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21. Comparison of Surgical and Medical Therapy for Type 2 Diabetes in Severely Obese Adolescents. Full Text available with Trip Pro

Comparison of Surgical and Medical Therapy for Type 2 Diabetes in Severely Obese Adolescents. Because of the substantial increase in the occurrence of type 2 diabetes in the pediatric population and the medical complications of this condition, therapies are urgently needed that will achieve better glycemic control than standard medical management.To compare glycemic control in cohorts of severely obese adolescents with type 2 diabetes undergoing medical and surgical interventions.A secondary (...) from adolescents with severe obesity and type 2 diabetes who underwent treatment with metabolic or bariatric surgery in the Teen-LABS study or medical therapy in the TODAY study were compared.Teen-LABS participants underwent a primary bariatric surgical procedure; TODAY participants were randomized to receive metformin therapy alone or in combination with rosiglitazone or an intensive lifestyle intervention; insulin therapy was given in cases of progression of disease.Glycemic control, body mass

2018 JAMA pediatrics Controlled trial quality: uncertain

22. General medicine: Drug discovery today: no molecules required

General medicine: Drug discovery today: no molecules required Drug discovery today: no molecules required | BMJ Evidence-Based Medicine Log in using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? Search for this keyword Search for this keyword Main menu Log in using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? You (...) are here Drug discovery today: no molecules required Article Text This article has a correction. Please see: EBM analysis General medicine Drug discovery today: no molecules required Alexander Y Panchin 1 , Nikita N Khromov-Borisov 2 , Evgenia V Dueva 3 Statistics from Altmetric.com Introduction During the last fifteen years, numerous peer-reviewed journals published articles about the incredible properties of so-called release-active “drugs” (RADs). 1–24 It is claimed that these “drugs” are effective

2019 Evidence-Based Medicine

23. US health policy and prescription drug coverage of FDA-approved medications for the treatment of obesity. Full Text available with Trip Pro

US health policy and prescription drug coverage of FDA-approved medications for the treatment of obesity. Obesity is now the most prevalent chronic disease in the United States, which amounts to an estimated $147 billion in health care spending annually. The Affordable Care Act (ACA) enacted in 2010 included provisions for private and public health insurance plans that expanded coverage for lifestyle/behavior modification and bariatric surgery for the treatment of obesity. Pharmacotherapy (...) , however, has not been included despite their evidence-based efficacy. We set out to investigate the coverage of Food and Drug Administration-approved medications for obesity within Medicare, Medicaid and ACA-established marketplace health insurance plans.We examined coverage for phentermine, diethylpropion, phendimetrazine, Benzphentamine, Lorcaserin, Phentermine/Topiramate (Qysmia), Liraglutide (Saxenda) and Buproprion/Naltrexone (Contrave) among Medicare, Medicaid and marketplace insurance plans

2017 International Journal of Obesity

24. Recent explanatory trials of the mode of action of drug therapies on lipoprotein metabolism. Full Text available with Trip Pro

Recent explanatory trials of the mode of action of drug therapies on lipoprotein metabolism. Dysregulated lipoprotein metabolism leads to increased plasma concentrations of atherogenic lipoproteins. We highlight the findings from recent studies of the effect of lipid-regulating therapies on apolipoprotein metabolism in humans employing endogenous labelling with stable isotopically labelled isotopomers.Fish oil supplementation and niacin treatment both reduce fasting and postprandial (...) oligonucleotides directed at apoB mRNA lowers plasma LDL-cholesterol and apoB chiefly by increasing the catabolism and decreasing the secretion of LDL-apoB in healthy subjects. That apoB ASO treatment does not lower hepatic secretion in humans is unexpected and merits further investigation.Kinetic studies provide mechanistic insight into the mode of action of lipid lowering therapies and lipoprotein disorders. Understanding the mode of action of new drugs in vivo is important to establish their effective use

2016 Current Opinion in Lipidology

25. Retrospective evaluation of postoperative adverse drug events in patients receiving rivaroxaban following major orthopedic surgery compared to standard therapy in a community hospital. (Abstract)

Retrospective evaluation of postoperative adverse drug events in patients receiving rivaroxaban following major orthopedic surgery compared to standard therapy in a community hospital. To evaluate the occurrence of bleeding and venous thromboembolic (VTE) events in patients receiving rivaroxaban, warfarin, or warfarin with the addition of enoxaparin during the immediate postoperative period following major orthopedic surgery.Patients older than 18 years who received at least one dose (...) of rivaroxaban the morning following surgery, adjusted dose warfarin, or adjusted dose warfarin with the addition of enoxaparin for VTE prophylaxis after major orthopedic surgery between October 1, 2011, and February 28, 2015, were included. Data collected from the electronic health record included patient demographics, renal function, inpatient aspirin, P2Y12 inhibitor and/or nonsteroidal antiinflammatory drug (NSAID) use, type of surgery, postoperative analgesia, and presence of VTE risk factors. Adjusted

2016 Pharmacotherapy

26. Oral drug therapy following bariatric surgery: an overview of fundamentals, literature and clinical recommendations. (Abstract)

Oral drug therapy following bariatric surgery: an overview of fundamentals, literature and clinical recommendations. Bariatric surgery is the most effective solution for severe obesity and obesity with comorbidities, and the number of patients going through bariatric surgery is rapidly and constantly growing. The modified gastrointestinal anatomy of the patient may lead to significant pharmacokinetic alterations in the oral absorption of drugs after the surgery; however, because of insufficient (...) available literature and inadequate awareness of the medical team, bariatric surgery patients may be discharged from the hospital with insufficient instructions regarding their medication therapy. In this article, we aim to present the various mechanisms by which bariatric surgery may influence oral drug absorption, to provide an overview of the currently available literature on the subject, and to draw guidelines for the recommendations bariatric surgery patients should be instructed before leaving

2016 Obesity Reviews

27. Long-term clinical effectiveness of continuous positive airway pressure therapy versus non-invasive ventilation therapy in patients with obesity hypoventilation syndrome: a multicentre, open-label, randomised controlled trial. (Abstract)

Long-term clinical effectiveness of continuous positive airway pressure therapy versus non-invasive ventilation therapy in patients with obesity hypoventilation syndrome: a multicentre, open-label, randomised controlled trial. Obesity hypoventilation syndrome is commonly treated with continuous positive airway pressure or non-invasive ventilation during sleep. Non-invasive ventilation is more complex and costly than continuous positive airway pressure but might be advantageous because (...) it provides ventilatory support. To date there have been no long-term trials comparing these treatment modalities. We therefore aimed to determine the long-term comparative effectiveness of both treatment modalities.We did a multicentre, open-label, randomised controlled trial at 16 clinical sites in Spain. We included patients aged 15-80 years with untreated obesity hypoventilation syndrome and an apnoea-hypopnoea index of 30 or more events per h. We randomly assigned patients, using simple randomisation

2019 Lancet Controlled trial quality: predicted high

28. Including Lifestyle Medicine in Medical Education: Rationale for American College of Preventive Medicine/American Medical Association Resolution 959. Full Text available with Trip Pro

and continuing medical education. Resolution 959 was passed to help address the current healthcare costs of lifestyle-related, noncommunicable chronic diseases that exert a devastating economic burden on the U.S. healthcare system. Approximately 86% of $2.9 trillion is spent annually on obesity, cardiovascular disease, type 2 diabetes, and some cancers, with very poor return on investment for health outcomes. Lifestyle medicine provides an evidence-based solution to the noncommunicable chronic disease (...) Including Lifestyle Medicine in Medical Education: Rationale for American College of Preventive Medicine/American Medical Association Resolution 959. Introduced by the American College of Preventive Medicine and released by the American Medical Association House of Delegates in 2017, Resolution 959 (I-17) supports policies and mechanisms that incentivize and/or provide funding for the inclusion of lifestyle medicine education and social determinants of health in undergraduate, graduate

2019 American journal of preventive medicine

29. Anti-Inflammatory Small Drug Adjunctive Therapy for Type 2 Diabetes

: Crossover Assignment Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor) Primary Purpose: Treatment Official Title: Neutrophil Elastase Inhibition as Adjunctive Therapy to Improve Glucometabolic Variables in Overweight and Obese, Insulin-Resistant Type 2 Diabetic Patients Study Start Date : November 2015 Estimated Primary Completion Date : April 2019 Estimated Study Completion Date : May 2019 Resource links provided by the National Library of Medicine related topics (...) of T2D-associated inflammation. This novel and innovative clinical trial will test the efficacy of a leukocyte-selective anti-inflammatory small drug as adjunctive therapy in improving insulin sensitivity in obese, insulin-resistant type 2 diabetic subjects. This trial also offers a first-in-kind opportunity to better understand the role of specific leukocyte populations in type 2 diabetes. The drug's clinical profile suggests that it will be well-tolerated with few, if any, side effects

2015 Clinical Trials

30. Outcomes from a Whole-Systems Ayurvedic Medicine and Yoga Therapy Treatment for Obesity Pilot Study. Full Text available with Trip Pro

Outcomes from a Whole-Systems Ayurvedic Medicine and Yoga Therapy Treatment for Obesity Pilot Study. To determine the feasibility and acceptability of an Ayurveda/Yoga intervention for weight loss, using dual-diagnosis inclusion criteria, dual-paradigm outcomes, and a semistandardized protocol with tailoring according to the Ayurvedic constitution/imbalance profile of each participant.Seventeen participants enrolled in a weekly intervention for 3 months. Outcome measurements were performed (...) also improved. No additional services were provided to participants during the follow-up period.A whole-systems Ayurvedic medicine and Yoga therapy approach provides a feasible promising noninvasive low-cost alternative to traditional weight loss interventions with potential added benefits associated with sustainable holistic lifestyle modification and positive psychosocial changes.

2019 Journal of Alternative and Complementary Medicine

31. A randomised controlled trial of a duodenal-jejunal bypass sleeve device (EndoBarrier) compared with standard medical therapy for the management of obese subjects with type 2 diabetes mellitus. Full Text available with Trip Pro

A randomised controlled trial of a duodenal-jejunal bypass sleeve device (EndoBarrier) compared with standard medical therapy for the management of obese subjects with type 2 diabetes mellitus. The prevalence of obesity and obesity-related diseases, including type 2 diabetes mellitus (T2DM), is increasing. Exclusion of the foregut, as occurs in Roux-en-Y gastric bypass, has a key role in the metabolic improvements that occur following bariatric surgery, which are independent of weight loss (...) , controlled, non-blinded trial, male and female patients aged 18-65 years with a body mass index 30-50 kg/m2 and inadequately controlled T2DM on oral antihyperglycaemic medications (glycosylated haemoglobin (HbA1c) 58-97 mmol/mol) will be randomised in a 1:1 ratio to receive either the EndoBarrier device (n=80) for 12 months or conventional medical therapy, diet and exercise (n=80). The primary outcome measure will be a reduction in HbA1c by 20% at 12 months. Secondary outcome measures will include

2017 BMJ open Controlled trial quality: uncertain

32. Distinct patterns in the gut microbiota after surgical or medical therapy in obese patients Full Text available with Trip Pro

Distinct patterns in the gut microbiota after surgical or medical therapy in obese patients Bariatric surgery is highly successful in improving health compared to conventional dietary treatments. It has been suggested that the gut microbiota is a relevant factor in weight loss after bariatric surgery. Considering that bariatric procedures cause different rearrangements of the digestive tract, they probably have different effects on the gut microbiota. In this study, we compared the impact (...) of medical treatment, sleeve gastrectomy and Roux-en-Y gastric bypass on the gut microbiota from obese subjects. Anthropometric and clinical parameters were registered before, 6 and 12 months after treatment. Fecal samples were collected and microbiota composition was studied before and six months post treatment using 16S rRNA gene sequencing and qPCR. In comparison to dietary treatment, changes in intestinal microbiota were more pronounced in patients subjected to surgery, observing a bloom

2017 PeerJ

33. Surgical and Advanced Medical Therapy for the Treatment of Type 2 Diabetes in Class I Obese Patients: a Short-Term Outcome. (Abstract)

Surgical and Advanced Medical Therapy for the Treatment of Type 2 Diabetes in Class I Obese Patients: a Short-Term Outcome. Bariatric surgery, incretin-based therapy (glucagon-like peptide-1 analogues), and sodium-glucose co-transporter 2 (SGLT2) inhibitors have antidiabetic properties in morbidly obese patients. However, their comparative efficacy in treating type 2 diabetes mellitus (T2DM) in class I obese patients specifically in Indian has not been studied yet. This study evaluates (...) and compares the efficacy and side effect of surgical and advanced medical management of T2DM in class I obese patients.T2DM patients with body mass index ranging from 30 to 35 kg/m2 and with a median duration of 3 years and HbA1c level >7.5% were recruited for the study. Selection of treatment option that is bariatric surgery, GLP-1 analogues and SGLT2 inhibitor, was kept on patient's choice. Each group had 30 patients after 12 months of follow-up. Fasting plasma glucose (FPG), HbA1c, and lipid profile

2017 Obesity Surgery

34. Cellular and Molecular Mechanisms Underlying Non-Pharmaceutical Ischemic Stroke Therapy in Aged Subjects Full Text available with Trip Pro

Cellular and Molecular Mechanisms Underlying Non-Pharmaceutical Ischemic Stroke Therapy in Aged Subjects The incidence of ischemic stroke in humans increases exponentially above 70 years both in men and women. Comorbidities like diabetes, arterial hypertension or co-morbidity factors such as hypercholesterolemia, obesity and body fat distribution as well as fat-rich diet and physical inactivity are common in elderly persons and are associated with higher risk of stroke, increased mortality (...) and disability. Obesity could represent a state of chronic inflammation that can be prevented to some extent by non-pharmaceutical interventions such as calorie restriction and hypothermia. Indeed, recent results suggest that H₂S-induced hypothermia in aged, overweight rats could have a higher probability of success in treating stroke as compared to other monotherapies, by reducing post-stroke brain inflammation. Likewise, it was recently reported that weight reduction prior to stroke, in aged, overweight

2017 International journal of molecular sciences

35. Identifying obesity/overweight status in children and adolescents; A cross-sectional medical record review of physicians' weight screening practice in outpatient clinics, Saudi Arabia. Full Text available with Trip Pro

the paper medical records of children and adolescents (6-14 years) who visited family medicine and pediatric outpatient clinics (Jan-June 2012) in a medical city in Riyadh. Investigators calculated BMI percentiles (using height, weight, age and gender data retrieved from the records) in order to identify patient weight status. Physician documentation of obesity/overweight diagnoses in patient problem lists were cross checked against their BMI percentile to assess the accuracy of physicians (...) Identifying obesity/overweight status in children and adolescents; A cross-sectional medical record review of physicians' weight screening practice in outpatient clinics, Saudi Arabia. BMI is a feasible and recommended measure for overweight and obesity screening in children and adolescents. The study aimed to determine how often physicians correctly identified obesity/ overweight status in children and adolescents by using BMI percentile charts.This retrospective cross-sectional study reviewed

2019 PLoS ONE

36. Dietary management of blood glucose in medical critically ill patients with overweight/obesity. (Abstract)

Dietary management of blood glucose in medical critically ill patients with overweight/obesity. As the obesity epidemic continues, there is a greater proportion of patients with overweight, obesity, and other forms of adiposity-based chronic disease that require intensive care. Nutrition therapy in the ICU is a vital part of critical care but can be challenging in this setting because of the increased risk of stress hyperglycemia and adverse impact of obesity- and diabetes-related (...) complications.Current guidelines favor early nutritional therapy with a hypocaloric, high-protein diet in patients with overweight/obesity. More aggressive protein intake may be useful in those with greater severity of overweight/obesity with an upper limit of 3 g/kg ideal body weight per day. Although there is no specific recommendation, choosing enteral formulas with higher fat content and slower digesting carbohydrates may assist with glucose control. Supplementation with immunonutrients is recommended, given

2020 Current opinion in clinical nutrition and metabolic care

37. Observational Comparative Effectiveness of Pharmaceutical Treatments for Obesity within the Veterans Health Administration. (Abstract)

Observational Comparative Effectiveness of Pharmaceutical Treatments for Obesity within the Veterans Health Administration. To compare the effectiveness of weight-management medications used to assist with weight loss in real-world clinical practice in the Veterans Health Administration (VHA).Retrospective, multicenter, observational cohort study.National VA Corporate Data Warehouse.A total of 66,035 VA patients aged 18 years or older with a body mass index of 25 kg/m2 or greater who had (...) an initial fill for a study medication (orlistat [6153 patients], phentermine [304 patients], lorcaserin [298 patients], or phentermine-topiramate extended release [233 patients]) or participation in the VA's MOVE! weight-management program with at least three total visits in a clinic coded as a MOVE clinic in the subsequent 24 weeks (59,047 patients) between January 1, 2012, and July 1, 2016.The primary outcome was the percentage change in weight from baseline to at least 20 weeks or later (i.e

2017 Pharmacotherapy

38. Progestin therapy for obese women with complex atypical hyperplasia: levonorgestrel-releasing intrauterine device vs systemic therapy. (Abstract)

Progestin therapy for obese women with complex atypical hyperplasia: levonorgestrel-releasing intrauterine device vs systemic therapy. Though hysterectomy remains the standard treatment for complex atypical hyperplasia, patients who desire fertility or who are poor surgical candidates may opt for progestin therapy. However, the effectiveness of the levonorgestrel-releasing intrauterine device compared to systemic therapy in the treatment of complex atypical hyperplasia has not been well (...) ) and a lower likelihood of progression to cancer (4.5% vs 15.7%; adjusted hazard ratio, 0.28; 95% confidence interval, 0.11-0.73) compared to those who received systemic therapy. In particular, women with class III obesity derived a higher relative benefit from levonorgestrel-releasing intrauterine device therapy in achieving complete response compared to systemic therapy: class III obesity, adjusted hazard ratio 4.72, 95% confidence interval 2.83-7.89; class I-II obesity, adjusted hazard ratio 1.83, 95

2020 American Journal of Obstetrics and Gynecology

39. Liraglutide (Saxenda) and obesity: there are still no satisfactory weight loss drugs

therapy. Full review (4 pages) available for download by subscribers. Abstract No existing weight loss drug has an acceptable harm-benefit balance. Liraglutide, a GLP-1 agonist administered by subcutaneous injection and already authorised in type 2 diabetes, is also approved for use in the European Union by obese patients or overweight individuals with other cardiovascular risk factors. The recommended dose in this setting is 3 mg per day, instead of the dose of 1.2 to 1.8 mg per day used in diabetes (...)  |   |  Spotlight Liraglutide (Saxenda°) and obesity: there are still no satisfactory weight loss drugs FEATURED REVIEW On average, daily liraglutide injections for one year help patients lose only a few kilograms compared with placebo, and weight is gradually regained after treatment discontinuation. Patients who are overweight or obese should not be exposed to the frequent gastrointestinal disorders and the risk of pancreatitis associated with long-term, high-dose liraglutide

2016 Prescrire

40. Echocardiographic Changes with Positive Airway Pressure Therapy in Obesity Hypoventilation Syndrome. Long-Term Pickwick Randomized Controlled Clinical Trial

Echocardiographic Changes with Positive Airway Pressure Therapy in Obesity Hypoventilation Syndrome. Long-Term Pickwick Randomized Controlled Clinical Trial Echocardiographic Changes With Positive Airway Pressure Therapy in Obesity Hypoventilation Syndrome. Long-Term Pickwick Randomized Controlled Clinical Trial - PubMed This site needs JavaScript to work properly. Please enable it to take advantage of the complete set of features! Welcome to the new PubMed. For legacy PubMed go to . Clipboard (...) collection: Name must be less than 100 characters Choose a collection: Unable to load your collection due to an error Add Cancel Add to My Bibliography My Bibliography Unable to load your delegates due to an error Add Cancel Actions Cite Share Permalink Copy Page navigation Am J Respir Crit Care Med Actions , 201 (5), 586-597 2020 Mar 1 Echocardiographic Changes With Positive Airway Pressure Therapy in Obesity Hypoventilation Syndrome. Long-Term Pickwick Randomized Controlled Clinical Trial

2020 EvidenceUpdates

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