ABSTRACT
Background: As the population continues to age, the number of elderly patients affected by obesity is rising. Metabolic and bariatric surgery (MBS) can benefit elderly patients seeking treatment for obesity and its related diseases. We aimed to quantify percent excess weight loss (%EWL) for elderly patients (≥ 65) undergoing MBS at a single institution and compare our results to %EWL previously reported for general and elderly populations. Additionally, we believe the safety and effectiveness of MBS is repeatable in our community setting. Methods: Laparoscopic sleeve gastrectomy and laparoscopic roux-en-Y gastric bypass performed from November 1, 2011 - April 30, 2017 at a single institution was retrospectively reviewed. Weight loss was measured at 3, 6, and 12 month follow-up. A total of 103 patients met inclusion criteria, mean age was 67.75 years old and mean pre-operative body mass index was 45.95 kg/m2. Results: Mean %EWL was 31.9%, 43.7%, and 53.4% at 3, 6, and 12 months, respectively. %EWL at one year was not statistically different to prior reports of elderly bariatric patients (p = 0.979). While statistically lower when compared to reports in the general population, %EWL in our elderly patients was clinically similar (p < 0.001). No 30-day mortality was observed. Conclusions: Elderly patients undergoing MBS were noted to have %EWL similar to previous reports in elderly and general populations. MBS is efficacious and well tolerated in the elderly population with repeatable results. Continued reporting on the safety and efficacy is important in ensuring wider coverage and availability of these important interventions in elderly populations.
Subject(s)
Bariatric Surgery , Gastric Bypass , Laparoscopy , Obesity, Morbid , Surgeons , Humans , Aged , Obesity, Morbid/epidemiology , Obesity, Morbid/surgery , Retrospective Studies , Treatment Outcome , Bariatric Surgery/methods , Gastric Bypass/methods , Weight Loss , Obesity , Laparoscopy/methods , Gastrectomy/methodsABSTRACT
This review will apply a multidisciplinary approach to GI symptoms with attention to symptom assessment (instruments and qualitative aspects), differential diagnosis, and recent findings relevant to management of symptoms and underlying diseases. We conclude that further development of supportive interventions for GI symptoms for both patient and caregivers has the potential to reduce distress from GI symptoms, and anticipate better symptom control with advances in scientific knowledge and improvement of the evidence base.
Subject(s)
Cachexia , Pancreatic Neoplasms , Humans , Anorexia , Pancreatic Neoplasms/diagnosis , Pancreatic Neoplasms/therapy , Pancreatic NeoplasmsABSTRACT
Multiple myeloma is a neoplastic disease of plasma cells. Plasma cell disorders can present as a single lesion (solitary plasmacytoma) or as multiple lesions (multiple myeloma). Solitary plasmacytomas can occur in bone (plasmacytoma of bone) or in soft tissues (extramedullary plasmacytoma), and both can serve as a precursor lesion to multiple myeloma. These lesions may occur anywhere, however, intracranial presentations are rare. Here, we present a rare case of solitary intracranial extramedullary plasmacytoma in a patient complaining of headaches and vision changes. Despite radiation treatment, intracranial progression and rare lymph node involvement were seen soon after, prompting myeloma-directed therapy followed by autologous stem cell transplant, which have resulted in remission to date.
