Bariatric Times

JUL 2017

A peer-reviewed, evidence-based journal that promotes clinical development and metabolic insights in total bariatric patient care for the healthcare professional

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C l i n i c a l D e v e l o p m e n t s a n d M e t a b o l i c I n s i g h t s i n T o t a l B a r i a t r i c P a t i e n t C a r e Volume 14, Number 7 July 2017 A P e e r - R e v i e w e d P u b l i c a t i o n W W W . B A R I A T R I C T I M E S . C O M LIKE us on Facebook • FOLLOW us on Twitter • CONNECT with us on LinkedIn Presorted Standard U.S. Postage PAID Lebanon Junction, KY Permit #344 DOWNLOAD OR UPDATE THE BARIATRIC TIMES APP TODAY! ITunes Google (Android) Download the BT app for your mobile device! Scan this QR code with your QR reader for the digital edition of Bariatric Times. EDITORIAL MESSAGES ................3 A Message from Dr. Raul J. Rosenthal: It is Our Obligation to Educate Colleagues on Chronic Abdominal Pain after Roux-en-Y Gastric Bypass for Best Management A Message from Dr. Christopher Still: The Endocrine Society's Scientific Statement Calling for More Research into Underying Mechanisms of Weight Maintenance is Telling of the Chronic and Relapsing Nature of Obesity Also Inside L E T T E R T O T H E E D I T O R . . . . . . . . . . . . . . . 9 I nt r a v e no us M i c r o nut r i e nt T he r a py ( I M N T ) f o r G a s t r i c B y pa s s P a t i e nt s : A S o l ut i o n t o Complications of an Often Unrecognized Problem ASK THE LEADERSHIP . . . . . . . . . . . . . . .10 The ASMBS 2017 Election Season: The Future of Society Leadership NEWS AND TRENDS . . . . . . . . . . . . . . . . . 18 ASMBS FOUNDATION NEWS AND UPDATE . . . . . . . . . . . . . . . . . . 20 SYMPOSIUM PREVIEW . . . . . . . . . . . . . . 24 Integrated Health Offerings at IFSO 2017 CALENDAR OF EVENTS ................26 CARTOON CORNER ...................... 26 MARKETPLACE ........................... 26 AD INDEX ....................................27 ORIGINAL RESEARCH Page 22 Applying Metabolic Surgery Research to the Type 1 Diabetes Treatment Algorithm A Novel Hypothesis Page 15 A Comparison of Abdominal Computerized Tomography Versus Magnetic Resonance Imaging in the Evaluation of Abdominal Pain after Gastric Bypass BACKGROUND Gastric bypass patients are frequently subjected to ionizing radiation (IR), sometimes during upper gastrointestinal (UGI) swallow studies but more often during computerized tomography (CT) to evaluate internal anatomy, generally in the setting of postoperative abdominal pain. About 30 percent of gastric bypass patients present emergently in the postoperative period, over half present for central abdominal pain. 1 The current gold standard study to evaluate such symptoms in gastric bypass patients is CT of the abdomen and pelvis. Such studies, depending on whether they are performed with or without contrast material, may subject patients to a range of 8 to 15 millisieverts (mSv) of IR. The average adult living in the United States receives an estimated 3 mSv per year in background radiation, and another 3 mSv per year from medical procedures. 2 The Biological Effects of Ionizing Radiation (BEIR) VII model for lifetime risk of developing cancer from low-level IR estimates that 1 out of 1,000 people exposed to 10 mSv of IR will develop cancer in their lifetime. 3 Based on a prior study, 4 we determined that in a cohort of laparoscopic gastric bypass patients, some individuals underwent as many as 25 abdominal CT scans in the first five years postoperatively. by ANN M. ROGERS, MD, and JARED CAPPELLI, RN, BS I NTERVIEW ESTEBAN VARELA, MD, FACS, FASMBS CARLOS FELIPE CHAUX, MD An Interview with I n a recent article published in CellR4, 1 Chaux et al proposed a novel hypothesis of utilizing metabolic surgery in combination with adult stem cell therapy to promote β-cell regeneration, which might result in insulin independence in type 1 diabetes mellitus. They discuss how intestinal reconstructions in metabolic surgery, which have proven effective in the treatment of patients with type 2 diabetes mellitus, could be extrapolated to type 1 diabetes mellitus. They concluded that metabolic surgery and stem cells should be considered as part of a multimodal treatment algorithm for type 1 diabetes mellitus treatments, and propose a protocol requiring a multidisciplinary team approach and infrastructure including metabolic surgeons, endocrinologists, immunologists, and regenerative medicine specialists.

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