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December 1, 2008, 5:50 PM CT

Bariatric surgery may resolve liver disease

Bariatric surgery may resolve liver disease
Obesity is a growing epidemic in the U.S. with a significant increase in prevalence from 15 percent to 32.9 percent from 1980 to 2004. Nonalcoholic fatty liver disease (NAFLD) is an emerging problem correlation to the obesity epidemic, becoming one of the most common causes of liver disease in the nation.

Bariatric surgery has become a popular and effective method for rapid and permanent significant weight loss in morbidly obese individuals. A recent study reports bariatric surgery results in improvement of histopathological features of NAFLD. Complications of NAFLD, including steatosis, steatohepatitis and fibrosis appeared to improve or completely resolve in a majority of patients after bariatric surgery-induced weight loss, as per results of a study published in Clinical Gastroenterology and Hepatology, an official journal of the American Gastroenterological Association (AGA) Institute.

"Even today, the effect of weight loss after bariatric surgery on the liver, especially NAFLD, remains unclear. There is a lack of well-defined trials exploring this relationship," said Gagan K. Sood, MD, of the University of Texas Medical Branch and lead author of the study. "Our team assessed and quantified this effect and found encouraging news: a majority of patients experience complete resolution of NAFLD after bariatric surgery, and the risk of progression of inflammatory changes and fibrosis seems to be minimal".........

Posted by: JoAnn      Read more         Source


August 31, 2008, 8:31 PM CT

New genes for inflammatory bowel disease in children

New genes for inflammatory bowel disease in children
Scientists have discovered two new genes that increase the risk of developing inflammatory bowel disease (IBD) in childhood.

While further study is needed to identify the specific disease-causing mutations in these new genes, the scientists say the genes are especially strong candidates to be added to the list of genes already known to affect IBD. "As we continue to find genes that interact with each other and with environmental influences in this complex, chronic disease, we are building the foundation for personalized therapys tailored to a patient's genetic profile," said co-first author Robert N. Baldassano, M.D., director of the Center for Pediatric Inflammatory Bowel Disease at The Children's Hospital of Philadelphia.

"We will resequence the gene regions we have identified to pinpoint the causative mutations in these genes," added study leader Hakon Hakonarson, M.D., Ph.D., director of the Center for Applied Genomics at Children's Hospital. "We strongly suspect one gene will provide a compelling target for drug development, given what's known about its biology".

Both authors direct research programs at Children's Hospital and are also faculty members of the University of Pennsylvania School of Medicine. Their study, performed in collaboration with scientists from the Medical College of Wisconsin, The University of Utah, Cincinnati Children's Hospital and two research hospitals in Italy, appears in advance online publication Aug. 31 in Nature Genetics........

Posted by: Scott      Read more         Source


June 19, 2008, 10:18 PM CT

Weight-loss surgery can cut cancer risk

Weight-loss surgery can cut cancer risk
Successful bariatric surgery allows morbidly obese patients to lose up to 70 percent of their excess weight and to maintain weight loss. The latest study by Dr. Nicolas Christou of the McGill University Health Centre (MUHC) and McGill University shows that this surgery also decreases the risk of developing cancer by up to 80 percent. Dr. Christou presented his preliminary results yesterday at the 25th Annual Meeting of the American Society for Metabolic & Bariatric Surgery.

The scientists compared 1,035 morbidly obese patients who underwent bariatric surgery at the MUHC between 1986 and 2002 with 5,746 patients with the same weight profile who did not undergo the operation. The number of cancer diagnoses in first group was 85 percent lower for breast cancer and 70 percent lower for colon and pancreas cancers, and was also distinctly lower for several other types of cancer.

"The relationship between obesity and a number of forms of cancer is well established," said Dr. Christou. "This is one of the first studies to suggest that bariatric surgery might prevent the risk of cancer for a significant percentage of morbidly obese people".

Obesity affects the body in multiple ways, so a single hypothesis cannot fully explain these results, say the researchers. However, excess body fat is widely believed to be responsible for increased hormone production, a major risk factor for breast and colon cancer. Thus so modifications to the patient's hormonal metabolism due to weight loss might explain the lower occurence rate of these cancers in patients who underwent surgery.........

Posted by: Janet      Read more         Source


June 3, 2008, 10:40 PM CT

Magnet-controlled camera in the body

Magnet-controlled camera in the body
The camera pill is not larger than a candy. It can be swallowed by the patient. The doctor steers it through esophagus and stomach by a magnetic device.
© Fraunhofer
Images from inside the body? It can be done with tiny cameras which the patient has to swallow. In the past there was no way of controlling the device as it passed through the body. Now it can be steered and stopped where desired, and even deliver images of the esophagus.

Images of the inside of the intestine can be obtained even today: The patient swallows a camera that is no larger than a candy. It makes its way through the intestine and transmits images of the intestinal villi to an external receiver which the patient carries on a belt. This device stores the data so that the doctor can later analyze them and identify any hemorrhages or cysts. However, the camera is not very suitable for examinations of the esophagus and the stomach. The reason is that camera only takes about three or four seconds to make its way through the esophagus - producing two to four images per second - and once it reaches the stomach, its roughly five-gram weight causes it to drop very quickly to the lower wall of the stomach. In other words, it is too fast to deliver usable images. For examinations of the esophagus and the stomach, therefore, patients still have to swallow a rather thick endoscope.

In collaboration with engineers from the manufacturer Given Imaging, the Israelite Hospital in Hamburg and the Royal Imperial College in London, scientists from the Fraunhofer Institute for Biomedical Engineering in Sankt Ingbert have developed the first-ever control system for the camera pill. "In future, doctors will be able to stop the camera in the esophagus, move it up and down and turn it, and thus adjust the angle of the camera as required," says IBMT team leader Dr. Frank Volke. "This allows them to make a precise examination of the junction between the esophagus and the stomach, for if the cardiac sphincter is not functioning properly, gastric acid comes up the esophagus and causes heartburn. In the long term, this may even cause cancer of the esophagus. Now, with the camera, we can even scan the stomach walls." But how do the scientists manage to steer the disposable camera inside the body? "We have developed a magnetic device roughly the size of a bar of chocolate. The doctor can hold it in his hand during the examination and move it up and down the patient's body. The camera inside follows this motion precisely," says Volke.........

Posted by: Sue      Read more         Source


May 26, 2008, 7:58 PM CT

Flat carbonated drinks not an effective alternative

Flat carbonated drinks not an effective alternative
Flat carbonated drinks should not be used as an alternative for oral rehydration solution to prevent dehydration in children with acute vomiting and diarrhoea, as per advice reported in the recent issue of Archives of Disease in Childhood.

Oral rehydration solution is a liquid containing the ideal balance of salts and sugars for avoiding dehydration in people with gastroenteritis who are losing fluids, salts and sugars through diarrhoea and vomiting.

It is usually believed that flat carbonated drinks are an effective alternative to these solutions, especially for children who dont like their taste. However, scientists at the childrens emergency department at Watford General Hospital were unable to find any published trials to back this up, so they looked for information about the contents of different types of liquids and compared them.

Carbonated drinks were found to contain too much sugar and not enough salts.

Current World Health Organisation recommendations are for oral rehydration solution to contain 75mmol/l of sodium and the same amount of glucose. Published biochemical analyses show carbonated drinks have much lower levels of sodium (1.09.9 mmol/l) and potassium (00.3 mmol/l), but much higher levels of glucose, with branded cola having 550mol/l of glucose (more than seven times the recommended amount).........

Posted by: Janet      Read more         Source


March 2, 2008, 8:34 PM CT

Steps leading to celiac disease

Steps leading to celiac disease
Researchers who last year identified a new genetic risk factor for coeliac disease, have, following continued research, discovered an additional seven gene regions implicated in causing the condition. The team, lead by David van Heel, Professor of Gastrointestinal Genetics at Barts and The London School of Medicine and Dentistry, have further demonstrated that of the nine coeliac gene regions now know, four of these are also predisposing factors for type 1 diabetes. Their research sheds light not only on the nature of coeliac disease, but on the common origins of both diseases. It is published online today (2 March 2008) in Nature Genetics.

Professor van Heel and his team, including collaborators from Ireland, the Netherlands, and the Wellcome Trust Sanger Institute, first performed a genome wide association study in coeliac disease. Genetic markers across the genome were compared in coeliac disease subjects versus healthy controls. They then assessed around 1,000 of the strongest markers in a further ~ 5,000 samples. Their results identified seven new risk regions, six of which harbour important genes critical in the control of immune responses, highlighting their significance in the development of the disease.

Coeliac disease is common in the West, afflicting around 1 per cent of the population. It is an immune-mediated disease, triggered by intolerance to gluten (a protein found in wheat, barley and rye containing foods), that prevents normal digestion and absorption of nutrients. If undetected it can lead to many often severe problems among them anaemia, poor bone health, fatigue and weight loss. Currently only a restricted diet can diminish symptoms.........

Posted by: Sue      Read more         Source


February 24, 2008, 9:38 PM CT

Optimal care for inflammatory bowel disease

Optimal care for inflammatory bowel disease
Inflammatory bowel disease (IBD) is a chronic recurrent gastrointestinal disease. The disease has a relatively higher morbidity in young adults, in whom growth, education, employment and wellbeing all are adversely influenced. Many guidelines for management of inflammatory bowel disease are available for bringing evidence-based medicine into full play to improve IBD patient care. What about the actual quality of care for patients with IBD in China?

An article would be published on January 28, 2008 in the World Journal of Gastroenterology addresses this question. The research team led by Dr. Jian-Min Si from Zhejiang University, China, conducted a retrospective review of medical treatment for a hospital based-cohort of patients with IBD, involving 71 patients with Crohn's disease (CD) and 106 with ulcerative colitis (UC). Medical treatment including use of oral aminosalicylates, topical treatment, corticosteroid agents and immunomodulatory agents were analyzed.

This article reported that all the patients with ulcerative colitis received optimal doses of aminosalicylate while 39.7% patients with ileal or colonic CD were suboptimal dosed. The occurence rate of suboptimal dose of aminosalicylate was significantly higher in CD patients with small intestine involvement only. This phenomenon may be explained by the relatively lower occurence rate of CD than that of UC in China and therefore less understanding of this disease.........

Posted by: Sue      Read more         Source


February 13, 2008, 9:36 PM CT

Exercise to avoid gallstones!

Exercise to avoid gallstones!
A new University of Illinois study shows that exercise-trained mice get far fewer gallstones than sedentary mice and identifies potential mechanisms to explain why this occurs.

The study, recently reported in the Journal of Applied Physiology, can be viewed online at: http://jap.physiology.org/cgi/reprint/01292.2007v1.

For the first time, we have direct evidence that physical activity reduces gallstone formation, adding to the ever-increasing number of reasons that people should get more exercise,?said Kenneth Wilund, a faculty member in the U of I Division of Nutritional Sciences and an Assistant Professor in Kinesiology and Community Health.

Gallbladder disease affects 10 to 25 percent of adults in the United States, eventhough some persons who are affected may not have symptoms. It has the second highest cost of any digestive disease at $5.8 billion annually and results in over 800,000 hospitalizations each year.

Gallstones form when bile cholesterol levels become high enough to precipitate, fall out of solution, and solidify, Wilund said.

In the study, 50 mice from a gallstone-susceptible strain were fed a high-fat diet containing cholic acid, which helps increase cholesterol absorption. They were then divided into two groups. One group of mice ran on treadmills 45 minutes per day five days a week; the other group did not exercise.........

Posted by: JoAnn      Read more         Source


January 24, 2008, 10:41 PM CT

Camera in a pill

Camera in a pill
The UW's scanning fiber endoscope fits in a pill that can be comfortably swallowed. The casing measures 6 millimeters wide and 18 millimeters long.
What if swallowing a pill with a camera could detect the earliest signs of cancer? The tiny camera is designed to take high-quality, color pictures in confined spaces. Such a device could find warning signs of esophageal cancer, the fastest growing cancer in the United States.

A fundamentally new design has created a smaller endoscope that is more comfortable for the patient and cheaper to use than current technology. Its first use on a human, scanning for early signs of esophageal cancer, will be reported in an upcoming issue of IEEE Transactions on Biomedical Engineering.

"Our technology is completely different from what's available now. This could be the foundation for the future of endoscopy," said lead author Eric Seibel, a University of Washington research associate professor of mechanical engineering.

In the past 30 years diagnoses of esophageal cancer have more than tripled. The esophagus is the section of digestive tract that moves food from the throat down to the stomach. Esophageal cancer often follows a condition called Barrett's esophagus, a noticeable change in the esophageal lining. Patients with Barrett's esophagus can be healed, avoiding the deadly esophageal cancer. But because internal scans are expensive most people don't find out they have the condition until it's progressed to cancer, and by that stage the survival rate is less than 15 percent.........

Posted by: Sue      Read more         Source


January 7, 2008, 10:46 PM CT

How To Overcome Colonoscopy Fears?

How To Overcome Colonoscopy Fears?
Patients who have had a colonoscopy can play a life-saving role by encouraging other patients to follow through with their own colorectal cancer screenings, as per new research from the University of Pennsylvania School of Medicine. These peer coaches can provide important information to combat myths and fears that serve as barriers to colonoscopy issues patients say their doctors often fail to address. In a randomized trial, clinicians in the Division of General Internal Medicine studied patients who were at increased risk of missing their scheduled colon study appointment. They observed that those who received telephone mentoring from a trained peer coach were two times more likely to keep their first colonoscopy appointment than those who received an educational brochure about the procedure in the mail or received no peer or literature support.

This study addresses an important gap in colorectal cancer prevention in the United States patients who dont follow through with their appointments, says lead author Barbara J. Turner, MD, MSEd, Professor of Medicine and Director of Penns General Medicine Clinician Scientist Fellowship. This is one of the first studies to show that patients can help other patients overcome barriers to getting tests that can prevent this deadly disease. The findings will be published this month in the Journal of General Internal Medicine.........

Posted by: Sue      Read more         Source



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Did you know?
The number of bariatric surgeries performed in the U.S. increased by 450 percent between 1998 and 2002, a growth the scientists say could be linked with use of the minimally invasive laparoscopic technique, according to an article in the recent issue of Archives of Surgery, one of the JAMA/Archives journals.

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