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Obesity: HELP
Articles from New York Harbor VA Medical Center
Based on 16 articles published since 2009
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These are the 16 published articles about Obesity that originated from New York Harbor VA Medical Center during 2009-2019.
 
+ Citations + Abstracts
1 Review Gout and Metabolic Syndrome: a Tangled Web. 2017

Thottam, Gabrielle E / Krasnokutsky, Svetlana / Pillinger, Michael H. ·Department of Medicine, Roger Williams Medical Center, Providence, RI, USA. · Crystal Diseases Study Group, Division of Rheumatology, Department of Medicine, New York University School of Medicine, 301 East 17th Street, Suite 1410, New York, NY, 10003, USA. · Rheumatology Section, Department of Medicine, VA New Harbor Health Care System, New York Campus, New York, NY, USA. · Crystal Diseases Study Group, Division of Rheumatology, Department of Medicine, New York University School of Medicine, 301 East 17th Street, Suite 1410, New York, NY, 10003, USA. michael.pillinger@nyumc.org. · Rheumatology Section, Department of Medicine, VA New Harbor Health Care System, New York Campus, New York, NY, USA. michael.pillinger@nyumc.org. ·Curr Rheumatol Rep · Pubmed #28844079.

ABSTRACT: PURPOSE OF REVIEW: The complexity of gout continues to unravel with each new investigation. Gout sits at the intersection of multiple intrinsically complex processes, and its prevalence, impact on healthcare costs, and association with important co-morbidities make it increasingly relevant. The association between gout and type 2 diabetes, hypertension, hyperlipidemia, cardiovascular disease, renal disease, and obesity suggest that either gout, or its necessary precursor hyperuricemia, may play an important role in the manifestations of the metabolic syndrome. In this review, we analyze the complex interconnections between gout and metabolic syndrome, by reviewing gout's physiologic and epidemiologic relationships with its major co-morbidities. RECENT FINDINGS: Increasing evidence supports gout's association with metabolic syndrome. More specifically, both human studies and animal models suggest that hyperuricemia may play a role in promoting inflammation, hypertension and cardiovascular disease, adipogenesis and lipogenesis, insulin and glucose dysregulation, and liver disease. Fructose ingestion is associated with increased rates of hypertension, weight gain, impaired glucose tolerance, and dyslipidemia and is a key driver of urate biosynthesis. AMP kinase (AMPK) is a central regulator of processes that tend to mitigate against the metabolic syndrome. Within hepatocytes, leukocytes, and other cells, a fructose/urate metabolic loop drives key inhibitors of AMPK, including AMP deaminase and fructokinase, that may tilt the balance toward metabolic syndrome progression. Preliminary evidence suggests that agents that block the intracellular synthesis of urate may restore AMPK activity and help maintain metabolic homeostasis. Gout is both an inflammatory and a metabolic disease. With further investigation of urate's role, the possibility of proper gout management additionally mitigating metabolic syndrome is an evolving and important question.

2 Review Intragastric Balloons in Clinical Practice. 2017

Papademetriou, Marianna / Popov, Violeta. ·Gastroenterology, New York University School of Medicine, 220 First Avenue, New York, NY 10016, USA. · Division of Gastroenterology, NY VA Harbor Healthcare (Manhattan), New York University School of Medicine, 423 East 23rd Street, 15 North, New York, NY 10010, USA. Electronic address: Violeta.popov@nyumc.org. ·Gastrointest Endosc Clin N Am · Pubmed #28292403.

ABSTRACT: Cost-effective therapies to address the growing epidemic of obesity are a leading priority in modern medicine. Intragastric balloons (IGBs) are one such option, with increased effectiveness compared with pharmacotherapy and lifestyle and a lower rate of adverse events than bariatric surgery. IGBs are endoscopically placed or swallowed space-occupying devices in the stomach. Three IGB systems were approved in 2015 to 2016 by the Food and Drug Administration for use in the United States, with more devices nearing approval. This paper reviews the adverse events and efficacy of IGBs, and practice setup, management of common complications, and dietary advice for patients.

3 Review The Impact of Intragastric Balloons on Obesity-Related Co-Morbidities: A Systematic Review and Meta-Analysis. 2017

Popov, Violeta B / Ou, Amy / Schulman, Allison R / Thompson, Christopher C. ·NYU Langone Medical Center and VA NY Harbor Healthcare System, New York University School of Medicine, New York, USA. · Brigham and Women's Hospital, Harvard Medical School, Massachusetts, USA. ·Am J Gastroenterol · Pubmed #28117361.

ABSTRACT: ObjectivesTherapies less invasive than surgery and more effective than lifestyle and pharmacotherapy are needed to contend with the obesity epidemic. Intragastric balloons (IGBs) are a minimally invasive endoscopic weight loss method recently approved for use in the US. The purpose of the study is to assess the effect of IGBs on metabolic outcomes associated with obesity.MethodsMEDLINE, Embase, and Cochrane Database were searched through July 2016. Dual extraction and quality assessment of studies using Cochrane risk of bias tool were performed independently by two authors. Primary outcomes included the change from baseline in metabolic parameters. Secondary outcomes included resolution and/or improvement in metabolic co-morbidities and association with baseline parameters.Results10 randomized controlled trials (RCT) and 30 observational studies including 5,668 subjects were analyzed. There was moderate-quality evidence for improvement in most metabolic parameters in subjects assigned to IGB therapy as compared to conventional non-surgical therapy in RCTs: mean difference (MD) in fasting glucose change: -12.7 mg/dl (95% confidence interval (CI) -21.5, -4); MD in triglycerides: -19 mg/dl (95% CI -42, 3.5); MD in waist circumference: -4.1 cm (95% CI -6.9, -1.4); MD in diastolic blood pressure: -2.9 mm Hg (95% CI -4.1, -1.8). The odds ratio for diabetes resolution after IGB therapy was 1.4 (95% CI 1.3, 1.6). The rate of serious adverse events was 1.3%.ConclusionsIGBs are more effective than diet in improving obesity-related metabolic risk factors with a low rate of adverse effects, however the strength of the evidence is limited given the small number of participants and lack of long-term follow-up.

4 Review Effect of Intragastric Balloons on Liver Enzymes: A Systematic Review and Meta-Analysis. 2016

Popov, Violeta B / Thompson, Christopher C / Kumar, Nitin / Ciarleglio, Maria M / Deng, Yanhong / Laine, Loren. ·NYU Langone Medical Center and VA NY Harbor Healthcare System, 423 East 23rd Street, 11 North, New York, NY, 10010, USA. Violeta.popov@nyumc.org. · Division of Gastroenterology and Hepatology, Harvard Medical School, Brigham and Women's Hospital, 75 Francis Street, Thorne 14, Boston, MA, USA. · Bariatric Endoscopy Institute Gastroenterology Weight Management, Addison, IL, 60101, USA. · Department of Biostatistics, Yale School of Public Health, 60 College Street, New Haven, CT, 06520, USA. · Yale Center for Analytical Sciences, Yale University, 300 George Street, Suite 555, New Haven, CT, 06515, USA. · Yale School of Medicine and VA Connecticut Healthcare System, PO Box 208019, New Haven, CT, 06520, USA. ·Dig Dis Sci · Pubmed #27207181.

ABSTRACT: BACKGROUND: Intragastric balloons (IGBs) are safe and effective in inducing weight loss in obese patients. The objective of this study was to review and analyze the available data of the effect of IGB on markers of nonalcoholic fatty liver disease (NAFLD) and liver enzymes. METHODS: Searches were performed of MEDLINE and Embase databases from inception through January 2016. Study inclusion criteria were the following: ≥5 overweight or obese adult patients undergoing intragastric balloon placement, with liver tests [alanine aminotransferase (ALT) or gamma-glutamyl transpeptidase (GGT)] or markers of NAFLD (e.g., imaging, biopsy) reported before balloon insertion and after balloon removal at 6 months. RESULTS: Nine observational studies and one randomized trial were identified. ALT decreased by -10.02 U/l (95 % CI, -13.2, -6.8), GGT decreased by -9.82 U/l (95 % CI, -12.9, -6.8), and BMI decreased by -4.98 kg/m(2) (-5.6, -4.4) with IGB therapy. Hepatic steatosis improved from baseline after 6 months of balloon therapy by magnetic resonance imaging (fat fraction, 16.7 ± 10.9-7.6 ± 9.8, p = 0.003), ultrasound (severe liver steatosis, 52-4 %, p < 0.0001). Histological NAFLD activity score was lower after 6 months of IGB versus control with sham endoscopy and diet (2 ± 0.75 vs. 4 ± 2.25, p = 0.03). CONCLUSION: The use of intragastric balloon decreases liver enzymes and is potentially an effective short-term treatment for NAFLD as part of a multidisciplinary approach. Larger, more rigorous trials are needed to confirm the effect of IGBs on NAFLD.

5 Review The new epidemiology of nephrolithiasis. 2015

Shoag, Jonathan / Tasian, Greg E / Goldfarb, David S / Eisner, Brian H. ·Department of Urology, New York Presbyterian Hospital, Weill Cornell Medical College, New York City, NY; Division of Urology, The Children's Hospital of Philadelphia, Philadelphia, PA; Department of Medicine, New York University Langone Medical Center, New York City, NY; Nephrology Section, New York Harbor Veterans Affairs Health Care System, New York City, NY; Department of Urology, Massachusetts General Hospital, Harvard Medical School, Boston, MA. ·Adv Chronic Kidney Dis · Pubmed #26088071.

ABSTRACT: Historically nephrolithiasis was considered a disease of dehydration and abnormal urine composition. However, over the past several decades, much has been learned about the epidemiology of this disease and its relation to patient demographic characteristics and common systemic diseases. Here we review the latest epidemiologic studies in the field.

6 Review Hyperuricemia, gout, and related comorbidities: cause and effect on a two-way street. 2014

Karis, Elaine / Crittenden, Daria B / Pillinger, Michael H. ·From the Division of Rheumatology, Crystal Diseases Study Group, New York University School of Medicine/Langone Medical Center, and the Department of Medicine, Rheumatology Section, New York Harbor Veterans Affairs Healthcare System, New York, New York. ·South Med J · Pubmed #24937517.

ABSTRACT: The prevalence of gout and hyperuricemia has increased dramatically during the last several decades, to the point that gout is the most common inflammatory arthritis in the United States, affecting approximately 8 million Americans. Patients with gout frequently have multiple comorbidities, including hypertension, chronic kidney disease, cardiovascular disease, obesity, diabetes, and hyperlipidemia, all of which have significant adverse impact on public health. In some cases (eg, chronic kidney disease) it is clear that the presence of the comorbidity contributes to the progression of hyperuricemia and/or gout. Conversely, the question of whether gout/hyperuricemia themselves contribute to the pathogenesis of gout comorbidities is an area of intensifying investigation. In vitro and animal models, large epidemiologic studies, and small clinical trials suggest that gout and/or hyperuricemia may contribute to hypertension, chronic kidney disease, and cardiovascular disease. More limited hypothesis-generating studies suggest a potential role for diabetes and obesity. Given that available drugs can lower serum urate levels and manage gout, it would be important to know whether not only gout and/or hyperuricemia can contribute to comorbidities but also better gout/hyperuricemic control can ameliorate some or all of these related conditions. We review the clinical associations between gout and its common comorbid conditions and the evidence supporting a causal relation between them. The evidence that gout and hyperuricemia contribute to the pathogenesis of their comorbidities creates greater urgency for appropriate gout management.

7 Review Latina food patterns in the United States: a qualitative metasynthesis. 2014

Gerchow, Lauren / Tagliaferro, Barbara / Squires, Allison / Nicholson, Joey / Savarimuthu, Stella M / Gutnick, Damara / Jay, Melanie. ·Lauren Gerchow, BSN, RN, is Master of Science in Nursing Student, College of Nursing, New York University. Barbara Tagliaferro, BA, MA, is Research Coordinator, Section on Health Choice, Policy, and Evaluation, School of Medicine, Department of Population Health, New York University. Allison Squires, PhD, RN, is Assistant Professor and Director of International Education, College of Nursing, New York University. Joey Nicholson, MLIS, MPH, is Assistant Curator and Education and Curriculum Librarian, School of Medicine, New York University. Stella M. Savarimuthu, is Medical Student, Hofstra North Shore-LIJ School of Medicine, Hempstead, New York. Damara Gutnick, MD, is Clinical Assistant Professor of Medicine and Psychiatry, School of Medicine, Division of General Internal Medicine, New York University. Melanie Jay, MD, MS, is Staff Physician and Clinician Investigator, Veterans Affairs Medical Center New York Harbor. ·Nurs Res · Pubmed #24785246.

ABSTRACT: BACKGROUND: Obesity disproportionately affects Latinas living in the United States, and cultural food patterns contribute to this health concern. OBJECTIVE: The aim of this study was to synthesize the qualitative results of research regarding Latina food patterns in order to (a) identify common patterns across Latino culture and within Latino subcultures and (b) inform future research by determining gaps in the literature. METHODS: A systematic search of three databases produced 13 studies (15 manuscripts) that met the inclusion criteria for review. The Critical Appraisal Skills Program tool and the recommendations of Squires for evaluating translation methods in qualitative research were applied to appraise study quality. Authors coded through directed content analysis and an adaptation of the Joanna Briggs Institute Qualitative Assessment and Review Instrument coding template to extract themes. Coding focused on food patterns, obesity, population breakdown, immigration, acculturation, and barriers and facilitators to healthy eating. Other themes and categories emerged from this process to complement this approach. RESULTS: Major findings included the following: (a) Immigration driven changes in scheduling, food choice, socioeconomic status, and family dynamics shape the complex psychology behind healthy food choices for Latina women; (b) in Latina populations, barriers and facilitators to healthy lifestyle choices around food are complex; and (c) there is a clear need to differentiate Latino populations by country of origin in future qualitative studies on eating behavior. DISCUSSION: Healthcare providers need to recognize the complex influences behind eating behaviors among immigrant Latinas in order to design effective behavior change and goal-setting programs to support healthy lifestyles.

8 Article Independence of diabetes and obesity in adults with serious mental illness: Findings from a large urban public hospital. 2018

Sun, Langston / Getz, Mara / Daboul, Sulaima / Jay, Melanie / Sherman, Scott / Rogers, Erin / Aujero, Nicole / Rosedale, Mary / Goetz, Raymond R / Weissman, Judith / Malaspina, Dolores / Ahmad, Samoon. ·New York University School of Medicine, Department of Psychiatry, New York, NY, United States. · New York University, Division of General Internal Medicine and Clinical Innovation, New York, NY, United States; Veterans Affairs New York Harbor Healthcare System, New York, NY, United States. · New York University, Department of Population Health, New York, NY, United States; Veterans Affairs New York Harbor Healthcare System, New York, NY, United States. · New York University, Department of Population Health, New York, NY, United States. · New York University School of Medicine, Department of Psychiatry, New York, NY, United States; New York University, College of Nursing (deceased), New York, NY, United States. · New York State Psychiatric Institute and Columbia University Department of Psychiatry, New York, NY, United States. · Icahn School of Medicine at Mount Sinai, Departments of Psychiatry and Neuroscience, New York, NY, United States; Veterans Affairs New York Harbor Healthcare System, New York, NY, United States. · Icahn School of Medicine at Mount Sinai, Departments of Psychiatry and Neuroscience, New York, NY, United States. Electronic address: Dolores.Malaspina@MSSM.com. ·J Psychiatr Res · Pubmed #29482065.

ABSTRACT: OBJECTIVE: There is limited research on metabolic abnormalities in psychotropic-naïve patients with serious mental illness (SMI). Our study examined metabolic conditions in a large, ethnically diverse sample of psychotropic-naïve and non-naïve adults with SMI at an urban public hospital. METHODS: In this cross-sectional study of 923 subjects, the prevalences of hyperglycemia meeting criteria for type 2 diabetes mellitus (T2DM) based on fasting plasma glucose and obesity defined by BMI and abdominal girth were compared across duration of psychotropic medication exposure. Multiple logistic regression models used hyperglycemia and obesity as dependent variables and age, sex, race/ethnicity, and years on psychotropics as independent variables. RESULTS: Psychotropic-naïve patients, including both schizophrenia and non-psychotic subgroups, showed an elevated prevalence of hyperglycemia meeting criteria for T2DM and a decreased prevalence of obesity compared to the general population. Obesity rates significantly increased for those on psychotropic medications more than 5 years, particularly for patients without psychosis (BMI: aOR = 5.23 CI = 1.44-19.07; abdominal girth: aOR = 6.40 CI = 1.98-20.69). Women had a significantly higher obesity rate than men (BMI: aOR = 1.63 CI = 1.17-2.28; abdominal girth: aOR = 3.86 CI = 2.75-5.44). Asians had twice the prevalence of hyperglycemia as whites (aOR = 2.29 CI = 1.43-3.67), despite having significantly less obesity (BMI: aOR = .39 CI = .20-.76; abdominal girth: aOR = .34 CI = .20-.60). Hispanics had a higher rate of obesity by BMI than whites (aOR = 1.91 CI = 1.22-2.99). CONCLUSIONS: This study showed disparities between obesity and T2DM in psychotropic-naïve patients with SMI, suggesting separate risk pathways for these two metabolic conditions.

9 Article Development of a 5As-based technology-assisted weight management intervention for veterans in primary care. 2018

Mateo, Katrina F / Berner, Natalie B / Ricci, Natalie L / Seekaew, Pich / Sikerwar, Sandeep / Tenner, Craig / Dognin, Joanna / Sherman, Scott E / Kalet, Adina / Jay, Melanie. ·VA NY Harbor Healthcare System, Manhattan Campus 423 East 23rd Street, New York, NY, 10010, USA. · New York University School of Medicine, 550 1st Avenue, New York, NY, 10016, USA. · VA NY Harbor Healthcare System, Manhattan Campus 423 East 23rd Street, New York, NY, 10010, USA. Melanie.Jay@nyumc.org. · New York University School of Medicine, 550 1st Avenue, New York, NY, 10016, USA. Melanie.Jay@nyumc.org. ·BMC Health Serv Res · Pubmed #29378584.

ABSTRACT: BACKGROUND: Obesity is a worldwide epidemic, and its prevalence is higher among Veterans in the United States. Based on our prior research, primary care teams at a Veterans Affairs (VA) hospital do not feel well-equipped to deliver effective weight management counseling and often lack sufficient time. Further, effective and intensive lifestyle-based weight management programs (e.g. VA MOVE! program) are underutilized despite implementation of systematic screening and referral at all VA sites. The 5As behavior change model (Assess, Advise, Agree, Assist, Arrange) is endorsed by the United States Preventive Service Task Force for use in counseling patients about weight management in primary care and reimbursed by Medicare. In this paper, we describe the iterative development of a technology-assisted intervention designed to provide primary care-based 5As counseling within Patient-Centered Medical Homes without overburdening providers/healthcare teams. METHODS: Thematic analyses of prior formative work (focus groups with patients [n = 54] and key informant interviews with staff [n = 25]) helped to create a technology-assisted, health coaching intervention called Goals for Eating and Moving (GEM). To further develop the intervention, we then conducted two rounds of testing with previous formative study participants (n = 5 for Round 1, n = 5 for Round 2). Each session included usability testing of prototypes of the online GEM tool, pilot testing of 5As counseling by a Health Coach, and a post-session open-ended interview. RESULTS: Three main themes emerged from usability data analyses: participants' emotional responses, tool language, and health literacy. Findings from both rounds of usability testing, pilot testing, as well as the open-ended interview data, were used to finalize protocols for the full intervention in the clinic setting to be conducted with Version 3 of the GEM tool. CONCLUSIONS: The use of qualitative research methods and user-centered design approaches enabled timely detection of salient issues to make iterative improvements to the intervention. Future studies will determine whether this intervention can increase enrollment in intensive weight management programs and promote clinically meaningful weight loss in both Veterans and in other patient populations and health systems.

10 Article Low-fat Dietary Pattern and Pancreatic Cancer Risk in the Women's Health Initiative Dietary Modification Randomized Controlled Trial. 2018

Jiao, Li / Chen, Liang / White, Donna L / Tinker, Lesley / Chlebowski, Rowan T / Van Horn, Linda V / Richardson, Peter / Lane, Dorothy / Sangi-Haghpeykar, Haleh / El-Serag, Hashem B. ·Department of Medicine, Department of Obstetrics and Gynecology, and Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, TX; Center for Innovations in Quality, Effectiveness and Safety (IQuESt), Michael E. DeBakey VA Medical Center, Houston, TX; Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA; Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Family, Population and Preventive Medicine, Stony Brook University School of Medicine, Stony Brook, NY; Texas Medical Center Digestive Disease Center, Houston, TX; Center for Translational Research on Inflammatory Diseases (CTRID), Michael E. DeBakey VA Medical Center, Houston, TX; City of Hope National Medical Center, Duarte, CA. ·J Natl Cancer Inst · Pubmed #28922784.

ABSTRACT: Background: Observational studies suggest that diet may influence pancreatic cancer risk. We investigated the effect of a low-fat dietary intervention on pancreatic cancer incidence. Methods: The Women's Health Initiative Dietary Modification (WHI-DM) trial is a randomized controlled trial conducted in 48 835 postmenopausal women age 50 to 79 years in the United States between 1993 and 1998. Women were randomly assigned to the intervention group (n = 19 541), with the goal of reducing total fat intake and increasing intake of vegetables, fruits, and grains, or to the usual diet comparison group (n = 29 294). The intervention concluded in March 2005. We evaluated the effect of the intervention on pancreatic cancer incidence with the follow-up through 2014 using the log-rank test and multivariable Cox proportional hazards regression model. All statistical tests were two-sided. Results: In intention-to-treat analyses including 46 200 women, 92 vs 165 pancreatic cancer cases were ascertained in the intervention vs the comparison group (P = .23). The multivariable hazard ratio (HR) of pancreatic cancer was 0.86 (95% confidence interval [CI] = 0.67 to 1.11). Risk was statistically significantly reduced among women with baseline body mass indexes (BMIs) of 25 kg/m2 or higher (HR = 0.71, 95% CI = 0.53 to 0.96), but not among women with BMIs of less than 25 kg/m2 (HR = 1.62, 95% CI = 0.97 to 2.71, Pinteraction = .01). Conclusions: A low-fat dietary intervention was associated with reduced pancreatic cancer incidence in women who were overweight or obese in the WHI-DM trial. Caution needs to be taken in interpreting the findings based on subgroup analyses.

11 Article Antibiotic-mediated gut microbiome perturbation accelerates development of type 1 diabetes in mice. 2016

Livanos, Alexandra E / Greiner, Thomas U / Vangay, Pajau / Pathmasiri, Wimal / Stewart, Delisha / McRitchie, Susan / Li, Huilin / Chung, Jennifer / Sohn, Jiho / Kim, Sara / Gao, Zhan / Barber, Cecily / Kim, Joanne / Ng, Sandy / Rogers, Arlin B / Sumner, Susan / Zhang, Xue-Song / Cadwell, Ken / Knights, Dan / Alekseyenko, Alexander / Bäckhed, Fredrik / Blaser, Martin J. ·Departments of Medicine and Microbiology, Human Microbiome Program, New York University Langone Medical Center, Medical Service, New York, New York 10016, USA. · Department of Molecular and Clinical Medicine, University of Gothenburg, 40530 Gothenburg, Sweden. · Biomedical Informatics and Computational Biology Program, University of Minnesota, Minneapolis, Minneapolis 55455, USA. · Systems and Translational Sciences, RTI International, Research Triangle Park, North Carolina 27709, USA. · Departments of Population Health, New York University Langone Medical Center, New York, New York 10016, USA. · Department of Biomedical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, Massachusetts 01536, USA. · Department of Microbiology, New York University Langone Medical Center, New York, New York 10016, USA. · Skirball Institute, New York University Langone Medical Center, New York, New York 10016, USA. · Computer Science and Engineering, University of Minnesota, Minneapolis, Minneapolis 55455, USA. · Biotechnology Institute, University of Minnesota, Saint Paul, Minneapolis 55108, USA. · CHIBI, New York University Langone Medical Center, New York, New York 10016, USA. · Novo Nordisk Foundation Center for Basic Metabolic Research, Section for Metabolic Receptology and Enteroendocrinology, Faculty of Health Sciences, University of Copenhagen, Copenhagen DK-2200, Denmark. · New York Harbor Veterans Affairs Medical Center, New York, New York 10010, USA. ·Nat Microbiol · Pubmed #27782139.

ABSTRACT: The early life microbiome plays important roles in host immunological and metabolic development. Because the incidence of type 1 diabetes (T1D) has been increasing substantially in recent decades, we hypothesized that early-life antibiotic use alters gut microbiota, which predisposes to disease. Using non-obese diabetic mice that are genetically susceptible to T1D, we examined the effects of exposure to either continuous low-dose antibiotics or pulsed therapeutic antibiotics (PAT) early in life, mimicking childhood exposures. We found that in mice receiving PAT, T1D incidence was significantly higher, and microbial community composition and structure differed compared with controls. In pre-diabetic male PAT mice, the intestinal lamina propria had lower Th17 and T

12 Article Adapting a weight management tool for Latina women: a usability study of the Veteran Health Administration's MOVE!23 tool. 2016

Perez, Hector R / Nick, Michael W / Mateo, Katrina F / Squires, Allison / Sherman, Scott E / Kalet, Adina / Jay, Melanie. ·Division of General Internal Medicine, Montefiore Medical Center, Bronx, NY, 10467, USA. · Program for Medical Education and Technology, NYU School of Medicine, New York, NY, 10016, USA. · Research, VA NY Harbor Healthcare System, 423 East 23rd Street, 15161N, New York, NY, 10010, USA. · Medicine, NYU School of Medicine, New York, NY, 10016, USA. · NYU College of Nursing, New York, NY, 10003, USA. · Population Health, NYU School of Medicine, New York, NY, 10016, USA. · Research, VA NY Harbor Healthcare System, 423 East 23rd Street, 15161N, New York, NY, 10010, USA. Melanie.Jay@nyumc.org. · Medicine, NYU School of Medicine, New York, NY, 10016, USA. Melanie.Jay@nyumc.org. · Population Health, NYU School of Medicine, New York, NY, 10016, USA. Melanie.Jay@nyumc.org. ·BMC Med Inform Decis Mak · Pubmed #27716279.

ABSTRACT: BACKGROUND: Obesity disproportionately affects Latina women, but few targeted, technology-assisted interventions that incorporate tailored health information exist for this population. The Veterans Health Administration (VHA) uses an online weight management tool (MOVE!23) which is publicly available, but was not designed for use in non-VHA populations. METHODS: We conducted a qualitative study to determine how interactions between the tool and other contextual elements impacted task performance when the target Latina users interacted with MOVE!23. We sought to identify and classify specific facilitators and barriers that might inform design changes to the tool and its context of use, and in turn promote usability. Six English-speaking, adult Latinas were recruited from an inner city primary care clinic and a nursing program at a local university in the United States to engage in a "Think-Aloud" protocol while using MOVE!23. Sessions were recorded, transcribed, and coded to identify interactions between four factors that contribute to usability (Tool, Task, User, Context). RESULTS: Five themes influencing usability were identified: Technical Ability and Technology Preferences; Language Confusion and Ambiguity; Supportive Tool Design and Facilitator Guidance; Relevant Examples; and Personal Experience. Features of the tool, task, and other contextual factors failed to fully support participants at times, impeding task completion. Participants interacted with the tool more readily when its language was familiar and content was personally relevant. When faced with ambiguity and uncertainty, they relied on the tool's visual cues and examples, actively sought relevant personal experiences, and/or requested facilitator support. CONCLUSIONS: The ability of our participants to successfully use the tool was influenced by the interaction of individual characteristics with those of the tool and other contextual factors. We identified both tool-specific and context-related changes that could overcome barriers to the use of MOVE!23 among Latinas. Several general considerations for the design of eHealth tools are noted.

13 Article Prevalence and Predictors of Obesity-Related Counseling Provided by Outpatient Psychiatrists in the United States. 2016

Rogers, Erin S / Sherman, Scott E / Malaspina, Dolores / Jay, Melanie. ·Dr. Rogers is with the Division of Research and Dr. Sherman and Dr. Jay are with the Department of Medicine, all at the Veterans Affairs New York Harbor Healthcare System, New York City (e-mail: erin.rogers2@va.gov ). Dr. Rogers and Dr. Sherman are also with the Department of Population Health, New York University, where Dr. Jay is with the Department of Medicine and Dr. Malaspina is with the Department of Psychiatry. ·Psychiatr Serv · Pubmed #27364811.

ABSTRACT: OBJECTIVE: This study sought to identify rates and predictors of obesity counseling performed by outpatient psychiatrists in the United States. METHODS: The 2005-2010 National Ambulatory Medical Care Surveys provided data from 7,309 outpatient psychiatry visits. Logistic regression was used to examine associations between patient, visit, and practice characteristics and outcomes. RESULTS: Most (81%) visits occurred in a private practice setting. Nine percent (N=657) of visits included measurement of patient body mass index (BMI); 30% of these visits were with patients who met the obesity criterion (BMI ≥30.0 kg/m CONCLUSIONS: There is a significant need to improve psychiatrists' obesity counseling.

14 Article High-fat diet-dependent modulation of the delayed rectifier K(+) current in adult guinea pig atrial myocytes. 2016

Aromolaran, Ademuyiwa S / Colecraft, Henry M / Boutjdir, Mohamed. ·Department of Physiology & Cellular Biophysics, Columbia University, New York, NY, United States. · Cardiovascular Research Program, VA New York Harbor Healthcare System, United States; Department of Medicine, State University of New York Downstate Medical Center, Brooklyn, New York, NY, United States; Department of Cell Biology, State University of New York Downstate Medical Center, Brooklyn, New York, NY, United States; Department of Pharmacology, State University of New York Downstate Medical Center, Brooklyn, New York, NY, United States; Department of Medicine, New York University School of Medicine, New York, NY, United States. Electronic address: mohamed.boutjdir@va.gov. ·Biochem Biophys Res Commun · Pubmed #27130822.

ABSTRACT: Obesity is associated with hyperlipidemia, electrical remodeling of the heart, and increased risk of supraventricular arrhythmias in both male and female patients. The delayed rectifier K(+) current (IK), is an important regulator of atrial repolarization. There is a paucity of studies on the functional role of IK in response to obesity. Here, we assessed the obesity-mediated functional modulation of IK in low-fat diet (LFD), and high-fat diet (HFD) fed adult guinea pigs. Guinea pigs were randomly divided into control and obese groups fed, ad libitum, with a LFD (10 kcal% fat) or a HFD (45 kcal% fat) respectively. Action potential duration (APD), and IK were studied in atrial myocytes and IKr and IKs in HEK293 cells using whole-cell patch clamp electrophysiology. HFD guinea pigs displayed a significant increase in body weight, total cholesterol and total triglycerides within 50 days. Atrial APD at 30% (APD30) and 90% (APD90) repolarization were shorter, while atrial IK density was significantly increased in HFD guinea pigs. Exposure to palmitic acid (PA) increased heterologously expressed IKr and IKs densities, while oleic acid (OA), severely reduced IKr and had no effect on IKs. The data are first to show that in obese guinea pigs abbreviated APD is due to increased IK density likely through elevations of PA. Our findings may have crucial implications for targeted treatment options for obesity-related arrhythmias.

15 Article Altering the intestinal microbiota during a critical developmental window has lasting metabolic consequences. 2014

Cox, Laura M / Yamanishi, Shingo / Sohn, Jiho / Alekseyenko, Alexander V / Leung, Jacqueline M / Cho, Ilseung / Kim, Sungheon G / Li, Huilin / Gao, Zhan / Mahana, Douglas / Zárate Rodriguez, Jorge G / Rogers, Arlin B / Robine, Nicolas / Loke, P'ng / Blaser, Martin J. ·Department of Microbiology, NYU Langone Medical Center, New York, NY 10016, USA; Department of Medicine, NYU Langone Medical Center, New York, NY 10016, USA. · Department of Medicine, NYU Langone Medical Center, New York, NY 10016, USA. · Department of Medicine, NYU Langone Medical Center, New York, NY 10016, USA; Center for Health Informatics and Bioinformatics, NYU Langone Medical Center, New York, NY 10016, USA. · Department of Microbiology, NYU Langone Medical Center, New York, NY 10016, USA. · Department of Radiology, NYU Langone Medical Center, New York, NY 10016, USA. · Departments of Population Health (Biostatistics) and Environmental Medicine, NYU Langone Medical Center, New York, NY 10016, USA. · Department of Biology, NYU Abu Dhabi, Abu Dhabi, United Arab Emirates. · Department of Biomedical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, MA 01536, USA. · New York Genome Center, New York, NY 10013, USA. · Department of Microbiology, NYU Langone Medical Center, New York, NY 10016, USA; Department of Medicine, NYU Langone Medical Center, New York, NY 10016, USA; New York Harbor Department of Veterans Affairs Medical Center, New York, NY 10010, USA. Electronic address: martin.blaser@nyumc.org. ·Cell · Pubmed #25126780.

ABSTRACT: Acquisition of the intestinal microbiota begins at birth, and a stable microbial community develops from a succession of key organisms. Disruption of the microbiota during maturation by low-dose antibiotic exposure can alter host metabolism and adiposity. We now show that low-dose penicillin (LDP), delivered from birth, induces metabolic alterations and affects ileal expression of genes involved in immunity. LDP that is limited to early life transiently perturbs the microbiota, which is sufficient to induce sustained effects on body composition, indicating that microbiota interactions in infancy may be critical determinants of long-term host metabolic effects. In addition, LDP enhances the effect of high-fat diet induced obesity. The growth promotion phenotype is transferrable to germ-free hosts by LDP-selected microbiota, showing that the altered microbiota, not antibiotics per se, play a causal role. These studies characterize important variables in early-life microbe-host metabolic interaction and identify several taxa consistently linked with metabolic alterations. PAPERCLIP:

16 Article Safety of hepatic resections in obese veterans. 2012

Saunders, John K / Rosman, Alan S / Neihaus, Dena / Gouge, Thomas H / Melis, Marcovalerio. ·Department of Surgery, New York Harbor Healthcare System Veterans Affairs Medical Center, New York University School of Medicine, 423 E 23rd St, New York, NY 10010, USA. ·Arch Surg · Pubmed #22184133.

ABSTRACT: OBJECTIVE: To determine the effects of body mass index (BMI; calculated as weight in kilograms divided by height in meters squared) on outcomes after liver resection performed at Veterans Affairs medical centers. DESIGN, SETTING, AND PATIENTS: We queried the Veterans Affairs Surgical Quality Improvement Program database for liver resections (2005-2008) and grouped the patients into 5 BMI categories: normal weight (BMI 18.5-24.9), overweight (BMI 25.0-29.9), obese class 1 (BMI 30.0-34.9), obese class 2 (BMI 35.0-39.9), and obese class 3 (BMI ≥ 40.0). Differences in risk factors and perioperative complications across groups were analyzed in univariate and multivariate analyses. RESULTS: Of 403 patients who underwent hepatectomy, 106 (26%) were normal weight, 161 (40%) were overweight, 94 (23%) were obese class 1, 31 (8%) were obese class 2, and 11 (3%) were obese class 3. Among these groups, higher BMI was associated with increased rates of hypertension (52%, 61%, 77%, 77%, and 73%, respectively; P = .002) and diabetes (18%, 27%, 36%, 39%, and 45%, respectively; P = .04) and lower incidence of smokers (53%, 35%, 30%, 16%, and 9%, respectively; P < .001). The BMI groups were similar in demographic characteristics and metrics correlating with preexisting liver disease. There were no differences across BMI groups in overall and specific morbidity or in length of stay. Compared with the other groups, obese class 3 patients received more blood transfusions (mean [SD], 4.3 [2.7] in obese class 3 patients vs 1.1 [0.2] in normal-weight patients; P = .02) and had a higher 30-day mortality (27% in obese class 3 patients vs 6% in normal-weight patients; P = .05). Multivariate analyses confirmed obese class 3 as an independent predictor of postoperative mortality. CONCLUSIONS: Obesity did not increase postoperative complications after liver resection in veterans. After adjusting for other clinical factors, extreme obesity (BMI ≥ 40.0) was an independent risk factor for increased mortality.