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Highlights from Jan-Feb issue of SOARD

The January-February 2014 (Volume 10, Issue 1) issue of Surgery for Obesity and Related Diseases is out now featuring literature reviews, case reports and comments. Here are some of the highlights:

Changes in post-prandial glucose and pancreatic hormones, and steady-state insulin and free fatty acids after gastric bypass surgery.
This study compared the changes of glucose and pancreatic hormones [C-peptide, glucagon, and pancreatic polypeptide (PP)] during a meal tolerance test (MTT) and steady-state insulin and free fatty acid (FFA) concentrations during euglycemic–hyperinsulinemic clamp 14 days and 6 months after RYGB in morbidly obese nondiabetic patients. the researcher studied two gropus at baseline and at 14 days: the RYGB followed by caloric restriction group (RYGB, n = 12) and the equivalent caloric restriction alone group (Diet, n = 10), to control for energy intake and weight loss. The RYGB group was studied again at 6 months to assess the changes after substantial weight loss. During MTT, the early and overall changes in glucose and pancreatic hormone concentrations were determined, and during the clamp, steady-state insulin and FFA concentrations were assessed. they found that in morbidly obese nondiabetic patients, RYGB produces early changes in postmeal glucose, C-peptide, glucagon, and PP responses, and it appears to enhance insulin clearance early after RYGB and improve insulin sensitivity in adipose tissue at 6 months postsurgery.

Twelve-year results for revisional gastric bypass after failed restrictive surgery in 131 patients.
This paper examined long-term results of rRYGB from 131 patients who had RYGB  at 2 university hospitals and completed questionnaire regarding their current status. The questionnaire was returned by 131 patients (75% follow-up rate, 66 VBG and 65 GB patients). Blood samples were obtained and medical charts studied. The reason for conversion was mainly unsatisfactory weight loss among the VBG patients and intolerable side effects among GB patients. they report that the overall result was satisfactory for 74% of the patients. Only 21% of the patients adhered to the recommendation of lifelong multivitamin supplements while 76% took vitamin B12. nevertheless, micronutrient deficiencies were frequent.

Bariatric-related medical malpractice experience: survey results among ASMBS members.
In this study, all US-based members of the American Society of Metabolic and Bariatric Surgeons were asked to complete a survey regarding their bariatric-related medical malpractice experience. Of the 1,672 eligible members that received the survey, 330 responded (19.7%). the mean annual cost of malpractice insurance was US$59,200±$52,000 and respondent surgeons experienced 1.5±3.2 lawsuits on average over the course of their practice. The mean lifetime amount paid for suits was US$250,000±$660,000.the researchers concluded that the probability of a medical malpractice lawsuit correlates positively to the number of procedures performed and the number of years the surgeon has been in practice.

Depression and infertility in women seeking bariatric surgery.
This study sought to explore potential psychosocial correlates of infertility in a female bariatric population. The researchers found that Women struggling with infertility may be more psychiatrically vulnerable than other bariatric surgery candidates and less likely to have received mental health treatment. The added that additional research on the association between fertility, depression, behavioral health treatment, and obesity is need and should consider whether this potential relationship changes after bariatric surgery.

Algorithm for weight loss after gastric bypass surgery considering body mass index, gender, and age from the Bariatric Outcome Longitudinal Database (BOLD).
The objective of this study was to create an algorithm describing weight loss after LRYGB in search for a better outcome metric to demonstrate unequivocally the influence of patient characteristics on bariatric results. They report tha both genders have age-independent metrics for which nadir relative weight loss after LRYGB is not influenced by initial BMI. The proposed metric percentage alterable weight loss (%AWL) reduces results to constant values for bariatric effectiveness.