Bariatric surgery outcomes following organ transplantation: A review study

Weight gain is a frequent postoperative complication following a solid organ transplant which can be solved by bariatric surgery. The outcomes of bariatric surgery among patients with an organ transplant history are always a challengeable subject for surgeons and surgery candidates. In this review article, we aim to investigate the existence literature about the rates of morbidity and mortality, frequent complications in terms of graft function, remission in diabetes, hypertension, pulmonary and cardiovascular disorders, hepatic and renal functions, and immunosuppressive stability, as well as the safety of bariatric surgery among patients.     

Strategic health communication on social media: Insights from a Danish social media campaign to address HPV vaccination hesitancy

ObjectiveTo evaluate whether the social media strategy developed for the campaign Stop HPV – stop cervical cancer was successful at engaging target groups in communication regarding HPV vaccination.IntroductionIn 2009, the Human Papillomavirus (HPV) vaccine became part of the Danish childhood vaccination program to protect Danish girls from cervical cancer. In 2015, after a period of massive media coverage questioning the safety of the HPV vaccination, a rapid decline in HPV vaccination coverage was observed. An information campaign was therefore launched in May 2017 to address HPV vaccination hesitancy.The social media strategy‘Heart-brain communication’ combined facts and emotions through varied content. Community management guidelines were worked out to ensure that there was positive dialogue. Key Point Indicators (KPI) for Engagement Rate (ER) and Click Through Rate (CTR) were chosen to uphold engagement and traffic from Facebook to the website. The KPIs were used to measure effectiveness.ResultsIn January 2019, the social media campaign had reached 8,020,000 people with an average of 127 comments per post. The average ER from May 2017 to halfway through 2018 was 6.07% and the CTR was 2.09%. The content subgroup personal stories was the most effective in creating positive dialogue. One year after the launch of the campaign, the number of positive comments had increased from less than 50% to approximately 75%.ConclusionA comprehensive social media strategy using ‘heart-brain communication’ proved useful in a campaign for HPV vaccination. The success of the social media strategy was due to meticulous planning prior to launching the campaign, the use of content subgroups, the allocation of adequate resources for community management, the empirical analysis of content, and the use of evaluation results as guidance for the production of new content.     

Bariatric surgery alleviates depression in obese patients: A systematic review and meta-analysis

BackgroundWith the rapid increase in the incidence of depression, there have been studies investigating whether bariatric surgery can alleviate this condition. In this study, we aimed to explore the effect of bariatric surgery on depression in obese patients.MethodsWe searched the PubMed, Embase, Web of Science and the Cochrane Library databases for studies on bariatric surgery and depression. Then, the clinical significance of bariatric surgery on depression was evaluated based on Beck Depression Inventory (BDI), Hospital Anxiety and Depression Scale (HADS) or Patient Health Questionnaire (PHQ-9). Subgroup analysis was carried out in terms of surgery types, assessment tool, follow-up time and nationalism. Dichotomous data were analyzed using odds ratio (OR), and continuous data were evaluated using the weighted mean difference (WMD) or standardized mean difference (SMD).ResultsOverall, 33 studies with a combined total of 12,556 participants met the inclusion criteria. Statistical results were significantly different whether continuous or dichotomous, and depression was improved in obese patients after surgery (SMD = ?0.87, p < 0.001; and OR = 0.29, p < 0.001, respectively). In addition, subgroup analysis showed that bariatric surgery improved depression in obese patients regardless of surgery types, assessment tool, follow-up and country.ConclusionBariatric surgery alleviates depression in obese patients. However, further studies are needed to elucidate on the complex effect of between bariatric surgery on depression.     

Self-efficacy after bariatric surgery for obesity. A population-based cohort study

Background: Eating behaviors often predict outcomes after bariatric surgery, and in this regard, self-efficacy has been shown to predict long-term behavior. We examined current eating self-efficacy in post-bariatric surgery patients comparing them to obese non-surgery patients to determine whether weight loss is associated with increased self-efficacy in post-bariatric surgery patients. Methods: We performed a population-based study of patients evaluated for Roux-en-Y gastric bypass and administered a survey using the Weight Efficacy Lifestyle (WEL) Questionnaire. There were 148 surgical and 88 non-operative patients who responded. Overall WEL score was assessed using linear regression models. Predictors of an increased self-efficacy score were also examined. Results: Follow-up was 4.0 and 3.8 years in the operative and non-operative groups, respectively. Operative responders were slightly older and had a lesser BMI compared to non-responders, otherwise the demographics were similar. Difference in overall WEL between groups was 25.5 ± 5.3 points on a 0–180 scale. A 25% change in weight was associated with a difference of 15.4 points on the total WEL between groups. Current self-efficacy scores were highly related to weight loss and correlated to quality of life at follow-up (ρ = 0.36). Conclusion: Profound weight loss after bariatric surgery is associated with increased eating self-efficacy in a population of obese adults seeking medical treatment for obesity.     

Addictive personality and maladaptive eating behaviors in adults seeking bariatric surgery

This study examined the relationship between addictive personality and maladaptive eating behaviors in bariatric surgery candidates. Ninety-seven bariatric surgery candidates completed the Eysenck Personality Questionnaire (EPQ-R) Addiction Scale, the Overeating Questionnaire (OQ), binge-eating questions from the Questionnaire of Eating and Weight Patterns (QEWP-R), and the Eating Attitudes and Behaviors Questionnaire. Participants with Binge Eating Disorder (BED) displayed addictive personality scores comparable to individuals addicted to substances (M = 17.5, SD = 5.3). Addictive personality was associated with Overeating (r = .45, p < .001), Cravings (r = .31, p = .005), Affective Disturbances (r = .62, p < .001) and Social Isolation (r = .53, p < .001). Addictive personality was associated with maladaptive eating behaviors, suggesting the potential for addictive eating.     

Effective vaccine communication during the disneyland measles outbreak

Vaccine refusal rates have increased in recent years, highlighting the need for effective risk communication, especially over social media. Fuzzy-trace theory predicts that individuals encode bottom-line meaning (”gist”) and statistical information (”verbatim”) in parallel and those articles expressing a clear gist will be most compelling. We coded news articles (n = 4581) collected during the 2014−2015 Disneyland measles for content including statistics, stories, or bottom-line gists regarding vaccines and vaccine-preventable illnesses. We measured the extent to which articles were compelling by how frequently they were shared on Facebook. The most widely shared articles expressed bottom-line gists, although articles containing statistics were also more likely to be shared than articles lacking statistics. Stories had limited impact on Facebook shares. Results support Fuzzy Trace Theory's predictions regarding the distinct yet parallel impact of categorical gist and statistical verbatim information on public health communication.     

Examining the relationship between social media engagement and hospital revenue

Abstract

Effective use of social media by hospitals has the potential to improve hospitals’ financial performance by facilitating customer service and providing hospitals with a low-cost marketing platform. This cross-sectional study explored the relationship between hospital Facebook engagement and patient revenue in a simple random sample of United States short-term acute care hospitals. There was a positive relationship between Facebook engagement and hospital patient revenue for rural hospitals, but not for urban hospitals. Additional research is needed to identify the mechanisms through which hospitals’ social media presence influences consumer health purchasing behavior and profitability.     

Using Facebook to increase coverage of HPV vaccination among Danish girls: An assessment of a Danish social media campaign

ObjectivesIn this study we assess how different Facebook (FB) posts resonate with parents hesitant about HPV vaccination and how to engage parents in positive dialogues on FB.BackgroundVaccination against human papillomavirus (HPV) was successfully introduced in the Danish childhood vaccination program in 2009 for 12 year-old girls, with coverage reaching approximately 90%. However, negative public debate questioning the safety of the vaccine coincided with a rapid decline in vaccination coverage from 2015. In May 2017, we launched the national campaign Stop HPV – stop cervical cancer with the aim to rebuild trust in the HPV vaccine and increase vaccination coverage. We used a FB page and a social media strategy to engage the campaign’s primary target group: mothers hesitant about HPV vaccination of their daughters.MethodsWe analyzed a variety of posts on the FB page Stop HPV – stop cervical cancer posted from May 2017 to December 2017. We performed analysis documenting post reach, engagement in the posts and sentiment (positive, neutral or negative) of the comments. Focus groups were recruited to provide data about attitudes to the posts and the responses from the FB management team.Results84 unique posts were published on the FB page from May 2017 to December 2017 reaching 3,476,023 individual FB profiles. In focus groups, parents requested more in-depth information. However, analyses of FB posts and sentiment of comments showed that personal stories generated higher engagement rates and more positive dialogues compared to factual posts.ConclusionThe FB page Stop HPV – stop cervical cancer has successfully reached and engaged FB users in dialogue about HPV vaccination. Personal stories are effective in creating positive dialogues on FB. However, it remains important to provide factual information to parents to enable informed decision making about HPV vaccination.     

Parent support for social media standards combatting vaccine misinformation

We sought to assess parental support for varying standards that social media sites can employ to combat vaccine misinformation. Between July and August 2019, we conducted a web-based survey with a national sample of 1073 parents of adolescents and who use social media. The survey assessed support for ten standards about vaccine misinformation. Multivariable logistic regression assessed correlates of support. Overall, 61% of parents supported at least one standard. Support for each standard varied greatly (12–51%), with higher support for less restrictive standards. Parents more often supported standards if their child had already initiated human papillomavirus (HPV) vaccination, if they were non-Hispanic black or Hispanic, if they agreed that vaccine misinformation is harmful, or if they saw information on social media in favor of HPV vaccine (all p < .05). Our findings suggest favorable support for standards that social media sites can implement to combat vaccine misinformation.     

减重手术患者的营养缺乏及管理现状

近年来全球肥胖、超重的发病率不断增高,超重或肥胖是多种慢性代谢性疾病的主要危险因素之一,减重手术是目前实现长期减重的有效方法之一.然而,国内外针对减重术前是否应该进行减重管理尚无明确定论.此外,手术改变了正常消化道解剖和功能,使胃容量减少、肠道吸收面积减少或胃酸分泌减少,减重手术在使患者获得满意的减重效果的同时也伴随着...     

Etonorgestrel concentrations in morbidly obese women following Roux-en-Y gastric bypass surgery: three case reports

Background

Pregnancy should be avoided for 12 to 18 months after Roux-en-Y gastric bypass (RYGB) surgery. The etonorgestrel (ENG)-releasing implant (Implanon®) may represent a safe and effective contraceptive method in morbidly obese women who are candidates for bariatric surgery. In addition, the subcutaneous delivery of steroid is unaffected by malabsorptive surgery.

Methods

Three cases of young women with ENG-releasing implant are reported. The device was inserted 1–2 months prior to RYGB.

Results

Their initial weights were 130 to 176 kg, and the mean weight loss was 33.6 kg at 6 months. The concomitant serum ENG concentrations decreased currently with weight loss but remained above the minimum concentration required for effective contraceptive effect of the implant for at least 6 months following RYGB (average, 170 pg/mL). The concentrations observed before weight loss were lower than in normal-weight women, but decreases in ENG concentrations following implant insertion were similar.

Conclusion

These unique data in morbidly obese women highlight the need for further pharmacokinetic studies of contraceptive agents in obese women during weight loss.     

Long-term complete remission of large hepatocellular adenoma after bariatric surgery

We report the case of an obese woman with a large hepatocellular adenoma (HCA) of 8.0 cm in diameter, followed for 5 years after Roux-en-Y Gastric Bypass, with a complete radiologic remission of the liver mass. Four other cases have been published with HCA regression after bariatric surgery, but none with long-term follow-up. As the association between obesity and HCA has been increasingly described, bariatric surgery should be considered a therapeutic option for stage 2 obese patients.     

The role of social media in preventing and managing non-communicable diseases in low-and-middle income countries: Hope or hype?

Non-communicable diseases (NCDs) pose major challenges for health systems in low-and-middle income countries (LMICs). Social media may be a low-cost, powerful tool to support NCDs prevention and management in LMICs through its ability to reach a large population. However, data on the role of social media for NCD prevention and management in LMICs is scares. This commentary paper explores the role of social media for prevention and management of NCDs and discusses how these may particularly have a role in supporting people in LMICs. We conducted a literature search using PubMed and Google Scholar to identify peer-reviewed articles using social media for NCDs in LMICs. Technology based interventions are increasingly being examined as a means to address healthcare gaps, especially in LMICs. The potential role of social media in NCD prevention and management includes patient health education and information sharing, psychological support, self-management, public health campaigns and health professional's capacity building. Nevertheless, there is little direct data on utilizing social media for NCD prevention and management in LMICs and thus a systematic review was not possible. However, social media may also have risks and challenges, such as conveying incorrect information, lack of data confidentiality, monitoring, and regulation, commercial interests, equity of access, and lack of standards. Regulatory guidelines and standards need to be developed and adhered to help avoid adverse consequences. Further research on effectiveness of social media for NCDs using robust methodologies in different population groups for short/long term impacts in LMICs is recommended.     

Chirurgie bariatrique : complications neurologiques

The number of bariatric surgery procedures is increasing. Neurological complications of such procedures are being more and more reported. They may result from mechanical, inflammatory mechanisms, but mainly from nutritional deficiencies. Vitamin B12, folate, thiamine, vitamin D and vitamin E are the most frequent deficiencies. At an early stage, immediate peripherical nerve injury, Wernicke encephalopathy, and polyradiculoneuropathy are the more frequent. Late complications include optic neuropathy, myelopathy, peripherical neuropathy, and myopathy.     

Chirurgie bariatrique : enjeux et limites chez l’adolescent obèse

Due to the increased frequency of extreme obesity in adolescents and the inefficiency of usual treatments, bariatric surgery is now largely discussed as novel therapeutic option. However, it is important to be cautious due the specificity of this age since adolescence is characterized by specific nutritional requirements and important modifications of body image. According to international recommendations, it is critically important that obese adolescents have meticulous follow-up before bariatric surgery with global evaluation (medical, psychological, nutritional) during at least 6 months. Indication of such surgery is then discussed case to case with multidisciplinary expert team (doctors, surgeons, psychologists, dietitians, anesthesiologists). Until now, the type of surgery (adjustable gastric banding, sleeve gastrectomy or Roux-en-Y gastric bypass) is still largely discussed even if Roux-en-Y gastric bypass should be the better option due to its higher efficacy.