10A multi-component model can predict outcome of restrictive surgery for obesity at baseline and 3 months

Introduction:  We previously reported that a multi-component model of autonomic and enteric factors may correlate with ultimate weight loss or gain after restrictive obesity surgery (NGM 2005; 17:472).
Patients:  We report on 39 patients, 4 male, 35 female, mean age 37.2 years, followed for up to 16 years post-operatively after vertical banded gastroplasty.
Methods:  Two autonomic measures (adrenergic: PAR and VC and cholinergic: RRI) and one enteric measure (electrogastrogram: EGG) were recorded at baseline as previously described (DDS 44: 74s–78s, 1999). We performed a discriminant function analysis to investigate whether a patient's EGG, PAR, RRI, and VC values could be used to classify that patient as a loser or gainer following weight control surgery. The patients were divided into two categories (10 gainers, 29 losers), depending on the latest weight compared to baseline; discriminant criterion derived from the patient's data was applied to each patient's autonomic and enteric values to determine whether these measurements separated the patients into their true weight category.
Results:  A discriminate model based on baseline measures successfully predicted ultimate weight gain in 8/10 (80%) of patients who subsequently gained weight and weight loss in 24/29 (83%) of patients who in subsequently lost weight for a total correct classification rate of 32/39 (82%). The same model with data at 3 months post-operatively predicted weight gain in 9 of 10 (90%) of patients and weight loss in 24 of 29 (83%) of patients, for a total correct classification rate of 34/39 pts (87%) (See table).
Conclusions:  A multi-component model demonstrates that baseline and 3 months post-operative measures can predict ultimate weight outcome from restrictive obesity surgery.
 

     

Using surveys in Mozambique for evaluation of diarrhoeal disease control

Mozambique has used surveys extensively to evaluate its DiarrhoealDiseases Control programme; topics have included diarrhoea morbidityand mortality, health centre management and home follow-up,diarrhoea prevalence and dehydration, and household knowledge.The surveys found high diarrhoeaassociated morbidity and mortalityratas. Although knowledge rates about oral rehydration salts(ORS) were between 88% and 93%, problems in the programme includedpoor distribution of ORS packets, varying availability of sugarand salt, inadequate case management, and poor effective usein the home. Policy and strategy were revised accordingly toimprove health worker training and to increase use of alternativehome solutions. We make recommendations for future surveys basedon the revised programme: a change from large surveys measuringmortality to small local surveys of health centre managementwith home follow-UD to measure effective use. with indicatorson knowledge included in routine Expended Programme on immunizationcoverage surveys.