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Use of bariatric surgery has increased dramatically in the USA. However, there are growing concerns regarding the safety outcomes of different bariatric procedures. We aim to compare the safety of sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB), which includes hospital readmissions, emergency room (ER) visits, gastrointestinal bleeding, and revisional surgery.A retrospective cohort analysis was conducted for adults (≥ 18 years) who received SG and RYGB in the USA. We used Truven MarketScan Commercial and Medicare supplemental claims databases from January 1, 2005, to October 1, 2015. To adjust for baseline demographic and clinical characteristics, we used stabilized inverse probability of treatment weighting using propensity score. Cox proportional hazard models was used to compare safety outcomes between SG and RYGB after bariatric surgery.A total of 194,248 patients met inclusion criteria; 79,813 patients (41%) received SG and 114,435 patients (59%) received RYGB. The use of SG was associated with a significantly lower 30-day hospital readmission rate [adjusted hazard ratios (aHRs) 0.77; 95% confidence interval (CI), 0.74-0.81] and ER visits [aHR, 0.82; 95% CI, 0.80-0.83], and decreased risk of gastrointestinal bleeding [aHR, 0.87; 95% CI, 0.78-0.98] compared to RYGB. However, SG was associated with an increased risk of revisional surgery, compared to RYGB [aHR,1.21; 95% CI, 1.08-1.35].Among patients receiving bariatric surgery in a real-world setting, SG was associated with lower complication rate but a higher risk of revisional surgery compared to RYGB. Further longitudinal studies are needed to assess long-term findings.

Despite the increase in the number of bariatric surgeries performed, little is known about the impact of the surgery on drug absorption. Unpredictability is assumed with drugs, given the anatomical changes after surgery.To evaluate the impact of bariatric surgery on drug absorption based on the type of procedure performed.We conducted a comprehensive literature review searching PubMed/Medline for published studies (from inception to December 2017) that evaluate the use of drugs and the assessment of drug absorption after bariatric surgery. Pharmacokinetic/pharmacodynamic studies, case reports, and observational studies were included in our review.We found 60 studies addressing drug use after bariatric surgery. Twenty-eight studies reported a decrease in drug absorption after bariatric surgery while only four studies showed an increase in drug absorption. Unchanged absorption of drugs was seen in 23 studies after the surgery.The available information shows variations in drug absorption after bariatric surgery. The unpredictability may result from factors related to the patient, drug, and/or type of surgery. Therefore, pharmacists' involvement and close monitoring of patients after bariatric surgery could be effective to avoid sub-/supratherapeutic responses.

Background: Prior studies show conflicting information regarding the association of reproductive year duration with cardiovascular diseases (CVD) in older women. The aim of this study is to determine whether a longer duration of reproductive years in women in the US population is associated with a lower risk of CVDs. Methods: Females ≥ 60 years who participated in the National Health and Nutrition Examination Survey from 2007-2012 were included. Subjects provided information about the age of both menarche and menopause as well as the presence/absence of CVD. Based on the reproductive year duration, participants were categorized into either a longer duration group (> 30 years) or shorter duration group (≤ 30 years). Subgroup analysis for each 5-year increment in the longer reproductive duration group was conducted. Generalized linear model was used in the analysis and relative risk (RR) regression was performed. Sensitivity analysis was performed excluding events after 55 years. Results: 3,081 patients were included in the analysis. A longer duration of reproductive years was associated with a lower risk of CVD, compared to a shorter duration (RR 0.71, 95% CI (confidence interval) 0.56-0.83, p= 0.002). The reproductive durations ranging from 35-40 and 41-45 years were associated with lower risk of CVDs (RR 0.66, 95% CI 0.51-0.68, p=0.002, and RR 0.73, 95% CI 0.54-0.79, p=0.03, respectively); however; those ranging in age from 30-35 and over 45 years were not associated with lower risk of CVD (RR 0.77, 95% CI 0.57-1.40, p=0.10, and RR 0.79, 95% CI 0.37-1.69, p=0.54, respectively). Sensitivity analysis excluding the events after 55 years yielded similar estimates (RR 0.66, 95% CI 0.44-0.99, p=0.04). Conclusion: Longer duration of reproductive years was associated with lower risk of CVDs in older women. This effect was more evident in older women who had duration of reproductive years ranging from 35-45 years.