Esophageal Reflux Disease Before and After Bariatric Surgery

Obesity increases the risk of various weight-related disorders, including esophageal reflux disease. In this chapter, we complete a focused review of GERD before and after bariatric surgery. We will discuss the prevalence and pathophysiology of reflux in bariatric surgery patients. The rationale and management of reflux before bariatric surgery will also be addressed including surgical options such as fundoplication and the various bariatric surgery procedures that can improve reflux disease. Finally, we will discuss anti-reflux treatment options after weight loss surgery, in particular conversion from sleeve gastrectomy to Roux-en-Y gastric bypass (RYGB), placement of LINX, as well as fundoplication after sleeve gastrectomy and RYGB

Multi-scale Modeling of the Cardiovascular System: Disease Development, Progression, and Clinical Intervention

Cardiovascular diseases (CVDs) are the leading cause of death in the western world. With the current development of clinical diagnostics to more accurately measure the extent and specifics of CVDs, a laudable goal is a better understanding of the structure-function relation in the cardiovascular system. Much of this fundamental understanding comes from the development and study of models that integrate biology, medicine, imaging, and biomechanics. Information from these models provides guidance for developing diagnostics, and implementation of these diagnostics to the clinical setting, in turn, provides data for refining the models. In this review, we introduce multi-scale and multi-physical models for understanding disease development, progression, and designing clinical interventions. We begin with multi-scale models of cardiac electrophysiology and mechanics for diagnosis, clinical decision support, personalized and precision medicine in cardiology with examples in arrhythmia and heart failure. We then introduce computational models of vasculature mechanics and associated mechanical forces for understanding vascular disease progression, designing clinical interventions, and elucidating mechanisms that underlie diverse vascular conditions. We conclude with a discussion of barriers that must be overcome to provide enhanced insights, predictions, and decisions in pre-clinical and clinical applications