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Yan M, Zheng G, Long Z, Pan Q, Wang X, Li Y, Lei C. Does bariatric surgery really benefit patients before total knee arthroplasty? A systematic review and meta-analysis. Int J Surg 2022; 104:106778. [PMID: 35870757 DOI: 10.1016/j.ijsu.2022.106778] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 06/29/2022] [Accepted: 07/07/2022] [Indexed: 10/17/2022]
Abstract
PURPOSE At present, whether bariatric surgery before total knee arthroplasty (TKA) affects the prognosis of subsequent TKA has been a topic of debate in the academic community. The primary purpose of this systematic review and meta-analysis was to investigate the effect of previous bariatric surgery on prosthetic revisions and postoperative complications after TKA. METHODS We included prospective and observational studies published in English involving patients who had undergone bariatric surgery prior to TKA and compared them with morbidly obese patients with no history of bariatric surgery. The Newcastle-Ottawa Scale was used to assess the methodological quality of non-randomized case-control studies. The outcomes included revisions, infections, venous thromboembolism (VTE), blood transfusion, mortality, stiffness or manipulation under anesthesia (MUA), and medical complications. RESULTS Of the 9 included studies with 166047 patients, 4 were matched cohort studies, 2 were unmatched cohort, and 3 were database studies. Methodological quality was high in ten studies and moderate in thirteen studies. Our analysis demonstrated that patients with TKA who had undergone prior bariatric surgery were associated with increased risks of long-term revision, long-term infection, long-term stiffness or MUA and blood transfusions, whereas prior bariatric surgery did not increase the risk of short-term complications and short-term revision. CONCLUSION This meta-analysis highlights the risks of bariatric surgery prior to TKA and suggests that prior bariatric surgery may increase the risk of perioperative blood transfusion and also the risk of revision and infection in long-term follow-up. Surgeons can use this information to help counsel patients undergoing bariatric surgery before primary TKA.
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Affiliation(s)
- Manli Yan
- Department of General Surgery, The Second Affiliated Hospital of Jianghan University (The Fifth Hospital of Wuhan), Wuhan, Hubei, 430050, China
| | - Gang Zheng
- Department of General Surgery, The Second Affiliated Hospital of Jianghan University (The Fifth Hospital of Wuhan), Wuhan, Hubei, 430050, China
| | - Zhixiong Long
- Department of Oncology, The Second Affiliated Hospital of Jianghan University (The Fifth Hospital of Wuhan), Wuhan, Hubei, 430050, China
| | - Qingyun Pan
- Department of Endocrinology, The Second Affiliated Hospital of Jianghan University (The Fifth Hospital of Wuhan), Wuhan, Hubei, 430050, China
| | - Xiaohui Wang
- Department of Nephrology, The Second Affiliated Hospital of Jianghan University (The Fifth Hospital of Wuhan), Wuhan, Hubei, 430050, China
| | - Yuan Li
- Department of General Surgery, The Second Affiliated Hospital of Jianghan University (The Fifth Hospital of Wuhan), Wuhan, Hubei, 430050, China
| | - Changjiang Lei
- Department of General Surgery, The Second Affiliated Hospital of Jianghan University (The Fifth Hospital of Wuhan), Wuhan, Hubei, 430050, China.
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Cho WK, Han K, Ahn MB, Park YM, Jung MH, Suh BK, Park YG. Metabolic risk factors in Korean adolescents with severe obesity: Results from the Korea National Health and Nutrition Examination Surveys (K-NHANES) 2007-2014. Diabetes Res Clin Pract 2018; 138:169-176. [PMID: 29427699 PMCID: PMC6221804 DOI: 10.1016/j.diabres.2018.01.030] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Revised: 12/06/2017] [Accepted: 01/26/2018] [Indexed: 02/06/2023]
Abstract
AIMS To investigate the metabolic risk factors according to the degree of obesity in Korean adolescents. METHODS Among 7197 subjects aged 10-18 years who participated in the 2007-2014 K-NHANES, 1326 adolescents (M = 744, F = 582) with age and sex specific body mass index (BMI) ≥85th percentile were included. These adolescents with obesity were classified as: overweight, obesity, severe obesity, and extreme severe obesity. For assessing central obesity, the subjects were further-classified as: normal waist obese, abdominal obesity I, abdominal obesity II and abdominal obesity III. RESULTS The prevalence of overweight, obesity, severe obesity and extreme severe obesity were 5.6%, 6.2%, 5.9% and 0.9% in Korean adolescents. With increasing levels of obese category, the incidence of metabolic risk factors such as HDL-C < 40 mg/dL or <50 mg/dL in girls older than 16 years-old (20.2%, 18.5%, 34.4%, 43.6%, P < .0001), TG ≥ 150 mg/dL (15.3%, 16.7%, 26.5%, 30.9%, P < .003), HbA1C ≥ 5.8% (12.8%, 13.5%, 21.9%, 42.2%, P < .006), SBP ≥ 130 mg/dL (3.5%, 6.4%, 8.1%, 19.5%, P < .003) significantly increased. With increasing levels of central obese category, the incidence of metabolic risk factors such as HDL-C < 40 mg/dL or <50 mg/dL in girls older than 16 years-old (20.2%, 26.2%, 37.9%, 35.7%, P < .0007), TG ≥ 150 mg/dL (16.1%, 21.2%, 25.8%, 29.8%, P < .004), glucose ≥ 100 mg/dL (7.7%, 7.3%, 11.7%, 17.4%, P < .009) and SBP ≥ 130 mg/dL (5.1%, 7.1%, 3.0%, 13.9%, P < .002) significantly increased. CONCLUSION Adolescents with severe obesity have more metabolic risk factors compared to adolescents with less severe degree of obesity.
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Affiliation(s)
- Won Kyoung Cho
- Department of Pediatrics, College of Medicine, St. Vincent's Hospital, The Catholic University of Korea, Republic of Korea
| | - Kyungdo Han
- Department of Biostatistics, College of Medicine, The Catholic University of Korea, Republic of Korea
| | - Moon Bae Ahn
- Department of Pediatrics, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Republic of Korea
| | - Yong-Moon Park
- Epidemiology Branch, National Institute of Environmental, Health Sciences, National Institutes of Health, 111 T.W. Alexander Dr., Research Triangle Park, NC 27709, USA
| | - Min Ho Jung
- Department of Pediatrics, College of Medicine, Yeouido St. Mary's Hospital, The Catholic University of Korea, Republic of Korea.
| | - Byung-Kyu Suh
- Department of Pediatrics, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Republic of Korea
| | - Yong-Gyu Park
- Department of Biostatistics, College of Medicine, The Catholic University of Korea, Republic of Korea.
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Abstract
Obesity is present in epidemic proportions in the United States, and bariatric surgery has become more common. Thus, emergency physicians will undoubtedly encounter many patients who have undergone one of these procedures. Knowledge of the anatomic changes specific to these procedures aids the clinician in understanding potential complications and devising an organized differential diagnosis. This article reviews common bariatric surgery procedures, their complications, and the approach to acute abdominal pain in these patients.
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Perception and Awareness of Bariatric Surgery in Canada: a National Survey of General Surgeons. Obes Surg 2015; 26:1799-805. [PMID: 26638153 DOI: 10.1007/s11695-015-1975-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND The objective of this study was to assess Canadian general surgeons' knowledge of bariatric surgery and perceived availability of resources to manage bariatric surgery patients. METHODS A self-administered questionnaire was developed using a focus group of general surgeons. The questionnaire was distributed at two large general surgery conferences in September and November 2012. The survey was also disseminated via membership association electronic newsletters in November and December 2012. RESULTS One hundred sixty-seven questionnaires were completed (104 practicing surgeons, 63 general surgery trainees). Twenty respondents were bariatric surgeons. Among 84 non-bariatric surgeons, 68.3 % referred a patient in the last year for bariatric surgery, 79 % agreed that bariatric surgery resulted in sustained weight loss, and 81.7 % would consider referring a family member. Knowledge gaps were identified in estimates of mortality and morbidity associated with bariatric procedures. The majority of surgeons surveyed have encountered patients with complications from bariatric surgery in the last year. Over 50 % of surgeons who do not perform bariatric procedures reported not feeling confident to manage complications, 35.4 % reported having adequate resources and equipment to manage morbidly obese patients, and few are able to transfer patients to a bariatric center. Of the respondents, 73.3 % reported residency training provided inadequate exposure to bariatric surgery, and 85.3 % felt that additional continuing medical education resources would be useful. CONCLUSIONS There appears to be support for bariatric surgery among Canadian general surgeons participating in this survey. Knowledge gaps identified indicate the need for more education and resources to support general surgeons managing bariatric surgical patients.
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Richardson AS, Arsenault JE, Cates SC, Muth MK. Perceived stress, unhealthy eating behaviors, and severe obesity in low-income women. Nutr J 2015; 14:122. [PMID: 26630944 PMCID: PMC4668704 DOI: 10.1186/s12937-015-0110-4] [Citation(s) in RCA: 90] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2015] [Accepted: 11/23/2015] [Indexed: 01/01/2023] Open
Abstract
Background Stress has been associated with poor eating behaviors and diet quality, as well as high body mass index (BMI). Low-income women may be particularly vulnerable to stress and severe obesity. Yet it is unknown how stress increases the risk of severe obesity through disordered eating behaviors and poor diet quality or through mechanisms independent of diet. Methods We examined cross-sectional data from women (n = 101) with a child enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children in Cumberland County, North Carolina (spring 2012). We collected measured heights and weights to calculate BMI. Using structural equation modeling, we differentiated pathways from stress to weight status: (1) indirectly through eating behaviors (cognitive restraint, emotional eating, and uncontrolled eating) and diet quality, which we examined with the Healthy Eating Index 2010 and 24-h dietary recalls, and (2) directly through possible unmeasured risk factors independent of diet. The analysis controlled for race/ethnicity, income, age, whether the dietary recall day was typical, and whether the respondent completed one or two 24-h dietary recalls. Results Perceived stress was positively associated with uncontrolled eating (β = 0.38, p < 0.001) and emotional eating (β = 0.50, p < 0.001). However, higher stress was not associated with weight status through eating behaviors and diet quality. Independent of eating behaviors and diet quality, stress was positively associated with severe obesity (β = 0.26, p = 0.007). Conclusions Improving stress coping strategies for low-income women may improve eating behaviors and reduce severe obesity. Electronic supplementary material The online version of this article (doi:10.1186/s12937-015-0110-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Andrea S Richardson
- RAND Health, RAND Corporation, 570 Fifth Ave. #600, Pittsburgh, PA, 15213, USA.
| | - Joanne E Arsenault
- U.C. Davis, Program in International and Community Nutrition, 3217A Meyer Hall One Shields Ave., Davis, CA, 95616, USA.
| | - Sheryl C Cates
- RTI International, Food and Nutrition Policy Research Program, 3040 E. Cornwallis Rd., Research Triangle, Park, NC, 27709-3910, USA.
| | - Mary K Muth
- RTI International, Food and Nutrition Policy Research Program, 3040 E. Cornwallis Rd., Research Triangle, Park, NC, 27709-3910, USA.
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Richardson AS, Dietz WH, Gordon-Larsen P. The association between childhood sexual and physical abuse with incident adult severe obesity across 13 years of the National Longitudinal Study of Adolescent Health. Pediatr Obes 2014; 9:351-61. [PMID: 24115589 PMCID: PMC3961565 DOI: 10.1111/j.2047-6310.2013.00196.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2013] [Revised: 06/21/2013] [Accepted: 07/26/2013] [Indexed: 12/14/2022]
Abstract
BACKGROUND Severe obesity has increased, yet childhood antecedents of adult severe obesity are not well understood. OBJECTIVE Estimate adult-onset severe obesity risk in individuals with history of childhood physical and/or sexual abuse compared with those who did not report abuse. METHODS Longitudinal analysis of participants from the US National Longitudinal Study of Adolescent Health (n = 10,774) wave II (1996; aged 12-22 years) followed through wave IV (2008-2009; aged 24-34 years). New cases of adult-onset severe obesity (body mass index [BMI] ≥ 40 kg/m2 using measured height and weight) in individuals followed over 13 years who were not severely obese during adolescence (BMI <120% of 95th percentile Centers for Disease Control and Prevention National Center for Health Statistics growth curves). RESULTS The combined occurrence of self-reported sexual and physical abuse during childhood was associated with an increased risk of incident severe obesity in adulthood in non-minority females (hazard ratio [HR; 95% Confidence Interval] = 2.5; 1.3, 4.8) and males (HR = 3.6; 1.5, 8.5) compared with individuals with no history of abuse. CONCLUSION In addition to other social and emotional risks, exposure to sexual and physical abuse during childhood may increase risk of severe obesity later in life. Consideration of the confluence of childhood abuse might be considered as part of preventive and therapeutic approaches to address severe obesity.
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Affiliation(s)
- A S Richardson
- Department of Nutrition, Gillings School of Global Public Health and School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Carolina Population Center, Chapel Hill, NC, USA
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Abstract
Obesity is rapidly becoming a major health concern and could be considered equal to smoking as a preventable cause of premature death. The National Institute for Health and Clinical Excellence (NICE 2006) estimated that 1.1 billion people are overweight, a number rivalling those who are underweight globally. Recent statistics for England from the National Health Service (NHS 2011) report that in 2009/10 there were 7,214 bariatric surgical procedures performed on people of varying ages.
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Affiliation(s)
- Angela Cobbold
- Anglia Ruskin University, 4th Floor William Harvey Building, Chelmsford Campus, Park Road, Chelmsford CM1 1LL.
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Byard RW. The complex spectrum of forensic issues arising from obesity. Forensic Sci Med Pathol 2012; 8:402-13. [DOI: 10.1007/s12024-012-9322-5] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2012] [Indexed: 12/28/2022]
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Fogger SA, McGuinness TM. The relationship between addictions and bariatric surgery for nurses in recovery. Perspect Psychiatr Care 2012; 48:10-5. [PMID: 22188042 DOI: 10.1111/j.1744-6163.2010.00298.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
PURPOSE Determinants of morbid obesity are complex and numerous, yet understanding the neurobiological underpinnings improves our knowledge of this serious issue. Emerging science supports a comparison of disordered eating with other addictive substances. DESIGN AND METHODS The study used a sub-analysis of a cross-sectional study of nurses in a state-monitoring program. FINDINGS A study of 173 participants in a state-monitoring program for impaired nurses revealed that 14% (n= 25) had undergone bariatric surgery. Of these, 17 developed an addiction after surgery. PRACTICE IMPLICATIONS Evidence suggests that some individuals may require additional treatment, similar to those with pharmacological addictions.
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Affiliation(s)
- Susanne A Fogger
- School of Nursing, University of Alabama, Birmingham, Alabama, USA.
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Bond S. OBESITY IN ADOLESCENCE IS ASSOCIATED WITH SEVERE OBESITY IN ADULTHOOD AND WORSENING HEALTH PROBLEMS. J Midwifery Womens Health 2011; 56:180-1. [DOI: 10.1111/j.1542-2011.2010.00054_3.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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The NS, Suchindran C, North KE, Popkin BM, Gordon-Larsen P. Association of adolescent obesity with risk of severe obesity in adulthood. JAMA 2010; 304:2042-7. [PMID: 21063014 PMCID: PMC3076068 DOI: 10.1001/jama.2010.1635] [Citation(s) in RCA: 267] [Impact Index Per Article: 19.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
CONTEXT Although the prevalence of obesity has increased in recent years, individuals who are obese early in life have not been studied over time to determine whether they develop severe obesity in adulthood, thus limiting effective interventions to reduce severe obesity incidence and its potentially life-threatening associated conditions. OBJECTIVE To determine incidence and risk of severe obesity in adulthood by adolescent weight status. DESIGN, SETTING, AND PARTICIPANTS A cohort of 8834 individuals aged 12 to 21 years enrolled in 1996 in wave II of the US National Longitudinal Study of Adolescent Health, followed up into adulthood (ages 18-27 years during wave III [2001-2002] and ages 24-33 years during wave IV [2007-2009]). Height and weight were obtained via anthropometry and surveys administered in study participants' homes using standardized procedures. MAIN OUTCOME MEASURES New cases of adult-onset severe obesity were calculated by sex, race/ethnicity, and adolescent weight status. Sex-stratified, discrete time hazard models estimated the net effect of adolescent obesity (aged <20 years; body mass index [BMI] ≥95th percentile of the sex-specific BMI-for-age growth chart or BMI ≥30.0) on risk of severe obesity incidence in adulthood (aged ≥20 years; BMI ≥40.0), adjusting for race/ethnicity and age and weighted for national representation. RESULTS In 1996, 79 (1.0%; 95% confidence interval [CI], 0.7%-1.4%) adolescents were severely obese; 60 (70.5%; 95% CI, 57.2%-83.9%) remained severely obese in adulthood. By 2009, 703 (7.9%; 95% CI, 7.4%-8.5%) non-severely obese adolescents had become severely obese in adulthood, with the highest rates for non-Hispanic black women. Obese adolescents were significantly more likely to develop severe obesity in young adulthood than normal-weight or overweight adolescents (hazard ratio, 16.0; 95% CI, 12.4-20.5). CONCLUSION In this cohort, obesity in adolescence was significantly associated with increased risk of incident severe obesity in adulthood, with variations by sex and race/ethnicity.
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Affiliation(s)
- Natalie S. The
- Carolina Population Center and Department of Nutrition, Gillings School of Global Public Health at the University of North Carolina
| | - Chirayath Suchindran
- Carolina Population Center and Department of Biostatistics, Gillings School of Global Public Health at the University of North Carolina
| | - Kari E. North
- Carolina Population Center and Department of Epidemiology, Gillings School of Global Public Health at the University of North Carolina
| | - Barry M. Popkin
- Carolina Population Center and Department of Nutrition, Gillings School of Global Public Health at the University of North Carolina
| | - Penny Gordon-Larsen
- Carolina Population Center and Department of Nutrition, Gillings School of Global Public Health at the University of North Carolina
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Shah PS, Todkar JS, Shah SS. Effectiveness of laparoscopic sleeve gastrectomy on glycemic control in obese Indians with type 2 diabetes mellitus. Surg Obes Relat Dis 2010; 6:138-41. [DOI: 10.1016/j.soard.2009.06.007] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2009] [Revised: 06/21/2009] [Accepted: 06/29/2009] [Indexed: 01/06/2023]
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Stengel A, Goebel M, Wang L, Taché Y. Ghrelin, des-acyl ghrelin and nesfatin-1 in gastric X/A-like cells: role as regulators of food intake and body weight. Peptides 2010; 31:357-69. [PMID: 19944123 PMCID: PMC3166546 DOI: 10.1016/j.peptides.2009.11.019] [Citation(s) in RCA: 101] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2009] [Revised: 11/12/2009] [Accepted: 11/16/2009] [Indexed: 02/07/2023]
Abstract
Numerous peptides released from endocrine cells in the intestinal mucosa were established early on to be involved in the physiological regulation of food intake with a prominent role in termination of food ingestion when nutrients pass along the intestinal tract. Recently, peptides released from X/A-like endocrine cells of the gastric oxyntic mucosa were recognized as additional key players in the regulation of feeding and energy expenditure. Gastric X/A-like cells release the octanoylated peptide, ghrelin, the only known peripherally produced hormone stimulating food intake through interaction with growth hormone secretagogue 1a receptor (GHS-R1a). Additionally, non-octanoylated (des-acyl) ghrelin present in the circulation at higher levels than ghrelin is currently discussed as potential modulator of food intake by opposing ghrelin's action independent from GHS-R1a although the functional significance remains to be established. Obestatin, a ghrelin-associated peptide was initially reported as anorexigenic modulator of ghrelin's orexigenic action. However, subsequent reports did not support this contention. Interesting is the recent identification of nesfatin-1, a peptide derived from the nucleobindin2 gene prominently expressed in gastric X/A-like cells in different vesicles than ghrelin. Circulating nesfatin-1 levels vary with metabolic state and peripheral or central injection inhibits dark phase feeding in rodents. Overall, these data point to an important role of gastric X/A-like cells in food intake regulation through the expression of the orexigenic peptide ghrelin along with des-acyl ghrelin and nesfatin-1 capable of reducing food intake upon exogenous injection although their mechanisms of action and functional significance remain to be established.
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Affiliation(s)
- Andreas Stengel
- CURE: Digestive Diseases Research Center and Neurobiology of Stress, Digestive Diseases Division, David Geffen School of Medicine at University of California Los Angeles and Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA 90073, USA.
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Mintchev MP, Deneva MG, Aminkov BI, Fattouche M, Yadid-Pecht O, Bray RC. Pilot study of temporary controllable gastric pseudobezoars for dynamic non-invasive gastric volume reduction. Physiol Meas 2009; 31:131-44. [DOI: 10.1088/0967-3334/31/2/001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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