Obesity surgery
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Review Meta Analysis
Systematic Review and Meta-Analysis of Occupational Outcomes after Bariatric Surgery.
Obesity has been linked with reduced productivity in the workplace and is associated with higher levels of unemployment and absenteeism. Studies have shown improvement in functioning and enhanced activity levels in patients after bariatric surgery. ⋯ There is limited evidence in the literature regarding occupational outcomes following bariatric surgery, and further studies are required before firm conclusions can be drawn. However, the existing evidence does suggest that bariatric surgery has a generally positive impact on occupational outcomes. This suggests that surgery may have wider economic, social and psychological benefits above and beyond its immediate health benefits.
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Multicenter Study
Long-Term Outcomes of Bariatric and Metabolic Surgery in Japan: Results of a Multi-Institutional Survey.
The number of bariatric procedures performed in Japan is increasing. There are isolated reports of bariatric surgery, but there have been no nationwide surveys including long-term data. ⋯ Bariatric and metabolic surgery for Japanese morbidly obese patients is safe and effective. These results are comparable with the results of previous studies.
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Clinical Trial
Optimal Cefazolin Prophylactic Dosing for Bariatric Surgery: No Need for Higher Doses or Intraoperative Redosing.
The goal of this pharmacokinetic (PK) study was to evaluate whether a single 2-g prophylactic dose of cefazolin given (IV) bolus provides effective protective cefazolin levels for prophylaxis against methicillin-sensitive S. aureus (MSSA), the primary skin pathogen in bariatric surgery. ⋯ Prophylactic cefazolin, given as a single 2 g (IV bolus 3-5 min before skin incision) was more than adequate in providing protective cefazolin levels for the duration of bariatric surgery. Cefazolin 2 g (IV dose bolus given just before skin incision) achieves protective adipose tissue levels (> MIC of MSSA) for the duration (usually < 4 h) of bariatric surgical procedures. In this study, cefazolin 2 g (IV bolus) provided protective adipose tissue levels for 4.8 h. Since cefazolin is a water soluble antibiotic (V d = 0.2 L/Kg), penetration into adipose tissue is not V d not dose-dependent. Extremely high-dosed cefazolin, i.e., 3 or 4 g is excessive and unnecessary for bariatric surgery prophylaxis. A single cefazolin 2 g preoperative dose also eliminates the need for intraoperative redosing at 4 h.
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Clinical Trial
Pre-Operative Ability of Clinical Scores to Predict Obstructive Sleep Apnea (OSA) Severity in Susceptible Surgical Patients.
Severe obstructive sleep apnea (OSA) is an independent risk factor for perioperative complications. Clinical scores such as Snoring, Tiredness, Observed apnea, high blood Pressure, Body Mass Index (BMI) higher than 35 kg m-2, Age older than 50 years, Neck circumference larger than 40 cm, and male gender (STOP-Bang), perioperative sleep apnea prediction (P-SAP), and OSA50 have been proposed for detecting OSA. We recently proposed a new score based on morphological metrics only, the DES-OSA score. This study compared the DES-OSA score to the three other ones with regard to their ability to detect OSA. Obese patients are particularly at risk of OSA. ⋯ ClinicalTrial.gov NCT02051829.