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1.
Dan Azagury Tara E Mokhtari Luis Garcia Ulysses S Rosas Trit Garg Homero Rivas John Morton 《Surgery》2019,165(3):565-570
Background
Laparoscopic Roux-en-Y gastric bypass, laparoscopic sleeve gastrectomy, and laparoscopic adjustable gastric banding all lead to substantial weight loss in obese patients. Long-term weight loss can be highly variable beyond 1-year postsurgery. This study examines and compares the frequency distribution of weight loss and lack of treatment effect rates after laparoscopic Roux-en-Y gastric bypass, laparoscopic sleeve gastrectomy, and laparoscopic adjustable gastric banding.Methods
A total of 1,331 consecutive patients at a single academic institution were reviewed from a prospectively collected database. Preoperative data collected included demographics, body mass index, and percent excess weight loss. Postoperative BMI and %EWL were collected at 12, 24, and 36 months. Percent excess weight loss was analyzed by the percentiles of excess weight lost, and the distribution of percent excess weight loss was evaluated in 10% increments. Lack of a successful treatment effect was defined as <25% excess weight loss.Results
Of the 1,331 patients, 72.4% (963) underwent laparoscopic Roux-en-Y gastric bypass, 18.3% (243) laparoscopic sleeve gastrectomy, and 9.4%(125) laparoscopic adjustable gastric banding. Mean percent excess weight loss was greatest for laparoscopic Roux-en-Y gastric bypass, followed by laparoscopic sleeve gastrectomy, and then by laparoscopic adjustable gastric banding at every time point: at 2 years mean percent excess weight loss was 77.9± 24.4 for laparoscopic Roux-en-Y gastric bypass, 50.8 ± 25.8 for laparoscopic sleeve gastrectomy, and 40.8± 25.9 for laparoscopic adjustable gastric banding (P < .0001). The rates of a successful treatment effect s for laparoscopic Roux-en-Y gastric bypass, laparoscopic sleeve gastrectomy, and laparoscopic adjustable gastric banding were 0.9%, 5.2%, and 24.3% at 1 year; 0.3%, 11.1%, and 26.0% at 2 years; and 1.0%, 25.3%, and 30.2% at 3 years. At 1 year, the odds ratio of lack of a successful treatment effect of laparoscopic sleeve gastrectomy versus laparoscopic Roux-en-Y gastric bypass was 6.305 (2.125–19.08; P?=?.0004), the odds ratio for laparoscopic adjustable gastric banding versus laparoscopic Roux-en-Y gastric bypass was 36.552 (15.64–95.71; P < .0001), and the odds ratio for laparoscopic adjustable gastric banding versus laparoscopic sleeve gastrectomy was 5.791 (2.519–14.599; P < .0001). At 2 years, the odds ratio for laparoscopic sleeve gastrectomy versus laparoscopic Roux-en-Y gastric bypass increased to 70.7 (9.4–531.7; P < .0001), the odds ratio for laparoscopic adjustable gastric banding versus laparoscopic Roux-en-Y gastric bypass increased to 128.1 (16.8–974.3; P < .0001), and the odds ratio for laparoscopic adjustable gastric banding versus laparoscopic sleeve gastrectomy decreased to 1.8 (0.9–3.6; P?=?.09).Conclusion
This study emphasizes the existing variability in weight loss across bariatric procedures as well as in the lack of a treatment effect for each procedure. Although laparoscopic adjustable gastric banding has the greatest rate of a lack of a successful treatment effect, the rate remained stable over 3 years postoperatively. Laparoscopic sleeve gastrectomy showed a doubling in the rate of a lack of a successful treatment effect every year reaching 25% at year 3. The rates for lack of a successful treatment effect for laparoscopic Roux-en-Y gastric bypass remained stable at about 1% for the first 3 years postoperatively. 相似文献2.
Mihaly Arato Ed Frecska Duncan J. MacCrimmon Rick Guscott Bishan Saxena Kornelia Tekes Laszlo Tothfalusi 《Progress in neuro-psychopharmacology & biological psychiatry》1991,15(6):759-764
1. Postmortem neurochemical investigations revealed interhemispheric asymmetry in the mediofrontal region of human brain. Significantly higher right hemisphere serotonin metabolite (5HIAA) content as well as increased maximal imipramine binding (IB) were found in the right hemisphere than in the left side.
2. IB did not show a gender difference in the mediofrontal area. However, women had higher IB in the right orbital frontal cortex than did men.
3. In vivo pharmaco-EEG results tend to support the postmortem neurochemical data. Intravenous chlorimipramine resulted in an asymmetric topographic distribution of the P300 auditory evoked potential, peak amplitudes were shifted to the right hemisphere. 相似文献
3.
目的观察葛根素对血管性痴呆(VaD)患者认知功能和听觉事件相关电位P300的影响。方法将70例VaD患者随机分成两组各35例,葛根素治疗组和对照组。应用简易精神状态检查量表(MMSE)评定两组患者治疗前后认知功能状况,并进行治疗前后P300检查。同时记录药物不良反应。结果两组各35例进入结果分析。治疗前两组MMSE评分、P300的潜伏期及波幅差异无显著性(均P〉0.05)。治疗14d、30d时,两组MMSE评分显著提高(均P〈0.01),P300潜伏期均有缩短,波幅均有提高(葛根素组P〈0.01,对照组P〈0.05);治疗后14d时认知功能改善葛根素组明显优于对照组(总有效率分别为91.4%,71.4%)(P〈0.05)。两组治疗期间无严重不良反应。结论葛根素能够改善VaD患者的认知功能,这可能与葛根素的扩血管、脑保护作用有关。 相似文献
4.
Sources of P300 attenuation after head injury: Single-trial amplitude, latency jitter, and EEG power
Single trial amplitude, latency jitter, and electroencephalographic (EEG) power were examined as sources of the group difference in averaged P300 amplitude among 15 traumatically brain injured and 20 control individuals in an auditory oddball paradigm. Mean amplitude of the individual trials was highly correlated with the amplitude of the averaged P300, with little additional unique variance attributable to latency jitter or EEG power. The group difference in P300 amplitude was also explained by the mean amplitude of the single trials. These results support the robustness of the event-related potential averaging technique within the paradigm used. 相似文献
5.
正规康复治疗对脑卒中患者P300的影响 总被引:5,自引:0,他引:5
目的研究正规康复治疗对脑卒中患者P300的影响,为脑卒中患者认知功能的康复提供临床依据.方法按照统一的入选条件选取2001年10月~2002年2月在本院住院的脑卒中患者60例为研究对象,随机分成康复组和对照组,康复组在脑卒中后3~7 d开始康复治疗,为期1个月.对照组未给予康复治疗,治疗前后进行P300检查.结果康复组在康复后与对照组及在康复后与康复前相比,P300的潜伏期明显缩短,波幅明显增高(P<0.01).结论正规康复治疗可以明显改善脑卒中患者的认知功能. 相似文献
6.
目的探讨精神分裂症患者的语词记忆能力与认知电位之间的相互关系。方法对102例精神分裂症患者首先进行了听觉诱发电位P300测定,然后按有无P300潜伏期延长或/和波幅降低分为P300正常与异常组,再采用选择性提醒测验方法对其进行语词记忆测验。结果P300正常组30例在10次语词记忆测验中通过总例数28例,占93.3%,前6次通过的比例为56.7%;而P300异常组72例在10次语词记忆测验中通过的总例数只有43例,占59.7%,前6次通过的比例只有25%;两组之间的差异非常显著(P〈0.001)。P300异常组回忆总数、保持数、长时再现数及恒定长时再现数减少,而不恒定长时再现数、提醒总数及插入数显著增多,两组比较有显著性差异(P〈0.01)。结论P300异常的精神分裂症患者较P300正常的精神分裂症患者存在更严重的语词记忆障碍。 相似文献
7.
8.
我们研究了不同记忆负荷条件下,ERP-P_(300)变化的规律性和特点及ERP-P_(300)与脑力负荷难度之间的关系。在三种脑力作业时,要求受试者记忆2、4、6位随机数字。结果表明,1、随着记忆数字增加,P_(300)波幅相应增大,三种记忆作业P_(300)波幅之间均有显著性差异。2、记忆错误率和记忆难度主观评价值,亦随着记忆数字增加而增大,且在三种记忆作业之间均有显著性差异。3、P_(300)波幅和记忆难度主观评价值之间相关分析表明呈正相关(P<0.01)。我们建议,P_(300)波幅测量可以作为评价脑力负荷的一项客观指标。 相似文献
9.
Event-related potential (ERP), electroencephalographic (BEG), and behavioral data were collected from squirrel monkeys (Saimiri sciureus) in a 90−10 auditory oddball paradigm. Background or target tones were presented once every 2 s, and responses to the targets were rewarded. ERPs were recorded from epidural electrodes following systemic administration of clonidine (0.1 mg/kg) or a saline placebo. EEG power spectra and behavioral performance were assessed simultaneously as indices of behavioral state. Clonidine significantly decreased the area and increased the latency of a P300-like potential. The amplitudes and areas of the earlier P1, N1, and P2 components and a later slow wave-like potential were not reduced, nor were their latencies altered. Clonidine produced increased EEG power in the alpha range (7.5–12 Hz) and decreased power in the upper beta range (20–40 Hz) but did not affect performance in the oddball task. Because two major effects of clonidine are to substantially reduce activity in the noradrenergic nucleus locus coeruleus (LC) and to reduce norepinephrine (NE) release from axons, the present results support the hypothesis that the LC and its efferent projection system are important in modulating the activity of P300-like potentials. 相似文献
10.
N. I. Triantafyllou K. Voumvourakis I. Zalonis K. Sfagos V. Mantouvalos S. Malliara C. Papageorgiou 《Acta neurologica Scandinavica》1992,85(1):10-13
Auditory event-related potentials (AERP) were elicited in 47 patients with relapsing-remitting (RR) multiple sclerosis (MS) and 24 age-matched controls. MS patients had significantly prolonged N2 and P3 latencies as well as low P3 amplitude compared with controls. Seven of them exceeded 3 standard deviations from the control mean values. The observed N2 and P3 alterations are associated with the patients' disability status as it is defined by the Kurtzke expanded disability status scale (EDSS), but are not related to the duration of the disease. A possible cognitive decline as reflected in the observed AERP components alterations in MS patients is subsequently discussed. 相似文献