Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 159
Filter
1.
Probl Endokrinol (Mosk) ; 67(4): 20-35, 2021 08 02.
Article in Russian | MEDLINE | ID: covidwho-2203923

ABSTRACT

Obesity affects over 700 million people worldwide and its prevalence keeps growing steadily. The problem is particularly relevant due to the increased risk of COVID-19 complications and mortality in obese patients. Obesity prevalence increase is often associated with the influence of environmental and behavioural factors, leading to stigmatization of people with obesity due to beliefs that their problems are caused by poor lifestyle choices. However, hereditary predisposition to obesity has been established, likely polygenic in nature. Morbid obesity can result from rare mutations having a significant effect on energy metabolism and fat deposition, but the majority of patients does not present with monogenic forms. Microbiome low diversity significantly correlates with metabolic disorders (inflammation, insulin resistance), and the success of weight loss (bariatric) surgery. However, data on the long-term consequences of bariatric surgery and changes in the microbiome composition and genetic diversity before and after surgery are currently lacking. In this review, we summarize the results of studies of the genetic characteristics of obesity patients, molecular mechanisms of obesity, contributing to the unfavourable course of coronavirus infection, and the evolution of their microbiome during bariatric surgery, elucidating the mechanisms of disease development and creating opportunities to identify potential new treatment targets and design effective personalized approaches for the diagnosis, management, and prevention of obesity.


Subject(s)
Bariatric Surgery , COVID-19 , Microbiota , Obesity, Morbid , Humans , SARS-CoV-2
2.
BMJ Open ; 12(11): e064893, 2022 11 04.
Article in English | MEDLINE | ID: covidwho-2103194

ABSTRACT

OBJECTIVES: This study aimed to explore adolescents' and professionals' incentives and experiences of metabolic and bariatric surgery (MBS) and to explore perceived needs and requirements for preoperative and postoperative support through an mHealth intervention to improve long-term healthy lifestyle behaviour and health outcomes. DESIGN: An inductive qualitative study using in-depth semistructured interviews. SETTING: Three hospital-based specialist paediatric obesity treatment units in Sweden. PARTICIPANTS: A total of 18 participants (14 women and 4 men). Nine adolescents aged between 17 and 22 years who had undergone or were about to undergo surgery, and nine professionals, including researchers and clinicians working in various professional roles such as physiotherapist, dietician, nurse, psychologist, physician and pedagogue. RESULTS: Both informant groups of participants highlighted that undergoing MBS is a complex process, and hence actions are required on several levels to optimise the positive, long-term effects of surgery. Efficient communication between the healthcare professionals and adolescents was considered crucial and a key success factor. Informants acknowledged the need for additional support that relates to psychosocial well-being and mental health in order to understand, form and accept new behaviours and identity. An mHealth intervention should be seen as complementary to physical appointments, and informants acknowledged that an app could be a way of improving access to healthcare, and a useful tool to allow for individually tailored and easily available support. CONCLUSIONS: The findings address the importance of a personal encounter and a need for additional support that relates to psychosocial well-being, mental health and healthy lifestyle behaviour. These findings should be incorporated into future research concerning mHealth interventions in MBS during adolescence.


Subject(s)
Bariatric Surgery , Telemedicine , Male , Child , Humans , Adolescent , Female , Young Adult , Adult , Qualitative Research , Bariatric Surgery/psychology , Health Personnel/psychology , Delivery of Health Care
3.
Obes Surg ; 32(11): 3807-3810, 2022 11.
Article in English | MEDLINE | ID: covidwho-2048520

ABSTRACT

Less is known whether bariatric surgery (BS) is associated with improved outcomes of COVID-19 complications among patients with class III obesity. Using data from the Florida's state inpatient database (SID) in 2020, we performed multivariable logistic regressions to investigate the impact of prior BS on three separate events, including admission due to COVID-19 among patients eligible for BS (non-BS) and those with prior BS, ventilator usage, and all-cause mortality among those admitted due to COVID-19. Of 409,665 patients included in this study, 25,116 (6.1%) had a history of BS. Results from adjusted logistic regression showed that prior BS was associated with decreased risk of admission due to COVID-19 than that in non-BS group. The risk reduction was smaller among those with class III obesity (adjusted odds ratio [aOR]: 0.58; 95% CI: 0.51-0.66; p < 0.001) than those without (aOR: 0.32; 95% CI: 0.28-0.38; p < 0.001). Compared with the non-BS group, aOR of ventilator use and all-cause mortality for patients without class III obesity decreased by 58% and 78% (p < 0.05), respectively. However, these significances disappeared among patients with continued class III obesity after BS. Our findings suggest that patients with continued class III obesity after BS were still at higher risk of severe COVID-19 outcomes than those without.


Subject(s)
Bariatric Surgery , COVID-19 , Obesity, Morbid , Humans , Obesity, Morbid/surgery , Florida/epidemiology , COVID-19/epidemiology , Bariatric Surgery/methods , Obesity/complications , Obesity/epidemiology , Obesity/surgery , Retrospective Studies
4.
Obes Surg ; 32(11): 3605-3610, 2022 11.
Article in English | MEDLINE | ID: covidwho-2035274

ABSTRACT

PURPOSE: The COVID-19 pandemic accelerated implementation of telehealth throughout the US healthcare system. At our institution, we converted a fully integrated multidisciplinary bariatric clinic from face-to-face visits to entirely telehealth video/telephone visits. We hypothesized telehealth would increase the number of provider/patient encounters and therefore delay time to surgery. METHODS: This is a retrospective review of consecutive patients who underwent total telehealth preoperative workup. Demographics, comorbidities, and surgical characteristics were compared to the same number of consecutive patients who underwent a face-to-face approach 12 months prior, using a Wilcoxon test for continuous variables and chi-square or Fisher's exact test for categorical variables. Differences between time and surgery were compared using inverse probability of treatment-weighted estimates and number of preoperative visits using Poisson regression with distance to hospital as a confounder. Noninferiority margin for time to surgery was set to 60 days, and the number of visits was set to 2 visits. RESULTS: Between March of 2020 and December of 2021, 36 patients had total telehealth workup, and were compared to 36 patients in the traditional group. Age, sex, body mass index, and comorbidities did not differ between groups. The average number of days to surgery was 121.1 days shorter in the telehealth group (90% bootstrap CI [- 160.4, - 81.8]). Estimated shift in the total number of visits was additional .76 visits in the traditional group (90% CI [.64, .91). CONCLUSIONS: The total telehealth approach to preoperative bariatric multidisciplinary workup did not delay surgery and decreased number of total outpatient visits and time to surgery.


Subject(s)
Bariatric Surgery , COVID-19 , Obesity, Morbid , Telemedicine , Humans , COVID-19/epidemiology , Pandemics , Pilot Projects , Obesity, Morbid/surgery
5.
BMJ Open ; 12(9): e067393, 2022 09 15.
Article in English | MEDLINE | ID: covidwho-2029508

ABSTRACT

INTRODUCTION: Bariatric surgery is currently the most effective treatment for obesity, and is performed yearly in over 8000 patients in Canada. Over 50% of those who live with obesity also have a history of mental health disorder. The COVID-19 pandemic has made it difficult for people living with obesity to manage their weight even after undergoing bariatric surgery, which combined with pandemic-related increases in mental health distress, has the potential to adversely impact obesity outcomes such as weight loss and quality of life. Reviews of virtual mental health interventions during COVID-19 have not identified any interventions that specifically address psychological distress or disordered eating in patients with obesity, including those who have had bariatric surgery. METHODS AND ANALYSIS: A randomised controlled trial will be conducted with 140 patients across four Ontario Bariatric Centres of Excellence to examine the efficacy of a telephone-based cognitive behavioural therapy intervention versus a control intervention (online COVID-19 self-help resources) in postoperative bariatric patients experiencing disordered eating and/or psychological distress. Patients will be randomised 1:1 to either group. Changes in the Binge Eating Scale and the Patient Health Questionnaire 9-Item Scale will be examined between groups across time (primary outcomes). Qualitative exit interviews will be conducted, and data will be used to inform future adaptations of the intervention to meet patients' diverse needs during and post-pandemic. ETHICS AND DISSEMINATION: This study has received ethics approvals from the following: Clinical Trials Ontario (3957) and the University Health Network Research Ethics Committee (22-5145), the Board of Record. All participants will provide written informed consent prior to enrolling in the study. Results will be made available to patients with bariatric surgery, the funders, the supporting organisations and other researchers via publication in peer-reviewed journals and conference presentations. TRIAL REGISTRATION NUMBER: NCT05258578.


Subject(s)
Bariatric Surgery , COVID-19 , Cognitive Behavioral Therapy , Bariatric Surgery/psychology , Cognitive Behavioral Therapy/methods , Humans , Mental Health , Obesity/surgery , Ontario/epidemiology , Pandemics , Quality of Life , Randomized Controlled Trials as Topic , Telephone
6.
Obes Surg ; 32(Suppl 1): 1-38, 2022 07.
Article in English | MEDLINE | ID: covidwho-1976864
7.
Obes Surg ; 32(Suppl 1): 1-38, 2022 07.
Article in English | MEDLINE | ID: covidwho-1976863
8.
Obes Surg ; 32(Suppl 1): 1-38, 2022 07.
Article in English | MEDLINE | ID: covidwho-1976862
9.
Obes Surg ; 32(Suppl 1): 1-38, 2022 07.
Article in English | MEDLINE | ID: covidwho-1976861
10.
Obes Surg ; 32(Suppl 1): 1-38, 2022 07.
Article in English | MEDLINE | ID: covidwho-1976860
11.
Obes Surg ; 32(Suppl 1): 1-38, 2022 07.
Article in English | MEDLINE | ID: covidwho-1976859
12.
Obes Surg ; 32(Suppl 1): 1-38, 2022 07.
Article in English | MEDLINE | ID: covidwho-1976858
13.
Obes Surg ; 32(Suppl 1): 1-38, 2022 07.
Article in English | MEDLINE | ID: covidwho-1976857
14.
Obes Surg ; 32(Suppl 1): 1-38, 2022 07.
Article in English | MEDLINE | ID: covidwho-1976856
15.
Obes Surg ; 32(Suppl 1): 1-38, 2022 07.
Article in English | MEDLINE | ID: covidwho-1976855
16.
Obes Surg ; 32(Suppl 1): 1-38, 2022 07.
Article in English | MEDLINE | ID: covidwho-1976854
17.
Obes Surg ; 32(Suppl 1): 1-38, 2022 07.
Article in English | MEDLINE | ID: covidwho-1976853
18.
Obes Surg ; 32(Suppl 1): 1-38, 2022 07.
Article in English | MEDLINE | ID: covidwho-1976852
19.
Obes Surg ; 32(Suppl 1): 1-38, 2022 07.
Article in English | MEDLINE | ID: covidwho-1976851
20.
Obes Surg ; 32(Suppl 1): 1-38, 2022 07.
Article in English | MEDLINE | ID: covidwho-1976850
SELECTION OF CITATIONS
SEARCH DETAIL