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Query: UMLS:C0028754 (obesity)
 124,988 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Sixty-five patients were studied prospectively after jejunoileal bypass for obesity. Dietary intake pre- and postoperatively was measured either directly by weighing food or by a research dietary history. Of 65 measurements, 59 were made at least 6 months after operation, when over 75% of weight loss had been achieved. Fat absorption was measured in 42 of the patients. The entire group ate fewer calories (mean +/- SE = 2595 +/- 135) postoperatively than preoperatively (mean +/- SE = 3261 +/- 138). This difference was highly significant (P less than 0.001). Forty-eight patients ate less after their operation. The caloric deficit calculated from the observed weight loss could be accounted for entirely by the estimated decrease in intake in 22 of the 48 patients who ate less postoperatively. Moreover, measured fat malabsorption accounted for only 31% of the observed weight loss in those who ate more postoperatively and 21% in those who ate less. We conclude that a decrease in caloric intake, along with malabsorption, is an important factor in the long term postoperative weight loss (1-9 months) after jejunoileal bypass for obesity.
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PMID:Role of caloric intake in the weight loss after jejunoileal bypass for obesity. 61 31

Bypassing the small intestine is used for the treatment of extreme obesity. Because of the altered morphological and functional situation, the assessment of radiological sequelae is different. Passage is rapid, continuous observation is essential. Passage time is related to weight loss. Multiple small fluid levels in the small intestine are an expression of the stasis in the bypassed intestinal loops. They are of clinical importance only when there are other complaints at the same time. A reflux is of particular importance in relation to the expected loss in weight. Absorption studies with radioactive isotopes show the extent of the malabsorption.
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PMID:[Radiological findings after jejunoileal shunt for the treatment of extreme adiposity]. 82 Sep 82

Intestinal bypass for obesity can be justified only if the risks of excess weight are higher than those of the surgery. Indications for this surgery need to be carefully defined and the patient and family should clearly understand the potential risks and benefits. Weight loss results from a decrease in food intake, altered taste preferences, and malabsorption. The benefits of this treatment are permanent weight loss, improved psychosocial function, and a reduction in medical morbidity. The potential risks consist of mortality, a variety of postoperative complications, liver failure, renal stones, and the consequences of bacterial overgrowth in the defunctionalized bowel. This operation trades the consequences of a short bowel for obesity and should only be undertaken where a skilled team of surgeons, internists, and psychiatrists are available and able to provide the necessary preoperative and postoperative managements.
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PMID:Intestinal bypass for obesity a summary and perspective. 83 34

Seven subjects who underwent jejunoileal bypass surgery for massive obesity participated in a study to examine the relative bioavailability of digoxin before and one to two months after surgery. They were given a loading dose of 1 mg digoxin in divided oral doses followed by oral maintenance doses of 0.5 mg daily. There were no significant differences in the area under the serum concentration time curve, steady state serum levels or 24 hour steady state excretion of digoxin before and after surgery. We conclude that the bioavailability of digoxin from the Lanoxin tablets employed is not impaired in these patients, although urinary d-xylose and 24 hour fecal fat excretion indicated moderate to severe malabsorption after surgery.
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PMID:The effect of jejunoileal bypass on the pharmacokinetics of digoxin in man. 83 89

More than 250 patients with extreme obesity were treated at the Chir. Univ.-Klinik Erlangen by 30 + 20 cm jejunoileostomy. The patients lose overweight and reach nearly normal weight after 9-12 months. Carbohydrate intolerance and hypertriglyceridema disappear. Ensuing malabsorption and also the surgical procedure are responsible for complications like wound infection or intussuception. The resulting chronic vomitting causes hypoproteinemia, hypokaliemia and liver dysfunction. Continuous therapeutical substitution is necessary, especially of potassium, to avoid deficiency. The diarrhea is treated by drug administration, i.e Reasec. The long time results are not yet sufficiently known. Calcium deficiency may occur many years later. The rate of cholelithiasis and nephrolithiasis ranges from 2 to 10%. The over-all lethality over 5 years is 2,8% as seen in the patients of our clinic during the past 6 years.
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PMID:[Internal complications following jejunoileostomy in the treatment of extreme obesity]. 88 50

The authors report a personal experience of 16 cases and in the light of data in the world literature, the authors discuss the controversial method of treatment of very severe obesity when medical treatment has failed. The onset of various complications linked mainly to intestinal malabsorption, should make one careful in the indications for surgery which may, however, be applicable in certain cases.
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PMID:[Jejuno-ileal short-circuit operations in the treatment of obesity. 16 personal cases (author's transl)]. 88 24

Food intake was measured in 22 obese patients before and after jejunioleostomy for obesity. Most of the weight loss could be accounted for by the observed reduction of caloric intake. Malabsorption was also present as indicated by increased loss of fat in the stools, and decreased absorption of D-xylose and vitamin B12. A dislike for sweet tastes developed after surgery in most patients. Preferences for concentrated solutions of sucrose and glucose were reduced after patients showed a depression of food intake by a 440-calorie preload which had not been detected before surgery. These studies show a decrease in food intake after intestinal bypass surgery and suggest a role for taste or other gastrointestinal factors in regulating food intake.
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PMID:Intestinal bypass surgery for obesity decreases food intake and taste preferences. 93 32

A study was conducted on 7 fertile women (ages 19-44) after end-side jejunoileostomy for obesity. The peak plasma norethindrone (norethisterone) and levonorgestrel (formerly known as d-norgestrel) levels were measured during separate 24-hour norethindrone or levonorgestrel loads using conventional oral contraceptives (OCs). Compared to normal control patients, the intestinal bypass patients had severely reduced mean levels. The levels were 5.0 versus 20.8 ng/ml for norethindrone and the levels were 1.63 versus 4.25 ng/ml for levonorgestrel. Investigation of the patients' sex steroid binding globulin levels showed markedly reduced levels, implying a defective hepatic synthesis of this globulin rather than malabsorption as the most important factor. The data shows a reduced plasma level of OC in patients operated in this way, and OCs cannot be considered safe after intestinal bypass.
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PMID:Oral contraceptives after intestinal bypass operations. 103 86

Using the glycine-l-14C-cholic acid (14C-GCA) test, bile salt deconjugation and excretion were studied in 26 subjects with morbid exogenous obesity before and at selected intervals after jejuno-ileal bypass. In the preoperative group there was no malabsorption or intestinal bacterial deconjugation of the bile salts. In the immediate postoperative period (with relative sterilization of the bowel) there was only a trace of 14C in the breath, but the fecal 14C was highly elevated, indicating severe malabsorption without bacterial activity. In the 8 to 10 day postoperative period both the breath and fecal 14C content were highly elevated, indicating malabsorption and normal bacterial activity. Five to 8 months postoperatively both the breath and fecal 14C content showed only moderate elevation, indicating adaptation. It is suggested that the 14C-GCA test is useful in evaluating the adequacy of small bowel bypass procedures and also in following the adaptive response after the bypass. A significant increase in the breath and fecal 14C soon after surgery followed by rapid decrease suggests an adequate bypass and unusually fast adaptation. If the increase in the breath and fecal 14C soon after the bypass is only moderate, then that suggests an inadequate bypass.
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PMID:Studies on bile salt deconjugation following small bowel bypass procedures. 113 Aug 57

Osteomalacia is characterized by large osteoid seams and a preserved volume of bone trabeculae. The mineralization of newly formed bone requires adequate concentrations of calcium and phosphate: the Ca.P product has been regarded as a useful, empirical diagnostic test of osteomalacia. It decreases in patients with osteomalacia mainly because they have very low plasma phosphate levels. At present total body bone mineral and total body bone density can be directly measured by whole body absorptiometry, which indicates the lowest total mineral content of the skeleton which can increase quickly after adequate treatment. The main symptoms of osteomalacia are: bone pain; muscular weakness (commonly as pelvic girdle myopathy); Looser-Milkman pseudofractures or more often a pattern of generalized demineralization at X-ray. The main biochemical parameters in osteomalacia include: defective calcium absorption with hypocalcemia and hypocalciuria; defective intestinal phosphate absorption with hypophosphatemia; there is often increased renal phosphate clearance due to hypocalcemia and secondary hyperparathyroidism; elevated alkaline phosphatase and osteocalcin levels; high bone turnover confirmed by kinetic studies carried out with radiocalcium or 99mTc-MDP. An etiological classification of the osteomalacias includes: 1) nutritional osteomalacia: a) inadequate exposure to sunlight and/or insufficient vitamin D intake; b) defective intestinal absorption of vitamin D because of malabsorption syndromes (e.g. jejuno-ileal bypass for obesity).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The osteomalacias. 166 41


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