Systematic review of advanced practice nurses' skin cancer detection knowledge and attitudes, clinical skin examination, lesion detection, and training.

Background And Purpose: Skin cancer is the most common malignancy in the United States; early detection reduces the public health burden. This systematic review updates the state of advanced practice nurses' skin cancer knowledge and attitudes, performance of and barriers to clinical skin examination (CSE), recognition of skin lesions, and related training activities.

Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement guided a search of eight literature databases that yielded 12 studies from 2010 to 2016.

Banded sleeve gastrectomy--initial experience.

Background: Isolated sleeve gastrectomy is being used with increasing frequency for the treatment of morbid obesity. This study was done to determine the potential benefit of placing a band of processed human dermis around the upper portion of a sleeve gastrectomy to prevent late dilatation and weight gain.

Methods: Twenty-seven patients underwent a sleeve gastrectomy followed by placement of a band of biological tissue (AlloDerm) placed 6 cm from the gastroesophageal junction.

Prevention of surgical site infections by an infusion of topical antibiotics in morbidly obese patients.

Background: The reported incidence of surgical site infection after abdominal surgery in morbidly obese patients is high (about 15% in most studies), and this is associated with considerable disability and an increased economic burden. Topical antibiotics may reduce the incidence of serious infections.

Methods: Standard techniques for the prevention of surgical site infections were used along with the introduction of kanamycin into the subcutaneous space of morbidly obese patients at the time of closure and allowing it to dwell for 2 h.

Improvement and stabilization of chronic kidney disease after gastric bypass.

Background: To more clearly establish the extent to which surgical weight loss can alter the course of established renal disease at a bariatric surgical service at a university-affiliated hospital.

Methods: Of a series of 45 nontransplant patients with established renal disease who had undergone gastric bypass, 9 had resolution, improvement, or stabilization of their kidney function. Two of these patients were already receiving, or were ready for, dialysis.

Influence of long chain polyunsaturated fatty acids and ornithine concentrations on complications after renal transplant.

Objectives: The present study, registered at clinicaltrials.gov with the unique registration number NCT00560014, sought to evaluate the relations between fatty acid concentrations in red blood cells or plasma and amino acid concentrations in plasma on rejection, calcineurin inhibitor toxicity, and new-onset diabetes mellitus.

Materials And Methods: Lipid profiles on plasma or red blood cell samples were performed preoperatively and postoperatively in 54 patients.

The impact of medicaid status on outcome after gastric bypass.

Background: Socioeconomic status has been a predictor of poor outcome in many surgical diseases including morbid obesity. Potential differences in treatment and initial severity of disease have often not been well controlled in patients with bariatric surgery. This study was performed to compare the results of bariatric procedures in financially disadvantaged Medicaid patients compared to patients with Medicare and those with Commercial insurance under controlled conditions.

Gastric bypass in chronic renal failure and renal transplant.

Background: Morbid obesity has reached epidemic proportions in developed nations worldwide, causing considerable mortality and increased healthcare expenditures. The use of gastric bypass surgery to achieve weight loss in morbidly obese patients with chronic renal failure (CRF) and postrenal transplant patients has not been studied adequately.

Methods: Forty-one patients with different stages of CRF (25 already receiving dialysis) underwent a gastric bypass (GBP), and an additional 10 patients underwent a GBP after becoming morbidly obese after transplantation.

Gastric bypass for morbidly obese patients with established cardiac disease.

Background: Bariatric surgery has often been avoided in patients with known cardiac disease because of the risks inherent in this patient population. This study was done to evaluate both the risks and benefits of Roux-en-Y gastric bypass (RYGBP) in morbidly obese patients with established cardiac disease.

Methods: Data were analyzed to compare preoperative with postoperative co-morbid cardiac risk factors, peri-operative and postoperative complications, and change in body mass index (BMI) in 77 consecutive patients who had a preoperative diagnosis of cardiac disease and underwent RYGBP between March 1998 and January 31, 2006.

Can immunonutrients reduce rejection rates in African Americans?

Objectives: African-American kidney allograft recipients have higher rates of rejection than do white patients. This study was performed to determine whether the use of immunonutrients may reduce the incidence of rejection in African Americans.

Materials And Methods: Two studies have been done at our institution that demonstrate that immunonutrients can reduce the incidence of rejection, calcineurin inhibitor toxicity, and cardiovascular risk factors.

The influence of immunomodulatory diets on transplant success and complications.

Background: Animal studies have shown that dietary supplementation with arginine and lipids containing the omega-3 and omega-9 fatty acids prolong allograft survival in animals receiving a short course of low-dose cyclosporine. They also reduce cardiovascular complications and infections in humans.

Methods: Adult renal transplant patients receiving standard immunosuppression were stratified according to gender, diabetic state, donor source (LD or CD), and first versus repeat transplant, and randomized to receive or not receive supplemental arginine and canola oil (containing both omega-3 and omega-9 fatty acids) twice daily.

Gastric bypass in morbidly obese patients with chronic renal failure and kidney transplant.

Background: Morbid obesity occurs frequently in patients with renal failure and is associated with an increased mortality, particularly from cardiovascular disease, as well as a marked increase in comorbid conditions affecting quality of life. Morbid obesity is also associated with an increased risk of complications and death in transplant patients and is often a cause for denial for access to transplantation.

Methods: Thirty morbidly obese patients with chronic renal failure or transplantation underwent gastric bypass (GBP).