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Caballero A, Tarascó J, Moreno P, López-Vendrell L, Pellitero S, Martínez E, Bonet G, Balibrea JM. Implementation of a same-day discharge bariatric surgery program and follow-up with a telemonitoring platform. Cir Esp 2023; 101:841-846. [PMID: 37783382 DOI: 10.1016/j.cireng.2023.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 07/05/2023] [Indexed: 10/04/2023]
Abstract
INTRODUCTION Some groups have initiated outpatient bariatric surgery programs in selected patients, publishing good results after sleeve gastrectomy. Recent studies show that outpatient surgery is also feasible and safe in Roux-en-Y gastric bypass. The aim of this paper is to describe and analyze the results of our initial experience after the implementation of a same-day discharge bariatric surgery program using a telemonitoring system. METHODS We have completed a prospective, observational study with 14 consecutive, selected patients undergoing primary bariatric surgery (sleeve gastrectomy or Roux-en-Y gastric bypass) at a single center from April 2021 to February 2023, with home follow-up using the REVITA® telemonitoring platform (HI Iberia, S.A.) and the Home Hospitalization Unit. RESULTS From April 2021 to February 2023, 14 patients were selected for this program, which meant 7.3% of the total of 191 patients who underwent bariatric surgery during this period. Ten out of the 14 patients selected completed the circuit (71.4%), 4 of whom consulted the emergency department within the first 24 h (40%). There were no serious complications, readmissions or re-operations typical of bariatric surgery. The estimated savings per patient who completed the circuit was 762. CONCLUSION Bariatric surgery without hospital admission is feasible and safe in selected patients using a telemonitoring platform and with the support of a home hospitalization unit.
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Affiliation(s)
- Albert Caballero
- Unidad de Cirugía Endocrino-Metabólica y Bariátrica, Hospital Universitario Germans Trias i Pujol, Spain; Universitat Autònoma de Barcelona, Spain.
| | - Jordi Tarascó
- Unidad de Cirugía Endocrino-Metabólica y Bariátrica, Hospital Universitario Germans Trias i Pujol, Spain; Universitat Autònoma de Barcelona, Spain
| | - Pau Moreno
- Unidad de Cirugía Endocrino-Metabólica y Bariátrica, Hospital Universitario Germans Trias i Pujol, Spain; Universitat Autònoma de Barcelona, Spain
| | - Laura López-Vendrell
- Servicio de Cirugía General y Digestiva, Hospital Universitario Germans Trias i Pujol, Spain
| | - Sílvia Pellitero
- Servicio de Endocrinología, Nutrición y Dietética. Hospital Universitario Germans Trias i Pujol, Spain
| | - Eva Martínez
- Servicio de Endocrinología, Nutrición y Dietética. Hospital Universitario Germans Trias i Pujol, Spain
| | - Glòria Bonet
- Unidad de Hospitalización Domiciliaria, Hospital Universitario Germans Trias i Pujol, Spain
| | - José M Balibrea
- Unidad de Cirugía Endocrino-Metabólica y Bariátrica, Hospital Universitario Germans Trias i Pujol, Spain; Universitat Autònoma de Barcelona, Spain; Cátedra de Investigación en Cirugía iVascular-UAB, Spain
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Miñambres I, de Hollanda A, Vilarrasa N, Pellitero S, Rubio MA, Flores L, Caixàs A, Lobo S, Martinez Salamanca JI, Acevedo B, Moizé V, Andreu A, Escalada J. Obesity and fertility. Position statement. ENDOCRINOL DIAB NUTR 2023; 70 Suppl 1:110-115. [PMID: 36907798 DOI: 10.1016/j.endien.2023.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 10/13/2022] [Indexed: 03/12/2023]
Affiliation(s)
- I Miñambres
- Servicio de Endocrinología, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), CIBER de Diabetes y Enfermedades Metabólicas (CIBERDEM), Sociedad Española de Endocrinología y Nutrición (SEEN), Spain
| | - A de Hollanda
- Servicio de Endocrinología, Hospital Clínic, Barcelona, Centro de Investigación Biomédica en red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Sociedad Española de Endocrinología y Nutrición (SEEN), Spain.
| | - N Vilarrasa
- Servicio de Endocrinología y Nutrición, Hospital Universitario de Bellvitge-IDIBELL, CIBER de Diabetes y Enfermedades Metabólicas (CIBERDEM), Sociedad Española de Endocrinología y Nutrición (SEEN), Spain
| | - S Pellitero
- Servicio de Endocrinología, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació, Badalona, Sociedad Española de Endocrinología y Nutrición (SEEN), Spain
| | - M A Rubio
- Servicio de Endocrinología. Hospital Clínico San Carlos, Madrid, IDISSC, Facultad de Medicina, Universidad Complutense, Madrid, Sociedad Española de Endocrinología y Nutrición (SEEN), Spain
| | - L Flores
- Servicio de Endocrinología y Nutrición, Hospital Clínic, Barcelona, CIBER de Diabetes y Enfermedades Metabólicas (CIBERDEM), Sociedad Española para el Estudio de la Obesidad, SEEDO, Sociedad Española de Endocrinología y Nutrición (SEEN), Spain
| | - A Caixàs
- Servicio de Endocrinología y Nutrición, Hospital Universitari Parc Taulí, Institut d'Investigació i Innovació Parc Taulí (I3PT), Departamento de Medicina Universitat Autònoma de Barcelona, Sabadell, Sociedad Española de Endocrinología y Nutrición (SEEN), Sociedad Española para el Estudio de la Obesidad, SEEDO, Spain
| | - S Lobo
- Servicio de Obstetricia y Ginecología, Hospital Universitario La Paz, Universidad Autónoma de Madrid, Grupo de Interés de Endocrinología Reproductiva, Sociedad Española de Fertilidad (SEF), Spain
| | - J I Martinez Salamanca
- Servicio de Urología, Hospital Universitario Puerta de Hierro, Majadahonda, Lyx Instituto de Urología, Universidad Francisco de Vitoria, Asociación Española de Urología, Spain
| | - B Acevedo
- Servicio de Ginecología y Obstetricia, Unidad de Reproducción Asistida, Hospital Fundación Jiménez Díaz, Madrid, Profesor asociado de Medicina de la Universidad Autónoma de Madrid (UAM), Sociedad Española de Ginecología y Obstetricia (SEGO), Spain
| | - V Moizé
- Servicio de Endocrinología y Nutrición, Hospital Clínic, Barcelona, Sociedad Española de Dietética y Nutrición (SEDYN), Spain
| | - A Andreu
- Servicio de Endocrinología y Nutrición, Hospital Clínic, Barcelona, Sociedad Española de Dietética y Nutrición (SEDYN), Centro de Investigación Biomédica en Red-Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Spain
| | - J Escalada
- Departamento de Endocrinología y Nutrición, Clínica Universidad de Navarra, Pamplona, Centro de Investigación Biomédica en Red-Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Sociedad Española de Endocrinología y Nutrición (SEEN), Spain
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Pellitero S, Piquer-Garcia I, Ferrer-Curriu G, Puig R, Martínez E, Moreno P, Tarascó J, Balibrea J, Lerin C, Puig-Domingo M, Villarroya F, Planavila A, Sánchez-Infantes D. Opposite changes in meteorin-like and oncostatin m levels are associated with metabolic improvements after bariatric surgery. Int J Obes (Lond) 2017; 42:919-922. [PMID: 29081506 DOI: 10.1038/ijo.2017.268] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 09/27/2017] [Accepted: 10/17/2017] [Indexed: 01/29/2023]
Abstract
Bariatric surgery is currently the most effective therapy for type 2 diabetes. However, the mechanisms underlying its beneficial effects remain elusive. Here we studied the effects of bariatric surgery on circulating meteorin-like (Metrnl) and oncostatin m (OSM) levels, two hormones intimately linked to energy homeostasis. Metrnl and OSM levels were assessed at baseline, 6 and 12 months after laparoscopic sleeve gastrectomy (LSG) in 25 patients with obesity, as well as in 33 normal-weight controls. At baseline, patients with obesity showed lower Metrnl and higher OSM levels compared to controls. LSG increased Metrnl and decreased OSM levels, in correlation to improvements in glucose and lipid homeostasis. Our data indicate that LSG conversely modulated Metrnl and OSM levels, and suggest that a dual approach modulating these two molecules might provide a novel strategy for obesity and type 2 diabetes treatment.
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Affiliation(s)
- S Pellitero
- Department of Endocrinology and Nutrition, Germans Trias i Pujol Research Institute, Barcelona, Spain and CIBER Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain
| | - I Piquer-Garcia
- Department of Endocrinology and Nutrition, Germans Trias i Pujol Research Institute, Barcelona, Spain and CIBER Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain
| | - G Ferrer-Curriu
- Department of Biochemistry and Molecular Biomedicine. Institut de Biomedicina de la Universitat de Barcelona (IBUB), Universitat de Barcelona, Barcelona, Spain.,CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Spain
| | - R Puig
- Department of Endocrinology and Nutrition, Germans Trias i Pujol Research Institute, Barcelona, Spain and CIBER Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain
| | - E Martínez
- Department of Endocrinology and Nutrition, Germans Trias i Pujol Research Institute, Barcelona, Spain and CIBER Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain
| | - P Moreno
- Department of Surgery, Germans Trias i Pujol Research Institute, Barcelona, Spain
| | - J Tarascó
- Department of Surgery, Germans Trias i Pujol Research Institute, Barcelona, Spain
| | - J Balibrea
- Metabolic and Bariatric Surgery Unit, EAC-BS Center of Excellence, Vall d'Hebron University Hospital, Barcelona, Spain
| | - C Lerin
- Endocrinology Department, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
| | - M Puig-Domingo
- Department of Endocrinology and Nutrition, Germans Trias i Pujol Research Institute, Barcelona, Spain and CIBER Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain
| | - F Villarroya
- Department of Biochemistry and Molecular Biomedicine. Institut de Biomedicina de la Universitat de Barcelona (IBUB), Universitat de Barcelona, Barcelona, Spain.,CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Spain
| | - A Planavila
- Department of Biochemistry and Molecular Biomedicine. Institut de Biomedicina de la Universitat de Barcelona (IBUB), Universitat de Barcelona, Barcelona, Spain.,CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Spain
| | - D Sánchez-Infantes
- Department of Endocrinology and Nutrition, Germans Trias i Pujol Research Institute, Barcelona, Spain and CIBER Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain
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Auguet T, Terra X, Quintero Y, Martínez S, Manresa N, Porras J, Aguilar C, Orellana-Gavaldà J, Hernández M, Sabench F, Lucas A, Pellitero S, del Castillo D, Richart C. Liver Lipocalin 2 Expression in Severely Obese Women With Non Alcoholic Fatty Liver Disease. Exp Clin Endocrinol Diabetes 2013; 121:119-24. [DOI: 10.1055/s-0032-1331696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- T. Auguet
- Servei Medicina Interna, Hospital Universitari Joan XXIII Tarragona, Tarragona, Spain
| | - X. Terra
- Grup de Recerca en Medicina Aplicada Hospital Joan XXIII. Departament de Medicina i Cirurgia. Universitat Rovira i Virgili (URV), IISPV, Tarragona, Spain
| | - Y. Quintero
- Grup de Recerca en Medicina Aplicada Hospital Joan XXIII. Departament de Medicina i Cirurgia. Universitat Rovira i Virgili (URV), IISPV, Tarragona, Spain
| | - S. Martínez
- Servei Anatomia Patològica, Hospital Universitari Joan XXIII Tarragona, Tarragona, Spain
| | - N. Manresa
- Servei Medicina Interna, Hospital Universitari Joan XXIII Tarragona, Tarragona, Spain
| | - J. Porras
- Servei Medicina Interna, Hospital Universitari Joan XXIII Tarragona, Tarragona, Spain
| | - C. Aguilar
- Grup de Recerca en Medicina Aplicada Hospital Joan XXIII. Departament de Medicina i Cirurgia. Universitat Rovira i Virgili (URV), IISPV, Tarragona, Spain
| | - J. Orellana-Gavaldà
- Grup de Recerca en Medicina Aplicada Hospital Joan XXIII. Departament de Medicina i Cirurgia. Universitat Rovira i Virgili (URV), IISPV, Tarragona, Spain
| | - M. Hernández
- Servei de Cirurgia. Hospital Sant Joan de Reus, Tarragona, Spain. Departament de Medicina i Cirurgia. Universitat Rovira i Virgili (URV), IISPV, Tarragona, Spain
| | - F. Sabench
- Servei de Cirurgia. Hospital Sant Joan de Reus, Tarragona, Spain. Departament de Medicina i Cirurgia. Universitat Rovira i Virgili (URV), IISPV, Tarragona, Spain
| | - A. Lucas
- Servei d'Endocrinologia i Nutrició. Hospital Germans Trias i Pujol, Badalona, Spain. Departament de Medicina. Universitat Autònoma de Barcelona. Barcelona, Spain
| | - S. Pellitero
- Servei d'Endocrinologia i Nutrició. Hospital Germans Trias i Pujol, Badalona, Spain. Departament de Medicina. Universitat Autònoma de Barcelona. Barcelona, Spain
| | - D. del Castillo
- Servei de Cirurgia. Hospital Sant Joan de Reus, Tarragona, Spain. Departament de Medicina i Cirurgia. Universitat Rovira i Virgili (URV), IISPV, Tarragona, Spain
| | - C. Richart
- Servei Medicina Interna, Hospital Universitari Joan XXIII Tarragona, Tarragona, Spain
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Vidal J, Morínigo R, Codoceo VH, Casamitjana R, Pellitero S, Gomis R. The importance of diagnostic criteria in the association between the metabolic syndrome and cardiovascular disease in obese subjects. Int J Obes (Lond) 2005; 29:668-74. [PMID: 15753955 DOI: 10.1038/sj.ijo.0802921] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To investigate whether the association between the metabolic syndrome (MS) and cardiovascular disease (CVD) in obese adults is influenced by the criteria used to diagnose the MS. DESIGN AND SUBJECTS Cross-sectional study in 389 obese adults (male/female: 26%/74%; body mass index (BMI): 30.1-63.2 kg/m2; age: 18-79 y). MEASUREMENTS To diagnose the MS by the WHO or the ATPIII criteria, body mass index, waist circumference, fasting and 2-h oral Glucose tolerance test plasma glucose, fasting plasma triglycerides and HDL cholesterol, systolic and diastolic blood pressure, 24-h albumin excretion, and fasting insulin were measured. The association between the MS diagnosed with either definition and self-referred CVD was investigated. RESULTS The prevalence of the MS by the WHO was higher than by the ATPIII criteria (WHO 69.1%, ATPIII 49.4%; P<0.001). The MS diagnosed by the WHO criteria was significantly associated with self-referred CVD (odds ratio (OR) 5.80, 95% CI 1.35-24.95, P<0.05), whereas the ATPIIII MS was not (OR 1.34, 95% CI 0.59-3.03). An elevated blood pressure (OR 5.04, 95% CI 1.41-18.01, P<0.05) and microalbuminuria (OR 2.61, 95% CI 1.06-6.40, P<0.05) were independently associated with CVD. Consideration of the OGTT data as part of the ATPIII MS definition improved its associations with CVD (OR 4.39, 95% CI 1.29-14.94, P<0.05). CONCLUSION The WHO criteria appear to identify a greater number of obese adults at risk for CVD. Nevertheless, the addition of an OGTT at least in nondiabetic patients with two ATPIII-defined metabolic risk factors may help to improve the association between the MS and CVD in obese adults.
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Affiliation(s)
- J Vidal
- Obesity unit, Hospital Clínic Universitari, Barcelona, Spain.
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Conget I, Aguilera E, Pellitero S, Näf S, Bendtzen K, Casamitjana R, Gomis R, Nicoletti F. Lack of effect of intermittently administered sodium fusidate in patients with newly diagnosed type 1 diabetes mellitus: the FUSIDM trial. Diabetologia 2005; 48:1464-8. [PMID: 15995847 DOI: 10.1007/s00125-005-1823-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2005] [Accepted: 03/30/2005] [Indexed: 10/25/2022]
Abstract
AIMS/HYPOTHESIS We evaluated in a double-blind study the effect of early treatment with the immunomodulatory drug fusidin in patients with newly diagnosed type 1 diabetes mellitus. METHODS Twenty-eight adults with newly diagnosed type 1 diabetes were included in the study. The patients were randomly assigned (computer-generated random number sequence) to two experimental groups. Patients allocated to the fusidin (FUS) group (n=15) received sodium fusidate (fusidin; 500 mg orally three times daily for 4 weeks). Subsequently the drug was given at the same dose and scheduled for two consecutive weeks a month followed by 2 weeks a month without the drug for 20 weeks. Subjects allocated to the placebo (PCB) group (n=13) received placebo according to the same schedule and conditions described for sodium fusidate in the FUS group. All patients received a diet adjusted to their age and BMI, and intensive insulin therapy. RESULTS There were no statistically significant differences between the FUS and PCB groups in beta cell function, evaluated by basal and glucagon-stimulated C-peptide values during the follow-up (24 and 48 weeks). There was also no difference between the two groups in insulin requirement after 48 weeks (0.4+/-0.2 and 0.4+/-0.2 U/kg body weight for the FUS and PCB groups, respectively). Antibody titres, including insulin autoantibodies, were similar in the two groups during the follow-up. CONCLUSIONS/INTERPRETATION Early treatment of newly diagnosed type 1 diabetes patients with intermittently administered fusidin failed to influence the natural course of the disease.
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Affiliation(s)
- I Conget
- Endocrinology and Diabetes Unit, Hospital Clínic, 08036 Barcelona, Spain.
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