Medicine and Health Sciences Commons^™

Weight Stability In Adults With Obesity Initiating Medical Marijuana Treatment For Other Medical Conditions, Michelle R. Lent, Meghan Visek, Paulina Syracuse, Karen L Dugosh, David Festinger

PCOM Scholarly Papers

Few studies have evaluated weight change in patients who initiate medical marijuana treatment to address diagnosed health concerns. The objective of this study was to examine whether patients initiating medical marijuana use for a qualifying health condition experienced changes in health and biopsychosocial functioning over time, including weight gain or loss. Specifically, this observational, longitudinal study evaluated changes in the body mass index (BMI) of adults with co-morbid obesity (body mass index [BMI] ≥ 30 kg/m²) and severe obesity (BMI ≥ 40 kg/m2) who were starting medical marijuana treatment for any of the 23 qualifying medical conditions at …

Is Phentermine/Topiramate Er With Lifestyle Modifications Effective In Achieving Weight Loss In Obese Patients With Comorbidities?, Elizabeth A. Stubbs

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not “Is phentermine/topiramate ER with lifestyle modifications effective in achieving weight loss in obese patients with comorbidities?”

Study Design: A systematic review of three placebo-controlled randomized controlled trials (RCTs) published in English in 2012 or after.

Data Sources: All three studies were found by searching PubMed and were published in peer-reviewed journals. The articles were selected based on ability to answer the proposed question.

Outcome Measured: Percent weight loss was the outcome measured in all three studies. This was measured based on mean percent weight loss from …

Do Adult Obese Patients Who Undergo Sleeve Gastrectomy Have A Greater Increase In Quality Of Life Compared To Those Who Undergo Gastric Bypass?, Jenna Loeser

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not obese patients have a better quality of life after undergoing gastric bypass rather than sleeve gastrectomy.

STUDY DESIGN: A review of 3 randomized controlled trials (RCT) that were published after 2014.

DATA SOURCES: The 3 peer-reviewed randomized controlled trials were found through PubMed. All studies were published in English.

OUTCOMES MEASURED: The outcome measured in these RCTs was overall change in quality of life after sleeve gastrectomy and gastric bypass. This was done by patients responding to questionnaires. Two articles Ignat et al. and Peterli et …

Obesity And Its Effect On Outcomes In Same-Day Bilateral Total Knee Arthroplasty, Ethan A Remily, Nequesha S Mohamed, Wayne A Wilkie, Tyler Smith, Anthony Judice, Salvador Forte, James Nace, Ronald E Delanois

Orthopedic Surgery Resident Research

Background: The niche surgery of same-day bilateral total knee arthroplasty (sd-BTKA) continues to create debate amongst specialists in arthroplasty. To date, there is a significant lack of literature on obese patients undergoing sd-BTKA, and no study has evaluated outcomes of this procedure when compared to non-obese patients. Therefore, this study will perform a retrospective analysis to compare (I) incidence, (II) demographics, and (III) complications of sd-BTKA in non-obese, obese, and morbidly obese patients in the United States from 2009 to 2016.

Methods: The National Inpatient Sample (NIS) database was queried for all individuals that underwent sd-BTKA from 2009 to 2016. …

Guggulsterone Activates Adipocyte Beiging Through Direct Effects On 3t3-L1 Adipocytes And Indirect Effects Mediated Through Raw264.7 Macrophages., Colette N Miller, Janaiya S Samuels, Yusra Azhar, Ashish Parmar, Rangaiah Shashidharamurthy, Srujana Rayalam

PCOM Scholarly Papers

Background: Plant-derived phytochemicals have been of emerging interest as anti-obesity compounds due to their apparent effects on promoting reduced lipid accumulation in adipocytes. Despite such promising evidence, little is known about the potential mechanisms behind their anti-obesity effects. The aim of this study is to establish potential anti-obesity effects of the phytochemical guggulsterone (GS). Methods: Mature 3T3-L1 adipocytes were treated with GS, derived from the guggul plant native in northern India, to investigate its effects on mitochondrial biogenesis and adipocyte "beiging." Further, to explore the relationship between macrophages and adipocytes, 3T3-L1s were treated with conditioned media from GS-treated RAW264.7 macrophages. …

Cytoprotective Effects Of Natural Compounds Against Oxidative Stress, Jay Mehta, Srujana Rayalam, Xinyu Wang

PCOM Scholarly Papers

Oxidative stress, an imbalance between reactive oxygen species and antioxidants, has been witnessed in pathophysiological states of many disorders. Compounds identified from natural sources have long been recognized to ameliorate oxidative stress due to their inherent antioxidant activities. Here, we summarize the cytoprotective effects and mechanisms of natural or naturally derived synthetic compounds against oxidative stress. These compounds include: caffeic acid phenethyl ester (CAPE) found in honey bee propolis, curcumin from turmeric roots, resveratrol abundant in grape, and 1-[2-cyano-3,12-dioxooleana-1,9(11)-dien-28-oyl] imidazole (CDDO-Im), a synthetic triterpenoid based on naturally occurring oleanolic acid. Cytoprotective effects of these compounds in diseases conditions like cardiovascular …

Novel Anti-Obesity Effects Of Beer Hops Compound Xanthohumol: Role Of Ampk Signaling Pathway, Janaiya S Samuels, Rangaiah Shashidharamurthy, Srujana Rayalam

PCOM Scholarly Papers

Background: Obesity alters adipose tissue metabolic and endocrine functioning, leading to an increased adiposity and release of pro-inflammatory cytokines. Various phytochemicals have been reported to contribute to the beiging of white adipose tissue in order to ameliorate obesity by increasing thermogenesis. Here, we show that the prenylated chalcone, xanthohumol (XN), induces beiging of white adipocytes, stimulates lipolysis, and inhibits adipogenesis of murine 3T3-L1 adipocytes and primary human subcutaneous preadipocytes and these effects are partly mediated by the activation of the AMP-activated protein kinase (AMPK) signaling pathway.

Methods: 3T3-L1 adipocytes and primary human subcutaneous preadipocytes were differentiated using a standard protocol …

Is Weight Loss An Effective Treatment Of Pain Symptoms Related To Knee Joint Osteoarthritis In Obese Adults?, Samantha Sokol

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not weight loss is an effective treatment of pain symptoms related to knee joint osteoarthritis in obese adults.

Study Design: Systematic review of 2 randomized-controlled trials and 1 cohort study. All three articles were published in English between 2011-2015.

Data Sources: Two randomized, un-blinded, controlled studies and one cohort found using Pubmed.

Outcomes Measured: Each study evaluated change in pain symptoms related to knee osteoarthritis in obese adults as compared to weight loss.

Results: Studies showed that weight loss lead to a …

Novel Anti-Obesity Effects Of Beer Hops Compound Xanthohumol: Role Of Ampk Signaling Pathway, Janaiya S Samuels

PCOM Biomedical Studies Student Scholarship

Obesity, a chronic disease, is a global epidemic that affects millions of lives and increases the risk of several comorbidities such as Type 2 diabetes, musculoskeletal disorders, cardiovascular disease, and cancer. Obesity is the leading cause of death globally, and is associated with an excessive accumulation of white adipose tissue (WAT). Although obesity is a serious condition, safe, long-term drug therapies are limited. A second type of adipose tissue is known as brown adipose tissue (BAT), which functions as an energy dissipater in the form of heat, as opposed to energy storing WAT. Previous research has shown that the mitochondrial …

Magnetic Drug Delivery Of Xanthohumol To Adipocytes Using Ultrasmall Superparamagnetic Iron Oxide Nanoparticles., Irandokht Khaki Najafabadi, Janaiya Samuels, Royce Dansby-Sparks, Srujana Rayalam, Vicky Mody

Research Day

According to the CDC’s National Center for Health Statistics, more than one-third (36.5%) of U.S adults are obese. It is the main risk factor for type-2-diabetes, hypertension, dyslipidemia and atherosclerosis. Nutraceuticals such as Xanthohumol have shown potential to inhibit adipogeneis, however, their bioavailability has remained controversial. Hence there is a need to develop targeted therapy which will increase the concentration of Xanthohumol on adipose tissues. Currently, magnetic drug delivery has been used to develop targeted therapies where conventional therapies have proven to be less effective. Among various types of nanoparticles ultrasmall superparamagnetic iron oxide nanoparticles (USPIO) have found considerable attention …

Are Soy-Based Proteins, Meals, And Diets An Effective Treatment In Reducing Waist Circumference In Overweight And Obese Adults Ages 20-75 Years?, Lisa Lin

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this evidence based medicine review is to determine whether or not soy-based proteins, meals, and diets are effective treatments in reducing waist circumference in overweight and obese adults ages 20-75 years.

Study design: Review of three published, randomized controlled trials (RCTs) published in 2003, 2007, and 2011. All English language.

Data Source: The three randomized controlled trials that used in this review were found using PubMed.

Outcomes measured: The outcomes measured were improvement of patient’s overweight and obesity status and their overall quality of life through the indication of reduced waist circumference. …

Are New Sodium Targets In The National School Lunch Program Feasible And Are They Necessary?, Yaneve Shemesh

PCOM Biomedical Studies Student Scholarship

In many societies, high salt intake is a continuing issue in adults, and is of growing concern in children due to the prevalence of processed foods. In response, the USDA has set three targets for sodium in meals offered in the National School Lunch Program (NSLP), and the National School Breakfast Program (NSBP). This 8-year goal is meant to decrease overall sodium levels in both meal programs. However, many associated with school nutrition ask if there is significant evidence to show what effect sodium plays on children’s health, and thus determine if these targets are necessary or achievable. In addressing …

Phytochemicals Added To The Feed Of Ovariectomized Adult Rats Increase Brown Adipose Activity, Colette N. Miller, Suresh Ambati, Erica Bass, Natalie Hohos, Diane Hartzel, Emily England, Mary Anne Della-Fera, Srujana Rayalam, Clifton A. Baile

Research Day

Background: Brown adipose tissue (BAT) uncouples respiration, using lipids as an energy source while dissipating heat. Increases in BAT activity are protective against obesity, thus compounds that increase BAT activation may help prevent weight gain. Resveratrol (R) increases BAT activity by upregulating thermogenic genes. As phytochemicals have synergistic properties, our research strategy has included investigation of the efficacy of relatively low concentrations of phytochemical blends on BAT activation. Methods: Previously, we showed that R combined with genistein (G) and quercetin (Q) reduced weight gain in aged ovariectomized (OVX) female rats. In the current study, OVX rats were fed diets containing …

Is Laparoscopic Gastric Banding An Effective Treatment For Obesity In Adolescents And Adults As Measured By Physical Function?, Shawna Mccormick

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not “Is laparoscopic gastric banding an effective treatment for obesity in adolescents and adults as measured by physical functioning?”

STUDY DESIGN: Review of all English language primary studies from 2009, 2010, and 2011.

DATA SOURCES: Two randomized control trials and one cohort study were found using PubMed, Medline, and OVID.

OUTCOMES MEASURED: There were multiple outcomes measured in the studies but the outcome of concern is quality of life post-operatively, specifically, physical functioning as measured by surveys including SF-36, Moorehead-Ardelt, BAROS, and CHQ CF-50. …

Does The Use Of Ginger Extract Effectively Help Patient With Obesity Loses Weight?, Linh H. Nguyen

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not ginger extract (NT) effectively helps obese patient loses weight.

Study Design: Two randomized controlled studies to determine the effectiveness of ginger extract in weight loss and a cross sectional observational study.

Data Sources: Randomized controlled studies published after 2006 relating to ginger extract (NT) and weight loss. Data obtained using PubMed, CINAHL, and OVID databases written in English.

Outcomes Measured: Studies measured weight loss, food intake, and safety such as pulses and blood pressure. Subjects are evaluated at baseline with CMP, CBC and urinalysis weekly.

Results: …

Does The Use Of An Oral Lipase Inhibitor (Orlistat) Increase Appetite?, Sandra Boyd

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: To determine whether or not Orlistat ingested prior to a meal causes an increased appetite response.

STUDY DESIGN: A Review of three randomized controlled trials studies from 2003-2008 that were in the English language.

DATA RESOURCES: Randomized controlled trials comparing the effect of Orlistat on satiety were found using PubMed, OVID, and Cochrane databases.

OUTOMES MEASURED: Outcomes measured in the studies were: sensation of appetite, hunger, fullness, nausea, bloating, heartburn, belching, epigastric burning, and prospective food consumption. Each study measured individual patient responses using a VAS (visual analogue scale). Demarchi et al (2004) used a gastric barostat to measure …

Is White Bean Extract A Safe And Effective Treatment For Weight Loss?, Jamie Berkowitz

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this systematic review is to determine whether or not white bean extract is a safe and effective treatment for weight loss.

Is Growth Hormone An Effective Adjunct To Standard Treatment Regimens For Promoting Fat Mass Loss And Retention Of Lean Body Mass In The Treatment Of Obesity?, J. Caleb Henson

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this systematic review is to determine whether growth hormone is an effective adjunct in the treatment of obesity for promoting fat loss while retaining lean body mass.

Does Caffeine Consumption Effect Exercise Performance In Healthy Adults?, Meaghan E. Jones

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this systematic review is to determine whether or not caffeine ingestion prior to exercise effects exercise performance in healthy adults.

Is Liraglutide Safe And Effective As A Monotherapy For The Treatment Of Obesity In Type 2 Diabetics And Healthy Individuals?, Erica Sheeran

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this systematic review is to determine whether or not liraglutide is safe and effective as a monotherapy for the treatment of obesity in type 2 diabetics and healthy individuals.

Pramlintide In The Management Of Obesity, Melissa C. Jones, Heather F. Debellis, Kimberly L. Barefield

PCOM Scholarly Papers

Obesity is a common problem that can lead to numerous comorbid conditions, including Type 2 diabetes. Currently, there are few pharmacologic options available to help obese patients lose weight. Pramlintide is an injectable, amylin analogue that is indicated in patients with Type 1 and Type 2 diabetes for use in conjunction with insulin to improve glycemic control. In addition to helping patients decrease hemoglobin A1c levels, pramlintide has also been shown to minimize weight gain, especially in patients with Type 2 diabetes. Studies have been conducted in various patient types, including those patients without diabetes, and the drug tends to …