACKGROUND Metabolic factors underlying the recent increase in stone prevalence over the past decades are not well understood. Herein, we evaluate temporal, geographic and gender-specific trends in metabolic risk factors in recurrent kidney stone formers. PATIENTS AND METHODS A systematic literature review of metabolic risk factors for stone formation was conducted, inclusive of the last four decades. Studies with inadequate 24 h urine metabolic data, pediatric or those with less than 50 patients were excluded. The primary outcome was prevalence of each metabolic risk factor, compared between studies published prior to the year 2000 vs those following. Geographic and gender differences were secondary outcomes. RESULTS Twenty-eight articles met inclusion criteria, of which 10 (n = 1578) were published prior to the year 2000 and 18 (n = 8747) were published thereafter. Comparing these groups, an increase in hyperoxaluria (29% vs 33%; p = 0.002), hypercalciuria (35 vs 36%; p = 0.446), hyperuricosuria (17% vs 22%; p < 0.0001), low urine volume (28 vs 38%; p < 0.0001) and hypocitraturia (23% vs 44%; p < 0.0001) was observed. The prevalence of hyperoxaluria, hypercalciuria, hyperuricosuria and hypocitraturia were significantly higher in males. There were also significant geographical differences, with higher prevalence of hyperoxaluria and hypocitraturia in non-Western countries and higher prevalence of hypercalciuria in Western countries. Prevalence of hyperoxaluria is increasing in the US. CONCLUSION Prevalence of metabolic risk factors for nephrolithiasis significantly increased in recent years. These findings are hypothesis-generating and may provide valuable insight into the epidemiology, prevention and management of recurrent stone disease. Dietary modifications and innovative medical therapies are needed to decrease metabolic risk factors underlying nephrolithiasis.
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3.
LICHENS' B-OLIGOSACCHARIDES IN THE CORRECTION OF METABOLIC DISORDERS IN TYPE 2 DIABETES MELLITUS.
Kershengolts, BM, Sydykova, LA, Sharoyko, VV, Anshakova, VV, Stepanova, AV, Varfolomeeva, NA
Wiadomosci lekarskie (Warsaw, Poland : 1960). 2015;(4):480-2
Abstract
INTRODUCTION Lichens of the genus Cladonia are used as medicinal plants in folk medicine. Biologically active food supplement (BAFS) on the basis of lichens p. Cladonia was derived by mechanical-chemical biotechnology in the Educational-Research-Engineering Laboratory "Mechanical-Chemical Biotechnology" of the North-Eastern Federal University (NEFU). As a result of biotech impact, the solid β-glycoside bonds are destructed on β-oligosaccharide molecules, and other groups of lichen BAS is mobilized. The content of hydrolysable carbohydrates in samples of lichen increased 8 times after mechanical activation. AIM: The aim of investigation was to study the effects of BAFS "Yagel-Detox" in patients with type 2 diabetes mellitus (DM 2). MATERIALS AND METHODS The 150 patients (group 1--100 patients receiving "Yagel-Detox", group 2--50 patients receiving placebo) with a diagnosis DM 2 were examined. The research included: general clinical and instrumental examination, biochemical and clinical blood tests. "Yagel-Detox" was used 1 capsule 3 times a day, the rate of admission was 3 months. RESULTS Clinical trials have shown that 3-month intake of BAFS "Yagel-Detox" reduces the concentration of blood glucose 1.3 1.6 times (in the control group--1.2 ÷ 1.4 times), glycosylated hemoglobin--from 9.8 ÷ 11.4% to 7.6% (in the control group--1.0%). The concentration of low-density lipoprotein (LDL) reduced on 1.3% through 6 months. Patients of both groups were on the similar tablet glucose-lowering therapy (randomized treatment), which have not been adjusted. CONCLUSIONS The obtained results allow us to recommend BAFS "Yagel-Detox" as an additional remedy to normalize blood glucose concentration in patients with DM 2.
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4.
Effects of rapid or slow weight loss on body composition and metabolic risk factors in obese postmenopausal women. A pilot study.
Sénéchal, M, Arguin, H, Bouchard, DR, Carpentier, AC, Ardilouze, JL, Dionne, IJ, Brochu, M
Appetite. 2012;(3):831-4
Abstract
To compare the effect of rapid or slow weight loss (WL) on body composition and metabolic risk factors following a caloric restriction. Ten obese, postmenopausal women were matched for total body WL. Dependent variables were: body composition, lipid profile and blood pressure. Both groups decreased obesity measures (all P≤0.05) while lean body mass decreased in the rapid WL group (P≤0.05). Significant improvements in fasting triglyceride level and diastolic blood pressure were observed only in the slow WL group. A slower WL seems to be more beneficial to improve body composition as well as metabolic risk factors in postmenopausal women.
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5.
Efficacy and metabolic influence of paliperidone ER, aripiprazole and ziprasidone to patients with first-episode schizophrenia through 52 weeks follow-up in China.
Zhang, Y, Dai, G
Human psychopharmacology. 2012;(6):605-14
Abstract
BACKGROUND There are no direct comparisons of paliperidone extended-release (ER), aripiprazole and ziprasidone in efficacy and metabolic influence in patients with first-episode schizophrenia. OBJECTIVE The present study examined the efficacy and metabolic influence of paliperidone ER, aripiprazole and ziprasidone in patients with first-episode schizophrenia in China. METHODS Subjects were recruited from outpatient and 254 patients entered the trial. These patients received treatment randomly with paliperidone ER, aripiprazole and ziprasidone and were assessed at baseline, 13, 26 and 52 weeks, respectively with Positive and Negative Syndrome Scale (PANSS), 7-item Clinical Global Impressions-Severity (CGI-S), anthropometric (weight, body mass index and waist circumference) and metabolic (fasting blood glucose, HbA1c, cholesterol, high density lipoproteins (HDL), low density lipoproteins and triglycerides) measures. RESULTS A total of 203 patients completed the trial. Paliperidone group had significant greater reduction in PANSS than aripiprazole group and ziprasidone group from 13 weeks, although the a reduction in PANSS of each group was more than 20%. There was no difference in CGI-S among the three groups, and all three groups had a significant reduction from baseline in CGI-S. Aripiprazole group increased in weight and body mass index despite no statistical change in waist circumference. Other two groups showed no changes in anthropometric measure. At the end of the study, two glucose metabolic indices (fasting blood glucose and HbA1c) of aripiprazole group were significantly higher than that of baseline. In lipid metabolism, aripiprazole group reduced triglycerides significantly and had no changes in other indices. Paliperidone group reduced HDL and increased triglycerides despite no changes in glucose metabolism. Ziprasidone group also had no significant changes in glucose metabolism, but reduced cholesterol, low density lipoproteins and increased HDL. Furthermore, 22 subjects in three groups reached the diagnostic criteria of metabolic syndrome. CONCLUSIONS Paliperidone ER, aripiprazole and ziprasidone are effective in treating first-episode schizophrenia, and the ranking of efficacy from high to low is paliperidone ER > aripiprazole > ziprasidone. Paliperidone ER can impair lipid metabolism potentially but had no influence on glucose metabolism. Aripiprazole can damage glucose metabolism and has little influence on lipid metabolism. Ziprasidone is considered an atypical antipsychotic with no evidence of harm to glucose and lipid metabolism.
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6.
Roux-en-Y gastric bypass versus a variant of biliopancreatic diversion in a non-superobese population: prospective comparison of the efficacy and the incidence of metabolic deficiencies.
Skroubis, G, Anesidis, S, Kehagias, I, Mead, N, Vagenas, K, Kalfarentzos, F
Obesity surgery. 2006;(4):488-95
Abstract
BACKGROUND In the non-superobese population, an agreement has not been made as to the optimal bariatric operation. The present study reports the results of a prospective comparison of Roux-en-Y gastric bypass (RYGBP) and a variant of biliopancreatic diversion (BPD) in a non-superobese population. METHODS From a cohort of 130 patients with BMI 35 to 50 kg/m(2), 65 patients were randomly selected to undergo RYGBP and 65 to undergo BPD. All patients underwent complete follow-up evaluation at 1, 3, 6, and 12 months postoperatively and every year thereafter. RESULTS Patients in both groups have completed their second postoperative year. Mean % excess weight loss (%EWL) was significantly better after BPD at all time periods (12 months, P=0.0001 and 24 months, P=0.0003), and the %EWL was >50% in all BPD patients compared to 88.7% in the RYGBP patients at 2-year follow-up. No statistically significant differences were observed between the 2 groups in early and late non-metabolic complications. Hypoalbuminemia occurred in only 1 patient (1.5%) after RYGBP and in 6 patients after BPD (9.2%). Only 1 patient from each group was hospitalized and received total parenteral nutrition. Glucose intolerance, hypercholesterolemia, hypertriglyceridemia and sleep apnea completely resolved in all patients in both groups, although mean total cholesterol level was significantly lower in BPD patients at the second year follow-up (t-test, P<0.0001). Diabetes completely resolved in all BPD patients and in 7 of the 10 diabetic RYGBP patients. CONCLUSION Both RYGBP and BPD were safe and effective procedures when offered to non-superobese patients. Weight loss after BPD was consistently better than that after RYGBP, as was the resolution of diabetes and hypercholesterolemia. Because the nutritional deficiencies that occurred following this type of BPD were not severe and were not significantly different between the 2 operations, both may be offered to non-superobese patients, keeping in mind the severity and type of preoperative co-morbidities as well as the desired weight loss.