Diseases of the Peripheral Nerve and Mononeuropathies
Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw in Hankey's Clinical Neurology, 2020
Decreased intake or abnormal absorption: Poor nutrition in alcoholism.Chronic vomiting (e.g. hyperemesis gravidarum).Total parental nutrition.Gastric bypass surgery.Restrictive diets.Hyperthyroidism: increased metabolism and utilization of thiamine may result in a relative deficiency.
Surgical Treatments of Obesity
Ruth Chambers, Paula Stather in Tackling Obesity and Overweight Matters in Health and Social Care, 2022
Laparoscopic Roux-en-Y gastric bypass (LRYGB): this procedure has been in practice for over 58 years and has stood the test of time—hence, some people refer to it as the ‘gold standard’. In the United States and Europe, gastric bypass surgery is widely used as a first-line procedure in obesity surgery. A 25–30-ml segment of the proximal stomach is isolated from the rest of the stomach and is anastomosed to the proximal jejunum, bypassing most of the stomach and the entire duodenum. This restricts food intake in the same way as gastroplasty does, as well as inducing a degree of malabsorption. This double action is what makes gastric bypass surgery so effective in inducing and maintaining long-term weight loss. Gastric bypass surgery is a bigger and more technically demanding operation than gastroplasty, and malabsorption of iron, folate and vitamin B12 can occur post-operatively, requiring supplements and careful monitoring for life. The excess weight loss of >50% is maintained at five years in most patients, and this can be sustained at ten years, too.
Weight Management in Patients with Type 2 Diabetes Mellitus
Jack L. Leahy, Nathaniel G. Clark, William T. Cefalu in Medical Management of Diabetes Mellitus, 2000
The very low caloric diet (VLCD) programs were popular in the 1980s, but fears over an association with increased cardiovascular death resulted in a dramatic decrease in use. However, there remains a role for a drastically reduced caloric intake in selected patients. Suggested circumstances include Hospitalized patients with massive obesity complicated by cardiovascular or respiratory failure who are in urgent need of decreased body weight to improve oxygenation and diminish fluid retention.In preparation for gastric bypass surgery in patients with a high surgical risk related to the massive obesity.For short periods in selected persons with type 2 diabetes to render them more responsive to oral hypoglycemic agents or insulin therapy. Moreover, a VLCD program can be repeated without diminution of its effectiveness so that some patients achieve and maintain their target glycemic control through periodic, limited periods of VLCD.
Effect of parathyroidectomy on osteopontin and undercarboxylated osteocalcin in patients with primary hyperparathyroidism
Published in Endocrine Research, 2018
Raelene E. Maser, M. James Lenhard, Ryan T. Pohlig, P. Babu Balagopal, Raafat Abdel-Misih
Table 1 provides participants’ physical characteristics and metabolic parameters before and 1 month following parathyroidectomy. As expected PTH and calcium levels were significantly lower following surgery. In addition OPN, ucOC, and the ucOC/OC ratio, were also significantly reduced postsurgery. OC, β-CTX, and OPG levels, however, did not change significantly, whereas lipocalin-2 concentrations were higher. Of note, two participants had a previous history of resolved malignant disease that did not require current treatment. Three of the females in this study were premenopausal. With the exception of one female that used Premarin vaginally twice per week, none of the participants indicated that they were currently taking bisphosphonates, estrogen, or raloxifene. Four participants had a history of type 2 diabetes mellitus (T2DM) that was treated with metformin (n = 4) and a sulfonylurea (n = 2) but none were using a thiazolidinedione. One participant had a previous history of gastric bypass surgery. Because of the characteristics of the study cohort, data analysis was repeated excluding (a) premenopausal women (n = 3), (b) individuals with T2DM (n = 4), and (c) the individual with bariatric surgery. The univariate statistically significant results for OPN, ucOC, and lipocalin-2 pre- versus post-surgery remained after reanalyses, despite the exclusion of these individuals (data not shown).
The negative effects of obesity on heart, especially the electrophysiology of the heart
Published in Artificial Cells, Nanomedicine, and Biotechnology, 2020
Haishan Chen, Xin Wang, Chongxiang Xiong, Hequn Zou
The health risks that obesity brings to human beings are far-reaching, so it is necessary to take active measures to lose weight. According to the surgical procedure, bariatric surgery can be divided into gastric bypass (Roux-en-Y gastric bypass; duodenal transposition; biliary-pancreatic shunt and Roux-en-Y gastric bypass), adjustable gastric banding, sleeve gastrectomy, and vertical occlusion gastroplasty. In the early days, most bariatric surgeries was vertical occlusion gastroplasty. However, in the United States, this procedure was associated with a number of complications, which have essentially been halted. Gastric bypass has resulted in more effective weight loss but is associated with more complications. Adjustable gastric banding is associated with lower mortality and comorbidities, while there is a higher rate of re-operation than gastric bypass and less weight loss. Sleeve gastrectomy, which is increasingly popular, reduces body weight more than adjustable gastric banding and is comparable to gastric bypass surgery [94].
Vague abdominal pain after Roux-en-Y gastric bypass: not always an internal herniation: case report and literature review
Published in Acta Chirurgica Belgica, 2020
T. Allaeys, V. Dhooghe, S. Nicolay, G. Hubens
Bariatric surgery, more specifically Roux-en-y gastric bypass surgery is gaining more popularity in the management of obesity. Dealing with complaints in these patients has become a daily practise. In literature, the list of recapitulations for short-term and long-term postoperative complications is enormous. Though a lot of them lack the notification of blind loop syndrome causing symptoms like abdominal distension, epigastric pain, nausea and diarrhoea. The purpose of this case report is to raise awareness about this possible diagnosis. Laparoscopic resection of this blind loop is a safe and effective way in the treatment of this syndrome. Needless to say, the emergence of a blind loop should be avoided during the first surgery.