BACKGROUND AND AIMS: Gastric restriction techniques have recently emerged as minimally invasive bariatric procedures. Endoscopic sutured gastroplasty (ESG) with the Endomina (Endo Tools Therapeutics, Gosselies, Belgium) triangulation platform proved to be safe and effective for the treatment of class I and II obesity in prospective studies. In this registry, we aimed to further assess on a larger scale the safety and efficacy of the procedure in routine practice with a dedicated device. METHODS: This was a multicenter, observational, prospective post-market study including patients with obesity undergoing Endomina ESG. The primary safety outcome was the occurrence of serious adverse device effects (SADEs) at 12 months. The primary efficacy outcome was the technical success defined by completing the procedure without premature abortion owing to technical issues. The rates of procedure-related adverse events, weight loss outcomes, and quality of life changes were collected. RESULTS: A total of 142 patients underwent ESG in 3 centers from July 2020 to March 2023. Of these, 67 (mean body mass index, 38.5 ± 6.3 kg/m2) reached at least 12 months of follow-up up to October 2022. Technical success was 100%. No SADEs occurred. Seven mild procedure-related adverse events were reported overall. Mean percentage of excess weight loss and total body weight loss at 12 months' follow-up were 48.5% ± 38.6 and 15.3% ± 10.6, respectively (n = 67). Improved quality of life was observed following ESG. CONCLUSIONS: ESG is safe and effective, thus offering a satisfactory therapeutic option for a wide range of obese patients on a large scale.

• MeSH
• dospělí MeSH
• gastroplastika * metody   škodlivé účinky   MeSH
• gastroskopie metody   MeSH
• hmotnostní úbytek MeSH
• kvalita života MeSH
• lidé středního věku MeSH
• lidé MeSH
• morbidní obezita chirurgie   MeSH
• obezita chirurgie   komplikace   MeSH
• pooperační komplikace MeSH
• postmarketingový dozor * MeSH
• prospektivní studie MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• pozorovací studie MeSH

PURPOSE: Obesity and its related severe comorbidities are increasing rapidly. The duodenal-jejunal bypass is an endoscopically implanted device (mimicking the Roux-en-Y gastric bypass) developed to support weight reduction and improve type 2 diabetes control. MATERIALS AND METHODS: Retrospective data analysis of consecutive patients undergoing duodenal-jejunal bypass (EndoBarrier®, DJB) implantation between 2013 and 2017 was performed to evaluate safety as well as short- and long-term efficacy. RESULTS: One hundred and twenty-one patients (mean BMI of 43.1 ± 7.2 kg/m2 and weight of 138.2 ± 28.6 kg) underwent DJB implantation. The mean dwelling time was 15.5 months, the mean total body weight loss (%TBWL) after explantation was 10.3% ± 7.9% (14.2 kg, p < 0.0001), and the mean BMI was 39.5 ± 7.3 kg/m2 (p < 0.0001). There was no significant weight gain 24 months after the explantation. Seventy-seven patients had type 2 diabetes mellitus (T2DM) with a mean HbA1c before implantation of 5.6% (n = 52). The mean HbA1c after explantation was 5.1% (p = 0.0001). Significant reductions in transaminase and lipid levels before and after explantation were observed. One complication occurred during implantation and another during explantation. In 16 patients, the device had to be extracted earlier than expected (7 for severe adverse events and 9 for adverse events; 13.2%). CONCLUSION: Despite an evident rate of adverse events, the DJB shows promise as a weight-loss procedure. Our results show that some patients implanted with the device maintained reduced weight even 24 months after explantation, while many improved T2DM control.

• MeSH
• diabetes mellitus 2. typu * chirurgie   komplikace   MeSH
• duodenum chirurgie   MeSH
• glykovaný hemoglobin MeSH
• hmotnostní úbytek MeSH
• jejunum chirurgie   MeSH
• lidé MeSH
• morbidní obezita * chirurgie   MeSH
• obezita chirurgie   komplikace   MeSH
• retrospektivní studie MeSH
• výsledek terapie MeSH
• žaludeční bypass * metody   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

Very low carbohydrate high fat (VLCHF) diet and high-intensity interval training (HIIT) are widely utilized for weight reduction and cardiorespiratory fitness improvement, respectively. To assess the acceptability of these approaches, it is essential to examine mental health-related indicators. This secondary analysis of a randomized controlled trial investigated the isolated and synergistic effects of VLCHF and HIIT on mental health-related indicators in individuals with excessive weight or obesity. Sixty-eight participants (age = 42 ± 10.2; 20-60 years; BMI = 29.8 ± 3.7) were analysed across four groups: HIIT (n = 15, 4 males, 11 females), VLCHF (n = 19, 4 males, 15 females), VLCHF + HIIT (n = 19, 4 males, 15 females), and control (n = 15, 4 males, 11 females). The 12-week intervention, involved VLCHF diet or HIIT sessions, depending on group affiliation and completing online questionnaires via Qualtrics software before and after the intervention. The questionnaires included the 12-item Short Form Survey (SF-12) for mental (MHS) and physical health scores (PHS), the Satisfaction with Life Scale (SWLS), and the Perceived Stress Scale (PSS). Using the Kruskal-Wallis test, we found no significant differences in mental health-related indicators between groups after 12 weeks, except for SWLS (p = 0.031; ES = 0.133; medium), which improved significantly in the VLCHF + HIIT group compared to the HIIT group. Our findings indicate that HIIT and VLCHF, alone or combined, do not significantly affect mental health-related indicators.

• MeSH
• dieta s omezením sacharidů * metody   MeSH
• dieta s vysokým obsahem tuků * škodlivé účinky   MeSH
• dospělí MeSH
• duševní zdraví * MeSH
• hmotnostní úbytek MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• obezita * MeSH
• randomizované kontrolované studie jako téma MeSH
• vysoce intenzivní intervalový trénink * metody   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Background: Intermittent fasting may be an effective tool for weight loss, but it is still unclear from previous studies to date whether it is as effective as a continuous energy restriction in terms of reducing adipose tissue and whether it leads to unwanted muscle loss. Objectives: The aim of this study was to compare the effect of intermittent fasting (IF) with continuous energy restriction (CER) on the body weight and body composition and to assess the effect of intermittent fasting also in isolation from the energy restriction. Methods: After completion of a three-week dietary intervention, differences in the weight loss and differences in the body composition were compared between three groups. The first group consumed 75% of their calculated energy intake requirements in a six-hour time window. The second group consumed 75% of their calculated energy intake requirements without a time window and the third group consumed 100% of their calculated energy intake requirements in a six-hour time window. The changes in the weight and body composition were assessed by BIA. Results: Of the 95 randomized participants, 75 completed the intervention phase of the study. The highest mean weight loss was achieved by the IF with ER (energy restriction) group (2.3 ± 1.4 kg), followed by the CER group (2.2 ± 1.1 kg); the difference between the groups did not reach statistical significance. The lowest mean weight loss was observed in the IF without ER group (1.1 ± 1.2 kg), the difference reaching statistical significance compared to the IF with ER (p=0.003) and CER (p=0.012) groups. The highest mean adipose tissue loss was observed in the CER group (1.5 ± 1.2 kg) followed by the IF with ER group (1.3 ± 1.1 kg), with no statistically significant differences between the groups. A mean adipose tissue loss was found in the IF without ER group (0.9 ± 1.1 kg) with no statistically significant differences compared to the IF with ER and CER groups. The highest mean fat-free mass loss was found in the IF with ER group (1.1 ± 1.0 kg), followed by the CER group (0.65 ± 0.91 kg) with no statistically significant differences. The IF without ER group showed the lowest mean fat-free mass loss (0.2 ± 1.3 kg), which reached statistical significance compared to the IF with ER group (p=0.027). Conclusion: The results showed a comparable effect in the weight loss and body fat reduction regardless of the timing of the food intake. The diet quality, together with the energy intake, appeared to be one of the most important factors influencing the body composition.

• MeSH
• antropometrie MeSH
• dospělí MeSH
• energetický příjem * fyziologie   MeSH
• hmotnostní úbytek * fyziologie   MeSH
• index tělesné hmotnosti MeSH
• kalorická restrikce * metody   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• obezita dietoterapie   patofyziologie   MeSH
• omezení příjmu potravy * fyziologie   MeSH
• přerušované hladovění MeSH
• složení těla * fyziologie   MeSH
• tělesná hmotnost fyziologie   MeSH
• tuková tkáň MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• randomizované kontrolované studie MeSH

• MeSH
• benzhydrylové sloučeniny * terapeutické užití   farmakologie   MeSH
• glifloziny * terapeutické užití   farmakologie   MeSH
• glukosidy * terapeutické užití   farmakologie   MeSH
• hmotnostní úbytek * účinky léků   MeSH
• lidé MeSH
• peptid YY * metabolismus   MeSH
• srdeční selhání * farmakoterapie   patofyziologie   MeSH
• tepový objem * fyziologie   účinky léků   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

Sedmnáctiletý chlapec byl přijat k hospitalizaci pro hlubokou žilní trombózu v neobvyklé lokalizaci - pravé podklíčkové a podpažní žíly. Při pátrání po příčině bylo zjištěno intenzivní posilování a recentní cílený váhový úbytek 20 kg, po němž přetrvávala stejnostranná gynekomastie. Diagnóza byla uzavřena jako Pagetův-Schrötterův syndrom. Jde o málo známou klinickou jednotku, avšak se vzrůstající publicitou mj. na sociálních sítích v souvislosti se sportem/posilováním. Po úspěšné antikoagulační léčbě došlo k ústupu obtíží a rekanalizaci trombózy.

A 17-year-old male was admitted due to a deep vein thrombosis in a less common location - in the right subclavian and axillary veins. Further investigation revealed an extensive physical activity leading to a recent weight loss of 20 kgs with a persisting ipsilateral gynecomastia. The diagnosis of Paget-Schroetter syndrome was established. This little-known clinical condition becomes increasingly discussed including social media with relation to sport and bodybuilding. A successful anticoagulant therapy led to resolution of symptoms and recanalization at the site of thrombosis.

• MeSH
• antikoagulancia aplikace a dávkování   farmakologie   klasifikace   terapeutické užití   MeSH
• cvičení klasifikace   škodlivé účinky   MeSH
• enoxaparin farmakologie   terapeutické užití   MeSH
• gynekomastie * diagnóza   etiologie   MeSH
• hluboká žilní trombóza horní končetiny * diagnóza   farmakoterapie   komplikace   MeSH
• hmotnostní úbytek MeSH
• lidé MeSH
• management nemoci MeSH
• mladiství MeSH
• Check Tag
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• Publikační typ
• kazuistiky MeSH
• práce podpořená grantem MeSH

BACKGROUND: Inflammation is thought to be an important mechanism for the development and progression of obesity-related heart failure with preserved ejection fraction (HFpEF). In the STEP-HFpEF Program, once-weekly 2.4 mg semaglutide improved heart failure-related symptoms, physical limitations, and exercise function, reduced the levels of C-reactive protein (CRP), a biomarker of inflammation, and reduced body weight in participants with obesity-related HFpEF. However, neither the prevalence nor the clinical characteristics of patients who have various magnitudes of inflammation in the context of obesity-related HFpEF have been well described. Furthermore, whether the beneficial effects of semaglutide on the various HF efficacy endpoints in the STEP-HFpEF Program are modified by the baseline levels of inflammation has not been fully established. Finally, the relationship between weight reduction and changes in CRP across the STEP-HFpEF Program have not been fully defined. OBJECTIVES: This study sought to: 1) evaluate baseline characteristics and clinical features of patients with obesity-related HFpEF that have various levels of inflammation in the STEP-HFpEF Program; 2) determine if the effects of weekly semaglutide 2.4 mg vs placebo across all key outcomes are influenced by baseline levels of inflammation assessed by CRP levels; and 3) determine the relationship between change in CRP and weight loss in the STEP-HFpEF Program. METHODS: This was a secondary analysis of pooled data from 2 international, double-blind, placebo-controlled, randomized trials (STEP-HFpEF and STEP-HFpEF DM). The outcomes were change in the dual primary endpoints (health status [measured by the Kansas City Cardiomyopathy Questionnaire-Clinical Summary Score (KCCQ-CSS)] and body weight) from baseline to 52 weeks according to baseline CRP levels. Additional efficacy endpoints included change in 6-minute walk distance (6MWD), a hierarchical composite endpoint that included death, heart failure events, and differences in the change in the KCCQ-CSS and 6MWD, and levels of CRP in semaglutide- vs placebo-treated patients. Patients were stratified into 3 categories based on baseline CRP levels (<2, ≥2 to <10, and ≥10 mg/L). RESULTS: In total, 1,145 patients were randomized, of which 71% of patients had evidence of inflammation (CRP ≥2 mg/L). At baseline, those with higher levels of inflammation were younger, were more likely to be female, and had higher body mass index, worse health status (KCCQ-CSS), and shorter 6MWD. Semaglutide vs placebo led to reductions in HF-related symptoms and physical limitations as well as body weight, and to improvements in 6MWD and the hierarchical composite endpoint that were consistent across baseline CRP categories (all P interaction nonsignificant). Semaglutide also reduced CRP to a greater extent than placebo regardless of baseline CRP levels (P interaction = 0.32). Change in CRP from baseline to 52 weeks was similar regardless of the magnitude of weight loss (P interaction = 0.91). CONCLUSIONS: Inflammation is highly prevalent in obesity-related HFpEF. Semaglutide consistently improved HF-related symptoms, physical limitations, and exercise function, and reduced body weight across the categories of baseline CRP. Semaglutide also reduced inflammation, regardless of either baseline CRP or magnitude of weight loss during the trials. (Research Study to Investigate How Well Semaglutide Works in People Living With Heart Failure and Obesity [STEP-HFpEF; NCT04788511]; Research Study to Look at How Well Semaglutide Works in People Living With Heart Failure, Obesity and Type 2 Diabetes [STEP HFpEF DM; NCT04916470]).

• MeSH
• C-reaktivní protein metabolismus   MeSH
• dvojitá slepá metoda MeSH
• glukagonu podobné peptidy * terapeutické užití   MeSH
• hmotnostní úbytek MeSH
• lidé středního věku MeSH
• lidé MeSH
• obezita * komplikace   patofyziologie   MeSH
• senioři MeSH
• srdeční selhání * farmakoterapie   patofyziologie   MeSH
• tepový objem * fyziologie   účinky léků   MeSH
• výsledek terapie MeSH
• zánět * farmakoterapie   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• randomizované kontrolované studie MeSH

• MeSH
• Gravesova nemoc * diagnóza   farmakoterapie   MeSH
• hmotnostní úbytek MeSH
• hypertyreóza diagnóza   farmakoterapie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• methimazol aplikace a dávkování   terapeutické užití   MeSH
• opožděná diagnóza MeSH
• pyridoxin aplikace a dávkování   terapeutické užití   MeSH
• thyreostatika MeSH
• vitamin B komplex MeSH
• vitamin D aplikace a dávkování   terapeutické užití   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• kazuistiky MeSH

Jedním z největších objevů v diabetologii posledních desetiletí je možnost dosažení remise DM 2. typu. DM 2. typu bylo podobně jako ostatní typy diabetu dlouho považováno za chronické, progredující a nevyléčitelné onemocnění. Jako první prokázaly možnosti remise DM 2. typu metody bariatrické chirurgie. V posledních letech ale přibývají studie, které dokládají možnosti dosažení remise také pomocí dietních intervencí jako je nízkoenergetická, středomořská, ketogenní dieta nebo přerušované lačnění. Klíčovým mechanismem dosažení remise DM 2. typu je redukce hmotnosti. Článek se zabývá jednotlivými metodami dosažení remise DM 2. typu a v závěru shrnuje praktická doporučení pro jejich aplikaci v klinické praxi.

One of the biggest breakthroughs in diabetes of the last decades is the possibility of achieving remission of type 2 DM. Type 2 DM, like other types of diabetes, has long been considered a chronic, progressive, and incurable disease. Bariatric surgery was the first to demonstrate the possibility of remission of type 2 DM. In recent years, however, an increasing number of studies have demonstrated that remission can also be achieved with dietary interventions such as low-calorie, Mediterranean, ketogenic diets or intermittent fasting. Weight reduction is a key mechanism for achieving remission of type 2 DM. The article reviews the different methods of achieving remission of type 2 DM and concludes with practical recommendations for their application in clinical practice.

• Klíčová slova
• studie DIRECT, studie DIADEM-I, studie LOOK AHEAD,
• MeSH
• bariatrická chirurgie metody   MeSH
• časové faktory MeSH
• diabetes mellitus 2. typu * diagnóza   metabolismus   patofyziologie   MeSH
• dietoterapie klasifikace   metody   MeSH
• hmotnostní úbytek * MeSH
• indukce remise * metody   MeSH
• inzulin terapeutické užití   MeSH
• lidé MeSH
• randomizované kontrolované studie jako téma MeSH
• Check Tag
• lidé MeSH

OBJECTIVE: To describe the outcomes of kidney transplant (KT) candidates with obesity undergoing sleeve gastrectomy (SG) to meet the criteria for KT. METHODS: Retrospective analysis was conducted of electronic medical records of KT candidates with obesity (body mass index >35 kg/m2) who underwent SG in our institution. Weight loss, adverse health events, and the listing and transplant rates were abstracted and compared with the nonsurgical cohort. RESULTS: The SG was performed in 54 patients; 50 patients did not have surgery. Baseline demographic characteristics were comparable at the time of evaluation. Mean body mass index ± SD of the SG group was 41.7±3.6 kg/m2 at baseline (vs 41.5±4.3 kg/m2 for nonsurgical controls); at 2 and 12 months after SG, it was 36.4±4.1 kg/m2 and 32.6±4.0 kg/m2 (P<.01 for both). In the median follow-up time of 15.5 months (interquartile range, 6.4 to 23.9 months), SG was followed by active listing (37/54 people), and 20 of 54 received KT during a median follow-up time of 20.9 months (interquartile range, 14.7 to 28.3 months) after SG. In contrast, 14 of 50 patients in the nonsurgical cohort were listed, and 5 received a KT (P<.01). Three patients (5.6%) experienced surgical complications. There was no difference in overall hospitalization rates and adverse health outcomes, but the SG cohort experienced a higher risk of clinically significant functional decline. CONCLUSION: In KT candidates with obesity, SG appears to be effective, with 37% of patients undergoing KT during the next 18 months (P<.01). Further research is needed to confirm and to improve the safety and efficacy of SG for patients with obesity seeking a KT.

• MeSH
• bariatrická chirurgie * metody   MeSH
• chronické selhání ledvin chirurgie   MeSH
• dospělí MeSH
• gastrektomie * metody   škodlivé účinky   MeSH
• hmotnostní úbytek * MeSH
• index tělesné hmotnosti MeSH
• lidé středního věku MeSH
• lidé MeSH
• obezita * chirurgie   komplikace   MeSH
• retrospektivní studie MeSH
• transplantace ledvin * MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH