Obesity surgery
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The prevalence of obesity in Spain is on the rise with the consequent increase in bariatric surgery. Studies in non-Mediterranean populations have shown that micronutrient deficits are present before surgery. However, there is no data on this topic in a Spanish population. ⋯ Nutritional deficiencies are commonly found in the Spanish obese population undergoing bariatric surgery and are significantly more prevalent than in normal weight individuals.
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The aim of this study was to investigate the effects of Roux-en-Y gastric bypass (RYGB) on glucose tolerance and insulin resistance in type 2 diabetic rats and the possible mechanisms involved in this process. ⋯ RYGB provides a valuable therapeutic option for patients with type 2 diabetes. GLP-1 may contribute to the regulation of pancreatic β-cell function through its receptor following RYGB.
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Although laparoscopic adjustable gastric banding (LAGB) and laparoscopic sleeve gastrectomy (LSG) are coexisting first-choice restrictive procedures for bariatric surgery candidates, it is possible, given their different modes of action, that these procedures have different effects on quality of life (QOL). We hypothesized that improvement of QOL and comfort with food could be better with LSG compared to LAGB. ⋯ Our results add further evidence to the benefit of LSG and LAGB in obesity management. Within the first year of follow-up, there is no lasting difference in the comfort with food dimension between LSG and LABG.
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Morbidly obese patients are at significantly elevated risk of postsurgery complications and merit closer monitoring by health care professionals after bariatric surgery. It is now recognized that genetic factors influence individual patient's response to drug used in anesthesia and analgesia. Among the many drug administered by anesthetists, we focused in this pilot study on morphine, since morphine patient-controlled anesthesia in obese patients undergoing gastric bypass surgery is frequently prescribed. ⋯ OPRM1118G allele was more frequent in our population than in most previously described European populations. Since the concept of "personalized medicine" promises to individualize therapeutics and optimize medical treatment in term of efficacy and safety, especially when prescribing drugs with a narrow therapeutic index such as morphine, further clinical studies examining the clinical consequences of the OPRM1 c. A118G polymorphism in patients undergoing gastric bypass surgery are needed.
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The impact of obesity on total knee replacement (TKR) outcomes is unclear. Studies use different classifications of obesity and heterogeneous methods, making comparisons difficult. The aim of this study was to evaluate health-related quality of life (HRQL) preoperatively and at 12 months of follow-up in severe and morbidly obese patients with knee osteoarthritis and a control group of nonobese patients undergoing TKR. ⋯ Severe and morbidly obese and nonobese patients had similar change scores and TKR outcomes in terms of HRQL at 12 months after TKR. Obese patients had more intraoperative difficulties and more-severe postoperative complications.