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07:43 09/01/14 | Owen Haskins | Editor in chief, Bariatric News

This week we report on papers from Clinical Endocrinology; Applied Physiology, Nutrition, and Metabolism; International Journal of Surgery Case Reports; Surgical Endoscopy and Echocardiography…

Effects of Bariatric Surgery on Pericardial Ectopic Fat Depositions and Cardiovascular function.

Published in Clinical Endocrinology, this study assessed myocardial triglyceride (TG) content, pericardial fat and cardiac function in obese, insulin-dependent type 2 diabetes patients before and 16 weeks after Roux-en-Y gastric bypass (RYGB) surgery. Ectopic fat accumulation and cardiovascular function and were assessed with MR imaging and myocardial TG content with MR spectroscopy before and 16 weeks after RYGB surgery. The results showed that surgical-induced weight loss leads to a larger decrease in paracardial than epicardial fat. Abstract

Healthy strategies for successful weight loss and weight maintenance: a systematic review.

Featured in the journal Applied Physiology, Nutrition, and Metabolism, this systematic review examined the evidence available for successful diet strategies for weight loss and weight maintenance among adults. The researchers found that for significant safe weight loss, an energy deficit was required, which was commonly achieved by reduced fat intake. Increased dietary fibre was also a component of 21% of successful interventions. Physical activity was included in 88% of successful interventions, and behaviour training such as self-monitoring was part of 92% of successful interventions. They concluded that a comprehensive approach, including reduced dietary intake, regular physical activity, and behavioural strategies, is warranted and is supported by the research evidence. Abstract

One stage laparoscopic left adrenalectomy and sleeve gastrectomy by direct supragastric approach.

Published in the International Journal of Surgery Case Reports, this paper presents a case of a sleeve gastrectomy and a left adrenalectomy by laparoscopy for a morbidly obese patient with Cushing's syndrome.

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03:08 03/01/14 | Owen Haskins | Editor in chief, Bariatric News

Just in case you missed any news last month, these were the 10 most read articles on bariatricnews.net in December 2013 including the latest research, product & industry news, policy news and more...

Duo Intragastric Balloon meets primary efficacy endpoints
ReShape Medical has announced that its REDUCE Trial for the ReShape Duo Intragastric Balloon, has met its primary efficacy endpoints. The trial, which reached full enrolment in less than six months, involved eight US sites and studied 326 patients. The company is the first medical device company to successfully meet its primary efficacy endpoints in a US, randomised, sham-controlled pivotal trial for weight loss...(more)

Specialists launch interactive pre-surgery consultation application
Leading UK bariatric surgery specialist, Phoenix Health, has officially launched the world’s first interactive, online personal weight loss surgery consultation application. Designed to demist the subject area of weight loss surgery, this is a truly innovative step forward for the company, the industry as a whole, and those contemplating weight loss surgery...(more)

Second Mini Gastric Bypass Conference Report
In October 2013, the Second Mini Gastric Bypass Conference took place in Paris, France. Here, we are delighted to published a report from the meeting by Professor Mervyn Deitel, Chief, Advisory Board, International Bariatric Club, Editor-in-Chief Emeritus & Founding Editor, Obesity Surgery...(more)

EndoBarrier meta-analysis data presented at World IDF Congress
New findings from a meta-analysis describing the ‘increasingly robust efficacy and safety profile’ of EndoBarrier Therapy, has been announced at the International Diabetes Federation’s World Diabetes Congress in Melbourne, Australia. The findings add to the growing body of clinical evidence supporting the use of EndoBarrier Therapy for patients with type 2 diabetes and obesity...(more)

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12:30 03/01/14 | Owen Haskins | Editor in chief, Bariatric News

The December issue of Obesity Surgery (Volume 23, Issue 12,), the official journal of the International Federation for the Surgery of Obesity and Metabolic Disorders, is now available online. Here are some of the highlights from this issue:

Gastric Bypass and Sleeve Gastrectomy for Type 2 Diabetes: A Systematic Review and Meta-analysis of Outcomes.
Researchers wanted to ascertain whether Roux-en-Y gastric bypass (GBP) or sleeve gastrectomy (SG) is the most effective procedure and their review compared T2D remission and weight loss in patients with T2D after each procedure.  A total of 21 prospective (three randomised control trials) and 12 retrospective studies, involving 1,375 patients were included. They reported that there were no significant differences in either T2D remission or weight loss, and weight loss with both procedures increase substantially between three and 12 months post-operatively.  They added that additional randomised controlled trials comparing both procedures are needed to evaluate relative benefits.
Abstract

Early Post-operative Complications: Incidence, Management, and Impact on Length of Hospital Stay. A Retrospective Comparison Between Laparoscopic Gastric Bypass and Sleeve Gastrectomy.
The investigators examined the incidence of early complications following LRYGB and LSG and their impact on hospital stay (HS). A total of 1,345 LRYGB operations and 686 LSG operations were evaluated. The results reported the differences between the procedures in terms of: gender, mean BMI, median length of HS, leakage and bleeding, and prolonged elevation of inflammatory markers. They concluded that although LSG was associated with more early complications, it could be attributed to higher BMI and predominance of males in LSG group.
Abstract

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08:00 24/11/13 | Anonymous (not verified) |

Following his recent paper, "Laparoscopic bariatric surgery can be performed safely in secondary health care centres with a dedicated service corridor to an affiliated tertiary health care centre" (Canadian journal of surgery. 2013 56(4):E68-74), Dr Nicolas Christou discusses the recent developments in Canada regarding access to bariatric surgery...

Under Canada’s publicly funded system, if two 40-year-old mothers, each with three children, require life-saving surgery, one a bariatric procedure for obesity and the other a mastectomy for breast cancer, it is almost always the latter who gets the surgery within a reasonable time period. The reason is that society views the obese mother as “a big fat slob who should go on a diet”. Politicians think, “Obesity is not a sexy political issue”. Policy-makers and the public don’t understand that obesity is a highly complex chronic disease, with causes rooted in a patient’s biology, metabolism and mental health. As a result, bariatric surgery is not well funded in most of Canada.

Bariatric surgery is the only known treatment that will reduce the risk of dying of cancer by 60%, from a diabetes complication by 90%, or reduces total mortality risk by 40% to 60%. There’s almost nothing else we do in medicine that’s so effective and has such a dramatic impact on one’s health. Remarkably, though, Canada only performs about 3,500 procedures per year in public hospitals. Private-pay clinics (mostly adjustable gastric banding) account for another 1,500 procedures per year. The country is only touching the tip of the iceberg in terms of dealing with the demand in the population.

Ontario is the only province willing to make a significant attempt at addressing the country’s shortcomings in this area. In July 2008, it announced $741 million in new funding for a comprehensive, four-year diabetes strategy, of which approximately 10% was targeted toward access to bariatric services. 

This $75-million initiative increased the province’s capacity for weight-loss surgery several fold over the last five years to about 2,500 cases per year or 250% increase in 2012-13.

The province of Quebec is unique within Canada’s health care system because of the Chaoulli v. Quebec (Attorney General), 2005 SCC 35, [2005] 1 SCR 791 decision1 by the Supreme Court of Canada which ruled that Section 15 of the Health Insurance Act and section 11 of the Hospital Insurance Act, which outlaw private medical insurance, violate the right to personal inviolability as guaranteed by the Quebec Charter of Human Rights and Freedoms. 

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