scholarly journals Role of ethnicity in overweight and obese patients with nonalcoholic steatohepatitis

Hepatology ◽  
2011 ◽  
Vol 54 (3) ◽  
pp. 837-845 ◽  
Author(s):  
Romina Lomonaco ◽  
Carolina Ortiz-Lopez ◽  
Beverly Orsak ◽  
Joan Finch ◽  
Amy Webb ◽  
...  
Keyword(s):  
Nonalcoholic Steatohepatitis ◽  
Obese Patients

scholarly journals The Role of Three‐Dimensional Magnetic Resonance Elastography in the Diagnosis of Nonalcoholic Steatohepatitis in Obese Patients Undergoing Bariatric Surgery

Hepatology ◽  
2019 ◽  
Vol 71 (2) ◽  
pp. 510-521 ◽  
Author(s):  
Alina M. Allen ◽  
Vijay H. Shah ◽  
Terry M. Therneau ◽  
Sudhakar K. Venkatesh ◽  
Taofic Mounajjed ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Magnetic Resonance ◽  
Nonalcoholic Steatohepatitis ◽  
Three Dimensional ◽  
Magnetic Resonance Elastography ◽  
Obese Patients

scholarly journals Nonalcoholic Steatohepatitis: An Evolving Diagnosis

2000 ◽  
Vol 14 (4) ◽  
pp. 321-326 ◽  
Author(s):  
Brent A Neuschwander-Tetri
Keyword(s):  
Alcohol Abuse ◽  
Liver Biopsy ◽  
Nonalcoholic Steatohepatitis ◽  
Aminotransferase Level ◽  
Obese Patients ◽  
Imaging Studies ◽  
Liver Transplants ◽  
Pathophysiological Role ◽  
Alanine Aminotransferase Level

Nonalcoholic steatohepatitis (NASH) is a histological diagnosis applied to a constellation of liver biopsy findings that develop in the absence of alcohol abuse. Steatosis, a mixed cellular inflammatory infiltrate across the lobule, evidence of hepatocyte injury and fibrosis are the findings that can be seen. This entity is often identified during evaluation of elevated aminotransferases after exclusion of viral, metabolic and other causes of liver disease. Obesity is a major risk factor for NASH. The role of diabetes is less certain, although evidence is accumulating that hyperinsulinism may play an important pathophysiological role. Patients sometimes suffer from right upper quadrant abdominal pain and fatigue; examination may reveal centripetal obesity and hepatomegaly. Although patients are often discovered because of persistent aminotransferase elevations, these enzymes can be normal in NASH. When they are elevated, the alanine aminotransferase level is typically significantly greater than the aspartate aminotransferase level. This can be particularly helpful for excluding occult alcohol abuse. Imaging studies identify hepatic steatosis when the amount of fat in the liver is significant; however, imaging does not distinguish benign steatosis from NASH. Ultimately a liver biopsy is needed to diagnose NASH. The biopsy may be useful for establishing prognosis based on the presence or absence of fibrosis and for excluding other unexpected causes of liver enzyme elevations. Weight loss is the mainstay of treatment for obese patients. About 15% to 40% of NASH patients develop fibrosis; how many of these cases progress to cirrhosis is unknown, but about 1% of liver transplants are performed with a pretransplant diagnosis of NASH.

The Role of Laparoscopic Anti-Reflux Surgery in Obese Patients with Gastroesophageal Reflux Disease

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
Flores Edgar Vargas ◽  
Cortez Juan Carlos Quintana ◽  
Contreras Jose Luis Ledesma ◽  
Medina Yazmin Berrones ◽  
Zhou Lucero Chao
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Obese Patients

scholarly journals Obesity and Spine Surgery: A Qualitative Review About Outcomes and Complications. Is It Time for New Perspectives on Future Researches?

2021 ◽  
pp. 219256822110223
Author(s):  
Fabio Cofano ◽  
Giuseppe Di Perna ◽  
Daria Bongiovanni ◽  
Vittoria Roscigno ◽  
Bianca Maria Baldassarre ◽  
...  
Keyword(s):  
Spine Surgery ◽  
Clinical Results ◽  
Grading System ◽  
Obese Patients ◽  
Lumbar Surgery ◽  
Operative Care ◽  
Operative Complications ◽  
Proper Weight ◽  
Level 2

Study Design: Literature review. Objectives: An increasing number of obese patients requires operative care for degenerative spinal disorders. The aim of this review is to analyze the available evidence regarding the role of obesity on outcomes after spine surgery. Peri-operative complications and clinical results are evaluated for both cervical and lumbar surgery. Furthermore, the contribution of MIS techniques for lumbar surgery to play a role in reducing risks has been analyzed. Methods: Only articles published in English in the last 10 years were reviewed. Inclusion criteria of the references were based on the scope of this review, according to PRISMA guidelines. Moreover, only paper analyzing obesity-related complications in spine surgery have been selected and thoroughly reviewed. Each article was classified according to its rating of evidence using the Sacket Grading System. Results: A total number of 1636 articles were found, but only 130 of them were considered to be relevant after thorough evaluation and according to PRISMA checklist. The majority of the included papers were classified according to the Sacket Grading System as Level 2 (Retrospective Studies). Conclusion: Evidence suggest that obese patients could benefit from spine surgery and outcomes be satisfactory. A higher rate of peri-operative complications is reported among obese patients, especially in posterior approaches. The use of MIS techniques plays a key role in order to reduce surgical risks. Further studies should evaluate the role of multidisciplinary counseling between spine surgeons, nutritionists and bariatric surgeons, in order to plan proper weight loss before elective spine surgery.

scholarly journals Obstructive sleep apnea syndrome in non-obese patients

2021 ◽  
Author(s):  
Caterina Antonaglia ◽  
Giovanna Passuti
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Obstructive Sleep Apnea Syndrome ◽  
Sleep Apnea Syndrome ◽  
Obese Patients ◽  
Obstructive Sleep ◽  
Obese Subjects ◽  
Apnea Syndrome ◽  
Symptoms And Signs

AbstractObstructive sleep apnea syndrome (OSAS) is characterized by symptoms and signs of more than 5 apneas per hour (AHI) at polysomnography or 15 or more apneas per hour without symptoms. In this review, the focus will be a subgroup of patients: adult non-obese subjects with OSA and their specific features. In non-obese OSA patients (patients with BMI < 30 kg/m2), there are specific polysomnographic features which reflect specific pathophysiological traits. Previous authors identified an anatomical factor (cranial anatomical factors, retrognatia, etc.) in OSA non-obese. We have hypothesized that in this subgroup of patients, there could be a non-anatomical pathological prevalent trait. Little evidence exists regarding the role of low arousal threshold. This factor could explain the difficulty in treating OSA in non-obese patients and emphasizes the importance of a specific therapeutic approach for each patient.

Obesity and inflammation: colorectal cancer engines

2021 ◽  
Vol 14 ◽  
Author(s):  
Lara J. Bou Malhab ◽  
Wael M. Abdel-Rahman
Keyword(s):  
Colorectal Cancer ◽  
Immune Cell ◽  
Obese Patients ◽  
Epigenetic Alterations ◽  
Molecular Alterations ◽  
Stat3 Signaling ◽  
Therapeutic Choice ◽  
Prevalence Of Obesity ◽  
Inhibitory Molecules

: The prevalence of obesity continues to increase to the extent that it became a worldwide pandemic. An accumulating body of evidence has associated obesity with the development of different types of cancer, including colorectal cancer, which is a notorious disease with a high mortality rate. At the molecular level, colorectal cancer is a heterogenous disease characterized by a myriad of genetic and epigenetic alterations associated with various forms of genomic instability (detailed in Supplementary Materials). Recently, the microenvironment has emerged as a major factor in carcinogenesis. Our aim is to define the different molecular alterations leading to the development of colorectal cancer in obese patients with a focus on the role of the microenvironment in carcinogenesis. We also highlight all existent molecules in clinical trials that target the activated pathways in obesity-associated colorectal cancer, whether used as single treatments or in combination. Obesity predisposes to colorectal cancer via creating a state of chronic inflammation with dysregulated adipokines, inflammatory mediators, and other factors such as immune cell infiltration. A unifying theme in obesity-mediated colorectal cancer is the activation of the PI3K/AKT, mTOR/MAPK, and STAT3 signaling pathways. Different inhibitory molecules towards these pathways exist, increasing the therapeutic choice of obesity-associated colon cancer. However, obese patients are more likely to suffer from chemotherapy overdosing. Preventing obesity through maintaining a healthy and active lifestyle remains to be the best remedy.

Comments on the updated recommendations of the American College of Rheumatology (ACR) for the treatment of gout. Lifestyle (part 2)

2021 ◽  
Vol 15 (2) ◽  
pp. 83-88
Author(s):  
M. S. Eliseev
Keyword(s):  
Body Weight ◽  
Food Habits ◽  
The Other ◽  
Obese Patients ◽  
American College Of Rheumatology ◽  
The Russian Federation ◽  
The One ◽  
Effective Drugs ◽  
First Time

Updated ACR recommendations for the treatment of gout concerning lifestyle are discussed. Factors related to a lifestyle, above all food habits, for many years were of leading importance in the treatment of patients with gout, even after application of effective drugs. The authors of the updated ACR recommendations for the first time offered to reconsider the role of environmental factors in the genesis of gout and objectively assess the possibility of its non-drug treatment. On the one hand, regardless of the activity of the disease, the need for restrictions of the alcohol, purine-rich products and fructose-containing beverages, as well as the decrease of body weight in obese patients and vitamin C usage unviability are confirmed. On the other hand, these recommendations are conditional. Their new version of ACR recommendations is significantly different from both its previous version and other international and national recommendations, including recommendations on the diagnosis and treatment of gout used in the Russian Federation.

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