(Obstet Gynecol 2012; 120: 37-43) DOI:10.1097/AOG.0b013e31825a6bc9
LEVEL OF EVIDENCE: II”
“Intragastric balloons may be an
option for obese patients with weight loss failure. Its mode of action remains enigmatic. We hypothesised depressed fasting ghrelin concentrations and enhanced meal suppression of ghrelin secretion by the gastric fundus through balloon contact and balloon-induced delayed gastric emptying.
Patients were randomised to a 13-week period of sham or balloon treatment, followed by a 13-week period of balloon treatment in everyone. Blood samples for ghrelin measurement were taken in the fasting state and every 15 buy Tipifarnib min for 1 h after a breakfast meal at the start, after HSP phosphorylation 13 weeks and after 26 weeks. Patients filled out scales to assess satiety and kept a food diary.
Forty obese patients (BMI 43.1 kg/m(2)) participated. At the start, fasting ghrelin
values were low with a blunted ghrelin response to a test meal. The presence of a balloon had no influence on fasting or meal-suppressed ghrelin concentrations. Despite a weight loss of 10 % after 13 weeks and 15 % after 26 weeks, fasting ghrelin concentrations did not change; neither did the ghrelin response to a meal. No relation was found between ghrelin and insulin, satiety, intermeal interval, the number of meals or subsequent energy intake. Ghrelin concentrations were more suppressed with greater weight loss or with balloons located in the fundus.
Ghrelin concentrations did not change by balloon treatment after 13 and 26 weeks and, unexpectedly, did not rise despite substantial
weight loss and negative energy balance. This suppression this website might be of benefit in the maintenance of weight loss but could not be ascribed to the balloon treatment.”
“This study proposes to evaluate the impact of different phosphate binders on the slowing of cardiovascular calcification and QT dispersion in incident hemodialysis patients with a follow-up of 36 months. This is to be a randomized, multicenter, perspective, interventional study. Inclusion criteria are age over 18 years and being an incident patient on hemodialysis. Exclusion criteria are congenital prolongation of QT segment syndrome, QT-c >440 ms, bradycardia <50 beats per minute, symptomatic arrhythmia or any other significant heart problems; electrolyte imbalances (especially hypokalemia, hypomagnesemia or hypocalcemia); abnormal liver function tests and hypothyroidism. An informed consent will be taken at study entry. The patients will be randomized to 2 cohorts: 180 patients in the sevelamer group and 180 patients in the calcium-binder phosphate group. Related vascular calcification mortality is the principal end point and will be evaluated at 36 months.”
“Endovenous laser ablation (EVLA) is successfully used to treat varicose veins.