Browsing by Subject "bariatric surgery"
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Item Open Access Imbalanced Coagulation in the Airway of Type-2 High Asthma with Comorbid Obesity.(Journal of asthma and allergy, 2021-01) Womble, Jack T; McQuade, Victoria L; Ihrie, Mark D; Ingram, Jennifer LAsthma is a common, chronic airway inflammatory disease marked by airway hyperresponsiveness, inflammation, and remodeling. Asthma incidence has increased rapidly in the past few decades and recent multicenter analyses have revealed several unique asthma endotypes. Of these, type-2 high asthma with comorbid obesity presents a unique clinical challenge marked by increased resistance to standard therapies and exacerbated disease development. The extrinsic coagulation pathway plays a significant role in both type-2 high asthma and obesity. The type-2 high asthma airway is marked by increased procoagulant potential, which is readily activated following damage to airway tissue. In this review, we summarize the current understanding of the role the extrinsic coagulation pathway plays in the airway of type-2 high asthma with comorbid obesity. We propose that asthma control is worsened in obesity as a result of a systemic and local airway shift towards a procoagulant and anti-fibrinolytic environment. Lastly, we hypothesize bariatric surgery as a treatment for improved asthma management in type-2 high asthma with comorbid obesity, facilitated by normalization of systemic procoagulant and pro-inflammatory mediators. A better understanding of attenuated coagulation parameters in the airway following bariatric surgery will advance our knowledge of biomolecular pathways driving asthma pathobiology in patients with obesity.Item Open Access Postoperative Depression, Eating Behaviors, and Physical Activity as Indicators of Weight Loss in Gastric Bypass Patients(2014) Martinez, Erin ElenaBackground: Bariatric surgery produces marked weight loss and improvement in comorbid health conditions among individuals with Class II or Class III obesity (Class I = 30.0 ≤ BMI ≤ 34.9kg/m2; Class II = 35.0 ≤ BMI ≥ 39.9kg/m2; Class III = BMI ≥ 40 kg/m2). However, suboptimal weight outcomes occur in a significant minority of patients. Evidence suggests that psychological and behavioral factors might affect weight loss, but most of the literature has focused on preoperative factors, with mixed results. The current study tested the hypothesis that postoperative depressive symptoms, eating behaviors, and lower levels of physical activity would be associated with poorer weight loss outcomes. Method: Preoperative data were obtained from an extant clinical database, and postoperative data were collected via a mail or online questionnaire in a sample of 141 female Roux-en-y gastric bypass (RYGB) patients at an average of 16.80 (SD=2.20) months post-surgery. Self-report measures assessed cognitive-affective and somatic symptoms of depression; binge eating, grazing, night eating, distress about overeating or loss of control over eating; and physical activity. Results: Weight outcome measures were defined as percentage of excess BMI loss (%EBMIL) and successful weight loss (≥ 50% EBMIL). Higher distress was associated with poorer %EBMIL, and higher level of physical activity was associated with greater %EBMIL. Decreased cognitive-affective symptoms and increased somatic symptoms of depression were associated with a higher probability of successful weight loss. Increased somatic complaints predicted greater %EBMIL unless those symptoms were associated with higher sedentary behavior. Conclusions: Consistent with hypotheses, preoperative depressive symptoms and binge eating disorder did not predict weight loss. Aspects of all three postoperative domains were associated with weight outcomes. Future research should explore the relations among these psychological and behavioral factors and weight loss over a longer follow-up period.