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Obesity Medication

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61. Chronic Kidney Disease - Medical management of coronary artery disease (excluding lipid-lowering therapy)

Chronic Kidney Disease - Medical management of coronary artery disease (excluding lipid-lowering therapy) ________________________________________________________________________________________________________________________ Cardiovascular Disease May 2013 Page 1 of 34 Medical management of coronary artery disease (excluding lipid-lowering therapy) Date written: May 2012 Author: Gursharan Dogra GUIDELINES Acute coronary syndrome a. We recommend that all chronic kidney disease patients (...) disease was defined as a CrCl 60 mL/min). Thus the RRR due to captopril was 31% in CKD patients versus 20% in non-CKD patients but the interaction between study drug and CKD was not statistically significant (p = 0.29). The effect of ACEi therapy post-AMI in dialysis patients (stage 5 CKD) has been examined in a retrospective analysis of prospectively collected registry data [19]. The cohort studied consisted of 145,740 patients without end-stage renal disease and 1025 patients on dialysis

2013 KHA-CARI Guidelines

62. Medical therapies to reduce chronic kidney disease progression and cardiovascular risk: glycaemic control

Medical therapies to reduce chronic kidney disease progression and cardiovascular risk: glycaemic control ____________________________________________________________________________________________________________ Early Chronic Kidney Disease July 2012 Page 1 of 9 Medical therapies to reduce chronic kidney disease progression and cardiovascular risk: glycaemic control Date written: July 2012 Author: Richard Phoon, David Johnson GUIDELINES a. We recommend that patients with early (stage 1-3 (...) ] ____________________________________________________________________________________________________________ Early Chronic Kidney Disease July 2012 Page 2 of 9 Taken together, CKD is a significant contributor of morbidity and mortality, and represents a major expense to the health care system. Early intervention with appropriate medical therapies is essential to address this public health burden and may reduce the progression of CKD and CV risk by up to 50%. [27] The objective of this guideline is to review currently available evidence in this regard and provide appropriate clinical recommendations

2013 KHA-CARI Guidelines

63. Gastric Contractility Modulation (GCM) therapy for patients with Type 2 Diabetes with Obesity (DIAMOND system Funding Application)

surgeons performing the procedure would undergo formal training by MetaCure at specialised centres. 3 6. Proposal for public funding The applicant sought MBS funding for the implantation, removal, replacement and interrogation of a GCM device for the treatment of obese patients with inadequately controlled T2DM on standard oral anti-diabetic medication. GCM therapy uses an implanted electro-stimulator to deliver meal-dependent gastric stimulation to induce early satiety. Once implanted, the device can (...) Gastric Contractility Modulation (GCM) therapy for patients with Type 2 Diabetes with Obesity (DIAMOND system Funding Application) 1 Public Summary Document Application No. 1386 – gastric contractility modulation (GCM) therapy for patients with type 2 diabetes and obesity Applicant: MetaCure Australia Pty Ltd Date of MSAC consideration: MSAC 64 th Meeting, 30-31 July 2015 Context for decision: MSAC makes its advice in accordance with its Terms of Reference, see at www.msac.gov.au 1. Purpose

2015 Medical Services Advisory Committee

64. Association of Obesity With Multiple Sclerosis Risk and Response to First-line Disease Modifying Drugs in Children. (Abstract)

Association of Obesity With Multiple Sclerosis Risk and Response to First-line Disease Modifying Drugs in Children. Obesity reportedly increases the risk of pediatric multiple sclerosis (MS), but little is known about its association with disease course.To investigate the association of obesity with pediatric MS risk and with first-line therapy response among children with MS.This single-center retrospective study used the medical records and database at the Center for MS in Childhood (...) survey for odds ratio (OR) estimates. Baseline magnetic resonance imaging findings, intervals between first and second MS attacks, annualized relapse rates before and during treatment with interferon beta-1a or -1b and glatiramer acetate, frequency of second-line treatment, and Expanded Disability Status Scale (EDSS) scores were compared between nonoverweight (BMI≤90th percentile), overweight (BMI>90th-97th percentile), and obese (BMI>97th percentile) patients.In total, 453 patients with pediatric MS

2019 JAMA neurology

65. 30-days effects of vildagliptin on vascular function, plasma viscosity, inflammation, oxidative stress, and intestinal peptides on drug-naïve women with diabetes and obesity: a randomized head-to-head metformin-controlled study. Full Text available with Trip Pro

30-days effects of vildagliptin on vascular function, plasma viscosity, inflammation, oxidative stress, and intestinal peptides on drug-naïve women with diabetes and obesity: a randomized head-to-head metformin-controlled study. Obesity is the main risk factor for diabetes and excessive visceral fat triggers low-grade inflammatory process, mediated by activation and release of cytokines and high flow of free fatty acids that contribute to insulin resistance, increased oxidative stress (...) , and impaired endothelial function. Metformin and vildagliptin have known vasculoprotective actions, but the value of these drugs on drug-naïve diabetic patients during 30 days use warrants investigation. Our purpose was to observe their effects on endothelial function, oxidative stress, inflammatory biomarkers, and plasma viscosity.38 women with obesity and type 2 diabetes drug-naïve, aged between 19 and 50 years, BMI ≥ 30 kg/m2, were recruited and subjected to measurements of endothelial function

2019 Diabetology & metabolic syndrome Controlled trial quality: uncertain

66. A comparative effectiveness trial of two family-based childhood obesity treatment programs in a medically underserved region: Rationale, design & methods. (Abstract)

was guided by a community advisory board (CAB) and the RE-AIM planning and evaluation framework within a systems-based and community-based participatory research approach. Families with overweight or obese children between 5 and 12 years old, in the medically-underserved Dan River Region, were randomly assigned to one of two FBCO treatment programs (iChoose vs. Family Connections) delivered by local Parks & Recreation staff. Both programs have previously demonstrated clinically meaningful child BMI z (...) A comparative effectiveness trial of two family-based childhood obesity treatment programs in a medically underserved region: Rationale, design & methods. While there is a large body of literature documenting the efficacy of family-based childhood obesity (FBCO) treatment interventions, there is little evidence that these interventions have been systematically translated into regular practice - particularly in health disparate regions. To address this research-practice gap, this project

2019 Contemporary clinical trials Controlled trial quality: uncertain

67. Obesity in older adults: Effect of degree of weight loss on cardiovascular markers and medications. (Abstract)

Obesity in older adults: Effect of degree of weight loss on cardiovascular markers and medications. Obesity worsens the age-related tendency towards cardiovascular disease and diabetes. Older adults are vulnerable to medication adverse effects. Intentional weight loss in older adults with obesity has been shown to improve cardiovascular and glycaemic markers. The effect of rapid weight loss induced by very-low-calorie diets (VLCDs) on these markers has not been evaluated in this group (...) and inflammatory markers. Reductions in anti-hypertensive or diabetes medication were made in 4/29, 7/36 and 16/37 participants in Ex/HE, Ex/Diet and Ex/VLCD, respectively (P = .017). Significant weight loss achieved with a VLCD gave rise to improvements in multiple cardiovascular risk markers, despite reduction in medication. Weight loss is an under-utilized method of cardiovascular risk management in this group.© 2019 World Obesity Federation.

2019 Clinical Obesity Controlled trial quality: uncertain

68. [Supporting Patients with Diabetes mellitus type 2 and Obesity in Transfer of Medically Indicated Lifestyle Changes into Everyday Life by a Planning Competence Training in a Randomized Controlled Trial]. (Abstract)

[Supporting Patients with Diabetes mellitus type 2 and Obesity in Transfer of Medically Indicated Lifestyle Changes into Everyday Life by a Planning Competence Training in a Randomized Controlled Trial]. Patients with Diabetes mellitus type 2 and/or obesity have difficulties to transfer medically indicated lifestyle changes into everyday life. Hence, this study investigates whether a planning competence training (Planungskompetenztraining, PKT) can support participants of a medical (...) -analysis. Additionally, differences were primarily revealed in a 2 group comparison between participants who participated at training (EG-A and KG-B) vs. those who did not (KG-C und KG-D).The implementation of the current training version cannot be recommended for medical rehabilitation. However, in consideration of relevant results a modification of the program could make sense.© Georg Thieme Verlag KG Stuttgart · New York.

2019 Die Rehabilitation Controlled trial quality: uncertain

69. Food Insecurity Is Associated with an Increased Prevalence of Comorbid Medical Conditions in Obese Adults: NHANES 2007-2014. (Abstract)

Food Insecurity Is Associated with an Increased Prevalence of Comorbid Medical Conditions in Obese Adults: NHANES 2007-2014. Numerous studies have examined if food insecurity (FI) leads to increased weight gain, but little is known about how FI affects obese participants.Our objective was to determine if obese, food-insecure adults are more likely to have medical comorbidities than obese, food-secure adults.We conducted a cross-sectional study using the 2007-2014 National Health and Nutrition (...) ). Very low food security was associated with increased odds of coronary artery disease, diabetes, and asthma.Obese adults living in food-insecure households were more likely to have an increased number of comorbid conditions than obese adults living in food-secure households. Clinicians should be aware of the association between FI and comorbid medical conditions when treating patients with obesity.

2019 Journal of General Internal Medicine

70. Foundational knowledge regarding childhood obesity: a cross-sectional study of medical students. Full Text available with Trip Pro

, and Weight Control to medical students at a single university. Descriptive analyses assessed knowledge and attitudes of childhood obesity and diabetes.Of the 213 participating students, 74% indicated being unfamiliar with obesity screening recommendations. Few correctly identified BMI percentile cut-points for child overweight (21.2%), obesity (23.7%), and normal weight (29.4%). They reported screening glucose 4.5 years earlier in patients with risk factors compared to those without (p < 0.001).Although (...) Foundational knowledge regarding childhood obesity: a cross-sectional study of medical students. Documentation and diagnosis of childhood obesity in primary care is poor and providers are often unfamiliar with guidelines. This lack of knowledge may be attributed to insufficient training in medical school and residency; however, no studies have evaluated medical students' knowledge of recommendations.We distributed a modified version of the Physician Survey of Practice on Diet, Physical Activity

2019 BMC Public Health

71. Validation of obesity coding among newly treated nonvalvular atrial fibrillation patients using an integrated electronic medical record and claims database. (Abstract)

Validation of obesity coding among newly treated nonvalvular atrial fibrillation patients using an integrated electronic medical record and claims database. Objective: To evaluate the validity of diagnosis codes for identifying obesity and morbid obesity among newly treated nonvalvular atrial fibrillation (NVAF) patients. Methods: An integrated electronic medical record (EMR) and claims database (1 January 2013-31 March 2018) was used. Adult patients with ≥1 claim for an oral anticoagulant (OAC (...) ) from 1 January 2014-30 September 2017 were identified (index date). Patients were required to have ≥1 atrial fibrillation diagnosis, no OAC use or valvular disease during the 12 months before index date, ≥12 months of continuous enrollment before and ≥6 months after index date, and ≥1 BMI measurement 6 months before or after index date. Patients with BMI ≥30 kg/m2 and BMI ≥40 kg/m2 were classified as obese and morbidly obese, respectively. Sensitivity, specificity and positive predictive value (PPV

2019 Current medical research and opinion

72. Is an obesity simulation suit in an undergraduate medical communication class a valuable teaching tool? A cross-sectional proof of concept study. Full Text available with Trip Pro

Is an obesity simulation suit in an undergraduate medical communication class a valuable teaching tool? A cross-sectional proof of concept study. With the growing prevalence of overweight and obesity, medical students should be prepared to engage in weight management and obesity-related communications in order to prevent patients from having stigmatising experiences. In addition, medical students should have training to reduce anti-fat prejudices.Cross-sectional proof of concept (...) study.University Hospital Tuebingen, Germany.246 participants (207 second-year medical students, 13 standardised patients (SPs) and 22 teachers) took part in the study.The primary outcome was the assessment of degree of reality of the encounter with the SP wearing an obesity simulation suit (OSS). The secondary outcome was the evaluation of students' awareness and prejudice against patients with obesity in a simulated role play. Additionally, a description of the advantages and disadvantages when using

2019 BMJ open

73. Obesity is associated with significantly increased risk for diarrhoea after controlling for demographic, dietary and medical factors: a cross-sectional analysis of the 2009-2010 National Health and Nutrition Examination Survey. Full Text available with Trip Pro

and severely obese. Stepwise logistic regression provided risk ratios of constipation and diarrhoea controlling for confounding factors (dietary, life-style, psychological and medical).A total of 5126 respondents completed the BHQ, had BMI data available, and met eligibility criteria. Of these, 70 (1.40%) were underweight, 1350 (26.34%) were normal weight, 1731 (33.77%) were overweight, 1097 (21.40%) were obese and 878 (17.13%) were severely obese. Up to 8.5% of obese and 11.5% of severely obese (...) Obesity is associated with significantly increased risk for diarrhoea after controlling for demographic, dietary and medical factors: a cross-sectional analysis of the 2009-2010 National Health and Nutrition Examination Survey. Obesity is associated with increased risk for various gastrointestinal and liver diseases. However, the relationship between obesity and abnormal bowel habits is poorly understood.To investigate the relationship between body mass index (BMI) and bowel habit, controlling

2019 Alimentary Pharmacology & Therapeutics

74. 8. Obesity Management for the Treatment of Type 2 Diabetes: <i>Standards of Medical Care in Diabetes</i>-<i>2019</i>. Full Text available with Trip Pro

8. Obesity Management for the Treatment of Type 2 Diabetes: Standards of Medical Care in Diabetes-2019. The American Diabetes Association (ADA) "Standards of Medical Care in Diabetes" includes ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, a multidisciplinary expert committee, are responsible

2019 Diabetes Care

75. A Medically Supervised Pregnancy Exercise Intervention in Obese Women: A Randomized Controlled Trial Full Text available with Trip Pro

A Medically Supervised Pregnancy Exercise Intervention in Obese Women: A Randomized Controlled Trial To evaluate whether an intensive, medically supervised exercise intervention improved maternal glycemia and gestational weight gain in obese pregnant women when compared with routine prenatal care.This randomized controlled trial compared a medically supervised exercise intervention with routine prenatal care. The primary outcome was a reduction in mean maternal fasting plasma glucose (...) of gestation, excessive gestational weight gain greater than 9.1 kg was lower in the exercise group, 23.5% compared with 45.2% in the control group (P<.05).An intensive, medically supervised exercise intervention for obese women from early pregnancy did not improve maternal glycemia. Pregnant women who are obese, however, should be advised to exercise because it attenuates excessive gestational weight gain.International Standard Randomised Controlled Trials (ISRCTN) registry, ISRCTN 31045925.

2017 EvidenceUpdates

76. A Randomized, Controlled Multisite Study of Behavioral Interventions for Veterans with Mental Illness and Antipsychotic Medication-Associated Obesity Full Text available with Trip Pro

A Randomized, Controlled Multisite Study of Behavioral Interventions for Veterans with Mental Illness and Antipsychotic Medication-Associated Obesity Weight gain and other metabolic sequelae of antipsychotic medications can lead to medication non-adherence, reduced quality of life, increased costs, and premature mortality. Of the approaches to address this, behavioral interventions are less invasive, cost less, and can result in sustained long-term benefits.We investigated behavioral weight (...) management interventions for veterans with mental illness across four medical centers within the Veterans Affairs (VA) Healthcare System.We conducted a 12-month, multi-site extension of our previous randomized, controlled study, comparing treatment and control groups.Veterans (and some non-veteran women) diagnosed with mental illness, overweight (defined as having a BMI over 25), and required ongoing antipsychotic therapy.One group received "Lifestyle Balance" (LB; modified from the Diabetes Prevention

2017 EvidenceUpdates

77. Adjustable gastric band surgery or medical management in patients with type 2 diabetes and obesity: three-year results of a randomized trial. (Abstract)

Adjustable gastric band surgery or medical management in patients with type 2 diabetes and obesity: three-year results of a randomized trial. Few randomized trials have compared surgical versus lifestyle and pharmacologic approaches for type 2 diabetes (T2D) patients with mild to moderate obesity.This study examined resolution of hyperglycemia (A1C <6.5% and fasting glucose <126 mg/dL) 3 years after randomization to either a laparoscopic adjustable gastric band (LAGB) or 1-year diabetes (...) and weight management (DWM) program.University medical center, United States.Forty T2D patients (mean ± SD: age, 51.3 ±10.0 yr; weight 109.5 ± 15.0 kg; body mass index [BMI] 36.5 ± 3.7 kg/m2; HBA1C 8.2% ± 1.2%) were randomized to LAGB (n = 18) or DWM (n = 22).At 3 years, 13% of 16 patients in LAGB and 5% of 17 patients in DWM achieved resolution of hyperglycemia (P = .601), with a modestly greater reduction in antidiabetic medications in the surgical group (P = .054). Reductions from baseline in A1C were

2019 Surgery for Obesity and Related Diseases

78. Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Pediatric Critically Ill Patient: Society of Critical Care Medicine and American Society for Parenteral and Enteral Nutrition Full Text available with Trip Pro

Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Pediatric Critically Ill Patient: Society of Critical Care Medicine and American Society for Parenteral and Enteral Nutrition Guidelines for the Provision and Assessment of Nutrition Sup... : Pediatric Critical Care Medicine 1 mo and < 18 yr) critically ill patient expected to require a length of stay greater than 2 or 3 days in a PICU admitting medical, surgical, and cardiac patients. In total, 2,032 citations were (...) Medicine, to describe best practices in nutrition therapy in critically ill children. The target of these guidelines is intended to be the pediatric (> 1 mo and < 18 yr) critically ill patient expected to require a length of stay greater than 2 or 3 days in a PICU admitting medical, surgical, and cardiac patients. In total, 2,032 citations were scanned for relevance. The PubMed/Medline search resulted in 960 citations for clinical trials and 925 citations for cohort studies. The EMBASE search

2017 Society of Critical Care Medicine

79. Treatment of obesity: cost-benefit assessment of behavioral therapy, placebo, and two anorectic drugs. (Abstract)

Treatment of obesity: cost-benefit assessment of behavioral therapy, placebo, and two anorectic drugs. Mazindol, diethylpropion, and a placebo were compared with behavioral therapy for effectiveness in producing weight reduction in an outpatient obesity clinic. Each method was also compared in cost and harmful side effects. The patients were recruited from the middle and lower socioeconomic groups. Of the 120 patients beginning treatment, only 33 completed the entire 14-week study (...) . There was no statistically significant difference in the weight loss among the treatment groups. The program of behavioral therapy was administered by a dietitian who as experienced in the techniques of behavior modification; the drug treatment groups were seen by physicians. We conclude that behavioral therapy may be the treatment of choice in an outpatient obese population since it requires little physician time, is less expensive, and avoids the side effects of anorectic drugs.

1978 The American journal of clinical nutrition

80. What is the Role of Drug Therapy in Treating Obesity?

What is the Role of Drug Therapy in Treating Obesity? What is the Role of Drug Therapy in Treating Obesity? – Clinical Correlations Search What is the Role of Drug Therapy in Treating Obesity? November 19, 2009 6 min read Arlene Chung Faculty Peer Reviewed Despite the high prevalence of obesity 1 and its associated morbidity 2 and mortality 3,4 , it represents one of the most difficult chronic conditions to treat. Barriers include a metabolically toxic environment, a history of ill-fated weight (...) can be treated in four different ways: (1) reduction of calorie intake through decreased appetite or (2) decreased nutrient absorption, (3) increase in energy expenditure, and (4) direct removal of fat. 6 These targets can be achieved through changes in diet and lifestyle, medication, surgery, or some combination of the above. All overweight and obese patients should follow a reduced-calorie diet and increase their physical activity, whether or not they choose to pursue adjunctive medication

2009 Clinical Correlations

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