Weight loss and health status 3 years after bariatric surgery in adolescentsSevere obesity in childhood may lead to serious health hazards. Bariatric surgery is increasingly considered for treatment of adolescents with severe obesity. This reports concerns a prospective study of the benefits and possible adverse effects of such treatments.Over 200 adolescents were enrolled. One hundred and sixty-one had gastric bypass surgery and 67 had sleeve gastrectomy. At 3-year follow-up, the mean weight of all patients had decreased by 27%. Remission of pre-diabetes occurred in 76% of those with this condition, and remission of type 2 diabetes occurred in 95% of those suffering from type 2 diabetes. There were similar benefits seen in those with hypertension, abnormal renal function and dyslipidaemia.Risks associated with surgery include micronutrient deficiencies and the need for abdominal procedures. Iron and vitamin B12 deficiency were noted. Vitamin D levels were found to be low in 42% of the subjects. Over the 3 years, 14% required further abdominal surgery and 15% required upper gastro-intestinal endoscopy. N Engl J Med 2016; 374:113-23 Maternal use of oral contraceptives and risk of birth defectsIs oral contraceptive use around the time of pregnancy onset associated with an increased risk of major birth defects? This proposition is examined in this prospective observational cohort study. Data on oral contraceptive use and major birth defects were collected among 880,694 live births from Danish registries between 1997 and 2011.The researchers compared the risk of birth defects in those who had never used oral contraceptives with mothers who had used them for longer than 3 months before conception, 3 months before conception, and after pregnancy onset. They found the incidence of major birth defects to be the same in each group a prevalence of 25 per 1,000 births.In summary, oral contraceptive exposure just before or during pregnancy does not appear to be associated with an increased risk of major birth defects. BMJ 2016;352:h6712 Sensitivity and specificity of mammography and adjunctive ultrasonography to screen for breast cancerMammography is the only proven method for breast cancer screening that reduces mortality, although it is inaccurate in young women or women with dense breasts.This report concerns a study involving the use of adjunctive ultrasonography which was conducted in Japan.Over 7,000 women were randomised to receive mammography or mammography and adjunctive ultrasonography. The researchers found that sensitivity was higher and specificity lower in the subjects with added ultrasonography. More cancers were detected in the patients who had added ultrasonography and they were more frequently at an earlier stage.The conclusion reached was that adjunctive ultrasonography increases sensitivity and detection rate in early cancers. Lancet 2016;387:347-48

Weight loss and health status 3 years after bariatric surgery in adolescentsSevere obesity in childhood may lead to serious health hazards. Bariatric surgery is increasingly considered for treatment of adolescents with severe obesity. This reports concerns a prospective study of the benefits and possible adverse effects of such treatments.Over 200 adolescents were enrolled. One hundred and sixty-one had gastric bypass surgery and 67 had sleeve gastrectomy. At 3-year follow-up, the mean weight of all patients had decreased by 27%. Remission of pre-diabetes occurred in 76% of those with this condition, and remission of type 2 diabetes occurred in 95% of those suffering from type 2 diabetes. There were similar benefits seen in those with hypertension, abnormal renal function and dyslipidaemia.Risks associated with surgery include micronutrient deficiencies and the need for abdominal procedures. Iron and vitamin B12 deficiency were noted. Vitamin D levels were found to be low in 42% of the subjects. Over the 3 years, 14% required further abdominal surgery and 15% required upper gastro-intestinal endoscopy. N Engl J Med 2016; 374:113-23 Maternal use of oral contraceptives and risk of birth defectsIs oral contraceptive use around the time of pregnancy onset associated with an increased risk of major birth defects? This proposition is examined in this prospective observational cohort study. Data on oral contraceptive use and major birth defects were collected among 880,694 live births from Danish registries between 1997 and 2011.The researchers compared the risk of birth defects in those who had never used oral contraceptives with mothers who had used them for longer than 3 months before conception, 3 months before conception, and after pregnancy onset. They found the incidence of major birth defects to be the same in each group a prevalence of 25 per 1,000 births.In summary, oral contraceptive exposure just before or during pregnancy does not appear to be associated with an increased risk of major birth defects. BMJ 2016;352:h6712 Sensitivity and specificity of mammography and adjunctive ultrasonography to screen for breast cancerMammography is the only proven method for breast cancer screening that reduces mortality, although it is inaccurate in young women or women with dense breasts.This report concerns a study involving the use of adjunctive ultrasonography which was conducted in Japan.Over 7,000 women were randomised to receive mammography or mammography and adjunctive ultrasonography. The researchers found that sensitivity was higher and specificity lower in the subjects with added ultrasonography. More cancers were detected in the patients who had added ultrasonography and they were more frequently at an earlier stage.The conclusion reached was that adjunctive ultrasonography increases sensitivity and detection rate in early cancers. Lancet 2016;387:347-48