Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0028754 (obesity)
 124,988 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Wernicke's encephalopathy (WE) is a disease caused by thiamine deficiency related to alcoholism, hyperemesis, or thiamine malabsorption. The clinical manifestations of WE are mental change, ataxia, and ophthalmoplegia. The typical magnetic resonance imaging (MRI) findings of WE are symmetrical involvement of medial thalamus, periventricular region of the third ventricle, periaqueductal area, and mammillary body. The atypical MRI findings are more common in nonalcoholic WE. Since the increasing population of obesity and the preference of weight loss surgery, the risk of developing thiamine deficiencies associated with weight loss surgery has become a considerable etiology of WE. We herein reported a case reminds clinicians that WE can be a possible diagnosis in patient who developed acute altered mental status with atypical MRI lesion involving bilateral centrum semiovale and corona radiata after receiving bariatric surgery.
 ...
PMID:Wernicke's Encephalopathy after Bariatric Surgery with Atypical Magnetic Resonance Imaging: A Case Report. 2875 11

Intragastric balloon (IGB) therapy is a widely used technique to counter obesity, and it is known to be safe and effective. Although there can be a high rate of side effects following IGB therapy, most are self-healing and they are mainly accommodative in nature. Few cases of Wernicke's syndrome under IGB therapy have been described in the literature, and to the best of our knowledge, none have been fatal. We present here a case of a 51-year-old woman who underwent IGB therapy over 8 months. Late diagnosed Wernicke's syndrome that first appeared as lower limb neuropathy progressively immobilized the patient, until she required bed rest. Finally, a major complication of pneumonia caused her death. Wernicke's syndrome has been mainly related to bariatric surgery techniques, but it must also be linked to IGB therapy (and also to other restrictive weight-loss interventions). As the use of IGB therapy spreads, the literature must alert physicians to this complication. Wernicke's syndrome is a severe but reversible condition when diagnosed and treated early.
 ...
PMID:An Autopsy Case of Misdiagnosed Wernicke's Syndrome after Intragastric Balloon Therapy. 2966 18

Thiamine is an important coenzyme, which is essential for metabolism and maintaining cellular osmotic gradient. Thiamine deficiency can cause focal lactic acidosis, alteration of the blood-brain barrier and the production of free radicals through cell death by necrosis and apoptosis. Wernicke encephalopathy (WE) is a clinical diagnosis. Cytotoxic and vasogenic oedema are the most typical neuroimaging findings of WE, presenting as bilateral symmetrical hyperintense signals on T2-weighted MR images. MRI is not necessary for the diagnosis of WE, but it can be helpful in ruling out alternative diagnosis. We present the case of an 61-year-old man with the history of class II obesity presenting with diplopia, dysarthria and vertigo, confirmed to be non-alcoholic WE. We aim to highlight the occurrence of WE in patients with large bowel resection though. Delay in diagnosis, particularly in obese individuals due to lack of suspicion, can lead to grim prognosis.
 ...
PMID:Non-alcoholic Wernicke encephalopathy: great masquerader. 3059 27

Objective: The development of these updated clinical practice guidelines (CPGs) was commissioned by the American Association of Clinical Endocrinologists (AACE), The Obesity Society, American Society of Metabolic and Bariatric Surgery, Obesity Medicine Association, and American Society of Anesthesiologists Boards of Directors in adherence with the AACE 2017 protocol for standardized production of CPGs, algorithms, and checklists. Methods: Each recommendation was evaluated and updated based on new evidence from 2013 to the present and subjective factors provided by experts. Results: New or updated topics in this CPG include: contextualization in an adiposity-based chronic disease complications-centric model, nuance-based and algorithm/checklist-assisted clinical decision-making about procedure selection, novel bariatric procedures, enhanced recovery after bariatric surgery protocols, and logistical concerns (including cost factors) in the current health-care arena. There are 85 numbered recommendations that have updated supporting evidence, of which 61 are revised and 12 are new. Noting that there can be multiple recommendation statements within a single numbered recommendation, there are 31 (13%) Grade A, 42 (17%) Grade B, 72 (29%) Grade C, and 101 (41%) Grade D recommendations. There are 858 citations, of which 81 (9.4%) are evidence level (EL) 1 (highest), 562 (65.5%) are EL 2, 72 (8.4%) are EL 3, and 143 (16.7%) are EL 4 (lowest). Conclusion: Bariatric procedures remain a safe and effective intervention for higher-risk patients with obesity. Clinical decision-making should be evidence based within the context of a chronic disease. A team approach to perioperative care is mandatory, with special attention to nutritional and metabolic issues. A1C = hemoglobin A1c; AACE = American Association of Clinical Endocrinologists; ABCD = adiposity-based chronic disease; ACE = American College of Endocrinology; ADA = American Diabetes Association; AHI = Apnea-Hypopnea Index; ASA = American Society of Anesthesiologists; ASMBS = American Society of Metabolic and Bariatric Surgery; BMI = body mass index; BPD = biliopancreatic diversion; BPD/DS = biliopancreatic diversion with duodenal switch; CI = confidence interval; CPAP = continuous positive airway pressure; CPG = clinical practice guideline; CRP = C-reactive protein; CT = computed tomography; CVD = cardiovascular disease; DBCD = dysglycemia-based chronic disease; DS = duodenal switch; DVT = deep venous thrombosis; DXA = dual-energy X-ray absorptiometry; EFA = essential fatty acid; EL = evidence level; EN = enteral nutrition; ERABS = enhanced recovery after bariatric surgery; FDA = U.S. Food and Drug Administration; G4G = Guidelines for Guidelines; GERD = gastroesophageal reflux disease; GI = gastrointestinal; HCP = health-care professional(s); HTN = hypertension; ICU = intensive care unit; IGB = intragastric balloon(s); IV = intravenous; LAGB = laparoscopic adjustable gastric band; LAGBP = laparoscopic adjustable gastric banded plication; LGP = laparoscopic greater curvature (gastric) plication; LRYGB = laparoscopic Roux-en-Y gastric bypass; LSG = laparoscopic sleeve gastrectomy; MetS = metabolic syndrome; NAFLD = nonalcoholic fatty liver disease; NASH = nonalcoholic steatohepatitis; NSAID = nonsteroidal anti-inflammatory drug; OA = osteoarthritis; OAGB = one-anastomosis gastric bypass; OMA = Obesity Medicine Association; OR = odds ratio; ORC = obesity-related complication(s); OSA = obstructive sleep apnea; PE = pulmonary embolism; PN = parenteral nutrition; PRM = pulmonary recruitment maneuver; RCT = randomized controlled trial; RD = registered dietician; RDA = recommended daily allowance; RYGB = Roux-en-Y gastric bypass; SG = sleeve gastrectomy; SIBO = small intestinal bacterial overgrowth; TOS = The Obesity Society; TSH = thyroid-stimulating hormone; T1D = type 1 diabetes; T2D = type 2 diabetes; VTE = venous thromboembolism; WE = Wernicke encephalopathy; WHO = World Health Organization.
 ...
PMID:CLINICAL PRACTICE GUIDELINES FOR THE PERIOPERATIVE NUTRITION, METABOLIC, AND NONSURGICAL SUPPORT OF PATIENTS UNDERGOING BARIATRIC PROCEDURES - 2019 UPDATE: COSPONSORED BY AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS/AMERICAN COLLEGE OF ENDOCRINOLOGY, THE OBESITY SOCIETY, AMERICAN SOCIETY FOR METABOLIC & BARIATRIC SURGERY, OBESITY MEDICINE ASSOCIATION, AND AMERICAN SOCIETY OF ANESTHESIOLOGISTS - EXECUTIVE SUMMARY. 3168 18

Wernicke encephalopathy (WE) is a rare and serious complication of obesity surgery. This is a report of one case of WE after a sleeve gastrectomy. The diagnosis is primarily clinical; the persistent and prolonged vomiting, and noncompliance to vitamin intake are two major risk factors to develop WE. It is especially important to rule out for stenosis or obstructions of the upper digestive tract after surgery. MRI is useful with high specificity to support the diagnosis as in our case, and discard other causes. Treatment should not be delayed. The outcome of WE is not always predictable. The full recovery is not always achieved, but there is improvement over the time as in this case.
 ...
PMID:Wernicke Encephalopathy After Sleeve Gastrectomy. 3259 67

We present a case report of a 17-year-old obese female with one-week onset of progressive confusion and double vision, associated with 50-pound weight loss in five months. On fundus examination, retinal hemorrhages and abnormalities of eye movements were seen. MRI showed abnormalities that were consistent with diagnosis of Wernicke encephalopathy (WE). Thiamine replacement caused gradual improvement in patient's symptoms. Peripapillary hemorrhages on fundus examination, as seen in our patient, have been rarely seen in WE. Obesity with retinal hemorrhages, diplopia, etc. can be misleading due to idiopathic intracranial hypertension being the most common presentation in this subset. Thus, fundoscopy should be part of routine examination in WE-suspected patients.
 ...
PMID:Thiamine Deficiency With Mashed Potatoes: A Novel Case of Wernicke Encephalopathy Manifesting With Retinal Hemorrhages in a Pediatric Patient. 3306 42


<< Previous 1 2