Oregon Health & Science University

About: Oregon Health & Science University is a education organization based out in Portland, Oregon, United States. It is known for research contribution in the topics: Population & Health care. The organization has 30245 authors who have published 65190 publications receiving 3302774 citations. The organization is also known as: University of Oregon Health Sciences Center & Oregon Health Sciences University.

Weight change and health outcomes at 3 years after bariatric surgery among individuals with severe obesity.

Abstract: Importance Severe obesity (body mass index [BMI] =35) is associated with a broad range of health risks. Bariatric surgery induces weight loss and short-term health improvements, but little is known about long-term outcomes of these operations. Objective To report 3-year change in weight and select health parameters after common bariatric surgical procedures. Design and Setting The Longitudinal Assessment of Bariatric Surgery (LABS) Consortium is a multicenter observational cohort study at 10 US hospitals in 6 geographically diverse clinical centers. Participants and Exposure Adults undergoing first-time bariatric surgical procedures as part of routine clinical care by participating surgeons were recruited between 2006 and 2009 and followed up until September 2012. Participants completed research assessments prior to surgery and 6 months, 12 months, and then annually after surgery. Main Outcomes and Measures Three years after Roux-en-Y gastric bypass (RYGB) or laparoscopic adjustable gastric banding (LAGB), we assessed percent weight change from baseline and the percentage of participants with diabetes achieving hemoglobin A1c levels less than 6.5% or fasting plasma glucose values less than 126 mg/dL without pharmacologic therapy. Dyslipidemia and hypertension resolution at 3 years was also assessed. Results At baseline, participants (N?=?2458) were 18 to 78 years old, 79% were women, median BMI was 45.9 (IQR, 41.7-51.5), and median weight was 129 kg (IQR, 115-147). For their first bariatric surgical procedure, 1738 participants underwent RYGB, 610 LAGB, and 110 other procedures. At baseline, 774 (33%) had diabetes, 1252 (63%) dyslipidemia, and 1601 (68%) hypertension. Three years after surgery, median actual weight loss for RYGB participants was 41 kg (IQR, 31-52), corresponding to a percentage of baseline weight lost of 31.5% (IQR, 24.6%-38.4%). For LAGB participants, actual weight loss was 20 kg (IQR, 10-29), corresponding to 15.9% (IQR, 7.9%-23.0%). The majority of weight loss was evident 1 year after surgery for both procedures. Five distinct weight change trajectory groups were identified for each procedure. Among participants who had diabetes at baseline, 216 RYGB participants (67.5%) and 28 LAGB participants (28.6%) experienced partial remission at 3 years. The incidence of diabetes was 0.9% after RYGB and 3.2% after LAGB. Dyslipidemia resolved in 237 RYGB participants (61.9%) and 39 LAGB participants (27.1%); remission of hypertension occurred in 269 RYGB participants (38.2%) and 43 LAGB participants (17.4%). Conclusions and Relevance Among participants with severe obesity, there was substantial weight loss 3 years after bariatric surgery, with the majority experiencing maximum weight change during the first year. However, there was variability in the amount and trajectories of weight loss and in diabetes, blood pressure, and lipid outcomes. Trial Registration clinicaltrials.gov Identifier: NCT00465829 Bariatric surgery results in large, sustained weight loss in severely obese populations. Although generally accepted as the most effective means for inducing weight loss in very heavy patients, few studies exist reporting outcomes longer than 2 years after the surgery was performed. Long-term outcome studies that do exist are mostly case series, are from limited geographical areas, or report surgical procedures no longer performed.1- 5 For example, high-quality long-term outcomes from the Swedish Obesity Study are well described, but most of the participants underwent a vertical banded gastroplasty procedure, an operation no longer used.6- 8 Six-year follow-up after Roux-en-Y gastric bypass (RYGB) was reported, but these data may not be generalizable because all the participants were from 1 surgical practice in Utah.9 Even though surgically induced weight loss is much more effective than nonsurgical treatments for seriously obese patients, surgery is still not universally accepted because of incomplete knowledge of long-term outcomes from the procedures. The Longitudinal Assessment of Bariatric Surgery (LABS) Consortium was formed to acquire long-term data on the safety, effectiveness, and durability of bariatric surgical procedures currently performed in the United States using standardized data collection practices. LABS is a multicenter, observational cohort study with standardized and detailed data collection protocols. LABS has 3 phases; LABS-1, LABS-2, and LABS-3.10 The 30-day safety of bariatric surgery was reported in LABS-1.11 LABS-2 focused on longer-term safety, outcomes, and durability of health changes. The major priorities for LABS-2 were to determine weight, medical, surgical, and behavioral outcomes, including incidence and remission of comorbid conditions, and to evaluate patient, procedure, and other characteristics that were associated with these outcomes. LABS-3 included 2 substudies that examined mechanisms of diabetes change and psychosocial aspects in more detail. We now report the major clinical outcomes from LABS-2, including 3-year weight change from baseline and diabetes, lipid, and hypertension outcomes after RYGB and laparoscopic adjustable gastric band (LAGB) procedures.

Regulatory mechanisms of AMPA receptors in synaptic plasticity

Abstract: Activity-dependent changes in the strength of excitatory synapses are a cellular mechanism for the plasticity of neuronal networks that is widely recognized to underlie cognitive functions such as learning and memory. AMPA (alpha-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid)-type glutamate receptors (AMPARs) are the main transducers of rapid excitatory transmission in the mammalian CNS, and recent discoveries indicate that the mechanisms which regulate AMPARs are more complex than previously thought. This review focuses on recent evidence that alterations to AMPAR functional properties are coupled to their trafficking, cytoskeletal dynamics and local protein synthesis. These relationships offer new insights into the regulation of AMPARs and synaptic strength by cellular signalling.

Melatonin shifts human circadian rhythms according to a phase-response curve.

Abstract: A physiological dose of orally administered melatonin shifts circadian rhythms in humans according to a phase-response curve (PRC) that is nearly opposite in phase with the PRCs for light exposure: melatonin delays circadian rhythms when administered in the morning and advances them when administered in the afternoon or early evening. The human melatonin PRC provides critical information for using melatonin to treat circadian phase sleep and mood disorders, as well as maladaptation to shift work and transmeridional air travel. The human melatonin PRC also provides the strongest evidence to date for a function of endogenous melatonin and its suppression by light in augmenting entrainment of circadian rhythms by the light-dark cycle.

Lutetium-177-PSMA-617 for Metastatic Castration-Resistant Prostate Cancer.

Abstract: Background Metastatic castration-resistant prostate cancer remains fatal despite recent advances. Prostate-specific membrane antigen (PSMA) is highly expressed in metastatic castration-res...