Average Percentage Weight Loss Research Articles

1131 A Multifaceted Weight Loss Program for Management of Obesity Related Gastrointestinal Disorders in a Community Based Gastroenterology Practice

INTRODUCTION: Obesity related gastrointestinal disorders including Non-Alcoholic Fatty Liver Disease (NAFLD) and Gastroesophageal Reflux Disease (GERD) are more frequent and usually present earlier than diabetes mellitus type 2 and cardiovascular disorders. This provides an opportunity for the gastroenterologist to intervene early with an effective weight loss therapy. We evaluated the outcomes of a gastroenterologist supervised weight loss program aimed at achieving a 10% total body weight (TBW) loss at 3 months, a known correlation with NAFLD and GERD regression. METHODS: Patients with NAFLD and GERD seen at the clinic between May, 2017 to January, 2019 were offered participation in a medically supervised weight loss program comprised of a calorie restricted (800 Kcal/day) meal replacement diet, supervised medical fitness program, and weekly behavioral support groups for 3 months. This was followed by monthly follow up visits with slow reintroduction of whole food plant-based or Mediterranean diet. Two-sample t-Test assuming equal variances was used for statistical analysis. RESULTS: One hundred and fifty-three patients presented for their baseline office visit, 56 patients dropped out within 12 weeks of enrollment, and 97 patients with NAFLD (64 patients had both NAFLD and GERD) continue to participate in the program to date. At baseline, the 97 participants (68 Females), had a mean age of 56 years, and a mean BMI of 38 kg/m2. Average percentage weight loss was (4.1% ± 3.5%), (10.5% ± 4.7%), and (13.3% ± 6.5%) at 1 month, 3 months, and 6 months follow up respectively. At 3 months, 63% of patients had lost at least 10% of TBW. Furthermore, patients who attended > 50% of the offered behavioral support groups lost 11.9% TBW at 3 months compared to 10.9% and 9.5% TBW loss for those who attended 10 - 50% and < 10% respectively. Attending > 50% of behavioral support groups was associated with a statistically significant higher TBW loss at 3 months when compared to no attendance (11.9% versus 10%, P-value = 0.042). CONCLUSION: Over 60% of patients who completed a 3 month follow up in a multifaceted, community based, gastroenterologist supervised, weight loss program have achieved a clinically significant TBW loss of at least 10%. Our results also suggest that incorporating weekly behavioral support groups into the program might be a useful adjunct to achieving a clinically significant weight loss in this patient population. Studies are ongoing to determine the sustainability of this weight loss over 1 year.

Are bariatric operations performed by residents safe and efficient?

BackgroundThe growing need for surgeons who are educated and trained in bariatric surgery has raised many issues related to training in this field. ObjectivesThis study was performed to evaluate the safety and efficacy of laparoscopic sleeve gastrectomy (SG) and laparoscopic Roux-en-Y gastric bypass (LRYGB) performed by doctors-in-training during their residency in general surgery. SettingTertiary referral university teaching hospital, Poland. MethodsWe retrospectively analyzed the data of patients who underwent bariatric surgery. One group underwent surgery performed by at least third-year residents learning particular types of surgeries (trainee group), and the second group underwent surgeries performed by experienced bariatric surgeons (mentor group). The primary endpoint was the safety of the procedures. We analyzed factors related to the intraoperative and postoperative course. The secondary endpoint was long-term weight reduction. A lower body mass index (BMI), fewer co-morbidities, and preferably female sex were the selection criteria for patients in the trainee group. ResultsWe enrolled 408 patients who met all inclusion criteria. Among them, 233 underwent SG and 175 underwent LRYGB. For both SG and LRYGB, the median maximum preoperative weight was significantly lower in the trainee than mentor group. We found no statistically significant differences in the demographic factors or co-morbidities between the 2 groups. The median duration of SG and LRYGB surgery was significantly longer in the trainee than mentor group. The median number of stapler firings during SG was significantly lower in the trainee than mentor group. The number of stapler firings during LRYGB did not differ between the 2 groups. The incidence of intraoperative difficulties, which were based on the operator’s subjective opinion, was higher in the trainee than mentor group for both SG and LRYGB. However, intraoperative difficulties had no significant impact on the intraoperative complication rate or risk of perioperative complications. The average percentage weight loss (%WL), percentage excess weight loss (%EWL), and percentage excess BMI loss (%EBMIL) in the all study group were 31.14%±9.11%, 56.17%±17.27%, and 65.42%±19.28%, respectively. For patients who underwent SG, we found no significant difference in %WL, %EWL, or %EBMIL between the trainee and mentor groups. ConclusionsThe performance of bariatric surgeries by residents does not affect the risk of reoperation, intraoperative adverse events, or surgical complications. Performance of SG and LRYGB by trainees takes significantly longer but has no untoward consequences for the patient. Both SG and LRYGB performed by a doctor-in-training and experienced operator lead to comparable outcomes in terms of weight reduction.

Development and Performance Evaluation of a Motorized Fish Smoking Kiln

Fish smoking is a major activity in the fish industry. In most riverside areas in Nigeria, where fish business is very prominent smoking operations are mostly carried out manually and under unhygienic conditions. The concept of the smoking kiln development is to ease the drudgery associated with traditional methods (drum smoking) in the riverside communities. In this study, a motorized fish smoking kiln was designed, fabricated with locally available materials. The smoking process is based on natural convection of heated air with temperature ranging between 60°C and 110°C. The fish smoking kiln has an overall dimension of1600×1220×70 mm and uses charcoal as the main source of energy. The average capacity of the smoking chamber is 120 kg. The performance test was conducted to ascertain its performance. The result showed that moisture content was reduced from 80% to 30% with an average smoking time of 60 mins. The study concluded that fishes smoked by the kiln have a longer shelf life during storage when compared with traditional (drum) method, due to hot smoking temperature which reduces moisture faster. The overall average percentage weight loss obtained for three species tested are as follows: Etholmosa Fimbriata (sawa)-36%, Scombridae mackerel (37%) and Clarias gariepinus (cat fish) -45%.

ÍNDICES BIOQUÍMICOS Y FUNCIONALES DE MALNUTRICIÓN EN PACIENTES CON CÁNCER NO MICROCÍTICO DE PULMÓN OPERABLE

Introduction The aim of this study was to assess non–microcellular lung cancer patients’ nutritional status impact on psychomotor performance, muscle strength and functional activity. Material and methods The study involved 60 consecutive patients admitted to the clinic for surgical treatment due to histologically verified non–microcellular lung cancer. The patients were divided, depending on the stage of weight loss, into two groups: relatively well–nourished – 29 patients and those with malnutrition – 31 patients. History, physical examination, anthropometric data, biochemical parameters as well as functional tests were carefully noted. Results Patients qualified for particular groups differed significantly in age, p<0.002. Mean values of albumin, transferrin and total protein for the well nourished patients ranged within proper values. In the malnourished patients they were respectively: 34.05±0.27 g/l, 1.764±0.27 g/l, 68.90±6.39 g/l and the differences were statistically significant. Total loss of urea nitrogen was significantly higher in malnourished patients 13.32±2.92 g/l (p<0.005). The average percentage weight loss in both groups differed significantly 0.111±0.044 vs. 0.031±0.028 at p<0.0005. In the group of malnourished patients the right hand average strength was 26.52±8.06 kg and the left one amounted to 25.35±6.04 kg, The values were significantly lower than the results recorded in well nourished patients: 34.93±11.27 kg, 32,37±11.72 kg, p<0.001. The tapping test average time of the right hand was 19.24±4.04 vs. 16.72±3.06 and of the left one 19.69±3.59 kg vs. 17.48±2.79 kg and were significantly longer in patients suffering from malnutrition (p<0.01). Simple reaction times for dominating hand were longer in the group of patients with malnutrition, for the visual stimulus 0.50±0.08 s vs. 0.45±0.087 s, (p<0,05) and for auditory one 0.43±0.08 vs. 0.39±0.08 s (non significant). Conclusions Malnutrition in the course of non–microcellular lung cancer significantly reduces psychomotor function assessed by reaction time to visual and acoustic stimuli as well as efficiency of the functional tests evaluated by tapping test and muscle strength measurement.

Biochemical and functional indices of malnutrition in patients with operable, non-microcelullar lung cancer.

The aim of this study was to assess non-microcellular lung cancer patients´ nutritional status impact on psychomotor performance, muscle strength and functional activity. The study involved 60 consecutive patients admitted to the clinic for surgical treatment due to histologically verified non-microcellular lung cancer. The patients were divided, depending on the stage of weight loss, into two groups: relatively well-nourished--29 patients and those with malnutrition--31 patients. History, physical examination, anthropometric data, biochemical parameters as well as functional tests were carefully noted. Patients qualified for particular groups differed significantly in age, p<0.002. Mean values of albumin, transferrin and total protein for the well nourished patients ranged within proper values. In the malnourished patients they were respectively: 34.05±0.27 g/l, 1.764±0.27 g/l, 68.90±6.39 g/l and the differences were statistically significant. Total loss of urea nitrogen was significantly higher in malnourished patients 13.32±2.92 g/l (p<0.005). The average percentage weight loss in both groups differed significantly 0.111±0.044 vs. 0.031±0.028 at p<0.0005. In the group of malnourished patients the right hand average strength was 26.52±8.06 kg and the left one amounted to 25.35±6.04 kg, The values were significantly lower than the results recorded in well nourished patients: 34.93±11.27 kg, 32,37±11.72 kg, p<0.001. The tapping test average time of the right hand was 19.24±4.04 vs. 16.72±3.06 and of the left one 19.69±3.59 kg vs. 17.48±2.79 kg and were significantly longer in patients suffering from malnutrition (p<0.01). Simple reaction times for dominating hand were longer in the group of patients with malnutrition, for the visual stimulus 0.50±0.08 s vs. 0.45±0.087 s, (p<0.05) and for auditory one 0.43±0.08 vs. 0.39±0.08 s (non significant). Malnutrition in the course of non-microcellular lung cancer significantly reduces psychomotor function assessed by reaction time to visual and acoustic stimuli as well as efficiency of the functional tests evaluated by tapping test and muscle strength measurement.

A retrospective audit of weight loss in bariatric surgery patients

Background: Bariatric surgery results in significant weight loss and a reduction in co-morbidities in morbidly obese patients (Colquitt et al., 2009). The number of patients undergoing bariatric surgery nationally has increased significantly since 2002 (Ells et al., 2007). The aim of this audit was to evaluate an emerging bariatric service by comparing the weight loss achieved by local bariatric patients with published literature. Methods: Case notes of 28 patients who underwent bariatric surgery in a University Hospital Trust were reviewed. Patients had undergone either Laparoscopic adjustable gastric banding (LAGB) (n = 7) or a laparoscopic Roux en Y gastric bypass (LRYGB) (n = 21). The initial weight (kg) on admission for surgery, and weight loss (kg) of patients at 6 months (n = 28) and at 1 year (n = 24) post-surgery were recorded. The mean weight loss and total percentage weight loss at 6 months and 1 year post-surgery were calculated and analysis of variance used to compare the groups at 6 and 12 months. Results: Patients undergoing LTYGB lost significantly more weight at 6 (P < 0.005) and 12 months P < (0.005) than the LAGB. The differential between the two groups increased over the next 6 months as shown in Table 1. Discussion: This audit showed a trend towards higher weight loss in patients who underwent LRYGB versus LAGB; a trend that has also been reported by larger published studies (Maggard et al., 2005; Strostrom et al., 2004). Maximum weight loss post-bariatric surgery occurs at 1–2 years (Colquitt et al., 2009; Strostrom et al., 2004). Because this was an audit of an emerging bariatric service, weight loss data at 1 year post-surgery were available for only 24 patients. The average weight loss and percentage weight loss of patients post-LRYGB was higher than the weight loss of 37 kg reported in a meta-analysis of controlled studies on weight loss in bariatric surgery (Maggard et al., 2005). However, in this audit of patients post-LAGB, the average total and percentage weight loss and average percentage weight loss was below the 24.2 kg reported by Maggard et al. (2005) and 21% by Strostrom et al. (2004). Before changes are made to clinical practice, this audit should be repeated to reflect increasing patient numbers over time. Future audits could address further outcome measures to facilitate a wider evaluation of the bariatric service. Conclusions: In this audit, weight loss post-LRYGB is greater, and weight loss post-LAGB is less than published data. Larger numbers are required before altering clinical practice.

Grazing and Loss of Control Related to Eating: Two High‐risk Factors Following Bariatric Surgery

Gastric restrictive surgery induces a marked change in eating behavior. However, the relationship between preoperative and postoperative eating behavior and weight loss outcome has received limited attention. This study assessed a range of eating behaviors before and 1 year after laparoscopic adjustable gastric banding (LAGB) and explored the nature and extent of change in eating patterns, their clinical associates, and impact on weight loss. A 12-month observational study assessed presurgical and postsurgical binge eating disorder (BED), uncontrolled eating, night eating syndrome (NES), grazing, nutrient intake and eating-related behaviors, and markers of psychological distress. A total of 129 subjects (26 male and 103 female, mean age 45.2 +/- 11.5 and BMI 44.3 +/- 6.8) participated in this study. Presurgical BED, uncontrolled eating, and NES occurred in 14%, 31%, and 17.1% of subjects, which reduced after surgery to 3.1%, 22.5%, and 7.8%, respectively (P = 0.05 for all). Grazing was prevalent before (26.3%) and after surgery (38.0%). Preoperative BED most frequently became grazers (P = 0.029). The average percentage weight loss (%WL) was 20.8 +/- 8.5%; range -0.67 to 50.0% and percentage of excess weight loss (%EWL) 50.0 +/- 20.7%; range -1.44 to 106.9% (P < 0.001). Uncontrolled eating and grazing after surgery showed high overlap and were associated with poorer %WL (P = 0.008 and P < 0.001, respectively) and elevated psychological distress. Consistent with recent studies, uncontrolled eating and grazing were identified as two high-risk eating patterns after surgery. Clearer characterization of favorable and unfavorable postsurgical eating behaviors, reliable methods to assess their presence, and empirically tested postsurgical intervention strategies are required to optimize weight loss outcomes and facilitate psychological well-being in at-risk groups.

Petroleum hydrocarbon degrading capability of freshwater autochthonous filamentous fungi

Petroleum hydrocarbon degrading capability and growth profile of indigenous filamentous freshwater fungi from four (4) different streams were determined in vitro. The result indicated that the streams under investigation contained an average heterotrophic fungal count of 5.55 &#61617;0.25x105 cfu ml-1 while the mean count of biodegraders of Qua Iboe light crude oil after 15 days of incubation was 3.17&#61617;0.21 x 104 cfu ml-1. The best four utilizers of petroleum hydrocarbons for carbon and energy isolated from the streams were Aspergillus-OUF7, Rhizopus-OUF8, Aspergillus-OUF11 and Fusarium-OUF14. The growth profile of the fungi on oil medium showed that the isolates have an average total viable count (TVC) of 16% after an incubation period of 35 days, hence their ability to utilize Qua Iboe light crude oil efficiently. The isolates equally demonstrated a high degree of crude oil degrading potentials with an average percentage weight loss of 92%, 78% and 55% after 35days of incubation on 1%, 5%, 10% pollution levels on Qua Iboe light crude oil respectively. The percentage weight loss among the test isolates showed a positive correlation between pollution levels and varied significantly (p

Bacterial seed tuber decay in irrigated sandy soils of New South Wales

Breakdown of newly sown seed tubers in semi-arid irrigated sands was shown to be caused byErwinia carotovora var.carotovora andE. chrysanthemi. The soil-borne bacterial population appeared to be more important than seed tuber population in initiating rots in soil. Pectolytic activity of tuber-borne bacteria in an anaerobic environment increased with increasing temperature; there was comparatively little rotting below 25°C. Average percentage weight loss of tubers was approximately seven times greater when they were dip-or puncture-inoculated withE. chrysanthemi than withE. carotovora. Control measures should perhaps be based on protection of the newly planted seed tuber rather than on development of clean seed sources. This is the first report ofE. chrysanthemi caused soft-rotting of potato tubers.