Bariatric Times Welcomes Dr. Christopher Still, Obesity Medicine Expert, as Co-Clinical Editor

| January 1, 2015

A Message from Dr. Raul J. Rosenthal

Raul J. Rosenthal, MD, FACS, FASMBS, Clinical Editor, Bariatric Times; Chief of Staff, Professor of Surgery and Chairman, Department of General Surgery; Director of Minimally Invasive Surgery and The Bariatric and Metabolic Institute; General Surgery Residency Program Director; and Director, Fellowship in MIS and Bariatric Surgery, Cleveland Clinic Florida, Weston, Florida


Dear Friends and Colleagues:
Welcome to the first issue of 2015. First, we are excited to welcome Dr. Christopher Still as our co-clinical editor. We are thrilled and honored that Chris accepted to join the leadership of our magazine. Chris’s extensive experience as an obesity medicine specialist will give our publication a more balanced and wider perspective by looking into nonsurgical approaches to potential treatment modalities of the obesity disease.

This month, we present a review titled, “Intensive Care Management, Sepsis, and Systemic Inflammatory Response Syndrome in the Bariatric Patient.” I thank Drs. Bindal and Sudan for an excellent overview on the most important aspects to keep in mind when handling the critically ill bariatric patient. In our experience with over 6,000 bariatric operations at Cleveland Clinic Florida, Weston, Florida, we are most concerned with respiratory arrest in the perioperative period mainly due to nondiagnosed and nontreated severe sleep apnea and, in many cases the so-called “negative pressure pulmonary edema.” Look for this condition in the young, muscular male patient. Patients with negative pressure pulmonary edema become hypercarbic and difficult to extubate. In addition, these patients show some features of renal failure and an alarming chest radiograph with diffuse bilateral infiltrates. It looks like bad aspiration pneumonia. The good news is that patients with negative pressure pulmonary edema all improve dramatically and fully recover after 24 to 48 hours of being kept on a ventilator.

In this month’s installment of The Medical Student Notebook, edited by Dr. Daniel Jones, author Wendy Liu reviews the gut microbiome in patients with obesity and reminds us of the potential for medical interventions. Dr. Randy J. Seely’s research on changes in gut flora in patients undergoing sleeve gastrectomy strongly supports Ms. Liu’s review. Is it possible that different types of gut flora might stimulate our ghrelin cells and produce less or more appetite? It would be a relatively easy solution to treat obesity with antibiotics and change the flora in an attempt to create anorexia.

In this month’s Hot Topics in Integrated Health, edited by Ms. Christine Bauer, author Diane Weiman reminds us of the importance of physical activity and the detrimental effects of sedentary lifestyles. I remember a famous American surgeon who used to give the following advice for maintaining a healthy lifestyle: “Take good care of your patients, use the stairs, and always greet the janitor.” I loved this advice and follow it as I rarely use the elevators in my daily routine.

Lastly, I would like to invite all Florida bariatric centers, surgeons, integrated health professionals, and patients to take part in the 2/22 Pedometer Challenge, an initiative of the ASMBS Foundation and ASBS Florida State Chapter. The challenge, which will take place February 22, 2015, will be a virtual walk across the state of Florida. We hope to walk from Pensacola to Key West, a distance over 820 miles. To learn more about the event and how you can participate, visit http://www.asmbsfoundation.org/pedometer-challenge/.

2/22: 2 better health, 2 a better life, 2 fight obesity. We thank the ASMBS Foundation, ASMBS Florida State Chapter, and Covidien for supporting this initiative. We hope we can collect 1.7 million steps and use this program to advocate and raise awareness for the fight against obesity.

Sincerely,
Raul J. Rosenthal, MD, FACS

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