Subject(s)
Bacteremia/complications , Colonic Neoplasms/complications , Endophthalmitis/etiology , Eye Infections, Bacterial/etiology , Streptococcal Infections/etiology , Streptococcus bovis/isolation & purification , Aged , Bacteremia/diagnosis , Bacteremia/microbiology , Colonic Neoplasms/diagnosis , Colonic Neoplasms/microbiology , Colonoscopy , Diagnosis, Differential , Endophthalmitis/diagnosis , Endophthalmitis/microbiology , Eye Infections, Bacterial/diagnosis , Eye Infections, Bacterial/microbiology , Humans , Magnetic Resonance Imaging , Male , Streptococcal Infections/diagnosis , Streptococcal Infections/microbiology , Tomography, X-Ray Computed , Vitreous Body/microbiologyABSTRACT
Obstructive sleep apnea (OSA) is a sleep disorder characterized by recurrent episodes of closure of the upper airway during sleep, and is highly prevalent among overweight individuals. A significant percentage of patients with OSA remain undiagnosed. This condition creates chronic nighttime hypoxemia that can result in significant complications including systemic and pulmonary hypertension, cor pulmonale, and stroke. Polysomnography is still the most widely used method for diagnosing OSA. Studies have shown that in the majority of patients with OSA the airway obstruction involves the retroglossal region. Upon performing esophagogastroduodenoscopy on patients with a wide range of body mass indices (from 21 to 63), we noticed a gradual increase in the concavity of the posterior epiglottal surface as the BMI increases. Upon following some of the patients who underwent laparoscopic gastric banding and lost significant weight, we noticed a dramatic change in the shape of the epiglottis. This reflects a relief in the pressure on the epiglottis created by the collapsing airways in periods of apnea. Thus, the deformity in the shape of the epiglottis reflects the chronic airway collapse in obese patients, and improvement in this deformity after weight loss indicates a relief of the chronic upper airway obstruction.
Subject(s)
Epiglottis/anatomy & histology , Sleep Apnea, Obstructive/prevention & control , Weight Loss , Humans , Sleep Apnea, Obstructive/etiologyABSTRACT
BACKGROUND: Surgical intervention represents the only treatment with long-term efficacy for morbid obesity. Laparoscopic adjustable gastric banding (LAGB) is a minimally invasive operation that is increasing in popularity. We hypothesized that attending support groups is beneficial to achieve optimal weight loss after LAGB. METHODS: 38 patients who underwent LAGB between Dec 2002 and Aug 2003 were studied retrospectively. Patients were divided into 2 groups; A included 28 patients who did not attend the support groups (surgery without support groups), and B included 10 patients who attended the support groups (surgery with support groups). Weight loss between the 2 groups was compared over a 1-year period. RESULTS: Patients who attended support groups achieved more weight loss (mean decrease in BMI = 9.7 +/- 1.9) than patients who did not attend support groups (mean decrease in BMI = 8.1 +/- 2.1), P = 0.0437 (unpaired t-test). CONCLUSION: Support groups appear to be an important adjunct for patients who undergo LAGB, to achieve and maintain improved weight loss.
