Obesity surgery
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The aim of this study was to determine the relationship between gastric wall thickness and BMI. ⋯ There was no significant correlation between gastric wall thickness and BMI. Mean gastric wall thickness of endoscopically normal stomachs was in the range of 3-4 mm.
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Laparoscopic sleeve gastrectomy (LSG) has evolved as a primary weight loss surgery. This study provides changes in lipid profiles in obese patients 1 year after LSG. ⋯ One year after LSG, significant weight loss and improvements in HDL and TG levels, TC/HDL and TG/HDL ratios were observed. TC and LDL levels were unchanged.
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Bariatric surgery is the most effective modality of achieving weight loss as well as the most effective treatment for type 2 diabetes mellitus (T2DM). Glucose-dependent insulinotropic polypeptide (GIP) is an incretin and is implicated in the pathogenesis of obesity and T2DM. ⋯ We searched PubMed and included all relevant original articles (both human and animal) in the review. Whereas most human studies have shown a decrease in GIP post-malabsorptive bariatric surgery, the role of GIP in bariatric surgery done in animal experiments remains inconclusive.
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Case Reports
Anesthetic management for cesarean delivery in a patient with severe aortic stenosis and severe obesity.
Valvular heart disease has significant effect on the maternal and fetal outcome of pregnancy. The severity and extent of aortic stenosis is of great value for risk assessment and for the design of a therapeutic plan. The therapeutic plan for such patients is further complicated by severe obesity. ⋯ The case was made complex due to the patient's deteriorating condition and not offering consent to emergency surgical procedures. The 34-year-old parturient underwent cesarean delivery at 32 weeks gestation under general anesthesia in the presence of a cardiothoracic surgical team. This case report demonstrates the importance of multidisciplinary preoperative assessment in such patients and careful anesthetic planning to avoid the deterioration of perioperative cardiac performance in parturients with complex valvular disease.
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Randomized Controlled Trial
Analgesic effects of a single preoperative dose of pregabalin after laparoscopic sleeve gastrectomy.
The treatment of pain in obese patients is always a challenge. These patients have low pain thresholds, and the use of opioids can be especially harmful. Intraoperative nervous fiber section and the high temperatures of electrical scalpels probably contribute to the generation of postoperative neuropathic pain. We hypothesized that an antineuropathic pain drug like pregabalin could be helpful to optimize postoperative analgesia by reducing the requirement for opioids and their associated side effects. ⋯ A single preoperative oral dose of 150 mg pregabalin is useful for reducing morphine consumption after a sleeve gastrectomy, and it guarantees effective and safe analgesia with a low incidence of adverse effects.