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At least 991 records · Page 55Linked to original sources
PubMed1980

Gastric bypass in morbid obesity.

Gastric operations for the treatment of morbid obesity have been standardized. They require close adherence to specifications for success. The upper stomach volume should be measured intraoperatively and fashioned to a capacity of 50 ml at a pressure of 25 to 30 cm of saline. The outlet should be no larger than 12 mm in diameter. The necessity for bypassing the remainder of the stomach and duodenum has not been established. Early maintenance of gastric decompression and immediate supervision and education of patients regarding new eating habits are crucial in the prevention of gastric rupture. Long-term care is usually minimal, but patients should be followed at least at 6 weeks, 6 months, 1 year, and at yearly intervals thereafter. Increasing numbers of intestinal bypass operations are being replaced by gastric bypass or gastroplasty. Many surgeons who once used intestinal bypass have decided to use the stomach operations instead because of the much less complicated long-term care required after the gastric procedures.

Avitaminosis↗
PubMed1991

Trace element and vitamin deficiency in alcoholic and control subjects.

A wide range of trace elements and vitamins was studied in alcoholic patients admitted for detoxification and in healthy controls. Alcoholic subjects were found to be deficient relative to controls in magnesium and vitamin E, while a relative excess of serum iron and copper, and sweat nickel, was noted. A surprisingly wide range of deficiencies, as compared with standard laboratory ranges, was seen in the control group. This finding emphasizes the need for adequate control groups in nutritional studies of alcoholism, the insufficiency of an adequate diet alone to guarantee adequate nutrition, and the likely high prevalence of undetected nutritional deficiency in the general population. Further research is required on the clinical benefits of nutritional supplementation as part of the treatment of alcoholism, and the value of conventional supplements as a routine treatment is questioned.

Adult↗
PubMed1991

Vitamin deficiencies and neural-tube defects: human and animal studies.

The evidence for an association between vitamin deficiency in early pregnancy and the prevalence of neural-tube defects in humans is reviewed, with particular emphasis on the methodological problems encountered in conducting such studies. It is apparent that there is strong evidence for an association between maternal vitamin status and the outcome of pregnancy, but this is not universally accepted, due to ethical and practical constraints on the design of the studies. There are also problems in obtaining precise information from experiments on animals in vivo. By culturing rat embryos in dialysed serum in which the micromolecular component is defined, it has been possible to demonstrate that significant numbers of neural-tube defects can be produced by the deficiency of a single vitamin (inositol), and that multiple vitamin deficiency produces a further significant increase in the frequency of such defects.

Animals↗
PubMed2006

Gastrointestinal complications of bariatric surgery: diagnosis and therapy.

Severe or morbid obesity, with body mass indexes exceeding 35 to 40, are often refractory to all therapies other than surgery. The increasing number of patients undergoing bariatric surgery will result in increasing numbers of patients with gastrointestinal complications. The types of complications vary with type of surgery, whether restrictive, malabsorptive, or both, depending on what anatomical and physiologic changes occur postoperatively. One complication of bariatric surgery (gallstones) is due to weight loss after surgery, not the surgery itself. Based on previous meta-analyses, most of the top 10 complications from bariatric surgery are gastrointestinal: dumping, vitamin/mineral deficiencies, vomiting (and nausea), staple line failure, infection, stenosis (and bowel obstruction), ulceration, bleeding, splenic injury, and perioperative death. Two other gastrointestinal complications of bariatric surgery are indirect consequences of the surgery: bacterial overgrowth and diarrhea. Awareness of the types and frequency of gastrointestinal complications of bariatric surgery allows for timely diagnosis and appropriate therapy. As new surgical, and even endoscopic, procedures to treat obesity are developed, new gastrointestinal complications will need to be recognized.

Avitaminosis↗
PubMed2006

Nutritional and metabolic complications of bariatric surgery.

Bariatric surgery is an effective treatment for patients with clinically severe obesity. In addition to significant weight loss, it is also associated with improvements in comorbidities. Unfortunately, bariatric surgery also has the potential to cause a variety of nutritional and metabolic complications. These complications are mostly due to the extensive surgically induced anatomical changes incurred by the patient's gastrointestinal tract, particularly with roux-en-Y gastric bypass and biliopancreatic diversion. Complications associated with vertical banded gastroplasty are mostly due to decreased intake amounts of specific nutrients. Macronutrient deficiencies can include severe protein-calorie malnutrition and fat malabsorption. The most common micronutrient deficiencies are of vitamin B12, iron, calcium, and vitamin D. Other micronutrient deficiencies that can lead to serious complications include thiamine, folate, and the fat-soluble vitamins. Counseling, monitoring, and nutrient and mineral supplementation are essential for the treatment and prevention of nutritional and metabolic complications after bariatric surgery.

Avitaminosis↗
PubMed1981

Gastric bypass for morbid obesity: a medical--surgical assessment.

With the operative modifications and dietary guidelines described in this report, death and complications from gastric bypass were minimal, and weight loss was marked. Ninety per cent of a group of 69 patients lost more than half of their excess weight within the first two years after operation. Stringent preselection of patients for operation was crucial to the success of the operation, and marked alterations of eating behavior was necessary to achieve the weight loss. Mild electrolyte deficiencies and hypovitaminosis occurred in up to one-fourth of the patients. While none of these abnormalities was harmful to the patients, and all were easily corrected, their occurrence demonstrates the importance of long-term follow-up after the operation. We conclude that gastric bypass, with a 50-60 cc pouch and a small (1-1.2 cm) gastrojejunostomy, remains the operation of choice for morbid obesity.

Adolescent↗