A Medical Device Daily

Obesity is seen as the latest public health epidemic, but weight loss is no easy feat for adults, who might be inclined to think it would be easier if they were younger. However, a recent study published in the Feb. 10 edition of the Journal of the American Medical Association hints that teens have a tough time making lifestyle adjustments to lose weight as well, and that one type of bariatric surgery may be more effective as an aid to weight loss.

The study, which was conducted in Melbourne, Australia, recruited 50 teens to test the efficacy of laparoscopic banding vs. lifestyle changes and featured the Lap-Band, made by Allergan (Irvine, California). The study was powered to check whether at least 60% of those in the study group could lose at least half their excess weight in two years versus 10% of the controls, who had to keep their calorie intake to between 800 and 2,000 kilocalories (kcal) per day, depending on age and weight status. The control group also had to engage in at least 30 minutes a day of exercise, with follow-up every six weeks for the 24-month duration.

The subjects enrolled for a Lap-Band were also required to conduct 30 minutes a day of exercise, but their eating habits were adjusted for meal size rather than for calorie count, and this group's meals had to be "eaten slowly . . . and chewed well."

The study group met and exceeded the target, with 21 of 25 losing at least half their excess weight for a rate of 84%. However, the authors state that the control group also exceeded the target of 10% who incurred a loss of at least half their excess weight (3 of 25, or 12%).

As handled for the purposes of the study, the gastric banding installation procedure required a stay of 23-32 hours, and these units averaged more than nine adjustments per patient over the 24-month course of the study. A dozen patients are said to have encountered a total of 13 adverse events, the most common of which were "proximal gastric enlargements" in six patients. Patients in the control arm experienced 18 events in 11 patients, including one patient who was admitted to the hospital eight times for "depression and intracranial hypertension."

The authors, a group that includes Paul O'Brien, MD, of the Centre for Obesity Research and Education (Melbourne, Australia), note that while the study was not powered to evaluate any changes in health associated with weight loss, the data nonetheless "demonstrate[d] reduction of the risk factors for cardiovascular disease and diabetes" inasmuch as measurements of insulin resistance and for metabolic syndrome normalized "for all gastric banding participants."

However, the article asserts that banding "is not a quick fix" inasmuch as it "requires long-term supportive follow-up," and they reiterate revisions were performed for 28% of the banding patients. The Lap-Band, they state, was chosen because it is "adjustable and reversible" and is "safer than Roux-en-Y gastric bypass surgery," the well-known gastric bypass procedure. The article also says that the outcomes of other studies provide "a reasonable expectation that the effect at two years will be durable."

HHS awards $1 billion for HIT

The Department of Health and Human Services reported last week that is preparing to award nearly $1 billion in awards from the American Recovery and Reinvestment Act to boost adoption of healthcare information technology and to train thousands of Americans to take jobs in the information technology industry.

The Feb. 12 statement, which includes remarks by Secretary of Labor Hilda Solis, says that the grants are intended to help make HIT available to more than 100,000 providers within four years and "train thousands of people for careers in healthcare and information technology." The statement observes that the awards are "expected to support tens of thousands of jobs ranging from nurses and pharmacy techs to IT technicians and trainers."

HHS will administer roughly $750 million of the sum, which will split into two categories of spending. Slightly more than half, $386 million, will be handed over to 40 states and qualified state designated entities "to facilitate health information exchange at the state level," and the remaining $375 million will be doled out to 32 non-profit organizations that will support the development of regional extension centers, whose mission it is to "aid health professionals as they work to implement and use health information technology." Additional awards for these two categories will be announced "in the near future," the statement notes.

HHS Secretary Kathleen Sebelius said in the statement that HIT "can make our healthcare system more efficient and improve the quality of care we all receive," adding that the awards "will help develop our electronic infrastructure and give doctors and other healthcare providers the support they need as they adopt this powerful technology."

The funding that will go through the Department of Labor, which is pegged at roughly $225 million, is aimed at training for 15,000 Americans for jobs in healthcare, information technology and "other high-growth fields." The statement indicates that "the recipients of these grants have already identified roughly 10,000 job openings for skilled workers that likely will become available in the next two years in areas like nursing, pharmacy technology and information technology."

The DoL grants will go to 55 training programs in 30 states, and Labor Secretary Solis said in the statement that the grants "will ensure thousands of workers across the nation can receive high-quality training and employment services, which will lead to good jobs in healthcare and other industries offering career-track employment and good pay and benefits."

NNI announces March nano meeting

The National Nanotechnology Initiative has announced a meeting titled "Risk Management Methods & Ethical, Legal, and Societal Implications of Nanotechnology." The meeting is set for March 30 and 31 in Rosslyn, Virginia.

The meeting will build upon the February 2008 document of the same name and is billed as the final meeting on environmental health and safety for nanoscale materials. For further information, see the National Nanotechnology Initiative web site at www.nano.gov.