My eye doctor, Evan Wolf, MD, PhD was telling me that I had bad eys with lots of complications. I told him my sugar was better, at 5.7 and I said I was hoping that my eyes had improved and he said "We'll see". So he sits down and shines that bright light in my eye so he can look deep inside and he says, "I can't believe this, all the damage you had, is completely gone! It's like you have new eyes. I've NEVER seen that happen before. He was so excited!!
I did have to get a new prescription though, cause now I need a magnifier for up close, no glasses for the tv or computer and then something for far away if I"m driving.
And he took me off the Acetazolamide. The only med I have to take is the Synthroid.
Good news
Cindy T
Alaska
http://ping.fm/hOojsLap Band Less Effective than Stomach Stapling 3
Laparoscopic Adjustable Silicone Gastric Banding vs Laparoscopic Vertical Banded Gastroplasty in Morbidly Obese Patients: Long-Term Results of a Prospective Randomized Controlled Clinical Trial
Level I Evidence: The Lap Band is inferior to the old stomach stapling
http://ping.fm/qlJV6Lap Band worse than stomach stapling.
Controlled prospective trial shows the old stomach stapling is better than the band!
;-(
Dr. Rutledge,
Like some of the people I have seen on your videos on you tube, I found your name after typing in failed lap-band. I have had my band for 3 years after I let myself be talked into it by my best friend. The vomiting is awful and has almost put a complete stop to my life for weeks on end as I try to get things under control time and time again. My question is do you ever just remove a lap band without doing the MGB surgery? I feel as though I am done with this and am slowly losing my mind as well as my health.
Thank you and thank you for this site which makes me feel not so alone.
J
The Comparative Dose-Response Effects of Melatonin and Midazolam for Premedication of Adult Patients: A Double-Blinded, Placebo-Controlled Study
Mohamed Naguib, MB, BCh, MSc, FFARCSI, MD*, and Abdulhamid H. Samarkandi, MB, BS, KSUF, FFARCSI{dagger}
Departments of Anesthesia, *University of Iowa College of Medicine, Iowa City, Iowa, and {dagger}King Saud University, Riyadh, Saudi Arabia
Address correspondence and reprint requests to Mohamed Naguib, MD, University of Iowa College of Medicine, Department of Anesthesia, 200 Hawkins Dr., 6JCP, Iowa City, Iowa 52242-1009. Address e-mail to mohamed-naguib@uiowa.edu.
We designed this prospective, randomized, double-blinded, placebo-controlled study to compare the perioperative effects of different doses of melatonin and midazolam.
Doses of 0.05, 0.1, or 0.2 mg/kg sublingual midazolam or melatonin or placebo were given to 84 women, approximately 100 min before a standard anesthetic.
Sedation, anxiety, and orientation were quantified before, 10, 30, 60, and 90 min after premedication, and 15, 30, 60, and 90 min after admission to the recovery room.
Psychomotor performance of the patient was evaluated at these times also, by using the digit-symbol substitution test and Trieger dot test.
Patients who received premedication with either midazolam or melatonin had a significant decrease in anxiety levels and increase in levels of sedation preoperatively compared with control subjects.
Patients in the three midazolam groups experienced significant psychomotor impairment in the preoperative period compared with melatonin or placebo.
After operation, patients who received 0.2 mg/kg midazolam premedication had increased levels of sedation at 90 min compared with 0.05 and 0.1 mg/kg melatonin groups. In addition, patients in the three midazolam groups had impairment of performance on the digit-symbol substitution test at all times compared with the 0.05 mg/kg melatonin group.
Premedication with 0.05 mg/kg melatonin was associated with preoperative anxiolysis and sedation without impairment of cognitive and psychomotor skills or affecting the quality of recovery.
Implications:
Premedication with 0.05 mg/kg melatonin was associated with preoperative anxiolysis and sedation without impairment of cognitive and psychomotor skills or affecting the quality of recovery.
http://sites.google.com/a/clos.net/mini/melatoninMelatonin
Anesth Analg 2007; 105:1263-1271
© 2007 International Anesthesia Research Society
ANESTHETIC PHARMACOLOGY
The Clinical Impact of Preoperative Melatonin on Postoperative Outcomes in Patients Undergoing Abdominal Hysterectomy
Wolnei Caumo, MD, PhD*{dagger}, Fernanda Torres, MSc{ddagger}, Nívio L. Moreira, Jr, MD§, Jorge A. S. Auzani, MD§, Cristiano A. Monteiro, MD§, Gustavo Londero, MD§, Diego F. M. Ribeiro||, and Maria Paz L. Hidalgo, MD, PhD||
From the *Anesthesia Service and Perioperative Medicine at Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS); {dagger}Instituto de Ciências Bsicas da Saúde, Pharmacology Department, UFRGS; {ddagger}Multidisciplinary Group of Development of Biological Rhythms of Universidade de São Paulo; §Registrar of Anesthesia Service and Perioperative Medicine at Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS); ||Psychiatric Service of Hospital Materno Infantil Presidente Vargas, Hospital de Clínicas de Porto Alegre (HCPA); and ¶Hospital de Clínicas de Porto Alegre (HCPA), Psychiatric Department of School of Medicine, UFRGS, Brazil.
Address correspondence and reprint requests to Dr. Maria Paz Loayza Hidalgo, Castro Alves 167 sala 204, CEP 90430-131 – Porto Alegre, RS, Brazil. Address e-mail to mpaz@cpovo.net.
BACKGROUND: Melatonin has sedative, analgesic, antiinflammatory, antioxidative, and chronobiotic effects. We determined the impact of oral melatonin premedication on anxiolysis, analgesia, and the potency of the rest/activity circadian rhythm.
METHODS: This randomized, double-blind, placebo-controlled study included 33 patients, ASA physical status I–II, undergoing abdominal hysterectomy.
Patients were randomly assigned to receive either oral melatonin 5 mg (n = 17) or placebo (n = 16) the night before and 1 h before surgery.
The analysis instruments were the Visual Analog Scale, the State-Trait Anxiety Inventory, and the actigraphy.
RESULTS:
The number of patients that needed to be treated to prevent one additional patient reporting high postoperative anxiety and moderate to intense pain in the first 24 postoperative hours was 2.53 (95% CI, 1.41–12.22) and 2.20 (95% CI, 1.26–8.58), respectively.
The number-needed-to-treat was 3 (95% CI, 1.35–5.0) to prevent high postoperative anxiety in patients with moderate to intense pain, when compared with 7.5 (95% CI, 1.36–{infty}) in the absence of pain or mild pain.
Also, the treated patients required less morphine by patient-controlled analgesia, as assessed by repeated measures ANOVA (F[1,31] = 6.05, P = 0.02).
The rest/activity cycle, assessed by actigraphy, showed that the rhythmicity percentual of 24 h was higher in the intervention group in the first week after discharge ([21.16 ± 8.90] versus placebo [14.00 ± 7.10]; [t = –2.41, P = 0.02]).
CONCLUSIONS: This finding suggested that
*** preoperative melatonin produced clinically relevant
*** anxiolytic and analgesic effects,
*** especially in the first 24 postoperative hours.
Also, it improved the recovery of the potency of the rest/activity circadian rhythm.
http://sites.google.com/a/clos.net/mini/lap-band-less-effective-than-stomach-stapling
Lap Band Less Effective than Stomach Stapling
The Lap Band is advertised as an attractive choice for weight loss. A recent controlled prospective randomized trial shows that the LapBand is not as good as the abandoned "Stomach Stapling!"
Obes Surg. 2009 Aug;19(8):1108-15. Epub 2009 Jun 10.Click here to read Links
Laparoscopic adjustable silicone gastric banding vs laparoscopic vertical banded gastroplasty in morbidly obese patients: long-term results of a prospective randomized controlled clinical trial.
Scozzari G, Farinella E, Bonnet G, Toppino M, Morino M.
Digestive Surgery and Center for Minimal Invasive Surgery, Department of Surgery, University of Turin, C.so A.M. Dogliotti 14, 10126, Turin, Italy.
BACKGROUND: Aim of the study is to present long-term results of a prospective randomized single-institution clinical trial comparing laparoscopic adjustable silicone gastric banding (LASGB) with laparoscopic vertical banded gastroplasty (LVBG) in morbid obesity.
METHODS: A total of 100 morbidly obese patients (body mass index 40 to 50 kg/m2) were randomized to LASGB (n=49) or LVBG (n=51) and followed up for a minimum of 7 years.
RESULTS: Mean operative time was 65.4 min in LASGBs and 94.2 min in LVBGs (p<0.05); mean hospital stay was 3.7 and 6.6 days, respectively (p<0.05).
Late complication rates were
36.7% in LASGBs vs 15.7% in LVBGs at 3 years (p<0.05),
46.9% vs 43.1% at 5 years (NS), and
55.1% vs 47.1% at 7 years (NS).
Late reoperation rates were
28.6% in LASGBs and 2.0% in LVBGs at 3 years (p<0.001),
38.8% and 2.0% at 5 years (p<0.001), and
46.9% and 7.8% at 7 years (p<0.001).
Excess weight loss in LASGBs was
41.8% at 3 years,
33.2% at 5 years, and
29.9% at 7 years;
excess weight loss in LVBGs was
60.9%,
57%, and
53.1%, respectively (p<0.05).
CONCLUSIONS:
This study demonstrates that
LVBG is significantly more effective than LASGB in terms of
late complications,
late reoperations, and
long-term results on weight loss.
http://sites.google.com/a/clos.net/mini/lap-band-less-effective-than-stomach-stapling
--
Dr. Rutledge
Email: DrR@clos.net
Private Cell Phone 702-215-9550
On the Web=> www.CLOS.Net
http://sites.google.com/a/clos.net/mini/increased-need-for-hospitalization-after-rny-gastric-bypassIncreased Need for Hospitalization after RNY Gastric Bypass
Unbiased Study shows RNY Gastric Bypass Increases Need for Hospitalization after gastric bypass surgery Primarily because of Complications
The rate of hospitalization in the year AFTER RNY was more than double the rate in the year preceding RNY (19% vs 8%, P<.001).
JAMA. 2005 Oct 19;294(15):1918-24.Click here to read Links
Comment in:
JAMA. 2005 Oct 19;294(15):1960-3.
JAMA. 2006 May 24;295(20):2355-6; author reply 2356.
Hospitalization before and after gastric bypass surgery.
Zingmond DS, McGory ML, Ko CY.
Division of General Internal Medicine and Health Services Research, Department of Medicine, The David Geffen School of Medicine at the University of California Los Angeles, Los Angeles 90095-1736, USA. dzingmond@mednet.ucla.edu
CONTEXT:
The use of Roux-en-Y gastric bypass (RYGB) has been reported to be effective in the treatment of obesity and its related comorbidities.
Need for Hospitalization after RYGB is less well understood.
OBJECTIVE:
To determine the rates and indications for inpatient hospital use before and after RYGB.
DESIGN, SETTING, AND PARTICIPANTS: Retrospective study of Californians receiving RYGB in California hospitals from 1995 to 2004.
MAIN OUTCOME MEASURE: Hospitalization in the 1 to 3 years after RYGB.
RESULTS: In California from 1995 to 2004, 60,077 patients underwent RYGB-11,659 in 2004 alone.
The rate of hospitalization in the year following RYGB was more than double the rate in the year preceding RYGB (19.3% vs 7.9%, P<.001).
Furthermore, in the subset of patients (n = 24,678) with full 3-year follow-up,
a mean of 8.4% were admitted a year before RYGB
while 20.2% were readmitted in the year after RYGB,
18.4% in the second year after RYGB, and
14.9% in the third year after RYGB.
** The most common reasons for admission prior to RYGB were obesity-related problems (eg, osteoarthritis, lower extremity cellulitis), and elective operation (eg, hysterectomy),
** while the most common reasons for admission after RYGB were complications procedure related,
such as ventral hernia repair and gastric revision.
In multivariate logistic regression models predicting 1-year readmission after RYGB, increasing Charlson Comorbidity Index score, and hospitalization in the 3-year period prior to RYGB were significantly associated with readmission within a year.
CONCLUSIONS: Increases in hospital use after surgery appear to be related to RYGB. Payers, clinicians, and patients must consider the not-inconsequential rate of rehospitalization after this type of surgery.
http://sites.google.com/a/clos.net/mini/h-pylori-and-iron-deficiency-anemiaH. Pylori and Iron Deficiency Anemia
Reversal of Iron Deficiency Anemia after Helicobacter pylori Eradication in Patients with Asymptomatic Gastritis
New studies show that treatment of H. Pylori can treat certain forms of Iron Deficiency Anemia
Cure of H. pylori infection is associated with reversal of iron dependence and recovery from iron deficiency anemia.
Reversal of Iron Deficiency Anemia after Helicobacter pylori Eradication in Patients with Asymptomatic Gastritis
right arrow Bruno Annibale, MD; Massimo Marignani, MD; Bruno Monarca, MD; Giorgio Antonelli, MD; Adriana Marcheggiano, MD; Gina Martino, MD; Franco Mandelli, MD; Renzo Caprilli, MD; and Gianfranco Delle Fave, MD
2 November 1999 | Volume 131 Issue 9 | Pages 668-672
Background: Iron deficiency anemia is the most common form of anemia worldwide. Recent studies have suggested an association between Helicobacter pylori infection and iron deficiency.
Objective: To investigate the effects of eradicating H. pylori with combination antibiotic therapy on iron deficiency anemia in patients with H. pylori-associated gastritis.
Design: Case series.
Setting: University hospital.
Patients: 30 patients with a long history of iron deficiency anemia in whom H. pylori-associated gastritis was the only pathologic gastrointestinal finding detected.
Intervention: Eradication therapy with two antibiotics and discontinuation of iron replacement therapy.
Measurements: Complete blood count, ferritin levels, and gastroscopy with biopsy to evaluate H. pylori status.
Results: At 6 months, 75% of patients had recovered from anemia (P < 0.001), ferritin values increased from 5.7 ± 0.7 µg/L to 24.5 ± 5.2 µg/L (95% CI, 8.85 to 29.97). After 12 months, 91.7% of patients had recovered from anemia.
Conclusions: Cure of H. pylori infection is associated with reversal of iron dependence and recovery from iron deficiency anemia.
http://sites.google.com/a/clos.net/mini/chocalate-and-death-from-heart-attackChocolate and Death from Heart Attack
Heart attack survivors who eat chocolate two or more times per week cut their risk of dying from heart disease about threefold
1.
AFP: Chocolate 'cuts death rate' in heart attack survivors
Chocolate 'cuts death rate' in heart attack survivors. By Marlowe Hood (AFP) – Aug 13, 2009. PARIS — Heart attack survivors who eat chocolate two or more ...
www.google.com/.../ALeqM5gxKbyt-iymZ-PS8tgMMyi65kM4Tw - Similar
2.
Health Highlights: Aug. 13, 2009 - US News and World Report
Aug 13, 2009 ... Chocolate Helps Heart Attack Survivors Childhood Radiation Tied to ... that chocolate can help prevent death in heart attack survivors. ...
health.usnews.com/.../health-highlights-aug-13--2009.html - Cached - Similar
3.
Death by Chocolate? Not for Heart Attack Survivors
Aug 14, 2009 ... If you've survived a heart attack, you could dramatically cut your risk of dying from heart disease by eating chocolate two or more times ...
digg.com/.../Death_by_Chocolate_Not_for_Heart_Attack_Survivors - Cached - Similar
4.
Chocolate 'cuts death rate' in heart attack survivors | NowPublic ...
Aug 13, 2009 ... Heart attack survivors who eat chocolate two or more times per week cut their risk of dying from heart disease about threefold compared to ...
www.nowpublic.com/.../chocolate-cuts-death-rate-heart-attack-survivors - Cached - Similar
5.
Study: Eating Chocolate Reduces Risk of Death in Heart Attack ...
Aug 13, 2009 ... Study: Eating Chocolate Reduces Risk of Death in Heart Attack Survivors, Here's one more reason to eat chocolate: A study finds that eating ...
www.foxnews.com/story/0,2933,539254,00.html - Cached - Similar
6.
Raw Story » Chocolate 'cuts death rate' in heart attack survivors
Aug 13, 2009 ... PARIS (AFP) – Heart attack survivors who eat chocolate two or more times per week cut their risk of dying from heart disease about threefold ...
rawstory.com/.../chocolate-cuts-death-rate-in-heart-attack-survivors/ - Cached - Similar
7.
Chocolate cuts death risk in heart attack survivors - Health ...
Chocolate cuts death risk in heart attack survivors. ... even indulging in chocolate once a week can nearly halve the risk of death from heart problems. ...
timesofindia.indiatimes.com/.../Chocolate...death...heart-attack.../4896143.cms - Cached - Similar
8.
Chocolate cuts death rate after heart attack - Washington Times
Heart attack survivors who eat chocolate two or more times per week cut their risk of dying from heart disease about threefold compared to those who never ...
www.washingtontimes.com/.../chocolate-found-to-cut-death-rate-after-heart-atta/?... - Cached - Similar
9.
Dark chocolate 'cuts death risk in heart attack survivors'
London, Aug 15 (ANI): A chocolate fix twice a week could be good for heart attacker sufferers, suggests a new study. The research, published in the Journal ...
www.thaindian.com/.../dark-chocolate-cuts-death-risk-in-heart-attack-survivors_100232765.html - Cached - Similar
10.
Study: Chocolate cuts risk of death in heart attack survivors - On ...
Aug 13, 2009 ... Chocolate lovers rejoice: A new study shows a substantial cut in the risk of death from heart disease for heart attack survivors who eat ...
blogs.usatoday.com/.../study-eating-chocolate-cuts-risk-of-heart-disease-for-heart-attack-survivors.html - Cached - Similar
11.
News results for Chocolate and Death from Heart Attack
A Woman's Heart, Eating Chocolate May Reduce Risk of Cardiac Death ... - 1 hour ago
What we are just now learning is that chocolate may also be beneficial to your heart health after a heart attack as well. A joint US-Swedish study recently ...
J Intern Med. 2009 Sep;266(3):248-57.Click here to read Links
Chocolate consumption and mortality following a first acute myocardial infarction: the Stockholm Heart Epidemiology Program.
Janszky I, Mukamal KJ, Ljung R, Ahnve S, Ahlbom A, Hallqvist J.
Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden. imre.janszky@ki.se
OBJECTIVES: To assess the long-term effects of chocolate consumption amongst patients with established coronary heart disease.
DESIGN: In a population-based inception cohort study, we followed 1169 non-diabetic patients hospitalized with a confirmed first acute myocardial infarction (AMI) between 1992 and 1994 in Stockholm County, Sweden, as part of the Stockholm Heart Epidemiology Program. Participants self-reported usual chocolate consumption over the preceding 12 months with a standardized questionnaire distributed during hospitalization and underwent a health examination 3 months after discharge. Participants were followed for hospitalizations and mortality with national registries for 8 years.
RESULTS: Chocolate consumption had a strong inverse association with cardiac mortality. When compared with those never eating chocolate, the multivariable-adjusted hazard ratios were 0.73 (95% confidence interval, 0.41-1.31), 0.56 (0.32-0.99) and 0.34 (0.17-0.70) for those consuming chocolate less than once per month, up to once per week and twice or more per week respectively. Chocolate consumption generally had an inverse but weak association with total mortality and nonfatal outcomes. In contrast, intake of other sweets was not associated with cardiac or total mortality.
CONCLUSIONS: Chocolate consumption was associated with lower cardiac mortality in a dose dependent manner in patients free of diabetes surviving their first AMI. Although our findings support increasing evidence that chocolate is a rich source of beneficial bioactive compounds, confirmation of this strong inverse relationship from other observational studies or large-scale, long-term, controlled randomized trials is needed.
