Gastric ypass
Multiple reports that more and more adults and even children have become morbidly obese in the United States have led to searches for effective interventions. One of the interventions beginning to receive widespread use is gastric bypass surgery, which limits the amount of food an individual can consume and thus helps prevent overeating that leads to or supports a state of obesity.

The articles selected for review in this paper related to gastric bypass surgery demonstrate both the growing population and success of this surgery and information regarding concerns about both safety and efficacy of the approach. The paper will provide an overview of discussion regarding gastric bypass surgery including benefits and risks.

Sugarman (2002) compared Roux-en-Y gastric bypass with other types of surgery and found it to be superior, resulting in loss of up to two-thirds of body weight within two years. He noted significant complications including a mortality rate…...

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BIBLIOGRAPHY

Berke, Ethan M. 2000. "Medical Management of Obesity." American Family Physician, July 15.

Bock-Lopez, Michelle. 2001. "Hope for the morbidly obese.(bariatric surgery)." RN, Dec.

Sugerman, Harvey J. 2002.

Gastric bypass surgeries or gastric bypass procedures divide the stomach into two compartments or pouches: a small upper portion and a much larger lower portion that is not used in digestion. These procedures then rearrange the small intestine to connect to both stomachs (Adams et al., 2007). Gastric bypass procedures lead to significant reduced stomach volumes and change the physiological process of digestion. Gastric bypass procedures are typically used to treat morbid obesity and other related conditions. Gastric bypass procedures lead to weight loss mainly the restriction of food intake (gastric restriction) but also as a result of malabsorption. This small amount of food that can be taken and following the surgery significantly reduces food intake and ingested food bypasses most of the stomach, the duodenum (this is the first part of the small intestine), and a small portion of the jenunum (second part of the small intestine). The bypass…...

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References

Adams, T.D., Gress, R.E., Smith, S.C., Halverson, R.C., Simper, S.C., Rosamond, W.D.,

LaMonte, M.J., Stroup, A.M., & Hunt S.C. (2007). Long-term mortality after gastric bypass surgery. New England Journal of Medicin, e 357, 753-761.

Becker, D.A., Balcer, L.J., & Galetta, S.L. (2012). The neurological complications of nutritional deficiency following bariatric surgery. Journal of Obesity, 2012, 1-8.

DeMaria, E.J. (2007). Bariatric surgery for morbid obesity. New England Journal of Medicine,

The finding is that gastric bypass surgery does not have an impact on life expectancy of the patient, only quality of life. The general trend is that the higher the BMI, the lower the life expectancy and quality of life. Males have higher life expectancies compared with females of equivalent age and BMI. That both life expectancy and quality of life both decrease with higher BMI and higher age is not surprising, and this holds up for both genders.
The latter finding is not necessary related to BMI. It is something that occurs naturally, as all people find that their age and general level of health will affect their life expectancy and quality of life. In this study, some control should have been implemented to determine the degree to which these factors are genuinely impacted by the obesity. There is an inference of causation when the authors have only truly…...

Cynthia J. Barrow, 2002 "oux-en-Y gastric bypass for morbid obesity"
In this article, gastric bypass surgery is explained as a procedure to control obesity in people. In the U.S., it is estimated that obesity is the second biggest cause of death in both males and females. In fact, the option of using gastric bypass surgery to reduce weight gained acceptance after surgeons were successful in removing large parts of the intestine, which was aggravated by ulcers and cancerous growth. Doctors observed the weight in patients who underwent the surgery and so tried it in people who were obese. Obese people stand to gain from the surgical procedure in two ways: Malabsoption, which is the reduction of nutrients that are absorbed by the body, and by restriction of the food that is consumed by the patient due to the reduction of the stomach cavity. A smaller cavity will also mean that the…...

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References

Cynthia J. Barrow, 2002, "Roux-en-Y gastric bypass for morbid obesity," AORN Journal, Issue: Oct, 2002,  http://www.findarticles.com/cf_0/m0FSL/4_76/93069834/p1/article.jhtml?term=+Gastric+Bypass+Surgery 

Dymek, D le Grange, K Neven, J Alverdy, "Quality of life after gastric bypass surgery," Nutrition Research Newsletter, Issue: Dec, 2002,  http://www.findarticles.com/cf_0/m0887/12_21/96070908/p1/article.jhtml?term=+Gastric+Bypass+Surgery+ 

Healthcare Risk Management, "No nutritional supervision: $75,000 arbitration award" Issue: Dec, 2001,  http://www.findarticles.com/cf_0/m0KGX/12_23/82128866/p1/article.jhtml?term=%22Gastric+bypass+surgery%22 

Susan Goldberg, Peggy Rivers, Kelly Smith, William Homan, 2000, "Vertical Banded Gastroplasty: A Treatment for Morbid Obesity," AORN Journal, Issue: Dec, 2000,  http://www.findarticles.com/cf_0/m0FSL/6_72/68534717/p1/article.jhtml?term=%22Gastric+bypass+surgery%22

America has been built on the idea that thin is attractive and capable, while fat is ugly and lazy. Morbid obesity is a growing problem in the United States. News channels have done stories about the nation's problem with weight and diet fads abound.
Whether it is South Beach, Atkins, bypass surgery, or weight watchers, the message is clear. If one wants to improve one's life, lose the fat. Morbid obesity is a serious health problem. The complications from the condition can not be denied. People who are morbidly obese not only suffer from the health consequences of their size, but often suffer from self-esteem issues because of what they believe society thinks about them based on their size.

This paper will explore a research proposal that will address the issue of societal attitude toward the morbidly obese. It will explore whether morbidly obese participants have felt discriminated against and if they…...

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References

The beauty and the beast in the workplace: appearance-based discrimination claims under EEO laws.Florida Bar Journal; April 1, 2001; Fowler-Hermes, Jennifer

Too fat? Don't diet. Change the discrimination laws. ().(laws prohibiting discrimination in employment based on weight)(Brief Article)

Westchester County Business Journal; June 10, 2002; Glenn, David J.

The fight against fat goes on the offensive in the workplace; by one estimate, obesity-related conditions cost organizations $12 billion a year. It's not a "nice to be thin" issue.(Health-care Benefits)

In principle, the logical basis for making any such distinctions would relate to whether or not patients could reasonably be considered to have contributed to the problem in the first place. The easiest choices would be individual at both ends of the spectrum: those who suffer from medical conditions that are known to be responsible on one end and those whose conditions are entirely the result of irresponsible choices. Almost everywhere else in between those extremes requires some kind of value judgment or the drawing of a line that is at least somewhat arbitrary. Generally, the more a person can be fairly considered to have caused his condition, the less right he has to demand free procedures; conversely, the less a person in responsible, the more right he has to the same.
When these surgeries have serious complications, should patients have the right to sue their doctors, even though the…...

http://www.bikingbis.com/blog/_archives/2006/2/11/1754124.html
Scientists examined the obese study participants to see whether this so-called obesity gene was disturbed in any way. They found that only 3% of people had an abnormal leptin gene -- indicating that leptin is probably not a factor for most obese people ("Scientists Debunk So-Called 'Fat Gene').

Exercises for Obese People needed" Accessed April 24, 2008 http://www.phenforum.com/forum/get-shape/23032-exercises-obese-people-needed.html

In America, a changing environment has broadened food options and eating habits. Grocery stores stock their shelves with a greater selection of products. Pre-packaged foods, fast food restaurants, and soft drinks are also more accessible. While such foods are fast and convenient they also tend to be high in fat, sugar, and calories. Choosing many foods from these areas may contribute to an excessive calorie intake. Some foods are marketed as healthy, low fat, or fat-free, but may contain more calories than the fat containing food they are designed to replace. It is…...

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References

Yanovski, Susan Z, and Yanovski, Jack a. (2002). Obesity. New England Journal of Medicine. Volume 346:591-602.

Helm, Janet. (2007). "Scientists Debunk So-Called 'Fat Gene'." Accessed April 24, 2008 at  http://abcnews.go.com/Health/Diet/story?id=2802503&page=1 

Exercises for Obese People needed" Accessed April 24, 2008  http://www.phenforum.com/forum/get-shape/23032-exercis-obese-people-needed.html 

Overweight and Obesity." Accessed April 24, 2008  http://www.cdc.gov/nccdphp/dnpa/obesity/contributing_factors.htm

capital purchase, costing more than $5,000, which your company could benefit from.
Background of the technology

The Da Vinci robot is one of the most recent innovations that I think would be extremely helpful for my organization.

The robot, created only a few decades ago and invented in 1985 with the PUMA 560 for helping surgeons conduct neurosurgical biopsies, has all the signs of an instrument straight out from some science fiction novel. There is one that acts as doctor, rolls over the patient, asks questions, observes symptoms, and even uses a stethoscope. Other robots provide lunch and even assist in surgeries. UCLA uses a state-of the art robot called Vespa that wanders the halls of nearly 600 hospitals worldwide.

In 1988, doctors had the PROBOT, which was designed for prostate work. The ROBODOC helped doctors with hip replacements, whiles the late 1990s led to telesurgery that enabled surgeons to speak to patients…...

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Sources

Benway BM, Wang AJ, Cabello JC, & Bhayani SB (2008) Robotic Partial Nephrectomy with Sliding-Clip Renorrhaphy: Technique and Outcomes; European Association of Urology,

Boggess JF, Gehrig PA, Cantrell L, Shafer A, Ridgway M, Skinner EN, & Fowler WC. (1994) A comparative study of 3 surgical methods for hysterectomy with staging for endometrial cancer: robotic assistance, laparoscopy, laparotomy. Am J. Obstet Gynecol. (4):360.e1-9.

Davinci surgery. Minimally Invasive Surgery

 http://www.davincisurgery.com/da-vinci-gynecology/treatment-options/minimally-invasive-surgery/

PICO Question: Bariatric Surgery As the obesity rate continues to be an issue of great concern in America, the question arises as to the best ways to reduce the BMIs of individuals already suffering from the condition, as well as how to enact preventative means. Although the ideal is for people to never become obese at all, the fact remains that there is a need to develop proactive measures to facilitate weight reduction. For most patients, modifications in diet and exercise is recommended but, as even people who have attempted casual weight loss know, deploying such techniques in an effective and consistent fashion is far easier said than done.
PICO Question
The PICO question for the purpose of this study is, from the perspective of a family nurse practitioner, when treating patients with type 2 diabetes and obesity, can bariatric surgery be more effective than standard medical therapy at increasing the probability of…...

A way to better distribute the information that is being taught in the classrooms is also through the community so that the changes are also effecting the parents to the students, as a change on their part as well would be helpful in the battle against obesity. It would be useful to initially target pamphlets, an informational booth or table at grocery stores, where the foundation of the problem lies. It would be effective if information is given before families go grocery shopping so they are more conscious of the items that they are purchasing. Furthermore, information should also be initially presented on TVs, in newspapers and magazines and other mediums that would likely be used in the more low-key and sedentary setting in order to galvanize individuals to get outside. Once outside, in order to sustain the physical activity, it would be nice to have water and juice at…...

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Bibliography

Ahuja, Gitika, & Salahi, Lara. (11, February 2010). School nutrition program takes up obesity fight. Retrieved from  http://abcnews.go.com/GMA/OnCall/school-nutrition-program-takes-obesity-fight/story?id=9802468 

CausesofChildhoodObesity.org, Initials. (2010). Causes of childhood obesity. Retrieved from  http://causesofchildhoodobesity.org/ 

Facts about obesity in the United States. (n.d.). Retrieved from  http://www.cdc.gov/pdf/facts_about_obesity_in_the_united_states.pdf 

Mayo Clinic Staff, Initials. (2011, May 06). Risk factors. Retrieved from  http://www.mayoclinic.com/health/obesity/DS00314/DSECTION=risk-factors

outstanding fact: Americans love to diet. The South Beach Diet, Lo-Carb Diet, Slimfast, Weight Watcher's, diet pills, gastric bypass sugary. These are all examples of ways that adults in America are trying to lose weight. This obsession with losing weight seems to be spinning out of control. The question is why do people diet? Is it to lose the couple pounds you packed on during the holiday season, to look like all the other stick figures on television, or, is there a deeper reason? The reality of it is that there are 100 million overweight adults living in America today, and that 300,000 people a year die from diseases that are directly related to obesity. Obesity in America has become such a problem that it is the 2nd cause death that can be prevented, only narrowly behind smoking. There must be some positive, even essential reasons to diet. The…...

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U.S Department of Health and Human Services. The Surgeon General's Call to Action

To prevent and decrease overweight and obesity. [Rockville, MD]: U.S.

Department of Health and Human Services, Public Health Service, Office of the Surgeon General; [2001].

Even if we ourselves are to analyze how we consume foods, we can realize that these influences listed by Food Psychology online have been actual influences to how we consume food. Isn't it that true that we tend to over-eat a particular food not only because we like its taste but because there is a characteristic in the food that we particularly like? For instance, there are those who unknowingly over-eat crackers because they like playing its crunchiness in their mouth. I myself tend to over-eat M&M chocolates not merely because I like chocolates, but because I like playing with its crispy chocolate shells in my mouth. Although it is known to me that too much sweet can cause weight increase, the external cue of the M&M chocolate somehow gives me the addiction to over-consume it. Or, isn't that there are those who tend to over-eat popcorns when watching…...

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Bibliography

Wansink, B., Van Ittersum K. Bottoms Up! The Influence of Elongation on Pouring and Consumption Volume. Food and Brand Lab, University of Illinois.

Chandon, P., Wansink, B. (2002). Does Stock Piling Accelerate Consumption? A Convenience-Salience Framework of Consumption Stockpiling." Journal of Marketing Research, 39:3 (August), 321-335.

Food Psychology.

Retrieved on May 22, 2006, from Online.

chronic and ongoing diseases and disorders have become an epidemic in the United States. It is also without a doubt that the treatment and mitigation of thos diseases and disorders is something that must be a primary focus of family practice. Even better, though, than properly treating the disorders when they emerge is helping to prevent them in the first place. After all, so many of the disorders and diseases in question are created by poor lifestyle choices. The diseases and disorders in question include diabetes, heart disease and many forms of cancer. While genetics and environmental factors have an effect on the emergence and aggravation of diseases and disorders, lifestyle choices are quite often the difference between quality of life and lack thereof.
Body

One major roadblock when it comes to lifestyle choices is teaching people and making it stick. Within the family practice realm, things are made more complicated…...

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References

Perusse, R., Kailimang, L., & Krell, M. (2009). Closing the Obesity Achievement Gap:

Evidence-Based Practices that School Counselors Can Help Implement. Journal Of

School Counseling, 7(23),

Rappange, D. R., Brouwer, W. B., Hoogenveen, R. T., & Van Baal, P. H. (2009). Healthcare

METABOLISM OF FOLATEMetabolism of FolateBailey and Gregory suggest that reactions that require folate occur as a one-carbon metabolism. Essentially, a polyglutamyl which happens to be in form of tetrahydrofolate (THF) is the central folate acceptor. In these processes, the main function of folate happens to be donation and acceptance of one carbon units in metabolic pathways.1 The first step in metabolism involves the conversion of tetrahydrofolate to 5, 10-methyltetrafolate. The said step is important in metabolism which uses the 3- carbons from serine as their source of carbon. 5, 10-methyltetrahydrofolate is then transferred to tetrahydrofolate from serine through the pyridoxal phosphate (PLP). PLP is a dependent serine hydromethyltransferase (SHMT) which forms glycine and 5, 10 methylene-TPF.1 Part of the 5, 10 methylenetetrahyhrofolate which was produced is then reduced by methylenetetrahydrofolate reductase (MTHF) through an irreversible enzymatic reaction to 5-methyl-THF. MTHF is only used in metabolism to methylation in synthesis of…...

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References1. Bailey L B, Gregory JF. Folate Metabolism and Requirements. The Journal of Nutrition. 1999; 129(4):779-782.2. Zheng Y, Cantley LC. Toward a Better Understanding of Folate Metabolism in Health and Disease. J Exp Med; 216(2): 253-266.3. Khan KM, Jialal, I. Folic Acid Deficiency. 2021. StatPearls Internet. Treasure Island (FL): StatPearls Publishing.

Hyponatremia in a 38-year-Old male
The constellation of signs and symptoms the patient presented with is consistent with a diagnosis of adrenal insufficiency (Betterle, Pra, Mantero, and Zanchetta, 2002, p. 330-331). These include a recent history of gastric distress, partial loss of consciousness, lethargy, dizziness, disorientation, weight loss, hyponatremia, borderline hyperkalemia, low serum and free cortisol levels, and the lack of a rapid cortisol response to ACTH stimulation (Wilson, 2008). Signs and symptoms that may not support a diagnosis of adrenal insufficiency include no mention of hyperpigmentation or pallor, and an unremarkable abdominal CT scan. A discussion of these signs and symptoms, and the possible relevance to a diagnosis of adrenal insufficiency follows.

True Hyponatremia Diagnosis

There are a large number of conditions and diseases that can lead to the development of hyponatremia, so this symptom alone has limited diagnostic utility (Wilson, 2008, p. 519). The combination of severe hyponatremia and low…...

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References

Al-Aridi, Ribal, Abdelmannan, Dima, and Arafah, Baha M., 2011. Biochemical diagnosis of adrenal insufficiency: The added value of dehydroepiandrosterone sulfate (DHEA-S) measurements. Endocrine Practice, Published online ahead of print December 6, 2010. Retrieved March 25, 2011 from  http://aace.metapress.com/content/u645qx2217t34124/fulltext.pdf 

Andrews, Marcia, Johnson, Peter H., Kothare, Vijay S., and Weinstock, Doris, eds., 1999. Handbook of Diagnostic Tests, 2nd Edition. Springhouse, PA: Springhouse

Anglin, Rebecca E., Rosebush, Patricia I., and Mazurek, Michael F., 2006. The neuropsychiatric profile of Addison's disease: Revisiting a forgotten phenomenon. Journal of Neuropsychiatry and Clinical Neurosciences, 18, 450-459.

Betterle, Corrado, Pra, Chiara Dal., Mantero, Franco, and Zanchetta, Renato, 2002. Autoimmune adrenal insufficiency and autoimmune polyendocrine syndromes: Autoantibodies, autoantigens, and the applicability in diagnosis and disease prediction. Endocrinology Reviews, 23, 327-364.