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Article ; Online: Results of Laparoscopic Sleeve Gastrectomy in 541 Consecutive Patients with Low Baseline Body Mass Index (30-35 kg/m

Noun, Roger / Slim, Rita / Nasr, Marwan / Chakhtoura, Ghassan / Gharios, Joseph / Antoun, Nayla Abi / Ayoub, Eliane

2016 Volume 26, Issue 12, Page(s) 2824–2828

Abstract: ... targets, among other obesity classes, patients with BMI 30-35 kg/m: Methods: Between February 2010 and ... August 2015, data on 541 consecutive patients with BMI 30-35 kg/m: Results: Mean age was 32 ± 8 years ... 1.5 kg/m: Conclusion: With appropriate surgical expertise, LSG in patients with BMI 30-35 kg/m ...

Abstract	Background: Laparoscopic sleeve gastrectomy (LSG) is currently the leading bariatric procedure and targets, among other obesity classes, patients with BMI 30-35 kg/m Methods: Between February 2010 and August 2015, data on 541 consecutive patients with BMI 30-35 kg/m Results: Mean age was 32 ± 8 years (13-65) and 419 (77.4 %) were women. Preoperative weight was 92.0 ± 8.8 kg (65-121) and BMI was 32.6 ± 1.5 kg/m Conclusion: With appropriate surgical expertise, LSG in patients with BMI 30-35 kg/m
MeSH term(s)	Adolescent ; Adult ; Aged ; Body Mass Index ; Comorbidity ; Female ; Gastrectomy/adverse effects ; Gastrectomy/methods ; Humans ; Laparoscopy/adverse effects ; Laparoscopy/methods ; Male ; Middle Aged ; Obesity/complications ; Obesity/epidemiology ; Obesity/surgery ; Operative Time ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Retrospective Studies ; Treatment Outcome ; Weight Loss/physiology ; Young Adult
Keywords	covid19
Language	English
Publishing date	2016-12
Publishing country	United States
Document type	Journal Article
ZDB-ID	1070827-3
ISSN	1708-0428 ; 0960-8923
ISSN (online)	1708-0428
ISSN	0960-8923
DOI	10.1007/s11695-016-2224-y
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Article ; Online: Laparoscopic sleeve gastrectomy for mildly obese patients (Body Mass Index of 30 <35 kg/m²): operative outcome and short-term results.

Noun, Roger / Chakhtoura, Ghassan / Nasr, Marwan / Skaff, Judith / Choucair, Naîm / Rkaybi, Nathalie / Tohme-Noun, Carla

Journal of obesity

2012 Volume 2012, Page(s) 813650

Abstract: ... body mass index (BMI) of 33 ± 2.5 kg/m² (range 30-34.9) undergoing LSG were studied. Mean age was 33 ± 10 years ... 20 kg/m². Comorbidities resolved in 70.5% or improved in 29.5%. Patient satisfaction scoring (1-5 ...

Abstract	Background: Data concerning laparoscopic sleeve gastrectomy (LSG) in mild obesity are under investigation. Aim/objective: May 2010 to May 2012, 122 consecutive patients with preoperative body mass index (BMI) of 33 ± 2.5 kg/m² (range 30-34.9) undergoing LSG were studied. Mean age was 33 ± 10 years (range 15-60), and 105 (86%) were women. Mean preoperative weight was 91 ± 9.7 kg (range 66-121), and preoperative excess weight was 30 ± 6.7 kg (range 19-43). Comorbidities were detected in 44 (36%) patients. Results: Mean operative time was 58 ± 15 min (range 40-95), and postoperative stay was 1.8 ± 0.19 days (range 1.5-3). There were no admissions to intensive care unit and no deaths within 30 days of surgery. The rates of leaks and strictures were 0%, and of hemorrhage 1.6%. At 12 months, BMI decreased to 24.7 ± 2, and the percentage of excess weight loss (% EWL) reached 76.5%. None of the patients had a BMI below 20 kg/m². Comorbidities resolved in 70.5% or improved in 29.5%. Patient satisfaction scoring (1-5) at least 1 year after was 4.6 ± 0.8 for body image and 4.4 ± 0.6 for food tolerance. Conclusion: LSG for mildly obese patients has proved to be technically relatively easy, safe, and benefic in the short term.
MeSH term(s)	Adolescent ; Adult ; Body Mass Index ; Female ; Follow-Up Studies ; Gastrectomy/methods ; Humans ; Laparoscopy/methods ; Male ; Middle Aged ; Obesity, Morbid/surgery ; Treatment Outcome
Keywords	covid19
Language	English
Publishing date	2012-12-11
Publishing country	United States
Document type	Journal Article
ZDB-ID	2573566-4
ISSN	2090-0716 ; 2090-0708
ISSN (online)	2090-0716
ISSN	2090-0708
DOI	10.1155/2012/813650
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Article ; Online: Advances in physiology, design and development of novel medications changing the landscape of obesity pharmacotherapy.

Chakhtoura, Marlene / Mantzoros, Christos S

Metabolism: clinical and experimental

2023 Volume 142, Page(s) 155531

MeSH term(s)	Humans ; Obesity/drug therapy ; Anti-Obesity Agents/therapeutic use
Chemical Substances	Anti-Obesity Agents
Language	English
Publishing date	2023-03-03
Publishing country	United States
Document type	Editorial
ZDB-ID	80230-x
ISSN	1532-8600 ; 0026-0495
ISSN (online)	1532-8600
ISSN	0026-0495
DOI	10.1016/j.metabol.2023.155531
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Article ; Online: Change in Provider Specialty Was Associated With Less Fluoroquinolone Use at a Veterans Affairs Long-Term Care Setting.

Bej, Taissa A / Wilson, Brigid M / El Chakhtoura, Nadim / Perez, Federico / Jump, Robin L P

Journal of the American Medical Directors Association

2024 , Page(s) 104927

Abstract: Objective: In July 2021, as part of a planned multiyear broad and long-term organizational realignment, the general medicine service assumed continuous care of residents at a Community Living Center (CLC), which are nursing homes within the Veterans ... ...

Abstract	Objective: In July 2021, as part of a planned multiyear broad and long-term organizational realignment, the general medicine service assumed continuous care of residents at a Community Living Center (CLC), which are nursing homes within the Veterans Affairs (VA) health care system. We hypothesized that practitioners accustomed to caring for patients in acute care would be more likely to prescribe antibiotics to long-term care residents. Design: Retrospective cohort study. Settings and participants: Residents of a 105-bed CLC associated with a large VA medical center. Methods: Our cohort included CLC residents between July 1, 2020, and June 30, 2022. We used administrative data to assess resident demographics and medical conditions in the 1 year before and after the change of practitioners. We also compared antibiotics agents prescribed and the following antibiotic use metrics in the year before and after the change: days of therapy (DOT) per 1000 bed days of care (BDOC), antibiotic starts/1000 BDOC, and mean length of therapy in days. Results: Resident characteristics and overall antibiotic use metrics were similar before and after the change in staffing. The specific agents prescribed differed, with a decrease in fluoroquinolones (14.3 to 5.8 DOT/1000 BDOC; P < .01) and an increase doxycycline (7.4 vs 19.1 DOT/1000 BDOC; P < .01) after the staff change. Rates of Clostridioides difficile infection also decreased, from 6.23 to 3.41 cases/10,000 BDOC after the change in staffing. Conclusions and implications: The comparable antibiotic use metrics before and after the general medical service assumed care of the CLC residents may be explained by constancy in resident population and other facility-related factors. Differences in the types of agents used suggests that antibiotic stewardship efforts can be tailored not only to the setting and patient population but also to the practitioners' discipline.
Language	English
Publishing date	2024-02-03
Publishing country	United States
Document type	Journal Article
ZDB-ID	2171030-2
ISSN	1538-9375 ; 1525-8610
ISSN (online)	1538-9375
ISSN	1525-8610
DOI	10.1016/j.jamda.2023.12.015
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Zs.A 5971: Show issues

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Article ; Online: The impact of metformin on weight and metabolic parameters in patients with obesity: A systematic review and meta-analysis of randomized controlled trials.

Haber, Rachelle / Zarzour, Fatima / Ghezzawi, Malak / Saadeh, Natalie / Bacha, Dania S / Al Jebbawi, Lama / Chakhtoura, Marlene / Mantzoros, Christos S

Diabetes, obesity & metabolism

2024 Volume 26, Issue 5, Page(s) 1850–1867

Abstract: ... in adults without diabetes mellitus, with mean body mass index (BMI) ≥ 25 kg/m ...

Abstract	There are conflicting data on the weight-reducing potential of metformin (MTF) in nondiabetic patients with obesity. The purpose of this systematic review and meta-analysis was to evaluate the effect of MTF on weight and cardiometabolic parameters in adults with overweight/obesity with or without nonalcoholic fatty liver disease (NAFLD) (CRD42018085512). We included randomized controlled trials (RCTs) in adults without diabetes mellitus, with mean body mass index (BMI) ≥ 25 kg/m
MeSH term(s)	Adult ; Humans ; Metformin/therapeutic use ; Non-alcoholic Fatty Liver Disease/complications ; Non-alcoholic Fatty Liver Disease/drug therapy ; Randomized Controlled Trials as Topic ; Obesity/complications ; Obesity/drug therapy ; Obesity/chemically induced ; Overweight/complications ; Overweight/drug therapy ; Weight Loss
Chemical Substances	Metformin (9100L32L2N)
Language	English
Publishing date	2024-03-11
Publishing country	England
Document type	Meta-Analysis ; Systematic Review ; Journal Article
ZDB-ID	1454944-x
ISSN	1463-1326 ; 1462-8902
ISSN (online)	1463-1326
ISSN	1462-8902
DOI	10.1111/dom.15501
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Zs.A 5442: Show issues

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Article: Combined laparoscopic pouch and loop resizing as a revisional procedure for weight regain after primary laparoscopic one-anastomosis gastric bypass.

Mouawad, Christian / Dahboul, Houssam / Chamaa, Bilal / Kazan, Daniel / Osseis, Michael / Noun, Roger / Chakhtoura, Ghassan

Journal of minimal access surgery

2023 Volume 19, Issue 3, Page(s) 414–418

Abstract: ... We included eight patients with a body mass index (BMI) ≥30 kg/m: Results: The majority of the eight ... and BMI were 150.25 ± 40.73 kg and 48.68 ± 11.74 kg/m: Conclusion: Combined pouch and loop resizing ...

Abstract	Introduction: One-anastomosis gastric bypass (OAGB) presents a satisfactory long-term outcome in terms of weight loss, amelioration of comorbidities and low morbidity. However, some patients may present insufficient weight loss or weight regain. In this study, we tackle a case series evaluating the efficiency of the combined laparoscopic pouch and loop resizing (LPLR) as a revisional procedure for insufficient weight loss or weight regain after primary laparoscopic OAGB. Materials and methods: We included eight patients with a body mass index (BMI) ≥30 kg/m Results: The majority of the eight patients were males (62.5%), with a mean age of 35.25 at the time of the primary OAGB. The average length of the biliopancreatic limb created during the OAGB and LPLR were 168 ± 27 and 267 ± 27 cm, respectively. The mean weight and BMI were 150.25 ± 40.73 kg and 48.68 ± 11.74 kg/m Conclusion: Combined pouch and loop resizing is a valid option for revisional surgery following weight regain after primary OAGB, leading to adequate weight loss through enhancement of the restrictive and malabsorptive effect of OAGB.
Language	English
Publishing date	2023-03-27
Publishing country	India
Document type	Journal Article
ZDB-ID	2186884-0
ISSN	1998-3921 ; 0972-9941
ISSN (online)	1998-3921
ISSN	0972-9941
DOI	10.4103/jmas.jmas_281_22
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Article ; Online: One anastomosis gastric bypass vs sleeve gastrectomy as a revisional bariatric surgery for weight loss failure after primary restrictive procedure.

Mouawad, Christian / Dahboul, Houssam / Chamaa, Bilal / Osseis, Michael / Noun, Roger / Chakhtoura, Ghassan

Asian journal of endoscopic surgery

2023 Volume 17, Issue 1, Page(s) e13248

Abstract: ... the average body mass index (BMI) before primary restrictive procedure was 43.7 kg/m: Conclusion ...

Abstract	Introduction: Weight loss failure after restrictive bariatric procedures initiated the debate about the choice of an adequate revisional intervention, a question still unanswered. While many surgeons went for a conversion to gastric bypass, others opted for re-trying a revisional restrictive procedure to avoid the side effects of gastric bypass. The objective of our study was to compare weight loss outcome between revisional laparoscopic sleeve gastrectomy (re-LSG) and revisional one anastomosis gastric bypass (re-OAGB) for insufficient weight loss or weight regain following primary restrictive bariatric surgery. Materials and methods: We included 20 obese patients, with a history of weight regain or insufficient weight loss after primary restrictive surgery, who underwent re-LSG (eight patients) or re-OAGB (12 patients) between January 2018 and January 2021. Patients were followed up 2 years after their revisional intervention. Statistics were performed using IBM® SPSS® software for Windows version 21. Results: In the re-LSG group, the average body mass index (BMI) before primary restrictive procedure was 43.7 kg/m Conclusion: For patients with insufficient weight loss or weight regain following primary restrictive bariatric surgery, re-OAGB has a better effectiveness in weight reduction compared with re-LSG after a 2-year follow up.
MeSH term(s)	Humans ; Gastric Bypass/methods ; Obesity, Morbid/surgery ; Laparoscopy/methods ; Reoperation/methods ; Retrospective Studies ; Bariatric Surgery/methods ; Gastrectomy/methods ; Weight Loss ; Weight Gain ; Treatment Outcome
Language	English
Publishing date	2023-09-26
Publishing country	Japan
Document type	Journal Article
ZDB-ID	2503256-2
ISSN	1758-5910 ; 1758-5902
ISSN (online)	1758-5910
ISSN	1758-5902
DOI	10.1111/ases.13248
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Article ; Online: Pharmacotherapy of obesity: an update on the available medications and drugs under investigation.

Chakhtoura, Marlene / Haber, Rachelle / Ghezzawi, Malak / Rhayem, Caline / Tcheroyan, Raya / Mantzoros, Christos S

EClinicalMedicine

2023 Volume 58, Page(s) 101882

Abstract: Obesity is an epidemic and a public health threat. Medical weight management remains one of the options for the treatment of excess weight and recent advances have revolutionized how we treat, and more importantly how we will be treating obesity in the ... ...

Abstract	Obesity is an epidemic and a public health threat. Medical weight management remains one of the options for the treatment of excess weight and recent advances have revolutionized how we treat, and more importantly how we will be treating obesity in the near future. Metreleptin and Setmelanotide are currently indicated for rare obesity syndromes, and 5 other medications (orlistat, phentermine/topiramate, naltrexone/bupropion, liraglutide, semaglutide) are approved for non-syndromic obesity. Tirzepatide is about to be approved, and other drugs, with exciting novel mechanisms of action primarily based on incretins, are currently being investigated in different phases of clinical trials. The majority of these compounds act centrally, to reduce appetite and increase satiety, and secondarily, in the gastrointestinal tract to slow gastric emptying. All anti-obesity medications improve weight and metabolic parameters, with variable potency and effects depending on the specific drug. The currently available data do not support a reduction in hard cardiovascular outcomes, but it is almost certain that such data are forthcoming in the very near future. The choice of the anti-obesity medication needs to take into consideration the patient's clinical and biochemical profile, co-morbidities, and drug contra-indications, as well as expected degree of weight loss and improvements in cardio-renal and metabolic risk. It also remains to be seen whether precision medicine may offer personalized solutions to individuals with obesity, and whether it may represent the future of medical weight management along with the development of novel, very potent, anti-obesity medications currently in the pipeline. Funding: None.
Language	English
Publishing date	2023-03-20
Publishing country	England
Document type	Journal Article ; Review
ISSN	2589-5370
ISSN (online)	2589-5370
DOI	10.1016/j.eclinm.2023.101882
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Article ; Online: A suggested protocol for the endocrine postoperative management of patients undergoing pituitary surgery.

Zarzour, Fatima / Hage, Mirella / Sanson, Marie-Laure Raffin / Baussart, Bertrand / Chakhtoura, Marlene

Annales d'endocrinologie

2023 Volume 84, Issue 4, Page(s) 413–423

Abstract: Purpose: Endocrine disorders are the most frequent postoperative complications in patients undergoing pituitary surgery. Given the absence of recent guidelines on the postoperative care following pituitary surgery, this article summarizes the available ... ...

Abstract	Purpose: Endocrine disorders are the most frequent postoperative complications in patients undergoing pituitary surgery. Given the absence of recent guidelines on the postoperative care following pituitary surgery, this article summarizes the available evidence on the topic. Method: We conducted a systematic search of PubMed up to 2021 and updated the search in December 2022. We retrieved 119 articles and included 53 full-text papers. Results: The early postoperative care consists of the assessment for cortisol deficiency and diabetes insipidus (DI). Experts suggest that all patients should receive a glucocorticoid (GC) stress dose followed by a rapid taper. The decision for GC replacement after discharge depends on the morning plasma cortisol level on day 3 after surgery. Experts suggest that patients with a morning plasma cortisol<10 mcg/dL should receive GC replacement at discharge, and those with 10-18 mcg/dL a morning dose only, with formal assessment of the hypothalamic-pituitary-adrenal axis at week 6 postoperatively. When the cortisol level is>18 mcg/dL, the patient can be discharged safely without GC, as suggested by observational studies. Postoperative care also includes a close monitoring of water balance. If DI develops, desmopressin is used only in case of uncomfortable polyuria or hypernatremia. The assessment of other hormones is indicated at 3 months postoperatively and beyond. Conclusion: The evaluation and treatment of patients following pituitary surgery are based on expert opinion and a few observational studies. Further research is needed to provide additional evidence on the most appropriate approach.
MeSH term(s)	Humans ; Diabetes Insipidus/etiology ; Glucocorticoids/therapeutic use ; Hydrocortisone ; Hypothalamo-Hypophyseal System ; Pituitary Diseases/surgery ; Pituitary Neoplasms/surgery ; Pituitary-Adrenal System ; Clinical Protocols/standards ; Postoperative Complications/diagnosis ; Postoperative Complications/therapy
Chemical Substances	Glucocorticoids ; Hydrocortisone (WI4X0X7BPJ)
Language	English
Publishing date	2023-04-04
Publishing country	France
Document type	Journal Article ; Review
ZDB-ID	299-9
ISSN	2213-3941 ; 0003-4266
ISSN (online)	2213-3941
ISSN	0003-4266
DOI	10.1016/j.ando.2023.03.026
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Article ; Online: Steatotic Liver Disease: Pathophysiology and Emerging Pharmacotherapies.

Kokkorakis, Michail / Muzurović, Emir / Volčanšek, Špela / Chakhtoura, Marlene / Hill, Michael A / Mikhailidis, Dimitri P / Mantzoros, Christos S

Pharmacological reviews

2024 Volume 76, Issue 3, Page(s) 454–499

Abstract: Steatotic liver disease (SLD) displays a dynamic and complex disease phenotype. Consequently, the metabolic dysfunction-associated steatotic liver disease (MASLD)/metabolic dysfunction-associated steatohepatitis (MASH) therapeutic pipeline is expanding ... ...

Abstract	Steatotic liver disease (SLD) displays a dynamic and complex disease phenotype. Consequently, the metabolic dysfunction-associated steatotic liver disease (MASLD)/metabolic dysfunction-associated steatohepatitis (MASH) therapeutic pipeline is expanding rapidly and in multiple directions. In parallel, noninvasive tools for diagnosing and monitoring responses to therapeutic interventions are being studied, and clinically feasible findings are being explored as primary outcomes in interventional trials. The realization that distinct subgroups exist under the umbrella of SLD should guide more precise and personalized treatment recommendations and facilitate advancements in pharmacotherapeutics. This review summarizes recent updates of pathophysiology-based nomenclature and outlines both effective pharmacotherapeutics and those in the pipeline for MASLD/MASH, detailing their mode of action and the current status of phase 2 and 3 clinical trials. Of the extensive arsenal of pharmacotherapeutics in the MASLD/MASH pipeline, several have been rejected, whereas other, mainly monotherapy options, have shown only marginal benefits and are now being tested as part of combination therapies, yet others are still in development as monotherapies. Although the Food and Drug Administration (FDA) has recently approved resmetirom, additional therapeutic approaches in development will ideally target MASH and fibrosis while improving cardiometabolic risk factors. Due to the urgent need for the development of novel therapeutic strategies and the potential availability of safety and tolerability data, repurposing existing and approved drugs is an appealing option. Finally, it is essential to highlight that SLD and, by extension, MASLD should be recognized and approached as a systemic disease affecting multiple organs, with the vigorous implementation of interdisciplinary and coordinated action plans. SIGNIFICANCE STATEMENT: Steatotic liver disease (SLD), including metabolic dysfunction-associated steatotic liver disease and metabolic dysfunction-associated steatohepatitis, is the most prevalent chronic liver condition, affecting more than one-fourth of the global population. This review aims to provide the most recent information regarding SLD pathophysiology, diagnosis, and management according to the latest advancements in the guidelines and clinical trials. Collectively, it is hoped that the information provided furthers the understanding of the current state of SLD with direct clinical implications and stimulates research initiatives.
MeSH term(s)	Humans ; Fatty Liver/drug therapy ; Fatty Liver/physiopathology ; Animals
Language	English
Publishing date	2024-05-02
Publishing country	United States
Document type	Journal Article ; Review ; Research Support, Non-U.S. Gov't
ZDB-ID	209898-2
ISSN	1521-0081 ; 0031-6997
ISSN (online)	1521-0081
ISSN	0031-6997
DOI	10.1124/pharmrev.123.001087
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