Obesidad y SARS-CoV-2: consideraciones sobre la cirugía bariátrica y recomendaciones para el inicio de la actividad quirúrgica / Obesity and SARS-CoV-2: Considerations on bariatric surgery and recommendations for the start of surgical activity

La pandemia SARS-CoV-2 ha tenido un gran impacto en todo el mundo, siendo España uno de los países más afectados. La demora en la cirugía bariátrica puede tener consecuencias fatales, ya que hasta el 50% de los pacientes que se encuentran en lista de espera desarrollan una nueva comorbilidad durante el tiempo que permanecen en ella y el 1,5% de pacientes fallecen mientras esperan la intervención. Es por ello por lo que la cirugía bariátrica no debe demorarse en cuanto la ocupación del hospital por pacientes COVID-19+ disminuya de forma significativa y se disponga de recursos y seguridad suficiente para realizar la cirugía en pacientes con patología benigna. Este documento recoge las principales recomendaciones para los programas de cirugía bariátrica en nuestro país desde el punto de vista tanto de seguridad como de preparación y seguimiento del paciente bariátrico en el contexto de la pandemia SARS-CoV-2

The SARS-CoV-2 pandemic has a great impact worldwide, being Spain one of the most affected countries. The delay in bariatric surgery can have fatal consequences since up to 50% of the patients who are on the waiting list develop a new comorbidity during the time they remain on it and 1.5% of patients die while waiting for the intervention. That is why bariatric surgery should not be delayed, if the occupation of the hospital by COVID-19+ patients decreases significantly, and sufficient resources and safety are available to restart surgery in patients with benign pathology. This document contains the main recommendations for the bariatric surgery programs in our country from the point of view of safety, bariatric patient preparation and follow up during the SARS-CoV-2 pandemia

Obesity and SARS-CoV-2: Considerations on bariatric surgery and recommendations for the start of surgical activity. / Obesidad y SARS-CoV-2: consideraciones sobre la cirugía bariátrica y recomendaciones para el inicio de la actividad quirúrgica.

The SARS-CoV-2 pandemic has a great impact worldwide, being Spain one of the most affected countries. The delay in bariatric surgery can have fatal consequences since up to 50% of the patients who are on the waiting list develop a new comorbidity during the time they remain on it and 1.5% of patients die while waiting for the intervention. That is why bariatric surgery should not be delayed, if the occupation of the hospital by COVID-19+ patients decreases significantly, and sufficient resources and safety are available to restart surgery in patients with benign pathology. This document contains the main recommendations for the bariatric surgery programs in our country from the point of view of safety, bariatric patient preparation and follow up during the SARS-CoV-2 pandemia.

Mi experiencia sobre el mejor momento para plantear un tratamiento con liraglutida / My experience about the optimal timing to propose treatment with liraglutide

Las opciones terapéuticas para tratar la diabetes mellitus de tipo 2 (DM2) son cada vez mayores, dato favorable, pero que ocasiona cierta incertidumbre. En este contexto, los agonistas del receptor del péptido similar al glucagón de tipo 1 (ARGLP-1) han recibido especial atención, por un atractivo perfil de acción, bajo riesgo de hipoglucemias y capacidad de provocar pérdida ponderal. Centramos nuestra revisión en liraglutida, el primer ARGLP-1 de administración diaria comercializado en España: escenarios de vida real en Europa y Estados Unidos, aspectos que deben considerarse entre las terapias inyectables existentes (insulina frente a ARGLP-1), ventajas sobre los inhibidores de la dipeptidilpeptidasa 4 (iDPP-4) y la experiencia en nuestro país. Concluimos: que el mejor momento para iniciar tratamiento con liraglutida es en las fases iniciales de la enfermedad, como candidata a la combinación con metformina. Otros escenarios también son favorables, como la sustitución de los iDPP-4 o bien su adición al tratamiento con insulina

The therapeutic options for treating type 2 diabetes mellitus are increasing; despite being a positive development, this wider choice may lead to uncertainty. In this context, glucagon-like peptide-1 receptor agonists (GLP-1-RA) have received special attention because of their interesting action profile, low risk of hypoglycaemia and weight loss-inducing ability. We focus our review on liraglutide, the first once-daily administration GLP-1-RA marketed in Spain. The topics discussed include real-life scenarios in Europe and the United States, aspects to be considered among existing injectable therapies (insulin vs. GLP-1-RA), the advantages of GLP-1-RA over the dipeptidyl peptidase 4 inhibitors (DPP-4-i), and experience in Spain. We conclude that the best time to start treatment with liraglutide is in the early stages of the disease, as a candidate for combination with metformin. Other scenarios are also favourable, such as the replacement of DPP-4-i or its addition to insulin therapy

Initial Approach to Childhood Obesity in Spain. A Multisociety Expert Panel Assessment.

PURPOSE: In recent years, the incidence of childhood obesity in Europe, and Spain in particular, has increased dramatically. Bariatric surgery could play a major role in treating of adolescents with severe obesity. However, no specific guidelines for bariatric surgery currently exist in Spain. METHODS: The Board of the Spanish Society for Obesity Surgery and Metabolic Diseases (SECO) proposed a study of childhood obesity by using the Delphi method. This prospective study involved 60 experts from nine national societies. Each society leader recruited experts from their society in obesity-related fields. Two online questionnaires were taken, and consensus on guidelines for various obesity treatments was reached according to the percentage of answers in favor or against inclusion of a given guideline. Based on these results, preoperative, surgical management and follow-up of childhood obesity management among others were analyzed. RESULTS: The survey results indicated significant concern among all societies regarding obesity. There was strong consensus with regard to adolescents and obesity, medical treatment, dietary recommendations, environmental and social factors, and goals for adolescents with obesity. Consensus on the use of intragastric balloons and other techniques was not reached. However, biliopancreatic diversion was rejected as a primary treatment, and mandatory psychological/psychiatric assessment was agreed upon. Inclusion criteria accepted were similar to those for adults with the exception of surgery in those with a body mass index <40. CONCLUSIONS: Spanish obesity-related societies are aware of the societal problem of childhood obesity. Multisociety development of national approaches may arise from consensus-building studies among specialists.

Fitobezoar en remanente gástrico tras cirugía bariátrica / Fitobezoar in gastric pouch after bariatric surgery

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Sobrecarga de hierro en la población adulta y su posible relación con la diabetes mellitus tipo 2 / Iron overload in adult population and it possible relation with diabetes mellitus type 2

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