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Pediatric bariatric

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https://www.readbyqxmd.com/read/29740791/nonalcoholic-fatty-liver-disease-in-children-not-a-small-matter
#1
REVIEW
Praveen Kumar Conjeevaram Selvakumar, Mohammad Nasser Kabbany, Naim Alkhouri
The prevalence of nonalcoholic fatty liver disease (NAFLD) has increased substantially in the past two decades and NAFLD has now become the most common cause of chronic liver disease in children and adolescents. NAFLD is a broad clinicopathologic spectrum ranging from simple steatosis to varying degrees of necroinflammation called nonalcoholic steatohepatitis (NASH), leading to fibrosis and subsequently to cirrhosis. Despite the increasing prevalence and progressive nature of NAFLD even among children, therapy for NAFLD in both adults and children are limited...
May 9, 2018: Paediatric Drugs
https://www.readbyqxmd.com/read/29732716/treatment-options-for-severe-obesity-in-the-pediatric-population-current-limitations-and-future-opportunities
#2
REVIEW
Justin R Ryder, Claudia K Fox, Aaron S Kelly
OBJECTIVE: Severe obesity is the only obesity classification increasing in prevalence among children and adolescents. Treatment options that produce meaningful and sustained weight loss and comorbidity resolution are urgently needed. METHODS: The purpose of this review is to provide a brief overview of the current treatment options for pediatric severe obesity and offer suggestions regarding future opportunities for accelerating the development and evaluation of innovative treatment strategies...
May 7, 2018: Obesity
https://www.readbyqxmd.com/read/29687342/predictors-of-preoperative-program-non-completion-in-adolescents-referred-for-bariatric-surgery
#3
Cassie Brode, Megan Ratcliff, Jennifer Reiter-Purtill, Sanita Hunsaker, Michael Helmrath, Meg Zeller
BACKGROUND: Factors contributing to adolescents' non-completion of bariatric surgery, defined as self-withdrawal during the preoperative phase of care, independent of program or insurance denial, are largely unknown. Recent adolescent and adult bariatric surgery literature indicate that psychological factors and treatment withdrawal play a role; however, for adolescents, additional age-salient (family/caregiver) variables might also influence progression to surgery. OBJECTIVES: The present study examined demographic, psychological, and family/caregiver variables as predictors of whether adolescents completed surgery ("completers") or withdrew from treatment ("non-completers")...
April 23, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29616469/racial-disparities-in-obesity-treatment
#4
REVIEW
Angel S Byrd, Alexander T Toth, Fatima Cody Stanford
PURPOSE OF REVIEW: Obesity rates in the USA have reached pandemic levels with one third of the population with obesity in 2015-2016 (39.8% of adults and 18.5% of youth). It is a major public health concern, and it is prudent to understand the factors which contribute. Racial and ethnic disparities are pronounced in both the prevalence and treatment of obesity and must be addressed in the efforts to combat obesity. RECENT FINDINGS: Disparities in prevalence of obesity in racial/ethnic minorities are apparent as early as the preschool years and factors including genetics, diet, physical activity, psychological factors, stress, income, and discrimination, among others, must be taken into consideration...
June 2018: Current Obesity Reports
https://www.readbyqxmd.com/read/29532078/comparison-of-surgical-and-medical-therapy-for-type-2-diabetes-in-severely-obese-adolescents
#5
Thomas H Inge, Lori M Laffel, Todd M Jenkins, Marsha D Marcus, Natasha I Leibel, Mary L Brandt, Morey Haymond, Elaine M Urbina, Lawrence M Dolan, Philip S Zeitler
Importance: Because of the substantial increase in the occurrence of type 2 diabetes in the pediatric population and the medical complications of this condition, therapies are urgently needed that will achieve better glycemic control than standard medical management. Objective: To compare glycemic control in cohorts of severely obese adolescents with type 2 diabetes undergoing medical and surgical interventions. Design, Setting, and Participants: A secondary analysis of data collected by the Teen-Longitudinal Assessment of Bariatric Surgery (Teen-LABS) and Treatment Options of Type 2 Diabetes in Adolescents and Youth (TODAY) consortia was performed...
May 1, 2018: JAMA Pediatrics
https://www.readbyqxmd.com/read/29427120/challenges-in-transition-of-care-for-pediatric-patients-after-weight-reduction-surgery-a-systematic-review-and-recommendations-for-comprehensive-care
#6
REVIEW
Sarah B Cairo, Indrajit Majumdar, Aurora Pryor, Alan Posner, Carroll M Harmon, David H Rothstein
Obesity in pediatric patients is rising with nearly one third of children in the USA classified as overweight and up to 16-18% of the adolescent population obese with at least one comorbid condition. Consequently, bariatric procedures in this population have increased without consistent recommendations for follow-up and transition to adult providers. This review describes the known and potential long-term consequences of bariatric surgery in pediatric patients, reviews the current literature on transitions of care for adolescent patients with chronic illnesses...
April 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29329689/pediatric-obesity-current-concepts
#7
REVIEW
Donald E Greydanus, Marisha Agana, Manmohan K Kamboj, Saad Shebrain, Neelkamal Soares, Ransome Eke, Dilip R Patel
This discussion reflects on concepts of obesity in children and adolescents in the early 21st century. It includes reflections on its history, definition, epidemiology, diagnostic perspectives, psychosocial considerations, musculoskeletal complications, endocrine complications and principles of management. In addition to emphasis on diet and exercise, research and clinical applications in the second decade of the 21st century emphasize the increasing use of pharmacotherapy and bariatric surgery for adolescent and adult populations with critical problems of overweight and obesity...
April 2018: Disease-a-month: DM
https://www.readbyqxmd.com/read/29119130/addressing-pediatric-obesity-in-clinic
#8
George G A Pujalte, Isabella Ahanogbe, McKennan J Thurston, Richard O White, Alva Roche-Green
There is an epidemic of pediatric obesity in the United States. In most cases, there is an excess in the amount of calories consumed, compared with the amount of calories expended. Numerous body systems are affected by pediatric obesity, with complications varying between boys and girls. Behavioral, genetic, and environmental factors affect the ability of children to avoid becoming obese. Primary care physicians should screen for obesity in children as much as possible. Associated risk factors for obesity should be uncovered...
2017: Global Pediatric Health
https://www.readbyqxmd.com/read/29074351/prospective-evaluation-of-urinary-incontinence-in-severely-obese-adolescents-presenting-for-weight-loss-surgery
#9
W Robert DeFoor, Thomas H Inge, Todd M Jenkins, Elizabeth Jackson, Anita Courcoulas, Marc Michalsky, Mary Brandt, Linda Kollar, Changchun Xie
BACKGROUND: Obesity has been associated with daytime urinary incontinence (UI), likely due to increased intra-abdominal pressure. OBJECTIVES: To assess incontinence symptoms in severely obese adolescents before and 3 years after bariatric surgery. SETTING: Tertiary care pediatric hospitals in the United States. METHODS: The Teen-Longitudinal Assessment of Bariatric Surgery is a prospective, multicenter study designed to evaluate efficacy and safety of bariatric surgery in adolescents...
February 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28960170/shunt-freedom-and-clinical-resolution-of-idiopathic-intracranial-hypertension-after-bariatric-surgery-in-the-pediatric-population-report-of-3-cases
#10
Kimberly B Hoang, Kristopher G Hooten, Carrie R Muh
Idiopathic intracranial hypertension (IIH), formerly known as pseudotumor cerebri, is a disease of elevated intracranial pressure that is thought to develop due to impaired CSF absorption related to elevated venous sinus pressure in the setting of increased intraabdominal and thoracic pressures. Symptoms can be disabling and, if left untreated, can lead to permanent visual loss. Previous treatments directed toward vision preservation include CSF diversion through shunting and optic nerve sheath fenestration...
December 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28760109/bariatric-surgery-in-adolescents-is-routine-nutrient-supplementation-sufficient-to-avoid-anemia-following-bariatric-surgery
#11
Hanna R Goldberg, Vivian L Chin, Jeffrey L Zitsman, Chengchen Zhang, Kristen M Williams, Sharon Oberfield, Ilene Fennoy
BACKGROUND: Anemia following bariatric surgery is a known complication. To prevent nutrient deficiencies, adolescents require multivitamin/mineral supplementation following bariatric surgery. The purpose of this study was to investigate if routine multivitamin/mineral supplementation is sufficient to prevent anemia in adolescents undergoing bariatric surgery, particularly sleeve gastrectomy (SG), a procedure that may induce nutrient malabsorption. METHODS: We conducted a retrospective review of pediatric patients who underwent SG (34 patients) and laparoscopic adjustable gastric banding (LAGB) (141 patients) (January 2006 through December 2013)...
August 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28755177/evidence-base-for-multidisciplinary-care-of-pediatric-adolescent-bariatric-surgery-patients
#12
REVIEW
Mohamed O Elahmedi, Aayed R Alqahtani
PURPOSE OF REVIEW: Severe childhood obesity, defined as having a body mass index (BMI) greater than the 99th percentile for age and gender, is rising in most countries and is associated with early morbidity and mortality. Optimal management of the health of the child with obesity requires a multidisciplinary approach that identifies and treats associated derangements. RECENT FINDINGS: Lifestyle interventions such as diet, exercise, and behavioral therapy for the severely obese pediatric patient are generally not effective...
September 2017: Current Obesity Reports
https://www.readbyqxmd.com/read/28600116/features-of-nonalcoholic-steatohepatitis-in-severely-obese-children-and-adolescents-undergoing-sleeve-gastrectomy
#13
Aayed Alqahtani, Mohamed Elahmedi, Khalid Alswat, Maha Arafah, Mosa Fagih, Jaehoon Lee
BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) is an underrecognized co-morbidity of obesity. The characteristic features and severity of NAFLD in severe childhood obesity remain unknown. OBJECTIVES: To investigate features of NAFLD in obese children and identify predictors of significant disease. SETTING: Academic center with a standardized pathway for pediatric bariatric surgery and a dedicated multidisciplinary team. DESIGN: This is a baseline cross-sectional analysis for a data set obtained from a prospective clinical outcome study that included severely obese children (≤14 yr of age) and adolescents (14-21 yr of age) who underwent laparoscopic sleeve gastrectomy between March 2008 and March 2015...
September 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28598799/clinical-outcomes-of-an-inpatient-pediatric-obesity-treatment-program-in-the-usa
#14
Sharonda J Alston Taylor, Kimberly Rennie, Cindy Jon
Background When treating recalcitrant and severe childhood obesity, pharmaceutical options are limited and few patients qualify for bariatric surgery. A prolonged inpatient program serves as an alternative treatment. The purpose of this project was to describe the development of a medically supervised inpatient weight management program and evaluate its effectiveness. Methods This is a retrospective chart review of 18 patients [4-18 years, mean body mass index (BMI) 50.2 kg/m2] admitted to an inpatient pediatric weight management program from October 2011 through December 31, 2012 to evaluate the biometric, laboratory, sleep and behavioral changes that occurred from admission to discharge from the program...
June 9, 2017: International Journal of Adolescent Medicine and Health
https://www.readbyqxmd.com/read/28573535/long-term-outcome-of-bariatric-surgery-in-morbidly-obese-adolescents-a-systematic-review-and-meta-analysis-of-950-patients-with-a-minimum-of-3-years-follow-up
#15
Saeed Shoar, Habibollah Mahmoudzadeh, Mohammad Naderan, Shahram Bagheri-Hariri, Catherine Wong, Ahmad Shahabeddin Parizi, Nasrin Shoar
BACKGROUND: Obesity in pediatric and adolescent population has reached a universal pandemic. This study aimed to summarize the literature on the longest available outcome of bariatric surgery in morbidly obese adolescents. METHODS: A systematic review was conducted to pool available data on the longest available (>3 years) weight loss and comorbidity resolution outcome in adolescent bariatric surgery. RESULTS: A total of 14 studies reporting the result of bariatric surgery after 3 years in 950 morbidly obese adolescents were included...
December 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28456730/usefulness-of-pbpk-modeling-in-incorporation-of-clinical-conditions-in-personalized-medicine
#16
REVIEW
Niloufar Marsousi, Jules A Desmeules, Serge Rudaz, Youssef Daali
Personalized medicine aims to determine the most adequate treatment and dose regimen to obtain the maximum efficacy and minimum side effect by taking into account patients' characteristics. For numerous reasons, one being ethical and methodological hurdles in including specific populations in clinical trials, innovative methods for optimization of drugs safety and efficacy in such patients have received increasing interest recently. Physiological-based pharmacokinetic (PBPK) modeling has emerged as a promising approach in designing adequate clinical trials and quantifying anticipated changes in unknown clinical situations...
April 26, 2017: Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28359099/pediatric-obesity-assessment-treatment-and-prevention-an-endocrine-society-clinical-practice-guideline
#17
Dennis M Styne, Silva A Arslanian, Ellen L Connor, Ismaa Sadaf Farooqi, M Hassan Murad, Janet H Silverstein, Jack A Yanovski
Cosponsoring Associations: The European Society of Endocrinology and the Pediatric Endocrine Society. This guideline was funded by the Endocrine Society. Objective: To formulate clinical practice guidelines for the assessment, treatment, and prevention of pediatric obesity. Participants: The participants include an Endocrine Society-appointed Task Force of 6 experts, a methodologist, and a medical writer. Evidence: This evidence-based guideline was developed using the Grading of Recommendations, Assessment, Development, and Evaluation approach to describe the strength of recommendations and the quality of evidence...
March 1, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28293902/perioperative-course-weight-loss-and-resolution-of-comorbidities-after-primary-sleeve-gastrectomy-for-morbid-obesity-are-there-differences-between-adolescents-and-adults
#18
Frank Benedix, Thomas Krause, Daniela Adolf, Stefanie Wolff, Hans Lippert, Thomas Manger, Christine Stroh
BACKGROUND: Morbid obesity in both adolescents and adults has risen in an alarming rate. Bariatric surgery is playing an increasing role in pediatric surgery. However, current evidence is limited regarding its safety and outcome. METHODS: Since 2005, data from obese patients that undergo bariatric procedures in Germany are prospectively registered. For the current analysis, all adolescent and adult subjects that had undergone laparoscopic sleeve gastrectomy (LSG) from 2005 to 2014 were considered...
September 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28292409/therapeutic-options-to-treat-pediatric-obesity
#19
REVIEW
Allen F Browne
Obesity in children and adolescents is a severe health, psychosocial, and economic problem. Treatment of obesity should be based on the physiology, biochemistry, and genetics of the disease. Treatment is designed to prevent the comorbidities of obesity and allow a healthy, high-quality, and productive life. Treatment is based on healthy living and usually involves tools such as pharmacotherapy, medical device therapy, and bariatric surgery. Bariatric surgery is not acceptable to most patients, parents, primary care providers, and payers...
April 2017: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/28242319/white-paper-aga-power-practice-guide-on-obesity-and-weight-management-education-and-resources
#20
REVIEW
Andres Acosta, Sarah Streett, Mathew D Kroh, Lawrence J Cheskin, Katherine H Saunders, Marina Kurian, Marsha Schofield, Sarah E Barlow, Louis Aronne
The epidemic of obesity continues at alarming rates, with a high burden to our economy and society. The American Gastroenterological Association understands the importance of embracing obesity as a chronic, relapsing disease and supports a multidisciplinary approach to the management of obesity. Because gastrointestinal disorders resulting from obesity are more frequent and often present sooner than type 2 diabetes mellitus and cardiovascular disease, gastroenterologists have an opportunity to address obesity and provide an effective therapy early...
May 2017: Clinical Gastroenterology and Hepatology
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