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The impact of gastrectomy on diabetes and related conditions, coronary heart disease, stroke, cancer, and survival
Descriptive
TitleInfo
Title
The impact of gastrectomy on diabetes and related conditions, coronary heart disease, stroke, cancer, and survival
SubTitle
follow-up from the Honolulu heart program
Name
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Gendrano
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Isaias Noel
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1972-
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Isaias Noel Gendrano III
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author
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III
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RHOADS
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GEORGE
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GEORGE RHOADS
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Advisory Committee
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chair
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Llanos-Wilson
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Adana
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Adana Llanos-Wilson
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Advisory Committee
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internal member
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(type = personal)
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(type = family)
August
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(type = given)
David
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David August
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Advisory Committee
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(authority = RULIB)
internal member
Name
(type = personal)
NamePart
(type = family)
Masaki
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(type = given)
Kamal
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Kamal Masaki
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Advisory Committee
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(authority = RULIB)
outside member
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Rutgers University
Role
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(authority = RULIB)
degree grantor
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Graduate School - New Brunswick
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school
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Text
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theses
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2017
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2017-05
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2017
Place
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xx
Language
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eng
Abstract
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Rationale for the study Gastric surgery is coming into widespread use to treat obesity, but the effects of these operations for health in old age are not known. Here we examine the long term effects of partial gastrectomy which was used in the 20th century to treat peptic ulcers and shares features with some of today’s bariatric (weight loss) operations. We compare long-term outcomes in 347 men with a partial gastrectomy who were subjects in a prospective study of 8006 American Japanese men in Honolulu with their non-operated peers. Methods Subjects were age 45-68 at the baseline examination in 1965-68 and survivors were assessed for diabetes and insulin resistance 25 years later. Incidence of heart attacks and strokes was ascertained from hospital records and incidence of cancer was obtained from the Hawaii Tumor Registry. Mortality data were collected by the state health department. Results Mean weight for the men with a prior gastrectomy was 11 pounds less than for their peers, a difference that persisted throughout. A substantially larger proportion of the gastrectomy group smoked cigarettes. At enrollment, the gastrectomy men had lower serum cholesterol, triglycerides, glucose and blood pressure than the other men. These differences also persisted except for blood pressure which increased more over time in the gastrectomy men than in the others. At the 25 year exam, systolic blood pressure was significantly higher in the gastrectomy men. The gastrectomy men had a 50% lower incidence of diabetes and significantly less insulin resistance than their peers. There was no difference in the occurrence of coronary disease, but stroke incidence and mortality were both higher in the gastrectomy group. Mortality from smoking related causes (lung cancer and emphysema) were also increased. Stomach cancer was decreased by more than half after controlling for confounders. Conclusion The protection against diabetes is consistent with other reports and appears long-lasting and robust. “Remnant” stomach cancers that have been reported after gastrectomy were not found. The increase in blood pressure and stroke is worrisome and suggests the need for evaluation of this potential problem following the several bariatric surgical procedures now in widespread use.
Subject
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Topic
Public Health
Subject
(authority = ETD-LCSH)
Topic
Gastrectomy
Subject
(authority = ETD-LCSH)
Topic
Coronary heart disease--Research--Hawaii
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Rutgers University Electronic Theses and Dissertations
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ETD_8012
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electronic resource
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text/xml
Extent
1 online resource (xiii, 158 p. : ill.)
Note
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Ph.D.
Note
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Includes bibliographical references
Note
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by Isaias Noel Gendrano III
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TitleInfo
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Graduate School - New Brunswick Electronic Theses and Dissertations
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rucore19991600001
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NjNbRU
Identifier
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doi:10.7282/T36Q213Q
Genre
(authority = ExL-Esploro)
ETD doctoral
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Rights
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The author owns the copyright to this work.
RightsHolder
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Name
FamilyName
Gendrano
GivenName
Isaias
MiddleName
Noel
Role
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Permission or license
DateTime
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2017-04-13 15:47:19
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Name
Isaias Gendrano
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Affiliation
Rutgers University. Graduate School - New Brunswick
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Author Agreement License
Detail
I hereby grant to the Rutgers University Libraries and to my school the non-exclusive right to archive, reproduce and distribute my thesis or dissertation, in whole or in part, and/or my abstract, in whole or in part, in and from an electronic format, subject to the release date subsequently stipulated in this submittal form and approved by my school. I represent and stipulate that the thesis or dissertation and its abstract are my original work, that they do not infringe or violate any rights of others, and that I make these grants as the sole owner of the rights to my thesis or dissertation and its abstract. I represent that I have obtained written permissions, when necessary, from the owner(s) of each third party copyrighted matter to be included in my thesis or dissertation and will supply copies of such upon request by my school. I acknowledge that RU ETD and my school will not distribute my thesis or dissertation or its abstract if, in their reasonable judgment, they believe all such rights have not been secured. I acknowledge that I retain ownership rights to the copyright of my work. I also retain the right to use all or part of this thesis or dissertation in future works, such as articles or books.
RightsEvent
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2017-05-31
DateTime
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2019-05-31
Type
Embargo
Detail
Access to this PDF has been restricted at the author's request. It will be publicly available after May 31st, 2019.
Copyright
Status
Copyright protected
Availability
Status
Open
Reason
Permission or license
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