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SOARD Category 1 CME Credit Featured Articles, Volume 9, March–April 2013
SOARD Category 1 CME Credit Featured Articles, Volume 9, March–April 2013 Restoration of glycemic control in patients with type 2 diabetes after bariatric surgery is associated with reduction in microparticles. Cheng V, Kashyap SR, Schauer PR, Kirwan JP, McCrae KR. Surg Obes Relat Dis 2013;9;207–12.
Risk factors for acute respiratory failure in bariatric surgery: data from the Nationwide Inpatient Sample, 2006–2008. Masoomi H, Reavis KM, Smith BR, Kim H, Stamos MJ, Nguyen NT. Surg Obes Relat Dis 2013;9;277–81.
Objectives: After reading the featured articles published in this issue of Surgery for Obesity and Related Diseases (SOARD) participants in the SOARD CME program should be able to demonstrate increased understanding of the material specific to the article featured and be able to apply relevant information to clinical practice. Objectives are stated at the beginning of each featured article; the questions follow with three to five response choices, and a critique discussing the objective. Disclosure Statement: It is the policy of the American Society for Metabolic and Bariatric Surgery that speakers and/or anyone in control of content of a CME Category 1 event must disclose any financial or other relationship with (1) any manufacturer(s) of commercial products that may be discussed in the speaker’s presentation and/or (2) commercial supporters of the event. Accreditation Statement: The American Society for Metabolic and Bariatric Surgery (ASMBS) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. The American Society for Metabolic and Bariatric Surgery (ASMBS) designates this educational activity for a maximum of 2 AMA PRA Category 1 Credits. Physicians should only claim credit commensurate with the extent of their participation in the activity. SOARD CME Online provides two articles from each issue for 2 credits per month; 1 credit per article. The articles this month on SOARD CME Online are:
Restoration of glycemic control in patients with type 2 diabetes after bariatric surgery is associated with reduction in microparticles Cheng V, Kashyap SR, Schauer PR, Kirwan JP, McCrae KR. Surg Obes Relat Dis 2013;9;207–12. Disclosures Dr. Schauer’s disclosures include Ethicon Endo-Surgery, consultant, scientific advisory board member, research support; Remedy MD, board of directors; Stryker Endoscopy, scientific advisory board, educational grant; Bard/Davol, scientific advisory board, consultant; Gore, consultant, educational grant; Baxter, educational grant; Barosense, Surgiquest, and Cardinal/Snowden Pencer, scientific advisory board; Covidien, educational grant; Allergan, educational grant; Surgical Excellence LLC, board of directors. Dr. Kashyap’s disclosures include Ethicon Endo-Surgery, consultant, research support. Dr. Kirwan’s disclosures include Bristol Myers Squibb, scientific advisory board; AstraZeneca, scientific advisory board; Nestle Int., research support. Drs. Cheng and McCrae have no conflicts of interest or financial ties to disclose. Risk factors for acute respiratory failure in bariatric surgery: data from the Nationwide Inpatient Sample, 2006–2008 Masoomi H, Reavis KM, Smith BR, Kim H, Stamos MJ, Nguyen NT. Surg Obes Relat Dis 2013;9;277–81.
1550-7289/13/$ – see front matter r 2013 Published by Elsevier Inc. on behalf of American Society for Metabolic and Bariatric Surgery. http://dx.doi.org/10.1016/j.soard.2013.02.006
332
Continuing Medical Education Program / Surgery for Obesity and Related Diseases 9 (2013) 331–333
Continuing Medical Education Program / Surgery for Obesity and Related Diseases 9 (2013) 331–333
333
ARTICLE 1
ARTICLE 2
Restoration of glycemic control in patients with type 2 diabetes after bariatric surgery is associated with reduction in microparticles
Risk factors for acute respiratory failure in bariatric surgery: data from the Nationwide Inpatient Sample, 2006–2008
Cheng V, Kashyap SR, Schauer PR, Kirwan JP, McCrae KR.
Masoomi H, Reavis KM, Smith BR, Kim H, Stamos MJ, Nguyen NT.
Surg Obes Relat Dis 2013;9;207–12.
Learning Objectives This article presents data on cellular microparticle concentrations that are associated with cardiovascular risk and its association to metabolic benefits conferred by bariatric surgery in obesity and type 2 diabetes.
Question 1 Cardiovascular risk related to morbid obesity is conferred by the following cytokines EXCEPT: A. B. C. D. E.
C-reactive protein levels TNFa Glucagon like peptide (GLP-1) Adiponectin Ghrelin levels
Question 2 Which of the following metabolic syndrome parameters confers the least cardiovascular risk in patient with Type 2 diabetes: A. B. C. D.
Hypertention Abdominal adiposity Hyperlipidemia Hyperglycemia
Question 3 Which of the following statements is true regarding microparticle concentrations in type 2 diabetes: A. Increased endothelial, platelet and monocyte microparticles have been documented in diabetic patients with retinopathy and microvascular complications B. Increased platelet microparticles have been documented in diabetic patients with peripheral vascular disease C. Increased monocyte microparticles have been linked to thrombotic events in patients with diabetes D. Increased microparticles concentrations predict cancer risk in patients with diabetes
Surg Obes Relat Dis 2013;9;277–81.
Learning Objectives 1. Understand factors associated with acute respiratory failure (ARF) in bariatric surgery. 2. Understand the frequency of acute respiratory failure after bariatric surgery. 3. Understand outcomes of patients with vs. without ARF.
Question 1 Acute respiratory failure (ARF) rate in bariatric surgery is: A. Lower after laparoscopic compared to open bariatric surgery B. Higher after non-gastric bypass compared to gastric bypass operations C. More than 10%
Question 2 Which factor has not been shown to be associated with ARF? A. B. C. D.
Open technique Congestive heart failure Female sex Chronic renal failure
Question 3 Compared to patients without ARF, patients with ARF have: A. B. C. D.
Longer hospital stay Lower hospital charges Lower in-hospital mortality Lower mean age
Question 4 The highest rate of ARF was observed after: A. B. C. D.
Laparoscopic Laparoscopic Open gastric Laparoscopic
gastric bypass gastroplasty bypass gastric banding
Risk factors for acute respiratory failure in bariatric surgery: data from the Nationwide Inpatient Sample, 2006–2008. Masoomi H, Reavis KM, Smith BR, Kim H, Stamos MJ, Nguyen NT. Surg Obes Relat Dis 2013;9;277–81.
Objectives: After reading the featured articles published in this issue of Surgery for Obesity and Related Diseases (SOARD) participants in the SOARD CME program should be able to demonstrate increased understanding of the material specific to the article featured and be able to apply relevant information to clinical practice. Objectives are stated at the beginning of each featured article; the questions follow with three to five response choices, and a critique discussing the objective. Disclosure Statement: It is the policy of the American Society for Metabolic and Bariatric Surgery that speakers and/or anyone in control of content of a CME Category 1 event must disclose any financial or other relationship with (1) any manufacturer(s) of commercial products that may be discussed in the speaker’s presentation and/or (2) commercial supporters of the event. Accreditation Statement: The American Society for Metabolic and Bariatric Surgery (ASMBS) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. The American Society for Metabolic and Bariatric Surgery (ASMBS) designates this educational activity for a maximum of 2 AMA PRA Category 1 Credits. Physicians should only claim credit commensurate with the extent of their participation in the activity. SOARD CME Online provides two articles from each issue for 2 credits per month; 1 credit per article. The articles this month on SOARD CME Online are:
Restoration of glycemic control in patients with type 2 diabetes after bariatric surgery is associated with reduction in microparticles Cheng V, Kashyap SR, Schauer PR, Kirwan JP, McCrae KR. Surg Obes Relat Dis 2013;9;207–12. Disclosures Dr. Schauer’s disclosures include Ethicon Endo-Surgery, consultant, scientific advisory board member, research support; Remedy MD, board of directors; Stryker Endoscopy, scientific advisory board, educational grant; Bard/Davol, scientific advisory board, consultant; Gore, consultant, educational grant; Baxter, educational grant; Barosense, Surgiquest, and Cardinal/Snowden Pencer, scientific advisory board; Covidien, educational grant; Allergan, educational grant; Surgical Excellence LLC, board of directors. Dr. Kashyap’s disclosures include Ethicon Endo-Surgery, consultant, research support. Dr. Kirwan’s disclosures include Bristol Myers Squibb, scientific advisory board; AstraZeneca, scientific advisory board; Nestle Int., research support. Drs. Cheng and McCrae have no conflicts of interest or financial ties to disclose. Risk factors for acute respiratory failure in bariatric surgery: data from the Nationwide Inpatient Sample, 2006–2008 Masoomi H, Reavis KM, Smith BR, Kim H, Stamos MJ, Nguyen NT. Surg Obes Relat Dis 2013;9;277–81.
1550-7289/13/$ – see front matter r 2013 Published by Elsevier Inc. on behalf of American Society for Metabolic and Bariatric Surgery. http://dx.doi.org/10.1016/j.soard.2013.02.006
332
Continuing Medical Education Program / Surgery for Obesity and Related Diseases 9 (2013) 331–333
Continuing Medical Education Program / Surgery for Obesity and Related Diseases 9 (2013) 331–333
333
ARTICLE 1
ARTICLE 2
Restoration of glycemic control in patients with type 2 diabetes after bariatric surgery is associated with reduction in microparticles
Risk factors for acute respiratory failure in bariatric surgery: data from the Nationwide Inpatient Sample, 2006–2008
Cheng V, Kashyap SR, Schauer PR, Kirwan JP, McCrae KR.
Masoomi H, Reavis KM, Smith BR, Kim H, Stamos MJ, Nguyen NT.
Surg Obes Relat Dis 2013;9;207–12.
Learning Objectives This article presents data on cellular microparticle concentrations that are associated with cardiovascular risk and its association to metabolic benefits conferred by bariatric surgery in obesity and type 2 diabetes.
Question 1 Cardiovascular risk related to morbid obesity is conferred by the following cytokines EXCEPT: A. B. C. D. E.
C-reactive protein levels TNFa Glucagon like peptide (GLP-1) Adiponectin Ghrelin levels
Question 2 Which of the following metabolic syndrome parameters confers the least cardiovascular risk in patient with Type 2 diabetes: A. B. C. D.
Hypertention Abdominal adiposity Hyperlipidemia Hyperglycemia
Question 3 Which of the following statements is true regarding microparticle concentrations in type 2 diabetes: A. Increased endothelial, platelet and monocyte microparticles have been documented in diabetic patients with retinopathy and microvascular complications B. Increased platelet microparticles have been documented in diabetic patients with peripheral vascular disease C. Increased monocyte microparticles have been linked to thrombotic events in patients with diabetes D. Increased microparticles concentrations predict cancer risk in patients with diabetes
Surg Obes Relat Dis 2013;9;277–81.
Learning Objectives 1. Understand factors associated with acute respiratory failure (ARF) in bariatric surgery. 2. Understand the frequency of acute respiratory failure after bariatric surgery. 3. Understand outcomes of patients with vs. without ARF.
Question 1 Acute respiratory failure (ARF) rate in bariatric surgery is: A. Lower after laparoscopic compared to open bariatric surgery B. Higher after non-gastric bypass compared to gastric bypass operations C. More than 10%
Question 2 Which factor has not been shown to be associated with ARF? A. B. C. D.
Open technique Congestive heart failure Female sex Chronic renal failure
Question 3 Compared to patients without ARF, patients with ARF have: A. B. C. D.
Longer hospital stay Lower hospital charges Lower in-hospital mortality Lower mean age
Question 4 The highest rate of ARF was observed after: A. B. C. D.
Laparoscopic Laparoscopic Open gastric Laparoscopic
gastric bypass gastroplasty bypass gastric banding