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Comment on: greater curvature as a gastric pouch for sleeve gastrectomy: a novel bariatric procedure. Feasibility study in a canine model.
Albaugh VL
(2018) Surg Obes Relat Dis 14: 1820-1821
MeSH Terms: Animals, Bariatrics, Dogs, Feasibility Studies, Gastrectomy, Obesity, Morbid, Stomach
Added January 4, 2019
0 Communities
1 Members
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7 MeSH Terms
Association of Health Literacy With Postoperative Outcomes in Patients Undergoing Major Abdominal Surgery.
Wright JP, Edwards GC, Goggins K, Tiwari V, Maiga A, Moses K, Kripalani S, Idrees K
(2018) JAMA Surg 153: 137-142
MeSH Terms: Adult, Aged, Colectomy, Digestive System Surgical Procedures, Educational Status, Elective Surgical Procedures, Emergency Service, Hospital, Female, Gastrectomy, Health Literacy, Hepatectomy, Humans, Length of Stay, Male, Middle Aged, Pancreatectomy, Patient Readmission, Proctectomy, Retrospective Studies, Treatment Outcome
Show Abstract · Added April 10, 2018
Importance - Low health literacy is known to adversely affect health outcomes in patients with chronic medical conditions. To our knowledge, the association of health literacy with postoperative outcomes has not been studied in-depth in a surgical patient population.
Objective - To evaluate the association of health literacy with postoperative outcomes in patients undergoing major abdominal surgery.
Design, Setting, and Participants - From November 2010 to December 2013, 1239 patients who were undergoing elective gastric, colorectal, hepatic, and pancreatic resections for both benign and malignant disease at a single academic institution were retrospectively reviewed. Patient demographics, education, insurance status, procedure type, American Society of Anesthesiologists status, Charlson comorbidity index, and postoperative outcomes, including length of stay, emergency department visits, and hospital readmissions, were reviewed from electronic medical records. Health literacy levels were assessed using the Brief Health Literacy Screen, a validated tool that was administered by nursing staff members on hospital admission. Multivariate analysis was used to determine the association of health literacy levels on postoperative outcomes, controlling for patient demographics and clinical characteristics.
Main Outcomes and Measures - The association of health literacy with postoperative 30-day emergency department visits, 90-day hospital readmissions, and index hospitalization length of stay.
Results - Of the 1239 patients who participated in this study, 624 (50.4%) were women, 1083 (87.4%) where white, 96 (7.7%) were black, and 60 (4.8%) were of other race/ethnicity. The mean (SD) Brief Health Literacy Screen score was 12.9 (SD, 2.75; range, 3-15) and the median educational attainment was 13.0 years. Patients with lower health literacy levels had a longer length of stay in unadjusted (95% CI, 0.95-0.99; P = .004) and adjusted (95% CI, 0.03-0.26; P = .02) analyses. However, lower health literacy was not significantly associated with increased rates of 30-day emergency department visits or 90-day hospital readmissions.
Conclusions and Relevance - Lower health literacy levels are independently associated with longer index hospitalization lengths of stay for patients who are undergoing major abdominal surgery. The role of health literacy needs to be further evaluated within surgical practices to improve health care outcomes and use.
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20 MeSH Terms
Management of duodenal carcinoid tumors in the setting of morbid obesity.
Spann MD, Idrees K
(2017) Surg Obes Relat Dis 13: 1635-1637
MeSH Terms: Adult, Bariatric Surgery, Carcinoid Tumor, Duodenal Neoplasms, Duodenoscopy, Duodenum, Female, Gastrectomy, Humans, Incidental Findings, Lymph Node Excision, Obesity, Morbid, Preoperative Care
Added April 10, 2018
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1 Members
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13 MeSH Terms
Bile acids and bariatric surgery.
Albaugh VL, Banan B, Ajouz H, Abumrad NN, Flynn CR
(2017) Mol Aspects Med 56: 75-89
MeSH Terms: Animals, Bile Acids and Salts, Diabetes Mellitus, Type 2, Enterohepatic Circulation, Gastrectomy, Gastric Bypass, Gastrointestinal Microbiome, Gene Expression Regulation, Glucose, Homeostasis, Humans, Insulin Resistance, Obesity, Morbid, Receptors, Cytoplasmic and Nuclear, Receptors, G-Protein-Coupled, Rodentia, Signal Transduction
Show Abstract · Added June 6, 2017
Bariatric surgery, specifically Roux-en-Y gastric bypass (RYGB) and vertical sleeve gastrectomy (VSG), are the most effective and durable treatments for morbid obesity and potentially a viable treatment for type 2 diabetes (T2D). The resolution rate of T2D following these procedures is between 40 and 80% and far surpasses that achieved by medical management alone. The molecular basis for this improvement is not entirely understood, but has been attributed in part to the altered enterohepatic circulation of bile acids. In this review we highlight how bile acids potentially contribute to improved lipid and glucose homeostasis, insulin sensitivity and energy expenditure after these procedures. The impact of altered bile acid levels in enterohepatic circulation is also associated with changes in gut microflora, which may further contribute to some of these beneficial effects. We highlight the beneficial effects of experimental surgical procedures in rodents that alter bile secretory flow without gastric restriction or altering nutrient flow. This information suggests a role for bile acids beyond dietary fat emulsification in altering whole body glucose and lipid metabolism strongly, and also suggests emerging roles for the activation of the bile acid receptors farnesoid x receptor (FXR) and G-protein coupled bile acid receptor (TGR5) in these improvements. The limitations of rodent studies and the current state of our understanding is reviewed and the potential effects of bile acids mediating the short- and long-term metabolic improvements after bariatric surgery is critically examined.
Copyright © 2017 Elsevier Ltd. All rights reserved.
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3 Members
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17 MeSH Terms
Gastric cancer, version 2.2013: featured updates to the NCCN Guidelines.
Ajani JA, Bentrem DJ, Besh S, D'Amico TA, Das P, Denlinger C, Fakih MG, Fuchs CS, Gerdes H, Glasgow RE, Hayman JA, Hofstetter WL, Ilson DH, Keswani RN, Kleinberg LR, Korn WM, Lockhart AC, Meredith K, Mulcahy MF, Orringer MB, Posey JA, Sasson AR, Scott WJ, Strong VE, Varghese TK, Warren G, Washington MK, Willett C, Wright CD, McMillian NR, Sundar H, National Comprehensive Cancer Network
(2013) J Natl Compr Canc Netw 11: 531-46
MeSH Terms: Combined Modality Therapy, Gastrectomy, Humans, Lymph Node Excision, Neoplasm Staging, Receptor, ErbB-2, Stomach Neoplasms
Show Abstract · Added April 12, 2016
The NCCN Clinical Practice Guidelines in Oncology for Gastric Cancer provide evidence- and consensus-based recommendations for a multidisciplinary approach for the management of patients with gastric cancer. For patients with resectable locoregional cancer, the guidelines recommend gastrectomy with a D1+ or a modified D2 lymph node dissection (performed by experienced surgeons in high-volume centers). Postoperative chemoradiation is the preferred option after complete gastric resection for patients with T3-T4 tumors and node-positive T1-T2 tumors. Postoperative chemotherapy is included as an option after a modified D2 lymph node dissection for this group of patients. Trastuzumab with chemotherapy is recommended as first-line therapy for patients with HER2-positive advanced or metastatic cancer, confirmed by immunohistochemistry and, if needed, by fluorescence in situ hybridization for IHC 2+.
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7 MeSH Terms
Gastric adenocarcinoma associated with gastritis cystica profunda in an unoperated stomach.
Deery S, Yates R, Hata J, Shi C, Parikh AA
(2012) Am Surg 78: E379-80
MeSH Terms: Adenocarcinoma, Aged, Diagnosis, Differential, Female, Gastrectomy, Gastritis, Gastroscopy, Humans, Lymph Node Excision, Omentum, Polyps, Splenectomy, Stomach Neoplasms, Tomography, X-Ray Computed
Added March 7, 2014
0 Communities
1 Members
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14 MeSH Terms
Gastric schwannoma.
Snyder RA, Harris E, Hansen EN, Merchant NB, Parikh AA
(2008) Am Surg 74: 753-6
MeSH Terms: Aged, Female, Gastrectomy, Humans, Laparoscopy, Male, Neurilemmoma, Stomach Neoplasms, Tomography, X-Ray Computed
Added March 26, 2014
0 Communities
2 Members
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9 MeSH Terms
Metabolic bone disease in gastrointestinal illness.
Williams SE, Seidner DL
(2007) Gastroenterol Clin North Am 36: 161-90, viii
MeSH Terms: Bariatric Surgery, Bone Density, Bone Diseases, Metabolic, Bone Resorption, Gastrectomy, Gastrointestinal Diseases, Humans, Liver Diseases, Nutrition Disorders
Show Abstract · Added September 30, 2015
Metabolic bone disease is often silent, often undiagnosed, and occurs frequently in patients with chronic gastrointestinal illnesses. Potentially modifiable risk factors, such as malnutrition, malabsorption, prolonged use of glucocorticoids, and a sedentary lifestyle, can lead to low bone mass, an increased rate of bone loss, and debilitating bone disease. This article explores common gastrointestinal illnesses that place patients at risk for developing metabolic bone disease. Concepts are presented to assist the practitioner in identifying patients at risk; clinical evaluation and diagnostic test selection are discussed, and therapeutic options for the prevention and treatment of metabolic bone disease in gastrointestinal illness are presented.
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1 Members
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9 MeSH Terms
Direct button percutaneous endoscopic jejunostomy: successful placement in a patient with severe malnutrition and previous gastric resection.
Dumot JA, Seidner DL
(1997) Gastrointest Endosc 45: 92-4
MeSH Terms: Adult, Enteral Nutrition, Female, Gastrectomy, Humans, Jejunostomy, Nutrition Disorders, Stomach Ulcer
Added September 30, 2015
0 Communities
1 Members
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8 MeSH Terms