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Find video protocols related to scientific articles indexed in Pubmed.
Effects of naltrexone sustained- release/bupropion sustained-release combination therapy on body weight and glycemic parameters in overweight and obese patients with type 2 diabetes.
Diabetes Care
PUBLISHED: 10-21-2013
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OBJECTIVE To assess the efficacy and safety of 32 mg naltrexone sustained-release (SR)/360 mg bupropion SR (NB) in overweight/obese individuals with type 2 diabetes with or without background oral antidiabetes drugs. RESEARCH DESIGN AND METHODS This was a 56-week, double-blind, placebo-controlled study in which 505 patients received standardized lifestyle intervention and were randomized 2:1 to NB or placebo. Coprimary end points were percent weight change and achievement of ?5% weight loss. Secondary end points included achievement of HbA1c <7% (53 mmol/mol), achievement of weight loss ?10%, and change in HbA1c, waist circumference, fasting blood glucose, and lipids. RESULTS In the modified intent-to-treat population (54% female, 80% Caucasian, and mean age 54 years, weight 106 kg, BMI 37 kg/m(2), and HbA1c 8.0% [64 mmol/mol]), NB resulted in significantly greater weight reduction (-5.0 vs. -1.8%; P < 0.001) and proportion of patients achieving ?5% weight loss (44.5 vs. 18.9%, P < 0.001) compared with placebo. NB also resulted in significantly greater HbA1c reduction (-0.6 vs. -0.1% [6.6 vs. 1.1 mmol/mol]; P < 0.001), percent of patients achieving HbA1c <7% (53 mmol/mol) (44.1 vs. 26.3%; P < 0.001), and improvement in triglycerides and HDL cholesterol compared with placebo. NB was associated with higher incidence of nausea (42.3 vs. 7.1%), constipation (17.7 vs. 7.1%), and vomiting (18.3 vs. 3.6%). No difference was observed between groups in the incidence of depression, suicidal ideation, or hypoglycemia. CONCLUSIONS NB therapy in overweight/obese patients with type 2 diabetes induced weight loss, which was associated with improvements in glycemic control and select cardiovascular risk factors and was generally well tolerated with a safety profile similar to that in patients without diabetes.
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Obesity consults-comprehensive obesity management in 2013: Understanding the shifting paradigm.
Obesity (Silver Spring)
PUBLISHED: 07-17-2013
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Although serious health concerns are associated with obesity, losing even 5% of body weight can produce clinically relevant effects. The initial goal of obesity management is usually a 5% to 10% weight reduction. Some people will sustain weight loss with changes in diet and exercise alone; however, these patients represent the minority, and a large percentage are unable to maintain weight loss over time. Patients and providers often wish to intensify obesity treatment, and therefore interest in new medications has been considerable. Until recently, only two antiobesity medications have received Food and Drug Administration approval for long-term use. In June and July of 2012, respectively, lorcaserin and combination phentermine/topiramate extended-release were approved for obesity therapy. The first section of this article reviews mechanisms, clinical trials, benefits and risks of available medications for treating obesity. Bariatric surgery is the next step for patients with a body mass index of ?40 kg/m(2) or ?35 kg/m(2) with comorbidities, based on National Institutes of Health Clinical Guidelines. These procedures and their risks and benefits are reviewed in the second section. The final section presents common clinical scenarios with guidance for choosing among evidence-based recommendations for developing optimal, individualized, long-term strategies for patients with obesity.
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The effect of leptin, caffeine/ephedrine, and their combination upon visceral fat mass and weight loss.
Obesity (Silver Spring)
PUBLISHED: 01-30-2013
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To evaluate the effects of combination caffeine/ephedrine and leptin A-200 on visceral fat mass and weight loss over 24 weeks.
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Nutrition therapy of the severely obese, critically ill patient: summation of conclusions and recommendations.
JPEN J Parenter Enteral Nutr
PUBLISHED: 09-02-2011
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This report compiles the conclusions and recommendations for nutrition therapy of the obese, critically ill patient derived by the group of experts participating in this workshop on obesity in critical care nutrition. The recommendations are based on consensus opinions of the group after review of the current literature. Obesity clearly adds to the complexity of nutrition therapy in the intensive care unit (ICU). Obesity alters the incidence and severity of comorbidities, tolerance of the prescribed regimen, and ultimately patient outcome through the course of hospitalization. Although the basic principles of critical care nutrition apply to the obese ICU patient, a high-protein, hypocaloric regimen should be provided to reduce the fat mass, improve insulin sensitivity, and preserve lean body mass. The ideal enteral formula should have a low nonprotein calorie to nitrogen ratio and have a variety of pharmaconutrient agents added to modulate immune responses and reduce inflammation.
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Nutrition and metabolic complications after bariatric surgery and their treatment.
JPEN J Parenter Enteral Nutr
PUBLISHED: 07-28-2011
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The increase in the number of bariatric procedures annually suggests that these patients will constitute an increasing portion of obese patients who require hospital and intensive care. Currently, little prospective information is available regarding the course of bariatric surgery patients requiring intensive care. Knowledge of the type of bariatric operation performed and an understanding of its anatomy and physiology are useful to provide optimal care to these patients, particularly when considering potential nutrition complications and their diagnosis and treatment. In this article, the authors describe nutrition problems that may be present and potentially affect the course of a hospitalized and/or critically ill patient who has previously undergone a bariatric operation.
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Office-based management of obesity.
Mt. Sinai J. Med.
PUBLISHED: 10-21-2010
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Appropriate recognition and management of obesity is imperative given the fact that one-third of Americans are clinically obese. Up to 25% of patients with a body mass index ? 30 are not appropriately identified by primary care physicians as being obese. An even smaller portion of recognized patients is offered any form of weight-loss treatment. This may be the result of approximately 40% of physicians possessing negative attitudes toward such patients given the challenges in managing this population. In the near future, physicians will be empowered with further knowledge regarding metabolic and neurologic adaptations that make weight loss so difficult. Along with this new information will come novel treatment options. It is predicted that many of the barriers preventing appropriate management of obesity will diminish as further knowledge and treatment options become available.
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Effect of naltrexone plus bupropion on weight loss in overweight and obese adults (COR-I): a multicentre, randomised, double-blind, placebo-controlled, phase 3 trial.
Lancet
PUBLISHED: 07-29-2010
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Despite increasing public health concerns regarding obesity, few safe and effective drug treatments are available. Combination treatment with sustained-release naltrexone and bupropion was developed to produce complementary actions in CNS pathways regulating bodyweight. The Contrave Obesity Research I (COR-I) study assessed the effect of such treatment on bodyweight in overweight and obese participants.
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Do gastric bypass patient characteristics, behavior, and health differ depending upon how successful weight loss is defined?
Obes Surg
PUBLISHED: 07-10-2010
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There is no standardized definition of "weight loss success" after bariatric surgery. The current study was designed to evaluate if various patient factors differed between those with successful and unsuccessful weight loss; and if these findings varied depending upon which definition of weight loss success was used. A chart review of psychiatric and medical files was conducted for 110 patients who had Roux en-Y Gastric Bypass and at least 1 year of follow-up data. Data were analyzed for four weight loss success criteria: body mass index (BMI)?
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A randomized trial of lifestyle modification and taranabant for maintaining weight loss achieved with a low-calorie diet.
Obesity (Silver Spring)
PUBLISHED: 04-08-2010
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Improving the maintenance of weight loss remains a critical challenge for obesity researchers. The present 1-year, randomized, placebo-controlled trial evaluated the safety and efficacy of weight maintenance counseling combined with either placebo or the cannabinoid-1 receptor inverse agonist, taranabant, for sustaining prior weight loss achieved on a low-calorie diet (LCD). Seven hundred eighty-four individuals who had lost ? 6% of body weight during six initial weeks of treatment with an 800 kcal/day liquid LCD were randomly assigned to placebo or once-daily taranabant in doses of 0.5, 1, or 2 mg. All participants were provided monthly, on-site behavioral weight maintenance counseling, as well as monthly phone calls. The primary end point was change in body weight from randomization to week 52. The randomized participants lost an average of 9.6 kg (9.5% of initial weight) during the 6-week LCD. The model-adjusted mean change in body weight during the subsequent 1 year was +1.7 kg for placebo, compared with -0.1, -0.6, and -1.2 kg for the taranabant 0.5, 1, and 2 mg doses, respectively (all P values ? 0.007 vs. placebo). The incidences of psychiatric-related adverse events, including irritability, were higher for taranabant 1 and 2 mg vs. placebo (P ? 0.038). In addition to reporting data on the safety and efficacy of taranabant, this study provides a method for studying the combination of lifestyle modification and pharmacotherapy for weight maintenance after diet-induced weight loss.
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Benefits of moderate weight loss in patients with type 2 diabetes.
Diabetes Obes Metab
PUBLISHED: 02-16-2010
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Weight loss is a primary goal of therapy in overweight patients with type 2 diabetes. This review examines whether positive patient outcomes are observed even after relatively small amounts of weight loss, that is, weight loss being more easily attainable in practice. Clinical studies demonstrate that therapeutic benefit rises with increasing weight loss, but that losses as low as 0.45-4 kg (1-9 lb) have positive effects on metabolic control, cardiovascular risk factors and mortality rates. Even the intention to lose weight, without significant success, can improve outcomes in patients with diabetes, presumably because of the healthy behaviours associated with the attempt. The current data support a continued focus on weight loss, including moderate weight loss, as a key component of good care for overweight patients with type 2 diabetes.
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Comparison of combined bupropion and naltrexone therapy for obesity with monotherapy and placebo.
J. Clin. Endocrinol. Metab.
PUBLISHED: 10-21-2009
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The efficacy of current centrally acting obesity pharmacotherapies is limited by compensatory mechanisms that mitigate weight loss.
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Naltrexone for the treatment of obesity: review and update.
Expert Opin Pharmacother
PUBLISHED: 06-23-2009
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Since their discovery in the brain and gastrointestinal tract nearly 40 years ago, endogenous opioid peptides have been progressively shown to play a role in the regulation of food intake. Animal and human studies regarding opioid peptides and ingestive behavior are reviewed. While the opioid receptor antagonist naltrexone is associated with minimal weight loss as monotherapy, it does have potential utility in the treatment of obesity when combined with the pro-opiomelanocortin activator bupropion.
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Obesity: why be concerned?
Am. J. Med.
PUBLISHED: 05-05-2009
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The obesity epidemic in the United States represents a critical public health issue that has the potential to incur major healthcare costs because of the substantial risks associated with excess body fat. Whereas many recognize the significant risk of cardiovascular disease and diabetes mellitus associated with excess body fat, a myriad of other health problems can accompany overweight and obesity, potentially leading to early morbidity and mortality. Public recognition of obesity as an important health crisis, and not simply a matter of cosmetics or lifestyle choice, is clearly needed. A greater awareness of the health risks associated with excess weight will facilitate more frequent obesity screenings and discussions about healthy weight management that have the potential to result in a greater commitment of healthcare resources to effective obesity prevention and management strategies.
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Pre- and postsurgery behavioral compliance, patient health, and postbariatric surgical weight loss.
Obesity (Silver Spring)
PUBLISHED: 01-22-2009
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This study investigated the relationship between weight loss from gastric bypass surgery, patient characteristics, and compliance with physician instructions before and after surgery. A chart review of psychiatric and medical files was conducted for an initial cohort of 172 patients in a postsurgical management program. A total of 112 patients (primarily women (85%), white (79%), and well educated) from this cohort had presurgical data. Of these 112 subjects, 67 (60%) had postsurgical compliance information and BMI at 24 months postsurgery. The relationships between weight loss and a number of demographic, psychiatric, comorbid, and behavioral compliance factors were examined for these 67 patients. Missed appointments and noncompliance with exercise and weight loss plan instructions were high before and after surgery (65% vs. 72% for missed appointments, 39% vs. 51% for exercise, 42% vs. 57% for weight loss instructions). Although poor food choices were not frequently a problem before surgery (11%), they increased significantly after surgery: 37%, chi(2)(1) = 25.00, P < 0.001. Participants who lost the least weight at 2 years postsurgery were more likely to be nonwhite (r = 0.27, P = 0.039), have a lower socioeconomic status (SES) (r = 0.285, P = 0.02), and have a diagnosis of binge eating before surgery (r = 0.25, P = 0.039). Having more contact with patients and requiring adherence to behavioral changes, especially with respect to exercise and dietary restrictions, may improve the long-term outcomes for bariatric procedures. In addition, those patients who are depressed and suffer from binge eating may need special attention from physicians during long-term postoperative follow-up.
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The EMPOWER study: randomized, prospective, double-blind, multicenter trial of vagal blockade to induce weight loss in morbid obesity.
Obes Surg
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Intermittent, reversible intraabdominal vagal blockade (VBLOC® Therapy) demonstrated clinically important weight loss in feasibility trials. EMPOWER, a randomized, double-blind, prospective, controlled trial was conducted in USA and Australia.
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JoVE Visualize is a tool created to match the last 5 years of PubMed publications to methods in JoVE's video library.

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We use abstracts found on PubMed and match them to JoVE videos to create a list of 10 to 30 related methods videos.

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In developing our video relationships, we compare around 5 million PubMed articles to our library of over 4,500 methods videos. In some cases the language used in the PubMed abstracts makes matching that content to a JoVE video difficult. In other cases, there happens not to be any content in our video library that is relevant to the topic of a given abstract. In these cases, our algorithms are trying their best to display videos with relevant content, which can sometimes result in matched videos with only a slight relation.