Pub Date : 2015-06-30DOI: 10.4172/2165-7904.1000268
Atif Abd-Elatif, T. Youssef, Mokhtar Farid, Y. Ali, Walid Gado
Background: A reduction of body weight can be achieved after Biliopancreatic diversion, but there is a risk ofmalnutritionanddiarrhea. This risk may be reduced by pyloric preservation with duodenalswitch. Loop duodenal switch (Single anastomosis duodeno-ileal bypass with sleeve gastrectomy=SADI-S) is hybrid operation combining moderate intake restriction with moderate malabsorption for treatment of morbid obesity. It is considered a modified version of the original duodenal switch operation in which after the sleeve gastrectomy, the duodenum is anastomosed in end to side, ante colic and isoperistaltic manner to the selected ileal loop with a length of 2 meters from ileocacal valve. Objective: To evaluate the nutritional outcomes as well as to determine weight loss success of Loop duodenal switch Procedure as surgical treatment for morbid obesity on a series of 37 consecutively operated patients in Endocrine surgery Unit, Mansoura University hospital, Mansoura University, Mansoura, Egypt. Patients and methods: A prospective study conducted during the period from July 2010 to January 2013. The mean age was 35.37 ± 7.78years. The mean BMI was 56.25 ± 8.43 kg/m². All patients were subjected to Loop Duodenal Switch after preoperative preparation and laboratory investigations including: Haemoglobin, serum iron, serum ferritin, serum vitamin B12, serum folic acid, serum albumen, serum calcium, serum magnesium, serum phosphorus, serum alkaline phosphatase, serum cupper, serum zinc, serum sodium, serum potassium, serum albumen, Aspartate Aminotransferase (AST), Alanine Transaminase (ALT) and serum bilirubin were followed up over 1 year. Results: Most of the patients had smooth postoperative course with no major morbidity and single mortality. The BMI decreased significantly, from: 56.52 ± 8.47, to 33.21 ± 3.91, with decrease of the amount of food ingested. Both hemoglobin and calcium in Loop DS readilyreturned to within the reference range followingsupplementation with iron and calcium respectively. The mean serum iron,serum ferritin, serum vitamin B12, serum folic acid, , serum calcium, serum magnesium, serum phosphorus,serum Alkaline phosphatase,serum cupper, serum zinc, serum sodium, serum potassium, serum albumen, Aspartate Aminotransferase (AST), Alanine Transaminase (ALT) and serum bilirubinremained within the normal range with no significant nutritional deficiency. Conclusion: LoopDS is not associated with broad nutritional deficiencies and does not appear to pose a threat to nutritional status. It provides excellent weight loss with preservation of good alimentation, even in the super obese. Postoperative supplementation with iron, multivitamins, calcium and vitamin D may be required continuously to prevent nutritional deficiency especially for adults and females in the Child bearing period.
{"title":"Nutritional markers after loop duodenal switch (SADI-S) for morbid obesity: a technique with favorable nutritional outcome.","authors":"Atif Abd-Elatif, T. Youssef, Mokhtar Farid, Y. Ali, Walid Gado","doi":"10.4172/2165-7904.1000268","DOIUrl":"https://doi.org/10.4172/2165-7904.1000268","url":null,"abstract":"Background: A reduction of body weight can be achieved after Biliopancreatic diversion, but there is a risk ofmalnutritionanddiarrhea. This risk may be reduced by pyloric preservation with duodenalswitch. Loop duodenal switch (Single anastomosis duodeno-ileal bypass with sleeve gastrectomy=SADI-S) is hybrid operation combining moderate intake restriction with moderate malabsorption for treatment of morbid obesity. It is considered a modified version of the original duodenal switch operation in which after the sleeve gastrectomy, the duodenum is anastomosed in end to side, ante colic and isoperistaltic manner to the selected ileal loop with a length of 2 meters from ileocacal valve. Objective: To evaluate the nutritional outcomes as well as to determine weight loss success of Loop duodenal switch Procedure as surgical treatment for morbid obesity on a series of 37 consecutively operated patients in Endocrine surgery Unit, Mansoura University hospital, Mansoura University, Mansoura, Egypt. Patients and methods: A prospective study conducted during the period from July 2010 to January 2013. The mean age was 35.37 ± 7.78years. The mean BMI was 56.25 ± 8.43 kg/m². All patients were subjected to Loop Duodenal Switch after preoperative preparation and laboratory investigations including: Haemoglobin, serum iron, serum ferritin, serum vitamin B12, serum folic acid, serum albumen, serum calcium, serum magnesium, serum phosphorus, serum alkaline phosphatase, serum cupper, serum zinc, serum sodium, serum potassium, serum albumen, Aspartate Aminotransferase (AST), Alanine Transaminase (ALT) and serum bilirubin were followed up over 1 year. Results: Most of the patients had smooth postoperative course with no major morbidity and single mortality. The BMI decreased significantly, from: 56.52 ± 8.47, to 33.21 ± 3.91, with decrease of the amount of food ingested. Both hemoglobin and calcium in Loop DS readilyreturned to within the reference range followingsupplementation with iron and calcium respectively. The mean serum iron,serum ferritin, serum vitamin B12, serum folic acid, , serum calcium, serum magnesium, serum phosphorus,serum Alkaline phosphatase,serum cupper, serum zinc, serum sodium, serum potassium, serum albumen, Aspartate Aminotransferase (AST), Alanine Transaminase (ALT) and serum bilirubinremained within the normal range with no significant nutritional deficiency. Conclusion: LoopDS is not associated with broad nutritional deficiencies and does not appear to pose a threat to nutritional status. It provides excellent weight loss with preservation of good alimentation, even in the super obese. Postoperative supplementation with iron, multivitamins, calcium and vitamin D may be required continuously to prevent nutritional deficiency especially for adults and females in the Child bearing period.","PeriodicalId":243288,"journal":{"name":"Journal of obesity and weight loss therapy","volume":"408 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126688168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-06-30DOI: 10.4172/2165-7904.1000267
Monica Sethi, H. Youn, C. Ren-Fielding, H. Lofton
Objective: To determine the effectiveness of a 6 month intensive medical intervention (IMI) with caloric restriction and high-protein meal replacements versus a conventional carbohydrate-restricted (CCR) diet. Methods: This is an observational study designed to determine weight outcomes at 6, 12, 18 and 24 months after completing the IMI or CCR treatment. Patients were also required to participate in at least 5 miles of walking and 240 minutes of overall exercise per week. The primary outcome was percent body weight loss (BWL). Results: A total of 604 patients with obesity or overweight were studied. Sixty-seven percent were in the IMI group, versus 33% in the CCR group. Initial BMI was similar in both groups (36.4 kg/m2 (SD=7.7) vs. 36.0 kg/m2 (SD=7.8), p=0.608). At 6 months, the IMI group had superior body weight loss (11.9% (SD=7.4) vs. 6.0% (SD=6.1), p<0.0001). However, the IMI group had greater weight regain than the CCR group, resulting in similar weight loss at two years (7.1% (SD=10.2) vs. 8.1% (SD=6.3), p=0.735). An adjusted analysis of outcomes averaged across 2 years demonstrated 2.8% greater BWL among the IMI group. Blood pressure significantly improved in both groups (p<0.001). Males (OR=1.77, 95% CI=(1.10,2.84), p=0.019) and patients with BMI ≥ 35 kg/m2 (OR=3.32, 95% CI=(1.95, 5.65), p<0.0001) were more likely to achieve weight loss success with the IMI. Conclusion: An Intensive Medical Intervention (IMI) characterized by high-protein meal replacements and caloric restriction can be highly effective in reducing body weight, even at two years post-intervention. This type of intervention should be strongly considered among obese patients who do not qualify for bariatric surgery, those with contraindications to weight loss medications, or those in need of weight loss prior to a medical procedure.
目的:确定为期6个月的强化医疗干预(IMI)与热量限制和高蛋白膳食替代相比于传统碳水化合物限制(CCR)饮食的有效性。方法:这是一项观察性研究，旨在确定完成IMI或CCR治疗后6、12、18和24个月的体重结果。患者还被要求参加每周至少5英里的步行和240分钟的整体运动。主要终点是体重减轻百分比(BWL)。结果:共研究了604例肥胖或超重患者。IMI组为67%，CCR组为33%。两组的初始BMI相似(36.4 kg/m2 (SD=7.7) vs. 36.0 kg/m2 (SD=7.8)， p=0.608)。在6个月时，IMI组的体重减轻更明显(11.9% (SD=7.4) vs. 6.0% (SD=6.1)， p<0.0001)。然而，IMI组的体重恢复高于CCR组，两年后体重下降相似(7.1% (SD=10.2) vs. 8.1% (SD=6.3)， p=0.735)。对2年平均结果的调整分析显示，IMI组的体重比对照组高2.8%。两组患者血压均显著改善(p<0.001)。男性(OR=1.77, 95% CI=(1.10,2.84)， p=0.019)和BMI≥35 kg/m2的患者(OR=3.32, 95% CI=(1.95, 5.65)， p<0.0001)更有可能通过IMI减肥成功。结论:以高蛋白膳食替代和热量限制为特征的强化医疗干预(IMI)在减轻体重方面非常有效，即使在干预后两年。对于不符合减肥手术条件的肥胖患者、有减肥药禁忌症的患者或在医疗手术前需要减肥的患者，应强烈考虑这种干预措施。
{"title":"Clinical efficacy of a medically supervised low-calorie diet program versus a conventional carbohydrate-restricted diet.","authors":"Monica Sethi, H. Youn, C. Ren-Fielding, H. Lofton","doi":"10.4172/2165-7904.1000267","DOIUrl":"https://doi.org/10.4172/2165-7904.1000267","url":null,"abstract":"Objective: To determine the effectiveness of a 6 month intensive medical intervention (IMI) with caloric restriction and high-protein meal replacements versus a conventional carbohydrate-restricted (CCR) diet. Methods: This is an observational study designed to determine weight outcomes at 6, 12, 18 and 24 months after completing the IMI or CCR treatment. Patients were also required to participate in at least 5 miles of walking and 240 minutes of overall exercise per week. The primary outcome was percent body weight loss (BWL). Results: A total of 604 patients with obesity or overweight were studied. Sixty-seven percent were in the IMI group, versus 33% in the CCR group. Initial BMI was similar in both groups (36.4 kg/m2 (SD=7.7) vs. 36.0 kg/m2 (SD=7.8), p=0.608). At 6 months, the IMI group had superior body weight loss (11.9% (SD=7.4) vs. 6.0% (SD=6.1), p<0.0001). However, the IMI group had greater weight regain than the CCR group, resulting in similar weight loss at two years (7.1% (SD=10.2) vs. 8.1% (SD=6.3), p=0.735). An adjusted analysis of outcomes averaged across 2 years demonstrated 2.8% greater BWL among the IMI group. Blood pressure significantly improved in both groups (p<0.001). Males (OR=1.77, 95% CI=(1.10,2.84), p=0.019) and patients with BMI ≥ 35 kg/m2 (OR=3.32, 95% CI=(1.95, 5.65), p<0.0001) were more likely to achieve weight loss success with the IMI. Conclusion: An Intensive Medical Intervention (IMI) characterized by high-protein meal replacements and caloric restriction can be highly effective in reducing body weight, even at two years post-intervention. This type of intervention should be strongly considered among obese patients who do not qualify for bariatric surgery, those with contraindications to weight loss medications, or those in need of weight loss prior to a medical procedure.","PeriodicalId":243288,"journal":{"name":"Journal of obesity and weight loss therapy","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133550113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-06-30DOI: 10.4172/2165-7904.1000266
Katharina Möller, J. Willers, A. Hahn
Background: While formula diets as meal replacements are evident for weight loss, the macronutrient composition is still in the focus of interest. This study was designed to determine effects of a carbohydrate-riched meal replacement on weight loss and waist circumferences (WC) in comparison with a protein-riched meal replacement. Methods: Two groups (high carbohydrate formula diet (HC) and high protein formula diet (HP)) of 80 matched subjects each underwent a randomized parallel intervention trial for eight weeks followed by a 12-week follow-up. The intervention consisted of three phases: (1) week 1 and 2: total replacement of three meals, (2) week 3 and 4: replacement of two meals and (3) week 5 to 8: replacement of one meal. Measurements were taken at week 0, 2, 8, and 20. Results: After two weeks of total meal replacement, there was a significant (p<0.001) weight loss in both groups (HC: -4.0 ± 4.7 kg vs. HP: -4.3 ± 1.8 kg). After eight weeks, 66.2% of all subjects achieved a weight loss of 5% and more (HC: -8.5 ± 2.5%, p<0.001 vs. HP: -8.8 ± 2.8%, p<0.001), and 18.2% of the participants lost more than 10% of their initial body weight. Waist circumferences decreased from 105.9 ± 9.7 cm to 97.4 ± 8.4 cm (p<0.001) after eight weeks. During the follow up, further weight loss was observed in both groups. There were no significant differences between the HC and HP-group regarding changes in weight and WC. Conclusion: Both dietary intervention strategies had a similar effect on weight loss and WC reduction. In this short-term study macronutrient compositions of meal replacements are not crucial for the efficacy of formula diets. Trial registration: German Clinical Trials Register DRKS00005481.
背景:虽然配方饮食作为膳食替代品对减肥有明显的作用，但大量营养成分仍然是人们关注的焦点。本研究旨在确定富含碳水化合物的代餐与富含蛋白质的代餐相比对减肥和腰围(WC)的影响。方法:高碳水化合物配方饮食(HC)和高蛋白配方饮食(HP)两组80名匹配的受试者，分别进行8周的随机平行干预试验和12周的随访。干预包括三个阶段:(1)第1周和第2周:完全替换三餐，(2)第3周和第4周:替换两餐，(3)第5至8周:替换一餐。分别于第0、2、8和20周进行测量。结果:全代餐两周后，两组患者体重均有显著下降(p<0.001) (HC: -4.0±4.7 kg vs HP: -4.3±1.8 kg)。8周后，66.2%的受试者体重减轻5%以上(HC: -8.5±2.5%，p<0.001, HP: -8.8±2.8%，p<0.001)， 18.2%的受试者体重减轻超过其初始体重的10%。8周后腰围由105.9±9.7 cm降至97.4±8.4 cm (p<0.001)。在随访期间，两组患者的体重都进一步下降。HC组和hp组在体重和腰围变化方面无显著差异。结论:两种饮食干预策略在减肥和减少腰围方面具有相似的效果。在这项短期研究中，代餐的大量营养素组成对配方日粮的功效并不重要。试验注册:德国临床试验注册中心DRKS00005481。
{"title":"Efficacy of High Carbohydrate versus High Protein Meal Replacements onWeight Reduction - A Randomized Controlled Trial","authors":"Katharina Möller, J. Willers, A. Hahn","doi":"10.4172/2165-7904.1000266","DOIUrl":"https://doi.org/10.4172/2165-7904.1000266","url":null,"abstract":"Background: While formula diets as meal replacements are evident for weight loss, the macronutrient composition is still in the focus of interest. This study was designed to determine effects of a carbohydrate-riched meal replacement on weight loss and waist circumferences (WC) in comparison with a protein-riched meal replacement. Methods: Two groups (high carbohydrate formula diet (HC) and high protein formula diet (HP)) of 80 matched subjects each underwent a randomized parallel intervention trial for eight weeks followed by a 12-week follow-up. The intervention consisted of three phases: (1) week 1 and 2: total replacement of three meals, (2) week 3 and 4: replacement of two meals and (3) week 5 to 8: replacement of one meal. Measurements were taken at week 0, 2, 8, and 20. Results: After two weeks of total meal replacement, there was a significant (p<0.001) weight loss in both groups (HC: -4.0 ± 4.7 kg vs. HP: -4.3 ± 1.8 kg). After eight weeks, 66.2% of all subjects achieved a weight loss of 5% and more (HC: -8.5 ± 2.5%, p<0.001 vs. HP: -8.8 ± 2.8%, p<0.001), and 18.2% of the participants lost more than 10% of their initial body weight. Waist circumferences decreased from 105.9 ± 9.7 cm to 97.4 ± 8.4 cm (p<0.001) after eight weeks. During the follow up, further weight loss was observed in both groups. There were no significant differences between the HC and HP-group regarding changes in weight and WC. Conclusion: Both dietary intervention strategies had a similar effect on weight loss and WC reduction. In this short-term study macronutrient compositions of meal replacements are not crucial for the efficacy of formula diets. Trial registration: German Clinical Trials Register DRKS00005481.","PeriodicalId":243288,"journal":{"name":"Journal of obesity and weight loss therapy","volume":"81 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122078656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-06-05DOI: 10.4172/2165-7904.1000263
Mohammad Mahdi Tavana, Taha Yegani, S. Hajiaghajani
Context: Orlistat is one of the few anti-obesity drugs that have been approved by FDA. It reduces the lipid absorption by 30% in its therapeutic dose by means of reversible inhibition of gastrointestinal lipases. Objective: Since vitamin K (a lipid soluble vitamin) is important in the synthesis of factors 2, 7, 9 and 10 of the coagulation cascade, we hypothesized that reduction in lipid absorption can cause vitamin K malabsorption and thus coagulation dysfunction. Subject: 18 Wistar rats divided in three groups. For the purpose of testing our hypothesis, we decided to give Orlistat to Wistar rats (in the form of solution in alcohol), for one week, one month and three months. Thus we made three groups including Control 1 group which only used water, Control 2 group which used water and alcohol and control 3 groups which used water, alcohol and Orlistat as its drink. After measuring PT and PTT of each rat, we used one way analysis of variants for the analysis of the results. Results: PT and PTT didn’t follow a predictable pattern through each series of experiments and therefore comparison wasn’t possible between different series of experiments. However, in every three series, both PT and PTT increased as a result of Orlistat consumption and the significancy of difference between control 2 and case group increased as the time of experiments got longer. This mentioned significancy was 0.905, 0.820 and 0.495 for PT, and 0.888, 0.734 and 0.538 for PTT during one week, one month and three months experiment, respectively. Conclusion: Our results showed that Orlistat didn’t have a significant effect on neither PT nor on PTT in the duration of our research (<3 months). However, it can be predicted that longer times of Orlistat consumption may lead to significant effects on PT and PTT.
{"title":"Effect of Orlistat on Prothrombin Time (PT) and Partial Thromboplastin Time (PTT) in Wistar Rats","authors":"Mohammad Mahdi Tavana, Taha Yegani, S. Hajiaghajani","doi":"10.4172/2165-7904.1000263","DOIUrl":"https://doi.org/10.4172/2165-7904.1000263","url":null,"abstract":"Context: Orlistat is one of the few anti-obesity drugs that have been approved by FDA. It reduces the lipid absorption by 30% in its therapeutic dose by means of reversible inhibition of gastrointestinal lipases. Objective: Since vitamin K (a lipid soluble vitamin) is important in the synthesis of factors 2, 7, 9 and 10 of the coagulation cascade, we hypothesized that reduction in lipid absorption can cause vitamin K malabsorption and thus coagulation dysfunction. Subject: 18 Wistar rats divided in three groups. For the purpose of testing our hypothesis, we decided to give Orlistat to Wistar rats (in the form of solution in alcohol), for one week, one month and three months. Thus we made three groups including Control 1 group which only used water, Control 2 group which used water and alcohol and control 3 groups which used water, alcohol and Orlistat as its drink. After measuring PT and PTT of each rat, we used one way analysis of variants for the analysis of the results. Results: PT and PTT didn’t follow a predictable pattern through each series of experiments and therefore comparison wasn’t possible between different series of experiments. However, in every three series, both PT and PTT increased as a result of Orlistat consumption and the significancy of difference between control 2 and case group increased as the time of experiments got longer. This mentioned significancy was 0.905, 0.820 and 0.495 for PT, and 0.888, 0.734 and 0.538 for PTT during one week, one month and three months experiment, respectively. Conclusion: Our results showed that Orlistat didn’t have a significant effect on neither PT nor on PTT in the duration of our research (<3 months). However, it can be predicted that longer times of Orlistat consumption may lead to significant effects on PT and PTT.","PeriodicalId":243288,"journal":{"name":"Journal of obesity and weight loss therapy","volume":"65 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124437785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-06-05DOI: 10.4172/2165-7904.1000262
K. Ireland, A. Manders, B. Corkey, C. Lenders
Introduction: To describe recruitment difficulties in a pediatric clinical trial targeting underserved pediatric obese populations. Methods: We planned a 6-month randomized, double-blind, placebo-controlled clinical trial of glutamine vs. placebo, to reduce HOMA_IR and weight gain in obese adolescents. Participation required 5 visits at a research center at 8:00 AM. Cash incentives were provided at visits. After recruitment difficulties, study design was modified and recruitment efforts were intensified over a 14-week period. Subjects were recruited from Boston Medical Center’s (BMC) pediatric outpatient clinics including the pediatric obesity program (NFL) which was staffed by members of the research team. Results: 2002 adolescents were evaluated: 546 met BMI and age criteria. After further exclusions, 179 were eligible for a screening visit but only 4 attended. Additionally, 120 recruitment letters were sent to NFL patients, resulting in 4 attending a screening visit. Seven of the 8 adolescents attending a screening visit were from NFL, and 2 were randomized but subsequently lost to follow-up. Discussion: Recruitment of pediatric patients from low-income and minority populations at BMC to a clinical trial is difficult. Challenges included strict inclusion/exclusion criteria and rigid appointment schedules. Existing patientclinician relationships may increase recruitment. Future trials should use more flexible study designs.
{"title":"Recruitment in a Pediatric Clinical Research Trial Targeting UnderservedPopulations: Efforts and Challenges","authors":"K. Ireland, A. Manders, B. Corkey, C. Lenders","doi":"10.4172/2165-7904.1000262","DOIUrl":"https://doi.org/10.4172/2165-7904.1000262","url":null,"abstract":"Introduction: To describe recruitment difficulties in a pediatric clinical trial targeting underserved pediatric obese populations. Methods: We planned a 6-month randomized, double-blind, placebo-controlled clinical trial of glutamine vs. placebo, to reduce HOMA_IR and weight gain in obese adolescents. Participation required 5 visits at a research center at 8:00 AM. Cash incentives were provided at visits. After recruitment difficulties, study design was modified and recruitment efforts were intensified over a 14-week period. Subjects were recruited from Boston Medical Center’s (BMC) pediatric outpatient clinics including the pediatric obesity program (NFL) which was staffed by members of the research team. Results: 2002 adolescents were evaluated: 546 met BMI and age criteria. After further exclusions, 179 were eligible for a screening visit but only 4 attended. Additionally, 120 recruitment letters were sent to NFL patients, resulting in 4 attending a screening visit. Seven of the 8 adolescents attending a screening visit were from NFL, and 2 were randomized but subsequently lost to follow-up. Discussion: Recruitment of pediatric patients from low-income and minority populations at BMC to a clinical trial is difficult. Challenges included strict inclusion/exclusion criteria and rigid appointment schedules. Existing patientclinician relationships may increase recruitment. Future trials should use more flexible study designs.","PeriodicalId":243288,"journal":{"name":"Journal of obesity and weight loss therapy","volume":"301 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116263753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-06-05DOI: 10.4172/2165-7904.1000265
A. Solmaz, O. Karagülle, O. B. Gülçiçek, C. Erçetin, E. Yavuz, H. Yiğitbaş, E. Sevim, A. Çelik, F. Çelebi, Rıza Kutaniş
Introduction: Management of obesity is difficult problem for doctors and patients. There are many methods for dealing with obesity. Intragastric Balloon (IB) is interventional and nonsurgical way of promoting weight loss in obese patients. Laparoscopic Gastric Plication (LGP) is most physiologic surgical method of bariatric surgery. This study aimed to evaluate and compare these two restrictive methods. Methods: Ninety-five obese patients (34 male and 61 female) included in this study. We compared patients treated with IB (n=52) and LGP (n=43). Data on patient demography, change in Body Mass Index (BMI) and %excess weight loss (%EWL) of 1st and 6th months were collected. Results: The study had started with 69 patients for IB group, but 4 (5.7%) of them did not tolerate the insertion and 13 had removed the balloon early after insertion (n=13 (20%)) were excluded from the study. There were 52 patients left in IB group and 43 patients in plication group. There were no statistically difference between IB and plication groups in terms of age (p=0.132), sex (p=0.262) and BMI (p=0.081). Change in total body weight (TBW), BMI and %excessive weight loss (EWL) parameters were statistically different in favor of the plication group. Conclusion: Our clinical experience has suggested that LGP and IB are effective in loss of weight in obese patients in short term. IB has an advantage of being done outpatient and has fewer complications, but it is less effective on weight loss compared to LGP. Prospective, randomized control trials are needed to choose best way.
{"title":"Comparison of Short-Term Results of Laparoscopic Gastric Plication and Intragastric Balloon","authors":"A. Solmaz, O. Karagülle, O. B. Gülçiçek, C. Erçetin, E. Yavuz, H. Yiğitbaş, E. Sevim, A. Çelik, F. Çelebi, Rıza Kutaniş","doi":"10.4172/2165-7904.1000265","DOIUrl":"https://doi.org/10.4172/2165-7904.1000265","url":null,"abstract":"Introduction: Management of obesity is difficult problem for doctors and patients. There are many methods for dealing with obesity. Intragastric Balloon (IB) is interventional and nonsurgical way of promoting weight loss in obese patients. Laparoscopic Gastric Plication (LGP) is most physiologic surgical method of bariatric surgery. This study aimed to evaluate and compare these two restrictive methods. Methods: Ninety-five obese patients (34 male and 61 female) included in this study. We compared patients treated with IB (n=52) and LGP (n=43). Data on patient demography, change in Body Mass Index (BMI) and %excess weight loss (%EWL) of 1st and 6th months were collected. Results: The study had started with 69 patients for IB group, but 4 (5.7%) of them did not tolerate the insertion and 13 had removed the balloon early after insertion (n=13 (20%)) were excluded from the study. There were 52 patients left in IB group and 43 patients in plication group. There were no statistically difference between IB and plication groups in terms of age (p=0.132), sex (p=0.262) and BMI (p=0.081). Change in total body weight (TBW), BMI and %excessive weight loss (EWL) parameters were statistically different in favor of the plication group. Conclusion: Our clinical experience has suggested that LGP and IB are effective in loss of weight in obese patients in short term. IB has an advantage of being done outpatient and has fewer complications, but it is less effective on weight loss compared to LGP. Prospective, randomized control trials are needed to choose best way.","PeriodicalId":243288,"journal":{"name":"Journal of obesity and weight loss therapy","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124451528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-06-05DOI: 10.4172/2165-7904.1000264
L. Souza, L. Quadros, R. L. K. Junior, J. Campos, I. Filho, F. Coimbra, Rodrigo Silvestre, Mário Flamini Júnior
About 40% of the population is overweight. It is estimated that there are about 80,000 deaths per year in Brazil for reasons arising from obesity. Bariatric surgery has been the most effective method for the treatment and prevention of complications caused by morbid obesity. The gastric bypass has shown good short term results in significant reduction of body weight. However, in the long run about 10 to 20% of patients tend to weight regained. This number seems to be relatively low; the reality is significantly higher when surgery is not accompanied by a long-term change in lifestyle. Thus, it was hypothesized that by applying argon plasma on the anastomosis, the weight regained is avoided. The aim of this work was to study the effect of argon plasma fulguration in the weight regained in patients undergoing gastric bypass. Of the 37 patients who underwent gastric bypass 24(75%) were female and 8(25%) were male. Considering the gastric bypass, the mean preoperative weight was 117.61 Kg. After the average weight surgery was 79.94 Kg. The mean difference of pre and post-operative weight was 37.66 kg, the difference being significant (p<0.0001). Regarding the use of argon, the average pre intervention weight was 94.52. The average difference pre and post intervention was 5.87 kg, with statistically significant (p<0.0001). There was a significant correlation between use of the ring and smaller diameter of the anastomosis at the third session (p=0.019). The average size of the pouch was 5. There was no statistical correlation between size of the pouch and efficacy of argon use. It was concluded that after application of argon was no significant reduction in the average weight of the patients, about 50% of patients, especially female.
{"title":"Argon Plasma Effect about Anastomosis was Significant to Inhibit the Weight Regained in Patients Undergoing Gastric Bypass","authors":"L. Souza, L. Quadros, R. L. K. Junior, J. Campos, I. Filho, F. Coimbra, Rodrigo Silvestre, Mário Flamini Júnior","doi":"10.4172/2165-7904.1000264","DOIUrl":"https://doi.org/10.4172/2165-7904.1000264","url":null,"abstract":"About 40% of the population is overweight. It is estimated that there are about 80,000 deaths per year in Brazil for reasons arising from obesity. Bariatric surgery has been the most effective method for the treatment and prevention of complications caused by morbid obesity. The gastric bypass has shown good short term results in significant reduction of body weight. However, in the long run about 10 to 20% of patients tend to weight regained. This number seems to be relatively low; the reality is significantly higher when surgery is not accompanied by a long-term change in lifestyle. Thus, it was hypothesized that by applying argon plasma on the anastomosis, the weight regained is avoided. The aim of this work was to study the effect of argon plasma fulguration in the weight regained in patients undergoing gastric bypass. Of the 37 patients who underwent gastric bypass 24(75%) were female and 8(25%) were male. Considering the gastric bypass, the mean preoperative weight was 117.61 Kg. After the average weight surgery was 79.94 Kg. The mean difference of pre and post-operative weight was 37.66 kg, the difference being significant (p<0.0001). Regarding the use of argon, the average pre intervention weight was 94.52. The average difference pre and post intervention was 5.87 kg, with statistically significant (p<0.0001). There was a significant correlation between use of the ring and smaller diameter of the anastomosis at the third session (p=0.019). The average size of the pouch was 5. There was no statistical correlation between size of the pouch and efficacy of argon use. It was concluded that after application of argon was no significant reduction in the average weight of the patients, about 50% of patients, especially female.","PeriodicalId":243288,"journal":{"name":"Journal of obesity and weight loss therapy","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125507154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-04-30DOI: 10.4172/2165-7904.1000260
M. Wasim, N. Fakhar
Congenital leptin deficiency is a rare autosomal recessive disorder, characterized by hyperphagia and early onset obesity. Worldwide data on this disorder includes only 25 cases out of this only six pathogenic mutations have been reported in the leptin gene. Most of these cases have been reported in Central Punjab region of Pakistan, harboring a (p.Gly133fsX145) mutation in homozygous state. This mutation has founder effect in Arain caste from Central Punjab region of Pakistan. In this study, carrier frequency of (p.Gly133fsX145) mutation was determined in 50 individuals belonging to Arain caste. Analysis of amplicons contains p.Gly133fsX145 mutation were analyzed by different techniques such as SSCP, Heteroduplex analysis and sequencing. Mutation was not found in any individual studied. This finding suggests that frequency of (p.Gly133fsX145) mutation in Arain caste is not as higher as its predicted founder effect in congenitally obese children of this caste was anticipated.
{"title":"Carrier Frequency of Congenital Leptin Deficiency in Central Punjab Region of Pakistan","authors":"M. Wasim, N. Fakhar","doi":"10.4172/2165-7904.1000260","DOIUrl":"https://doi.org/10.4172/2165-7904.1000260","url":null,"abstract":"Congenital leptin deficiency is a rare autosomal recessive disorder, characterized by hyperphagia and early onset obesity. Worldwide data on this disorder includes only 25 cases out of this only six pathogenic mutations have been reported in the leptin gene. Most of these cases have been reported in Central Punjab region of Pakistan, harboring a (p.Gly133fsX145) mutation in homozygous state. This mutation has founder effect in Arain caste from Central Punjab region of Pakistan. In this study, carrier frequency of (p.Gly133fsX145) mutation was determined in 50 individuals belonging to Arain caste. Analysis of amplicons contains p.Gly133fsX145 mutation were analyzed by different techniques such as SSCP, Heteroduplex analysis and sequencing. Mutation was not found in any individual studied. This finding suggests that frequency of (p.Gly133fsX145) mutation in Arain caste is not as higher as its predicted founder effect in congenitally obese children of this caste was anticipated.","PeriodicalId":243288,"journal":{"name":"Journal of obesity and weight loss therapy","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131476560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-04-30DOI: 10.4172/2165-7904.1000258
M. Wasim
Obesity has been the problem in the societies of developing and developed world. Some diseases caused by obesity. To overcome of those diseases it is necessary to control obesity. Most of the articles showed that the Leptin may be a vital tool to fight against obesity because it is the anti-obesity hormone. By using leptin therapy may be possible to prevent obesity and diseases like hypertension and diabetes mellitus before their occurrence.
{"title":"Role of Leptin in Obesity","authors":"M. Wasim","doi":"10.4172/2165-7904.1000258","DOIUrl":"https://doi.org/10.4172/2165-7904.1000258","url":null,"abstract":"Obesity has been the problem in the societies of developing and developed world. Some diseases caused by obesity. To overcome of those diseases it is necessary to control obesity. Most of the articles showed that the Leptin may be a vital tool to fight against obesity because it is the anti-obesity hormone. By using leptin therapy may be possible to prevent obesity and diseases like hypertension and diabetes mellitus before their occurrence.","PeriodicalId":243288,"journal":{"name":"Journal of obesity and weight loss therapy","volume":"54 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125910440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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