Users of chronic prescription opioids decrease in the first 12 months following bariatric surgery.

Objective: Obesity is an independent risk factor for chronic pain frequently treated with opioids. Our study investigated the effect of Roux-en-Y gastric bypass (RYGB) and vertical sleeve gastrectomy (VSG) on chronic opioid prescription use.

Methods: Using the IBM MarketScan database (2010-2017), we analyzed adult chronic opioid users who underwent bariatric surgery.

Secured Lumen-Apposing Fully Covered Metallic Stents for Stenoses in Post-Bariatric Surgery Patients.

New approaches for refractory stenosis in post-bariatric surgical patients include fully covered lumen-apposing metallic stents (LAMS); however, stent migration continues to be a problem. Endoscopic suture placement to LAMS can reduce the migration. Aiming to assess the feasibility and safety of the procedure, we evaluated nine consecutive patients with inability to tolerate a solid diet due to a benign gastrointestinal stricture recalcitrant to previous attempts at endoscopic therapy.

A Real-World, Insurance-Based Algorithm Using the Two-Fold Running Suture Technique for Transoral Outlet Reduction for Weight Regain and Dumping Syndrome After Roux-En-Y Gastric Bypass.

Background And Aims: Transoral outlet reduction (TORe) by devitalization and/or endoscopic suturing (ES) has been implemented in the management of weight regain post-RYGB. This study aims to assess the efficacy and safety of TORe following an insurance-based algorithm.

Methods: A prospectively maintained database of patients who underwent TORe between September 2015 and January 2018 at a single academic center was reviewed.

Effect of Mandatory Centers of Excellence Designation on Demographic Characteristics of Patients Who Undergo Bariatric Surgery.

Importance: From February 21, 2006, through September 24, 2013, the Centers for Medicare & Medicaid Services (CMS) required, via the National Coverage Determination manual, that bariatric surgery be performed only in hospitals that had been designated as a Center of Excellence (COE). The effect of this certification requirement on access to bariatric surgery has been reported only anecdotally.

Objective: To investigate whether the COE certification requirement proved to be a barrier to patients' access to bariatric surgical procedures.

Does bariatric surgery affect urinary incontinence?

Objective: To determine International Classification of Disease, 9th Revision, (ICD-9) coding patterns as a proxy for incidence and prevalence of urinary incontinence (UI) in a population of patients before and after a bariatric surgical procedure for the treatment of obesity.

Methods: We evaluated claims from a national private insurer over a 5-year period (2002-2006) to identify female patients who underwent bariatric surgery and had 3 years of follow-up claims data. The cohort of patients who underwent bariatric surgery (treatment) was matched to a cohort of obese female patients who did not undergo bariatric surgery (control), who were followed from the start of their enrollment.

Warm-up on a simulator improves residents' performance in laparoscopic surgery: a randomized trial.

Introduction And Hypothesis: Our aim was to assess the impact of immediate preoperative laparoscopic warm-up using a simulator on intraoperative laparoscopic performance by gynecologic residents.

Methods: Eligible laparoscopic cases performed for benign, gynecologic indications were randomized to be performed with or without immediate preoperative warm-up. Residents randomized to warm-up performed a brief set of standardized exercises on a laparoscopic trainer immediately before surgery.

Impact of bariatric surgery on health care utilization and costs among patients with diabetes.

Background: The effect of bariatric surgery on health care utilization and costs among individuals with type 2 diabetes remains unclear.

Objective: To examine health care utilization and costs in an insured cohort of individuals with type 2 diabetes after bariatric surgery.

Research Design: Cohort study derived from administrative data from 2002 to 2008 from 7 Blue Cross Blue Shield Plans.

An ACE unit with a delirium room may improve function and equalize length of stay among older delirious medical inpatients.

Background: Patients with delirium, compared with those without, are at increased risk for loss of function, longer hospital stays, and increased mortality. We studied the effect that an Acute Care of the Elderly Unit, which includes a delirium room, has on patients with delirium.

Methods: Retrospective observational study.

The effect of restrictive bariatric surgery on urinary stone risk factors.

Objectives: Malabsorptive bariatric procedures such as Roux-en-Y gastric bypass (RYGB) place patients at risk for developing kidney stones. Stone risk factors after purely restrictive procedures such as gastric banding and sleeve gastrectomy are not well characterized. Therefore, we performed a study to examine urinary risk factors of patients who underwent restrictive gastric surgery for bariatric indications.

Obstructive sleep apnea, insulin resistance, and steatohepatitis in severe obesity.

Rationale: Obstructive sleep apnea is associated with insulin resistance and liver injury. It is unknown whether apnea contributes to insulin resistance and steatohepatitis in severe obesity.

Objectives: To examine whether sleep apnea and nocturnal hypoxemia predict the severity of insulin resistance, systemic inflammation, and steatohepatitis in severely obese individuals presenting for bariatric surgery.

Dyslipidemia and atherosclerosis induced by chronic intermittent hypoxia are attenuated by deficiency of stearoyl coenzyme A desaturase.

Obstructive sleep apnea leads to chronic intermittent hypoxia (CIH) and is associated with atherosclerosis. We have previously shown that C57BL/6J mice exposed to CIH and a high-cholesterol diet develop dyslipidemia, atherosclerosis of the aorta, and upregulation of a hepatic enzyme of lipoprotein secretion, stearoyl coenzyme A desaturase 1 (SCD-1). We hypothesized that (1) SCD-1 deficiency will prevent dyslipidemia and atherosclerosis during CIH; and (2) human OSA is associated with dyslipidemia and upregulation of hepatic SCD.

Abdominal exercise intensities on firm and compliant surfaces.

Muscle activities at 15 sites were compared within a group of healthy young adults to evaluate their relative intensities during six abdominal exercises: partial and full sit-ups on a firm surface (floor) and on an exercise ball that was either stabilized or unstabilized. The most strenuous abdominal exercise overall (i.e.