Rexinoids Induce Differential Gene Expression in Human Glioblastoma Cells and Protein-Protein Interactions in a Yeast Two-Hybrid System.

Rexinoids are compounds that bind to the rexinoid X receptor (RXR) to modulate gene expression and have been proposed as a new class of therapeutics to treat Alzheimer's disease. Different rexinoids will initiate downstream effects that can be quite marked even though such compounds can be structurally similar and have comparable RXR binding affinities. RXR can both homo- and heterodimerize, and these protein-protein interactions and subsequent transactivating potential lead to differential gene expression, depending on the RXR dimeric partner, additional cofactors recruited, and downstream transcription factors that are up- or downregulated.

Indications and Operative Outcomes of Gastric Bypass Reversal.

Background: Roux-en-Y gastric bypass (RYGB) is one of the best-known and most commonly performed bariatric procedures. However, this procedure carries infrequent but serious long-term complications, which may require revisional procedures. This study reports the indications and outcomes of gastric bypass reversal that have not been described well in the literature.

Bariatric-related medical malpractice experience: survey results among ASMBS members.

Background: The medicolegal aspects of bariatric surgery are very difficult to analyze scientifically because there is no central, searchable database of closed case claims and little incentive for malpractice insurers to divulge data. Examining medicolegal data may provide insight into the financial and psychological burden on physicians. Detailed data also may be used to improve patient safety and determine common causes of negligence.

Acute liver failure complicating jejunojejunal intussusception presentation in a gastric bypass patient.

Over 200 000 weight loss procedures are performed annually in the United States. Physicians must therefore be cognizant of the unique array of complications associated with these procedures. We describe a case of jejunojejunal intussusception in a gastric bypass patient who presented with acute liver failure (ALF) due to acetaminophen (APAP) toxicity.

Ethnic differences in weight loss and diabetes remission after bariatric surgery: a meta-analysis.

Objective: It has been postulated that the effectiveness of bariatric surgery varies between ethnic groups. However, data regarding this topic are inconclusive, as most studies included few patients from minority groups. We conducted a meta-analysis to determine the difference in percentage of excess weight loss (%EWL) 1-2 years after bariatric surgery in people of African and Caucasian descent.

Longitudinal analysis of cardiovascular parameters after gastric bypass surgery.

Background: Identifying the predictors of co-morbidity improvement after gastric bypass surgery (Roux-en-Y gastric bypass) might give insight into disease pathophysiology.

Methods: We performed an observational study of 949 patients undergoing primary RYGB from 2005 to 2010. Multivariate mixed models were used to determine the predictors of change in hemoglobin A1c (HbA1c), lipids, systemic blood pressure, and C-reactive protein.

Analysis of perioperative outcomes, length of hospital stay, and readmission rate after gastric bypass.

Background: Hospital lengths of stay (LOS) and readmission rates often are used by third parties to measure quality of outcomes despite only a few published series that analyze risk-adjusted data and predictors of these events.

Methods: Single-institution retrospective multivariable analysis of consecutive Roux-en-Y gastric bypass (RYGB) patients was performed to determine variables that may influence LOS and the readmission rate.

Results: Between 2006 and 2010, 1,065 consecutive RYGB procedures were analyzed.

Analysis of leukopenia and anemia after gastric bypass surgery.

Background: Although anemia is a well-described complication after Roux-en-Y gastric bypass (RYGB) in association with iron deficiency, no studies have been published regarding changes in the white blood cell count.

Methods: Mixed longitudinal models were used to follow the changes in white blood cell count, platelet count, and hematocrit over time after RYGB.

Results: A total of 590 patients, who had undergone RYGB from 2006 to 2010, inclusively, had laboratory studies available.

Analysis of weight loss after bariatric surgery using mixed-effects linear modeling.

Background: The standard analysis of bariatric surgery weight outcomes data (using t tests) is well known. However, these uncontrolled comparisons may yield misleading results and limit the range of research questions. The aim of the study was to develop a valid approach to the longitudinal analysis of weight loss outcomes after bariatric surgery using multivariable mixed models.

Sexual dysfunction is common in the morbidly obese male and improves after gastric bypass surgery.

Background: There has been limited research examining the mechanisms and epidemiology of sexual dysfunction in the morbidly obese. Our objectives were to measure sexual function in the morbidly obese man before and after substantial weight loss induced by gastric bypass surgery.

Study Design: All male patients in undergoing gastric bypass completed the Brief Male Sexual Function Inventory (BSFI) before and after operation.

The effect of stoma size on weight loss after laparoscopic gastric bypass surgery: results of a blinded randomized controlled trial.

Background: To determine the effect of different stoma sizes on the percent excess weight loss (%EWL) following laparoscopic Roux-en-Y gastric bypass surgery (LRYGBP).

Methods: Blinded randomized prospective controlled study in two American Society for Bariatric Surgeons-designated Centers of Excellence hospitals. Two hundred gastric bypass patients between January 2005 and September 2005 were prospectively randomized into two groups of 100 patients each in the operating room, after the induction of anesthesia.

Management of ventral hernias during laparoscopic gastric bypass.

Background: Despite the relatively high incidence of ventral hernias in the morbidly obese, their management in bariatric surgery patients remains difficult and controversial. We sought to define a rational approach to ventral hernia management in the gastric bypass patient in a university hospital setting.

Methods: We performed a retrospective, single-institution analysis of all patients who had undergone concomitant ventral hernia repair (VHR) during antecolic gastric bypass.

Outcomes with the adjustable gastric band.

Background: The laparoscopic adjustable gastric band (LAGB) has been offered as a safe, effective, and reversible alternative to more invasive weight loss procedures.

Methods: All LAGB procedures performed from May 2001 to July 2005 were reviewed retrospectively with respect to complications and weight loss.

Results: During this time period, 186 LAGBs were placed.

Gouty attacks occur frequently in postoperative gastric bypass patients.

Background: Both obesity and surgery are known risk factors for instigating gouty attacks. We describe the incidence and management of postoperative gouty attacks after bariatric surgery.

Methods: We performed a retrospective, multi-institutional review of 411 consecutive laparoscopic gastric bypass patients and identified all patients with postoperative gouty attacks.

Medicare and Medicaid status predicts prolonged length of stay after bariatric surgery.

Background: The outcomes of Medicare patients undergoing bariatric surgery have been particularly scrutinized, especially with the Center of Medicare and Medicaid Services' decision to offer bariatric surgery benefits.

Methods: The length-of-stay (LOS) data were analyzed from the National Hospital Discharge Survey from 2002 to 2004. To test the hypothesis that Medicare and Medicaid beneficiaries were more likely to have a prolonged length of stay (PLOS), we used a multivariate logistic regression model controlling for age, gender, hospital size, and year of procedure.

"Candy cane" Roux syndrome--a possible complication after gastric bypass surgery.

Background: An excessive length of nonfunctional Roux limb proximal to the gastrojejunostomy can cause abnormal upper gastrointestinal symptoms after gastric bypass surgery. The purpose of this study was to characterize the syndrome and provide the practitioner with diagnosis and management options.

Methods: We performed a retrospective descriptive review of patients who had undergone revisional surgery for "candy cane" Roux syndrome.

Comparative analysis of short-term outcomes after bariatric surgery between two disparate populations.

Background: Risk adjustment is a critically important aspect of outcomes research. Racial, geographic, cultural, and socioeconomic differences are nonclinical parameters that can affect clinical outcomes measurement after gastric bypass surgery.

Methods: A single surgeon's experience with 217 consecutive laparoscopic gastric bypass patients in private practice in Southern California was compared with the same surgeon's experience with 124 consecutive patients in an academic institution in Philadelphia.

Back to basics--clinical diagnosis in bariatric surgery. Routine drains and upper GI series are unnecessary.

Background: The routine use of closed suction drains and upper GI (UGI) series has been used to aid in the diagnosis and management of gastrojejunal leak after gastric bypass as well as diagnose intra-abdominal bleeding.

Materials And Methods: 352 consecutive laparoscopic gastric bypass procedures were performed without the use of routine drains or post-operative UGI series.

Results: There were no adverse events related the lack of routine drains or UGI studies.