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Gastric bypass surgery helps diabetes but doesn't cure it, study suggests

ScienceDaily (Nov. 26, 2012) ? After gastric bypass surgery, diabetes goes away for some people -- often even before they lose much weight. So does that mean gastric surgery "cures" diabetes? Not necessarily, according to the largest community-based study of long-term diabetes outcomes after bariatric surgery. For most people in the study, e-published in advance of print in Obesity Surgery, diabetes either never remitted after gastric surgery or relapsed within five years.

Among the two thirds of the study's patients whose diabetes at first went away, more than a third re-developed diabetes again within five years after gastric surgery. After adding in the one quarter of patients whose diabetes never remitted after surgery, most (56 percent) of the study's patients had no long-lasting remission of their diabetes following gastric surgery. However, when diabetes did go away, the research team extrapolated, it stayed away for a median of eight years.

Which kinds of obese people with type 2 diabetes are likely to get the most benefit from gastric surgery? "Our results suggest that, after gastric surgery, diabetes stays away for longer in those people whose diabetes was less severe and at an earlier stage at the time of surgery," said principal investigator David E. Arterburn, MD, MPH, a general internist and associate investigator at Group Health Research Institute. "Gastric surgery isn't for everyone," he said. "But this evidence suggests that, once you have diabetes and are severely obese, you should strongly consider it, even though it doesn't seem to be a cure for most patients."

The multi-site study tracked 4,434 adults at Kaiser Permanente Northern California, Kaiser Permanente Southern California, and HealthPartners for 14 years: from 1995 to 2008. The research arms of all three of these integrated health care delivery systems -- and Group Health Research Institute, where the study's results were analyzed -- belong to the HMO Research Network. The patients had type 2 diabetes that was either controlled with medication or else uncontrolled, and they were also obese enough to be candidates for gastric bypass surgery.

"Diabetes is an increasingly common disease that tends to keep getting worse relentlessly," Dr. Arterburn said. More than 25 million American adults have diabetes -- and as populations age and keep gaining weight, 50 million are predicted to have it by 2050. Already, diabetes accounts for 5 percent of all U.S. health care spending. And it raises the risk of blindness, kidney disease, heart attacks, strokes, and deaths.

"Prevention is by far the best medicine for diabetes," Dr. Arterburn said. "Once you have diabetes, it's really hard to get rid of. Attempts to treat it with intensive lifestyle changes and medical management have been disappointing." For instance, the National Institutes of Health recently halted the Look AHEAD study of intensive lifestyle changes for people with diabetes. Despite improvements in risk factors like body weight, fitness, and blood pressure, sugar, and lipids, that study showed lifestyle changes did not lower the outcomes that matter most: heart attacks, strokes, and deaths.

"No wonder so many were excited to learn that diabetes can remit after gastric surgery -- even, in some cases, before any significant weight loss -- and many were hoping that gastric surgery might be a 'cure' for diabetes," Dr. Arterburn said. "Our study is the first major evidence that diabetes often recurs after gastric bypass surgery." Still, he added, even after diabetes comes back, having had a long period of post-surgery remission is likely to have many positive effects, such as fewer complications of diabetes: less damage to eyes and kidneys, and fewer heart attacks, strokes, and deaths. The researchers are now funded by the National Institutes of Health to study that possibility in this same population. Dr. Arterburn is also leading a randomized controlled pilot trial of intensive behavioral treatment vs. gastric surgery at Group Health with colleagues from the University of Washington.

It's still not clear whether diabetes relapse happens because of gaining weight back or because of underlying the progression of diabetes. But patients' weight -- before and after surgery -- was not strongly correlated with remission or relapse of diabetes in this population.

As part of the Developing Evidence to Inform Decisions about Effectiveness (DEcIDE) program, the Agency for Healthcare Research and Quality (AHRQ) of the U.S. Department of Health and Human Services funded this project under contract HHSA290-2005-0033-I-TO10-WA1, led by Dr. Arterburn.

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The above story is reprinted from materials provided by Group Health Research Institute.

Note: Materials may be edited for content and length. For further information, please contact the source cited above.

Journal Reference:

David E. Arterburn, Andy Bogart, Nancy E. Sherwood, Stephen Sidney, Karen J. Coleman, Sebastien Haneuse, Patrick J. O?Connor, Mary Kay Theis, Guilherme M. Campos, David McCulloch, Joe Selby. A Multisite Study of Long-term Remission and Relapse of Type 2 Diabetes Mellitus Following Gastric Bypass. Obesity Surgery, 2012; DOI: 10.1007/s11695-012-0802-1

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Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

Source: http://feeds.sciencedaily.com/~r/sciencedaily/top_news/top_health/~3/rmyeHWJJJb0/121126142957.htm

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Syrians want to know: 'Are you okay after Superstorm Sandy?'

With the sound of mortars in the background, Syrians in Aleppo express concern for our American correspondent and his storm-battered homeland.

By Tom A. Peter,?Correspondent / November 18, 2012

Syrian women work on their field in the village of Tarafat, Syria in October. Many Syrians have expressed concern for Americans hit by hurricane Sandy.

Manu Brabo/AP

Enlarge

I had just sat down to interview a commander of the Free Syrian Army in Aleppo and we were exchanging the normal pre-meeting pleasantries as some distant gunfire cracked in the background. After 20 months of conflict here, most artillery and gunfire goes unnoticed unless people are close enough to be directly affected.

Skip to next paragraph Tom A. Peter

Correspondent

Tom A. Peter is a journalist based in Kabul, Afghanistan where he covers news and features throughout the country. He has also reported for The Monitor from Iraq, Yemen, Jordan, and throughout the United States.

Credit Expert Completely Destroys Occupy Wall Street's Financial

A couple of months ago, Occupy Wall Street quietly published its own version of a personal finance manifesto.

In a nutshell, "The Debt Resistor's Operations Manual" is 122 pages of some of the dodgiest financial advice we've ever seen.

Though there are a few decent pieces of information, it's all lost as soon as they start encouraging cash-strapped consumers to lie, cheat, and steal their way to a debt-free lifestyle.

In one particular passage, Occupy hashes out several steps to living credit-free. We ran them by credit expert John Ulzheimer, President of Consumer Education at?SmartCredit.com and blogger for?Mint.com.?

And he found it all quite amusing.

Below, we list a few parts of Occupy's strategy, along with Ulzheimer's reaction.

Occupy Wall Street:? For housing utilities, if you have a roommate, you can ask them to put the accounts in their name. If you live alone, ask a relative or friend.

John Ulzheimer: And as far as turning your family into lenders, family members don't want to lose money any more than lenders want to lose money. They'll know after the first "default" that you're not worthy of borrowing money. So technically, you're still being assessed, just by family members. Further, nothing tears a family apart faster than lending money to other family members. ?Suggesting that people borrow money from family members is step one toward family disharmony.

OWS: Opt for services that don?t require credit checks. If a company requires a check, try to talk them out of it. Build up an old-fashioned trusting relationship by spending time?talking with the person. They may choose to bypass the?credit check.?

JU: The problem is that most lenders and service providers pre-determine their underwriting standards so talking to someone or building the trust of one person in a large bank is meaningless because the decision to let you have the service has already been made by someone else you'll never meet in a city you'll never visit.

OWS: Create your own credit report: put together a portfolio showing you are a trustworthy person (reference letters,?job history, life narrative).

JU: That's as worthless as the paper it's written on. ?Lenders and service providers don't consider self made credit reports because of the chances that they're not honest...The only way to reject the system, other than ceremonially, is to never, ever borrow money for any reason from any company. Otherwise, you're in the system. You may not like it, but you're in the system.

OWS: Build networks of mutual support in your community so you?rely less on outside services.

JU: I'm sorry but I'm laughing reading this. ?There are over 100,000,000 people in this country (part of the 99%) that have great credit and don't have any issues getting loans or services at great rates and terms. Again, like their letter to the CFPB, it appears that whomever is in charge of OWS's "credit strategy" doesn't understand credit. And you can quote me on that one.

Source: http://www.businessinsider.com/expert-owss-finance-advice-is-hilarious-2012-11

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NEC shows 2014-era portable DNA analyzer that could outpace your favorite crime drama

NEC gave us promises of truly on-the-spot forensics when it unveiled its first portable DNA analyzer back in 2007, although the reality hasn't been quite in line with the dream: its current system takes an hour to get a result and won't win any awards for sleekness. From what we're seeing of a next-generation analyzer due in 2014, those expectations are more likely to be met. The new version puts the full DNA extraction, amplification and separation processes on a newer chip that meets NEC's original goal of producing output in 25 minutes -- faster than a short cop drama, if you include the commercial breaks. Few beyond the police will be casually tossing the analyzer around given its 70.5-pound weight and $120,000 price, but a much slicker design at least gives it the profile of a small, rolling suitcase. The upgrade could be vital for identifying suspects and victims in record time; if our only worry is that NEC takes all the mystery out of our favorite TV shows, we'll be more than satisfied.

Filed under: Science

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Via: PCWorld

Source: NEC (PDF)

Source: http://feeds.engadget.com/~r/weblogsinc/engadget/~3/XyjREGUMfeQ/

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Eight policemen wounded in Russian prison protest

MOSCOW (Reuters) - Eight Russian policemen were injured trying to disperse a crowd outside a prison where 250 inmates staged a roof-top protest demanding the release of a group of fellow prisoners from a punishment cell, authorities said on Sunday.

Russian state television showed pictures of a group of inmates standing on the roof of the prison holding white banners reading "people, help" in the town of Kopeysk near the industrial city of Chelyabinsk in the Urals mountains.

Details of the incident remain unclear with human rights activist Oksana Trufanova telling the Echo Moskvy station that OMON special police troops attacked a group of inmates' relatives outside the prison.

"They beat us with batons. Their eyes were shining. I had never been in such mayhem," Trufanova said. Police said 38 people were detained, but denied OMON officers had beaten people outside the prison.

Trufanova said the protest was a consequence of regular beatings in Kopeysk prison. The local prison authority said in a statement the situation inside the prison was now stable and under control.

Police said the troops were attacked by groups of drunken youths who were throwing bottles and shouting obscenities. Prison mutinies in Russia are relatively rare.

More than 700,000 Russians are currently behind bars and human rights activists regularly complain of poor living conditions, cases of torture, beatings and disease in prisons.

Conditions in Russian prisons came to international attention after Sergei Magnitsky, a lawyer for equity fund Hermitage Capital died a Moscow prison. The Kremlin's own human rights council says he was probably beaten to death.

The local prison authority said the protesters had no demands other than the release of a group of their fellow inmates from a punishment cell. It said the group had violated prison rules and the demand to release them was illegal.

(Reporting by Gleb Bryanski; Editing by Jon Hemming)

Source: http://news.yahoo.com/eight-policemen-wounded-russian-prison-protest-173357896.html

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An Arrow to Shoot.

In the high north of Alaska is a tribe. A tribe of Native Americans who live in harmony. The village is then burned down and all desperate measures are forced to conclude.

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