- Sublimis Argentina offers affordable bariatric surgery abroad

Chicago — Among obese individuals, having bariatric surgery was associated with a reduced long-term incidence of cardiovascular deaths and events such as heart attack and stroke, according to a study in the January 4 issue of JAMA.

Most epidemiological studies have shown that obesity is associated with increased cardiovascular events and death. “Weight loss might protect against cardiovascular events, but solid evidence is lacking,” according to background information in the article.

Lars Sjostrom, M.D., Ph.D., of the University of Gothenburg, Sweden, and colleagues conducted a study to test the hypothesis that bariatric surgery is associated with a reduced incidence of cardiovascular events and examined the relationship between weight change and cardiovascular events. The study (Swedish Obese Subjects [SOS]) is an ongoing, nonrandomized, prospective, controlled study conducted at 25 public surgical departments and 480 primary health care centers in Sweden, and includes 2,010 obese participants who underwent bariatric surgery and 2,037 matched obese controls who received usual care.

Patients were recruited between September 1987 and January 2001. Date of analysis was December 31, 2009, with median (midpoint) follow-up of 14.7 years. Inclusion criteria were age 37 to 60 years and a body mass index of at least 34 in men and at least 38 in women. Surgery patients underwent gastric bypass (13.2 percent), banding (18.7 percent), or vertical banded gastroplasty (68.1 percent), and controls received usual care in the Swedish primary health care system. Physical and biochemical examinations and database cross-checks were undertaken at preplanned intervals. The average changes in body weight after 2, 10,15, and 20 years were -23 percent, -17 percent, -16 percent, and -18 percent in the surgery group and 0 percent, 1 percent, -1 percent, and -1 percent in the control group, respectively.

- Before and after bariatric surgery in Argentina

During follow-up, there were 49 cardiovascular deaths among the patients in the control group and 28 cardiovascular deaths among the patients in the surgery group. In total (fatal and nonfatal), there were 234 cardiovascular events among patients in the control group and 199 cardiovascular events among patients in the surgery group. After adjustment for a number of variables, bariatric surgery was associated with a reduced number of fatal cardiovascular deaths and a lower incidence of total cardiovascular events.

Bariatric surgery was associated with reduced number of fatal heart attack deaths (22 in the surgery group vs. 37 in the control group), with analysis indicating that bariatric surgery was related both to reduced fatal heart attack incidence and total heart attack incidence. Also, bariatric surgery was associated both with reduced number of fatal stroke events and total stroke events.

However, the researchers found no significant relationship between weight change and cardiovascular events in the surgery or control group. The authors suggest that the lack of association between weight loss and reduction of cardiovascular events could be related to inadequate statistical power to detect this relationship. “Alternatively, following relatively modest weight loss induced by bariatric surgery, there is no further risk reduction attributable to greater, subsequent weight loss. Our negative findings also emphasize the need to explore weight loss independent of effects of bariatric surgery.”

“In conclusion, this is the first prospective, controlled intervention to our knowledge reporting that bariatric surgery is associated with reduced incidence of cardiovascular deaths and cardiovascular events. These results– together with our previously reported associations between bariatric surgery and favorable outcomes regarding long-term changes of body weight, cardiovascular risk factors, quality of life, diabetes, cancer, and mortality– demonstrate that there are many benefits to bariatric surgery and that some of these benefits are independent of the degree of the surgically induced weight loss.”

Undergoing Bariatric Surgery Associated With Obese Family Members Adopting Healthier Lifestyles

Having an obese family member undergo gastric bypass surgery for weight loss appears to be associated with additional benefits of weight loss and improved healthy behaviors of obese family members, according to a report of Archives of Surgery, one of the JAMA/Archives journals.

One of the biggest risks for becoming an obese child is having an obese parent, and data show that childhood obesity is strongly associated with obesity in adulthood, according to background information in the article. “The obesity rate in children of mothers who have had Roux-en-Y gastric bypass is 52 percent lower after surgery compared with the obesity rate in children born to the same mothers before surgery,” the authors write. “If one member of the family makes drastic lifestyle changes following surgery, it is possible that other family members will adopt similar healthy habits.”

- Before and after bariatric surgery in Argentina

Gavitt A. Woodard, M.D., and colleagues from Stanford University School of Medicine, Stanford, Calif., observed the weight and lifestyle changes of patients who underwent Roux-en-Y gastric bypass surgery and their family members. The study was conducted between January 2007 and December 2009, and included 85 participants; 35 bariatric surgery patients, 35 adult family members and 15 children under 18 years of age. Obese adult family members were define as having a BMI greater than 30 and obese children were defined as having a BMI at the 95th percentile or higher, using the BMI for sex and age growth charts of the Centers for Disease Control and Prevention (CDC).

The weight loss in patients observed by the authors one year following surgery was typical for patients undergoing gastric bypass surgery at the study institution. The mean (average) weight loss of all adult family members decreased from 220 pounds to 198 pounds but was not statistically significant. However, among obese family members, the weight decreased from 234 to 226 pounds, a difference that did reach statistical significance. The same results were observed for waist circumference, as the results among all adult family members did not change significantly (from 108 cm to 105 cm; 42.5 inches to 41.3 inches), but did significantly decrease among obese adult family members (from 119 to 111 cm; 46.9 inches to 43.7 inches).

In obese children only, the authors observed a lower BMI than was expected for their growth curve at the one-year follow-up, however this finding did not reach statistical significance.

One year following surgery, both patients and adult family members had significant changes in their eating habits, with patients significantly increasing cognitive control of eating while decreasing uncontrolled and emotional eating. Adult family members showed no significant changes in cognitive control of eating, but did significantly decrease uncontrolled eating and emotional eating. Additionally, children of bariatric patients were twice as likely to report being on a diet to lose weight one year post-surgery. Children also benefited from fewer daily hours of television watching and increased hours of physical activity after a parent underwent bariatric surgery.

For more information about Bariatric Surgery in Argentina please do not hesitate to contact us.

Hair Restoration Surgery Market Increased 47% Worldwide In 2010

- Middle East and Asia Experience Largest Gains

- Note: Sublimis Argentina offers affordable hair transplant abroad. Contact us for further information.

Despite slow economic growth worldwide, the demand for procedures to correct hair loss proved to be stronger than ever, according to statistics released from a recent member survey conducted by the International Society of Hair Restoration Surgery (ISHRS) – the world’s leading medical authority on hair loss and hair restoration.  From 2008 to 2010, the total extrapolated market size for hair restoration surgery increased 47.9 percent.

Specifically, the extrapolated worldwide number of surgical hair restoration procedures performed in 2010 was approximately 279,381, up 11 percent from 2008. Since the ISHRS starting compiling membership data in 2004, the number of procedures performed around the world jumped 66 percent – with the Middle East (454 percent increase) and Asia (345 percent increase) experiencing the largest growth.

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Catherine Zeta-Jones and Patrick Dempsey earn top Hair Honors

Members of the International Society of Hair Restoration Surgery (ISHRS) know good hair when they see it, and they like what they see in Catherine Zeta-Jones and Patrick Dempsey.

According to results released today of a new member survey conducted by the ISHRS, 43.8 percent of members voted Catherine Zeta-Jones as the female celebrity with the best tresses, while 71.5 percent of members chose Patrick Dempsey as the male celebrity with the best hair.

The spotlight will be on all things hair at the ISHRS’s 19th Annual Scientific Meeting when more than 500 physicians and surgical assistants from around the world dedicated to advancing the art and science of hair restoration are expected to attend this premier educational event, September 14-18, 2011, at the Dena?ina Civic and Convention Center in Anchorage, Alaska, USA.

This year’s scientific program, with the theme “New Vistas & Trusted Techniques in Hair Transplantation,” will feature presentations by the world’s foremost hair restoration experts on the latest research and scientific advances in diagnosing and treating hair loss.

“The growth we are seeing in hair restoration surgery is a testament to the great strides made over the years in the field and our commitment as a medical specialty to ongoing medical education and research,” said Jerry E. Cooley, MD, president of the ISHRS.  “Exciting new technologies are being investigated that will only further expand our ability to perfect the science of hair restoration and further help more people with hair loss.”

Risk of Bladder Cancer From Smoking Greater Than Previously Reported

Note: Our Medical Spa in Argentina offers programs to Quit Smoking. Feel free to contact us for more information

An analysis of data that includes nearly 500,000 individuals indicates that the risk of bladder cancer among smokers is higher than reported from previous population data, and that the risk for women smokers is comparable with that of men, according to a study in the August 17 issue of JAMA.

More than 350,000 individuals are diagnosed with bladder cancer per year worldwide, including more than 70,000 per year in the United States. Tobacco smoking is the best established risk factor for bladder cancer in both men and women, with previous studies indicating that current cigarette smoking triples bladder cancer risk relative to never smoking, according to background information in the article. “However, the composition of cigarettes has changed during the past 50 years, leading to a reduction in tar and nicotine concentrations in cigarette smoke, but also to an apparent increase in the concentration of specific carcinogens, including beta-napthylamine, a known bladder carcinogen…,” the authors write. They add that changing smoking prevalence and cigarette composition warrant revisiting risk estimates for smoking and bladder cancer.

Neal D. Freedman, Ph.D., M.P.H., of the National Cancer Institute, Department of Health and Human Services, Rockville, Md., and colleagues conducted a study to examine the association between tobacco smoking and bladder cancer using data from men (n = 281,394) and women (n = 186,134) in the National Institutes of Health-AARP (NIH-AARP) Diet and Health Study, who completed a lifestyle questionnaire and were followed up between October 1995 and December 2006. Previous studies of smoking and incident bladder cancer were identified by systematic review of the available literature.

During the course of follow-up, 3,896 men and 627 women were newly diagnosed with bladder cancer. Cigarette smoking was a significant risk factor for bladder cancer in both sexes. Relative to never smokers, former and current smokers had increased risk of bladder cancer in both men and women. Analysis of the data indicated that former smokers had a 2.2 times increased risk of bladder cancer and that for current smokers, the risk was about 4 times higher, relative to never smokers. “In contrast, the summary risk estimate for current smoking in 7 previous studies (initiated between 1963 and 1987) was 2.94,” the authors write.

Ever smoking explained a similar proportion of bladder cancer in both sexes, with population attributable risks of 50 percent in men and 52 percent in women.

The researchers write that factors that may have strengthened the cigarette smoking-bladder cancer association include changes in the constituents of cigarette smoke (such as increased concentrations of beta-napthylamine), and increased awareness of bladder cancer risk in smokers, which may prompt earlier diagnostic workup.

“These results support the hypothesis that the risk of bladder cancer associated with cigarette smoking has increased with time in the United States, perhaps a reflection of changing cigarette composition. Prevention efforts should continue to focus on reducing the prevalence of cigarette smoking.”

Tests That Use DNA From Mother’s Blood to Determine Sex of Fetus Often Effective

As a noninvasive method of determining the sex of a fetus, tests using cell-free fetal DNA obtained from the mother’s blood after 7 weeks gestation performed well, while urine-based tests appear to be unreliable, according to a review and analysis of previous studies, reported in the August 10 issue of JAMA.

Noninvasive prenatal determination of fetal sex could provide an important alternative to invasive cytogenetic determination, which is currently the gold standard for determining sex and single-gene disorders. Amniocentesis has small but measurable rates of procedure-related pregnancy loss; and sonography can be performed as early as 11 weeks’ gestation to determine fetal sex, although not reliably, according to background information in the article. “The availability of a reliable noninvasive alternative to determine fetal sex would reduce unintended fetal losses and would presumably be welcomed by pregnant women carrying fetuses at risk for disorders,” the authors write.

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New approach to Thyroid Surgery eliminates neck scar

- Minimally invasive approach allows surgeons to remove thyroid tumors by way of the armpit
- Note: Sublimis Argentina offers affordable thyroid surgery abroad. Feel free to contact us for further information

As the rate of thyroid cancer continues to climb, doctors are urging patients to be more cautious about thyroid nodules, a common disorder that is responsible for a small but growing number of thyroid cancer cases. Thyroid nodules affect nearly 13 million Americans and are a result of abnormal cell growth on the gland. Until recently, the only way to remove nodules and rule out cancer was through surgery that required a five centimeter incision across the front of the neck. The procedure, and the large scar that resulted, was a deterrent for many patients who feared altering their appearance for something that may not be life threatening. Today however, a new option exists that allows surgeons to access the neck through the armpit, allowing for a biopsy of tissue with no visible scar.

“We now have a minimally invasive way of determining if a thyroid nodule is cancerous,” said Jose Dutra, MD, head and neck surgical oncologist and director of the Thyroid Surgical Clinic at Northwestern Memorial Hospital. “It’s an approach that more patients are comfortable pursuing. If we can identify cancerous cells earlier we increase the chance of removing the cancer before it spreads.”

The procedure, transaxillary robotic thyroid surgery, utilizes 3D cameras and specially designed robotic arms to create a small incision within the armpit, the mechanical arms work just like hands allowing the specialized surgeon to operate remotely with precise control and movements to remove suspicious nodules.

“The underarm area has fewer nerve endings than the anterior neck area, so there’s less pain, no scarring on the neck, and with good care, the incision will heal faster,” said Dutra who is also an associate professor at the department of otolaryngology/head and neck surgery at Northwestern University Feinberg School of Medicine.

This summer, Socorro Delaluz became one of the first patients at Northwestern Memorial to undergo transaxillary thyroid robotic surgery. The mother of two was impressed to have the option that left no visible scar and the quick recovery associated with the technique.

“I didn’t want to be reminded constantly, every morning when I get dressed that I had a scar across my neck. I would have to explain to everyone what happened all the time,” expressed Delaluz.

Another benefit of the minimally invasive approach is that the precision of the robot allows physicians to remove all of the potentially cancerous tissue while sparing more of the structure surrounding the gland.

“The thyroid gland controls how the body uses energy. Changes to the gland can cause a myriad of health issues,” explained Dutra, member of the Robert H. Lurie Comprehensive Cancer Center of Northwestern University.

Thyroid nodules are six-times more common in women than men and can be difficult to diagnose because they often do not present signs or symptoms. Most nodules are small and are often found incidentally during a routine physical or imaging for an unrelated condition. Conditions that can cause one or more nodules to develop in the thyroid gland range from overgrowth of normal thyroid tissue, tumors, a cyst, inflammation and goiters. Individuals should routinely check their neck and should talk with their doctor if they notice any lumps or experience symptoms such as swelling, trouble swallowing, and pain in the throat or hoarseness of the voice.

Robotic surgery is currently widely used for minimally invasive heart and lower abdominal procedures, only recently have the robotic arms been applied to the confined space involved in neck and head surgery. The benefits for robotic thyroid surgery include shorter recovery period, less pain in neck following surgery and better preservation of the laryngeal nerves and the parathyroid glands.

Jennifer Panaro recently had a large nodule removed from her thyroid gland by way of transaxillary thyroid robotic surgery and was back on the tennis court just six weeks after her surgery. The 28 year old was impressed with the speedy recovery and was pleased her voice was protected. “I was thrilled to not experience any changes in my voice or to have deal with a large scar on my neck. As an accountant, I talk to clients all day and I would be self conscious about having a foreign mark across my throat,” said Panaro, patient at Northwestern Memorial.

While the new technology has great advantages, Dutra stresses this option is not the best for all patients and not all tumors can be removed with this approach.

Botox Receives A Positive Opinion for Urinary Incontinence

- Botox injections can provide long-lasting bladder control for patients with neurogenic bladder
- Note: Sublimis offers different treatments with Botox in Argentina

Marlow, United Kingdom – Allergan is pleased to announce that BOTOX® (botulinum toxin type A) has received a positive opinion from the Irish Medicines Board for the management of urinary incontinence in adults with neurogenic detrusor overactivity (NDO) resulting from neurogenic bladder due to stable sub-cervical spinal cord injury, or multiple sclerosis. This is an important step towards securing national licences in the 14 European countries involved in the Mutual Recognition Procedure and marks a key milestone in bringing this innovative treatment to patients suffering from urinary incontinence due to neurogenic detrusor overactivity. The positive opinion is specific for BOTOX® and is based on Allergan’s successful global phase III programme.

Between 60-80% of people with multiple sclerosis (MS) and 75-80% of people with spinal cord injury (SCI) will suffer from some degree of bladder dysfunction including urinary incontinence which can be distressing. Urinary incontinence in patients with MS or SCI is frequently caused by a condition called neurogenic detrusor overactivity (NDO), which results in involuntary contractions of the bladder during the filling stage when the bladder should be relaxed. This overactivity can lead to urinary incontinence (uncontrolled urinary leaking). Targeted injections of BOTOX® into the bladder muscle have been shown to reduce the involuntary contractions and increase bladder capacity. In turn, this reduces the number of urinary leaking episodes and may even stop leaking altogether in some patients.

In Europe, approximately 656,000 people live with MS and, on average, nearly 11,000 people are diagnosed with SCI per year. Many of these people face long-term mobility issues, yet remain professionally and socially active. Urinary incontinence can be a disabling and socially isolating condition. It is also associated with significant quality of life and emotional well-being implications such as embarrassment, low self esteem, depression and loss of independence. Other health implications of urinary incontinence in people living with MS or spinal cord injury include skin irritation and ulcers, kidney failure and recurrent urinary tract infections, which may lead to serious health consequences, if the overactivity of the detrusor muscle is not treated.

“We are pleased that BOTOX® has received a positive opinion following the Mutual Recognition Procedure for the treatment of urinary incontinence in people living with multiple sclerosis or spinal cord injury,” said Douglas Ingram, President of Allergan in Europe, Africa and the Middle East. “For many people with spinal cord injury or multiple sclerosis, gaining effective control over their bladder and staying dry can be a significant step towards improving daily functioning and overall quality of life. Our task now is to work closely with the national health authorities to secure the relevant national licences so that we can bring this valuable treatment option to patients, as quickly as possible.”