World journal of surgery
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Recent international cancer prevention guidelines recommend weight loss, where appropriate, for the purpose of cancer risk reduction. However, limited research associates voluntary weight loss to subsequent cancer incidence because of the difficulty of achieving long-term weight loss maintenance among large participant groups. ⋯ Reduced cancer mortality and incidence as well as reduced cancer-related physician visits after bariatric surgery are presented. Study limitations and future research questions related to cancer and bariatric surgery are briefly discussed.
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World journal of surgery · Oct 2009
Obesity and diabetes: the impact of bariatric surgery on type-2 diabetes.
Weight gain and obesity are driving the global epidemic of type-2 diabetes through metabolic and inflammatory pathways that cause insulin resistance and impair pancreatic beta-cell function, the two important factors that are directly responsible for the development of this disease in susceptible populations. Lifestyle methods and modest weight loss are powerful at preventing and managing type-2 diabetes, but sustaining substantial weight loss is problematic. Bariatric surgery provides exceptional sustained weight loss and remission of type-2 diabetes in 50-85% of subjects, especially if treated early before irreparable beta-cell damage has occurred. ⋯ A range of novel surgical, endoluminal procedures/devices, and pharmacologic therapies are likely to evolve when we better understand how bariatric surgery enables long-term changes in energy balance and non-weight-related metabolic improvements. Bariatric surgery should be considered for adults with BMI >or= 35 kg/m(2) and type-2 diabetes, especially if the diabetes is difficult to control with lifestyle and pharmacologic therapy. Although all bariatric procedures produce exceptional results in the management of type-2 diabetes, choice of procedure requires a careful risk-benefit analysis for the individual patient.
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World journal of surgery · Oct 2009
Development of a large animal model for investigating resuscitation after blast and hemorrhage.
Blast injuries are an increasing problem owing to the widespread terrorist threat, but hemorrhage remains the second leading cause of civilian trauma death. Against this background, increasing numbers of prehospital and military trauma organizations are advocating a hypotensive approach to resuscitation of the hypovolemic casualty, deliberately aiming not to achieve a normal blood pressure so as not to disturb any newly formed blood clots at the site of a vascular injury. ⋯ The preliminary results confirm the reliability and reproducibility of this model.