The effectiveness of bariatric surgery has been well-studied. However, complications after bariatric surgery have been understudied. This review assesses <30-d major complications associated with bariatric procedures, including anastomotic leak, myocardial infarction and pulmonary embolism. This review included 71 studies conducted in the USA between 2003 and 2014 and 107,874 patients undergoing either gastric bypass, adjustable gastric banding or sleeve gastrectomy, with mean age of 44 years and pre-surgery body mass index of 46.5 kg m . Less than 30-d anastomotic leak rate was 1.15%; myocardial infarction rate was 0.37%; pulmonary embolism rate was 1.17%. Among all patients, mortality rate following anastomotic leak, myocardial infarction and pulmonary embolism was 0.12%, 0.37% and 0.18%, respectively. Among surgical procedures, <30-d after surgery, sleeve gastrectomy (1.21% [95% confidence interval, 0.23-2.19%]) had higher anastomotic leak rate than gastric bypass (1.14% [95% confidence interval, 0.84-1.43%]); gastric bypass had higher rates of myocardial infarction and pulmonary embolism than adjustable gastric banding or sleeve gastrectomy. During the review, we found that the quality of complication reporting is lower than the reporting of other outcomes. In summary, <30-d rates of the three major complications after either one of the procedures range from 0% to 1.55%. Mortality following these complications ranges from 0% to 0.64%. Future studies reporting complications after bariatric surgery should improve their reporting quality.
2. Davies P, Lillie J, Prayle A, et al. Association between treatments and short-term biochemical improvements and clinical outcomes in post-severe acute respiratory syndrome coronavirus-2 inflammatory syndrome.
Objective To test the utility of brief social contact–based video interventions of a Black adolescent girl to reduce stigmatized attitudes and increase help‐seeking intentions around adolescent depression. Methods We conducted a randomized controlled trial (RCT) with 14‐ to18‐year‐old healthy volunteers drawn from the general US population. We enrolled participants through a crowdsourcing platform (n = 1,093) and randomly assigned participants to one of three video conditions (117 s each): depressed (DEP); depressed, adjusted to aspects unique to being a Black adolescent girl (including experienced or internalized racism; ADJ); and control (CONT). The primary outcome was the Depression Stigma Scale (DSS); secondary outcomes were the General Health‐Seeking Questionnaire (GHSQ), and thermometers for Black and white race perception “warmth”. Results Following the intervention, the DSS changed from baseline across the three conditions (p < .001). ADJ outperformed both DEP (p = .031) and CONT (p < .001). A race‐by‐intervention interaction (p < .001) revealed different response profiles between Black (ADJ = DEP = CONT; p = .726) and non‐Black participants (ADJ > DEP > CONT; p < .001). DEP and ADJ both resulted in higher treatment‐seeking intentions for both the emotional problems and the suicidal thought subscales of the GHSQ. We found a race‐by‐intervention interaction (p = .01) for the Black thermometer, which revealed a significant 2° increase in warmth among white (p < .001), but not Black, viewers (p = .06). Conclusions On a short‐term basis, brief social contact–based videos proved effective among adolescents in reducing depression‐related stigma, increasing help‐seeking intentions, and providing an “empathic foothold” in the lives of racially stigmatized groups. Even as the enduring effects of these interventions remain to be determined, the deployment on social media of short videos opens new opportunities to reach a large number of at‐risk youth.”
Background: The Albert J. Solnit Integrated Training Program (AJSP) is an educational initiative designed to prepare physician-scientists for independent careers in the investigation and treatment of childhood psychiatric disorders. Methods: We compared fifteen cohorts (each representing a consecutive year of matriculation) of AJSP trainees and graduates (n = 30) to peers who were comparably ranked in our original match lists but ultimately pursued residency programs elsewhere (n = 60). Outcomes of interest between the two groups included professional affiliation, as measured by: (1) membership in the American Academy of Child and Adolescent Psychiatry (AACAP); and (2) certification by the American Board of Psychiatry and Neurology (ABPN), as well as three domains of research productivity: (1) Competitive awards received from AACAP; (2) Publication-related metrics derived from the National Library of Medicine (NLM); and (3) Federal grant funding from the National Institutes of Health (NIH). Results: AJSP participants were more commonly affiliated with AACAP and board certified in CAP. AJSP graduates and trainees outperformed their control group peers in several research outcomes: (1) Receipt of AACAP awards and number of awards per recipient were higher, and time to first award shorter in the AJSP than in the control group; (2) AJSP participants had more publications in PubMed, more first-authored publications, a higher h-index, and a shorter time to first publication than participants in the control group; and (3) NIH K-or R-series funding success rate was higher among AJSP participants (p < 0.05 for all comparisons). Conclusions: A program designed to support the development of clinician-scientists specifically dedicated to childhood mental health needs has been successful in fostering scientific creativity, productivity and independence. The expansion and replication of similar training initiatives will be an in important step forward to address the high level of morbidity and mortality associated with child and adolescent psychiatric disorders.
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